HomeMy Public PortalAbout4813 RYLAND AVE_Plumbing__ •76A667 17 11-49 APPLICATION,FOR PERMIT
i DEPARTMENT OF BUILDING AND SAFETY PLUMBING
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
D 5 R NO. GROUP I ZONE P
FOR APPLICANT TO FILL IN
PLUMBER �,��-7 / LGY� // �� RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION A v
ADDRESS a, � ��
®(!7(J BUILDING 171 gyp,
CITY TEL No _ ADDRESS `` (/ N
i
COUNTY LOCALITY !
LI ENSE NO. All EXPIRES �J' 3/1 ��
NEAREST
PERMIT FEES CROSS ST. t 2 �+
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER � /.� 3!' 7/� (.' a
MAIL
WATER CLOSET(TOILET) @ 0.50 $ ADDRESS
BATH TUB @ 0.50 CITY ,7 �,, . TEL. NO.
SHOWER @ 0.50 1 HEREBY ACKNOW GE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN BINK @ 0.50 AND STATE LAWS REGULATING PLUMBING.
/ I CEELERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGS COUNTY LICENSE, OR 1 AM THE LEGAL OWNE
OF THE g IQ CECI_TJ�ALr' RdPERT BJBVE
GAS SYSTEM OUTLETS @ 0.50 LLII�RRJ AID,
SIGNAT E OF
WATER HEATER @ 0.50 PERMITTE
SLOP SINK @ 0.50 INSPECTION RECORD
FLOOR SINK @ 0.50
(FLOOR DRAIN @ 0.50
DISHWASHER @ 0.501 �g 7-E37- AfG
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50 J
Q
HOUSE SEWER @ 0.50 _Z
MISCELLANEOUS
o
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING f �. • / .117
GAS VENT Y.
V
CESSPOOL @ 1.a0 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 I SEWER
PERMIT I 1.003 GAS TEST
_ UTILITY CO.NOTIFIED•
TOTAL FEE L FINAL
76A667 - CE817 5/70
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUMMINGf /19*
y 0
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS J t �G. L/
�CbLEMA'N Ws JENKINS. SUPT. OF BUILDINGLOCALITT 459211OZ6
FOR APPLICANT TO FILL IN(PR NT OR TYPE NE��T �
NUMBER FIXTURE OR ITEM EACH" FEE. ^ f}
WATER CLOSET 1.50 OWNER
KAM
BATH TUB 1.50 ADDRESS /
SHOWER 1.50 CI
LAVATORY 1.50 CONTRACTOR/-2
9e-��,�
SINK 1.50 XDDRESS
DISHWASHER 1.50 TEL.N
CLOTHES WASHER 1.50 STATELIC
LICENSE NO. CLASS
SWIMNUNG POOL RECEPTOR 1.50 DISTRI NOS, GRO. Zp E P ES BY
LAWN SPRINKLER SYSTEM 2.00 GJ�/
WATER HEATER 1.50
AASTTE�i INDUSTRIAL
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD
OUTLETS OVER 30
5 PER SYSTEM
_ �g�U,p
g
Ie
N
z
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE-S 3, 00
TOTAL FEE
- J, APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City. Tel.' NO. HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT ! NAVE READ THIS APPLICATION PLUMBING FIXTURES
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _
WIT" ALL' COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT'I AM THE LEGAL OWNER' F AND INTEND TO -
BESIDE IN.THE ABOVE B RESIDENT[A OPERTY. FINAL117
SIGNATURE .LACI{ R.ALLEN, SUPERVI I CHANICAL.ENG'R.
OF PERMITTEE PERMIT VALIDATIO c M.O. CASH,
r .
PLAN CHECK VVALIDATIOJ1 CK. M.O. CASH
Ao-4 a 8 s';S Jiw 7 5 D 4.7 5-
WORKERS'COMPENSATION DECLARATION i APPLICATI®N FOR PLUMBING PERMIT
hereby affirm that I have a certificate of consent to self 76A667A
sure, or a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81)
cern' ied copy thereof(Sec. 3800, Lab C. COUNTY OF LOS ANGELES BUILDING AND SAFETY
K,2 Company ' L
v� ❑ Certified copy is hereby furnished.
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING 119
,Certified copy is filed with the county building inspec- i ADDRESS
OCERTI
RICATE
NUMBER FIXTURE OR ITEM @ FEE LOCALITY
WATER CLOSET
DateAppli.gant NEAREST
EXEMPTION FROM WORKERS' BATH TUB CROSS ST.
COMPENSATION INSURANCE OWNER' .
(This section need not be completed if the work Involved by SHOWER
the permit is for one hundred dollars($100)or less.) LAVATORY MAIL
ADDRESS
I certify that in the performance of the work for which this
permit is issued, I shall not employ any person in any manner SINK CITY TEL.NO.
so as to become subject to the Workers'Compensation Laws. DISHWASHER
CONTRACTOR
Date Applicant I CLOTHES WASHER ADDRESS
NOTICE TO APPLICANT: If, after making this Certificate of
Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR
Compensation provisions of the Labor Code, you must forth- CITY TEL.NO.�
LAWN SPRINKLER SYSTEM
with comply with such provisions or this permit shall be STATELIC.
deemed revoked. WATER HEATER LICENSE N /„7 CLAS
LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED Y
I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS _5
(commencing with-Section 7000)of Division 3 of the BusinessOUTLETS OVER I
and Professions Code;and my license is in full force and effect. 5 PER SYSTEM FINAL •�� VALIDATION O
DATE �®� U
I License Numbe Lic. Clas "
`�-��d� tom°
FINAL t' O
Contractor Date a �y „ BY 4 .a-� ,1 9J
f
I am exempt under Sec. �
B.BP.C. for this reason �
,Plan check fee
Date: PLUMBING PERMIT ISSUING FEE$ ® 1 0. 1 P
Signature
TOTAL FEE i}A8 0'a 0.0
SINGLE FAMILY Plan check applicant ? o o 3 C,5 C
HOME OWNER-BUILDER DECLARATION Name �`c o 5 n 5 C?
1 hereby affirm that I am exempt from the Contractor's License Address n
Low for the following reason (Section 7031.5; Business and
Professions Code): City Tel. No.
❑ I, as owner of the property, will do the work and the
structure is not intended or offered for sale (Section S,
704.4, Business and Professions Code).
CONSTRUCTION LENDING AGENCY
I 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
I certify that I have read this application.and state that the
above information is correct. I agree to comply with all County j
ordinances and State laws regulating Plumbing, and hereby
authorize representatives of this County to enter upon the
e-mentioned property for inspection purposes.
o SEE REVERSE FOR EXPLANATORY LANGUAGE
aSignof Per tee D