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HomeMy Public PortalAbout9873 FLAHERTY ST_Plumbing__ 76A667-CE817-6-57 APPLICATION FOR PLUMBING PERMIT L� COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ADDRESS JOHN A, LAMBIE, COUNTY ENGINEER CASSATT D. GRIFFIN, SUP'Y OF BUILDING LOCALITY - ---' FOR APPLICANT TO FILL IN NEAREST ` CROSS ST. NUMBER FIXTURE OR ITEM .. �- OWNER _ WATER CLOSET MAIL BATH TUB ADDRESS SHOWER CITY TEL.NO. LAVATORY CONTRACTOR SINK ADDRESS DISHWASHER CITY TEL.NO. y f LAUNDRY TUB CONTRACTOR'S STATE REGISTRATION NO. a COUNTY CLOTHES WASHER DISTRICT NO. GROUP ZONE READY FOR INSPECTION � WATER HEATER GAS SYSTEM INDUSTRIAL WASTE APPROVAL r INSPECTION RECORD APPROVALS @a $1.00 PER ITEM DATE INSPECTOR'S SIGNATURE OR FIXTURE $ UNDER SLAB WORK ROUGH PLUMBING PERMIT $ 1 00 GAS PIPING - TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APP KATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES PLUMBING. 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO. NOTIFIED DESCRIBED RESIDENTIAL PROPERTY. SIGNATURE OF PERMITTEE FINAL ROBERT A. WOOD, o, VALIDATION SUPERVISING MECHANICA'_ ENG'R CK. M. 0. CASH COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY i WILLIAM J. FOX, County Engineer PLUMBIMP DISTWMT NO. SPOUP ZONE PERMIT NO. FOR APPLICANT T- FILL IN PLUMBER (i( J sT /O REC IVED BY READY FOR DATE ISSUED ` FIRST INSPECTION / C ADDRESS _ v'�NJ m _✓ �./ BUILDING 9',E-7,3 /—7�Qj ,3 y )�A eA k CITY /C-�j� ADDRESS /6Y J�--`^'''I F IO� TEL No. /,ryJ COUNTY /�j� LOCALITY ,iG��0 ('. LICENSE NO. Q /d/ EXPIRE A NEARESTv PERMIT FEES _cRDss BT.�r�..— r� NUMBER I ` TYPE OF FIXTURE OR ITEM FEE OWNER-� MAIL _A." WATER CLOSET(TOILET) 0.50 $ ADDRESS BATH TUB @ 0.50 CITY S d0A.y4 tf® TEL. NO SHOWER a 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) 0-50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT - AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN BINK @ 0.50 AND BTATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOSS ' LAUNDRY TUB OR TRAY @ 13.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER OF THE RESIDE XIAL ROPERTY DESCRIBED ASOVE:�� GAS SYSTEM OUTLETS @ D.50011 SIGNATURE O WATER HEATER @ O.SO PERMITTEE _ SLOP SINK @ 0.513 INSPECTION RECORD FLOOR SINK 0.50 FLOOR DRAIN @ 0.50 DISHWASHER - 0.50 DRINKING FOUNTAIN Q 0.50 URINAL @ 0.50 Q HOUSE SEWER @ O.SO _Z MISCELLANEOUSs. (D ' v APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING(J' GAS PIPING —IZ ,0,�.bQ/� GAS VENT I�'20 / b`,. i CESSPOOL @ 1,013 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT1.00 GAS TEST • �+A UTILITY CO. NOTIFIED _ ..7- -;-J— TOTAL FEE $ J I S Y q L FINAL { S^ �Lr E(.('�P 76A667 DBS 17 6-52 76A667-CE817-8-57 APPLICATION FOR PLUMBING PERMIT L� COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS / ! / ¢; t JOHN A. LAMBIE, COUNTY ENGINEER CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM s _ f WATER CLOSET OWNER � MAIL BATH TUB ADDRESS SHOWER CITY TEL.NO. LAVATORY CONTRACTOR J ; >i -"iJG L SINK ADDRESS DISHWASHER CITY / .{ _ J TEL.NO. LAUNDRYTUB CONTRACTOR'S / .� STATE REGISTRATION NO. / �c :r,' COUNTY ❑ CLOTHES WASHER DISTRICT NO. GROUP ZONE READY FOR INSPECTION WATER HEATER GAS SYSTEM INDUSTRIAL WASTE APPROVAL P INSPECTION RECORD APPROVALS DATE INSPECTOR'S SIGNATURE @ $1.00 PER ITEM OR FIXTURE $ UNDER SLAB WORK ROUGH PLUMBING PERMIT S 1 00 GAS PIPING TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO. NOTIFIED DESCRIBED RESIDENTIAL PROPERTY. - SIGNATURE OF PERMITTEE FINAL ©\ ROBERT A. WOOD, VALIDATION SUPERVISING MECHANICA_ ENG'R CK. M. O. CASH ORKERS'COMPENSATIONDECLARATION APPLICATION FOR PLUMBING PERMIT I`hereby affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation Insuranc',b, CE 817 (REV 10/81) or a certified copy thereof (Seca 3800, Lab. C.) COUNTY OF LOS ANGELES / r BUILDING AND SAFETY Policy No 66aw - Company —'-7-A.4 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING _%W1 C� � ❑ ADDRESS % l-�l� LSA Certified copy is fated with th �01'ty bu in inspec- tion department. 