HomeMy Public PortalAbout6436 LIVIA AVE_Plumbing__ 7t,,1887 -C q81 7 10-82 o
• APPLICATION FOR PLUMBING PERii�
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A JENSEN, SUPT OF BUILDING LOCALITY TP
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER a a°S E'
WATER CLOSET $I.25
MAIL
BATH TUB 1.25 ADDRESS
SHOWER 1.25 CITY TEL.IL
NO. -D����
LAVATORY 1.25 CONTRACTOR K, G�
SINK 1,25 ADDRESS
DISHWASHER 1.25 CITY TEL. NO-7 47
LAUNDRY TUB 1.25 CONTRACTOR'S STATE
REGISTRATION NO. _ COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PR
TS
WATER HEA1.50 J
GAS TE ' OUTLETS 1.50 INDUSTRIAL d
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 (�j
IN�SyPECTION RECORD
�9/// A lks— I�`,X" te d? alel .te r
,a
APPROVALS A'-TE s INSPECTOR-$ IG 'C•U REQ
PERMIT $ 2 00 UNDER SLAB WORK IV
ROUGH PLUMBING
TOTAL FEE 3 GAS PIPING
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION -`I
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF mac. 4
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO GAS TEST _.
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
CKVALIDATION ROBERTA WOOD
M O CASH SUPERVISING MECHANICAL ENG R
Lt't�o 8 -,72 1-2 FEB 17 5 D 3.50-
7BA667-CE817-11-57
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER "
BUILDING AND SAFETY DIVISION BUILDING j / C1 Y
JOHN A. LAMBIE, County.Engineer ADDRESS Y C�
C SSATT D. GRIFFIN, Sup t of Building LOCALITY
FOR APPLICANT TO FILL IN NEAREST
NUMBER FIXTURE OR ITEM CROSS ST.
WATER CLOSET OWNER
MAIL
BATH TUB ADDRESS GL-Cf�
SHOWER CITY TEL NO. f
LAVATORY CONTRACTOR
SINS ADDRESS
DISHWASHER CITY TEL. NO.
LAUNDRY TUB CONTRACTOR'S STATE ❑
REGISTRATION NO. COUNTY
.K
CLOTHES WASHER pISTRI GR UP ZONE READY FOR INSPECTION
WATER HEATER
GAS SYSTEM INDUSTRU L
I/ WASTE APPROVAL
Aja/ t, INSPECTION RECORD
v.-zu t b
- a
APPROVALS
/ @ $1.00 PER ITEM DATE INSPECTOR'S SIGNATURE
OR FDnURE $
19-0 UNDER SLAB WORK
PERMIT $ ROUGH PLUMBING
TOTALFEE ��100
OGAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
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
1ICHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I TH OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL PR P
SIGNATURE
OFPERM TTE FINAL
ROBERT A WOOD.
®� z VALIDATION SUPERVISING MECHANICAL ENG'R
CK. b O CASH ;
2 6 3 Oa; FEB 20 5 A 3.0 0
WQRKERS'COMPENSATION DECLARATION Fl/ rt rt n n p� A`' ��8`�
%20'0026 DPW 4/87 .APPLICATION FOR � NIG
i'hereb"y, . 3irm that have a certificate of consent to self in- 76A667A _ r-',
2, ora cemficate;of Workprs'Compensation,lnsurance,ora ,CE 817(REV 8/86) - .' -`•-.' - - - - - ,
cer41ad copy thereof (S4. 3800,'Lab C ) ti r
,i COUNTY OF LOS ANGELES DEPT OF PUBLIC46RKS` • .,
Polic}No Company „
a, Certified copy is,hereby furnished :
FOR APPLICANT TO FILL IN (PRINT OR TYPE), BUILDING ( F36 L�✓r� �' Tc ���gp
Certified copy is filed with the county-building inspection _ . ADDRESS ir _
NUMBER FIXTURE OR=ITEM FEE LOCALITY r `
`dtipartment• @.
Date Applicant WATER CLO_SET'(TOILET) a NEAREST ,t(�or-, :
r
'1 •' CERTIFICATE OF EXEMPTION FROM'WORKERS'= BATH TUB CROSS ST t_0/V
'COMPENSATION INSURANCE, OWNER VJW T• C441U. "
SHOWER
(This.'section'need not`be completed if the work involved by MAIL - GA
the permit•is for one hundred dollars ($100)or less.) 'LAVAT6RY ' 0 ADDRESS-
-
•1 certify that in the performance of•the work far which this per �. ,4 ~,
SINK„ 'CITY TEL-NO
mit is issued, I sholI not employ any person in any'manner so s' �$-/03
as to become subject to the'Workers`'Comp"ensatiornlaws DISHWASHER
CONTRACTOR
Datec Applicant ' - • ' 5 CLOTHES WASHER ADDRESS '
NOTICE TO APPLICANT If, after making this.Certificate of Ex,- SWIMMING POOL RECEPTOR
m
eption, you should become sublect'to'the Workers'CompenCITY JL NO
cation pro visions;of.the Labor Code, you most forthwith comp- LAWN SPRINKLER SYSTEM ,
ly with such provisions or this permit shcilhbe deemed revok- STATE ;LIC
ed, WATER HEATER LICENSE•NO CLASS
LICENSED CONTRACTORS DECLARATION DISTRICT NO h PROCESSED BY
I hereby affirm that I am,licensed under'provisions oPGhapter GAS SYSTEM - ' OUTLETS 4
9'(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER
fed Professions Code, and my license is in full force and e-f, 5 PER SYSTEM FINA �' VA
LLIDATION
DATE { O
License Number Lic'Class L U
: FINAL 1 ^
Contractor Date, ; BY O
I am-exempt under Sec „ W
_ N a O' y , a,
B&P-C for this'reasom D f/1
e Plan check fee
Date_ _ PLUMBING PERMIT'ISSUING FEE O� -
`Sigr ature
TOTAL FEE (� -• .
SINGLE FAMILY
HOME'OWNER'BUILDER DECLARATION Plan-check applicant -
I hereby affirm that'I am exempt from the Contractor's License Ngme (�{//�(/
• .Law'for lite following reason (Section'7031 5, Busine"ss'and � - _ , -•, -ti. - '
Professions Code) Address Vt
AI; as•owner of the property, will do the work the Gty;, C Tel No
stru'ctur6 is not intended or offered for sale(Section 7044, r r
,Business and Professions Code) :{ g '`" _• (EMS
CONSTRUCTION LENDING AGENCY - �. 1V FF7Z-/ tilt 35 ' 5.0
I hereby affirm that there is a construction lending ogencyfor _ CH
( zi.!c i
the performance of the work for which this permit is issued 1214 L �Mr
�si�dl= K e h 1.
(Sec 3097, Cry'C ) ; IJ III
Lender's Name
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 -�=t�'= --
ordinances and State laws regulating Plumbing, and hereby
authorize representatives of this County to enter upon the
-above-me boned r erty for inspection purposes
SEE REVERSE FOR EXPLANATORY LANGUAGE
Si n ure of ermittee Date