HomeMy Public PortalAbout9888 WENDON ST_Plumbing__ APPLICATION FOR PERMIT
M DEPARTMENT OF BUILDING AND SAFETY L
COUNTY OF LOS ANGELES
WILLIAM J. FOX,. CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRI O. GROUP I ZONE PERMIT NO
PLUMBER RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
ADDRESS �'.'J •� 'U(/. �d�(/St�� �''!
BUILDING
CITY ��yU;'J.pQi��f� TEL. N0I ADDRESS �O7 OO OO
COUNTY ������ r, a LOCALITY
LICENSE NO. EXPIRES
NEARE§•T
PERMIT..FEES CROSS ST. l / ./J/
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER GI? Ly ��+•�'
MAIL
WATER CLOSET (TOILET) @ 0.50 S (X-O,:. ADDRESS
!�+ I BATH TUB @ 0.50 CITY TEL. NO.
A SHOWER @ 0.50 I 1 HEREBY ACKNOWLEDGE THAT 1 .HAVE READ THIS
d LAVATORY WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL. COUNTY ORDINANCES AND
STATE LAWS REGU G PLUMBI
KITCHEN SINK @-O'.50 3 V
I CERTIFY 1 POSSESS TH ABQ1%E 'Y LOS
LAUNDRY TUB OR TRAY @ O.50. j ANGELES COU Y LIC- . OR I A TEtE,LEG• C O NER
OF THE REST NTA O TY ESC /CH
GAB SYSTEM�OUTLETS. @ 0.50 I SIGNATURE �E
WATER HEATER @ 0.561
PERMITTE ` _
SLOP BINK @ 0.50 INSPECTION RECORD
FLOOR.SINK @ 0.501
FLOOR DRAIN Is 0.50
DISHWASHER @ 0.50 I !c]L./
DRINKING FOUNTAIN. @ 0.501 r r� /�D P//� zAlb
URINAL @ 0.501 S J J
HOUSE SEWER @ O.SO:I /� a
�- &-0-12
MISCELLANEOUS / UI
r f p-r dam-<vA-!f1 s r o• Col.�.
4-f7-gf7c•hAv- ,
1 APPROVALS M®d/j✓G/I✓j ,
1 •RATE - INSPECTOR'S NAME
ROUGH PLUMBING
• GAS PIPING.
GAS VENT
CESSPOOL @ 1.00 CESSPOOL '
SEPTIC TANK: I SEPTIC TANK ,
DRAIN ( ) PIT ( @. I..Do 1 SEWER
PERMIT . LOO GAS TEST
UTILITY CO. NOTIFIED
TOTAL FEE I $
41
Ido ( Dv�
(p FINAL
ION
'WORKER'S I ve*a certificate
of consent to 20.0026DPW 9/89 APPLICATION FOR PLUMBING PERMIT
I hereby affirm that I have'a certificate of consent to self insure, 76Af➢67A
or a-Certificate of^Worker's Compensation Insurance, or a certified
copy thereof(Sec.9800 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 47(,7 rJV�(e��
❑ Certified copy is filed with the county building inspection ADDRESS
department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY
Date Applicant WATER CLOSET
NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST.
COMPENSATION INSURANCE ASSESSOR
MAP BOOK PAGE PARCEL
(This section need not be completed if the work involved by the SHOWER
permit is for one hundred dollars($100)or less.) OWNER
I certify that in the performance of the work for which this permit MAIL
LAVATORY
Is issued, I shall not employ any person in any manner so as to SINK ADDRESS 1r;10/1 46
become subject to the Workers'Compensation Laws.
DISWASHER CITY TEL.NO.
/.atAFAZ Applicany �/�clylfL`
CLOTHES WASHER CONTRACTOR
NOTICE TO APPLICANT: If, after making this Certificate of (/ G
Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRESS
provisions of the Labor Code,you must forthwith comply with such
provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM
LICENSED CONTRACTORS DECLARATION CITY TEL.NO. �-
WATER HEATER
V((((•„�
I hereby affirm that I am licensed under provisions of Chapter 9 S STATE LIC.
(commencing with Section 7000)of Division 3 of the Business and GAS SYSTEM OUTLETS s LICENSE NO. CLASS (�
Professions Code,and my license is in full force and effect. OUTLETS OVER DISTRICT NO. CESSED BY cc
5 PER SYSTEM O
License Number Lie.Class
FINAL VAL ATION �
DATE �fy 7i
Contractor Date CO)
El
FINAL ,(�� Z
I am exempt under Sec. BY �W
B.&P.C.for this reason
Date: Plan check fee 10111.
Signature
PLUMBING PERMIT ISSUING FEE$ 26 40
^
❑ TOTAL FEE
SINGLE FAMILY
Pian check applicant
_
HOME OWNER-BUILDER DECLARATION Name
I hereby affirm that I am exempt from the Contractor's License Law
for the following reason(Section 7031.5, Business and Professions Address _ _
Code): {_jou C!o=1.i
❑ City Tel.No. _
I,as owner of the property,will do the work and the structure T� :r
is not intended or offered for sale(Section 7044, Business
{ ri
and Professions Code).
UI)—® Q 3
CONSTRUCTION LENDING AGENCY CHECK La7._ 1
1 herebyaffirm that there is a construction lending agency for the
9 9 Y
performance of the work for which this permit is issued(Sec. 3087, �'i�Fii�L ° °�
Civ.C.)
Lender's NameUIL!—Lii t 2/ 8/94 fl''j
Lender's Address 3861 1 Ar.I 1':f2
1 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 fo i�ti�pulp �5.�_= 2 � � SEE REVERSE FOR EXPLANATORY LANGUAGE
�Siiggnature of PermitteeL/�//' Date