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Home My Public Portal About5544 PERSIMMON AVE_Plumbing__ ~ 76A667 (CE-817)-4/72 APPLICATIO FOR^PLU kIING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY EINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: 77 �� V J HARVEY T. BRANDT, COUNTY ENGINEER `,� 4� FOR APPLICANT TO FILL IN (PRINT OR TYPE) NUMBER FIXTURE OR ITEM . � FEE ^ WATER CLOSET 1.75 OWNER 4 MAIL n BATH TUB 1.75 ADDRESS 4 #0 �'A" J-"ejAf Q SHOWER 1,75 CITY Q�y� l e' r' TEL. NO. -J LAVATORY 1,75 CONTRACTOR SINK 1.75 ADDRESS DISHWASHER 1.75 CITY TEL. NO. CLOTHES WASHER 1.75 STATE LIC LICENSE NO, CLASS SWIMMING POOL RECEPTOR 1.75 DISTRICT NO. GROUP 6ZONEJPROCESSED BY LAWN SPRINKLER SYSTEM 1.75 r WATER HEATER 1.75 INDUSTRIAL WASTE APPROVAL off. GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD v OUTLETS OVER 5 PER SYSTEM 30 p W O. y Z Plan Check fee See Reverse PLUMBING PERMIT ISSUING FEE $ �300 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPINGi -City Tel. NO. GAS VENT If j I f r I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF - CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. , FINAL SIGNATU RE OF PERMITTEE � PERMIT VALIDA 10 • cK� M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH ,1 `„ 0 2 9 673 APR 2 5 D 4.75- 76A667-CE917 12/59 APPLICATION FOR PLv IMG PERMIT COUNTY OF LOS ANGELES ' DEPARTMENT OF COUNTY ENGINEER RUILDRiG �� F BUILDI J ANR�,5.1�FETY IVISION ADDRESs JOHN LAM 1 OUNTY NGINEER WILLIAM A.JENSEN,SOFT R?BUILDING a LO FOR APPLICANT TO FILL IN NEAREST o•cam CROSS ST NUMBER FIXTURE OR ITEM WATER CLOSEY OWNER MAIL d BATH TUB DRESS . CITYNO. SHOWER _7 LAVATORY CONTRACTO T SII48 �LDDRESS DISHWASHER CITY TEL. NO. CONTRACTOR'S STATE ❑' LAUNDRY TU8 REGffiTBATION N -COUNTY ❑ CLOTHES WASHER DISTRICT NO. GROUP ZONE P SSED BY WATER FILTER ' U rGAS SYSTEM INDUSTRIAL *ASTE APPROVAL INSPECTION RECORD a. a Ha 00 B 0 $1.00 PER.ITEM I ;J OR FIXTURE AP OVA D T,k INSPEC.OR'S SIGNATURE PERMIT $ 2 00 iiivD WORK MAX-, el TOTAL FEE ROUGH.PLUMBING GAS PIPING I HEREBYACKNOWLEDGE'THAT I HAVE READ:•THIS APPLICATION GAS VENT r AND STATE THAT THE ABOVE 13 CORRECT.AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING OT WATER HEATER PLUMBING. _ I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR P. UMBING FIXTURES Nl 1 IV 0 LICENSED AS'REQUIRED BY LOS ANGELES COUNTY AND. STATE OF ► ,p CALIFORNIA OR THAT I AM THE.LEGAL OWNER OF THE ABOVE TEST J �� L BED RESIDENTIAL. ROPERTY. ILITY CO.NOTIFIED ./ I TUREERMITTE FINAL DF om VALIDION ROBERT A.WOOD, B.O. c"R SUPERVISING,MECHANICAL ENG'R r Lnuo 5 1 8 1 ,i APR 1 �, 5 D 6.0 0 76A887-CE817 12/59 APPLICATION FOR PLU IMG PERMIT COUNTY OF LOS ANGELES DEPARTNIENT OF COUNTY ENGINEER FAIDDRM r BUI lA G�1D SAFETY RMSION JOHN BI COUNTY NGINEERWILLIAM A.JENSEN,SUPIT of BUILDINGFOR APPLICANT TO FILL IIF NUMBER FIXTURE OR ITEMWATER CLOSET BATH TUB SHOWER NO. LAVATORY CO N TR A CTO sm ADDRESS ` DISHWASHER CITY TEL. NO. � CONTRACTOR'S STATE [I LAUNDRY TUB —REGISTRATION N COUNTY p' CLOTHES WASSER. DISTRICT NO. GROUP ZONE P ESSED BY WATER HEATER U `� GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD � V A $1.00 PEs rrEM QR FI=VE $ I AP OVA D T.9 INSPEC,OR'S SIGNATURE PERMIT S 2,100 UND WORK - e 1 A6/I - - TOTAL FEE ROUGH.