The URL can be used to link to this page

Home My Public Portal About9517 GIDLEY ST_Plumbing__ Woex>Rs' lhaveNSAnON DECLARATION �,^,.,,® APPLICATION FOR PLUMBING PERMIT J here�jl^affhm tftahl have a certfflcate of consent to self fin- A .nre,ora t�ertificate of Wo4ersrConi�ensatlon Insurance,brf! (may B/�) cerflfJed copy theradf (Sec. 3800, dab.t=.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Pollcy'No. Company Certlfled copy Is hereby furnished. KA rR APPLICANT TO FILL IN(PRINT OR TYPE) Certified copy Is filed with the county building Inspectlon ADDRESS �1 department. NUMBER FIXTURE OR ITEM 8 FEE LOCALITY Date Afpllcant WATER CLOSET(TOILET) "T L CERTIFICATE OF IX '°`TM� EMPTION FROM WORKERS' B & CROSS ST. `J V n COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed ff the work Involved by. O MAIL the permit Is for on*hundred dollars(SIDO)or leu:} LAVATORY' SS I certify that In the performance of the work for which this per- rrt� mit Is Issued, I shall not employ an rson In any m ner so SINK CITY TEL NO as to become subject to the Worke ompensatlorj DISHWP*HER `"�+`��y CO{.TTRACTOR .� Date 1Appllcan CLOTHES-WASHER NOTICE TO APPLICANT: If, after making flAs Certificate of Ex- 7 emptlon,you should become subject to the Workers' =C Compen- SWIMMING POOL RE >R satiora provisions of The Labor Code,you must forthwith comp- LAWN SPRINKLkR SYSTEMCITY TEL NO ly with such provisions or this permit shall be.deemed revok- STATE 3-71 644 uC ed. WATER HEATER LICENSE NO. CLASS -- LICENSED CONTRACTORS DECLARATION BY I hereby affirm that I am licensed under provisions of-CFopter CAS SYSTEM OUTLETS 9(commencing with Section 7000)of.Division 3.of the Business OUTLETS OVER C r f.d Professions Code, and my Ilcense Is In full force and of- 5 SYSTEM 7 VALIDATION DATE r 1 / DATE 0 ticense N bar Llc Class ��.��y V FINAL Contractor to �� BY 0 I am exempt Under Sec. {# W B.BP.C_ for this reason Plan check fee ► a Data: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE SINGLE FAMILY applicant k heca HOME OWNER-BUILDER DECLARATION Plan cPP 1 j hereby affirm that I am exempt from the Contractor's License NameT.A Law for the following reason (flection 7031.5, Business and Professions Code): Address 3M7 11M.50 1, as ovyner of the property, will do the work and the City Tel. No. 1 ITEI' structure'Is not Intended or offered for sale(*ectlon 7044, L•Business and Professlons Code). TOTAL 106 - 50 CONSTRUCTION LENDING AGENCY, ► C#iE�Yi 146■50 I hereby affirm that there Is a construction lending agency for {ttwlwS the perfoamonto of the work for whlth this permit Is Issued �7i�lL .00 (Sec. 3097;Cfv . C.). i f Lender's Name LRRR01 11 20/81 Lender -7 s Address I 1 AM113:41 I certify that I have read this application and state that the above Informatlpn Is correct. I agree to comply with all County ► Inances and State laws reguloting Plumbing', and hereby ut orIze representatives of this County to enter upon the bo o-mentioned props or Inspection purposes.. . , SEE REVERSE FOR EXPLANATORY LANGUAGE Slgnatur of Permlftee Date r OF COUNTY l2fCaNEM PLUMBING 1 DIVISION OF BU=ING AND SAFETY PERMIT APPLICATION COUNTY OF IAS ANGF T. BUILDING !1 WILLIAM J. FOX, COUNTY ENOINECR ADDRESS l1p k.4 FOR APPLIC T TO FILL IN LOCALITY BUILDING Cl ADDRESS + CROSS ST. 1 DISTRICT NO. GROUP ZONE PERMIT NO. LOCALITY � � NEAREST CR088 ST. RECEIVED BY Ready twr Iaapedla■ DAT ISSU D OWNER MAIL IM USTRIAL ADDRESS WASTE APPROVAL INSPECTION RECORD CITY TEL N0. PLUMBER 16 / CITY TEL N If STA LICENSE NO. COUNTY FEES 'Ir 7!