HomeMy Public PortalAbout5033 SULTANA AVE_Plumbing__ f 0 APPLICATION FOR PLUMBING PE MIT
COUNTY OF LOS_J O
DEP�A�R�pTME�NT�{OF�/yf.IOFu�rTnYrpEN
B OTiNIIA 1AM91E. GOUIITY Jr ON
JHID�DH 88 .7 O /O- A.�
WILLIAM A JENSEN, SUPT OF BUILOING
LOCALRT /El/
FOR APPLICANT TO FUL IN REA�i
BY
J
NUMBER FIXTURE OR ITYM OWMM �•� -
WATRE CLOSET /
MAR
� ADDRESS DATE TUB
CTR TEL RO.
BROWEB
COIfTRAf.T08
LAVATORY
em Awms 122 Valle Blvd.
DIHEWASHER clrTEl Moate TEL No ai.3 9 3
CONTILICTOR'S STATE 1H
LAUTWRY TOE REGETaaaor NO. 203.380 coum
` CLOTERE WAsim DISTRICT NO GROUP I mom I PaWESSED BY
WATER HEATHS
DMUSTRIEL
GAS etEtBM WASTE APPROVALV
DISPHCTTON RECORD
a
p BE PER Mw /
OR FQTDBE S APPR VALE It XAT91llillllnii"A S1IGNATURZ, luI/
PERMIT Z 2100 UNDER SLAB WORK I
TOTAL FEE �� ROUGH PLUMBING
GAB PIPING
1 HIREST ACKNOWL[DO[ THAT 1 MAV1 I THIS APPLICATION
AND STATE MAT ME AEOV1 Ie CORRe= ANO AGRUR TO COMPLY GAB VENT I' i/ •,�v���
WITH ALL COUNTY IMNt AMD STATE LAWS REOULATIMD HOT WATER HEATER I ' A
ILU.0INO
I H1R1.r I THAT AM PROP111LT IROIST�1fO AND/GR PLUMBING FIXTURES
LIC[NSEO M I O e ANGELES COUNTY AND RATE OF GA9,FEST
CALIFORNIA OR T 1 TX1 LE OWNER OF ME ABOVE
OISCRIDED REBID[ i L RTY UTILITY CO MOTIF D ✓1
SIGNATURE
OF PERM
FINAL
VALIDATION ROBERT A WOOD
CK M O WH SUPERVISING MECHANICAL ENG R
LC0 3 0 6 7 AUG 1 Jr' 5 D 15.00-
P
'Des 17'10 BB APPLICATION FOR PLUMBING PERMIT 1
DIVISION OF BUMDUM AND SAFETY
Dopcmtmw t of County Eaglnser
City of Las Angel" BUILDING
JOHN A L-AMBIE, COUNTY ENGINEER ADDRESS �b
CASSATT D.GRIFFIN,SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO MIN NEAREST
CROSS ST
OWNER DISTRI O GROUP I �INSPEUIOA
MAIL 2
ADDREHB
INDUSTRIAL
CI T!L NO WASTE APPROVAL
PLUMBER INSPECTION CORD
ADDRHSS 9 d
CITY I TEL NO 4
LICENSE NO
NUMB"I TYPE OF FIXTURE OR ITEM IBE `
WATER CLOSET (TOILET) 0 $100 S 1
BATH TUB @ ft DO
SHOWER @ $100
LAVATORY (WASH BASIN) f1 00
KITCHEN SINK @ ft 00
DISHWASHER @ f1 00
LAUNDRY TUB OR TRAY @ ff 00
CLOTHES WASHER @ ft 00
WATER HEATER @ fl 00
GAS SYSTEM f 1 00
Al
AP OVALS
DATE INSPECTOR S SIGNATURE
UNDER LAB WORK
PERMIT f DO ROUG 42LUMBING
{ GASPI IND
TOTAL FEE GAB v NT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LE A W R OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RE910EN L PROP
SIGNATURE
OF PERMITTEE FINAL
JOHN A LAMBIE COUNTY ENGINECR VALIDATION ROBERT A WOOD CHIEF PLBG INSPHCTOR
® ■ • uFx
0 2 2 1—. .uta 15 3 1 1 0 0 kn
Oeyei�
TSASST•CERSIT 9/55
APPLICATION FOR PLUMBING 'PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
JO � E
OVNYADDNaa
Q NGINEER
WILLIAM A JENSEN SUP T OF BUILDING
FOR APPLICANT TO FRS IN CHAR /
NUMBER FIXTURE OR ITEM EACH. FEE CROSS
WATER CLOSET BI.S
RATH TOB 145 ADDRESS
f SHOWER 175 CETT TEL NO
1 - CONTRACTOR N
LAVATORY 175
BINK 115 ADDRESS
DISHWASHER 115 CRTAdATEL NO , it
LAUNDRY TOB 145 CONTRACTOR 9 TE
UGMTRA770H NO COUNTY
CLOTHES WASHER 115 0 DIST CT NO GROUP KOH.¢ ROC EP 7
WATER HEATER 150
OAS SYSTEM OUTLETS 150 DNDOSTHIAL a
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM 70 DNSPECTION RECORD U
O
o_
N
Z
APPROVALS IVkTEj INMECTOR S slovxtypa
PERMIT IS 2 00 UNDER SLAB WORK f.
