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Home My Public Portal About4929 HALLOWELL AVE_Plumbing__ D.B.S.17 25M SETS 2-47 + APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WM. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION , DISTRICT NO. GROUP I ZONE PERMIT NO. ' ROUGH FIXTURES COMPLETE A— l � 0'3/ HEATER CESSPOOL I—I SEPTIC TANK4 RECCEIVED BY READY FOR DATB ISSUEDc J AS MISCELI ANEOUS L �-- FIRST INSPECTION #?PLIrANT FILL IN HEAVILY OUTLINED PORTION ONLY t jOB E NAME ' ADDRESS S r' W I ADDRE88 r LOCALITY. O7 NEAREST a. CITY TEL.No. 7 CROSS ST. COUNTY CERT.No. EXPIRES d NAME LOCATION OF SEPTIC TANK, OR CESSPOOL 3 MAIL aa 6 ' Q ltV.(� NORTH ADDRESS' O CITY TEL.No v/� u U T 7V 1 AM THE LE AL POS@ O O THE ABOVB LOS ANGELES COUNTY CERTIFICA E Q ALIFICATION. l PLUNDER I AM THE LEGAL OWNER O HE PROPERTY DESCRIBED ABOVE. `f OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK _Z BATH TUB FURNACE ROWER" DISHWASHER Q AVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SANDTRAP SLOP.SINK *+LOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE •INSPECTOR'9 NAME WATER HEATER ENTAL LAVATORY ROUGH PLUMBING METER GAS SODA FOUNTAIN OUTL GAS PIPINf3 I GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK I I CESSPOOI SEPTIC TANK �� SEWER I S c� UTILITY CO.NOTIFIID I I? TOTAL FEE „,G y/E FINAL .P.B. 7 25M BETS 12-43 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES WM. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICTGROUP zo P RMI o. ROUGH FIXTURES COMPLETE HEATER CESSPOOL 1-1 SEPTIC TANK RECEIVED qy READY FOR DATA ISSUED FIRST INSPECTION GAS M18CELLANEOU J JOB f AP LICfANT FILL IN'HEAVILY OUTLINED PORrTIONN �Y C NAME p � �A,i �J'�� ..ss �s� ADDRESS 1 $ ADDRESS ( � � /�iT�rw�►. LOCALITY NEAREST "1 CITY / T,EL.No. � , CROSS ST. •COUNTY /� ivyy �� e ' CERT.No.Y4,f i EXPIRES® _LOCATIONOF SEITICTANK, 0 GESSPOOL z MAIL pmjADDRESS ) 1?a O NORTH O IAM THE—CEGAC POSSESSOR OFeTHE ABOVB LOS ANGELES COUNTY CERTIFICATv F UAL'IFICATION. • ' �� PLUMBB� 1 AM THE LEGAL OWNER O HE PROPERY DESCRIBED ABOVE. v a OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK i HATH TUH FURNACE n SHOWER DISHWASHER O LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SANDTRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE IN8VECTOR'8 NAME /WATER NEATER DENTAL LAVATORY ROUGH PLUMBING GA9 6ODA FOUNTAIN GAS PIPING dun. / GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK I I CESSPOOL._' EPTICTANK SEWER S ,py {yam -UTILITY CO.NOTIFIED TOTAL FEE � FINAL WORKER'S COMPENSATION DECLARATION 20-0026 DPW 9/89 APPLICATION FOR PLUMBING PERMIT 'l6A667A I'hereby affirm that I have a certificate of consent to self insure, • or a certificate of'Worker's Compensation Insurance, or a certified copy thereof(Sec 3800 Lab. C) " COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS DEPT. OF PUBLIC WORKS DIV. � Policy No Company - • '*I "' t Certified copy is hereby furnished ` BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE)❑ ADDRESS Certified copy is filed with the county building inspection department NUMBER FIXTURE OR ITEM den FEE LOCALITY' Date Applicant WATER CLOSETl BATH TUB NEAREST �V''v r /J� CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST �r COMPENSATION INSURANCE ASSESSOR p (This section need not be completed if the work involved by the 1 SHOWER MAP BOOK u PAGEPARCEL Y permit Is for one hundred dollars($100)or less.) OWNER I certify that in'the performance of the'work'for which this permit LAVATORY is issued, I shall not employ any person in any manner so as to SINK MAIL ADDRESS - become subject to the Workers' Compensation Laws. _ .. DISWASHER CITY TEL NO Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of CONTRACTOR r Exemption,you should become subfect to,the Workers'Compensation � SWIMMING POOL RECEPTOR ADDRESS - provisions of the Labor Code, you must forthwith comply with such _ provisions or this permit shall be deemed revoked. - _ LAWN SPRINKLER SYSTEM _ LICENSED CONTRACTORS DECLARATION CITY _ TEL NO } I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER - - 1, fl (commencing with Section 7000)"of Division 3 of the Business and STATE LIC NO CLASS 0 Professions Code,and my license is in full force and effect GAS SYSTEM OUTLETS _ (� OUTLETS OVER DISTRIYO� BY 5 PER SYSTEM 0 License Number Lic.Class FINAL ATE ��J VAL3PATION = 1•I D �� l t=•_�,i=. Contractor Date FINAL , 4 T iT 1��1 t� C0 ❑I am exempt under Sec. C90 cro BY TI TTL '35 - 6t B.