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Home My Public Portal About5031 SERENO DR_Plumbing__ veAAnc�u•14-07 APPLICATION FOR PLUMBING PERMIT 1 COUNTY OF LOS ANGELES DEPAMIENT OF COUNTY ENrAN= BUILDING AND SAFETY DMSION 0 3/ o>IsaAa D aHRra to v LOCAUTY FOR APPLICANT TO FILL IN REAREST CROSS ST Ge NUMBER FIXTURE OR ITEM ' DWNBB WATTM CLOSET NAIL RATH TOS ADDRESS SHOWER CRY — AO 'p LAVATORY coN=creR SDR ADDRESS oar e C DISHWASHER CITY TE. NO LADNDRT TOR CONTRA =19=110N NO COUNTY 13 CLott»WASHER DISTRI O GROUP I /r ' BRADY PDR UUIP[CTIOR WATER HEATER yT /J GAS SYSTMI D7DDSTRIAL WASTE APPROVAL g(SPECTION RECORD a ►� UaAPPHOVALS 080 FELTURE , /��PER ITEM DATE INSPECTOR 'NATURE UNDER SLAB WORK PERMIT S 00 ROUGH PLUMBING TOTALFEE GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GASVENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PLUMBING FIXTURES 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GASTEST I ri LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED DESCRIBED RESIDENTIAL PROPERTY SIGNATURE OF PERMITTE FINAL ROBERTA 00 0, VALIDATION SUPERVISING MECHANICAL ENGR C[ M O GSH • _ LG1342OR DEC 26 5 A 3.00 76A667 CEB17 8 57 // APPLICATION FOR PLUQ'66MERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ADD RSDS 2'0s' r S F ` N a JOHN A LAMBIE COUNTY ENGINEER y, CASSATT O GRIFFIN SUP T OF BUILDING LOCALITY `�T FOR APPLICANT TO FILL IN NEAREST CROSS ST NUMBER FIXTURE OR ITEM S',"171Y WATER CLOSET OWNER ` !LAIC BATH TUB ADDRESS IF SHOWER CITY TEL NO LAVATORY CONTRACTOR p ar A, 1411 LSO N NC• smx ADDREss2 53/x4. A10 . SA /V ¢A 13 RI rL p DISHWASHERTY SAN 41MRIFLTEL NO AT CGS 2S LAUNDRY TUB CONTRACTORS /610 17 3 ATE REGISTRATION NO CL07745 WASHER I COUNTY El DISTRIC100, GROUP rE Seim roll INSPECTION WATER HEATER fir: /w7 GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD �F.. A"ROVIUS 3100 PER ITEM O Tfi INSPE&OR S SIGNATURE OR FQTURE D UNDER SLAB WORK 1 ITe PERMIT $ 00 ROUGH PLUMBING GAG PIPING TOTAL FEE 0 GAS VENT 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTRES PLUNBI NG If I HEREBY CERTIFY THAT 1 AB PROPERLY REGISTERED AND/OR GAS TEST L 17 LICENSED AS REOUIRED BY S ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 H LEGAL NER OF T ABOVE UTILITY CO NOTIFIED DESCRIB-D RESIDENTIA R E SIGNATURE OF PERMITTEE FINAL VALIDATION ROBERT A WOOD SUPERVISING MECHANICAL ENG R CE ■ 0 r CASH LA6 5-9 0 9 m NOY 21 5 A 9.0 0 WORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I here6 affvm that I have a certificate of consent to self 7eAe67A �n1're or a certificate of Workers Compensation Insurance CE 817(REV 10/81) or a caroled copy thereof (Sec 3800 Lob C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY 9olcy No Company ❑ n Certified copy Is hereby furnished • ❑ allltDING FOR APPLICANT TO FILL IN)PRIM OR TYPE)Certified copy is filed with the county building Impec- ADDRESS ADDRESS non department NUMBER FIXTURE OR ITEM ® FEE IOCAAITY _ P[a !• i Ly WATER CLOSET ("' Date AppMPTI NEAREST nW�'F.•s..•sy BR-�R T7 v.! CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB A COMPENSATION INSURANCE OWNER pi"I C�RIk L'NT7�iZ Is secllon need trot be co SHOWER (Tb rd dolls H this work less ) ed by =KESS .� � 1M Permit Is for one hundred dollars(7180)or Ins) LAVATORY MAR O �Q.v I certify that In the performance of the work for which this q/ permit is Issued, 1 shall not employ any person in any manner SINK CITY TEL NO so as to become subject to the Workers Con3pensation Laws DISHWASHER CONTRACTOR DoteS 2A....hcant CLOTHESWASHER ADDRESS NOTICE TO APPLICANT If after making this Certificate of SWIMMING POOL RECEPTOR lixemption you should become subject to the Workers Compensation provisions of the Labor Code, you must forth- CITY TEL HD with comply with such provisions SPRINKLER SYSTEMons or this permit shall be STATELIC deemed .evoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO SSED BY I here affirm that I or;licensed under GAS SYSTEM OUTLETS by provisions of Chapter 9 a (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 FDIAN / VALIDATION Ly_ License Number L,c Class TE 14 FINAL Contractor Dote BY W ❑ I am exempt under Sec U B BP C for this reason Dote 'I Plan check fee , q ELI 11 u� PLUMBING PERMIT ISSUING FEE E Z Signature TOTAL FEE Plan check appllccrm SINGLE FAMILY HOME OWNER BUILDER DECLARATION Name I hereby off rat that I am exempt from the Contractor s License address Law far the following reason (Section 7031 5, Business and Pro on,ons Code) I City Tel No I os owner of the property, will do the work and the , structure Is not intended or offered for sale (Section e 7044 Business and Professions Code) CONSTRUCTION LENDING AGENCY _ I hereby offlrm that there Is a construction lending agency far ;2542-5A the performance of the work for which this permit Is issued # is • 0 s 05 (Sec 3097 Gv C ) I • • 2a5,o Lender's Name • • 2 8 505 Lender s Address I certify that I have read this application and state that the ► 091 1 t 1 t-86 above mformahon Is correct I agree to comply with all County ardinances,and State laws regulating Plumbing and hereby authanze re �entabves of this County to enter upon the above-m n tied arty for inspection purposes s SEE REVERSE FOR EXPLANATORY LANGUAGE nature of Permittee Da