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Home My Public Portal About5446 PERSIMMON AVE_Plumbing__ 74fi67- 09817 5/70 APPLICATION FORS PLUMBIN PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING / JOHN.A. LAMBIE. COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT.'OF BUILDING _ LOCALITY FOR APPLICANT TO FILL IN PR NT'OR TYPE NEAREST CROSS ST. NUMBER FIXTURE OR ITEM E CH .FEE - OWNER WATER CLOSET 1. 0 MAIL BATH TUB 1. 0 ADDRESS SHOWER 1, 0 CITY TEL. NO. LAVATORY 1. 0 CONTRACT R SINK 1. 0 ADDRESS DISHWASHER 1. 0 CITY TEL. NO. ST CLOTHES WASHER 1. 0 STATE LIC LICENSE NO. J, y Z7/ CLASS SWIMMING POOL RECEPTOR 1. 0 DISTRI N GFOFJ� Cj. � P BY LAWN SPRINKLER SYSTEM. • 2. - (d/J r WATER HEATER 1: 0 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1. 0 PECTION RECORD CUTLETS.OVER- 5 VER-5 PER SYSTEM 0 / w Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE•S 00 TOTAL FEE /.� APPROVALS DATE INSPECTOR'S SIGNATURE Plan Check applicant .UNDER.SLAB WORK Name ROUGH PLUMBING �� on Address GAS PIPING City. Tel. No. 'GAS VENT HOT WATERHEATER 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT,AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL,' COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AN D. STATE OF - CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN.THE ABOVE DESCRIBED RESIDENTIAL PROPE Y.. ',FINAL f�2 SIGNATURE OF PERMITTEE JACK R. ALLEN, Lt SUPERVISIN ICAEN'G'R. � PERMIT VALIDATION cK. CASH PLAN CHECK ALIDATION c.K'. M.O. CASH '� 4 4-S 5 D 1.1.7 5- � DEPARTMENT OF BIDING AND SAFETY- COUNTY APPLICATION FON PERffiIT COUNTY OF LOS ANGELES WM.J. FOX.CHIEF ENGINEER PLUMBING NATURE OF INSTALLATION DIGTRICT NO. GRPUPI ZONE . PERMIT RRIO.. ROUGH FIXTURES COMPLETE HEATER __CESSPOOL -I SEPTIC TANK RECEI ED Y READY FOR DAT B ISSUED FA MISCELLANEOU FIRST INSPECTION APPLICA PILL IN HEAVILY'O MINED PORTION ONLY- Joe � AME / ADDRESSDDRESS�O .• LONEAREST ITYTEL.No. CROSS ST:OUNTYERT:No. EXPIRES 3 NAMB' v. LOCATION OF SEPTIC ANS, OR CESSPOOL z Ma1L NORTH ADDR G� y�, . _ CITY D TELYNO:a 1 AM THE L POSE R OF THE ABOVE-LOS ANGELES COON czwrzrzc OF gUALIFi TION. PWMo6R I AM THE-LEGAL OWNER OF THE PROPERTY DESCRIBED f ABOVE. Ij OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK _Z BATH TUB FURNACE 0 SHOWER DISHWASHER Q VATORY REFRIGERATOR /LKITCHEN SINK WATER SOFTENER ' FI:OOR SINK BAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS _WATER CLOSET DRINKING FOUNTAIN TB.... Imsp TOR's NANX WATER`HEATER DENTAL LAVATORY ROUGH PLUMBING. ETER v GAS .. SODA FOUNTAIN OUTL GAS PIPING I I GAS VENT I CESSPOOL I TOTAL NUMBER OF FIXTURE8 SEPTIC TANK I I p�__CESSPOOL______SKPTIC TANK SEWER I. I UTILITY CO.NOTIFIED I 4 I W, TOTAL FEE ` v e ® FINAL f WORI(ER'SCO'MPEIdSATIONDECLARATION 20-0028DPW 8/89 APPLICATION FOR PLUMBING PERMIT 78ABBZA 14iereby affirm that I have a¢ejtificate of consenTto self irfsure, or a certificate of Worker's Compensation Insurance, or certified w copy 4hereof•(Sec.3800 1-:6.C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policy No. Company ❑ Certified copy is hereby.furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE)❑ ADDRESS Certified copy is filed With the county building inspection ' department: NUMBER FIXTURE OR ITEM FEE LOCALITY M " Date ie Applicant / WATER CLOSET DN.