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Home My Public Portal About5516 HALLOWELL AVE_Plumbing__ 76ASS7 17 15-49® APPLICATION FOR PERMIT DEPARTMEIJT OF BUILDING AND SAFETY -COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. J— = 14-I �I� 5 VF PLUMBER w p RECEIVED BY READY FOR DATE ISSUED n FIRST INSPECTION / ADDRESS _ -y ^� Y-7 C G � ��A6 BUILDING CITY L H TEL. NO. ADDRESS COUNTY /�0 �� EXPIRES /`�� Si A LOCALITY /e / LICENSE NO. NEAREST PERMIT FEtS CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER N O U MAIL f WATER CLOSET (TOILET) @ O.50 ®� ADDRESS f BATH TUB Q 0.50 b CITY TEL. NO. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) Q 0.50 O d APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK Q 0.50 STATE LAWS REGULATING PLUMBING. / ^ 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS E f Q ��/ ANGLES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER LAUNDRY TUB OR TRAY 0.50 @0.50d OF THE RESIDENTIA/ PROPERTY DESCRIBED ABOVE. GAS SYSTEM OUTLETS SIGNATURE OF / WATER HEATER 0.50 515 PERMITTE 111 SLOP S I N K @ 0.50 INSPECTION RE FLOOR SINK @ 0.50 A. FLOOR DRAIN @ 0.50 DISHWASHER Q 0.50 _I II V IL�T i.V-G+, Cif DRINKING FOUNTAIN @ 0.50 �� lit�� /✓-Cs URINAL @ 0.50 - .J HOUSESEWER Q 0.501 Z MISCELLANEOUS Q.' APPROVALS DATk INSPECTOR'S//NAME ROUGH PLUMBING GAS PIPING GAS VENT Ieee CESSPOOL Q 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) Q 1.00 SEWER a PERMIT . 1.00 GAS TEST UTILITY CO. NOTIFIED TOTAL FEE $ ly() - FINAL Yexee> rr -rs. ®. APPLICATION FOR PERMIT DEPARTMNT OF-BUILDING AND SAFETY COUNTY .MJF LOS ANGELES' L WILLIAM J.` FOX. CHIEF ENGINEER 3ICTFOR APPLICANT TO FILL IN DISTRNO. GROUP lJNE 4PER�11'1;X10. • /J ) �..hh�� A .w�./y7 3 L3 RECEIVED BY READY FOR DATE ISSUED PLUMBER �� S,t-i / FIRST INSPECTION ADDRESS 3 � f1//„iLsA �v�'" 0 BUILDING 14 >"... cITl ,�/,�+�a'./�tLiltiil ,fs',f,IF1,:TEL. NO `/ % J //!/1 ADDRESS COUNTY LOCALITY LICENSE NO EXPIRES NEAREST PERMIT FEES- cRoss ST. 4PA a NUMBER I TYPE OF FIXTURE OR ITEM FEE OWNER / �I�yh/fApfy^ ..+„/J MAIL le < < WATER CLOSET (TOILET) Q 0.50 $ I ADDRESS BATH TUB Q 0.501 II CITY TEL. NO. ISHOWER Q 0.501 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) Q 0.501 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINKQ 0.50 I STATE LAWS REGULATING PLUMBING. I CERTIFY THAT t POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY Q 0.50 ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED •HOVE. GAS SYSTEM OUTLETS '" Q O.50 WATER HEATER Q.0.50 SIGNATURE OF PERMIT O SLOP SINK Q 0.501 INSPECTION RECORD FLOOR SINK Q '0.50 I FLOOR DRAIN Q 0.50'1 DISHWASHER Q 0.501 DRINKING FOUNTAIN Q 0.501 .i / S,to URINAL .Q 0.501 HOUSE SEWER Q 0.5011. _Z MISCELLANEOUS 0 I •I� I I • I APPROVALS DATE INSPECTOR'S NAME ROUGH' PLUMBING GAS PIPING ��} GAS VENT CESSPOOL Q 1.001 LJ CESSPOOL SEPTIC TANK: I SEPTIC TANK / 7a DRAIN ( ) PIT ( ) Q 7.00 1 SEWER / PERMIT'. I.00 GAS TEST I I(� ® UTILITY CO. NOTIFIED TOTAL FEE $ 1 FINAL G� G s J ,I .,WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT • -I,kereby affirm that I have a certificate of consent to self 20-0026 DPW 6/87 insure, or a certificate of Workers' Compensation insurance, 76A667A or a certified copy thereof (Sec. 3800, Lab C ) COUNTY OF LOS ANGELES DEPT, OF PUBLIC'WORKS 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 inspec- ADDRESS /6 HAA L0-1.JA5_C L tion department. NUMBER FIXTURE OR ITEM @ 'FEE LOCALITY WATER CLOSET Date Applicant'- NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS'. BATH TUB CROSS ST. f 1/ IY T COMPENSATION INSURANCE SHOWER k OWNER EA RJ0'a ' (This'section need not be completed if the work involved by MAIL the permit Is for one hundred dollai.s ($100)or less.) LAVATORY ADDRESS..S, 6 .19Al LD k/� L I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CI7Y��j�� TEL. N6"" y-�'7 