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Home My Public Portal About9623-9623 1/2 LONGDEN AVE_Plumbing__ 76 A 667 - CE 617 7-69- APPLICATION -69 APPLICATION FOR PLUMBING ' P., COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING-AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT. OP BUILDING LO.CALTfY FOR APPLICANT TO FILL IN PR NT OR TYPE) NEAREST NUMBER FIXTURE OR ITEM EACH FEE CROSS ST. OWNER WATER CLOSET 1.50 MAIL BATHTUB 1.50 ADDRE SHOWER. 1.50 CITY TE NO�Oe��D� LAVATORY 1.50 CONTRA R SINK 1.50 ADDRESS DISHWASHER 1.50 CITYTEL,N �.6 CLOTHES WASHER 1.50 STATE LIC LICENSENO. CLASS SWIMMING POOL RECEPTOR 1:50 DRnICNO. GROUP ZQNEI.,JngCESSED BY LAWN SPRINKLER SYSTEM 2.00 WATER HEATER 1.50 a INDUSTRIAL WASTE.APPROVAL GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD OUTLETS OVER:. 30 5 PER SYSTEM IIA U) Z. Plan check fee 25% of'above. See reverse. PLUMBING PERMIT ISSUING FEE 8 2 00 TOTAL FEE D APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS'VENT _ 1 City Tel. No. HOT WATER HEATER �• �1 ` � � 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL, COUNTY ORDINANCES AND STATE LAWS. REGULATING GAS TEST ' PLUMBING. ' I HEREBY CERTIFY THAT' 1 AM PROPERLY REGISTERED AND/OR - UTILITY CO.NOTIFIED LICENSED AS REQUIRED BY 'LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF;AND INTEND TO RESIDE IN,THE ABOVE DEZR"" RESIDENTIAL PROPERTY. M ! "' • % ' INAL ( � �J• SIGNATURE, JACK R. ALLEN, SUPERVISING MECHANICAL EN-G.R. OF PERMITTEE3 ' PERMIT VALIDATION 'CK. M.O.. CASH.' PLAN CHECK VALIDATION CK. M.O. CASH 10 _15-0 -We. M29m 5, 35 0 1BABH7 ` 388.17IO.BB APPLICATION FOR PLUMBING PERMIT 1 DIVISION OF BUILDRgG AND SAFETY Deportment of County Engineer ' County of Los Angeles BUILDING9, �J JOHN A.LAMBIE. COUNTY ENGINEER ADDRESS 7 �y •QRI`j AP" CASSATT D,GRIFFINS SUPT OF BUILDINLS �` LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. ✓ OWNER MAIL I G Mi41 L ROUP I AONE I.READY FOR INSPECTION ADDRESS _ INDUSTRIAL I CITY TEL.NO. WASTE APPROVAL PLUMBER- Ll� RJV F. _T �i.��_ INSPECTION RECORD ADDRESS e0 - / �:;5 f�f CITY / `' li i TEC.NO. / (?"� 33. `f �rlr/c / e I .Ifm s LICENSE NO. / 7� 3 7 r` AlNUMBER TYPE OF FIXTURE OR ITEM FEE t y p�,J a, � �, r l # / 22 WATER CLOSET (TOILET) @ $1.00 $ am vC4&-r-/_/ `� i-r 6- ,r22 BATH TUB @ $1.00 2 �f�.P- SHOWER @ $1.00 94p- �� LAVATORY (WASHBASIN) Q $1.0'0 10 S EjsS p�� KITCHEN SINK @ $1.00 p DISHWASHER @ $1.00 42 LAUNDRY TUB OR TRAY @ $1.00 TO,*e Af)w 7d &,*A CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 1 (r�' ��/ tfed/ GAS SYSTEM @ $1.00 A e J Pr APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK 'a^---" PERMIT 1 00 ~ ROUGH PLUMBING S • � ,� GAS PIPING TOTAL FEE �S GAS VENT IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION. HOT WATER HEATER AND STATE THAT THE 'ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LV �$ LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER F TH ABOVE UTILITY CO.NOTIFIED Q DESCRIBED RESIDENTIAL PR RT ' SIGNATUREreMI OF PERMITTEE FINAL b� ,f) OHN A.LAMBIE.COUNTY ENGINEER VALIDATION ROBERT A.WOOD,CHIEF PLBG. INSPECTOR �xQ. 6 5 1 3 LD MAY 2 9 3 1 5.0 0 '� ION WORKER'S I have a certificate of consent to 76AS68DPW 9I89 APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self Insure, 78A887A or a certificate of Worker's Compensation Insurance,or a certified I �• copy thereof(Sec.3800 Lab.C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policy No. Company Certified copy is hereby furnished. BUILDING f F1FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Certified copy is filed with the county building inspection department. NUMBER FIXTURE OR ITEM ® FEE LOCALITY Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST. COMPENSATION INSURANCE BATH TUB ASSESSOR (This section need not be completed If the..work Involved by the SHOWER MAP BOOK PAGE/ PARCEL permit is for one hundred dollars($100)or less.) OWNER I certify that in the performance of the work for which this permit LAVATORY �G ter✓ L is issued, I shall not employ any person in any manner so as toMAIL become subject to/tSINK/he Workers'Compensation Laws. ADDRESS � Applicant ] DISWASHER CITY TEL.NO� � Date/ Applicant „ z— CLOTHES WASHER -NOTICE TO.APPLICANT: If, after making this Certificate of CONTRACTOR Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRESS � � provisions of the Labor Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATIONCITY TEL.NCl �,V } I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business and STATE ,` 2 G` LIC. Professions Code,and my license is in full force and effect. GAS SYSTEM OUTLETS LICENSE NO. p' 7 CLASS e��X OUTLETS OVER DISTRICT NO. PROCESSED BY cc 5 PER SYSTEM License Number r✓ Lic.Class/ FINAL 1" � �j /� - DATE VALIDATION W Contractor Data f ❑ I aexempt under Sec. BY AL Z m B.&P.C.for this reason Date: Plan check fee , Signature PLUMBING PERMIT ISSUING FEE$ ad", () El Plan FEE Plan check applicant E=s SINGLE FAMILY i HOME OWNER-BUILDER DECLARATION Name ACCT a I hereby affirm that I am exempt from the Contractor's License Lawi `c for the following reason(Section 7031.5, Business and Professions Address 3730-33 Code): E I TT ❑ City Tel.No. G I,as owner of the property,will do the work and the structure � is not intended or offered for sale(Section 7044, Business TOTAL and Professions Code). 100. CHECK 4 1 o GVl. •" CONSTRUCTION LENDING AGENCY CHANGE .00 I hereby affirm that there Is a construction lending agency for the �i performance of the work for which this permit is Issued(Sec.3097, Civ.c.) �ti ILI'`Ll—�i[Ij 1 12/15/93 Lender's Name y A11113:22 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 001. and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property fo ' spect n osas. � SEE REVERSE FOR EXPLANATORY LANGUAGE ; Signature of Permittee Date