-PLUMBING ZS 6 i OAS PIPING 1 HEREBY ACKNOWLEDGE'THAT I HAVE.READ;THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE iS CORRECT".AND AGREE TO COMPLY' r WITH. ALL 'COUNTY ORDINANCES AND'STATE LAWS REGULATING HOT WATER HEATER PLUMBING. _ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED 'AND/OR PLUMBING FIXTURES LICENSED AS-REQUIRED BY LOS ANGELES -COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE.LEGAL :OWNER OF THE ABOVE c DESCRIBED RESIDENTIAL "HOPIRTY. UTILITY-CO.NOTIFIED / SIGNATURE ` OF PERMIYTE FINAL ®r VALIDATION ROBERT A.WOOD. cK.'. N.'o. CASH SUPERVISING.1b1ECHANICAL ENG'R -• .5. 1 8 1Z-01APR 11 5 D. 6.0 0 76A667-CM1712/59 -T- —E CITE' APPLICATION FOR PLUMBING PERMIT' COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGIIMR B}JII.D IG iN IE3 ZTY RIVISION BUILDING OHN M 1 COUNTY NGINEER ADDRESS WILLIAM A.JENSEN.SOP'S OF BUILDING ` LO FOR APPLICANT TO FILL IN NEAREST CROSS ST... NUMBER FIXTURE OR ITEM OWNER. . WATER CLOSET � BATH TUB SHOWER cn?7--. TEL.L4/4— LAVATORY CONTRACTOR=,c - sum ADDRESS DISHWASHER CITY TEL. NO. CONTRACTOR'S STATE ❑ LAUNDRY TUB REGISTRATION NO. COUNTY ❑ CLOTHES WAMM DISTRI NO. GR O}1 ZONE P OC BY WATER HEATER .'L/� GAS SYSTEM IIMUSTRIAL WASTE APPROVAL INSPECTION RECORD n J L51.00 ORFDPER r= ITURR APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK A TOTAL FEE ROUGH PLUMBING !pR/ .n Pig- I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS PIPING AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT . WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER.HEATER PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES V F.,00,: I A) A_ ILICENSED AS REQUIRED BY LOS ANGELES COUNTY AND ATATE OF. GAS TEST J� L /.7CALIFORNIA OR T T I AM. THE LEGAL OWNER OF THE ABOVE DESCRIBED R IAL PROPS UTILITY CO.NOTIFIED A SIGNATURR'' �� r� OF PERMI FINAL �e VALIDATION ROBERT A.WOOD: M.0. CASH SUPERVISING'MECHANICAL ENG'R U`l7744 �,A► 29 5 D 3.00 M '.B.°:.,' 25M eETa ,-aB APPLICATION FOE_RJMP IT DEPARTMENT OF-BUILDING-AND SAFETY COUNTY OF LOS ANGELES WM.J.FOX.CHIEF M01NMR a PLUMBING NATURE OF. 3TAI:LATI0N, P o E P O:, S '/ 4U ROUGH FIXTURESCOMPLETE HEATER CESSPOOL.. NK czlvYED:•®Y READY FOR DATE'188U �I 1' GAS- MISC LAN US Y�'!..' FIRST INSPECTION . APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY Jo® B K' NAME- ADDRESS ® ADDS LOCALITY R . JNEAREST 6 CITY d ' TEL:No. CROSS ST. e CORN. a EXPIRES �f CERT..No. - B NAME �- Aazo LOCATION OF SEPTIC TANK, ORdESOPOI MAIL NORTH O. ADD.RESB Q CRY -„ TEL.No.- 1 AMTHE' LEGAL POSSESSOR OF _THE ABOVE LOS ANGELES COUNTY-CERTIFICATE O,FfAL[FICATION.. PLuMs6R I AM'THE LEGAL OWNER OF THE PROPERTY'DESCRIBED .a ABOVE.. . - owmmt- CORRECTIONS SOUTH DESCIRIPTION OF WORE Z ATH TUB FURNACE SHOWER' DISHWASHER 0_ VATORY .