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Home My Public Portal About5237 HALLOWELL AVE_Plumbing__ 76A667 APPLICATION FOR PLUMBING PERMIT .PBS-17 loss DIVISION OF BUILDING AND SAFETY Department of County Engineer County of Los Angeles BUI7,�Y _r6lA4PjF !F A t JOHN A. LAMBIE, COUNTY ENGINEER ADDa[ t'6•' 1 !CASSATT D,.GRIFFINSUP'T•OF BUILDINGLOC / Ty FOR APPLICANT TO FILL IN NEAREST .� � L- �] CROSS ST. cl OWNER g q JL.'., q.J��^I l� DISTRICT NO. GROUP ZONE READY FOR INSPECTION MAIL ADDRESS �7 WA_ a/ Ldlre,�P/-±/ d .�a! CITY r [ TEL. NO,C�I� s�'�G d INDUSTRIAL WASTE APPROVAL PLUMBER INSPECTION RECORD, jl ADDRESS :S CITY TEL. NO. LICENSE NO. NUMBER TYPE OF FIXTURE OR ITEM FEE y+� 4v WATER CLOSET (TOILET) @ $1.00 $ OF BATH TUB @ $1.00 SHOWER @ $1.00 _ 4 LAVATORY (WASHBASIN) @ $1.00 KITCHEN SINK @ $1.00 DISHWASHER @ $1.00 0 L LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @ $1.00 WATER HEATER @ $1 00 GAS SYSTEM @ $1.00 D APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 1 OO ROUGH PLUMBING GAS PIPING vv� TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT'AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF p CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED `�- DESCRIBED RESIDENTI PROPERTY, j,►{qo t�/(j/�� SIGNATURE9 ff y / r OF PERMITTEE- FINAL JOHN`A. LAMBIE, COUNTY ENGINEER VALIDATIOROBERT A.WOOD. CHIEF PLBG. INSPECTOR CK. M.0. CASH ._a,00 0 .1 JJL 2 2 3 2 .00 76KO67 17 5-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING 1 WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO !TO FILL IN �J DISTRIC 0. GROUP ZONEPERMIT NO. PLUMBER J V, �•^�` i `IV V 1� G'•SSI RECEIVED BY READY FOR DATE I SUED I va%l W A_ / FIRST INSPECTION ADDRESS VO• +t ,1 b BUILDING ADDRESS )-b AaA"Je./I7/u= CITY Ir OV�•�V TEL. NlrO-O-)�, �Y COUNTY (Y� ,[/ LOCALITY LICENSE NO. �� • EXPIRES V�• li NEAREST • PERMIT FEES CROSS ST. �y NUMBER TYPE OF FIXTURE OR ITEM FE OWN ERC')] /4e / ' S}�J h• sMAIL �✓V'e'i I / I V WATER CLOSET (TOILET) Cat 0.50 $ '�I ADDRES93 10-r BATH TUB Q 0.501 CITY / SCG/e/Z.Gc TEL. NO.y SHOWER Q 0.50 1 HEREBY ACKNOWLEDGE THAT 1 AVE READ THIS I I LAVATORY (WASH BASIN) Q 0.50 I C APPLICATION AND STATE THAT E ABOVE IS CORRECT AND AGREE TO COMPLY WITH COUNTY ORDINANCES AND KITCHEN SINK Q 0.50 STATE LAWS REGULATIN MBING. J I LAUNDRY TUB OR TRAY Q O.50 I CERTIFY THAT OSSESS THE ABOVE VALID LOS IZ' ANGELES COUNTY ENS OR I AM THE LEGAL OWNER GAS SYSTEM OUTLETS Q 0.50 I I OF THE RESIDE PR RTY DESCRIBED AS VE. SIGNATURE OF, WATER HEATER ICS 0.5.0( r o PERMITT SLOP SINK Q 0.50 I INSPECTION RECORD FLOOR SINK Q 0.50 FLOOR DRAIN Q 0.50 DISHWASHER Q 0.501 DRINKING FOUNTAIN Q 0.501 I URINAL Q 0.501 J HOUSE SEWER Q 0.501 I _Z MISCELLANEOUS - 2 I O I I I I APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING A \ �b 'y a9 GAS PIPING GAS VENT 'CESSPOOL Q 1.00I CESSPOOL SEPTIC TANK: I SEPTIC TANK DRAIN ( ) PIT ( ) Q 1.001 SEWER PERMIT . I 1.00 GAS TEST dsem' UTILITY CO. NOTIFIED TOTAL FEE G•/ FINAL p 1 76AG67 DBS 17 11-50 - APPLICATION FOR PERMIT DEPARTMENT OF BIIILDING AND SAFETY PLUMBING �� ' COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER D . FOR APPLICANT TO FILL IN PLUMBER%' /_ (J �� ' / RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION ADDRESS CITY TEL. No. (/ 6� 9 ADDRESS COUNTY LOCALITY �• LICENSE NO. EXPIRES NEAREST ' PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET(TOILET) @ 0.50 111 ADDRESS BATH TUB @ 0.50 CITY TEL No. SHOWER @ 0.50 I HEREBY ACKNOWLEDGE THAT I 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 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER GAS SYSTEM-OUTLETS @ 0.50OF THE RESIDENTIAL PROPERTY DESCRIVD ABOVE. '��''' SIGNATURE OF WATER HEATER @ 0.50 PERMITTEE 1/ SLOP SINK @ 0.50 INSPECTION RECORD 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 L7 O APPROVALS DATE INBPECTOR'9 NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 1.00 / C� CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT I 1.DD GAS TEST UTILITY CO.NOTIFIED ' TOTAL FEE J� FINAL WORKERS'COMPENSATION'DECLARATION 20-0026 DPW 4/90 APPLICATION FOR PLUMBING PERMIT a,-.I hereby, affirm that I have a certificate of consent-to self in- 76A667A' sae,or a certificate of Workers'Compensation Insurance,or a ,. certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELESDEPT. 