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Home My Public Portal About5833 GOLDEN WEST AVE_Plumbing__ S D.b'.'S. 17 25M SETS 12.44 APPLICATION FOR PERMIT 1 DEPARTMENT OF BUILDING AND SAFETY PLUMBING 1 COUNTY OF LOS ANGELES Wm. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRlQj_NO. GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE FOR HEATER CESSPOOL `I SEPTIC TANK R Ci1VED my READY DATE IffUBD FIRST INSPECTION CTAS MISCELLANEOUS P AN FI VILY OUTLINED PORTION ONLY_ JOB /It NAME i ADDRESS _ I&I R {' m ADDRES __zZ-T_3 LOCALITY f NEAREST ' OJ. CITY TEL. No CROSS ST. x" C OU NTY /{/I CERT.No. '•1 EXPI 8 NAME W LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL 3 ADDRESS NORTH O CITY TEL.No. 1 AM THE LEGAL OR F TtiE. AHOVK S j ANGELES COUNTY Cl UAicJ,ElCAT10Nt PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. yF W OWNER I CORRECTIONS SOUTH DESCRIPTION OF WORK z BATH TUB FURNACE H C.5 �-n SHOWER DISHWASHER O -LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN a WASH TRAY URINAL APPROVALS _WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I J _.METER GAS .-SODA FOUNTAIN OUTL GAS PIPING GAS VENT CESSPOOL I TOTAL NUMBER OF FIXTURES "`- SEPTIC TANK CESSPOOT SEPTIC TANK SEWER UTILITY CO.NOTIFIED I TOTAL. FEE FINAL 76A667A" CE 817 1REV 6/78) t5 APPLICATION FOR PLUMBING ,PERMIT '• COUNTY OF LOS ANGELES BUILDING'AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ^ I 9 ADDRESS NUMBER FIXTURE OR ITEM ® FEE LOCALITY' C-1 WATER CLOSET NEAREST / BATH TUB CROSS ST SHOWER OWNER LAVATORY MAIL ADDRESS. SINK CITY DISHWASHER CONTRACTOR ' CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR , CITY TEL NO LAWN SPRINKLER SYSTEM STATE LIC WATER HEATER LICENSE NO CLASS GAS SYSTEM OUTLETS APPROVALS DATE' INSPECTOR s SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING GAS VENT HOT WATER HEATER PLUMBING FIXTURES GAS TEST N Plan check fee UTILITYCO NOTIFIED PLUMBING PERMIT ISSUING FEE$ 17 _ TOTAL FEE 0 FINAL ff�1�79 Plan check applicant PLAN CHECK VALIDATION Name r. . Address City Tel No I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS'APPLICATION AND STATE- ' THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES , -AND STATE LAWS REGULATING PLUMBING - PERMIT VALIDATION a 6;7,7,7 A I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND%OR LICENSED AS - ' REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE - _ # 0 0 0-'0,9 5 LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL, PROPERTY ` 2 Q ,0 1 I1 O O ,1.1 li s SIGNATURE OF PERMOF PERMITTEE - - Q O O 1'0,005 DISTRICT NO P ESSED BY Q-79 INDUSTRIAL WASTE APPROVAL _ •o B.S.17 25M SETS 12.44 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY I COUNTY OF LOS ANGELES q/,�1�� PLUMBING " I. Wm. J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. ROUGH FIXTURES _I COMPLETE HEATER CESSPOOL I SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED FIRS INSPECTION GAS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED.PORTION ONLY �p. JOB NAM eT, ADDRESS ' W F ADDRESS g 712,0 mow LOCALITY zz D ��jjj'''--- t •e-•r- NEAREST _ i - y CITY C o�N TEL.No. CR068 ST r /J COU tY CERT.No. Tool EXPIRES WC NAME 6 A -LOCATION OF SEPTIC TANK, OR CESSPOOL z MAIL NORTH - 03, ADDRESS - CITY TEL.No.` I AM THE.LEGAL- POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMB I AM THE LEGAL'OWNER OF THE PROPERTY DESCRIBED • ABOVE. �. OWNBR CORRECTIONS SOUTH- DESCRIPTION OUTH-DESCRIPTION OF WORK ATH TUB �URNACE H O _SHOWER DISHWASHER LAVATORY REFRIGERATOR ITCHEN BINK WATER SOFTENER _ FLOOR'SINK SAND TRAP - SINK LOP ++ . - FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOBL*T ^RINKINd FOUNTAIN DATE r/ 148PIECTpOR'9 NAME _WATER HEATER DENTAL LAVATORY ROUGH-PLUMBINGJ/7 `(,bIVYI./ kI i- �• –METER--$—" GAS -------SODA FOUNTAIN mA8 PIPING Ill` .,vu ,I/f�`W1f OUTL GAS VENT' CESSPOOL - i• - I LOTAL NUMBER OF FIXTURES • SEPTIC TANK ESSPOOL SEPTIC TANK SEWER I• i h UTILITY CO.NOTIFIED'] TOTAL FEE �/ I �• / y FINAL 7`,6A667 (CE-817) - 5/73 APPLICATION FOR -PLUMBING_ PE_ RM.IT- .r COUNTY OF LOS-ANGELES DEPARTMENT OF COUNTY ENGINEER Al BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO, BUILDING-5Q /,��,,_�.:�i��✓ ADDRESS ' HARVEY T. BRAN DT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) - NEAREST _ CROSS ST �U/✓ S y ,.,.. ,' NUMBER FIXTURE OR ITEM @ FEE OWNER WATER CLOSET 1.75 MAIL G BATH TUB 1,75 ADDRESS :l SHOWER 1,75 CITY 1 TEL NO3'� LAVATORY 1,75 CONTRACTOR SINK2 1-7fr ADDRESS /�s�,,.,Q� DISHWASHER 3. 