HomeMy Public PortalAbout5626 GRACEWOOD AVE_Plumbing__ 7e,"7 r, "N Nr7R 7 APPLICATION FOB PERIM
DEPART�T OFI NG AND
N13aEBBAFE
WK.J. OF FOX CHIEF IDIOM= PLUMBING
NATURE 5F INSTALLATION DiSTMCT NO ZON11 PZRMff NO.
ROUGH FIATURES COHrum � Z—
HEATER CESSrOOL SZPTIC TANK RlCCEVID _ READY POR
Fi1ttl 1NSPEQTIOM
min wous
APPLICANT FILL IN HEAVILY OD`I INN PORTION ONLY
.lo.
NAYS ADDRds
ADURIe1. LocwuTY
a
CRY CROSS ST
COUNTY
LIO NO. EXPIRES HAMM
LOCATION OF SEPTIC TANS, OR CESSPOOLMAIL
ADDRES. 7
NORTH
ctry . TEL.NO.
I AY THE *raA CW THE A!•OVt LS
O
ANGELES C,OUMTY CERTM !ATE QUALIFICATION.
I AY THE LEGAL OWNER OFT7is D
ASOYE. ,
ow"m
CORRECTIONS
SOUTH J
DWCRIPTION OF WORK i
MATH TUS o
owER DISHWASHER O
JLAVATORY r CMIGERATOR
EiSUM WATERSOFTEiER
XLOOR SINK TRAP
SiMC art xW DAN
WASH TRAY URtHAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE IN1w9Xrr0q Y KAJ119
WATER HEATER_ DENTAL LAVATORY RU
OGH PLUYSING
7
J.ffa"Vwff
rrzR eAs NTAIN agar TITINS
OUTL
CLfPOOR.
TOTAL NUWEt OF FI:Lf
IBM-TIC TANK
[ff1�00i [� *EWER
TOTAL PHE UTILITY CO.NOTw=
GFKAL V/,
� ��
DJLM6„ N MWrM 1-40 APPLICATION FOR PRI MIT
DEPARTMMNT OFNG AND BAFSTY PLUMBING
COUNTY OFF LOS LOS ANGELES
WM.J. FOX,CHID ENOINImt
ROUGH FCMRM coMrirm
H[ATIM c><wrool_ t wrm TANK MYaT FtM M DATK HOWKD;;�.
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONL
Eo? atd SOLmr, AMVM� Nt1
ADTMs LOCALrTY
CrTY 1 NVAREW
No. I clto s N T.
cou
cuff.No, NAMN
LOCATION OF SEPTIC TANS, OR CESSPOOL NAM
NORTH wDDRn�
crrY
I AM TM LAM" FO NIZOGM CWT" A>•0VZ LO/
ANNNJD-=Ri��� �I
CCATi OR QUALI!►iCA
` MAfu
I A THY L DMAL OVVMM GR THRAbaM
rltQrEITY D
onxa
2_ / CORRECTIONS
9CRYTH -
DESCRIPTION OF WORE l;
ATH T" —PU(AC= - O
"INIINwAtHot Q
vATORY RXFMGK tATOR -
rrCHQ1 MLMK WATEt 8OtTO"M
FLOM SINK SAND TRAP
SLOP/INK DRADI
WA*H TRAY UFUNAL grPROYALS
AT=CL.OMLT �RUiK1Na FOUNTAIN APPROVALS
TK nwrt
WATM RZATOt DENTAL L.AVATCMW ROUGH FL.UMNtHO G
A^DA•FOUNTAIN QA!�INa
3A!V1QiT
TOTAL NUMMat OF FD=Rif !E'TIC TANK
G TANK swim
U ru_rry CO.NOTIFIRD � 1 l
TOTAL FES �Jrj�.7/`�'
r
?WLBYl-CE317-II-V
APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGE M
DEPARThf= OF COUNTY ENGIINIMM
BUILDING AND SAFETY DIVISION a
T�OpEgN�A, r IS30 �y ENV J,
cimn=D. G> nym �t LOCALITY
FOR APPLICANT TO FILL IN >IBAB>$t
NUMBER FIX'TUREOR ITEM
V/ATFB CLOT OWffi
MAII.
