HomeMy Public PortalAbout9416 OLEMA ST_Plumbing__ 76AG67 DBB 17 7-61 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN
DISTRICT R P ZONE PERMIT— �- .
PLUMBER l �f�/��l/Y 4+ READY FOR (D
/ REP, VED BY FIRST INSPECTION
DATE ISSUED
ADDRESS �o�[. /f✓/%�i l��v'�( / `�^�i
BUILDING
CITY f��/J..•�6r � EL.No. Q ADDRESS
COUNTY 'tf 7 O EXPIRES /A .r� LOCALITYNEAREST
r P
LICENSE NO.
PERMIT FEES v CROSB S�►T..y�
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER(�� c91
,r WATER CLOSET(TOILET) 0 0.50 $ ADDRESS
/1 BATH TUB 0 0.50 CITY .�-� TEL Na.
/ SHOWER 13.513I H§REBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE 18 CORRECT
ANDAGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN BINK O.SO AND STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY 0.50 ANGELES COUNTY LIOENSEv OR I AM THE LEGAL OWNER
BA8 SYSTEM UTLETB ® 0.60 OF THE REBID IN AL PR�PERTYrDF-BRIBED ABOVE.
B10N
WATER HEATER t(a 0.50 PA RMITTE r I
SLOP BINK Q 0.60 J1ySPECTION RECORD
FLOOR SINK 12 0.50
FLOOR DRAIN 0 0.50
DISHWASHER O.'so r ✓
DRINKING FOUICIIAIN 0.50 ,'.///��7
URINAL 0.50 S 1'1/ CobeeLk-54A- -I
HOUSE SEWER @ 0:60 Au V15 Z
MISCELLANEOUS 5
O
APPROVALS
DATE�/ INBPECTORIB NAME
ROUGH PLUMBING /2-
BAB
2GAB PIPING
GAB VENT LL -1 I
CEBBPOOL 1,00 CESSPOOL
SEPTIC TANKt SEPTIC TANK
DRAIN ( ) PIT ( ) 1.00 SEWER
PERMIT 1.00 BAR TEST
UTILITY CO.NOTIFIED I a
TOTAL FEE FINAL '7J5(j ✓► f
:o WORKER'S COMPENSATION DECLARATION I i 20-0026
6 ADPw9/89 APPLICATION FOR PLUMBING PERMIT
I"�,prdby`effirm that I have a certificate of consent to self Insure,
or d ceralflft of Worker's Compensation Insurance,or a certified
copy thr . f(Sec.3800 Lab.C.) ``
1-- 9-Com JfY G ��� COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV.
Policy No. pony
❑ Certified copy is hereby furnished.
9`1FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
9 Certified copy Is filed with the county building Inspection ADDRESS of
department. // NUMBER FIXTURE OR ITEM @ FEE
Date —V Applicant , 2a 4/ Iww e p, LOCALITY C ��
�e� WATER CLOSET NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST.
COMPENSATION INSURANCE BATH TUB ASSESSOR
(This section need not be completed If the work Involved by the SHOWER MAP BOOK PAGE PARCEL
permit Is for one hundred dollars($100)or less.) LAVATORY OWNER — �-
I certify that in the performance of the work for which this permit
is issued, I shall not employ any person in any manner so as toSINK ADDRESS O(C
prk
AIL
become subject to the Workers'Compensation Laws.
DISWASHER CITY C. TEL.NO.,? 4 v
Date Applicant CLOTHES WASHER CONTRACTOR I _ r [�
NOTICE TO APPLICANT: If, after making this Certificate of
Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR
provisions of the Labor Code,you must forthwith comply with such ADDRESS IYCj
provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM �
LICENSED CONTRACTORS DECLARATION CITY TEL.
TEL.NO. a
I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER
(commencing with Section 7000)of Division 3 of the Business and GAS SYSTEM OUTLETS CENSE NO. QS L�4 CLASS Cao
Professions Code,and my license is in full force and effect.
OUTLETS OVER DISTRICT NO. PROCESSED BY �
5 PER SYSTEM
License Number-50,5 /Y Lic.Class !/ V
FINAL en
�3 _ r VALIDATION
Contractor e a
❑ ,'/(J�--',,^_'�I am exempt under Sec. FINAL Z
BY
B.&P.C.for this reason
Date: Plan check fee ,
Signature
PLUMBING PERMIT ISSUING FEE$ Al
❑ TOTAL FEE
Plan check applicant c
SINGLE FAMILY rr
HOME OWNER-BUILDER DECLARATION Name
I hereby affirm that I am exempt from the Contractor's License Law KE,
for the following reason(Section 7031.5, Business and Professions Address __E, x_1
Code): T-
F1 _ ,_
t
I,as owner of the property,will do the work and the structure City Tel.No. _
IC
is not intended or offered for sale(Section 7044, Business ! I? iL � . 50
and Professions Code). �•. 10.cl
CONSTRUCTION LENDING AGENCY CHANGE
e
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.) T
I.0 ct-10 131 1
Lender's Name 530 1 AK11:5i
Lender's Address
I certify that I have read this application and state that the above 001.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 purpo S.S.y SEE REVERSE FOR EXPLANATORY LANGUAGE