HomeMy Public PortalAbout6432 TRELAWNEY AVE_Plumbing__ TDAeeT CEnen O S)
APPLICATION FOR , PLUM ING PER(IT 1
COUNTY OF LOS ANGELES
DEPARTMENT, OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION D
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPT OF BUILDING LOCALMY
FOR APPLICANT TO FELL IN CNH R 7 Al
NUMBER FIXTURE OR ITEM EACH FEE OWNU
WATER CLOSET $125 MAQ
PATH TUE 125 ADDRESS
SHOWER 125 TEL NO _ 3
LAVATORY 125 CONTRACTOR
sum ADDRESS O
DUBIWASHEH 125 .0 TEL HO O
LIC
LAUNDRY TUB 125 LICENTAY ESE NO p( CLASS
CLOTHES WASHER 125 DISTRICT NO GR P Z NE P BY
WATER HEATER 158
GAS SYSTEM OUTLETS I50 MDUSTRULL
WASTE APPROVAL
O OVER 5 PEE SYSTEM m BUIPECTION 1ECOPD d
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2
APPROVALS DATE INSFECTOR[SIGNAWRE
PERMIT S1 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE CAS PIPING
1 HERESY ACKNOWL¢DO[ THAT 1 HAVE ROAD TH15 AMLIGTION GAS VENT
AND 6TATE THAT THE ASOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
FLUMSINa HOT WATER HEATER
I HERESY CERTIFY THAT I AM P FERLr REGI.ER[D AND/OR PLUMBING FIXTURES
LICEHEEO AS R[OUIR[O eY LOS ANO¢LEy Counir AND STATE 0/ GAS TEST
CALIF IA OR THAT NC OWNER OF AND INTENTS TO
R[sloE m TH¢Aw D[ eE R[n eNn R F[RTY UTILITY CO NOTIFIED
SIGNATURE
OP PERMITTE FINAL
/VjAIIDATTON JACK R. ALLEN
cK✓/ M D CASH SUPERVISING MECHANICAL ENG'R
LAC03 4 9 its- w 7 5 D _ 5A00N a
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4-68
76A8B7—DEB+'APPLICATION FOR PLUMB��MI r
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER RDaDING _
BUIWING AND SAFETY DIVISION AnnRPJts E
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN IN JENKINS SUPT OF BUILDING LODALm
FOR APPLICANT TO FILL IN PR )TT 01TYPE DMOSS ST
C�
NUM SER FI%TURF OR ITEM EACH FEE
DWAIEH
AREST
WATER CLOSET 150 NAd
BATH TUB 150 ADDRESS
SHOWER 150 CITY TEL NO
LAVATORY 150 caNrRA
SINK 1 50 ADDRESS
DISHWASHER 150 ` alrk TEL N
CLOTHES WASHER 1 50 STATELICENSE NO -Q a G CLASS LIC
SWIMMING POOL RECEPTOR 1 50 DISTRICT NO 6R P ZONE PROCE66lD S
LAWN SPRINKLER SYSTEM 2 00 1 '
WATER HEATER 1 50 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 1 50 IBPECTIOS RECORD O
OUTLETS OVER
5 PER SYSTEM 30
Plan check fee 25-0 of above See revers]7:PLUMBING PERMIT ISSUING FEE2 00
TOTAL FEE
APPROVALS GATE INSKciOR naiONATUR¢
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
GI[y el NoHOT WATER HEATER
I HERSEY ACKNOWLEDGE THAT 1 HAVE READ ICATION
AND STATE THAT THE AEOVE IE CORRECT AND COMPLY PLUMBING FIXTURES
WITH ALL COUNTY pEDINANCIS AND RATE ULATING GAB TEST
PLUMSIN6
1 HERSEY CERTIFY THAT 1 AM PROPERLY RAMD/OR UTILITY CO NOTIFIED
LICEMSEO AS REQUIRED RY LOS ANGELES COUNTATE OF
CAUPORM A ON THAT 1 AM E LEGA] OWNER TEND TO i
REtIM IN THE AiOK DE I EO/lE/r1J[MTIA FINAL
SIGNATUREPORMI 1/]r{mTJACK R ALLEN, SUPERVISi CHANICAL ENO R
PERMIT VALIDATION
PLAN CHECK VALIDATION CK M o CASH CK mo CASH
LAC079a7G J"13 - 5 a 3.50- V
47^�
A667-CE*617
6p-6 9� ` aApPLICATION FORPLUMBING PERMIT
w COUNTY F LOS ANGELES
DEPARTMENT SF COUNTY �I�
-moi Fj 1� `067 2 wDe19s JATYE JO A AM IE OUNTY WILLIAM A JENS[N YUP T OF BUILDING LOCALITY
FOR APPLICANT TO FRS IN Cel aT
NUMBER FIXTURE OR ITEM EACH FEEOWNEs
WATER CLOM n1s /7! NAM
HATH TDB 1ss ADDRESS
SHOWER 1.15CITi' TEL NO
LAVATORY 1,15 CONTRACTOR Alert RiTimbing
HIRE 115 ADDRESS 13933 So- CranDISHWASHER 115 CITY Hawthorne TEL NOLADNDRY TUR I75 �GIBTHA�T7011 No 193617 C-36
-0LOTmS WASEM 115 DIQTRICT NO GROUP ZONE F EBBED BY
WATER HEATER 150 SQ
