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Home My Public Portal About9655 OLIVE ST_Plumbing__ 7GA667A ICE 61781-11/76 - APPLICATION FOR PLUMBING PERMIT BUILDING AND SAFETY DIVISION R APPLICANT TO FILL.IN(PRINT OR TYPE) BUILDING ISD F7BATH FIXTURE OR ITEM @ FEE ADDRESS ,�G✓ R CLOSET LOCALITY TUB NEAREST, CROSS ST. SHOWER OWNER LAVATORY MAIL ADDRESS SINK CITY C`T TEL.NO. DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR - CITY J TEL.NO. LAWN SPRINKLER SYSTEM STATE LIC. WATER HEATER LICENSE NO. CLASS GAS SYSTEM OUTLETS DISTRICT NO. GROUP ZONE P CESSED Y OPERTS OVER TEM INDUST67 Q ' WASTE APPROVAL INSPECTION RECORD gg ub z Plan check fee PLUMBING PERMIT ISSUING FEE$ TOTAL FEE 1 71�Z Plan check'ap licant APPROVALS DATE INSPECTOR'S SIGNATURE Name - UNDER SLAB WORK Address ROUGH PLUMBING City Tel.No. GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL'COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES f REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST ,�� 7� •�T—,< LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE _ y OFPERMITTEE 4fa�� FINAL ✓.��.L- PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 54 1.fi OCT 1'? 5 d 7.5 0 Aub es y. i 76A.687yfCE-8.17)-4/7.2 T APPLICATIO FOR P BINE PERMIT V4 6,COUNTY OF LOS ANGELES DEPARTMENT OF_COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE T0: BUILDINGADDRESS S S HARVEY T. BRANDT, COUNTY ENGINEER LOCALFTY• FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST NUMBER FIXTURE OR ITEM @FEE CROSS ST. WATER CLOSET 1,75 '�. OWNER "711.4 1 111 MAIL BATH TUB 1.75 ADDRESS . SHOWER, 1.75 CITY TEL. NO..j r �` LAVATORY 1.75 CONTRACTOR SINK ! 1.75 ADDRESS DISHWASHER 1.75 l CITY TEL. NO. CLOTHES WASHER 1.75 17,5 STATE LIC SWIMMING POOL RECEPTOR 1.75 LICENSE_NO. CLASS DISTRICT NO. GROUP FRO SSED Y LAWN SPRINKLER SYSTEM 1.75 i WATER HEATER 1.75 IND USTpIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.75 INSPECTION.RECORD Com? OUTLETS OVER 5 PER.SYSTEM .30 /6 �� CD L+1 CL. �'y %�Qpa H Plan check fee Sea Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 ®� A:A 'J TOTAL FEE ® Jr APPROVALS DATE _ INSPECTOR'S S.IGNAYURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Te.i. NO. GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER.HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO!COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING: GAS TEST IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL P PERTY. FINAL i SIGNATU RE OF PERMITTEE hoommimmmmmmmmlimift PERMIT VALID ATI ®r� 'M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH Af' .9 5 0 873 `IAR 1.2 5b 2 0.5 0 ' 78AB57 (CE-817)-4/72 APPLICATION R' PLU BING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ADDRESS 7 1C MAKE CHECKS PAYABLE TO: , HARVEY'T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST50 NUMBER FIXTURE OR ITEM @ FEE OWNER WATER CLOSET 1.75 MAIL BATH TUB 1.75 ADDRESS (() SHOWER 1,75 CITY 2 TEL. NO LAVATORY 1.75 C ONTRAC TO SINK 1.75 ADDRESS DISHWASHER 1.75 CITY TEL. NO. CLOTHES WASHER 1.75 STATE LIC LICENSE NO. CLASS SWIMMING POOL RECEPTOR 1.75 DISTRICT NO. GROUP ON O;ES DBY LAWN SPRINKLER SYSTEM 1.75 O _lam WATER HEATER 1.75 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.75 O INSPECTION RECORD C? OUTLETS OVER p, 5 PER SYSTEM .30 O ' W CL N Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE' Plan check applicant . UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT City Tel. No. HOT WATER HEATER ewe) �N 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION16� •p[i AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSEDAS REOUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOV DESCRIBED RJEESID/EENTI P&T� FINAL SIGNATURE1!