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Home My Public Portal About9921 LA ROSA DR_Plumbing__ PLUMBING 1 -DIEPARTbiENT OF COUNTY ENGINEER DIVISION OF BUILDING AND SAFETY PERMIT APPLI ATION, COUNTY OF LOS ANGELES BUILDING�� WILLIAM J. FOX, COUNTY ENGINEER ADDRESS V LOCALITY T C. ajci 7,1 FOR A PLICANT TO FILL IN NEAREST -"� BUILDING n L /J CROSS DISTRICT NO. GROUP ZONE PERMIT N0. ADDRESS 7 �j f //!��L d// Rh.S r�. _(((T r LOCALITY L- L=1 7 /G L I A-� $%�o NEAREST CROSS ST. t, tV1 Al �R GEIIVVEI)BY Raady for Inspection DATE,ISSUEUD OWNER Ra �C ✓ L/j HAIL // IN ADDRESS / Q '�. n lY G O WASTE APPROVAL CITY S'if,r CAG� I.I�n TEL.NO. INSPECTION RECORD L_, PLUMBER ..7/ I L_ `r-3 /N ADDRESS / // a, a .)r /,j XLij 6a1- Te M f lv CITY P IP C1` y' TEL.NO. FO d 7 �oTfr STATE LICENSE NO. / /J 3 f}COU NTY J PERMIT FEES < z_ a.M.ER TYPE OF FIXTURE OR ITEM FEE a WATER CLOSET(TOILET) @ 0.80 S O it O BATH TUB @ 0.80 8 d SHOWER @ 0.80 A, Q LAVATORY(WASH BASIN) @ 0.80 O KITCHEN SINK @ 0.80 LAUNDRY TUB OR TRAY @ 0.80 <1 SLOP RINK @ 0.80 FLOOR SINK @ 0.80 FLOOR DRAIN @ 0.80 DISHWASHER @ '0.80 DRINKING FOUNTAIN @ 0.80 URINAL @ 0.80 _ GAS SYSTEM------~---OUTLETS @ 1.00 099 WATER HEATER @ 1.00 O MISCELLANEOUS APPROVALS _ DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING TOTAL FEE 9 10 GAS PIPING 1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI. GAS VENT CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATERHEATER TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED �{- AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST AND STATE OF CALIFO NIA R THgi I AM THE LEGAL OWN. V ER OF THE ABOVE 0 RIB 1) 1(ESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED ) R/ (/,( f l- SIGNATURE PERMIITTEE. .. O_„ ..... ...�✓FeN.�Y.L......_.._._...._......_.... FINAL V 777—/ 76A667 DB817 rA� sn_A� WORKERS' that COMPENSATION DECLARATION . APPLICATION PPLIC TION COR PLUMBING PERMIT I hereby, affirm Ihot Lhave a certificate of consent to self in- 20-0026b �4v� Mr r \r/'1 1 1\ r R r ,Y, 1,V PERMIT sure,or a certificate of Workers'Compensation Insurance,oro c I certified copy thereof (Sec. 3800, Lob. C. ,ILJII Policy-No. Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS 7 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING9qZ/La k0JA DG, Certified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY 7P�, Dote Applicant WATER CLOSET(TOILET) (� 7J NEAREST /pp CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. 9?4z' ttiw COMPENSATION INSURANCE SHOWER OWNER Cff*+N4 1�fu.Vy� GDf/ (This section need not be completed If the work Involved by MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY �� D ADDRESS I certify that in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so CITY r TEL. NOd IId 3 —o 4/61P as to become subject to the Workers Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- emption,you should become subject to the Workers'Compen- CITY TEL. NO. lotion provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATE - LIC. ed. WATER HEATER LICENSE NO. cCLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. ROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL WIDATION x50 fect. HOSE BIB DATE License Number lic. Class O FINAL ' U Contractor Date BY cc 1 am exempt under Sec. a �� TyyO.�TTAL ITE1179 )9.50500 - B.BP.C. for this reason MG W Plan check fee ► M Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE J!"D 0000-0001 8/21/95 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant 1919 I hereby affirm that I am exempt from the Contractor's License Name 1 AM 8'37 Law for the following reason (Section 7031.5, Business and Professions Code): Address Irl 1, as owner of the property, will do the work and the City Tel. No. �! 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 r 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-mpection purposes. cP—IJ'-7-r— SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of Permittee Date \yOffirm that I PENSATIONDECLARATION ,^^«, l APPLICATION FOR PLUMBING PERMIT I hereby affirm that I Rove a certificate of consent to self ce ev Iz-sol insure, o• acAtitice,te of Workers'Compensation Insurance,or ° a certi9ied copy thereof(See. 3800,Lab.C.) COUNTY OF LOS ANNG AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING O - ADDRESS Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • F ' C department. LOCALITY WATER CLOSET Date Applicant NEAREST BATH TUB \ CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' / COMPENSATION INSURANCE SHOWER OWNER C LAVATORY MAIL s (This section need not be completed if the work