WXTR TUB ADDEEB8
313OVIF.li CIST NO,
LAVATOHT CoNr A=R all
Hl>'JQ ADDEM
DISHIFASM CITETg30. / 4
L&UMBT Tn WXI=aAaOu NO.
CLOTS WASEaM DISTRI NO. GROUP ZONE READY FORvJPl=rXdl
WATER REAM
Cas PTUMN L
WASTE APPROVAL
D=OX RECORD
APPROVALS
a u.oa mm rmm DATER INSPECTOR SIGIATURK
O8
UNDER SLAB woRx
PERMIT ; 00 ROUGH PLUMBING
TOTAL FEE Q GAB PIPING
1 RERi3T ACI110W1JMGI THAT I HATE READ THIS APPLICATIOn!t GAS VENT
AAD STATI TEAT THE ABOVE M CORRECT AND AGRMM TO COIPLt HOT WATER HEATER
WITH ALL COUNTY ORDIUMCES AND STATE LATE REGULAnNG
PLUMBING. PLUMBING FLKT-UREB 1 �'
1 HEREBY C£ TIF
RT THAT I All FROPERLT REGISTERED AND/OR G"TEST
LICENSED AS REQUIRED BT LOS ANGELES COUNTY AND STATE OF
CALIFORMIA OR THAT 1 Al 7I1S LEGAL OWNER Ry THE ABOVE UTILITY CAD.NOT]PIIED
DESCRIBED REBID PY 7
81 G NATURE
OF PERM FINAL I ��
ROBERT A WOOD.
VALIDAIION SUPERVISING MacHA ICAL ENq-
�(/'-') t.0. CAM
LC 6 8 5 8 S NOV 2 0 5 A 5.0 0 �i
7EAW-CEW-I1-V
APPLICATION FOR'PLUMBING PERMIT 1
CouNff oil LOS "GELES
DEPARTMENT OF COUNTY ENdINMH
BUTMpgDNIN�IA
SAFETY DIVISION SNUMDMQ
D
CARNM D. SRFM�t ADDEE 6
LOCAL
ol
FOR APPIICANT TO FILL IN MIR ,
Now
�)
NUMDEI4 FIXTUROR ITEM !ff
E
WE= CLOS OWE
1(AII.
R=TUB ADDIS
6HOWER CAT! so.
LAVATORT COm7BiCTOB
am ADDEM
DIBErWAMEM car I Ito. UF r
CowTRACTKm CE
LAURDET Tog iD rRILTMI m °�Pti— -
CLOTE30 WARM DISTRICT NO. 6 7ONE au1DT lot nupx TIox
WATER BEAM
GAS SYSTEM D�
WAM APPROVAL
{
APPROVALS
• (1-00 PER M31 �+ DATE
INEPECTOQ'E EIGMTUQE
on FECrvRE at
UNDER BLAB WORK
PERMIT i 00 ROUGH PLU1413t O
TOTAL FEEGAS PIPING
I HMLEBFT ACKNOWUDQE THAT I HAVE READ THIS &PPLICATION OA.B VENT
AND STATE THAT THE ABOVE 13 CORRECT AND AGREE TO COYPLT HOT WATER HMAT ER
WITH A{{.L COUIITT ORDINANCES AND STATE LAMB REGULATING
PLURBIIIG. PLUMBING FIXTURES
I HEREBT CERTIFT THAT 1 A■ PROPERLT REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BT LOS ANGE COUNTY AND STATE OF
CALIFORRIA OR TIN
ZZ�
OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED REBID
M.
eoFIE Rg FINALkk
ROQERTA.WOOD.
m. VALIDILTION SUPERVISING MECHANICALENG•te
K.0. Cug
,.
