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Home My Public Portal About6420 SULTANA AVE_Plumbing__ 6 WOMMRS'COMPENSATION DECLARATION APPLICATION FOR tl LUMMONG PERMIT 1 +ereby;-dffirwm that I have a certificate of consent to self 76A887A in ,+re, or a certificate of Workers'Compensation Insurance, CE 817(REV.8/88) f��, +fled copy thereof(Sec. 3800 Lab. C.) cy. - Company COUNTY OF LOS ANGELES DEFT. OF PUBLIC WORKS X ❑ Certified copy is hereby furnished. BUILDING rq FOR APPLICANT TO FILL IN(PRINT OR TYPE) 1 11X�f+ Certified copy is filed with the county buildininspec- ADDRESS /19 NUMBER FIXTURE OR ITEM ® FEE I' a rtment. LOCALITY L Date j t Appli4ant WATER CLOSET NEAREST CERTIFOCATE OF EXEMPTION FROM WORKERS' � � ) 9.� BATH TUB CROSS ST. COMPENSATION INSURANCE OWNER Q )Z-? •O V This s0etion SHOWER ( mod not ba completed if the work involved by the permit is%r ono hundred dollars($100)or 0058.) LAVATORY MADAIL t DRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL.NO. so as to become subject to the Workers'Compensation Laws. DISHWASHERd I CONTRACTOR /lL Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR ' Exemption, you should become subject to the Workers' CITY ` TEL. NO. f Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION ✓ DISTRICT NO. PROCESSED BY 1 hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM K,7")OUTLETS < ry J (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER 9 and Professions Cod ,and my license is in full rce and effect. 5 PER SYSTEM FINAL VALIDATION L �r �tJ DATE 14 tj License Number Lic. Class FINAL ' d Contractor Dote BY U ❑ I am exempt under Sec. r 916 B.BP.C. for this reason Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ Signature -n TOTAL FEE Plan check applicant SINGLE FAMILY )+1�: °c HOME OWNER-BUILDER DECLARATION Name T:t� I al} I hereby affirm that I am exempt from the Contractor's License 3.0 f0° Law for the following reason (Section 7031.5, Business and Address i TTEN_ Professions Code): I City Tel. No. ❑ I, as owner of the property,.will do the work and the TOTAL �� structure is not intended or offered for sale Section ICEE '� '?; Y' 7044, Business and Professions Code). ( all� l� "`0° 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.). J Lender's Name W-717.3 f AN 9955 Lender's Addross I certify that I have read this application and state that the above informotion is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby cut orize presentatives of this County to enter upon the a t' me roperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Sig ure o PerFn ttee Date WORKERS'COMPENSATION DECLARATION c I Q ` APPLICATIONFOR PLUMBING PERMIT 1-hereby affirm that •1 have a..certificate of consent. to•self. ,1•76A667A insure,.or a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) or a certified copy.the (Sec. 3800; Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished. FOR.APPLICANT TO FILL IN(PRINT OR TYPE) Certified;co: is filed with the.count buildin BUILDING PY Y g inspec- ADDRESS �.`. ...