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Home My Public Portal About4937 ROBINHOOD AVE_Plumbing__ OBS-17 16-511 APPLICATION FOR PLUMBING. PERMIT OBS-17 DIVISION OF BUILDING AND SAFETY Department of County Engineer County of Los Angeles BUILDING JOHN A.LAMBIE, COUNTY ENGINEER f ADDRESS CASSATT D.GRIFFIN.SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. OWNER DISTRICT NO. GROUP ZONE READY FOR INSPECTION MAIL ADDRESS �O/ ' J� I /A�I I CI TEL NO. OT- -�� 3LINDUSTRIAL WASTE APPROVAL PLUMBER // ' INSPECTION RECORD y ADDRESS (D 1 CITY 40Z t.�aJ TEL.NO. LICENSE NO. (J �� 1= •/7�A !'�.C'�A t '9 J� /��1: r � NUMBER TYPE OF FIXTURE OR ITEM FEE .,a�.;Lsi WATER CLOSET (TOILET) @ $1.00 v 1 BATH TUB @ $1.00 �`, fi«.y �,E.r III/''✓Jr� s�J SHOWER @ $1.00 LAVATORY (WASH BASIN) @ $1.00 0 . ,•f KITCHEN SINK @ $1.00 DISHWASHER @ $1.00 LAUNDRY TUB OR TRAY @ $1.00 ✓—� �� 1 y''! / CLOTHES WASHER $1.00 Q 0 WATER HEATER @ 51.00 Q 0 GAS SYSTEM @ $1.00 Q Q APPROVALS DATE INSPECTOR'S SIGNATURE UNDER 9LAz6 WORK 11MA PERMIT ROUGH PLUMBING e J �(r ✓,'-LL.1't%�n r $ 1 00 GAS PIPING TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY + HOT WATER HEATERWITH ALL PLUMBING, COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES I 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 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL PROPERTY, - r SIGNATURE OF PERMITTEE 1&k 8 v FINAL i r � �/ •rte OHN A.LAMBIE,COUNTY ENGINEER VALIDATION ROBERT A.WOOD,CHIEF PLBG. INSPECTOR CK. N.0. CASH , LACoO JAN 2 3 A 12.00 1% 1 78A887-CE817-8-58 APPLICATION FOR PLUMBING PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISIONBIIlLDIIdG IOM A. LAMBIE, County Enahmer ADDREss 9 7 �;/AJ r o d . .:,:.:..CASSATT D.GRnTIN.Supt of Building d►t / -. ,�..:-....:..:; LocALrrY 7e T i FOR APPLICANT TO FILL IN NEAREST • NUMBER FIXTURE OR ITEM CROSS ST. OWNER OAri I u -/ � wATi�CLOSET BATE TOR ADDRESS Q 3 Al o a s saowER CITY 7c --)Pk CJJ TEL NO. LAVATORY CONTRACTOR g ADDRESS DISHWASHER CITY TEL.NO. LAUNDRY TOS CONTRACTOR'S STATE 13E: REMSTRATION NO. CO UNTY 01 CLOTHES WASHER DISTRIC�. GROUP ZONE P S BY.. ki WATER HEATER GAS SYSTEM INDUSTMAL WASTE APPROVAL INSPE=ON RECORD v P l APPROVALS gOPER r= g DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 2100 ROUGH PLUMBING TOTAL FEE GAS PIPING -H I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AHD/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF .: CALIFORNIA 0 THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RE ENTI PROPERTY . SIGNATURE OF PERM1TTEy FINAL / G/�� r �-.'•o••''+y /%w. a n'"" ROBERT A.tWOOD. Or UPERVISING MECHANICAL ENG'R ,VALIDATION M.o. LAC04,6 5- 66t APR °7 5 A 3.0 0 � ' P WORKERS'COMPENSATION DECLARATION ^s -C 8 617 ). APPLICATION F� PLUMBING PERMIT I hereby affirm that I have a' certificate of consent to self cE efr(z-ao insure,or a certificate of Workers'Compensation Insurance,.or Ltepplicant ( eei3800,Lab.C /� COUNTY OF LOS ANGE S BUILDING AND SAFETY hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING fated with the sou Iding inspection NUMBER FIXTURE OR ITEM 0 FEEADDRESS �- WATER CLOSET LOCALITY � �� -- NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved LAVATORY MAIL by the permit is for one hundred dollars ($lOQ) or les..) ADDRE SINK, CITY lv CL I certify that in the performance of the work for which this DISHWASHER 0 permit.is issued, I shall not employ any pALpon in any manner CONTRACTOR p pp so p m ject to the .o. ers" ti Laws. CLOTHES WASHER ADDRESS DONS, Qtlq�: Q D1Spflcant SWIMMING POOL RECEPTOR NOTICE TO APPLICANT: If, after making this Certificate of CITY SAN GA[3RIEL, CALM q to I t Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM LIC. 06 STATE Compensation provisions of the Labor Cade,you must forth- WATER HEATER LICENSE NO. � SS with comply with such provisions or this permit shall be deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. R SED LICENSED CONTRACTORS DECLARATION OUTLETS OVER �� I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM t 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL �^ ness and Professions Code,and my license is in full force and DATE •'t � VALID TI N effect. FINAL License ber Lie..Clasp s BY Q Contras Date �r m exempt from the licensing requirements as I am a Plan check fee icensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and PaOf si ns Cod!). ATOTAL FEE Lic.or Reg.No Da Pian check applicant HOME OWNER-BUILDER DECLARATION Name' CALUERRA1799 POOL% hf I hereby affirm that•I am exempt from the Contractor's Address 88011 EAST LAS TUNAS QRlVFV License Law for the following reason (Section.7031.5, Bust- City A RI L, CALIfl@RWA e17?g 4 0 3,9 A ness and Professions Code): T, as owner of the property, am exclusively contracting ' 5. wio a �° o °th licensed contractors to construct the project ° ° Z (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY ° ° ° 2 Q 5 O 50 I hereby affirm that these is a construction lending agency O _$ for the performance of the work for which this permit is 5, 1 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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize representatives,of this County to enter upon the Y,s- tinned propert inspection pur � ature of Permittee Date .�.