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Home My Public Portal About9533 PENTLAND ST_Plumbing__ .J A ' `➢ewEeTn Ice Ene) t the lj'L APPLICATION FOR PLU'M�BING .PERMIT BUILDING A D SAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT OR TYPE) L BUILDING ` 9533 PF.NTLAND ST NUMBER FIXTURE OR ITEM ® FEE ADDRES �1t�e]��+ WATER CLOSET .LOCALITY 'I P'lN'1C 1 1'. CITY NEAREST - BATHTUB CROSS ST �A SHOWER +OWNER OJIVEZ, PAUL LAVATORY MAIL 5+ + ADDRESS SINK CITY TainE CITY TEL No 285-2841 DISHWASHER - CONTRACTOR TRANE HCC CLOTHES WASHER ADDRESS 2034 N. PECK RD SWIMMING POOL RECEPTOR CITY SO ELA= TEL NO 579=7982 (AWN SPRINKLER SYSTEM STATELIC WATER HEATER LICENSE NO 265094 CLASS rGASSYSTEMr OUTLETS DISTRICT NO GROUP E P SSED B 55 PERESYSTEMR_ J c ` INDUSTRIAL WASTE APPROVAL 0 O INSPECTION RECORD V cc O d N Plan check fee Z PLUMBING PERMIT ISSUING FEE E TOTAL FEE 540 Plan check applicant APPROVALS DATE INSPECTOR SSIGNATURE Name UNDER SLAB WORK Address ROUGH PLUMBING City Tel No GASPIPING A za CIL I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT 26— THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE uwS REGULATING PLUMBING HOT WATER HEATER 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES - FEOUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY _ UTILITYCO NOTIFIED , SIGNATURE ' OF PERMITTEE 71 FINAL PLAN CHECK VALIDATION CK mo CASH PERMIT VALIDATION CK MID CASH ^2,4 6ti'iL6 ;U.0 b D 7_/.J U ebb Ss I Q� °A°°' APPLICATION FOR PLUMBING PERMIT DeB IT)�DIVISION OF BUILDING AND SAFETY Department of County Engineer County of Los Angel" BUILDING WM J FOX COUNTY ENGINQHR 111R155 CASSATT D GRIFFIN SUP T OF BUILDING J LOCALITY �i FOR APPLICANT TO FILL IN NEARER SS ST L l E OWNER AH .F m/ DISTRICT NQ- I GROUP I ZONE READY FOR INSPECTION MAIL (�r/ ADDRESS INDUSTRIAL CImE:9TkTEL NO WASTE APPROVAL PLUMBER INSPECTION RECORD ADDRESS IF LI CP/e 'J L r, . CITY TEL NO AlfrAl v LICEN E NO NUMB[RTYP[OF PINTURQ OR ITEM PEC WATER CLOSET (TOILET) s 00 BATH TUB _ SHOWER O LAVATORY (WASH BASIN) _L KITCHEN SINK DISHWASHER _ LAUNDRY TUB OR TRAY �Q CLOTHES WASHER TOTAL NO 0 080 1212 APPROVALS — ATED INSPECTO S SIGNATURE GAS BYSTEM_3--OUTLETS 0 100 A UNDER SLAB WORK -I • ..,,� c/ WATER HEATER ® 1 00 ,Z QQ ROUGH PLUMBING 0 lb r� PERMIT S I t 00 GAS PIPING TOTAL FEE 00 GAS VENT 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 REGWLATING PLUMBING FIXTURES II 71 PLUMBING V I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REOUIRED B LOS ANGELES COUNTY AND TATE OF UTILITY CO NOTIFIED CALIFORNIA OR THAT NpP/THE LEGAL OWNER OF ABOVE DESCRIBED RES I DENT] .PR ERTY SIGNATURE (/// OFPERMITTEE FINAL IZ ^'� WILLIAM J FOX COUNTY ENGINEER VALIDATION 9_8 0 2 AU.31 3 900 to BY r DEPUTY WORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby offvm that I have a certificate of consent to self m 0'0 1026 DPN 4190 sure or a certificate of Workers Compensation Insurance,ora '76A667A cerffied copy thereof (Sec 3800 Lab C ) Policy No Company COUNTY OF LOS ANGELES " ' DEPT. OF PUBLIC WORKS t Certified copy is hereby furrnshed / ❑ Certified copy is filed wFOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDINGwith the the county budding inspection department NUMBER FIXTURE OR ITEM ,®/ FEE LOCALITY Date Applicant WATER CLOSET(TOILET) 7 _ NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER WNER L(UL /NC 2,.._ r (This section,nwd not be completed If the work Involved by J ) ADDRESS 9f 3MAIL 3 �r vT< .✓� the Permit Is for one hundred dollars($108 or loss LAVATORY ' I certify that m the performance of the work for which this per mi `� a S_1 Qlri t is issued I shall not employ any person in any manner so SINK CITY T,E/fJ r[E TEL NO o T! as to become subject to the Workers'Compensation Laws DISHWASHER CONTRACTOR Data Applicant CLOTHES WASHER - ADDRESS NOTICE TO APPLICANT If after making this Certificate of Ex- SWIMMING POOL RECEPTOR emphon you should become subject to the Workers Compen- CITY TEL NO sahon provisions of the Labor Code you must forthwith comp LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok STATE LIC ed I WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM yOUTLETS D p 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER O and Professions Code and my license is In full farce and of 5 PER SYSTEM FINAL - VALIDATION fect HOSE BIB DATE - >_ License Number Lic Class // C c l FINAL p Contractor Date _ _ BY ❑ I am exempt under Sec /t U B 8P C for this reason _ Plan check fee O� , N Date PLUMBING PERMIT ISSUING FEE$ nlll .i Signature � _ TOTAL FEE d - SINGLE FAMILY -U= r4.1!I HOME OWNER-BUILDER DECLARATION Plan check applicant 1—E FLS I hereby affirm that I am exempt from the Contractor s License Name _ _ L Law for the following reason (Section 7031 5 Business and f T�ITf-jam .+.;-;. 10 Professions Code) Address ' I, as owner-of the property will do the work and the City Tel No structure Isnot intended or offered for sale(Section 7044 _ CH_,'�'.E Busmess and Professions Code) ' CONSTRUCTION LENDING AGENCY ► i'I'�4i_r�il}((i - y;y1,Cc I hereby affirm that there is a construction lending agency for _ I the performance of the work for which this permit is issued i I[I:cS 1 f+, _ :77, (Sec 3097 Civ C ) , I ` Lender s Nome 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 ord'nonc and State laws re ting Plumbing and hereby author a epresentahv s County to enter upon the abov phoned r e y or sprgcbon purposes - LF_ Z�_CSEE REVERSE FOR EXPLANATORY LANGUAGE 'gnature of Permittee Date `