The URL can be used to link to this page

Home My Public Portal About9216 OLIVE ST_Plumbing__ s-1T Sb1K SET$18-46 y - APPIACATION FOR PERMIT • I iTMENT OF BUILDING AND SAFETY _ COUNTY OF LOS ANGELES • ,. , ' PLUMBING 7 WM.J. FOX.CHIEF ENGINEER' NATURE OF INSTALLATION. DISTRICT,NO. ,GROUP PTIZONE ' PERMIT NOS.1 , 41 .,,/ JGH FIXTURES COMPLETE +� _ RBC IVSD BY sEAYER CESSPOOL BBC TANK. READY FOR. IK DATE ISSUED�. eb FIRST INSPECTION OAS MISCELLANEOUS r1'►�(' 'L '`�� _ �� APPLICANT,FILL IN HEAVILY OUTLINED PORTION ONLY, JOB K NAME . ADDRESS B ADDRESS LOCALITY. a e¢ NEAREST, t 1 t CITY / ! Al'r <: a TFL;:No. CROSS ST. .f J COUNTY CERT.No. EXPIRES NAM � L}eii/�,�trV�/j Qsll ryl LOCATION OF SEPTIC TANH, OR CESSPOOL. �' MAIL NORTH C ADDRESS./ /� CITY wl�ll..+f PrEL..NO: - tfg I AM THB •L_ AL POSSESSQ* OF THE.ABOVE LOB ANGELES CCUNTICERTIFICATE OF QUALIFICATION. • PLUMBER I AM THE LEGAL 9WNER OF THE PROPERTY DESCRIBED ABOVE.r OWNER CORRECTIONS //7, .R SOUTH �/ G G G 6, o �i •. DESCRIPTION OF WORN ATH TUB 17URNACE ROWER Rt/ DISHWASHER O ��eVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER -FLOOR BINK SAND TRAP SLOP SINK, FLOOR DRAIN �. WASH TRAY 1/ URINAL ' APPROVALS • WATER CLOSET (/ DRINKING FOUNTAIN DATE�/ tNSPEcroR•s NAME • WATER HEATER ^ENTAL.LAVATORY ROUGH PLUMBING. I 'X s "1 C —METER-----AAS BODA FOUNTAIN GAS PIPING OUTL GAS VENT I CESSPOOL TOTAL NUMBER OF FIXTURES r �� SEPTIC TANK I ESSPOO� SEPTIC �U SEWER I I I a z . TOTAL FEE :? "' •� UTILITY co:NOTIFIED FINAL vy f41 fy. V.4`7 S WORKERS'COMPENSATION.DECLARATION '20-0026 DPW 4/87 APPLICATION FOR PLUMBING PERMIT "I 'fl t I hero offirm that I have a certtifi¢ate df consent to self in- 76A667A sure,or a certificate of ftrke:s'Compensation Insurance,ora CE 817(REV.8/86) y c'Brtifidd copy thereof(Se' 3800,Lab. C.) COUNTY OF LOS ANGELES DEPT.'OF PUBLIC WORKS Policy No. Company , ❑ Certified copy is hereby.furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING y J 191 Certified copy is filed with the county building inspection I ADDRESS p(, 1�1 department. NUMBER. FIXTURE OR ITEM @ FEE _ �//� LOCALITY Date Applicant , WATER CLOSET(TOILET) U ✓ NEAREST41 t CERTIFICATE OE EXEMPTIO FROM-WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE, ` SHOWER �fJ OWNER (This section need not be completed if the work Involved by MAIL the permit is for one hundred dollars($100)or less.)' LAVATORY ()� ADDRESS , I certify that in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so CITY TEL. NO. as to become subject to the Workers'Compensation Laws... DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER 4 NOTICE TO APPLICANT: If,'after making this Certificate of Ex- ADDRESS 14 em tion,you should become subject to the Workers'Com en'- SWIMMING POOL RECEPTOR P Y I Compen:- �� TEL. NOZ� Z"S//d/ sation provisions.of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such.provisions or this permit shall be deemed revok-, STATEc LIC. ed. WATER HEATER LICENSE NO:ZO.! -3�Z- CLASSe 2C9.1e34-–/3 LICENSED CONTRACTORS DECLARATION DIST$ICT ryO 'PR77Y ES D I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS G // 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER JJ f/' and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL Z VALI'ATION d feet. ' DATE'` License Num r—` 7/ Lic. ClassC?014C3G'�6 0 IseContractor Date Y I am.a empt under Sec. W CL B.&P.C. for this reason X • Plan check fee � oil. �$7 64 A X Date: PLUMBING PERMIT ISSUING FEE$ U 0 0 0 0 0 5 Signature ' TOTAL FEE SINGLE FAMILY Plan check applicant S ) o 0 2 a 5 0 HOME OWNER-BUILDER DECLARATION I hereby-affirm that I am exempt from the Contractor's License Name o o o 2 a 5 0.50 Law for the following reason (Section 7031.5, Business and Professions Code): Address Q 1. 13-88 ❑' 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 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 ead this application and state that the above in correct.i agree to comply with all County ordinances an to laws regulating Plumbing', and hereby authorize re tatives of this County to enter upon the above-mei propert for ins ecflon pur oses. SEE REVERSE FOREXPLANATORY LANGUAGE Signatu ermittee D. e 'WORKERS'COMPENSATION DECLARATION 6 DPW 4/87 APPLICATION FOR PLUMBING PERMIT thereby, affirm that I have 76A66 a certificate of consent to self in- 76A667A sure,or a certificate of Workers'Compensation Insurance,or a CE 817(REV.8/86) certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company E] Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING r Certified copy is filed with the county building inspection ADDRESS /d/C department. NUMBER FIXTURE OR ITEM @ FEE LOCALITYTE , WATER CLOSET(TOILET) V t Date Applicant NEAREST i. CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. 