HomeMy Public PortalAbout9240 KENNERLY ST_Plumbing__ f 76A667 DBS 17 11-50 APPLICATION FOR PERMIT
DEPARTMENT OFNG AND SAFETY'
COUNTY OFF Y
LOS LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER PLUMBING 1
DISTR NO. GP-13UP )PERMIT NO.
FOR APPLICANT TO FILL IN
PLUMBER R16wEIVBY READY FOR DATE 1�99YPED
ADPRE89 FIRST INSPECTION
CITY15? TEL. N._g l� BUILDING
ADDRESS
COUNTY p y
LENE NO. / G /J �I'� LOCALITY
EXPIRES
NEAREST
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
iMAIL
WATER CLOSET(TOILET) @ 0.50 # ADDRESS 3 O r4 4" � �f a✓� .�e�1
BATHTUB 0.50 CITY ���� TEL No. / J—,
SHOWER (L 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN)` @ 0.50 APPLICATION AND BTATE THAT THE ABOVE 18 CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT I POSSEBS THE ABOVE VALID LOB
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
r OF THE RESIDENTIAL PROPER DESCRIBED ABOVE.
GAS SYSTEM OUTLETS (� 0.50 SIGNATURE OF� �r♦ 1
WATER HEATER 0.50 PERMITTED
SLOP SINK 0.50 INSPECTION RECORD
FLOOR SINK 0.50
FLOOR DRAIN 0.50
DISHWASHER ® 0.50
DRINKING FOUNTAIN Q 0.50
URINAL 0.50 J
Q
HOUSE SEWER @ 0.50 Z
MIBC LLANEOUS 6
O
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING ✓
OAS PIPING ?�
GAB VENT
CESSPOOL Q 1;00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) a 1.00 SEWER
PERMIT 1.00 GAS TEST
UTILITY CO.NOTIFIED 1
TOTAL FEE $ ^ r�
O FINAL �7 r
76A667-CE#817 2-66 ��'•7� �) &
APPLICATI�O�, / lF R PL MBING ERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION PADDRESS
JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN•W. JENKINS. SUP''T OF BUILDING FOR APPLICANT TO FILL IN NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET $1.25 MAIL
BATH TUB 1.25 ADDRESS
CITY TEL. NO
SHOWER 1.25
LAVATORY 1.25 CONTRACTOR
SINK 1.25 ADDRESS Q
DISHWASHER 1.25 cl TEL. N O
LAUNDRY TUB 1.25 LATE LIC
LICENSE NO. / CLASS
CLOTHES WASHER 1.25 DISTRRIC/Z N G P TE P E BY
WATER HEATER 1.50 y G Ct_
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL p
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD
O
F-
U
W
N
. Z
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
ROUGH PLUMBING '
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS A PLICATION GAS VENT
ANO 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 REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DE CRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL �s
�jAUDATION JACK R. ALLEN
cK/ M O CASH SUPERVISING MECHANICAL ENG'R,
LC o0 3 5 5 AUG29 5 D 4.75— co
Wh,-
COMPENSATION DECLARATION APPLICATION=FO.R. PLUMBING PERMIT
20-0026'DPW 4/87, , at I'h'ave a certificategof•consent toself in- .76A667A' ; I I
} U
sur e,or�ocertifiedte"of'Workers"Compensationlnsurance,or a' CE 817;(REV"8/B6)°' =• -
•: certified)copy ther@of (Sec--3.800, Lab. G.) i'
Policy No ��''rJ� �� ,000NT'Y',OF LOS.AN_ GELES ,DEPT'. OF PUBLIC WORKS'
Oompany . . ,
:k
��Ced copy ,s'hereby•fu"rnished. y ` :,, ;
" FOR APPLICANb TO FILL IN (PRINT,OR TYPE) BUILDING ;
ied,copy•is,filed-wit♦rthe•cbunfy.buildirig inspection• i :ADDRESS
nt NUMBER ' FIXTURE'OR ITEM' @,' FEE' y-
J' -LOCALITY.
