HomeMy Public PortalAbout9224 LONGDEN AVE_Plumbing__ D.B. 17 25M SETS is-aa - APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY,'
COUNTY OF LOS ANGELES. PLUMBING .
WM.J. FOX.CHIEF ENGINEER
NATURE OF INSTALLATION DISTRI o. - GROUP. O E P/ rtmiT NO"
ROUGH FIXTURES ' OMPL:ETB
HEATER CESSPOOL I Y .1 SEPTIC TANK RECEREADY FOR DATE ISSUED
GAS- . MISCELLANEOU RIRST INSPECTION
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APPLICANT FILL�IN HEAVILY OUTLINED PORTION ONLY
LC NAMB c i�l' // J :�f OZ ZX ~ _q_ L/
N
g ADDRESS � / //T �jat/ LOCALITY .NEAREST
" CITY L, p� i0
CROSO ST.
COUNTY `
CERT.No. _ - EXPIRES NAME
LOCATION OF SEPTIC T z
ANS, OR CESSPOOL' Z : MAIL
3 ADDRESS
NORTN i O
CITY TEL.No.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOB
ANGELES COUNTYY CC RTIf CATR OF/Qy�UALIFICATION.
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_ PL{IMBBR
I.AM THE LEGAL OWNER OF THE PROPERTY.DESCRIBED
ABOVE.
3 � -
OWNER
CORRECTIONS
SOUTH
- - J
DESCRIPTION of WORK a
Z
ATH TUB FURNACE
ROWER DISHWASHER Q
LAVATORY. REFRIGERATOR
--KITCHEN SINK WATER SOFTENER
—FLOOR SINK SAND TRAP
—SLOP SINK FLOOR DRAIN
WASH TRAY ------URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN.' DATE INSPECTOR'S NAME
WATER HEATER ^ENTAL LAVATORY ROUGH PLUMBING i
ETES GA_8 SODA FOUNTAIN GAB PIPING I I
OUTL
GAB VENT
CESSPOOL
TOTAL NUMBER OF FIXTURES SEPTIC TANK I I
__/__CES8pOO SEPTIC TANK SEWER I j
8 UTILITY CO.NOTIFIED I "!
TOTAL FEE FINAL ° ; `4
0.13. I7 asM sEre ta-aa APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING. AND SAFETY ,
�CGUNTY OF LOS ANGELES PLUMBING '
`VVM.J. FOX.CHIEF ENGINEER
NATURE OF INSTALLATION DlffrRlCr NO. GROUP ZONE PERMIT NO.
ROUGH If
FIXTURES COMPLETE..
-
HEATER CESSPOOL —I SEPTIC TANK RECE .ED B�f"I READY FOR... DATE 188U[+.D
�,E,IRST INSPECTION
RAM-
•..MIS�CEpLILANEO�UB
APPLICANT �FILL IN
HEAVILY OUTLINED PORTION ONLY
NAME : T Atl fuGl/T117JOB
' Y
�
DDRESSJ J c ✓4l - .�'�J`
ADDRESSl /ljt� (ii.�.lsP// i/..�/i/!�� LOCALITY
f� Iy /J NEAREST
' L
' CITY{��' (i,,Sy�!Gy TEL.NO.�`X /�7 CROSS 8T. -I.-(
COUNTY } -y,+, `
CERT.NO. f AJ EXPIRES.?—j X"" ON: NAME !
LOCATION OF SEPTIC TANK, OR CESSPOOL; Z .MAIL
NORTH ADDRESS
CITY TEL.NO.
I AM THE LEGAL POSSESSOR OF THB ABOVE LOS
ANGELES CCODUNT-Y�/CE/RTIFICA/T�Ep OF QUALIFICATION.
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PLummum
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE. if
.a OWNER
CORRECTIONS
SOUTH J
DESCRIPTION OF WORK z
/ BATH TUB - FURNACE
r _
HWWER 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 INsr;seTOR'e NAME
WATER HEATER DENTALLAVATORY ROUGH PLUMBING
ETE AS SODA FOUNTAIN
OUTL A9 PIPING
GAS VENT'
CESSPOOL I
TOTAL NUMBER OF FIXTURES' f r /
BEPTlC TANK
CEBBPOOI- SEPTIC TANK SEWER na
i,
S UTILITY CO.NOTIFIED
TOTAL FEE
FINAL
i
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...CE 817.f1iEW.6/'JBlr
t APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TY?EI BUILDING
NUMBER FIXTURE OR ITEM ® FEE ADDRESS '
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST.
