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Home My Public Portal About9708 LEMON AVE_Plumbing__ D.B. 17 25M BETS 17-43 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY', COUNTY OF LOS ANGELES I PLUMBING ' WM. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT N57. ROUGH FIXTURES COMPLETE C/ d PJ RECEIVED BY READY FOR DATE ISSUED HEATER CESSPOOL 1-1 SEPTIC TANK h��ygc�yr FIRST,,INSPECTION AS -MISCELLANEOUSX' � s�-� ?_7 ` -f_s APPLICANT}FFIILL IN. HEAVILY OUTLINED PO/R�TION ONLY p� } NAME � /C /f/ / e� ADDRESS (� ® IIS A44 J� m ADDRESS Q LOCALITY D NEAREST .ao� a CITY �►� Ala TEL.No. CROSS ST. COUNTY —- � CERT.No. ll�_® EXPIRES ��r.: m NAME • �! LOCATION OF SEPTIC TANK, OR CESSPOOLz MAIL ADDRESS /V/ NORTH O CITY TEL.No. 1 AM THE LEGAL POSSESSOR OF THE AJ30V LOS ANGELES COUNTY CERTIFICAT OF Q AL IFIC TION. 1 )$PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. N OWNER '1 CORRECTIONS SOUTH J DESCRIPTION OF WORK a Z_ BATH TUB FURNACE R' —SHOWER DISHWASHER Q LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP r' SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAMi WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER GAB SODA FOUNTAIN GAS PIPING OUTL GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES rw SEPTIC TANK I I 1 CESSPOOL SEPTIC TANK. _ SEWER S , UTILITY CO.NOTIFIiD TOTAL FEE l T'- FINAL / D.B.S.17 25M SETS 7-47 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WM. J. FOX. CHIEF ENGINEER - PLUMBING NATURE OF INSTALLATION DISTRICT O. GRI111 ZONE PERMIT O. ROUGH FIXTURES COMPLETE RECEIV D P READY FOR DAVE ISSUED HEATER CESSPOOL I-I SEPTIC TANK FIRST INSPECTION AS MISCELLANEOUS ze APPLICANT FILL IN IIEAVIT OUTLINED PORTION ONLY NAM TTY•1 TTIAN CO. I ADDRESS 36 O `/ � V, �e ADDRESINA) over yAve. LOCALITY TEMPLE CIT NEAREST '� CITY 1f CROSS BT. �► IKi IL COUNTY CERT.NO. EXPIRES m NAME LOCATION OF SEPTIC TANK, OR CESSPOOL z MAIL 3 ADDRESS NORTH O CITY TEL.No. IAM THE LEGAL POSSESSOR OF THE ABOVE LOB ANGELES COUNTY CERTIFI T >�(CATION. PL SHR M JOVE THE LEGAL OWNER OF THE PROPERTY DESCRIBED A p W OWNER CORRECTIONS i SOUTH J DESCRIPTION OF WORD i BATH TUB FURNACE 9 lY SHOWER 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 I METER-GAS SODA FOUNTAIN OUTL GAS PIPING GAS VENT 'CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK I I CEBSPOOI SEPTIC TANK c SEWER UTILITY CO.NOTIFIiD TOTAL FEE FINAL i WORKERS'COMPENSATION DECLARATION ' APPLICATION FOR PLUMBING PERMIT I.hereby affirm that I have a•certificate of consent to self' X20-0026 DPW 6/87 insure, or a certificate of Workers' Compensation Insurance, 76A667A `dor a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS 'Policy No Company ❑ Certified copy is hereby furnished F1 Certified APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building mspea ADDRESS d '•I tion department NUMBER FIXTURE OR ITEM Q FEE LOCALITY 'T' Z Date Appligant ' � WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WOR kERS' BATH TUB ( 1150 CROSS ST COMPENSATION INSURANCE OWNER (This section need not be completed if the work involved by 2 SHOWER �,� �! the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS lei [i 641 O/V v 1 certify that in the performance of the work for which this n permit is issued, I shall not employ any person in any manner ' SINK b CITY l� D� TEL N �r�Js7�,02� so as to become subject to the Workers'Compensation Laws DISHWASHER CONTRACTOR O WA)TrR Date Applicant CLOTHES WASHER �nI NOTICE TO APPLICANT- If, after making this Certificate of ADDRESS fb ov Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY TEL NO LAWN SPRINKLER SYSTEM STATE LIG with comply with such provisions or this permit shall be deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATIONB", RICT NO PR SED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect 5 PER SYSTEM FINAL DATE ALI ATION a License Number Lic Class 0U FINAL Contractor Date BY OO ❑ I am exempt under Sec V W B&P C for this reason Plan check fee CO Date PLUMBING PERMIT ISSUING FEE$ Z Signature TOTAL FEE SINGLE FAMILY Plan check applicant c HOME OWNER-BUILDER DECLARATION Name aCC`ov I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031 5, Business and ��I� 38.00Professions Code)•❑ City Tel No 1 ITEMS I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section , TOTAL 1.3,.4101, ® �� 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY CHECK 83.00 I hereby affirm that there is a construction lending agency for .HANGE oCl the performance of the work for which this permit is issued (Sec 3097, Civ C ) Lender's Name 1000-0001 6/212/90 Lender's Address 1425 1 AM 7:42 1 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 pop- authorize representa es of this County to enter upon the above-n�ntioned op rty for inspection 6 7��l o 1h/t/�k SEE REVERSE FOR EXPLANATORY LANGUAGE Sign ture of Per ittee Da