-... . ❑ tion department. I NUMBER FIXTURE OR.ITEM @ FEE LOCALITY CV7V Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB ROSS ST. ' COMPENSATION INSURANCE OWNER " (This section need not be completed if the work Involved by I SHOWER the permit is for one hundred dollars($100)or less.) I LAVATORY MAIL e' �••�� Z � ADDRESS /(/ � �7�+L/�t/L/� I certify that in the performance of the .work for which this permit is;issued,,I shall'not employ an arson in an manner, SINK CIN TEL.NO. r� P P Y YP. y ,`s� � / G so as to become•subject to the,Workers'Compensation Laws. I DISHWASHER CONTRACTOR Date Applicant I CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making 'this Certificate .of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Comp'ensatfon provisions of the Labor Code., you-must foFth- LAWN SPRINKLER'SYSTEIVI CITY TFL. O.NO •. with,comply with such provisions or this permit shall be I STATE LIC. deemed revoked. ti WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. P CES ED BY I hereby affirm that I am licensed under provisions of Chapter 9 I GASSYSTEM OUTLETS (commencing;with Section 7000)of Divisf6n.,3,of the business ` OUTLETS:OVERA. and professions Code,and my license is in full force and.effect. 5 PER SYSTEM FINAL DATE VALIDATION License Number. Lic. Class FINAL Contractor Date i BX' � ❑ IL I am exempt under Sec: � B.&P;C. for this reason I Plan check fee Date: ' PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE Plan cheek•applicant SINGLE'FAMILY HOME OWNER-,BUILDER DECLARATION Name x;5.;4'$ 1 A. I hereby affirm that'I-am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business-and. ' 0 0 0 5 Professions Code): City Tel. No. #,0,0 • ❑ I, as owner of the property, will do.the work and the 2'0 1 5 0 structure is-not intended or offered'.,for sale (Section ' •7044, Business and Profession's Code). ; ® o ..•o `�;6 5 03 CONSTRUCTION LENDING AGENCY �' 019 22--8 3 1 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=mention. roperty for inspection purposes. f SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date 7 IL 76A667-CE#517 5/63 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT�OF COUNTY ENGINEER BUILDING BUILDING AMBIE SAFETY ENG ION ADDRESS 61L20 No Sultana WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY S Gab 'P FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR'ITEM EACH FEE OWNER' Ao. WATER CLOSET 81.25 Ferraro BATH TUB 1.25 ADDRESS same SHOWER 1.25 I CITY TEL. NO. LAVATORY 1.25 CONTRACTOR Pacific Installers SINK 1.25 ADDRESS 10 20 Eo Grand DISHWASHER Ln c7 Te le City TEL.NO• 442-12 LAUNDRY TUB 1,25 CONTRACTOR'S STATE 29 REGISTRATION NO. 211898 COUNTY ❑ CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PRO SEED BY WATER HEATER 1.50 1 a9 0 , a GAS SYSTEM-OUTLETS. 1.50 INDUSTRIAL OVAL O OUTLETS OVER 5 PER SYSTEM .80 INSPECTION RECORD O IHU - IL a . to replacement z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE c O GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE -LAWS IJEGULATING 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 GAS TEST CALIFORNIA OR THAT 1 AM THE EGAL OWNER O AND INTEND TO RESIDE IN,THE ABOVE DE RIBS RESIDENT P ERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTEE FINAL ATION ROBERT A.WOOD ! ^• M.O. CASH SUPERVISING MECHANICAL ENG'R ir�Lo 6 1 .0 1\0 HAR 2 5 D 3.50- b i r: Am w g-m 0 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETYY, COUNTY OF LOS ANGELES PLUMBING 1 WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GRf UP I ZONE PERMIT NO. PLUMBER 5AN GABRIEL VALLEY PLUMBINGRECEIVwElk READ11 FOR DATE idisuft // FIRST INSPECTION Y� ADDRESS GARVEY, CALIF. j /1 ?