1 COMPENSATION INSURANCE SHOWER OWNER r (This section need not be completed If the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY Lf ADDRESS a I certify that in the performance of the work for which this per- SINK r mit is issued, I shall not employ any person in any manner so CITY r WZ, e TEL. NOM r/33 as to become subject to the Workers' mpensatio ws. DISHWASHER �nf � CONTRACT Date d Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of Ex- ADDRESS SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY TEL. NO. sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS �, 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VAL DATION >' fect. DATE C License Number Lic. Class 0 FINAL pc Contractor Date BY O H I am exempt under Sec. W a 8.8P.C. for this reason ► 2E Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE SINGLE FAMILY ;993 7.Q A HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name U 0 0 2 2 5 6 Law for the following reason (Section 7031.5, Business and 0 00 2 2 J�Q v Professions Code): Address (6 I, as owner of the property, will do the work and the city Tel. No. 12-88 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-prigntioned property for inspection purposes. � SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WOFIKERJ'SCOMPENSATION DECLARATION 20.0028DPW9189 APPLICATION FOR PLUMBING PERMIT I heresy affirm thht I have a certificate of consent to self Insure, 78A667A or a cerxificate of lNorker's Compensation Insurance, or a certified copy thereof(Sec.3800 Lab.C.) COUNTY OF LOS ANGELES I DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. PollAy No. Company ❑ Certified copy Is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) ABUDING DDR SS Q/6 C� Ov_ U ElCertifiedcopy is filed with the county building inspection department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant WATER CLOSET j NEAREST in CERTIFICATE OF EXEMPTION FROM WORKERS' d�� CROSS ST. e /�� COMPENSATION INSURANCE BATH TUB ASSESSOR1..�� / (This section need not be completed if the work involved by the SHOWER MAP BOOK PAGE P�ffIC permit is for one hundred dollars.($100)or less.) OWNER RAM CC& I certify that in the performance of the work for which this permit IL LAVATORY is issued, 1 shall not employ any person in any manner so as to SINK ADDRESS Upw become subject to the Workers'Compensation Laws. DISWASHER CITY TEL.NO. Date Applicant CLOTHES WASHER CONTRACTOR NOTICE TO'APPLICANT: If, after making this Certificate of W V'1 L Exemption,you should become subject to the Workers'CompensationRE, SWIMMING POOL RECEPTOR provisions of the Labor Code,you must forthwith comply.with such ADDRESS , provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL.NO. > I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER STATE LIC.. (commencing with Section 7000)of Division 3 of.the Business•and OAS SYSTEM /� OUTLETS LICENSE NO. CLASS V Professions Code,.and my license is.in full force and effect. J i OUTLETS OVER DISTRICT NO. PROCSSED BY 5 PER SYSTEM �D Q License Number Lic.Class �J V FINAL DATE VALIDATION a -•� Contractor Date fA El am exempt under Sec:. FINAL Y� � M&P.C.for this reason Plan check fee Dater ys Signature PLUMBING PERMIT ISSUING FEE$ TOTAL FEE El ACCo v SINGLE FAMILY Plan check applicant 3307 1ST a 71� HOME OWNER-BUILDER DECLARATION Name' N ,� .1 ITEMS I hereby affirm that I am exempt from the Contractor's License Law . LA for the following reason(Section 7031.5, Business and Professions Address _J V,f E 4QT. TOTALCode): Q City o �. Tel.No. 1 J CHECK 1.55071 155.70 I,as owner of the properly,will do the work and the structure K� Is not intended or offered for sale(Section 7044, BusinessLl�ll E .00 and Professions Code). pop. L•rT"lA CONSTRUCTION LENDING AGENCY I hereby affirm that there is.a'construction lending agency for the 0000-0001 1 J/J*.7/q..- performance of the work for which this permit Is issued(Sec.9097, ' Civ.C.) 6473 1 AM 8:52 Lender's Name ;Lender's Address I , 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 re resents e o his County to enter upon the above-mentioned p arty ns Ion purpo s. SEE REVERSE FOR EXPLANATORY LANGUAGE hz _ Slanature of Permittee Dide