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Home My Public Portal About9716 LEMON AVE_Plumbing__ 76A667 (CE-817)-8-71 APPLICATION FOR PLUMBI G PER COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ADDRESS i CQ G LOCALITY 1�1,ee�,¢fi �Y FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST "T- £ % NUMBER FIXTURE OR ITEM @ FEE OWNER WATER CLOSET 1 75 MAIL BATH TUB 1 75 ADDRESS 6 <L, _f SHOWER 1 75 CITY TEL. NOy _ LAVATORY 1 75 CONTRACTOR �� L SINK 1 75 ADDRESS DISHWASHER 1 75 CITY J TEL. NO yy CLOTHES WASHER 1 75 STATE LIC LICENSE NO CLASS SWIMMING POOL RECEPTOR 1 75 DIST RI pl0 G5QOJP ZdaN E BY LAWN SPRINKLER SYSTEM 1 75 (//) WATER HEATER 1 75 7 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1 750 INSPECTION RECORD U OUTLETS OVER 5 PER SYSTEM .30 _O u 196 z Plan check fee See reverse. PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INS PECTOR'3 SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. NO. GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OFaA INTENDTORESIDE IN THE ABOVE DESCRIs RESIDE FIAL PTY FINAL SIGNATURE OF PERMITTEE PERMIT VALIDATION OCK M o CASH PLAN CHECK VALIDATION CK M O CASH I 13 4,75- t 0547 ! N AN 7GA667 n s-eo K APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY I COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISrCT NO. GROUP I ZpN% PERMIT a PLUMBER ! '1'I� �^ ' 1 ' •J R QEIVED BY READY FOR DATE ISSUED ' '� ", ��.ry-� FIRST INSPECTION [ADDRESS�i '_j��rJ _ BUILDING ,/ ADDRESS / /�I P.r^ i- }_'1.'ii 1 •' CITY 1� �iC7 r L/'-" 11 <t TEL NO. COUNTY /r 7 A r -; LOCALITY LICENSE NO �� / A EXPIRES(% L/-/I J". f- NEAREST PERMIT FEES CROSSST NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET (TOILET) @ O 50 $ �' ADDRESS BATH TUB @ O 50 I ' CITY TEL. NO. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) Q O 50 i� i APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND p AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND '.{ KITCHEN SINK @ O 50 STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ O 50 'i '•', ANGELES COUNTY LICE SE, OR 1 AM THE LEGAL OWNER GAS SYSTEM RESIDENTIAL PZ ESCRIBt AB E OUTLETS @ O So SIGNATURE OF • WATER HEATER @ 0.50 '�r PERMITTEE SLOP SINK _ Q o so INSPECTION RECORD FLOOR SINK @ O s0 1 / FLOOR DRAIN @ O 501 DISHWASHER @ O SoI / _,.oS _-�anC DRINKING FOUNTAIN Q O 50 ( d •G URINAL Q O 501 �• I HOUSE SEWER Q O 501 ' T N Z MISCELLANEOUS I � 6�1�,d1r,c i /J,e•r� � I� APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING nn --* GAS PIPING A�4'� 14 GAS VENT CESSPOOL @ 1 00 CESSPOOL 1 SEPTIC TANK' I SEPTIC TANK I DRAIN ( ) PIT ( ) Q 1 001 SEWER J PERMIT I 1 00 GAS TEST UTILITY CO NOTIFIED TOTAL FEE I $ FINAL 76A667 DBS 17 7-s1 APPLICATION FOR PERMIT - DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER DIST = PERMIT NO. FOR APPLICANT TO FILL IN RGROUPZ PLUMBER AR EIVED BY READY FOR E ISSUED FIRST INSPECTION ADDRESS v �-A (- B ILDING CITY n X� 4 A� TEL No. ADDRESS QOUNTY u v n NHtv E NO. EXPIRES LOCALITY _/� � NEAREST PERMIT FEES CROSB ST. e NUMBERTYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET(TOILET) 0.60 S ADDRESS BATH TUB @ 0.50 'CITY TEL No. SHOWER a 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK 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 OF THE REBIDENTIALRROPE Y E RIBED ABOVE GAB SYSTEM �UTLETB 0.60 -SIONATURE OF ) WATER HEATER � 0.50 PERM ITTE ^ SLOP SINK 0.50 INSPECTION RECORD PLOOR BINK 0.30 FLOOR DRAIN 0.50 DISHWASHER 0.50 DRINKING FOUNTAIN 0.30 URINAL 0.50 Q HOUSE SEWER D.BO C� - _Z MISCELLANEOUS E7 IY O APPROVALS , DATE INSPECTOR'• NAME ROUGH PLUMBING GAB PIPING OAS VENT / CESSPOOL @ 1,pp � CESSPOOL ` SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER �- PERMIT 1.00 GAS TEST TOTAL FEE -0 UTILITY CO.NOTIFIED FINAL ELYiGr�s; - •,.,.,ERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT m that I have a certificate of consent to self 20-0026 DPW 6/87 I certificate of Workers' Compensation Insurance, 76A667A or •d copy thereof (Sec 3800, Lab C ) ,p ^� COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Qcy Company Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS � tion departmentNUMBER FIXTURE OR ITEM @ FEE LOCALITY Date �"� Applicant °�•�� \:1TVA\1 WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE OWNER (This section need not be completed if the work Involved by SHOWER the permit is for one hundred dollars $100 or less. MAIL P ( � � LAVATORY """ ADDRESS ., I 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 TEL NO so 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 $t L Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY TEL NO with comply with such or this permit shall be LAWN SPRINKLER SYSTEM P Y provisions P STATE1 Q 0, LIC deemed revoked WATER HEATER LICENSE NO Z—L CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of,Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division.3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect 5 PER SYSTEMFINAq f�j DATE VALIDATION License Number `� Lic Class_ FINAL Contractor Date BY C� R I am exempt under Sec W �.' B 8P C for this reason Plan check fee ® Z U) Date / a PLUMBING PERMIT ISSUING FEE$ v Signature TOTAL FEE Plan check applicant �i SINGLE FAMILY 5 HOME OWNER-BUILDER DECLARATION Name —"O �/�/� s I hereby affirm that I am exempt from the Contractor's License ttt+4Te4 Law for the following reason (Section 7031 5, Business and Address 50 Professions Code) City Tel No 3,307 ° ❑ . I, as owner of the property, will do the work and the 1 ITEM structure is not intended or offered for sale (Section 7044, Business and Professions Code) ® TOTAL 34 .50 CONSTRUCTION LENDING AGENCY MICK 34.511 j hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued �'� - °00 (Sec 3097, Civ C ) Lender's Name [1000-mol 8/14/8' Lenders Address r WU 1 AM10: rr5 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 jaws regulating Plumbing, and hereby authorizer presentatives of this County to enter upon the abo -me t o e grope for inspection purposes - SEE REVERSE FOR EXPLANATORY LANGUAGE Signature ofermittee Date