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Home My Public Portal About5214 PERSIMMON AVE_Plumbing__ 7OM67-CE617 6-60 APPLICATION FOR PLUM ING PERMIT � RTFOENDEPAS OLOS EER BUILDING AND SAFETY DMSION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS ' WILLIAM A.JENSEN.SUPT OF BUILDING BE LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM / OWNER WATER CLOSET KAM BATH TUB ADDRESS J CITY TEL.NO. SHOWER LAVATORY CONTRACTOR /6. -4'j avz•x' SINK ADDRESS / r`• DISHWASHER CITY TEL NO. CONTRACTOR'S STATS LAUNDRY TUB REGISTRATION NO. 0 Z 2 COUNTY CLOTHES WASHER DISTRICT SIO. l'ofoup I ZONE I PRCESSED BY WATER HEATER GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD 0 $1.00 PER ITEM J OR F crURE $ I J APPROVALS PATE/r-l. SP.ESXOR'S SIGNATURE PERMIT $ E 00 UNDER SLAB WORK TOTAL FEE ROUGH PLUMBING '�v GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER I HEREBY.CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTER ' FINAL 7Jr VALIDATION ROBERT A.WOOD, `.0, c.z SUPERVISING MECHANICAL ENG'R l��g 5 1 6 Ju 13 �, j 5D 3.0 0 COUNTY of Los ANGELES APPLICATION FOR PERMIT Department of Engineer DIVISYON OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer PLUMBING 1 FOR APPLICANT TO FILL IN DISTRI.CT NO. GRO PO E PERMIT INLI. .5000" M 6 "r PLUMBER RECEIVED BY READY FOR DATE ISSUED LEVARD PLUMBING RST INSPECTION CO.. ADDRESS `r ST VALLEY SUILDINM J CITY BT _go. ADDRESS / v COONAT. 2-2719 LOCALITY gelLICE SE NO.---- EXPIRES 6-•30- CROSS ST. PERMIT FEES NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER 4 �� MAIL WATER CLOSET(TOILET) @ 0.50 a ADDRESS BATHTUB Q 0.50 CITY TEL. No. SHOWER 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN BINK tR 0.50 AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER OF THE RESIDENTAAL PROPERTY DEBCRISEDVE. GAS SYSTEM OUTLETS @ 0.50 a w,>�r SIGNATUREQF �„p�+•p -„ - WATER HEATER @ O.SO PERM, E SLOP SINK @ 0.50 INSPECTION RECORD FLOOR SINK 0.50 FLOOR DRAIN 0.50 DISHWASHER 0.50 DRINKING FOUNTAIN Q 0.50 URINAL ® 0.50 J Q HOUSE SEWER a 0.50 _Z MISCELLANEOUS .� G 4 led O APPROv 's ' D E INBPECTOR•8 AME ROUGH PLUMBING r CO GAB PIPING OAS VENT CESSPOOL 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) 1.00 SEWER PERMIT 1.00 GAS TEST UTILITY CO.NOTIFIED n / TOTAL FEE $ � 19- FINAL ��C e. 7GA667 DBS#17 6-58 - i COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY PLUMBING WILLIAM J. FOX, County Engineer FOR APPLICANT TO FILL IN DISTRICT •D. GROUP I ZONE � ��4�7��'1� PLUMBER BOULEVAM 1 RECEIJM'l�v FIRST INSPECTION D READY FOR �Is- PsBUED ADDRESS U LLEy , 'aha BUILDING CITY ,+ TEL No. ADDRESS COUNTY LOCALITY LICENSE N0. AR M EXPIRES NEAREST PERMIT FEES CROSS 9T. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL ZIBATH CLOSET(TOILET) a 0.50 ADDRESS UB a 0.50 CITY TEL No. R a 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS RY (WASH BABIN) 0 0.50 APPLICATION AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES N BINK a 0.50 AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB LAUNDRY TUB OR TRAY a 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE -LEGAL OWNER GAS BYBTEM CUTLETS a 0.50 OF THE RESIDENTIA PROPERTY DEBORIBED ABV. SIGNATURE OF WATER HEATER a 0.50 PERMITTE - SLOP BINK a 0.50 INSPECTION RECORD ff FLOOR SINK a 0.50 FLOOR DRAIN a 0.50 DISHWASHER a 0.50 DRINKING FOUNTAIN a O.SO URINAL. a 0.50 Q HOUSE SEWER a 0.50 _Z MISCELLANEOUS 2 a 0 APPROVALS D 'E IN9PE0TCR•3 NAME ROUGH PLUMBING AA /S�y GAS PIPING GAS VENT CESSPOOL a 1.00 CESSPOOL SEPTIC TANK., SEPTIC TANK DRAIN ( ) PIT ( ) Q 1.001 1 SEWER PERMIT • 1.00 GAS TEST / TOTAL FEE CJLO UTILITY CO.NOTIFIED //��!' ✓/� 76A667 DBS#17 6-5E 761{667-CE817 12/59 TEMPLE CRTY APPLICATION FOR- PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY .ENGIAl NEER FTEL. B�IILDING AND SAFETY RIVISION BEING 0W A. L.AMBI COUNTY N %%t ADDRESS.WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEp g$ST. NUMBER FIXTURE OR'ITEM ' owNEaZ/a gWATER CLOSETADDRESS 1 yo& RATE RUR CITY M NO . — " ,s- SEOWER CONTRACTOR P -14 S G LAVATORY SINS ADDRESS` ) O Y! DISHWASHER CITY' C' ! TEL NO. FED R ap V CONTRACTOR'S STATE LAUNDRY TUB REGISTRATION NO.