`. 7- CCa Z 4UMBER TYPE OF FfXTURE OR ITEM FEE Q WATER CLOSET(TOILET) ! 0.10 O U / (� _ BATH TUB ! O.SI GHOWER ! 0.11 LAVATORY(WASH BASIN) ! 0.10 KITCHEN SINK ! 0.10 LAUNDRY TUB OR TRAY ! O." SLOP SINK ! 0.80 FLOOR SINK ! 0.60 FLOOR DRAIN ! 1.10 DISHWASHER ! 0.10 DRINKING FOUNTAIN O.SO URINAL ! O.SI GAS SYSTEM OUTLETS ! I.10 d C) WATER HEATER ! 1.00 MISCELLANEOUS APPROVALS DATE INSPEOTOR'S SIGNATURE UNDER SLAB WORK PERMIT ; I 1 00 ROUGH PLUMBING TOTAL FEE 1 —5-1.2 O GAS PIPING 1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI• BAS VENT CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED r AMD/OR LICENSED AB REQUIRED BY LOS ANGELES COUNTY GAS TEST _ AND STATE OF CALIFORNIA OR THAT I AN THE LEGAL OWN- ER OF THE ABOVE DESCRIBED RESIDVITIX PROPERTY. UTILITY CO.NOTIFIED ti SIGNATURE OF PERYITTE FINAL 7a&M DRB 17 W 7""7 17 2AM •m 7-M APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING 1 COUNTY OFF LOSLOS ANGELES WILLIAM J. FOX. OHI[F tNdIN[rR F APPLICANT TO FILL IN _ I rWMSKR RE0Kr4'W NY RKADY FOR / DATE IMUMD rIRfT IKUPEQTION A.DDRIONE .� CITY TEL No. - ADDRt•� OOUKTY LOCALITY r I CERTIFY THAT 1 PDMKSR THE MOVE VALID LOW NE'Amx:wr ANSKLFA OOUNTY LIOKNI E. OROMN WT. OWNKR MAIL Pn-US410M ADDR PERMIT rrE is #1.U0 FOR T7-Ir FIK IRT rIXTURE OR CITY TTL N KD ITEM LIST ■ELPL OW, U1 SDa rDR EACH ADDITIONAL 1 AM THE LEMAL OWNKR OF THE MMIDEKTIAL PROP-ITEM. FOR EACH SEPTIC TANK AND PIT OR DRAINFIELD KFr Y DESORImED A1.OVr. 41.OD. MINIMUM FEE FOR A14Y PERMIT 41.00. EACH UAZ SYSTEM 10 A SEPARATE ITEM. Numm" TYT[ or rmrtJRi alt ITCH WATER OLOSLT (TOILET) CQRRECTIONS LATH TUN ■HCWER LAVATORY (WANH BASIN) ' KITCHEN MINK LAUNDRY TUN OR TRAY MAN EYSTKM --- OUTLKTR WATKR HEATER ■LOP MINK ..I t FLOOR ■INK _Z' FLOOR DFWN DIBHWA60HKR O DRINKIN■ FOUNTAIN URINAL MIBCELLA>NEDUB. APPROVALS DATE IK1l'Wf13R'i MAJ4K ROUGH PLUMSINO DAB PIPING OAS VENT O0LEPOOL ■EPT10 TANK - DRAIN FIT ( ) # oEPT10 TANK OriSPOOL {p NEWER GAJI TENT TOTAL FEE # UTIUTY OR NOTIFIED �� r 7LASI7 DW 17 7-51 APPLICATION FOR rEMIT IWARTNIMT BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF EHOINEER PLUMBING 1 DiErMir NE IT FOAPPLICNT ATO FILL IN E M No. PLUMBER RIO[ SY READY FOR DATE ISSUtD FIRST IMliOT1ON APDA ESS 'r ■UILDINO L.. AD D Rif• ODUNTY ITV r NEAREST PERMIT FMIS ORo=RT. NUMmq TM OF F1XT111m OR n mm FK[ ONVNKR MAIL WATER CLOSET(TOILET) • 0.60 * ADDRES6 BATH TUR • 0.60 DITY TIL No. ■HOWER • CLEC I PSTATIC THAT [ D KI3Y AOKNOWL=O[ =THAT I HAVREAD THIN LAVATORY (WAaH BASIN) 0.60 AND AND STATHAT THE ASOV1■ DRRKCIT AHD AGREE TO COMPLY WITH ALL COUNTY ORDINANDKS KITOHKN ■INK • 0.60 AND STATIC LAWS RIMULATIND PLUM61NO. LAUNDRY T ■ 0 TRAY • 0.60 ANO119 TLEC IAL FY NY LIOK K. THE LEAL VAUD UER OF IDKNTLA4 K DKSORISED AS m" ■YeT[ uTuro • a 6a NATURE OF WATEI! HIATFR • 0.60 P[RMI 6LDP OINK • CLEC TP SPECTION RECORD FLOOR MINK • 0.60 , FLDOR DRAIN • 0.60 D12HWAAHICR • O." DRINKINO FOUWrA]N • 0.60 URINAL • o.SO -I t HDUSE ■EWtR • 0.60 _Z M I SO ELLAN K O US 0 R' O APPROVALS DATE lKZFnE vPrM NAA" ROUGH PLUMSINO SIJ PIFINO