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Home My Public Portal About5137-5139 1/2-5141 SERENO DR_Plumbing__ D t 17 '°"` °T 11- 1 APPLICATION FOR PEFim DEPARTMENT OF BUILDING AsAFSTY PLUMBING COUNTY OFFLOSLOB ANGELES _ • I YVM.J PDX,CHIEFQNeINIMER Qsw 4 �} ROUGH FUITURRS COY a Q &-S 4-4e2, [S HEATER CRPOOI. BJaTIC TANK FIRST INSPECTION READY FORT[ISSUED APPLICANT FELL IN HEAVILY OUTLINED PORTIO ONLY NAME // / ADO ' ADDROS ADDRESS uZ LOCALITY �, L3C' N[ARVT CITY L No CROSS ST COUNTY CURT No EXPIRKS MAY[ Of 3 LOCATION OF SEPTIC TANK, OR CESSPOOL MAIL. S / NORTH O cl7r ' y I AM THE LEGAL POSSESSOR OF THE ABOVE LOU ANGELEU COUNTY CERTIFICATE OF QUALIFICATION ►Lur[cR 1 AM THU LEGAL OWNER OF THE D ABOVE �a CORRECTIONS BOUTH J DESCRIPTION OF WORK a z- ATH TUU FURNACE l7 _ HowER DIBNwweNER p LA VATORY REFRIGERATOR ITCHEN SINK WATER SOFTENER FL OINK SANDTRAP LOP BINK F ^^R DRAIN WASH TRAY URINAL APPROVALS WATER CIAeR ^RINKINO FOUNTAIN DATTE� INE'[CTRE•NAM[ WATER NEATER DENTAL LAVATORY ROUGH PLUMBING / -y UT[R nAB �n^A FOUNTAIN OAB PIPING OUTL OAS VENT CESSPOOL y s TOTAL NUMBER OF FIRTU_ RUQ SEPTIC TANK c[SSPOO� SEPTICTANK SEWER B UTILITY CO NOTIFIED I TOTAL FEE FINAL Z"/— G i APPLICATION FOR PERBUT D iIRTCOUN OF BUILDING AND SAFSIR PLUMBING ' COUNT_ Y OF LOB ANGELES WM J FOX.CHIEF ENGINEER r19A" FIETURm COMlLBT[ � � Tv GESBlpOL StPTK:TANKpu READY POR DATE NNW= lIRAT INSPECTIONAPPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY.los ADDRESSS LOCALITY NEAREST TEL No CROSS ST EMPIRES p! NAYS OF SEPTIC TANK, OR CESSPOOL MAIL. / NORTH O i CTTY Td No ' IS THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION PLBMI= 1 AM THE LEQAL OWNER OI THE PROPERTY DwSqRlSxD ABOVE. OWN= CORRECTIONS K,S, eSA_„IJ SOUTH / K -/o -S�� OYrsa DESCRIPTION OF WORK _ BATH TUB FURNACE O lz HOWER DISHWASHER o VATORY REFRIGERATOR ITCHEN BINK WATER SOFTENER Fn'R SINK RAND TRAP LOP SINK F DDRDRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN G DATE (, •NIPBCTOR•MAN[ WATER NEATER DENTAL LAVATORY ROUGH PLUMBING /-�' /? �V 1ICJS` ETSRJ.LSAB SODA FOUNTAIN GAS PIPING OUTL OAS VENT � a CESSPOOL TOTAL NUMBER OF IIXTURES BlPTIC TANK 27 07 P• ✓ _C ESSPOOL eEPTICTANK SEWER S UTILES CO NOTIFIED /G-"a -.!Ay TOTAL FEE D ILS-Ir :6M SETS E4E 1 APPLICATION FOR PERMIT DEPARTMENT OFNG AND SAFETY , PLUMBING COUNTY OFF LOS LOS ANGELES WM J FOX.cNly mIGINEER NATURE O NO. — ROUGH FIKTURE6 COMPLETE _ 53-5-j HEATER CESSPOOL SQPTIC TANK READY FOR RECEIVED FIRST IDY FOTION DATE tD APPLICANT FILL IN HEA O PORTION ONLY ¢� NAME s, 7 �[.{/ /17Q`Y/ ADg 1. 0. . RUG I. r4.-;11) 0 r,^ B ADDRESS O V Q L LITY ` O V In �• I NEAR {_� n 1 J ,6t CITY TEL Ne Q CROGOST 1. .l S 6 �•, E.R�i ��4 �• `GU NTY ERT No EXPIRES '36 ` NAME 'N 1 GL Cr. J di. [- 1 /0'"� LOCATION OF SEPTIC TANK, OR CESSPOOL MAIL ADDRESS NORTH O CITY T0L, No 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIPICJ)T�P TA71CA 1 GG////11 .-//11 // TI � ILUME® 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE OYYlIq CORRECTIONS SOUTH J DESCRIPTION OF WORK i ATM TUB FURNACE 0 rc HOWER ✓ - DISHWASHER VATORY �' REFRIGERATOR L SCHEN SINK 0. WATER SOFTENER R BINK RAND TRAP kTOTAI-VIF' EE OP SINK e.