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Home My Public Portal About5034 RIO HONDO AVE_Plumbing__ DBS-17 .- APPLICATION FOR PLUMBING PERMIT Dee.n'DIVISION OF BUILDING .AND SAFETY Deportment of County Engineer County of Los Angeles BUILDING / JOHN A.LAMBIE. COUNTY ENGINEER ADDRESS CASSATT D.GRIFFIN,SUPT OF BUILDING • LOCALITY FOR APPLICANT TO FILL IN NEAREST / CROSS ST. OWNER /G 405j rvv-) a 4,_ DISTRICT NO. GRMAILOUP ZONE READY FOR INSPECTION ADDRESS INDUSTRIAL CITY titTEL.NO. � . I WASTE APPROVAL PLUMBER .- INSPECTION RECORD ADDRESS CITY TEL.NO. LICENSE N NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 BATHTUB @ $1.00 SHOWER @ $1.00 LAVATORY (WASH BASIN) @ $.1.00 KITCHEN SINK @ $1.00 DISHWASHER @ $1.00 LAUNDRY TUB OR TRAY @ $1.00' CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 GAS SYSTEM @ $1.00 �• P APPROVALS• DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 7 00 r ROUGH PLUMBING S _zc . D " GAS PIPING TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION. HOT WATER HEATER AND'STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY .. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 THE LEGAL OWNER OF VE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL YVPEVY. SIGNATURE OF PERMITTEE FINAL IOHN A.LAMBIE.COUNTY ENGINEER VALIDA ROBERT A.WOOD.CHIEF PLBG. INSPECTOR CK. N.O. BH - ! � o.02-,, oct 4 .3 2.0 -0_ 7SX667 DBB 17 71-513 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING GOUNTY OF LOS ANGELES WILLIAM J. FOX. CHIEF ENGINEER I T GROUP ZONE PERMIT NLI. FOR APPLICANT TO FILL IN PLUMBER 01r (II.p R CEIVED BY READY FOR DATES ISSL(ED // FIRST INSPECTION ADDRESS b � � ��_/ - J BUILDING CITY TEL.NO.90 ADDRESS IX' COUNTY / y LOCALITY .� LICENSE NO. d � f EXPIRES NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER f �Y/✓t.,�� MAIL T WATER CLOSET(TOILET) S 0.50 111 ADDRESS3 D F:, CX-&'L-& BATH TUB G 0.50 CITY TEL N 10135 SHOWER 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES 50 KITCHEN SINK @ 0. AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY 0 0.50 ANGELES COUNTY LICENSE. OR 1 AM THE -LEGAL OWNER GAS SYSTEM OUTLETS @ 0.50 OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. (� SIGNATURE OF � (S 0. �`� WATER HEATER 0.50 PERMITTED SLOP SINK @ 0.50 INSPECTION RECORD FLOOR SINK 0 0.50 FLOOR DRAIN 0 0.50 DISHWASHER 0 0.50 DRINKING FOUNTAIN 0 0.50 URINAL 0.50 Q HOUSE SEWER O.5D Z MISCELLANEOUS 2 QA 1R' i O APPROVALS DATE INSPEOTOR'S NAME ROUGH PLUMBING GAS'PIPING GAS VENT CESSPOOL 0 1:00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT 1.00 GAS TEST r UTILITY CO.NOTIFIED � TOTAL FEE S 1 f J l7 �6s�• FINAL 3HSe7IO-VS 'N APPLICATION F®P PLUMBING PIE FdI4iIIT 1 DIVI4ION OF BUILDING AND SAFETY _ j Department of County Engineer County of Loa Angeles BU.ILDINa3-Q ° JOHN A.LAMBIE, COUNTY ENGINEER ADDRESS CASSATT D.GRIFFIN.SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN I NEAREST �j CROSS ST. [:AL)DRESS WNER �C g DISTRICT NO. GROUP ZONE READY FOR,INSPECTION O Q INDUSTRIAL CITY PA k C C// TEL.NO. 6 Q cx WA TE APPROVAL PLUMBER - a R INSPECTION RECORD ADDRESS W Cr, 1.