%�r��%�/ l OF PERMITT G "11WW-I/ PERMIT VALIDATIONCK. M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH n2 4 2- n nj 5 D 8254 76A667 (CE-617)- 3/73 � APPLICATIO ' FO/(R PL BINE •PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION NG MAKE CHECKS PAYABLE TO: BUILDING HARVEY T. BRANDT, COUNTY ENGINEER ADDRE LOCALITY_ FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST a NUMBER FIXTURE OR ITEM @ FEE CROSS ST.. ' i WATER CLOSET 1,75 G OWNER 7 J MAIL BATH TUB 1,75 ADDRESS q 5 / SHOWER 1,75CITY TEL. NO.,.j / LAVATORY 1,75 CONTRACTOR SINK 1,75 ADDRESS DISHWASHER 1.75 CITY TEL. NO.' CLOTHES WASHER 1.75 STATE LIC SWIMMING POOL RECEPTOR 1,75 LICENSE NO: CLASS LAWN SPRINKLER SYSTEM 1,75 DISTRICT NO. GROUP N P CES ED BY WATER HEATER 1.75 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD C) OUTLETS OVER 30 5 PER SYSTEM p CD U LJ d G7 Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 31 00 TOTAL FEE APPRJIVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER 'h Name ROUGH PLUMBING /f •da •�`�� Address GAS PIPING CityTel'. No. GAS VENT I H EBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER, AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES �7� � WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING . PLUMBING. GAS TEST 1 HEREBY CERTIFY 'THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REf1UI RED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCR�I/B'EED�R/EES/I DENTIAL ROPER TY. FINAL SIGNATURE �0P0 j.4a7.rry'✓ OF PERMITTEE PERMIT VALID cK�)M,o. CASH PLAN CHECK VALIDATION CK. M.O. CASH 3 6 16 5 'U 8.2 5 end WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I h�rekfy, ai4irrrt thatd,' have a certificate of consent to self in- z�26 DPW 4/90 sure,or a certificate of"Workdrs'Compensation Insurance,or a 76A667A certified copy thereof(Sec. 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 Certified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Dcite Applicant WATER CLOSET(TOILET), NEAREST ' CERTIFICATE OF EXEMPTION FROM WORKERS' • BATH TUB CROSS ST. COMPENSATION INSURANCE WNER SHOWER. L� (This section need not be completed if the work-involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK CITY TEL.NO. mit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. . DISHWASHER CONTRACTOR Date. Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY TEL.NO. sation provisions of the Labor Code,you must forthwith comp- ly with such provisions or this permit shall be deemed revok- JO STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSEb BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Cdde, and my license is in full force and of-' S PER SYSTEM FINAL VALIDATION fect. HOSE BIB DATE —tel ,OV y. License Number Lic. Class a FINALC Contractor Date BY V I am exempt under Sec. V B.$P.C. for"this reason Plan check fee ► CL Date: PLUMBING PERMIT ISSUING FEE$ " Signature TOTAL FEE SINGLE FAMILY HOME OWNER-BUILDER DECLARATIONPlan check applicant 3303 {}°s� I hereby affirm that I am exempt from the Contractor's License Name ITEM Law for the following reason (Section 7031.5,-Business and Professions Code): Address. TOTAL -59- 150 I, as owner of the property, will do the work and the City Tel. No. CHECK 59°50 structure is not intended or offered for sale.(Section 7044,. Business and Professions Code). Poo, 00 CONSTRUCTION LENDING AGENCY ° I hereby affirm that there is a construction lending agency for �QO�_��1 1/� /9h the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). 4437 1 AM $:44 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 Pool ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the ve mentioned property for inspection purposes. tune RP 6'�rtZ: � SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date '