The URL can be used to link to this page

Home My Public Portal About4954 ROBINHOOD AVE_Plumbing__ iBA669�C.EBl�-'E-58 APPLICATION FOR PLUMBING PERMIT 1 . COUNTY OF LOS ANGELES ' DEPARTNNIENNT OF COUNTY ENGINM BUILDING AND SAFETY DIVISION HUM '0 G JOHN A. LAMBIE. County ees BATT D.GRIFFIN.Supt of Building --� LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER ' FIXTURE OR ITEM OWNER WATER CLOSET MAIL BATH TUB ADDS 9 -4 6 d SHOWER CITY ' a L, TEL.NO. LAVATORY CONTRACT STHS ADDRESS DISHWASHER CITY TEL.NO. LAUNDRY TUB CONTRACTOR'S STATE E3 REGISTRATION NO. COUNTY CLOTHES WASHER DISTRlr—T:NO:.j GROUP, ZVNEA P SSED BY WATER BEATER GAS SYSTEM INDUSTRIAL ' WASTE APPROVAL SPE=ON RECORD ls' t y ��11S APPROVALS @ Oo °a � I 10(,. DATE INSPECTOR'S.SIGNATURE UNDER SLAB WORK PERMIT $ 2 00 ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY HOT WATER HEATER 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 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED �v DESCRIBED RESIDENTIAL PROPERTY. SIGNAY-URE FINAL OF PERMITTE e' ROBERT A.WOOD. ®e VALIDATION SUPERVISING MECHANICAL ENG'R CR. R.0. CARR LT05364S APR 20 5 A 3.00 r^ 7BB CG 81717B-BE APPL..ICATION FOR PLUMBING PERMIT 1 BUILDING AND SAFETY DMSION Department of County Engineer County of Los Angeles BUILDING �� O JOHN A.LAMBIE,COUNTY ENGINEER ADDRESS CASSATT 0.GRIFFIN,SUPT OF BUILDING LOCALITY <C- FOR APPLICANT TO FILL IN I NEAREST �r CROSS ST. OWNER L1r DISTR . GROUP I ;?NF- I READY FOR INSPECTION MAIL ADDRESS e INDUSTRIAL CITY qp Co.EL.NO, WASTE APPROVAL Valley alley Plumbing `NINSPECTION RECORD ADDRESS 442 W. s lee Wood Pl. CITY Glendora TEL.NO. Ed 5-129 LICENSE NO. 160847 NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 / ,.0 BATH TUB @ $1.00 [• SHOWER @ $1.00 d LAVATORY (WASH BASIN) @ $1.00 Q KITCHEN SINK @ $1..00 (� DISHWASHER @ $1.00 LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 ®Q GAS SYSTEM @ $1.00L (� APPROVALS DATE INSPECTOR'S SIGNATURE r UNDER SLAB WORK PERMIT $ 7 00 ROUGH PLUMBINGZZ GAS PIPING TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WALTER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES PLUMBING. 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 RESIDENTIA ROP RTY. SIGNATURE f OF PERMITTE INAL -2U ROBERT A.WOOD, JOHN A.LAMBIE.COUNTY ENGINEER VALIDATION SUPERVISING MECHANICAL ENG'R CR. M.o. CASH � 3 6 5 01;; OCT 23 3 11 -00 I WORKERS'COMPENSATION DECLARATION 20'0026 DPW 4/90 APPLICATION FOR PLUMBING PERMIT I ereb ,'bffirm that I have a certificate of consent to self in- sure,or certificate of Workers'Compensation Insurance,or a 76A667A certified cop ther of(Sec. 3800, Lab. policy N�}�Company 1 COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS u ❑ Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM FEE department'. ® LOCALITY Ddte Applicant WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS,' 'BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS 1 certify that in the performance of the work for which this per- SINK CITY mit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws.. DISHWASHER CONTRACTOR S Date• Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of Ex- , ADDRESS tion,you should become subject to the•Workers'Com en- SWIMMING POOL RECEPTOR em P Y I P CI TEL.N $F:��'a sation provisions of the Labnr Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed,revok- STATE / LIC.. ed. WATER HEATER LICENSE NO. G-rp CLASS LICENSED,CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000.)of Division 3 of'the Business OUTLETS OVER of . and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION /t �{ ' fect. HOSE BIB DATE Vl ZZ {� y. License Numbe ga Lic. Class �C E u O FINAL °s Contracto Date _ BY C7 I cm exempt undo Sec. 330 �040 V B.BP.C. for this reason Plan check.fee 1 ITEM LU Date: ; PLUMBING PERMIT ISSUING FEE$ TOTAL ��_4� z Signature TOTAL 5$°4L1 TOTAL FEE Cj CHANGE °00 • SINGLE FAMILY' 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 7031.5, Business and 0000-0001 11/15/95 Professions Code): Address 3317 1 AM10: 7 I, as owner of the property, will do the work and the City Tel. No. 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 i 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 s ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-m w roperty for. inspection purposes*oses, • "� — SEE REVERSE FOR EXPLANATORY LANGUAGE Signaturof ermittee Date