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Home My Public Portal About10662 FREER ST_Plumbing__ 7:, ft6F,+7 z CE 817 7-69 APPLICATION FOR PLUMBING PERMI COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING (J JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY FOR APPLICANT TO FILL IN(PR NT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER , WATER CLOSET 1.50 MAIL /\ BATH TUB 1.50 ADDRESS SHOWER 1.50 CITY TEL. NO. —� ° —� LAVATORY - 1.50 CONTRACTOR Ci SINK 1.50 ADDRESS 1 DISHWASHER 1.50 CITY T NO. CLOTHES WASHER 1.50 STATE I / LIC LICENSE NO. CLASS G Zr7 SWIMMING POOL RECEPTOR 1.50 DISTRICT N GR/OyP I ZONE P OICES�j.E BY LAWN SPRINKLER SYSTEM 2.00 TT 0 WATER HEATER 1.50 V INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.50 INSPECTION WPRD 55 PERETS SYSTEMR .30 3 /16 Plan �✓ ,�C� Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE 9 2 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT City, Tel. No. HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION - AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES • WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OW R OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBE (DENT L ROPERTY. FINAL SIGNATURE .TACK R. ALLEN, SUPERVISING CH ANIC AL ENG'R. OF PERMITTEE PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION CK. M.0. CASH A", 4-1 2 9C-- HAR 17 - 5 0 3.5 O N '. 'eX&4 76AG67-CE#817 5/63 G, APPLICATION FOR PLUMBING PERMIT 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 LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $1.25 IrIAIL /, BATH TUB 1.25 ADDRESS (/ CITY ��IA TEL. NO. SHOWER 1.25 LAVATORY 1.25 CONTRACTOi{�� SINS 1.25 S ADDRESS AISHWASHE 1.25 CITY U;W TEL. NO. LAUNDRY TUB 1.25 CONTRACTOR-'S STATE REGISTRATION NO. � COUNTY El WASHER 1.25 DISTRICT No. GROUP NE P ICES D BY WATER HEATER 1.50 } GASYSTEM—OUTLETS—OUTLTS1.50 INDUSTRIAL B' WASTE APPROVAL 0 OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD O V w IZ t� APPROVALS DATE INSPECTOWS SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ' ROUGH PLUMBING / TOTAL FEE ��'' GAS PIPING J. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS A PLICATION .4` GAS VENT I V AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING `^ HOT WATER HEATER ✓ PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO GAS TEST RESIDE IN, THE ABOVE DESCRIBED RESID�AL PROPERTY. `- UTILITY CO. NOTIFIED SIGNATURE OF PERMITTEE FINAL I✓ la`6' t�� / i� si:.. 6'.'N VALIDATION ROBERT A. WOOD V CK. M.O. CASH SUPERVISING MECHANICAL ENG'R Li t;o 1 4 2 8 OCT 14 5 D 4-50-- 1 76Aee7 17 9-48 ® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRgAIO. GROUP ZONE PERMIT NO. PLUMB , '•„L' .f-�`-�'>.�'�C� �i ` RECEIVED BY READY FOR DATE ISSUED 1 ,p FIRST INSPECTION ADDRES e CITY / ' e;.! v TEL. NOB ®[/+�� BUILDING -` l J ADDRESS u 6 COUNTY N/ �_„• LOCALITY� � LICENSE NO.NO. - EXPIRES g NEAREST ,+ PERMIT FEES CROSS ST, NUMDER. TIYPE OF,.FISCTU RE OR ITEM FEE OWNER yp' / r.- --• MAIL 1,,WATER;CL;:�SETt'F(TO0ILET) @ 0.50 $ 1 ADDRESS BATH TUBS +j~ Q 0.50I CITY TEL. NO, ISHOWER, ` a@ 0.501 I 1 HEREBY ACKNOWLEDGE THAT I HAVE -READ THIS LAVATORY (WASH BASIN) a 0.50 I APPLICATION AND STATE THAT THE ABOVE IS CORRECT-AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ 0.501 STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAU NDRY,YbB OR TRAY @ 0.501 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. GAS SYSTEM OUTLETS @ O 501 SIGNATURE OF (,•WATER HEATER @ O 501 PERMITTE -�y-��/•'•�i-��'- -v'R. SLOP SINK @ o 501 INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.501 DISHWASHER @ O.SOI -DRINKING FOUNTAIN @ 0.501 1 URINAL @ 0.5017-ti HOUSESEWER @ 0.50 1 Ism /111,6 -'c— - -7- 1��,”' �. /' r/aa jr. Z 1 MISCELLANEOUS I ••'"lll�� _ ho -4 4,70 1 F 6 m P 1.]�P O In t' 1,/X-1�7'n n -J1 g t) APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING �- GAS VENT CESSPOOL@ 1.00 ISI CESSPOOL SEPTIC TANK: I 1 SEPTIC TANK DRAIN ( ) PIT ( ) Q 1.001 I SEWER •`l(" 7 PERMIT . I 1,00 JGAS TEST UTILITY CO. NOTIFIED TOTAL FEE �� FINAL 1KJ ' APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY 0 COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. I GROUP ZONE PERMIT NO. PLUMBER / RECEIVED BY READY FOR DATE ISSUED O'R FIRST INSPECTION _ -_C�e-no ADDRESS S� BUILDING �o 2- COUNTY - CITY TEL. NO. ADDRESS r�� G / ,mss/ //'j+ cy� dZ- LIOCENSE NO. EXPIRES LOCALITY �j--�:/ (L, [-' ( ` / NEAREST- PERMIT FEES CROSSST ' NUMBER I TYPE OF FIXTURE OR ITEM FEE