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Home My Public Portal About5059 FRATUS DR_Plumbing__ 76A 667 (CE,-817) - 1/75 APPLICATION FO LUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER i BUILDING AND SAFETY DIVISION BUILDING MAKE CHECKS PAYABLE TO ADDRESS SOS �G( S p HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY se- FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST , CROSS ST NUMBER FIXTURE OR ITEM @ FEE OWNER WATER CLOSET 200 MAIL , BATH TUB 200 ADDRESS SHOWER 200 CITY TEL NO LAVATORY 200 CONTRACTOR &— e SINK 200 ADDRESS w �� DISHWASHER 2 00 CITY TEL NO S Z CLOTHES WASHER 200 STATEj 3 LIC Z SWIMMING POOL RECEPTOR 200 LICENSE NO / (7� CLASS DISTRICT NO OUP ZONE P CESS D BY LAWN SPRINKLER SYSTEM 200 WATER HEATER 200 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 200 INSPECTION RECORD CL- OUTLETS OVER 5 PER SYSTEM 30 y �� C O a N I Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE S 3 001V ,t TOTAL FEEpryp"�� A ROV $ ( E INSPE T R S SIGNATURE Plan check applicant UNDER SLAB RK ' Name ROUGH PLUMBING Address GAS PIPING City TA No 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 PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS REQUIRED BY COS ANGELES COUNTY _AND S-----y OF �1� CALIFORNIA OR THAT I AM THE LE jNER OF, ND INT ND TO CP o1, 6 _e� ��t° "lr-24�4p r:�"1 RESIDE IN THE ABOVE DESCRIBE 1 NTIAL PRO R FINAL SI GNA TU RE l OF PERMITTEE PERMIT VALIDATION CK M.0 CASH PLAN CHECK VALIDATION CK M o CASH 7 0- C.JNJUL G9 5 D 6.5 0 896 I 76A66-f DSS 17 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER F DI TRO. ROUP NU. ®OR APPLICANT TO FILL IN ERMIT y 3y PLUMBER `6 � � R EIVED BY READY FOR ATEJI88 ED �, r FIRST INSPECTION — ADDRES9 � -Q BUILDING �� Ice CITY IcC /� TEL N y��s*�� ADDRESSCOUNTY ei LICENSE NO / i V y EXPIRES 6 ;olu-1,,,LOCALITY . NEAREST PERMIT FEES CROss ST NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER ° MAIL WATER CLOSET(TOILET) @ O 50 $ ADDRESSU ••�.� 9 BATH TUB @ 0.50 CITY ` ., TEL ND , 0) J J� SHOWER @ O 513 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) @ 0513 APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ O 513 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 1350 ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED A OVE GAS SYSTEM R OUTLETS @ 0.50 SIGNATURE O� WATER HEATER @ 0.50 PERMITTE SLOP SINK @ Oso INSPECTION RECORD FLOOR BINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50 DRINKING FOUNTAIN @ 0.50 URINAL @ 0.50 J Q HOUSE SEWER @ O SO _Z MIS L EOUS C7 Q O APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING A .. ` GAS PIPING /A AW 9 b v 9 w GAS VENT Y CESSPOOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ) PIT ) @ 1 OO SEWER PERMIT I 1 00 GAS TEST UTILITY CO NOTIFIED A TOTAL FEE $ �A FINAL �/ WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of cc"Jgsent to h�if 76A6k-/A '` ✓ insure, or a certificate of Workers' Compensation Insurance, CE 817(REV 1G/81) or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy NoAn27� k ompony PY j Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING r Certified copy is filed with the county building inspec- ADDRESS "y 0 tion department NUMBER FIXTURE OR ITEM a FEE n LOCALITY V4P' Date r fi F Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' 1 BATH TUB CROSS ST COMPENSATION INSURANCE OWNER C /'• (This section need not be completed if the work involved by SHOWER `� the permit is for one hundred dollars ($100)or less ) LAVATORY MAIL '' ADDRESS I certify that in the performance of the work for which this L::T2 permit is issued, I shall not employ any person n any ma ner SINK CITY TEL NO so as to become subject to the Work rs Coin motion ws DISHWASHER CONTRACTOR 1► I � � �^� Date r 6 Applicant CLOTHES WASHER "Z, A iJ NOTICE TO APPLICANT If, along i ADDRESS Certificate of S, 15`_,� /-AVE Exemption, you should become subject the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY EL NO I „ LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE ' deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO CESSED BY/ I hereby affirm that 1 am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER >_ and Professions Code,and my license is in full force and effect 5 PER SYSTEM FINA ( CL DATEL `� VALIDA ION UO r✓ License Number Lic Class_ �.�(� FINA Contracto� � Date ° f J` 'OQ,5 BY O U r_1 LU I am exempt under SecLl [ j , 9_qN B &P C for this reason Plan check fee 00, L [ Z Date PLUMBING PERMIT ISSUING FEE$ Signature— . TOTAL FEE �r o SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name 1 7 $A I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031 5, Business and # o 0 0 0 0 5 Professions Code) City Tel No ❑ 1, as owner of the property, will do the work and the t' ° o40.50 structureis not intended or offered for sale (Section , 7044, Business and Professions Code) ° ° ° 4 Q 5 0 50 CONSTRUCTION LENDING AGENCY 0325-85 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 ► above information is correct I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize representatives f this County to enter upon the bo 'e #entoed propert or inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE gnaturettee Date