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HomeMy Public PortalAbout5940 RENO AVE_Plumbing__ '�E 817 8/68 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUMDING-%AND SAFETY DMSION RUMDING � 41 �a,� JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT. OF BUILDING r LOCALIl YIto FOR APPLICANT TO FILL IN PR NT OR TYPE) NEAREST CROSS ST. '71706,¢ ~ NUMBER FIXTURE OR ITEM EACH FEE OWNER �� 4A,m WATER CLOSET 1.50 �+ y, ,1 BATH TUB 1.50 ADDRESS J TD E V AVY SHOWER 1.50 CI'T'Y Ly f TEL. NO.ae - QOa LAVATORY 1.50 CONTRACTOR SINK 1.50 ADDRESS V E DISHWASHER 1.50 CITY �� �I�� TEL.NO. CLOTHES WASHER 1.50 STATE LICLICENSE NO. �� CLASS L'1 SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROUP ZONE P D B LAWN SPRINKLER SYSTEM 2.00 o C IO v WATER HEATER 1.50 INDUSTRIAL APPROVAL Z GAS SYSTEM OUTLETS 1.50 O INS CTION RECORDzt v OUTLETS OVER .30 GL DW 5 PER SYSTEM rA Plan check fee 25% 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 1 H HEREBY ACKNOWLEDGE THAT I AVE READ THIS APPLICATION ANDSTATE 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 THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESID N 1AL PROPERTY. FINAL e. SIGNATURE JACK R. ALLEN, SUPERVISI ECHANICAL ENG-R. OF PERMITTEE PERMIT VALIDATIO cul. M.o. CASH. ' PLAN CHECK VALIDATION CK. M.O. CASH AY` 0 7 6_ Jg5 fl 35 0- WORKERS'COMPENSATION DECLARATION }GA667A I hereby affirm that I have a' certificate of consent to self cm 617 (:_60) APPLICATION FOR PLUMBING PERMIT insure,or a certificate of Workers'Compensation Insurance,or I "fl 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) BUILDING � � /p Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM, • FEE ADDRESS -•� - /J department. WATER CLOSET LOCALITY 0/7 Date Applicant NEAREST CR CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB OSS ST. COMPENSATION INSURANCE SHOWER J� WNER &f Z,0 (This section need not be completed if the work involved LAVATORY dFMAIL ADDRESS � i loe) f� by the permit is for one hundred dollars ($100) or less.) SINK } CITY /y TEL.NO.' ^,� ti I certify that in the performance of the work for which this t✓ O DISHWASHER �r U permit is issued, I shall not employ any arson in any manner CONTRACTOR SO as to eco a subject to the W e o nsationws. CLOTHES WASHER Dat Applicant ADDRESS Q 5� ��� © f'�ai F- SWIMMING POOL RECEPTOR NOT E O APPLICANT: f, after making this C ificate of CITY TEL.NO. ,� W Exemption, you should. become 'subject to a Workers' LAWN SPRINKLER SYSTEM STATE !! LIC. N Compensation provisions of the Labor Code,you must forth- LICENSE NO.M4 lr CLA with comply with. such provisions or this permit shall be WATER HEATER _ deemed revoked. GAS SYSTEM OUTLETS DI ICTT�N �CESB LICENSED CONTRACTORS DECLARATION OUTLETS OVER r" I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL ness and Professions Code,and my license is in full force and DATE ^- VALIDATION effect. f '/ FINAL License Number.3Q_ Lic.Class -� BY Contractor eL Date 1-2 '�3 2-- I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and 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): 0 3 2 7.2 A I, as owner of the property, am exclusively contracting with licensed contractors to construct the project 0 0 0 0 0 v (Section 7044,Business and Professions Code). 2oa1250 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency 0 0 0 1 2 5 0=50 for the performance of the work for which this permit is issued(Sec.3097,civ.C.). 0312-82 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 authorize representatives of this County to enter upon the abov khed' roperty inspection pIrposes. t na umi Date.