HomeMy Public PortalAbout9437 KENNERLY ST_Plumbing__ r� A COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer
DIVISION OF BUILDING & SAFETY PLUMBING 1
WILLIAM J. FOX. County Engineer
DISTRICT NO. GROUP I Z N
FOR APPLICANT TO FILL IN � _ /
PLUMBER Gam` R VED BY READY FOR E- IBS ED
FIRST INSPECTION
ADDRESS _
CITY TEL Na. ADORES _
COUNTY LOCALITY ♦/�I� ,s�I.� �/ / l//lY
LICENSE NO. EXPIRES
NEAREST
PERMIT FEES CROSS ST. y ,or�r,"? A
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
' WATER CLOSET(TOILET) @ 0.V13 ADDRESS .1 L( �filil
BATH TUB @ O 50 �4
CITY � TEL. No.
SHOWER @ .50 q 01 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) Q O. O APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK- @ 0,5 AND STATE- LAWS REGULATING PLUMBING.
I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ ❑. ❑ ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER
OF THE RESIDENTIAL.,PROPERTY DESCRIBED ABOVE.
GAS BYSTEM__OUTLET9 @ .50 /*
SIGNATURE OF, �:-��.
WATER HEATER @ 0.50
PERMITTEE —'
SLOP SINK .50 INSPECTION RECORD
FLOOR SINK @ .SO 7
♦�"VS ( / iIL/
FLOOR GRAIN @ -50
DISHWASHER @ 0.50
i
DRINKING FOUNTAIN @ 0.50 Z 6O fW `4v-*,vqi4
URINAL C>1 0.50 �j(f`C� / �F "� ♦ Q
HOUSE SEWER
MISCELLANEOUS54,11YA
A!? q �
APPROVA S
DAIj IN.PECTOR'9 N E
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL @ 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT 1.00 GAS TEST
UTILITY CO. NOTIFIED
TOTAL FEE
FINAL
7GA667 DBS#17 10/52
SA- 7 17 25M SETS 7-48 I APPLICATION FOR PERMIT
DARTMENT OF BUILDING AND SAFETY �' �'
CO'tJNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
DISTRICT O. ROUP Z P .
FORA�P)PLICAN_T T❑ FILL IN / �f
PLUMBER / /� (' RECEIVED,BY READY FOR DATE ISSUED
ADDRESS 1,6), // �i //��/,�/ ( -/� ��/ 9 G - // FIRST INS/PE/CTION
CITY.._ i�%/'7/ �9��.✓O,Y' TEL. No. �/ / / JOB
- ADDRESS
COUNTY
LICENSE NO. Sd"�� EXPIRES - LOCALITY
I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NEAREST
ANGELES COUNTY LICENSE. CROSS ST.
OWNER • ,,
MAIL 9
PLUMBER ADDRE5��9��,, /
PERMIT FEE IS $1.00 FOR THE FIRST FIXTURE OR CITY ��/ yJTEL. No.
ITEM LISTED BELOW, PLUS 50c FOR EACH ADDITIONAL 1 AM THE LEGAL OWNER OF-THE RESIDENTIAL PROP-
ITEM. FOR EACH SEPTIC TANK AND PIT OR DRAINFIELD ERTY DESCRIBED ABOVE.
$1.00. MINIMUM FEE FOR ANY PERMIT $1.00. EACH
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 TU®pR TRAY .
GAS SYSTEM .J( OUTLETS
WATER-HEATER
SLOP SINK J
Q
FLOOR SINK Z
FLOOR DRAIN L9
DISHWASHER
DRINKING FOUNTAIN
URINAL
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING ' a- I ,.-
GAS PIPING
GAS VENT
CESSPOOL I _
SEPTIC TANK - DRAIN ( ) PIT ( ) $ SEPTIC TANK
CESSPOOL $ SEWER
HOUSE SEWER $ GAS TEST
TOTAL FEE $ UTILITY CO. NOTIFIED
FINAL
I
76AB67-CES 17-8-58
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING
]]OHN A. LAMBIE, Counq Enggi�nneer ADDRESS i
CASSATT D. GRIFFIN.Sup t o!Baildiag LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM u
' OWNER C ��-
WATER CLOSET MAIL /
BATH TUB DRESS Hyl
CITY TEL. NO.
SHOWER
LAVATORY CONTRACTOR
SINK ADDRESS
DISHWASHER CITY TEL. NO.
