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Home My Public Portal About5337 PAL MAL AVE_Plumbing__ 76AG69-CM17-2.57 APPLICATION FOR PLUMBING PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS J .3.3 qCOUNTY JOHN A. LAMBIE. COUNTY ENGINEERCASSATT D. GRIFFIN. SUPT OF BUILDING LOCALITYFOR APPLICANT TO FILL IN NEARESTCROSS ST.NUMBER FIXTURE OR ITEM \�S�P�OWNER« YVAAAq WATER CLOSET MAILBATH TUB ADDRESS `3PSHOWERCITY TEL.LAVATORY CONTRACTOR SINK ADDRESS DISHWASHER CITY TEL.LAUNDRY TUB CONTRACTOR'S REGISTRATION NO. CLOTHES WASHER DISTRICT NO. GRO ZONE READY FOR INSPECTION WATER HEATER `� GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPE TION RECORD r • L / L L S - A P /VACS' @ $1.00 PER ITEM DATE INSPECTOR'S SIGNATURE OR FIXTURE S DO UNDER SLAB WORK ROUGH PLUMBING PERMITS 1 00 GAS PIPING TOTAL FEE O GAS VENT I I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES PLUMBING. 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO. NOTIFIED DESCRIB'-D RESIDENTIAL PROPERTY. (� SIGNATURE 4 OF PERM ITTEE "A FINAL J ROBERT A. WOOD. a LIDATION SUPERVISING MECHANICAL ENG'R O, CASH �� i,T,01703OR JUN 10 3 A 3.00 TSAees n e-EO 0!) APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTO. GROUP ZONE � I Al PLUMBER EIVED BY READY1R DATE ISSUED [[ FIRST INSPECTION J /X ADDRESS I :�, E. Vv 6-,, B ILD'NG CITY TEL. NO. ADDRESS i COUNTY ` LOCALITY Z LICENSE NO. ' EXPIRES NEAREST PERMIT FEES CROSS ST. NUMBER MAIL TYPE OF FI%TURE OR ITEM FEE OWNER d -xW WATER CLOSET (TOILET) ® 0.50 S ADDRESS BATHTUB ® 0.501 CITY TEL. NO. , SHOWER @ 0.501 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) ® 0.50 APPLICATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ 0.50 STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY Q 0.50 ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. I GAS SYSTEM--l—OUTLETS Q 0.501 SIGNATURE OF - WATER HEATER ® 0.50 PERMITTEE -T— SLOPSINK 0 O.So _ INSPECTION RECORD FLOOR SINK a 0.501 FLOOR DRAIN a 0.50 DISHWASHER Q 0.501 DRINKING FOUNTAIN0.50 URINAL �4 0.90 J HOUSESEWER Q 0.901 I Q _ Z_ MISCELLANEOUS U' O APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL Q 1.00I CESSPOOL J SEPTIC TANK: I SEPTIC TANK DRAIN [ ) PIT f 1 ® 1.00 SEWER PERMIT . 1.00 GAS TEST UTILITY CO. NOTIFIED TOTAL FEE 5 EE I FINAL APPLICATION FOR PERMT DEPARTMENT OF BUILDING AND SAFETY ' COUNTY OF� ANGELES IS 2394 PLUMBING!L'' ROUGH FDITURtl COMPLETE J/ � igT 3 NEATER COSPOOL E�►IC TAME a IV/m� � /p1�TEADY FOR DATE�ED Id-Ir � - APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY NAME Harr E. Deem DDRMM 1 Pal Mal R ADoRtls 01 S. Ho LOCALITY Temple Cit Calif. a Cm El Monte TEL.No.FD 861 crtw�i n Freer COUNTY CENT No IEEE NAME F. M Burkett LOCATION OF SEPTIC TANS, OR CESSPOOL wcoREEE e NORTH CITY 1 AM THE LEGAL PO ROGON OP THE AE01/E LOS ANGELES COUNTY COMPICATE ► UALIFI 1. Ss 1 AN THE LEGAL OWNER OF THE F PORP DEOCIUB® ASOVE. owwo CORRECTIONS SOUTH DESCRIPTION OF WORK z TN TUB, �'RNwcs HOWOI SH WASHER C ae YATORY X REP'R IOOIATOR KITCHEN SINK WATER SOPTOIER SINK SAND TRAP SINK ^^R DRAIN WASH TRAY "RIMAL APPROVALS WATER CLOSET ^RINKING FOUNTAIN OATS IRpR6 -s MAlIE WATER NEATER DENTAL LAVATORY ROUGH PLUMBING ETER GAS SODA VOUNTAIM GAS PIPING OUT! GAS VOfT / CESSPOOL TOTAL NUMBER OF FDITURES C'U SEPTIC TANK tlGPCC WVTIC TANK SEWER S UTILITY CO NOTIFIED TOTAL FEB 1 U S OO NA - WORKERS'COMPENSATION DECLARATION raAasrA I hereby affirm that I have a certificate of coaisent to .cif- C914117(240) APPLICATION FOR PLUMBING PERMIT Inure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec 3800,Lab C) COUNTY OF LOS ANGELES Tf BUILDING AND SAFETY Policy No Company C3 Certified copy n hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING 32 /J ❑ Certified co NUMBER FIXTURE OR ITEM • FEE ADDRE copy o filed with the county building Inspection / department LOCALITY LC C WATER CLOSET Date Applicant NEAREST BATH TUB CROSSST OL VE CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER (This section nixes not be completed if the work involved MAIL ed ADDRESS —72 G� 3 by the permit is for one hundred dollars ($I00) or less.) SINKQj CIT TEL NO 1 certify that In the performance of the work for which this DISHWASHER CONTRACTOR 0 permll n Issued, I shall not employ any person In any manner OF Yso as t b=71—me come ject to the orken'Com uti asys� r CLOTHES WASHER ADDRESS S" L L U _Dat 7 Applicant � SWIMMING POOL RECEPTOR NOTICE TO APPLICANT after making this Certificate of CITY TEL NO / 22271 Exemption you should become subject to the Workers LAWN SPRINKLER SYSTEM STATE LIC Compensation provisions of the Labor Code, you must forth WATER HEATER LICENSE NO CLASS with comply with such provision or this permit shall be deemed revoked GAS SYSTEM OUTLETS DISTRICTll, PR ESS60 BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER J I hereby affirm that 1 am licensed under provisions of Chapter B PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the BuaaFINAL VALIDATION nese and Profession Code, and my license Is in full force and DATE effect FIN A Licenu Number Lac ClassBY Contractor Date I am exempt from the licensing requirements as I am a Plan Check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE f f acting in my profession) capacity (Section 7051 Bn mess and Profession Code) TOTAL FEE �j so Lic or Reg No Date Plan check applicant HOME OWNER BUILDER DECLARATION Name ✓ /ff, 1 hereby affirm that I am exempt from the Contractor's Address �- License Law for the following reason (Section 7031 5 Boil Clty !,E (:Z/4 Tal No D—r/ �ne-ssy and Professions Code) .2 1 u.j P 1, as owner of the property, am exclusively contracting T with licensed contractors to construct the project k • •.• • (Section 7000,Business and Profession Code) 2'• • 1 650 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency • • • ) 6 5 C ns. for the performance of the work for which this permit is issued(Sec 3097 Civ C 1201 —8 ) Lender's Name Lender's Address 1 certify that 1 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 laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above mentioned property for p tion purpotes — gntum of Permittee Date