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Home My Public Portal About5638 GRACEWOOD AVE_Plumbing__ D.B.S. 17 25M SETS 12.44 APPLICATION FOR PERMIT DEPARTMENT OF .BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING 1 Wm. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE RECEIVED BY READY FOR DATE ISSUED HEATER CESSPOOL SEPTIC TANK FIRST INSPECTION GAS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY .IoB NAME F..E.HoekPtt ADDRESS 21B Gra��xe-re f ADDRESS2r724 L, 4th, Street LOCALITY TAYnDl fa L;I tVNEAREST --- CITY LV$ Angeles TEL. Nan. 2-412 CROSS ST.IL I'= COUNTY St 78839 EXPIRES n* CERT.No. W NAME Hafi.Le.� .T-A LOCATION OF SEPTIC TANK, OR ESSPOOL z MAIL NORTH 0 ADDRESS 2800 LnngA ly 'hey CITY Arcadia TEL.No. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. F > OWNER i CORRECTIONS i SOUTH DESCRIPTION OF WORK - z BATH TUB FURNACE SHOWER DISHWASHER 1 LAVATORY REFRIGERATOR rL KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN ` DATE V INSPECTOR'S NAM[ ____ WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I 1 e�.._r.�.METER �= GAS SODA FOUNTAIN GAS PIPING � OUTL GAS VENT II _CESSPOOL I TOTAL NUMBER OF FIXTURES - SEPTIC TANK CESSPOOL SEPTIC TANK SEWER TOTAL FEE I CC UTILITY CO.NOTIFIRD FINAL D.B.S.17 25M SETS 2-47 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES E WM.J. FOX. CHIEF NGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE _ RECEIVED BY READY FOR DATH ISSUED HEATER CESSPOOL _1-1 SEPTIC TANK FIRST INSPECTION A9 MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB E NAME. ADDRESS 1 m ADDRESS LOCALITY f D NEAREST ... A CITY { { ,, TEL.No. CROSS ST. ' r COUNTY If At ' CERT.No. EXPIRES W NAME LOCATION OF SEPTIC TANK, OR CESSPOOL z MAIL 3 ADDRESS' NORTH O CITY TEL.No. IAM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED q q ABOVE. W > 3 V/ OWNER _I CORRECTIONS SOUTH J DESCRIPTION OF WORK Q - _z BATH TUB FURNACE SHOWER DISHWASHER Q LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSP[CTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER-GAS SODA FOUNTAIN OUTL 6A9 PIPING 1 GAS VENT I I CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK I I CESSPOOI SEPTIC TANK SEWER I I UTILITY CO.NOTIFIED TOTAL. FEE FINAL J D.B.S.-17 25M SETS 11-46 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY �� COUNTY OF LOS ANGELES Wm. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT No. GROUP ZONE P R IT NO. ROUGH FIXTURES COMPLETE 1 6 2 2 RECEIVED BY READY FOR DATE ISSUED HEATER CESSPOOL SEPTIC TANK FIRST INSPECTION GAS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB a NAME ADDRESS W m ADDRESS �Zl.A ALITY g REST CITY TEL.No. CRSS ST. IL COUNTY CERT.No. EXPIRES W NAME LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL ADDRESS NORTH O { CITY TEL.No. I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED I11 ABOVE. W D 3 i OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK Z BATH TUB FURNACE ❑ Q' SHOWER DISHWASHER ❑ LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK BAND TRAP SLOP SINK FLOOR DRAIN AWASH TRAY URINAL APPROVALS'' ATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY I I ROUGH PLUMBING METER-GAS SODA FOUNTAIN OUTL GAS PIPING GAS VENT CESSPOOL I/ 71_v -TOTAL TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOI SEPTIC TANK / Q� SEWER I I 3 UTILITY CO.NOTIFIED .. TOTAL FEE FINAL 79Aa67 n a-ao 0 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING �� ' COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. PLUMBER - - RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION �.. ADDRESS - •�'�+ q , ADDRESS s CITY TEL. NO. ffflll ' LOCALITY —LICENSE N0. i EXPIRES d�-`�'-C _ NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEMFEE OWNER MAIL WATER CLOSET (TOILET) @ 0.50 $ ADDRESS BATH TUB @ 0.50 CITY TEL. NO. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND LAVATORY (WASH BASIN) Q 0.50 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK Q 0.50 STATE LAWS REGULATING PLUMBING. 1 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. �I GAS SYSTEM—OUTLETS @ 0.50 I i SIGNATURE OF i"�f � WATER HEATER @ 0.501 PERMITTEE SLOP SINK @ 0.501 INSPECTION RECORD FLOOR SINK @ 0.5011 FLOOR DRAIN @ 0.5011 IDISHWASHER @ 0.501 DRINKING FOUNTAIN @ 0.50 I URINAL @ 0.501 HOUSESEWER @ 0.501 I Q MISCELLANEOUS I I (9 I� O I I I� I APPROVALS IDATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING Zi 11 GAS VENT CESSPOOL @ I.Do CESSPOOL SEPTIC TANK: I I SEPTIC TANK DRAIN ( ) PIT ( @ 1.001 I SEWER 1 PERMIT . I 1.00 GAS TEST //'o \,'C I TOTAL FEEI $ 1 I S G ( UTILITY CO. NOTIFIED 11 FINAL herbby, affirm that have a�certificate�of consent to self-In- 7�A� APPLICATION FOR PLUMBING PERMIT sure,ora certificate of Workers'Compensatlon Insurance,or a tertlfled copy thereof (Sec. 3800, Lab. COUNTY .OF LOS ANGELES DEPT. OF PUBLIC WORKf, Policy No. Company n Certified copy Is hereby furfiished. FOR APPLJCANT TO FILL IN (PRINT OR TYPE) ❑ BUfLDRJG Certtffed copy Is filed with the county bullding'Inapectlon A�� department. MIM .ER R)7URE OR ITEM 8 FEE LOCALTY Ddte Applicant WATER CLOSET(fCNLm /T NEAREST CERTIFICATE OF E)MMTION FROM WORKERS' BATH TUB CROSS ST F COMPENSATION INSURANCE SHOWER OWNER (Thio section need not be completed if+e work Involved by MAIL the per-mN Is for one hundred dollars(=100)air lop.) LAVATORY ADDRESS (v I certify that In the performance of the work for whlth this per- SINK CITY TEL NO. mit Is Issued, I shall not employ any person In any manner so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date T Applicant CLOTHES WASHER NOTICE TO APPUCANT: if, after making this.Certificate of Ex- SWIMMINGADDRESS emptlon,you should become subject to the Worker'Cornpeo- 'PCbL.Rf70R CITY TEL NO cation provislbns of the Labor Code,you must forthwith comp- LAWN SPRINI(LER SYSTEMS- ly'with such provisions or this permit shah be degmed revok- STATE LIC ed. WATER HEATER qC2,JSE NO. CUSS LICENSED CONTRACTORS DECLARATION GAS SYSTEM Dt51T�GT NO. Y I herebyafflrm that I am licensed under provisions of Chapter JL O (tpmmencing with Section 7000)of Division 3 of the Euslness OUTLETS 5 t and Professions Code, dnd my license Is In full force and ef- FINAL VA AMN fect. HOSE BIB DATE —21'46 -- Y License Number LIc. Class�� a FINAL ACCT.T v Contractor Date BY �y�+ 91.70o. I am exempt yndaT Sec. D 1 ITEM U B.BP.C, for this reason Plan check fee Date: PLUMBING PERMIT ISSUING Fes;L 191 TOTAL 91 . 701 CHECK 9.1.70- Signature _ TOTAL FES C .00 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name0000-Ml 12/ 1/95 Law for the following reason (Section 7031.5, Business and Professions Code): Address 3526 1 AM10,.N f 1, as owner of the property, will do the work and the City Tel. No. J " structure Is not Intended or offered for sale(Section 704.1,- Business and Professions Code). ' CONSTRUCTION LENDING AGENCY. I hereby afflrm that there Is.a construction lending agency for the performance of the,work_for which this permit Is Iss-yed (Sec.-3097, Cly. C.). Lender's Name Lenders Address ' i I certify that I have rood this application and state that the above Information Is correct. I agree to-comply with all County ► ordinances laws regulating Plumbing, and hereby rl epresentatives o Is. County to enter upon the bove entloned pro oc Ion u ` a SEE REVERSE FOR EXPLANATORY LANGUAGE ure of Perrrllttee bote