�i'a � 4. v W tM ` aI CITY TEL NO. LICENSE NO. NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 $ BATH TUB @ $1.00 SHOWER @ $1.00 LAVATORY (WASH BASIN) @ $1.00 KITCHEN SINK @ $1.00 DISHWASHER @ $1.00 LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 GAS SYSTEM @ $1.00 APPROVALS DATE INSPECTORS SIGNATURE UNDER SLAB WORK 1 PERMIT $ 1 00 ROUGH PLUMBING ,A,, GAS PIPING TOTAL FEE �/ GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE.IS CORRECT AND AGREE TO COMPLY` _ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I IM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL OP RTY. SIGNATURE OF PERMIT TE FINAL I/ 7 IOHN A.LAMBIE,COUNTY ENGINEER VALTFIO . ROBERT A.WOOD.CHIEF PLB�PECTOR CK. N.0. CASH � 0 2 ,� SEP 18 3 3.4 0 m I WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT i hereby,affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers'Compensation Insurance, CE 817(REV.8/86) P02celIil�t��ifigdc''o�� the y �ec. 3800, L��`. C.) q Po�ltc �Nb�'U `��"�ompony�I �Ifi91') COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec NUMBER FIXTURE OR ITEM (g� FEE —.ADDRESS tion department. LOCALITY Date 3 Appligant ` WATER CLOSET NEAREST 1 CERTIFICATE OF EXEMPTION F A M WORKERS' ; BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed If the work Involved by rrn) IL the permit is for one hundred dollars($100)or less.) LAVATORY Dac-72 i, 1 I certify that in the performance of the work for which this SINK CITY .1a Jt TEL.NOS 1'. � � permit is issued, I shall not employ any person in any manner , +; so as 10 become subject to the Workers'Compensation Laws. DISHWASHERCONTRACTOR 4^ n ' f►i^ !I . Date Applicant CLOTHES WASHER ADDRESS IC g � NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR ^% Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- CITY 7 TEL.NO. P P Y LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. ) CLASS L Y LICENSED CONTRACTORS DECLARATION DISTRICT NO. PRQCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER '9Z and Professions Code,and my lice is in full force�and effect. 5 PER SYSTEM FINAL VALIDA ON CC JLC r OU DATE License Number Lic. Class 0 y mrllA __ 7 FINAL Contractor �tv �? + Date BY B ❑ I am exempt under Sec. r B.BP.C. for this reason v Plan check feel r Date: PLUMBING PERMIT ISSUING FEE$ 1— rL► 2 7 5&8 A Signature L� ' o 0-0 0 0 5 9 t TOTAL FEE �§_ / J Plan check applicant // V 1 `0' o I ��(�U c ) SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name [[[ Q a O 3`'8 7 j hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. ❑ j, 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 I authorize representatives of this County to enter upon the above-mention d property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signatui of Permittee Date WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I'hereby affirm that I have a certificate of consent to self 20-0026 DPW 6/87 insure, or a certificate cof Workers'Compensation Insurance, 76AS67A ILjf or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING r Certified copy is filed with the county building inspec- ADDRESS ((// tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Appligant WATER CLOSET 14 NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB 14_ 5 CROSS ST.�paS COMPENSATION INSURANCE SHOWER OWNER C (This section need not be completed if the work involved by the permit is for one hundred dollars($100)or less.) LAVATORY q' SSS DDRESSY r AVY, I certify that in the performance of the work for which this , permit is issued,I shall not employ any person in any manner SINK CITY L. NO. Zs d_g p so as to become subject to the Workers'Com enation Laws. DISHWASHER LL// CONTRACTOR S d Datey—Zl—9Z Applicant CLOTHES WASHER 14 55 ADDRESS NOTICE TO APPLICANT: If, after makin 1' is Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY TEL.NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. ROcESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS 119, ST (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER ` and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL VWIEWTION DATE License Number Lic. Class------ (C,, FINAL Contractor Date BY ❑ I am exempt under Sec. t. LL B.BP.C. for this reason Plan check fee ® U Date: PLUMBING PERMIT ISSUING FEE$ ZL� 75 Signature TOTAL FEE 00 SINGLE FAMILY Plan check applicant ; HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License _; z�� Law for the following reason (Section 7031.5, Business and Address Pro,tessions Code): City Tel. No. I, as owner of the property, will do the work and the L i j� .