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Home My Public Portal About6424 TRELAWNEY AVE_Plumbing__ J TEA DA5617 to so APPLICATION FOR PLUMBING PERMIT 1 DIVISION OF BUII.DING AND SAFETY DeporhBent of County Engineer of Los Angel" ' BUI JOHN J�MBIE COUNTY ENGINEER ADDRE139 CASSATT D GRIFFIN,SUP T Or BUILOINO LOCALITY FOR APPLICANT TO FILI IN NEAREST BT OWNER DISTRICT NO GROUP I ZONE I READY FOR INSPECTION MAIL ADDRESS INDUSTRIAL CITY TEL NO WASTE APPROVAL PLUMBER 1640k INSPECTION RECORD ADDRESS Z; EffRFIEW CITY I p TEL NO LICENSE NO NUMBER TYPE OF FIXTURE OR ITEM R[[ I WATHRCLOSHT (TOILET) Q $1 00 SiG V _ BATH TUB sl oo u LF C,19D SHOWER sl 00 LAVATORY (WASH BASIN) $100 I �U KITCHEN SINK Q $1 W U J L 0' /Q ' ^ j1 Mrr ( DISHWASHER Q it 00 LAUNDRY TUB OR TRAY Q SI Oo CLOTHESWASHER @ 1100 QV I WATER HEATER Q it 00 4U OAS SYSTEM Q sl 00 APPROVALS DATE INSPECTOR 9 SIGNATURE UNDER SLAIII WORK PERMIT s t 00 ROUGH PLV GING TOTAL FEE I DL OAS PIPING OAS VENT 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATE HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PLUMI3INq FIXTURES 1 HEREBY CERTIFY THAT 1 AN PROPERLY REGISTERED AND/OR GAD TEST //YPnI LICENSED AS REQUIRED BY LOS ANGELES COUlLTY AND STATE OF LOF ORNIA OR THAT I A THE L AL OWNER OF THE ABOVE UTILITY CO NOTIFIED IBED RESIDENT A P P ATURE PERMITTEE FINAL JOHN A LAMBIE. f O NTA NGINEER VC ALIDATION ROBERT A WOOD CHIEF PLBG INGPETOR G[ e e CASK A5095r.; FEB 13 3 8.00 in WORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76AS67A Insure or a certificate of Workers Compensation Insurance, CL 817(REV 10/81) or a certifiejlcopy thereof (Sec 3800 Lob C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Vcy ComId copy .a here fu shedFOR APPLICANT TO FILL IN(PRINT OR TYPE)copy Is filed t co wilding inspec- tion ADDRESS a NUMBER FIXTURE OR ITEM Date AppliSa WATER CLOSET NEAREST CERTIFICATE OF EX T RKERS' BATH TUB CROSS ST COMPENSATIO SHOWER OWNER (This scMlun need not ba completed R the"Fit Involved by MAR the pormlt Is for ons hundred dollars($100)or lets ) LAVATORY ADDRESS I certify that in the performance of the work for which this permit.s Issued I shall not employ any person In any manner SINK CITY TEL NO so as to become subject to the Workers'Compensation Laws DISHWASHER coNTRAcr //—,OW4S l/rCi-/ Dote- Applicant CLOTHES WASHER �^f NOTICE TO APPLICANT If after making this Certificate of ADDRESS —rA Exemption you should become subject to the Workers SWIMMING POOL RECEPTOR �7�7 y Compensation provisions of the Labor Coda you must forth- LAWN SPRINKLER SYSTEM CITU p� TEL N�I /.S�O with comply with such Provisions or this Permit shall be STATE �y g/ LIC /t deemed revoked WATER HEATER LICENSE NO O Z A LICENSED CONTRACTORS DECLARATION DISTRICT D BY I hereby offlnn that I arts licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code,and my license Is In full force and effect 5 PER SYSTEM FINAL VAL ATION d License Number Lic Class DATE U C) FINA IN Contractor Date BY � U ❑ I am exempt under Sec N B dP C for this reason = Plan check fee Dote PLUMBING PERMIT ISSUING FEE$ JrU ;5 3 1 8 OA Signature TOTAL FEE # sass • 5 SINGLE FAMILY Plan check applicant I is • 1 650 HOME OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor s License Law for the following reason (Section 7031 5 Business and Addrau «-� 'v%r�1/N W • ' 1 6 5 0 Fi Professions Code) Clry 9g� Tel No ❑ IQ16-85 I as owner of the property will do the work and the 110111structure Is not intended or offered for axle (Section 44 70Business and Professions Code) 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 hove read this application and state that the , above mformation is correct I agree to comply with all County montes and State laws regulating Plumbing and hereby e representatives of this County to enter upon the v ntioned property for inspection purp SEE REVERSE FOR EXPLANATORY LANGUAGE Si a Pe .tree e