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Home My Public Portal About10009-10011-10015 OLIVE ST_Plumbing__ BA661 CEB17 12/59 APPLICATION OR PLUM IMC PERMIT COUNTY OF LOS ANGELES DEPARTMW OF COUNTYDENGINEER BUILDING B.o'Div�i R►n , AcOUHTY,r EN6 NEOERi ADDRESS WILLIAM A.JENSEN,SO'IT OF BUILDING LOCALTrY I � FOR APPLICANT TO ML 3N NBAHEW CROSS ST. NUMBER FIXTURE OR ITEM - OWNER � a WATER CLOSET MAIL RATS TUB ADDRESS , CITYS. TEL NO. SHOWER LAVATORY CONTRACTOR s t SIMADDRESS d DISHWASHER CITY TEL NO. 0.1 Y"Q 7� CONTRA // STATE ❑ LAUNDRY TUB REGISTRATION NO. (y COUNTY ❑ CLOTHES WASHER DII.S.TRIC�NG ZONE P BY cl WATER HEATER t7 . G c GAS SYSTEM INDUSTRUil' WASTE APPROVAL INSPECTION RECORD 0 U • Pt i. 0 y O PER 1= OR FDLTURE $ I Q® - APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2100' UNDER SLAB WORK TOTAL FEE, 0 ROUGH PLUMBING GAS PIPING 1 HEREBY ACKNOWLEDGE THAT' I HAVE READ. THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE 1S .CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER / PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES �/(p ,•�O�Le.. LICENSED AS REQUIRED BY LOS.ANGELES COUNTY AND STATE OF GAS TEST � CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL OPERTY.' UTILITY CO.NOTIFIED SIGNATURE OF PERMITTE FINAL �v VALIDATI OBERT A.WOOD, 'CK. M.o. CASH ,SUPERVISING MECHANICAL ENG'R - L�Co 2 6.4 5 S JU14 22 3 5 D ' 7.0 0 76A667C (C1B-81719) -9/7S APPLICATION' FOR PLUMBING PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING D NUMBER FIXTURE OR ITEM @ FEE ADDRESS ' WATER CLOSET LOCALITY NEAREST BATH TUB 00CROSS ST. SHOWER OWNER LAVATORY MAIDL O r ADRESS SINK CITY TEL. IVO �. DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR CITTEL. NO. LAWN SPRINKLER SYSTEM STATE LIC L7 WATER HEATER LICENSE NO. CLASS �(Q O DISTRICT NO. GROUP ZONE O SED Blf, v GAS SYSTEM OUTLETS I C=OUTLETS OVER �+� Q !� a v 5 PER SYSTEM I INDUSTRIAL ,//ma�y L+I WASTE APPROVALjO-11 , 6/'* 44 7 y INSPECTION RECORD Z Plan check fee PLUMBING PERMIT ISSUING FEE $ TOTAL FEE f(J Plan check applicant Name APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK Address ROUGH PLUMBING City Tel. NO. GAS PIPING I HEREBY ACKNOWLEDGE THAT"I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS .CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSEDAS REQUIRED BY LO GELES CO TY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM L AL OWN O INTEND - RESIDE IN THE ABOVE DES BED ES NT L P TY. UTILITY CO. NOTIFIED SI GNATU RE OF PERMITTEE FINAL PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. .0. CASH I• 077EZMAY 310 0 10.50 ® 3 76A667-CE817 12/59 �� APPLICATION FO PLUMBI G PERMIT, COUNTY OF LOS ANGELES ' DEPARTMENT OF COUNTY ENGINEER BIII.DINGiND SAFETYIVISION BmLDnvG OHN A. MBI COUNTY NGINEER ADDRESS OQ/ O�/!✓ WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY �r c,�ze FOR APPLICANT TO FILL IN Coss T. •Wp ev/AJ NUMBER FIXTURE OR ITEM GWNER WATER CLOSET MA>1. BATS TUB ADDRESS/S'C7/ X L"4C1AJEfr' CII7�mA / .JI /��+/6El� TEL.IvO.. SHOWER CONTBACTOR/4eoGm./ i�vy�/A/!✓ /CF�- LAVATORY n anus ADDRF=//6 x/ �'6 rte+ ✓Y DISHWASHER CTTYg TEL. NO."]-00,88 CONTRACTOR'S STATE LAUNDRY TUB REGISTSATION NO. JV COUNTY ❑ CLOTHES WASSER DIISST+RICT NO. .GROUP ZONE P CESSED BY Z WATER HEATER �'.L 09 f- GAS SYSTEM INDUSTRIAL WASTE APPROII INSPECTION RECORD / .a .e .Jo'•cry £� .iS.:fie Rl a L490 °o g y6 (Q G' Z . Ca .le W m is OR PFMTQBE $ I APPROVALS; DATE INSPECTOR'S SIGNATURE PERMIT $ 2100 UNDER SLAB WORKI TOTAL FEE ROUGH PLUMBING , r� � GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING: HOT WATER HEATER I HEREBY CERTIFY THAT I AM 'PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST R! CALIFORNIA OR T AT,%[ AM THE LEGAL OWNER OF THE ABOVE DESCRIBED REST TIA PROPER UTILITY CO.NOTIFIED 2wo SIGNATURE OF PERMITTE FINAL L n oF VALIDATIROBERT A.WOOD, " CK. M.p. cnsH SUPERVISING MECHANICAL ENG'R ��4 1 5 S r,U,2' -10 5 D 17.00 `' WORKERS'COMPENSATION DECLARATION I APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 176A667A insur@.c or a certificate of Workers'Compensation Insurance, "CE 817(REV. 10/81) or a cern i copy thereof�SJec. 3800, Lab. C.), " ,r. I COUNTY OF LOS ANGELES � A BUILDING AND SAFETY � r� Pgli y No. 33I �ny�t�'a'✓ i . Certified copy is hereby furnished. _ ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ADDRESS Certified copy is filed with the my building inspec.