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Home My Public Portal About5730 NOEL DR_Plumbing__ -SAe67 CE#817 2 62 APPLICATION FOR PLUMBING PE IT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINM BOILDINc BUILDING AND SAFETY DIVISION ADDasss 5730 oA JOHN A LAMBIE COUNTY ENGINEER WILLIAM A JENSEN SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST E NUMBER FIXTURE OR ITEM EACH FEE $ ,¢✓�L.4 WATER CLOSET :115 OWNER W BATH TOB 115 ADDRESS 573o N O E SHOWER 115 CITY 7-CA4 arry, TEL NO RT Cj1V LAVATORY 125 CONTRACTOR aZ�� SINK 125 ADDRESS DISHWASHER 125 CITY TEL NO LAUNDRY TOB 125 AEGISTRACTO TOR SATEW CO TUNTY CLOTHES WASHER 125 DISTRICT NO GROUP I ZONE P ESSED BY WATER HEATER ISO L GAS SYSTEM OUTLETS ISO kL WASTE APPROVAL OUTLETS OVER S PER SYSTEM 90 INSPECTION RECORD d O V OC O lu N Z APPROVALS DATE INSPECTOR 8 SIGNATURE PERMIT g 2 OO UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE O GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE MAD THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED A8 REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO RESIDE IN THE A OVE DESCRIBED RESIDENTS PROPERTY UTILITY CO NOTIFIED SIGNATURE OF PERMITTE 2 FINAL � VALIDATION ROBERT A WOOD CK M o As SUPERVISING MECHANICAL ENG R LhC04 W13 5 A 3.50- 4 76Aw 667A • CE 617 IREV 6/76) ®f APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING f ADDRESS l4V NUMBER FIXTURE OR ITEM ® FEE WATER CLOSET LOCALITY g NEAREST BATH TUB CROSS ST IC SHOWER OWNER LAVATORY ADDRESS D .1 Ve SINK CITY ,67 A TEL NO ff;eDISHWASHER CONTRACTOR �. CLOTHES WASHER ADDRESS / V SWIMMING POOL RECEPTOR CIT TEL NO �'j LAWN SPRINKLER SYSTEM STATE LIC n WATER HEATER LICENSE NO Q CLASS GAS SYSTEM OUTLETSAPPROVALS DATE INSPECTOR S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING r GAS PIPING O GAS VENT V mg HOT WATER HEATER 0 PLUMBING FIXTURES GAS TEST Plan check fee UTILITY CO NOTIFIED PLUMBING PERMIT ISSUING FEE$ O TOTAL FEE FINAL Plan check applicant PLAN CHECK VALIDATION Name --" ? Address .29869A CI l Tel • • • • • 5 I HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION AND STATE 2 • 01000 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION • • • 1 u 0 0 5 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE r1 p LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL 0 4. 1 G v O PROPERTY SIGNATURE OF PERMITTEE f DISTRICT CESSD BY INDUSTRIAL WASTE APPROVAL 09817ass APPLICATION FOR PLUMBING PERMIT 1 Des I7 DMSION OF BUMDMG AND SAFETY r Deportment of County Engineer County of Loa Angeles WM J FOX COUNTY ENGINEER BUILDING ADDRESS CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY FOR APPLICANT TO M IN NEAREST ROSS ST OWNER DISTRICT NO GROUP Z BEADY FOR INSPECTION MAIL w ADDRES O ry O+d INDUSTRIAL 1.0- CITY TEL NO ASTE APPROVAL PLUMBER INSPECTION RECORD ADORES_ CITY YEL NO LICENS NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) $ BATH TUB SHOWER LAVATORY (WASH BASIN) KITCHEN SINK DISHWASHER LAUNDRY TUB OR TRAY CLOTHES WASHER TOTAL NO 0 080 APPROVALS DATE INSPECTOR S SIGNATURE GAS SYSTEM OUTLETS ® 100 WATER HEATER too UNDER SLAB WORK ROUGH PLUMBING PERMIT S 1 00 GAS PIPING TOTAL FEE GAS VENT I HEREPY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES `O PLUMBING I HEREBY CERTIFY THAT I PRO LY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY L AN ES COUN AND STATE OF CALIFORNIA OR THAT t A HE GAL 0 OF p YE UTILITY CO NOTIFIED DESCRIBED RESIDENTIAL P T ZOFPERM NATUREWW If rI ITTEE FINAL O WILLIAM J FOX COUNTY ENGINEER VALIDATION R A WOOD CHIEF PLBG INSPECTOR t G87 4 E!A OCT 7 3 180 0 �Ak 0 • v •LWORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT s'wl her affirm that I have a certificate of•consent to self 20 0026 DPW 6/87 insure or afc rtificote of Workers Compensation Insurance 76AS67A or a Tertrfied l6py thereof(Sec 3800 Lab C ) COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS Policy No Company Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county budding inspec ADDRESS tion department NUMBER FIXTURE OR ITEM ® FEE LOCALITY Date Appli4ant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION ROM W &KERS BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed If the work involved by MAIL the permit is for one hundred dollars(:100)or less) LAVATORY ADDRESS I certify that in the performance of the work for which this n�,/4�O' permit Is issued I shall not employ any person in any manner SINK CITY TEL NO,2 so as to become subject to the Workers Compensation Laws DISHWASHER CONTRAcm Date Applicant CLOTHES WASHER ADDRESS .y 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 CITY TEL NOL LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC nn deemed revoked WATER HEATER LICENSE NO d, CLASS V_C ZU LICENSED CONTRACTORS DECLARATION j `J.STRICPMO SSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM / OUTLETS Ov J 6%j (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER �:f:r and Professions Code and my license is in full force and effect 5 PER SYSTEM FINAL VALIDATION O: License Number-1k S 3'71= Lic Class e-Z4-,'g DATE Z� 3�� J V A C)p FINAL no Contractor to �' BY ❑ 1 am a empt u er Sec ow B 8P C for this reason Plan check fee t/>' Date PLUMBING PERMIT ISSUING FEE$ D 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 Address '' s Law for the following reason (Section 7031 5 Business and �r1f � Professions Code) City Tel No +7iA1/ 58.50 ❑ I as owner of the property will do the work and the 1 INS structure is not intended or offered for sale (Section /�� 7044 Business and Professions Code) 1 11�V At�AL 58.50 CONSTRUCTION LENDING AGENCY MCK 58.501 1 hereby off irm that there is a construction lending agency for �t� the performance of the work for which this permit is issued s00 (Sec 3097 Civ C) Lender s Name 00*.OWI 6/14/84 Lender s Address $9[17 1 AM10100 I certify that I have read this application and state that the 100above information is correct I agree to comply with all County ordinances and State I ws regulating Plumbing and hereby authorize reprep nt es of this County to enter upon the ' above mentio party for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE t� Signature afe i e to