LAGo151 .9M JAI 5 5 A 3.00
WOF4SEA'S CrOMPEM3ATFON DECLARATION 20-0028 DPW 0/8B I
I heraly affirm that `have a oertlflcata of consent to sell Insure, 79MAPA APPLICATION FOR PLUMBING PERMIT ILI
or a carNflcate bf Viorker's Compeneation Insurance, or a cetthled
Dopy thereof(84".3800 Lab. C.) - .
COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT. OF PURUC WORKS DIV.
Porgy Y
❑ CorttM1ed copy Is hereby furrkhed. YY
FOR APPLJGVrf TO FllJ N(PRINT OR TYPE)
CBA � �b2/'
II�q{�j✓
❑, ertified copy b flied with the county bufkibhie
g pection
department. MJYBM I DnIFE OR ITEN • FEF { CID Deis Appfosrrt WATER CL08ET NLAFEBT'
CFK)CERTIFICATE OF E)CE MPT10N FROM WORKERS' A8SE 8�'
__ BATH TUB
I NSU RANGE
(This section need not be oomplsted HH the work Imohred by the SHOWER MAP BOOM OJ�� PA43EE eI,104 PAfiCE1�
parmtt Is for one hundred dollars(iltw)or I*".) LAVATORYOWNER 0 kJ ( ►� ��
I oerlfy that In the performanoe of the.work for which this permit /
is Issued, I shell not employ any.person In any manner so as to �fp� M �G
become subjegf to the Workers'Compensation Laws. ADORE88
241
Dt WASHER, CITY ! L-I"+. TEL.NO.
Date APpkant CLOTHES WASHER
NOT]CF TO APPLICANT: It, after making this Certificate of JADDRESS
NTRACTOR
Exempdon,you should beoorhe subject to the Workers'Compansav" SWI MMING POOL RECC�FTOR
provisions of the Lebof Code, you must forthwith comply whh such
provisions or this permit shall be deemed revoked. LAWN SPFLNIaFA SYSTB,1
LKP48ED CONTRACTORS DECLARATIOfj TY TEL.NO.
I hereby affirm (hat I em llcensed under provisions of Chapter B WATER
(commencing with Sectlon 7000) oT DMelon 3 of the Buslneiai and ATE LIC.
ProfessionsCode, and my Iloense Is In full force and effect. CTAS SYSTEM OUTLETS BNSE NO. CLA88
OW OVER D48TRK7 NO. P BY
Lberu a Number Lb.Class
Fl"AL
DATE VALIDATION
-
Contractor Date RNAL
❑ I am exempt under Sec. BY / —
B.AP.C.for this reason
Data:
Plan check fee
Slgn urs PLUMEING PERMIT ISSUING FEE$ a AICCT.T
❑ TOTAL FEE 3307n 97.50
PUw SINGLE FAMILY check applk�nt w11 ITM
ER
HOME OWN -BUILDER DECL RATION Name TOTAL c-a
I hereby affirm that I am exempt from the Contractor's License Law
for the following reason (Section 7091.6, Businsaa and Professions AWrsea ��yy/1, p��c11
Code): , 7 Al
( City Tel.No.
I,as owner of the property,will do the work and the stnicture � •00
is not Intended or offered for sale (Section 7044, Business
._ and Profesabnp Code). i i�I a r
�
CONSTRUCTION LENDING AGENCY 1 r rr TI
I hereby affirm that there Is a oonetructlon lending agency for the946 1 Fel ?;`27
08
performance of the,work for which this permit Is Issued (Sec. 37, O!
Ctv.C.)
LendeYs Name
,Lender's Address
I aertNy that I have rood this application and state that the above ,
inforrr�ilon Ie oorrect I agree to comply wkh all County ordlnanose
and State Tawe regulating Plumbing, and hereby authorize
reprthis County to enter-upon the ■bova-;,rntloned
Tor In �on ^ /� SEE I'MVERSE FOR EXPLANATORY Ll1lJCil1A(iE
Signal6fe of Pefmfttee /�Daft