^^R DRAIN yyp1ASH TRAY V URINAL APPROVALS ATER CLOSET U DRINKING FOUNTAIN DATE IMWP R S MANE ATERMtATER DENTAL LAVATORY ROUGH PLUMBINGETER.�GAB RODAFOUNTAIN ` "OUT• 6AB PIPINGOAS VENT CESSPOOL OTAL NUMBER OP►IXTURES �� SEPTIC TANK ESSPOOLEPfIC TANK + SEWERS UTILITY CO NOTIFIED L O D B R-IT 25M Rsrra'e-" APPLICATION FOR PERffiT DEPARI�NT OFF LOS NG AND SAFETY ��'��_ COUNTY OF LOS ANGELES WM J FOX.CHIEF ENGINEER A O `UPI ZONE PERMIT /7.. ROUGH FIXTURES COMPLETE HEATER CESSPOOL SEPTIC TANK R [tV@YY READY FOR PATH IEEUED MISCELLANEOUS FIRST INHPECTION 07 f/L_` .f -7 CAR APPLICANT IN HEAVIL VOUTLINED PORTION ONLY JOE y, NAME ADDREIE A G ADDRESS ! LOCALITY N[ARKET CITY Td No CROS[R COUNTY CERT No mcPIRES �' NAM[ LOCATION O SEPTIC T OR CESSPOOL MAIL NORTH ADDRESS i CITY TEL No IAM THE LEGAL POSSEO/OR OF THE ABOVE LOS ANOELES COUNTY COTTIFI IOP QUALI U NN1 ► u"m 1 AM THE LEGAL OWNER OF THE PROPERTY D[SCRIBID ABOVL O�IM01 CORRECTIONS SOUTH J DESCRIPTION OF WORK a ATX TUB FURNACE . O_ C HOWER W GH WASHER O AVATORY REFRIGERATOR ITCHEN SINK WATER SOFTENER LOOR SINK BAND TRAP LOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET ^RINKING FOUNTAIN DAT[ IIgN[C1pR NwN[ WATER HEATER_ _ ^ENTAL LAVATORY ROUGH PLUMBING 6T[RGAS CODA FOUNTAIN OUTL GAB PIPING OAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK Ca"POOL SEPTICTANK G SEWER S TOTAL FEE / CIO VTILITY CO NOTIPI<0 FINAL ^-- Tv °INSET' IAB APPLICATION FOR PERMIT %DEPARTMENT OFLOS NG AND SAFETY PLUMBING ' COUNTY OFF LOS ANGELES WY J. ROH.CMV ENGINEER 1 NATURE OF INSTALLATION ROUGH FIXTlIRE6 COMPLETE _ HEATER C0SP001. SVTIC TANK RICIN READY FOR DATE ISSUED FIRST INSPECTION APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JoeaNAME \ 1 ADDRESS ° ADDRESS D LoeAlm a NEAREST Cm TEL NO. CROSS ST COUNTY CERT.NO e r1r., QPIRES R NAME LOCATION OF SEPTIC TANK, OR CESSPOOL Y NA,L NORTH � wDDRw q � Cm_ b.CO TET. NO 1 AM THE LANIAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFI TE OF OU IFICAFION. PWIIEBt 1 AM THE LEGAL OWNER OF THE PROPURTY DINIM10E0 ABOVL wTRo CORRECTIONS SOUTH J DESCRIPTION OF WORK a z kH TUB Y'�RNACE O C ER - DISHWASHER p TORY Oa�IGERATOR HEN SINK WATERSOPTOIER R SINK - SANDTRAP SINK O.^^R DRAM TRAY URINAL APPROVALS M CLOSET DRINKINGFOUNTAIN DATE IwommR•r z WATER NEATER _ DENTALLAVATORY ROUGH PLUMBING LIWAL �AS w`A FOUNTAIN GAS PIPING QUTLGAB VENT COSPOOI.NUMBaii OF FIETUREB �� SEPTIC TANK OOL SEPTIC TANK BEWOI S� .f unE.m eo NOTmED TOTAL FEE 7M +T 2"errs 7- I APPLICATION FOR PHEtWT DEPAR USAFETY TO OF LOS ANG EI �� WM J.FOX.CHIEF EiGINE ut ROUGH FIXTURES COMPLETE ! / '? cy NEATER CEDBPOOL SKPTIC TANKREADY FOR RIC PIRBT INSPECTION [SWIM MimcgLLANNOUs ATEl APPLICAWT FML IN HEAVILY OUTLINED PO ON ONLY JOB NAME ADORNW72 LITY B ADDREB6 LOCA 7 NEAREST CITY KL No CROSS COUNTY1. LICENSE NO KXPIRKB y NAME LOCATION OF SEPTIC TANK, OR CESSPOOL MAIL NORTH ADDRESS CRY TEL.No I AM THE LEGAL POESEBBOR OF THE ABOVE LOB ANOKLI S COUNTY CERTIFICATE OF QUALIFICATION. lLYIIKO I AM THE LEGAL OWNei PF THE D TEED ABOVE awA CORRECTIONS SOUTH J DESCRIPTION OF WORK ATN