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Home My Public Portal About10126 LA ROSA DR_Plumbing__ D.5,6.17 PMWSET5 1:.44 - - APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY p p �e/�o COUNTY OF LOS ANGELES �LV�®',®4� '" Wm. J. FOX. CHIEF ENGINEER fR TURE OF INSTALLATION D19TRIGT NO. GROUP [AZj�O E PPjERMIT NO. FIXTU REB _I COMPLETE J, !`� /'�^7 Z I� MESCELLANEOUS SEPTICTAMK RECEIVED BY READY FOR DATE ISSUED/ FIRST IN8 EC ON 'D -q5 APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY mow_ JOB O� w.e1 �f ��]] /I� ADDRESS/, y 'may , .2/D I ' /1 �1I� /� LOCALITYLQ.y �O TE4/NOJT-/� /�y/sJe.7 CROSSST.I �/ 'A/ „U_ �EXPIRES lljyi K NAME /X/(/[%VL.OF SEPTIC TANK, OR CESSPOOL 2 MAIL . / 7j ADDRESS NORTH O �- i CITY � . TEL.No. I AM THE LEGAL f ANGELES COUNTY CERTPIRS ATfi OP qUA IPsmosdR OF 6 ATIBONg LOB PLUMBER 1 AM THE LEGAL OWNER OP THE PROPERTY DESCRIBQD ABOVE. 9 OWNER CORRECTIONS I i SOUTH a DESCRIPTION OF WORK c 1 ATH TUB FURNACE S/ ' l SHOWER -DISHWASHER 0 LAVATORY REFRIGERATOR KITCHEN BINK WATERSOFTENER 414 FLOOR BINK SAND TRAP SLOP BINK FLOOR DRAIN WASH TRAY URINALVPTPING APPROVALS WATER CLOSET DRINKING FOUNTAINDATE �NvINSPECTOR-8 NAME _.._WATER HEATER DENTALLAVATORY M ETEM GAB SODA FOUNTAIN •(Y” OUR rn CESSPOOL TOTAL NUMBER OP FIXTURES SEPTIC `� SEPTIC TANK CESSPOOI SEPTIC TANK SEWER I B TOTAL FEE J _V;; UTILITY CO.NOTIFIED FINAL ' -/64667 •C E#R1T 5/63 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AN� SAFETY DIVISION BUILDING a 'Z JOHN A. LAM 1E, COUNTY ENGINEER ADDRESS WILLIAM A. JENSEN. SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST csoss sr. .,] ��ti• NUMBER FIXTURE OR ITEM EACH FEE ..� t OWNER �r WATER CLOSET $1.25 I..7 MAIL BATH TUB 1,25 ADDRESS CITY TEL. NO. SHOWER 1.75 LAVATORY 1.25 CONTRACTOR W F SINK 1.25 ADDRESS I Zo I a.v2 % DISHWASHER 1.25 CITY { TEL. NO { LAUNDRY TUB 125 CONTRACTOR'S STATE REGISTRATION NO. 3 COUNTY ❑ CLOTHES WASHER 1.25 DISTR CT N G u 20NE ESSED BY WATER HEATER 1.50 ,( Y a GAS SYSTEM-OUTLETS- 1.50 INDUSTRIAL WASTE APPROVAL 0 OUTLETS OVER 5 PER SYSTEM .30 V INSPECTION RECORD ]crur?-m IA, OL&coA o,jQ ° V s W a N Z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT JINTEND 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING HEREBY ACKNOWLEDGE THAT 1 HAVE READ ICATION GAS VENT AND $TATE TNAT THE ABOVE IS CORRECT ANO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LATING HOT WATER HEATER PLUMBING. ^ MEREDY CERTIFY THAT 1 AM PROPERLY REANO/OR PLUMBING FIXTURES Z LICENSED AS REQUIRED BY LOS ANGELES COUNATE OF GAS TEST CALIFORNIA OR THAT AM THE LEGAL OWNER OEND TORESIDE IN, THE AYOVE DESCR;BED RESIDENTIAL PRUTILITY CO. NOTIFIED J SIGNATURE OF PERMITTEE FINAL ATION ROBERT A. OOD U cK. W o. CASH SUPERVISING MECHANICAL ENG'R L ILo 6 4 1 0 MAR ]. 0 5 D 5.7 5~ 1 ole-der-� 76A6U-CE*aI7 4-67 APPLICATION FOR PLUMBIPdG PERMI COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ADIL DRESS JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 31.25 8 MAIL HATH TUB 1.25 J a ADDRESS CITY S L. NO. SHOWER 1.25 LAVATORY 1.25 �� CONTRACTOR SING: 7,2,5 ADDRESS t 0 I DISHWASHER 1.25 CRY a TEL. NO. T '� LAUNDRY TUB 1.25 LSATE Lic ICENSE NO. CLA 55 3 CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PR ESSED BY WATER HEATER 1.50 , �� 5 1.50 SO INDUSTRIAL } GAS SYSTEM OUTLETR U WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .00 INSPECTION RECORD CD F- U W d N Z APPROVALS DATE INSPECTORS SIGNATURE PERMIT JTOCOMP�Y 2 00 UNDER SLAB WORKt ROUGH PLUMBINGTOTAL FEEJ U GAS PIPING1NEREBY ACKNOWLEDGE TNAT 1 NAVE READIUTIONAND STATE THAT THE ABOVE IS CORRECT AND COMPLY