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Home My Public Portal About9931 MILOANN ST_Plumbing__ ,;Y6A66-r(CE-B17•Sr- 5/73 r •APPLICATIO OR -PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING C ADDRESS BUILDING T. BRANDT, COUNTY ENGINEER LOCALITY' L FOR APPLICANT TO FILL IN (PRINT OR TYPE) CROSS S7. Z(J NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET 1.757- OWNER 15, MAIL BATH TUB 1.75 ADDRESS SHOWER 1.75 CITY L� V TEL. NO. ..�5 LAVATORY 1.79 2.5 CONTRACT I SINK 1.75 ADDRESS DISHWASHER 1.75 CITY Rdd TEL. NO. 11jl_ CLOTHES WASHER 1.75 STATE LIC LICENSE NO. (0 CLASS SWIMMING POOL RECEPTOR 1.75 DISTRICT NO. GROUP77-n.-\-6,4e- WATER P ESSED BY LAWN SPRINKLER SYSTEM 1.75 (�p HEATER 1.75 INDUSTRIAL o y, WASTE APPROVAL a GAS SYSTEM OUTLETS 1.75 S INSPECTION RECORD v OUTLETS OVER 5 PER SYSTEM .30 p V W a N Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant r UNDER SLAB WORK a � •+.��7,� � �y�itlt€�)� Name ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THEABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES ,� 'o `'W �. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS RECUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RE51DE IN THE ABOVE ESCRIBED RESIDENTIAL PR PERTY. FINAL rs=,. .. SIGNATU RE OF PERMITTEE PERMIT VALIDATION cK. o. CASH PLAN CHECK VALIDATION CK. M.O. CASH it G.rt EtS 5 D v.G •:'o f 4 i 76A667-CE#817 2-62 1 ' APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND.SAFETY DIVISION fNMEAREST LDING JOHN A. LAMBIE. COUNTY ENGINEER DRESS WILLIAM A.JENSEN, SUP'T•OF BUILDING CALITY FOR APPLICANT TO FILL IN OSS ST. NUMBER FIXTURE OR ITEM EACH FEE v OWNER ` WATER CLOSET $1.2 MAIL BATH TUB 1.25 ADDRESS SHOWER 125 CITY TEL. NO LAVATORY 1.25 CONTRACTOR SINS 1.25 ADDRESS DISHWASHER 1. CITY TEL. NO. 5 REGISTRATION STATE N LAUNDRY TUBO. J COUNTY CLOTHES WASHFR 1.25 'DISTRICT NO. GROUP NE, PRO SSED BY WATER HEA 1.50 r/ OUTLET$ GAS SYSTEM 1.50 INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD nog r✓f W N z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE D CRIBED R IDENTI ROPERTY UTILITY CO.NOTIFIED SIGNATURE f _ OF PERMITTEE FINAL �,��µr'� ✓ .,4 � 0ALMATION ROBERT dWOOD M.O. CASH SUPERVISING MECHANICAL ENG'R Vi160 b 8:-5 9 NOV 13 5 D 3.5 O N h 4 WORKERS'COMPENSATION DECLARATION20-0026 DPW 4/90 APPLICATION FOR PLUMBING PERMIT ' I hereby, affirm that I have a certificate of consent to self in- 76A667A sure,ora certificate of Workers'Compensation Insurance,ora certified copy thereof(Sec. 3800, Lab. C.) - COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company FJ Certified copy is hereby furnished. BUILDING /��y� FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS � °rf/ �. w o Certified copy is filed with the county building inspection department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Ddte Applicant WATER CLOSET(TOILET) NEAREST �s®rte "� CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. ed#? COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL the permit Is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK CITY TEL. NO mit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. DISHWASHER ®� disc •' /��/ ® CONTRACTOR Date. 4/-4 " �' Applicant 61 •6 CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: if, after making this Certificate of Ex- yy SWIMMING POOL RECEPTOR 9ss'I� emption,you should become subject to the Workers'Compen- CITY 6%C��/G6eI TEL. NO sation provisions of the Lahr Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATEg� LIC. ed. / WATER HEATER LICENSE NO. -90 � CLASS if AA V.11 LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSEI)BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS a� _ 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL / V.ii4LlDlWION fect. HOSE BIB DATE _ License Number SIVU510" Lic. Class FIN } yo4/ A T 777.= V Contractor Date BY _ 1'—1 h` F1 am exempt under Sec. �f }'j tt mr� B.BP.C. for this reason ► �J'"�/ ! '-HES•K if,�' 3 Plan check fee 'H ii Date_ CRs® : ECK j 1..)_Z PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE `'H�'I SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name U FI l'1—=l_l+F1 4/211--p'c Law for the following reason (Section 7031.5, Business and Professions Code): Address '''r: I- Ark 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, 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-men?�. roperty for inspection purposes. 64�e64� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date