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Home My Public Portal About5308 NOEL DR_Plumbing_7/6/1977_ 70A667C (CB-8178) -9/73 ' • APPLICATION FOR PLUMBING PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ADDRESS a"6gO OC NUMBER FIXTURE OR ITEM FEE WATER CLOSET V LOCALITY 6� BATH TUBNEAREST 0-6 CROSS ST Az SHOWER 3 ACLQ OWNER LAVA TORY v MAIL ADDRESS ov SINK CITY TEL NO DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS 2 SWIMMING POOL RECEPTOR CITY EL NO LAWN SPRINKLER SYSTEM LIC WATER HEATER STATE CENSE NOC?/ f. CLAS C". DISTRICT NO GROUP ZONE PRO SSED BYCD GAS SYSTEM OUTLETS C.2 OUTLETS OVER ste U �r C 5 PER SYSTEM INDUSTRIAL CD� WASTE APPROVAL 13 LLI INSPECTION RECORD CCO2 Plan check fee PLUMBING PERMIT ISSUING FEE $ TOTAL FEE I(p Plan check applicant Name ��.�• Vc Z �v APPROVALS DATE INSPECTOR S SIGNATURE rUNDER SLAB WORK ZZ Address �. ,6 ♦i e ♦ i ROUGH PLUMBING i2 ' City Tel NO r GAS PIPING i H ESY ACKNOWLEDGE THA 1 NAVE 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 IH CERTIFY THAT I 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 RIBED RESI TIAL PROPERTY UTILITY CO NOTIFIED SIGNATU RE OF PERMIT FINAL PLAN CHECK VALIDATION CK M o cA f PERMIT VALIDATION C L M o CASH "APR 14 1 6.5 0 mb 1 � 7•wsd7w Q GE 817 1REV 6/78) es APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDINGQ NUMBER FIXTURE OR ITEM ® FEE ADDRESS C a/E C ` LOCALITY F I � WATER CLOSET Wr NEAREST BATH TUB CROSSST -NOW- SHOWER OWNER MAIL LAVATORY,LAVATORY, ADDRESS SINK CITY TEL NO , k DISHWASHER CONTRACTOR CLOTHES WASHER ,ADDRESS SWIMMING POOL RECEPTOR CITY TEL NO LAWN SPRINKLER SYSTEM STATE LIC WATER HEATER LICENSE NO CLASS GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING O GAS VENT ' V HOT WATER HEATER 0 PLUMBING FIXTURES 9 GAS�TEST 13 ,i f, r 16 Plan check fee UTILITY CO NOTIFIED Z PLUMBING PERMIT ISSUING FEE$ TOTAL FEE FINAL 7 e ,✓L��'`� Plan check applicant I PLAN CHECK VALIDAT16N Name ' Address Ira City Tel No ;=034 1 HEREB ACKNOWLEDGE TH 1 HAVE READ THIS APPLICATION AND STATE " THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING - PERMIT VALIDATION + 1 HEREBY CERTIFY PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS Al S COUNTY STATE OF CALIFORNIA OR THAT I AM THE t 3 7 Q 6 A LEGAL OWNER OF D INTEND TO REST IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY SIGNATURE OFFERMITTE 2 • • ' 9 0 O DISTRICT NO PROC ED BY •I• • j 9 0 0 is INDUSTRIAL , 0416-79 WASTE APPROVAL .--- CORKERS COMPENSATION DECLARATION �APPII�ATION FOR PLUMBING PERMIT t'herety,affirm that I have a certificate of consent to self 76A667A ' rA insure or a certificate of Workers Compensation Insurance CE 817(REV 8/86) u or a certified copy thereof(S 3800 L b C ) ��$ - NS. /✓� COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS Po cy No ompany Certified copy is hereby furnished 13 FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING A5PD Certified copy is filed with the county building inspec ADDRESS t� V �E�RTIFICATE NUMBER FIXTURE OR ITEM @ FEE LOCALITY C ' •/( WATER CLOSET _ DateApph4ant L� O NEAREST OF EXEMPTION FROM WORKERS BATH TUB CROSS ST �1 G COMPENSATION INSURANCE SHOWER /i OWNER D L- )61,9'(This section need not be completed if the work involved by V MAIL the permit is for one hundred dollars($100)or less) LAVATORY �j ADDRESS I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner SINK 12, CITY TEL NO so as to become subject to the Workers Compensohos DISHWASHER CONTRACTOR �6 v Date pplicanf CLOTHES WASHER O V ADDRESS (a 3 '�� Ow NOTICE I APPLI ANT If ofter long this Certificate Exemption you should becom subject to the Wor s SWIMMING POOL RECEPTOR q Compensation provisions of the Labor Code you must forth CITY TEL NO 3 /- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE �, �I, LIC deemed revoked WATER HEATER LICENSE NO GFJ`''J CLASS LICENSED CONTRACTORS DECLARATION ,l DISTcJjj��T NO P SSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS 1/ V .J , /v) (commenting with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code and my license is in full force and effect5 PER SYSTEM FINAL e� VALI TION 0 License Number Lic Class DATE V FINAI Contractor J 27 u[ / ar c~1 ❑ I am exempt under Sec 27 1 8 g A d S 8P C for this reasonW 6 Plan check fee 10, # . . . e 05 Z Date PLUMBING PERMIT ISSUING FEES U IS 0 Signature 11 a 0 5 a 5 0 TOTAL FEE Plan check applicant •,• • 5 x 5 0 5 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name 0 6 0 8 1 8 7 1 hereby affirm that I am exempt from the Contractor is License Address Low for the following reason (Section 7031 5, Business and Professions Code) City 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 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 tCountto enter upon the above mentioned;,,�opertyfor7spectiony purposes/ SEE REVERSE FOR EXPLANATORY LANGUAGE IV ature o ermittee Date