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Home My Public Portal About5734 NOEL DR_Plumbing__ + DEP"TMLNT OF COUNW ENGINEER PLUMBING 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF IAS ANG}ELE$ BUILDING t�73 WILLIAM J FOX COUNTY ENGINEER ADDRESS v FOR APPLICANT TO FILL IN LOCALITY C� BUILDING NEAREST ADDRESS Q ' ✓ CROSS ST E DISTRICT NO GRO P ZONE MIT NO LOCALITY TSA-, �/�2�x r/ jf2 4601 NEAREST CROSS ST D Z RE IYE Ready for laepeagoB DA E UED /✓ �C OWNER MAIL DI/� 2/C SEPDRESS �7 WATAP AL CITY T��+yw�t Y TEL NO f/ L4 2.;,/ INSPECTION RECORD PLUMBER D(i(J H .P ✓"' ADDRESS I � g1 CITY TEL NO [3 STATE '9se LICENSE NO ❑COUNTY J PERMIT FEES �` t_ NUMBER TYPE OR rUCTURE OR ITEM FEE WATER CLOSET(TOILET) 4D 080 : S O BATH TUB 0 080 I SHOWER ! 0.80 LAVATORY(WASH BASIN) 0 080 D KITCHEN SINK Q 080 LAUNDRY TUB OR TRAY 0 080 SLOP SINK 0 080 FLOORSINK a 080 FLOOR DRAIN 0 080 DISHWASHER ! 080 DRINKING FOUNTAIN ! 080 URINAL a 080 GAS SYSTEM _OUTLETS a 100 WATER HEATER 0 100 MISCELLANEOUS APPROVALS DATE INSPEC OWSSIGNATURE UNDER SLAB WORK AZ PERMIT ; 1 00 ROUGH PLUMBING TOTAL FEE GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI GAS VENT CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PLUMBING FIXTURES 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST AND STATE OF CALI NIA OR THAT 1 AN THE LEGAL OWN ER OF THE ABOVE RIBED ESIDENT�PROPERTY UTILITY CO NOTIFIED SIGNATURE r OF PERMITTEE _ _ FINAL TOA08T DB817 lifilf UIORKER8COMPENSATION DECLARATION DPW er89 APPLICATION FOR PLUMBING PERMIT I hereby afyrlh that I h'Ave a certificate of consent to self Insure MAMA 5r.a<certificate of Worker a Compensation Insurance or a certified copy thWoof(Sec 3800 Lab C) COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS DEPT OF PUBLIC WORKS DIV Policy No Comby ❑ Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING �+ ❑ Certified copy Is filed with the county building inspection ADDRESS J r department NUMBER FIXTURE OR REM ® FEE LOCALITY Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERSCROSS ST + COMPENSATION INSURANCE BATH TUB seMAP BOOK PAGE PARCEL (This motion need not be completed If the work Involved by the SHOWER permit Is for one hundred dollars($100)or less) LAVATORY OWNER I certify that in the performance of the work for which this permit Is issued 1 shall not employ any person in any manner so as toBINK MAIL become subject to the Workers Compensation Laws ADDRESS DISWASHER CITY TEL NO Date Appliceid CLOTHES WASHER CONTRACTOR NOTICE TO APPLICANT If after making this Certificate of Exemption you should become subject to the Workers Compensation SWIMMING POOL RECEPTOR ADDRESS provisions of the Labor Code you must forthwith comply with such provisions or this permit shall be deemed revoked LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION yypTpR HEATER CITY TEL NO d I hereby affirm that I am licensed under provisions of Chapter 9 A (commencing with Section 7000)of Division 3 of the Business and OAS SYSTEM OUTLETS VISE GLASS 5V� Professions Code and my license is in full force and effect OUTLETS OVER DISTRICT N,,O,✓✓/ P 6 PER SYSTEM ES!>j(D BY License Number Q�� %3 1.1c; Class Lime 106 � Lr'� /1 y � p A �_ �D� VALIDATION Wn Contractor 4AM Date M ❑ 1 am exempt under Sec BY Ai�T ? B&P C for this reason Plan check feealp _ _ Signature PLUMBING PERMIT ISSUING FEE S Z 1 `i LIE ❑ TOTAL FEE TJ I AL 4 j-�E115 SINGLE LY Plan check applicant C HEC is 41 9 HOME OWNER BUILDER IDECLARATION Name C HAN TE Cr I hereby affirm that I am exempt from the Contractor s License Law for the following reason(Section 7031 5 Business and Professions Address Code) City Tel No OWC-CCC 1 Q/gid"C4 ❑ I as owner of the property will do the work and the structure �J�� 1 f g•4� 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 loop, 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 in Pe ons SEE REVERSE FOR EXPLANATORY LANGUAGE Sign Permittee Date WORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT �I hereby affirm that I have a certificate of consent to self in � ADPW 4/90 suress�,or a certaficdle of Workers Compensation Insurance or a [� certiTied'copy thereof(Sec 3800 Lob C) lul COUNTY OF LOS ANGELES DEPT OF PUBLICWORKS Policy N.o Company Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection F ADDRESS department NUMBER FIXTURE OR ITEM d. ® + FEE LOCALITY WATER CLOSET(TOILET) r Ddte Applicant NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB -10 CROSS ST COMPENSATION INSURANCE SHOWER OWNER Q s (This section need not be completed if the work involved by the permit Is for one hundred dollars($100)or less) LAVATORY MAIL zz34' �J7if I certify that in the performance of the work for which this per SINK CITY � TEL NO Ave- mit is issued I shall not employ any person in any ma ner so as to beco a subject to the Workers Compensation wa DISHWASHER b CONTRACTOR DateziZ Applicant CLOTHES WASHER ADDRESS WAWA NOTICE O A PLICANT If after mak g this Certificate of Ex SWIMMING POOL RECEPTOR emption you should become subject to the Workers Compen CITY aki I Q6 TEL NO sation provisions of the LaE-j Code you must forthwith comp LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok STATE ILI LIC ed WATER HEATER LICENSE NO 01 CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER �! and Professions Code and my license is in full force and of 5 PER SYSTEM FINAL VAUCATION fact HOSE BIB DATE 2+-1(� License Number L216 Lic Class �}� ;it d FINAL V Contractor Date BY 1 ITcI� OC I am exempt under SecFb TI iTAL 242.70R B&P C for this reason + KCI% ,.rpi "I]W Plan check fee rlftF��,E AL 0.t cc Date PLUMBING PERMIT ISSUING FEE$ a6 �O Signature TOTAL FEE pZ SINGLE FAMILY Plan check applicant HOME OWNER BUILDER DECLARATION PP I hereby affirm that I am exempt from the Contractor s License Name �i1# AMID Law for the following reason (Section 7031 5 Business and Professions Code) Address I as owner of the property will do the work and the City Tel No 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 this County to enter upon the above me nod roperty for inspection purposaiii SEE REVERSE FOR EXPLANATORY LANGUAGE Sig671" tteebale f,