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Home My Public Portal About4950 ROBINHOOD AVE_Plumbing__ } APPLICATION FOR PLUMBING PERMIT 1 : COUNTY OF LOS ANGELES' ,DEPARTMENT OF COUNTY ENGINEM BUILDING BUILDING AND SAFETY DIVISION ADDRESS � � �0A iiOHN A.LAMRIE. C0 ly Far CASSATT D.GBIPFirI.Sup td $n91d4aS LOCALITY]t: FOR APPLICANT TO FII,IN CR�ST.. NUMBER FIXTURE OR ITEM R..� s OWNERWATER CLOSET t o DD TUB ADDRESS 4-' SRATH HOWBR ClTY 7 TEL.NO. 4 12� 1 ' LAVATORY CONTRACTOR SI ADDRESS. DISHWASHER CITY .TEG.NO. Arngo CONTRACTOR'SQ r�_--p ST TE LAUNDRY TUB REGISTRATION NO. L"tel L COIINTY 'CLOTHES WASHER DIST RI nNO: f3R�UP ONE1 BEADY FOR IxsPEcr10N WATER HEATER GAS SYSTEM INDUSTRIAL WASTE APPROVAL t INSPECTION RECORD APPROVALS ¢ $1.00 PER ITEM' J DATE' INSPECTOR'S SIGNAYURE OR FIXTURE $ .� { UNDER SLAB WORK PERMIT 5 OQ ROUGH PLUMBING TOTAL FEE GAS PIPING 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. i PLUMBING FIXTURES r _ ? I HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR ' GAS-TEST F r� LICENSED. AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF C I CALIFORNIA_ OR THAT I AM THE LEGAL OWNER OF THE A8 VE UTI-LITY CO.NOTIFIED DESCRIBED RESIDENT/ L PROPERTY. StGNATURE47 FINAL OF PERMITTE ROBERT A.WOOD. VALIDATION SUPERVISING MECHANICAL ENG'R R.o. r,Asx . M4 5.7 7� iti'8 6 5 A 3.00 � a. .CE 817 8fB8' APPLIOATIO-N FOR PLUMBING PERMIT 7GAGGII ,.� BUILDING AND SAFETY DMSION Department of County Engineer ,, County of Los Angeles ADDRESS .e A-1"4UILDING 04-4-,JOHN A.LAMBIE,COUNTY ENGINEER CASSATT•D.GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. OWNER �j (,L DISTRICT NO. GROUP Z NE READY FOR INSPECTION MAILADDRESS lrr®. A '� INDUSTRIAL CITY 71v I (SL TEL.NO.•v��G//d' �Z WASTE APPROVAL PLUMBER V+ / �� INSPECTION RECORD ADDRESS W Cp AallL0114-1 .r.��l CITY TEL.NO. Cf-/% .'a A4 � ,.. a •• �_.!' .,4 ) LICENSE NO. NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 St •' � d 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 j WATER HEATER @ $1.00 I GAS SYSTEM @ $1.00 APPROVALS DATE INSPECTORS SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING GAS PIPING TOTAL FEE J i''d GAS VENT 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOTVI(.4TERHEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBMG. 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 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NO.TIF.IED r `l DESCRIBED RESIDENTIAL PROPERTY. 41SIGNATURE �� OFERMITTEE -FINAL. 6 ROBERT A.WOOD, JOHN A.LAMBIE,COUNTY ENGINEER VALIDATION SUPERVISING MECHANICAL.ENG'R CK.J R.0. CASH �� (&5 2 9 5.NO, SEP 2 9 5 A 12.0 0 M „ . . WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT -d h'ereby'offirm that I have a certificate of consent to self 76A667A ihsure, or a.certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) u or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No.-Company- Certified o. CompanyCertified copy is hereby furnished. Q [� ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS BUILDING #C;o Certified copy is filed with the county building inspec- NUMBER FIXTURE OR ITEM FEE tion department. LOCALITY eh'tL e &i rr r Date Appli4ant WATER CLOSET NEAREST � CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. 4/4,i4q;U CL COMPENSATION INSURANCE OWNER SnLl (This section need not be completed If the work involved by SHOWER �.�I� td 2,� the permit is for one hundred dollars($100)or less.) j LAVATORY ADDRESS Ra 1319 J cod I certify that in the performance of the work for which this permit is issued, I shall not emplo�.rjke any p on.in any manner SINK CITY � �.� TEL.NO.&He_1 p so as to become jsubject to the Ws; ompe alio .Laws. DISHWASHER Date�� CONTRACTOR pplicant. Ir CLOTHES WASHER ADDRESS 9 NOTICE TO APPLICANT: If, after making this Certific o Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR I Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITYd TEL. NO.14&y 3f0 with comply with such provisions or this permit shall be STATE B LIC. deemed revoked. WATER HEATER LICENSE NO. O�CJ CLASS LICENSED CONTRACTORS DECLARATION DI.STRIINO,� 077 I hereby affirm that I am licensed under provisions.of Chapter 9 GAS SYSTEM OUTLETS /VEL (commencing with Section 7000)of Division.3 of the Business OUTLETS OVER and Professions Code;and my license is in full force andeffect. 5 PER SYSTEM DATE � _ VALID s� TION License Number- C4 S- Lic.Class /� G! FI C Contractor �/� /TDu�A'r'9a � te ��) ❑ I am exempt under Sec. C IL B.&P.C. for this reason LL Plan check fee ► n Date: ' U PLUMBING PERMIT ISSUING FEE$ Signature � e TOTAL FEE: ;24678A Plan check applicant SINGLE.FAMILY 0 0 0 0 0 5 HOME OWNER-BUILDER DECLARATION Name ''1 002250 I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section.7031.5, Business and o o - 22505 Professions Code): City Tel..No. ❑ I, as owner of the property, will do the work and the Q S.2 a 8 6 structure is not intended or offered for sale (Section , 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY 1 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 epresentatives of this County to enter upon the abov - ntioned property for inspection purposes. SEE-REVERSE FOR EXPLANATORY LANGUAGE �n.ture of Permittee Date ,