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Home My Public Portal About10141 LYNROSE ST_Plumbing__ 76AS67 17 a-SO APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY p COUNTY OF LOS ANGELES 6 WILLIAM J. FOX, CHIEF ENGINEER 1 FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. VALLEY BOUtEVARD PLUMBING M. S1 - I -- /7.200- PLUMBER RECEIVED BY READY FOR DATE ISSUED 8300 EA61 VALLLY BLVD. !r— FIRST INSPECTION _ / —� ADDRESS BUILDING CITY TEL NO ADDRESS COUNTY I / LOCALITY LICENSE NO EXPIRES NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER WATER JS ADDRESS CLOSET (TOILET) Q O 50 $ _ JAI BATH TUB Q O 501 9 • CITY TEL. NO. � SHOWER Q 0.50 1 HEREBY A N LEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) Q 0.50 Q. APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND Q STATE LAWS REGULATING PLUMBING. KITCHEN SINK Q 0.50 _ I CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB R TRAY Q O 50 I ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER OF THE RESIDENTI ROPERTY DESCRIBED ABOV GAS SYSTEM OUTLETS Q O SOI SD SIGNATURE OF WATER HEATER Q 0.50 ® PERMITTE SLOP SINK O 50111 INSPECTION RECORD FLOOR SINK O 50 FLOOR DRAIN Q O 501 DISHWASHER O SO DRINKING FOUNTAIN Q O 501 URINAL @ O SOI J HOUSE SEWER Q O 501 Z MISCELLANEOUS I I� 0 I� O I I I I APPROVALS DATE / INSPECTOR'S NAME ROUGH PLUMBING ,/ f � GAS PIPING A✓/ ref' GAS VENT CESSPOOL Q 1 00 I CESSPOOL SEPTIC TANK I SEPTIC TANK I DRAIN ( ) PIT ( Q 1 001 SEWER PERMIT . I 1 00 GAS TEST UTILITY CO NOTIFIED TOTAL FEE I $ ..7 FINAL • r ,76A667-CE#817 10-62 , APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING J�y y//cc -JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS / e/ c` WILLIAM A JENSEN, SUP T OF BUILDING LOCALITY. \ .,, W-12 FOR APPLICANT TO FILL IN T NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER ol WATER CLOSET $1.25 MAIL; BATH TUB 1,25 ADDRESS CITY 'TEL. NO. SHOWER 1.25 LAVATORY 1.25 CONTRAC ^ SINK1.25 ADDRESS 9'1_,27 - DISHWASHER 1.25 CITY �F£L LQ3 LAUNDRY TUB 1.25 CONTRACTOR'S STATE ElREGISTRATION NO. e7 L-,/ COUNTY ❑ CLOTHES WASHER j 1.25 DISTRICT NO T ;T E REfiS3 D BY. WATER 1.50 GAS SYSTEM OUTLETS 1.50 INDUSTRIAL per„ WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .30 0 0 I INSPECTION RECORD 0 F U W t a APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT , WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING- 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN, THE ABOVE DESCRIBED RESIDENTI PROPERTY UTILITY CO NOTIFIED SIGNATURE OF PERMITTE _ FINAL LIDATION ROBERT A' WOOD ' 'CK M O CASH SUPERVISING MECHANICAL ENG'R ' :_ LACO,8 7 0 8�8 JAN 11 5 D 350- 76A667 (CE-817) - 1/75 _- APPLICATIOI�I F_OR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING MAKE CHECKS PAYABLE TO- ADDRESS D S C HARVEY T. BRANDT, COUNTY ENGINEER LOCAL( FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM @ FEE OWNER WATER CLOSET 200 MAIL BATM•TUB 200 ADDRESS SHOWER 2 00 CITY TEL. � LAVATORY 200 CONTRACT i SINK 200 ADDRESS DISHWASHER 200 CLOTHES WASHER 1 200 S1/ATE- LIC SWIMMING POOL RECEPTOR2 00- LICENSE X61 CLASS DISTRICTNQ G UP NE LAWN SPRINKLER SY EM 200 (Ju �X C.=� , WATE T • 200 6>0INDUSTRIAL WASTE APPROVAL GAS SYS OUTLETS 200 INSPECTION RECORD v OUTLETS OVER 5 PER SYSTEM .30 0 � d N Z x � - 6 Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ TOTAL FE APPROVALS DATE INSPECTOR 8 SIGNATURE Plan check applicant UNDER SLAB WORK Name , ROUGH PLUMBING, Address GAS PIPING a City TelGAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT 1 HAVE RAPPLICATION AND STATE THAT THE ABOVE IS CORRECT E TO COMPLY PLUMBING FIXTURES 3 WITH ALL COUNTY ORDINANCES AND STAREGULATING•F PLUMBING - • GAS TESTI HEREBY CERTIFY THAT I AM PROPERLERED AND/OR