GASVENTWIIUMBLLCOUNTY ORDINANCES AND STATE ULATING HOT WATER HEATER IHEREBY CERTIFY THAT I AM PROPERLY RAND/OR PLUMBING FIXTURESLICENSED A6 REQUIRED BY LOOS ANGELES COUATE OF GAS TESTCALIFORNIA OR THAT 1 AM Tnq EGALOWNE END TOREBIOE IN, TME ABOV 6CRI8 61OENTIUTILITY CO. NOTIFIED {' SIGNATURE /I A OF PERMITTEE1, FINAL LIDATION JACK R. ALLEN cK. M,0. CASH SUPERVISING MECHANICAL ENG'R. L&O 1 7 2 1 NOV 15 5 D 9.50- D.B.S.IT 25M SETS I2.44 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ® , e COUNTY OF LOS ANGELES T V�� ®�01p,p� 7 IWM. J. FOX. CHIEF ENGINEER fROU TURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT ./N OO.. I� FIKTURES .COMPLETE fTq / I RECEIVED, Y READY FOR DA SSUEO CESSPOOL SEPTIC TANK FIRST IN PECTION ` / ,p MIHCELLANEOUB /l-/�/ ,� i"1 91/16/YI1I1 APPLICANT FILL IN HEAVILY OUTLINED �PJORTIOJNp_O/NLL'YJOB �' //y.�� l}�--I/.�.,. ?/A�+�✓i./ ADDRESS //8 Z4 / 444lvsP �/// ��-rY-i7 /iM � .o..a+ / LOCALITYHE EST yy,,.(I„..,, /�. +.-.ice{EL�No. CROSS HT. om,�//�COUNTY . /EXPIRES 6NAME T'IC'i dW. Ale.Cf . OF SEPTIC TANK, OP. CESSPOOL 2 MAIL tt �(. NORTH Q ADDRMS J� �G�f c w* CITY CL! LeiGl Q... TEL.NO. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOB ANGELES COUNTY CERTIFICATE OF QUALIFICATION. b'PLBHOER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. V 2 y OWNER CORRECTIONS i I i I SOUTH a DESCRIPTION OF WORK HATH TUB FURNACE CS N SHOWER DISHWASHER O LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR BINK FANDTRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S MAKE WATER HEATER DENTALLAVATORY ROUGH PLUMBING I METER GAO SODA FOUNTAIN GAS PIPING I I OUTL GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOL SEPTICTANK 0 SEWER I B UTILITY Co.NOTIFIED TOTAL FEE I �� FINAL WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hes�fim that I have a certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) or a certified copy thereof (Sec. 3800, Lob, C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. BUILDING � F-1Certified APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS e/ Ja Certified copy is filed with the county building inspec- tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date—Applicant WATER CLOSET NEAREST a �1 CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. // G/✓k A/ COMPENSATION INSURANCE SHOWER (�� P OWNER (This section need not be completed if the work involved by 6 MAIL /, p Qa C p the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS 11h /►. SA I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY Ls/7—)"TEL NO so as to became subject to the Worke Comp anon Laws. DISHWASHER CONTRACTOR Date17`_�� _9_Applicant a 7 CLOTHES WASHER �� NOTICE TO APPLICANT: If, after making this tificote ADDRESS Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY TEL NO. j with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO.p PROC SED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER lt. and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL VALIDA ON d rX� DATEZ— ,� License Number �V Lic Class V FINA V9 ContractorDate BY 0 3UQ7 W ❑ am exempt under c r�r -21 5 4 3 A W B.SP.C. for this reason Z Plan check fee # - • 9 - 05 Date: PLUMBING PERMIT ISSUING FEE$ 1 Q Signature Noll, TOTAL FEE 116,15-40 l - 1 650 Plan check applicant ' 1 6505 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name 0219-85 1 hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and 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 ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above- entione property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permitt !Date