involved CADDRESS �( y by the permit is for one hundred dollars (SI00) or less.) SINKCITVTEL. NO. 0 �` 1 certify that in the performance of the work for which this DISHWASHER V permit is issued, 1 shall not employ any person in any manner CONTR ACTO so as to become subject to the Workers' Compensation Laws. CLOTHES WASHER 0 ADDRESS Date Applicant SWIMMING POOL RECEPTOR U NOTICE TO APPLICANT: If, after making this Certificate of CITY TEL. NO. d Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATEIC. N Compensation provisions of the Labor Code, you must forth- LICENSE NO. ASS Z with comply with such provisions or this permit shall be WATER HEATER deemed revoked. / GAS SYSTEM OUTLETS DISTRICT NO. P CESSED BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER 1 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 VALIDATION ness and Professions Code, and my license is in full force and DATE effect. FINAL License Number Lic.Class BY Contractor Date I am exempt from the licensing requirements as I am a! Plan Check fee licensed architect or a registered professional engineer PLUM8ING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Lic,or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address �,3 0 3 1 A License Law for the following reason (Section 7031.5, Busi- City Tel.No. rQe �ss a"nd Professions Code): o 0 0 o a 5 y*t, as owner of the property, am exclusively contracting �wrth licensed contractors to construct the project 2 0 0 2 8 0 0 (Section 7044, Business and Professions Code). eOe2aoo5 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency ( 1. 1 2-80 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 1 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 la1.apccti�. lumbing, and ereby authorize representativesto enter up n thebo - ntioned propertyurposes. igna a of Permittee Date 'WORKERS't1na COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby, aflirm that have b certificate of consent to self in- 76A��A PW 4/87 n sure,or a certificate of Workers Compensation Insurance,or a CE 817(REV. 8/86) �ILJII certified copy thereof (Sec. 3800, Lab, C.) Policy No. Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS C Certified copy is hereby furnished. - BUILDING FOR APPLICANT TO FILL IN (PRINT OR TYPE) 9z/ 4, d Certified copy is filed with the county building inspecti ADDRESS 7 L (/ NUMBER FIXTURE OR ITEM FEE LOCALITY department/. @ Date S'�0�7 Applican WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS Si. G (,(�jN E COMPENSATION INSURANCE SHOWER OWNER v �� C- d ��ERs• (This section need not be completed if the work involved by MAIL the permit Is for one hundred dollars ($100)or less.) LAVATORY17 ADDRESS I certify that in the performance of the work for which this per- mit is issued, I shall not employ any person in any manner so SINK CITY L� �'T TEL. NO. S as to become subject to the Workers Compensation Laws. DISHWASHER CONTRACTOR 'LLE S Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR em prion,you should become subject to the Workers'Compen- � sation provisions of the Labor Code, you must forthwith comp- ly with such provisions or this permit shall be deemed revok- SLICTATE LIC. ed. WATER HEATER ENSE NO. CLASS ..L7 LICENSED CONTRACTORS DECLARATION ' DISTRICT NO.. ROCESSED BY I hereby affirm that I am licensed under provisions of Chapter r GAS SYSTEM / OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and mylicenseis in full force and at- 5 PER SYSTEM FINAL F VALIDATION FIa fest. GZ /O .O License Number Lic. Class O FINAL IZ V Contractor CiI...O�c `�F/�iL/�Eo/ / BY O I am exempt under Sec.. W B.BP.C. for this reason Plan check fee , 2 Date: PLUMBING PERMIT ISSUING FEE S pp Signature TOTAL FEE OT SINGLE FAMILY. HOME OWNER-BUILDER DECLARATION Plan check applicant - �t I hereby affirm that I am exempt from the Contractor's License Name ` Law for the following reason (Section 7031.5,'Business and R .i C:I t. Professions Code): Address 33cp 'G.alj I, as owner of the property, will do the work and theCity Tel. No. ITEN 'structure is not intended or offered for sole(Section 7044, t I' Business and Pr ofessions Code). TOTAL5 Ito. - 50 IFC CONSTRUCTION LENDING AGENCY GF Et:P JU.. Li I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued Ci'IirNGE =Ile t (Sec. 3097, Civ. C.). #. Lender's Name [I_11I{I-flf_kUi _tl�CV7 S Lender's Address 1I_1! 1 HPI 714ce• t 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 representativ of his County to genter upon the a e mentionedpro rty spection pur oes � SEE REVERSE FOR EXPLANATORY LANGUAGE Sign ure of Permitp Date ,