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Home My Public Portal About9179 FORTSON DR_Plumbing__ ' ! / 78A887-CE#817 9/63 � �q APPLICATION FOR PLUMBING PER l T COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE• COUNTY ENGINEER ADDRESS , WILLIAM A. JENSEN, SUPT OF BUILDING LOCALI? FOR APPLICANT TO FILL IN NEAREST CROSS NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSE? $1.25 MAIL BATH TUB 1.25 ADDRES CITY TEL. NO. SHOWER 1.25 LAVATORY 1.25 CONTRACTOR SINE 1.25 ADDRESS DISHWASHER 1.2S CITY TEL. NO. LAUNDRY TUB 1.25 CONTRACTOR'S STATE ❑ REGISTRATION NO. COUNTY ❑ CLOTHES WASHER 1.25 DISTRICT NO. OU ZONE PR BY _ WATER HEATER 1.50 `' O y /J GAS SYSTEM OUTLETS 1.50 J INDUSTRIAL WASTE APPROVAL O OUTLETS OVER 5 PER SYSTEM .30 — U I ,INSPECTION RECORD n Aw r ` w APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK TOTAL FEE J1 ROUGH PLUMBING �/fp V GAS PIPINGh'dr� t;J� I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO GAS TEST RESIDE IN, THE ABOVE DESCRIBED RESIDEN IAL RTr. UTILITY CO. NOTIFIED SIGNATURE OF PERMITTEE FINAL \ , VALIDATI(0N OBERT A. WOOD CK. M'O I CASH SUPERVISING MECHANICAL EiJG R LAC3 7 9 5% SEP15 - 5 D .3,50~ L= I`T'V 0 �, h• I� T_ - 76A667-CE#817 10-62 Its ' APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY.ENGINEER BUILDING AND SAFETY DIVISION BUILDING q/'7 f r7�r 5 i►� ./ JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS "( ( / (JFK-f C/N WILLIAM.A. JENSEN, SUPT OF BUILDING LOCALITY )9L FOR APPLICANT TO FILL IN NEAREST CROSS ST. �/� 4�.-• :� `f`-�'i NUMBER I FIXTURE OR ITEM EACH FEE OWNER �T�/CR f'` �'J•-�L1D WATER CLOSET $1.25 BATH TUB 1.25 MAIL ADDRESS SHOWER 1.25 CITY/�/��L� Gr T'r' TEL. NO. 10 f LAVATORY 1.25 CONTRACTOR SINK 1.25 ADDRESS �g(9� t A-Qj rU�1A� DISHWASHER 1.25 CITY ij"R't(„_, TEL. NO.A%�j� # LAUNDRY TUB STATE 1.25 CONTRACTOR'S RR COUNTY REGISTRATION NO. f�S�4 ❑ CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PROCESSED BY / WATER HEATER 1.50 - 0 D p O-ce /2-/ Gam.-4--- GAS SYSTEM OUTLETS 1.50 INDUSTRIAL d WASTE APPROVAL OUTLETS OVER'5 PER SYSTEM .30 INSPECTION RECORD u mcwitme s � Lu 916 IA A41 —� APPRO\/AL,S DATE INSPECTOR'S SIGNATURE PERMIT $ 2 OO UNDER §kB ORK � of ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPL CATION GAS VENT ' AND.STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. ' I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNERr�D INTEND TORESIDE IN,THE ABOVE EACRIBESI E TIA RTY. UTILITY CO. NOTIFIED SIGNATURE ��OF PERMITTEE { FINAL Cr/� �fzuA�� VALIDATION ROBERT A. WOOD cK M O CASH SUPERVISING MECHANICAL ENG'R LfLo3 1 3 2Z AUG 25 5 D 4.7-5" 25My$ETs 6-46 APPLICATION" FOR PERMIT . -DEPARTMENT OF OF AND SAFETY ��'�� - COUNTY OF LOS ANGELES -Wm. J. FOX,CHIEF ENGINEER NATURE OF INSTALLATION DIST,RICT No. GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE - e �� z_ ` RECEIVED BY.- READY FOR DATE ISSUED HEATER CESSPOOL I—I SEPTIC TANK 1 p FIRST INSPECTION �/ -K GAS MISCELLANEOUS ' A]PPLL-ITAAI!T FILL IN HEAVILY OUTLINED PORTION QNLY JOB , Ik NAM Erb; }/� �/ � ADDRESS �� m ADDRESS c / LOCALITY ✓ NEARESTaCITYX/�¢'V�, .nl TEL.N & CROSS ST. COUNTY CERT.NO. EXPIRES - 6' NAME-,'-, `°.�•� S� *JCS LOCATION OF SEPTIC TANK, OR CESSPOOL �,j Z MAIL 3 Sr•ADDRESS ` NORTH O CITY /f F� TEL.No. I AM THE LEGAL POSSESSOR OF THE ABOVE ,LOS /ANGELES COUNTY CERTIFICATES OF�QUALII/FICATION. •�= PLUMBER I AM THE LEGAL OWNER OF THE.PROPERTY DESCRI ED ABOVE. W D W OWNER -1 CORRECTIONS SOUTH J DESCRIPTION OF WORK Z BATH TUB FURNACE 17 SHOWER —DISHWASHER. Q LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP GLOP BINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER GAS +ODA FOUNTAIN GAS PIPING OUTL GAS VENT I I CESSPOOL TOTAL NUMBER OF FIXTURES �� SEPTIC TANK I' CESSPOOI SEPTIC TANK �4J SEWER UTILITY CO.NOTIFIED TOTAL FEE FINAL I t D.e.9-1s 25M SEw9 11-46 APPLICATION FOR PERMIT ° DEPARTMENT OF BUILDING AND SAFETY PLUMBING �- ''COUNTY OF LOS ANGELES WM. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GRO/jUPo` E PERMIT NO. ROUGH FIXTURES COMPLETE / el/ 4e; I/A 6 HEATER CESSPOOL Ii SEPTIC TANK RE IVED BSG READY FOR DATE ISSUED FIRST INSPECTION r f' GAS MISCELLANEOU 3 �/ APPLIC;yANT FILL IN HEAVILY 'OUTLINED PpORTION`_ONLY JOB � IY NAME Ua� L1 (/� �/ >/�_�✓ ' tJ ADDRESS ADDRESS LOCALITY y,7 I �? NEAREST d CITYTEL�`No. P A COUNTY CROSS ST. �7 y' - �✓� , _. /`��i CERT.No. J/ � EXPIRES 0 NAME ��- LOCATION OF SEPTIC TANS, OR CESSPOOL p� J Z MAIL 3 ADDRESS NORTH O CITY TEL.No. IAM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES CERTIFICATE OF QUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED m ABOVE. W N 3 0) OWNER '1 CORRECTIONS SOUTH J / DESCRIPTION OF WORK _Z BATH TUB FURNACE SHOWER DISHWASHER O LAVATORY REFRIGERATOR / KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN j WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I METER.LGAS -------SODA FOUNTAIN OUTL GAS PIPING GAS VENT I I ®G CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOL__SEPTIC TANK SEWER UTILITY CO.NOTIFIED I 1- TOTAL FEE 86 "?e' ft� VI "s'"" FINAL t WORKER'S COMPENSATION DECLARATION 20-002 6DPW9/89 APPLICATION FOR PLUMBING PERMIT 76A667A I hergG affirm that hav 76A66 a,,:ertii cate of consent to self insure, or a certificate of Worker' Compensation Insurance, or a certified copy theseof-(Sec.3800 Lab. C.) Policy No Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS DEPT. OF PUBLIC WORKS DIV. , J , 0, Certified copy is hereby furnished❑ BUILDING` Ph FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Certified copy is filed with the county building inspection department. NUMBER FIXTURE OR ITEM @ FEE LOCALITYr Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST 1 BATH TUB COMPENSATION INSURANCE 5 ASSESSOR his section need not be completed if the work involved b (_TY the SHOWER MAP BOOK PAGE PARCEL P � permit is for one hundred dollars($100)or less.) OWNER I certify that in the performance of the work for which this permit LAVATORY � 'yeissued, I shall not employ any person in any manner so as t SINK MAIL J ecome subject to the Workers'Com nsat,on Laws. I ADDRESS 46 DISWASHER CITY r TEL NO D,tel O Applicant �� u CLOTHES WASHERTICE T APP ICANT If, after making this Certificate o CONTRACTOR Exemption,you should become subject to the markers'Compensat n SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with su ADDRESS ..� provisions or this permit shall be deemed revoked - LAWN SPRINKLER SYSTEM " LICENSED CONTRACTORS DECLARATION CITY TEL NO. I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER 0- (commencing (commencing with Section 7000) of Division 3 of the Business and STATE LIC O Professions Code,and my license is in full force and effect. GAS SYSTEM OUTLETS LICENSE NO CLASS V OUTLETS OVER DIaJRICT ESSED Y 0 5 PER SYSTEM '/ H License Number -Lic.Class Ly W FINAL Z $� VALIDATION n. DATE Contractor Date U) I am exempt under Sec. FIN Z� �•_. B.&P.0 for this reason Plan check fee �{� Q► Date: Signature PLUMBING PERMIT ISSUING FEE$ �3 ❑ TOTAL FEE Plan check applicant SINGLE FAMILY - HOME OWNER-BUILDER DECLARATION Name hereby affirm that 1 am exempt from the Contractor's License Law I a T for the following reason (Section 7031 5, Business and Professions -Address ��7 Code). ' _5 City Tel. No. ❑ `�� :t I, as owner of the property,will do the work and the structure I 1 i�t-•.i E, is not intended or offered for sale (Section 7044, Business and Professions Code). I � �_ CONSTRUCTION LENDING AGENCY - _• �l•il —5.50 I hereby affirm that there is a construction lending agency for the ('HA G performance of the work for which this permit is issued (Sec. 3097, °Cal Civ C) Lender's Namea) to _ Lender's Address �!i S r'x fil I 1 certify that I have read this application and state that the above , O information is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE