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Home My Public Portal About9121 PRIMROSE AVE_Plumbing__ D.B.S.17 25M BETS 12.44 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING WM.J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONEPERMIT NO. ROUGH FIXTURES COMPLETE ter` ! HEATER CE88POOL I—I SEPTIC TANK RECEI ED BY READY FOR DATE ISSUED l �r FIRST INSPECTION GAB MISCELLANEOUS t 'i'"• Z rc�/" r`�� APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB ,qq+ry E NAME bS�• �Yl: 4-a =I�.1 ADDRESS 9� i/�t•lI ��. . mrfa' � Cad g ADDRESS LOCALITY ..+1.ti• a D NEAREST J CITY „ TEL.No. CROSS ST. COUNTY CERT.No. EXPIRES C' NAME LOCATION OF SEPTIC TANK, OR CESSPOOL z MAIL NORTH ADDRESS O CITY i TEL.No. 1 AM THE LEGAL POSIESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFI TE OF Q pLIF°IyCA'TION. I ! • 1 PLUNDER t � I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. 3 OWNER CORRECTIONS I i SOUTH .a DESCRIPTION OF WORK z BATH TUB FURNACE ROWER DISHWASHER O —LAVATORY REFRIGERATOR ' *KITCHEN SINK WATER SOFTENER FLOOR SINK BAND TRAP LOP BINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOBET DRINKING FOUNTAIN DATE INSPECTOR'S NAMR WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I I METKR GAS SODA FOUNTAIN OUTL GAS PIPING I I GAS VENT I I CESSPOOL I I TOTAL NUMBER OF FIXTURES SEPTIC TANK I ,1 a .r_ CESSPOOL SEPTIC TANK A SEWER (� Ji �. Q $ V UTILITY CO.NOTIFIED I 1 ! I TOTAL FEE �, �' I s I — FINAL V.S. 17 -S SETS 12-43 APPLICATION FOR PERMIT U ARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING 1 WM.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE _ HEATER CESSPOOL I—I SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED FIRST INSPECT{ON AS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY NAME 7JOB It ADDRESS - tr! ADDRESS LOCALITY g .d D NEAREST A CITY f/�'.-may moi" TEL.No. � CR068 BT. 1� d y y COUNTY i CERT.No. P f EXPIRES ' I W NAME LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL 3 ADDRESS NORTH O CITY TEL.No. IAM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. r ' E PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. R D 3 V/ OWNER "1 CORRECTIONS SOUTH J DESCRIPTION OF WORK a Z_ BATH TUB FURNACE _n Q' " SHOWER DISHWASHER Q AVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP BLQP'SINK FLOOR DRAIN H TRAY URINAL APPROVALS WR CLOSETDRINKING FOUNTAIN V/ DATE INBP[CTOR'B NAME WATER HEATER DENTALLAVATORY ROUGH PLUMBING I I METER GAB nODA FOUNTAIN GAS PIPING I OUTL GAS VENT I I CESSPOOL I I TOTAL NUMBER OF FIXTURES SEPTIC TANK CESBPOOI SEPTIC TANK —�-1{- SEWER I S UTILITY CO.NOTIFIED I I TOTAL FEE FINAL IDEPAR'1'WOM OF COUNTY ENGINEER PLUMBING DIVISIOPT OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES BUILDING WILLIAM J. FOX, COUNTY ENGINEER ADDRESS FOR APPLICANT T2FILL JIM LOCALITY EAEST BUILDING r7 / ' i/ ! CROSS ST. –"Crl��- ADDRESS • � DISTRICT NO. GROUP ZONE PERMIT NO. LOCALITY NEAREST f - EIVED BY Ready for nspection DATE IS ED CROSS ST. [I .� •— (��t?/!99 � MAILER ' INDUSTRIAL ADDRESS �/Yi WASTE APPROVAL _7" C" a—Ar1Q INSPECTION)RECORD CITY J rJ, t„(� 4 )� TEL.N0. PLUMBER ADDRESS f f le CITY TEL.N0. ❑STATE (•' LICENSE NO. ❑COUNTY, J PERMIT FEES Q _z }1MBER TYPE Or FIXTURE OR ITEM FEE (�] s WATER CLOSET(TOILET) @ 0.80 • sU O BATH TUB @ 0.80 Q SHOWER @ 0.80 LAVATORY(WASH BASIN) @ 0.80 U KITCHEN SINK @ 0.80 LAUNDRY TUB OR TRAY @ 0.80 ' b SLOP SINK @ 0.80 FLOOR SINK @ 0.80 FLOOR DRAIN @ 0.80 DISHWASHER @ 0.80 DRINKING FOUNTAIN @ 0.80 - URINAL @ 0.80 GAS SYSTEM..--'I—..OUTLETS' @ 1.00 'WATER HEATER @ 1.00 Y 6Q MISCELLANEOUS APPROVALS //-- DATE INS`P,E�C R'S SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING /�;' c/�-,�� Gr_df,�(• ��/ TOTAL FEE r � GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GAS VENT CATION AND STATETHAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES LI I't �ILi.•Le.�.-1 I HEREBY CERTIFYTHAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS.REQUIRED BY LOS-ANGELES COUNTY GAS TEST AND STATE OF CALIFORJUA OR THAT I AM THE LEGAL OWN- ER OF THE ABOVE D L IBED RES DENTIAL PROP RTY. UTILITY CO.NOTIFIED SIGNATURE • OF PERMITTEE..._.. _.. ._.. ..... ..._._.: •�. FINAL 76A807 DBS 11 1/63 WORKER'S I have a certificate of consent to 7BA667 DPW 9189 APPLICATION FOR PLUMBING PERMIT ' I hereby affirm that I have a certificate of consent to self Insure, 78A557A or apertificate•of Worker's-Compensation Insurance,or a certified copy thereof(Sec.3900 Lab.C.) - • � 'i ' Policy No. Company 4 COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF•PUBLIC WORKS DIV. ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDINGA`/C1\ ❑ Certified copy is filed with the county building Inspection ADDRESS N W 'PLr L Rib department: NUMBER FIXTURE OR ITEM ® FEE LOCALITY Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST. COMPENSATION INSURANCE BATH TUB ASSESSOR (This section need not be completed If the work Involved by the ' SHOWER MAP BOOKS PAGE W� PAFlCEI� permit Is for one hundred dollars($100)or less.) OWNERZ V L W J I certify that in the performance of the work for which this per its LAVATORY MAIL I Is Issued, I shall not employ any person in any Manner so a SINK ADDRESS!31 ua ep become subject to the Works Campensatio Laws. �'` DISWASHER C rT TEL.NO. Date J —I`'�0 Applicant -� CLOTHES WASHER CONTRACTOR NOTICE TO APPLICANT: If, after make this Certificate of �r�jGpRJ Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRESS provisions of the Labor Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION , •i CITY TEL.NO. I hereby affirm that I am licensed,under provisions of Chapter 9 �I WATER HEATER `. R. (commencing with Section 7000)of Division,3 of the Business and GAS SYSTEM OUTLETS LICENSE.NO. LIC. Code,and my license is in full force and effect. OUTLETS OVER DISTRICT NO. CESSED BY 5 PER SYSTEM c License Number Lic.Class ✓ FINAL2 G VAL. A AtION DATEa Contractor Date FINAL J W 51".3.55,5051Z ❑ I am exempt under Sec. BY I ITEMS 8.&P.C,for this reason _ y, �..,..,, �.,. Date: Plan check fee TLITAL = :3= 85 PLUMBING PERMIT ISSUING FEE$ , CREUIL Signature , ❑ TOTAL FEE f��-[ANG-. �;j i i Plan check applicant SINGLE FAMILY HOME OWNER=BUILDERDECLARATION Name 5/15/92 92 1 hereby affirm that I am exempt from the Contractor's License Law � for the following reason(Section 7031.5, Business and Professions Address ,3360 ! At? 8:43 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 Pol- and is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize representatives of this Countyter upon the above-mentioned p pert for pe e . SEE REVERSE FOR EXPLANATORY LANGUAGE 4 SIgnituNe of Permittee Date WORKER'S COMPENSATION of consent to 7!AG66DPw9/89 APPLICATION FOR PLUMBING PERMIT ' I hergby affirm that I have a certificate of consent to self Insure, 78A887A , or a certificate ofViorker's Compensation Insurance, or a certified copX thereof(Sec.3800 Lab.C.) Policy No. Company COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. I ❑ Certified copy is hereby furnished. BUILDING ]� ❑ Certified copy is filed with the county building Inspection FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST. LO Y" COMPENSATION INSURANCE BATH TUB ASSESSOR p� JP (This section need not be completed if the work Involved by the SHOWER MAP BOOK 4 PAGED PARCELOJ permit is for one hundred dollars($100)or less.) LAVATORY OWNER P. I certify that in the performance of the work for which this permit Is issued, I shall not employ any person in any manner so as to SINK ADDRESS 1 X)L;N�Q � L 9, become subject to the Workers'Compensation Laws. DISWASHER CITY TEL.NO. +^v-(j Date Applicant CLOTHES WASHER CONTRACTOR v NOTICE TO APPLICANT: If, after making this Certificate of Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRESS provisions of the Labor Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL.NO. } I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER STATE LIC. 0 (commencing with Section 7000)of Division 3 of the Business and GAS SYSTEM �-OUTLETS CENSE NO. CLASS 0 Professions Code,and my license Is in full force and effect. OUTLETS OVER DISTRICT NO.e f PROCESSED BY O 5 PER SYSTEM �J` �� License Number Lic.Class E' FINAL VALIDATION a Contractor Date U) ❑ FINAL C Z I am exempt under Sec. B.&P.C.for this reason Plan check fee Date: 1, PLUMBING PERMIT ISSUING FEE$ Signature D 1001. a `, 0 1t3EN= Plan check applicant TOTAL FEE TOTAL 88. 20 SINGLE FAMILYK HOME OWNER-BUILDER DECLARATION Name �� ':11 1 hereby affirm that I am exempt from the Contractor's License Law CHANE .00 for the following reason(Section 7031.5, Business and Professions Address Code): City Tel.No. I,as owner of the property,will do the work and the structure 11513301-11313131 11/12; is not intended or offered for sale(Section 7044, Business and Professions Code). 001. 2534.