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Home My Public Portal About5527 WELLAND AVE_Plumbing__ 76A667 (CE-817)-&-71 APPLICATION FOR PLUMBING PERMIT {� COUNTY OF LOS.ANGELES LI DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING �f ADDRESS 7 J !� , LOCALITY . FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM @ FEE OWNER WATER CLOSET 1.75 MAIL BATH TUB 1.75 ADDRESS SHOWER 1.75 CITY TEL. NO.e4 LAVATORY 1.75 CONTRACTOR SINK 1.75 ADDRESS DISHWASHER 1.75 CITY TEL. NO. CLOTHES WASHER 1.75 STATE LIC SWIMMING POOL RECEPTOR 1.75 LICENSE NO. CLASS DISTRICT NO. GROUP ZONE.1 PROCESSED BY LAWN SPRINKLER SYSTEM 1.75 r" WATER HEATER 1.75 INDUSTRIAL WASTE.APPROVAL GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD OUTLETS OVER 5 PER SYSTEM'' 30 x • s V W 9. N z Man check fee See reverse. PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INS TOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS VENT I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES Flu : nA WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. 1 NEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO..NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES UNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE'.LEGAL OW R OF AND INTEND TO 1 RESIDE IN THE ABOVEDE R.IBED REBID-EN Y• FINALVol SIGNATURE w OF PERMITTEE PER ALIDATION CK M.O. CASH PLAN CHECK VALIDATION CK. M.0. CASH L 0 3 3,n-N OCT19 5 0 6.50- ''MA887=CE0817 10-87 i - k '`% R APPLlGA7ION FOR PLUMB. G PETIT CO '.,OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS G- COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALrfY �P/n P C 1 IV FOR APPLICANT TO FILL IN(PRINT OR TYPE NEAREST CROSS Si. � NUMBER FIXTURE OR ITEM EACH FEE OWNER A) kl e l . , N, WATER CLOSET 1.50 ` +� -7 BATH TUB 1.50 ADDRESS SHOWER 1.50CITY e Al NO. ` LAVATORY 1.50 6 U CONTRACTOR SINK 1.50 ADDRESS DISHWASHER 1.50 CITY TEL. NO. CLOTHES WASHER 1.50 STATE LIC LICENSE NO. CLASS SWIMMING POOL.RECEPTOR 1.50 DISTRICT NO. Gp ll� ZONE �+ E ED BY LAWN SPRINKLER SYSTEM 2.00 0 __Z_ C WATER HEATER 1.50 INDUSTRIAL WASTE APPROVAL CD GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD � OUTLETS OVER _ d 5 PER SYSTEM .30 Q �� Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE S 2 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER . RK Name ROUGH PLUMBING ` Address GAS PIPING 6 GAS VENT City Te1..NO. HOT WATER HEATER 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST OCK PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED " LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN'R OF,AND INTEND TO RESIDE IN,THE ABOVE DEDC .BED RESIDENT. RO Y. FINAL SIGNATURE JACK R. ALLEN, SUPERVISIN HANICAL ENG'R. OF PERMITTE , . PERMIT VALIDATION cK. M.O. CASH PLAN CHECK VALIDATION CK. M.O. GZSH Lob 8 3 O% OCT14 5 D 8.DQ`". ..q= laex � — -' COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department-of-County Engineer ,.DIVISIONOF BUILDING & SAFETY �--2?' WILLIAM J. FOX, County Engineer PLUMBING' 1 DISTRICT NO. GROUP OPERMIT NO. FOR APPLICANT TO FILL IN PLUMs"NERAL INSrl RECEIVED BY READY FOR DATE 98UED FIRST INSPECTION 311 E. SOth STREET L, A. 3 L Co ADDRESS want 3.2541 BUILDING /,^ -1 CITY TEL No. ADDRESS COUNTY LOCALITY LICENSE NO. EXPIRES NEAREST % PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER OL09ET(TOILET) 0.50 $ ADDRESS BATH TUB @ 0.50 _CITY TEL No. SHOWER 0 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK C.50AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER OF THE RESIDENTIAL PROPE DESCRIBED ABOVE. GAS SYSTEM OUTLETS Q 0.50 SIGNATURE OF WATER HEATER Q 0.50 PERMITTEE SLOP SINK @ 0.50 INSPECTION RECORD FLOOR SINK 0.50 S`3 FLOOR DRAIN Q 0.50 / DISHWASHER 0.30 DRINKING FOUNTAIN 0.50 �c7r��,�ti ' rG/L act�•�s URINAL 0.50 Q HOUSE SEWER @ 0.50 _Z MISCELLANEOUS s APPROVALS -- DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING t+ OAS VENT CESSPOOL 1.130 CESSPOOL ' SEPTIC TANK: BE 'TIC TANK DRAIN ( ) PIT ( ) @ 0-36 SEWER PERMIT 1.00 GAS TEST TOTAL FEE Isca G?J UTILITY CO.NOTIFIED 1 FINAL /� 76A667 DBSa#17 6-58 ��„ WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby, affirm that I have a certificate of consent to self in- 20-0026 DPW 4/87 2 sure,or a certificate of Workers'Compensation Insurance,or a CE 817(REV.8/86) A Irv' 1J certified copy thereof (Sec. 3800, Lab. C.) 11 CE 817 COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING {� Certified copy is filed with the county building inspection ADDRESS �! department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY DateApplicant WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so CITY TEL. NO. as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS ' NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY TEL. NO. sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC. t ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS �� } 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER d and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION 4 LU fect. DATE W License Number ,� N'. ��.-- !' Lic. Class J FINAL Li Contractor'_P' Date 1 '! BY >.. cc I am exempt under Sec. ais B.&P.C. for this reason O Plan check fee ► a Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION ; I 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 I, as owner of the property, will do the work and the City Tel. No. structure isnot intended or offered for sale(Section 7044, r. O Business and Professions Code). , CONSTRUCTION LENDING AGENCY S 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 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