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Home My Public Portal About9218 PENTLAND ST_Plumbing__ 75A557�851T 11-50 APPLICATION FOR PERMIT DEPARTMENT OFNG AND SAFETY COUNTY OFF LOS LOS ANGELES WILLIAM J FOX. CHI[f ENGINEER PLUMBING 1 MIT NEI. Ulu Oup �F+OR APPLICANT TO FILL I�N,y.�,T z s — � PLUMBER E"/L __T-✓• EIVED BY READY FOR DATE�'WED ADDRESS �ny5 FIRST INSPECTION —/CITY TEL Ndf`_ a y -1 G BUILDING ADDRESS G COUNTY N / 9 0 v EXPIRES U J LOCALITY CENB NEAREST PERMIT FEES CROBH HT NUMOZR TYpc or Fl%TIRf OR ITEM FEE OWNER MAIL WATER CLOSET(TOILET) a 050 S ADOREBB 3o BATH TUB 050 CITY TEL, NR 1 SHOWER a D Bo 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) a 050 APPLICATION AND STATE THAT THE ABOVE IH CORRECT AND AGREE TO COMPLY WITH ALL COUNTY OROMANCES KITCHEN SINK 030 AND STATE LAMS REGULATING PLUMBING 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY O s0 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER GAB SYSTEM OUTLETS ® 050 OF THE RESIDENTIAL /P OPE BC�RR1(B/jD ABOVE WATER HEATER 050 SIGNATURE:FERMI' / SLOP BINK o so INSPECTION RECORD FLOOR BINK 0 D 30 FLOOR DRAIN ® 050 DISHWASHER ® 050 DRINKING FOUHTAIN ® 050 URINAL 050 J a HOUSE SEWER ® O 30 Z MIBCEL EOUB 0 a �V G 0 APPROVALS DATE INEPEOlOR'll NAME ROUGH PLUMBING GAS PIPING 'rY GAB VENT 2 CESSPOOL ® lO0 CESSPOOL SEPTIC TANK SEPTIC TANK DRAIN ( ) PIT ( ) 1 DO SEWER PERMIT 1 OD GAB TEST UTILITY CO NOTIFIED TOTAL FEES SO FINAL TCA067-CER617 1062 APPLICATION OR PLUMBING PERMIT COUNTY OF LOS'ANGELES DEPARTNIENT OF COUNTY ENGINEER auaDrnc J BUMDING AND SAFETY DIVISION - ADDpFNQ JAT2- STATE JOHN A LAMBIE COUNTY ENGINEERWILLIAM A JENSEN SUP T of BUILDING LOCALITY I'FOR APPLICANT TO FILL. IN NEAREST CROSS STNUMBER FIXTURE OR ITEM EACH FEE / OWNER DWATER CLOSET $125 1y MAILBATH TUB 125 ADDRESSSHOWER 125 f y CITY TEL NO LAVATORY 125 1 CONTRACTOR %10NTEREY PARK PLUMSING 125 ADDRESS 410 SO GARFIELD DISHWASHER 125 Cm MONTES NLAUNDRY TUB 125 EGIS�TRATION NO I O CTOR S CLOTHES WASHER r 125 DISTRICT NO GROUP ZONE WATER HEATER 1 50 GAS SYSTEM If OUTLETS 150 INDUSTRIAL y ,WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM 00, INSPECTION RECORD T U o d z An ' AP,PRO_VALS DATE INSPECTOR 55IONATURE • PERMIT 2 00 UNDER, WORK ,aka ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY,ACKNOWLEOGE THAT 1 HAVE READ X19 AF LIGATION GAS VENT °AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED RY L09 ANGELES COUNTY AND STATE OR GAS TEST CALIIORNIA'OR THAT 1 A THfi LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DE R19EO EIDENTIAL PROPERTY UTILITY CO NOTIFIED SIGNATURE OF PERMITTEE FINAL -- DATION ROBERT ROBERT A WOOD ( c� M D CASH SUPERVISING MECHANICAL ENG R �,1i o 7 5 5`F12 JUL 16 5 D 725- d WORKERS'at I have a ION DECLARATION CE4". APPLICATION FOR PLUMBING PERMIT-, _ {� I hereby affirm that I have a certificate of consent to self Ice m (z-ea) L.I ,Insure, or a certificate of Workers'Compensation Insurance,or Y a certified copy thereof(Sec 3800 Lab C) /J r e COUNTY OF LOS ANGELES \ BUILDING AND SAFETY Policy No T Company - Certified copy is hereby furnished FOR APPLICANT TO FILL IN (PRINT'OR TYPE) BUILDING ADDRESS Certified copy isfiled with the county buildinginspection NUMBER FIXTURE OR ITEM, • FEE - department LOCALITY WATER CLOSET Date Applicant NEAREST BATH TUB CROSS ST ' CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER ` LAVATORY r MAIL (� (This section need not be completed if the work involvedADDRESS } by the permit ts for one"dollusB(1) o[ Ie36) SINK CITY,T TEL NOZN7O I'certify that in the perforr which this DISHWASHER U'permit is issued I shall notany manner CONTRACTOR +so a�AoAo bb0lrg7ub)ect toatlon Laws CLOTHES WASHER ADORES 2Q31 S, Dat N UVAppin:an SWIMMING POOL RECEPTOR i U i NOTICE TO APPLICANT If after making this Certificate of CITY TEL NO Exemption you should become subject to the Workers' LAWN SPRINKLER SYSTEM ° STATELIC N Compensation provisions of the Labor Code„you must forth WATER HEATER LICENSE NO CLASS - Z 'with comply with such provisions or this permit shall be - deemed revoked GAS SYSTEM OUTLETS DISTRICTNOPR CESSED B LICENSED CONTRACTORS DECLARATION, OUTLETS OVER 3, Or y. I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with,Sectmn 7000) of Division 3 of the Busl FINAL VALIDATION ness and Professions Code and my license is in full force and DATE effect License Numhe� Lic