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Home My Public Portal About5524 PAL MAL AVE_Plumbing__ 7SA667 ICE-BVI - 1/75 APPLICATION FOR✓ PLUMBING PERMIT {� COUNTY OF LOS ANGELES �J DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING _ MAKE CHECKS PAYABLE TO: ADDRESS HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST. _ NUMBER FIXTURE OR ITEM ® FEE WATER CLOSET 2.00 OWNER QjhAkL' MAIL BATH TUB 2.00 ADDRESS SHOWER 2.00 CITY TEL. NO. LAVATORY 2.00 CONTRACTOR IF SINK 2.00 ADDRESS DISHWASHER 2.00 CITY TEL. NO. CLOTHES WASHER 2.00 STATE LIC LICENSE NO. CLASS SWIMMING POOL RECEPTOR 2.00 DISTRICT NO.GROUP C7�1 N/@ PR SSED BY LAWN SPRINKLER SYSTEM 2.pp �—C)p r /` / _,.��..p�" WATER HEATER 2.00 INDUSTRIAL WASTE APPROVAL d GAS SYSTEM OUTLETS 2.00 INSPECTION RECORD OUTLETS OVER 5 PER SYSTEM .30 U N Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ TOTAL FEE APPROVALS DATE INSPECTOR S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS VENT HOT WATER HEATER - 1 HEREBY THAT TH LEGGE THAT HAVE READ THIS APPLICATION AMDWIT STATE TNAT TXE ABOVE IS CORRECT AND AGREE E COMPLY PLUMBING FIXTURES WITN ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. , — I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND IN ND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTI PROPERTY. FINAL SIGNATURE OF PERMITTEE � PERMIT VALIDATION CK. CA-H PLAN CHECK VALIDATION CK. M.O. CASH i 7 U 6 U MAY i v APPLICATION FOR PLUIVBING PER COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING S 5 /� JOHN A. LAMBIE• COUNTY ENGINEER ADDRESS WILLIAM A. JENSEN. SUPT OF BUILDING LOCALITY ifqNO. FOR APPLICANT TO FELL IN NEAREST CROSS ST.NUMBER FIXTURE OR ITEM EACH FEEWATER CLOSET 51.25 OWNEA �� MAIL RATH TUB 1.25 ADDRESSS /�RHOWEA1.25 Cin / /j/ r/c TLAVATORY 1.25 CONTRACTOR SINK 1.25ry DISHWASHER 1.25 Cln � TLAUNDRY TUB 1.25 REGSTRAYON NO. ATE CLOTHES WASHER 1.25 DISTRICT N . GR E PRD2E� SY WATER HEATER 1.50 J' GAS SYSTEM OUTLETSINDUSTRIAL } I]REGU"TING WASTE APPROVAL 0 O OUTLETS OVER 5 PER SYSTEM INSP Tt N RECORD V O u W N _ Z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT 00 UNDER SLAB WORK _ ROUGH PLUMBING TOTAL FEEGAS PIPING I HERESY ACKNOWLEDGE THAT I HAVE READ LICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT ANO COMPLY WITH ALL COUNTY OROINANCES AND STATE GULATING HOT WATER HEATER PLUMBING. I HEaEBY CERTIFY THAT I AMPROPERLY REANDIOR PLUMBING FIXTURES q LICENSED AS REQUIRED BY LOS ANGELES COUNSTATE OF GA$TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OTEND TORESIDE IN, THE ABOVE OESCRIBEO gEel NTIAL PRIIT LITY CO. NOTIFIEDAv SIGNATUREOF PERMITTEE LFINAL VALIDATION ROBERT A. WOOD CK. M.O. cwSH SUPERVISING MECHANICAL ENGR 4 4 0 6 5 D 6.2 5~ n woR at I have COMPENSATION DECLIRATION �DPW 9189 APPLICATION FOR PLUMBING PERMIT -I hereby affirm that I have •certificate of consent to Galt Insure or a certificate of Worker a Compensation Insurance, or a certified copy thereof(Sac 3800 Lab CPotky ) ./O - 90 �m�t..ir, COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS DEPT OF PUBLIC WORKS DIV p❑ Canif ed copy is hereby tarnished FOR APPLICANT TO RLL IN(PRINT OR TYPE) BUILDINGSSy j �f• �� CT Centrad copy b 84d with the county but ADDRESS department NUMBER FIXTURE OR ITEM 0 FEE L yv T Data �lT_ y Appl WATER CLOSET SEgy [ CERTIFICATE OF EXEMPTION FROM WORKERS / CROSS ST __ BATH TUB p O/ (This atetbn need notlpa eompatad H the �orR Involved by the SHOWER MAP BOOK O✓�O rp PAGE ^,O�I��D��`PARCEL�,2.� Permit h fw one hundred delan(8100)or low) LAVATORY cwNER ff --7►/wG/� I certify that In the performance of the work for which this permit Is Issued I shall not employ any person in any manner so as to SIM( ADORE38 ^f. /�'(� (lj�A/r}(,� become subfeci to the Workers Compensation Laws 'L'L�• dBWASHFA CT' _ TEL /��INO��7 Y/ a NOTICE TO APPLICANT If alter making this Certificate of CLOTHES WASHER IDONTRACTOR (20AA97 Exampbon you should become sub)eci to the Workers Compensation SWIMMING POOL RECEPTOR /a/6 provisions of the Labor Code you must forthwith comply with such ADDRESS provisions or this permit shall be deemed revoked LAWN SPRINKLER SYSTEM /�, �,s,.