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Home My Public Portal About9075 LONGDEN AVE_Plumbing__ DEPARTMENT OF COUNTY ENGINEER [P L U M 6 U IM 3 DIVISION OF BUILDING AND SAFETY PERMIT APPLUCA` TON COUNTY OF LOS ANGELES BUILDING 20 WILLIAM J. FOX, C13UNTY ENGINEER -'ADDRESS ' FOR APPLICANT TO FILL IN LOCALITYNEARESTBUILDL ADDRNG ,� <!� / CROSS ST � /i 9" y DISTRICT NO. GROUPZONE PERMIT NO. LOCALITY I —/ NEAREST CROSS ST �� +�. RECEIVED BY Ready for Inspection DATE ISSU D �(1/�� .� y � OWNER c ' � Jo / INDUSTRIAL MAIL ADDRESS ��// WASTE APPROVAL CITY / TEL.NO. INSPECTION RECORD PLUMBER`/� • ADDRESS CITY /�� -� '---=� TEL.NO. STATE LICENSE N0.�" ��Q l� O COUNTY J a PERMIT FEES Q z_ 4UMBER TYPE OF FIXTURE OR ITEM FEE (' WATER CLOSET(TOILET) @ 080 S BATH TUB @ 0.80 �-, � �c�G 09)41 `7T/R,TVf7Rl21W12 4%<-- SHOWER %<SHOWER @ 0.80 :-rz)A ". LAVATORY (WASH BASIN) @ 0.80 KITCHEN SINK @ 0 80 LAUNDRY TUB OR TRAY @ 0 80 SLOP SINK @ 0 80 FLOOR SINK @ 080 FLOOR DRAIN @ 0.80 DISHWASHER @ 0.80 DRINKING FOUNTAIN @ 0.80 URINAL @ 080 GAS SYSTEM..............OUTLETS @ 1.00 WATER HEATER @ 1 00 MISCELLANEOUS APPROVALS DATE INSPECTOR'S SIGNATURE 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 4 REGULATING PLUMBING. 8 PLUMBING FIXTURES 1 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 SIGNATURE ..��.K..✓- OF PERMITTEE...-...._..__• -- - --* FINAL '7-,3 76A067 DBS 17 Ob 12.53 •,P.6.5.47 25M BETS 12.44 , - - - APPLICATION FOR PERN[IT - ' - • DEPARTMENT OF BUILDING AND SAFETY - PLUMBING r � , COUNTY.OF LOS ANGELES .Wm. J. FOX. CHIEF ENGINEER, NATURE OF INSTALLATION DIST7 NO. GROUP ,.-ZONE,, - PERMIT NO. ROUGH FIXTURES COMPLETE HEATER CE88POOL SEPTIC TANK R EI BY READY FOR L7-- pT ISSU FIRST INSPECTION . S GAS MISCELLANEOUS zemamm �j APPLICANT FILL IN HEAVILY OUTLINED PORTION (ONLY _ JOB � 4 NAME - ADDRESS /J 1 Y ADDR �I(S d' j 1J/%� G / LOCALITY NEARE J CITY W'1/ /(,�t.GO -TEL.N0171,G,�,hyfJ C.a CROSS ST. L _ COUNTY CERT.NO. O v • EXPIRES m NAME LOCATION OF SEPTIC'TANK, OR CESSPOOL = MAIL 3. ADDRESS la • _ - NORTH O - -. CITY ' -TEL.No. 1 AM THE LEGAL POSSESSOR -OF THE 'ABOVK LOB ANGELES COUNTY CERTIFICATE OF QUALIFICATION. �. � PLUMBen 'I AM THE LEGAL OWDII`RE OF THE PROPERTY DESCRIBED. ABOVE. " A _ OWNER' CORRECTIONS . SOUTH DESCRIPTION OF WORK // HATH TUB FURNACE a �LSHOWER DISHWASHER �lAVATORY REFRIGERATOR ITCHEN BINK WATER SOFTENER FLOOR SINK SAND TRAP LOP SINK OOR DRAIN WASH TRAY URINAL APPROVALS __WATER CLOSET DRINKING FOUNTAIN DATE iNePicrotw'S NA_UK _WATER HEATER DENTAL LAVATORY ROUGH PLUMBING II �h. -Y\�jI. 1! / METER_ uATSt. SODA FOUNTAIN GAS PIPING ✓i !/ I I Y/ c GAS VENT o CESSPOOL TOTAL NUMBER OF FIXTURES - ® SEPTIC TANK -CESgP'O SEPTIC TANK SEWER I TOTAL FEE I UTILITY CO.NOTIFIED r` FINAL D.B.B.17 23M BETS 12.44 -/ I' DEPARTMENT OF BUILDING AND SAFETY; - APPLICATION FOR PERMIT COUNTY. OF LOS ANGELES PLU 1 G. Wm. J. FOX. CHIEF ENGINEER NATURE -OF INSTALLATION_ DISTRICT NO. GROUP -ZONE PERMIT NO. ROUGH FIXTURES COMPLETE l HEATER CESSPOOL —I SHPTIC TANK RECEIVED BY READY FOR DATB'ISSUED A � FIRST INSPECTION GAS - MISCELLANEOUS Cl L� APPLICANT FILL IN HEAVILY OUTLINED PORTION-ONLY JOB NAME 'f�^ �l ADDRESS q F ADDRESS - Y./If 10 r LOCALITY / ' �e+ E�.l F . J NEAREST CITY • •�� TEL.No. -r CROSS ST. /-"7 U / , •- - COUNTY ' ® /� CERT.NO. EXPIRES m (JAMB ! LOCATION OF SEPTIC TANK; OR CESSPOOL Z MAIL �1 �o 3 ADDRESS C] C NORTH O q CITY TEL.No. ., 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS • - ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. 