HomeMy Public PortalAbout5062 SULTANA AVE_Plumbing__ DEPARTAffiHT OF COUNTY ENGINEER PLUMBING 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDINO `
WILLIAM J. FOX, COUNTY ENDINQER ADDRESS
CLZ
FOR APPLICANT TO FILL IN LOCALITY
BUILDING // ,{ NEAREST
ADDRESS 062- SG yc., GROSS BT
/ DISTRICT NO GROUP ZONE PT No
LOCALITY T�,.1., �, r �� /
NEAREST
CROSS BT Q (/ AEC IVCD Y pudY for letDuflAA DATE ISSUED
-�o-S
OWNER I
MAILINDUSTRIAL
ADDRESS �O w� tt7--g.� U -L WASTE APPROVAL
CITY .r/�/(A r;ZaEL NO R 7--00a G INSPECTION RECORD
PLUMBER S c�
ADDRESS
CITY TEL NO
STATE
LICENSE NO [7�COUNTY J
PERMIT FEES a
z
+u MCER Trc or r, T.r oR ITEM FEE Q
eZ WATER CLOSET(TOILET) @080 >< D
-.BATHTUB @ 080 O O
,SHOWER a 080 d
LAVATORY(WASH BASIN) 0 0 80 11O
KITCHEN SINK 0 080 RD
LAUNDRY TUB OR TRAY @ 080 0
SLOP BINK 0 0 80
FLOORSINK @ 080
FLOOR DRAIN 0 080
DISHWASHER @ 080
DRINKING FOUNTAIN @ 080
URINAL 0 080
OAS SYSTE _OUTLETS 0 IAO �'bb
WATER HEATER @ 100 d ,
YISCELLANEOUB
APPROVALS
DATE INSPECTOWS SIGNATURE
UNDER BLAB WORK 10 1
PERMIT $ l 00 ROUGH PLUMBING
TOTAL FEE la d GASPIPING K
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GASVEMT
CATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOB ANGELES COUNTY GAS TEST I II
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESC/RIBED ESIDENTI/AL PROPERTY UTILITY CO NOTIFIED `- T
SIGNATURE S/ G1
OF PERMITTEE VO
_
FINAL G SS
76AO87 DBSIT rl1 I,.RA
70A607-CEE17 10.80C_�,P�
i
APPLICATION FOR PLUMBING PER IT;
COUMN OF LOS ANGELES
DEPARiMTOF CO nE
MGLpgoGINEE�
a11DISm. GINEER ADDRESS
JoG 1 �1 2`L
WILLIAM A JENSEN, SUPT OF BUILDING IACALRY _
FOR APPLICANT TO I= IN
CROSS B -
NUMBER FIXTURE ON ITEM OWNER
WATER CLoffi'
SATS TOB ADDRESS
SHOWER CITY / • TEL No i—G 3020
LAvaroaT
coNTRAcma
mm ADDRESS a
DISHWASHER CRY TEL NO
LAUNDRY TOB REGISTRATION NO. COUNTY
CLOS® WASHER DISTRICT NO I ORQj�7.. Z NG' P ED BY
WATER HEATER - y9
OAS SYSTEM IIYDOBTffim
WASTE APPROVAL -
DONCrtON RECORD Q
V
a
O
d
I
• nOB PTZTOeEJn P8R Rees '
f APPROVALS DATE INSPECTOR•SIONATURS
PERMIT $ 2 DO UNDER SLAB WORK .LIA
TOTAL FEE ROUGH PLUMBING
OAS PIPING
1 HERESY ACKMOV/LEDQE THAT I NAVS READ TNIS --awni
ANO STATE THAT THC AROVE IS CORKS= AND AGRQ TO coM Y GAS VENT
WRN ALL COUNTY DRDINANCEE AND STATE LAWS SIMULATING
PLUMBING HOT WATER HEATER -
I HERSDY CERTIFY THAT I AM PRGFURLY MOISTORD AND/OS PLUMBING FIXTURES
ES
LICENSED AN
REQUIRED BY LOS AGELES ND COUNTY ASTATE OF GAS TENT
CALIFORNIA OR THAT I AM THE LEGAL OWNED OF THE ABOVt
DEEcmamR¢SIDWTIAL UTILITY CO NOTIFIED
SIGNATURE ,& iL / A4
OP PERM
FINAL ( Alr lli�
VAMATIOROBERT A W D
K M
Co I CASH SUPERVISING MECHANICAL ENO R
M6 1 2 2: oEc l 4 5 0 3.0 0 x
� p tt
WORKERS'Cha0e ATIOtd DECLARATION APPLICATION FOR PLUMBING PERMIT,
I hereby affirm
m that have n certificate of consent to soli 20-0048 DPW 8/87
