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Home My Public Portal About9207 WEDGEWOOD ST_Plumbing__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAlIII.J. FOX, County Engineer irl3y APPLICANT TO FILL IN . P I — I) 1� (016 PLUMBER a ECEIVED BY READY FOR DATE ISSUED �q FIRST INSPECTION ADDRESS fv* c -p s-- Pan-,Y-4 CITY TEL N ADDRESS sL to 7 0 COUNTY LOCALITY LICEN8E N �(p1REg V NEAREST PERMIT FEES CROSS ST. e NUMBER TYPE OR FIXTURE OR ITEM REE OWNS a ° MAIL WATER CLOSET(TOILET) a qodo S ADDRESS BATH TUB a .5O CITY TEL. Na. SHOWER a O. O IH BY ACKN EDDE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) . O. APPLIC ION AND ATE THAT THE ABOVE Ig CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK 0 OJ(13 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I POSSESS THE ABOVE VALID LOB LAUNDRY TUB OR TRAY a Qrso ANGELES COUNTY LIC RB OR 1 AM THE LEGAL OWNER OF THE RESIDENTIAL ERTY 8C SD ABOV . GAB BYSTEM OUTLETS .50 SIGNATURE OF � WATER NEATER O. O Q U PERMITTE GLOP SINK 0.10 INSPECTION RECORD FLOOR SINK CAD FLOOR DRAIN .50 DIBHWABHER 010.50 DRINKING FOUNTAIN .50 URINAL O O J HOUSE SEWER OLD _Z MISCELLANEOUS 0 0 APPROVALS DATE INSPECTOR-19 NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) 7.00 SEWER PERMIT 7,00 GAB TEST TOTAL FEE o� UTILITY CO, NOTIFIED S �! _ FINAL Y << �'��•�•:�':`�' 70A007 DBS#17 10/52 < .yXORK,tK COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT + 76A666 DPW q/87 ?'! r d`9 k1 1� j� d✓J11f1� PERMIT [� I�Pereby, affirm;tfidt I have a certificate of consent to self tip- .76A667A IL as to become subject to the Workers'Co ensation Laws. DISHWASHER CONTRACTOR / Date Applicant CLOTHES WASHER a II/ NOTICE TO APPLICANT: If, after making this Certificate of Ex- ADDRESS emption,you should become subject to the Workers'Compen- SWIMMING POOL RECEPTOR CITY / TEL. NO. sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM 'l.y with such'provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. aASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that Pam licensed under provisions of Chapter GAS SYSTEM OUTLETS �^tD� 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER v and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION fect. DATE IL O License Number Lic. Class rJ FINAL Contractor Date BY O H I am exempt under Sec. W . . I a B.&P.C. for this reason W _ Plan check fee 11 n po p � Date: PLUMBING PERMIT ISSUING FEE$ o Signature TOTAL FEE C ( o o -1 6.50 SINGLE FAMILY HOMEOWNER-BUILDER DECLARATION Plan check applicant M�G•r�J o a o 1 (� 5 0 3 1 hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and •�, 9 8 8 Professions Code): Address rte t��dr6tJvm I, as owner of the property, will do the work andthe City ' G le Tel:No. structure is not intended or offered for sale(Section 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY 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.). Lerider't 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 property for inspection purposes. `!� �` SEE REVERSE FOR EXPLANATORY LANGUAGE ignat a of Pe ittee Date WORKERS'COMPENSATION DECLARATION APP`ICATI®iV FOR PLUMBING PERMIT 20-0026 DPW 4/87 I here�y, affirm that Ihave a certificate-of consent to self.in- 76A667A I sure,or a cer}ificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) c%tyf;--d copylhereof(Sec. 3800, Lab. C.) ftolicy Nn, Company I COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Ce�fied copy is hereby furnished. s filed the count building P � FOR APPLICANT 70 FILL IN(PRINT OR TYPE) BUILDING' Certified copy iy gins inspection ADDRESS : I a (9 3 (wer!N 4 department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY'. Idle- �� WATER CLOSET(TOILET) ��F77 Date Appl icont NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' I BATH TUB CROSS 57., COMPENSATION INSURANCE I SHOWER OWNER i",+ f� (This section need not be completed if the work involved by MAIL i the permit is for one hundred dollars($100)or less.) I LAVATORY ADDRESS C[ �1 W e •C av'ov D I certify that in the performance of the work for which this per- SINK `' mit is issued, I shall not employ any person in any manner so I CITYnl@ �L TEL. as to become subject to the Workers'Compensation Laws. I DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER I ADDRESS NOTICE TO APPLICANT: If, after making this Ceftificate of Ex- I , SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- sation provisions of the Labor Code,you must forthwith comp- CITY TEL. NO. P Y P- � LAWN SPRINKLER SYSTEM ' ly with such provisions or this permit shall,be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECIEARATION DISTRICT NO ROCESS D BY I hereby affirm that I am licensed under provisions of Chapter :. GAS SYSTEM OUTLETS o 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER v and Professions Code, and my License is in full force and ef- 5 PER SYSTEM FINAL , ALIDATION >' fect. I DATE 0 License Number Lic. Class I O C7 FINAL Contractor Date I BY A O VTI • I.