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Home My Public Portal About9842 LA ROSA DR_Plumbing__ `s 76A067 -<E#BI7 4-64 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 LOCALITY FTEE R APPLICANT TO FILL IN NEAREST o CROSS S7 LJ�/ IXTURE OR ITEM EACH FEE OWNER `/ CLOSET 71.25 MAIL @ !C g``- UB 1.25 ADDRESS FJ f'J} .LQ-✓ l� CITY TEL. NO. R 1.25 RY I.PS CONTRACTOR C� 1.25 ADDRESS SHER 1.25 CI TEL. N 7ps-I,- RY TUB 1.25 CONTRACTOR'S STATE Z) REGISTRATION NO. COUNTY ❑ S WASHER 1-25 * Z DlSTRIC7 NO. GROUP ZONE PROCESSED BY HEATER 1.50 1.50 INDUSTRIALCAS SSTEM OUTLETS WASTE APPROVAL OUTLETS OVER S PER SYSTEM .20 INSPECTION RECORD 0 O A. s 4 �A Z a tCi APPROVALS DATE INSPECTOR'S SIGNATURE LCE�r!FY ERMIT S 2 00 UNDER SLAB WORK = f ROUGH PLUMBING TOTAL FEE O GAS PIPING EBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT TE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY LL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER G. EBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANDIOR PLUMBING FIXTURES `�D A$ REOVIRED BV LO$ A 5 COVNTY ANOTATE OF GAS TEST ,y' 6NIA OR 1�EG L A WNE F ANO INTEND TON,THE V T IYEO UTILITY CO. NOTIFIEDURE RMITT VALID ( CASH 1 ROBERT A. WOOD cK. M.O.. CASH SUPERVISING MECHANICAL ENG"R n�� 3 6 7 3 3 JUL 2 2 5 D 1 2.5 0 a 78A66/-CF8I7,-113/, APPLICATION FOR PLUMBING PERMIT 1 . COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUDDING AND-SAFETY DIVISION BUILDING �) }}OHN A. LAMBIE, County Engineer ADDRESS -T ICOUNTY CASSATTD. GRIFFIN. Sup t of Building LOCALITY " L G TYFOR APPLICANT TO FILL INCRosS Si.NUMBER FIXTURE OR ITEMWATER CLOSET OWNER '� 'Mill. BATH TUB ADDRESSSHOWER CITY'ic TEL. NO.LAVATORY CONTRACTOR SINE ADDRESS DISHWASHER CITY TEL. NO. LADNDRY LRB CONTRACTOR'S REGISTRATION CLOTHES WASHER DISTRICTNO: GROUP I ZONE READY FOR INSPECTION WATER HEATER 1 GAS SYSTEM INDUSTRIAL WASTE APPROVAL t - INSPECTION RECORD APPROVALS @ $1.00 PER ITEM DATE INSPECTOR'S SIGNATURE OR FIXTURE $ UNDER SLAB WORK PERMIT $ 00 ROUGH PLUMBING 1 I TOTAL FEE GASPIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION —VENT 1 �� AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES —� I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF _ DESCRIBED RESIDEN CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO. NOTIFIED IAL PROPERTY. SIGNATURE OFPERMITTE ' _ FINAL ROBERT A.WOOD. ®P VALIDATIONS\gUPERVISING MECHANICAL ENG' CK. M.0. (`/yC,AS'N � R > [ Fico 2595'n FEB 19 5 A 3.0 0 n 7GA667 D9917 1I-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY m m PLUMBING COUNTY OF LOS ANGELES WILLIAM J. FDX, CHIEF ENGINEER _ PERMIT NLI. FOR PP >;ANT TO FILL IN DIB C O. ROUP D PLUMBER RECEIV[�D I READY FOR D JJ IJJHS��O.JE�G FIR INSPECTION ADDRESS i BUILDING 4AJCITY TEL. ADDRESS � COUNTY �� LOCALITY _. LICENSE O. E%PIRE9 J I/ EK NEAREST PERMIT FEES ORoss sr.�(ay NUMBER TYPE OF FIXTURE DR ITEM FEE OWNER / /EKY�2 r MAIL F WATER CLOSET(TOILET) 0.50 B &7V ADDRESS BATHTUB ® 0.50 CITY TEL SHOWER 0.50 1 HER AY ACKNON(LE GE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) Q 0.50 APPLICA ON AND ST%pTX THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK Q 0.50 AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY Q 0.50 ANGELES CDUNTY LICE SE. DR I AM THE LEGAL OWNER OF THE RESIDENTIAL OP RTYDESCRIBE ABO E. GAS SYSTEM-OUTLETS Q 0.50 SIGNATURE OF WATER HEATER Q 0.50 PERMITTE SLOP BINK