ROUGH PLUMBINGJpyr-
TOTAL FEE
CAS PIPING
I A
N[RSSY ACKNOWL[OGE THAT I HAVE RED THIS APPLICATION
ANO RATE THAT TN[ ABOVE IS CORRECT ANO AORfL TO COMPLY GAS VENT �'�
WITH ALL COUNTY ORDINANCES AND RAT[ LAW[ REGULATING
PLUMBING HOT WATER HEATER
I H[RISY GRATIFY THAT I AM PROPERLY R[GIR[IRD AND/OR PLUMBING FIXTURES
LICINSED AS REOUIMBD BY LOS ANGELES COUNTY AND RAT[ OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND IM[MO TO
RIVIUM IN THE ASOVS DANCHRIIIUD• RES NT PROPERTY UTILITY CO NOTIFIED
SIGNATURE I Y Y-
OF PERMITTEE NN/MWM .
FINAL ]
AMATION ROBERT A WOOD
CK M G CASH SUPERVISING MECHANICAL ENG R
LL06 5 5 6 DI 7 5 D 5.75- v
1
' WORKER'S thatIhave a certiIONficate
of consent to 78ASV DPW B/88 APPLICATION FOR R PLUMBING PERMIT ll
7M8S/A
I hereby e111rm that I have a certlllcete of consent to self insure
or a certificate of Worker a Compensation Insurance or a certified - '
copy thereof(Sec 3800 Lab C) I t - - -
COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS DEPT OF PUBLIC WORKS DIV
Policy No Company -
❑ Cerbfl d copy m hereby furnished BUILDING
ElCertflad copy IS filed with the county budding Inspection FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS c.i��S//�
depart nd NUMBER FI%TURE OR ITEM O FEE L
Date ApplIcant WATER CLOSET NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS CROSS ST
COMPENSATION INSURANCE ' STN TUB MAP PAGE PARCEL �-
ASSESSOR
(This section need not be completed If the work,Involved by the SHOWER
permit le for one hundred dollars($100)or leu) - _ LAVATORY - - MAP B
I certify that In the performance of the work for whlch ihl ermlt �j�
is Issued I shell not employ any person In a se to BIjy1( �gESS>;X)3�
become
/.subject
�to the Workers Compense Le aApop
Data L(_/__ Applcent CLOTHESEW ,$ , C RP 7 a�
IA CLOTHES WASHER �D �6 '
NOTICE TO APP CANT If after mak ng thl III to of �/✓ �
Exemptlon you should become subject to the W Compensation SWIMMING POOL RECEPTOR p
provisions of the Labor Cade you must/orthwt ply with each 9202
provisions or this permit shell be deart&dr LAWN SPRINKLER SYSTEM
LICENSED CONTRACTORS DECLARATION
WATER HEATER
I hereby effvm that I em licensed antler provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and GAS SYSTEM OUTLETS LLKA SE NO CLASS �'3�/ 0
Professions Code and my license Is In full force and effect ,
C OUTLETS OVER DISTRICT NO PROCESSED BY O
License Numb C� 5 PER SYSTEMp
/ U
/ 3/`� DATE VW9D W
DATE G_
Con Dete _ _ °
❑ am a under Sec FIFINAL SSD. 41.u Z
1 ITEM
B 8P a thei reasonO5
Date Plan check fee ► TnTaL 41_ u--
Signature PLUMBING PERMIT ISSUING FEE 609— "-nCHECK 41. 5
❑ TOTAL FEE / Y ' �V GH�'Il7E 'Uri
Plan check applKdmt
SINGLERBUIFAMILY p
� HOME OWNER BUILDER DECLARATION Name T i]rluv-i�i]i]1 7�19l�'4
I hereby affirm that I em exempt from the Contractor a License Law
for the following reason (Section 7031 6 Business and Professions Address 6141 1 Fd11Ci�1,
Code) - / I
ElCy Te No
I se owner of the property will do the wxk eM the Mructure
is not Intended or offered for Bale (Section 7044 Business
and Professions Code)
f
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 3087
Clv C)
Landers 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 lawn latl u bing and herebyauthorize
representahv of t e u enter upon the above mentioned
property to osse BEE REVERSE FOR EXPLANATORY LANGUAGE
- � I
Signature of rm Dara