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Home My Public Portal About4910 GOLDEN WEST AVE_Plumbing__ 78AS87AICE017A1 � 9/75 I � APPLICATION FOR PLUMBING PERMIT � COUNTY OF L08 ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAF8TY DIVISION MAKE CHECKS PAYABL8 TO: FLOC G HARVF,Y T. ■RANDT, COUNTY SHOINQER Y FOR APPLICANT TO FILL IN (PRINT OR TYPEJ �Z NUMBER -FIXTURE OR ITEM FEE 'CROSS 3T. WATER CLOSET OWNER MAIL BATH TUB ADDRESS SIHOWRR CITY TEL. NO. LAVATORY CQNTRACTOR SINK ADQRESS DISHWASHER CITY TEL N C-LOTtIES WASHER STATE l-IC LICENSE NO. CLA" SWIMMING POOL RECEPTOR D1STRICT NO. GRO P Z40 ROC D SY LAWN SPRINKLER SYSTEM ,0z /� WATER HEATER 1Y,4STE APPROVAL GAS SYSTEM OUTLETS d INSPECTION RECORD UTLETS 6VER V 5 R SYSTEM OE O tntn Z Plan check fpe See RtwrGG PLUMBING PERMIT ISSUING PEE 8 TOTAL FEE APP OVALS DATE iryG F[cTOR B 6I4NATURC Plan Check appl1Cant UNDER SLAB WORK Nanle• ROSIGH-PLUMEI NG' Address GAS PIPING City Tel. No. GAS VENT HOT WATER HE LD RCAY.ACKNOWLEDGE THAT' I HAVE R[AD THIS APPLItATiOM ANDTE THAT THE ABOVE U CO FIRECT AND AGR[[ 76 COMPLY PLUMBING FIXTUpES LL OOUATY ORDINANCES AND STMT LAWS REGULATING GAS TEST G. REBY CERTIFY THAT I AM PRQPERLY Rt§14TEA[Q AND/OR U`riLITY CO. NOTIFIED D AS REQUIRED BY LOB ANS[L[S ,000KTF AND STATE OF NIA 0" THAT I A L[SAL 0W M OF, AN y1 N.TEND T6 M THE ASOV[.D GR [D-RES MOPE*1"Y. FINAL U ' ERMI#TEE PERMIT VALIDATIONCR. Q, CABH PLAN CHECK VAL OATFON CR. M.O. LASH 759 ii+ �, 750 � 76A667 12-54APPLICATION FOR PLUMBING PERMIT.--...._. 17IVISION OF BUILDING AND SAFETY 1. Department of County Engineer County of Los Angeles BUILDING WM.J. FOX, COUNTY ENGINEER ADDRESS CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST s CROSS ST. OWNER "• ;� DISTRICT NO. .GROUP , READY FOR INSPECTION MAIL ��ZONE s ADDRESS ¢ •� INDUSTRIAL CITY (,_+'�" ;'� TEL. NO WASTE APPROVAL PLUMBER INSPECTION RECORD ADDRESS CITY TEL. NO. LICENSE NO. NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) BATH TUB SHOWER T LAVATORY (WASH BASIN) KITCHEN SINK DISHWASHER 1 I LAUNDRY TUB OR TRAY I CLOTHES WASHER I I TOTAL NO. —2 @ o-so APPROVALS DATE INSPECTOR'S SIGNATURE GAS SYSTEM OUTLETS @ 1.00 UNDER SLAB WORK WATER HEATER @ 1.00 _ ROUGH PLUMBING PERMIT $ 1 00 GAS PIPING TOTAL FEE I GAS VENT 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER _ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGYLATING PLUMBING FIXTURES PLUMBING. IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF UTILITY CO. NOTIFIED CALIFORNIA OR THAT 1 AM THEg�L4EALOWNER OF THE BOVfDESCRIBED RESIDENTIAL PERT - t t I T SIGNATURE ^ OF PERMITTEE FINAL WILLIAM J. FOX, COUNTY ENGINEER ALIDATION el 1 8 3- KVt 7 3 2 ZQo BY \ ._ I DEPUTY n I `76A667 17 25M SETS 7-48 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING i COUNTY OF LOS ANGELES 0 WILLIAM J. FOX, CHIEF ENGINEER DISTRICT NO. GROUP ZONE PE . FOR APPLICANT T❑ FILL IN i PLUMBER RECEIVE,b BY READY FOR DATE ISSUED ADDRESS FIRST INSPECTION r -" CITY TEL. No. JOB ADDRESS COUNTY LICENSE Nn. EXPIRES w M `-7 / ' LOCALITY v I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NEAREST r I ,r ANGELES COUNTY LICENSE. CROSS ST. 4 Gn Js t OWNER MAIL PLUMBER ADDRESS q► �.�� /�'" VFXIt PERMIT FEE IS $1.00 FOR THE FIRST FIXTURE OR CITY. ef C LTEL. No. ITEM LISTED BELOW, PLUS SOO FOR EACH ADDITIONAL I AM THE LEGAL OWNER OF THE RESIDENTIAL PROP- ITEM. FOR EACH SEPTIC TANK AND PIT OR DRAINFIELD ERTY DESCRIBED ABOVE. $1.00. MINIMUM FEE FOR ANY PERMIT $1.00. EACH GAS SYSTEM IS A SEPARATE ITEM, A-.4 r � O NER NUMBER TYPE OF FIXTURE OR ITEM WATER CLOSET (TOILET) CORRECTIONS BATH TUB SHOWER LAVATORY (WASH BASIN) KITCHEN SINK LAUNDRY TUB OR TRAY GAS SYSTEMyOUTLETS WATER HEATER SLOP SINK -� Q FLOOR SINK Z _ FLOOR DRAIN DISHWASHER DRINKING FOUNTAIN _ URINAL MISCELLANEOUS APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL SEPTIC TANK - DRAIN ( ) PIT ( ) _$ SEPTIC TANK CESSPOOL '$ SEWER HOUSE SEWER Si GAS TEST UTILITY CO. NOTIFIED I TOTAL FEE � � a �.