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Home My Public Portal About6272 SULTANA AVE_Plumbing__ IBUV-CE817-8-58 APPLICATION FOR PLUMBING PERMIT 1 COUNTY OF LOS ANGELES DEPARTNB+NT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDINO JOHN A. LAM M CountFees ADDRESS � 1 a. !. Le CASSATT D.GRIFFIN.Sup t of$nll& ypcAL1TY � FOR APPLICANT TO FILL INNEAREST CROSS ST . NUMBER FIXTURE OR ITEM OVYNRS WATER CLOSET BATH TUB DAD�RESS Y 'ate SHOWER CITY TEL.NO. LAVATORY CONTRACTOR SRS ADDRESS DISHWASHER CITY TEL.NO. LAUNDRY TUB CONTRACTOR'S STATE ❑ REGISTRATION NO. COUNTY ❑ . CLOTHES WASHER DISTRICT HO. GROUP ZONE CESSED BY WATER HEATER GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD 3-7- 9 /,r Il lir f fir rP N AAl GT 1',* 1111&Z,012' A17- ,f IAI P/t/ APPROVALS so'R°PER aR 1 DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 2100 ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES . I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST 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 ° FINAL OF PERMITTE ®p VALIDATION�UPRRVISINGRORMOOHANICAL ENG'RCH. M.O. I,lr,3. 9049tMR23 5A 3.00 � DEADY FGS W&LUm-4 CE 81 7A CITY OF pO,aRRA'fT E CITY CE 817(REV.B/78) TMOLE 6r es APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING A D SAFETY 2 FOR APPLICANT TO FILL IN[PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM ® FEE ADDRESS 6272 Sultana WATER CLOSET LOCALITY Ttmg3.e Cit NEAREST BATH TUB CROSS ST. SHOWER OWNER Heath LAVATORY MAIL ADDRESS same as above SINK CITY Same TEL.NO.-287-4335 DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS 6558 West Blvd. SWIMMING POOL RECEPTOR CITY Lo A® TEL.NO. 753-254 LAWN SPRINKLER SYSTEM STATE 1 WATER HEATER 3 QQ LICENSE NO. C36-151839 CLASS GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S.SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PERSYSTEM ROUGH PLUMBING GAS PIPING GAS VENT u 99 HOT WATER.HEATER PLUMBING FIXTURES GAS TEST Plan check fee UTILITY CO.NOTIFIED PLUMBING PERMIT ISSUING FEE$ 7 ,00 TOTAL.FEE 10,00 FINAL 14/K`�l v J4M'1�)?__ Plan check applicant PLAN �CHECK ,VALIDATON! Name Address City Tel.No. 51 a 0 A I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION # O O•O.O O 5 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/,OR LICENSED AS - 1 n O O REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE 2 1A LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. Q��) ��/[7 yn� O O O 1 OQ L SIGNATURE OF PERMITTEE '"' ��" •�/� U 628 _ "79 DISTRICT NO. PR ESSED INDUSTRIAL WASTE APPROVAL ;1 '+ WORKERS'COMPENSATIONDECLARATIO-N �' APPLICATION FOR-PLUMBING PERMIT I :heregy affirm that I have a certiftccte. of eonsent'to self '20-0026 DPW 6/87 insuf0', 0 a:; rtificate of Workers'Compensation Insurance, 76A66.7A or a certified copy thereof (Sec. 3800, T I Labs.C.) COUNTY O.FIOS ANGELES DEPT.OF PUBLIC WORKS Poacy No. Company �`+�' ' ® Certiled copy is hereby furnished. BUILDING FOR.APPLICANT TO FILL IN(PRINT OR TYPE) ' Certified copy is filed with the county building inspec- ADDRESS tion.department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY - Date Applicant WATER CLOSET IRMU NEAREST ..N CROSS.ST. CERTIFICATE OF..EXEMPTION FROM WORKERS' DD COMPBATTUB NSATION.INSURANCE SHOWER OWNER _ f (This section,meed'not be completed IF the•work involved by the MAIL .permit is for one hundred dollars($100)or less.) � LAVATORY OQ . ADDRESS �l o I certify that in the performance of the work for which this permit.is issued,I•shall not employ any person in any manner SINK CITY TEL..N. so as•to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR a Date - Applicant CLOTHES WASHER ADDRESS ' (C%S NOTICE TO,APPLICANT:: .If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR CITY• TEL. NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER.SYSTEM with comply with 'such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT IVO. PROCESSED BY • I hereby affirm••that l.am licensed.underprovisions of Chapter 9 I OAS:SYSTEM OUTLETS ie (commencing with'Section 7000)of Division'3-of•the Business OUTLETS OVER ' and professions Code,and'my-license is in full force and effect. 5 PER'SYSTEM, FINAL- VALIDATION i DATEQ License Number I? Lic..Class f ff FINAL Contractor to i BY IM `a , I am exempt under Sec. 19 B,BP..G. for this reason. f Plan check fee cli Date: � PLUMBING PERMIT ISSWING FEE$ Signature TOTAL FEE }f ' Plan check applicarit ' SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I.hereby;affirm.that lam-exempt from the.Contractor's License I AddressACC' Law for the following reason (Section 7031.5; Business and Professions Code):. City TeI..No. 3307 ,t6,5U..L0 :a I, as owner of.-the property, will do the work and,:the" 1 ITOS structure is not intended or offered for.sole (Section 7044, Business and Professions Code). PooTOTAL625.50 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for CHICK 65.5 ) the performance of the work for which this permit is issued L:'HANGE -(Sec. 3097) Civ. C.). Y� Lenders Name Lender's Address I certify that I have read this application and state that the ® 911302 1 All -1:2171above 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 abdve=mention..ed property for inspection purposes. _ SEE REVERSE FOR EXPLANATORY LANGUAGE Signature Permittee�— Date