3 �I OWkIER CORRECTIONS . SOUTH a d DESCRIPTION OF WORK BATH TUB FURNACE - a —SHOWER DISHWASHER 0 LAVATORY - REFRIGERATOR ITCHEN SINK -WATER SOFTENER FLOOR SINK SAND TRAP L-OP SINK FLOOR DRAIN ' WASH TRAY —URINAL APPROVALS - r WATER CLOSET- DRINKING FOUNTAIN DATE IwePec7OR'S NAME WATER HEATER DENTAL LAVATORY ' ROUGH PLUMBING METER GAS RODA FOUNTAIN GAS PIPING OUTL GAS VENT ( I CESSPOOL LC OTAL NUMBER OF FIXTURES SEPTIC TANK ESSPOOL SEPTIC TANK j_ SEWER OEM 1 —UTILITY av , CO.NOTIFIED ill. y TOTAL FEE Q FINAL ,., 76A667A " CE 817(REV 6/78) Os APPLICATION i®',, PLUMBING 5 �qy - Y COUNTY OF LOS ANGELES i BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING 9 � NUMBER FIXTURE OR ITEM ® FEE ADDRESS LOCALITT�VFL+ CI WATER CLOSET - - .NEAREST BATH TUB CROSS ST SHOWER OWNER KimHMiG LAVATORY MAIL DDRESSSAM v SINK CITY TEL NO DISHWASHER CONTRACTOR IPME HCC CLOTHES WASHER ADDRESS 12041. 2034 N. PEIM SWIMMING POOL RECEPTOR CITY 1 TEL NO LAWN SPRINKLER SYSTEM STATE LIC WATER HEATER LICENSE NO 265094 CLASS C-20 GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING (96 GAS VENT 11129 HOT WATER HEATER 0p� PLUMBING FIXTURES (D GAS TEST U 7= /L&4�,4'& Plan check fee UTILITYCO NOTIFIED PLUMBING PERMIT ISSUING FEE$ OO TOTAL FEE 10.P0 FINAL L32l�det�- r Plan check applicant," PLAN CHECK VALIDA (ON' �,, D`�i^.--•� ,�,/�t�, Name �L / C7 / / 0 0 0 0 (a 0 7(.o Address City Tel No I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE - THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS - 947 3 5 A REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE ¢{ LEGAL OWNER OF AND INTEND TO RESIDE IN THE AB E DESCRIBED RESIDENTIAL N 0 0 O O O 5 PROPERTY SIGNATURE 2 - O 1.000 /A OF PERMITTEE 0 0 0 1 00 0* DISTRICT NO PRO SED BY .S OY 0404-79 INDUSTRIAL WASTE APPROVAL • � .•WORKERSCOMPENSATION DECLARATION A1T U"UCA 11 MN FOR PLUM MIG PERM57 I herhby 1$ffirm that J have a certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation Insurance, CE 817(REV 10/81) or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnished❑ BUILDING 9 FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS l �.� Certified copy is filed with the county building inspec- tion department NUMBER FIXTURE OR ITEM FEE LOCALITY Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER OWNER f f (This section need not be completed if the work Involved by /� MAIL the permit Is for one hundred dollars($100)or less.) LAVATORY DDRESS%O 7� 4E—�1 Le)W - I certify that in the performance of the work for which this ,�� `' permit is issued, I shall not employ any person m SINK CITY TEL NO any manner �� A- D � L/"� �6"P,�d � so as to become subject to the Workers Compensation Laws DISHWASHER Date /r� ' Applicant_! "�"7f� 0'4,"., CLOTHES WASHER CONTRACTOR ADDRESS NOTICE TO APPLICANT If, after making t is Certificate of Exemption, you should become subject td the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY TEL NO LAWN SPRINKLER SYSTEM with comply with such provisions or this permit-shall be STATE LIC deemed revoked - WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT Nn MED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS h'` (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER J A. and Professions Code,and my license is in full force and effect 5 PER SYSTEM FINAL VALID TION O DATEU License Number Lic Class OC. FIN 0 Contractor Date B U LiE I am exempt under Sec N B&P C for this reason Plan check fee Date PLUMBING PERMIT ISSUING FEE$ lo Signature d X 4 0 7,O A TOTAL FEE •# co•coo5 Plan check applicant SINGLE FAMILY A o o 1 6 5 0 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address o 0 0 5 0 Law for the following reason (Section 7031 5, Business and Pr(Jessions Code) I City Tel No •0 220-86 1, as owner of the property, will do the work and the structure is not intended or-offered for sale (Section 7044, Business and Professions Code) 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 1 Ate/ /�� 1-7-11 Lender's Address 1 certify that I have read this application( nd state that the D above information is correct I agree to comply with all County ordinances and State jaws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes �✓ � �� /� SEE REVERSE FOR EXPLANATORY LANGUAGE100i S nature of Per ittee Date WORKERS;.COMPENSATIONDECLARATION A�'"t�L�BCA��®N FOR I�I�C�JCC`J BNq PERMIT I hereby�af m,thQt.I ha4e.a certificate of consent to self 76A667A �3 PERMIT orsircerofiec�copy thereoait6 of (SWorkers'ec Compensation aInsurance, CE 817(REV 10/81) � COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No ny f /6p/I + Gjl'yn� Certified copy is hereby furnishe�d7''`'` FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ❑ Certified copy is filed with the county uv1dins ec- ADDRESS Ti dep invent NUMBER FIXTURE OR ITEM FEE �t `` LOCALITY Date � t4" WATER CLOSET to NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE OWNER (This section need not be completed if the work involved by SHOWER the permit Is for one hundred dollars $100 or less. MAIL P ( ) � LAVATORY ADDRESS - I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL NO so as to become subject to the Workers Compensation Laws DISHWASHER Gr CONTRACT? Date Applicant CLOTHES WASHER ADDRESS NOTICETO APPLICANT If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY TEL NO LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NOESSED BY I hereby affirm that 1 am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS v�' (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER �,6 ` A and Professions Code,and my license is in full force and effect 5 PER SYSTEM DATE 5-, Jri BALI ATIOP) License Number Lic Class -1 G &S � imw& NMdg�A^Contractor B I am exempt under Sec � B&P C for this reason Plan check fee Date PLUMBING PERMIT ISSUING FEE$ Signature _ TOTAL FEE 2746A SINGLE FAMILY Plan check applicant # 0 0 0 0 0 5 ' HOME OWNER-BUILDER DECLARATION Name 12&5 Q I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031 5, Business and Professions Code) City Tel No o 0 - 2a505 ❑ 1, as owner of the property, will do the work and the 0 a 2 Q-8 5 structure is not intended or offered for sale (Section 7044, Business and Professions Code) 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 information is correct I agree to comply with all County PIP ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above- ention prop t for nspection pur ores (� SEE REVERSE FOR EXPLANATORY LANGUAGE i n i e OT Permittee Date