The URL can be used to link to this page

Home My Public Portal About4857 FRATUS DR_Plumbing__ DDES67,1059 APPLICATION FOR PLUMBING PERMIT DIVISION OF BUILDING AND SAFETY Deportment of County Engineer County of Loa Angeles rA LDING JOHN A LAMBIE, COUNTY ENGINEER DRESS o CASSATT D GRIFFIN,SUP T OF BUILDING CALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST OWNER DISTRICT NO 'GROUP -I_ ZONE I READY FOR INSPECTION MAIL ~ ADDRESS INDUSTRIAL CITY TEL NO WASTE APPROVAL PLUMBER INSPECTION RECORD ADDRESS Valley Plum ung Co. of e ora 1444 Ffeerwood Place CITY GlendorafiECakEprnia EDSewood 5-1293 LICENSE NO NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1 00 BATH TUB @ $1 00 v SHOWER @ $1 00 q LAVATORY (WASH BASIN) @ $100 !� KITCHEN SINK @ $1 00 DISHWASHER @ $1 00 LAUNDRY TUB OR TRAY @ $1 00 CLOTHES WASHER @ $100 WATER HEATER @ $1 00 GAS SYSTEM @ $1 00 41 APPROVALS DATE INSPECTOR S SIGNATURE ti UNDER SLAB WORK PERMIT S 1 00 ROUGH PLUMBING �nl � I �6 GAS PIPING TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER p Vll AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PLUMBING FIXTURES 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 I AM THE LE AL OWNER OF THE OVE UTILITY CO NOTIFIED rLn p� DESCRIBED RESIDENTIAL TY SIGNATURE OF PERMITTEE FINAL JOHN A LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR CR m O CASH AC 7 6 2 2& APR 2 a 3 1 0.0 0 In r4 76A667-CE817 3-59 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION r— JOHN A LAMBIE County Engineer 7 ADDRESS CASSATT D. GRIFFIN, Supt of Building LOCALITY w it LL 7e FOR APPLICANT TO FILL IN NEAREST J� CROSS ST. NUMBER FIXTURE OR ITEM OWNER WATER CLOSET MAIL C BATH TUB ADDRESS SHOWER CITY �— TEL. NO. LAVATORY CONTRACTOR L �dt SINS ADDRESS DISHWASHER CITY �' TEL, NO. CONTRACTO 'S STATE LAUNDRY TUB REGISTRATION NO COUNTY ❑ CLOTHES WASHER DISTR� ROUP ZON� PROCESSED BY WATER HEATER i'90 L/ //�� GAS SYSTEM INDUSTRIAL r WASTE APPROVAL SOL INSPECTION RECORD 0 $100 PER ITEM I / _� OR FIXTURE $ APPROVALS DATE INSPECTOR S SIGNATURE PERMIT $ 2100 UNDER SLAB WORK TOTAL FEE 6d ROUGH PLUMBING GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 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 1 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 I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPER UTILITY CO NOTIFIED SIGNATURE OF PERMITTEEF FINAL OF VALIDATION ROBERT A WOOD, ctc m O Cl"H SUPERVISING MECHANICAL ENG'R I APfluo s 7 6 ti r1Fft 4 5 A 3.0 0 WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby, affirm that I have a certificate of consent to self in- 76A667A DPW 4/90 sure,or certificate of Workers'Compensation Insurance,or a 6A667 �1 certified copy thereof (Sec aLab C ) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS LIIL JIII Policy No —Company any Certified copy is hereby furnished FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ,r 7—�/�� j� Certified copy is filed with the county building inspection ADDRESS �7 4 4 J5 01P_ department NUMBER FIXTURE OR ITEM @ FEE LOCALITY —��L WATER CLOSET(TOILET) Dtlte'• Appl scan NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER OWNER 0 (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less ) LAVATORY ADDRESS I certify that in the performance of the work for which this per- m er- SINK mit is issued, I shall not employ any person in any manner so CITY as to become subject to the Workers'1 j mpensation Laws DISHWASHER iC1/ J�� / 7` �n CONTRACTOR ,{r Date -116 Applicant /l CLOTHES WASHER 9 do l OLS NOTICE TO APPLICANT If, after making this CertificaADDRESte of Ex- SWIMMING POOL RECEPTOR emptio you should become subject to the Workers'Co - CITY sation provisions comp of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATELIC ed WATER HEATER LICENSE NO 7-,7Sg CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS �D (i ?,�1 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER O and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL f VALIDATION fect �J�� _ 2� HOSE BIB DATE License Number' Lic Class J a NAL cc FI fes'/ 4 `9 Fl Q Contractor Date _ Q ❑ O I am exempt under Sec U B&P C for this reason Plan check fee W ► a N Date PLUMBING PERMIT ISSUING FEE$ Z Signature D TOTAL FEE SINGLE FAMILY l HOME OWNER-BUILDER DECLARATION Plan check applicant j 1 hereby affirm that I am exempt from the Contractor's License Name ACGT.s Law for the following reason (Section 7031 5, Business and Professions Code) Address 3303 - 43.40 ❑ 1, as owner of the property, will do the work and the City Tel No 1 ITEMS structure is not intended or offered for sale(Section 7044, Business and Professions Code) TOTAL -43 - 40 CONSTRUCTION LENDING AGENCY CHECK 43.40 I hereby affirm that there is a construction lending agency for CHANGE .00 the performance of the work for which this permit is issued (Sec 3097, Civ C ) Lender's Name 0000-0001 4/ 8/96 Lender's Address 5775 1 AMIV 15 1 certify that I have read this application and state that the above information is correct I agree to comply with all County + ordinance Sta s regulating Plumbing, and hereby authors re re nt es of this County to enter upon the abov me property for inspection purposes z-,r SEE REVERSE FOR EXPLANATORY LANGUAGE Signature 55-Per it a Date