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HomeMy Public PortalAbout5550 PERSIMMON AVE_Plumbing__ a 76_9:Ce .SCE 817 8/68 `� ' APPLICATION FOR PLUMBING PER 1T COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BUILDING •��'O ��Z'JS//'//�Q JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY P1FOR APPLICANT TO FILL IN(PR NT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE WATER CLOSET 1.50 OWNER IL BATH TUB 1.50 ADDRESS 56� pJ9 D j SHOWER 1.50 CITY /b�L-T TEL. NO. � O([�Of LAVATORY 1.50 CONTRACTOR ��� f/V C, SINK 1.50 ADDRESS ,/ 10S A1.4f DISHWASHER 1.50. CITYpj jr� TEL.NO. � //�Y/ CLOTHES WASHER 1.50 LICENSE NO. .4160 l3 CLASS SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROU Z E E BY LAWN SPRINKLER SYSTEM 2.00 v (Jp o WATER HEATERS1.50 INDUTRIAL v WASTE APPROVAL Z / GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD 2 OUTLETS OVER v 5 PER SYSTEM •30 y Z Plan check fee 257o of above. See reverse. PLUMBING PERMIT ISSUING FEE 8 2 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 I 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. gat 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 1 AM LEGAL OWNER OF,AND INTdND TO RESIDE IN,THE ABOVE DEBC IB D RESIDENTIAL PROPERTY FINAL _ SIGNATURE JACK R��d . OF PERMITTEE ALLEN, SUPERVI IN HANICAL EN G'R. PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH._ 17 ..I � C . N 76A657_CE0817 10_67 rG AP,PLICAT'ION- FOR PLUMBI> PERMIC -G COUNTY` OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION FNEAREST ILDING JOHN A. LAMBIE. COUNTY ENGINEER DRESS COLEMAN W. JENKINS. SUPT. OF BUILDING CALITY . FOR APPLICANT TO FILL IN(PR NT OR TYPE) OST. NUMBER FIXTURE OR ITEM EACH FEE WATER CLOSET 1.50 f OWNERka -E' ,. IL BATH TUB 1.50 ADDRESS 1:5 SHOWER 1.50 CTEL. NO. LAVATORY 1.50 CONTRACTOR P/¢oys P�c/ssyr�/�C�Cs SINK 1.50 ADDRESS -�;9d:7 A �'�G/.fii d�C �✓F DISHWASHER 1.50 CITY ��iY�9�Gao,,w TEL.NO.lelS--6OO CLOTHES WASHER 1.50 STATE LIC LICENSE CLASS SWIMMING POOL RECEPTOR 1.50 DI�RIC�T N f GROU ZOLIE P S BY LAWN SPRINKLER SYSTEM 2.00 r �' / 41, —C, O WATER HEATER 1.50 ITE APPROVAL V WAAS O GAS SYSTEM OUTLETS 1.50 TION XWORD ~ OUTLETS OVER W 5 PER SYSTEM .30 r G e a- t r Ap n L Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE S 2 00 TOTAL FEE APPROVALS DATF, INSPECTOpq SIGNA R 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. 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED 'AND/OR UTILITY CO.NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR TNA AM THE GAL OWNER OF.ANO ND TO RESIDE IN, OR ABOV ECCRI�RESIDENTIAL PROPS FINAL SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICAL EN'GIR. OF PERMITTEE PERMIT VALIDATIONCK. M.O. CASH PLAN CHEG'K ALIDATION GK. M.0. CASH U 4 5 1 2 MAY 3 5 D 6.5©^' D.BJi.1apsaM eEra 1-aa APPLICATION MR PERBUr DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WM.J.FOX.CHIEF ENGINEER �` BI NATURE OF INST TIO ;DISTRI J ZOPKRMITNO. ROUGH FIXTURES COMPLETE '/ 7 Z--3 HEATER_ CESSPOOL 1-1 SEPTIC TANK R CEIVED BY READY FOR DATE 188U F IBC LANEOUBqmIl + FIRST'INSPECTIONAPPLICANT FILL IN-HEAVILY OUTLINED PO N ONLY - JOB�^� ADDRESS S / akk:o LOCALITYNEARESTs d TEL.No. CROSS ST.. o EXPIRES NAME b A LOCATION OF