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Home My Public Portal About5822 KAUFFMAN AVE_Plumbing__ 76A667C (CE-617B) -9/75 APPLICATION FOR-. PLUMBING PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDINGAl NUMBER FIXTURE@ FEE OR ITEM ADDRESS WATER CLOSET LOCALITY / w7 D NEAREST BATH TUB CROSS ST. ` t.� �/ JOO SHOWER OWNER , Q 1% LAVATORY ADDRESS S�� -2— r*a.t �� 1 /Q SINKy CITY N^ C TEL. NO. Z4;-- DISHWASHER �^`L''�, _(�V CONTRACTOR CLOTHES WASHER U ' ADDRESS 12—L .wJ -1 SWIMMING POOL RECEPTOR • LAWN SPRINKLER SYSTEM CITY I� �` TEL. NO. Z STATELIC WATER HEATER LICENSE NO LBI W CLASS o DISTRICT NO. GROUP ZONE OCE S D BY v GAS SYSTEM OUTLETS OUTLETS OVER /_3 5 PER SYSTEM INDUSTRIAL w WASTE APPROVAL I NSPEC TI ON REC ORD Z Plan check fee PLUMBING PERMIT ISSUING FEE $ TOTAL FEE Plan check applicant Name APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK Address ROUGH PLUMBING City Tel. NO. GAS PIPING v ��• I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED_ AS REOU I RED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALI FO RNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED SIGNATURE q 71501 OF PERMITTEE FINAL PLAN CHECK VALID TION cK. M.o. cns M,0. CASH 0 0 ,nALIDATION G:5 5, 1 0 �' 78A867 -C ENS17 4-64 APPLICATION FOR PLU BING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FADDRESS DING JOHN A. LAMBIE. COUNTY ENGINEER WILLIAM A JENSEN, SUPT OF BUILDING ALITY, FOR APPLICANT TO FILL IN RESTSS 3T. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS SHOWER 1.25 CITY TEL. NO. LAVATORY 1.25 CONTRACTOR % / e SINS 1.25 ADDRESS / 7 lj IV, 0 ZR,17S DISHWASHER 1.25 CITYMa& kale TEL. NO.& L CTOR'S STATE LAUNDRY TUB 1.25 REGIr STRATON NO. 2- e7 CLOTHES WASHER 1.25 .DISTRICT NO. GROUP ZONE PROCESSED BY WATER HEATER 1.50 GAS SYSTEM OUTLETS 1'50 INDUSTRIAL p}„ WASTE APPROVAL 0 OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD /> V It Ir — N APP %{ALS �6ATE1 INSPEC_TgR'S SIGNATURR PERMIT $ 2 00 UNDE B WORK ROUGH PLUMBING 17 ?N; TOTAL FEE GAS PIPING17 jY' I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER '- PLUMBING. 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF D INTEND TO RESIDE IN, THE ABOVE DEB IB[D RESIDENTIAL RTr. UTILITY CO. NOTIFIED SIGNATURE OF PERMITTEE a ' FINAL O LIDATION ROBERT A. OOD 1+1 CK. M O CASH SUPERVISING MECHANICAL RG'R f LACo 2 8 9 9 JUIN 21 5 D 725- 76A667 A tl P L I V A TION FOR PLUMB I lid.A P E Y Y Ilii,�T� . DBS-17 12-54 DIVISION OF BUILDING AND SAFETY Department of County Engineer J. ntyFO of Los TYENAngeles BUILDING _r d 1 WM. J. FOX, COUNTY ENGINEER ADDRESS o� CASSATT D.GRIFFIN, SUPT OF BUILDING �^ FOR APPLICANT TO FILL IN _NEARe TY / v CROSS ST. OWNER DISTRICT NO. GRTOUP• ZONE READY FOR INSPECTION MAIL ADDRESS t''' CITY • - ��!/' / TEL. NO. INDUSTRIAL WASTE APPROVAL PLUMBER s INSPECTION RECORD ADDRESS IS— / CITY TEL. 7� LICENSE NO. NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) $ - BATH TUB SHOWER , ��✓ LAVATORY (WASH BASIN) - KITCHEN SINK - DISHWASHER LAUNDRY TUB OR TRAY CLOTHES WASHER TOTAL NO. Q 0.90 APPROVALS DATE INSPECTOR'S SIGNATURE GAS SYSTEM OUTLETS @ 1.00 - • WATER HEATER @ 1.00 UNDER SLAB WORK ROUGH PLUMBING Pl RMIT S 1 00 GAS PIPING TOTAL FEE JAND/OR GAS VENT IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APHOT WATERHEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TWITH ALL COUNTY ORDINANCES AND STATE LAWS REPLUMBING•FIXTURES PLUMBING. 