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Home My Public Portal About9047 OLIVE ST_Plumbing__ 76 A 667'- CE 617 7-69 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING �D QL �� JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY 72 L e (317-V FOR APPLICANT TO FILL IN(PRINT OR TYPE) NEARSTT. Sal-r/4^1�/ CROSSNUMBER FIXTURE OR ITEM EACH FEE OWNER e5v,,qNs WATER CLOSET 1.50 L�R/OrY'v BATH TUB 1.50 ADDRESS SHOWER 1.50 CITY TEL. No.9607— 7 LAVATORY 1.50 CONTRACTOR SINK 1.50 ADDRESS 1I3 S ",JIL/2,41/11-. DISHWASHER 1.50 CITY ?L) CO vIr�A61 g TEL. NO.03aas74 STATELIC CLOTHES WASHER 1.50 LICENSE NO.,4d3�2 :5 CLASS �`� ✓!D SWIMMING POOL RECEPTOR. 1.50 DISTRICT NO. GROUP ZONE P BY LAWN SPRINKLER SYSTEM 2.00 � WATER HEATER 1.50 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.50 IIdSPECTION RECORD OUTLETS OVER 5 PER SYSTEM .30 O Lu go Z. Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE 8 2 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT L Tel. No. HOT WATER HEATEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIONATE THAT THE ABOVE I8 CORRECT AND' AGREE TO COMPLY PLUMBING FIXTURES LL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS,TEST NG.EBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. TIFIED D ASREQUIRED BY LOS.ANGELES COUNTY AND STATE, OFNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TOIN,THE OVE DESCRIBED RESIDENTIAL PROPERTY. FINAL J11f.1U JACK'R. ALLENSUPERVISING MECHANICAL EN'G'R. R iE PERMIT VALIDATION (h�'. M.o. CASH. PLAN-CHECK VALIDATION CK. M.o. �CA+SH ��--�� !, {(rt'..l.r 9 4.5 7s. MAR 3 0 50 3.5 0- 73AS67-d6B617 4-64 S APPLICATION FOR PLUMBING PER' IT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BDIG AND SAFETY DIVISION BUILDING ACOUNTY ENGINEER ADDRESS Q WILLIAM A.JENSEN,SUP'T OF BUILDING LOCALI FOR APPLICANT TO FILL IN STSUL:Z.4 NUMBER FIXTURE OR ITEM EACH FEE OWNER 6711AflX WATER CLOSET $1.25 BATH TUB 1.25 DRMAIL ESS. 6 SHOWER 125 CITY TEL. NO , l LAVATORY 1.9.5 CONTRACT SINS 1.25 ADDRESS � .Kwl DISHWASHER 1.25 CITY 41.4 TEL.NO LAUNDRY TUE 1.25 REGISTTRRATIOATE- N NO Q f COUNTY O CLOTHES WASHER 1.25 DISTRICT NO�� OU E P B WATER HEATER 1.50 0Ufa 1- GAS.SYSTEM OUTLETS 1'5 INDUSTRIAL D- WASTE APPROVALI O OUTLETS OVER 5 PER SYSTEM .80 INSPECTION RECORD V U W 4. IA . Z r APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 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 IB 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 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER O AND INTEND T . RESIDE IN,THE ABOVE D C BED RE,BIDENTIA 1iO UTILITY CO.NOTIFIED SIGNATURE OF PERMITT FINAL ft ErmIATION ROBERTA.W'OD .O. CASH SUPERVISING MECHANICAL ENG'R i Vic-9 o 5 .8 ;moi 9 D �.,5 a�- 0 r� , RKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT ` tl+r'.'i'have'a certificate of consent to self in- 20-0026 DPW q/87 n I rp,or a certificate in CE 817 A sure,or a certificate of Workers'Compensation Insurance,ora CE 817(REV.8/86) certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS �licy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING F-1 Certified copy is filed with the county building inspectionADDRESS g department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicont WATER CLOSET(TOILET) �� 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($100)or less.) ?/ LAVATORY 00 ADDRESS I certify that in the performance of the work for which this per- mit is issued, I shall not employ any person in any manner so SINK CITY TEL. NO. as to become subject to the Workers'Compensation Laws. DISHWASHE J�Q ` CONTRA TOR Da,te?X 7—U (j Applicant — CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this -rt ificote of Ex- emption,you should become subject to the Workers'Compen- CITY TEL. NO. sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. R ESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS , 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM17 fect. FINAL 01 VALIDATION a DATE License Number Lic. Class O V FI cc Contractor Date B O I am exempt under Sec. V W CL B.&P.C. for this reason Plan check fee Pool to Date: PLUMBING PERMIT ISSUING FEE$ D Signature TOTAL FEE 4 50 SINGLE FAMILY heck • HOME OWNER-BUILDER DECLARATION Plan capplicant I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and Professions Code): Address I, as owner of the property, will do the work and the City ' Tel. No. structure is not intended or offered for sale(Section 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY 0 0 G I hereby affirm that there is a construction lending agency for p the performance of the work for which this permit is issued o o e 76505 (Sec. 3097; Civ. C.). 0307-88 307i88 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 Zbentioned property for ' pection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature Permittee Date