The URL can be used to link to this page

Home My Public Portal About4928 SERENO DR_Plumbing__ „ABBT TT ['[B o' APPLICATION FOR PERM DEPARTMENT OFDING ASAFETY COUNTY COUNTY OFF LOS ND OS ANGELES WILLIAM J FOX CHIEF ENGINEER UMBING 1 FOR APPLICANT TO FILL IN DISTRIICTNO GROUP Z E PERMIT NO PLUMBER • REC 7V READY FOR / DIT[IsoU6D FIRSTINSPECTION ADDRESS ` BUILDING CITY TEL NO ADDRESS COUNTY LOCALITY I / LICENSE NO EXPIRES NEAREST PERMIT FEES CROSS ST NUMBiR TYPE of FIXW 1[OR ITEM FEE OWNER i MAIL WATER CLOSET TOIL O SO S ADDRESS BATHTUB 0 O SO CITY TEL NO SHOWER Q O SO 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY WASH BASIN) 0 SO APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ O SO STATE LAWS REGULATING PLUMBING 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOB LAUNDRY TUB OR TRAY O SO ANGELES COUNTY LICENSE OR 1 AM THE LEGAL OWNER I OP THE RESIDENTIAL PROPERTY DESCRIBED ABOVE GAS SYSTEM OUTLHTB O BO SIGNATURE OR WATER HEATER ® 030 1 - SLOPSINK O 50 INSPECTION RECORD FLOORSINK 0 SO FLOOR DRAIN O SO DIBHWABH ER O 80 DRINKING FOUNTAIN 0 BO URINAL O SO ,J HOUSESEWER O SO Q Z_ MISCELLANEOUS 0 O APPROVALS DATE INSPECTOR t NAM[ ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @I DO CESSPOOL 19 SEPTIC TANK SEPTIC TANK I DRAIN ( I PIT ( ) ® 1 00 SEWER PERMIT 1 00 GAB TEST UTILITY CO NOTIFIED TOTAL FEE "7'* -27- 7777 FINAL ode 76A667 CESBYI 167 �y 1 � APPLICATIOKF�R PLUMBING PERMIT COUNTY OF LOS ANGELES • DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING9 JOHN A LAMBIE COUNTY ENGINEER ADDRESS COLEMAN W JENKINS SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL, iN NEAA 8T NUMBER FIXTURE OR ITEM EACH FEE CROSS — OWNER WATER CLOSET it 75 NAIL BATH TUB 125 ADDRESS 7 SHOWER 1 2 CITY ' TEL NO ,5 �2 LAVATORY 175 CONTRACTOA 1 SINK 175 ADDRESSAO 946 od DISHWASHER 125 Ta N 6�7 D CJ LAUNDRY TOB 123 STATE LIC LICENSE NO CLASS CLOTHES WASHER 125 DISTRICT NO GRO Z ! P BV WATER HEATER 150 V s CAS SYSTEM--OUTLETS 150 INDUSTRIAL WASTE APPROVAL OUTLETS OVER S PER SYSTEM JO NNSPECTION RECORD d O U CC O H U W CL C7 Z APPROVALS DATE INSPECTOR S SIGNATURE PERMIT jdA"LICATION O UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS N GAS VENT ANO [TATE THAT TM[ PROVE IR CORRECT AND AGREELYWITH ALL COUNTY ORDINANCES AND STATE LAWSG MOT WATER HEATER PLUMBING1HERESYCERTIFY THAT I AM PROPERLY R[DIfT[ R LIC[NEEO AS REQUIRED RY LOS ANGELES COUNTY AF CALIFORNIA OR THAT 1 AM THE L[WL OWNER Oi ANTO RUED[ IN TN[Abov[D[ECRISCD SIDEN L PUTILITY GO NOTIFIED SIGNATURE OF PERMITTEE FINAL KLIDATION _ JACK R. ALLEN CK N o CASH SUPERVISING MECHANICAL ENG'R - (PGD2 s 114-•"26 5 D,b=. 3.50~ 79AS97 n 9 9 m APPLICATION FOR PERMT DEPARTMENT OF BUILDING AND SAFETY L 1 COUNTY OF LOS ANGELES WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO GROUP ZONE _ PERMIT O PLUMBER I I RECEIqkD BY READY FOR 7D-♦♦•f,T[919VUED ��1 FIRST INSPECTION /�-•rO ADDRES Q�� I' VY , BUILDING ^ .m A CITY TEL NO ADDRESS COUNTY , 74 LOCALITY LICENSE O �✓� E%PIR I NEAREST PERM I,•M CROSS BT NUMO[R TY of■IKTURE OR ITIIK FEE OWNER MAIL W 9 MJ _ s'� ATER CLOSET TOILff) O 00 MAIL 6S6I� ��/ BATH TUB O 60 TEL NO SHOWER O BB 1 HE ROY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY WASH BASIN O SO APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND • KITCHEN SINK O 60 HTATQ LAWS REGULATING PLUMBING / 1 CERTIFY THAT 1 POSSESS THE AIIOVE VALID LOS LAUNDRYTUBORTRAY WO SO ANGELES COUN LICENSE OR 1 AM THE LEGAL OWNER OF THE RE9IDEN 1 L rROPER RIBBD ABOVE OAB BY9ifiM OUTLfiTB a O SO r-- SIGNATURE OF WATER HEATER O SO FERMI TTQ SLOP BINK O sa INSPECTION RECORD FLOOR SINK W O SOI FLOOR DRAIN0 O 60 DISHWASHER 0 O SO DRINKING FOUNTAIN O 00 •� /-�-. URINAL w O SO i'Dv J HOUSEBSWER O SOI Z Z MISCELLANEOUS S Q IJ 0 I I I I APPROVALS DATE INRECCTOR R KAMR ROUGH PLUMBING GAB PIPING !