Loading...
HomeMy Public PortalAbout6228 LOMA AVE_Plumbing__ DEPARTMENT OF COUNTY ENGINEER PLUMBING 1 DIVISION OF BUILDING AND SAFETY r, PERMIT APPLICATION COUNTY OF LOS ANGELES BUILDINGiy�) WILLIAM J. FOX, COUNTY ENGINEER ADDRESS ��//' )FOR AP`PLILI OANT TSO FILL IN LOCALITY` ,y BUILDING I 7� NEAREST 6 �y U (((��Iby/// lJ CROSS ST. < rLd / G/ ADDRESS /J DISTRICT N0. GROUP ZONE PERMIT N LOCALITY 1_49v,,14NEAREST CROSS ST. Sy�1�flJNXn �RIECEIVED BY Ready for Inspection DATE ISSUE 1 OWNER AR ^ VV Oo»P!1 ! 55— 4.:�s�ll AMAIL DDRESS, � �, INDUSTRIAL_) WASTE APPROVAL clTv !(��,f T'EL.NO. ;/ �D 9417� INSPECTION RECORD PLUMBERy(�(pr�T Jl/(�.flJ/� `, j ADDRESS /fir L c � /'!1!. 11/d��P�'/ �7 CITY�i1AA, 6� d / /TEL.NO'S / (6 ///� / Y 1 D-STATE LICENSE NO. COUNTI'c J PERMIT FEES Q _z NUMBER TYPE OF FIXTURE OR ITEM FEE P WATER CLOSET(TOILED @ 0.80 S O BATH TUB @ 080 SHOWER @ 0.80 LAVATORY(WASH BASIN) @ 0 80 KITCHEN SINK @ 0 80 LAUNDRY TUB OR TRAY @ 0 80 SLOP SINK @ 0.80 FLOORSINK @ 080 FLOOR DRAIN @ 080 DISHWASHER @ 0 80 DRINKING FOUNTAIN @ 0.80 URINAL @ 080 GAS SYSTEM_____________OUTLETS @ 1.00 WATER HEATER @ 1 00 MISCELLANEOUS i n ,Sap > e(/ gQ APPROVALS DATE INSPECTOR'S SIGNATURE CIO, UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI• GAS VENT CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE.LAWS REGULATING PLUMBING PLUMBING FIXTURES I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY) UTILITY CO.NOTIFIED SIGNATUR222 OF PERMITTE ................................. FINAL VEL/'�(G LY ��bI11.C,1jw 76A667 DBS 17 1/58 v D.B.S.17 25M BETS 10-47 APPLICATION FOR PERNW DEPARTMENTOF OF LOS BUILDINGANDSAFETY LE PLUMBING WM.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT R UP ZONE R }7 O. ROUGH FIXTURES COMPLETE HEATER CESSPOOL I-I SEPTIC TANK R 1=8 Y READY FOR DATB issuEb FIRST INSPECTION AS MISCELLANEOUS APPLICANT FILL IN HEAVILY VTLINED PORTION ONLY JOB NAME Iri a I sE ADDRESS W m ADDRESS o LOCALITY NEAREST A CITYTEL.No. CROSS ST. IL COUNTY CERT.No. EXPIRES W NAME LOCATION OF SEPTIC ANE, OR CESSPOOL Z MAIL 3 ADDRESS NORTH O CITY TEL.NSOR OF o. ANGELES COUNTY CERTAM THE LEGAL IF CATS OF gUAL f+lg ATIOVE LOS 1- _� It PeuNSCR I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. N - a OWNMI CORRECTIONS SOUTH J DESCRIPTION OF WORK i BATH TUB FURNACE c� Q' ROWER DISHWASHER 0 LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPQCTOR'S NAMi WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER-GAS SODA FOUNTAIN GAS PIPING OUTL / I GAS VENT {�/ � CESSPOOL {/ ►�I .�� 1 V 1""V �' TOTAL NUMBER OF FIXTURES SEPTIC TANK I CESSPOOL-----SEPTIC TANK SEWER I ' 8 I UTILITY CO.NOTIFIED 1 TOTAL FEE FINAL 76A 667 -CE#817,10-62 APPLICATION FOR -PL LIMBI G P'ERMI'T COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER . y BUILDING AND SAFETY DIVISION BUILDING 6'n� addition JOHN A. LAMSIE, COUNTY ENGINEER ADDRESS' F2O N©• U gar, WILLIAM A JENSEN, SUPT OF BUILDING 1 le ��� LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. T ,,_�- y �s� �t NUMBER FIXTURE OR ITEM EACH FEE OWNER Om JoSteck C Weber W�wOO, WATER CLOSET $1.25 BATH TUB 1.25 MkEss5926,No. T le Gia SHOWER 1.25 CITY Temple 0i TEL. NO, LAVATORY 1.25 CONTRACTOR Va.Uey P3a=b -Go, SINK 1,25 ADDRESS 442 V. FlewLvood FL DISHWASHER 1.25 CITY Glendora TEL. NO. LAUNDRY TUB 1.25 CONTRACTOR'S STATE ❑ REGISTRATION NO. 20WI COUNTY ❑ CLOTHES WASHER 1.25 DISTRI T NOGROUP I ZONE PRO SEED BY WATER HEATER 1.5007 GAS SYSTEM OUTLETS 1.50 INDUSTRIAL d WASTE APPROVAL 0 OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD V O u W CL y z i APPROVALS DATE I SPPECTOR-SSIGNATURE- PERMIT $ 2 00 UNDER SLAB WORK 3[ ROUGH PLUMBING 01 TOTAL FEE 4tGAS 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 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES ' LICENSED AS REQUIRED'BY LOS ANGELES COUNTY AND STATE OF GAS TEST - CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO ' RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY 'UTILITY CO NOTIFIED /! SIGNATURE 1. 