HomeMy Public PortalAbout10721 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