Q D.SD INSPECTION RECORD FLOOR BINK Q 0.50 FLOOR DRAIN Q. 0.50 DISHWASHER Q 0.30 DRINKING FOUNTAIN Q 0.50 URINAL Q 0.50 Q HOUSE SEWER I Q' 0.50 - Z MISCELLANEOUS Q D O APPROVALS DAT��]]E�� INSPECTOR'S NAME ROUGH PLUMBING 6" — 9'/J y GAS PIPING GAB VENT CESSPOOL Q LOOT CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) Q 1.00 SEWER PERMIT I Loa GAS TEST TOTAL FEE S UTILITY CO. NOTIFIED FINAL ��7 , WORKERS `OMPE"SAT'°" °E""RAT'°"• O APPLICATION FOR: PLUMBING PERMIT: - {j « zo-oose DPW'4/87 LJ I here,hy gffiFtq�.ihat I hdve`a certificate of consent to self in ]6A66]A sure,oro certificate of Workers'Compe'6s6fion IIsurance,or a -'CE 817(REV. 8/86) certifie-Inypfjeseof(Sec 3800 lab t )'' - - - 0 - COUNTY OF LOS ANGELES'•, DEPT. OF PUBLIC WORKS ?oicyyNo_ Company _ - , . Ce ifred copyi is hereby furnished. _ 'FOR APPLICANT TO FILL-IN (PRINT OR TYPE):' - 8UILDING' Ceriified copy"is filed wlth'the countybuilding inspection ; ADDRESS deportment. s NUMBER ,. - FIXTURE OR ITEM @ FEE t LOCALITY ` Date WATER CLOSET(TOILET) Picdnt NEARESTOu ; .. CROSS'ST' TUB UB . � �I CERTIFICATE OF EXEMPTION FROM'WOR KERS' ^ 1, - . . COMPENSATION INSURANCE SHOWER OWNER_ „ -(This section need not be`cornpletedif*the work involved by - - "MAIL - - '. the permit is for one hundred dollors($100) or less.)+• _ LAVATORY+ ADDRESS' —' I certify that ni t6e pertormance of the work for winch this per- SINK _JaOO CITY �--' - TEL. NO./, b l,� mit is issued, I shall not employ'any person in any mamner so - 1 as to become'subject to the-Workers'Compensation Laws. .. ..DISHWASHER ' ' •'r -' - CONTRACTOR Date Applicant - k.. CLOTHES WASHER, _ NOTICE TO APPLICANT: If, after making this Certificate oF:Ex- SWIMMING- �i D ADDRESS POOL RECEPTOR _ emption youshould.become subject to the Workers'Camper- CITY - TEL. NO. ' sation provisions of the Labor Cade, you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions:or this permit shall be deemed revok- - - STATE LC. ' ed. .. ` I - ;, WATER HEATER, _ LICENSE NO.. - CLASS ' UCENSED•CONTRACTORS DECLARATION DISIRICTjJO� ROCE S •BY - I hereby affirm that am licensed undeq provisions of Chapter "GAS SYSTEM - .OUTLE75 /vv''l) a 9-(commencing with Section 7000)of Division 3 of the:Business OUTLETS OVER - - ond-Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL _ fecC LVALIDATION- .. DATE ir S /lJ _ O License Number Lic-Class r N ' ' '' FiN. • N cc . Controcior Date - - BY l-' Q �t 77 . am ekeFnpt under Sec - - _, ; - W - B 8P C for lFiis reason - - p U) . Plan check fee - ti Dale: - lop. f -3a�-;. .n 2: PLUMBING PERMIT ISSUING FEE$ - ,- ' Signature ,SIN _. _ - - - , TOTAL FEE SINGLE FAMILY .. . _. -...0 _ HOME OWNER-BUILDER DECLARATION m Plan eck.chapplica5 nt _L ✓< i� t t f`• ., I hereby affirm.that I am exempt from b�.I t�the Contractor's License Name ' "' - + _ ANT Law far the following reason(Section,7031:5,.Business and - - - - Profe`ssidns Code): . .Address �� RQ *�„ ;r JJ�7 ri34.513 I, as owner'of'the property; will do the work and.rhe Cit '` Tel. No. ;� 1� q + 4,.� , 5• - 1 ITEMS - !'-.kStructure is not mtended or offered for sale(Section 7044, �. Business ood'Professions Code). - - • T(ITAL. 34 -r® ` CONSTRUCTION LENDING AGENCY' .F _ _ .