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Home My Public Portal About10667 FREER ST_Plumbing__ 76A667-CE617 6-60 APPLICATION FOR PLUMBING P MIT COUNTY NTFCYGEDEPATTM OCOUNTY 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. A& ' NUMBER FIXTURE OR ITEM OWNER WATER CLOSET MAILp ADDRESS BATH TUB CITY TEL T&C- SHOWER LAVATORY CONTRACTOR ' SINK ADDRESS DISHWASHER CITY TEL NO. CONTRACTOR'S STATE ❑ LAUNDRY TUB REGISTRATION NO. COUNTY El CLOTHES WASHER DISTRICT O G�P ZONE R E D BY WATER HEATER a GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD a ' O n p C< W a N ' 0 $1.00 PER ITEM I /, / OR FIXTURE $ ov APPROVALS . DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK TOTAL FEE ROUGH PLUMBING GAS PIPING 1 HEREBY ACKNOWLEDGE THAT t 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 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,,oTHE LEGAL OWNER OF THE ABOVE , DESCRIBED R DENTIAL PR��T . UTILITY CO. NOTIFIED SIGNATURE r: ' OF PERMITTE FINAL ®R VA MONY'�RoeERT A. WOOD. M. 0. CK. .o. CASH UPERV►SING MECHANICAL ENG'R 71 DEC 5 5 C 3-00 c• ` �� 76P:667-CE817 12/59 APPLICA"T"ION FO PLUMB G PERMIT. COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING r� JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS /D to�0 7 /�� >° 1e S T WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY FOR APPLICANT-TO FILL IN NEAREST C' CROSS ST. �p�C� NUMBER FIXTURE OR ITEM OWNER WATER CLOSET MAIL ADDRESS BATH TUB CITY TEL.' NO. SHOWER //�� LAVATORY CONTRACTOR A Ae &O A -S / SINS ADDRESS ,/.� ff iy yy dr V DISHWASHER CITY TEL.o p +� TEL. NO. CONTRACTOR'S STATE LAUNDRY TUB REGISTRATION NO. led .rCOUNTY ❑ CLOTHES WASHER DISTRICT` NO. GR� ZONE I P CESSED BY WATER HEATER " e/ GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD a O U 4�C @ O ' F _ a rev/q'�'be9 ♦�,"n+' A..:,) FL /f @ $1.00 PER ITEM v OR FIXTURE $ dQ APPROVALS DATE INSPECITOR'S SIGNATURE PERMIT $ I00 UNDER SLAB WORK 13y TOTAL FEE ROUGH PLUMBING 9.� H / Ol� GAS PIPING e 9 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 LDESCRIBED CERTIFY THAT I AM PROPERLY REGISTERED, AND/OR PLUMBING FIXTURES ♦ 9 i S REQUIRED BY LOS ANGELES COUNTY ANDSTATEOF GAS TEST OR THAT I AM THE LEGAL OWNER OF THE ABOVE RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIEDEITTE FINAL /cliA( ®� ALIDATION ROBERT A. WOOD, cs. M.0. CASH SUPERVISING MECHANICAL ENG'R [_i,L'G`� 9 8 5 ilaJl�i �4 D l7 t;.l3 0 i' 76A 667-CE#817 4-67 APPLICATION FOR PLUMBING PERM T COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ADDRESS JOHN A. LAMBIE• COUNTY ENGINEER COLEMAN W. JENKINS. SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST STC CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNEF WATER CLOSET $1.25 MAIL y BATH TUB 1.25 ADDRESS b rp C.7 CITY -7 c • TEL. NO. SHOWER 1.25 LAVATORY 1,25 CONTRACTOR SINK 1.25 ADDRESS DISHWASHER 1.25 CITY TEL. NO. STATE LIC LAUNDRY TUB 1.25 LICENSE NO CLASS CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE BR CESSED BY WATER HEATER 1.50 ' s GAS SYSTEMOUTLETS 1.50 INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD O U O I- U W d N Z t APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE I -o 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 HOT WATER HEATER