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Home My Public Portal About9503 LA ROSA DR_Plumbing__ • COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer PLUMBING� � -DIVISION OF BUILDING & SAFETY WILLIAM J. FOk, County Engineer FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PLUMBER i 0 umb nLT Serv, RECEIVED BY READY FOR FIRST INSPECTION DATE/SSU_Ep ' ADDRESS 1465 San Marino Ave BUILDING CITYSan Marino TEL. No.At 1-1742 ADDRESS 9503 !�. La Rosa ,Dr• COUNTY CENTE NO. EXPIRES LOCALITY Temple. City NEAREST PERMIT FEES CRSS ST. TAmj)lQ�rll t7. Blvd.. _ e NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER Knet� Stewart- WATER p MAIL WATER CLOSET(TOILET) @ 0.5D SO ADDRESS 9503 F c T,;.] }RnRA Dr . BATHTUB @ 0.50 CITNTemble 'City TEL. No. SHOWER 8 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS I LAVATORY (WASH BASIN) 0.50 80 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY-ORDINANCES KITCHEN BINK Q 0.50 AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY � 0.50 ANGELES COUNTY LICENSE, OR I AM THE/LEGAL OWNER GAS SYSTEM OUTLETS 0.50 OF THE RESIDENTIAL P PERTY DD CRIBED ABOV SIGNATURE OF WATER HEATER @ 0.5D PERMITTEE SLOP BINK 0.50 _ INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ ,0.50Z01/45-5 w�.i/lFa, C,tl Z.i& _ DISHWASHER 0.50 _ DRINKING FOUNTAIN 0.50 URINAL 0.50 -J a HOUSE SEWER 0.50 Z_ MISCELLANEOUS (7 O APPROV/ALS ATE INSPECTOR' NAME ROUGH PLUMBING ;61 -e. GAB PIPING GAS VENT CESSPOOL 1:00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) (it 1.00 SEWER PERMIT 1.00 GAS TEST UTILITY CO.NOTIFIED TOTAL FEE 2 6 FINAL 7GA667 DBS#k 17 6-52 1 D.B.S.-17 25M SETS 6-46 APPLICATION FOR PERMIT- DEPARTMENT OF BUILDING AND SAFETY. �� 'GOUNTY OF LOS ANGELES WM.J. FOX. CHIEF ENGINEER NATURE OF'INSTALLATION DISTRICT . GR/)OUP ZONE PRIlmly NO. ROUGH FIXTURES COMPLETE d - RECEIVED BY READY FOR DATE ISSUED HEATER CESSPOOL SEPTIC TANK L/� FIRST INSPECTION` q C/ ASMISCELLANEOUS to }}�� 1JOB APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY /1 It -NAMA. C. NOTTINGHAM CO. ADDRESS f-+J/V 1. S _ dl� ��.1�J&. A` g ADDREssl23 Nco. CIoyerY" IA-y�{'�AyP- LOCALITY- n NEAREST TEMPLE OJ. CITY CITYTEta. Lig CZOSS BT. �I� Jul /�J«"L�11C✓I,�.. CERT.TNo. EXPIRES • �• NAME �`i`l'L LOCATION OF SEPTIC TANK, OR CESSPOOL AIL 3 ADDRESS. } 94 NORTH' O 1110 CITY 1_, . ,A TEL.No. I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CEgRTTIFICA}TE OF QUALIFICAATION. . PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. A \ D OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK z BATH TUB FURNACE HOWER DISHWASHER O LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN . WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING ME3'ER GAS SODA FOUNTAIN GAS PIPING OUTL GAS VENT CESSPOOL ( Vp`,fig N� L�/✓ TOTAL.NUMBER OF FIXTURES -- SEPTIC TANK I I ` / CESSPOOI If SEPTIC TANK, SEWER - I UTILITY CO.NOTIFIED TOTAL FEE ( FINAL 7t,kB67 ,n s-Bo 0 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY, COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN � DISTRICT NO. GROUP ZONE PERMIT NO. d' PLUMBER ' RECEIVED BY READY FOR DATE ISSUED 1 _ FIRST INSPECTION ADDRESS 1�I m-��' �} NOW 9 . C City wrXy 'B U/ILDING ft.. CITY Culver City TEL. NOE -72151 r(41 J1 ADDRESS 9101-LR .Rrvta - COUNTY LOCALITY LICENSE NO. EXPIRES EXPIRES t!i..3n..ri1 NEAREST PERMIT FEES CROSS ST. SUngAt RJ (J. F. StIlArt NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET-(TOILET) Q 0.50 $ ADDRESS n ' BATH TUB Q 0.50 CITY TEL. NO. SHOWER Q 0.50 I I HEREBY� ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND LAVATORY (WASH BASIN) Q 0.50 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK Q 0.50 STATE LAWS REGULATING PLUMBING. , 1 CERTIFY THAT 1 POSSES-S, THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, O I AM TH L GAL OWNER OF THE RESIDENTI ROP�FR DE CRIB VE. GAS SYSTEM OUTLETS Q 0.50 I SIGNATURE OF WATER HEATER Q 0.50 PERMITTEE, SLOP SINK @ 0.50 INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN Q 0.50 DISHWASHER Q 0.501 DRINKING FOUNTAIN Q 0.50 URINAL Q O 50 W h HOUSE SEWER @ 0.50 Q U_ MISCELLANEOUS -1 IL Wigtor Softener so 0 . I . APPROVALS I DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING I GAS VENT { CESSPOOL @ 1.00 I CESSPOOL SEPTIC TANK: I SEPTIC TANK DRAIN ( ) PIT ( -W-I SEWER PERMIT . 