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Home My Public Portal About5217 GOLDEN WEST AVE_Plumbing__ FPO- 76A667 (CE-817) - 5/73 APPLICATION FOR P MBING PERMIT - COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER - BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO -BUILDING., ' . ADDRESSt— HARVEY T. BRANDT, COUNTY ENGINEER 'LOCALITY (/ FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST d CROSS NUMBER FIXTURE OR ITEM @ FEE - WATER CLOSET 1.75 OWNER MAIL BATH TUB 1.75 ADD f ESS, / SHOWER 1,75 CIT TEL NO LAVATORY ' 1,75 CONTRAC OR SINK 1.75 ADDRESS Q _ DISHWASHER 1.75 CIQ 00 g TY TEL NO O CLOTHES WASHER 1,75 STATE LIC. LICENSE-NO > CLASS •�� SWIMMING POOL RECEPTOR1,75' DISTRICT NO 'GROUP ZONE = 76A667A CE 817(REV 6/78) OS ` APPLICATIO FOR PLUMBING PERMIT COUNTY OF LOS ANGELES, BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING / ADDRESS NUMBER FIXTURE OR ITEM @ FEE LOCALITY WATER CLOSET NEAREST BATH TUB CROSS ST SHOWER OWNER LAVATORY MAIL ;4DDRESS SINK CITY TEL NO DISHWASHER CONTf%CIFIC INSI-ALLERS CLOTHES WASHER ADDREIS0920 E. Cl-AND AVE, SWIMMING POOL RECEPTOR CITY TEMPLE C11-Y, CAL FP LAWN SPRINKLER SYSTEM STATE LIC WATER HEATER DO LICENSE NO CLASS GAS SYSTEM E T S APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING GAS VENT BS- HOT WATER HEATER PLUMBING FIXTURES 9 GAS TEST °A tid Plan chec ee UTILITY CO NOTIFIED PLUMBING PERMIT ISSUING FEE$ TOTAL FEE D FINAL 2 Plan check applicant PLAN CHECK VALIDATION ,Name Address City Tel No p I HEREBY ACKNOWLEDGE THAT I HAVE READ THI5 APPLICATION AND STATE 28 S a 2 A THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION # O O O O o5 IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES CO CALIFORNIA OR THAT 1 AM THE !1 O O LEGAL OWNER OF AND INT TO RESIDE IN THE A E DESCRIBED RESIDENTIAL O C 1 a PROPERTY Q Q 0 1; Q00C2): SRE OF PE RMIT DISTRIC^T'NO f PRO,ESSED)B r L) L:5 �, INDUSTRIAL W WASTE APPROVAL " 25m d rs '-48 APPLICATION FOR PERMIT APkRTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES , PLUMBING WM.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRIC . aRO�Pj ZONE PERMITNO. ROUGH FIXTURES COMPLETE HEATER CESSPOOL SEPTIC TANK RECEIVED� DA%9��Fj' By FIRST INSPECTION c� AS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY BC NAME 0A%•DDRESS , tZ [ 3 Id M ADDRESS 'ry �,ag , , g /2.� LOCALITY J NEAREST U A. CITY TNo EL. . �� CROSS ST. COUNTY �p CERT.No. D� EXPIRES9 "�1 u E NAME11 LOCATION OF SEPTIC TANK, OR CESSPOOL $ ADDRESS NORTH O CITY TEL.NO. 1 AM THE LEGAL POSE S7YFIfYU�LIFICAT FTHE AB6 LOS ANGELES COUNTY CER •tFIC ON. PLUMBER I AM THE LEGAL OWNER OF THE-PROPERTY DESCRIBED ABOVE. N D pp OWNQ F CORRECTIONS SOUTH . J u DESCRIPTION OF WORK z ATH TUB FURNACE O Q' ROWER DISHWASHER Q LAVATORY REFRIGERATOR I—KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS _WATER CLOSET DRINKING FOUNTAIN DATE INSPHCTOR'S NAME _.WATER HEATER DENTAL LAVATORY ROUGH PLUMBING �'v L/ I ✓AN 9 —METER-3--GAS SODA FOUNTAIN OUTL 6A8 PIPING GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOL__SEPTIC TANK SEWER TOTAL FEE �^� UTILITY Co.NOTIFIED 1101-14 '� FINAL I//r y Q 76A667 17 15-49® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY.' ; COUNTY OF LOS ANGELES PLUMBING I WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ' PLU O, RECEIVED G BY READY FOR DATE ISSUED ADDRE9 i E. HUNTINGTON DRIVE FIRST INSPECTION p� CA.