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Home My Public Portal About10258 OLIVE ST_Plumbing__ D.B.S.-17 26M SETS 12-40 ,APPLICATION FOR PERMIT REPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP I ZONE PERMIT NO. ROUGH FIXTURES COMPLETE ✓— • 1 HEATER CESSPOOL H SEPTIC TANK READY FOR FIRST INSPECTION �j�ATB I88U6D SAS MISCELLANEOUS 1 V� t `�"'�' v r l APPLICANT FILL IN HEAVILY'OUTLINED PORTIO OLE 7 NAME A/, �+ roe S . C � .) T,'.�sr�/C r no . ADD W ci � B ADDRESS LOCALITY �6a Sje J NEAREST n a CITY TEL.No. CROSS ST. COUNTY CERT.No. EXPIRES ljpAlg ` LOCATION OF SEPTIC TANS, OR CESSPOOL Z MAIL 3 ADDRESS NORTH 0 CITY. yet TEL.No. I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATF QPUALIFICATION. •PLUMENR I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. oWNEB CORRECTIONS SOUTH DESCRIPTION OF WORK BATH TUB FURNACE SHOWER DISHWASHER � —LAVATORY REFRIGERATOR —KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP LWA P SINK F ^OR DRAIN H TRAY URINAL APPROVALS ER CLOSET DRINKING FOUNTAIN DATE INSPILTOR•S NABS ER HEATER DENTAL LAVATORY I I ROUGH PLUMBING ER GA8 SODA FOUNTAIN I I OUTL GAS PIPING GAS VENT I CESSPOOL I. 7 ,-,� L NUMBER OF FIXTURES SEPTIC TANK a POOI- SEPTICTANK rd SEWER I SIBBIBB TOTAL FEE ,a t- 8 UTILITY CO.NOTIFIED I f Q FINAL �0/ ,q ASiRTMENT 'O IBM Secs I2.aa. F BUILDING AND SAFETY. APPLICATION FOR PERMIT� ® COUNTY OF LOS ANGELES PLUMBING 7 Wm.J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP I ZONE PERMIT NO. ROUGH FIXTURES I COMPLETE . HEATER CESSPOOL I—`SEPTIC TANK R FVVED BY AD REY FOR DATE 111SUED GAS MISCELLANEOUS vU��JI FIRST INSPECTION � / y r, APPLICANT FILL HEAVILY OUTLINED PORTION ONLY JOB ADDRESS W / e _ B ADDR 6 f-� �• ��i4 Q �. LOCALITY yO400 NEAREST BCITY (/(/j- .- TEL.NC. CROSS ST. COUNTY e.a ® �.d CERT.No. —EXPIRES. NAME b ' a LOCATION OF SEPTIC TANS, OR CESSPOOL z •MAIL �"` 3 ADDRESS t= 52— NORTH O' ei CITYIAM THE LEGAL P9SBE8SOR OF THE ABOVE LOS ANGELES COUNTY CERT F ATE OR QUALIFI TO�t t' 'PLUMBeB I AM THE,LEGk O NER OF THE PROPERTY DESCR ABOVE: OWNER CORRECTIONS SOUTH DESCRIPTION OF WORK B BATH TUB FURNACE w O HOWER DISHWASHER 02--LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER a FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN / WASH TRAY URINAL ' APPROVALS` r` �.,--WATER CLOSET DRINKING FOUNTAIN 1 DATE /�'\INSPECTOR'S Nl1[I@�' WATER HEATER DENTAL LAVATORY ROUGH PLUMBING yIL 1 I�it v`: l�` �NETER_�CiA6 SODA FOUNTAIN / Y I OUTL GAS PIPING GAS VENT -I I CESSPOOL I I. TOTAL NUMBER OF FIXTURES C a 4r SEPTIC TANK CESSPOOT- SEPTIC TANK U Q SEWER I I TOTAL FEE t6 d UTILITY'CO.NOTIFIED] FINAL 0.6.5. 17 25M SETS 12.44 OF BUILDING AND SAFETY APPLICATION FOR PERMIT D1±:13ARTMENT COUNTY OF LOS ANGELES PLUMBING 1 Wm. J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUPI ZONE PERMIT NO. ROUGH FIXTURES COMPLETE - HEATER CESSPOOL 1_1 SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION GAS MISCELLANEOUS % APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB E NAME ; �: ADDRESS W ADDRESS r- LOCALITY O J CITY (��'�I NEAREST IL TEL. No. 4)" CROSS ST. COUNTY CERT.NO. r EXPIRES C _NAME oz LOCATION OF SEPTIC TANK, OR CESSPOOL 3 MAIL DDRE38 NORTH O -. i CITY 7 TEL.No. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMBER 1 AM THE LEGAL OWN E OF THE PROPERTY DESCRIBED F- A BO V E. > 3 i OWNER CORRECTIONS i SOUTH DESCRIPTION OF WORK -- _--- - ---- z BATH TUB FURNACE Ur SHOWER DISHWASHER C LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK -_FLOOR DRAINkA .Nl WASH TRAY URINAL APPROVALS WATERCLOSET DRINKING FOUNTAIDATE INSPECTOR'S NAME WATER HEATER _ DENTAL LAVATORYBING METER GAS SODA FOUNTAINOUTL CESSPOOL TOTAL NUMBER OF FIXLF SEPTIC TANK CESSPOOL f SESEWER (/ UTILITY CO.NOTIFIED I TOTAL FEE FINAL 79AGO7 17 8-50 i® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING ��' COUNTY OF LOS ANGELES WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICTNO. GROUP I ZONE PERMITNO. r— 9A V' PLUMBER M. C. Nottingham Co. of Temple Ci RECEIVED BY READY FOR °DATISSU9D FIRST INSPECTION ADDRESS 5933 N. CLOVERLY AVE. C1 , CALIF. BUILDING CITY TEL. NO. ADDRESS O COUNTY LOCALITY _ • 6, LICENSE NO. EXPIRES NEAREST PERMIT FEES CROSS ST. L iotgg NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER massa'Y6 MAIL WATER CLOSET (TOILET) @ 0.50 S ADDRESS BATH TUB @ 0.50 CITY TEL. NO. SHOWER 0.50 I HEREBY ACKNOWLEDGE THAT 1 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. 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 I ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER OF TJHF,,Rj SID ENTIAL.P OP RT DESC IBF0 ABOVE. GAS SYSTEM OUTLETS 0.50 I SIGNIA7 U E OF }}/�JLL,, ..rye v •� /,� WATER HEATER @ 0.50 P ITTE w, j ■ SLOP SINK @ o.so 1 INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.501 DRINKING FOUNTAIN 0.50 URINAL @ 0.501 „J HOUSESEWER @ 0.501 1 Q Z MISCELLANEOUS I _� 1� 0 i O 1 APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 1.001 CESSPOOL 0 . q 101, 1 SEPTIC TANK: I SEPTIC TANK 1•J I DRAIN ( ) PIT ( ) @ 1.00 I SEWER Y A PERMIT . . I I.00 GAS TEST G • 'a E UTILITY CO. NOTIFIED TOTAL FEE 7I „�.. FINAL WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I herrtby affirm that I have a certificate of consent to self 76A667A a insure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) or a certified copy thereof e 3800, Lab. .) COUNTY OF LOS ANGELES BUILDING AND SAFETY olicy o. ompany Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING 12 Certified copy is filed with the co my bui 'ng inspec- ADDRESS �� J Cl 6 '� ,$ tion department. NUMBER FIXTURE OR ITEM (41 FEE LOCALITY Date 9 Applica WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION F M WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE OWNER L^� (This section need not be completed if the work involved by SHOWER the permit is for one hundred dollars ($100)or less.) LAVATORY MAIL ADDRESS C, d AV.,-"Oe S I certify that in the performance of the work for which this t permit is issued, I shall not employ any person in any manner SINK CITY- TEL. No-,y j}�76s✓ so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTIR Date Applicant CLOTHES WASHER ADDRESS 3 NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR / - Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY fj(/�.,'Y�/Lrcl� TEL. O. with comply with such provisions or this permit shall be STATE 7 LIC, deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION �� DISTRICT NO. BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code, and m license is in full force and effect. 5 PER SYSTEM t y oAFINAL TEV (DATION 0 License N u m b e �y ] Lic. Class �—�E ce FINAL O Contractor Date BY ~ V ❑ I am exempt under Sec. H B.BP.C. for this reason ► z Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE J Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License 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 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 nd State laws regulating Plumbing, and hereby ou�hr'i representatives of this County to enter upon the abntion d oerty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 1 7_ Signature ermittee Date