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Home My Public Portal About9304 LA ROSA DR_Plumbing__ _ ,6^O ?4.817 12-84 ' APPLICATION FOR PLUMBING P RMI' COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY'.TD FOR APPLICANT TO FILL IN NEAREST CROSS ST NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $1.25 MAIL ' BATH TUB 1.25 ADDRESS O CITY TEL. NO. SHOWER 1.25 t LAVATORY 1.25 CONTRACTOR SINK1.25 'ADDRES DISHWASHER 1.25 CITY f TEL. NO. LAUNDRY TUB 1.25 CONTRACTOR'S STATE REGISTRATION NO. COUNTY ❑ CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE P CESSED B WATER HEATER 1.50 �� GAS SYSTEM OUTLETS 1.50 INDUSTRIAL WASTE APPROVAL �. OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD F® C3 LLI A. N APPROVALS DATE INSPECTOR'S SIGNATURE I UNDER SLAB WORK PERMIT $ 2 00 ROUGH PLUMBING TOTAL FEE GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER . PLUMBING. A A SIJ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF �r / CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO GAS TEST RESIDE IN,THE ABO DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED SIGNATURE I a R e t OF PERMITTEE FINAL N f LIDATION ROBERT A.4WOOD cK M o CASH SUPERVISING MECHANICAL ENG'R OCT 28 5 D 3.25- 4 �L(,v5 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES' DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS WILLIAM A. JENSEN, SUPT OF BUILDING n ' LOCALITY I FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER )- (,T>, WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRE SHOWER 1.25 CITY r TEL. NO.CZt f LAVATORY 1.25 CONTRACT SINK 1.25. ADD / DISHWASHER 1.25 CITY L. NO. LAUNDRY TUB 1.25 CONTRACTOR'S St A tE REGISTRATION NO. COUNTY ❑ CLOTHES WASHER 1.25 DIST IICT y0. GROUP ONE P ESSED BY WATER HEATER 1.50 C4' �['�' r GAS SYSTEM OUTLETS 1.50 INDUSTRIAL O_ WASTE APPROVAL' O OUTLETS OVER 5 PER SYSTEM .90 INSPECTIONrRECORD V 0 CL z APPROVALS - DATE e[NSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ROUGH PLUMBING I TOTAL FEE '7AfOr5 GAS PIPING i IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT a AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY f WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER ' 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES 0 �. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST 17 Iii.N CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO p RESIDE IN, THE A OVE DESC IDED RESIDENTIAL P RTr. UTILITY CO NOTIFIED SIGNATURE OF PERMITTEE FINAL' W �LIDATION ROBERT A. WOOD M o CASH SUPERVISING MECHANICAL ENG'R 8 4 Z 0 Z MIAY 55 D 3.50- K l 76A667 Des 17 11-50 APPLICATION FOR PERMIT DEPARTMENT OFNG AND SAFETY COUNTY OFF LOS LOS ANGELES WILLIAM J. FOX, CHIEF EN0I14EER DISTRICT GROUP O . FOR APPLICANT TO FILL IN 1306'0_ ;�(,./, PLUMBER RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION ADDRESS W -IOUILDING CITY TEL NO. J ADDRESS COUNTY. 7 D '%SCALITY LICENSE NO. D EXPIRES '.� NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL �� H � MAIL bbb��- WATER CLOSET(TOILET) @ 0.50 s ADDRES Q F- MCQ_QsL-,a, BATH TUB @ 0.50 CITY TEL N. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. 1' S 0ERTIFY THAT 1 POSSESS THE ABOVE VALID LOS' LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER GAS SYSTEM..-22—OUTLETS 0 0.50 OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. B10NATURE OCC JR ,C\� WATER HEATER @ 0.50 PERMITTE �Y SLOP SINK @ 0.50 INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER ® 0.50 DRINKING FOUNTAIN @ 0.50 URINAL @ 0.50 J Q HOUSE SEWER @ 0.50 Z MISCELLANEOUS L7 APPROVALS DATE INSPE R'B NAME ROUGH PLUMBING GAS PIPING 134 GAS VENT / CESSPOOL @ 1:00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT 1.0o GAS TEST /, _ UTILITY CO.NOTIFIED At TOTAL FEE s 7 -45 O v FINAL / „WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I'heietfy 'affirm that I have a CE 81 certificate of consent to self etz (?.-SO) insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab.C.) COUNTY,OF LOS ANGE LE` 4 BUILDING AND SAFETY Policy NA 29 �1 Company U.�lG/��D 0 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ^ S }Certified co NUMBER FIXTURE OR ITEM • FEE ADDRESS ��D /t copy is filed with the county building-inspection 1rP rt fe � - & _ WATER CLOSET LOCALITY Date J Applicant � ,A(FL 11 G6 NEAREST, n [� BATH TUB CROSS ST. Io CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER k,11 //f ,✓J 'L(//GE (This'section need not be completed if the work'involved LAVATORY MAIL 3 by the permit is for one hundred dollars ($100) or less.) ADDRESS SINK CITY k' 1Za_ T E L.N 0. S'ZY7 0 I certify that in the performance of the work for which this DISHWASHERn! U permit u issued;I shall not employ any person in any manner CONTRACTOR l) F-��¢ L L/.�.J<�6�� tU L CC so as to become subject to,the Workers' Compensation tiLaws. CLOTHES WASHER w f 0!� Q n, T .CL/M/4� `' 1*OL ADDRESS• Date/047-140Applicant d SWIMMING POOL RECEPTOR - t w NOTICE TO APPLICANT: If, after making this Certificate of CITY �ws� TEL. NO. 6/-31� d Exemption, you' should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. U) Compensation provisions of the1abor Code, you must forth- LICENSE NO. ��6 -CL SS C�� Z with comply with such provisions or this permit shall be WATER HEATER — deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. OCESSED BY LICENSED CONTRACTORS DECLARATION f OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL �L ness and Professions Code, and my-license is in full force and' DATE l r ' �� VALI ATION effect. License NumberL cc�� /4 Lic.Class C20 S/4) FINAL �n L I� ��'e - BY Contractot�f+/[dl/mA-0 k-e-ft"bate /✓I/�� . I am exempt from the licensing requirements as I am a Plan check fee. licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ 7 acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE /o c9d Lic,or Reg.No. Date Plan check applicant b , HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section.7031.5, Busi- City Tel.No.' 2 8 2 9 A ness and Professions Code): O1, as owner of the property, am exclusively contracting # 0 0 0 0-o 5 with licensed contractors'to construct the project r (Section 7044, Business and Professions Code). 2 -.0 1 •Q 0 Q CONSTRUCTION LENDING AGENCY 0 0 0 1 0,0 0 , I hereby affirm that there is a construction lending agency for the performance of the work for which this permit isyt�jLE G�q�� GAG �--�/p - 1 0,2 8.—8 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 SEE REVERSE-FOR EXPLANATORY LANGUAGE - ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County Jo enter upon the above-mentioned property for inspection purposes. \ Signature of Permittee Date