1.00 GAS TEST TOTAL FEE J $ 1 CO UTILITY CO. NOTIFIED FINAL D.0.17. 5M SETS 4.43 p- t' APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY a COUNTY OF LOS ANGELES PL��'�� WM. J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE RE EIVED BY READY FOR DATE ISSUED HEATER __CESSPOOL SEPTIC TANK /C_y FIRST INSPECTION ! GAS MISCELLANEOUS " ,APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY C NAME /I ,A„' ,?I +�- ADD11 ADDRESS LOCALITY- L A. t• ..4 d �� _ //may / /f NEAREST nJ. CITY '' TEL.N0:�J I4�(� CROSS ST. ,� ,� COUNTY S CERT.No. '� EXPIRES `�� W NAME LOCATION OF SEPTIC TANK, OR dlESS"'bi, Z MAIL 3 ADDRESS NORTH O CITY TEL.No I AM THE LEGAL POSSESSOR OF THE ABOVE L09 ANGELES COUNTY CERTIFICAT OF QUALIFICATION. � r ._ (PLUMBER I AM THE LEGAL OW ER OF THS PFIOPER .1 DES ED ABOVE. F W D 3 OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK a z_ BATH TUB FURNACE pJ ROWER DISHWASHER 0 LAVATORY REFRIGERATOR ® KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP LOP SINK FLOOR DRAIN pp� WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER H TER DENTAL LAVATORY ROUGH PLUMBING A A METE GAS SODA FOUNTAIN OUTL GAS PIPING GAS VENT CESSPOOL I I TOTAL NUMBER OF FIXTURES SEPTIC TANK I F CESSPOOL SEPTIC TANK SEWER s UTILITY CO.NOTIFIED I TOTAL FEE .e z J ra 9 FINAL 6 L V-7 / • .�`A'ORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have'a certificate of consent to self 20-0026 DPW 6/87 . Asure, or a certificate of Workers'Cofnpensation Insurance, 76A667A IL JI or a certified copy thereof (SYc 3800`Lobb C COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Poli No. "8LRI-C-oompany ✓-'``T �UNO Certified copy is hereby furnished.❑ �O 3 &. ! �V ,J . �vc FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the co y builds inspec- ADDRESS t n de artment NUMBER FIXTURE OR ITEM @ FEE I /��/ LOCALITY Date ` ^� Appli4ant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM RKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER rn� �� So e (This section need not be completed if the work Involved by MAIL /k--0 � n�� fi the permihis for one hundred dollars($100)or less.) LAVATORY ADDRESS``''[[JJ AO SA certify that in'the performance of the work for'which this permit is issued, I shall not employ any person in any manner SINK CITY TEy`,1 PL. C1T TEL NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR SU" S 2.6-452- al 15i94/5 Date Applicant CLOTHES WASHER ADDRESS 71$v ��kr[-� cl NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should- become subject to the Workers' CITY p /`rRLD TEL. NO. qyE,- Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE ? LIC. deemed revoked. WATER HEATER LICENSE NO. v Z1�Z CLA55 LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED 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 BusinessOUTLETS OVER J and Professions Code,and m licnense is in full force and affect. 5 PER SYSTEM FINAL Gj VALIDATION a� i- C. . DATE License Number ^ Lic. Class pFINAL A_ U �- /� e "tom S //�✓' Contractor Date g BY j O. ❑ A I am exempt under SecU. W BAP C for s reason C/)Plan check fee , Poo. Z PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE Plan check applicant - SINGLE FAMILY •'s HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031 5, Business and Address Professions Code): - City Tel. No. ❑ I, as owner of the property, will do the work and the " structure is not intended or offered for sale (Section ' Pilo T?_!TAI _20 ® 50 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY - '- I hereby affirm that there is a construction lending agency for CHANGE AG the performance of the work for`which this permit is issued (Sec. 3097, Civ. C.). Lender's Name ia''•)!tt i-I i(il_r j _., IL%;`i-3 Lender's Address 6 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-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date