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Home My Public Portal About6237 SULTANA AVE_Plumbing__ r i L M I'L E APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING f � JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS WILLIAM A. JENSEN. SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS SHOWER 1.25 CITY TEL. NO. LAVATORY 1.25 CONTRACTOR SINK 1.25 ADDRESS - lit/ DISHWASHER 1.25 CITY TEL. LAUNDRY TUB 1.25 CONTRACTOR'S STATE REGISTRATION NO. COUNTY ❑ CLOTHES WASHER 1.25 J DISTRICT NO. GRO_UP�^ ZONE PROCESSED BY WATER HEATER 1.50 a p p j, V" J 1 G 50 Q INDUSTRIAL GAS SYSTEM OUTLETS 1. `S WASTE APPROVAL __l__tOUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD 67 Ix 0 H U W CL . H Z S APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE 7 75 GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO GAS TEST RESIDE IN,THE APOVE / DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED SIGNATURE OF PERMITTEE FINAL ti- �LIDATION ROBERT A. WOOD M.O. CASH SUPERVISING MECHANICAL ENG'R DES-17 12-54 APPLICATION FOR PLUMBING PERMIT DES-17 DMSION OF BUILDING AND SAFETY Depcstment of Couatp Eagiaeer County of LOB Aag@leB BUILDING WM•J. FOX, COUNTY ENGINEER ADDRESS CASSATT D.GRIFFIN,SUPT OF BUILDING , LOCALITY FOlt APPLICANT TO FILL IN NEAREST J n CROSS ST. OWNER ADDRESS (p o� DISTRIO. I GROUP READY E READY FOR INSPECTION INDUSTRIAL CITY L L. NO. WASTE APPROVAL PLUMBER o o ', ��-� !"vJ -��' _ INSPECTION RECORD ADDRESS ! / `i SFS<<=s,.�'.�%a�.,.•+ , q�r``�J CITY TEL. NO.A&' LICENSE NO. NUMBER TYPE OF IrIXTURi OR ITEM FEE WATER CLOSET (TOILET) $ BATH TUB SHOWER LAVATORY (WASH BASIN) I KITCHEN SINK • DISHWASHER LAUNDRY TUB OR TRAY CLOTHES WASHER TOTAL NO. Q 0.80 APPROVALS DATE INSPECTOR'S SIGNATURE GAS SYSTEM OUTLETS A 1.00 i UNDER SLAB WORK WATER HEATER @ 1.00 ROUGH PLUMBING PERMIT 8 7 00 GAS PIPING TOTAL FEE L�J" GAS VENT I HEREBY ACKNOWLEDGE THAT i 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 FIXTURES PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY OS A LES COUNTY AND STATE OF UTILITY CO. NOTIFIED CALIFORNIA SI THAT 1 OWNER OF THE ABOVE J DESCRIBED RESIDENTIAL E SIGNATURES OF PERMITTEE WILLIAM J.FOX,COUNTY ENGINEER MATION E &4 0 1 E, MAR 12 S 2.V Um BY ® � / DEPUTY • O1;.KFii"jaS'COMPENSATION DECLARATION �7awes7w I�ire b s,�f;;s ,'th,t I havR as certificate of conseStt to self CE 81712-80) " APPLICATION' FOR PLUMBING PERMIT igsure,pr 3 certificaterof Wofkets Compensation Insurance,or a certified copy thdieol(Sec.3800,Lab.C.) i'?_8849 Zenith COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company `❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING 6237 N. Sultana Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM O FEE ADDRESS department. WATER CLOSET LOCALITY Temple Cit Date Applicant NEAREST BATH TUB CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER Don Viray LAVATORY MAIL (This section. need not be completed if the work involved ADDRESS by the permit is for one hundred dollars ($100) or less.) SINK CITY TEL.NO. CL Tpmple City I certify that in the performance of the work for which this DISHWASHERV permit is issued, I shall not employ any person in any manner CONTRAC ORBryantA. cc so as to become subject to the Workers'Compensation Laws. CLOTHES WASHERO ADDRESS 1350 E. Las Tunas Dr. Date Applicant V SWIMMING POOL RECEPTOR NOTICE TO APPLICANT: If, after making this Certificate of CITY San Gabriel TEL.NO-286-1141 a Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. Compensation provisions of the Labor Code, you must forth- LICENSE NO. 221751 CLASS C20 with comply with such provisions or this permit shall be WATER HEATER deemed revoked. 