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Home My Public Portal About5820 PRIMROSE AVE_Plumbing__ 70As57-css17 s-so APPLICATION FOR . PLUMBING , PERMIT- COUNTY OF LOS ANGELES DEPARTMENT.OF COUNTY ENGINEER BUILDIlVG AND SAFETY DIVISION BUMDING JOHPI.A. Lr4MB1E. COUNTY,ENGINEER ADDS WILLIAM A.JENSEN,SuwS OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST.. CROSS.SL ' NUMBER -FIXTURE OR ITEM OW NER WATER CLOSET TUB AADDDRESS BATHCITYTEL. NO. SHOWER ' CONTRACTOB LAVATORY SII•iS ADDRESS DRSHWASHER CITY , TEL No-4-roe) O. , ®e) CONTRACTOR'S /I STATE LAUNDRY TUB. 8EGffiTAATION NO. G.� o6 0 - coIINTY. CLOTHES WASHER DISTRICT NO. GROUP :L E CESSED BY WATER HEATER i L� ' Y� GAS SYSTEM ]NDUSTRUiL WASTE AWROVAL INSPECTION RECORD '< O, APPROVALS dDATE/ 1RSPECTOR'S,SIGNATURE PERMIT $ 2 '00 UNDER SLAB WORK 1 d ._ —✓ 1 ..� " TOTAL FEEROUGH PLUMBING' 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 1 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. DESCRIBED RESIDENTIAL PROPEt1TY: UTILIRY CO.NOTIFIED SIGNATURE c c �� B .P' OF PERMI7TE p s FINAL ATION ROBERT A.WOOD ,. M.9. "Z SUPERVISING MECHANICAL ENG'R ` C, 'o4 30 �9 OCT ? 5,G J � v Y 76AG67-CE#8'17 4-67 j�� I7 APPLICATION FOR PLUMBING PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS �Y1 COLEMAN W..JENKINS. SUPT. OF BUILDING LOCA19TY� FOR APPLICANT TO FILL IN NEAREST CROSS ST.I NUMBER FIXTURE OR ITEM EACH FEE OWNED WATER CLOSET $1.25 NAM BATH TUB' 1.25 ADDRESS SHOWER 1.25 CITY L.NO. LAVATORY 1.25 CONTRA _ SINK 1.25 ADDRESS tr DISHWASHER 1.25 STAr4 LIC LAUNDRY TUB 1.25 L I CENSE hd.�Ieel4eo CLASPS CLOTHES WASHEP 1.25DISTRICT NO. GROUP NE PR• EBS D BY WA 1.50 1 1 GAS S OUTLETS 1.50 WASTE p�ppROVAL v OUTLETS OVER 5 PER'SYSTENi .90 INSPECTION RECORD ti W . O. rA y � APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT. S 2 O.O UNDER'SLAB WORK y ROUGH PLUMBING. TOTAL FEE % GAS PIPING I HEREBY.ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITH ALL COUNTY OILDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. I HEREBY CERYIFW THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND*STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF.A INTEND TO RESIDE'IN,THE ABOVE DESCRIBED R NTIAL PROP UTILITY CO.NOTIFIED SIGNATU OF PER EG- FINAL V ATION JACK R.ALLEN CK. M.O. CASH SUPERVISING MECHANICAL ENG'R. 4 8 Sk.9� AN 3 5' U 3.5 0 xv . . WORKERS'COMPENSATION DECLARATION. 7eAe6.7w I liereby a{firm that I have- x certificate.-of consent to self cS a»(2-80) APPLICATION FOR PLUMBING P E.R M.I T insure,ora certificate of Workers'Compensation:Insurance,or a certified copy thereof(Sec.3800,Lab' C;). ' • . - COUNTY OF LOS ANELES 'B .1LD. DSAFETY - Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (BRINY OR TYPE) ILDING ADDRESS 6 PZ/ O 51 0 copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE department WATER CLOSET Date Applicant NEAREST BATH TUB CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' , COMPENSATION INSURANCE. SHOWER OWNER ,' 019A4 S. - MAI L. �1 (This section need not be completed if the work involved LAVATORY AD D R ESS S 0 /V/1149, .5��— O by the permit is for one hiindied dollars ($.100);or less:,) _d��11 SINK. CITY %t 9/ LF C!T T.E.L.NOaT6 l'IIsFS' .V I certify that 'I in the performance'•of the work-for which.this Di$HWASH•ER O permit is issued, shall not employ any person in any manner CONTRACTOR, so as to become subject,to the Workers"Compensation Laws. 'CLOTHES.WASHER —AP DRESS Applicant' r ! d DRESS SWIMMING POOL.RECEPTOR ,V NOTICE'TO APPLICANT:=•If, after making this Certificate of. CITY T rA Exemption,. you should become .subject'to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. Compensation provisions of the'Labor Code,you must forth- LICENSE CLAS _ with comply with such provisions or 'this .permit shall be WATER.HEATER deemed revoked. GAS SYSTEM OUTLETS DISTRICT-NO.,- O SS lf. / ® ' LICENSED:CONTRACTORS DECLARATION, OUTLETS OVER I hereby affirm that Iain licensed under provisions of Chapter 8 PER SYSTEM . 9 (commencing with Section 7000)•of Division 3 of the Busi- v FINAL` ness anPr d ofessions .DATE Code,and my license is in full force and !� � " .