UTILITY CO' NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES ND STATE OFCALIFORNIA OR THAT IAMTHE LEGAL OWNND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTITY. FINAL S SIGNATURE OF PERMITTFy� -' PERMIT VALIDATION CK. M.0. CASH PLAN CHECK VALIDATION CK M.0. CASH 7 6.1 E--t!AR 17 5 D 7.5'0 ,&98 76A667 - CE817 5/70 APPLICATION -FOR PLUMBING PERMIT- COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING j JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS COLEMAN W.JENKINS. SUP T of BUILDING LOCALITY �fI FOR APPLICANT TO FILL IN PR NT OR TYPE) NEAREST / CROSS ST. eq-1fckl7la (' NUMBER FIXTURE OR ITEM EACH FEE OWNER ' ' IYIe WATER CLOSET 1. 0 r ' MAIL BATH TUB 15 ADDRESS SHOWER 1.5 CI ,i�_r TEL. NO. LAVATORY 1 5 CONTRACTO SINK 1.5 ADDRESS DISHWASHER 1.5 CITY TEL. NO. CLOTHES WASHER1 50 STATE LIC LICENSE NO CLASS SWIMMING POOL RECEPTOR 1 50 DIST RICT Np GROUP ZO E LAWN SPRINKLER SYSTEM 2.00 WATER HEATER 1.50 INDUSTRIAL 0 WASTE APPROVAL GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD OUTLETS OVER 30 0 5 PER SYSTEM CL z a Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE 8 00 TOTAL FEE APPROVALS ATE I ECTOR' S NATURE Plan check applicantUNDER SLAB WORK -71 Name ROUGH PLUMBING 1 Address UA reGAS PIPING / GAS VENT City j Tel. No HOT WATER HEATER 1 HEREBY A NOWLEOGE THAT/[ HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THEL GAL OWNS OF,AND INTE D TO RESIDE IN,THE OVE DE SC [ E E TIA PROPERTY FINAL SIGNATURE JACK R. ALLEN, SUPE ISI CHANICAL ENG'R _ OF PERMITTEE PERMIT VALIDAT CK M o CASH PLAN CHECK VALIDATIAc M o CASH u�(,o 5 1 6 7 v mA,R,2 8.2 5�' WORKERS'COMPENSATIONDECLARATION CE: APPLICATION FOR -PLUMBING PERMIT I hereby at_'firin_that I.have a certificate of consent to self ce en (z-ao) /�a insure, or a'certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab C.) I COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnished FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ADDRESS - E Certified copy is filed with the'county building inspection NUMBER FIXTURE OR ITEM • FEE department. WATER'CLOSET LOCALITY Date 'Applicant NEAREST BATH TUB CROSS ST CERTIFICATE OF.,EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER E n ! LAVATORY ES � t ✓VYG ld(This section need not be completed if;the work involvedby the permif'is for one hundred'dollars ($100) or less.) SINK ' TEL NO c/ 0 i T,y"(tu U I certify that in the pdrforman of a work for which this DISHWASHERCC permit is is ued, I shall not em oy any erson m any manner CONTRACTOR O so as to b co a subject to the or s ompensatwn Laws CLOTHES WASHER - U ADDRESS Date AppLCant W SWIMMING POOL RECEPTOR d NOTIC TO APPLICANT If, after making this Cert ficate of CITY TEL.NO. N Exemption, you should,-become subject to the Workers' LAWN SPRINKLER SYSTEM Z Compensation provisions of the Labor Code, you must forth- STATE LICABY _ with comply with such provisions or this permit 'shall,be WATER HEATER LICENSE NO CLASS deemed revoked. + GAS SYSTEM OUTLETS �p DI TRICT NO PROCESSE LICENSED CONTRACTORS DECLARATIONOUTLETS OVE I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL �^�b/ VALIDATION ness and Professions Code, and my license is in full force and DATE 6 a effect F INAL- License ! License Nuber Lic Class y Contractor Date I am exempt from 1.the licensing requirements as I am a Plan-check fee licensed architect or a'registered-professional engineer PLUMBING PERMIT ISSUING FEE$ 17 O acting in my professional capacity (Section 7051, Bus- iness and Professions Code). pQ ` 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 License Law for the following reason (Section 7031 5, Busi- City Tel.No ness and Professions Code). 