Class �� r FINAL \r 1 ''') �,IyO� BYcc Contractor`1 L Date 7 _ L2 v 1 - 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$ d U q_(6 acting in my professional capacity (Section 7051 Bus n e mess and Professions Code) TOTAL FEE �" Sl, Lic or Reg No Date Plan check applicant HOME OWNER-BUILDER DECLARATION Neme I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section 7031 5 Busl City - Tel No ness and Professions Code) I ' - 34 I, as owner of the property, am exclusively contracting 1 3'8 A a >` with lu.ensed contractors to construct the project ' (Sectaon,7044 Business and Professions Code) •t• 5 r r j 'CONSTRUCTION LENDING AGENCY _ ., . 2 r�1• 1 2 5 O'� - I hereby affirm that there is a construction lending agency , for the performance of the work for which this permit is _ r 1 2 50 issued (Sec 3097 Civ C) Lender's Name - x;527-82 `'_ Lender's Address I certifyttN I have read this application and state that the abov r orm ion is correct 1 agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE - ordi n s an State ws regulating Plumbing and hereby auth +epr a r of this County to enter upon the , 0 on d o y for inspection purposes j- gn tore o Permittee Date � ' WORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT /7 Lhera a certificate that have a certificate of consent r self 720 00266A667 DPW 8/87 I ^insure ora certificate of Workers Compensation Insurance 76A667A U or a certified copy thereof (Sec 3800, Lab C I ,1L COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS Policy No lq 21 Compony 5+ +e �' " ' ❑Certified copy is hereby furnished ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDINGqq Certified copy is filed with the county building inspe< ADDRESS 2-J y e N • tion depart IT b nt NUMBER FIXTURE OR ITEM � @ FEE f/b n�V LOCALITY Dote Applicant y WATER CLOSET fhAREST r CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB CROSS ST E JAG i" COMPENSATION INSURANCE OWNER M +&AEUG E N C O A N1CI_S (ThSHOWER the permit I need not be completed lla Ff ffio work involved by • MAIL - ,A. the certify th t for one hundred cellon e woo or less ) LAVATORY ADDRESS w1 I certify that in the performance of the work for which-this l ^ p permit is issued I shall not employ any person in any manner SINK CITY I L Y, `�c Gr TEL NO ftp 1.- O`J so as to become subject to the Workers Compensation Laws DISHWASHER n CONTRACTOR 2 ..11 C�' yts 4, A- DoteApphcant CLOTHES WASHER O ADDRESS �T e�y�pyL-`. ytV G NOTICE TO APPLICANT If after making this Certificate of SWIMMING POOL RECEPTOR L Exemption you should become subject to the Workers 1 \ Compensation provisions of the Labor Code you must forth LAWN SPRINKLER SYSTEM CITU �\ _A d D( c TEL NO 63�4a with comply with such provisions or this permit shall be STATE q !7 deemed revoked G' O LICENSE NO � I 0 32 CLASS C WATER HEATER LICENSED CONTRACTORS DECLARATION s-, DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 ( GAS SYSTEM OUTLETS (/ O (commencing with Section 7OD0) of Division 3 of the Business OUTLETS OVER yy and Professions Code,and my license is in full force and effect 15 PER SYSTEM FINAL VALIDATION a License Number S ! 0 If 3 "—Lic Class DATE a Q FINAL T.A- `L. 5ssel b 9� BY O Contractor Dote o ❑ 1 am exempt under Sec / U W B 8P C for this reason ILI Plan check fee // ► Z Date PLUMBING PERMIT ISSUING FEE$ r0 O Signature TOTAL FEE SINGLE FAMILY Plan check applicant = HOME OWNER BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor s License Address H,CCT.t Lowrfor the following reason (Section 7031 5, Business and Professions Code) City Tel No -��s7 C_r,Qi_ ❑ 1, as owner of the property will do the work and the structure is not intended ar offered for sale (Section 7044 Business and Professions Code) , 101 HL 65 - 00 CONSTRUCTION LENDING AGENCY LHE K I hereby affirm that there is a construction lending agency for the performance of the work for which This permit is issued CKNIiE Oct (Sec 3097, Cry C ) Lenders Name [IflQil"-�jQ}1 1UI i�/`/1 Lender s Address' •�cl j 1 r1t l _ I ft I certify that I hove read this application and state that the , above information is correct I agree to comply with all County crdmonc State jaws regulating Plumbing and hereby out ¢e repro tatives of this County to enter upon the abo mentioned erty for inspection purposes 56 SEE REVERSE FOR EXPLANATORY LANGUAGE _ Signature of Permlitee Doti -