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Home My Public Portal About5514 RYLAND AVE_Plumbing__ sNsess s' V-w m MOICA71ON FOR PSS= / UTDOW BURDUM AND SAFErY PLUMBING 1 CODII'rY of LOS ANGffi.ffi WILLIAM J. FOX. CHIEF ENGINICKR RORryApPPLICANT TO FILL IN DISTRIQNO. CARO ZONE P RMITNO. y PLUMBER YALLL 1 BOULEVARD RECEIVED BY READY FOR DATE UyiED 1 FIRST INSPECTION �j � l0r� ADDRKNN 900 EAST II 6 CITY RMEMEAD ADD NUDING CRESS TR. No. AT.2- 1 CLlCKNsx NO. ME OUNTY 93M PIR 6�O•�,/ LOCALITY NKARKST P�= FEES CRON R. RYMSO{ WIN OR R1zmm OM ITEM FKE OWNS MAIL WATER CLOSET TOILR O.SO ADDREIN , BATH TUB 0.00 d CI L- NOR0 A< S� SHOWER 0.m O 1 HKRKEYE THAT 1 HAVE READ THIN LAVATORY WASH BASIN 0.50 —a APPLICATION A NTATK THAT THE ANOVK IN CORRECT AND AGREE TO CO Y WITH ALL COUNTY ORDINANCEN AND KITCHEN BINK a a.=,, -d STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 PONSENS THE ABOVK VALID LOS LAUNDRY TUB OR TRAY 0.80 ANGELR COUNTY LICKNSK. OR 1 AM WE LEGAL OWNER OF THK R=lDKNTI PROPERTY DESCRIBm ABOVE. GANSYNT UTLEiS O.SO SIGNATURE OF WATER HKATKR 0.00 d PERMITTK SLOP BINK 0.02 110 FLOOR SINK O.BO FLOOR DRAIN 0.50 DISHWANNER 0.80 DRINKING FOUNTAIN a 0.50 URINAL a 0.50 J NOUSK NKWUN a O.SO Z MISCELLANEOUS a E O APPROVALS DATE IM K YGI( PLUNBINO GAS PIPING /+ GAB 0KNT CESSPOOL- 1.00 CESSPOOL SEPTIC TANK. NKPTIC TANK DRAIN ( ) PIT ( ) ® 1.00 NEWER PERMIT . 1,0O GAN TENT UTILITY CO. NOTIFIED TOTAL FEE i d d FINAL ORKER'SCOMPENSATIONDECLARATION 200026 DPW 9/69 APPLICATION ��e ��p��®I,B ®11 ��Itsll®I�� r�tf"EBYII� hat I have a certificate of consent to self Insure, 75A667A n A L A ��A o Worker's Compensation Insurance, or a certified cc 3800 Lab.C.) qq�� COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policy Noir+ Company Certified copy Is hereby furnished. ADDRESS 4' FOR APPLICANT TO FILL IN(PRINT OR TYPE) Certified copy is filed with�thecount uii ' sp iondepartment. NUMBER 'FIXTURE OR ITEM FEE LOCALITY Date 10" 3 Applic �jSURF WATER CLOSET NEAREST / CERTIFICATE OF EXEMPTION FROM WORKERS CROSS ST. COMPENSATION INSURANCE BATH TUB ASSESSOR O�Q (This section need not be completed If the work involved by the SHOWER p MAP BOOK O [! PAGEPARCEL0P3 permit is for one hundred dollars($100)or less.) LAVATORY YL OWNER I certify that in the performance of the work for which this permit i is issued, I shall not employ any person in any manner so as toSINK MAIL _ become subject to the Workers'Compensation Laws. ADDRESS DISWASHER CITYTEL.NO. [P Date Applicant CLOTHES WASHER CONTRACTOR 1 �! NOTICE TO APPLICANT: If, after making this Certificate of $� Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code,you must forthwith comply with such gDDRESS provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY ( TEL.N(&.? fit/ d I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER STATE LIC. 0 NO.� (commencing with Section 7000)of Division 3 of the Business and �?� GAS SYSTEM OUTLETS LICENSE CLASS f (� Professions Code,and my license is in full force and effect. DISTRICT NO. P OCESSED BY Q OUTLETS OVER Q 5 PER SYSTEM �9 O O License Number Lic.Class r V FINAL — -- VA ®A+ ON LU DATE 1 CL Contr er�� 7 Date 330 r TfA FTWWF FINAL �Aj :t.!t_,r I am exempt under Sec. BY i T—r- ; 313] «' B.&P.C.for this reason TOTAL 12�75 Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ 4 Q CHECK _r R�` Signature ir.La of ❑ TOTAL FEE CHANGEo )'tj SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name s.;1.11J13—I30 1 113 15/Y_. 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason(Section 7031.5, Business and Professions Address 2160 1 AM 9:fF 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 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there 1s 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 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 ting Plumbing, and hereby authorize representative f t is C ty to enter upon the above-mentioned prop o pec . purp es. SEE REVERSE FOR EXPLANATORY LANGUAGE row- _ Signature o Permittm Date WORKER'S COMPENSATION DECLARATION aDPW 9le9 APPLICATION FOR PLUMBING PERMIT 1 h?dreby affirm that I have a certificate of consent to self insure, 76AS676A567A or a certificate of Worker's Compensation Insurance,or a certified copy thereof(Sec.3800 Lab.C.) q 8 Lab `' r COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. 6 Policy No.0� Company �+C� ertified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county b • i ' s ecti ADDRESS �J department. NUMBER FIXTURE OR ITEM FEE LOCALITY Date Z""/ ` Appli t 6 WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST. COMPENSATION INSURANCE BATH TUB ASSESSOR (This section need not be completed if the work Involved by the SHOWER MAP BOOK PAGE PARCEL permit is for one hundred dollars($100)or less.) OWNER I certify that in the performance of the work for which this permit LAVATORY AIL is issued, I shall not employ any person in any manner so as to SINK ADDRESS become subject to the Workers'Compensation Lawg {f \ DISWASHER CITY TEL.NO. Date -Z- Applicant b�° G CLOTHES WASHER NOTICE TO APPLICANT: If, after making this CertIfIc6t6 of CONTRALTO Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code,you must forthwith comply with such ADDRESS 1i provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATIONCI TE . vJ! I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER I]. (commencing with Section 7000)of Division 3 of the Business and GAS SYSTEM OUTLETS LICENSE NO._TATE CLASS �-f 0 Professions Code,and my license is in full force and effect. DISTRI NO:' QC1rS D BY OUTLETS OVER .- ,s r7 5 PER SYSTEM — 01-91 License Number �v:� _ t'-�'-'• L!t- �)` DATE FINALZ _��/ VALIDAT1OVI( LU Contractor a42�" IL DateVv - /9TOT I T + ,� -r :f=,, cc ❑ I am exempt under Sec. FINAL`v G/ E. �- s. �..r-= B.&P.C.for this reason n C_t3EC K T a Date: Plan check fee ® CHANGE Signature PLUMBING PERMIT ISSUING FEE$ a El 0000 FEE J, Il Jlli,'#-11]111 2.1 i:' SINGLE FAMILY Plan check applicant "' j Pr 5l68 _::p s. HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Law for the following reason(Section 7031.5, Business and Professions Address 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 7044, 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 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 re g Plumbing, and hereby authorize representatives of h' Coun to enter upon the above-mentioned pr y fo ;ln purpos �1 r/ SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of 126rmittee Date