- REFRIGERATOR RCNEN.SINK WATER SOFTENER W.9^OR BINK SAND TRAP -SLOP SINK - .FLOOR DRAIN _ 'WASH TRAY' URINAL APPRo018 WATER CLOSET DRINKING FOUNTAIN K1ATB IN9P6CTOR'B NAME _WATER.HEATER DENTAL•LAVATORY ROUGH PLUMBING rAr ETAS SODA FOUNTAIN E U p' OUR OAS PIPING ) f AAS VENT / CESSPOOL : I TOTAL NUMBER OF FIXTURES i;, SEPTIC TANK a. CE88P00T SEPTIC TANK SEWER S UTILITY CO.NOTIFIED- a�.s % . TOTAL FEE - 'f FINAL WORKERS'COMPENSATION DECLARATION l- 76A887A I I hereby affirm that I have g certificate of consent'oto self ICE 8 f 7(R-80) APPLICATION FOR. PLUMBING PERMIT insure,ora certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.c.) COUNTY OF LOS ANGELES / �' BUILDING AND SAFETY Policy No. Company i Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING �+ ,�{j � AlO / Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM O FEE ADDRESS J LOCALITY Date P Applicant. °tYt3/f�� Ir•1tA/V�S L.L/R. WATER CLOSET NEAREST BATH TUB CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER MAIL, (This section need not'be completed if the work involved LAVATORY ADDRESS -by the permit is for one hundred dollars ($100) or less.) } SINKCITY TEL.NO. O I certify that in the performance of the work for which this DISHWASHER V permit is issued, I shall not employ any person in any manner CONTRACTOR �i' �(+��' C� tr so as to become subject to the Workers'Compensation Laws. CLOTHES WASHER Date Applicant ADDRESS s �l� C7 O SWIMMING POOL RECEPTOR G ~ NOTICE TO APPLICANT: If, after making this Certificate of CITY.41� TEL.N �� W Exemption, you should become subject to the Workers'. LAWN SPRINKLERSYSTEM C tl Compensation provisions of the Labor Code, you must-forth- STATE LICENSE NO. �/' CLASS -- s(� with comply with such provisions or this permit shall be WATER HEATER deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. 9SSE BY LICENSED CONTRACTORS DECLARATION -OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL ness and Professions Code, and my license is in full force and DATE evsVALIDATION effect. X997 � er FINAL L Wnse Number 3�y 97/ Lic.Class- 4 BY CxAwtorDS �1 "A Date 0 I am exempt from the licensing requirements as I am a Plan Check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Lic.or Reg.No. Date Lme k applicant' HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section.7031.5, Busi'- Tel.No. ness and Professions Code): 9 5 2 A I, as owner of the property-, am exclusively contracting , with licensed contractors to construct the project # 0 0 0 0 0 5 (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency ° ° ° 12 5 0 61 for the performance of the work for which this permit is ' issued(Sec.3097,civ.C.). 0 3.3 1 '—8 2 Lender's Name ..Lender's Address bthat.1 have read this application and state that the ormation is correct.I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE s d State laws regulating Plumbing, and hereby r p esentative of this County to enter upon the a to a pe y for inspection purpoure of Permi Dat