GAB SYSTEM-OUTLETS--
OUTLETS
150 INDUSTRIAL ASTEASTEAPPROVAL O
ODTLE7H OVER S PEH SYSTEM 3) INSPECTION RECORD U
nC
O
a
N
Z
APPROVALS PATE INSPECT R 6 81Gn
PERMIT i 2 OO UNDER bLAS WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HKR Y ACKNOW"DG6 THATI HAV[ READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE 16 CORMCT AND AGWK TO COMPLY
WPTH ALL COUNTY ORDINANC66 AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING IL 14el��
I HERESY CERTIFY THAT I A RLT R[OIET[RED AND/OR PLUMBING FIXTURES
LIC[HUO AS REQUIRED eY L A [LES COLA AND RAT[ 01 GAS TEST
CALIFORNIA OR THAT I AM TH L OWNER AND INTEND TO
R iM IN THE AEov[DESCRI I L RRTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL -/
/"' ATION R08ERT A WOOD
cK M O cw[H SUPERVISING MECHANICAL ENO R
LAC03A5 0 6—� JUL 9 5D 11.25-
WORKERS't I have
a certificate
cafe f corse APPLICATION FOR PLUMBING PERMIT
I hereby affirm that I Fwve a certificate of consent to self 7eA6yq
insure, ora rtsicate of Workers Compensation Insurance, CE S17(REV 10/81)
or a cert d copy thereof (Sec 3800, Lob C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY
P I No Compos
Certified copy s r nn
❑ FOR APPLICANT TO FILL Ut(PRINT OR TYPE) BUILDING rJ�J / ^W
Certrf co s Til s(h n building inspec- ADDRESS JL L/� J r'
non a NUMBER FIXTURE OR ITEM ® LOCALITY''
Dote hSont WATER CLOSET NEAREST T�
CERTIFICATE OF E ION ORKERS' BATH TUB CROSS ST
COMPENSATIO RANCE SHOWER OWNER
(This section need not he completed If the work Involved by
the permH Is for one hundred dollen(SI00)or less) LAVATORY AJ)DRM
I certify that in the performance of the work far which this
permit is Issued, I shall not employ any person in any manner SINK CITY T TEL NO
so as to become subject to the Workers Compensation Laws
DISHWASHER CONTRALTO 14/
Date Applicant CLOTHES WASHER n
NOTICE TO APPLICANT If after making this Certificate of ADDRESS 6 .4 .Q 57_
Exemption you should become subject to the Waken SWIMMING POOL RECEPTOR
Compensation provisions of the Labor Code you must forth- CITY
LAWN SPRINKLER SYSTEM TEL No44 7-7578
deecomply with such provisions a the permit shall be STATE t37LIC
deemed revoked WATER HEATER LICENSE NO 2� CL.455
LICENSED CONTRACTORS DECLARATION DISTRICT-.L40 If
SSED BY
I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS rllt.J4JT_V0
(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 LIDATION
v
v
License Number Lic Class DATE
I W
QQ FINAL act
Contractor Dote Q Dote LLL777U111
❑ I am exempt under Sec v
N
B 8P C for this reason 2
Plan check fee
Date
PLUMBING PERMIT ISSUING FEE S
Signature
TOTAL FEE TO
Plan check applicant
SINGLE FAMILY • Y i
HOME OWNER-BUILDER DECLARATION Name �, f7 S- 4 UAVA
I hereby affirm that I am exempt from the Contractor's License Address 41E- T191N ���
Low for the following reason (Section 7031 5, Business and
Professions Code) city Tel No
❑ 1 as owner of the property, will do the work and the ( • • 16,50
structure is not intended or offered fa sole (Section
44
70Business and Professions Code) 00 • • • 1 6 5 Q 6
CONSTRUCTION LENDING AGENCY ( a '
I hereby off um that there is a construction lending agency for 6-85
the performance of the work fa which this permit is issued
(Sec 3097, Civ C )
Lender's Name
Lenders Address
I certify that I hove read this application and state that the ►
above information is correct I agree to comply with all County
Mnc4 Slatepawsreguatinsentatives ofhis Ced property forSEE REVERSE FOR EXPLANATORY LANGUAGE
rmmee to