� FINAL T 0-IL . 46M GETS 1-48 APPLICATION FOR PERMIT 'IIFPARTNT OF BUILDING AND SAFETY CO PLUMBING OF LOS ANGELES WM. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. G OUP o E PER r�lr No. ROUGH FIXTURES COMPLETE READY FOR RECEIVED BY DATE iiUED HEATER CESSPOOL -I SEPTIC TANK RFIRST INSPECTION GAS M 13CELLANEOUB ''-- APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY F JOB NAME ADDRESS W m ADDRESS LOCALITY F ONEAR EST J I 4 CITY TEL.No. CROSS ST. COUNTY CERT.No. EXPIRES � NAME LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL NORTH ADDRfi88 O CI '� TEL.No. 1 AM THR LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMMER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIUED ABOVE. 4 D OWNER i CORRECTIONS SOUTH J DESCRIPTION OF WORK a BATH TUB FURNACE C7 Q SHOWER DISHWASHER 0 LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPRCTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER GAS SODA FOUNTAIN ----��-- t, OUTL GAS PIPING v GAS VENT ` CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOI SEPTIC TANK SEWER TOTAL FEE UTILITY CO.NOTIFIED FINAL ^ ' W6p�am$COMPENSATION DECLAAAT)DN -, 2D-OM DPW 9/e9 w I hereby atlflrm that I have a oartlfloate of convent to self Insure, APPLICATION FOR PLUMBING PERMIT JJ or a obrtH{oate of Workers Compensation IneurtnW, or a oerUfled oogy thereof(Seo. 3800 Lab.C.) OOUNTY OF LOS AtNGEI DEPT. OF PUBLIC WORKS DEPT.' OF PUBLIC WORKS DIV. Policy No, Y Cert ndd copy b hereby turrSYhed.' ❑ A✓FOP APPt-r—WT TO F LL N(PRM W TYP) I DO} B8 ��f!D lOr✓�R�`+ W rw T� L Cerithed Dopy b toed with the county building lnsQeotlon d.p.r rrerrL NUNBEA FD(TURE OR D • FEE IACAJJTY `1 em pl•,6_ t°.1 TY Date ApOMMK r WATEI:1 CLOQET CERTIFICATE QFp�IPTION FROM WOF BATH TM C ST. NA VV00 COMPENSATION IN8l1RANCE MAP PAGE PAF10Et (this&eotldn n0ed not be oompW6d if the wort,Invoflnq py the SHOWER u permtt I*for one hurtdrW,dollefs(1100)onr lets,) LAVATORY OmN MI�A 6-- A- YL I certify that,In the perfgrmanos of the work fdr Which.this permit MAIL Is [&sued, I shall not OmPIoY NY Person In shy manner to aq to WlK �� AODRE88 /¢ /p (' 0 036rJ WW3T A (/'k become ecoe aub).sct to the Wbrken'Com pensatlon Law", yam+ 4 A Q DISWASHER CITY `f 2M 19� " G �NO + r _U Data Ap~ CLOT1-IE�8 WASHER AOR- NOTICE O A PLICANT: It, after meking-thlk1 tt of Exempt)on,you shoukl beoome.eubfeot to.V»Worksrs'�Compeneatlon 91MJ1fai0 POOL F{l� proviNons of the Labor Code, you must forthwith comply with such ADDRESS provisions pr this permit shall be deemed revoked. LAWN 8PRINl<LER1 YSTHl - LJCENd COfiFAAOTOFtB DPU ARATK3N CITY TEL_40. d I hereby aMrn1 that•I am licensed under provtslona of Chapter 9 WATER HEATER STATE(commencing whh 8ectlori 7DDO)df DMaton 3 of the Business and NO, CL8g 8 Profeeakwm Code, and my license.fa In hfll force and efleot GAS � 0t3iFrCT No. PI MEBSED BY 666 PER OVER 71 7 Q 1 O L.Ioense Number Lk:-Claes () FINAL DATE 170-43 _ VALIDATION a Con"" beta I am exempt under Seo. By Z B.BP.C.for this ropson - DeaK Plan Check fee , PLUMBINO PERMIT ISSIIINQ FEF ' TOTAL FEE ' � Plan chegk appflcanJt . 