OWNER f !1// t!t �{ MAIL A / /7 7 I WATER CLOSET (TOILET) C 0.50 $ /I,,Qv�G.fryi ADDRESS ^ D},�Z.'V/ ` A l'T/4 � BATH TUB Qa O Sol 4,90 CITY /'/ p /Y TEL. NO. SHOWER @ 0.501 I . I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS / I O- APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND LAVATORY (WASH BASIN) u O Sol AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. KITCHEN SINK c+ O 50 [9-0 I C[RTIFY-THAT. 1, POSSESS ^THE- ABOVE VALID LOS LAUNDRY TUB OR TRAY @ O 50I �$ ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. }� _ I GAS SYSTEM�OUTLETS @ 0.501 IAp!'a SIGNATURE f" LI WATER HEATER Q 0.501 eta PERMITTEE '� 1 SLOP SINK Cil 0.50 II3SPECTION RECORD FLOOR SINK @ O 50 l I FLOOR DRAIN @ 0.501 L 1•DISHWASHER Q 0.501 �"�"E -7=H1,�I �( � O��'�� r/) )J�7y-��r DRINKING FOUNTAIN a 0.501 I URINAL @ 0.501 I �"-,�� C N AflzI•�iir�%,/;1�J I HOUSESEWER a 0.501 1,�- A c 1 Q — — �� /1�!�//J � �`�3:f r c�/G� � � z_ MISCELLANEOUSJ� p. U' I ell"®A✓i,: o.r a Al Cfsy 17 . 1 -3 -sn C-�S n�� , APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING iI _ I 1 GAS PIPING GAS VENT CESSPOOL Q 1 001 1 CESSPOOL I _I SEPTIC TANK: I I SEPTIC TANK DRAIN ( ) PIT ( ) a 1.001 1 SEVER PERMIT . I 1.00 GAS TEST I /" �J/ .� UTILITY CO NOTIFIED I{' /IA/p/l TOTAL FEE FINAL / 1 i YVORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT t hereby, offiim that.l'have a certificate of consent to self in- 26-0026 DPW 4/90 76A667A sure,or a certificate of Workers'Compensation Insurance,ora certified copy thereof,(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) Certified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant WATER CLOSET(TOILET) NEAREST y�� ✓0 a by CERTIFICATE OF EXEMPTION FROM WORKERS', i . BATH TUB CROSS ST. �,' Me t\k COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars (;100)or less.) LAVATORY ADDRESS 16(o te" I certify that in the performance of the work for which this per- SINK`` mit is issued, I shall not employ any person in any manner so 1 CITY L �_e TEL. NO. as to become subject to the Workers'Compensation.Laws. ! '• DISHWASHER L CONTRACTOR Date Applicant I CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of Ex- ADDRESS tion,you should become subject to the Workers'Com en- SWIMMING POOL RECEPTOR em p Y I p CITY NO. sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLAFS LICENSED CONTRACTORS DECLARATION DISTRICT NO. P ES D BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division.3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINALVn ATION fact. HOSE BIB DATE >. License Number Lic. Class CL FINALr1 0 Contractor Date BY ACCT a 4 0 I am exempt under Sec. 33031 ITEMS140 B.&P.C. for this reason Plan check fee ► CL CL Date: PLUMBING PERMIT ISSUING FEE$ p TOTAL �-�o�� Signature TOTAL FEE � Q SINGLE FAMILY 11 HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and Professions Code): Address I, as owner of the property, will do the work and the City Tel. No. 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 (Seca 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 of this County to enter upon the A ove-menti ed proIjerty for inspection purposes. 7 aS_� SEE REVERSE FOR EXPLANATORY LANGUAGE nature o Permittee 1 GlDate WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby, affirm that I have a certificate of consent to self in- 76A667A PW 4/90 sure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY WATER CLOSET(TOILET) Date Applicant NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK CITY TEL. NO mit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws. DISHWASHER CONTRACTOR Date. Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- tion, you should become subject to the Workers'Com en- SWIMMING POOL RECEPTOR em P Y I P CITY TEL:NO. cation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER a and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION O fect. HOSE BIB DATE U UJ License Number Lic. Class FINAL jy Contractor Date BY >. I am exempt under Sec. Q B.&P.C. for This reasonPlan check fee o ► a Date: PLUMBING PERMIT ISSUING FEE$ LJ F Signature TOTAL FEE i,4 f' SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant r A]I Vi. I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and Professions Code): Address ❑ I, as owner of the property, will do the work and the City Tel. No. 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 , above 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 Signature of Permittee Date