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HomeMy Public PortalAbout6032 IVAR AVE_Plumbing__ 76AS67 DBS 17 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LAS ANGELES PLUMBING WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN I RPC O. ROUP ON p {^/ � .'1n/ S PLUMBER /1 p�.P�., Q: /Y l•1NVlAaC. RECEIVED BeY}, READY FOR DATE ISSUED ADDRESS d q 25_ 'l, 4 � 0, ' I2bd (/3pxq)�--5_�(_ FIRST INSPECTION �/ // r3 BUILDING O CITY A TEL. NO. ut �' ADDRESS ,I {►UZW OA" j - /, I COUNTY s � .. .. i "'-.d LOCALITY Civlail,.Cx. \_.1i(.0 l-AX�.�/ LICENSE NO.. `�' 1 EXPIRES - .��-s•., Y NEAREST PERMIT FEES ! CROSS ST. /1 NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET(TOILET) � 0.50 $ ADDRESS (� �/j� /I V I.V✓ ,�J �/ BATH TUB @ 0.50 CITY 4'p' l''A TEL. ND. SHOWER @ 0.50 1 HEREBY I 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 @ O.SO AND STATE LAWS REGULATING PLUMBING. I• CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB LAUNDRY TUB OR TRAY @ O.SO ANGELES COUNTY LICENSg.,OR I AM THE LEGAL OWNER OF THE RESIDENTItYP F i BTT•,DESCRIBE ABOVE. GAS SYSTEM OUTLETS @ 0.50 :• )/� /� /� SIGNATURE OF WATER HEATER @ O.�Sfl (�'�/� PERMITTE "`' '•�''"� r SLOP SINK @ 0.50 INSPECTIO; IIEC:ORD / 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 O Q' O APPROVALS > - DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING ' .f. GAS VENT v. I CESSPOOL @ 1:00 CESSPOOL --SEPTIC TANK: SEPTIC TANK. ' DRAIN (- ) PIT ( ) @ 1.00 SEWER PERMIT I 1.00 GAS TEST TOTAL FEE UTILITY CO. NOTIFIED A Igo FINAL 7 A667 IDB S•17 10.55 APPLICATION FOR PLUMBING PERMIT DIVISION OF BUILDING AND"SAFETY Deportment of County Engineer County of Los Angeles BUILDING16� �y JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS (D CASSATT D. GRIFFIN •SUP'T OF BUILDING /J LOCALITY FOR APPLICANT TO FILL^ R NEAREST �. CROSS ST. OWNER DISTRICT�O� `GROUP ZONE READY FOR INSPECTION MAIL .� ADDRESS Q3 11INDUSTRIAL CITY / TEL..NO. / WASTEAPPROVAL PLUMBER ,U�7° INSPECTION RECORD ADDRESS°//Q/ 7 n' CITY 'TEL. NO. 2 s LICENSE NO. �✓ NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 $ .ih., BATH TUB @ $1.00 SHOWER @ $1.00 LAVATORY (WASH BASIN) @ $1.00 KITCHEN SINK @ $1.00 fi DISHWASHER @ $1.00 LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @ $1.00 - WATER HEATER @ $1.00 GAS SYSTEM @ $1.00 APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK S PERMIT '$ 00 ROUGH PLUMBING GAS PIPING TOTAL FEE GAS VENT 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY 't HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES -/S— I PLUMBING. IHEREBY CERTIFY TH T I M P ERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED Y LO A RLES COUNTY AND TATE OF CALIFORNIA OR THAT I SAM H ,L GAL OWNE OF HE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL P P 1 SIGNATURE •.� �Ls OF PERMITTEE �' FINAL JOHN A. LA E, COUNTY ENGINEER VALIDATION ROBERT A.WOOD, CHIEF PLBG. INSPECTOR CASH U : .:2=9194FEB25 . 5A4.00 it WORKERS'COMPENSATION DECLARATION /;�l PP(� �C/,a 5r�QN .F©R ILII [) []fl(���r�p�a pERnj�8 Il I hereb affirm thata have o certificate of consent to self in- 20-0026.6PW 4/90 G�1 Is G�1 ll Q 11V IT h� lT LSV uvu$ ��] l� IJ\SUVII Y� 76A667A sure,or a•Certificat4 of Workers'Compensation.Insurance,or'a n certified copy thereof (Sec. 3800, Lab. C.) - U Policy-No. Company COUNTY OF. LOS-ANGELES ' DEPT. OF PUBLIC WORKS F-] 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(TOILET) / Date Applicant ' / © NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. SS COMPENSATION'iNSU RANCE SHOWER -d OWNER l� (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) / LAVATORY ADDRESS Z I certify that in the performance of the work for'which this per- SINK. mit is issued, I shall not employ any person in any manner so CITY TEL. NO. as to become subject to the Workers'Compensation Laws. DISHWASHER -5� rl Date. 5- , Applicant � CLOTHES WASHER CONTRACTOR � `x+""J•' NOTICE TO APPLICANT: If, after making this'Certificate of Ex- ADDRESS ZAt, V- emption,you should become subject to the Workers':Compen- SWIMMING POOL RECEPTOR CITY TEL. NO. $-7 ef ') +Z4 sation provisions of the Lab,),Code, you must forthwith comp- LAWN SPRINKLER SYSTEMS t ly with such provisions or this permit shall be.deemed revok- STATE LIC. ed. WATER HEATER • LICENSE NO. (k I CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETSC -e�� J 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is,.in full.force and ef- 5 PER SYSTEM FINAL ALI DATION fect. HOSE BIB. DATE _ ' License Number 3 ��� Lia Class &r` a O FINAL ACCT.e U Contractor Date 5-�1—��' BY -,-� 3303 91e70 cE I am exempt under Sec. B.&P.C. for this reason Plan Check fee91 - 70 Date: TOTAL ca PLUMBING PERMIT ISSUING FEE$ Q CASH 91.70 T: Signature g. '. TOTAL FEE ,0I� SINGLE FAMILY CHANUE HOME OWNER-BUILDER DECLARATION .. Plan check applicant I•hereby'affirm that I am exempt from the Contractor's License Name8 i Law for the following reason (Section 7031.5, :Business and — �� r"7l '�/g''u Professions Code): Address 6293 1 Ali 8:44 0 I, as owner of the property, will do the work and the' City Tel. No. structure is not intended or offered for sale(Section 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm.that there iso 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 ordinances and State laws regulating Plumbing, and hereby ortsentatives of this County to enter upon the above enti ed p rty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee ' Date