TUB FURNACE � HowKR ^IelRwweHKa p LAVATORY REFRIGERATOR KITCHEN BINK WATER SOFTKNKR R SINK BAND TRAP SINK ^^R DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET -------DRINKING FOUNTAIN DATE iR4aafR11 RArE WATER NEATER - DENTAL LAVATORY ROUGH PLUMBING ETER X115 &ODA FOUNTAIN OAS PIPING _ GAS VENT mmmuw COSPOOI. TOTAL NUMBER OF FORURKS SEPTIC TANK KSBPOOL 9EFTIC TANK SEWER TOTAL PEE / S UTILITY CO NOTIFIED �� y..W,ORKERS'COMPENSATION DECLARATION �I herebyycif rm that I have a certificate of consent to self m- , DPW 4187 APPLICATION FOR PLUMBING PERMIT , sure,or a cartiticate of Workers Compensatio.Insurance or a CP 017(REV 8/96) - cerhfied copy thereof (Sec 3800 Lab C ) `0 No CompanyCOUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS Policl' nCertified copy is hereby furnished ❑ Certified co is filed with the county bvidin in FOR APPLICANT TO FILL IN(PRIM OR TYPE) BUILDING copy ty g Spection ADDRESS �' / �rpl0 F-+✓� department NUMBER FIXTURE OR ITEM ® FEE LOCALITY WATER CLOSET(TOILET)Date Applicant � NEAREST CERTIFICATE OF EXEMPTION"FROM-WORKERS' , BATH TUB CROSS ST_ r^ COMPENSATION INSURANCE - SHOWER OWNER l._ O H L (This stolon need not be comploted If the work inwlw_ d by 1l the permit is for arta hundred dollars($100)or Has) LAVATORY ADDRESS J i1,& � T O Ue5- I certify that in the performance of the work for which this per- �8 �/� mit is issued I shall not employ any person in any manner so SINK CITY TEL W L as to become subject to the Workers Compensation Laws � 1 DISHWASHER - CONTRACTOR Dote S�V'-�✓ Applicant / CLOTHES WASHER _r NOTICE TO APPLICANT If after making this Certificate of Ex ADDRESS emption you should become subject to the Workers Compen- SWIMMING POOL RECEPTOR CITY EL tJ0 lotion provisions of the Labor Code you mutt forthwith comp LAWN SPRINKLER SYSTEM ly with such provisiani or this permit shall be deemed ravok- STATE LIC ed WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DIST C1 NO D BY 1 herebyaffirm that I am licensed under , GAS SYSTEM ' OUTLETS pravisions�of Chapter 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER fed Professions Code and my license is in full force and of 5 PER SYSTEM FINAL VALI TION y DATE License Number_Ln: Class U FINAL G Contractor Dote BY O ❑ I am exempt under Sec W IL B$P C for this reason Plan Check fee Z Date PLUMBING PERMIT ISSUING FEE S ;2967 3 A Signature Al,OTAL FEE ( #te it a e 05 SINGLE FAMILY h Plan check applicant ' HOME OWNER BUILDER DECLARATION PPPicant I ra e 2 8 5 0 I hereby affirm that I am exempt from the Contractor s License Name Low for the following reason (Section 7031 5, Business and _ is • - 28.505 Professions Code) Address s I as owner of the property will do the work and the City Tel No r O5 2 4 t 8 8 structure is not intended or offered for sale(Section 70", , Business and Professions Code) _ ► ' - CONSTRUCTION LENDING AGENCY r I hereby affirm that there is a construction lending agency for t the performance of the work for which this permit is issued (Sec 3097 Civ C ) ' Lender's Name ' v Lender s Address I certify that I have read this application and state that