SEPTIC TANK, OR S 0600 z MAIL NORTH O ADDRESS CITY TEL.NO. 1 AM THE .LEGAL POSSESSOR OF THE ABOVE LOS ..ANGELES COUNTY CERTIFICAT� KATION. PLUMIK01 I AM-THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. OWRER CORRECTIONS SOUTH J DESCRIPTION M 'WORK z ® BATH TUB FURNACE O. HOWER DISHWASHER JLA�{ VATORY REFRIGERATOR /-KITCHEN SINK WATER.SOFTENER. L^OR SINK - SAND TRAP LOP SINK. _FLOOR DRAIN WABN TRAY +URINAL APPROVALS le WATER CLOSET DRINKING FOUNTAIN fjfpTg / _INgpecryOR•®Nwaa _ H:WATER HEATER DENTAL LAVATORY ROUGH PLUMBING -R/, Y-1-1110 -1 I METERGAS SODA FOUNTAIN OUTL GAS PIPING GAS VENT CESSPOOL 6TOTALTF'EE OTAL NUMBER OF FIXTURES SEPTIC TANK ESSPOOL SEPTIC TANK ® SEWER $ UTILITY CO.NOTIFIED - FINAL :?�� �I►. 'WORKERS'COMPENSATION DECLARATIONAPPLICATION FOR PLUMBING PERMIT I hbt'eby affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers'Compensation Insurance, CE-817(REV. 10/81) or a certified copy thereof(Sec. 3800 Lob. C.d)/ e! COUNTY OF LOS ANGELES BUILDING AND SAFETY kN99>!7_2Q4 dtCompany t9iAQ1yT- Certifi�id copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING r, ertif.ed cu�v is filed with the county building inspec- ADDRESS .!q NUMBER FIXTURE OR ITEM @ FEE Q 9 Q�/i LOCALITY Date �� '� ` Appligant�� AJ �"�s � WATER CLOSET Ly� NEAREST, n6L AJ CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CRO55 ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by NAIL ,/ the permit is for one hundred dollars($100)or less.) LAVATORY ADDRES 5 AWA I certify that in the performance of the work for which this permit is.issued,I shall not employ any person in any manner SINK CITY TEL.N 2 so as.to become subject to the Workers'Compensation Laws. DISHWASHERJ CONTRACTOR Date Applicant CLOTHES WASHER ADDRES NOTICE TO APPLICANT: If, after making this Certificate of S Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR P Y I CITY TEL.NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM D 7 f with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. OCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER l7 V() � and Professions Code,and my license is in full force and effect. 5 PER YSTEM FINALV IDATION O �-77 4 DATE 09 License Numbe 0 Lic. Class � C A S� j Ar / FIN O A �--P't`I V i! Date � ' �� BY V ❑ rL I am exempt under Sec, y9Lj B.BP.C. for this reason Plan check fee ► Date. PLUMBING PERMIT ISSUING FEE$ /0150 Signature TOTAL FEE S� Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Address .L z 2 4 G.3 A Professions Code): City❑ ]PULTel. No.74(71-31 # o 0 o b o 5 I, as owner of the property, will do the work.and the structure is not intended or offered for sale (Section , ( o - 3(150 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY o o - h505.' I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued o 7. 1 2-85 (Sec. 3097, Civ. C.). Lender's Name Lender's Address I certify that I have read this application and state that the Poo information is correct. I agree to comply with all County ordinances and Statela regulating Plumbing, and hereby authorize represe tali es f this County to enter upon the ,le-menti o ro er inspection purposes. t _ � 'SEE REVERSE FOR EXPLANATORY LANGUAGE .$ ignature f ermittee Date