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Home My Public Portal About10656 ROSEGLEN ST_Plumbing__ 1 OOUNTY OF LOB ANGELES APPLICATION FOR PERMIT Depastmwnt of County Engineer DMSION• OF BUILDING & SAFETY PLUMBING 1 WILLIAM L FOX, County E[gl*wr FOR APPLICANT TO FILL IN JU PLUMS[ READY FOR DATE ISSUED FIR1T INSPEOTION ADDREM R100 FAST VALLEY BLVD, BUILDING6 / OITY EM D TEL NO. ADDRERS b,I OOUNTY 6-30- !1 LO DAL ITY C, PERMIT FEES cRDM ST. mumor1 TYPE OF FIXTURE OR ITEM Fii OWNER MAIL WATER OLOSET(TOILET) ! 0.60 0 ADD. BATH TUB ! 0.543 Ory TIL. No. SHOWER ! 0.60 I HEREBY AOKNOWLI DGE THAT I HAVE READ THIN LAVATORY (WASH BASIN) ! 0.50 AFr LI0ATION AND BTATZ THAT THE ABOVE IB OORREOT AND AGREE TO DOMPLY WITH ALL COT UHY ORDINANDKE KIT13HKN MINK ! 0.60 AND STAT[ LAWS REGULATING PLUMBING. 1 OERTIFY THAT I POeR[SS THE ABOVI VALID LOB LAUNDRY TUB OR TRAY ! 0.60 ANGELES OOUNTY LIOENS[. OR 1 AM THE i1GAL OWNF-R OF THE RESIDENTIAL PROPERTY D6.SORINED GAS BYSTi UTZ[T'S ! 0.60 • S10NATURE DF WATER HEATER ! 0.60 P[RMI � BLOP BINK ! 0.60 INSPECTION RECORD FLOOR MINK ! 0.BO FLOOR DRAIN ! 0.60 1312HWAHHER ! 0.60 DRINKING FOUNTAIN ! 0.60 URINAL ! 0.60 ..1 a HOUSE SEWER ! 0.60 _Z MISOE LANICOU!• O APPROVALS DATE IN R'S NAi1[ ROUGH PLUMBING GAD PIPIN■ GAS VENT GE66P130L ! 1.130 OKAMPOOL ■[PTIO TANKI BEPTIC TANK DRAIN ( ) PIT ( ) ! 1.00 ■EWER PERMIT 1.00 GAR TEST O UTIuTY OO,NOTIFIED TOTAL FEE 4 IrIHAL TGIIIQT DHH.#1T 642 78ABV-=17 10-W APPLICATION FOR PLUMBING PERM DEPTTT��TTT�AS�TT0 {a�aOyFMom .D r / B LAMdI ",wr7WCUEDDY t G G fJ zz s WILLJAM A. JM24MX I. SUP-T OF ;ftLJl•LDDI. �ocuJTi s C� T FOR APPLICANT TO = IN �. ty NLIMIiR ForruRs OR rrD1 OVA OW7EIK r.. WAM CLOSET yup Bm TUB Movnm `lff LAVLTOBT cw w G� Alm DMWbQMM czTT rm NO. Ty CLOTIM WAREM Earmcrr Ptp. ry WATSH DRATFM an Ram[ >mm'auL r IN— WAM AFPSOVAL MUSCTM ARD O Li $ APPROVALA DATE IHSrRCTOR'■mONATURS PERMIT !* 2 00 UNDER BLAB WORK TOTAL FEZ 0-VROUGH PLUMDING OAS PIPING I HST AC"GWLmai THAT I HAVE READ THIS APFUCATION AICD *TAT= THAT 71-M ASOVX UI CORRECT AND ASISS TO OOMPLY GAS VENT' wrrH ALL COUNTY OIDb[Amcxw Alm STAT[ LAQIS- asouLATDIa PLUMApla, HOT WATER HEATER I H>®Y CQTRT THAT 1 AY rRorEaLY FmmLv'Emm Alm/opt PLUMBING FIXTURES UCXMS= AS WQUIRMST L0* ANS X+ COUNTY AID STAT[ OF CALIFORNIA OR THAT I AY THE LEGAL QWXJKR OF THE ASOV E GAS TEST DESCRIBED P"IEKXTIAL rROFKK Y. UTILITY CO.NOTIFIED •IaNATURB OR PQiM FINAL VALMATIO�ROBERT A. WOOD C)L hL Ol c�+rH SUPERVISING MffxpiANICAL ENG•R << -5 9 7 9 0 T-1'6 5 D .;� .. WORKERS'COMP�NSAT`ION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 20-0028 DPW 6/87 Insure, or a certffl a of Workers' Compensation Insurance, 7BA6457A cK a cerffftbd copy thereof (Sec. 3800,tab. C. COUNTY OF LOS ANGELES DEPT.OF PUBLICWOnKS Policy No. Company ❑ Certffied copy Is hereby furnished. ❑ 1 QR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certlfled copy Is f#ied with the coonty building Inspec- 'w M tion department. NUMBER FIXTURE OR ITEM p FEE LOCALITY Date Appll4ant WATER CLOSET NEASEST CERTIFICATE Of EXEMPTINS ON FROM WORIO:RS' BATH TUB CROSS ST. � COMPENSATION INSURANCE OSARIER Y (1 hit sec"on need not be Xompleted If the wont Inyofred by d SHOWER the perrrrlt Is for one hwW red dollars ($190)or less.) LAVATORY MAIL � �� ..� I certify that In the perfoirmance of the work for wHlc.lr this permit Is ISWad,I shall not employ arty person-In any manner StNIK ChY IT �• it"— to us to become sub act tC.IT AMU o the Workers Compensation Laws. DI,SHWA.SkU CONTRACTOR Date O Ilca CLOTHES WA51 Ek NOTICE ICAN I: If, VeLabor kfng this CertlH e f � NG P� OR A Exemption,• you shouwbject to the � TEL NO . Compenwilon provlsloru of Code, you mu h- LAWN SPRING SYSTEM with comply with Stich provIslons,or this permlt shall be STATE LIC. deemed revoked. WATER HEATER UC[N5E NO. CLASS LICENSED CONTRACTORS DECLARATION y DISTRK-7 NO.� PROCUSEP BY I bereby affirm that I am Ilcertled under provisions of Chapter 9 GAS OUTLETS ` / Q (commeeciro with Section 7000) of Division 3 of the,Business OUFl.ETS CNEq A V.ALI AT10N 1.1 and Profeaiorr Code,and my license b ratn fullfodnd effect. 