The URL can be used to link to this page

Home My Public Portal About5547-5547 1/2 SANTA ANITA AVE_Plumbing__ 76A667 17 11-49 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER uh FOR APPLICANT TO FILL IN DI :R � O. �UP ZONE^ �� . PLUMBER O lS® • �l. �- ,LtJ RECEIVED BY READY FOR DATE ISSUED A y jl.t FIRST INSPECTION ADDRESS _ �L�Iol�,��jJ `� BUILDIN�j` A� a __o- CITY �!J lSls "-��TEL NO.4) �1` ADDRES CEJ - y COUNTYc LOCALITY LICENSE NO. EXPIRES u NEAREST PERMIT FEES ORD 8 ST.�/r -�I-_ft/J� NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER a- � 6yy�..�. y ftp MAIL WATER CLOSET(TOILET) @ 0.50 S ADDRESS BATH TUB @ 0.50 CITY TEL NO. SHOWER @ O.SO I HEREBY ACKNOWLEDGE 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 SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS I LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER GAS SYSTEMOUTLETS 0.50 1 OF THE RESIDENTI PROPERT DESCRIBAD ABOVE. SIGNATURE OF ,_ on-+ WATER HEATER @ 0.50 PERMITTEE SLOP SINK @ 0.501 I INSPECTION RECORD FLOUR SINK @ 0.501 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.511 1 DRINKING FOUNTAIN @ 0.501 URINAL 1 J 0.50 HOUSE SEWER @ 0.501 Z 1MISCELLANEOUS 19 o APPROVALS DATE INSPECTOR-B NAME ROUGH PLUMBING x.JF i i_.e/ /-u� __/��Z��'� GAS PIPING I C - -f GAS VENT 3/ CESSPOOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( i ) @ 1.00 I SEWER PERMIT . I 1.00 GAS TEST UTILITY CO.NOTIFIED TOTAL FEE I'm ks FINAL v 76ASS7 17 11-49 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER PERMIT NLJ FOR APPLICANT TO FILL IN DI TR O. G P O PLUMBER A-t C:- __ j READY FOR �7 /c: PI EIVED BY DATE ISSU D /��4�� FIRST INSPECTION /0` ADDRESS °"{ '13- {r A'fi�� C / BfJILDI CITY �.. `L�<: -c. ..IZTEL.No. b' (9COUN96 `6 c� �� ADDRE99 5� [�3 may' [j -/1�1 •p^�, �� 4,(L�/FZ 2/ LICENSE NO. �� EXPIRES y® LOCALITY C' NEAREST PERMIT FEES CROSS ST. NUMBERTYPE OF FIXTURE OR ITEM FEE OWNER (� c:�--�!/�• G n MAIL u WATER CLOSET(TOILET) @ 0.50 $ ADDRESS BATH TUB @ 0.50 1 CITY TEL No. SHOWER @ 0.50 I 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ D.SO I APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0.501 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LD9 LAUNDRY TUB OR TRAY @ 0.5131 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER OF THE RESIDENTI PROPERTY DESCRIBE ABOVE. GAS SYSTEM OUTLETS @ 0.50 ` ,SIGNATURE OF WATER HEATER @ 0.50 I PERMITTE SLOP SINK D.5D[ INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.501 DISHWASHER @ 0.501 DRINKING FOUNTAIN @ 0.501 URINAL @ 11.501 J HOUSE SEWER a 0.501 _Z MISCELLANEOUS 01 lzo APPROVALS DATE INBPECTOR-9 NAME ROUGH PLUMBING \ N GAB PIPING ,0 li GAS VENT i CESSPOOL a 1.00 CESSPOOL SEPTIC TANK, SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT I 1.00 GAB TEST UTILITY CO.NOTIFIED / TOTAL FEE $ FINAL JT'"" • WORKERS'COMPENSATION DECLARATION i APPLICATION FOR PLUMBING PERMIT I hereby affirm"that''I'have'ac ertificate of consent to self 76A667A insure,•ora certificdie of.Workers' Compensation Insurance, CE 817(REV. 10/81) u or a certified copy-thereof(Sec. 38 b. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy.No�Company • �� 7 ❑ Certified copy is hereby furnished. `f i-lvwef FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING AD RENS Certified copy is filed with toe county b Ilding inspec- tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applican. WATER CLOSET lei�' NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' _ BATH TUB � CROSS ST. COMPENSATION INSURANCE OWNE - � SHOWER .. (This section need not be completed If the work Involved by MAIL •� the permit is for one hundred dollars($100)or less.) LAVATORY ' 01' ADDRESS.c 1`., r. \.