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Home My Public Portal About9647 GARIBALDI AVE_Plumbing__ f 76A667-CE4817 6-65 / APPLICATION FOR PLUMBI PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY G FOR APPLICANT TO FILL IN CROSS ST . NUMBER FIXTURE OR ITEM EACH FEE OWNER ,G! 1107/A/ WATER CLOSET $1.25 MAIL BATH TUB 1,25 ADDRESS CITY TEL NO. SHOWER 1.25 JPool A FIs LAVATORY 1.25 CONTRACT SINK 1.25 ADDRESS 7 DISHWASHER 1.25 CITY-/'—SArE IC .� LAUNDRY TUB 1.25 LICENSE NO. C V_el eZSS CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE I P CE D Y WATER HEATER 1.50 GAS SYSTEM OUTLETS 1.50 INDUSTRIAL a WASTE APPROVAL O OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U O f— V LU a N Z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT S 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE a GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT ANO 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 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTENP...TO GAS TEST RESIDE IN,THE ABOVE DESCRIBED RESIDE ROPERrv. UTILITY CO. NOTIFIED SIGNATURE •(�'/ OF PERMIT " / FINAL )ALIDATION C K..,/ M.O. CASH ` �,0 2 8 7 0' JUN 16 5 D 3.5 0cv 76A667-CES17-8-58 APPLICATION FOR PLUMBING PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BUILDING JOHN A. LAMBIE, County Engineer ADDRESS CASSATT D. GRIFFIN,Supt of Building LOCALITY _ C FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM _ OWNER WATER CLOSET MAIL BATH TUB ADDRESS SHOWER J CITY TEL. NO. LAVATORY CONTRACTOR SINK ADDRESS DISHWASHER CITY LJ} TEL. NO K'//,Y,3 CONTRACTOR'S STATE ❑ LAUNDRY TUB REGISTRATION NO. C 36 /a ZcPz- COUNTY ❑ CLOTHES WASHER DISTRIC NO. GROUP ZONE PRQCESSED BY WATER HEATER �— 4 V GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD III APPROVALS @ $1.00 PER ITEM .t OR FIXTURE $ / DATE INSPECTOR'S SIGNATURE 6 UNDER SLAB WORK PERMIT $ 2 00 ROUGH PLUMBING TOTAL FEE S PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY TH PROPERLY REGISTERED AND/O GAS TEST LICENSED AS REQUI Y L S AN ES AND STATE CALIFORNIA OR T I A E / WNE OF THE 0 UTILITY CO.NOTIFIED DESCRIBED RESI NTIAL SIGNATURE ^ FINAL OFPERMITT E ROBERT A.WOOD. OF VALIDATION SUPERVISING MECHANICAL ENG'R cc�-CK. Y.0. CASH I)f5196�; APR16 5 A 3.00 76A667 (CE-817)- 5/73 • APPLICATIONYOR PLU BING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FADDRESS LDING 1 MAKE CHECKS PAYABLE TO: Cg HARVEY T. BRANDT, COUNTY ENGINEER !+, ALITYFOR APPLICANT TO FILL IN (PRINT OR TYPE) REST OSS ST. NUMBER FIXTURE OR ITEM @ FEE OWNER / n WATER CLOSET 1,75 ' /l! D G� MAIL BATH TUB 1,75 ADDRESS y SHOWER 1,75CITY ��+� _ TEL. NO. LAVATORY 1,75 4, CONTRACTOR i &AA- ; SINK 1,75 J ADDRESS DISHWASHER 1,75 CITY , '' ? , TEL. NO. '7 CLOTHES WASHER 1'75 STATE L C NSE NO. CLASS SWIMMING POOL RECEPTOR 1,75 30 DISTRICT NO. GROUP ANE CESSE BY I! LAWN SPRINKLER SYSTEM 1,75 �Q ; �c WATER HEATER 1,75 INDUSTRIAL ' WASTE APPROVAL d GAS SYSTEM OUTLETS 1.75 NSPECTION RECORD Q OUTLETS OVER 30 5 PER SYSTEM p F— U W O_ Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK - Name ROUGH PLUMBING " Address GAS PIPING City Tel. NO. GAS VENT _ 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` 1 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST I HEREBY CERTIFY THATLOAM AM PROPERLY RE STERED AND/OR UTILITY CO. NOTIFIED ,:'�i' � LICENSED AS REQUIRED BY LOS ANGELES COUNT(! AND STATE OF CALIFORNIA OR THAT CCRLI'D E LEGAL OWNER 0 AND INTEND TO RESIDE IN THE ABOVE RESIDENTIAL PR PERTY. FINAL SIGNATURE ' I;OF PERMITTEE t ��''� wy. dm PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH 5 0 f1UG 13 5 D 82 5 • WORKERS'COMPENSATION DECLARATION 20-0026 DPW 4187 APPLICATION FOR PLUMBING PERMIT eby, dfflrm that I have a certificate of consent to self In- 76A667A ■ r a'certlflcate of Workers'Compensation Insurance,or a CL 817(REV.8/86) cert fed copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is hereby furhlshed. �. FOR APPU CANT TO Flu IN (PRINT OR TYPE) BUILDING rtified-copy Is filed with the county building Inspectlon ADDRESS NUMBER FIXTURE OR ITEM TEE Pa LOCALITY q Date Applicant WATER CLOSET(YOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER C �� (This section heed hot be completed If the work Involved by MAIL the perm?