7 NUMBER FIXTURE OR ITEM Q FEE LOCALITY Date ��1� Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTIO FR M WORKERS' BATH TUB CROSS STC' COMPENSATION INSURANCE OWNER SHOWER (This section need not be completed if the work involved by MAIL Q 1 the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS 8-1 7SY'LIPrt'llj�ev_ I certify that in the performance of the work for which this �4 permit is issued, I shall not employ any person in any manner SINK CITY 11 ` TEL NO ` so as to become subject to the Workers'Compensation Laws DISHWASHER 1 CONTRACTOR •i� Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Sf` Exemption, you should become subject to the Workers' CITY TEL NO c� _ Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE ,,// LIC deemed revoked WATER HEATER LICENSE NO � 7 CLASS-SST Cc3 E .LICENSED CONTRACTORS DECLARATION DISTRICT NO PR ESSED BY n I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS cam,/�/ (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER. S'U � � and Professions Code,and my license is in full force �and ��effect. 5 PER SYSTEM FINAL VALIDATION � License Number 310 v,�� Lic Class_ 414 c / �6 DATE kI FINAL V9 Contractor Date BY ❑ V I am exempt under Sec. 1-3 W CJ B 8P C. for this reason v9 Plan check fee , Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE C) O Plan check applicant zi p 8 7.5 A SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name P.0'o 0 0 0'5 i hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Address �1O 0 v O 5 Professions Code)- City Tel No. Fc.o`0 - , p v ❑ I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section , 05. 0,1 --84 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097, Civ C ). Lender's Name Lender's Address I certify That I have read this application and state that the 1111110.above information is correct. I agree to comply with all County ordinances and State jaws regulating Plumbing, and hereby au on epresentatives of this County to enter upon the ab a- ion pro er for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE • gn ure of Permittee Date WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76A667A �vsure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) Yor f r pp t fMc. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY cel i5� Co Policy No.-Company AMA Certified copy is hereby furnished. ® FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the c unty buil ing pec- ADDRESS tion department NUMBER FIXTURE OR ITEM @ FEE LOCALITY F � � 9WATER CLOSET Date Applican NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER OWNER SHAW (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL NO. so as to become subject to the Workers'Compensation Laws DISHWASHER CONTRACTOR SERVX4TIC SOLAR SYS-fM,INC. Date Applicant CLOTHES WASHER NOTICE TO APPLICANT. If, after making this Certificate of ADDRESS 2060 NrJNTROSE AVE. Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY 01000E TEL NO 957=101 with comply' with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER LICENSE NO 3906/45 CLASS�-I/F LICENSED CONTRACTORS DECLARATION DISTRICT PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license-is in full force and effect. 5 PER SYSTEM FINAL VALIDATION r C/��-Sim 1 SOLAR WATER HEATER 20 00 DATE �'Z/ License Number Lic. Class V FINAL Contractor 5� Date BY V `""" ❑ I am exempt under Sec V LL1 B.BP.C. for this reason H Date. Plan check fee 011111.PLUMBING PERMIT ISSUING FEE$ Signature 10 50 • TOTAL FEE Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Nameata o 3 O U, I hereby affirm that I am exempt from the Contractor's License Address ' Law for the following reason (Section 7031 5, Business and. Professions Code) City Tel No. 0'9.2 9+;8 3 I, as owner of the property, will do the work and the , structure is not intended or offered for sale (Section 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address I certify that I have read this application and state that the pop.above information is correct I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby &be representatives of this County to enter upon the ntion pro rty f r inspection purposes ,y SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of P rmittee Date /,