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Home My Public Portal About5309 NOEL DR_Plumbing__ 7ew887 (CC 817) 1/78 I. APPLICATIO TO PLUMBING PERMIT ` COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO SS _3O /O L L �/eADDE HARVEY T BRANDT, COUNTY ENGINEER LOCALITY --IyMPL6r 1Q 1 FOR APPLICANT TO FILL IN (PRINT OR TYPE) L CROSS ST Ii Up S 1 NUMBER FIXTURE OR ITEM ® FEE Q WATER CLOSET 2 OWNER 0 Q O �� O�E� LOHEAJt1 MAIL QQ BATH TUB 200 ADDRESS 1,312 SHOWER 200 CITY SO Cv'q-/3ie 1 IF L— TEL NO LAVATORY 2100 3610 CONTRACTOR SINK 4 00 ADDRESS DISHWASHER 00 CITY TEL NOS , CLOTHES WASHER 00 STATE LIC SWIMMING POOL RECEPTOR 00 LICENSE NO CLASS DISTRICT NO GROUP ZONE CES ED Y LAWN SPRINKLER SYSTEM pp fj7,0 8 Z �' WATER HEATER 00 11VARSTETAPPROVAL GAS SYSTEM OUTLETS00 INSPECTION RECORD OUTLETS OVER 5 30 ( CD PER SYSTEM GC OF C7 W CL fA 2C Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ TOTAL FEE APPROVALS DATE INSPECTOR 9 SIGNATURE Pian check applicant UNDER SLAB WORK Name ROUGH PLUMBING Addressle-00� GAS PIPING City Tel NO GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS AS TEST IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT IAM THE LEGAL OWNER OF AND fRT19D TO .42 RESIDE IN THE ABOVE D/EESCRIBED RESIDENTIAL PROPERTY FINAL SIGNATURE //_ _:' &� OF PEiIMI'f�E_ PERMIT VALIDATION CK M 0 CASH PLAN CHECK VALIDATION CK M 0 CASH 0 �k rig► 28 5 0 10 5 0 ,&9b l , WORKERS COMPENSATION DECLARATION r20 0026 DPW 4/87 ' APPLICATION FOR PLUMBING PERMIT I herebyaffirm that I have a certificate of consent to self inP CE 8176A667A [� sure or certificate of Workers Compensation Insurance or a CE 817 ,uI (REV 8/86) certified copy thereof(Sec 3800 Lab C ) COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS Policy No Company Certified copy is hereby furnished BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) 2 Certified copy is filed with the county building inspection ADDRESS e`�36 � De' department NUMBER FIXTURE OR ITEM @ FEE LOCALITYern � Date Applicant C1~ WATER CLOSET(TOILET) CROSS ST O �1�e, CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB A'^ COMPENSATION INSURANCE SHOWER OWNER dlJG *I 6 r14 (This section need not be completed if the work involved by MAIL �� Q' /, the permit is for one hundred dollars($100)or less) LAVATORY ADDRESS I certify that in the performance of the work for which this-per mit is issued I shall not employ any person in any manner so SINK CITY eyY1 le—C/ as to become subject to the Workers Compensation Laws DISHWASHER Q CONTRACTOR f�' Date.4—�r+-O 7 Applicant CLOTHES�WASHER NOTICE TO APPLICANT If`after making thi ertificate Ex SWIMMING POOL RECEPTOR ADDRESS emption you should become subject to the Workers Co pen CIN TEL NO safion provisions of the Labor Code you must forthwith comp LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok STATE / LIC ed WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO �� ROCESSED Y I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS v�'` 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER fend Professions Code and my license is in full force and of 5 PER SYSTEM FINALct DATE ALIDATION d O License Number Lic Class //l-G^ FINAL me Or Contractor DateAIL tZtr BY O I am exempt under Sec W t1 B 8P C for this reason Plan check fee Poo. I + Z Date PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE / 9 SINGLE FAMILY ;@9250A HOME OWNER BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor s License Name ame # • • • •to 5 Law for the following reason (Section 7031 5 Business and Professions Code) I • • 1b50 F1I as owner of the property will do the work and the ty Tel No • • • 16500! structure is not intended or offered for sale(Section 7044 ' Business and Professions Code) CONSTRUCTION LENDING AGENCY 111110. o328-88 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 e Lender s Address I certify tjtat I have read this application and state that the 111111.above infgrmation 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 propertlr for inspection purposes 12 ZAP a J A3,'�g-.�g' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of rmittee Date WORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT . hereby affirm that I have a certificate of consent to self 76A667A insure or a certificate of Workers Compensation Insurance CE 817(REV 10/81) * �o ®cerwhed copy thereof(Sec 3800 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No sAflee ompony Certified copy is hereby furnished j ❑ FOR APPLICANT TO FILL IN(PRIM OR TYPE) BUILDING ��,y ��/ Certified copy is filed with the county building inspec ADDRESS 1! tion department NUMBER FIXTURE OR ITEM FEE —f WATER CLOSET LOCALITY �G Date Appl�4ant CNEAREST ROSS ST /t, CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB VC COMPENSATION INSURANCE SHOWER OWNER �n �l (This section need not be completed