♦Is for one hundred dollars ($100)or leas.) LAVATORY ADDRESS &qq I certify that In the parformance of the work for whlcFr this per- mit Is Issued, I shall not employ any person In any mariner so CTY as to become sGblect to the Workers'.Compensatlon Laws. DISHWASHER CONTRACTOR Date Appllcarit CLOTHES WASHER ADDRESS NOTICE TO'APPLICANT: If, after making this Certificate of Ex- emption,you should become subject to the Workers'Compen- SWIMMING POOL RECEPTOR satlon provlflons of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM CITY J TEL NO. ly with'such provisions cr this permit shall be deemed revok- - STATE LIC ed. WATER HEATER LICENSE NO. CLASS LICEIJSM CONTRACTORS DECLARATION DISTRICT NO. BY . I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS v j7 9(commencing with Sectlon 7000)of Division 3 of the Business OUTLETS OVER o POP and Professions Code, and my license Is (n fulF-Force and ef- 5 PER SYSTEM FINAL —�J VALIDATION S fart. DATE / CL O Llrense Number Llc Class U FINAL � Contractor Date BY O ❑ I am exempt under Sec. W B.BP.C. for this reason Plan check fee Dais: PLUMBING PERMIT ISSUING FEE; Q(J Signature TOTAL FEE SINGLE FAMILY FKEC )ME OWNER-BUILDER DECLARATION a* check applicant a* I hereby affirm that I am exempt from the Contractor's License Name Low for the following reason (Section 7031.5, Business and ACCT 1 Professlont Code): Address �T I, as owner of the property, will do the work and the .City Tel. No. 7 20.•`�l T EM structure Is not Intended or offered for&ale(Section 7044, 1 I Business and Professloru Code). , TOTAL OT 0 - 50 CONSTRUCTION LENDING AGENCY { . 50 I hereby affirm that there Is a construction lending agency for ��u--� the perforr6ance of the work for which this pNGE permit Is Issued La (Sec. X097, CIV. C.). Lendees Name - 1 1l 8/91 Lender's Address IM7 1 9 } I ceriify that I have read this application and state that the abgve Information Is correct. I agree to comply with all County , d p ordinances and State laws regulating plumbing, and hereby authorize representatives of this County to enter upon the abo mentioned roperty for Irnspectlon purposes. c SEE REVERSE FOR EXPLANATORY LANGUAGE SI re of Permittee Date n WORKERS'COMPENSATION DECLARATION f I hereby, affirm that l have a certificate of consent to ae lr, °PW 4/WAPPLICATION FOR PLUMBING PERMIT sure,or a cortl#I4ate of Workers'Compensation Insurance,or a certified copy th reef (Sec. 3800, Lab. C.) "CompanyGr-�+y EACt�If< COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Pollcy NoM* ❑ Certified copy Is hereby furnished. FOR APPU CANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy Is filed with the county building Inspection NUMBBt FIXTURE OR PEM FEE ADDRESS 1R L department. LAY kA Date 6 -1`K-'IG Applicant WATER CLOSET(ra �Lt�ST, f VL CERTIFICATE OF EXEMPTION FROM WORKERS' BATH RUB CROSS ST. 13 COMPENSATION INSURANCE _ SHOWERS F —1 (This section need rat be compkvted If the work inwhred by MAIL the permit Is for one hundred dollars (:100)or less.) LAVATORY Q.+ A I.V l I certify that in the performance of the work for which thts per- mit Is Issued, I shall not employ any person In any manner so 54N]C rr{ a C7ll + �nP>,. Cly TL as to become subject to'the Workers'Compen*atlon Laws. DISk-WASHER . , ` CONTRA(,1 M 1 t Date. Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWLYAUNG POOL RECEPTOR DDARESS subject emption,you should become bject to the Workers'Compen-d �Y TR ' satlon provisions of the Lab�x`_'ode,you must forthwith com LAWN NaER SYSTEMS ��^{ '� ly with such provisions or this permit shall f)e deemed revo STATE LIC ed. WATFR HEATER LKDa4SE NO.34 I'ln CYAS$ L`�• LICENSES CONTRACTORS KCLARATION 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 and Professlons Code, and my license Is in full.force and of- S.PER SYSTEM FlNAL VALDATION fect. HOSE DATE ` p BIB } License Numb,3 7 1 Llc..Cla»C . FlNAL Contractor Date 1 R— BY r 1 am exempt under Sec. ACCT. ��7• � B.BP.0 for this reason Plan check fee 1 ITEM PLUMBING PERMIT ISSUING FEE; 7 o TOTAL 43 - 40 Signature TOTAL FES SINGLE FAMILY CHECK 43'40 HOME OWNER-BUILDER DECLARATION Plan check applicant CHANGE .00 I hereby affirm that I am gqxempt from the Contractor's Llcenie Name Law for tho following rdason (Section 7031.5, Buslness and Professions Code): Address 0000-"l 6/18/96 ❑ 1, as owner of the property, will do the work and the City Tel. No. 6978 1 At910�39 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). 1,ender's Name ` Lenders Address I certify that I have read this app4icatlon 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-m ii ad property for Inspection purposes.. ,11,:V 11,:CL—mew\ �_` _ SEE REVERSE FOR EXPLANATORY LANGUAGE Slgnnaafure of Permittee Date