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HomeMy Public PortalAbout6037 LOMA AVE_Plumbing__ 76A667 17 2SM SETS 7-48 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFE COUNTY OF LOS ANGELES Wm.J. FOX. CHIEF ENGINEER PLUMBmG NATURE OF STA ATION DISTRICT NO. GROUP ZONE P MI O. ROUGH FIXTURES COMPLETE / 7 HEATER CESSPOOL I-I SEPTIC TANK RECE{VE READY FOR ` DATE ISSUED FIRST INSPECTION / ,9 keg GAS. MISCELLANEOUS V APPLICANT FILL IN HEAVILY OUTLINED PORTION_ ONLY JOB cc NAME �f �'y] J ADDRESS M ADDRESS ' LOCALITY / D ! NEAREST 0. CITY� �i �•-�_���,�_TEL.No. CROSS ST. COUNTY LICENSE NO. - EXPIRES pC NAME /� �wa.d.•'J�fj� LOCATION OF SEPTIC TANK, OR CESSPOOL a MAIL [J ADDRESS NORTH O CITY TEL.No. 1 AM THE LEGAL POSSESSOR OF THE.AIDOVE LOS ANGELES COUNTY CERTIFI AXE OR QUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE.PROPERTY DESCRIBED ABOVE. m a is7 OWNER CORRECTIONS L i i /-/161 - x SOUTH J DESCRIPTION OF WORD � 7 a BATH TUB FURNACE R' ROWER DISHWASHER 17 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 I METER GAS SODA FOUNTAIN GAS PIPING OUTL' GAS VENT CESSPOOL 15-'I7`I/J . TOTAL NUMBER OF FIXTURES SEPTIC TANK I I CESSPOOL SEPTIC TANK SEWER II $ UTILITY CO.NOTIFIED I TOTAL FEE / FINAL ,.76 A667-CE#817 10-67 - /EM P / C--/ 7'y APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION PA UILDING /�3 / /. oM yI_ JOHN A. LAMBIE, COUNTY ENGINEER DDRESS ((J /�/ L COLEMAN W. JENKINS. SUPT. OF BUILDING OCALITY /�Q � FOR APPLICANT TO FILL IN(PR NT OR TYPE) ROSSSS g/ - NUMBER FIXTURE OR ITEM EACH FEE ye ,���/_Y, OWNER _j't1 WATER CLOSET 1.50 MAIL BATH TUB 1.50 ADDRESS SHOWER - 1.50 CITY TEL. NO,-,( a S6/Z2 LAVATORY 1.50 CONTRACTORYb�O'��C.� SINK 1.50 ADDRESS / 3r� l 7 Al - DISHWASHER 1.50 CITY GI� V/'�� TEL. NO.33,) ��90 CLOTHES WASHER 1.5ATE LIC 0 LICENSE NO V j) CLASS( � 36. SWIMMING POOL RECEPTOR 1.50 DISTRICT NO G OUP' ZONE PC ED B _ LAWN SPRINKLER SYSTEM 2.00 ✓ t O WATER HEATER 1.50 .INDUSTRIAL - U WASTE APPROVAL, C= O GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD f- U OUTLETS OVER .30 d 5 PER SYSTEM Z Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE S 2 00 TOTAL FEE QQ APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicanL UNDER SLAB WORK Name - ROUGH PLUMBING - Address GAS PIPING GAS VENT City, Tel. No. HOT WATER HEATER IH ACKNOWLEDGE THAT P HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES -- -WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. 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 OF.AND INTEND TO �-I RESIDE IN,TME VE DESCRIBED RESID NTIAL PROPERTY. FINAL C SI GNATU�,.( JACK R. ALLEN, SUPE VI ING CHANICALEN G'R. - OF PER PERMIT VALIDATION CK. M.0. CASH PLAN CHEC ALIDATION CK. M.0. CASH ti 76A667-CE9817 4-67 • ` APPLICATION FOR PLUM ING PE IT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ADDRESS 6037 North Loma JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS. SUPT. OF BUILDING' LOCALITY FOR APPLICANT TO FILL IN CROSS NEAREST LO den & Garibaldi NUMBER FIXTURE OR ITEM EACH FEE OWNER Lod Surdam WATER CLOSET $1.25 MAIL BATH TUB 1.25 I "ADDRESS 6037 North Lona CITY L' TEL. NO. SHOWER 1.25 LAVATORY 1.25 CONTRACTOR U nols. Inc. SINK 1,25 y ADDRESS DISHWASHER 1.25 CITY San Gabriel TEL. NO. _ 3163 SATE LIC LAUNDRY TUB 1.25 LICENSE N0190179-053 CLASS CLOTHES WASHER 1.25 DISTRICT]NO. GROUP 11 O E PROCESSED BY WATER HEATER 1.50 b g/ `?o" M GAS SYSTEM OUTLETS 1.50 INDUSTRIAL - WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM 30 _.INSPECTION RECOR Dom,. CD 150 -7V W O_ N Z 4. APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 QQ UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE3 50 GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGIS ERE D AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES CO NO STATE OF GAS TEST CALIFORNIA OR THAT I M THE LEGAL OW. F. NO INTE D TO RESIDE IN, TH E.ABOV SCRIBED RESI I P ERTY UTILITY CO. NOTIFIED SIGNATURE OF PERM NAL ALIDATION JACK R. ALLEN K. M.0. CASH SUPERVISING MECHANICAL ENG'R, v �`�jfJ�i�l1�✓f� •l.' W913KERS" COMPENSATION DECLARATION`, ®: „ 20-0026 DPW 4/87 " 1 E;�`0t7tl,ll� '`{:,fa r EXjr".