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Home My Public Portal About6326 SULTANA AVE_Plumbing__ 76A667-CE8IMj2/59TEMPLE' _ ITY APPLICATION FOR •PLUMBING PERMIT � COUNTY OF LOS ANGELES. DEPARTAUM OF COUNTY ENGRIM BUILDING BUILDIIGA SAFETY VISION ADDS r � • JOHN I .,.COUNTY NGINEER' WILLIAM A.JENSEN.SUPT OP BUILDI$I6 LOCALITY r FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM OWNER WATER CLOSET MAIL // 9 BATH TUB ADDRESS �Jwe SHOWER • CITY ° � �/� LAVATORY CONTRACTOR SINS ADDRESS L . DISHWASHER CITY TEL NO Q7v— CO R'S STATE LAUNDRY TUB REGISTRATION N � COUNTY D. CLOTHES WASHER DI S TRICT N GROUP Z E 7LCS - WATER HEATER J I 0. GAS SYSTEM INDUSTRIAL WASTE APPROVAL ,r rINSPECTION�!RECORD, ' O z - 4 - i B 'pi $ I ` APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT S 2 .00 UNDER SLAB WORK TOTAL FEE J ROUGH PLUMBING GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT �y;•/ AND STATE THAT THE ABOVE.IS CORRECT AND AGREE-TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT.WATER HEATER I HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND 'STATE OF GAS TEST CALIFORNIA OR THAT I A THE LEGAL OWNER OF THE ABOVE /� DESCRIBED RESIDENTIAL P PE ILITY CO.NOTIFIED i n SIGNATURE OFPERMITEvrFINAL v I `fV Y�/>✓ �■ VALIDATI ROBERT A.WOOD.. Gg, N.0, SS SUPERVISING MECHANICAL ENG'R 5267 OCT $ 5- D 3.50- Q '�.� WORKEn°''COMPENSATION DECLARATION 0026 DPW 4/87 APPLICATION FOR PLUMBING PERMIT I'he4e, y,`affirm thct I have a certificate of consent to self in- 76A667A sure,0 i. certificate of Workers'Compensation Insurance,or a CE 817(REV.8/86) certified'Bopy thereof(Sec. 3800, Lab. C.) Policy Ng.- Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS F ,Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE _ LOCALITY •(r� L� �+ z•{� c pf'7 11:12-0Date Applicant WATER CLOSET(TOILET) Q 'r NEAREST �Yr 7 7 CERTIFICATE OF EXEMPTION FROM WORKERS' 3 BATH TUB Aa CROSS ST. ,[pa/(-D D/�/ 1�lJS EN? I-� COMPENSATION INSURANCESHOWER ri, OWNER ��. / v (This section need not be completed if the work involved by i7 v MAIL 6v the permit is for one hundred dollars($100)or less.) .s¢ LAVATORY 6'0 CITY 5p e— ADDRESS 6-32-6 vdkm I certify that in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so S OW Mel., 9l77.S� TEL. NO. as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If,after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY TEL.NO. sation provisions of the Labor Code,you must forthwith comp- LAWN.SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER O and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINA VALIDATION fect. DATE a License Number Lic. Classf O FIN V cc Contractor Date BY AIL O /P,44" F- I am exempt under Sec: Q� W B.BP.C..for this reason Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ 0 � Signature SINGLE FAMILY TOTAL FEE 00 -c HOME OWNER-BUILDER DECLARATION Plan check applicant ACC-1.14 hereby affirm that I am exempt from the Contractor's License Name -j 10I DD for the following reason (Section 7031.5, Business and ,:�-�10 �. DD Professions Code): Address 1 i TGll` }� I, as owner of the property, will do the work and the City Tel. No. TOTAL o structure is not intended or offered for sale(Section 7044, 103 Business and Professions Code). ® CHECK 1'071 CONSTRUCTION LENDING AGENCY CHANGE .10 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.). I'17117-ISI � , 7 A Lender's Name �'-rt Al. 7 4-I rt, 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- entioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee I Dale �' •. WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereB affir'tn that I have a certificate of consent to self in- 26-0026 DPW 4/87 Too ®r E� lLJl R�Y� Y, 76A667A su..e,or a certifir+ate of Workers'Compensation Insurance,or a CE 817(REV.8/86) 004141 t'opy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No." Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING J 32 Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM ADDRESS J / department. @ FEE —y LOCALITY T�i� r✓� L!F/ Cc,4 'I y �-7y 0 Date Applicant WATER CLOSET(TOILET) NEAREST / CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. I-DA16evei g0S&046, -0 COMPENSATION INSURANCE SHOWER OWNER "OW-ow/ 6+0 (This section need not be completed if the work involved by the permit is for one hundred dollars($100)or less.) LAVATORY 7 DDRESS 6 3 26 X Ulf awa E I certify that in the performance of the work for which this per- SINK CITY TEL. NO.8t� r mit is issued, I shall not employ any person in any manner so S'r4/ 619-df, L tf177,' 7hu-d�3 as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- emption,you should become subject to the Workers'Compen- CITY TEL. NO. sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICCJ-NO. OCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM 2 OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAZS VALIDATION fect. DATE a License Number Lic. Class 0 FIN _ Q Contractor Date BY O J 7— F- I am exempt under Sec. yVj CL B.