81NOLE FAMILY HOAC OWNER-BUILDER DECLARATION dame K.'CT•T I hereby afflnn that 1 am bxempt hole the Contcaotors Wcente Law for the following reason (Section 7031.5, Buslneeeand Profeesbhs Address I LU• Oode): Tel.No. 1 ITEMS I,as owner df the property,wlIr do the Work and the acture � is not Intended'nr offered for sale (Section 7044, Business TOTAL 21D c� and Professions Code). , 110.9 CONSTRUCTIOft LENDING AGENCY I hereby q lrm that there Is a cdnstructlon lending agency for the perlormanoe of the wodk for which this permit 1a laeued(Bev. 3097, - - OGa6-"I 12J 12/Wi Lenders Name �tfF 1O 1 AM 8'-27 Lenders Address I ca MN that I have read this application and state that the above Information Is oorreoL I agree tq comply with all County ordlnances , and State Tawe regulating Plumbing, and hereby authorize repreeentatheft of this County to enter upon the abova-mentioned property for Inspection purpooss• EEE R DiETSE FOR tXPLANATORY LANGUAGE WORKEFI` ON DPW 4 rherebyaMrm that I�havee aPwrfti9ofe.Df nt to @@If Insure, ^ 9/� APPLICATION FOR PLUMBING PERMIT LI ora oerkcate'of Worker's Compensation Insurenoe, or a carttfled oop�tlfersq(baa.38WLab. C.) P."` 'Cc-mpwq COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. ❑ Ce,H d copy h herebyfurrk»d AD LDM ❑ cs,dw copy Is mod with the county butkfing hop-6-hop-6- FbR "rM TO RILL IN(PLANT oq TYTYPE) L 4-910 6 OLZ3£h! WEST AVE.. depertn—t. NUMBER FDCTUAE OR ITBA • FEE LOCALITY T£N1 PL.E G I'T Y Data Appfloerd WATER CLOSET NEAREST CETT IFtCATE OF EXEMPTION FROM WOR<EIW I BATH TUB 0 ST_ HA LZ WOO D COAtPBWSUR JSATtON ANCE ASSEEIGOR MU*section need not be compf fed H tlw sort Involved by the SHOWER NAP BOOK PAGE PARCEL permtt to for one hundred dollarsor I oertlty that In the performance ofthe wprk�which thlo,p•rmn I LAVATORY OWE M If L . YV le issued,i shall not employ any person In any manner so as toWAIL gI A E88 4910 (Jyi�L+DLCrJ V4 61S7 AVE become sub)ect to the Workers'Compenaatlon Laws De. 940 MWASHER CITY M PLE C IT`( TEL NO.(A*)288 XX - APPrt CLOTHES WASHER NOTICE TO APPLICANT: if, atter making this CsrtIfloate of CONTRACTOR Exemption,you should beoorne"eot to the Workers'Compensatlon SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply wtth such ASS prow orm or this permit ahall be deemed revoked. LAWN SPRlNO_Si SYSTEM �ICE7rSm CONTRACTORS DECLAFLAT1oN WATER HEATER CITY N0. a I hereby affirm that 1 ■m licensed under provisions of Chapter 9 ^ (commencing wfth Seotlon 7000) of Dhrlslon 3 of the Busina&d and STATE 4U{ Profeseioru Code,and my license Is In full force and eReot GAS SYSTEM � OUTLETS LKA94SE NO. OUTLETS OVER t)mn-FfCT NO. PROCESSED BY C[ 6 PER SYSTEM - O Lkxrrse Number Lb.Claes FINAL VAUDA7ION W - DATE _ a Contractor oeio v) F-1F1NAL z I am exempt urdr Seo. BY < . - - B.6P.C.for thk reeion Deter Plan cheCk flee , PLUMBING PERAfrr ISSUING FEE TOTAL FEE 80JGLE FAMILY Flan ot►eak aPPkwtt 5 HOME OWNER-BULDER DECLARATFON Ngr I hereby a flan that I am exempt from the C:ontraatcrs Licence Law XCT.T for the following reason (Sectbn 7031.6, Business and Professions Address Code): Ctty JM7 50.50,' er R I, as ownof the property,will do the work and the alsuoturs Tel.N0. 1 ITEM Is not Intended or offered for sale (8eotlon 7044, Business and Prof*" no Code). , TOTAL 50 . 50 CONSTRUCTION LENDING AGENCY CWCK 50.50 I hereby afflrtn that there Is a construction lending agency for the performarwe of the work for whbh this permit Is Issued (Seo. 3097, OWE CC Ctv.C.) Lenders Name LIGO&--000 1 A9/10/90 Lenders Address 2M 1 A I 7:58 I oertffy that I haw read this appllcatlon and state that the above Irrformatlon be oorreot. I agree to comply wfth all County ordinances , and State laws regulating Plumbing, and hereby authorize representatives of thla County to enter upon the above-mentloned prop"for Inspection purposes. WM REVERSE FOR EItPL.AKATORY LANQUACE