HomeMy Public PortalAbout8837 1/2 LAS TUNAS DR_Plumbing__ 7d%0Q n n-BO APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY LOS ANGELES
FO
WILLIAM J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN I DISTRICT NO. GROUP ZONE PERMIT NO.
�y// RECEIVED BY READY FOR DATE ISSUED
LI-5::—PLUMBER - _�+�P FIRST INSPECTION
ADDRESS
1 BUILDING /
ADDRESS
CITY TEL. NO. y,/ ryj
OOUNTY LOCALITY /M_fil1 'A /
LICENSE NO. : NO.
i� NEAREST
PERMIT FEES CROSS ST. UUi. . A
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER il1,2L,11
MAIL a
WATER CLOSET (TOILET) @ 0.50 5 ADDRESS
BATH TUB @ 0.501_1 CITY TEL. NO.
SHOWER @ 0.501 1 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.501 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING PLUMBING.
KITCHEN SINK @ 0.50 I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY CENSE. OR 1 AM THE LEGAL OWNER
OF THE RESIDEN IAL ROPERTV DESCRIBED ABOVE.
GAS SYSTEM OUTLETS @ 0.50 �7
SIGNATURE OF /
WATER HEATER @ 0.501 PERMITTE
SLOP SINK @ ow so INSPECTION RECORD
J FLOOR SI NK @ O.SO
FLOOR DRAIN @ 0.50
1 DISHWASHER @ 0.501
ORI NKING FOUNTAIN @ 0.501
1 URINAL @ 0.501 1 J
�1 HOUSE SEW Eft @ 0.501_1_
MISCELLANEOUS D
1 0
1 11
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
• GAS PIPING
GAS VENT L
LCESSPOOL @ 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK \
1 DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT . . 1.00 GAS TEST I I
{JYf1
UTILITY CO. NOTIFIED
TOTAL FEE $ VV FINAL
WORKERS'COM have ar ION DECLARATION ranasrn APPLICATION FOR PLUMBING PERMIT
1 hereby affirm that I have certificate of consent to self c en Iz-eo&
insure, gr a certificate of Workers'Compensation Insurance,or
a cprI I dy/ there e�38-q00 La/b/. 9,.JJ � A � � COUNTY OF LOS ANGELES 7, C BUILDING AND SAFETY
of Company f
Certified copy is hereby furnished. '///—'�� a� FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDINGNUMBER FIXTURE OR ITEM • FEE � ��I [1 J
Certified copy is filed with the county building inspection ADDRESS
4epartment. / WATER CLOSET LOCALIT -
E7L,f aLVr G(
Date Applicant NEAREST
BATH TUB CROSS ST. RCOj f>�VI Im
CERTIFICATE OF EXEMPTION FROM WORKERS' ^ '
COMPENSATION INSURANCE SHOWER OWNER - 10 /"`7�Clc ) -3
MAILI p�
.(This section need not be completed if the work involved LAVATORY ADDRESS
f'- `
e �t3 61
by the permit is for one hundred dollars ($100) or less.) SINK •p
CITY �d/Ln a TEL.NO:'L�s'��y� U
I certify that in the performance of the work for which this DISHWASHER
CONTRACTOR
permit is issued, I shall not em plo any person in any manner ��eJ �' O
so as to become subject to the rker ompen tion ws. CLOTHES WASHER 9/ U
ADDRESS'3Y LN N
Date Applican _ W
,Dat
SWIMMING POOL RECEPTOR d
NOTICE TO APPLICAN of r making this Certificate of CITY 51 2�.L TEL.NO. N
Exemption, you should beco a subject to the Workers' LAWN SPRINKLER SYSTEM STATErr LIC. z
Compensation provisions of the Labor Code, you must forth- LICENSE NO.3170 CLAS
with comply with such provisions or this permit shall be WATER HEATER
deemed revoked. - SYSTEM DISTRICT NO. "�v{a%6 BED
BYGAS
L
OUTLETS OVER OUTLETS
LICENSED CONTRACTORS DECLARATION OUTLETS OVER
I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM ^
9 (commencing with Section 7000)of Division 3 of the Busi- FINAL / _ �j & VAI
DAT& N
ness and Professions Code, and my license is in full force and DATE /
effect.
1 r ' FINAL
License Numbnce.r 7" O-L Li.. Class BY
Contractor !1/!�t'�.�0' Date��/ L � /
I am exempt from the licensing requirements as 1 am a Plan check fee `3 L
licensed.architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ t
acting in my professional capacity (Section 7051. Bus-
iness and Professions Code). TOTAL FEE 3
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
License Law for the following reason (Section,7031.5, Busi Icity Tel.No.
ness and Professions Code):
1, as owner of the property, am exclusively contracting AR Jr 2.2 8 A
with licensed contractors to construct the project
(Section 7044, Business and Professions Code). # e o e e - 5
CONSTRUCTION LENDING AGENCY 2 e ^ ) 3 O O
I hereby affirm that there is a construction lending agency
for the performance of the work for which this permit is 0 0 0 ) 3 0 0'X0
issued (Sec. 3097.Civ.C.)
Lender's Name — 0 S1 2-81
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))e resentatives of this County to enter upon the
abov 6ti d property for inspection purposes.
�l��
n ore of Permittee Date -