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Home My Public Portal About9244 GARIBALDI AVE_Plumbing__ M1 76A657 (CE-817)-4/72 APPLICATION F R PL IBING PERMIT Co�UNN��yy OF LOS ANGELES DEPAR'I`h�NT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: FAD NG 3HARVEY T. ERANDT, COUNTY ENGINEER TY FOR,APPLICANT TO FILL IN (PRINT OR TYPE) T ST. NUMBER FIXTURE OR ITEM_ 0 FEE WATER CLOSET 1,15 OWNER t. MAIL BATH TUB 1.76 ADDRESS SHOWER 1.75 CITY a TEL. NO. LAVATORY 1.75 CONTRACTOR SANK 1.75 ADDRESS DISHWASHER 1.78 CITY NV TEL. N0. CLOTHES WASHER 1.75 STATEc �/ CILA � LICENSE NO. C (C7 SWIMMING POOL RECEPTOR 1.78 -DISTRICT NO. GROUP NE ESSED LAWN SPRINKLER SYSTEM 1.76 WATER HEATER 1.75 IN %OVAL p�p GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD C] OUTLETS OVER 90 p� 6 PER SYSTEM Plen check fee S.. R•v.r.. PLUMBING PERMIT ISSUING FEE 8 3 00 TOTAL FEE 00 APPROVALS DATE •Fccro 1 SI411ATUR Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS VENT I HERESY ACKNOWLEDSE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE 12 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LALWS RESULATINS PLUMSI NO. GAS TEST 0 B I HERESY CERTIFY THAT I PROF [SISTER[D AMD/OR UTILITY CO. NOTIFIED LI CENS[D AS RKOUIRSD BY S C TY AND STATE OF CALIFORNIA OR THAT I E ES R OF, AND IN DTD RESIDE IN THE ABOVE DE I TIAL PROPERTY. FINAL SIGNATURE OF PERM,TTE jIFjmd PERMIT VALI TION CK. M.0. CASH PLAN CHECK VALIDATION �/M CASH f 352 -3 OG 1 5 D 1 0'00 a ieAe07-CH61117 4-E7 APPLICA ON,,I�POR PLUMBING ERMIT COUNTY OF LOS ANGELES u DEPARTMENT OF COUNTY ENGINEER BUILDING. . BUILDING AND SAFETY DIVISION BUILDI a JOHN A. LAMBIE, COUNTY ENGIN¢sR elv COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALTIT FOR APPLICANT TO FILL IN CROSSNEAREST RT e c NUMB[R FIXTURE OR ITEM EACH FEE O WNEB WATER CLOSET 5133 MAII. BATH TUB 133 ADDRESS sHowEa 1.73 CITY TEL. NO. LAVATORY 123 CONTRJICTO SINK 133 ADDHF38 p p DISI•IWABHER 1.15 TEL. NO.LIC Q�� LAUNDRT TUB 135 BTATE LICENSE NO. �� CLASS CLO71ma WASHER 1.25 DISTRICTNO. GRO}J� ZON P [ BY WATER HEATER Im p� `(fes --GAS RYBTE![ OUTLETS lsoUBTELILL ASTEASTE APS PROVAL OUTLE" OVER 3 PER BTSTEM .70 INSFECnON RECORD S APPROVALS DATE IN■PI<CTOR'S SIGNATUR[ PERMrr S 2 oo UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE C`/1 GAS PIPING I HIEMMY ACKNOWL[DGK THAT I HAV[ RLAD THIS APPLICATION AND STATE THAT TRK ABOY[ 15 CORRLCT AND AGRII TO COMPLY GAS VENT WITH ALL CQUNTY ORDINANCLS AND STATK LAWS RKGULATING PLU wSINa. HOT WATER HEATER 1 HKRDY CiRTIFY THAT I AM PRO"RLY RLGISTERLD AND/OR PLUMBING FIXTURES LICLN Sm AS R[OUIRLD BY LOS ANGLLLS CI COUNTY AND STATOF GAS TEST CALIFORNIA OR THAT 1 AM THS L[GAL OWNSR OF.AND INTLND TO R[SIDK IN. TH[Aiwov[DLSc RISLD PmsioxmTpo PRo P[RTY. UTILITY CO.NOTIFIED SIGNATURE OF PKRMITTEE FINAL ,'�LIDATION JACK R. ALLEN cK.f M.0. UTAI SUPERVISING MECHANICAL ENG'R. ' 0.2.5 2T7�3 JAN,l fl 15 D 3.3 U- 76A687•CE#817 4-64 J �I APPLICATION FOR PLUMBIN 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 LOCAL FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS TEL. 2Jr3� SHOWER 1.25 LAVATORY 1.25 CONTRACTOR SINS 1.25 ADDRESS DISHWASHER 1.25 c TEL. NO. LAUNDRY TUB 1.25 CONTRAC R'S �� i STATE REGISTRATION NO—Z / COUNTY ❑ CLOTHES WASHER 1.25 DIST T NO GROUPZ E P OCES D Y WATER HEATER 1.50 O GAS SYSTEMZ 1.50 INDUSTRIAL OUTLETS WASTE APPROVAL O OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD u ladO ,/J LUCLH N Z - -714 Irn v 'APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 OQ UNDER SLAB WORK ROUGH PLUMBING TOTAL FEEGAS PIPING I HEREBY ACKNOWLEDGE THAT I 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. