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Home My Public Portal About9636 VAL ST_Plumbing__ ?SAW v i5O ® APPLICATION FOR PMUM DEPARTMENT OF BUILDING AND SAFETY PLUMBING 8 w COUNTY OF LOS ANGELES ` v WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRI O GROUP ZONE PERMITNO PLUMBERALLCr BOULEVARD PLUMBING M RECEIVED BY READY FOR , DATE ISSUED pry� FIRST INSPECTION AODRESPW EAST VALLEY BLVD. I r� i- - S� A 27 9 BUILDING CITY RDzEMEAD TEL NQCT,/2�'i/li ADDRESD � 7 COUNTYOff 630',S� LOCALITY LICENSE NO m( 1 " NEAREST PERMIT FEES CROSS ST NOMRER TTP[OF FIYTYR[OR ITEM FEE OWNERMAIL WATER CLOSET TOILET ADDRESS O DO ID 0 ••//.^. BATH TUB O SO CITY TEL NO (� SHOWER O 50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY WASH BASIN 050 O APPLICATION AND STATS THAT THE ABOVE IS CORRECT AND AGRfiE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING KITCHEN BINK 050 i CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRYTUBORTRAY O 50 ANGELES COUNTY LICENSE OR 1 AM THE LEGAL OWNER OF THE RESIDENTI P OPERTY DESCRIBED ABOVE a"SVST[ OUTLETS @ O DO ` 91G �lr l WATER HEATER 050 PERMITT F � SLOP BINK O 5o INSPECTION RECORD FLOORBINK a 050 FLOOR DRAIN O 50 DISHWASHER O 50 DRINKING FOUNTAIN O 50 URINAL O 50 ..I HOUSE SEWER ® O 50 Z MISCELLANEOUS O APPROVALS DATE INSFECTOR E N. m ROUGH PLUMBING OAS PIPING GAS VENT y C688PooL 100 0 D CESSPOOL {-IO SEPTIC TANK SEPTIC TANK DRAIN ( ) PIT ( ) ® 1 DO 9[WER PERMIT1 DO GAS TEST - 'J UTILITY CO NOTIFIED TOTAL FEE [ Q FINAL vases. IT s 0 APPLICATION FOR PERM DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTr NO GROUP ZONE PERMITNO PLUMBER REC IVSD BY READY FOR DATE ISSUED FIRST INSPECTION ;2 ^ ` ADDR[68 � S .w D'LDS ^Z CITY L/) TEL ADRES � �f qqLL COUNTY LOCALITY LICENSE NO EXPIRES NEAREST CROSS ST v PERM FEES NUMBER TYPE of FIXTURE DR ITEM FEE OWNER u MAIL S SQ K I WATERCLOSET (TOILET) 050 0ADOR®B BATH TUB O SO CITY TEL NO L SHOWER a O SO 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY WASH BASIN 050 APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING KITCHEN BINK O 60 I CERTIFY THAT I POSSESS THH ABOVE VALID LOS LAUNDRYTUBORTRAY O SO ANGELES COUNTY LICENSE OR 1 AM HE LEGAL OWNER OF THE RESIDENTI P ERTY D C Im AB VE GAB SYSTEM-OUTLETS ® O 59 SIGNATURE OF WATER HEATER Q O SO PERMITTi SLOPSINK a OBD INSPECTION RECORD FLOOR SINK @ O SO FLOOR DRAIN O S DISHWASHER O SO DRINKING FOUNTAIN O SO URINAL O SO J Q HOUB[BEWER O 60 Z MISCELLANEOUS 19 K O APPROVALS DATE INSPECTOR B NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL ® f 00 CESSPOOL SEPTIC TANK SEPTIC TANK DRAIN ( ) PIT ( ) ® 1 00 SEWER PERMIT 1 00 GAB TEST 1 UTILITY CO NOTIFIED TOTAL FEE [ S 6 FINAL j^!R SI V H Ifw ow 1�ID as APPLICATION FOR PLUMBING PERMIT 1 DIVISION OF BIJILDING AND SAFETY DepmbneW of County Engineer COOLty Of LOIS Angeles BUILDING JOHN A LAMBIE COUNTY ENGINEER ADDRESS CASSATT D GRIFFIN,SUP Top BUILDING LOCALI FOR APPLICANT TOLFILL IN NEAREST C OSB ST OWNER / DISTRtGTPOUP MAIL oJ.!/�- NO �I Z_ I READY FOR INSPECTION ADDRESS I ' INDUSTRIAL CI TEL O I WASTE APPROVAL PLUMBER INSPECTION RECORD ADDRESa CI TEL N LICENSE NO NUMB" TYPE OP PIXTum on M PSE WATERCLOSET (TOILET) fl 00 shoo BATH TUB 111 00 SHOWER Q $100 O LAVATORY (WASH BASIN) ® f100 KITCHEN SINK @ 111 00 DISHWASHER @ $1 DO LAUNDRY TUB OR TRAY 100 CLOTHES WASHER $1 00 WATER HEATER ® 1 00 O OAS 6YSTE Q st00 Q� APPROVALS DATE INSPECTOR S SIGNATURE UNDER SLAB WORK PERMIT 11 t 00 ROUGH PLUMBING ,1 GAS PIPING PIPING TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER Q WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PLUMBING FIXTURES 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST _ LICENSED AB REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT AM THE LEGA WNEq OF TH ABOVE UTILITYCO NOTIFIED DESCRIBED RESIDENT PROPERTY SIGNATURE OF PERMITTHB FINAL Z' J4 JOHN A LAMBIE COUNTY ENGIN/19R VALIDATION ROBERT A WOOD CHIEF PLGG INSPECTOR CS ■ • CASH 1&2457 ^ SEP19 3 6.00 R Q D WORKERS CQMPENSATION DECLARATION ^'V r I Hereby, cirrm that I hove a certificate of consent to self in 20-0m ./B�f M APPLICATION FOR PLUMBING PERMIT sure oro certificoPete of Workers Compensation Insurance,or a 764m7A CE817(REV 8/96) certified copy ttreof (qSe�c 3900 Lob C ) Policy Ncp_1 101�C`om COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Y poor ❑ Certified copy is hereby furnished \ FOR APPLICANT TO FILL IN (PRIM OR TYPE) BUILDING ^�� ( Jq I — VS Certified