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HomeMy Public PortalAbout5415 WELLAND AVE_Plumbing__ 76A6671C ICE 61.7-A1-11/76 APPLICATION OR-PLUMBING PERMIT JE COUNTY OF'L ANGELESDEPARTMENT OF COUNTY ENGIN BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING' 5415 .AVE. NUMBER. FIXTURE.OR ITEM ® FEE ADDRESS WATER CLOSET LOCALITY ` NEAREST BATHTUB CROSS ST. �T�����rr��++r�s� �+�pr1+ SHOWER OWNER FAMM,, HEME 1� LAVATORY MAIL Sw ADDRESS SI ��++ e�I �1p��+ NK CITY 14 :+��C1+u QTY, M.NO. 2279 1— DISHWASHER CONTRACTOR + H.Ci.Ci. CLOTHES WASHER � 10. ADDRESS . . SWIMMING POOL RECEPTOR CITY S. EL,MM, CAE.No. 579-7982 LAWN SPRINKLER SYSTEM STATE LIC. WATER HEATER LICENSE NO. 265094 CLASS C-20 GAS S OUTLETS DIST O. wUP OUTLETS OOVER E PROC SED BY LE OVER 5 PER SYSTEM INDUSTRIAL WASTE:APPROVAL INSPECTION RECORD in 6 oA Plan check fee PLUMBING PERMIT ISSUING FEE$ TOTAL FEE Plan check applicant /Q' Name APPROVALS DATE INSPECTOR'S SIGNATURE UNDER.SLAB WORK Address ROUGH PLUMBING City Tel..No. GAS PIPING 1 HEREBY ACKNOWLEDGE THAT•1 HAVE READ THIS APPLICATION AND STATE GAS VENT THATTHE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBNG. HOT WATER HEATER I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE GAS TEST yb Vf , ry LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTEE FINAL PLAN CFECVWDTOV �+ Kr PERMIT VALIDATION K. M.O. CASH � .? 7 5 D 10.0 0 0,�d POLICY NU SER: 0 4 CE 817(REV:6/76) ' �S APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING gi/I ` �''LL NUMBER FIXTURE OR ITEM ® FEE WATER CLOSET LOCALITY PL�i f NEAREST BATHTUB CROSS ST. SHOWER OWNER �—^ T LAVATORY MAIL ^ /J �� ADDRE SINK CITY e/,y©G� /�V TEL. �y DISHWASHER CONTRACTOR L ��- CLOTHES WASHER ADDRESS 7© L ✓� SWIMMING POOL RECEPTOR CITY (I TEL.NO LAWN SPRINKLER SYSTEM. STATE �/�/ LIG. WATER HEATER �• LICENSE NO T� CLASS GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING GAS VENT HOT WATER HEATERCp PLUMBING FIXTURES GAS TEST Plan check fee UTILITY CO.NOTIFIED c� PLUMBING PERMIT ISSUING FEE$ '' o TOTAL FEE Z:11FINAL. d , Plan check applicant PLAN CHECK VALIDAT N Name ryry Address N City Tel.No. tX�/ �j� {/�y�y-1��f2d�ifs X676®�u CKNOWLEDGE THAT I HAVE READ TIS APPLICATION AND STATE THAT TNEABOVEHEREBYIS CORRECTAND AGREE TO COMPLY WHTH ALL COUNTY ORDINANCES `'..017 ° - 20 6 5 A AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION # U 0 O O 0 5 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE 2 0 - 1 (100 LEGAL OWNER OF.AND TEND TO RESIDE IN THE OVE ES BED RESIDENTIAL PROPERTY. 0 0 0 1 0'00j5 SIGNATURE OFPERMIITEE 0222-79 DISTRICT NO: PR ESSED BY D S , INDUSTRIAL WASTE APPROVAL '4W. R ° BEN "''S1T OF BUILDING AND SAFETY APPLICATION FOR PERMIT M COUNTY OF LOS ANGELES PLUMBING g !. WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICTg-- • GRO N 3,511 PLUMBERREADY FOR f RECMy R ITE IBB ED I FINSPE T ADDRESS � m / _Is ` V v - BUILDING v q CITY TEL No. ADDRESS yvir—leq� /• g b-AA lyp COONTY LOCALITY- 1• P k ff C i 0 CA6 I V, L NSE NO. EXPIRES NEAREST Alp PERMIT FEES DRDBB BT. Al /ic ��.aa R� NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER X ,/ . 14A r• e&T- y MAIL WATER CLOSET(TOILET) 0.50 $ ADDRESS BATH TUB @ 0.50 CITY TEL No. SHOWER @ 0.50 '1 HgREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) a 0.50 ANH D AGREE T COMPLY WITH ALL COUNTY ORMINANOES KITCHEN SINK 0 0,50 AND STATE LAWS REGULATING PLUMBING. I CERTIFY TH/�T 1 POSSLI ESS THE ABOVE VAD LOS LAUNDRY TUB OR TRAY 0 0.50 ANGELES COUNTY/LICENSE• OR 1 AM THE LEGAL OWNER GAS SYSTEMUTLETS 0 13.150 or THE RESIDENTIAL PROPERTY DESC5IBED A-BOVE. SIGNATURE OF .(%rV �E/�C� WATER HEATER 0.50 PERMITTEE= SLOP SINK 6 0.50 IRSPECTION RECORD FLOOR BINK 0.50 FLOOR DRAIN ® 0.50 DISHWASHER O.BO C° � fi C 0'j I- d;bd" &C" DRINKING FOUNTAIN 0.513 r C1-- c URINAL m5D HOUSE SEWER 0.50 MIBOELLANEDU APPROVALS DATE on BP6 OR1B NAME ROUGH PLUMBING �e® MA41 PIPING GAS VENT CESSPOOL 1.00 CESSPOOL SEPTIC TANKS SEPTIC TANK DRAIN ( ) PIT ( ) 1.00 SEWER PERMIT 1.00 GAS TEST UTILITY CO.NOTIFIED TOTAL FEE J FINAL O.B. 17 25M SETS I2-43 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES WM. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE _ HEATER CESSPOOL 1-1 SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION GAS- MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB K NAME 2kL / v _ ADDRESS W � m ADDRESS �.