if the work Involved by -Stevc I If the permit is for one hundred dollars($100)or less) LAVATORY DDRESS 5-3Dl Al Aloe-1 .1- I certify that in the performance of the work for which this permit is issued I shall not employ any penton in any manner SINK CITY TEL NO gs�� so as to become subject to the Workers Compensation Laws DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT if after making this Certificate of Exemption you should become subject to the Workers SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code you must forth {AWN SPRINKLER SYSTEM CITYw6a 7: wo TEL NO 4.6 with comply with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRI NO '/ BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS Lei y (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER V and Professions Code and my Ikon is in full force and effect 5 PER SYSTEM FINAL �— VALID ON V License Number Lic Class DATE pp FINAL 0 Contractor Date BY V ❑ I am exempt under Sec N B&P C for this reason a Plan check fee Date PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE SINGLE FAMILY Plan check applicant 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 Address 2377 0 A Pryfessions Code) Cit Tel No LTti(�.7j Y 1 as owner of the property will do the work and the # • • 5 structure is not intended or offered for sale (Section pop • • 2 a 5 7044 Business and Professions Code) CONSTRUCTION LENDING AGENCY • • * 28505 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued o 107-86 (Sec 3097 Civ C) Lender s Name Lender s Address I certify that I have read this application and state that the Poo 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 Signature of COrmittee V Date —WORKERS'COMPENSATION DECLARATION APPLICATION FOR PERMIT .i 4 h�reb�affjrm that I have a certificate of consent to self � insure or a certificate of Workers Compensation Insurance HEATING VENTILATING - AIR CONDITIONING ?,6r7�3�cr a certified copy thereof(Sec 3800 Lab C ) CE el a(REV 10/81) Policy No Company Certified copy is hereby furnished COUNTY OF LOS ANGELES BUILDING AND SAFETY Certified copy is filed with the county building i spec FOR APPLICANT TO FILL IN BUILDING tion departme t ADDRESS O Date3 � � (PRINT OR TYPE ONLY) � p, Applicant LOCALITY a.. NO TYPE OF APPLIANCE OR EQUIPMENT FEE CERTIFICATE OF EXEMPTION FROM WCjJWS NEAREST COMPENSATION INSURANCE CROSS ST (This section need not be completed if the work involved by ABSORPTION UNIT BTU DISTRICT NO PROCESSED B the permit Is for one hundred dollars($100)or less) es1�►f rK( 1 certify that in the performance of the work for which this AIR HANDLING UNIT CFM ✓ (/Q permit is Issued I shall not employ any person in any manner BOILER BTU so as to become subject to the Workers Compensation Laws APPROVALS DATE IN PE R S SIGN URE Date Applicant COMPRESSOR BTU K)?QUo ! U ROUGH NOTICE TO APPLICANT If after making this Certificate of VENTILATION SYSTEM FINAL Exemption you should become subject to the Workers Compensation provisions of the Labor Code you must forth EVAPORATIVE COOLER '11 IDJ(76N with comply with such provisions or this permit shall be deemed revoked FURNACE FAU GRAVITY LICENSED CONTRACTORS DECLARATION FLOOR BTU I hereby affirm that I am licensed under provisions of Chapter 9 HEATER SUSPENDED UNIT ' (commencing with Section 7000)of Division 3 of the Business WALL and Professions Code and my license is in full force and effect License Num Lic Classes , W OC Contractor Date �— 0 1:11 am exempt un ec W Plan check fee _ N B 6P C for this reason PERMIT ISSUING FEE$ Z Date Signature TOTAL FEE OWNER BUILDER DECLARATION PLAN CHECK APPLICANT fi 41 a 2 A I hereby affirm that I am exempt from the Contractor s License , Law for the following reason (Section 7031 5 Business and NAME # • • • • • 8 Professions Code) ElI as owner of the property or my employees with ADDRESS I • •3 Q 5 0 wages as their sole compensation will do the work and CITYTEL NO the structure is not intended or offered for sale(Section • • •3 0 0 5 7044 Business and Professions Code) ❑ I as owner of the property am exclusively contracting OWNER o 3 0 7 r'8 b with licensed contractors to construct the project (Sec MAIL ' tion 7044 Business and Professions Code) Q ADDRESS Q CONSTRUCTION LENDING AGENCY CITY C` TEL NO 7 Z [ I hereby affirm that there is a construction lending agency for PUQUW AN 41C Poo performance of the work for which this permit is issued CONTRACTOR (Sec 3097 Civ C ) - r ADDRESS Lender s Name CITY TEL NO Lender s Address STATELIC I certify that 1 have read this application and state that the LICENSE NO gap CLASS ` above information is correct I agree to comply with all County ordi ances and State jaws relating to building construction an erebygou �orize of this County to enterthe arty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Appli or Agent Date '