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Home My Public Portal About5643-5645-5647 NOEL DR_Plumbing__ t COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J FOX, County Engineer PLUMBING 1 DISTRICrO. BROUP ZONE PLItMIT . OR APP (CANT TD FILL IN - -Irlufflullig at neaung W. Imunalitz �� PLUMBER RECEI ED BY READY FOR FIDATE 1 ULD RST INSPECTION ADDRESS MONROVIA,CALIFORNIA BUILDING CITY TEL.No ADDRESS�� OOUNTY pr LOCALITY I EN9E NO EXPIRES-�./ NEAREBT PERMIT FEES CROSS BT NUMBER TYPE OR FIXTLIR[OR ITEM FEE OWNER MAIL Jo WATER CLOSET(TOILET) @ D 50 *.?,,/o pZ o ADDRESS OF BATH TUB O SD 0 CITY TEL NO SHOWER O 050 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIN LAVATORY (WASH BASIN) 41 O 50 O APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK a 050 O AND STATE LAWS REGULATING PLUMBING 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB y LAUNDRY TUB OR TRAY a 050 O ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER GAS SYSTEM�OUTLETB O 50 Q O OF THE RESIDENTIAL PROPERTY EBCRISED ABOVE. WATER HEATER O 50 O a SIGNATURPERMITTEE wE OF /l A j SLOP SINK 050 INSPECTION RECORD FLOOR RINK ® O 50 ,IV,, T- FLOOR DRAIN 0513 DISHWASHER 0513 ~ DRINKING FOUNTAIN 050 LIM �r URINAL O 50 at .ap 46 -' Q OF HOUSE SEWER ® 1350 w Q v.a� _Z MISCELLANEOUS 3 C AIJI& mO ro ° s O O a o APPR VALS DqTE INBP[6T 'B NAME ROUGH PLUMBING GAB PIPING GAS VENT �l CESSPOOL M 100 CESSPOOL ,r1 SEPTIC TANK SEPTIC TANK DRAIN ( ) PIT ( ) Q 1 0131 1 SEWER PERMIT 1001 GAS TEST A O UTILITY7CO NOTIFIED TOTAL FEE B'/�/ yb FI NAL 76A667 DB$#17 6-58 78A667 CE#817 6-85 APPLICATION FOR PLUMBING P RMIT COUNTY OF LOS ANGELES O&Z DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION TAUDDR'N JOHN A LAMBIE COUNTY ENGINEER COLEMAN W JENKINS SUP T OF BUILDINGLITYFOR APPLICANT TO FILL IN E iNUMBER FIXTURE OR ITEM EACH FEE W WATER CLOSET al ss OWNER MAIL BATH TUR 1u ADDRESS SHown I a CITY TEL NO � LAVATORY 1!5 CONTRALTO SINK 1>e,f' ADDRESS DISHWASHER 125 CITY a TEL NO STATE LIC LAUNDRY TUR 125 LICENSE NO O CLASS CLOTHES WASHER 1 u DISTRICT NO GROUP ZONE I PROCESSED BY WATER 150 10 1p 7W-xv, } GAS SYS OUTLETSSTRIAL WASTE SO DTE OVAL 0 OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD U DC 10 o_ N Z APPROVALS DATE INSPECTOR S SIGNATURE PERMIT S 2100 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE 13 GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE 18 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 A8 REgU1RE0 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 DESCRIBED RE NTIAL PRO UTILITY CO NOTIFIED I If SiGNATUR OF PERMS G� jX FINAL CK M ATIONASH LAC0 4 6 3 6% SEP 12 5 D 3,5 0 •W'URkft,COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I 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 \r a certified copy thereof(Sec 3800 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY cy No Company O 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 LOCALITY Date Applicant WATER CLOSET NEAREST 00,' CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB CROSS ST Jocv COMPENSATION INSURANCE / SHOWER OWNER 001 (This sedion need not be completed if the work involved by the permit is for one hundred dollars(:100)or less) LAVATORY MAIL 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 CITY TEL / so as to become sub[ ct to the Workers Compensation Laws DISHWASHER Y r CONTRACTOR Date plicani CLOTHES WASHER ADDRESS NOTE TO APPLI ANT If after making this Cert fico of SWIMMING POOL RECEPTOR Exemption you should become sub[ect to the kers CITY TEL NO Compensation provisions of the labor Code you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT tu0O D�BY 7 t I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS � (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER d and Professions Code,and my license is in full force and effect 5 PER SYSTEM FINAL VALIDATION O DATE V License Number Lic Class 09 FINAL 0 Contractor Date t BY V ❑ I am exempt under Set y B&P C for this reason Z Plan check fee Date PLUMBING PERMIT ISSUING FEE$ Signature 7 5 1 9 A TOTAL FEE IiAd 6.0 Jr Plan check applicant ;� o a • • 0 SINGLE FAMILY HOME OWNER BUILDER DECLARATION Name 2 ° • 28.50 I hereby affirm that I am exempt from the Contractor s License Address �' ° ° 2 5 u Law for the following reason (Section 7031 5, Business and Professions Code) City Tel No 3 ❑ 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 1 certify that I have read this application and state that the - above information is correct I agree to comply with oil County ordinances and State laws regulating Plumbing and hereby authorize representatives of this County to enter upon the above mentioned property for inspection purpos s� SEE REVERSE FOR EXPLANATORY LANGUAGE ' ignature of Per itt Dole