HomeMy Public PortalAbout9569 LAS TUNAS DR_Plumbing__ 7BA667-CE817 6-60 �j J /
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A.JENSEN. SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM tol
OWNER
WATER CLOSET
MADRIL �
BATH TUB �S?/ NO G a'�/c3
SHOWER CCONTRACTO4 1/A
LAVATORY
SmADDRESS
DISHWASHER CITY
CONTRACTOR 5 STATE
LAUNDRY TUB REGISTRATION NO. i ;Z7 a COUNTY
CLOTHES WASHES DISTRICT NO. GROUP ZONE P D BY
WATER HEATER D —
GAS SYSTEM INDUSTRIAL _
WASTE APPROVAL
INSPECTION RECORD
a
O
U
P4
O
a
0 $1.00 PER ITEM
y
OR FIXTURE $
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE S
ROUGH PLUMBING
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.
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 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PR PERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERM1.. FINAL J
m� VALIDATION ROBERT A. WOOD,
X.O. l/ B� SUPERVISING MECHANICAL,ENG'R
7 2 '" Wl �_ 1 5 D 3.0 0 �'
r76A667 (CE-317) - 173
APPLICATION F PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION _
MAKE CHECKS PAYABLE TO: BUILDING `` �!
ADDRESS b l� 9 e. S
HARVEY T. BRANDT, COUNTY ENGINEER LOCAL(
FOR APPLICANT TO FILL IN (PRINT OR TYPE( NEAREST
CROSS ST. C
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET
2.00 OWNER
MAIL + '
BATH TUB 2.00 ADDRE
SHOWER 2.00 CITY TEL. NO.
LAVATORY 2.00 CONTRACTORjr
SINK 2.00 ADDRESS ,Z• �.
DISHWASHER 2.00 r �
CLOTHES WASHER 2.00 TATELIC
L I C E N E N0' L1 CLASS
SWIMMING POOL RECEPTOR 2.00
DISTRICT NO.GROUP ZONE OCESSED BY
LAWN SPRINKLER SYSTEM 2,00 U O ,_ y 0 _/
WATER HEATER 2.00 7 Ute' INDUSTRIAL y
WASTE APPROVAL p
GAS SYSTEM OUTLETS 2.00 INSPECTION RECORD V
OUTLETS OVER
5 PER SYSTEM .30 to
O
t;
W
N
Z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEES 6,0
TOTAL FEE Ste'
APPROVALS DATE INSPECTOR'5 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. No. GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ .THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST
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
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PER TY. FINAL
SIGNATURE
OF PERMITTE
PERMIT VALIDATION CCK. M.O. CASH
PLAN CHECK VALIDATION CK. M.0. CASH
1 7 FFR l 5 u 7.1t
T V �3
O. B. 17 7-40 25M APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBING
WM. J. FOX, CHIEF ENGINEER
NATURE OF INSTALLATION DISTRICT NO. GROUP ( ZONE PERMIT No.
ROUGH
PLUMBING I FIXTURES COMPLETE RECEIVED BY READY FOR DATE ISSUED
HEATER CESSPOOL SEPTIC TANK ;yf ` FIRST INSPECTION
GAS MISCELLANEOUS
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
i JOB
NAME �' ` / ,/ ADDRESS
W `f f
fADDRESSl� /y _^ �f I��1 �" ( r' LOCALITY '
7 NEAREST _
IL CITY �d Qr�"�r� TEL No. CROSS ST.
COUNTY
CERT. NO. EXPIRES III NAME z MAIL
f'
OCATION OF SEPTIC TANK, OR CESSPOOL O ADDRESS
w�S 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.
Ste) , OM1^ OWNER
w�l ! CORRECTIONS
DESCRIPTION OF FORK Z
-BATH TUB FURNACE
IY
SHOWER 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 INSPECTORS NAME
_--WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I�
__. METER GAS SODA FOUNTAIN GAS PIPING I
OUTL
GAS VENT
-- CESSPOOL
TOTAL NUMBER OF FIXTURES SEPTIC TANK
SEWER
,----CESSPOOL SEPTIC TANK -
$ / —(/t— UTILITY CO. NOTIFIED I
TOTAL FEE I // "+
FINAL
D. B. 17 7-40 25M APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND
COUNTY OF LOS ANGELES SAFETY PLUMBING 2
WM. J. FOX, CHIEF ENGINEER
NATURE OF INSTALLATION DISTRICT NO. GROUP I ZONE PERMIT No.
ROUGH I L_T ( F 1,( J j is i 2 oe
PLUMBING FIXTURES COMPLETE RECEIVED BY I READY FORD T �E ISSUED
HEATER CESSPOOL SEPTIC TANK FIRST INSPECTION �
GAS MISCELLANEOUS
LIC T FILL JN HEAVILY OUTLINED PORTION ONLY
/ Jos
K NAME ADDRESS
W t+
ADDRESS �, OCALITY ,f
O -NEAREST
L CITY rI'EL No CROSS ST.
L
COUN lk •
CERT. NO. EXPIRE NAME
Z MAIL OCATION FSE IC TANK, OR CESSPOOLO ADDRESS
NORTH
CITY TEL No.
1 AM THE LEGAL POPS E R OF THE A!��LOS
ANGELES COUNTY CERTYF/ OF LIFI .
♦ P BE
I AM THE LEGAL O R OF H ROPERTY DE CRIBED
ABOVE.