-n 1 AM 11`e 4_, 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 Pol.information is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to ante upon the above-mentioned �Slanatuof s. SEE REVERSE FOR EXPLANATORY LANGUAGE 11� ! Date 6N(ORKERCOMPENSATIONDECLARATION APPLICATION FOR PLUMBING PERMIT �.t I'heit�iy affirm that I harre a certificate of consent to self 76A667A insure, or a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) u or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. BUILDINGp2 1F+l�ppA ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Vt A� ,2F� Certified copy is filed with the county building inspec- tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY m 5 C ATV Date Applicant WATER CLOSET NEAREST �r CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB CROSS ST. GO` ,44p ; COMPENSATION INSURANCE OWNER � *AJ)0 . 215) (This section need not be completed If the work Involved by SHOWER a the permit Is for one hundred dollars $100 or less. MAIL )0�W(/ L P ( ) ) LAVATORY ADDRESS �w/ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK i 00 gMCITY CJJ TEL.NO. gb—(1a& so as to become subject to thip Workers'Compe do a DISHWASHER r CONTRACTOR Date�'3�d `°' applicantkxj - , CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after m king this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY TEL. NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. ME7 I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS L� /[� (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER (J - and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL VALI TION DATE / / a License Number Lic. Class C FI L C; Contractor Date 13: C I am exempt under Sec. C BAP.C. for this reason La Plan check fee ® p, Date: PLUMBING PERMIT ISSUING FEE$ Z Signature TOTAL FEE Plan check applicant 5 2 3:3 A SINGLE FAMILY /HOME OWNER-BUILDER DECLARATION Name # 0 0 0 0 0 5 hereb irm that I am exempt from the Contractor's License AddressIoo2a50 following reason (Section 7031.5, Business andCode): City Tel. No. o oo28505 owner of the property, will do the work and the ® $ 2-86 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- ntione�. pe fo 'nspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signatbr,e of Permittee Date �f +v s VIORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT j t 4i4itby afflrnig that I h8ve a certificate of consent to self 76A667A insure, or a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) LJ or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING1 ^ ^^) Certified copy is filed with the county building inspect ADDRESS I QL T'w, tion department. NUMBER FIXTURE OR ITEM @ FEE ^�� y r G� '-)RD LOCALITY r (� Date Applicant WATER CLOSET NEAREST n,� {{ �y^ CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. (ZOS _,n snA -t 3 VADWil COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed If the work Involved by the permit Is for one hundred dollars($100)or less.) LAVATORYQ e' /� ADDRESS �r L KD I certify that in the performance of the work for which this permit is issued, I shall n employ any person in any manner' SINK CITY A R TEL. NO.q( O so as to become subject t he orkers'Compe ors ws DISHWASHER CONTRACTOR 1• Date A pplicant t CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after king this Certificate of Exemption, you should become s ect to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY TEL. NO. LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION I DISTRICT NO. PR D BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM 1� OUTLETS �JJ(lJJ( (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect, i 5 PER SYSTEM FINAL VALID TION DATE � `& O}. License Number Lic. Class Q FIN (� Contractor Date B ❑ I am exempt under Sec. Q B.BP.C. for this reason W Plan check fee ® a Date: PLUMBING PERMIT ISSUING FEE$ Z Signature � TOTAL FEE Jh 0 6 5 Q 2 A Plan check applicant SINGLE FAMILY � L ^ � # 0,0 0 0 0 5 HOME OWNER-BUILDER DECLARATION Name I h reby affirm that I am exempt from the Contractor's License Address rvy��.. La for the following reason (Section 7031.5, Business and /�� D P fessions Code): City � YY11 LZ. G1' Tel. No. )a o o 1650 I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section o 0 0 1 Q 5 0= 7044, Business and Professions Code). v CONSTRUCTION LENDING AGENCY 02- 12-87 1 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 representativ of is County to enter upon the ab4 ove-m ni n ope t fo inspection purposes. 1� 7 SEE REVERSE FOR EXPLANATORY LANGUAGE Signa a of Permittee Date