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Home My Public Portal About6009 OAK AVE_Plumbing__ =110042819 M APPLICATION FOR PLUMBING PERMIT 1 COIINTY OF LOS ANGELES DOM71MM OF COURW =GII M SU�Rp�MG AND SAumm CFoE�T1Y� DIVISION sv a O CAR9dn D CA.1 Sdidla4 >�,pCAT.i!! FOR APPLICANT TO FILL IN NUMBER FIXTURE OR ITEM OWNER WATER CLOM MIM. BATS TOB ADD8B88 SOWER CITr TEL lW LAVATOR? dc COMTEACTOR DIREWARHBR crr: fLs4 /'/ TEL NONrA TUB Tcoa Ro `1r�f CDUM CLOT=WAS Gc-p DISTRICT � ZONE P OCESSED BY GROUP 'f WATER HER= OHB ormm umugrmu WASTE APPROVAL M1192=0311 RECORD APPROVALS �W 8 DATE INSPECTOR 8 SIGNATURE UNDER SLAB WORK PERMIT Sr 2 FOO ROUGH PLUMBING TOTAL FEE GAS PIPING 1 EEREST ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER NEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PLUMBING FIXTURES 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY L ANGELES COUNTY AND STATE OF CALIFORNIA BOB THAT T E LEGAL OWNER OF1E ABOVE UTILITY CO NOTIFIED DESCRIBED ESIDENT P �TT � SIGNATURE FERMI ` FINAL ROBERT A WOOD m� VALIDATION SUPERVISING MECHANICAL ENG R cc r 0 clues LG4 eU3M OCT ?0 5 A 300 P om4a v f 7BwQe7elcEe+7w) ei75 APPLICATION PER PLUM G PERMIT M • DEPARTMENT OF LOS ENGINEER BUILDING AND SAFETY DIVISION F.O. DING MAKE CHECKS PAYABLE TO RESS 600 1Q OBI[ rr-�— HARVEY T BRANDT, COUNTY ENGINEER ALITY T FOR APPLICANT TO FILL IN (PRINT OR TYPE) REST NUMBER FIXTURE OR ITEM ® FEE CROSS ST OWNER N=9 Peterson •�49 y/Al WATER CLOSET MAIL L BATH TUB ADDRESS 6Q N SHOWER CITY Tesiple City TEL NO Z 86 " s0 LAVATORY CONTRACTOR SINK ADDRESS 9125 E. Las Turim Dre DISHWASHER fI Y T e City TEL NO CLOTHES WASHER TE 2 to CLIC LASS SWIMMING POOL RECEPTOR ENSE NO W LAWN SPRINKLER SYSTEM DI NO G UPS _E SEO WATER HEATER TE A�PROVAL GAS SYSTEM OUTLETS INSPECTION RECORD e OUTLETS OVER— PER 5 PER SYSTEM O h Z r Plan check fee See Remorse PLUMBING PERMIT ISSUING FEE 8 TOTAL FEE Plan check applicant APPROVALS GATE IN8 PECTOR 9 SIGNATURE UNDER SLAB WORK Name Johnny s Plumbing Service ROUGH PLUMBING Address 91g5 Ee Las TUnBB pr, GAS PIPING LRESIDE emple C3 C&eifTel No GAS VENT REBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER TE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES LL COUNTY ORDINANCES AND STATE LAWS REGULATING G GAS TEST REBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CONOTIFIED D AS REOUIRED BY S ANGE S COUNTY AND STATE OF NIA OR THAT 1 AM LEGA WNER O 0 INTEND TO IN THE ABOVE DESCR B D RES TIAL 0 TY FINALTU RE ERMITTEE PERMIT VALIDATION K M 0 CASH PLNM MPENSrAT1ON POLICY HOLDER POLICY NUMBER Q y C:::p WORKERS COMPENSATION DECLARATION 7ea5e7A ' 0 r I hereby affirm that I have a certificate of consent to self es s»(z so) APPLICATION FOR PLUMBING PERMIT Insure or a certificate of Workers Compensation Insurance or 'fl /' , a certified copy thereof(Sec 3800 Lab C) ` COUNTY OF LOS ANGELES t BUILDING AND SAFETY Policy No Company. 0 Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING 0 Certified copy si filed with the county budding inspection NUMBER FIXTURE OR ITEM FEE ADDRESS department ` WATER CLOSET LOCALITY Date Applicant NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS BATHTUB CROSS ST 1 COMPENSATION INSURANCE SHOWER OWNERI:arftdot 7CrsJA/ (This section need not be completed if the work involved LAVATORY MAIL Dir by the permit is for one hundred dollars ($100) or leas) ADDRESS ji0tJ�1/� I�.. Ate SINK CITY TEL N0OV6%V& I certify that in the performance of the work for which this DISHWASHER CONTRACTOR permit to issued I shall not employ any person in any manner Lf//�L��' W so as o become subject to t Worke p ion Laws CLOTHES WASHER ADDRESS 0 Date-! Appitca 9 �� 'NOTICE SWIMMING POOL RECEPTOR OTICE TO APPLICANT If after makin this Certificate of CITY TEL NO Wfi. Exemption you should become subject to the Workers LAWN SPRINKLER SYSTEM STATE LIC IL Compensation provisions of the Labor Code you must forthZ with comply