5 PER SYSTEM /�License Number Ic,Class ConM for _f/ t* BY ❑ L am exempt under Seq.- L�d 1 /1 vo 01 B.&P.C. fpr this reason d6A2 6Plan check fee. N Date: PLUMBING PERMIT ISSUING FEE; ,,) - Slgnatur TOTAL FEE SINGLE FAMILY Plan check applicant ' ` HOME OWNER-BVILDER DECLARATION Name 1 I hereby affirm that I am exempt from fhb Contractor's License Addreu ACC•T. r Lary for the following reason (Sectlon 7031.5, Business and T 1{ Rrofoulp s Code): City Ul. No. ' •1 I fCp]Tl 1, as owner of the property, will do the work and the f ZTWI struMrq is not Intended oroffered for sale (Settlon 7U44, Business and Profeselans Coc#q). TOTAL 35-- 90 CONSTRUCTION LENDINC?AGENCY C (ECK LL's Q�I I hereby affirm that there Is a construction fending agency for the performance of the work for which this pwmlt Is Issued ClY (Sec. 3097, Cly.C.). Lendees Name11, Lender's Addrqu 99,-4 j AM 15:39 L certify that I have read this appllcatfon and state that the pollabove Informatloh Is correct. I agree to comply with all County otcllnanves and State lows regulating Plumbing, and hereby authorize repra1entatives of this Cobnty to enter upon the gbove-mentioned property f Inapgctlon purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Slgna of Perm Date WORKERS'COMPENSATION 6EQARAT10N APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certfflcate df consent to self 76,667A, Insure, or a certlflcafe of Wbrkere Comp6nsatlon Insurance, CE 817 T(RfV. 10/gl) or a Gertl{If, py thfy�(,Sec. 3800, La c ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. mpany QCertfF copy Is hereby furnished. FOR AP-JGANT TO FILL IN(PRINT-OR TYPE) BUILDING D Certffigd copy Is filed with the unty Iding inspec- ti/o�n deportment. NUMBER FIXTURE OR ITEM O Pl E LOCAIJTY Date v Appll4ant WATH2 QOSET CERTIFICATE OF KRC3M WQR}CER$' BATH TUB CROSS ST. COMPENSATION INSURANCE' SHOWER OWNER (This seCHon heed not be completed N the w9rk Irrvc4v by the permit Is for one hundred dollars(=100)-or leu.) -LAVATORY MAll I certify that In the performance of the work for which this perrult Is Issued, I shall not employ any Person In any manner SIMC Cfr1' Te- NO. so as to become tubjecf to the Workers-Compensatlon Laws. DtSHWA5f*R CONTRACTOR Date Applicant .aoTH6 WASHER ADDRESS NOTIa TO APPLICANT: If, after making this CertifloWe of SWII\ShAItJG POOL R iOR f Exemption, you should become subject to the Workers' CrIFY TEL NO (v Compensation provl#ions of th'e Labor Code, you must forth- LAWN-1 FRINKLERSYSTEM with comply with such provistons or this permit shall be STATE } LK-1 13 r deemed revoked. WATER HEATER Lcow PS LICENSED CONTRACTORS DECLARATIOND STRICT B I hbrpby afffrrh that I am licensed under provisions<2f Chapter 9 Gu SYSTEM OUTLETS (commencing with Sectlon 7000)of Dlvltlon 3 of the Business and Professions Code,anb and my Iloerse Irl full force and effect. 5 PER SYSTEM FINAL > YALIDATION License Nvmbe, Ls �L—i� ic. Class ^ FINAL Contractorll k F taA." pate -BYEl oo r I om exempt under Sec. �r/_ B.ILP.t. for thn lr reaso , v(� - Plan cFlpgk fee date:' PLUMBING PERMIT ISSUING FEE$ d Slgnaturw _ _ TOTAL FEE C? Plan check applicant y SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Nam 1 I hereby affirm that I am Qxempt from the Conhactor's Ucerse ` 6.9A Law for the following reason (Sectron 7{131.$, Business an¢ Addfess Prronofesslpns Code): City Tel, No, #'0 0 0 'o 0 5"- 1, as owner of the prop", will do the work and the 2!u'0'2 2 5 0 ded structure Is not Intenor offerbd for sale (Section 704",Business and Professions Code). o o - 22506 CONS-MUCT10N LENNNG AGR4CY thereby affirm that theca Is a construction Ipndlnd aggncy for Q '9182 the performante of the work for which this permit Is (slued (Sec. 3097,Civ. C.) Lendoes Name Lender's Address I Certify that I have read this appllcgtlon and state that the QinforTnatlon b correct. I agree to comply with all CAuaty o (ponces and State laws regulating Plumbing, and hereby _ ihorize re elenlatives of this County to enter upon the vo- ent ped property for Inspectlonpurpose#• / SEE REVERSE FOR EXPLANATORY LANGUAGE 7 �— Slgnaturq a{Permittee Date