HomeMy Public PortalAbout9414 GIDLEY ST_Plumbing__ "A°°7
t]ata.t 7 to e APPLICATION FOR PLUMBING PERMIT
D ON OF BUILDING AND SA "TY
- Commttof LaRlA.=*w
BUILDING
JOHN A. LAMBIE, COUNTY ENG-IN"N ADDRX88
CJA"A7T D.GRIFFIN,.BUP^T of PutLDtno
AWdqaE TO FILL IN N REBT
CROSS ST.
OWN DJBTRICT O. rptoup NE atAJ7Y r0■Il4ritTtom
ADDREG!•
1h1DIJ MIAL
NO.
W APPROVAL
PLu1r ER INsp TION REMRD
ADDR .
CITY TEL N
LICENDE NO.
hu"Kit Trrabt+r^Tuns dN rtar rTA
WA CLO ET (TOILET) 1.00 �0
19ATH TUB 1.ob
AHOVIKR t.00
-LAVATORY (WAOH ISADIN) 41.00 .
KITCHEN RINK $1,00
DIBHWAD ER 1p 1.o0
LAPNDFJYTUEjOR Y sI.Oo
CLOTH68 WAS ER 1.00
WATER HEATER ® 11.00
GAS 1.00
AMOYA,LS
DATtS I ECTQR'9 91QIIATURE
UNDER BLAB WORK l�
PERMIT ; j 00 ROUGH RLu EM G
dAb PIPING
TOTAL FEE
77H/� liAy� 0AE PENT
AND HSTATrL THAT THE ABo 13 _ EC7 A!1-DD Aa �0 CO11PLY
HOT WATER HEATER
i►ITH ALL. COUNTY ORDINANCES AND STATE LAWS CEWUL.ATING
PLUliJ3ING. -PLUM19MG FIXTURES
1 ItEk1�Y CERTIFY THAT 1 AN PROPERLY RE919MED AND/OR GAS TEST' I
LJC"BED- AS REQUIREDB ANGELES COUNTY AND $TATE OF
CALIFORNFA OR THAT � LE 'AL
OWNER OF THE ABOVE UTILITY CO.NOTIFIED
,RFSgR16ED RUIDEN'T IiRTY.
810NATURE ,
OF PFRNtTTEE FINAL u
JOHN A.I,.AMBIF—COUNTY ENGINEER r�.�/AIMATION ROBERT A.WOOD, CHIEF PL-Bo. INAPIKQTOR
{ LAbo5 1 1 4 FEB 14 3 7.0 0 In
VWORKER'S CQYPENSATPN DECLARATION 20-OM DPW 9/80
I horeby afflrp that 1 have a oertiflcate of consent to self Insure, 7°AW7A APPLICATION FOR PLUMBING PERMIT
or a oertiftoste of Worker's Compensation Iruurenoe, or a certMed
oepy theroof(Seo.3800 Lab.C.) i
COUNTY OF LOS ANGIR DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV.
❑ Caroled oopy Is hereby fruriahsd.
FOR APPLJC,.4J1 TO FILL W OR BUIIDNG
(PR1Nf TYPE]
Certified In filed with the oollrty � �I ADDRESS
❑ deQa=—t NUMBER FIX URE OR rf'EN • FEE LOCALfTY
Deis Applk erd WATER CLOSET NEAREST
CEFMFICATE OF EXE PTFON FROM WOA*(EJ CRKM ST.
BATH TUB
COMNa&I1ATK)N INSURANCE ASSE88OR
(This aaotlon need not be oorapketed K the work Involved ¢y the SHOWER MAP BOOK PAGE PAAC✓3
pernft Is for one hundred dollars(11109)or lees.) LAVATORY OWNER
I ce"that In the performance of the work for which this permit
Is issued, I shall not employ any person In any manner so as to 81NK ��
beoonw subject to the Workers'Compensation Laws,
DiBWASHIA CITY' to—NO.
Date CLOTHES WASHER OFI _
NOTICE TO APPLICANT: If, after making this Certificate of
Exemption,you should become subject to the Workers'Compsnsatlon 8YAMMNG POOL RECEPTOR
provisions of the Labor Code,you must forthwith oonipty with tach ADDRESS
JI
provisions or this permit shall be deemed revoked. L LAWN HAFINKLEt SYSTEM
LIC04SED CONTRACTORS DECLAFlAT014 CITY TES NO _1
I hereby affirm that I am Iloensed under provisions of Chapter 8 WADI NEATH�
(commencing with Seatlon 7000) of Division 3 of tha Bualness and STATE LIC,
Profesako"Code,and my Iloerieo Is In full force end 0egL GAS SYSTE 1 OUT�TS LICF]t8E NO. CLA68 7`�'
OUTLETS OV13�
No, BY Q
Lkmnse NumberLk,Ck. Q' C
I'D AL VALIDATION
Coniraobr ��,
Data DATE l 0_( `
r
I am exempt under Seo. B� /O�y/�(+�
B.SP.C.for tills re&adrl
IM1•4r.T
oma: Pkn Check fee , 3307 20.50
j PLUMBING PERMF VMING FEE i 1 ITEMS
TOTA, FEE p TOTAL _ �
M
SINGLE FAILY Mn rack _ OECt 20.50
HOME QWNEFI-BUILDER DECLARATipN Name
I hereby affirm that I am exempt from the Contradtor's Lloense Law ■011
for the following re4son (Section 7031.6, Business and Professions Address '
Code): �yy. ,�,yy
❑ 1,ro owner of the property,will do the work and the structure CnY Tel.No. LJ��-.+ILr V 01 9/2t7r/90,
Is not Intended or offered for sale (Section 7041, Business M31 1 ASM 8:07
and Profesalons Code).