A licant WATER"CLOSET--jOILET)'1
Date' pP �i�, ��G-� V!, NEAREST
' w
" ATE OF EXENIPTIONrFROM WORKERS' BATH TUB `'', V CROSS ST
' COMPENSATION'INSURANCE' t OWNER' !+ y" n' -•
- �..,'' • :SHOWER'"' ... :v
(This section need not be completed if the work involved by
the permit is;for.one'hundred.d'ollors„(5100)�or,less:) LAVATORY' e, 'ADDRESS
F t.
1 certify that in the performance of the workfor which This per-, SINK
CITY :' TEL NO— . =I
.,mit is issued?tshall not employ.6ny'person in'any,mannerso• .f r 'w'
as•to-becomersublecf to the'Workers' Compensation Laws v
y DISHWASHER-
�.. v CONTRACTOR
Date Applic6nl� CLOTHES WASHER.
ADDRESS t C%_� ..��G r `
••^NOTICE;TO'APPLIGANT-';If;'after making this'Gertificate'of Ex- SWIMMING POOL RECEPTOR
emphon,you should become'sublect t'o the;Warkers'Compen- f CITY TEL N
�sation provisi 'hs;o8the Labor•Code;�'ybU;miist.forthwith:corrip-`- LAWN•SPRINKLER SYSTEM '' �f
ly With_sich:p}rovisioni-i r this permit shall be'deemed•revok; STATE .2
;WATER HEATER LICENSE NO 1 _ ��. CLASS
LICENSED CONTRACTORS DECLARATION a DISTRICT.NO PROCES D BY.
'I hereby;affirm',that`:I dm licensed under provisions of'Chapter GAS.SYSiEN.: OUTLETS''
3 : '
9(commencing with Section 7000)of Division:3 of the Business OUTLETS OVER. '
<qnd'Professions Code,`and°my license is it full force an'd ef- r 5•PER'SYSTEM °' FINAL LIDATION a,
fect: �y f DATE
LicerisewNumberY 3� v'Li Class /`' -vi U
/f FIN ' cc
Contractor'” ` Date' O
b7. 'I am exempt under,S c. LU
B.BP:C'•for this reason - 'P'Gn�check fee
+ "Date" PLUMBING'PERMIT ISSUING'FEE$ ► °
Signature; �. ti '
TOTAL'FEE'
SINGLE FAMILY / �. I yew°"H S' '5.O
�,. Plbn•check,appl�cant. `�
-' HOME"OWNER BUILDER-DECLARATION ' �`
s '
I hereby affirm that I am exempt'from_the Contractor's License Name _ �^ 4 4r''ry�'.8''�.5 p
-LaW'for'the following reason (Section,7031.5, Business and '
=Professions Code)- ca' Address
I, as.owner of the-property, will da the'-,work andythe City Tel N l �r2"1 "88
s �• Q y 1
'`structure is n"I- oroffered for sale(Section 70.44; - �;•
Business and ns Code)„ > a '•', i ¢ a a' +` ' ' n
•, :ti' CONSTRUCTION LENDING.AGENCY,'
�1 hereby,affirm that thefe'is d construction lending agencytor
the.performance of the•work-•for which'this pecrriit is issued r ; z $•
Sec'300,
Civ"C") °T' �R ;
.L'ender's Name. I
Lender's Address v n
I certify thatrl'have read this application and state tk'I the
above information is correct. I agree to comply with all County :{ $ , y :_
Y..
ordinances and State laws regulating Plumbing, and;herebjt
-autho ' e.representatives 'of this-County to enter upon the a-
'ab y e n t 'ned pe for insp6ction pun oses'.
SEE^REV_REVERSE FOR EXPLANATORY LANGUAGE
;'n
�• 6 ;:fir•' i. t, �•' _ ,
Signature,of P,ermritee