©, Irm that I'hQve�.a ceihficate of consent to se If in 76A667A - sure, er',a.cerhf.R fe oflWorke`rs''.Corn ensation Insurance ora`,' P CE 817(REV-8/86) " cert ried.,cboy thereof (Sec:3800•L'ab C ) ' t. t COUNTY OF'LOS ANGELES DPT OF>PUBLIC WORKS Policy 'Company,' No' Certified copy,is•:hereby furnished 4 ' f0 .BUILDING ' -', _,.r,,_. .'. N°(PRI YPE)` R APPLICANT,TO FILL' NT OR'T .' C&rtified,co is filed',with-the count buildin ms ecttops_, , - ADDRESS department} a r MBER' FIXTURE.:OR ITEM FEE ' LOCALITY.• - _ d NU .WA Date= x APPhcant r TER CLOSET (TOILET) -• j �l NEAREST 'Y f" CERTIF..ICATE,OF EXEMPTION',FROM WORKERS'; §: BATH TUCROSS,ST,-' � EOMPENSATION INSURANCEt SHowER'.• ° -/-2�r (This section need"not,be.`completed:if,the.work AIME , the'peimit is fon hu one ndred dollcrs;(S'100),or;less') _•LAVATORY {, y,.- - "' 'ADDRESS !r� � `•_ "C I:certif,y that in the'perfarManceof tl e work for w,hiehchis per=': _ mit is".issued, f shall not em. to any erson'in'an manner so", ,.,,'SINK ! rc , 'CITY,'- , TEL N - P ,Y. Y P- Y:' C as To°beco e subject to the WoM,,kKI m ensatio DISHWASHER p Dae` pylic a, CLOTHES WASHER' CONTRACTOR y � ut DR , AD-� ESS f: „NOTICE:} APPLICANT 'If,'aftermaking this Certificate of Ex;" <.' - -'• SWIMMING POOL RECEPTOR emption you should.b'ecome subject tol e.Workers,-Compen- CIT sation,prov,isions of the Labor Gode,'you,must forthwith comp LAWN SPRINKLER'SYSTEM ly with-such provisions orthls.permif shalt be deemed.revok'-. ',.' STA E LIG N �r,•�y @,. LICENSE NO. CLASS /c.! ed WATER HEATER , , - a _ LICENSED CONTRACTORS.DECLARATION CESSED.BY l,'hereby affirm ihat`I am'licensed'underp"roy.isions,of'Ghabter GAS SYSTEM O }LETS .( encmg with Section 7000)of D,v,s,on'3 of the.Business OUTLETS'OVER ; DISTRIG 9'comm andProfessions Code, and my license is in full force cind'ef' Y 5 PER SYSTEM FINAL fect •a^ ` DATE /�f•®' VALIDATION a .License Numb Lic.Class ., ���,�� • Contractor'®� dy�.CYYrDate"��] ' FIN �l B O I aM.exempt under Sec B &R.0 for this reason .Plan CheGIC fe6s'aa _- {. Date ' PLUMBING PERMIT-ISSUING FEE$ .+ Signature i f TOTAL.FEE �Z ;a t SINGLE FAMILY " NOME°OWNER-BUILDER'DECL'ARATION Plan check-.apphcgnti Ther`eb`y',-affirrri,tl at I am.ezempt from the.Contracfor,' lbcens`e Name _ +. _Low,for:the follow,,ng'reason (Section 7031:5 Business and' ? Professions Code):- Ad )' j, :� dress , • � fl Cit Tel .N: ; f as owner of the,-proper:typ will do the work:and=the Y =structure is not intended or,offeced for sale(Section 7044,,. ? _ Business and'Professions Code CONSTRUCTION LENDING AGENCY I'hereby affirm tn'at thereJs a construction'lending"'ager cy'for fhe performance"of the work fo'r"which-fhis'permit,'Js issued • ;(Sec:.3097, Civ C:.) ' a a ` Lender's,Name.... :ar r Lender s Address ;p E` t3 '°f" 4 ;certify':that have read-this applcation..and state,ithat'.the _s^ above information",is correct. agree to comply,with all County a" ord nces'gnd'State laws'reguf ting Plumbing,°'and hereby. th e �esentati s y thi .Count"y°to ente ,'upon the ab'o ed,pro e, or in 'ection'purpos r , SEE"REVERSE FOR.EXPLANATORY LANGUAGE gnatuce'of P ittee D toll p x r