�0�R'Nj)� BUILDING ^� CITY A}3CA,RIA, '' TEL. NO. ADDRESSCOUNTY r7 LICENSE NO. EXPIRES LOCALITjLYi'L�♦ NEAREST PERMIT FEES cRoss sr. o NUMBER TYPE OF FIXTURE OR ITEM `FEE OWNER MAIL ff WATER CLOSET (TOILET) @ O 50 $ I ADDRESS BATH TUB Q O 50 CITY TEL NO. SHOWER @ O 50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) Q 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ O 50 STATE LAWS REGULATING PLUMBING I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY Q 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER GAS SYSTEM OUTLETS O.50 OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. Q � SIGNATURE OF WATER HEATER Q 0.50 PERMITTEE SLOP SINK @ O 50 INSPECTION A ECORD FLOOR SINK Q O 50 FLOOR DRAIN Q 0.50 �fy+n DISHWASHER Q O SOI DRINKING FOUNTAINQ O 50 / V URINAL @ O 50 „J HOUSE SEWER Q O 50 I '9' Q Z MISCELLANEOUS U' n � O I I APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL Q 1 00I 'CESSPOOL SEPTIC TANK- I 'SEPTIC TANK I DRAIN ( -)-PIT-(-)- Q 1 00 g SEWER PERMIT 1.00 GAS TEST .-- FINAL UTILITY CO NOTIFIED TOTAL FEE $ v 76APPLICATION FOR PL.lJMBING PERMIT DBS.17 9•SS 'I7 DIVISION OF BUILDING AND SAFETY '2, Department,of County Engineer County of Los Angeles (BUILDING WM.J. FOX, COUNTY ENGINEER ADDRESS CASSATT D. GRIFFIN, SUPT OF BUILDING Q__ iLOCALITY ✓ I F R APPLICANT TO FILL IN NeaREsr "CROSS ST OWNER DISTR�T•NO:" ` GROUP Z NE READY FOR INSPECTION MAIL ADDRESS Somesi I —I I Now INDUSTRIAL CITY TEL NO .WASTE APPROVAL PLUMBER GENERAL INSTALLATION CO:" INSPECTION RECORD I - ADDRESS 6558 West Blvd. CITY L,A. 43 'TEL NOPLeasant 32541 LICENSE NO 787 - C-36 151839 - NUMBER TYPE OF FIXTURE OR ITEM FEE _ WATER CLOSET (TOILET) $" BATH TUB ' SHOWER LAVATORY (WASH BASIN) KITCHEN,SINK DISHWASHER LAUNDRY TUB OR TRAY - CLOTHES WASHER 1 WATER SOFTENER 1 00 TOTAL NO @ 080 APPROVALS DATE - INSPECTOR'S SIGNATURE GAS SYSTEM OUTLETS @ 1 00 WATER HEATER @ 1 00 UNDER SLAB WORK ROUGH PLUMBING PERMIT g 1. 00 - _ 'GAS PIPING TOTAL FEE 2 OO GAS VENT I 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 REGULATING PLUMBING FIXTURES PLUMBING 1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST _ LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM-THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED, DESCRIBED RESiDENT1AL PROPERTY. /A - SIGNATURE /f(�� OF PERMITTEE - }�riT� FINAL • �Odw WILLIAM J. FOX, COUNTY ENGINEER VALIDATION " R.A.WOOD, CHIEF PLBG. INSPECTOR' _ ...ACO7 2 6'3'S AUG 2 9 3 _ 2.Q U In w PLUMBING " ' . 1 DEPARTMENT OF COUNTY ENGINEER DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION 'COUNTY OF LOS ANGELES BUILDING' .�y WILLIAM J. FOX, COUNTY ENGINEER ADDRESS G FOR APPLICANT O FILL IN LOCALITY BUILDING �'� / EAREST ADDRESS CROSS ST — DISTRICT NO. GROUP Z NE PERMIT NO. LOCALITY NEAREST CROSS ST �-� RECEIV D Ready for Inspection DATE ISSUE OWNER INDUSTRI ADDRE WASTE AP OVAL S cIT TEL• INSPECTION RECORD ., PLU ER ADDRESS �2 r CITY TEL.NO. 11 ❑STATE LICENSE NO. ❑COUNTY J, PERMIT FEES a z_ NUMBER "TYPE OF FIXTURE OR ITEM FEE WATER CLOSET(TOILET) @ 0.80 11 BATH TUB @ 6 80 SHOWER @ 0.80 LAVATORY (WASH BASIN) @ 0 80 KITCHEN SINK @ 0 80 LAUNDRY TUB OR TRAY @ 0.80 SLOP SINK @ 0 80 FLOORSINK @ 080 FLOOR DRAIN @ 0.80 DISHWASHER @ 0 80 DRINKING FOUNTAIN @ 0.80 URINAL @ 080 GAS SYSTEM.............OUTLETS @ 1.00 WATER HEATER @ 1 00 MISCELLANEOUS APPROVALS DATE INSPECTOR'SSIGNATURE UNDER SLAB WORK c{ PERMIT $ 1 00 ROUGH PLUMBING �/� TOTAL FEE 6b GAS PIPING ..