The URL can be used to link to this page

Home My Public Portal About9410 GIDLEY ST_Plumbing__ DBS-17 I O-5A APPLICATION FOR PLUMBING PERMIT 1 8S-1 DIVISION OF BUILDING AND SAFETY Deportment of County Engineer County of Los Angeles BUILDING R JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS CASSATT D. GRIFFIN,SUPT OF BUILDING LOCALITY n LICANT TO FILL INNEAREST CROSS ST. OWNER MAIL ADDRESS / I' DISTRICT NO. GROUPI ZONE READY FOR INSPECTION 5' INDUSTRIAL CITY TEL. NO. WASTE APPROVAL PLUMBER t INSPECTION RECORD ADDRESS v J CITY TEL. NO. LICENSENO b 0 IFI NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 $ DIV BATH TUB @ $1.00 SHOWER @ $1.00 LAVATORY (WASH BASIN) @ $1.00 D� KITCHEN SINK @ $1.00 DISHWASHER @ $1.00 LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 GAS SYSTEM @ $1.00 APPROVALS DATE INSPECTORS SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING .p r 0a GAS PIPING TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 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 THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I HE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIA P ERTY. SIGNATURE OF PERMITTEE FINAL `+ a JOHN A. LAMBIE, COUNTY ENGINEERVALIDATION ROBERT A. WOOD, CHIEF PLBG. INSPECTOR CK. M.0. CASH 5 1 1 7- FEB 14 3 7.1 0 � J +_ r � woRKEA'8 COktPelsATloN DECLARATION 204aze DPW oleo I hereby affirm that I have ■ certhIcate of oonsont to "if Insure, . TWA APPLICATION FOR PLUMBING PERMIT or a oartittoate of Worker's Compenaatlon Insurance, or a certified copy thwool(8ec.39W Lab,C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WQRKS DrV. Pol5cy No. Con-Imm ❑ Certtlled copy Is herby harrfetracL d,o Appy ANT TO FRL N(PRDfT OR TYPE) ` ❑ Certlfled cdoy is fled with the county buidtrQ frrapaation t" [ department FWARA3ER FOnURE OR IT 3M 0 FEE LOCaU JTY T� L e! Dale Appberrt WATER cLosa r NEAREST CSTI-FICAIE:OF B(Elh ION FROM WORKER CFIO88 ST. b0MIO PEN8ATN DZURANCE BATH TUB ASSES" (This section coed not be ooaplatsd tf the work Lnvoty d by the SHOWED MAP BOOK PAGE PARCEL pprmft to for one hundred¢ochre($1Q0)or lass.) OWNER I ca"that In the performance of the work for whlch this permit -LAVATORY Is Issued, I shall not employ any porion.In any manner_eo as to81NK MAIC y become suN&&to the Workers' Compensetlon Laws, D99WABHER CFrY /^ TEL.NO. Irr DW f!:Z--FICO AWk rd CLOTHES WASHER CONTRACTORL NOTICE TO APPLICANT: R, after making this Certlfloats of F_xerrrptkm,you ah(uki become eub)aot to the Workers'trompensailon SWrMMM POOL RECEPTOR proyWons of the Labor Code, you must forthwith cornply with such provisions or ihte permtt shall be deemed revoked. LAWN 8FFA*a-ER 8Y8TBd LICENSED CONTRAMA8 DEOLAPATi N CITY TEL NO. d I hereby affirm that I am licensed under provisions of Chapter 9 wAT9#HEATER (commencing with Section 7000) cf DMaton 3 of the Business ander OUTLETS8TH NO. CLABB r 9r C Profasabns Code,and my Ilcenae Is In full}oras and effect OUTLETS OVER DISTRICT NO. BY ([ � f p��+ 6 PER SYSTEM 1 Q� Lk.Ntmrbw `-� O p z o Uo.Q. S4* FDATEINAL VALIDATION C o— —� a pco��ntr,oior �`� �4 Data •S''3�—lAf CO t9-1 am exempt under Sao. UY Z B_SP.C.for this meson Plan check fee 5 MBINO PERM INO FEE , PLU esu i ACCT.0 ❑ I roTAL FEE 3307 20.50 81NGLE FAMILY 'dw)o t Alba"! 1 ITEMS HOWE OWNER BULDER DECLAFI)TTON Nanno TOTAL 20_ 50 I hereby affirm that I am exempt from the Contractor's Ucense Law or h)following reason (section 7031.!5, Buslnass and Prbfeaslons Address 20.50 E-1 MVV+ri�rJTeJ. I,as owner o}the prop ,wfil do the work City No ft and the structure '0 Is not Intended or offered for sale(section 7044, Business and Profesakno Code). 