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Home My Public Portal About9658 LIVE OAK AVE_Plumbing__ 7. 7 !J'11tl 11 � L4mICFi"'41TO® TOR U LURY�0 �19�:1G PEI1BN�Il �T . DSS-17 12.54 DIVISION OF BUILDING AND SAFETY . Department of County Engineer County of Los Angeles BUILDING WM.J. FOX, COUNTY ENGINEER ADDRESS i(aCd G CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY G0`d�� FOR APPLICANT TO FILL IN NEAREST CROSS ST. OWNER � !� - DISTRICT NO. GROUP ZONE READY FOR INSPECTION MAIL tom' �j J� -�' ADDRESS _- .0 `F� B X�./ e., I CITY�''/"gy,/, ,- d' i:.�F '?TEL. NO. r ,7JJ�/�(;• INDUSTRIAL f WASTE APPROVAL PLUMBER & - INSSPECTION RECORD ADDRESS CITY TEL. NO. - LICENSE NO. NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) BATH TUB - SHOWER LAVATORY (WASH BASIN) KITCHEN SINK DISHWASHER LAUNDRY TUB OR TRAY CLOTHES WASHERa. TOTAL NO. @ 0.80O APPROVALS DATE INSPECTOR'S SIGNATURE GAS SYSTEM OUTLETS @ 1.00 UNDER SLABWORK WATER HEATER @ 1.00 ROUGH PLUMBING. PERMIT 8 1 00 GAS PIPING TOTAL FEE I I �� GAS VENT 'r 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. 1 HEREBY CERTIFY THAT IAM PROPERLY REGISTERED AND/OR GAS TEST - LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE,OF UTILITY CO. NOTIFIED ' CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY.' SIGNATURE OF PERMITTEE �L��"- r��r-•Y/-Y-/"�%.- FINAL WILLIAM J. FOX, COUNTY ENGINEER VALIDATION _.To4 0"3':1 u' :CRY 23 3 1 .80 M .� DEPUTI�'( 0 - ate,. r �V��RKERS' COMPENSATION DECLARATION'. {, � I�I��I /�p� I r j� `(j �,nnnn, j�. (�� (�"�. I nn 20-0026DPW•4/87. A p LS�C/r�Y��N FOR PLVUVl1U�I1V`C�J pERl�lV T I hereby, affirm that I have a.certificate of consent to self in- '76A667A - I surex,or a•certificate of Woekers'Compensation Insurance,or a CE 817(REV.,8L86) e2rtrtQ copy thereof (Sec. 3800; Lab.-C.) u - :COUNTY OFLOS.ANGELES DEPT. OF-PUBLIC WORKS Policy No. • :Company. , G'ertified copy is hereby furnished. , FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING r Certified copy is filed with the county building inspection ADDRESS r. I vL? NUMBER FIXTURE OR ITEM FEE LOCALITY ., department. @ CROSS ST Date ApplicantNEAREST 1 • .B WATER CLOSET(TOILET) CERTIFICATE OF EXEMPTION FROM WORKERS" ATH TUB ,- 161 4L-. COMPENSATION INSURANCE SHOWER OWNER i (This secton need not be completed if tlie.'work MAIL revolved by the permit is for one hundred dollars ($100)or less.) ' LAVATORY ADDRESS t i3 d1E d cerfiN that in the performance of the work for which this per- mit is issued, I.sha11•nat employ any person in'any manner so SINKCITYTEL. NS ' L.- as:to become subject to the-Wcirkers'Compensation Laws: DISHWASHER CONTRACTOR 'Date Applicant. .„ - CLOTHES•WASHER - • v _/ - NOTICE TO A,OLICANT:'If, after making this Certificate of Ex-- ADDRESS emption,•yooshould become subject to the Workers'Compen- SWIMMING POOL RECEPTOR 56tion provisions.of the Labor Code,.y,ou mustforihwith comp- LAWN SPRINKLER SYSTEM CITY TEL. NO ly with such provisions or this permit sh611'be deemed•revok- _ STATE LiC. ed.:: WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION.. -. DISTRICT NO. PROCESSED BY I•herebyaffirm that,l am licensed under prov;isionsof Chapter GAS'SYSTEM OUTLETS (� ?:(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- FINA 5 PER SYSTEM feet. - �. DATEVALIDATION �.. License Number Lic. ClassFINAy U Contractor_ Date BY C. - ;- exempt under Sec. 0 . UJ B&P.0 for this reason D Plan check'fee Date: PLUMBING PERMIT ISSUING FEE$ Signature' fir] r TOTAL FEE. U SINGLE FAMILY HOMEOWNER-BUILDER DECLARATION Plan check applicant itTlv (F I hereby affirm that I am exempt from the Contractor's License Name. Law for the following reason (Section 7039.5, Business and ,• r Professions Code)--- 7 Address 1' _ .Ft'I€NI 20 50 ❑ I,,as