SHOWER( OWNER ! 'Tv
MAIL
LAVATORY ADDRESS 9 o-L . j. La v vciej
SINK CITY r4-efj4,V TEL.NO: C._
DISHWASHER If
CONTRACTOR
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL.NO.
LAWN SPRINKLER SYSTEM STATE LIC.
WATER HEATER _310-0 LICENSE NO. CLASS
GAS SYSTEM OUTLETS APPROVALS DAJE INSP T (GNAT E
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING
GAS VENT
LR
HOT WATER HEATER
PLUMBING FIXTURES
GAS TEST o t " I qnqn
Plan check fee UTILITY CO.NOTIFIED vg
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL
Plan check applicant PLAN CHECK VALIDATION
Name
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 I AM PROPERLY REGISTERED AND/OR LICE ED AS r 3 97 6,1'
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I M THE
LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESI NTIAL O O O r O F
PROPERTY.
SIGNATURE 2 O O i
OFPERMI _
O
DISTRICT NO CESSED 8Y
-11
Q 0424
INDUSTRIAL
WASTE APPROVAL
WORKERS'COMPENSATION DECLARATION 76AS07A
I hereby affirm that I have a' certificate of AnseW tp selfl- •ce 41`17(Z,.o): APPLICATION FOR PLUMBING PERMIT
insure, or a certificate of Workers'Compensation Insurance`,'or % 'fl
a certified copy thereof(Sec.3800,Lab.C.)
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company
❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING
O - ADDRESS
Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE
department. WATER CLOSET rte, LOCALITY
Date Applicant I NEAREST /
BATH TUB CROSS ST. L d11_1
CERTIFICATE OF EXEMPTION FROM WORKERS' n
COMPENSATION INSURANCE ( SHOWER r- OWNER
MAI L
(This section need not be completed N the work involved LAVATORY "� ADDRESS Z L �r9✓ -l/+�J }
by the permit IS for one hundred dollars ($100) of less.) SINK 4f CITY TEL.NO.adfp_2Z tL
1 certify that in the performance of the work for which this DISHWASHER
permit is issued, I shall not loy any person in any manner CONTRACTOR w
so as to become subject the�rs Compensation Laws. CLOTHES WASHER 0
ADDRESS O
Da ApplicA /t-�� "'�- `� SWIMMING POOL RECEPTOR U
NOTIC�TO APPLICANT: If, after making this Certificate of CITY TEL.'NO. W
Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. fU)
Compensation provisions of the Labor Code, you must forth- T- LICENSE NO. CLASS
with comply with such provisions or this permit shall be WATER HEATER
deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. PROCESSED BY
LICENSED CONTRACTORS DECLARATION OUTLETS OVER
I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM
9 (commencing with Section 7000)of Division 3 of the Busi- FINAL. VALIDATION
ness and Professions Code, and my license is in full force and DATE
effect. J
NAL
License Numbel'�1�/9!�r a/6 Lic.Class r� BY
ContractorallkPJ m 9 e."timate - 21C M Z
1 am exempt from the licensing requirements as I am a Plan check fee
licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$
acting in my professional capacity (Section 7051, Bus-
iness and Professions Code).
TOTAL FEE
Lic.or Reg.No. Date Plan check applicant
HOME OWNER-BUILDER DECLARATION Name
I hereby affirm that I am exempt from the Contractor's Address 5 0 9 4 A
License Law for the following reason (Section 7031.5, Busi- City Tel.No. f+ 0 a a a a
ness and Professions Code):
ElI, as owner of the property, am exclusively contracting Z , a 32.50
with licensed contractors to construct the project
(Section 7044,Business and Professions Code).
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CONSTRUCTION LENDING AGENCY 07,2 1 -82
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 SEE REVERSE FOR EXPLANATORY LANGUAGE
ordinances and State laws regulating Plumbing, and hereby
authorize representatives of this County to enter upon the
ove a perty for inspection purposes.
Signature of PeEmittee Date