HomeMy Public PortalAbout9531 GIDLEY ST_Plumbing__ 7dA`4P7 °S" '-0' APPLICATION FOR PEBWEIT
D 1' NT OF HU AND SAFETY COUNTY COIINTY OF LOS OS AN ANGELES
WILLIAM J. FOX. OHI[F [NGINEat
NG 1
FOR APPLICANT TO FILL IN .
PLLIMD / RECKWED BY FIRfT REAMY
11OR DATI 1■fum
/ ✓
ADDR[■■
■u1LDING �
OFT, TIL No. ADDR[!>aZ me
ODUNTYL OUA ITY
N[AR[■T
PERMIT OROS■T.
NLIMDIR TYri OF FLCMPM PR mcm FII OWN IR
MAIL
WATIR DLO■LT(TDIL[T) Q O.■D 10ADDR[M
DATH TUB Q D.Da DITY T[L. No.
■HOWIR Q 0.60 I HICR[ Y ADKNOWLXDGI TAT I HAVRIATHIS
LJIVATORY (WASH EASIN) Q a60 APPLQHI D
IOATION AND STATK THAT TH[ ANOVI 17 OORRIOT
AND A13REK TD OOMPLY WITH ALL OOUNTY ORDINANOE■
KfTOH[N MINK Q 0.60 AND ■TATI LAW■ RIGUL.ATINO PLUMDING.
`T O[RTIFY THAT I PO®[B■ TH[ OVI VAL1D La!
LAUNDRY TUB OR TRAY Q 0.60 ANG[L.i6 ODUNTY LJO E' OR I A I L.IGAL OWNIR
OF THK RKOID[ O 19[D A1OVL
OAS DYSTE UTLM" Q 0.60
■IONATUR[ OF
WATER H[ATLR Q o.6o FI RMITT[
GLOP ■INKQ 0.60 060
I PF.CZi 'ION RFa
FLOOR MINK Q 0.60
FLOOR DRAIN Q CL am L UJ y
DIDHWAAH[R Q O.bo
DRINKING FOUNTAIN Q 0.60 LIP 4r
URINAL Q 12180 -I
Houm ■Lvfm Q D.go
0
APPROVALS
DATI INMrt3Tr3R'2 MANN
ROUGH PLUMING
SAE PIPINS
GAS VENT
OKO&POOL Q 1.00 0931"DOL
EtPT10 TAN KI ■L7TIO TANK
DRAIN ) PIT ( Q I.Do S&WIrR
PERMIT . 1.00 ■ T=aT - C
IeV-
TOTAL FEE —
LITILJTY Do.NOTIFI[D f r•
� I
FINAL
� J
rT . -7° �°°'" ''°"°EC` "°" 20-00�°R"9/99 APP KATION FOR PLUMBING PERMIT
i; 78ABe7A
I hereby-arm that�Yhn'�e ";,Wm o1 consent to-self Insure,
or a oyrUtebf Worker's CompenaptUon Insurance, or a wrttfled
copy ther (See.3800 Lab.C.)
COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OFPUBLIt WORKS DIV.'
Ponoy No. Company
❑- Cerfflw copy Is hereby tumFslvxi BUILDM• ,
FOR APPL.K,ANr TO RLL IN(PRINT OR TYPE) ADDRESS .
CerlMsd copy b find with the'oounty buikitr�g tnepection
deparM—L NUMBER FIXTURE OR rrEN • FEF;. LOCALITY
Date Appiloerd WATER CLOSET / NEAREST
CROSS ST.
CERTIRCATE OF EXE]MPTION FROM W0(*CER8
BATH TUB
COMPENSATION INSURANCE IABSESSOR
MAP BOOK PAGE PARCEL
(This seodiom need not be complated tf the work Involved by the SHOWER
psrmitt b for one hundred dollars(i1 DO)or lose.) J o
I oerttfy that In the performance of the work for which this permit LAVATORY wf�
' Is Issued,'I shall not employ any person In any manner so as to SIM( ADDRESS
become subject to a Worker' Compensation Laws.
DISWASF6i Crry TEL 40.
�' .2 Apocant CLOTFE8 WARNER
NOTICE TO APPLICANT: If, after making this Certificate ofCDKTRACTOR
Ll
!�
Exemption,you should beooms subject to the Worker'Compensation SWfMMINO POOL RBCBPTOR ./
provisions of the Labor Cods, you must forthwith comply with such ADDRESS (p Y
provisions or this permlt•shall be deemed revoked.. LAWN SPRINKLER SYSTEM f
LICENSED CONTRACTORS DECLARATION Crry w d Q� NO.r, d a y a
I hereby affirm that I am licensed under provisions of Chapter B ATE
WATER
(commencing with Section 7000) of Division 3 of the Business and STj SE NO a SS C
Profaselone Code,and my Iloense Is In full force and effect (SAS SYSTEM �
No. PFK)CESSED BY
�J 5 PER SYSTEM ° T� 0
Lloe Nranber — `�/ / Lie.Class U
/� RNAs r VALIDATION W
d zG2.�-�-.'� 1 °AIS - _ �— Z
z
❑ I am exempt underec.S { BY 5
B.hP.C.for fhb reason Y
Plan check fee
°eta ,
JH7 �.40.
,
PLUMBING PERMfr ISSUING FEE i
e r�
❑ TOTAL FFIE i,Cl r"
Plan check applkcartt TI1+L 63 - 40
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATFON Name
t1E
1 hereby affirm that I am exempt from the Contractor's Lloense Lawt' �J
for the following recon (Ssctlon 7031.6, Buslneaa and Professions. Address
Code):
❑ city Tel.No.
1,as owner of the property,will do the work and the sbuoture
Is not Intended or offered foe sale Section 70-44, Business
and Profeeslonb Code).
f�7 1 2:25
.
CONSTRUCTION LE NDINQ Al3ENCY
1 hereby afflrrn that there to a construction lending agency for the
psrformanoe of the work for which this permit to Issued (Seo.,3097,
Ctv.C.)
Lenders Name
Lenders Address
I oert y that I have read this application and state that the above ,
Inforntatlon is correct. I agree to comply wkh all (rDunty oidlnanoes
and State laws regulating Plumbing, and hereby authorize
representatives
o�f pthis County to enter upon the above-mentloned
nSEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee
76A667-CE#817 9/63
APPLICATION FOR PLUMBING PERMI
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION FNEAREST
//,�
JOHN A. LAMBIE. COUNTY ENGINEER y�
WILLIAM A.JENSEN, SUPT OF BUILDING Y
FOR APPLICANT TO FILL IN T. 1
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 31.2S MAIL
BATH TUB 1.25 ADDRESS
SHOWER 1.25
CITY SEL. NO.
LAVATORY 1.25 CONTRACTOR / I
SINE 1.25 ADDRESS
DISHWASHER 1.25 CITY �` TEL. NO,,g,
LAUNDRY TUB 1.25 CONTRACTOR' STATE
REGISTRATION NO. ' �� COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PR ESSED BY
I
WATER HEATER 1.50
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL 'd
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U
oc
U
CL
317 APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK -Z O 6j
ROUGH PLUMBING '�
TOTAL FEE GAS PIPING
1 fed KeXAQ25e
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING. �r
I HER CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES .7 1.9.�.-
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO GAS TEST
._.�_
' RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTEE -/
VALIDATIO ROBERT A. WOOD
CK. M.o. cnsH SUPERVISING MECHANICAL ENG'R
;028241 AUG 19 5 D 5.75— c'