� NEAREST r CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST. , COMPENSATION INSURANCE BATH TUB ASSESSOR I • (This section need not.be completed if the work Involved by the, SHOWER 0 MAP BOOK PAGE PARCEL' permit Is for one hundred dollars($100)or less.) VC+� OWNER � �/ ' I certify that in the performance of the work for which this permit LAVATORY c7 is Issued, I shall not employ any person'in any'manner so,as to }.• SINK' MAIL! i ADDRESS• become subject to the Workers'Compensation Laws. - - 1, DISWASHER CITY TEL.NO. Date lik1hcant CLOTHES WASHER / NOTI PLI ANT: If, after making this ertificate of .0 CONTRACTOR ^ Exempt! ,y houl become subject to the Wor Compensation SWIMMING.POOL RECEPTOR ADDRESS provisions of6e Labor Code,you must forthwith comply.with such provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM, ,LICENSED CONTRACTORS DECLARATIONo _CITY TEL.NO. a I'hereby affirm that 1 am licensed under provisions of Chapter 9 WATER HEATER (commencing with Section 7000)of Division 3 of the Business andSTATE LIC. 0 Professions Code,and'my license is in full force and effect. GAS SYSTEM OUTLETS LICENSE NO. 1'g `] CLASS V OUTLETS OVER DIS ICT O CES BY 5 PER SYSTEM License Number Lie.Class FINAL VALID TION W DATE • •�+f a Contractor Date r y E1 _I am exempt under Sec. BY FINAL z B.&P.C.for this reason Plan check fee , Date: ( Signature PLUMBING PERMIT ISSUING FEE'$ ❑ 5 TOTAL FEE,; 43 oa Plan check applicant 1 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name ACCT°T I hereby affirm that I am exempt from the Contractor's License Law for the following reason(Section 7081.5, Business and Professions. Address 3307 _ 103.00 ' Code): El1,as owner of the property,will do•the work and the structure City Tel.No. 1 TT'EM8 Is not intended or offered for sale(Section 7044, Business TOTAL (33 m 00 and Professions Code). , i CFLECK107.110 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the l ; CHANGE .130 performance of the work for which this permit Is Issued(Sec. 3097, Civ.C.) S/ 6/90 i Lender's Name 2242 1 AM 4:221 Lender's Address I I certify.that I have read this application and state that the above , Information is correct. I agree to comply With all County ordinances and State laws regulating Plumbing, and hereby authorize i representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 7§A667;- 08817 5/70 h - APPLICATION FOR' PLUMBIN PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION fADDRESS ILDING JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W. JENXINS.. SUPT. OF BUILDING CALITYFOR APPLICANT TO FILL IN PR NT OR TYPE) _ __ ARESTROSS ST. NUMBER FIXTURE OR ITEM E CH FEE OWNER WATER CLOSET 1. 0 _ BATH TUB 1; p ADDRESS .SHOWER 1, p CITY TEL.NO. LAVATORY 1, p CONTRAC R J SINK 1. 0 ADDRESS DISHWASHER 1. 0 CITY TEL.NO. CLOTHES WASHER 1. '0 STATE LIC LICENSE'NO. �j 7� CLASS SWIMMING POOL RECEPTOR 1. 0 DISTRI NQr/ G�OEI� Y P By . •LAWN SPRINKLER SYSTEM 2. 0 (CJI/ r WATER HEATER 1, p INDUSTRIAL wasTE Arz+Ieovu GAS SYSTEM OUTLETS 1. '0 PECTION RECORD OUTLETS OVER 5'PER SYSTEM 0 / r Plan check fee.25% of above. See reverse. PLUMBING PERMIT ISSUING FEE•8 00 TOTAL FEE /. APPROVALS DATE INSPECTOR'S SIGNATURE Plan Check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING -GAS VENT City Tel.. No. HOT WATER HEATER 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS.CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES _ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. 1HEREBY 'CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPE Y. •FINAL SIGNATURE aA OF PERMITTEE JACK R. ALLEN, SUPERVISIN ICALf ENG'R. �L� "� PERMIT VALIDATION CK. CASH PLAN CHECK .ALIDATION CK. M.O. CASH LG o'z 4-g Ou.2 S D 1-1.75, a