CONSTRUCTION LENDING AGENCY
I hereby Wrm that there Is a constructlon lending agency for the
performanos of the work for whloh this permit Is Issued (Seo. 3097,
Ctv.C.)
Lender's Name
Lender's Address
I oertlty that I have read this application and state that the above
lhformhtlon Is correct I &gree to comply with all County ordlnancee ,
and State laws regulating Plumbing, and hereby authorize
representaAyes of this County to enter upon the above-mentloned
propel for Inspectlon pur off• SEE RBVEFISE FOR EXPLANATORY LANGUAGE
Vm thatiBGOMPENSATIOfJ Df c6nsord to , '"`° °° APPLICATION FOR PLUMBING PERMIT
I hereby affirm that I have a oerlMcete of consent to self Ins�re,
or a oertMoate of Wotkefs 1mpensatlon Inauranoe, or a oartMed
oopy thereof(86o_3800 Lab.C.)
COUNTY OFLOS ANGELES DEPT. OFPUBUG WORKS DEPT.OF PUBLICINORKS DIV,
No. G«oparrY
Certlffed CRY`hereby furnished.
' FOR APPLICANT TO FILL IN(PRINT Oft TYPE) Sufis
copy Is f led with the county buWaig Inepeodon ADDRESS
NLIh(B83 FT)CiiA3E Oe ITEM • F� Got Y
LO CAUTY
Date Applicant WATER UDBET NEAFEST
CEFmFICATE OF EXEN0 TK?N FPOM WORKE3W BATH TUB CROSS BT.
GOMPENSATI(M INSURANCE
{rhLa.Motion nand not to ooawpbted H the fork Involved by the t31IOVyFA Al/1P BOOK PAGE PARCEL
Permit M tor.one t—dred go4pre($1100)9 ia...) OWNER
I oerHfy that In the performande of the work for which this permit I LAVATORY
Is Issued, I shall not employ any person In any manner so its toL MAJI
beoome subject to the Workers'Gompensatidn Laws, A88
NSWASHER CITY Ta-NO
Data Ap~ CLOTHES WASHER
NOTICE TO APPLICAN r: If, after making this Certlfloqtte of CONTAACTPR
Pmnptlon,you should become subjeot to the Wooer}'Compensabofi 6""ll`�POOL RKEPTOR
provlalons of the Libor Code, you must forthwFth opmply with such
prvAwoha or this parmft ahajL be dwned revoked. LAWN 8PRINKLEA 8Y8TE M
LICENSED CONTRIIG'TORS DECLAAATLQN CITY TEL N0.
I hereby alflrm that l ■m licensed under provisions df Chapter B WATER HEATER
STATE(commencJng with Section 7000)of Division 3 of the Buslne" and �'
Profesabns Code,and my license M In full force and aflact. OAS 8YS'f� oLrn.ETB
O.
OUTLETS OVER'
6 PER Lloerw Number 130.Clan 1 -
FIN"'` // L� YALJDA O�1
DATE t Q - f 10 T l
Contreosor Date' - -
❑ I am exempt under Sep. B
B.BP.C.for this reason
Deas; Plan check fee ,
PLUMBING PERMFr ISSUING FFF$
+
❑ - TOTAL Fly
SINGLE FAMILY P7•n CiTeCk
HOME QWNERWLDEA DECLARATION Nome ) x15.41 ■i �
1 hereby affirm that I am exempte (_
from the Contnkctor's tloensaro
for the following reason (8Woh 703.1.6, Business and ProfseelonsAddress 3307 43.011
Code); crty dj TeL No. 1 ITEM
Isas owner of the property,will.do the work and the structure
Is not Intended or offend for sale(Sectlon 7014,Bualneo TOTAL 43- 00
a„d?rofesslonsCode). pop.. { W5 43.00
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a oonstructlon lending agenpy for the •O�l
performanos of the work for Whloh this pgrmtt Is Ieaued (8ec. 3097,
CN.C.)
0000—OWI 8/21/90
/9'0
Lenders Name 2510 1 AM 9:4"1
Lenders Addraw
I certify that I have read this application and &tato that the above ,
Informatlon Is porrooL I agree to comply with all County ordlnancee
and St4(A laws regulating Plumbing, and hereby authpr(ze
representatNes of this County to enter upon the above-mentioned
property for Inepecdon pµrposee. SEE REVERSE FOR E)C3'LANAT6RY LAPOGUAGE