Loading...
HomeMy Public PortalAbout5742 LOMA AVE_Plumbing__ �D.s.S.-r7 25M SETS 12-45 .APPLICATION FOR PERMIT jEPARTMENT OF BUILDING AND SAFETY j1 COUNTY OF LOS ANGELES Wm. J. FOX, CHIEF ENGINEER .NATURE OF INSTALLATION DISTRICT NO. GROUP /ZONE /PERMIT NO. ROUGH` _ FIXTURES ' H COMPLETE I. / ` O 6 HEATER CESSPOOL SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED FIRST IN TION '7 �`®0- GAS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLYJOB K NAME M. C. NOTTINGHAM CO. ADDRESS 'A----2_ ,'�.ds/'•S•4�.fS " ADDRESS 1-23 No. Cloverly Ave. LOCALITY C/ fi/Ls'I r1J"4t". 6L R CITY TEMPLE-��TI- �•C1'�A.Ag�s_ CROSS ST. ���t��S2�..� . COUNTYJyy,� CERT.No. EXPIRES 0L NAME ir ¢ j-j/(fi^•� m LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL 3 ADDRESS NORTH O - CITY TEL.No. CAM THE LEGAL POSSESSOR OF THE ABOVE LOS _ ANGELES.COUNTY CERTIFICATE OFQUALIFICATION. •' PLUMBER 1,AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. D OWNER CORRECTIONS SOUTH Q DESCRIPTION OF WORK � BATH TUB FURNACE C) SHOWER DISHWASHER LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP L:EE�MOE NK FLOOR DRAIN RAY URINAL APPROVALSCLOSET DRINKING FOUNTAIN DATE INSP CTO 'S NAME HEATER DENTAL LAVATORY ROUGH PLUMBING GAS SODA FOUNTAINGAS PIPINGOUTLGAS VENT CESSPOOLUMBER OF FIXTURES SEPTIC TANK OI- SEPTIC TANK /� SEWER $ TOTAL FEE UTILITY CO.NOTIFIED I I n III FINAL D.B.17 3.41 23M APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES WM. J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. ROUGH C�/ 45 PLUMBING FIXTURES COMPLETE RECEIVED BY -READY FOR DATE ISSUED HEATER CESSPOOL SEPTIC TANK Grp r FIRST INSPECTION // � GAS MISCELLANEOUS (1 �iI APP ICANT FILL IN HEAVILY OUTLINED PORTION, ONLY JOB C NAME\ ,q ADDRESS f ADDRESS(\— '1` I A LOCALITYNEAREST 'ice�"�► d IL CITY Y�aJ�ii `v-k TEL.No. / D G�j CROSS ST. Y COUNTYfI1 CERT.No. vim.��p/y� EXPIRES lb.J � W NAME L MAIL LOCATION OF.SEPTIC TANK, OR CESSPOOL 3 ADDRESS NORTH O CITY TEL.No. 1 AM THE LEGAL P SE 4OR OF THE ABOVE LOS ANGELES COUNTY CER IF ,E O QUALIFICATION. PLUMBER I AM THE LEGAL OWNE O THE PROPERTY DESCRIBED ABOVE. F 01 W 3 m OWNER i CORRECTIONS SOUTH J .Q DESCRIPTION OF WORK i --BATH TUB FURNACE SHOWER _ DISHWASHER LAVATORY REFRIGERATOR — KITCHEN SINK - WATER SOFTENER —. 0 —FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS . WATER CLOSET DRINKING FOUNTAIN DATE INSP CTOR,S NAME WATER HEATER -DENTAL LAVATORY ROUGH PLUMBING METER__Y_' GA3 SODA FOUNTAINGAS PIPING I - O U TL 1—�-- ' GAS VENT r I ` CESSPOOL ' TOTAL NUMBER OF FIXTURES a SEPTIC TANK O ���TTTT CESSPOOL SEPTIC TANK 1 SEWER I ` $ UTILITY CO. NOTIFIED -�/ r 7i^tPti er"1 TOTAL FEE FINAL CORKERS'COMPENSATION DECLARATION 20-0026 DPW 4/87 APPLICATION FOR PLUMBING PERMIT I hereby, of i that I have a certificate of consent to self in- 76A667A sure,ora certi ate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) certified copy th of (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is h eby furnished. BUILDING FOR APPLICANT TO FILL IN (PRINT OR TYPE) k17-0, Certified copy is filed th the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE /}/� LOCALITY Date Applicant WATER CLOSET(TOILET) 19 NEAREST & iv CERTIFICATE OF EXEMPTION FR M WORKERS' BATH TUB CROSS ST. �, S COMPENSATION INSURANCE OWNER �� (This SHOWER section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS I'certify that in the performance of the work for which this per- SINK mit i issued, I shall not employ any person in any manner so ) CITY TEL. NO. as to Ne subject to the Workers'Compensation Laws. DISHWASHER .. - CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO PLICANT: If, after making this Certificate of Ex- em tion,you ould become subject to the Workers'Com en- SWIMMING POOL RECEPTOR C a P Y I P CITY TEL. NO. sat,ion provision f the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provi ns or this permit shall be deemed revok- STATE LIC. ed. / WATER HEATER 0 LICENSE NO. CLASS LICENSED C TRACTORS DECLARATION v DISTRICT NO. PR ESSED BY I hereby affirm that I am tensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Sectio 7000)of Division 3 of the Business OUTLETS OVER fed Professions Code, and license is in full force and ef- 5 PER SYSTEM FINAL /� � VALIDATION DATE/0_/'6J A. A. License Number Lic. Class V Contractor Date BY / O I am exempt under Sec. B.