& S 7 :0 O COUNTY p CLOS WASHER DISTRICT NO. GRQ.UpONE P ESSED BY WATER HEATER -.I','* 9, ,[ GAS SYSTEM INDUSTRIAL WASTE APPROVAL . INSPECTION RECORD .i�r(.v✓I i'.,K.7 J. ..1�"-i•S.�- `I/.fir f�E•i�l�l� �F`� / If L PER I'm O$1.00 FDcrUBE $ I APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT 51 7-100 UNDER SLAB WORK ^'`-^. ROUGH PLUMBING I n I •�� TOTAL FEE m GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE, READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER6,/0/4� C•��=>.�2� J PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUN AND STATE OF GAS TESTI .aC ?r CALIFORNIA OR THAT M T LEGAL' 0 OF THE ABOVE i -- DESCRIBED RESIDENT P UTILITY CO.NOTIFIED SIGNATURE OF FERMI TTE FINAL gyp. VALIDATION ROBERT A.WOOD. is,0. CASH SUPERVISING MEC14ANICAL ENG'R [ .8 5 .919 o FEB 19 5 D 4 0 Q 9 WORKERS'COMPENSATION DECLARATUQN 76AS67A 1 hereby affirm that I have a• certificate of con4"eitt to :011' CE a,'X(Z.aei ,APPLICATION FOR PLUMBING /(fp P LU M B I N G PERMIT insure,or a Certificate of Workers'Compensation Insurance,or ;7.- a _ edcopy 800, -C.)a certifCOUNTY OF L`OGEL*_S � BUIDING AND SAFETY Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ADDRESS T 7 L + Certified copy is filed With the count building inspection NUMBER FIXTURE OR ITEM • FEE de artment. ` �1 y,As l ` WATER CLOSET 2 LOCALITY . Date A" L Applicant yT,&( =� ,^, - '7 NEAREST _ i _ BATH TUB — CROSS ST. .0L CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER V OWNER _ LAVATORY MAIL (This section need not be completed if the work involved : ADDRESS , by the permit is for one hundred dollars ($100) or less.) SINK CITY �� TEL.NO. U I certify that in the performance of the work for which this DISHWASHER ' permit is issued, I shall not employ any person in any manner CONTRACTOR 0 so as to become subject to the Workers'Compensation Laws. CLOTHES WASHER ADDRE U Date Applicant -c pp SWIMMING POOL RECEPTOR a NOTICE TO APPLICANT: If, after making this Certificate of CITY VZ L.NO. N Exemption, you should become subject to the. Workers' LAWN SPRINKLER SYSTEM STATE LIC. Compensation provisions of the Labor Code,you must forth- WATER HEATER LICENSE NO. L2&>61 r-- CLASsC_ 3 a with comply with such provisions or this permit shall be deemed revoked. DISTRICT NO. PR CESSED Y GAS SYSTEM OUTLETS �y � LICENSED CONTRACTORS DECLARATION OUTLETS OVER �sdd I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL �// ness and Professions Code, and my license is in full force and DATE S VALIDATION effect. d 9 FINAL I License Number U Lic.Class BY c Contractor .L11 A � ff- Date 0 —4 S 'S F1 I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ 1 acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Lic.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section 7031.5, Busi- City Tel.No. ness and Professions Code): I, as owner of the property, am exclusively contracting with licensed contractors to construct the project n c 0 0 A (Section 7044,Business and Professions Code). I _ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency 2 C G for the performance of the work for which this permit is issued(Sec.3097,Civ.C.). C 0 � r Lender's Name I '' r '1• b � 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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the a ove-menti ned property Kor in purposes. purposes. ignature of Perm' tee Date