Loading...
HomeMy Public PortalAbout9478 OLEMA ST_Plumbing__ 76A+�q CE 817(REVA 1`/78) APPLICATION FOR. PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN.(PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM @ FEE - ADDRESS O WATER CLOSET 1. LOCALITY - NEAREST BATH TUB CROSS ST. O d 7TE SHOWER OWNER li jppL 'OhLAVATORY• MAIL c�ADDRESS e4�p AEv ©1- 571SINK CITY T.GDISHWASHER CONTRACTORCLOTHES WASHER MOVADAbDRE55 s SWIMMING POOL.RECEPTOR CITY ^rC .4 ! •, LAWN SPRINKLER SYSTEMI tSTATE LIC / WATER HEATER j.' bl/LiD ?J ICENSENO. C"3�d�� CLASS ' GAS SYSTEM OUTLETSAPPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER§LAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING. _ GAS VENT/ HOT WATER HEATER a PLUMBING FIXTURES IL GAS TEST , c.."t i 11 .iif1G td g Plan check fee UTILITY CO:NOTIFIED t " PLUMBING PERMIT ISSUING FEE$ dn TOTAL FEE' FINAL Plan check applicant PLAN CHECK VALIDATI N Name I Address 7 7 9,5 A City .Tel.No. # 0 0 0 0 0.5 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE - THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES O o o 1 600 OO AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION L I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS o o O 1 b O O M REOU IRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. 'I 1. 157-79 - SIGNATURE ' OF PERM ITTE , DISTRICT NO. ROCESSED BY INDUSTRIAL. WASTE APPROVAL 76AGp66,7,,A ! — GE.13 q.(RE�e�7 es ®gyp PERMIT APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN IPRINT OR TYPE) BUILDINS Cl Al •� (� Lp, Q f NUMBER FIXTURE OR ITEM ® FEE ADDRES WATER CLOSET LOCALITY NEAREST BATH TUB CROSS ST 62 SHOWER OWNER LAVATORY MAIL ADDRESS SINK CITY TEL.NO. DISHWASHER CONTRACTO CLOTHES WASHER ADDRESS f O f ` SWIMMING POOL RECEPTOR , CITY t� ` TEL.NO J- 4, •y / LAWN SPRINKLER SYSTEM TATE yy021, - WATER HEATER LICENSE NOS/-,4-2,;k-U CLASS 6 GAS SYSTEM OUTLETS — APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETSOVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING GAS VENT u HOT WATER HEATER PLUMBING FIXTURES GAS TES " Plan check fee UTILITY CO NOTIFIED PLUMBING PERMIT ISSUING FEE$ v ( o TOTAL FEE FINAL Plan check applicant PLAN CHECK VALIDATION Nome Address City Tel.No. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION I 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 LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. SIGNATURE n q CIFPERMITTEE DIS13CT N61 P ESSED BY VDUSTRIAL VASTE APPROVAL 76A6611 (CE-817) - 1/75 APPLICATION R PLUM SVG PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING ADDRESS. HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM FEE , WATER CLOSET 2.00 OWNER MAIL BATH TUB 2.00 ADDRESS SHOWER 2.00 CITY TEL. NO:" 60�, LAVATORY 2.00 CONTRACTOR SINK 2.00 ADDRESS DISHWASHER 2.00 CITY TEL. NO. CLOTHES WASHER 2.00 STATE ULIC LICENSE NO CLASS SWIMMING POOL RECEPTOR 2.00 DISTRICT NO.GR P NE R ESS B LAWN SPRINKLER SYSTEM 2.00 ��' WATER HEATER 2.00 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 2.00 �J U INSPECTION RECORD OUTLETS OVER 30 C) 5 PER SYSTEM O U. W a N 1 Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicari J UNDER SLAB WORK Nagle ROUGH PLUMBING Address 001GAS PIPING city el. NO GAS VENT HOT WATER HEATER IAERIfSY'AdfflowTkoejrTHATf HAVE READ .THIS APPLICA ON AND STATE THAT THE ABOVE IS 11CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED ' LICENSED AS.REQUIRED BY LOS ANGELES COUNTY AND STATE OF _ CALIFORNIA OR THAT I AM THE-LEGAL OWNER OF, ANEIID-6 IATTO f� RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PAOPERTY. FINAL SIGNATURE OF PERMITTEES PERMIT VALIDATION ,D: CASH PLAN CHECK VALIDATIO CK. M.O. CASH 4 4 8�`�f.0 z3 5 0 '7.5 0 ,&�. '76A667A JZ—/- �® 11 A 07•-(11/.11/78) 0��� / 11SS APPLICATION FOR FL MBING PERMIT COUNTY OF LOS ANGELES. BUILDIN AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING / ADDRESS C(/ NUMBER .'FIXTURE OR ITEM & FEE - WATER CLOSET A _•+ - o LOCALITY NEAREST BATH TUB CROSS ST. SHOWER +Al WNER LAVATORY AIL DRESS SINK CITY- TEL.NO. DISHWASHER CONTRA TO CLOTHES WASHER ,ADDRESS Q SWIM-MING POOL RECEPTOR CITY TEL. – " LAWN SPRINKLER SYSTEM STATE LIC f� WATER HEATER _ LICENSE NO.