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Home My Public Portal About10915 WILDFLOWER RD_Plumbing__ 76A667-CE#817 2-62 APPLICATION FOR PLUMBING. PERMIT COUNTY OF LOS ANGELES DEPARTNUIT OF COUNTY ENGINEER BUILDING BUDIVr Road JOHN AM SAFETY II LAMBIE. COUNTY ENGINEER ADDRESS log- Wil-(If WILLIAM A.JENSEN.SUPT OF BUILDING 0 t3: LOCALITY FOR APPLICANT TO FILL IN NEAREST 4CROSS T. UMBER FIXTURE OR ITEM EACH FEE OWNER Frank B. Stark WATER CLOSET $1.25 MAIL BATH TUB 1, ADDRESS Same 25 CITY TEL. NO. SHOWER 1.25 LAVATORY 1.25 CONTRACTOR Anth= pas, Inc. SING 1.25 I ADD!!S5871_ Fi-r eat onaBl-vd. DISHWASHER- 1.25 CITY S out h Gate TEL.No-SP 3 2210 CONTRACTOR'S STATE LAUNDRY TUB 1.25 REGISTRATION NO. 1-901-79 COUNTY ❑ CLOTHES WASHER 1.25 pISTRIGT NP- - I G U Z:04H 7E R 0 r�E jSr-i 101 183 Y 1p ?F 1.50 ef WATER BEATER 15" L 50 ET AP L GAS SYSTEMOUTLETS1. WINDUASTE APPROVAL OUTLETS OVER 5 PER SYSTEM AO INSPECTION RECORD 0 presb water --T 0to swim P—O-&l 0 Lu ull Z APPROVALS DATE II&SP EEAV-x-NATURF PERMIT 2 00 UNDER SLAB WORK it vz ROUGH PLUMBING jv, 1A, TOTAL FEE GAS PIPING d IHERSEY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT JA AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER J PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES -.11AP LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA R THAT I Abj THE LEGAL OWRE 9F,AND INTEND TO RESIDE IN, THE ABOVI RI) RESIDE A Pp, RT UTILITY CO.NOTIFIEDZ SIGNATURE OF PERM -za� FINAL AIJ�!TIO� ROBERT A.WOOD ASH SUPERVISING MECHANICAL ENG'R 2-r 4.0-001 Z 5 D q� 47 a =23 E%- -- - ' ISTEE L)-�TREOU zJ OF PERM uANCELLET"I 78A887 1 6,7'1, =.' ' APPLI CAT10191 FOR PIIJ`IVI I IVGPERMIT. - BUII.DII�TG AND SAFETY ,DIVISION Department of County Engineer County Of LosAngeles BUILDING JOHN A.LAMBIE;COUNTY ENGINEER ADDRESS CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY I G FORAPPLICANT TO FILL IN NEAREST CROSS ST. OWNER -,DISTRICT NO. GROUP ZONE I READY FOR.INSPECTION MAIL ADDRESS � I r CITY INDUSTRIAL TEL.NO. g �v WASTE APPROVAL > PLUMBER Y&IM r 7[�IUM $b vC° INSPECTION RECORD . ` ADDRESS 442 W. Fleetwood G er. ora CITY TEL.NO. LICENSE NO. c NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 $ BATH TUB ' @ $1.00 SHOWER @ $1.00 LAVATORY (WASHBASIN) @ $1.00 KITCHEN SINK @ $1.00 DISHWASHER @ $1.00 LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @. $1.00 WATER HEATER @ $1.00 GAS SYSTEM @. $1.00 APPROVALS DATE INSPECTORS SIGNATURE' i � UNDERALAB:WORK •'::? ti' IIle,"1'tK/^ l -;• PERMIT $ 1. ..00 ROUGH PLUMBING GAS PIPING TOTAL FEE = GAS VENT ey_ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER •�p �.A+�NL AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY s WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING F PLUMBING. PLUMBING FIXTURES !� ypr iw✓'�I+C�1yi i I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM E LEG L OWNER OF THE ABOVE LISILITY CO.NOTIFIED DESCRIBED. RESIDENTIAL P RTY. OF PERM ITTE SIGNATURE E NAL ROBERT A.WOOD. JOHN A.LAMBIE,C NT•Y ENGINEER VALIDATION SUPERVISING MECHANICAL ENG'R M.0. - CASH tCo"3 5 1"6s;s; OCT 18 " 3-- ' 1 0.0 0 9 I • ,WORKERS'COMPENSATION DECLARATION i APPLICATION FOR PLUMBING PERMIT J,hereby affirm that I have a certificate of consent to self 20=0026 DPW 6/87 insure, or a certificate of Workers'Compensation Insurance, 76XG67A lu' or a.certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS Policy No.--Company Certified copy is hereby furnished. BUILDING pp • ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS /d��,� LUfG��GGC�� /�•-9 Certified copy is filed with the county building inspec- tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Appligont ` WATER CLOSET ?,f NEAREST 'r CERTIFICATE OF EXEMPTION FROM WORKERS' I BATH TUB CROSS ST. L0GL0 COMPENSATION INSURANCE OWNER �� a �• IL �� (This section need not be completed if the work Involved by SHOWER the permit Is for one hundred dollars($100)or less.) j LAVATORYADDRESS DSS Lr//csi/�GD I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner SINK CITY TEL.NO.LXtjrqg SO as to become subject to the Workers'Compens ion Law" DISHWASHER op CONTRACTOR Dateo'27 7( Applicant d ACLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If,•after Waking t is Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' I CITY TEL. NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit .shall be STATE LIC. deemed revoked. WATER HEATER D LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm-that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect.' 5 PER SYSTEM FINAL } DATE 8-/� 92 VALIDATION C License Number Lic. Class C FINAL 0: Contractor Date I BY N F ❑ I.am exempt under Sec. o LL B.&P.C. for this reason 01 Flan check fee Cr Date: j PLUMBING PERMIT ISSUING FEE$ •� Signature TOTAL.FEE Q Plan check applicant Cr SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name 7 t I hereby affirm that I am exempt from the Contractor's License ACI,( a4 Law for the following reason (Section 7031.5, Business and _ _ Address i _ L-.+•.d f 1 3 o 501 Professions Code): City Tel. No. _ �, as owner of the property, will do the work and the j I ITEND structure is not intended or offered for sale (Section 7044, Busiriess and Professions Code). I '( L m1 CONSTRUCTION LENDING AGENCY j CHECK 511.5D I hereby affirm that there is a construction lending agency for i i- the performance of the work for which this permit is issued CHANGE ■111j (Sec. 3097, Civ. C.). i i Lender's NameI C1010Cl—[E .01 Lender's Address I syr't I f+l'! `?a •i 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-men tione ro for in ection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ,I -27-74 c' Si ure of ermittee Date