2 0 7 5.O A I, as owner of the property, am exclusively contracting with-licensed contractors to construct the project #,0'0,0,0 d 5 (Section 7044, Business and Professions Code) 2 0'o`� Q Q Q CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency 0,0.0 1 d, Q= U for the performance of the work for which this permit is issued(Sec 3097,Civ C). i OR 1 3'-8 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 aut rite representatives of this County to enter upon the abo a-men oned property for inspection p ses /34/ Signature of Permittee Da e WORKERS"COME ENSATIOIV D;CLARATfON n n n p C n 11 O H FOR (fi n p ((n/� D M G (�E RM T 76A667 DPW 4/87 G=�11T If L5 G�1 U ll V FOR I�L�V UVU Il V IT LS ll�❑vu ' `.I hereby,'affirtn that I-have a certificate of consent to self in- 76A667A - Isure,or a<ertificate of Workers'Compensation Insurance,ora CE 817(REV. 8/86) ccrf1'lied copy thereof (Sec. 3800, Lab.-C._) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company, E, Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING a Certified copy is filed with the county building inspection ADDRESS NUMBER FIXTURE OR ITEM FEE LOCALITY department., @ (�^_ • WATER CLOSET(TOILET) Date Applicant. NEAREST CERTIFICATE'OF EXEMPTION FROM WORKERS BATH TUB CRO55 ST - ` U! COMPENSATION INSURANCE OWNER SHOWER z,,-- (This '✓' (This section need.not be completed if the work involved by MAIL the permit.is for one hundred dollars ($100)or less.) LAVATORY ",' AD RESS se?)-n I certify that in the performance'of the work for which this per- SINK " �{ mit is issued, I shall not employ any person in any manner so CITY - `� eiT'q • TEL. Nt613.:- #77� as to become subject to the.Workers'-Compensati , Laws. -- DISHWASHER CONTRALTO / �a ' ! 4", Date./Z I/rWe Applicant CLOTHES WASH_ER .' ADDRESSG� NOTICE TO APPLICANT: If, after making this Certificate.-of Ex- emption,you should become subject to the Workers'Compen- SWIMMING POOL RECEPTOR. :sotion'provisions.of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEM CITY Gu lv C/ f�� TEL. NO�`�/��j ly with such'provisions or this permit-shall be deemed revok- STATE / LIC. ed: WATER HEATER 676(LICENSE NO— CLASS L� LICENSED CONTRACTORS DECLARATION. DIS RICT NO. NIT ESSED BY 1 hereby.affirm that I pm licensed under.provisions.ofChapter GAS SYSTEM OUTLETS 9,(commencing.wi'th Section 7000)of Division 3 of the Business OUTLETS OVER and Professions_ Code, and my license is in full force and ef- 5 PER SYSTEM FINAL - p/—� ALIDATION �' feet DATE `i`-,/I O License Number7�� Lic. Class (� FINAL Confracto f• Date �7 BY �/ O I am exempt under Sec. UJ B.BP.C. for'this reason' Plan check fee, Date: `PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE 160 15 SINGLE FAMILY ` HOME OWNER-BUILDER DECLARATION. Flan check applicant' I hereby affirm that I orn exempt from the Contractor's License Name Law for the following reason(Section 7,031.5,' Business andACCT°JL Professions Code): Address. . r 2- 7 10 I;'as owner of the property, will do the work and the City. Tel. No. structure is not intended or offered for sale(Section 7044, 1 ITEMS Business and Professions Code). 5 D TOTAL 16 o -_�0 CONSTRUCTION LENDING AGENCY CHE16. I hereby affirm that'there is a construction lending agency for _ !`'SSI the performance of the work for which this permit is issued - " CHANGE °1310 (Sec. 3097, Civ. C.). Lender's Name 0000-0001 12/11/89 Lender's Address TlF}! 1 AMID", I certify that 1,have read this application and state that the ' above-information is correct.•I agree to comply with all County D ordinances and State laws regulating Plumbing, and hereby' authorize representatives of this County to enter upon the aroperty for inspection%puirposes. SEE REVERSE.FOR EXPLANATORY LANGUAGE Signature of Permittee Dafe