HomeMy Public PortalAbout5505 RYLAND AVE_Plumbing__ 'G"BB''" 9'S0 't .APPLICATION FOR PERMIT I
DEPARTB ENT .OF BUILDING AND.:SAFETY
COUNTY OF LOS ANGELES 1 �. • .'
WILLIAM. J. FOX, .CHIEF ENGINEER
,. STRI NO. I 'ZONE RMrr.NO..
FOR APPLICANT TO FILL 1N DI - � GRO_�'�
-PLUMBER r RECEIVED BY READY FOR.. DATE I98 HIS
O LA'-,I- ' _L_L FIRST'INSPECTION +� s
ADDRESS ®'�4 ...®�
n n
IVIG -X-d BUILDING
CITYpop TEL. NO. -ADDRESS - ( /_•._ J1 ✓L�y+sf✓/
COUNTY LOCALITY
LICENSE NO. EXPIRES
' NEAREST
PERNIIT FEES- CROSSST
rER TYPE OF FIXTURE ORITEM FEE � OWNERMAILWATER CLOSET (TOILET.). Q O.50 S 6(, "ADDRESS.BATH TUB. @ 0.50 'ld CITY. 0 i TEL. NO.I e a SHOWER `' (S .'0.50. l HEREBY A KNOWLEDGE THAT '1 HAVE READ THIS
/° LAVATORY (WASH BASIN) 0.50 Q 'APPLICATION AND STATE THAT THE'.ABOVE IS CORRECT AND
AGREE: TO' COMPLY WITH .ALL COUNTY`ORDINANCES AND
STATE LAWS REGULATING PLUMBING.
KITCHEN.SINK Q 0.50 I..'CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY T.UB OR TRAY Q ').50 tea._ !ANGELES COUNTY,. LICENSE.' OR I .AM THE LEGAL OWNER
:.OF THE RESIDENTI PROPERTY DESCRIBED ABOVE.
I. 6AS SYSTEM' OUTLETS. _(� 0.50 . re)
RE
SIGNATU .OF: �f� -
WATER HEATER v 0.50 anh PER MITTE.
SLOPSINK ® D.to-
INSPECTION RECORD '
FLOOR SINK Q 0:.50
FLOOR DRAIN ® O.50
DISHWASHER (g? 0.50. '
DRINKING FOUNTAIN . ® 0.50
URINAL ® 0.-50
J'
HOUSE SEWER a-0.56 Z
MISCELLANEOUS ;(_�
0
APPROVALS
• II DATE_. INSPECTOR'S NAME "
R U.G PLUMBING
AS PIPING.
GASVENT
F. •
CESSPOOL 1.00 CESSPOOL
SEPTIC'TANK: SEPTIC TANK
DRAIN ( ) PIT ( )' @ .1:001 SEWER
PERMIT.. 1.0o GAS TEST
• UTILITY CO. NOTIFIED
TOTAL FEEAOV
C FINAL
76A667-CE#`77 4-67
APPLICATION FOR PLUMBING,PERMIT
COUNTY OF .LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER `
BUILDING AND SAFETY DIVISION BUILDING C/
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS. SUP'T. OF BUILDING LOCALITY ' r
FOR APPLICANT TO FILL IN NEAREST
cross sr.
NUMBER FIXTURE OR ITEM EACH FEE
OWNEF
WATER CLOSET 51.25 MAIL
BATH TUB 1.25 'ADDRESS
SHOWER J 1.25 CITY - TEL. NO.
LAVATORY 1.25 CONTRACTORilAa
SINK 1.25 ADDRESS
DISHWASHER 1.25 CITY TEL. N0.g2U
STATE LIC
LAUNDRY TUB 1.25 r� LICENSE NO. . CL SSC S.o
CLOTHES WASHER 1.25 V DISTRICT NO. GROUP ZONE PROCESSED BY
WATER HEATER 1.50 0
C
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .50
INSPECT40N RE9:01lb 11 a
V
CDEd
1 i
1-
i� CA)
A� r f
r _ MAi17A wwrl
ra
APPROVALS DAT§ INSPE TOR'S.5 N URE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LIGATION GAS VENT
AND STATE THAT THE ABOVE 13 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES STATE LAWS REGULATING HOT WATER HEATER
PLUMBING. _
I HEREBY CERTIFY T T 1 PRO ER LY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRE TAT
ANGE COUNTY AND STATE OF GAS TEST m� •f�L
CALIFORNIA OR THAT AM TN LEGAL OF,AND INTEND TORESIDE IN,THE ABOVE DESCRIB RESI TI�NER
ROPERTY. UTILITY CO.NOTIFIED
SIGNATURE /
OF PERMITTE
INAL
DATION JACK R.ALLEN
CK. M.0. CASH SUPERVISING MECHANICAL ENGIR.