insure or a car if f Of Workeri Co pensution Insurance, 76A867A ,
or a certified ccoppycIll-i:,,.ff (Sec La COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS
Policy No�-Compony
Certified copy is hereby furnished
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING 01.1
ED::'Certif,ed copy is filed with thcou uddmg tnspec- ADDRESS
Z-
n e n e r NUMBER FIXTURE OR ITEM ® FEE
ti
LOCAL
IA ApphGant WATER Cl06kT _ NEAREST
RTIFI TE OF EXEMPTION FROM WORKE BATH TUB CROSS ST
COMPENSATION INSURANCE OWNER
(This seNfen need not be comploted k Fite work Involved by
SHOWER
she Permit ts for ossa hundred dollen ($100)or loss ) LAVATORY I' MAILADDR
N fir) r
1 certify that In the performance of the work for which this
permit Is Issued 1 shall not employ any person in any manner SINK CITY TEL NO
so as to become subject to the Workers Compensation Laws
DISHWASHER - CONTRACT /
Dots Applicant CLOTHES WASHER -
NOTICE TO APPLICANT If after making this Certificate of 's' E
SS AJ
Exemption you should become subject to the Workeri SWIMMING POOL RECEPTOR
Compensation provisions of the Labor Code you must forth LAWN
TEL NO
LAWN SPRINKLER SYSTEM
with comply with such provisions or this permit shall be STATElIC
deemed revoked WATER HEATER LICENSE NO CLASS
LICENSED CONTRACTORS DECLARATION _pISTRI PROCESSED BY
I hereby affirm that I am licensed under,provisions of Chapter 9 GAS SYSTEM
(commencing with Section 7000)of Divaan 3 of the Business OUTLETS OVER
and Professions;Code,and my license Is In full force effect 5 PER SYSTEM FINAL � VALIDATION o
�-�I / U
License Numb —yl!c Class DATE,,
FI
Contractor Date BY Q
❑ 1 am exempt under Sec W
B dP C for this reason n r
Plan check feePoo Z
Dote
PLUMBING PERMIT ISSUING FEE E
Sigrafure
TOTAL FEE
L Plan check applicant 5
SIUFAMILY '
HOME OWNERR BUILDER
ACCTx1rLDER DECLARATION Name `• �rs-z
I hereby affirm that I am exempt from the Contractor a License Address 'gvwf 16. 1
Law fee the following reoaon (Section 7031 5, Business and 1 IT
Professions Code) City Tel No - '
❑ 1, as owner of the property will do the work and the RITAL 16.50
structure is not intended or offered•for sale (Section
7040, Business and Professions Code) CWCK 16.50
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for , vrr>s s00
the performance of the work for which this permit is issued n '
(Sec 3097 Cry C ) a
GG'-OM1 6/26/89
Lender s Name 41"J JO 1 ill 8336
Lender s Address iT
I certify that I have read this application and slate that the pop
information is correct I agree to comply with all County
ordinances and ate lows regulating Plumbing and hereby
authorize repr an es of this County to enter upon the t
above m h ed o r for inspecngn p rposes(/o SEE REVERSE FOR EXPLANATORY LANGUAGE ,
Signature of Permdtee Me '