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HomeMy Public PortalAbout9535 OLEMA ST_Plumbing__ /76A667 CBS 17 11-60APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY �' COUNTY OF LOS ANGELES • WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICTPERMIT NLI. � P 6 73 G PLUMBER +�1/ RECEIV�ED.aS-Y READY FOR DATEISSUED U��� FIRST INSPECTION ApDREBB ..+ e 6 CITY ® G TEL.No.�v ADDRESBUILDINS COON ,s1 EXPIRES LOCALITY LICENSE NO. NEAREST PERMIT FEES GROSS ST. J NUMBER TYPE OF FIXTURE OR ITEM• FEB ' OWNER I i'� MAIL WATER CLOSET(TOILET) 0.50 is ADDRESS BATH TUB 0.50 CITY TEL NO. SHOWER Q C.50 1 HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS d LAVATORY (WASH BASIN) (� 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCEB KITCHEN SINK 0.50 AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS ® LAUNDRY TUB OR TRAY 0.50 ANGELES COUNTY LICENSE. OR IAM THE LEGAL OWNER 0.50 OF THE RESIDE PROPERTY DES IBED ABOVE. GAS SYSTEM�OUTLET9 SIGNATURE O .WATER HEATER @ 0.50 PERMITT SLAP RINK 0.50 SPECTION RE FLOOR SINK 0.50 �'• �, FLOOR DRAIN 0.50 DISHWASHER ® 0.50 DRINKING FOUNTAIN 0.50 w x URINAL 0.50 HOUSE SEWER 0.90 I.- 4_E i r—/r j-vL 01-gr. Z M19CELLANEOUHI T F I N11- L G A'e t7 1 Nf 'r Q p H-n _ S r r- o Li37- 12 �-ra v q APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING SAS PIPING OAS VENT CESSPOOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) 0 1.00 SEWER PERMIT . • 1.00 GAS TEBT 1 /V UTILITY CO.NOTIFIED J TOTAL FEE R� dr FINAL 1SA367 10.33 APPLICATION FOR PLvMBING PERMIT 1 )Bs.17 DIVISION OF BUILDING AND SAFETY l Department of County Engineer County of Los Angeles BUILDING (� JOHN A.LAMBIE, COUNTY ENGINEER ADDRESS CASSATT D.,GRIFFINS SUPT OF BUILDING LOCALITY �i'J°E .•'�--ti+ � `'"`k'•��/l. FOR APPLICANT TO FILL IN NEAREST s �J� 1° I_ CROSS ST. 1-� OWNER i DISTRICT NO. GROW ZfONE J READY FORINSPECT ION. MAIL ..� `tf" I . 11 I " 'i (?Q ADDRESS CITY•Y.(.''?�S rrgC�. TEL.NO�C� 7"7 (,5 f�I 1A TE APIAL PROVAL PLUMBER INSPECTION RECORD `� ADDRESS 1. f ' CITY TEL.NO. LICENSE NO. NUMBER TYPE OF FIXTURE OR ITEM FEE ,I A WATER CLOSET (TOILET) @ $1.00 $ Do BATHTUB @ .91.00 v�/�� �. SHOWER @ $1.00 J f,/7rY'6 LAVATORY (WASH BASIN) @ $1.00 KITCHEN SINK Q. $1.00 DISHWASHER @ $1.00 ,,s-Y//7 LAUNDRY TUB OR TRAY Q $1.00. OD P/ A. f/YA/le'll DWalkif 1111 CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 i GAS SYSTEM @ $1.00 le,--,abV APPROVALS R,Ql • Lf C9�'� DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK - PERMIT• $ 1 OO ROUGH PLUMBING - /awl r GAS PIPING TOTAL FEE OO GRAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY `r f WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES J U.f.y, I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GiASTEST aq;}�-1 P LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDEN L PROPER ,��r`� SIGNATURE q I r OF PERMITTEE FINAL S r,i' IOHN A.LAMBIE,COUNTY ENGINEER AI.IDATION ROBERT A.WOOD,CHIEF PLBG. INSPECTOR CASH 2332 JA1130 3 4.00 10 , ' WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT •I hereby affirm that I have a certificate of consent to self 20-0026 DPW 6/87 r insure, or a certificate of Workers'Compensation Insurance, 76A667A u of a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS . Policy No. Company 151 !F Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) �. Certified copy is filed with the county building inspec- ADDRESS � r• ©L-�� � V. tion depart ent. NUMBER FIXTURE OR ITEM @ FEE LOCALITY T WATER CLOSET Date �ppligant s CROSSNEARESS. Q CERTIFICATE OF EXEMPTIQN FROM WORKERS' BATti TUB COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work Involved by MAIL the permit is.for one hundred dollars($100)or less.) LAVATORY ADDRESS' ti. ` .�• -*• �:• I certify that in the performance of the work for which this _ - permit is issued,I shall not employ any person in any manner SINK CITY TEL.NO. so as to become.subject to the Workers'Compensation Laws. DISHWASHER .� •, CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS n NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR t Exemption, you. should become subject to the Workers' TEL.NO. y Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM \—�� CITY with comply with such provisions or this permit shall be STATE LIC. �e deemed revoked. WATER HEATER LICENSE NO. C LICENSED CONTRACTORS DECLARATIONDISTRICT N P ESSED BY /) I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS � (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER &L�� and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL14 VALIDATION ' DATE L C License Number Z� Lic. Class' II� FINAL C Contractor,^CjnE& � Date BY I.am exempt under Sec. r t. B.&P.C. for this reason Plan check fee 4 PLUMBING PERMIT ISSUING.FEE$ Q 0 Signature Do TOTAL FEE Q SINGLE FAMILY Plan check applicant ••� �i HOME OWNER-BUILDER DECLARATION Name ACG`T I hereby affirm that I am exempt from.the Contractor's License o v Law for the following reason (Section 7031.:5, Business and Address � �(� . Professions Code): CityTel. No. 3M7 34°50 � cl r<• ❑ I, as owner of the property, will do the work and the 1 ITEMS structure is not intended or offered for sale (Sectionpop �.��.� e � 7044, Business and Professions Code). o CONSTRUCTION LENDING AGENCY CHECK 34.5D I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued e00 (Sec. 3097, Civ. C.). Lender's Name =-M01 6/ 2/$9 Lender's Address 3731 1 AM 82-21 I. certify that I have read this application arbd,state that the ► above.information is correct. 1 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 purposes. iSEE REVERSE FOR EXPLANATORY LANGUAGE �a t ��_ . Sign . of Permit Date