with such provisions or this permit shall be WATER HEATER LICENSE NO CLASS deemed revoked GAS SYSTEM OUTLETS DISTRICT NOY PRO SSED BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER v I hereby affirm that I am licensed under provisions of Chapter 8 PER SYSTEM 9 (commencmg with Section 7000)of Division 3 of the Busi FINAL VALIDATION ness and Professions Code and my license is in full force and DATE J effect � FINAL � egLicense Number Lie Class BY Contractor Date I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ 0 acting in my professional capacity (Section 7051 Bus iness and Professions Code) TOTAL FEE 6 d Lie or Reg No Date Plan check applicant HOME OWNER BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractors Address License Law for the following reason (Section 7031 5 Busi JCItv Tel No 5 C 1 O H nese and Professions Code) I as owner of the property am exclusively contracting e e a a e with licensed contractors to construct the project ? e a G (Section 7044 Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency 1 9-1!2 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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing and hereby authorize representatives of is County to enter upon the abovi"rntlonproPCFI,i a ton purposes .v -A/46-&z ffignature of ttes Date 4 41 1 Herb gaffirmE that RS COMPENSATION a certificate of consent to to self in APPLICATION FOR PLUMBING PERMIT 20A026 DPW 4/87 surb certificate of Workers Compensation Insurance or a a 81 7A 'fl CE 817(REV 8/86) . ±drh `py thereof(See 3800 lab C) COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS Pehcy Company 019rtified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING L/��} �/ Certified copy is filed with the county building inspection ADDRESS C jW� Y e, NUMBER FIXTURE OR ITEM ® FEE department LOCAUTe1'/) i WATER CLOSET(TOILET) Date Applicant % NEEARE ST ST ru CERTIFICATE OF EXEMPTION FROM WORKERS ` BATH TUB CROSSO COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed If the work involved by MAIL „+ the permit Is for one hundred dollars($100)or less) LAVATORY ADDRESS 1 certify that in the performance of the work for which this per SINK 00 pTYCliv 7ur- mit is issued I shall not employ any person in any manner soemple as to become subject to the Workers Combp ws DISHWASHER 0 CONTRACTOR .� �- e, Date G "I�.L Applican CLOTHES WASHER ADDRESS NOTICE TO APPLICANT If after making this Certificate of Ex SWIMMING POOL RECEPTOR emption you should become subject to the Workers Compen CITY TEL NO sation provisions of the Labor Code you must forthwith comp LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok STATE LIC ed • WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT ROCS 20 1 hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER fand act Professions Code and my license is in full force and of 5 PER SYSTEM FINAL [ ALIDATION a DATE ��" oo License Number Lac Class O 0 FINAL ZVI cc Contractor Date BY 1H 0 1 am exempt under Sec W IL B&P C for this reason Plan check fee ► Date PLUMBING PERMIT ISSUING FEE$ 11015 1 Signature TOTAL FEE SINGLE FAMILY Plan check applicant HOME OWNER BUILDER DECLARATION5 1 hereby affirm that I am exempt from the Contractor s License Nome Law for the following reason (Section 7031 5 Business and ACCTA Professions Code) Address 3W7 58.50 is1 as owner of the property will do the work and the Gty Tel No structure is not intended or offered for sale(Section 7044 1 ITEMS Business and Professions Code) ► TOTAL 58.50 $.50 CONSTRUCTION LENDING AGENCY 01ECK 58.501 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued 01ANGE 00 (Sec 3097 Gv C) Lender s Nome i 10/ 4/39 Lender s Address W44 1 AM 8212 1 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 outkorsze rep en ves of this County to enter upon the abP a mert>�oned pr for inspection purposes �v T s r l� j-��' SEE REVERSE FOR EXPLANATORY LANGUAGE Sign�f Permittee Date