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Home My Public Portal About9915 OLIVE ST_Plumbing__ ►BAS67 APPLICATION FOR PLUM BING 'PER1!lIIT �Bs:n,o:ss �DMSION OF BUILDING AND SAFETY Deportment Of County Engineer County Of 1.08 Angeles BUILDING J � JOHN A.L.AMBIE. COUNTY ENGINEER ADDRESS /( CASSATT D,GRIFFIN,SUPT OF BUILDING L / LOCALITY FO LIC T TO FILL IN(Z NEAREST CROSS ST. ,�/iC3 ' OWNER DISTRICT NO. GROUP ZONE READY FOR INSPECTION MAIL / I ADDRESS INDUSTRIAL- CITY TEL.NO. WASTE APPROVAL PLUMBER dew2nr INSPECTION RECORD ADDRESS ti CITY /0.�L_*1 TEL.NO. l LICENSE NO. 0��w/L NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ S1.00 $ BATH TUB @ $1.00 / r SHOWER @ $1.00 LAVATORY (WASH BASIN) @ $1.00 4 KITCHEN SINK @ $1.00 DISHWASHER @. $1.00 LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 GAS SYSTEM @ $1.00 APPROVALS DATE INSPECTOR'S SIGNATURE U14DER SLAB WORK ^ _ PERMIT $ 1 ,00 ROUGH PLUMBING GAS PIPING TOTAL FEE 0 GAS VENT 1 HEREBY ACKNOWLEDGE THAT i HAVE'READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE.ABO.VE IS CORRECT AND. AGREE TO COMPLY .. p WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST U k LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND S ATE OF CALIFORNIA OR THAT I A THE LEGAL NER OF ABOVE UTILITY CO.NOTIFIED' ^� 1 Q n - DESCRIBED RESIDENTIAL ROOPERTY. �-I IGNATURE SOF PERMITTEE FINAL OHN A.LAMBIE.COUNTY ENGINEER VLID AATION ROBERT A.WOOD.CHIEF PLBG. INSPECTOR es. M.o. CASH 2-277:8 EV13 3 8.00 � S. rORKERS'COMPENSATION DECLARATION c � 20-0026 DPW 4/87 APPLICATION FOR PLUMBING PERMIT hereby, affirm that I have a certificate of consent to self in 76A667A ,.. • vT or a certificate of Workers'Compensation Insurance,ora CE 817(REV.8/86) ice ti !) copy tthereof (Sec. 3800, Lab. C.) Policy No. Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS qa( OE AVE, department. NUMBER FIXTURE OR ITEM Oa FEE LOCALITY Date Applicant WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUBIf'ZCROSS ST. P► LDWIN COMPENSATION INSURANCE SHOWER OWNER 614 (This section need not be completed if the work involved by MAIL the permit Is for one hundred dollars($100)or less.) LAVATORY ADDRESS 5,06 I certify that in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so CITY TEL. NO 81g Q as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR QGc� Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY TEL. NO. safion provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I..am licensed under provisions of Chapter GAS SYSTEM OUTLETS -5—L 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER —� and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL7 �p VALIDATION a fect. DATE '<� License Number Lic. Class V FINAL Contractor Date BY O H I am exempt under Sec. C. B.&P.C. for this reason Plan check fee CO) Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant _ I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and ACCT.0 Professions Code): Address 31-107 .513 61 A-5 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, 1 IT j_ ' Business and Professions Code). ® 5 35- 50 CONSTRUCTION LENDING AGENCY CHECK �L`6� I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued .tTl (Sec. 3097, Civ. C.). Lender's NameLl._l0r;_�l0l.� a/f ,(,.- Lender's Address 5796 p�; 1 certify that I have read this application and state that the U t� above information is c rrect. I agree to comply with all County , or antes nd Sta e I ws re luting Plumbing, and hereby orl7e prese i es t is County to enter upon the o r f r inspection purposes. 2^2(o"gI�_ SEE REVERSE FOR EXPLANATORY LANGUAGE Signature ermitte Date WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT • "off 76A666 DPW 4/87 • I herelly, irm that I have a certificate of consent to self in- 76A667A sure,or a certificate of Workers'Compensation Insurance,or a CE 817(REV.8/86) cerDled copy thereof(Sec. 3800, Lab. (ft.) Policy No. Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS 4 Certified copy is hereby furnished. Certified co is filed•with the count building p FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Llv Ei copy y gins inspection NUMBER FIXTURE OR ITEM ADDRESS ' department. @ FEE LOCALITY Date Applicant WATER CLOSET(.TOILET) NEAREST ' CERTIFICATE OF EXEMPTION FROM WORKERS' SS �) BATH TUB CROST. COMPENSATION INSURANCE SHOWER OWNER M ® V (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so CITY TEL. NO. as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of Ex- ADDRESS SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CIN TEL. NO. sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. ROCESSED BY I hereby affirm that I.am Licensed under provisions of Chapter GAS SYSTEM OUTLETS • r/ 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER d and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION >_ fect. DATE License Number Lic. Class FINAL Contractor Date BY' O - F- am exempt under Sec. W CIL B.&P.C. for this reason Plari check fee oil.Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE SINGLE FAMILY Plan'check applicant HOME OWNER-BUILDER DECLARATION PP I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and . p:1 Q L Professions Code): Address {.}jj[[ f{f{ 050�{ ' ' I, as owner of the property, will do the work and the City Tel. No. VV177 020 structure is not intended or offered for sale(Section 7044, f ITEMS Business and Professions Code). , TTL 20 .50 CONSTRUCTION LENDING AGENCY / .� ls 1j I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued CHANGE �IJU (Sec. 3097, Civ. C.). ; Lender's Name 0000-0110 3/14119 1 Lender's Address 6072'7 • o I certify that I have read this application and state that the 1 "AN ID 19 above information is correct. I agree to comply with all County , or ' antes and State laws reg ting Plumbing, and hereby ou rize r prese ves o i+; County to enter upon the e-m inspection purpose In �lp4�Q p SEE REVERSE FOR EXPLANATORY LANGUAGE Sig ermittee Date