the above information is correct I agree to comply with oil County ► ordinances and State laws regulating Plumbing, and hereby , authorize reprnentotives of this County to enter upon the above-mentioned property fa u s action purposes _ IL SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date , WORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby, ofhconsent to that I have a certificate of conseto self in 20-0026 DPW a/87 s7 i 76A667A sure,or o cerldicate r satl of Workers Cbmpenan Inswonce ora CEE82 877(REV g/BA) certified copy thereof(Sec 3800 Lab C ) Policy Nor.�ldiVi .V loony MSeiit-see_c ICOUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS Certified copy is hereby furnished BUI DING , ❑ FOR APPLICANT TO FILL IN(PRINT C8!TYPE) Certified copy is filed with the county building inspection ADDRESS department NUMBER ` FIXTURE OR ITEM ® FEE - _ LOCALITY Date Applicant WATER CLOSET(TOILET) NEAREST /J+�'KK�.•.�Q/�-��7 CERTIFICATE OF EXEMPTION FROM WORKERS BATHTUB CROSS ST CQ.X�/""�/ COMPENSATION INSURANCE / SHOWER OWNERIO/elz (This section n"d not be completed If the work Involved by MAIL the Permit Is for one hundred dollars ($100)or less ) LAVATORY ADDRESS 1 candy that in the performance of the work for which this per mit is issued I sholl not employ any person in any manner so SINKCITY r TEL NO as to become subject to the Workers Compensation Laws DISHWASHER J�1 CONTRACTOR - - Date � 7// Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT If otter makingth Certificate of Ex 'CG emption,you should become subject to the Workers Compen- SWIMMING POOL RECEPTOR motion provisions of the Labor Code, you must forthwith comp LAWN SPRINKLER SYSTEM CITY e TEL NO �?y ly with such provisions or this permit shall be deemed revok STATEs9�G LIC Q ed WATER HEATER LICENSE NO 7 CL455 C� LICENSED CONTRACTORS DECLARATION RICJ.NQPROCEiSNP BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code and my license is in full force and of S PER SYSTEM FINALVALI TION fact DATE License Number Lic Class U //d/ FINAL IC Contractor �1. 4220" BY O El I am exempt under Sec . W a B 8P C for this reason plan check fee ► 2 Date PLUMBING PERMIT ISSUING FEE$ Signature � TOTAL FEE SINGLE FAMILY - HOME OWNER-BUILDER DECLARATION Plan check applicant 1 hereby affirm that I am exempt from the Contractor's License Name y Law for the following reason (Section 7031 5 Business and ACCT.T Professions Code) Address 3307 .28.00 I as owner of the property will do the work and the City Tef No 1 IT structure is not intended or offered for sale(Section 7044 Business and Professions Code) PON. 28.00 CONSTRUCTION LENDING AGENCY - CfCK 28.011 1 hereby affirm that there is a construction lending agency for i �y�L the performance of the work for which this permit is issued (,` .W (Sec 3097 Civ C ) r ' 7 t Lender s Name r OOOO-0DO1 2/ 1/90 Lender s Address 8714 1 PM12:02 I certify that I have read this application and state that the obove 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-mentioned ropeny for inspection purposes (I� SEE REVERSE FOR EXPLANATORY LANGUAGE Signal of ermittee V Date