&P.C. for this reason ® W Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ /3 Signature TOTAL FEE Q SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant - - A Li'_�•.07 I hereby affirm that I am exempt from the Contractor's License Name -: ;E"1`7 3�- Law for the following reason (Section 7031.5, Business and wL�:; ;,,: ,iu,� Professions Code): Address , t r- 3 I, as owner of the property, will do the work and the City Tel. No. structure is not intended or offered for sale(Section 7044, 1 Business and Professions Code). >I_ CONSTRUCTION LENDING AGENCY ® 13j-IANi3-LE 1-11 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.). . r rs Lender's Name 1 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 aut prize representatives of this County to enter upon the abo� -menti ned property for inspection purposes. u f e l4l q SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date p �e PERMIT PERM ., WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING IT I hereby affirm that I have a certificate of consent to self 20-0026 DPW 6/87 insure, orro certificate of Workers'Compensation Insurance, 76A667A or a certtifiyd*copy thereof(Sec. 3800; Lab. C.) COUNTY OF.LOS ANGELES 'DEPT.OF PUBLIC WORKS Policy No. ' Company Certified copy is hereby furnished. BUILDING ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS 'y•%�- �tf! .i � Certified copy is filed with the county building inspec- tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Appligant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB CROSS'ST. 4d'tet 11 ice' G t'St�►;�E tri COMPENSATION INSURANCE OWNER (This soction need not bo complotod If tho work involvod by SHOWER the ormit Is for ono hundred dollars 100 or loss. MAIL , ��;, P (S J ) LAVATORY ADDRESS E:h��E• =��'I-�n�`• + /iV = 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 rw L�1f. E~ L TEL.NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS N ^/ ✓' + NOTICE TO APPLICANT: If, after making this Certificate of you s , Exem tionhould become subject to the Workers' SWIMMING POOL RECEPTOR P Y I 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 NOPROCESSES I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (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 _ �' DATE �j VALIDATION License Number Lic. Class & r Z FIN _ I= Contractor Date BY ❑ `� I am exempt under Sec. L� B.BP.C. for this reason ® U) Plan check fee to Signature Z Date: PLUMBING PERMIT ISSUING FEE$ e�' O'jJ TOTAL FEE s (� SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address °�1`'i °3 Law for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. I, as owner of thero ert , will do the work and the P P Y structure is not intended or offered for sale (Section 7044, Business and Professions Code). �!;;i � 203 o '_ef CONSTRUCTION LENDING AGENCY E.� ��1 PE iL°L:�_ I hereby affirm that there is a construction lending agency for _ the performance of the work for which this permit is issued ti•Eelivt_ (Sec. 3097, Civ. C.). Lender's Name ,;i_Ijlj—I.Iji;.j ::i"�4.1 91 Lender's Address I certify that I have read this application and state that the 71 °-;4 ='Li 1 A'i I.1 /`"2. above information is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize reprellentatives of this County to enter upon the a\ove-mentioned property for inspection.purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Sign tura of Permittee Date 76A667-CE817.^12/59 �'Li ��PL�r •C9TY i APPLICATION FOR PLUMBING PERMIT � COUNTY OF LOS ANGELES DEPARTMENT T�Es7aOmvFyeCOUNTY��+ENGINEER FNEAMT B l%?LAMBIC.C�NTV ENGINEOER� ADDRESSpr C� WILLIAM A.JENSEN.BUP!T OF BUILDING r FOR APPLICANT TO ML IN NUMBER FIXTURE OR ITEM ` OWNER WATER CLOSET / 9 ADD�Rm (J�J RATE TUB CITY SHOWER LAVATORY CONTRACTOR SINS ADDRESS DISHWASHER CITYTEL. NO7,3� CO R'S STATE - LAUNDRY TUB 'REGISTRATION N COUNTY ❑ CLOTHES WASHER DISTRICT N GROUP PE i PR CE BY WATER HEATER J i 0 1/ GAS SYSTEM INDUSTRIAL WASTE APPROVAL '> INSPECTION.RECORD /' w o APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ E��Oot UNDER SLAB WORK TOTALFEE ROUGH PLUMBING GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION l AND STATE THAT. THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT //f _ y a •:.! WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. �' •� 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES f LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 A THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PI P - iLITY CO.NOTIFIED 1.`/.� SIGNATURE A IAf �hI i OF PERMITTE FINAL Sr VAIMATI ROBERT A.WOOD. CK. N.0. CASH SUPERVISING MECHANICAL ENG'R LCO:5 2 6 7 Ql OCT 8 5 D 3.5 0- Q