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Home My Public Portal About5710 PRIMROSE AVE_Plumbing__ )ES-17to.sB. APPLICATION FOR PLUMBING PERMIT 1 les.t� DMSION OF BUILDING AND SAFETY Department-of County Engifieer County of LOS 'Angeles BUILDING, JOHN A.LAMBIE. COUNTY ENGINEER ADDRESS CASSATT D,GRIFFIN..SUPT OF BUILDING LOCALITY F R APP C T Tp,,t5 IN NEAREST ti CROSS ST. OWNE DISTRICT NO. I GROUP I ZONE I READY FOR INSPECTION MAIL , ADDRE CITY TEL.NO7 . INDUSTRIAL ' J WASTE APPROVAL PLUMB INSPECTION RECORD ADDRESS CI TEL.N LICE NO Zy NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET), @ $1.00 $ BATH TUB @ $1.00 SHOWER @ $1.00 LAVATORY (WASH BASIN.) @A$1.00. KITCHEN SINK $1.00 B DISHWASHER @ $1.00 LAUNDRY TUB-OR TRAY @.5i.00 CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 GAS SYSTEM @ $1.00 APPROVALS DATE INSPECTOR`S SIGNATURE UNDER SLAB WORK PERMIT ' g 1 00 ROUGH PLUMBING 0. GAS PIPING TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGE THAT 1. 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 REGULATING PLUMBING. PLUMBING FIXTURES 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY'AND STATE OF CALIFORNIA OR THAT IT LEGAL OWNER OF .THE.. ABOVE TILITY CO.NOTIFIED DESCRIBED RESIDENTIAL 0 RTY. SIGNATURE 4 — a OF PERMITTEE FINAL OHN A.L.AMBIE.COUNTY ENGINEER VALIDATION ROBERT A.W OD.CHIEF PLBG. INSPECTOR 0. CASH 7-3 5C,- SEP 2'7 3 2:0 0~19a, 'SASS' IBB.17,C.BB APPLICATION 11lION FOR PLUMBING PERIT 1 DIVISION.OF BUILDING AND SAFETY Deportment of County Engineer County of Los Angeles BUILDING JOHN A.LAMBIE, COUNTY ENGINEER ADDRESS O Q CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FALL IN NEAREST CROSS ST. iyG� i OWNER DISTRICT NO. GROUP I ZONE I READY FOR INSPECTION MAIL " ._�/F ADDRESSINDUSTRIAL p� CITY XA TEL.NO a d WA TE APPROVAL PLUMBER2/ . INSPECTION RECORD ADDRESS I , l y I - CITY LL/�fL� I r.L,rtp TEL.NO. . LICENSE NO. f J aJ,� �—oto--meq*"" L NUMBER TYPE OF FIXTURE OR ITEM FEE f�'�e,A;,�°,� /.,��!®,p•°i ti.e'7�:.'S_ � �t�° .f WATER CLOSET (TOILET) @ $1.00 BATH TUB @ $1.00 > SHOWER @ $1.00 LAVATORY (WASH BASIN) @ $1.00 KITCHEN SINK @ $1.00 DISHWASHER @ $1.00 LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @ $1.00 WATER HEATER @ $.1.00 GAS SYSTEM @ $1.00 APPROVALS DATE INSP.ECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 1 .00. ROUGH PLUMBING GAS PIPING TOTAL FEE A OG 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 REGULATING PLUMBING. PLUMBING FIXTURES 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL PROPERTY. SIGNATURE OF PERMITTEE �� FINAL OHN A.LAMBIE,COUNTY ENGINEER7,41, . VALID ATIO ROBERT A.WOOD,CHIEF PLBG. INSPECTOR (/ CK. M.t. CASH PLO 8 9 8 7 XN 7 3 2.0 0 '� 76A667 (CE=817)-4/72 APPLICATIO OR .P MB.ING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING r MAKE CHECKS PAYABLE TO: ApDRESS7 JP• HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) CROSS ST. NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET 1,75 OWNER MAIL BATH TUB 1.75 ADDRESS s SHOWER 1,75 CITY TEL. N - LAVATORY 1.75 CONTRA TOR SINK 1.75 ADDRESS A P S DISHWASHER 1.75 CITYTEL. No CLOTHES WASHER 1.75 STATE LIC 'j f/ LICENSE NO. CLASS SWIMMING POOL RECEPTOR 1.75 DIST ICT N GROUP NE P CESSED.BY LAWN SPRINKLER SYSTEM '1.75 WATER HEATER 1.75 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD V OUTLETS OVER 5 PER SYSTEM .30 CD W O.. rA Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE S 3 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS VENT HOT WATER HEATER IHEREBY ACKNOWLEDGE THAT I 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 PLUMBING. GAS TEST i HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I.AM TH LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRII D RESIDENTIAL PROPE TY. FINAL �,r 1�.•J 1 �� r/��G - SIGNATURE • - OF PERMITTEE PERMIT VALIDATION CK. M.O CASH PLAN CHECK VALIDATION CK. M.O. ASH - `/ +✓ 9JUL 23 5 D 4.7 5 �w KERS'COMPENSATION DECLARATION 6 ]-v-`, f :a--/ - !// 7A APPLICATION FOR PLUMBING PERMIT � 'irm that I have a' certificate of consent to self CIE cE e17(z-eo) ins o,a�•^ertificate of Workers'Compensation Insurance,or a..cbrtified No y thereof(Sec.3800,Lab.C.) ±, COUNTY OF LOS ANGELES BUILDING AND SAFETY^ Policy No. Company E] Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING. ADDRESS 10 1 i -Se Certifiey�dcopy is filed wit hounty building inspection NUMBER FIXTURE OR ITEM FEE LOCALITY Dateari " � Applicant WATER CLOSET NEAREST G BATH TUB CROSS ST. y CERTIFICATE OF EXE TION FROM WORKERS' 1 COMPENSATION INSURANCE SHOWER OWNER I r V 6 (This section need not be completed if the work involved LAVATORY MAIL } by the permit is for one hundred dollars ($100) or less.) ADDRESS b r � aO i SINK CITYtp TEL.NO. E� I certify that in the performance of the work for.which this DISHWASHER a permit is issued, I shall not employ any person in any manner CONTRACTOR O so as to become subject to the Workers'Compensation Laws. CLOTHES WASHER ADDRESS .0 Date ApplicantLU NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR CITY TEL.NO. CLcn Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATEO��j' LIC. Compen$ation provisions of the Labor Code, you must forth- LICENSE NO-I V CLASS with comply with such provisions or this permit shall be WATER HEATER deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. RO ESSED)RY LICENSED CONTRACTORS DECLARATION OUTLETS OVERLJ� 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 (]r VALIDATION ness and Professions Code, and my lice se is in full force and DATE effect. FI jLicense Numb Lic.Class oA Contract Date 1 I am/exempt from a licensing requirements'as I am a Plan check fee I C, S �� o licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ lacting in ray professional capacity (Section 7051, Bus- iness and Professions.Code.). TOTAL FEE s) 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. 6$(�9 A ness and Professions Code): ElI, as owner of the property, am exclusively contracting # 0 0 0 0 0 5 with licensed contractors to construct the project (Section 7044,Business and Professions Code). .1 0 o 2 8,5 0 CONSTRUCTION LENDING AGENCY o o o 2 a 5 0 5 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is 0 k 16-87 issued(Sec.3097,Civ.C.). Lender's Name 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 a horize representatives of this County to enter upon the a ve to ed r p ty for inspection purposes. Y ignatilre of Permittee Date