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Home My Public Portal About4849 ROBINHOOD AVE_Plumbing__ ...IN.B4 APPLICATION FOR PLUMBING PERMIT nplsaemE.d � cow�vaB'-o-mG.e � BUILDING WM.J.FOX.COUNTY ENGINERN ADDRESS CAGSATT D.GRIMM.GUP'T OF BUILDING LOCALITY FOS APPLiGM TO FILL IN NEAREST OWNER YAIL 5 DISTRIcr. GROUP BRADY Fol INYPECTIOR ADDRESS -r INDUSTRIAL 9HTv TEL.M92. WASTE APPROVAL PLUMBS Eft, .�� QCT= NBC= ADDRES� aL/ /�- /7��Gjj7 PA L CITraG:' � /FN& TENO./TTIctpl LICENSE NQ -qdV/7 OL-i , • .. A NUMBER TYPE OF FIXTURE OR ITEM FEN WATER CLOSET (TOILiTI $ ! .A BATH TUB / SHOWIMG LAVATORY (WASH SAWN) KITCHEN SINK DISHWASHER + LAUNDRY TUB OR TRAY CLOTHES WASHER e- AL NO 0.60 AirAPPSOYALS Z DATE Immum9c OR'S SIGNATURE _OAS SYSTE UTLETS A 1.00 1 ' WATER NEATER 1.001 �C• UNDER BLAB WORK ROUGH PLUMBING /6 --"• 119RYIT • 00 GAS PIPING TOTAL FEE GAS VENT I HEREBY ACRNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER f AND STATE THAT THE ASOYE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES PLUNGING. 1 HEREBY CERTIFY THAT 1 AN PROPERLY REGISTERS p GAB TEST LICENSED AS REQUIRED BYPitCO TY AT F UTILITY CO.NOTIFIED �- CALIRORNIA OR THAT OF THE YEDESCRIBEDRRSIDEPROAr SIGNATURE OF PERMI FINAL , • wraz 21111111110 WILLIAM J.FOX.COUNTY ENGINR3R YALMT '6' �� G/ q a five 0107+.e . C06 7 7 2`S AUG 17 3 9.A 0 °f f /yv X,n �m/a A �� r � DEPUTY ,7,BAB7 1?135.17 3•50 APPLICATION FOR -PLUMBING. PERMIT. DM- SION OF BUILDING AND SAFETY q Department of .County Engineer f7 County of Los Angeles ' WM.J. FOX, COUNTY ENGINEER BUILDING ADDRESS GABSATT D. _.GRIFFIN,SUPT OF BUILDING ' rarm.m.%,ffjx1drtLOCALITY FOR APPLICANT TO FILL IN NEAREST. CROSS ST. � �. OWNER k- &, -1:8 y _ � �qY-tDISTRICT NO. GROUP ZONE ADY FOR INSPECTION MAIL I � - ADDRESS deff,�% "•. � "' CITY INDUSTRIAL x TEL. . WASTE APPROVAL .PLUMBER INSPECTION RECORD cy ADDRESS , CITY TEL.NO. LICENSE NO. NUMBER' TYPE OF FIXTURE OR ITEM F.6E ' z _ _ WATER CLOSET (TOILET) S. BATHTUB L SHOWER LAVATORY (WASH BASIN) KITCHEN SINK DISHWASHER LAUNDRY TUB OR TRAY . �" + CLOTHES WASHER TOTAL NO. 0.80 APPROVALS DATE - INSPECTOR'S SIGNATURE" GAS SYSTEM OUTLETS_ @ 1.00 �• .WATER HEAVER @ 1.00 UNDER SLAB WORK A � ROUGH PLUMBING. �!Y a ALV PERMIT. S. I 7 yu GAS PIPING TOTAL FEE 1 GAS VENT -1 HEREBY ACKNOWLEDGE THAT:1'HAVE RSAD 'THIS APPLICATION HO`I WATER.HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES Ea PLUMBING, LHEREBY CERTIFY THAT I AM -PROPERLY REGISTERED AND/OR GAS TEST G•� ENSED AS. REQUIRED BY LOS ANGELES COUNTY AND STATE 'OF IFORNIA OR THAT t AM' THE LEGAL OWNER 'OF THE ABOVE' UTILITY CO.NOTIFIEDCRIBED RESIDENTIAL PROPERTNATUREF PERMITTED FINAL WILLIAM J.FOX.COUNTY ENGINEER VALIDATION R.A.WOOD.CHIEF PLBG.INSPECTOIt IU 6'0 4.2�. SEP 1.6 3 2.0.0 !n . • s WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby,affirm that I have a certificate of consent to self 7BA667A insure, or a certificate of Workors'Compensation Ipsurance, CE 817(REV.8/86) or a certified cop t e a (Sec. 3800, La C. In; /�(J , COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS PolNbt' 'N" mpany ❑ Certified copy is horeby furnished. ® FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ADDRESS Certified copy is filed with the county building inspec- I 4q. PAbaq hw6 &C- ' n e NUMBER FIXTURE OR ITEM @ FEE LOCALITY tt a '� rWATER CLOSET Date Appl ica of NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This soction nood not bo complotod if tho work involved by MAIL lkMo tho permit is for ono hundrod dollars($100)or loss.) LAVATORY ADDRESS I certify that in the performance of the work for which this �nj�/)~ permit is issued, I shall not employ any person in any manner SINK CITY TEL. NO. jJ f/J so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY TEL.NO. E Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM 1b rblA with comply with such provisions or this permit shall be STATE LIC. s /_ deemed revoked. WATER HEATER LICENSE NO. CLASS !l/ LICENSED CONTRACTORS DECLARATION DIST�NO.� c/ ESSE BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS J U IIX (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code,and m license is in full force and effect. 5 PER SYSTEM FINAL LIDATION C G� DATE License Number Lic. Class 0" X1 FIN � Contractor I ,r Date BY ❑ D 76 il' l�_ I am exempt under Sec. D B.BP.C. for this reason tf Plan check fee c Date: PLUMBING PERMIT ISSUING FEE$ 5 G Signature TOTAL FEE Plan check applicant A 7 7 8 0 A SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name 0 0 0 0 0 5 j hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and I 0 0 1 6 5 0 Professions Code): City Tel. No. o 0 0 16 5 0 ❑ I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section ® o Q 1 8-87 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby off irm 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 obov en�df�ed property for i pection purpose ��((// 411 � SEE REVERSE FOR EXPLANATORY LANGUAGE Signatu#of Permjftee Date