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Home My Public Portal About9449 KENNERLY ST_Plumbing__ 76•A667 (CE-817) -,1175 1 1 Sr °APPLICATION FOR PLUMBING -PERMIT ' COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER -BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUIDRELDISS NG AD9449 R. KPNEERTKY HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST. HELFO NUMBER FIXTURE OR ITEM @ FEE 0 OWNER WATER CLOSET MAIL BATH TUB 0 ADDRESS SHOWER Ho CITY TEMPLE_ CITY TEL. NO. 286-Q708 • LAVATORY 1 0 CONTRACTOR IN SINK 00 Ford ADDRESS :L DISHWASHER 00 CITY IEL TEL. ND. ''28 5M CLOTHES WASHER 00 STATE LIC LICENSE NO. CLAS .SWIMMING POOL RECEPTOR 00', DISTRICT'NO. ROUP ZONE PR SSED BY LAWN SPRINKLER G SYSTEM, pp (j—Q - �,'% WATER HEATER .00 INDUSTRIAL Y. WASTE APPROVAL GAS SYSTEM OUTLETS 00 INSPECTION RECORD. CD OUTLETS OVER / i CD 5 PER SYSTEM CD V W CL ' VJ _ Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 00 TOTAL FEE APPROVALS DATE INSPE CTO R'S SIGNATURE Plan check applicant j 0-0 UNDER SLAB WORK. -7 Name ROUGH PLUMBING Address GAS PIPING City Tel. NO. GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS ,CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES'- WITH, ALL COUNTY. ORDINANCES AND STATE LAWS REGULATING GAS TEST ' PLUMBING. I•i I HEREBY ,CERTIFY -THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSEDAS REQUIRED BY. LOS ANGELES COUNTY AND STATE OF _ CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL SIGN RE `\^+ OF,PERMI TTE PERMIT IDATION CK. " M.O.. CASH PLAN CHECK VALIDATION CK. M.0. CASH 1� 1 6'r'--JAN 1_ 5�u 1 5.0.0 ��' 'FE P1 7(RE� APPLICATION FOR PLUMBING-PER,MIT COUNTY'OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE). BUILDING ADDRESS 9449 E, KEXNPIRLY NUMBER FIXTURE OR ITEM'.' @ FEE „ LOCALITY TR Mp up . WATER CLOSET ” �ZJ NEAREST -• BATH TUB CROSS ST-- SHOWER OWNERglf OWNER ,, �� !3 7� ADDRESS 2449 R SINK _ CITY , rigiaiTTy TEL NO DISHWASHER CONTRACTOR D• PLUMBING CLOTHES WASHER ADDRESS- 41 SWIMMING POOL RECEPTOR LAWNSPRINKLERSYSTEM CITY 'SAN ,GABRIEL TEL N928 1 WATER HEATER STATE Lic LICENSE NO .307766 CLASS 3 GAS SYSTEM OUTLETS APPROVALS, DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK , .'7 OW&Sw S PER SYSTEM ROUGH PLUMBING GAS PIPING GAS VENT . BS HOT WATER HEATER PLUMBING FIXTURES GAS TEST 7!7 Plan check fee UTILITYCO NOTIFIED PLUMBING PERMIT ISSUING FEE$ ' TOTAL FEE FINAL' Plan check'appllcant PLAN CHECK VALIDATION Name •> Address P,e v t} , City Tel No .I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS,APPLICATION,AND STATE •_�33 7 1 A THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING- � - PERMIT VALIDATION • � ' '�`p.o•o O o 5 I HEREBY CERTIFY THAT I AMPROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE 2 O 0 LEGAL'.OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY - - �• ' o'0 0 2 2. 0 0#, SIGNATURE , ' OF PERMITTE 'G• 032.2-79, DISTRICT NO PR, C SSED BY �' D J INDUSTRIAL WASTE APPROVAL WORKERS'COMPENSATION DECLARATION APPLICATI ING PERMIT Aereby affirm that I have a certificate of consent to self 76A667A R1re, or a certificate of Workers' Compensation Insurance. CE 817(REV 10/81) 1_emp1e flitscertified copy thereof (Sec. 3800, Lab. C ) COUNTY OF LOS ANG BUILDING AND SAFETY Policy 40TS311287 „pony Fremont•. Indemnity Certified copy is hereby furnished. BUILDING I,,' FOR APPLICANT TO FILL IN(PRINT OR TYPE) Ei Certified copy is filed with the county buil in mj ec- 44 ADDRESS E• genneTl • tion department A" prove4. �1�g• NUMBER FIXTURE OR ITEM @ ' FEE LOCALITY TtMnle City Dat; Q-26-83 Appli4• Z�� Htg° WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION.FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE OWNERBushe D ' S• (This section need riot be completed if the work involved by SHOWER the permit is for one hundred dollars $100 or less. MAIL P ( ) ) LAVATORY ADDRESS ' �� E: gennerl I certify That in the performance of the work for which this � permit is issued, I shall not employ any person in any manner SINK CITY Temple Cit TEL N p286-0 08 so as To become subject to the Workers'Compensation Laws DISHWASHER, CONTRACTORAAA Approved E-lb . & Ht • Date Applicant CLOTHES WASHER • • NOTICE TO APPLICANT- If, after making this Certificate of ADDRESS Exemption, you should become subject to the Workers', SWIMMING POOL RECEPTOR Compensation provisions of The Labor Code,.you must forth- LAWN SPRINKLER SYSTEM CITY Gardena,910248 TEL. N l -0404 with comply with such provisions or this permit shall be STATE LIC deemed revoked. WATER HEATER LICENSE NO 250005 /t CLASS C 36 LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby,affirm that I am licensed under provisions of Chapter 9 1 GAS SYSTEM OUTLETS O (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER V and Professions Code, and my license is in full force and effect. 5 PER SYSTEM FINALCL VALIDATION O License Number 250005 Lie. Class_ DATE�((�� FINAL O Contractor Plumbing DatelO-26-83 BY V ❑ 1 am exempt under SectL W 5 y/ B BP.0 for this reason Z Plan check fee Date, PLUMBING PERMIT ISSUING FEE$ 0 ;2 6 3'5 5.A Signature ` TOTAL FEE 6 S #,o o 0 o o.5 Plan check applicant 2:o o 1 ,650 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name 0 0 0 16506 1 hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and 1 0,2 6783 Professions Code): City Tel. No. ❑ 1, as owner of the property, will do the work and the structure is not intended or offered for sale (Section 7044, Business and Professions Code) 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 ) 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 pop- ordinances and State jaws regulating Plumbing, and hereby authorize representatives of this County to ,enter upon the above entioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Z6-4 5 Signature of Permittee Date