�� CLASS` GAS SYSTEM OUTLETS 'Da APPROVALS DATE INSPECTOR'S SIGNATURE. OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH-PLUMBING GAS PIPING 0 GAS VENT 99 HOT WATER HEATER PLf1MBING FIXTURES GAS TEST Plan Check fee IS UTILITY CO.NOTIFIED PLUMBING PERMIT ISSUING FEE$ Fy TOTAL.FEE v Q FINAL J�,�� � ylai!y Plan check applicant PLAN CHECK VALIDATION' r Name. ! Address City Tel.No. 28 9 2.2.A I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE 0 0 0.o-o 5 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORD IN..ANCES ' AND STATE LAWS REGULATING PLUMBING., _ i'. PERMIT VALIDATION. I HEREBY CERTIFY THA I AM PROPERLY REGISTERED AND/OR LICENSED AS 2 O O 1 Q.0.0 REQUIRED BY LOS ANGEL C U.NTY AND:STATE OF CALIFORNIA OR.THAT I AM THE !O O O 1. Q O O U LEGAL OWNER OF:AND E 6 TO RESIDE IN THE ABO DESCRIBED RESIDENTIAL --PROPERTY. �!!�� r/ pQ • G -7 . O' SIGNATURE OF PERMITTEE DISTRICT NO, ROCES$ED BY l• .10 VbUSTR1AL VASTE APPROVAL. � A1,78)76A66i`ACE 6`17(-k L� APPLICATION FOR PLUMBING PERMIT 7 COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING foe 7 ADDRESS NUMBER FIXTURE OR ITEM @ FEE p WATER CLOSET LOCALITY NEAREST BATHTUB CROSS ST. SHOWER. OWNER LAVATORY MAIL Sit ADDRESS ,1 SINK CITY TEL.NO. lrj3036 DISHWASHER CONTRACTORit ( G b--v CLOTHES WASHER ADDRESS Q/ (f ^ -rn ,u, SWIMMING POOL RECEPTOR CITY 1ZaA P/4. T .N0.yfl�• AWN SPRINKLER SYSTEM STATEJ t'�G�(� CLASS WATER HEATER LICENSE NO. / 3 GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER t UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING d GAS PIPING GAS VENT as HOT WATER HEATER PLUMBING FIXTURES GAS TEST Plan Check fee UTILITY CO.NOTIFIED g PLUMBING PERMIT ISSUING FEE$ o TOTAL FEE Q o : FINAL Plan check applicant ` L PLAN CHECK VALIDATION' PIP Name Address /�// 9 7 5 6 5 A City .No. �` 9,Av� #t a o o o 0 5 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE - THAT THEABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES 2 o O I O O O AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION J I HEREBY C THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS .O o 0 1 0 0 0 1— REQUIRED BY ANGEL COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OW OF,AN�INTE,TORESIDE INT CRIBED RESIDENTIAL 1 O 7 f1 PROPER I Y SIGNATU OF PERMITT DISTRICT NO. OCESSED BY JDUSTRIAL BASTE APPROVAL • WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby off irm,thpf I have•a certificate of consent to self ~20-0026 DPW 6/87 insure,,,or•a certificate of Workers'Compensation Insurance, 76A667A or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS Policy No.—Company7`ftZ� Certified copy is hereby furnished. BUILDING _ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS e L Certified copy is filed with the county building inspec- tion department. NUMBER FIXTURE OR ITEM @ FEE _ 3—(/ LOCALITY L WATER CLOSET Date Applicant ���� CNEAREST ROSS ST. G CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB COMPENSATION INSURANCE OWNER L - (This soetion need not be comploted if tho work tnvolvad by SHOWER MAIL tho pormit is for one hundred dollars($100)or loss.) LAVATORY ADDRESS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner SINK CITY TEL. NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR �. Date Applicant r CLOTHES WASHERgDDRESS o �� NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY TEL. NO. with comply with such provisions or this permit shall be STATEO� G CLASS deemed revoked. WATER HEATER LICENSE NO. LICENSED CONTRACTORS DECLARATION WERI, PROD BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER yy and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL ,�) ALID TIOR9 it License Number �POZ y�� Lic. Class A� ! DATE L FIN~/ BY LT Contractor��%�'��<<bE Date O OR ❑ I am exempt under Sec. Lt.' B.BP.C. for this reason ®. Plan check fee Cr Date'' PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE Plcn check applicant SINGLE FAMILY •_I HOME OWNER-BUILDER DECLARATION Name A�GTe4 I hereby affirm that I am exempt from the Contractor's License q8dress Law for the following reason (Section 7031.5, Business and ,;, 1]7 58.013Professions Code): City Tel. No.❑ 1 ITEMS I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section TOTAL 58.00 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY CHECK 5$00 1 I hereby affirm that there is a construction lending agency for CGE old] the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name � 0000-0001 3/19/90 Lender's Address 9577 1 AN 9 0 40 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 authorize representatives of this County to enter upon the above-me itioned property for Inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permi ee Date