&P.C. for this reason g Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ C6 SO-1 pool Signature TOTAL FEE SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the,Contractor's License Name _ Law for the following reason (Section 7031.5, Business and Prof scions Code): Address r ) `( I, as owner of the property, will do the work and the City Tel. No. 46.51 structure is not intended or offered for sale(Section 7044, r'°' =_ �i�3 Business and Professions Code). _ CONSTRUCTION LENDING AGENCY k,3FCV �6.50I hereby affirm that there is a construction lending agency for 11 the performance of the work for which this permit is issued CHANGE .00 (Sec. 3097, Civ. C.). . Lender's Name Lender's Address io z AN 8:56 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 authorize representatives of his County to enter upon the above-m tioned property f inspection purposes. e i SEE REVERSE FOR EXPLANATORY LANGUAGE d gnature of Permittee 2' WORKERS'COMPENSATION DECLARATION ' Zo-oo26oPW 4,87 APPLICATION F®R P',LUMBING PERMIT I hereby, aft m that I have'a"certificate of=consent•to self in- - 1 76A667A' . . . r - surer br.o cert�ticate'of Workers'Compensation Insurance,or a. CE 817(REV.-8/86), certified copy thereof(Sec: 3800, Lab C )= ; PT F P Policy No. Co. _ s.. DE,:: LICa ,WORKS. COUNTY OF LOS-.ANGELES ,. UB Certified 'copy is hereby furnished FOR APPLICANT TO FILL IN (PRINT,OR TYPE) BUILDING[r7y 2 Loma 'Ave Certified copy is filed with the'countybuilding inspection ADDRESS J l department,,; NUMBER ' FIXTURE;OR ITEM FEE LOCALITY T e ' .> t' WATER CLOSET(TOILET) f mple 1 y' Date Applicant% NEAREST c w ;' CERTIFICATE OF EXEMPTION FROM WORKERS S BATHTUB' _ CROSSST.SOUtYT' Of: Las, Tunas NCE • ,SHOWER OWNER . Tacq•ulyn' R. COMPENSATION INSURA � cJ C OI115t0 Ck .. (this section need not,be complefed if the work involved by MAIL. the permit irfor'ohe hundred dollars($100)Orless.) LAVATORY ADDRESS same­ as above: I certify,ikai in the`performance"of'the work for which this per-s- ?.'SINK CITY ': TEt N0: 286_ mit is`issued,J shall not employ'any person in-any manner' 533 as to become subject to'tF e Workers' Compensation Laws. DISHWASHER CONTRACTOR . n�ne Date `_-'Applicant CLOTHES WASHER ADDRESS NOTICCTO APPLICANT.,If, after,mdking'this Certificate of Ex SWIMMING POOL RECEPTOR `emption,'you should become subject to tRe.Workers'Compen- CITY` TEL. NO.. "sahon provisions'of-the"Labor Code;'you must forthwith.comp ;. LAWN SPRINKLER SYSTEM ly with such provisions or-;this pe'r.mit shdll:be deemed,revok- '' STATE LIC' ed: µ, WATER,HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PRO fSED�BY ' I herebybffirm that I am licensed under provisions of Chapter GAS SYSTE OUTLETS OVERM -OUTLETS 9(commencing with Section'7000)of Division Sof the Business ; and Professions Code; dnd,m license is in full force and ef- 5'PER SYSTEM_ fect: Y DA EL IL O _ VALI ATION License Number Lic:Class V t FINAL tS Contractor Date r. BY O 1.am exempt under Sec. W , . a B.BP.C\for-this reason Pjon Check fee Date: PLUMBING PERMIT ISSUING.FEE$ i O S© Signature TOTAL'FEE SINGLE FAMILY. S� 9 4 7.5 A HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Cont #�o ° ® 5 ractor's License - c' o Nome Low for the'following reason (Section 7031.5, Business and Professions Code;): Address v i'® ' 2 ,. _ 250 Cit Tel. No,_ 0•c, 5 I, as owner of`the property, wilt do:the work,and`The Y 2,Z'5"0 c� S is not intended or,offered for sale(Section 7044, Business and Professions Code). x'4;.2`]'�;8 8 CONSTRUCTION PENDING AGENCY 1 hereby affirm that there is a construction lending agency for the p'erforrhdnce of the work for which this permit is issued (Sec. 3097; Civ* C.). none'' L6nder's.Name t Lender's Address I cert fy that I have read thea`application and state that the above information is correct. lagre'e.to.comply_with all County ordinances and State faws'regufatin"g Plumbing,,and�'hereby utliorize representatives of .this County-,to enter upon the a ve-Ment nedproperty for inspection purposes. / LI_:27 88 SEE.REVERSE FOR,EXPLANATORY LANGUAGE' not re of ermittee Date ;',