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Home My Public Portal About6223 RENO AVE_Plumbing__ 7GA667C (CE-8176) -9/79 t 7 /e ry)p/lam ( Ty APPLICATION FOR PLUMBING PERMIT / BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM @ FEE ADDRESS7 WATER CLOSET LOCALITY �n f/�� ,,/(/,7 NEAREST / BATH TUB CROSS ST. rJ�I / V �U SHOWEROWNER M l-2 LAVATORY MAIL ADDRESS , I '�^ ADDRESS SINK CITY pp99 /� TEL.fVO� p� 7 DISHWASHER CONTRRGPrIF '��vv 1� ``J A CLOTHES WASHER ADDRES10920 E. G RATNI D AVE. SWIMMING POOL RECEPTOR 7 LAWN SPRINKLER SYSTEM CITY LE CITY CALW% �7O"�� STATE / Cid] F LIC WATER HEATER LICENSE NO.,:2 '] Q CLASS Q CD DISTRICT NO. GROUP2 RO SED BY, v GAS SYSTEM OUTLETS OUTLETS OVER 15 'U C�Q I � v CD 5 PER SYSTEM 12NDUSTRIAL a WASTE APPROVAL rn INSPECTION RECORD Z Plan check fee PLUMBING PERMIT ISSUING FEE $ TOTAL FEE Plan check applicant Name APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK Address ROUGH PLUMBING City Tel. NO. GAS PIPING IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THEABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICEN SEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM TE LEGAL 0 NER OF, AND INTEND TO RESIDE IN THE ABOVE DESC B D(/,�R�ESID N IAL PROPERTY. UTILITY CO. NOTIFIED SIGNATU RE / 1157 - OF PERMITTEE L FINAL `'� -77 �04�- , PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDAT 0 CCK-) M.D. CASH 5 2 0 CEEB 7 7.5_ . 0Y' WORKERS'COMPENSATION DECLARATION' APPLICATION FOR PLUMBING PERMIT k affirm that I have a certificate. of consent to self 76A667q or a certificate of Workers'Compensation Insurance, CE.8.17(REV. 10/81) �J or'a-.,lifted copy thereof(Seca 3800, Lab. C.)' COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. v Company ❑ 'Certified copy is hereby furnished. ❑ FOR.APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING (J � •. Certified copy is filed with the county building-inspec- ADDRESS tion department. NUMBER FIXTURE OR ITEM ® FEE LOCALITY WATER.CLOSET Date '. . APPI.igant. - .. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS.', �I BATH TUB ,� Coots. ST.. �pis., COMPENSATION INSURANCE SHOWER OWNER f (This section need not be completed if the'work Involved by MAIL f r� the permit is for one hundred dollars(;100)or less.) LAVATORY . ADDRESS certify that in the performance of the*work for which this TEL. NO. permit is issued,.1 shall not employ aRy,person to any manner SINK �--- CITY �`' so as.to become subject to the'Workers'Compens tion Laws. DISHWASHER CONTRACTOR Date!2 1 Applicant CLOTHES WASHER v NOTICE TO APPLICANT: If, after making_ is Certificate of ADDRESS Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR P I .. CITY TEL.NO. Compensation provisions of the Labor Code, you.must forth- LAWN SPRINKLER SYSTEM with comply:with such provisions or thik. permit,shall be STATE LIC. deemed revoked. 'G r WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO, PRO ESSED BY L^ I hereby affirm.that I am licensed under provisions GAS SYSTEM OUTLETS of Chapter 9 � J Q pj (commencing with Se-tion 7000)of Dlvislon.3.of.the Business OUTLETS OVER and,Professions.Code,and my license is in full force.and effect. 5'PER SYSTEM FINAL. VALIDATION DATE License Number Lic. Class. C FINAL. lass- FINAL. C' Contractor Date ByQ ❑ I am exempt under Sec. C B.&P.C. for this reason 4 Plan check fee ► Q Date: U PLUMBING PERMIT ISSUING.FEE'$ p. C Signature TOTAL FEE Plan check applicant 'a SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I' 1 hereby affirm that.I am exempt from the Contractor's License Address Law for the following..reason (Section.7031.5, Business and Pfo essi0ns Code): City Tel. No. I, as owner of the property, will do.the work and the structure is not intended or offered for sale (Section5 3 7 A 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY # 0'0 0 0 0 5 1 hereby affirm that there is a.construction lending agency for 4 0 °.5 2 5 0 the performance of the work for which this permit is issued. (Sec. 3097, civ: C.). ' - o'o5250,01 Lender's Name 0 0 9 8-8 6 Lenders 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, ohd hereby 'authorize representatives of this County to enter Upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 0 Stgnatur of f1cirmittee Date lo pI ~ WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT • T'ge4y"affirmlthat I have a certificate of consent to self 20-0026 DPW 6/87 �nsufe o�or a ceftificate of Workefs'Compensation Insurance, 76A 17A or a certified copy thergof(Sec..3800; Lab..C.) k COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS PolS�, icy No. Company f "rawd Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Certified copy is filed with the county building insp - tion department. /� NUMBER FIXTURE OR ITEM � FEE LOCALITY Date ?