so as to become subject to the Workers'Compensation Laws DISHWASHER CONTRACTOR Date- /applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS " SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY TEL NO Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT.NO PROCESSED BY 1 hereby affirm that I am licensed;under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of-the Business OUTLETS,OVER and Professions Code,and my license is in full force and effect 5 PER SYSTEM FINAL VALIDAT16N Z O. License Number Lic. Class DATE __e7 • FINAL Contractor Date BY 4 -• 3 n= ❑ I am exempt under SecVil� L7d W B.BP.0 for this reason �l Plan check fee ® i�" Z Date PLUMBING PERMIT ISSUING FEE$ {• 0-rel( 8 .f 1''4 ' 5• Signature i m _s TOTAL FEE CCE,;K I?2 y -5 Plan check appliccint p_ {`M l ? SINGLE FAMILY `�- 1 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Law for the followingreason Section'7031 5, Business and Address Professions Code) City Tel No '� ® .I, as owner of the property, will do the-work and theme - structure is not 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 Nome 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 ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the ; above-mentioned property fo inspection purposes . SEE REVERSE FOR EXPLANATORY LANGUAGE QSAnciture' of rmittee Date WORKERS'COMPENSATION DECLARATION 76A667A I here))y affirm that I have a certificate of consent to self CE e17 (2-80) APPLICATION FOR PLUMBING P E-RMI T insure, or a certificate of'W'orkers'Compensation Insurance,or a certified copy theieof(Sec. 3800,Lab C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy•is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING f I' - E] Certified copy is'filed With the county building-inspection NUMBER FIXTURE OR ITEM • FEE ADDRESS�`� LOCALITY �(' �� department. WATER CLOSET Date Applicant NEAREST. 1 BATH TUB ROSS ST. Ll v CERTIFICATE OF EXEMPTION FROM WORKERS' e COMPENSATION INSURANCE SHOWER r OWNER MAI L (This section need not be completed if the Work involved LAVATORY r ADDRESS vd ��.✓�At"°`��.�m } by the permit is for one hundred dollars'($100) or less.) �/ O SINK CITY TEL. NO. Y I certify that in the performance of the work for which this DISHWASHER V -permit is issued, I shall not employ any person in any 41�anner CONTRACTOR so as to become subject tot a Worker o ensationy ws. CLOTHES WASHER Q ADDRESS Date Applicant SWIMMING POOL RECEPTOR U NOTICE TO APPLICANT: If4fter'maki this Certifica off' CITY TEL. NO. W Exemption, you should become subject to the Workers' LAWN SPRINKLERSYSTEM STATE LIC. N Compensation provisions of the Labor Code, you must forth- LICENSE NOCLASS Z with comply with such- provisions or ,this permit shall be WATER HEATER ,90 . deemed revoked. DIST CT NO. PROCESSED,BY GAS SYSTEM OUTLETS p� LICENSED CONTRACTORS DECLARATION OUTLETS OVER 'a I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi-, FINAL VALIDATION ness and Professions Code, and my license is in full force and DATE effect. FINAL License Number Lic.Class BY Contractor Date 0 I am exempt from the licensing,requirements-as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT,ISSUING FEE$ Q acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE 0 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, Bus, City Tel.No.o nes7 1 4 A s and Professions Code - � _ #000005 I,-as owner of the property, am exclusively contracting with licensed contractors to construct the project2 0'0 Q 5 Q (Section 7044, Business and Professions Code). . , CONSTRUCTION LENDING AGENCY o 0 0 }6 S O tzi 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 • r 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 i,hereby authorize repr entatives of this County to enter upon the above-mention p opy for inspecon purposes; ; Si nature of Perrittee 'Bate