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HomeMy Public PortalAbout5327 FRATUS DR_Plumbing__ 76A667 -CE#817 2-62 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING LL� JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS d WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER V kyr WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS SHOWER 1.25 CITYt�CX +�{ TS3rIi9r�� LAVATORY 1.25 CONTRACTOR SINK 1.25 ADDRESS DISHWASHER 1.25 CITY - ` /TEL. NOjiL CONTRACTOR'SSTATE LAUNDRY TUB 1.25 REGISTRATION NO. -7/ ��Y COUNTY CLOTHES WASHER 1.25 DISTRICT N G P PR ES B WATER HEATER 1.50 ,\ 0 / n, GAS SYSTEMOUTLETS 1.50 INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD u 0 . a e� ti tu a H Z AP OVALS PATE INSPECTOR'S SIGNATURE-«-' UNDER WORK PERMIT $ 2 00 OUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. p 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 E LEGAL OWNER OF,AND INTEND TO RESIDE IN, THE ABOVE DES �ED RE:�M�TY. UTILITY CO. NOTIFIED SIGNATUREOF PERMITTEE FINAL VALIDATION ROBERT A. WOOD CK. M.0. CASH SUPERVISING MECHANICAL ENG'R 76A667A CE 817(REV 6/78) ©s APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM ® FEE ADDRESS WATER CLOSET LOCALITY NEAREST BATH TUB CROSS ST SHOWER OWNER LAVATORY MAIL ` ADDRESS SINK CITY � �,� TEL NO DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR v CITY TEL NO � LAWN SPRINKLER SYSTEM STATE LIC WATER HEATER LICENSE NO CLASS GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING a GAS VENT u HOT WATER HEATER 0 �4,t PLUMBING FIXTURES GAS TEST Afy Plan check fee UTILITY CO NOTIFIED it' W PLUMBING PERMIT ISSUING FEE$ VV !Y TOTAL FEE FINAL Pion check applicant PLAN CHECK VALIDATION Nome AddressNIS � --7757— c� City Tel No I HEREBY NOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION 2 5 7 a 3 A I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS R EOUI D BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AME # O O O O O 5 LEGAL O OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY 2 0 0 1 3 0 0 SIGNATURE OF PERNM TEE 0 0 0 1 + O V DISTRICT NO7, „ / E ED BY J fY U IS U bUy 027-7Q INDUSTRIAL WASTE APPROVAL 76A6'`7C ICE 817 A) 11/76 1 ��j F APPLECAT I®N l OL�R:PM B ING PERMIT COUNTY OF LOS ANALES � DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM ® FEE ADDRESS WATER CLOSET LOCALITY NEAREST ( nn BATHTUB CROSSST A � 1'C I SHOWER OWNER 01a v LAVATORY MAIL �^ Z ADDRESS ! SINK CIT G7 CL]IJ TEL NO 34/ DISHWASHER �Q CONTRACTOR ` \ S`S AZ CLOTHES WASHER ADDRESS /0"MD SWIMMING POOL RECEPTOR CITY �17)IXF Q TEL NO ( LAWN SPRINKLER SYSTEM STATE LIC WATER HEATER LICENSE NO CLASS v 9�:� GAS SYSTEM OUTLETS DISTRICT NO GROUP ZONE CESSED BY OUTLETS OVER O / �l wr-onJ 5 PER SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD u at W a 4n c� Plan check fee PLUMBING PERMIT ISSUING FEE$ TOTAL FEED Plan check applicant APPROVALS DATE INSPE R S SIGNATURE Name UNDER SLAB WORK '?D Address ROUGH PLUMBING �� n City Tel No GAS PIPING 0 v $ , v I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT �( Y THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES y' AND STATE LAWS REGULATING PLUMBING HOT WATER HEATER e '� I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES , �S REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED SIGNATURE OFPERMITTEE - FINAL PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION y o CASH _ r--AUG 2 _ CK D 331 , 7.50 ® r o5 y,�JpRKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT ILKer�by.affirm'thpt I have a certificate of consent to self 76A667A insure, or cr certificate of Workers Compensation Insurance, CE 817(REV 10/81) LLJJ or a certifieyd�copy the f (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy Ngo,/, mpony 02 TI elYlG �I co91/7/ G��///� ❑ Certified copy is hereby furnished ` ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUIING 532LDMi Certified copy is filed with the county building inspec- ADDRESS f„ Q ` tion department NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant / WATER CLOSET U V NEAREST y CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST 'O i COMPENSATION INSURANCE / SHOWER ( o] OWNER Coc le c ` (This section need not be completed if the work involved by [! MAIL the permit is for one hundred dollars (:100)or less) ` LAVATORY ADDRESS 4 I certify that in the performance of the work for which this r permit is issued, I shall not employ any person in any manner / SINK v� CITYiTr +L TEL NO so as to become subject to the Workers'Compensation Laws DISHWASHERD CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS 1�y2� p / ,, NOTICE TO APPLICANT If, after making this Certificate of �L^�+�/ J o1I k�@4 Exemption, you should become subject to the Workers' WeS�SWIMMING POOL RECEPTOR r �� Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY Oye ,k TEL NO 3� —292 Y with comply with such provisions or this permit shall be STATE 7��5 LIC deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO CESSED 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 VA DATION DATE License Number Lac Class 0 FINA U Contractor P Date 91 >^`G� BY F-1I am exempt under Sec U B RP C for this reason W Plan check fee [L' Date N PLUMBING PERMIT ISSUING FEE$ Z Signature TOTAL FEE Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address 5 1 q' Law for the following reason (Section 7031 5, Business and # 0 0 0 010 Professions Code) City Tel No I 0 0 Jr x ❑ I, as owner of the property, will do the work and the 0' 0 structure is not intended or offered for sale (Section lop.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 r+ (Sec 3097, Civ C ) Ohl Lender's Name 'V hl Lender's Address V 4 ' I certify that I have reail 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 outhonze representatives of this County to enter upon the above-mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE 2- /- TV/ - Signature Permittee Date