1,75 CITY '7�fl�rv� TEL. NO CLOTHES WASHER - 1.75 STATE LIC LICENSE NO W'- 11 CLASS l�✓� SWIMMING POOL RECEPTOR 1.75 DISTRICT NO - GROUP NE OCESSED•BY ` < - LAWN SPRINKLER SYSTEM 1,75 - i�� v�(7. � � , �J r WATER HEATER 1.75 INDUSTRIAL ` WASTE APPROVAL y. GAS SYSTEM / OUTLETS +-175 INSPECTION RECORD v OUTLETS OVER 30 _ 5 PER SYSTEM #, p • - t, < - W co z Plan check fee See Reverse L PLUMBING PERMIT ISSUING'FEE $ TOTAL FEE APPROVALS DATE INSPECTOR S SIGNATURE Plan check applicant S UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING CItY Tel No , 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 PLUMBING FIXTURES , WITH ALL COUNTY 'ORDINANCES AND STATE LAWS REGULATING - PLUMBING GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY GO NOTIFIED r LICEN SEDAS REQUIRED BY LOS ANGELES'COUNTY AND STATE OF 1 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO ' RESIDE IN THE ABOVE DES REST ENTIAL PROPERTY. FINAL SIGNATU RIE OF PERMITTEE / ER IT VALIDATION CK M.O. CASH PLAN CHECK VALIDATION CK M 0 CASH v 5.6.0-SEP 19 5 a 13.50o�� J 76A667 oas 17 11-611. APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY - ' COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER 7DISTRICT` CiRO P ONE IT N . FOR APPLICANTTO FILLINPLUMBER / `ZJVED BY READY FORDATE ISSUED FIRST INSPECTION ��ADDRESS i �BUILDIN CITY TEL NO.[ti/ COUNTY 610 �� EXPIRES�-� LOCALITY �G l NSE NO. NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET(TOILET) @ 0.50 s ADDRESS BATH TUB @ 0.50 CITY TEL. SHOWER @ 0.50 '� I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY T T I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY Q 0.50 ,ANGELES COON LICENSE, OR THE LEGAL OWNER OF THE RESIDE PROP SCRIBED ABOVE. OAS SYSTEM OUTLETS @ 0.50 SIGNATURE OF WATER HEATER @ 0.50 TiTPERMITTE - SLOP SINK @ O.SO INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50 DRINKING FOUNTAIN (f$ 0.50 A�1110`P'IT 8 A6"IV URINAL @ 0.50 Q HOUSE SEWER @ 0.50 Z L7 MISCELLANEOUS Q' O APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAB PIPING GAS VENT CESSPOOL @ 1,00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT 1,00 GAS TEST - �l UTILITY CO.NOTIFIED TOTAL FEE >5 G ./ z� 5-2— FINAL 76A667-CEu817 10-67 APPLICATION FOR PLUMBING. PERMI- COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING p� ✓ BUILDING AND SAFETY DIVISION O (i(v,/ JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS COLEMAN W JENKINS. SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN (PR NT OR TYPE) JNEAREST ..... CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE - J�Ih� a WATER CLOSET 1 50 OWNERCJCJ MAIL BATH TUB 1 50 ADDRESS SHOWER 1.50 CIr4 TEL. NO. LAVATORY 1 50 CONTRACTOR SINK 1 50 ADDRESS /Q D DISHWASHER 1.50 C TEL.CLOTHES WASHER WASHER 1.50 STATE LIC LICENSE NO CLASS SWIMMING POOL RECEPTOR 1.50 DISTRI T NO GRO P ZONE E D BY - LAWN SPRINKLER SYSTEM 2.00 O U WATER HEATER 1 50 INDUSTRIALWASTE APPROVAL O GAS SYSTEM OUTLETS 1.50 ,� INSPECTION REC D ~ U OUTLETS OVERI L (`�/ I .,/,/ W 5 PER SYSTEM 30 -u rj0 F�•,�/ i,Qn CLZ Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE $1 2 00 TOTAL FEE DO APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER-SLAB WORK Nagle ROUGH PLUMBING - Address GAS PIPING GAS VENT City Tel. No HOT WATER HEATER LANDSTATE BY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION TE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBINGFIXTURES LL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS'TEST GEBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED D AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF NIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO N,THE ABO D C ESIDENTIAL PROPERTY FINAL UREJACK R. ALLEN, SUPERVISIN HANICAL ENG'R RMITT PERMIT VALIDATION cK M o CASH-- PLAN CHECK VALIDATION CK M o CASH APIRi WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) or a certified copy thereof (Sec. 3800, Lab. C. COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. BUILDING r-1Certified APPLICANT TO FILL IN(PRINT OR TYPE) Certified copy is filed with the county building inspec- ADDRESS tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' f BATH TUB CROSS ST. COMPENSATION INSURANCE OWNER (This section need not be completed if the work involved by ' SHOWER the permit is for one hundred dollars ($100)or less.) `' LAVATORY MAIL ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY TEL. NO. with comply with such provisions or this permit shall be STATE LIC. deemed revoked. ! WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 c GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER p}, and Professions Code, and my license is in full force and effect. 5 PER SYSTEM FINAL VALIDATION O DATE V License Number Lic. Class W J FINAL Contractor Date BY >_ I am exempt under Sec. Q B.&P.C. for this reason Plan check fee ► Oa Date: PLUMBING PERMIT ISSUING FEE$ W Signature TOTAL FEE SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name t I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and Professions Code): City Tel. No ❑ I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section pool7044, Business and Professions Code). 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 ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Dote �W,ORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT ?-}d eby affirm that I have a certificate of consent to self 76A667A insure, ora certificate of Workers' Compensation Insurance,_ CE 817(REV 10/81) or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY 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 inspec- ADDRESS tion department NUMBER FIXTURE OR ITEM ® FEE LOCALITY WATER CLOSET, Date Appl igant NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB 0 CROSS ST COMPENSATION INSURANCE SHOWER DO OWNER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this I � permit is issued, I shall not emplo any person in—any manner SINK CITY TEL NO 5 so as to becV subject to the o er Comp nsaTion Laws DISHWASHER r' CONTRACTOR Date In icant _. CLOTHES WASHER NOTICE OICANT If, aft making this Certificate of ADDRESS l� Exempts n, you should bee9me subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of`the Labor Code, you must forth- CIW TEL NO LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC deemed revoked / WATER HEATERPl� LICENSE NO 7 CLASS !J LICENSED CONTRACTORS'DECLARATION (/ DISTC O � P ESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS U (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER } CL and Professions Code, and my license is in full force and effect 5 PER SYSTEM FINAL. - ` 0 G V DATION O DATE V License N m er Lic Class 1K FIN _ O Contractor Date r BY V ❑ w m exempt under Sec N L•B'8P C for this reason Plan check fee Date PLUMBING PERMIT ISSUING FEE$ s/O Signature ro TOTAL FEE 2 SINGLE FAMILY U Plan check applicant ;23 5 9,2 A • HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License # o 0 o o o5 Law for the following reason (Section 7031 5, Business and Address Professions Code) City Tel No J ° o 5 2 5 0 ❑ I, as owner of the property, will do the work and the . 0 0 0 52 5 0 v structure is not intended or offered for sale (Section 7044, Business and Professions Code) ,) 2 0 4=85 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 ordinances and State I ws regulating Plumbing, and hereby autl;iQrize epresentati s of this County to enter upon the above- nti d prop ty for inspection purpos ' SEE REVERSE FOR EXPLANATORY LANGUAGE • /S g""nature of Permittee Date