CONTRACTOR'S STATE ❑
LAUNDRY TUB REGISTRATION NO. COUNTY El
CLOTHES WASHER DISTRICT O. G7
ZONE CESSED BY
WATER HEATER ?
AJ
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
)O SPECTION RECORD
a
APPROVALS
OH O PER rD[TUES $ DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT 151 2 00 ROUGH PLUMBING
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR TH AM THE LEGAL OWNER—OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDE IAL PROPERTY.
SIGNATURE n I ^y VO
OF PERMITTE FINAL
ROBERT A.WOOD.
®F VALIDATION SUPERVISING MECHANICAL ENG'R
CK. M.O. CASH
` lCo 8 3 6 9 ° DEC 5 A 3 ,Q 0
WORKERS'COMPENSATION DECLARATION 76A887A '
I hereby affirm that I have a. certificate of consernt-to self _CE_817 (2-86) APPLICATION P O R 'P L U M B I.N G i.-P E R M IT
insure, or a certificate of Workers'Compensatibn•Insur'ance,or > '
a certified copy thereof(Sec. 3800,Lab.•C.)
��/ q� a�uT COUNTY OF LOS ANGELES, ' BUILDING
AND SAFETY;
Policy Ng�L�/Company`
Certified copy is hereby furnished. FOR•APPLICANT TO FILL IN (PRINT OR TYPE)' BUILDING
C ADDRESS
O Certified copy is filed with the county building inspection NUMBER FIXTORE OR ITEM ®A FEE
department. LOCALITY'
i
Date ApplicantWATER CLOSET, • � _ NEAREST - ,
{ f BATH TUB CROSS ST. . r L
CERTIFICATE-OF'EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE SHOWER OWNER
L'AVATORY- _� MAIL
(This section need not be completed'if the work 'involved ADDRESS a7
by, the permit is for one hundred dollars ($100) or less.) SINKCITY r- PL ` TEL.N' a:
I certify that in the performance of the work for which this DISHWASHER U
permit is issued, I'shall not employ any person in any manner CONTRACTOR
so' as to,become subject to the Workers' Compensation Laws. CLOTHES WASHER. ADDRESS D •O
Date- Applicant, SWIMMING POOL RECEPTOR
NOTICE TO APPLICANT: If, after making this•Certificate'of CITY ��� TEL. NO' g , tL
Exemption, you, should become 'subject to the'Workers' LAWN SPRINKLER SYSTEM
Cn
STATE y LICA
Compensation provisions of the Labor Code, you must.forth- LICENSE NO. a a/ CLASS
with comply with such-provisions or° •this permit sh'all be WATER HEATER'
deemed revoked. GAS•SYSTEM OUTLETS DISTRICT NO.
t. PROCESSED BY
LICENSED CONTRACTORS DECLARATIONI . . � `�
OUTLETS OVER
I hereby'affirm that I am licensed under provisions of Chapter 5 PER.SYSTEM
9-(commencing.with Section 7000) of Division 3 of the Busi- FINAL VALIDATION
ness and Professions Code, and my license is in.full force and 'DATE �� �
,effect. tt
l 6 /J FINAL fJ r
License.Number Lie.Class. BY
ContractoAfJfL U1/L,AF Date, 7_/'_457
I am exempt from the licensing'requirements as Iain a Plan check fee _
licensed architect or a, registered professional engineer PLUMBING PERMIT'ISSUING FEE$ `
acting,in my professional capacity (Section 7051; Bus,
iness and Professions Code). TOTAL FEE
Lie.or Reg.No. Date Plan check•applicsnt
HOME OWNER-BUILDER DECLARATION Name c 06 4 A'
I hereby 'affirm-that I am exempt from ,the Contractor's Address #'o 0 0 0 0 5
License Law for the following reason (Section 7031.5, Busi- Cit 'o'.
City Tel.N 2 yo 0'2 4,•5'�
ness and Professions'Code):
OI, as owner-of the property, am exclusively contracting" • � " '*to'o 2 li.'S Q v
with-'licensed contractors to construct the project
(Section 7044, Business and Professions Code). _ 7V0 2�—8 2
CONSTRUCTION LENDING AGENCY ;
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.). ry
Lender's.Name
Lender's Addr-ss
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 SEE,REVERSE FOR EXPLANATORY LANGUAGE
authorize representatives of-this County to enter upon the
above-mentioned property for inspection purposes..-
Signature
urposes,Signature of Permittee 'Date