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HomeMy Public PortalAbout5426 HILTON AVE_Plumbing__ bslcseDaT. . s-av ® - APPLICATION FOR PERMIT P�ARTIANT OF BUILDING AND SAFETY /( r "PLUMBING COUNTY OF LOS ANGELES . WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PEr,R-MTIT NZO. PLU"T'I 1PLUMBING 1 ' 1 i In r� MTR IYrY DRS RECEIVED BY READY FOR DATE ISSUED � t`'Y���T't 1`�t�� O���TVTT'Z'f'TGT« ,�� FIRST INSPECTION /� -�'� ADDR^iE' S W. Garvey - Monterey Park fnlif � /� ����.���cc.._�� A1'lantic 2-4654 ( rmgk�prland 3-1040 ADDRESS TOG to I© . V-C�aI-T BUILDING CITY 146 �E `}std. / /( LICENSECOUNTY NO. / \ � EXPIRES KJ /JCI /�').r LOCALITY t, <i �"'E� NEAREST PERMIT FEES CROSS ST. NUMBER I TYPE OF FIXTURE OR ITEM FEE OWNER p MAIL l WATER CLOSET (TOILET) @ 0.50 I S I�� ADDRESS BATHTUB (� O.SO L� CITY TEL. NO. SHOWER O.SOhG I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) I 0.50 'APPLICATON AND STATE THAT THE ABOVE IS CORRECT AND @ p•Q AGREE TCOMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK C) 0.501 STATE LAWS REGULATING PLUMBING, I CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY (a) 0.so ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER // OF THE RESIDENTIAL P ERTY IBEDr ABOVE. I GAS SYSTEM OUTLETS (lbO.SOI 1-?� SIGNATURE OF / WATER HEATER R O.SO -K'7:;, PERMITTEE SLOPSINK C o.so INSPECTION RECORD FLOOR SINK O.SO I _ FLOOR DRAIN (a 0.so DISHWASHER Qji O.SOI DRINKING FOUNTAIN CnJ 0.501 1 URINAL @ O.SOI _J HOUSESEWER (a 0.501 Q Z MISCELLANEOUS U' Fr I I I �— APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING - GAS PIPING GAS VENT CESSPOO1.00 __ CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) Q 1.00 SEWER PERMIT 1.00 GAS TEST s TOTAL FEE S UTILITY CO. NOTIFIED FINAL J WORKERS'COM have a* ]ON Date of AT[ON CE APPLICATION FOR PLUMBING PERMIT 1 heretiy affirm that I have a certificate of consent to self cE ev (z-eo) insure,or a ceatificate o.(-Workers'Compensation Insurance,or aLLertiji�d co y'7ther4eof(Sec. 3soo,Lab.C.) COUNTY OF LOS ANGELES / r ' ` r BUILDING AND SAFETY J1 icy No��79'/'3 any- -�if/.4 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ADDRESS I Certified copy is filed with the county bui Inspection NUMBER FIXTURE OR ITEM • FEE rt/ Sv ./ n� /' LOCALITY GCSE Date Applicants 7/ /T��II �J WATER CLOSET NEAREST BATH TUB CROSS ST. COM .a/ CERTIFICATE EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER LAVATORY MAIL r (This section need not be completed if the work involved ADDRESS } by the permit is for one hundred dollars (SIOO) or less.) SINKa CITY TEL. NO 1 certify that in the performance of the work for which this DISHWASHER _ U permit is issued, I shall not employ any person in any manner CONTRACTOR so as to become subject to the Workers' Compensation Laws. CLOTHES WASHER ADDRESSJ p a v� L) Dale Applicant SWIMMING POOL RECEPTOR Q TEL. N � W CITY NOTICE TO APPLICANT: If, after making this Certificate of �f,/ Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STAOrELIC. N Compensation provisions of the Labor Code, you must forth- WATER HEATER LICENSE NO. / < < - CLASS�_ I3 z with comply with such provisions or this permit shall be deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. P CES�ED BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER (5 ,0011 I hereby affirm that I am licensed under provisions of Chapter 15 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. / �` ] _ C" FINAL License Number 'J Lic.Cla—ss7-^' �f BY Contrac - Date / F] I am exempt from the licensing requirements as 1 am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus iness and Professions Code). TOTAL FEE rx 3 Lic.or Reg.No. Date Plan check a licant HOME OWNER-BUILDER DECLARATION Name i I hereby affirm that 1 am exempt from the Contractor's Address J:z License Law for the following reason (Section 7031.5, Busi- City Tel. N _ ness and Professions Code): 53. 1 Q ❑ 1, as owner of the property, am exclusively contracting •# o 0 o e o 5 with licensed contractors to construct the project (Section 7044, Business and Professions Code). 'j o 0 1 3 Q Q CONSTRUCTION LENDING AGENCY0 0 0 1 3 0 0 c=a I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is 07.28-81 issued(Sec. 3097,Civ.C.). Lender's Name Lender's Address 1 certify th• ve read this application and state that the above inf fi correct.I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE or'd an Sta a laws regulating Plumbing, and hereby uth iz p sent Lives of this County to ter upon t b med p perry for inspection urp es. Si ' tee D' e