-- 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- GAS 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 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED i v AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ER OF THE ABOVPDEfCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTEE-------• FINAL q'�/� '� •� ' 76A667 DBS 17 J5 WaRkfERS'_,COMPENSATION DECLARATION 76A667A I hereby affirm that_I have a certificate of consent to self ce ev7 (z-so) APPLICATION FOR PLUMBING PERMIT insure, or a certificate of Workers'Compensation Insurance,or a certified cop thereof(Sec 3800,Lab C) 91 COUNTY OF LOS ANGELES �7 BUILDING AND SAFETY Policy o ompany (Q c Certified copy is hereby furnished FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING A ADDRESS SZIT �O.c�Ogt/4�lSST /� �Certifi copy.is filed with a my bu g pec n NUMBER FIXTURE OR ITEM • FEE LOCALITY lT��LG' ie a m nt WATER CLOSET Date Apph - NEAREST ' BATH TUB CROSS ST. iiN�Ey CERTIFICATE O EMP FROM W �E' COMPENSATIO INSURANCE SHOWER OWNER ✓ !l7►��11� LAVATORY MAI L (This section need not'be completed if the work involved ADDRESS } by the permit is'for one hundred dollars ($100) or less.) , SINKCITY TEL NO p I certify that in the performance of the work for which this / DISHWASHER U CONTRACTO permit is issued, I shall not employ any person in any manner R 6 ` ' so as to become subject to the Workers' Compensation Laws CLOTHES WASHER 0 ADDRESS9.g'i9 E �/Q��GQ� � Date Applicant SWIMMING POOL RECEPTOR ,,�.�� ,�y� U NOTICE TO APPLICANT If, after making this Certificate of CITY/�4�Z, TEL NO�"' a Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE `` LIC. to Compensation provisions of the Labor Code, you must forth- LICENSE NO Zle r oc�y CLASS z .. with comply with such provisions or this permit shall be WATER HEATER deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO �� P SSE Y LICENSED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that I am licensed under,provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINALVALID T ness and Professions Code, and my license is in full force and DATE " 4 �� ION effect FINAL License Numbe Lic Class BY/ +� Contr or Date 0 Jr 0 1 am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ ` acting in my professional capacity (Section 7051, Bus- i iness and Professions Code). TOTAL FEE l Lic or Reg.No Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's I Address R 3 015 A License Law for the following reason (Section 7031 5, Busi- City Tel.No # 0 0 0 0 o 5 ness and Professions Code) 1, as owner of the property, am exclusively contracting 2 0 0 1 9 o Q with licensed contractors to construct the project '(Section 7044,Business and Professions Code) 0 0 0 1 9,003- CONSTRUCTION ) QQ3- CONSTRUCTION LENDING AGENCY I 1. 1 2-80, I hereby affirm that there is a construction lending agency for the performance of th 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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regu IumbIng, and hereby authorize re entat�ves f is Count to enter upon the above en ed prope rin pect purposes �-�Igna7 Permittee Date