--W 0430 AT Will " ,i v BUILDING ar" � CITY / Jf n TEL. NO. ADDRESS ` ®.!! fir Imo• 1 A 7c LICENSE NO. / / �J/! I A EXPIRES 2 / LOCALITY NEAREST /nJ PERMIT FEES CROSS ST. 416L1,11 NUMBER OWNER TYPE OF FIXTURE OR ITEM FEE - MAIL_ WATER CLOSET (TOILET) @ 0.50 ffi ADDRESS BATH TUB @ 0.50: CITY / ,YA7foTEL. NO. SHOWER ® 0.50 I HEREBY LACKNOWLEDG THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE TH T THE ABOVE 19 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ 0.50. STATE LAWS REGULATING PLUMBING: - - 1 CERTIFY THAT i POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER OF THE RESIDENTIAL PR PERT ESCR BED ABOVE. GAS SYSTEM T1 OUTLETS 0.50 SIGNATURE OF WATER HEATER @ O.SOI PERMITTE SLOP SINK @ 0.50 INSPECTION RECORD_/, FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50 DRINKING FOUNTAIN @ 0.50 1 1 URINAL @ 0.50 ,_( HOUSE SEWER @ 0.501 Q Z MISCELLANEOUS (� tl: I O . I APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING i ( J GAS PIPING GAS VENT CESSPOOL @ 1.00. CESSPOOL SEPTIC TANK: I SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT . • 1.00 GAS TEST /! TOTAL FEE UTILITY CO. NOTIFIED f I � � �� FINAL 76A667�-CE817 8-60 v f APPLICATION FOR PLUMB3ING ERMIT � COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A.-LAMBIE, COUNTY ENGINEER ADDRESS WILLIAM A.JENSEN.SUPT OF BUILDING 1111 LOCALITY -72e"lp FOR APPLICANT TO FILL IN NEAREST CROSS ST. /� L NUMBER FIXTURE OR ITEM / OWNER � WATER CLOSET MAIL b BATS TOB ADDRESS 10 ' CITY NO,#ile'- SHOWER CONTRACTOR �- `� �.t, LAVATORY SINS ADDRESS D DISHWASHER CITY TEL. N �� CONTRACT0,KjF �. STATE ol LAUNDRY TUB REGISTBAT NO. COUNTY CLOTHES WASHER DISTRICT NO. GROUP- 1ZON ROCS FD BY ` WATER HEATER. O GAS SY INDUSTRIAL WASTE APPROVAL INSPECTION RECORD �a O V 0 $1.00 PER ITEM OR FIXTURE D a $ APPROVALS DATE. INSP CTOR'S SIGNATURE PERMIT $ 2100 UNDER SLAB WORK14, _ TOTAL FEE ROUGH PLUMBING r GAS PIPING I 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. NOT 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 AM THE LEGAL OWNER' OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED w SIGNATURE OF FERMI FINAL �S�P COIL' Dr VAMATIOI--, ROBERT A.WOOD, cm. M,O, (� SUPERVISING MECHANICAL ENG'R .78A887. 17 $-ae® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ILA a% COUNTY OF LOS ANGELES WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. PLUMBEr R E-IVVED BY READY FOR / C/SDA/TE ISSUED FIRST INSPECTION ADDRESSGf �TEL. NO.aBUILDING ,tau CITY ��&4' -(/-a?/, ADDRESS per' " l .-i� go, COU �j r L CEN E NO. ��0o EXPIRES LOCALITY //J' OG CROSS T. � NEAREST PERMIT FEES NUMBER TYPE OF FIXTURE OR ITEM - FEE OW ER MAIL /� v WATER.CLOSET (TOILET) 0.50 ADDRESS l �� BATH TUB @ 0.50 CITY fig_ . JD 'T' L�ENO. �jr SHOWER a 0.50 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) ® 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK O.SO STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER OF THE RESIDENTIAL P TDESCRIBED ABOVE. GAS SYSTEM OUTLETS @ 0.50 SIGNATURE OR WATER HEATER @ 0.50 PERMITTE --- SLOP SINK 0.50 INSPECTION RECORD FLOOR SINK 0.50 FLOOR DRAIN @ 0.50 _ DISHWASHER @ 0.50 DRINKING FOUNTAIN @ 0.50 URINAL @ 0.50 4�,� 2 a HOUSESEWER @ 0.50 �f i//I�� 1 Mewl-r-r '11 Z MISCELLANEOUS 3 • APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER u�/� ,�a /�6tl►N PERMIT . 1.0o GAS TEST UTILITY CO. NOTIFIED TOTAL FEE �� FINAL