- F] F] I am exempt under Sec. I W B.&P.C. for this reasona. ® U)j Plan check fee Date: � PLUMBING PERMIT ISSUING FEE$ .Signature TOTAL FEE SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION PP•cant I hereby affirm that I am exempt from the Contractor's License Name 5 Law for the following reason (Section 7031.5, Business and Professions Code): Address FYev i I, as owner of the property, will do the work'and the City I Tel. No. 3307 lL �d! structure is not intended or offered for sale(Section 7044, 1 ITEMS Business and Professions Code). l CONSTRUCTION LENDING AGENCY ! TOTAL j. }e, I hereby affirm that there is a construction lending agency for i �� 4,r- the performance of the work for which this permit is issued ,.r (Sec. 3097, Civ.'C.). I ~Hf ]E .{ILI I Lender's Name ' Lender's Address i ODt- la1 11J! .f: I certify that I have read this application and state that thef];L i AM 8;fly above information is correct. I agree fo comply with all County ® 4 ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter.upon the above-mentioned property for inspection purposes. ,9' /� _ 7 _.�� r SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o Permittee Date WORKERS'gOMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereljy,affirm that I have d certificate of consent to self 76A887A ✓I I insure,'or a certificate of Workers'Compensation Insurance, CE 817(REV.8/88) IL so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date 3 ��'-�7 Applicant LC`- Z CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Cer ificate of you, Exem tionshould become subject to the Workers' SWIMMING POOL RECEPTOR Exemption, y f 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 DI RICT PROCESSED BY GAS SYSTEM OUTLETS I hereby affirm that I am licensed under provisions of Chapter 9 �. CN (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 V (DATION DATE —' License Number Lic. Class ff FIN O Contractor Date BY L I am exempt under Sec. 9L� B.BP.C. for this reason Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ Signature 6 7 7.2 TOTAL FEE # 0 0 0 0 0 Plan check applicant 10 ° I IS 0 IS 5 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name 0 33 1 —87 1 hereby affirm that I am exempt from the Contractor's License Address Law for-the following reason (Section 7031.5, Business and Professions Code): City Tel. No. I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section 7044, Business and Professions Code). 00 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency fqr the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). i Lender's Name Lender's Address I certify that I have read this application and state that the No.above information is correct. I agree to comply with all Counly ordinances and State laws regulating Plumbing, and hereby authorize ropresentatives of this County to enter upon the above-mentioned property for Inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Peffninee Date ION ° WORKER'S I have a certificate of consent to �BA687APW9/89 APPLICATION FOR PLUMBING PERMIT I her affirm that I have a certificate of consent to self insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof(Sec.3800 Lab.C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ❑ ADDRESS E/Certified copy is filed with the county building Inspection r department. NUMBER FIXTURE OR ITEM ® FEE LOCALITY Date Applicant WATER CLOSET .i NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST. COMPENSATION INSURANCE BATH TUB ASS / (This section need not be completed if the work Involved by the SHOWER MAP BOOK ;Z.�fry PA�I��a' PARCEL permit is for one hundred dollars($100)or less.) OWNER 1 certify that in the performance of the work for which this permit LAVATORY d�.r MAIL is issued, I shall not employ any person in any manner so as to SINK ADDRESS �(�i e- become subject to the Workers'Compensation Laws. DISWASHER CITY S/tr✓wE, TEL.NO. CONTRACTOR NOTICE TO APPLICANT: If, after making this Certificate of Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRESS provisions of the Labor Code,you must forthwith comply with such GLy�Ljuil/ provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL.NO. } I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER CL (commencing with Section 7000)of Division 3 of the Business and STATE LIC.GAS SYSTEM OUTLETS LICENSE NO. CLASS C Professions Code,and my license is in full force and effect. OUTLETS OVER DISTRICT NO. PROCESSED BY a: 5 PER SYSTEM p C License Number Lic.Class O U FINAL VALIDATION oil C DATE O IL Contractor Date ❑ I am exempt under Sec. gy AL B.tAP.C.for this reason ACCLO°g Date: Plan check fee ® 3307 175.6-5 Signature PLUMBING PERMIT ISSUING FEE$ 1 ITEM 9 TOTAL FEE TIJJAL 175.65 SINGLE FAMILY Plan check applicant CHECK f7c°i