Loading...
HomeMy Public PortalAbout10238 GREEN ST_Plumbing__ 75A557A(CE817A) - 8/75 APPLICATIONF PLU BING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION -37- AD ILI MAKE CHECKS PAYABLE TO: ADDRESS G Z 7 ,LCIU �/ - HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM @ FEE OWNER Gt/ r WATER CLOSET MAIL BATH TUB ADDRESS SHOWER 36D CITY TEL. NO. JqyZ._2c LAVATORY CONTRACTOR I�lO� j�O�/�� �I/i;[D SINK " 0 ADDRESS )Z S +-- DISHWASHER "f CITY �� TEL. NO. CLOTHES WASHER STATE q 6 LIC LICENSE NO. "/ CLASS SWIMMING POOL RECEPTOR DISTRICT NO. GROUP NE OC SED BY LAWN SPRINKLER SYSTEM `sem- Ole �� WATER HEATER INDUSTRIAL 11 WASTE APPROVAL GAS SYSTEM OUTLETS INSPECTION RECORD 0C,. OUTLETS OVER O 5 PER SYSTEM V OC O I.- C7 w CL V) Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE PI check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES ra WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST - PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I M THE LEGA OWNIRPOF, AND INTEND TORESIDE IN THE ABOVE D CRIBED RE ENT( ROPERTY. FINAL SIGNATU RE OF PERMITTEE PERMIT VALIDATION CK. M.O. CASH PLAN CHECK V I TION M.O. CASH 6 0 b�.°.;m 25 5 a 19.5 0 A 76A667-CE817-8-57 APPLICATION FOR PLUMBING PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER DING BUILDING AND SAFETY DIVISION A DDRESS0238 Green Street U'L JOHN A. LAMBIE. COUNTY ENGINEER /� CASSATT D. GRIFFIN, SUPT OF BUILDING emple City FOR APPLICANT TO FILL IN NUMBER FIXTURE ORITEM OWNER Larkwood Const• 2 WATER CLOSET MAIL 1 BATH TUB ADDRESS 712 V allamb ro sa SHOWER CITY Pasadena TEL.NO. 2 LAVATORY CONTRACTOCichard Cavanaugh Plumb* 1 SINK ADDRESS 13354 Central Ave • DISHWASHER CITY Chino TEL.NO.LY 8-4721 LAUNDRY TUB CONTRACTOR'S r STATE REGISTRATION NO. 155' O COUNTY ]. CLOTHES WASHER DISTRIg.T NO. GROUP ZONE READY FOR INSPECTION WATER HEATER 116T 4 — 1 GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD APPROVALS $1.00 PER ITEM DATE INSPECTOR'S SIGNATURE 9 OR FIXTURE $ 9.00 UNDER SLAB WORK ROUGH PLUMBING LR S 1 00 GAS PIPING �- EE 10 00 GAS VENT 1 HEREBY ACKNOWLEDGE VE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVCT AND AGREE TO COMPLY WITH ALL COUNTY ORDINASTATE LAWS REGULATING UMBING FIXTURES PLUMBING. I HEREBY CERTIFY THAT PERLY REGISTERED AND/ GAS TEST LICENSED AS REQUIRED BYCOUNTY AND STAT OF CALIFORNIA OR THA OWNER OF THE OVE UTILITY CO. NOTIFIEDDESCRIBED RESID IASIGNATUR `,/OF PER T �— �- FINAL „S c. ,��( ROBERT A. WOOD, ©. ALIDATION SUPERVISING MECHANICAL ENG'R CASH Ij 2259 JR MAR 24. 3 A 10.00 WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a CRriFflcate of consent to-self 20-0028 DPW 9/81 "yre,�°f q certlflcate of Worlters' Compensation Infurahce, 79A687A or o certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy Nd. 19116$Company Certlfl*d copy Is hereby furnished. /— —'f l;l FOR APPLK:4Ni Tp FILL IN(PRINT OR TYPE) BUILDING . Certified copy Is filed with the county building inspec- ADDRESS tion department. NUMBER FIXTURE OR ITEM Q FEE q0SET LOC Vem le Cit Date 3-41-91 Appll4ant rpt CERTIFICATE OF EXEMPTN FROM WOR BATH TUB CROSS� IQ COMPENSAMN INSURANCE SHOWER OWtBt J (Thls section need not ho corrtp6ted If tine work Irmcfwd by the pet is for ane hundred dollars (:100)or es.) LAVATORY ADDRESS permit leRESSS I certify that In the performance of the work for which this psyimlt Is Issued, I shall not employ any Person In any manner SINK � TE14 2 L _ so as to become subject to the Workers Compensation Lawn. DISFIWASHER AOR Caliber Heatincr Date AN IIcant - cwrws WASHER NOTICE TO APPLICANT: If, after making this Certlflcate of ADDRESS 195 South C Street " ujj r pfRSn 7j dd�]Sbl3ltfY b3corrii"ii]}S t�to thtFWVorkera1i� Compensation provisions of the Labor Code, you most forth- LAWN SPRINKLER SYSTEM with comply with sucK lirovlslons or this permit shall be STATE LIC deemed revoked. WATER HEATER LKB7SE ND.$8 9 5 4.4 CLASS C—2 LICENSE15 CONTRACTORS DECLARATfON DISTR1CTt4O. PROCESS BY I hereby affirm that I am licensed under provisions of Chapter 9 OAS S OUTLETS (corbmendrp with Section 7000) of Division 3 of tt» Buslness OUTLETS OVER and Professions Code,and my license Is In full fo"and effect. S PER SYSTEM, FINAL DATE �.Z�`�f VALIDATION , License Number 589544 LIc, Class C—210 FINAL Contractor BY Dlam exempt ur er r B.RP.0 for this reason Plan check fee ' Date: PLUMBING PERMff-MUING FE$ Signature TOTAtFg Q SINGLE FAMILY Plan check applican t HOME OWNER-BUILDER XCLARATION Name I hereby affirm that I am exempt from theControctors License h Tei Law for the followlrlg reason (Section 7Q31.5, Business and Address Professions Code): City Tel. No. 1 1 I, as Owner of the property, will do the work and the TIM structure is not Intended or offered for sale (Settlon TOTAL 20 - 50 7044, Business and Professions Code). CONMUCTION LENDING AGENCY MCY` 20.al. I hereby affirm that there Is a construction lending agency for � � .00the performance of the work for which this permit Is Issued (Sec. 3097, Clv. C.). -.r,�. Lenders Name - 000[i—CM1 3/21/91 Lenders Address 6165 1 AM 8:26 1 certify that I have read this application and state that the above Infohnatlon Is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize reprelentotives of this County to enter upon the above-mentloned property for Inspection purposes. SEE REVERSE.FOR EXPLANATORY LANGUAGE Signature of Perm flee Date