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Home My Public Portal About9202 ROSEGLEN ST_Plumbing__ 7BAW7-CEW7-Ila APPLICATION FOR PLUMBING PERMIT COUIM OF LOS ANGST DuAHTmuft OF COONTY ENGRUEH YORK AAND SAF= LAMM znah�L)IVISION � d�- G` of LOCAL= FOR APPLICANT TO FILL IN 1QSE�B�f . NUUE3MFt F XTUFMOR ITEM waTl�cLoeEr Owm uAll nATR Toa ADDSW Sill— =Y NO. LAVATORY COWMACTOR — eua Annea�s — nISEwABECE2 errr TEL NO. LAUNDRY TUB RExgffTRivm NO. COUNTY CLO72M wAAZEM D18iRICT GROUP I z9tm wAm 8Faffi �� 1-4 — aiD BY37EN R[DOETRIAL RAMS APPROVAL ON f J ) ) APPROVALS O / ° / ate. DATE IRbFSCT01t'S SIGNATURE UMDERJH-"WORK PERMIT ; Z ROUGH PLUMBING TOTAL FEE GAS PIPING I HEUMT AMOWLEPDQ t THAT I HAVE R M THIS APPUCATIo!!}} AAS�T A��,H�I V•rAJJ..]]T.X, THAT THt.A"OnCIs ORRECT AND AND STATE LA REE TO REGULATING HOT WATER H -11M L%ll10. Cb LING Q LXTUTMS I HXMY CERTIFY THAT I Al P20MLT REGISTERED AND/OR I10ElRRpDED AS WJ W Hj IAS ANGES{SS COUIIIT ARD pTA7� OF 9"TOST D6fCltIRNI1311b p=SIDTH�ATA I KI THE "GAL OWMM Ol T}tI &" J<IGINAIIRRE I ��+ r OF IIAL- Or YAL.II}AlION )RQB 004. UPXR)nSING MECHANICAI,ENG'R (Q 3 6 2 4 F#AR l g 5 3.00 APPLIEATIGN FOR PLUMBING PERMIT DriMON 01' BU11DING AND SAFETY D"-mft-o of C--tr EhvUb6Q COVAIT of Lo+ Angolms �ndRass L JOHN A. LAMBIE, COUNTY ENGINEER CASSATT D,GRIFFIN,SUFT OF BUILDING LOCALITY FOR APPUCANT TO IN NELA REST CRQEW ST. OWN<ZR DISTRICT[`40. GROUP ZONENKADT rolaIMYf RCTj OY IL D RES!< rlITY TEL.. NO INQUIBTR1AL �p AJi'!E APPR VAL /� ��.�./�n� PL BER = llg l�O INSP=ON �iG. On . 442 W. Fleetwood P1. DR Iblidura CITY TSL NO. Ed 5--129 3 y -� •Q s LICENSE NO. JiUYm[R TYTt OF rLKrURZ OR CIZH F[i WATER CLOSET (TOILET) 1.00 BATH iV B 41.00 SHOWER t.00 LAVATORY (WASH BASIN)' $1.00 KITCHEN SINK •1.(>0 DISHWASHER 1.00 L AtYNDRY TUB OR TRAY V.00 CLOTHILP WASHER- a 101.00 WATIER HEATER 411.00 GAIS BYSTB;M 111.0.0 . APPROVALS DATE IMSPE NATURF UNDIER 36dA WOR PERMIT00 R UGH PLUMBING S DAH PIPING TOTAL FEE oAe vuv-r 1 HER"Y AC@(OWLEPr.9 THAT I RAVE AE.A0 THIS APPLICATION A116 STATE. THAT THE ABOVE 18 CORRECT AND Ar.B." 79 COMPLY ttOT WATER HEATER 111TH ALL COUN•fY ORDINANCES ANI) STATE LAUD REGULATING , PLUMBING-. PLUMBING FIXTURIIB I HE4KBf QErR7WY THAT I AN PROPER4Y REGISTERED AND/OR GAS TI&T LICENSED AS REQI1 IRED BYMLT ANGELES ¢¢OUNTY ND STATE OF CALIFORlIiA pR YHAT ) AM THE LEGAL 0WN9:R 0 THE ABOVE UTILITY CO.NOTIFIED -DESCRIBED RESIDENTIAL P PERTY. BIGNATURS O(r PERM ,JOHN A. LAMBJE, �--OUNTY E;NQININA A MAIION ROGER-t A.WOOD, CHIIF PL.BG.1N9PXCTOR ■.'s. CANE '� � 5,03 3 3A 7enee7 (CE-817) - e/73 Q APPLICATION FO PLUMBING PERMIT�r COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING � � �� ADDRESS - HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TY PEI NEAREST CROSS ST. CP7 t, NUMBER FIXTURE OR ITEM O FEE WATER CLOSET 1.75 OWNER Z n MAIL BATH TUB 1.75 ADDRESS SHOWER 1.75 CITYyuzaL 61,44 �Fef NO. LAVATOfiY 1.75 CONTRACTOR SINK 1.75 ADDRESS DISHWASHER 1.75 CITY TEL NO. CLOTHES WASHER 1.75 STATE LIC SWIMMING POOL RECEPTOR 1.76 LICENSE NO. CLASS DISTRICT NO. GROUP N P ZE BY LAWN SPRINKLER SYSTEM 1.75 WATER HEATER 1.75IIqq�� WZ4"MOVAL �ppy