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Home My Public Portal About10721 MILOANN ST_Plumbing__ 710,08 APPLICATION FOR PLUMBING PERMIT 1 D MCM OF BUMUM J= RAFM JOHN A.LAMBIE.COUNTY ENGINEER ADz)n S 107232 Pd1Oa= CABSATi D.ORIFFIN.SUPT OF BUILDING LbCALTTY in FOS = TO Pm M NEARMST ST. OWNER DISTRICT NOGROUP XO E BUMP"HISPRerwll MAIL AODREM —YT as ® a Cat No.d 81S/75 INDUSTRIAL A T6 APPROVAL PLUMBER MBPECT= NBC= ADDRESS! ' CI TML.NO. LICSNSR NO. IfMIFS NUNGSII TTPS OF FIXTURS OR IT= PRS WATER CLOSET(TOILET) 61.00 BATH TUB 61.00 SHOWMR 01.00 LAVATORY(WASHBASIN) O 1.00 KITCHEN SINK ® 81.00 DIS ASHER 41.00 LAUNDRY TUB OR TRAY 81.00 CLOTHMS WASHER ® 81.00 WATER HRATMR 61.00 GAS sywmm it 61.00 AMMAN DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT R 00 ROUGH PLUMPING GAS PIPING TOTAL FEE GAS VENT 1 HEREBY ACKNOWLEDGE THAT 1 HAVE BRAD THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER =1 -,.7"e WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES 1 HEREBY CERTIFY THAT i AN PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AN THE LEGAL OWNER THE ABOVE UTILITY CO.NOTIFIRD DRSCNIBED RESIDENTIAL PRO KRTY. SIONATURS OF PSRMITTE6 FINAL monsoon I IOHN A.L.AMBIE.COUNTY AGINSUR VALIDATION ROBERT A.WOOD.CHIEF PL 30. INSPRCTOR a. a G. R L�Co2 s�. FM 10 5 A 3.00 i COUNTY OF LOS ANGELES I APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Englneer I FOR APPLICANT TO FILL IN DISTRICT N.D. GROUP ZONE PLUMBER VAI I FY RawFlusin I flr mnRECEI �LrD BY READY FOR DATE ISSUED -••-- - FIRST I NBPECTI ON ADDRESS ,"-7': ':-1 ' y RI yin r JBUILDING A +y CITY RO..�..,. . TEL.No. AT 9-977 C IADDRESS !/ I A COUNTY LOCALITY L+t LICENSE NO. 5.r,.1 EXPIRES C. =•.��7-� N EAR EST PERMIT FEES CROSS BY. NUMBER TYPE Or FIXTURE OR ITEM rEE J OWNERMAIL _ WATER CLOSET(TOILET) 0.50 J ADDRESS ® BATH TUB Q 0.50 CITY TEL. No. SHOWER 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) db 0.50 APPLICATI13 AND STATE THAT THE ABOVE IS CORRECT ` AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK 13.50 1 AND STATE LAWS REGULATING PLUMBING. i 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY a 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER OAS SYSTEMOUTLETS 0.50 OF THE RESIDENTIAL ROPERTY DESCRIBED ABOV /'+ WATER HEATER 0.50 1 SIONP MRTTE ( „ SLOP SINK @ 0.50 INSPECTION RECORD 1091 FLOOR SINK 0.50 FLOOR DRAIN 0.50 . DISHWASHER 13.513 DRINKING FOUNTAIN @ 0.50 URINAL @ 0.50 J Q HOUSE SEWER @ O.SO _Z MISCELLANEOUS 17 O APPROVALS DATE INSPECTOR'S NAME j ROUGH PLUMBING 4n gmz.k ,1 J GAS PIPING ,d 3 M7A i GAS VENT CESSPOOL 1.00 j CESSPOOL SEPTIC TANK. I SEPTIC TANK 14 DRAIN ( ) PIT ( ) @ 1.00 j SEWER PERMIT 1.00 I GAS TEST y ZCG i TOTAL FEE UTILITY 00.NOTIFIED FINAL 76A667 DBS#k 17 6-5E '11'F� '� 4ORKER'S.COMPENSATJON DECLARATION 200026 DPW 9/89 '1 I 76A667A APPLICATION FOR PLUMBING PERMIT ILII afNrm�t}iat I have a certificate of consent to self Insure, or a da;gficate oti'Worker's Compensation Insurance,or a certified copy;hereof(Sec...9800 Lab.C.f Policy Ni. " Company COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. ❑ Certified copy is hereby furnished. 1/10 . Z I / FOR APPLICANT TO FILL IN(PRINT OR TYPE) ABUILDING DDRESS Certified copy is filed with the county build' nsp ction department. NUMBER FIXTURE OR ITEM @ FEE ,v LOCALITY G� Date pplicantWATER CLOSET rr NEAREST r _ CROSS ST. �Z CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB D D ASSESSOR COMPENSATION INSURANCE (This section.need not be completed If the work Involved by the SHOWER MAP BOOK PAGE' PARCEL permit is for one hundred dollars($100)or less.) '/ LAVATORY O v OWNER ��y^ I certify that in the performance of the work for which this permit v MAIL is issued, I shall not employ any person in any manner so as to SINK ADDRESS become subject to the Workers'Compensation Laws. DISWASHER CITY TEL.NO ,:$-7Date Applies � fi NOTICE