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Home My Public Portal About6047 HART AVE_Plumbing__ Irl"SumBi DEPARTMENT OF COUNTY ENGINEER ' DIVISION OF BUILDING ARID SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES gU I L D I N G WILLIAM J':. FOX, COUNTY ENGINEER ADDRESS I FOR APPLICAN TO ILL IN' LOCALITY , BUILDINGNEAREST ADDRESS ® GROSS ST. / Y DISTRICT NO. GROUP ONE PERMIT NO. LOCAL�TY �G'f lTi? 5-7 CROSS ST. r �ED BY Ready for Inspection DATE ISSUED OWNER MAIL INDUSTRIAL ADDRESS 1 WASTE APPROVAL CITY TEL.NO. INSPECTION RECORD PLUMBER` p ADD ,�} a ADDRESS Q `� +� 14- CITY TEL.NO. ❑STATE LICENSE NO. /Ga ad ❑ COUNTY .J PERMIT FEES z 4UMSER TYPE ❑F FIXTURE OR ITEM FEE ur WATER CLOSET(TOILET) @ 0.80 S V D BATH TUB @ 0.80 �V SHOWER @ 0.80 LAVATORY (WASH BASIN) @ 0.80 pyQ KITCHEN SINK @ 0.80 I5 LAUNDRY TUB OR TRAY @ 0.80 SLOP SINK @ 0.80 FLOOR SINK @ 0.80 FLOOR DRAIN @ 0.80 DISHWASHER @ '0.80 DRINKING FOUNTAIN @ 0.80 URINAL @ 0.80 f,r1� GAS SYSTEM.- -? __OUTLETS @ 1.00 �[/ WATER HEATER @ 1.00 0 MISCELLANEOUS' ., it 0 APPROVALS DATE INSPECTOR'S SIGNATURE' __•' UNDER SLAB WORK �/` PERMIT $ 1 00 ROUGH PLUMBING f�,l il`l, TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- GAS VENT I:ATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER T 7- To COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS �p REGULATING PLUMBING. a PLUMBING FIXTURES. G — ( 5 ��✓� AND/OR LICENSED FY HEREBY CERTIAS R THAT QUIREDABYPLOS ANGE ROPERLY ES REG(COUNTY GAS TEST STERED ��, /, >-A/ IeW,AND STATE OF 1 THAT I AM THE LEGAL ER OF THE AB UX D SCR B DORNIAR RESIDENTIAL PROPERTY.OWN UTILITY CO.NOTIFIED SIGNATURE OF PERMITTEE--_ _... _.........._...------....... FINAL /'1—St, ( ' - 70A667 IDBS 17 'db )2-53 DEPARTMENT OF COUNTY ENGYNEER L DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES BUILDING WILLIAM J. FOX, COUNTY ENGINEER ADDRESS CD 1— FOR APPLICANT TO FILL IN LOCALITY ( BUILDING C CROSS ST. ADDRESS � �Y tr>C � /T / DISTRICT NO! GROUP ZONE 1 PERMIT N0. LOCALITY � y/ �� NEAREST per, /� „ J iii U CROSS ST. {/��RECEIVED BY Ready Ready for Inspect on DATE ISSUED OWNER ' -.AV CN'/,tm � � MAIL INDUSTRIAL ADDRESS WASTE APPROVAL CITY TEL.No. INSPECTION RECORD PLUMBER G,V` f L:-I /� 1 !!u (Y ADDRESS S� L '� l.? . � ,..-.y Jv '�✓ , CITY �fj((/� -+%�,��+ — TEL.N0. LICENSE N0. C, ❑COUNT)' J PERMIT FEES Q _z NUMBER TYPE OF FIXTURE OR ITEM FEE ur WATER CLOSET(TOILET) @ 0.80 S O BATH TUB @ 0.80 SHOWER @ 0.80 LAVATORY(WASH BASIN) @ 0.80 KITCHEN SINK @ 0.80 LAUNDRY TUB OR TRAY @ 0.80 SLOP SINK @ 0.80 FLOORSINK @ 0.80 FLOOR DRAIN @ 0.80 DISHWASHER @ 0.80 DRINKING FOUNTAIN @ 0.80 D URINAL " @ 0.80 GAS SYSTEM._._.... @ 1.00 O d ------ff-- WATER HEATER @ 1.00 MISCELLANEOUS APPROVALS : DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING _ TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GAS VENT CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN- ER OF THE ABOVE ESCRIBED ESID TIAL PROP Y. UTILITY CO.NOTIFIED SIGNATURE / r � / OF PER MITT EE........ __._.. 4 --- -----_- ............."� FINAL -J �U�LF lam(/h bvLa_ 76A667 DBS 17 1/53 WORKER'S COMPENSATION ate of consent to 76A666DPW9/69 APPLICATION FOR PLUMBING PERMIT 76A667A u�1f � U u�'u Lp u�f PERMIT 1 hak'eby affirm that I have a certificate of consent to self insure, or a certificate of Worker's Compensation Insurance, or certified copy thereof(Sec.3800 Lab.C.) - COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policy No. Company Certified copy is hereby furnished. BUILDING EJ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Certified copy is filed with the county building'inspection ' department. NUMBER FIXTURE OR ITEM Q FEE 'LOCALITY ' Date Applicant WATER CLOSET NEAREST CROSSST. arl10ERTIFICATE OF EXEMPTION FROMBATH TUB ,WORKERS' CI C /� COMPENSATION INSURANCE, ASSESSOR (j o//' /�/� (This section need not be completed if the work involved by the SHOWER MAP BOOK Q PAGE /_ PARCEILJ :j permit is for one hundred dollars($100)or less.) OWNER j�' I certify that in the performance of the work for which this permit LAVATORY / C;71; is issued, I shall not employ any person in any manner so as to SINK % MAILAl become•subject to the Workers' Compensation Laws. ADDRESS , QvT DISWASHER CITY Gj p ` TL TEL.NO. �/y Date Applicant CLOTHES WASHER l ',rte CONTRACTOR NOTICE TO APPLICANT: If, after making this Certificate of Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such ADDRESS provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL.NO. I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER - ' CL (commencing with Section 7000) of Division 3 of the Business and STATE LIC. 0 Professions Code,and my license is in full force and effect. GAS SYSTEM OUTLETS /� O LICENSE NO. CLASS U OUTLETS OVER DISTRICT NO. PROCESSED BY O 5 PER.SYSTEM �/� Q� \ 0 License Number Lic.Class Chi V FINAL W DATE _ VALIDATION Contractor Date (n ❑ I am exempt under Sec. FINBY AL Z B.&P.C.for this reason Date: Signature Plan check fee PLUMBING PERMIT ISSUING FEE$' 7 o ® c , ❑ TOTAL FEE 3 ACCToa SINGLE FAMILY Plan check applicant 3,603 43040 HOME OWNER-BUILDER DECLARATION Name `, 1 ITEMS I hereby.affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Address TOTAL 43 m 40 Code)- City Tel.No. CHECK 43 a 40 I,as owner of the property,will do the work and the structure I t' Q0 is-not intended or offered for sale (Section 7044, Business CHANGE and Professions Code). 1 n CONSTRUCTION LENDING AGENCY ryn i -. i t I hereby affirm that there is a construction lending agency for the 0000-0001 3/21/96 performance of the work for which this permit is issued (Sec. 3097, • 5448 1 AM11*42 Civ.C.) Lender's Name 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 propert for inspection urposes. I SEE REVERSE FOR EXPLANATORY LANGUAGE Alu ignature of Permittee Dae 9