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Home My Public Portal About10249 NADINE ST_Plumbing__ 78A887 n E-49® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING 1 COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT�O. GROUP ZONE PERMIT NO. PLUMBER r' RECEIVED READY FOR DATE ISSUED FIRST INSPECTION ADDRESS BUILDING CITY l , ' TEL. NO. ADDRESS COUNTY LOCALITY (-- LICENSE NO. EXPIRES ? NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER _ MAIL WATER.CLOSET (TOILET) @ 0.50 ADDRESS BATH TUB @ 0.50 CITY TEL. NO. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT I 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 @ 0.50 STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. GAS SYSTEM OUTLETS 0.50 SIGNATURE OF WATER HEATER @ 0.50 PERMITTEE SLOP SINK @ 0.50 INSPECTION RECORD FLOOR SINK Q 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50 DRINKING FOUNTAIN @ 0.50 URINAL @ 0.50 J HOUSE SEWER @ 0.50 Q z MISCELLANEOUS It 0 APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 1,00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) Q 1.00 SEWER PERMIT . 1.00 GAS TEST i� UTILITY CO. NOTIFIED 1' - TOTAL FEE 1 $ L FINAL I 7aiLow r, 9-49 ® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING 1 WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DIST RIC O GRQUP ZONE PERMIT NO � RE Y READY FOR � DAT ISSUED PLUMBER FIRST INSPECTION ADDRWSA 0 d 6 BUILDING CITY TEL NO ADDRESS COUNTY v LOCALITY lffArAd LICENSE NO EXPIRES NEAREST PERMIT FEES CROSS ST a 4 NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET (TOILET) 050 S ADDRESS _ BATH TUB @ 050 CITY t TEL NO SHOWER ® O SO 1 HER Y ACKNOWL E THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) O SO APPLICATI N AND STATE AT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ 050 STATE LAWS REGULATING PLUMBING 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS ANGELES COUNTY LICENSE OR I AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE GAS SYSTEM-3-OUTLETS @ 050 SIGNATURE OF 0 3 w{/�✓ �Ai+ WATER HEATER @ 050 PERMITTE SLOP SINK 050 INSPECTION RECORD FLOOR SINK ® 050 FLOOR DRAIN ® 050 DISHWASHER @ 050 DRINKING FOUNTAIN @ 050 URINAL @ 050 d HOUSESEWER @ O BO Z MISCELLANEOUS I a It O I APPROVALS DATIZZ INSPECTOR B NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 1 00 CESSPOOL SEPTIC TANK SEPTIC TANK I DRAIN ( ) PIT ( ) @ too SEWER PERMIT 100 GAS TEST _ UTILITY CO NOTIFIED y TOTAL FEE I s 0 FINAL � j WORKERS COMPENSATION DECLARATION 20 hereby affirm that I have a certificate of consent to self m 76A667A 4/ B7 APPLICATION FOR PLUMBING PERMIT sure or a certificate of Workers Compensation Insurance or a CE 817(REV 8/86) ► certified copy thereof(Sec 3800 Lab C ) COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS Pobcy No Company F1 Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ^J Certified copy is filed with the county building inspection ADDRESS2. department NUMBER FIXTURE OR ITEM FEE LOCALITY Date Applicant WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB CROSS ST AA V 1 s%l it, COMPENSATION INSURANCE SHOWER OWNER !" l (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less) LAVATORY ADDRESS tiA WAUt I certify that in the performance of the work for which this per mit is issued I shall not employ any person in any manner so SINK CITY l TEL NO as to become subject to the Workers Compensati n laws DISHWASHER &C*1 Tom"' C CONTRACTOR Date =0Applicant vJ A��` ;' CLOTHES WASHER ADDRESS NOTICE TO APPLICANT If after making this Certificate of Ex SWIMMING POOL RECEPTOR emption you should become subject to the Workers Compen CITY TEL NO sation provisions of the Labor Code you must forthwith comp LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok STATE r- LIC ed WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NQS OCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 5 9V70Y W?:::1 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code and my license is in full force and of 5 PER SYSTEM FINALALIDATION d fect DATE License Number Lic Class O V FINAL Contractor Date BYL O H I am exempt under SecIL V W B&P C for this reason- ► Plan check fee Z z Date PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE GLE FAMILY Plan check a licant HO OWNER BUILDER DECLARATION PP C t I hereby affirm that I am exempt from the Contractor s License Name {�/�/+T Law for the following reason (Section 7031 5 Business and 1'Rr41 eA Profess Code) Address 33Q� 1�.� I as owner of the property will do the work and the City Tel No it structure is not intended or offered for sale(Section 7044 1 ITEMS Business and Professions Code) � Tt iZAt. 16.50 CONSTRUCTION LENDING AGENCY .�[t 1 hereby affirm that there is a construction lending agency for CHECK the performance of the work for which this permit is issued (Sec 3097 Civ C ) CK%4M .00 Lender s Name -W01 12/22 89 Lender s Address 7713 1 AM 8:2. 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 ifflbve mentio ed property for insp ction purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Siature f Permittee Date