A
IS
3 0 OWNER
CORRECTIONS
SOUTH
w
F
DESCRIPTION OF WORK v
BATH TuB FURNACE a
SHOWER DISHWASHER
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
[�__FLOOR SINK SAND TRAP
SLOP SINK FLOOR DRAIN
WASH TRAY URINAL
APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE INSPECTORS NAME
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING
METER GAS SODA FOUNTAIN GAS PIPING
OUTL
GAS VENT
CESSPOOL
TOTAL NUMBER OF FIXTURES SEPTIC TANK
�MCESSPOOL SEPTIC TANK SEWER
UTILITYCO. NOTIFIED
TOTAL FEE
�$'.,Z
FINAL
D. B. 17 7-40 25M APPLICATION FOR PERMIT
DEPARTMENT OF P,UILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBING
WM. J. FOX, CHIEF ENGINEER
NATURE OF INSTALLATION ! DISTRICT NO. GROUP I ZONE I PERMIT No.
ROUGH I FIXTURES I I COMPLETE f
PLUMBING RECEIVED BY ( READY FOR I p TE 196UED
HEATER CESSPOOL SEPTIC TANK FIRST INSPECTION
GAS MISCELLANEOUS 1 ,
APPLICANT FILL. IN HEAVILY OUTLINED PORTION ONLY
t F �.+ JOB - ✓
NAME � 1'�- /��-. /��r�� TP i J ADDRESS.:�.- / ,, I
m ADD SSER (�� i� LOCALITYNEAREt
a. CITY%�1 TEL NOr?A2 �O
1 ! - CROSSSST. �
COUNTY n
CERT. NO. EXPIRES W NAME q
Z MAIL
LOCATION OF SEPTIC TANK, OR CESSPOOL o I ADDRESS
NORTH
-i CIT'/ TEL No.
I AM THE LEGAL POSSESSOR OF THE ABOVE LOS
,y ANGELES COUNTY CERTIFICATE OF QUALIFICATION.
iPLUMBER
1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
N >
' i OWNER Y�y
7 CORRECTIONS
E
k
y --"-- SOUTN-------._ ---- J
DESCRIPTION of WORK _I Z
BATH TUB FURNACE
IL
__ SHOWER _DISHWASHER
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER 17. t7
FLOOR SINK SAND TRAP _
__ SLOP SINK FLOOR DRAIN
APPROVALS
---WASH TRAY URINAL
__—_--WATER CLOSET DRINKING FOUNTAIN DATE INSPECTORS NAME
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING
METER GAS SODA FOUNTAIN GAS PIPING i! �4" .'y'►''1•
OUTL
GAS VENT
CESSPOOL
TOTAL NUMBER OF FIXTURES SEPTIC TANK
,---CESSPOOL SEPTIC TANK SEWER
I$ UTILITYCO. NOTIFIED I
TOTAL FEE I` FINAL
WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT
�I hgreb� affirm that I have a certificate of consent to self 20-0026 DPW 6/87
insure, or a certificate of Workers' Compensation Insurance, 76A667A
or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
Policy No Company
❑ Certified copy is hereby furnished BUILDING
F-1ADDRESSAPPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS �i( V
Certified copy is filed with the county building inspec-
tion department NUMBER FIXTURE OR ITEM @ FEE LOCALITY
Date Applicant WATER CLOSET NEAREST L
CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST L6� C
zrz
COMPENSATION INSURANCE SHOWER OWNER
(This section need not be completed if the work involved by MAIL
the permit is for one hundred dollars ($100)or less.) -2— LAVATORY V 0 ADDRESSSAY
1 certify that in the performance of the work for which this
permit is issued, I shall not employ any person in any manner SINK CITY TEL NO
so as to become subject to the Workers'bmpensation Laws DISHWASHER
CONTRACTOR
Date Applicant { CLOTHES WASHER
NOTICE TO AP (CANT If, after mi kin t Certifica e of ADDRESS
Exemption, you should become subje to the Workers' SWIMMING POOL RECEPTOR p
Compensation provisions of the Labor Code, you must forth- CITY TEL NO
p p y LAWN SPRINKLE STEM
with comply with such provisions or this permit shall be STATE LIC
deemed revoked WATER HEAT LICENSE NO CLASS
LICENSED CONTRACTORS DECLARATION DISTRICT fn PROCESSED BY
I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTE UTLETS
(commencing with Section 7000) of Division 3 of the Business OUTLETS OVE
and Professions Code, and my license is in full force and effect 5 PER SYSTEM FINAL VALIDATION
DATE
License Number Lic Class ! (��� U
,,����� FINAL
Contracto>��--.�—a-109 to 0— BY v Q
❑ I am exempt under SecJILLF
.0v ����'B/ / U'
B 8P C for this reason a
Plan check fee CO
Date PLUMBING PERMIT ISSUING FEE$ 7
Signature
TOTAL FEE
Plan check applicant
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATION Name °_F. �s
I hereby affirm that I am exempt from the Contractor's License Address - -a
Law for the following reason (Section 7031 5, Business and
Professions Code) Cir Tel No
❑ Y
I, as owner of the property, will do the work and the _
structure is not intended or offered for sale (Section 011. ;i(3 HL _� m 50
7044, Business and Professions Code)
CONSTRUCTION LENDING AGENCY T'
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 �42 a H. a T
I 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 jaws regulating Plumbing, and hereby
authorize representatives of this County to enter upon the
ZbZntioned property for inspection purposes
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signare o ermittee Date