�. Onas I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK .�, CI TEL. N RT so'os to become 'subject to the Workers'Compensation Laws. ISHWASHER / C.ONTRACTO •,e Date Applicant CLOTHES WASHER ADDRESS g'60 � NOTICE TO APPLICANT: If; after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject. to the Workers' CITY TEL. N Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this: permit shall be STATELIC. deemed revoked. WATER HEATER LICENSE N CLASS. LICENSED CONTRACTORS DECLARATION DIS Ntr PR E ED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS 0 (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER 6 and Professions Code,and my license is in full force�ia�effect. 5 PER SYSTEM DATE VAL TIO IN License Number-7 Lic. Class y C F. C; Contractor �d� Date � ❑ I am exempt under Sec. - C B.BP.C, for this reason Plan check fee Date. Signature. PLUMBING PERMIT ISSUING FEE$ M 5 0 6 9 A 2 e TOTAL FEE . # 0 0'0 0 0 5 Plan check applicant SINGLE FAMILY J o - 96.00 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address 0 o o 96005 Law for the following reason. (Section:7031.5, Business and . 7 7 z$6 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� 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 regulating Plumbing, and hereby authorize representatives of this County to enter upon the a ove-me ed property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm'that:I'have a certificate of consent to self 76A667A insure, Or a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) L! or a•certified coy thereof(Sec. 38 Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No.dthpre�9Company ❑ Certified copy is hereby furnished.�'J� FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING 6 Certified copy is filed with the count ing insp ADDRESS tion department. NUMBER FIXTURE OR ITEM ® FEE LOCALITY Date Applicant 3 WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' '2 BATH TUB _'CROSS ST. COMPENSATION INSURANCE SHOWER OWNER_ 1 (This section need not be completed if the work involved by the permit i3 For one hundred dollars($100)or less.) LAVATORY ADDRESS ` �v I certify that in the performance of the work for which this NO. � T't<' permit is issued,I shall not employ any person in any manner SINK CITEL. '_ 7 so as to become subject to the Workers'Compensation Laws. DISHWASHER / CONTRACTOR�� Date Applicant CLOTHES WASHER (p ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Exem P Y I CITY Md TEL. � s Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or,this permit shall be STATELIC. deemed revoked. WATER HEATER LICENSE NOZqrl T911 CLASS LICENSED CONTRACTORS DECLARATION DIS.JRICT Kn. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS /5 vd�o (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL VAL TION �/�(]laA DATE411-0. q/__/ License Numbe+ ` 1ST Lic. Class Contractor° �a�ne Date ❑ I am exempt under Sec. H B.BP.C. for this reason Plan ch@CIC fee ® d Date: Cr PLUMBING PERMIT ISSUING FEE$ Q �D Signature TOTAL FEE -- -25068A Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name # 0 0 0 0 0 5 1 hereby affirm that I am exempt from the Contractor's License Address (. 9 0 9 6 0 0 Law for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. 0 0 0 96,,0 0 czi ❑ 1, as owner of the property, will do the work and the , structure is not intended or offered for sale (Section ® �' 0 7,-1'7-8,6 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 regulating Plumbing, and hereby authorize representatives of this County to enter upon the aove-me a property for inspection purposes. �` SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of Permittee Date t'