11.1 OF PERMITTEE FINAL VALIDATION ROBERT A WOOD cK M O CASH SUPERVISING MECHANICAL ENG'R —3.9 2'G ='AUG 2 7 5'--D 5.75- '_q ' WORKER'S COMPENSATION DECLARATION 200026 DPW 9/89 ��������8®� ®'� �������� ������ 7� I hl y Affi m'that I have a certificate of consent to self insure, 76A667A IL11 or a certificate of Worker's Compensation Insurance, or a certified copy thereof(Sec 3800 Lab C) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policy No Company - _ Certified copy is hereby furnished ' FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ❑ Certified copy is filed with the county building'inspection ADDRESS - Q department NUMBER FIXTURE OR ITEM Q FEE LOCALITY - Date Applicant WATER CLOSET NEAREST G - CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST . - COMPENSATION INSURANCE ASSESSOR ` • (This section need not be completed if the work involved by the SHOWER MAP BOOK PAGE PARCEL permit is for one hundred dollars($100)or less) OWNER I certify that in the performance of the work far which this per it LAVATORY C is issued, I shall not employ any person in any man r SINK MAIL become su ject to the Workers' Compensation ws ADDRESS �� DISWASHER \ / CITYTEL NO Date Applicant CLOTHES WASHER NOTI E TO APPLICANT If, aft m.k,'ng this Certifi ate of CONTRACTOR G Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Latior Code, you must forthwith comply with such ADDRESS provisions or this permit shall be deemed revoked LAWN SPRINKLER SYSTEM ` LICENSED CONTRACTORS DECLARATION CITY 1 TEL N ��a_ I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER STATE �, LIC O '>od� Q (commencing with Section 7000) of Division 3 of the Business and GAS SYSTEM OUTLETS LICENSE NO �� CLASS C�O Professions Code,and my license is in full force and effect V cX, OUTLETS OVER DISTRICT NO An PROCESSED BY I License Number -S41 420 u Lic Class 5 PER SYSTEM �!/ �L�C��G/ 0 � Q FINAL VALIDATION \ DATEContractor���UlVal7 ate /.10c Z I am exempt under Sec FINAL ALt `i B&P C for this reason • Plan check fee's a � ! i a Date �!+_ , ' Signature PLUMBING PERMIT ISSUING FEE$ .' P ❑ TOTAL FEE SINGLE FAMILY Plan check applicant IAL u 4 1 85 HOME OWNER-BUILDER DECLARATION Name r1 i Ery_N t ,CJ 41 hereby affirm that I am exempt from the Contractor's License Law for the following reason(Section 7031 5, Business and Professions Address Code) ❑ I City Tel No 1,as owner of the property,will do the work and the structure _ is not intended or offered for sale,(Section 7044, Business �)i L '; and Professions Code) 0.® 1 AN CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097, - _ Civ C) , Lender's Name Lender's Address I certify that I have read this application and state that the above ® V information is correct I agree to compl with all County ordinances and State laws regulatin lu b and hereby authorize ' representatives of this o upon the above-mentioned property f in pecti pu os SEE REVERSE FOR EXPLANATORY LANGUAGE gnaturf ermittee Dafe