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Home My Public Portal About5009 RYLAND AVE_Plumbing__ 76 A 66 CE817 468 ".Jr� Ile e. 7 Ii •�� APPLICATION FOR PLUMBING PERMIT • 3 COUNTY OFOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ADDRESS p0 .��. JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY FOR APPLICANT TO FILL IN(PRINT OR TYPE) NEAREST ROSS ST. , NUMBER FIXTURE OR ITEM EACH FEE OWNER /a e WATER CLOSET 1.50 dMAIL 6 BATH TUB 1.50 ADDRESS GrJ SHOWER 1.50 CITY TEL. NO. LAVATORY 1.50 fj CONTRACTOR SINK 1.50 ADDRESS A DISHWASHER 1.50 CITY a TEL.NO - -7,676 STATE LIC CLOTHES WASHER 1.50 LICENSE NO. %7` CLASS SWIMMING POOL RECEPTOR .1.50 DISTRICT NO. GROUP I ZONE PROCESSED BY LAWN SPRINKLER SYSTEM 2.00 v f Q WATER HEATER 1.50 INDUSTRIAL WASTE APPROVAL GAS SYSTEM ;L.OUTLETS 1.50 INSPECTION RECORD OUTLETS OVER 5 PER SYSTEM 30 ( ��Z f�7 ��1+zd�!1'dYC/ C.._ Lu Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE S 2 00 TOTAL FEE APPROVALS DATE I ECTOR'S I ATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING B Address GAS PIPING GAS VENT City Tel. No. HOT WATER HEATER .A 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES 41A� r WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST 6 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 1 AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL SIGNATURE JACK R. ALLEN, SUPERVISIN E ANICAL EN'G'R. OF PERMITTEE PERMIT VALIDATION CK. M.O. CASH PLAN CIIECK ALIDATION CK. M.0. CASH WORKERS'COMPENSATION DECLARATION I APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers'Compe sation Insurance, ICE 817(REV. 10/81) or a certified copy thereof(Sec. 3800, L C.) COUNTY OF LOS ANGELES B D NGND SAFE Policy No. Company Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(.PRINT OR TYPE) gDDRESS Certified copy is filed with the county bui in inspec- NUMBER FIXTURE OR ITEM Q FEE tion department. LOCALITY Id Date ppligant f A A4 WATER CLOSET NEAREST RTIFICATE OF EXEMPTIO. FROM WORKERS' BATH TUB CROSS ST. CA 4 Ole. 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. MAIL P ( ). ) LAVATORY 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.N05 so as to'become subject to the Workers'Compensation Laws. DISHWASHER CONTRALTO Date Applicant 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 NO. OF CLASS C C LICENSED CONTRACTORS DECLARATION DISTRICT NO. PRESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER �-lb and Professions Code,and license is in full force and effect. 5 PER SYSTEM FINALc; VALIDATION License Number Lic.Class Lf3 DATE ', ` FINA Contractor _ Date V e —� a r 1 ❑ I am exe c. 5TO— ' 1 S N B.BP..C, for this reason d Plan check fee lei1 Y Date: PLUMBING PERMITI EE Signature L FEE SINGLE FAMILY Plan check applicant <+ ' HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address -7 4 1.0 A Law for the following reason (Section 7031.5, Business and Professions Code).: City Tel. No. o o`0 0 0 5 ❑ I, as owner of the property, will do the work and the o o structure is not intended or offered for sale (Section 1> �' 1 2' 7044, Business and Professions Code). 0 0'0'1 P. y 0 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for ,) 1, 0.5 2 the performance of the work for which this permit is issued . (Sec. 3097, Civ. C..). Lender's Name Lender's Address 1 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 represe Ives of this County to enter upon the above-mentioned ro erty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE i Si ure of Permittee / % ate 6 1 A 76A667 17 71-49 .APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DI TR N . G D �ONE . [ADDRESS LUMBER % // '��fy READY FOR �� ® �Y1 J o20M4 RECEIVED BY FIRST INSPECTION DATE ISSUED r-J(!� `� ;!„� � L A TEL. Nl CITY y 1 TE4 No.7,7/& �q �j ADORE COUNTY �� EXPIRES '�o m 'e� LOCALITY BE NO LICEN . - NEAREST � PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER AIL WATER CLOSET(TOILET) @ 0.50 IllADDREBB G. BATH TUB @ 0.50 CITY TEL. No. SHOWER 49 0.50 1' HEREBY ACKNOW EDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN BINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. 1CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER GAS 5Y9TEMOUTLETS 0.50 OF THE RESIDENQTIAL PROPS Y D BCRIB D AB WATER HEATER @ 0.50 SIGNATURE (/ G' PERMITTEE SLOP SINK @ 0.501 INSPECTION RECORD FLOOR BINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.501 DRINKING FOUNTAIN @ 0.50 URINAL 0.50 J _ Q HOUSE SEWER @ 0.50 _Z MISCELLANEOUS m O 1 1 APPROVALS DATE IN9PECTOR'B NAME i ROUGH PLUMBING 1 1 GAS PIPING GAS VENT CE99POOL @ 1,130 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER ! PERMIT I 1.00 BAB TEST UTILITY CO.NOTIFIED TOTAL FEE 1-9 �'U FINAL