&P C for this reason ' Date: Plan check fee CHECK 85.65 ' Signature _ PLUMBING PERMIT ISSUING FEE$ �js I '•:HHE fl' �(!il TOTAL FEE j, (0J ❑ Plan check applicant 0000-9 T? k'•r SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name d T / AN 1-12 I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031 5, Business and Professions Address -- ' 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 7044,•Business and Professions Code) _ t CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the .performance of the work for which this permrt.is issued (Sec. 3097, Civ.C.) Lender's Name % Lender's Address 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 representativ s of this County to nter upon the above-mentioned prop or mspBc0 purpose >> �v SEE REVERSE FOR EXPLANATORY LANGUAGE Sig ature of Permittee ate Jr "t :WORKER'S COMPENSATION DECLARATION 76AW DPW 9189 APPLICATION .FOR PLUMBING PERMIT " I hereby affirm that I have a certificate of consent,to self insure, or a certificate of Worker's Compensation Insurance, or a certified - copy thereof(Sec 3800 Lab.C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS ;: DEPT.OF,PUBLIC,WORKS,DIV. Policy No Company El Certified copy is herebyfurnished. BUILDING � j / -4-� `` ,I// ❑ FOR'APPLICANT TO FILL IN(PRINT OR TYPE). ADDRESS Z 1 rl f�VV e_. U40;�, Certified copy is filed with the county building inspection department. NUMBER FIXTURE OR ITEM FEE LOCALITY Date Applicant WATER CLOSET ae I - NEARE CROSS ST !-Uw Iii AZUSr1 CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB t COMPENSATION INSURANCE ASSESSOR. �� / (This section need not be completed if the work involved by the SHOWER - MAP BOOK' ) PAGE �(o PARCEL�- permit is for one hundred dollars($100)or less.) OWNER 1• LAVATORY !_` MAIL I certify that in the'performance of the work for which this permit is issued;") shall not employ any person in any manner.so as to 'SINK _ _ ADDRESS - become subject to the Workers' Compensation Laws. DISWASHER CITYIl TEL.NO Date -Applicant CLOTHES WASHER ' CONTRACTOR NOTICE TO APPLICANT: If, after making this Certificate of Exemption,you should become subject to'the Workers' Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such ADDRESS provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM /- LICENSED CONTRACTORS-DECLARATION, CITY TEL'NO. I hereby affirm that I am,licensed under provisions of Chapter 9 WATER HEATER (commencing with Section 7000) of Division 3 of the Business and l STATE LIC. O LICENSE NO CLASS Professions Code, and my license is in full force and effect GAS SYSTEM OUTLETS V _ OUTLETS OVER DISTRICT NO. PROCESSED BY 5 PER SYSTEM ro� Q License Number Lie.Class c J V DINAL? ` 'q,p VALIDATION W ' DATE J 3_// d: Contractor Date iyt_C�.$ CD FINAL //f - -- -- Z ❑ I am exempt under Sec BY " 355 E BiD r.r.a. i•_ B.BP.C.for this reason ITEM Date Plan check fee PLUMBING PERMIT,ISSUING FEE$ ,� ' TOTAL— 35 Signature ® � `J r- � g / TOTAL FEE IIEL•I. Plan check applicant �- °FRJ SINGLE FAMILY - HOME OWNER-BUILDER DECLARATION Name i I hereby affirm that I am exempt from the Contractor's License Law r� i si,�; for the following reason (Section 7031 5, Business and'Professions Address � rL / 11 Code), City Tel No. / li.:r0 , � AM :0 j 1, as owner of the property,will do the work'and the•structure -- isnot intended or offered for sale (Section 7044, 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 1 • � _- ` s v I certify that I have read this application and state that the above t information is correct. I agree to comply with all County ordinances o and State laws regulating Pumbing, and hereby authorize representatives of this Coun o enter upon the above-mentioned \ proper pVy ion Flurperes. i— SEE'REVERSE FOR EXPLANATORY LANGUAGE Signature of Permitte ate �� 1 /