1 GAS SYSTEM OUTLETS 6 00 DISTRICT NO. PRO'ESPEp B LICENSED CONTRACTORS DECLARATION OUTLETS OVER V I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL VALIDATION ness and Professions Code, and my license is in full force and DATE effect. License Number 221751 Lic.Class C 2 0 F A Contractor Date (-j� 1'o�� I am exempt from the licensing requirements as I am a Plan Check fee MM%J ey licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE 16 50 Lic,or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address _ ! License Law for the following reason (Section 7031.5, Busi- City Tel.No. ness and Professions Code): oq-Z 7,- I, as owner of the property, am exclusively contracting with licensed contractors to construct the project O � (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY 4 I hereby affirm that there is a construction lending agency r f for the performance of the work for which this permit is issued(Sec.3097,Civ.C.). Lender's Name Q �n Lender's Address I certify that I have read this application and state that the above' rmation is correct.I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE ordin ce and State laws r sting Plumbing, and hereby autho ' epresentatives o is County to enter upo the abo - Toned propert r spection pu oses. ' Signature of Permittee r Date ai WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERWT I hereby affirm that I hal a certificate of consent to self 76A667A " insure 6r a ciAtificate of orkers'Compensation Insurance, CE 817(REV. 10/81) or a Artified copy th'tereof{Sed. 3600, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company 5-r 17'—( &/I Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS �� (,�L �/�/9' uCertified copy is filed with the county building inspec- tion department. NUMBER FIXTURE OR ITEM @ /FEE LOCALITY _ �+ Date/-2,o—,q,7 AppliOf -gant a T ,� ! WATER CLOSET (� Q NEAREST r� �� ` /T f BATH TUB CROSS ST.L A!e'D Al OF EXEMPTION FROM WORKERS' / d COMPENSATION INSURANCE SHOWER d OWNER N ! {� (This section need not be completed 6 the work involved by MAIL �7 the permit is for one hundred dollars($100)or loss.) LAVATORY ADDRESS G Z / 614 I certify that in the performance of the work for which this _ permit is issued, I shall not employ any person in any manner SINK CITY PC C_ �` lT TEL. NOa OS so as to become subject to the Workers CONTRACTOR Compensation Laws. DISHWASHER f Date Applicant CLOTHES WASHER ADDRESS JP P C� NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY c�e— g1b TEL. NO Z with comply with such provisions or this permit shall be STATEp LIC. deemed revoked. WATER HEATER LICENSE No. 36,00 CLASS LICENSED CONTRACTORS DECLARATION DIST NO� ESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (,Jl (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL VAUbATION } ` License Number-3_6001Z/ DATE p, Lic.Class ` Q CJ Controcto6_`r4�■ te5a S7— Date ' 2 0-15?7 FBIY AL M ❑ a I am exempt under Sec. U B.BP.C. for this reason W Plan check fee [ D, DatSignature PLUMBING PERMIT ISSUING FEE$ Z TOTAL FEE c3 let Plan check applicant SINGLE FAMILY �6 3 7.8 A HOME OWNER-BUILDER DECLARATION Name # o 0 0 0 0 5 1 hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7631.5, Business and ° - 34.50 Professions Code): City Tel. No.❑ ° o ° 3 4,5 0 I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section 7044, Business and Professions Code). \ 0 1.21 -87 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. 3097, Civ. C.). Lender's 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 laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. --7 ` SEE REVERSE FOR EXPLANATORY LANGUAGE 1 zo -�7 Signature of Perm—Wee' Date