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Home My Public Portal About10715 LORA ST_Plumbing__ •=r- COUNTY OF LOS ANGELES APPLICATION FOR PERMIT 'Department of County EngineerPLUMBING DIVISION OFF BUILDING & SAFETY WILLIAM J. FOX, County Engineer RMIT NEI. FOR APPLICANT TO FILL IN DISTRICT NO. ORDLIP ZONE ` sI, PLUMBER ALLEY r,0: �� rl i !'(L_ RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION ADDRESS $�C-, - ) �"' I /S'— BUILDING q CITY r�'� TEL.No. ^ ')� ADDRECOUNTY SS (/ LICENSE NO. 'J""' EXPIRES LOCALITY NEAREST PERMIT FEES CROSS HT. NUMBER TYPE OR FIXTURE CR ITEM FEE OWNER MAIL WATER CLOSET(TOILET) Q 0.50 S ADDRESS BATH TUB 0.513 CITY TEL. No. SHOWER 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK 0.50 AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY O.SO ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER GAS SYSTEMOUTLETS 0 0.50 OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. AT WATER HEATER ® 0.50 BIGNPERMITTEF SLOP BINK @ 0.513 INSPECTION RECORD FLOOR BINK 6 0.50 FLOOR DRAIN 0 0.50 DISHWASHER Q 0.90 DRINKING FOUNTAIN ® 13.51 URINAL @ 0.90 Q HOUSE SEWER 0.50 Z MISCELLANEOUS 5 APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING -10-s.J /�_ a GAS PIPING GAS VENT CESSPOOL 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) 49 1.00 HEWER PERMIT 1.013 GAS TESTS TOTAL FEE $ UTILITY CO.NOTIFIED A 6' 6 FINAL / 76A667 DBS$#17 6-52 WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) or a certified copy thereof (Sec. 3800, Lob. C. CIMTe !7itv T4TY OF LOS ANGELt9 BUILDING AND SAFETY Pal cy No. ;s f)19 1 rCompany Certified copy is hereby furnishe1.-2 r BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Certified copy is filed with the county building inspec- tion department. NUMBER FIXTURE OR ITEM C FEE LOCALITY WATER CLOSET T ~ Date _ _ Applicant NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' )` BATH TUB CROSS ST. COMPENSATION INSURANCE OWNER (This section need not be completed if the work involved by SHOWER the permit is for one hundred dollars ($100)or less.) LAVATORY ±ADDRESI IL I certify that in the performance of the work for which thispermit is issued, I shall not employ any person in any manner SINK Y TE . NO.r 23 so as to become subject to the Workers Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR . CITY TEL. NO. Compensation provisions of the Labor Code, you must forth- !- 1 with comply with such provisions or this LAWN SPRINKLER SYSTEM p y p permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSENO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT PROCESSYD BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of Jhe Business OUTLETS OVER a and Professions Code, and my license is in full force and effect. 5 PER SYSTEM FINAL VALIDATION C DATE C License Number15Jf";q_Lic. Class FINAL I'i' Contractor Date 4 55 _— BY LL ❑ • • I am exempt under Sec. > B.BP.C. for this reason Q Plan check fee ► C Date: PLUMBING PERMIT ISSUING FEE$ Signature ' TOTAL FEE IL Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. ❑ I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section Poo7044, Business and Professions Code). 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 representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date i WORKERS'COMPENSATION DECLARATION0-0026 APPLICATION FOR PLUMBING PERMIT 'hhereby, affirm that I have a certificate of consent to self in- 7PW 4/87 6A667A sure,or a certificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) `IILJI� Wf' Lab. C) ' Com pan COUNTY OF LOS ANGELES i DEPT. OF PUBLIC WORKS C. P ertified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) 'BUILDING ified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY• �)• Date Applica�' WATER CLOSET(TOILET) NEAREST 1 CERTIFICATE OF EXEMPTION FROM ORKE S' BATH TUB CROSS ST. COMPENSATION INSURA SHOWER OWNER C (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS LZ 09 I certify that in the performance of the work for which this per- SINK C17Y� TEL. mit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. DISHWASHER / Z CONTRACT Date Applicant CLOTHES WASHER ADDRESS 101 - NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- a sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM CIT` T O. ly with such provisions or this permit shall be deemed revok- STATE LIC. /� ed. WATER HEATER LICENSE NO. CLASS CZ LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER fed Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL c� VALIDATION a ` �Y i DATE ,� �S I I O License Number S�&_)> Lic. Class 361 V W (} FINAL r� P Contractor Date -� "'� BY O I am exempt under Sec. W a 8.8P.C. for this reason ® 2E Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE t SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION PP I hereby affirm that I am exempt from the Contractor's License Name ' Law for the following reason (Section 7031.5, Business and , o� Professions Code): Address F-1 1, as owner of the property, will do the work and the City Tel. No. "' _ •y`-_='- structure is not intended or offered for sale(Section 7044, Business and Professions Code). _ _ CONSTRUCTION LENDING AGENCY ® 2�ra 50 I hereby affirm that there is a construction lending agency for '1- the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name �•�f+•l-`�lei='i �. � 1,`, - Lender's Address — s I certify that I have read this application and state that the above information is correct. I agree to comply with all County Lop ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the abo mentioned pfig rty for i pection purposes. a � SEE REVERSE FOR EXPLANATORY LANGUAGE Signatur of Permittee Date i