- tioeparttgttSSJJ(( eny LOCALITY NUMBER FIXTURE ITEM @ FEE -42,�^ff// Date ppliqant ; WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. LI<�ft COMPENSATION INSURANCE OWNER `+e 1,5 L f�GQO fie (This section need not be completed if the work involved by MAIL SHOWER the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance oft work for which this permit is issued; I shall not employ erson in any manner SINK CITY�p/((��J .4 TEL.Nci. 577./% so as to become subjy to the W er nsation L Sv[ DISHWASHER. CONTRACTOR�� Q� Dater pelican CLOTHES WASHER ADDRESS Sores �� NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY�� /��d TEL.NO.W/ �jJ Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply With such provisions or this permit shall be STATE. LIC. deemed revoked. WATER HEATER LICENSE NO. / 7 CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO /PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS ® (commencing With Section 7000) of Division 3 of the BusinessOUTLETS OVER IL >_ and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL 0 /j DATE ��' VALIDATION OU License Number2-5'93 L/7 Lic. Cilass�— 6 '� of /�/�!�V 7 `�� FINAL Contractor ate_ �� > e BYr�„i' �►� V I am exempt under Sec. A0 9L ❑ � B.BP.C. for this reason Plan check fee Date: 00 PLUMBING PERMIT ISSUING FEE$ 0 Signature TOTAL FEE Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name 2 2 2 7 A I hereby affirm that I am exempt from the Contractor's License 0 0 0 0 0 Address '' Law for the following reason (Section 7031.5, Business and . Professions Code): City Tel. No. ❑ I, as owner of the property, will do the work and the l ° 1 6 5 0 structure is not intended or offered for sale (Section , s 1 C J 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY 0 25-8Z 1 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.). a 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 authoriz epresentatives of this County to enter upon the ab o d property for' spection purposes. I SEE REVERSE FOR EXPLANATORY LANGUAGE SrrZ Y�� Signature of Permittee Date WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76A667A insure,1or a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS tion department. NUMBER FIXTURE OR ITEM ® FEE �-� s / LOCALITY � � Date I 3�' ppligant G� WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER !� (This section need not*be completed if the work involved by � �' MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS /r « �f1 +v� s r 1 certify that in the performance of the work for which this permit is issued; I shall not employ any person in any manner SINK CITY NO. CONTRACTOR7�MA� ��wP-� so as to become subject to the Workers'Compensation Laws. TEL.DISHWASHER j L. NO. /r Date A licanf CLOTHES WASHER Pp ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY �i®�j'� TEL,NO LAWN SPRINKLER SYSTEM rrs ` ` with comply with such provisions or this permit shall be STATE L! IC. �� d� deemed revoked. WATER HEATER LICENSE NO. � T CLASS L� LICENSED CONTRACTORS DECLARATION DISTRICT NO. P OCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL0 ,(-7 g DATE Z� VALIDATION � License Number?�fitLIC. Class IngL V r //!!e— _Q FINAL clContractor Date ` BY - '� v ❑ � I am exempt under Sec. W W B.BP.C. for this reason 10,Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE Plan check.applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License 3 1. Law for the following reason (Section 7031.5, Business and Address ? Professions Code): City Tel. No: L0 0 0 0 0 0 9z ❑ 1, as owner of the property, will do the work and the �9 o 0 1 E 5 0 structure is not intended or offered for sale (Section /L, 7044, Business and Professions Code). , 0016505 CONSTRUCTION LENDING AGENCY ' I hereby affirm that there is a construction lending agency for Q the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address I I certify that I have read this application and state that the poll, information is correct. I agree to comply with all County ordina s and State laws regulating Plumbing, and hereby outh ze epresentatives of this County to enter upon the a e- ntioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signatu of Permittee Date