_//_91 AppIiga (� WATER CLOSET ,� NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS 5T. COMPENSATION INSURANCE OWNER (This section need not be completed if the work involved by SHOWER ✓� 7 IL MA the permit is foone hundred dollars($100)or less.) LAVATORY r ADDRESS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner SINK CITY TEL.NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER �1 CONTRACTOR Date applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY L.NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER:SYSTEM with comply with such,provisions or this .permit shall be STATE `/p G LIC. deemed revoked. IWATER HEATER LICENSE NO. /7p a 7 CLASS LICENSED CONTRACTORS DECLARATION DI TRICT NO. PROCESSED.BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS p (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER 4r,0O and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL VALIDATION C DATE License Number WE � Class �� ! � �� C-rig FINAL LY Contractor 7 BY ❑ I am exempt under Sec. o di0 CC B.BP.C. for this reason ® ®' Plan check fee � Date:. ' PLUMBING PERMIT ISSUING FEE$ 3 Az Signature TOTAL FEE 3 B0 Plan check applicant .SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Namevi:•��$ 1 hereby affirm that I am exempt from the Contractors License Address Law for the following reason (Section 7031.5, Business and ,Y,yll+ i" l SIrL O'.,a� Professions Code): City Tel. No, __ ❑ s f f EPID I, as owner of the property, will do the work and the structure is not intended of offered for sale (Section ;;t � 7044, Business and Professions Code). r 03 CONSTRUCTION LENDING AGENCY CHECK BECK I hereby affirm that.there.is a construction lending agency for I ARMSE the performance of the work for which this permit is issued =+'l (Sec. 3097, Civ. C.). Lender's Name 'iC(J�)`r-1 C•'" r� Lender's Address `' s-' i i•A�'�s _, 1 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 f this ounty to enter upon the ov -mentioned rope for' ection purposes. ' SEE REVERSE FOR EXPLANATORY LANGUAGE Sig Lure of Permitte Date '' i--WORKERS'COMPENSATION DECLARATION 20-0026 DPW 4/90 APPLICATION FOR PLUMBING PERMIT I hereby,tffgrm that I have a certificate of consent to self in- 76A667A sd'rb,,gr dee�r iftate of Workers'Compensation Insurance,or a certified°�PY thereof(Sec. 3600, Lab. C. l 'fl t r7d Com an I COUNTY OF LOS.ANGELES DEPT. OF PUBLIC WORKS•_ ;;�Zified . p y t : copy is hereby furnished. BUILDING {r V erg FOR APPLICANT TO FILL IN(PRINT OR TYPE) Certified copy is filed with the county building inspection ADDRESS department./�ac NUMBER FIXTURE OR ITEM FEE L n] (/J Z_ WATER CLOSET(TOILET) / LOCALITY Dtlte Applicant t' NEAREST v�- CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS.ST. COMPENSATION INSURANCE SHOWER OWNER ter -f— (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so s CITY TEL.NO. as to become subject to the Workers'Compensation Laws. l DISHWASHERr CONTRACTOR e 5 e S �, Date Applicant t CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- TEL. l0 r sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS CITYA-LksC, TEL. NO. 4 S ly with such provisions or this permit shall be deemed revok- STATECxCT516- LIC. ed.. WATER HEATER LICENSE NO. - D CLASS I LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSEb BY I hereby affirm that I am licensed under provisions of-Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER 6Ze and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION fect. �+ 93001-1.1c. y f� r HOSE BIB DATE License Numbbfer/=� G O 30� Lic. Classy a Contractor%t/ ' 4 e —Date ( S BY AL � �T e g V I am exempt under Sec. P �" 3303 220°50 B.&P.C. for this reason L Plan check fee ; 1 ITEMS d PLUMBING PERMIT ISSUINGFEE$ � SignauM TOTAL220. TOTAL FEE 220 SINGLE FAMILY ME HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 703.1.5, Business and Professions Code): Address 0000-0001 11/ 9/95 F1 I,'as owner of the property, will do the work and the City Tel. No. 3244 1 Aft 9e3� 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. 30971 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 entioned property f_ oranspec'on purposes. \``\\' `t- 55 SEE REVERSE FOR EXPLANATORY LANGUAGE a ure of Permittee Date