- 4H�=Yv 34•50 hereby affirm bai.ihere is a construction lending agency for - ,l; l`�(iE •110 The'performance of the work.for which,this permit is issued - (Sec:,:3097,"Civ. C.). - - - Lender's Name' ` + t 00+00-0001 Zd/ 9184. Lemder's'Adclress i - i, - - 6117 1- AM 9%24 I cerfify thatl--have read this application and state that the .. - above informs ion.is correct.,I agree to,comply with all County s - ordi ' ces a dstaie low ting Plumbing,.and hereby <�e,' -' - uth -ey re r eM tivo is. unty to.enter upon the - 1 - 60 - enti ed o rty or insp tion purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Sig rat re o Permittee - r Dcte - WORKERS''COMPENSATION DECLARATION 7GA667A I .hereby affirm that I have a certificate of consent to self CE etr (2-ae) APPLICATION FOR PLUMBING PERMIT insure, o4a certificate of Workers'Compensation Insurance,or certified copy thereof(Sec.3800, Lab.C.) l.-f COUNTY OF LOS ANGELES rl BUILDING AND SAFETY Policy No. Company - ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ADDRESS r_1 ,T Certified copy is filed with the county building inspection- NUMBER FIXTURE OR ITEM • FEE `� department. WATER CLOSET LOCALITY _ /f/ e Date Applicant NEAREST /^/Q[AJ o A/'�-�_ 4/v `CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. Car. COMPENSATION INSURANCE - SHOWER - OWNER r (This section nebe completed if the work involved . by� the permit iss for ADDRESS LAVATORY MAIL for one hundred do0ars ($100) or less.) SINK � O - CITY TEL..NO. 7 U I certify that in the performance of the work for which this DISHWASHER permit is issued, Ishall not employ any person in any manner CO NTRACTOso as qr �F.r7Hn Date to become�� DApplicanttheWorkers'J26a'I allo� ni ' - CLOTHES WASHER -•p/ 7 '� / W f/ / ADDRESS L.J ��19. SWIMMING POOL RECEPTOR /4 ^C,` ,r �� NOTICE TO APPLICANT: If, after makingthis Certificate of CITY /� /l �I TEL. NO7KIFto - Exemption, you should become subject. to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. Z Compensation provisions of the Labor Code, you must forth- - LICENSE NO. B / CLASS with comply :with such provisions or this permit shall be WATER HEATER deemed revoked. GAS SYSTEM OUTLETS DISTRICT,� NO. PR CESSED BV LICENSED CONTRACTORS DECLARATION' OUT LETS OVER S'Va I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINAL wpVALIDATION ness and Professions Code, and my license is in full force and DATE 4 (� effect. FINAL License Numb Lie.Class FBY I r.J Contractor�MsA Date I am exempt from fie licensing requirements as I am a Plan Check fee -2s- acting -"�_" licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ /S acting in my professional capacity (Section 7051, Bus- tT , iness and Professions Code). TOTAL FEE Q Lie.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name 21 8 A • 5' I hereby affirm that I am exempt from the Contractor's Address ° o • s License Law for the following reason (Section,7031.5, Busi- ' City - Tel. No. 2 ° ° 1000 ness and Professions Code): ❑ 1, as owner ofthe property, am exclusively contracting - ,°•° ° 1 0.005 with licensed contractors to construct the project (Section 7044, Business and Professions Code). 2'5r•8.0 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 readthis application and state that the - above information is correct. 1 agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE- ordinances and State laws regulating Plumbing, and hereby - authorize representatives of this County to enter upon the alm - entioned prop y f t s e tion purposes. ., &.,, 7-25 0 " 'Signaturemitt)ee- Date