owner=of the property,,will do,the work and the City, Tel. No.T structure is not•intendecl or offered for sale(Section 7044; _HET.. Busiriess and Professions Code).. CONSTRUCTION.LENDING AGENCY (Hereby affirm that there is a construction lending agency for , the.performance of the work for which this permit is%issued'• ti. rTr I r' : rh•: Lender's_Naj}M Leride'r's Address I'certify that I have read this:application'and state that the . above information is correct!]agree:to comply with all County D ordinances'and State-laws regulating Plumbing, and.hereby L authorize representatives of this County to'enter upon the above-mentioned propert far inspection purposes._' r� .. SEE,REVERSE FOR EXPLANATORY LANGUAGE Signature of Per itteV Date WORKERS' COMPENSATION DECLARATION � n PPO C n T��.N FO^ P p n� MMIG, ffher-by -5ffirm'that I have a certificate of consent to self in-.' 20-0026 DPw:a/,ez G�11T lr L� (� (IBJ ((�( (L�U�1 n (J�J •�stjre,.or a certificate of Workers'Compensation Insurance,ora CE 817(REV. 8/86) cera fie `;opy t6re6f.(Sec..3800,,Lab C:) Policy .; Company. COUNTY OF LOS.ANGELES �' DEPT.-OF PUBLIC WORKS Certified copy is hereby furnished FOR APPLICANT TO FILL IN`(PRINT OR TYPE) BUILDING ❑ Certified copy is filed with the county building inspection ADDRESS -C department. NUMBER FIXTURE OR4TEM, @ FEE . _ LOCALITY Date. - Applicant - - �� NEAREST .. - . WATER CLOSET.(TOILET) 'CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB �! CROSS ST.' COMPENSATION INSURANCE - - OWNER + SHOWER ��.': (This section need not be corripleted•if the work involved by MAIL the permit is for one.hundred dollars ($100)or less.) LAVATORY ADDRESS ! I certify that in the-performance of the work'for which this per= SINK mit is issued; l shall not employ any person in any'manner so YS3 CITY TEL. NO. as to_become subject to the Workers' Compensation,Laws. i DISHWASHER _ - CONTRACTOR , i Date Applicant CLOTHES WASHER ` NOTICE TOAPPLICANT:.If, after making this Certificate;of Ex ADDRESS emption, you should become subject to the Workers'Compen- SWIMMING POOL RECEPTOR /t,f, TEL. NO. sation provisions of the Labor Code, you must forthwith comp-� - LAWN.SPRINKLER SYSTEM CITY !V V 'ly with,such provisions or'this permit shali''be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. �PROCESSED BY, I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9'(commencing with Section 7000)of Division 3 of the Business OUTLETS-OVER., Q and Professions Code, and my Iicense,is•in full force arid,ef`- 5 PER SYSTEM'tett. FINAL / VALIDATION'. Z d License Number" Lic. Class 0 FINAL U Contractor DateBYO E . I am exempt under Sec. LLI_ B.&P.C. for this reason H Plan check fee D ;E Date:" PLUMBING PERMIT,ISSUING FEE$ .Signature _ SINGLE FAMILY., TOTAL FEE G(� HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that 1 am exempt from the Contractor's License Name Law for the'following reason (Section.7031.5,'Business and y .; .ir Professions Code):', Address 6s owner of the°property, will do'the'w"ark.and the City Tel. No. J structure is not.intended or offered for sale(Section 7044; _ 'i€— •= Business,and Professions Code). D f E CONSTRUCTION LENDING AGENCY _ ; c ;! I:hereby affirm that there is.a construction lending agency,for NEC ' the'performance of the work for which this permit is issued r + €! ,i f€ (Sec. 3097, Civ. C.). lender s Name - Lender s Address -!q<4 I certify.that I:have read this application and state that the above-information is correct. Lagree to comply with all County e ordinances'`and State laws regulating Plumbing, and hereby D , outhorve repr entotives' of this County to'enter upon the above enti ' ed property for inspection purposes. ��. SEE (REVERSE FOR EXPLAWATORY LANGUAGE Signature:of Permittee Date