0110. 1 9/27/90 CONSmtic loN LENTANG AGENCY J J'2 1- . All u:07 I hereby affirm that there Is a oonstructlon lending agency for the perfortnwoe of the work for which this permit to issued (sec. 9097, cir.C.) Lenders Nsma Lenders Address L certify that I have read this application end state that the ebovs 010.Infomurtlon Ls-oon*ot Wee ee to pompfy with all County ordlnanoes end state laws regulating Plumbing, and hereby authprizo representattvea of this County to enter upon the above-mentlonid p-patty for Inspection pmPoees• SIE AEVF}'tt3E FOR 00311LAIiATORY L APOGUAQE i Z woRiCER'8 COA4PETlSAT10G1 DECIAAATI0N20-0026 DeW 9/09 APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have ■ certificate of consent to self Insure, ' or a certNicats of Worker's Compeasatlon Insurance, or a certtffed copy thereof(Seo.38W Lab.C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policy No. Company ❑ Cer&W oopy in hereby furnished.e BUILDlFO / ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) Z RESB Certtfled copy h flied with thcounty bu6dtng Inspeotbn dm-r&-TL NUMBER FDCTURE OR ITEM FEE LOCALITY Data Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORK RS BATH TUB CROSS ST.CO#IPENSATFON INSURANCEASSESSOR B004< PAGE PARCEL (This seotbn need riot be oompletsd tf the work Invotvsd by the SHOWER permit Is for one hundred dollars 0100)or kris.) OWNER I certify that In the performance of the work for whloh this permit LAVATORY Is Issued, I shall not employ any person In any manner to as toS MAIL become subject to the Workers'Compansatton Laws. ADIN E DISWASHER CITY TEL-NO. l- Date APpkent CLOTHED WASHER CONTRACTOR NOTICE TO APPLICANT: If, after making this Certificate of Exemption, om YOU should beoe subject to the Workers'Compensation SWTMW04G POOL RECEPTOR provisions of the Labor Code, you must forthwtth comply with such ADOREIB provisions or this pertnit shall be deemed revoked. LAWN SMNKLER SYSTEM LICENSED GONTRACT098 DECLARATION CITY TEL NO. d I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER STATE(commencing with Section 7D0O) of DMsion 3 of the Business and NO ASS 8 Professions Code,and my Iloenee is In full force and effect OUTLE78 OVER OAT SYSTEM OUTLETS DISTRICT NO. PROCE88ED BY Q 6 Phi SYSTEM Q Uowm Number Lk:.Clew F*M VALIDATION w Contraoror Date DATE 'D CL m ❑ l am exept under Seo. BY P l B.SP.a for this reason Date: ck Plan Chefee ► PLUMEMNG PERMIT ISSUING FEE i / re ❑ TOTAL FEE C Plan check applicant •1 SINGLE FAMILY HOWE OWNER-BUILDER DEGLAR(TION Name r �y ACCT.T I hereby affirm that I am exempt from the Contractor's License Law �r�nl3�307 `Fc3.0tiI for the following reason (8eodon 7031.6, Business end Professions Address Code): �y � Tel.No. � � 1 ITEMS ❑ 1,as owner of the property,will do the work and the structure w� 43 - 00�--1 Is not Intended or offered for salTri 4 e (Section 7044, Business MAL 3 - L••r0 end Professions Coda). , C1iECY, 43.00 CONSTRUCTION LENDING AGENCY .Oil I hereby affirm that there Is a construction lending agency for the performance of the work for which this pw-mlt Is Issued (Sec. 3097, CIv.C.) ' 0 04-001 8/21/90 Landers Name 25108 1 AM 9:42 Lenders Address I oartHy that I have read this application and state that the above Pol.Informtio Information is correct I agree to oompfy with all County ordinances and State laws regulating Plumbing, and hereby authorize repreaentativae of this County to enter upon the above-mentloned property for Inapectlon purposes. SEE FE1fERSE FOR EXPLANATORY LANGUAGE