1HEREBY CERTIFY THAT I AM PROPERLY REGISTEREGAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND UTILITY CO. NOTIFIED CALIFORNIA ORTHAT AM THE LEGAL OWNER OF T DESCRIBED RISIDENTI PROPERTY. - SIGNATURE / OF PERMITTEE - FINAL WILLIAM J. FO COUNTY ENGINEER VALIDATION 1 :&0 � By DEPUTY DEPARTMENT OF COUNTY ENGINEER ' PLUMBING ' 1 .DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES BUILDING' •-�-� Z - - WILLIAM J •FOX,-COUNTY-ENGINEER :ADDRESS - J FOR APPLICANT TO FIL IN LOCALITY ' BUILDING r L NEAREST �I/D wt b ✓t ADDRESS r� CROSS ST. Y DIST CT NO. GROUP �jONE PERMIT NO. LOCALITY NEAREST lJ / CROSS ST. .8 Ready for Inspection DATE ISSUED r OWNER 2 _ MAILINDUSTRIAL 'A L/ - `� WASTE APPROVAL ADDR ESS a � A CITv! .z'r" P TEL. INSPECTION RECORD I ' PLUMBE L ADDRES � �+ • • CIT TEL.N `Or✓�i7 ATE LICENS4Z. 000,Z 7 47 D COUNTY J PERMIT FEES a _z JUM9ER TYPE OF FIXTURE OR ITEM FEE _ WATER CLOSET(TOILET) @ 0.80 3 IY O BATH TUB @ 0.80 SHOWER @ 0.80 LAVATORY(WASH BASIN) @ 0.80 KITCHEN SINK @ 0.80 LAUNDRY TUB OR TRAY @ 0.80 SLOPSINK @ 0.80 FLOOR SINK @ 0.80 FLOOR DRAIN @ 0.80 DISHWASHER @ 0.80 DRINKING FOUNTAIN @ 0.80 URINAL @ 0.80 GAS SYSTEM.-------------OUTLETS @ 1.00 WATER HEATER @ 1.00 MISCELLANEOUS r APPROVALS ' i DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK r` PERMIT ¢ 1 00 ROUGH PLUMBING TOTAL FEE uJ GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 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 AHD/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST AND STATE OF CALIFO NIA TE I AM THE LEGAL•OWN- ER OF THE ABOVE D RI RESIDENTIAL PRRPERTY. UTI PTY CO.NOTIFIED SIGNATURE r OF PERMITTEE FINAL 76A667 DBS 17 Cdb 12-53 DECUTATI 2"026 WORKER'S COMPENSATION certificate of consent to 76A667 DPW 9/89 APPLICATION FOR PLUMBING PERMIT 76A667A I hereby affirm i))at I have a certificate of consent to self insure, , or a certificate of Worker's Compensation Insurance, or a certified r copy thereofAe�cc.3380000 Lab.C.) Policy No.-�� Company l`�. COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS_ DEPT.OF-PUBLIC WORKS DIV-. ❑ C Ped copy is hereby furnished. I FOR APPLICANT TO FILL IN(PRINT OR TYPE) 'BUILDING 'Certified copy is filed with the county Idm inspection depa ment NUMBER FIXTURE OR ITEM p FEE LOCALITY ell - Date v Applicant WATER CLOSET - NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE I MAP BOOK PAGE PARCEL SSOR (This section need not be completed If the work Involved by the SHOWER permit is for one hundred dollars($100)or less.) LAVATORY OWNER I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to SINK MAIL ADDRESS , become subjecttothe Workers' Compensation Laws. vz A DISWASHER CITY r TEL.NO. Date Applicant CLOTHES WASHER CONTRACTOR NOTICE TO APPLICANT If, after making this'Certificate of Exemption,you should become,subject to the Workers' Compensation SWIMMING POOL RECEPTOR - provisions of the Labor Code, you.must forthwith comply with such ADDRESS /6&Q provisions or this permit shall be deemed revoked LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL. O. _ } I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER IL (commencing with Section 7000) of Division 3 of the Business and ] LIC If LICE SE NO STATE / CLASS V Professions Code, and my license is in full force and effect ( GAS SYSTEM OUTLETS OUTLETS OVER DISTRICT NO. a� PROCESSED,BY 5 PER SYSTEM 1 � O License Number Lia y�_Class w U FINAL DATE i_2 ! �/ VALIDATION LU 0. Contractor Date 3 D I i 0) ❑ I am exempt under Sec ' FINBy AL /5� Z B.&P.0 for this reason Date Plan check fee Signature PLUMBING PERMIT ISSUING FEE$ , El Plan FEEQ Plan check applicant r SINGLE FAMILY 'HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's.License Law Irw for the following reason (Section 7031.5, Business and Professions Addresss` DIP Code): City Tel.No. _ ❑ �_ -, 1 j E r§3- I I, as owner of the property; will do the work-and the structure I .ti is not intended or offered for sale (Section 7044, Business I - (._ I;-�:: ti.= ,.,:z � ,_._•� and Professions Code). l }_�-r•� Dy, .J`«I CONSTRUCTION LENDING AGENCY - I hereby affirm that there is a construction lending agency for the � rt2- 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 authorize - - represen f this County jo enter upon the above-mentioned proper n SEE REVERSE FOR EXPLANATORY LANGUAGE _ Signature cf Perfnitte ate