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Home My Public Portal About4906 HELEO AVE_Plumbing__ D.B.S.17 25M BETS 1-48 APPLICATION FOR JrT DEPARTMENT OF BUILDING ANANDSAF' COUNTY OF LOS ANGELES WM.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. P ZONE PERMIT NO. 1 ROUGH FIXTURES COMPLETE R, as A® A NEATER _GE88?OOL I-I SEPTIC TANK RECg�/ED HY READY FOR FIRST INSPECTION g ISS ED � -- yam„ � GA - MISCELLANEOUS ' Aef f APPLICANT FILL IN HEAVILY OUTLINEID PORTION ONLY JOB d, NAME ADDRESS - 0 ADDRESS LOCALITY g NEAREST `1 Q A .N'eV� _ CITY TEL.NO. CROSS ST. 6 COUNTY CERT.NO. EXPIRES W NAME LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL , I � 3 ADDRESS NORTH O �j tt e CITY TEL.NO. '/ P P 1 AM THE LEGAL POSSESSOR OF THE r OVB LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. � .y 3 OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK a Y BATH TUB FURNACE _SHOWER DISHWASHER O -LAVATORY REFRIGERATOR _KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP GLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME _WATER HEATER '-DENTAL LAVATORY ROUGH PLUMBING METEQ ==LGAS SODA FOUNTAIN OUTL GAB PIPING GAS VENT 'CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOL SEPTIC TANK SEWER 8 TOTAL FEE UTILITY CO.NOTIFIED �`V FINAL 70,A667 17 2SM SETS 7-49'' - APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY " COUNTY OF LOS ANGELES WILLIAM'J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRI:CTjA7O. GROUP ZONE PERMIT PLUMBER RECEIV Y READY FOR ' DATE ISSUED T FIRST INSPECTION e ' ADDRESS � CITY -TEL. No. JOB ADDRESS COUNTY T / LICENSE NO. EXPIRES �, LOCALITY 0 1,,,.ocGga�„a�,0 't.�! ��3 - 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS NEAREST - vx ANGELES COUNTY- LICENSE. - CROSS- aw_-.•,d.sai .(,p'):.,,:- _,,I2 91C OWNER / � [7 MAIL fd! ' PLUMBER ADDRESS PERMIT FEE IS $1.00 FOR THE FIRST FIXTURE OR CITY t, '.Y`--:q-' TEL. NO. tt ITEM LISTED BELOW, PLUS 50C FOR EACH ADDITIONAL I AM THE LEGAL OWNER OF THE RESIDE01 IAL PROP-. ITEM. FOR EACH SEPTIC TANK AND PIT OR DRAINFIELD ERTY DESCRIBED ABOVE. $1.O0. MINIMUM FEE FOR ANY PERMIT. $.1.00. EACH - ,q GAS SYSTEM IS A SEPARATE ITEM. OWNER NUMBER TYPE OF FIXTURE OR ITEM .. WATER CLOSET-(TOILET) CORRECTIONS - BATH TUB - - SHOWER LAVATORY (WASH BASIN) - - KITCHEN SINK LAUNDRY TUB OR TRAY - GAS SYSTEM OUTLETS WATER HEATER - - SLOP SINK - Q -FLOOR SINK -Z FLOOR-DRAIN - E9 DISHWASHER - ii O DRINKING FOUNTAIN - URINAL - - MI5CELLANEOUS I APPROVALS. • DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT -CESSPOOL SEPTIC TANK - DRAIN ( ) PIT ( ) a SEPTIC TANK CESSPOOL $ 'SEWER HOUSE SEWER $ GAS TEST /�•1 UTILITY CO. NOTIFIED TOTAL FEE C FINAL. WORKERS'COMPENSATION DECLARATION 76A667A n p �p p p p �p I hereby affirm that I have a' certificate of"consent to self ce z-8o) A I�P L�I C A T�Q,u CI F®�L�U M� �1�1 G PERMIT insure, or a certificate of Workers'Compensation Insutance,or � ' . a certified copy thereof(Sec. 3800,Lab.C.) J COUNTY OF LOS AiUGELES � � BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING' a, ADDRESS Certified copy is filed with the county building inspection NUMBER FIXTURE OR,ITEM O FEE 9O(QLG S7�` 'I,partment. LOCALITY �o Date Applicant I WATER CLOSET,.'. NEAREST BATH TUB CROSS ST. fcos A- CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER LAVATORY MAIL >_(This section need not be completed if the work involved ADDRESS a by the permit is for one hundred dollars ($100) or less.) SINKO CITY TEL NO��•s'uCl'L? U I certify that in the perform e of the work for which this DISHWASHER CONTRACTOR I permit is issued, I shall not em toy in any anner Q. so as/tombecome subject to th W p ati Laws. CLOTHES WASHER ADDRESS 2i (� Date? Applica SWIMMING POOL RECEPTOR LU, NOTICE TO APPLICAN f, after making this Certificate of 76ITY TEL. NO. to Exemption, you shout become subject to the Workers' LAWN SPRINKLER SYSTEM � � STATE LIC. Z Compensation provisions of the Labor Code, you must forth- t LICENSE NO. V CLASS with comply with such provisions or this WATER HEATER p y p permit shall be !� deemed revoked. v DISTRICT NO. PR CESSED BY GAS SYSTEM OUTLETS A t v LICENSED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINAL VALIDATION ness and Professions Code, and my license is in full force and DATE ( J effect. — FINAL / License Number Lic:Class BY •�.��--O Contractor Date I am exempt from the licensing requirements as I am a' Plan Check fee: licensed architect' or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ S Q acting in my professional capacity (Section 7051, Bus- iness and Professions Code). s0 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 0'3.7 41. 1 A License Law for the following reason (Section.7031.5, Busi- City Tel.No. ' ness and Professions Code): # o'o 0 0 0 5 I, as owner of the property, am exclusively contracting L o-.2.11,5�, with licensed contractors to construct the project (Section 7044, Business and Professions Code). ;o*o i 0 2/L 5 0 CONSTRUCTION LENDING AGENCY 4,2 2-.;8 2 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 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 ord' an s and State laws regulating Plumbing, and hereby au r' rese atives of�this County to enter upon the a o e yen i p o e/ty6r inspection purposes. �22"3 C�- • Signature of Permittee Date