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Home My Public Portal About10226 OLIVE ST_Plumbing__ 78A887-CE#B17 4-84 APPLICATION FOR PLUMBING PERMI;TT �. • �� COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER. BUILDING AND SAFETY DADD MSION SS BUILDING ADDRESS ( p ZZ-Co L.J U . JOHN A. LAMBIE, COUNTY ENGINEER '�j, r /� T WILLIAM A.JENSEN,SUPT OF BUILDING BE LOCALITY '� C W C,J J ] v FOR APPLICANT TO FILL IN NEAREST CaOSS ST. Ij NUMBER FIXTURE OR ITEM EACH FEE OWNER h WATER CLOSET $1.25 �` Y BATH Tlls 1,25 ADDRESS 1 CO-ZZ--(c, C- U�-(U E SHOWER 1.2s CITx- .(.JT TEL.NO-ql4 7 T 9 LAVATORY 1,25 CONTRACTOR { l<��1 C �N$T IF1 L,I S?,�, ,. SINK 1.25 ADDRESS 1 O Zp G' DISHWASHER 1.25 CITY P l T TEL.NO. �1 4) LAUNDRY TUB. 1.25 REGISTRATION NO. Z J 9 STATE COUNTY CLOTHES WASHER 1.25 � DISTRICT NO. GROUP ZnONE 7PR ESSED WATER HEATER 1.50 ( 'S0 D• ` /� GAS SYSTEM OUTLETS 1,50 _ w8°TE A PAoyAL p OUTLETS OVER 5 PER SYSTEM ,80 s I INSPECTION RECORD // V r L y , I - 'tom • a r Z . J U APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT S 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING 1 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 1. AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTEE FINAL CATION ROBERT A.WOOD O. CASH SUPERVISING MECHANICAL ENG'R LKD 9 13 3 JAN 2 6 5 0 3.50,- r ,a irm'"NER'9COMPENSATIONate of consent to 7gp887DPW 9l89 APPLICATION FOR PLUMBING PERMIT I hereby•affirih�ti'('at i have a certificate of consent to self Insure, or a certificate of Wgrker's Compensation Insurance, or a certified 11 copy thereof(Sec.3800 Lab.C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. 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 inspection ADDRESS department. NUMBER FIXTURE OR ITEM ® FEE LOCALITY Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE •� ASSESSOR �J� (This section need not be completed if the work Involved by the � SHOWER MAP 800K Q d PAGE 7 PARCEL permit is for one hundred dollars($100)or less.) OWNER /1 I certify that in the performance of the work for which this permit 'a- LAVATORY vy�r MAIL Is issued, I shall not employ an p y y person in any manner so as to SINK ADDRESSe become subject to the Workers'Compensation Laws. �� DISWASHER CITY .' �. TEL.NO. Date Applicant CLOTHES WASHER G: NOT1`6E TO APP ICANT: If, after makinbMs—Certificag of CONTRACTOR Exemption,you should become subject to theWorkers'Compensation SWIMMING POOL RECEPTOR v� provisions of the Labor Code,you must forthwith comply with such ADDRESS r provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM 11" / LICENSED CONTRACTORS DECLARATION / WATER HEATER CITY TEL.Nta� I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business and TATE LIC. GAS SYSTEM OUTLETS LIC NSE NO. �3� CLASS��/J U Professions Code,and my license is in full force and effect. � OUTLETS OVER NO. DISTRICT �� [�-CTi'G PROCESSED BY OF loe � 5 PER SYSTEM License Number ® Lic.Class�� 1® FINAL DATE ;� VALIDATION a Contractor Date '� O '^ j!_CT.®r cc ❑ rt_-� =�_ I am exempt ndr SFINAL —,ti 7:ec. G [).' O� J.! _r B.BP.C.for this reason BY i `�,3 1 Plan check fee i _I�1 25 Signature Date: PLUMBING PERMIT ISSUING FEE$ �Q , �I{�L_ �CK '" " TOTAL FEE G1 227.215 SINGLE FAMILY CHANGE check applicanCHANGE .00 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Law for the following reason(Section 7031.5, Business and Professions Address �=0300-0001 7/20/03 }3 Code):❑ [17 95 1 Ar! 8:210 City, Tel.No. [I I,as owner of the property,will do the work and the structure is not intended or offered for sale(Section 7044, Business and Professions Code). , CONSTRUCTION LENDING AGENCY 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.) 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 authorize representatives of this County to enter upon the above-mentioned property er inspe tion rposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signatu o Permitte Date WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76A667A • 'insure, or 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 LOCAL)T ' Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER .r I (This section need not be completed if the work involved by MAIL JJ the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESSOR I certify that in the performance of the work for which this �� permit is issued,I shall not employ any person in any manner SINK CIT TEL. NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOi� �C Date—� r�Applican CLOTHES WASHER ADDRESS cJ 1✓ / e NOTICE O PLICANT: If, after making this Certi tate of Exemption, you should' become subject to the Workers' SWIMMING POOL RECEPTOR CITY TEL. N06,7# rO ' r•' // Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE `� /y LIC. deemed revoked. WATER HEATER LICENSE NO.3/0f! 9 CLASS LICENSED CONTRACTORS DECLARATION DISTRIX NO P CESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS t/f/7U� (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER L and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL .,r VAL ATION } DATE p„ License Number �� 2/,Q Lic.Class Q �p� F U ConfractorAW Date ❑ I am exempt under Sec. Q U B.BP.C. for this reason LtJ Plan check fee ® IL Date: V) PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE Plan check applicant SINGLE FAMILY ;2 4, 8 A HOME OWNER-BUILDER DECLARATION Nam I hereby affirm that I am exempt from the Contractor's License # 0 0 0 0 0 5 Low for the following reason (Section 7031.5, Business and Address Professions Code): City `� Tel. No. �1J0 0�� 5 Q ❑ I, as owner of the property, will do the work and the i o 0 0 l 6 5 Q= structure is not intended or offered for sale (Section ® 5 7044, Business and Professions Code). 0623-86 CONSTRUCTION LENDING AGENCY 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.). 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 authorize representatives of this County to enter upon the ab ve-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Lhlsb ignature of Permittee Date 1