�,. LICENSED CONTRACTORS DECLARATION WATER HEATER CITY G✓ A ,&Ap er TEL NO (rT4.i3-j�7 a I hereby affirm that r am licensed under provisions of Chapter g(commencing with Section 7000)of Division 3 of the Business and GA8 SYSTEMOUTLSTATE NO -y 3 LIC C4Jr Professions Code and my license is In lull farce end effect OUTLETS OVER DISTRICT N6 PROCESSED BY S PER SYSTEM �. O Cisme Number •"r��.�. — LIc Cla® f" FINAL W contrwor � Data 7-2-71 DATE 12 Iq VALIDATION (L rn ❑ 1 am exempt under Sac FINAL Z By B 8P C for this rsenon Plan check tee ► Signature PLUMBING PERMIT ISSUING FEE$ 17 ❑ TOTAL FEE Z 6 SINGLE FAMILY Plan check aPPlIcant HOME OWNER BUILDER DECLARATION Name I hereby affirm that 1 am exempt from the Contractor a License Law _ for the following reason(Section 7031 8, Business and Professions Address _-„ J„-�•�. Code) City Tel No ❑ I as owner of the property will do the work erW the structure Is not Intended or offered for sale(Section 7041 Business 26 - 60 and Profmsioru Code) f iN=iJ L� CONSTRUCTION LENDING AGENCY 1 hereby affirm that there Is a construction lending agency for the y dL •-I- performance of the work for which this permit Is Issued(Sec 3087 CIV C) C' C-:CC 1 �7i rt Lecher's Nemo _ 4�14 ♦ Eft +':1. Lando•Address I certify that f have read this application and Hate that the above lot.Information b 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 Slpeture of Permittee Date WIDRKEW COMPENSATION DECLARATION 204M DPW 4/90 APPLICATION FOR PLUMBING PERMIT I fierel�y dFFirm'that Ihave a certificate of consent to aeti In- 7b1607A lure,or a caflificate of Workeis'Compensation Insurance,or o . certified copy thereof(Sec 3800, Lab C ) Policy Ad91168 Company Q* BundG COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS ❑ Certified copy u hereby furrit /— /—/� rtrfied c is filed with th c { FOR APPLICANT TO FILL IN(PRIM OR TYPE) BUILDING ry§•ponmenopy g inspection NUMBER FucruRE OR ITEM e P ff ADDRESS 5524 N. Pa1Ma1 A � Lovam Dats8/26 Appliiw t J WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKE BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER OWNER (This section need not be cemplea if the work Involved by the penult Is for one hundred dollars($100)or len) LAVATORY ADDRESS 1 certify that in the performance of the work for which this Per- mit n issued, I shall not employ any person in any manner so SINK CITY 8/4 48-896plo as to become subject to the Worker'Compensation Laws D15HWASHER TRACTOR Caliber H Dote Applicont CLOTHES WASHER NOTICE TO APPLICANT If, after making this Certificate of Ex- ADDRESS 18301 Irvine B1 emption you should become subject to the Waken'Compen- SWIMMING POOL RECEPTOR sonon provisions of the Labnr(-ode,you must forthwith comp- LAWN SPRINKLER SYSTEMS Dir T669-911NO ly with such provisions or this permit shall be deemed revok- STATE LIC ed WATER HEATER LICENSENo 589544 C2 0 CLASS LICENSED CONTRACTORS DECLARATION DISTRICT No PROCESSED BY I here affirm that I am licensed under OAS 5VSTEM by provisions the / 9(commenting with Section 7000)of Division 3 of the Buarross OUTLETS OM AL and Professions Code, and my license is in full force and of- S PER SYSTEM FINAL VALIDATION fact HOSE BIB DATE .Z >. License Number S A 9 5 d d Lic Clan r?0 C FINAL G Contractor CAT fiber Date 8,/26 BY j= 1 am exempt under Sec OI.- V B 8P C for this reason Plan check fee poll LU Dots PLUMBING PERMIT ISSUING FEE$ 5 Sgnoture TOTAL f$ SINGLE FAMILY s �` HOME OWNER BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's license Name Low for the following reason (Section 7031 3, Business and ACCT.A. Professions Code) AddressIs I, as owner of the property will do the work and the City Tel No 3307 39.30 structure is not intended or offered for sale(Section 7044 1 ITET15 Business and Professions Code) Poo.CONSTRUCTION LENDING AGENCY ry�ryr TOTAL 39.30 I hereby off um That there is o construction lending agency for *ECC 39.30 the performance of the work for which this permit is issued �LsAasr� ��rT (Sec 3097, Civ C ) VfV97VC .00 Lender s Nome Lender's Address 01 8/27/92 1 bcert,one that I recd this application and state that the ► 5712 1 AM 7:43 above mfor eon i correct I agree to comply with all County ordim nd jaws regulating Plumbing, and hereby author a pr t as regulating County to enter upon the above pr rty for inspect p rposes �([� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date