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Home My Public Portal About9627, 9627 1/2 LAS TUNAS DR_Plumbing__ DEPARTMENT OF COUNTY ENGINEER PLUMBING 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES BUILDING WILLIAM J. FOX, COUNTY ENGINEER ADDRESS Q v FOR APPLIC NT TO FILL IN LOCALITY NEAREST BUILDING � U CROSS ST. ADDRESS DISTRICT N0. GROUP LONE PERMIT N0. LOCALITY _TC nt Ai 5 �- Ch-7 -Z l Z S NEAREST CROSS ST. �� ( I RECEIVED BY Ready for Inspection DATE ISSUED OWNER /bt fI� a' MAIL INDUST L ADDRESS WASTE APPROVAL CITY TEL.NO. INSPECTION RECORD PLUMBER P, I A41*1tti C Tf ADDRESS S CITY s ads K G TEL.NO. [� G br.>— ®STATE LICENSE N0. PERMIT FEES --ltIMOER TYPE OF FIXTURE OR ITEM FEE �' . p�`4'A Z'wo `/A sir~ �' - Z WATER CLOSET(TOILET) @ 0.80 S �L !tf !��.51 . eg-"/1ti• O BATH TUB SHOWER @ 0.80 �/ LAVATORY(WASH BASIN) @ 0.80 yc' KITCHEN SINK @ 0.80 ,7 G LAUNDRY TUB OR TRAY @ 0.80 SLOP SINK @ 0.80 FLOORSINK @ 0.80 / LI �. FLOOR DRAIN @ 0.80 7 �S DISHWASHER @ 0.80 DRINKING FOUNTAIN @ 0.80 URINAL ��[[- @ 0.80 �v 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 REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS GELFS COUNTY GAS TEST ° ��,/L fiV AND STATE OF CALIFORNIA HAT I AM HE LEGAL OWN- ER OF THE ABOV S B ESIDEdTI PROPERTY. UTILITY CO.NOTIFIED --)y- SIGNATURE OF PERMITTE ..... - - .----.........................................._....--- FINAL !� f 76A667 DBS 17 1/53 )BS-17 10.55 APPLICATION FOR PLUMBING PERMIT 1 )BS-17 DIVISION OF BUILDING AND SAFETY Department of County Engineer County Of LOS Angeles BUILDING / Z. Q�efJ JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS (p CASSATT D. GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST /� q —Z CROSS ST. 0WNER�I t DISTRICT NO. GROUP ZONE READY FOR INSPECTION MAIL ADDRESS 6/1 f �� CITY TEL. NO. INDUSTRIALWASTE APPROVAL PLUMBER 5~ (_� INSPECTION RECORD ADDRESISC /T�� /`� _W /�Taf�)l/� My CITY VV /T `I ��•-� TEL. NOV �/ ! `v .3 - - LICENSE NO. '1`6 �� D NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 $ BATH TUB @ $1.00 SHOWER @ $1.00 LAVATORY (WASH BASIN) @ $1.00 KITCHEN SINK @ $1.00 DISHWASHER @ $1.00 LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 GAS SYSTEM @ $1.00 - 0 0own - v APPROVALS DATE INSPE S SIGN URE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING IF ". _ _ $ GAS PIPING TOTAL FEE GAS VENT _ 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES PLUMBING. ' P — IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST ' __ti ..4' LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ✓I .�,,�„•, CALIFORNIA OR THAT 1 AM THE LE AL OWNER OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL PR SIGNATURE OF PERMITTEE FINAL { !OHN A. LAMBIE, COUNTY ENGINEER ,-VALIDATION ROBERT A.WOOD, CHIEF PLBG. INSPECTOR CAr �0 3 8 3 4 - AUG 13 5 A 5.0 0 I WORxERSCOMPENSATION DECARATION 20-0026 DPW PW9i89 APPLICATION FOR PLUMBING PERMIT I hereby-affirm tact I have a certificate of consent to self insure, -or a c&Aificate of Worker's Compensation Insurance, or a certified copy theredf(Sec.3800 Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Polic�No Company LYJ� Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) AUILDING DD ESS Certified copy is filed with the my building in on de artm nt. NUMBER FIXTURE OR ITEM ® FEE LOCALITY Date Applica WATER CLOSET NEAREST CROSS ST C TIFICATE OF EXEMPTION FROM WORKERS' BATH TUB COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the work involved by the SHOWER MAP BOOK 7 PAGE el'7 PARCEL ' permit is for one hundred dollars($100)or less.) OWNER LAVATORY I certify that in the performance of the work for which this permit MAIL r is issued, I shall not employ any person in any manner so as to SINK ADDRESS become subject to the Workers'Compensation Laws. DISWASHER CI TEL.NO.'�'f/I� Date Applicant �j CLOTHES WASHER v O CONTRACT R .f��l NOTICE TO APPLICANT: If, after making this Certificate of Exemption,you should become subject to the Workers' Compensation SWIMMING POOL RECEPTOR ADDRESS provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. AWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL.NO. } I hereby affirm that I am licensed under provisions of Chapter 9 STATEWATER HEATER It v O (commencing with Section 7000) of Division 3 of the Business and GAS SYSTEM OUTLETS tet— LICENSE NO. �_n Cl LIC.SS (� Professions Code,and my license is in full force and effect. �.J C./ OUTLETS OVERt� DISTRICT NO. PROCESSED BY 22f 5 PER SYSTEM Q C �� Q License Number l" ) Lic.Class � FINAL DATE VALIDATION a _ Contractor Date C0 ❑ FINAL Z I am exempt under Sec. BY D B.&P.C.for this reason Plan check fee qJq - Date: PLUMBING PERMIT ISSUING FEE$ �lp D ' s Signature ❑ TOT"E Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Namet' 250 f� I hereby affirm that I am exempt from the Contractor's License Law I iH4' u'8 for the following reason (Section 7031.5, Business and Professions Address t c" Code): Tel.No. F1 1, �'t'tI-fNt�F't r I,as owner of the property,will do the work and the structure G' ` I is not intended or offered for sale (Section 7044, Business and Professions Code). , r_ 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 ordinances and State laws regulating Plumbing, and hereby authorize r sentatives of this ty toe r upon the abov -mentioned proper for' spection rpo es. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Per tteeDD to