GAS SYSTEM OUTLETS 1.75 'INSPECTICvj C C� OUTL VER 6 PER SYSTEM .30 aSr �O IES LLJd to Plan check fee See Revers. PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INI P[CTO R'5 SIGNATURE Plan check ap Icant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND [TATE THAT THEABOVE IL CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AMD/OR UTILITY CO. NOTIFIED v L l 42 REdUIRED BY LOB ANSELEB COUNTY AMD STATE OF OR TH}.T 1 AM THE LEGAL OWNER OF, AND INTEND TO E ABOVE DED RIBED RESIDENTI P R FINAL L ITTE P RMI`f'GALIDATION CK. M.O. CASH PLAN CHECK VALIDAT N CK. M.O. CASH I 8 9 ILLI-FEB5 D 4,7 5 e I WORKERS'COMPENSAnON DECLARATION APPLICATION FOR PLUMBIN "IT I'15weby affirm that I have a certificate of consent to self 76A667A -� Insure,-or a certificate of Workers' Compensation Insurance, O<817(REV. 10/81) u or a certlfled copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy Is hereby fumished. FOR APPLICANT TO RLL IN(PRINT OR TYPE) ❑ Certified copy Is filed with the county building Inspec- NUMBER FIXTURE OR ITEM O FEE vim+ tion department. LOCALITY APP, Date II4a nt WATER CLOSET NEAREST CERTIFICATE OF EXEMPTIpN FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This sec&m need not be completed If the work Imrohred by MAIL y the permit Is for one hundred dollars($100)or has.) LAVATORY o` I certify that In the performance of the work for which this permit Is Issued, I shall not employ any person In any manner SJNK TEI Na. saas to become subject to the Workers Compensation Laws. DISJ-WASHER Dote plica QOTHES WASHER ADDRESSNOTKE fO A I • If, after making this Ce tate of / JoZill Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR QTY 7EL Compensation provisions of the Labor Code, you must forth- LAWN SPRItdQER SYSTEM with comply with such provisions or this permit shall be STA LIC deemed revoked. WATER HEATER LCENSE NO CLASS UCENSED CONTRACTORS DECLARATION MSTRI Pt� BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS ``(((v/////QJ/ (c(>mmendng with Section 7000) of Division 3 of the Business OUTLETSovER and Professions Code,and my license b In full force and effect. 5 PER SYSTEM FINAL DATE 2 v IDAnoN License Num Ic. Class _ FINAL �. Conimic BY ❑ I am exempt under Sec. B.&P.C. for this reason Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ 261 4,1 A Signature 116 15V rorA�.r� #,000005 Plan check applicant SINGLE FAMILY ( 'o 0 1 6 5 0 HOME OWNER-BUILDER DECLARATION Name o o o 1 65025 I hereby affirm that i am exempt from the Contractors License Law far the following reason (Stiction 7031.5, Business andf°sss Professions Code)r City Tel. No. 2.1 9t6 86 ❑ I, as owner of the property, will do the work and the structure Is not Intendbd or,offered for sale (Section , 7044, Business and Professions Code)_ I C'ONSTRUCnON LENDING AGENCY I hereby affirm that there Is a construction lending agency for the performance of the work for %yhlch this permit Is Issued (Sec. 3097, Clv. 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 reprelentatives of this County to enter upon the a e mentlo property for Inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature ee