HomeMy Public PortalAbout6003 MUSCATEL AVE_Plumbing__ 76"66' 1' 6-49® APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBING 1
WILLIAM J. FOX. CHIEF ENGINEER
OR APPLICA 70' F L 1 •� D13TRICT NO. GROUP ZONE PEI ZN
!l Y'V
PLUMBER ,( r A�. RECEIVED BY READY FOR/ DATEISSUED
/y/�,� _ FIRST INSPECTION
ADDRESS /pJ O .-�.(,r�..• '.K' ,+� / ✓_`S s6 ��j ,/�►•�I•^
UILDING
` C17Y _ f"l+� : .:fs� TEL N0.11-
COUNTY
. IJc9 ADDRESS /
COUNTY �¢le v. { :i .fi - �� r LOCALITYN � ✓�� C
LICENSE NO. ./ EXPIRES Y�
• I NEAREST
PERMIT FEES ceoss ST. �F.� -
NUMBER
TYPE OF FIXTURE OR ITEM FEE OWNER 1 'l..•E'fJ•'GZ--2�-'ih-' �•�"
MAIL ��
WATER CLOSET (TOILET). (� 0.50 S ADDRESS.
BATH TUB 0.50': CITY
SHOWER 0.50 I 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 AND
KITCHEN SINK O.50 STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB.OR TRAY 0.50 ANGELES COON LICENSE, OR 1 AM THE LN(iAL OWNER.
OF THE RESIDENTIAL PR P /TY� DES IBED OVE-
GAS SYSTEM OUTLETS @ 0.50 SIGNATURE OF ( � ^
WATER HEATER @ 0.50 PERMITTE `_ • , ��•�— —e, `
SLOP SINK 0.50 IN ECTION RECORD
FLOOR SINK ® 0.50i
FLOOR DRAIN @ 0.50 Y `v �.�7„„�j.e"Ae—
DISHWASHER 0.50
DRINKING FOUNTAIN 0.50
URINAL Q.0.50 a.
HOUSE SEWER @ 0.50 )//a S' �( � (t�,/��,.. Z
MISCELLANEOUS /✓ 19
I.
i
' I
i APPROVALS '
• DATE IN6PF.CTOR'6 NAME
ROUGH PLUMBING
GAS PIPING
I
GAS VENT
CESSPOOL 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN .(... ) PIT ( ) @ 1.00 SEWER
PERMIT . LOO I GAS TEST
UTILITY CO. NOTIFIED n�I�
TOTAL FEE I ffi Id'C1 FINAL
•tF WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT
Is hereby ta$ffirm 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 certifie copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No,r . — ;11Company-1s,rlxra/;E7`
Certified copy is hereby furnished. ,
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
Certified copy is filed with the county building inspec- ADDRESS
tion department. NUMBER FIXTURE OR ITEM @ FEE
.12
LOCALITY ✓
Date'• o ma- AppliganT �!�>>�� (< WATER CLOSET NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS'
BATH TUB CROSS ST.
COMPENSATION INSURANCE OWNER r
(This section need not be completed if the work involved by SHOWER 1 MAIL
= /F?• t
the permit is for one hundred dollars($100)or less.) LAVATORY A ./ ADDRESS
1 certify that in the performance of the work for which this
permit is issued, I shall not employ any person in any manner SINK CITY TEL. NO.
so as to become subject to the Workers'Compensation Laws. DISHWASHER
CONTRACTOR �G� jl.J',-,n,7 Z7 h
Date Applicant CLOTHES WASHER ADDRESS
NOTICE TO APPLICANT: If, after making this Certificate of ! 7 f? C/h`
Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR
Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CIT &�4-�rC� TEL. NO!
with comply with such provisions or this permit shall be STATE --7/ C.LLLL
deemed revoked. WATER HEATER LICENSE NO. Ass
LICENSED CONTRACTORS DECLARATION DISTRICT NO. P SSED BY
I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS 0 SD[
(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER ,
and Professions Code,and my license is in full force and effect. 5 PER SYSTEM DATELf
L3._.�/ 1S VALID ION
License Number Lic. Class
FIN 0
ContractorCe:)&Q_�M/rf!L Date BY ,L 0
I am exempt under Sec. �
B.BP.C. for this reason
Date: 11110 �
Plan check fee J21 9 Q3 A
PLUMBING PERMIT ISSUING FEE$
Signature o v # 0 0 0 0 0 5
TOTAL FEE v
SINGLE FAMILY Plan check applicant Io o 3[(,5 0
HOME OWNER-BUILDER DECLARATION Name
I hereby affirm that I am exempt from the Contractor's License 00 0 3 4, =
5 0
Law for the following reason (Section 7031.5, Business and
Address �'
Professions Code): City Tel. No. O G.2 2—8 5
❑ I, as owner of the property, will do the work and the
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
abov.-mentioned rope ty for inspection purpo;es.
\ SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date