• structure is not intended or offered for sale (Section 7044, Business and Professions Code). ;''•y+ 97 a C-:L CONSTRUCTION LENDING AGENCY - "'r z-I, I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued i: ;jilx (Sec. 3097, Civ. C..,). Lender's Name ��'E`� !!- -- ^• 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-me Toned property fo inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 6� 3 z�9z Signature of Per i "e Date DECLAR WORKER'S.I COMPENSATION ate of consent to 57AP1N91� APPLICATION FOR PLUMBING PERMIT 'ri'hetaby'affirm that I have a certificate of consent to self Insure, , or a certificate of Worker's Compensation insurance,or a certified copy thereof.(Sec.3800 Lab.C.) Policy No. Company COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. El k • Certified copy is hereby furnished. EllDFOR APPLICANT TO FILL IN(PRINT OR TYPE) BU RESS Certified copy is filed with the.county building inspection ' department. NUMBER FIXTURE OR ITEM FEE LOCALITY Date• ApplicantWATER CLOSET ,-jloe 99 NEAREST CRO . CERTIFICATE OF EXEMPTION FROM WORKERS' BATHSo TUB . ASSESSST. SSOR COMPENSATION INSURANCE' (This section need not be completed If'.the work Involved by the SHOWER 0 MAP!BOOK PAGE PARCEL permit is for one hundred dollars($100)or less.) LAVATORY OWNER ..�� dA wa r L I certify that in the performance of the work for which this permit Is issued, I shall not employ any person in any manner so as to SINK ` MAIL ADDRESS SO V become subject to the Workers'Compensation Laws. �i��' 1 DISWASHER CITY CONTRACT R 917WL.NO. yo Date `Applican 9 ' CLOTHES WASHER vV Q _ NOTICE TO APPLICANT: If, after m' ki g this Certificate of - � " Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRESS provisions of the Labor Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL.NO. } I hereby affirm'that I am licensed under provisions of Chapter 9 WATER HEATER Q O. TE LIC. (commencing.with Section 7000)of Division 3 of the Business and GAS SYSTEM OUTLETS CENSE NO.• CLASS (Q,� Professions Code,and my license is in;full force and effect. Q OUTLETS OVER DISTRICT NO. PROCESSED BY 5'PER SYSTEM Q License Number Lia Class FINAL DATE VALIDATION W Contractor Date (f� ❑ 1 am exempt under Sec. FBY INAL ? B.&P.C.for this reason ..O Date: Plan check.fee , Signature PLUMBING PERMIT ISSUING FEE$ , ❑ TOTAL FEE SINGLE FAMILY Plan check applicant 5 � tiY .s HOMEOWNER-BUILDER DECLARATION 'Name ► 4e ebV AC �^? I hereby affirm that I am exempt from the Contractor's License Law 11 .511 for the following reason(Section 7031.5, Business and Professions Address Sp Code): � �� Cit I,as owner of the property,will do the work and the structure Tel.No. Z8' 0?V49 ,* is not intended or offered for sale(Section 7044, Business \ TOTAL 65.._ac 0 and Professions Code). C:NE�€� ��,, �' 65.50 CONSTRUCTION LENDING AGENCY CHANGE .00 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.) 1313106-001131 4!29l f L Lender's Name O%iuL 1 AM 10 06 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 p rpo SEE REVERSE FOR EXPLANATORY LANGUAGE ✓� �z 9�i