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Home My Public Portal About6218 RENO AVE_Plumbing__ 7GA887-CE#817 12-84 , APPLICATION FOR PLUMBING PERMIT - COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 62181 NO PReno COLEMAN W. JENKINS,SUPT OF BUILDING , LOCALITY TempT e Ci t FOR APPLICANT TO FELL IN NEAREST T Longdon NUMBER FIXTURE OR ITEM EACH FEE OWNER Robert Shom er WATER CLOSET $1.25 BATH TUB 1.25 ADDRESS Same SHOWER 1.25 CITY TEL. NO. LAVATORY 1.25 CONTRACTOR General Installation Co. SINK 1.25 ADDRESS 6558 west Blvd. DISHWASHER 1.25 cITY Los Angeles TEL. NO. PL 3-2541 CONTRACTOR'SC-36 151839 787coTY LAUNDRY TUB 1.25 REGISTRATION NO. UN CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PROCESSED BY WATER HEATER 1.50 5 0j 1 r L ^•� GAS SYSTEM OUTLETS 1.50 IND AP INDUSTRIAL d OUTLETS OVER 5 PER SYSTEM 30INSPECTION RECORD v Softener I Rn Ready for Inspection Now m 0 ps W 0. h Z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT S 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE 3 SO GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I 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 HOT WATER HEATER PLUMBING. 1 HEREBY CERTIFY THAT 1 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,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESIFAROPE Y. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTEE FINAL ____VALIDATION ROBERT A.WOOD CK. M.O. CASH SUPERVISING MECHANICAL ENG'R t1Lo a n JV] 21 5 D3.50- cr wOaKERs'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hyo ffirm that I have o certificate of consent to self in- �6A66�A PW 4/87 [� sure S rfificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) �I(ull Corti, co " thereof(Sec. 3800, Lab. C.) Pdlicy No. Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Fj Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING CePtified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEELOCALITY WATER CLOSET(TOILET2--2-1 / Date Applicant � NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB �Z � CROSS ST. S�' laLa p. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by n s,� MAIL the permit is for one hundred dollars($100)or less.) LAVATORY 22 ��/ ADDRESS I certify that in the performance of the work for which this per- mit is issued, I shall not employ any person in any manner so SINK CITY /j , TEL. NO. as to become subject to the Workers'Compensation Laws. DISHWASHER C` CONTRACTOR SGe 1q1 Date Applicant CLOTHES WASHER ADDRESS Se NOTICE APPLI ANT: If, after mak' this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subjee) the Workers'Compen- CITYb��y ti TEL. NO. sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM e ly with such provisions or this permit shall be deemed revok- STATE /+ / LIC. ed. WATER HEATER l 5� LICENSE NO.; �f CLASS C— LICENSED CONTRACTORS DECLARATION DISTRICT NO. OC,ES$ED Y I hereby affirm that I am licensed under provisions of Chapter OUT SYSTEM OUTLETS -7 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER J and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL ' VALI f TN fect. ,. DATE License Number Lic. Class O �/� FINAL � .- 0 Contractor�p`��I�IG��Date � BY O I am exempt under Sec. W B.&P.C. for this reason Plan check fee ► c Date: PLUMBING PERMIT ISSUING FEE$ /3 (�� Signature eir.•(•)'a TOTAL FEE 9 SINGLE FAMILY y c Plan check applicant J =�•��i� ``i•?o:E:) HOME OWNER-BUILDER DECLARATION i T s MISS i.1E❖ 1 hereby affirm that I am exempt from the Contractor's License Name 50—. Law for the followingreason Section 7031.5, Business ands _s6 ( TOTAL�1� f -_ � Professions Code): Address -� 'L 0 lj S, r F1 1, as owner of the property, will do the work and the City Tel. No. structure is not intended or offered for sale(Section 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY (t 1 I hereby affirm that there is a construction lending agency for "I'`�- �'" the performance of the work for which this permit is issued 021 5 1 Nrl 9:37 (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 property for inspection purposes. IL igL SEE REVERSE FOR EXPLANATORY LANGUAGE Sign e o Permittee Date WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby, affirm that I have a certificate of consent to self in- 20 0026 DPW 4/90 sure,or certificate of Workers'Compensation Insurance,ora I 76A667A /1 certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Certified copy is filed with the county building inspection - department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant" WATER CLOSET(TOILET) NEAREST .r CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed If the work Involved by MAIL ( the permit Is for one hundred dollars $100)or less.) LAVATORY ADDRESS [�V I certify that in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so / CIN TEL. NO. as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date. Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY TEL. NO. sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PRO I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINA�i TION fect. HOSE BIB DATE 6^°� �` "I V a License Number Lic. Class FINAL �n^� 3303 76e2.00 Contractor Date BY /,! "v 1ITEtiS c I am exempt under Sec. TOTAL 76 o IB'"0 w B.$P.C. for this reason Plan check fee ® CHECK 76.80� Date: PLUMBING PERMIT ISSUING FEE$ 27 CHANGE .003 Signature TOTAL FEE SINGLE FAMILY l k hecapplicant HOME OWNER-BUILDER DECLARATION Plan c 0000`0801 ti.rl 5I96 1 hereby affirm that I am exempt from the Contractor's License Name 7821 1 Ph 5:30 Law for the following reason (Section 7031.5, Business and Professions Code): Address I, as owner of the property, will do the work and the City Tel. No. structure is not intended or offered for sale(Section 7044, Business and Professions Code). pop- 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�entioned property for inspection urposes. N ea�) S- Z SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Per tee Date