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Home My Public Portal About6201-6201 1/2 GOLDEN WEST AVE_Plumbing__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer PLUMBING 1 DISTRICT NO. GROUP ZONE . FOR APPLICANT TO FILL IN S� J 2 G/ PLUMBER a, E RECE ED BY READY FOR DATE ISSUED ADDRESS FIRST INSPECTION yy� y2i V BUILDING ! � P { )e� CITY TEL No ADDRESS Y L7d s 44 COUNTY LOCALITY .//•" LICENSE N0. EXPIRES --1 - �' V NEAREST 1 PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNERMAIL V' ,c, _ WATER CLOBET(TOILET) 0 0.50 $ 0 ADDRESS .-4.2 "rr )W P/es �/�!i V al-kY. BATH TUB 0.50 r1 T- CITY e Z' /TEL No. ' SHOWER 0.50 1 HEREBY ACKNOWLEDGE/THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) 0.50 Q APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK Q 0.50 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY a 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER GAS SYSTEM--'3—OUTLETS 4 0.50 Df THE RESIDENTIAL PROPERTY DE CRIBED ABOVE. SIGNATURE OF WATER HEATER 0.50 -� PERM ITTEE CCCiii -- SLOP SINK 0.50 INSPECTION A167ORD f FLOOR SINK 0.50 FLOOR DRAIN 0.50 DISHWASHER 0.50 _ DRINKING FOUNTAIN 0.50 URINAL 0.50 'J Q HOUSE SEWER 0.50 Z MISCELLANEOUS 0 Qy O APPROVALS DATE INSPECTOR•9 NAME ROUGH PLUMBING OAS PIPING GAS VENT ) ` CESSPOOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT 1.DO OAS TEST _ �, UTILITY CO. NOTIFIED TOTAL FEE FINAL 76A667 DBS$17 6-52 COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department OF of CountBUILDING Engineer DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer DISTRICT O. GROUP ZON . FOR APPLICANT TO FILL IN PLUMBER t, a �y 1.-; \! C?l b�I RECEIVEW BY READY FOR DATE IHT 9U D _ f FIRST INSPECTION ADDRESS J./J 't � �•' �C,� +•v 1 ) � fr, % �M.,..f BUILDING �1 r- CITY �r- ]!/ TEL.. NO. ,,.,� t7 J' ADDRE88COUNTY LICENSE NO. !{ j h� EXPIRES -.1,s,�•; �- LOCALITY NEAREST ST. tj Y PERMIT FEES CROSS a- o NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER r '1 "0' JIMAIL I WATER CLOSET(TOILET) 0.50 L{, ADDRESS I BATH TUB @ 13.513 -1 CITY - D / I TEL NO. SHOWER Q 0.50 1 HEREBY ACKNOWLEDO THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ O.SO APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN BINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL dWNER GAS SYSTEM `� OUTLETS @ 0.50 P, OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. WATER HEATER @ 0.50 i,. , BIGNATURE PERMIT'TEF �r ��1 SLOP SINK @ 13.50 INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.513 DISHWASHER @ 0.50 DRINKING FOUNTAIN @ 0.50 URINAL@ p,gp W HOUSE SEWER @ 0.50 Cal MISCELLANEOUS J a v APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL 1,130 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT . . 1.00 GAS TEST UTILITY CO.NOTIFIED TOTAL FEE $ �, FINAL 761667 DBS##17 6-52 COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. PLUMBER &jI� READY FOR V' REC�1 ED BY DATE ISSUED FIRST INSPECTION —53 ADDRESS fj BUILDING � CITY -!s� TEL Na. `j ADORES" O Wes COUNTY 3 EXPIRES LOCALITY -- 2z C.%�)V LICENSE NO. _�f-� NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEEMAIL OWNER .a WATER CLOSET(TOILET) 0.50 s Q ADDRESS SQ 3f -,;&c7—; pfe �i �i�/ ��j.•.� BATH TUB ® 0.50 CITY �'y'yJ p��, C--t V'TEL. NO. SHOWER 0.50 --r 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. I CERTIFY THAT 1 POHSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER OAS SYSTEM--*7—OUTLETS 0.50OF THE RESIDENTIAL PROPERTY DE CRIBED ABOVE. WATER HEATER 0.50 SImNPERMRITTEF P SLOP SINK 0.50 INSPECTION CORD FLOOR BINK Q 0.50 FLOOR DRAIN @ 0.50 DISHWASHER 0.50 DRINKING FOUNTAIN 0.50 URINAL Cry 0.50 HOUSE SEWER 0.50 k�Lz Vb MISCELLANEOUB ED M X20-<Si O W-y2 Writ ffo t-/lUALl9'MS 19'� r ID 0W✓ APPROVAE:S— 51 kSf✓RQ (Q DATE �uJINSPECTOR'S NAME ROUGH PLUMBING `" lJp(j vb�, OAS PIPING GAS VENT CESSPOOL 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT 1,00 G ..AS TEST �r Y1 � I1.j'' 'a ( �l ' UTILITY CO.NOTIFIED !h�2,-7 TOTAL FEE rINAL —-2 h-I 76A667 DBS#17 6-52 W RKERS'COMPENSATION DECLARATION '*. 4 20-0026 DPW 4/87 APPLICATION FOR PLUMBING PERMIT ^'I.hereby, ditlrm-that•I have a certificate of consent to self in- 76A667A sure,or a cerci•,.tate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) certifjed copy thereof (Sec. 3800, Lab. C.) `� � rn-0044_j 044 COUNTY OF LOS ANGELES: DEPT. OF PUBLIC WORKS., Policy No pang _ . 19 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS / w department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY - Date Applicant WATER CLOSET(TOILET) NEAREST CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB G 6 COMPENSATION INSURANCE SHOWER OWNER ` y (This section need not be completed if the work involved by MAIL ' the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS. I certify that in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so CITY TEL. NO. as to become subject to the Workers' Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of Ex- ADDRESS L L 10 emption, you should become subject to the Workers'Compen- SWIMMING POOL RECEPTOR sotion.provisions of the Labor Code;you must forthwith comp- LAWN SPRINKLER SYSTEM CITY / t TEL. NO. ly with such provisions or this permit shall be deemed revok- STATE �(L LIC. ed. WATER HEATER LICENSE NO. [ CLASS LICENSED CONTRACTORS-DECLARATION DISTRICO. PROC QED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS SG 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER V Q fed Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINALr'� VALID ION �� nDATE fJ O License Number 729241 Lic. Class V FIN Contractor Fie,Kon— ate BY O I am exempt under Sec. B.BP.C. for this reaso A Plan check fee ► co 1_51___;�p qQq _PPLUMBING PERMIT ISSUING FEE$ Signatur TOTAL FEE 3 SINGLE FA Plan Check-applicant .HOME OWNER=BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Name A 9 3 S 7 A Law for the following reason (Section 7031.5, Business and Professions Code): Address # 0 0 0 0 o 5 ElI, as owner of the property, will do the work and the City Tel. No. ( o 6 34.5 0 structure is not intended or offered for sale(Section 7044, Business and Professions Code). ► o o o 3 IL 5 0 5 CONSTRUCTION LENDING AGENCY OIL 08' 88 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 Addiess I certify that I have read this application and state that the above information is correct. I agree to comply with all County ordin es and State laws regulating Plumbing, and hereby a oriz repr n tives of this County to enter upon the b ntio ed r perty for inspection purposes. L f' A SEE REVERSE FOR EXPLANATORY LANGUAGE gnature&W,ttee Date