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Home My Public Portal About6109 PRIMROSE AVE_Plumbing__ 7W►ee7 17 s-So 1� L �� APPLICATION.FOR PERNIIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES ;: WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT IyO. GROUP ZONE PERMIT NO. WIN I O t 'QIYI BROS., INC. PLUMBER :RECEIVED BY READY FOR DATE ISSUE — Dt•� FIRST INSPECTION 6 V ADDRESS ALHAMRRA, CAI��FDRN�A ]' BUILDING CITYTEL. NO. ADDRESS COUNTYpA pp a� . LICENSE NO. L U EXPIRES . I-OCALITY , PERMIT FEES CROSS ST .S . Irye M C 6 Iry R ye a OWNER �� M2p 0 LAND * NUMBER TYPE OF FIXTURE OR ITEM FEE p 4 WATER CLOSET(TOILET) a 0.50 .S ADDRESS .OA 1"MAIL16 �: O#J�Ti DAEt 1�47;rO BATH TUB @ 0:50 I 60 CITY AMA A& QA TEL. NO. i; SHOWER ' Ccs•0.50 �# 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) (0 0.50 APPLICATION AND.STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY%WITH ALL,COUNTY ORDINANCES AND KITCHEN SINK Q 0.50 STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS II LAUNDRY TUB OR TRAY @ 0.50 'ANGELES COUNTY LI SE OR 1 AM E LEGAL OWNER ' GAS&YSTEMOUTLETS Q 0.50 OF THE RESIDENTIA RO TY ED ApOVpv. 6 SIGNATURE OF tl I WATER HEATER (g1 0.50PERMITTEE III SLOP SINK @ 0.501 NSPECTION RECORD I FLOOR SINK @ 0.50 FLOOR DRAIN ® O.50 I DISHWASHER 0.501 DRINKING FOUNTAIN 0.50 URINAL �. 0.50 .J HOUSESEWER' ® 0.50. Q Z MISCELLANEOUS UI APPROVALS . DATE INSPECTOR'S/NAME RCUGH'PLUMBING. — A GAS PIPING ' GAS VENT 1.4 PSEPTIC SSPOOL 1.00 CESSPOOL TANK: SEPTIC TANK ' DRAIN ( ) PIT ( ) 1.00 SEWER RMIT . 1.00 GAS TEST (5 I.�� UTILITY CO. NOTIFIED Z A_6_ 1 IJA. , TOTAL FEE & % I G V I U• Ir(N 1 FINAL ION `a W that I have &certificate of consent to 756A687A Pw9l69 APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have,a certificate of consent to self insure, or a certificate of Worker's Compensation Insurance, or a certified r copy thereof(Sec.3800 Lab.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 ElCertifiedcopy is filed with the county building inspection department. NUMBER FIXTURE OR ITEM @ FEE LOCALI Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION ST. FROM WORKERS' BATH TUB ASSESSOR COMPENSATION INSURANCE (This section need not be completed if the work involved by the SHOWER MAP BOOK PAGE PARCEL permit le for one hundred dollars($100)or less.) LAVATORY OWNER Y. I certify that in the performance of the work for which this permit MAIL is issued, I shall not employ any person in any manner so as to SINK ADDRESS S become subject to the Workers'Compensation Laws. DISWASHER Cl TEL.NSA Date - Applicant��ti 4' 4. __ CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of CONTRACTOR 4 ,r Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRES provisions of the Labor Code,you must forthwith comply with such I UDy provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM L4 P44 LICENSED CONTRACTORS DECLARATION CITY 1� TEL.NO.5-1 J I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER 0, (commencing 7000)of Division 3 of the Sec ion ofe sions Codeh andd tmy license Is In full force and effect.nse and / GAS SYSTEM OUTLETS ` CENSE NO.3 75— CLASS �DISTRICT NO. PROCESSED BY V P OUTLETS OVER IT 5 PER SYSTEM D Q _ _ _ License Number Lic.Class �) FINALAU DATE yAfiION� -9-e,-4v W a Contractor l� ��,. TX% Date -1_3I1 3 411j. -DrA ❑ I am exempt under Sec. FI AL I I i E `� Z B.&P.C.for this reasonr Plan check fee i (��- m "�� Date: l Signature PLUMBING PERMIT ISSUING FEE$ ��p % �^ /� �'HEc�ft g�j.`00 TOTAL FEE CHANGE`✓ �'=fit SINGLE FAMILY Plan check applicant r HOME OWNER-BUILDER DECLARATION Name 110110-0001 41 6/9 I.hereby affirm that I am exempt from the Contractor's License Law i to AM for the following reason(Section 7031.5, Business and Professions Address x'668 S 9:48 Code): ❑ City Tel.No. I,as owner of the property,will do the work and the structure is not Intended or offered for sale(Section 7044, Business and Professions Code). , CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending,agency for the performance of the work for which this permit is 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 ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned ,prop rt inspection pur oses. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WORKERS'COMPENSATION DECLARATION 81 � ) APPLICATION FOR PLUMBING PERMIT I herei6y affirm that I have a' certificate of consent to self CE ce e» z-eo insure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company . El Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING F] , A �.. Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • ADDRESS FEE ro J�'i � department. WATER CLOSET LOCALITY B Date Applicant NEAREST + CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER LAVATORY MAI L (This section need not be completed if the work involved ADDRESS 141eMSd9 } by the permit is for one hundred dollars ($100) or less.) SINK �+ ' IL CITY lejd(�� GJT TEL.NO. S 0 I certify that in the performance of the work for which this DISHWASHERV permit is issued, I shall not employ any person in any manner CONTRACTOR cc so as to become subject to the Workers'Compensation Laws. CLOTHES WASHER O ADDRESS � Date Applicant SWIMMING POOL RECEPTOR W NOTICE TO APPLICANT: If, after making this Certificate of CITY TEL.NO. it Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. N Compensation provisions .of the Labor Code,you must forth- < LICENSE NO. CLASS z with comply with such provisions or this permit shall be WATER HEATER — deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. R SSED BY Jt LICENSED CONTRACTORS DECLARATION OUTLETS OVER r - I hereby affirm that I am licensed under provisions of Chapter IS PER SYSTEM 9 (commencing with Section 7000.)of Division 3 of the Busi- FINAL r�r� VALIDAT N ness and Professions Code, and my license is in full force and DATE effect. FINAL License Number Lic.Class BY Contractor Date I am exempt from the licensing requirements as I am a Plan check fee licensed architect of a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- inessland Professions Code). TOTAL FEE 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. ness and Professions Code): I, as owner of the property, am exclusively contracting 2 6 5 A with licensed contractors to construct the project (Section 7044,Business and Professions Code). �j 0 0 0 0 0 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency 2 ° o 2 2.0 C for the performance of the work for which this permit is issued(Sec.3097,Civ.C.). 0 0 0 ?2 C Lender's Name 10.23-80 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 authorize representatives o this County to enter upon the ab -mentione pr�erty o inspection purposes. Signature of Pe mittee Date