�„�� NQ_ L .lL�L.a LOCALITY I 41, NEAREST IL CITY a_ 4 TEL.No. ��t-�i CROSS ST. COUNTY --I CERT.No. EXPIRES W NAME 1 LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL 3 ADDRESS NORTH O CITY TEL.No. I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. T 3 1 OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK z BATH TUB FURNACE SHOWER DISHWASHER O LAVATORY REFRIGERATOR KITCHEN SINK _WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTALLAVATORY ROUGH PLUMBING METER GAS SODA FOUNTAIN GASPIPING OUTL 1 GAS VENTI I CESSPOOL I I TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOI SEPTIC TANK SEWER UTILITY CO.NOTIFIED TOTAL FEE FINAL D.B.S. 17 25M SETS 12.44 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING Wm. J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP) ZONE PERMIT NO. ROUGH FIXTURES COMPLETE HEATER CESSPOOL —I SEPTICTANK {� RECEIVED BY READY FOR FIRST INSPECTION DATE ISSUED GAS MISCELLANEOUS h APPLICANT FILL IN HEAVILY OUTLINED P�O/RTION� ONLY j� JOB 7� 1 NAME ADDRESS . W AD / LOCALITY NEAREST IWO J NO.CITY . CROSS ST. COUNTY CERT. No. EXPIRES W NAME /r LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL NORTH O G ADDRESS {+ , f CITY TEL.NO. I I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. I I PLUMBER I AM THE LEGAL OWNER.OF THE PROPERTY DESCRIBED ABOVE. N D 3 i OWNER CORRECTIONS t SOUTH DESCRIPTION OF WORK - -- -- � z BATH TUB FURNACE �. rSHOWER DISHWASHER O LAVATORY REFRIGERATOR _KITCHEN SINK _WATER SOFTENER FLOOR SINK SAND TRAP —SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME _WATER HEATER DENTAL LAVATORY _ROUGH PLUMBING I ` _METER GAB SODA FOUNTAIN OUTL _GAS PIPING GAS VENT I I CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOL SEPTIC TANK SEWER I I I TOTAL FEE lI UTILITY CO.NOTIFIED I FINAL WORKERS'COMPENSATION DECLARATION CEE 8 817 6 DPW 4/87 APPLICATION FOR PLUMBING PERMIT I hereby, affirm that I*have a certificate of consent to self in- 76A66A n sure,df a E •tificate of Workers'Compensation Insurance,or a 7 �ILJII 17(REV.8/86) certified copy ereof(Sec. 3800, Lab. .) l7 Compan COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No/4(/ ❑ Certified copy is hereby furnished. _ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ) � n Fit Certified copy is filed with the county building inspection ADDRESS y'/ )e u Ko department. NUMBER FIXTURE OR.ITEM @ FEE LOCALITY to 1$ CiC A Date Applicant eWATER CLOSET(TOILET) NEAREST p ' CERTIFICATE OF EXEMPTION FROM WORKERS' l BATH TUB CROSS ST. D rY!o S COMPENSATION INSURANCE SHOWER OWNER D (A V Ll ZM (This section need not be completed If the work involved by MAIL �^ the permit is for one hundred dollars($100)or less.) of LAVATORY�� r�L._ ADDRESS J 5 -5 AN� )A•E I certify that 1n.the performance of the work for which this per- mit is issued, I shall not employ any person in any manner so CITY Z S CJ4 TEL NO. / SINK 9� as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR _ fP� � w Date Applicant CLOTHES WASHER ADDRE NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY L TEL. N . sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE' - LIC. ed. WATER HEATER LICENSE NO. j dam$ Z C! CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PR ESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS Q 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL J� VALIDATION a fect. / p' ^� a v DATE License Nu er/ d Z ic. Class%� r o �y Contractor PL-k—Bate ® 0� � 8 ' F1 I a exempt under Sec. f W B.&P.C. for this reason Plan check fee W Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and Professions Code): Address ACCTov I, as owner of the property, will do the work and the City Tel. No. 377 50.511structure is not intended or offered for sale(Section 7044, Business and Professions Code). 1 ITEMS CONSTRUCTION LENDING AGENCY ® TOTAL 0 o 50 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued CHECK 50.•1e 0 (Sec. 3097, Civ. C.). CHANGE .011 Lender's Name Lender's Address 1/ 2/90 1 certify that I have read this application and state that the above Information is correct. I agree to comply with all County 7�'y 4r7 1 PM12"V ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the abov -mention. pro ty for inspection purposes. �— SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date