0F_PUBLIC'WOR0, Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR'TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @• FEE LOCALITY WATER CLOSET(TOUT), Dote ApplicantNEAREST BATH TUB CROSS ST. AV CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE.' SHOWER OWNS 4 1 4 ° (This section need not be completed If the work Involved by MAIL r the permit is for one hundred dollars(=100)or less.) LAVATORY ADDRESSS L (rJjg 1I I certify that in the performance of the work.for which this per- mit is issued, I shall not employ,any person in any manner so SINK I 4E:, G as to become subject to the Workers'Compensation Laws. DISHWASHER ' CONTRACTOR Date Applicant CLOTHES WASHER, ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of•Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY TEL. NO sation provisions of the Labor Code, you must forthwith comp- LA WN:SPRINKLER'SYSTEMS ly with such provision_s or this permit shall be deemed revok- STATE . LIC. ed. WATER HEATER. LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS D p 9(commencing with-Section 7000)of Division 3 of the Business OUTLETS OVER , - a and Professions Code, and m license is in full force and ef- 5 PER SYSTEM.. FINAL y. q lr� VALIDATION fect.- -HOSE-BIB, DATE a AL License Number Lic. Class - // o C BY 'Contractor Date ACCT.A/ G '" U G 0 1 am exerript,under Sec. 330.3 7hyvu[�U B.&P.C. for this reason LU Plan-check fee 1 ITEM y Date: PLUMBING PERMIT ISSUING FEE$ TOTAL 76 ®41-30a ` Signature r TOTAL FEE �� CHEt)Y 76.80 SINGLE FAMILY. licant Plan check a • -HOME OWNER-BUILDER DECLARATION P pp CHANGE ,00• I hereby affirm that I am exempt from the•Contractor's License Name Law for the following reason (Section 7031.5,.Business and Professions Code):• Address 0000-0001 = , 7/18/96 I, as owner of the property, will,do thework and,the City 'Tel. No. 7552 1 fill 5=015 structure is not-intended or offered for sale(Section 7044, Business and Professions-Code). CONSTRUCTION LENDING AGENCY. I hereby affirm that there is a constructron lending agency for the performance of the work for which this permit is issued " (Sec 3097, Civ C )• , Lender's Name �4 Lender's Address I certify that-I have read this applicationand state that the ?" above information is correct I agree to comply with all County pop. ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above mentioned propert for inspection purposes. -• SEE,REVERSE.FOR EXPLANATORY LANGUAGE. Sig7oture of Permittee WORKERS'COMPENSATION DECLARATION 7GA667A I hereby affirm that I have a certificate of consent to,self CE e» (z-eo) APPLICATION FOR P L U.M B I N G P E R M I T insure,'or a certificate of Workers'Compensation Insurance,or �. a certified copy thereof(Sec. 3800,Lab.C.) . 1 COUNTY OF LOS ANGELES (. BUILDING AND SAFETY I Policy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN'(PRINT OR TYPE) BUILDING �) ADDRESS��C Ul ❑ Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM FEE LOCALITY epartment. WATER CLOSET Date Applicant NEAREST BATHTUB CROSS ST. •CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER G LAVATORYMAI L (This section need not- be"completed if'the work involved ADDRESS / } by the permit is for one hundred dollars ($1,00) or less.) �--a' a SINK CITY TEL.N°��6 0 I certify that in the performance'of-the•work for which this DISHWASHER U permit,is is ued I shall not employ any person in any manner CONTRALTO �� nl ✓ G so a to c e blect to the•Wo Iters' ompe satin •Laws. CLOTHES WASHER ADDRESS 'sem 0 SS� F" SWIMMING POOL RECEPTOR / U W NOT CE TO APPLICANT: If, after making this Certificate of CITY Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE- LIC+� . Compensation provisions of�the Labor Code, you must forth- LICENSE NO. , � 2�/`L—CLASS C . Z-� Z with comply with such provisions or this permit shall be WATER HEATER deemed revoked. GAS SYSTEM OUTLETS DISTRICTf/N O. PR CESSED BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER �i�a I hereby affirm that I'am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINAL �� ` VALIDATION ness and Professions Code, and my license is in full force and DATE f/ !( effect. � a- License Number ?1,21.2 FINAL' L c.Class BY 9�Z � Lft't �1 ate 0�, I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ �'ZG acting ih my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Lic.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address' License Law for the following reason (Section 7031.5, Busi- City Tel.No. ness and Professions,Code): I, as owner of the property, am exclusively contracting R-2006'A with licensed contractors to construct the project (Section 7044, Business and Professions Code). # o 0 0 0 o 5 CONSTRUCTIONS LENDING AGENCY 2 0 0 100 0 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is ° 0 °, 0, 0 0 issued(Sec:3097,Civ.C.). Lender's,Name 1 1, 1 8-8 1 Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purpos s. Signature of Permittee Dafte