W VENT OKSSPOOL • 1.00 0E3STO3L IN PTIO TANKi REPTIO TANK DRAIN ( PIT ( • 1.00 ezvn R PERMIT 1.Do °Aw TUT UTILITY o0.NOTIFIm TOTAL FEE • Q FINAL I D ae rIr 2.5m Elm �-se . APPPCATION FOR P$ Mfg -•" D 'f4$THMNT OF 1?' U)S NG AND SAFETYPLUMBI � 1 COUNTY OF LOS ANG$LSS , WY.J. FOX,cHnw pMINEXX NATURE 01 DISTItICT NO, Grtou ZONE rl"FT NO. ROUGH FI7[Tup" COMpLX= READY FOR DATZ tSSUm HKATM CISSrOOL SQTIC TANK FIRST IN*ltCrxm APPLICANT IN HEAVILY OUTLINED PORTION ONLY . .to. NAY[ ADD IO ADDRESS LOCALITY NKARI*T i Cr1Y TIL.No. CROSS/T. UNT - C>03Y KXPIRt s NAY[ LOCATION OF SEPTIC TANS, OR CXSSPOOL A AMii11,,,, DbItJUS NORTH PITY TIC-No ANLAY THR LJDMAL POSSESSOR OF THR A lOVX LAS KLm COukTY GRTIFICATz Or QuALnw=ATH)N. _ PLUICOQ / ? 1 AY THKLZMAL OWNOt D �1 7r AIOVC RREMONS SOUTH J DESCRIPTION OF WORK i MATH TUS. '^'RNACi 0 HOVam / -TISHWASHQt O VATORV RSRIGN ATOt JUTCHIEN SINK WATIOtSOFT11NIM -FLOOR SINK - §►NDTRAP - SINK DRAIN ` "M TRAY' u*IHAL APPROVALS WATLR CLOS[T nRINKINO FOUNTAIN DATE tRttKc-row'S wwYtc WAT1Ot HIIATIt ^QITAL LAVATORY ROUGH PLUMBING ild A4p+*►FOUNTAIN CIAO PIPING OUTL GAS Var CIESSPOOL TOTAL HUYSIC!OF FIXTURES � v 813TIO TANK �y I [SSROO ICTANK U SIW>OZ J� S /L I.I gLrrY CO.NOItrflm IF TOTAL F ELE T d ' WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT 1 hereby, affirm that I have a certificate of consent to self in- 76A6667A PW 4/87 sure,or a certificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ❑ Certified copy is filed with the county building inspection ADDRESS j department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY WATER CLOSET(TOILET) t Date Applicant NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL c 1 the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS 'i I certify that in the performance of the work for which this per- SINK mit is issued, 1 shall not employ any,person in any manner so CITY f TEL. NO. ^ as to become subject to the Workers'Compensation aws. DISHWASHER ,{ f CONTRACTOR Date J 5�` Applicant +`r ✓L y a� CLOTHES WASHER -- NOTICE TO APPLICANT: If, after making tADDRESS ficate of Ex- :} tion,you should become subject to the Workers'Com en- SWIMMING POOL RECEPTOR em P Y I P CITY TEL. NO. sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE / LIC. ed. WATER HEATER LICENSE NO. � 1 CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY- 1 hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER a and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION C fect. DATE U License Number � ;�>�It f Lic. Class 3 L, J ''ti FINAL LL. Contractor'; i �1-=:�,. ESate `� a. ,'a—' BY >_�— rY I am exempt under Sec. Q B.&P.C. for this reason Plan check fee C CL Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and Professions Code): Address I, as owner of the property, will do the work and the City Tel. No. structure is not intended or offered for sale(Section 7044, Business and Professions Code). ► _ .Jt<`'-{ 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.). Lender's Name Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all County o.Fdinances and State laws regulating Plumbing, and hereby Zorize representatives of this County to enter upon the i` bore-mentioned proper y for inspection purposes. +, SEE REVERSE FOR EXPLANATORY LANGUAGE Signatur o Permittee Date