-� OAS VENT CESSPOOL I DOI I CESSPOOL SEPTIC TANK I I SEPTIC TANK DRAIN ( ) PIT ( ) @ 100 HEWER PERMIT 1 OD GAS TEST UTILITY CO NOTIFIED TOTAL FEE • .FINAL 7 WORKERS COMPENSATION DECLARATION,',* APPLICATION FOR PLUMBING PERMIT {� �L I-here affirm that I have a certificate of <o*riaent to lelf 76A467A u .Insure & a certificate of Workers Compensation Insurance CE 817(REV 10/81) or a certified copy thereof (Sec 3800 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnished ❑ Certified co Is filed with the court building I FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING !� PY county ng mpec ADDRESS�� S 1"'eT0 rk hon department NUMBER FIXTURE OR ITEM ® FEE LOCALIN 1 - t � \11 .`` Date Applltont WATER CLOSET DQ NEAREST1 CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB Q CRO55 57 g 1 COMPENSATION INSURANCE 'Z'- 2 I (This stolon need not be complN.d If this work Involved by SHOWER OWNER T MAIL the permit Is for one hundred dollars ($100)or loss) LAVATORY I comfy that m the performance a the work for which this ADDRESS ('� S 4l Y permit is Issued I shall not employ any person m anyy manner SINK CITY `�k TEL NO S W as to become subject to the Workers'Compensation Laws DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT If after making this Certificate of SWIMMING POOL RECEPTOR Exemption you should become subject to the Workers' CITY TEL NO Compensation provisions of the Lobar Code you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be deemed revokedSTATE LIC WATER HEATER LICENSE NO QLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7OD0) of Division 3 of the Business OUTLETS OVER 7 O and Professions Code and my license is In full force and effect 5 PER SYSTEM FINAL VAUDATI License Number Lic Closs TE FINAL Contractor Dote BY I am exempt under Sec 8 8P C for this reason R53 2 6 0 Plan check fee Date # . . a sis Signature s PLUMBING PERMIT ISSUING FEE$ i vTL TOTAL FEE ') is 2$S SINGLE FAMILY Plan check applicant Is 0 s 2 8 5 Q 6T HOME OWNER BUILDER DECLARATION Name O 8 2 8'8 6 1 hereby affirm that I am exempt from the Contractor s License Address Law for the following reason (Section 7031 5 Business and FPr fassiam Code) City Tel No I as owner of the property will do the work and the Poo structure Is not intended or offered for sale (Section 7044 Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby nffum that there Iso construction lending agency for the performance of the work for which this permit Is issued (Sec 3197 Civ C ) Lenders Name Lender s Address I certify that I have read this application and state that the Poo.Information is correct I agree to comply with all County ordinances and State laws regulating Plumbing and hereby authorize repre3ematives of this County to enter upon the above mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee �",acito '