�•. VALIDA 'ON. .effect. _.... .. FINAL: License Number ' Lic..Class BY' "0""""� Contractor ,Date I am exempt from the licensing,requirements as.Lam a L.Name eck fee licensed architect:-or a registered professional,•engineer UMBING PERMIT ISSUING FEE$ ` acting in my professionai capacity (Section_ 705.1; Bus- ` iness and.Professions Code)', 'TOTAL FEE Lip.or Reg.No. Date ck applicant HOME OWNER-BUILDER.DECLARATION I'•here ffirm that I an ' exempt from. the Contract•or's:bice Law for the:folio n reason S3-siVely ion.703.1.5., Busi-( Tel. nes nd Professions Coder I, as owner of the pr rty, am ex contractingRe 3'2118 with licensed contractors to construct the project' # 0 0 0 0 0 5 (Section 7044,Business and Professions Code). 'CONSTRUCTION.LEN'DING,AGENCY � - '2.c, .o 1 3'.G O' I hereby affirm that ,there. is a construction lending agency for the performance'of the work for which this permit is "o• o• 0 1 3 Q 0 5- issued(Sec..3097,'Civ.C'.). Lender's Name 1 1.26-80 Lender's.Address I certify'that I.haveroad. 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., Paws regulating Plumbing, and hereby orize representatives of this• County to enter upon the. ab ve-ment ed.property for,inspection purposes.. �. Signet re gf'Per. fee Date « .WORKERS'COMPENSATION DECLARATION 76AG67A I hereby%ftZi•m that I have a' certificate of consept to self CE 6,7(z_60) APPLICATION FOR PLUMBING PERMIT insure,•or a certificate of Workers'Compensation Insurance,or a certified copy.thereof(Sec..3800.,Lab.C.) q State Comp insFund COUNTY OF LOS AN S D SAFETY Policy No. lUany Certified copy is.hereby furnished. APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING,--,0— FOR NUMBER FIXTURE OR ITEM' • FEE ADDS ES 5820 Primrose ® Certified copy is filed with the county building inspection LOCALITY department. 14mple Q. Date Applicant WATER CLOSET NEAREST BATH TUB CROSS.,ST. CERTIFICATE OF EXEMPTION-FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER 'McKenney Adams LAVATORY MAI L (This section need not be completed if the work involved ADDRESS 5820 $ } by'the permit is for'one hundred dollars ($100) or less) SINK a CITYTempl.e City TEL.'N0.8.6-7845 U I certify that in the performance of the work for which this DFSHWASFIER permit is issued, I shall not employ any person in any.manner CONTRACTORBr ant Heat,. & Air Conc so as to become subject to,the Workers'Compensation Laws. CLOTHES WASHERO Date Applicant Applicant SWIMMING POOL RECEPTOR ADDRES NOTICE TO APPLICANT: If, after making this Certificate of CITY San Gabd,lel_ TEL.N0.286-114 a Exemption, 'you should become subject--to the. -Workers' LAWN SPRINKLER SYSTEM STATE LIC. Compensation provisions of the Labor Code,you must forth- LICENSE NO. 221751 CLASS —Q-20 with comply with such provisions or thisr permit shall be WATER HEATER deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. O SED BY LICENSED CONTRACTORS DECLARATION. OUTLETS OVER Thereby affirm tliat.I am licensed.under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section..7000)of Division 3 of the Busi- FINAL � VALIDATI ness and Professions Code, and'my license is.in full.force and DATE effect: FINAL v / License � Lic.Cla�/.�(' � BY Contra Date / 7 Clm exemp om the licensing requirements as I am a Plan check fee cam " I ar . act or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional. capacity (Section 7051, Bus- 7. 00. iness and Professions Code). TOTAL FEE Lic.or Reg,No. Date FAddresi plicant HOME OWNER-BUILDER DECLARATION e. I hereby affirm that I am,exempt from the .Contractor's License Law for-the following reason (Section 7031.5, Busi- City Tel.No. ness and Professions Code): 2 3 2 5 4 A I, as owner of the property, am exclusively,contracting with licensed contractors to construct the project # o 0 o 0 0 JA (Section 7044,Business and Professions Code). `• 2 .0 CONSTRUCTION LENDING AGENCY 1GOO I hereby affirm that there is a construction lending agency a 0 0 1 Q 0 0 for the performance of the work for which this permit is issued(Sec.3097,Civ.C.). Lender's Name l 201 "$0 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 ut orize re tives 'of this County to. enter upon the o n "o o erty for inspection purposXZ416� 411 ign Lure of Per• a Date