5 D 9. 0
..WORKERS'COMPENSATION DECLARATION 20-0026 DPW 4/90 APPLICATION FOR PLUMBING PERMIT
],hereby, affirm that.I have a certificate of consent to self in- 76A667A
_,sure,ora certifit:ate of Workers'Compensation,Insurance,or a
certlfied copy thereof(Sec. 3800, Lab. C.)
COUNTY OF LOS-ANGELES� DEPT: OF•PUBLIC WORKS,
Policy No. Company
❑ Certified copy is hereby furnished. BUILDING p
FOR APPLICANT TO FILL IN(PRINT OR TYPE)_ ADDRESS �-s «N
❑ Certified copy is filed with the county building inspection rBER. FIXTURE OR ITEM L Q FEE /
department. LOCALITY
WATER CLOSET(TOILET)
Ddte Applicant NEAREST
• BATH TUB 'CROSS ST.
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE ( OWNER SHOWER
(This section need not be completed-if the work Involved by MAIL.
the permit is for one hundred dollars($100)or less:) CZ,. LAVATORY ADDRESS
I certify that in the performance of the work for which this per- SINK CITY TEL.NO.
mit is issued, I,shall not employ any person in any manner so
as•to become ubject to the Workers'Compensation Laws. DISHWASHER .1 -`
CONTRACTOR_r'�CAN 10 4N 610%
Date 114TApplicant CLOTHES WASHER
NOTICE T s.APPL CANT: If, after making thiCertificate of Ex- ADDRESS
SWIMMING POOL RECEPTOR p
emption,you should become subject to the Workers'Compen- CITY /` TEL.NO.
sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS
ly with such provisions or this permit shall be deemed revok= STATE LIC. p
ed. WATER HEATER " LICENSE NO.. . 8.O. CLASS p
LICENSED CONTRACTORS.DECLARATION DISTRICT NO.. PROCESSEb BY
GAS SYSTEM OUTLETS
'I hereby affirm that I am licensed under•provisions of Chapter / v
9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER G
EM
and Professions Code, and my license 5 PER'SYST
is in full force and of- FINAL VALIDATION
fact. HOSE.BIB DATE -i
License Number Lic.Clots
FINAL V
Contractor �� i Date � f ¢ — BY
❑ I am exempt under Sec.
B..BP.C. for this reason
H
Plan check.fee
Dat. 2v PLUMBING PERMIT ISSUING FEE$• Z
�j� E,
Signature TOTAL FEE
SINGLE FAMILY • �� .'�� ACC 1 °Lo -
HOME OWNER-BUILDER DECLARATION Plan check applicant 3301` ) °10
I hereby affirm that I am exempt from the Contractor's License Name
Law for the following reason.(Section 7031.5,,Business and 1 ITEMS
Professions Code): AddressTOTfLl I ,fig
i, as owner of the property, will do the work and the City Tel. No. i i
structure is not intended or offered for sale(Section 7044, CHECK 119.10
Business and.Professions Code). ► {jl]
Nf+li�_F
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there it a construction lendingagency for r
the performance of the work for which this perssit is issued
(Sec. 3097, Civ. C.).- 5656
1 - AI M 1■L0
Lender's Name
Lender's Address ;
I certify that I have read .this application and state that the Poo.above.information is correct.I agree to comply with all County
ordinances and State laws regulating Plumbing, and hereby
authorize representatives of this County to. enter upon the
above-menti ned property for inspection purpo es'. y
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signa ure o Permittee Da