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AN OR PLUMBING FIXTURES LICENSED AS REQU BY-LOfi ANGELES COUNTY AND S E o GAS TEST CALIFORNIA OR AT i AM $ LEGAL OWNER OF,AND 1 END T RESIDE IN,TH ABOVE DES E RESID NTIAL PROPERTY. UTILITY CO. NOTIFIED SIGNATUR OF PERMI FINAL ' VCK. ALIDATION ROBERT A. WOOD M.0. CASH SUPERVISING MECHANICAL ENG'R LALO 6 7 1'31 JAN 16 5 D 3.5 0 IV WORKERS'COMPENSATION DECLARATION A P P L I CAT I O N FOR PLUMBING P E RM I T I hereby afflrr�that I have a certificate of consent to self 76A667A Insurey or a cerfiflcate of Workers' Compensation Insurance, U.Q17(RFV. 10/81) u or a cerrtlfieto copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Pollcy N �Compan'19rA 7G � Z Q •Cbrtlfled copy Is hereby furnished. FOR APPLtCAM TO RLL IN(PfZIhIT OR TYPE) BW LDI NG C �I Certified copy Is filed with the county building In"c- ADDRM CSC tlon rt ret. NUMBER FIXTURE OR rTEM O FEE LOCALITY• r Date Apa*"pll4aNEAREST //!}X WATER gQ6ET CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB GROSS ST. COMPENSATION INSUkAN(1 SHOWER OWNER i)Fl! �S• (This sect)on rimed not be completed If the wohk Imrotred by the pwrnlit Is for one hundred dollars ($100)ror Is".) LAVATORY I certify that In the performance of the work fat which this permit Is Issued, I shall not employ any person In arty manner. SI NC r C to as to become subject to the Worker'Compensation Laws. DISI-(WASHER . cotJrRA4T /p Y DateATpl lcarlt ao7HES wASHER NOTICE TO APPLICANT: if, after making this Cbrttflcate of Exemption, you should- become subject to the Workers' SWIMMING POOL RECEPTOR- Ti Compens,crtlpn provisions of the Labor Code, you must forth- LAWN SPRINlCIH25Y5tEM Gffl �� ' .�5"/-?/0 with comply with such provisions or this permit shall be STATE /�� deemed revoked. WATER HEATER LASE 7 LICENSED CONTRACTORS DECLARATION D3TRJCT No. Y I hereby affirth m- wt I am licensed under ptovI&Ians of Chgpter 9 GAS SYSTFA'1 OUTLETS 4� rk (commencing with Section 7000)of DivlOon 3 of the Business OATS OVER .J V 0 and Profelslons Code,and my license Is In full farce and effect. S PER SYSTEM F1 NAL VAtI TION } ilcense NuFl oomIc. DATE Class a20 Contractor 1 am exempt under Sec. B.O3P.C. for this reason_ —� Plarr check fee Date: R p 81,3 A PLUMBING PERMIT ISSUING FEE; Z Signature x OTAL FEE # o 0.0 ° 0 5 ^` T (J _ -Plan check applicant ) .'61 E1 rJ 0 SINGLE FAMILY HOME OWNE -BUILDER DECLARATION Name0 � I hereby<rflrm that am exempt from the Contractor's License 5 Law for the following reason (Section 7031.5, Business and Address Rrofealons Code): City Ted. No. I Q Q3 3i 8 8 I, m owner of the property, will do the work and the struerure Ts not Intended or offered fcf sale (Section , 70.14, Business and Professions Code), CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the perfoomance of the wgrk for which this permit Is laued (Sec.3097, CIv. C. Lender's Name Lenders Address I certify that I have read this appllcatlon and state that the , ,above Informotioh Is correct, I agree to comply with all County ordinances and State laws regulating Plumbing, and,-hereby aythorlxe reprelentatives of this County to enter upon the above-menti nod pr rty for Inspectlon purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Dqfe '