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Home My Public Portal About9872 WENDON ST_Plumbing__ WORKERS'COMPENSATION DECLARATION LA If—ffn_U C ' TT O N FOR PLUMBING PERM113 I hereby affirm..that I have a certificate of consent to self 20-0026 DPW 6/87 insure,'or a certificate of Workers'Compensation Insurance, 76AS67A or a certified copy thereof(Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS policy No. Company Fyflj Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE �]o ✓ Certified copy is filed with the county building inspec- ( ) ADDRESSLKJ tion department. NUMBER FIXTURE OR ITEM ® FEE LOCALITY , Date Appli;ant iWATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if tho work Involved by PLAIL tho permit Is for one hundr'ed dollars($100)or less.) LAVATORY ADDRESSR S-7Z \�f I certify that to the performance of the work for which thisa permit is issued,L shall not employ any person in any manner SINK CIT a L��,� TEL. NO:Z��..� so as to become subject fo the Workers'Compensation Laws. DISHWASHER '14 Sr CONTRACTOR Date Applicanti CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of 61 Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR , Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY �� I�- TEL. NQ.�p � with comply with such provisions or this permit shall be STATE LIC, deemed revoked. ! WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm•that I am licensed under provisions of Chapter 9 GAS SYSTEM �.7 OUTLETS .0_ 0� (commencing with Section 7000)of Division 3 of the Business ! OUTLETS OVER O and Professions Code,and m license is In full force and effect. 5 PER SYSTEM FINALr_g y DATE r�✓ / z VALIDATIOIN ELI License Number r5Ltc. Class I _ 0, FINAL Contractor Date BY :,,;•r�r s � I am exempt under Sec. B.BP.C. for this reason i Plan check fee °' " ,:Mw� Z Date: �i!v PLUMBING PERMIT ISSUING FEE$ a 7 IAL 6G- o 4C Signature ' TOTAL FEE /mss Plan'check applicant Ain (_t i[-1(�IiC 1� SINGLE FAMILY - i HOME OWNER-BUILDER DECLARATION Name C,5 (i►/I I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and �1��4 4.;F0 0►� , i '_Professions Code): �A�ddress ity �1 i� Tel. No. ,06wa E j ❑ I, as owner of the property, will do the work and the I `'�e 94 y 1:01 ='°0121. 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 Lender's Address 1 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-me nti oned'property for in tion purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permit ee Date GE 817'(REV.6)78) ' 85 APPLICATION OR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING �ry ADDRESS NUMBER FIXTURE.OR ITEM ® FEE LOCALITY WATER CLOSET NEAREST .BATH TUB CROSS ST. SHOWER OWNER Z, a W. LAVATORY MAIL ADDRESS SINK CITY TEL.NO.. �y DISHWASHER CONTRACT CLOTHES.WASHERr /1DDRESS/ _ SWIMMING POOL RECEPTOR CITY TEL.N LAWN SPRINKLER SYSTEM ST LIC... WATER HEATER LICENSE NO.. CLASS r GAS.SYSTEM OUTLETS APPRO ALS WE INSPECTOR'S SIGNATURE - OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS'PIPING GAS VENT ' HOT WATER HEATER PLUMBING FIXTURES GAS TES v==r - "" , 96 wo Plan Check fee UTILITY CO.NOTIFIED PLUMBING PERMIT ISSUING FEE$ = o TOTAL FEE ,i . FINAL Plan check a_pplicant PLAN CHECK VALIDATION Name / IV A- Address City Tel.N :P 3 5 21 A I HEREBY ACKNOWLEDG T I HAVE READ THIS'A LIGATION AND STATE ii O O O O O JC THAT THE ABOVE IS CORRE AND AGR E T OMPLY WITH ALL COUNTY ORDINANCES tF AND STATE LAWS REGULATI PLUMBING. PERMIT VALIDATION 2 O c 1300 I HEREBY CERTIFY THAT PER L 'REGISTERED AND/OR LICENSED AS REQUIRED B. ANGELES C AND.STAT OF CALIFORNIA OR THAT I AM THE LEGAL OWNER F.ATI .INTE TOR _ E' E ABOVE DESCRIBED RESIDENTIAL .0 O O 1 3005 PROPERTY. SIGNATURE 0 11.0 2-79 OF PERMITTEE DISTRLCT-Ne— P C , � 0 INDUSTRIAL WASTE APPROVAL COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J. FOX. County Engineer PLUMBING 1 FOR AP LICANT TO FILL IN DISTR�C� O. GR�I) RMIT Nu. P I ZO r J 1 PLUMBER READY FOR E EIVED BY DATE ISSUED /�/ FIRST INSPECTION to ADDRESS e� �� BUILDING CITY L, N ADDREBB COUNTY or LOCALITY LICENSE NO. EXPIRES NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET(TOILET) Q 0.50 N d ADDRESS BATH TUB Q O. O 6 CITY TEL No. SHOWER @ 0. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE REAQ THIS LAVATORY (WASH BASIN) 0 O. A APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK O. ® AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOB LAUNDRY TUB OR TRAY @ O. ANGELES COUNTY LICENSE&ISR 1 AM THE LEGAL OWNER GAS SYSTEM OUTLETS @ O. d u' OF THE REBIDENTI P I2 Y DESCJVBED ABOVE. SIGNATURE OF WATER HEATER Q O. O o PERMITTE GLOP BINK @ D. IllINSPECTION RECORD FLOOR BINK @ 0. FLOOR DRAIN t10 O. DISHWASHER O 5it H DRINKING FOUNTAIN 0 0.50 Al URINAL 0.50 Q HOUSE SEWER 0.50 �� l" ( � Z MISCELLAO � r' �).D�� edg& APPROVALS DATE IN SPE�CTOR'S NAME ROUGH PLUMBING -/ n T/ GAS PIPING --�^ GAB VENT CESSPOOL 0 7,130 CESSPOOL SEPTIC TANK. SEPTIC TANK DRAIN ( ) PIT ( ) 7.1313 SEWER PERMIT . 1.00 r GAS TEST 1 UTILITY CO.NOTIFIED TOTAL FEE FINAL 7GA607 DBS#17 10/58 76A887-C E#817 10-67 � � ® � �e_ � Coo APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS Zug COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN(PR NT OR TYPE) CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER ob WATER CLOSET 1.50 MAIL •- BATH TUB 1.50 ADDRESS SHOWER 1.50 CITY TEL. NO LAVATORY 1.50 COMAC R SINK 1.50 ADDRESS DISHWASHER 1.50 CITY TEL.NO.Y#f'"10S7 CLOTHES WASHER 1.50 StATf LI LICENSE NO-jr CLASS SWIMMING POOL RECEPTOR 1.50' DISTRICT NO GROUP ZONE PROCE ED BY LAWN SPRINKLER SYSTEM 2.00 C WATER BVEATER 1.50 26 INDUSTRIAL G) WASTE APPROVAL GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD v OUTLETS OVER u.l 5 PER SYSTEM .30 d +' LE Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE E 1 2 100 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE- Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT City. Tel. No. HOT'111/ATER HEATER 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION - - AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL. COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. 1 HEREBY CERTIFY THAT 1' AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED Al LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I A;7FINALRESIDENTIALTME LEGAL OWNER OF,AND INTEND TO _RESIDE IN,THE ABOVE DE PR 4+.. SIGNATURE � .TACK R. ALLEN OF PERMITTEE , SUPERVISING MECH AN.ICAL PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH LALo58b7-1208, 12 5 D 3,5Qn 76A667o.(CE-617) - 1/75 APPLICATION R PLUMBING PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDINGD .� MAKE CHECKS PAYABLE TO: ADDRESS or 72 HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT O TYPE) NEAREST NUMBER FIXTURE OR ITEM @ FEE CROSS S 9 WATER CLOSET 2.0 OWNER �� Cfk//7V MAIL y� BATH TUB 2.0 ADDRESS SHOWER 2.0 75 CITY TEL. NO. f LAVATORY V) 2,0 CONTRACTOR SINK 2.0 5 ADDRESS 6. Adk 016 DISHWASHER 2. CITY TEL. NO. — S� c CLOTHES WASHER 2. O r 5 STATE _ LIC SWIMMING POOL RECEPTOR 2. 0 0 LICENSE NO. �� CLASS 63 DISTRICT NO.GROUP NE P 2. 0 CES D BY LAWN SPRINKLER SYSTEM ' WATER HEATER 2, 0 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 2.00INSPECTION RECORD v OUTLETS OVER I L 5 PER SYSTEM 30 �' =j�J 614-rd'' gvvS� gQR CD y . Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE Q L60 APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK _� T Name ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS VENT 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ -THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST .y //�•I.r•rt / I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED 1V LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF r �/ CALIFORNIA OR THAT I THE LEGAL OWNER 0 AN 0?TENbTO Alli /Y��• Ai RESIDE IN THE ABOVE DE THE RESIDENTIAL PR ERTY. FINAL SIGNATURE OF PERMITTEE { PERMIT VALIDITIO CK. 'M.O: CASH I PLAN-CHECK VA ATION CK. M.O. CASH I s� 9f 4./ t- 3 1 :6XICAUG 27 5 n 2 0.5 0 ��