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Home My Public Portal About9460 KENNERLY ST_Plumbing__ `76A' 67 17 2SM SETS 7 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY LUMBING WOUNTY OFILLIAM J. o)LOSIANGEEF' ^LES FOR APPLICANT TO FILL IN DIS RI GROUP P . Agar/ PLUMBE A 1 RECEIVED B7r READY FOR' DATE ISSUED ADDRESS /A �� /�� /!A� /,J FIRST INSPECTION TEL No JOB COUNTY - r ADDRESS Li CENSE NO. � EXPIRES LOCALITY I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NEAREST ANGELES COUNTY LICENSE. CROSS ST. OWNER ! _ ^� MAIL iA PLUMBER ADDRESS PERMIT FEE IS $1.0 FOR THE FIRST FIXTURE OR CITYTEL. No. ITEM LISTED BELOW, PLUS SOC FOR EACH ADDITIONAL I AM THE LEGAL OWNER OF THE RESIDENTIAL PROP- ITEM. FOR EACH SEPTIC TANK AND PIT OR DRAINFIELD ERTY DESCRIBED ABOVE. $1.170. 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 TUB OR TRAY GAS SYSTEM— T OUTLETS WATER HEATER w SLOP SINK .� FLOOR SINK Z FLOOR DRAIN M DISHWASHER Fx 0 DRINKING FOUNTAIN URINAL MISCELLANEOUS APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL f SEPTIC TANK - DRAIN ( ) PIT ( ) $ SEPTIC TANK CESSPOOL Si SEWER HOUSE SEWER $ GAS TEST _ UTILITY CO. NOTIFIED TOTAL FEE FINAL 76A667 -CE#817 5/63 4111 APPLICATION FOR PLUM ` ,qG. PERM COUNTY OF LOS ANGELES � DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION L..FBUILDING/ fJOHN A. LAMBIE. COUNTY ENGINEER . 9460 KennerlV WILLIAM A. JENSEN, SUPT OF BUILDING T m l ('i a.Tr.. FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER No Norton ' WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS Same SHOWER 1.25 CITY TEL. NO. LAVATORY 1.25 CONTRACTOR Pacific Installers— -- SINK 1.25 ADDRESS 10920 E.. Grand DISHWASHER 1.25 CITY Temple Citv TEL. NO.442\�-124 LAUNDRY TUB 1.25 -CONTRACTOR'S STATE 9 REGISTRATION NO. 1899, COUNTY ❑ CLOTHES WASHER 1.25 DISTRIC NO. GROUP ZONE PROtWSSED BY l WATER HEATER 1.50 1150 ;3 � 1.50) INDUSTRIAL GAS SYSTEM OUTLETS WASTE APPROVAL O OUTLETS OVER 5 PER SYSTEM .30 \ INSPECTION RECORD V t N en acemerit �\ APPROVALS` DATE;., INSPECTOR'S SIGNA RE ! PERMIT $�ul !UNDER SLAB WORK TOTAL FEE -Rou� PLUMBING� � GAS PIPING v 1 V 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS-APPLICATION-N,-' l \••, AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VELNT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER (r PLUMBING. I `1..sJ 4,♦�,18 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES'' L1�ENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS,T.E ST X CAL IF�ORNIA OR THAT 1 AM THE EGAL OWNER OF,AND INTEND TO ! �'� `�../� RESIDE`IN;THE ABOVE DE RIBE RESIDENTIAL PROP TY. UTILITY CO. NOTIFIED r Y" SIGNATURE-It. OF PERMITTEE -� -- FINAL r;� f cF" O'.. K" or ALIDATION ROBERT A. WOOD CK. M.0. CASH SUPERVISING MEC.ANICAL/ENG'R ( -/ - WORKERS'COMPENSATION DECLARATION 76A667A I hereby affirm that I have a' certificate of consent to self cE,e17 (z-so) APPLICATION FOR PLUMBING PERMIT insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company �—�' 9 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING as r - a �(�' Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM 40F E ADDRESS / department. LOCALITY /•• Date WATER CLOSET Applicant NEAREST - BATH TUB CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' _ COMPENSATION INSURANCE SHOWER OWNER *7 /704 a,/19 1� L MAIE (This section need not be completed if the work involved N LAVATORY. ADDRESS d v by the permit is for one hundred dollars ($100) or less.) SINK- CITY } - ' TEL. N �•,Jk I certify that in the performance of the wor for w r h this DISHWASHER O permit is issued, I shall not empvew per, n in an anner CONTRACTOR so as to become subject to the ' C mp n L CLOTHES WASHER 0 Date 2�Applicant � ADDRESS O SWIMMING POOL RECEPTOR NOTICE TO APPLICANT: If after making this Certificate of CITY TELO. W . N Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. � Compensation provisions of the Labor Code, you must forth- LICENSE NO. CLASS _ with comply with such provisions or this permit shall be WATER HEATER _ deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. 70 SSED BY -•--� � ,may �t� LICENSED CONTRACTORS DECLARATION OUTLETS OVER Uj/ �y''��C/� I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINAL ness and Professions Code, and my license is in full force and DATE v'�` ��- VALIDATION effect. FINAL License Number Lie.Class. BY Contractor Date In I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code), TOTAL FEE Lie.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's /address 6Q 2 v.3, 1 1, License Law for the following reason (Section 7031.5, Busi- City Tel.N - ness and Professions Code): o o c u o I, as owner of the property, am exclusively contracting 2 O T with licensed contractors to construct the project fT� (Section 7044, Business and Professions Code). 'Q J r -_ CONSTRUCTION LENDING AGENCY O 2 0 2-J I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(See. 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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize representati s of this County to enter upon the above-rn tion prop ty for inspection purposes. %nature of Permittee Date >l Q� WORKERS',Cc�,APENSAxION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby,affirm. that INhave o certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 8/86) or a certified copy thereof (Sec. 3800, Lob.-C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company ❑ Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY WATER CLOSET Dote Appligant NEARECROSS TT. C�0 VES. CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB COMPENSATION INSURANCE SHOWER OWNER r L (This section need not be completed if the work Involved byv Ir q the permit is for one hundred dollars ($100)or less.) LAVATORY MAIL ADDRESS IL FkiPJ N epl. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY rVV, ;� TEL. NO., so as to become subject to the Workers'Compensation Laws. DISHWASHERCONTRACTOR / / L �n { Date— (lD Applicant L� n2 le#1os CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS T L Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CI r—,TEL. 2�% ��y,/ with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICLNC). PROCESSE Y I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS S_ ()Ly (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and effect. 5 PER SYSTEM FINAL 70/A DATI®N O DATE Q License Number Lic. Class W FINAL O Contractor Date BY % a' 1 am exempt under Sec. � B.&P.C. for this reason Plan check fee 001 Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE 1 A7 Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address Low for.the following reason (Section 7031.5, Business and #9747.8 ` P�fessions Code): City Tel. No. ( o o 1 6,50 /yam I, 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). 0 7,'1 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 ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the abo11 ve- on ropers inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE - (G - 9 ? Sign ur rmi rtee Date