copy copy a fled with the county budding inspection ADDRESS ` \I LLLlllaaa department NUMBER FIXTURE OR ITEM ® FEE LOCALITY DateWATER CLOSET(TOILET) 'T Dote O 7 Applicant K � NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB CROSS ST r COMPENSATION INSURANCE SHOWER OWNER - (This sectlon need not be completed IF the work involved by MAIL the permit Is for a"hundred dollars ({100)or less) LAVATORY ADDRESS roJ s� YL� I certify that in the performance of the work for which this per SINK CITY TEL NO mitis issued I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws DISHWASHER CONTRACTOR Date I Applicant CLOTHES WASHER gDDRE55 NOTICE TO APPLICANT If after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption you should become subject to the Workers Compen sotion provisions of the Labor Code you must forthwith comp- LAWN SPRINKLER SYSTEM CITY TEL NO ly with such provisions or this permit shall be deemed revok- STATE '7�,� ^ UC ��--s ed WATER HEATER LICENSE NO a7✓ CUCoZpSS LICENSED CONTRACTORS DECLARATION DISTRICT NQ P SSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 70DO)of Division 3 of the Business OUTLETS OVER feed Professions Code, and my license is in full force and of- 5 PER SYSTEM FINAL VALI TION y r� eQ Ca DATE 0 License Number «8/""� L0< Class � p FINAL cc Contractor A�c Date/J Z?/—n BY 0 r I am exempt under Sec - W B 8P C for this reason , FA Plan check fee Date PLUMBING PERMIT ISSUING FEE 5 Signature TOTAL FEE SINGLE FAMILY HOME OWNER BUILDER DECLARATION Plan check applicant • • 5 1 hereby affirm that 1 am exempt from the Contractor s License Name ,I • •0 6 5 0 Law for the following reason (Section 70.31 5 Business and Professions Code) Address • • • 1 6 5 0 6i I as owner of the property will do the work and the City Tel No Q Qi bi!8 8 structure is not intended or offered for sale(Section 70x4 r Business 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 ) r 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 mentioned party or inspection purposm awdfAt8L Az— SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of Permittee Dote _ - - WORKERS'COMPENSATION DECLARATION20 APPLICATION FOR PLUMBING PERMIT /-I I ITereby affirm that I have a certificate of consent to self in- 7446aDPW 4/B7 r� I 7A sv*act- tolgete of Workers Compensation Insurance or a CE 817(REV B/8e) U certified copy thereof(Sec 3800, Lab C ) Policy No Company COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS Certified copy is hereby furnished FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING f(0,1 r/ Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM ADDRESS Y /� department FEE LOCALITY Date Applicant WATER CLOSET(TOILET) NEAREST -/� ` CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB CROSS Si / 9/15L✓6. ,I. COMPENSATION INSURANCE SHOWER OWNER ILd �t-atke . (This stolon need not be completed If the work In"Ived by MAIL the permit to for one hundred dollars($100) or less ) LAVATORY ADDRESS V I certify that in theperformonce of the work for which this per SINK mit Is Issued I shall not employ any person in any manner so CITY TEL NO as to become subject to the Workers'Compensation Laws DISHWASHER CONTRACTOR Dale �k_2—?_Qsr V Applicant •`� CLOTHES WASHER ADDRESS NOTICE TO APPLICANT If, after making this Cftiflcote 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 D 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and of 5 PER SYSTEM FINAL �� VALIDATION > fact DATE G tl License Number be Class O U FINAL S Contractor Dote BY O H I am exempt under Sac W B 8P C for this reason y Plan check tea =, Date PLUMBING PERMIT ISSUING FEE $ Q , Signature TOTAL FEE SINGLE FAMILY 19 9 9 9 A HOME OWNER BUILDER DECLARATION Plan check applicant • • • • • 5 1 hereby affirm that I am exempt from the Contractor s License Nome for the following reason (Section 7031 5 Business and Pa"-Pot- Low ( - - 2250 Professions Code) ' Addrau we s 4-4- f . . . 22505 I as owner of the property will do the work and the City u� `/A Tel No Q 6 2,� 8 8 structure is not intended or offered for sale(Section 7044 Business 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 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 ordinances and State lows regulating Plumbing and hereby t authorize representatives of this County to enter upon the above mentioned pr rty for inspection purposes �f' �v�+�'' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee tK Date