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Home My Public Portal About9665 OLIVE ST_Plumbing__ 76^667 Deg 17 11-50 APPLICATION FOR PERMIT DEPARTMENT OFNG AND SAFETY PLUMBING COIINTY OFF LOS LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IIT NLJ. N. DISTRICT D. Q L/I PLUMBER RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION ADDRESS +/ "7 ~-r/ BUILDING CITY TEL.No. ADDRESS r COUNTY LOCALITY LICENSE NO. EXPIRES NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER lkeg / , MAIL '2 19 ATER CLOSET(TOILET) @ 0.50 Q 0 ADDRESS 6 BATH TUB 0 D.5D �C CITY TEL No. SHOWER @ 0.50 1 HEREBY CKNOWLEDGE NAT 1 HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 i �'� AND AGREE TO OMPLY WITH ALLAPPLICATION AND STATE THATHABOVE IS CORRECT COUNTY ORDINANCES IT HEN SINK @ 0.50 SD AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB UDIDRY TUB OR TRAY @ 0.50 -rio ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY D ESCRI B EDCO- WATER OVVE. OAS SYBTEMOUTLETB 0.50 Q /G�li✓ M' /w/SIGNATURE OF • f HEATER @ 0.50 fl PERMITTEE_. M • . SLOP SINK @ 0.50 INSPECTION RECORD FLOOR BINK @ 0.50 T �� FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50 DRINKING FOUNTAIN Q 0.50 URINAL 0.50 HOUSE SEWER @ 0.50 MISCELLANEOUS 13 APPROVALS DATE IN13PE97ORIS NAME ROUGH PLUMBING OAS PIPING GAS VENT y� CESSPOOL 1:00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT . 1.00 GAS TEST �� a- G UTILITY CO.NOTIFIED ;7 �� O TOTAL FEE 16 FINALJj b""�"I WORKERS'COMPENSATION DECLARATION 76A667A •I hereby affirm that I have a certificate of consent to self cE e17(z-eo) APPLICATION FOR PL �J M B I N G PERMIT N insure,or a certificate of Workers'Compensation Insurance,or a ertifi�ad copy thereoff(Sec.3800,Lamb.C'.)^ COUNTY, OF LOS ANGELES BUILDING AND SAFETY " l icxo =" �l�bmpanll�'{�-- =_A Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUIL ING Certified copy is filed with the count building NUMBER FIXTURE OR ITEM • FEE ADDR SS j ��]]] g inspection , Dateart nt �,- _ WATER CLOSET NEARLUL;ATY �"��plican - �D ,a, �C: NEAR ST BATH TUB CROS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved LAVATORY MAIL ADDRESS vfa by the permit is for one hundred dollars ($100) or less.) } SINK CITTEL.NO D- I certify that in the performance of the work for which this DISHWASHER U permit is issued, I shall not employ any person in any manner CONTRACTOR so as to become subject to the Workers'Compensation Laws. A' P= CLOTHES WASHER ADDRESS Q Date Applicant SWIMMING POOL RECEPTOR go 75;_ .S- U NOTICE TO APPLICANT: If, after making this Certificate of CITY ® TEL.NO.2!4MIS` I1,J Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. tom!) Compensation provisions of the Labor Code, you must forth- LICI_NSE NO. � CLASS �= with comply with such provisions or this permit shall be WATER HEATER deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. PRO EBBED LICENSED CONTRACTORS DECLARATION OUTLETS OVER C.J r t/ 1 LIA I hereby affirm that I am licensed under provisions of Chapter 1 15 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL Ig VAL ATION ness and Professions Code, and my license is in full force and �J Si DATE effect. '��-�[/� License/N�urmbberM �.�-E�-/{•-ee- Lic.Class zvzplid 4S7i ateV��i'V Date 7— I am exempt from the licensing requirements as I am a Plan Check fee licensed architect or a registered professional engineer _'e acting in my professional capacity (Section 7051, Bus- PLUMBING PERMIT ISSUING FEE$ V inees and Professions Code). TOTAL FEE Lic.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION NamLD , C c I hereby affirm that I am exempt from the Contractor's Addres License Law for the following reason (Section 7031.5, Busi- Ciry _ Tel.N ness and Professions Code): I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State ws regulating Plumbing, and hereby authorize represent 1v of this County to enter upon the mentio p for inspection purposes. r Signatqffof Perml tee IL Date WORKERS'COMPENSATION DECLARATION, ` r APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) A or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES 7 - BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ElCertifiedcopy is filed with the county building inspec- ADDRESS f tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY _" C Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. f J It T 1J COMPENSATION INSURANCE OWNER InfI4/✓) , _HIggl) ,' F Cl/J (This section need not be completed if the work involved by SHOWER the permit is for one hundred dollars ($100)or less.) LAVATORY MAIL ADDRESS Pc 1 certify that in the performance of the work for which this isissued, I shall not em to an erson in an manner SINK CITY• -•�� TEL. NOP Y Y P Y - r 2Zrmit as o become subject to the Workers'Compensation Laws. DISHWASHER ` }}��-� CONTRACTOR Date/0 / J _9 -ZpplicantJr G � CLOTHES WASHER ,� NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS O1 ` '/,/,— p J) Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR CITY TEL. NO."/ 7 i Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM 'i '� with comply with such provisions or this permit shall be STATE �!� C / LIC. deemed revoked. WATER HEATE / 0^ LICENSE NO. .j 7 p Ir CLAS l LICENSED CONTRACTORS DECLARATION l l DISTRICT NO. P CESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLE S (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER /[ d and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FIN DAT SR I VALIDATION 0 License Number Lic. Class a Ix , O Contractor �V Date B U U Y W F1 �rJ ti. am exempt under Sec. H B.&P.C. for this reason ? Plan check fee 1111111.Date: PLUMBING PERMIT ISSUING FEE$ c Signature /`� � �_V__ TOTAL FEE 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 and State laws regulating Plumbing, and hereby �uthorize representatives of this County to enter upon the bove-mentionep roperty for inspection purposes. .V/ SEE REVERSE FOR EXPLANATORY LANGUAGE 7 Signature of Permittee Date WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) or a certified copy thereof (Sec. 3800, Lab. C. COUNTY OF LOS ANGELES BUILDING AND SAFETY 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 inspec- ADDRESS tion department. NUMBER FIXTURE OR ITEM t?a FEE LOCALITY Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE OWNER (This section need not be completed if the work involved by SHOWER the permit is for one hundred dollars $100 or less. MAIL P ( ) ) LAVATORY ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL NO. SO as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR ttJ Date . Applicant - CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR CITY TEL. NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER ; ..... LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO._f PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS i (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER d and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL VALIDATION O DATE V License Number Lic. Class -- W J FINAL W Contractor Date BY } I am exempt under Sec. Q tr B.BP.C. for this reason Plan check fee pill. a Date: w PLUMBING PERMIT ISSUING FEE$ 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 r^, t c 1 Law for the following reason (Section 7031.5, Business and .: Professions Code): City Tel. No. ♦ a ❑ 1, 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 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 Signature of Permittee Date