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Home My Public Portal About4913 RYLAND AVE_Plumbing__ 76A667 17 11-48 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER PLUL DISTRI O. GROUP O . FOR APPLICANT TO FILL IN � r �� !7 ® /) PLUMBER l/ I :/ RECEIVED BY READY FOR DATE ISS ED ADDRESS /Y �1 1Dw Q� I(/�I FIRST INFECTION 3 w 17 c ,� n BUILDING CITY TEL.No.=f,1 -A&6 ADDRESS COUNTY �lN EXPIRES A�� 'O LOCALITY LICENSE NO. NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE DWNER 1 f• /.Q/ //10 �Q $ R� MAIL • WATER CLOSET(TOILET) @ 0.50 $ ADDRESS BATH TUB 0.511 CITY / . e./ '/ TEL No. SHOWER @ 0.513 1 HERESY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ 11.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 11.50 AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 11.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER OF THE RESOF 0-/�1.p�7OPEsjTY DES BED,AB V e1 GAS SYSTEM OUTLETS @ 0.50 v/J � L� SIGNATURE OF � r ,J WATER HEATER @ 11.50 PERMITTED err SLOP BINK @ 0.50 INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 13.SD DRINKING FOUNTAIN @ 0.50 URINAL @ 0.50 J Q HOUSE SEWER 0.50 Z MISCELLANEOUS m O APPROVALS DATE INBPECTCR'6 NAME ROUGH PLUMBING GAS PIPING I/- GAS VENT CESSPOOL 1,1311 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.001 SEWER PERMIT 1.00 GAB TEST %�,,..• +=2� d� UTILITY CO.N11TIFI TOTAL FEE $ l*- eiV r v FINAL ` �2 7:e-17 8•BS 5APPLICATION FOR .PLUMBING PERMIT. DB -17 DIVISION OF BUILDING AND SAFETY Deportment of County Engineer County of Los Angeles WM.J. FOX. COUNTY ENGINEER BUILDING Q•' 3 ADDRESS I CASSATT D.GRIFFIN,SUPT OR BUILDING LOCALITY_ FO APPLICANT TO FILL IAT -NEAREST � CROSS ST. OWNER _/C�J�1 �+ DISTRI T NO. GR�1dP ZONE READY R'T SPE MAIL. Saline � _ I I OW ADDRESS aa��'' +r INDUSTRIAL CITY TEL.NO. WASTE APPROVAL PLUMBER GENERAL INSTALLATION CO. �_ 1.� :J';,INSPECTION RECORD ADDRESS r`-• " 6558 West Blvd. `.2 ` ' CITY L•A. 43 TEL.:NOPLeasant 3-2541 LICENSE NO. 787 C-36 151839 ��'�`- r ` i f ` <' '�• �"! NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) $ BATH TUB SHOWER LAVATORY (WASH BASIN) . KITCHEN SINK DISHWASHER LAUNDRY TUB.OR TRAY s CLOTHES WASHER TOTAL NO. @-0.80 APPROVALS DATE INSPECTOR'S SIGNATURE GAS SYSTEM OUTLETS @ 1.00 WATER HEATER UNDER SLAB WORK �, 1.00 / [ / ROUGH PLUMBr ING /.lff•I�:' 1Rr� f•'A J 5 0' PERMIT 1 GAS PIPING ° TOTAL FEE 2 00 GAS VENT I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ROT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES 1 HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEG�j OWpIER O THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL PROPERTY.- j' SIGNATURE Co. OFPERMITTEE ' FINAL Y.s2 r' f `//��7,i�f1.?-7 f I WILLIAM J. FOX.COUNTY ENGINEER VALIDATION R..A.WOOD..CHIEF PLBG.INSPECTOR Ar 6'5 1 8 MAR 2 8 - 3 2.0 0 -,WORKER'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I'hereby,affirm that I have a certificate of consent to self 20-0026 DPW 6/87 k-insDre, or a certificate of Workers'Compensation Insurance, 76A667A or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. BUILDING ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS ��3 L.+AID Certified copy is filed with the county building inspec- NUMBER FIXTURE OR ITEM ® FEE tion department. LOCALITY Date Appllganf WATER CLOSET L" NEAREST � CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB 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($100)or less.) LAVATORY ADDRESS �+ .4—P I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK Q CITY r_ C .f TEL. NO. fJ2 so as to become subject to the Workers'Compensation Laws. DISHWASHER �t CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY TEL. NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. t WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby off irm.that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS , Q (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL VALIDATION a DATE L License Number Lic. Class Contractor Date BY Q ❑ I am exempt under Sec. C W B.BP.C. for this reason ® c' Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ () Signature TOTAL FEE Q SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby-affirm that I am exempt from the Contractor's License Address 'SCC.€'T Law for the following reason (Section 7031.5, Business and F sions Code): City Tel. No. 330 7 10 I, as owner of the property, will do the work and.the I NEMS structure is not intended or offered for sale (Section 7044, Business and Professions Code). ® T O€T AL 74- ® 70 CONSTRUCTION LENDING AGENCY CHECKio r'l1 1 hereby affirm that there is.o construction lending agency for the performance of the work for which this permit is issued CP.A C.E t€yl (Sec. 3097, Civ. C.). Lender's Name € 1313 €11,;!31 11i Lender's Address j -, I certify that I have read this application and state that the ® X575 F AM i e t.i a binformation is correct. I agree to comply with all County A State laws regulating Plumbing, and hereby ze ves of this County to enter upon the perty for inspection purpose . SEE REVERSE FOR EXPLANATORY LANGUAGE �n z� . re of Permittee Date