HomeMy Public PortalAbout10231 OLIVE ST_Plumbing__ ;' • •�.
ab .WORKER'have a certificIONate
of consent to 76AB66DPw9189 APPLICATION FOR PLUMBING PERMIT
'!hereb,,��affirm that I have a certificate of consent to self insure, 78A867A
or ce!Ri�yf cate of Worker's Compensation Insurance,or a certified
copy th®iepf(Sec.3800 Lab.C.).
Policy'No. Company 1 COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV.
0 Certified copy is hereby furnished.
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
❑ Certified ®��L� j
Certified copy is filed with the county building inspection
department. NUMBER FIXTURE OR ITEM
to FEE
,w.��77 LOCALITY
Date Applicant WATER CLOSET Pr✓ NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' / BATH TUBCROSS ST. oh-4
COMPENSATION INSURANCE ` e4lOjE ASSESSOR y
(This section need not be completed.if the work Involved by the SHOWER
MAP BOOK a PAGE0(—� PARCEL fttp
permit is for one hundred dollars($100)or less.) 3 LAVATORY A `� OWNER
I certify that in the performance of the work for which this permit o� �J MAIL
vi- A&CAUrAw
is issued, I shall not employ any person in an manner so as to Y / SINK ADDRESS
become subject to the Workers'Compensation Laws.
DISWASHER Q CITY '' TEL.NO.
I/Date ( 7� Applicant
CLOTHES WASHER CONTRACTOR �j
NOTICE TO APPLICANT: If, after makin his Certificate of w w6� A,&
Exemption,you should become subject to th orkers'Compensation SWIMMING POOL RECEPTOR 3 i/
provisions of the Labor Code,you must forthwith comply with such ADDRESS 7 7 '�® Pe5•
provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM
LICENSED CONTRACTORS DECLARATION CITY �� TEL.NO.Y(���7.�53 0.
I hereby affirm that I am ifcensed under provisions of Chapter 9 WATER HEATER 7
(commencing with Section 7000)of Division 3 of the Business and GAS SYSTEM OUTLETS LICENSE NO. J®� CLASS ATE LIC. V
Professions Code,and my license is in full force and effect. OUTLETS OVER DISTRICT NO. PROCESSED BY jY
ro 019 9 5 PER SYSTEM ��f/ Q
License Number S Uc.Class (� �5 O0 , O W
FINAL VALIDATION
Contracto &NACAate V-0-91 ' DATE CO3
❑ FINAL z
I am ex mpt under Sec. G� BY
B.BP.C.for this reason
e:
' Plan check fee "
PLUMBING PERMIT ISSUING FEE$
Signature Q
❑ TOTAL FEE
SINGLE FAMILY
Plan check applicant
- �t •
HOME OWNER-BUILDER DECLARATION Name N
I hereby affirm that I am exempt from the Contractor's License Law ACXT o 4
for the following reason (Section 7031.5, Business and Professions AddressI�
Code): • ;'�! 3.a 03
City � � Tel.No. I f y`��
❑ I,as owner of the property,will do the work and the structure j TEEMES
is not Intended or offered for sale(Section 7044, Business
and Professions Code). ► TCITAL -133 .00
CONSTRUCTION LENDING AGENCY CHECK 133.0""1
1 hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is Issued (Sec.3097, CHANGE •11L
Civ.C.)
Lender's Name I f;/29/9
Lender's Address 1 602 i; 1
4i.;� 1 C�'.:il' �b
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-mentioned
property for Inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
78"887- f7 0-49® APPLICATION FOR PERMIT
- .DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBING 1
WILLIAM J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT .O. GROUP ZO E PERMIT NO.
PLUMBER P- d v 1 e ►rte Aibw REC
L � EIVE •I READY FOR D TE'ISSUED r
{+ ] I FIRST INSPECTION ry J
ADDRESS �E//fa� - G ® / i V e
CITY 6 rD TEL. NO./V J5 /J.1ADD EISS
COUNTY J_ s LOCALITY
LICENSE NO. O •� EXPIRES as+
' NEAREST
PERMIT FEES CROSS ST. ,./,,►J .0
NUMBER TYPE OF FIXTURE OR ITEM_ FEE OWNERl,.I../��l�1// .•.•o
MAIL
WATER.CLOSET (TOILET) @ 0.50 11; ADDRESS /44j/ /f--�stst2an+ fit/
BATH TUB ® 0.50 CITY TEL. NO. `/
SHOWER @ 0.50 1 HEREB ACKNOWLEDGE THAT i HAVE READ THIS
LAVATORY WASH BASIN) ® 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK @ 0.50 STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT I POSSESS THE ABOVE VALID 'LOS
LAUNDRY TUB OR TRAY @ O.50 ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER
OF THERE
SIDEN 1 L PROPERTY D CRIBED ABOVE.
GAS S•YSTEM�OUTLETS (P) 0.50
• SIGNATURE OR
WATER HEATER 0.50 PERMITTEE O ® P •t.t d9 1��.el!�/�-Af
SLOP SINK @ 0.50 INSPECTION RECORD
FLOOR SINK 0.50
FLOOR DRAIN @. 0.50
DISHWASHER 0.50
DRINKING FOUNTAIN 0.50
URINAL �. 0.50
HOUSE SEWER @ 0.50 a
Z
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL @ 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) 1.00 SEWER J
PERMIT . 1.00 GAS TEST.
UTILITY CO. NOTIFIED
• TOTAL FEE S -' 2
FINAL �D/�
75"957 17 9-49 ® _. APPLICATION FOR PERM
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBING 1
WILLIAM J. FOX,, CHIEF ENGINEER
FOR APPLICANT TO FILL IN , DISTRICT NO. GROUP I ZONE PERMIT NO.
A�-- 6 5'6)'/
PLUMBER (S Q ;'dad y C C ED Y READY FOR DATIS UED
FIRST INSPECTION
ADDRESS -
I
CITY ADDRESS
TEL- NO._ r
COUNTY LOCALITY /�1.✓G/,/ If
LICENSE NO. EXPIRES y
NEAREST JIV
PERMIT FEES CROSS ST.
�Glsfl:4s�✓ S
NUMBER OWNER TYPE OF FIXTURE OR ITEM FEE -
M•AI'L
WATER CLOSET (TOILET) @ 0.50. S ADDRESS
BATHTUB 0.50 CITY TEL. NO.
SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.5.0 I ;APPLICATION AND STATE.THAT THE.ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK @ 0.50 I STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY CENSE, OR I AM THE LEGAL OWNER
OF THE RESIDEN AL PROPE�TY DESCRIBED ABOVE.
GAS SYSTEM OUTLETS @ 0.50 SIGNATURE OF
WATER HEATER @ 0.50. PERMITTE
SLOP SINK @ 0.501 INSPECTION.RECORD
FLOOR SINK @ 0.50
FLOOR DRAIN @ 0.50
DISHWASHER @ 0.50
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50 `]
HOUSESEWER� @ 0.50 a.
z
MISCELLANEOUS (�
I . O
FEFI
APPROVALS
DATE INSPECTORS NAME
ROUGH-PLUMBING
GAS PIPING
GAS VENT
[CESSPOOL @ 7.00 I CESSPOOL
SEPTIC TANK: SEPTIC TANK u/
DRAIN ( . ) PIT ( )' @�1.00 SEWER
PERMIT . 1.00 GAS TEST
I TOTAL FEE ��J.
UTILITY CO. NOTIFIED /
FINAL A:Tl'• w r a w .l.�f�•/R'