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HomeMy Public PortalAbout6153 LOMA AVE_Plumbing__ D B.S.-17 25M SETS 6-46 j APPLICATION FOR PERPHT DEPARTMENT OF BUILDING AND SAFETY 1 COUNTY OF LOS ANGELES PL WM.J. FOX,CHIEF ENGINEER ' NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. S— Z �J-1 �� � ib ROUGH FIXTURES COMPLETE _ HEATER CESSPOOL �I SEPTIC TANK RECEIVED BY READY FOR DATH ISSUED SUED- SEPTIC INSPECTION /� GAS MISCELLANEOU 11, C1/�� APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY � JOB v NAME ADDRESS W ' m ADDRESS LOCALITY 7 _ NEARE ST • - CITY IL - TEL.No. CROSS ST. IL COUNTY CERT.No. EXPIRES IK NAME - ►ti L •�'Y1• LOCATION OF SEPTIC TANK, OR CESSPOOL 3 MAIL 6 )'da � - NORTH O �/J,/ �P CITY TEL.No.ew�'Y b. 1 AM THE LEGAL PO ESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. c PLUMBER ­-t AM THE LEGAL OWMR OF THE PROPERTY DESCRIBED. ABOVE. OWNER y r CORRECTIONS . Ala.. SOUTH $ J, -DESCRIPTION OF WORK z BATHTUB FURNACE ❑ C SHOWER DISHWASHER ❑ LAVATORY REFRIGERATOR ' KITCHEN SINK WATER SOFTENER, ' FLOOR BINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'!NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER GAS SODA FOUNTAIN OUTL 13g8 PIPING GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES _SEPTIC TANK CESSPOOI�-SSEPTICTANK ® SEWER $ I.UTILITY CO.NOTIFIED TOTAL FEE FINAL D.S S.-17 25M SETS 6-46` APPLICATION FOR PERMIT DEP.&RTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES �L WM. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRIICj NO. GROUP ZONE P RMIT . ROUGH FIXTURES COMPLETE HEATER CESSPOOL I—I SEPTIC TANK RECEt BY READY FOR DA ISSUED FIRST INSPECTION GAS MISCELLANEOUS asamcm APPLICANT FIGLG�L IN HEAVILY OUTLINED PORTION ONLY JOB E NAME ,�/ly /�cLt_hs A/hl !�y �y �/ ADDRESS c��s��`' Q R D -0" 2 ADDRESS G GO �ZJ P�Lk C( LOCALITY 1 .J IA /�k� o NREAREST 4. CITY /� TEL.No �' COSS 8T. � �ry f �+ COUNTY CERT.No. (r� �) EXPIRES � �I' X NAME / / /C z �� / P/ ,[� LOCATION OF SEPTIC TANK, OR CESS OOL 2 MAIL G� 3 ADDRESS NORTH O ,� A _ CITY /`tel /YG .Nb. IAM THE LEGAL' POSSESSOR AF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF UALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY-DESCRIBED ABOVE. OWNER CORRECTIONS SOUTH _ J DESCRIPTION OF WORK i BATHTUB FURNACE E9 Q' SHOWER DISHWASHER O ZZ JLAVATORY REFRIGERATOR �KITfHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN ✓DATE t eCTOR'S NAME LWATER HEATER DENTAL LAVATORY ROUGH PLUMBING 7�� METER-3-GAS SODA FOUNTAIN OUTL GAS PIPING GAS VENT_-7: 1 mmumi I I nye CESSPOOL TOTAL NUMBER OF FIXTURES Vy SEPTIC TANK CESSPOOL SEPTIC TANK SEWER I I S Q� 'UTILITY CO.NOTIFIED TOTAL FEE filwne_ FINAL /� v1//'u'"L / D.B.B:17 25M BETS 11,46 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY rCOUNTY OF LOS ANGELES WM. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRI�IalG. GROUP o E PERMIT-NO. ROUGH FIXTURES COMPLETE 2,- I-I R C IVED BY READY FOR DATE ISSUED HEATER CESSPOOL BEPTICTANK FIRST INSPECTION AS MISCELLANEOUScamumm WR,11.11 APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY p' • JO � It NAME �f ,.�> ��/p�J'7/-� ADDREfSi m ADDRESfzo • LOCALITY D vW ♦ '_ NEAREST JCITY TEL.No. CROSS ST. COUNTY- CERT. OUNTY-CERT.NO. EXPIREStl NAME LOCATION OF SEPTIC TANK, OR CESSPOOL, z MAIL .3 ADDRESS i NORTH O • CITY TEL.No. I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. D - OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK a z_ HATH TUB FURNACE 2 SHOWER' DISHWASHER Q 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 METER GAS SODA FOUNTAIN OUTL (3qB PIPING I GAS VENTmallGallow II CESSPOOL- TOTAL NUMBER OF FIXTURES SEPTIC TANK I I CESSPOOL SEPTIC TANK / �\ SEWER I I $ UTILITY CO.NOTIFIED TOTAL FEE __ �-- — • FINAL -�f WORKERS'COMP,Eh:5AT10N DECLARATIONAPPLICATION FOR PLUMBING PERMIT -'./ f� certificate of consent to self in- 76A667A �l 'sure, or cerlLficafe of Workers'Compensalion Insurance,ora CE 817(REV. 8/86) U certified'evpy thereof (Sec. 3800, Lab.•C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company F Gertifiecl,copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING F] Certified copy is filed with the county building inspection ADDRESS 53 ` department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY D WATER CLOSET (TOILET) ` Date Applicant C NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' 2 — BATH TUB CROSS 5r. COMPENSATION INSURANCE SHOWER OWNER t � � (This section need not be completed if the work involved by ` MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS I certify That in the performance of the work for which this per- SINK — -9t mit is issued, I shall not employ any,person in any manne so � CIT C� TEL. NO. as to become subject to the Workers' C p 14citio.n.Laws. DISHWASHER CONTRACTOR Date �� - Applica9 -- CLOTHES WASHER _ ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption, you should become subject to the Workers'Compen- CITY TEL. NO. sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTR�NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER fed Professions,Code, and my License is in full force and ef- 5 PER SYSTEM FINAL 330 Q VALIDATION O DATE License Number Lic. Class V FINAL Contractor Date BY i O .I am exempt under Sec. � B.BP.C. for this reason S Plan check fee � Date:—. PLUMBING PERMIT ISSUING FEE'$ © v 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 c Law for the following reason (Section 7031.5, Business andGT �' Professions Code): Address °4 Cit Tel. Na. 3607 �°�� �, as owner of the property, will do:the work and the y structure is not intended or offered for sale(Section 7044, 1ITEM Business and Professions Code). CONSTRUCTION LENDING AGENCY , //T++OTAL 70.50 I'hereby affirm that there is a construction lending agency.for `ELK 70°5II the performance of the work for which this permit is issued (Sec. 3097, Civ.'C.). .03 Lender's Name WOD1 6/14/89 Lender's Address �Vu 1 certify that I have read this application and state that the 396 1 AN °4r above information is correct. I agree to comply with all County ordinances and State laws re sting-Plumbing,'and hereby authorize re pr onto es thi County to enter upon the. aboK_ e d propert for i spection purposes. SEE.REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Daet]' ;'