PLUMBING. - I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANDIOR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED R SID TIAL PROP TY UTILITY CO NOTIFIED SIGNATURE /'-_ OF PERMITTEE c one FINAL VALIDATION JACK R. ALLEN CK M•O CASH SUPERVISING MECHANICAL ENG'R. Li,u o tiC i 6 5 D .5 WORKED!COMPENSATION DECLARATION APPLICATI®NTOR.PLUMBING PERMIT ` herefjy,Saffirrn that I have a"certificate of consent.to self 76A667A ' , insung,.or a certificate of Workers Compensation'Insurance, CE 817 (REV,,8/86) or a certified copy thereof (Sec ,3,800;Lab. C ) , COUNTY_ OF'.-LOS. ANGELES DEPT. OF,PUBLIC'-WORKS Policy No Company , ' r 0 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING /Q`' 7,�A��A` ST- ' Certified copy is filed with the county building inspeo ADDRESS s7 ff /� +S I tion department NUMBER FIXTURE OR ITEM @ FEE LOCALITY WATER CLOSET Date Applicant CROSS ST � NEAREST �r f . J�� • •CERTIFICATE'OF'EXEMPTION FROM WORKERS' /t BATHTUB' � � - /� /JIJ•� ' 'COMPENSATION INSURANCE, OWNER SHOWER KRA iY � 1l�/�r / : (This,section need not be completed if the•work involved by ` - •the permit I'foii. 'do one hundredllars ($100)or less.) LAVATORY MAIL �' ADDRESS certify that in the'performance of the work for which this. r permit is issued, I shall not employ any person in any manner SINK CITY TEL NO. so as I. become'sublect'to the Workers,Compensation Laws DISHWASHER CONTRACTOR Dote Applicant CLOTHES.WASHER= ADDRESS NOTICE,TO APPLICANT- If, after making this Certificate of Exemption; you should become subject'to-the'.Workers', SWIMMING POOL RECEPTOR • ` CITY. -- ' TEL NO. - Compensation provisions of'the,Labor Code,`you must forth- LAWN SPRINKLER SYSTEM ' with"comply with such provisions or, this permit'shall be STATE deemed revoked. WATER HEATER LICENSE NO. SS ? LICENSED•CONT,RACTORS,DECLARATION ,DISTRICT NO. P CESSED BY GAS SYSTEM OUTLETS ''I hereby affirm that I om licensed under provisions of Chapter 9 c (J .(commencing.with'•Section 7000) of Division`3 of the Business OUTLETS OVER T VALIDATION and Professions Code,and my license is In full•force and effect. 5 PER SYSTEM ` FINAL � all DATE License•Numbeo• LIc Class FINA OG Contractor Date BY ❑ I am exempt under Sec.' W W B.BP.C. for this reason Plan'check fee Date: PLUMBING PERMIT ISSUING FEE$ r, TOTAL FEE 'Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License ' Address r Law for"the following'reosoh (Section 7031.5, Business and Professions Code): City Tel. No. .I,•as owner'of the property, will-do the work and the _ - ///��\ structure 'is not intended or offered for sale (Section 70A4, Business and Professions Code): - 746r2A CONSTRUCTION LENDING AGENCY #:o+o;•o',o 0 5 I,hereby affirm that.therelsa construction lending agency for • r the performance of the'work for which this permit is issued;' °'° 34..5.0. (Sec: 3097,'Civ. C.'). 3 5 0 o,o,o • .. .- .. . . _ - - - ' - . .. 714 87 ' Lender's Nome Lender's Address' I certrfy that.1 have read this appltcotion"and state that the` ► above1 Information is correct .agree'to comply with-all County ordinances and State laws regulating Plumbing, cind hereby outhorizePh esentatives of thi unty to enter upon the' t. above-niened_property for i sp coon'purposes. — 'SEE REVERSE FOR EXPLANATORY LANGUAGE . Sign t re of Permittee " . Date