TO APPLICANTPIf, after making this Certificate of CLOTHES WASHER CONTRACTOR f�O 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 DECLARATION CITY 7EL.NO.p 1 hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER STATE �i /�� `Zg�� 0. (commencing with Section 7000)of Division 3 of the'Business and GAS SYSTEM OUTLETS O LICENSE NO.c��/ CLASS. Professions Code,and my license is in full force and effect. OUTLETS OVER DISTRICT NO. PROCESSED BY 5 PER SYSTEM License Number Lic.Class AS FINAL ��/� VALIDATION LU ContractoDATE� �L Date �� r] FINAL I am exempt under Sec. BY 4� B.&P.C.for this reason Date: `1- Plan check fee t Signature 50 PLUMBING PERMIT ISSUING FEE$ O ❑ Plan check applicant SINGLE FAMILY .a HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Law —, ae �t for the following reason(Section 7031.5, Business and Professions Address c3307 Code): 1 � �'i'] El 1, Tel.No. I,as owner of the property,will do the work and the structure is not intended or offered for sale(Section 7044, Business TOTAL 65 .50 and Professions Co ).de , CHECK 50 CONSTRUCTION LENDING AGENCY - N hIGE a i[I 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.) 01300-00011 12/'10/',ij Lender's Name 4374 i AM 9:27. 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 ION WORKER'S I Ve'a certificate of consent to 78GA667A PW9/a9 APPLICATION FOR PLUMBING PERMIT ' 'I he'r.Rby affRm t oat I have a certificate of consent to self insure, or a cdrVicate of Worker's Compensation Insurance, or a certified copy t1 ereof(Sec.3800 Lab.C.) ` . COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policy No. Company ❑lBUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) 7 L % /S (^� Q�-!✓�✓ J Certified copy is filed with the county building Inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE �7 _ ^ LOCALITY !� L 7--/✓ Date��,?r��Appllcant �� (�� 2�/ eg- WATER CLOSET Q NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. //J,q 2&t /,14 COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the work Involved by the SHOWER O MAP BOOK PAGE PARCEL permit Is for one hundred dollars($100)or less.) LAVATORY D OWNER iq&T11 20 O l2—{, I certify that in the performance of the work for which this permit Q is issued, I shall not employ any person in any manner so as to SINK 1 Q ADDRESS AIL J_ � j become subject to the Workers'Comp e pation La DISWASHER Q CITY TEL.NO. Date ApplicaCLOTHES WASHER /Q CONTRACTOR NOTICE TO APPLICANT: If, aft making this Certificate o -C,0"L Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such ADDRESS provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM P919 Y LICENSED CONTRACTORS DECLARATION CITY / TEL.NO. } I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER �" r �� (commencing with Section 7000)of Division 3 of the Business and GAS SYSTEM OUTLETS LICIL ENSE NO. ''( CLAATE LISSS 0 Professions Code,and my license is in full force and effect. OUTLETS OVER DISTRICT NO. PROCESSED BY 5 PER SYSTEM n License Number �.-/2 Lic.Class IQFINAL C r 19G CEr DATE b /{ VALIDATION all Contractor-1 PV-rk� ate ��- f1 � j ❑ I am exempt under Sec. BY AL _ 7.7�tro,,� B.&P.C.for this reason Date:1Z— 13—?.7 Plan check fee Signature PLUMBING PERMIT ISSUING FEE$ as ❑ TOTAL FEE �+ Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Law _ for the following reason(Section 7031.5, Business and Professions Address � ;1 j,ii.i Code): City Tel.No. I ITEMS ❑ I,as owner of the property,will do the work and the structure is not intended or offered for sale(Section 7044, Business TON iO{ _ 73. 00 and Professions Code). CONSTRUCTION LENDING AGENCY �t�- I hereby affirm that there is a construction lending agency for the CHANGE ,CICS, performance of the work for which this permit is Issued(Sec. 3097, Civ.C.) -t Lender's Name 131-00-113101111 1 11.=i of I tiF a fel i o 49 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