The URL can be used to link to this page

Home My Public Portal About4819 WILLMONTE AVE_Plumbing__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY PLUMBING 1 WILLIAM J. FOX, County Englneer STRI' O. GROUP ONE PERMIT NU. FOR APPLICANT TO FILL IN ` �ry ` /�� PLUMBER \ RECE ED BY READY FOR DATE ISSUED rj C``/' FIRST INSPECTION I v, 2- ADDRESS � Z.. � BUILDING CITY TEL No. ADDRE89 COUNTY LOCALITY LICENSE N0. EXPIRES NEAREST PERMIT FEES CROSS 9T. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL 0 WATER CLOSET(TOILET) � O.SO S ADDRESS $ �y BATH TUB @ 0.50 CITY � TEL N044 e 0 SHOWER 13.613 I 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 @ 0.50 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB LAUNDRY TUB OR TRAY 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. GAB SYSTEM OUTLETS ® 0.50 �( SIGNATURE OF WATER HEATER 0.50 PERMITTEIE r` SLOP SINK @ 0.50 INSPECTION RECORD FLOOR BINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50 DRINKING FOUNTAIN @ 0.50 URINAL @ 0.50 J Q HOUSE SEWER Q 0.50 Z MISCELLANEOUS 5 O �o r. APPROVALS DATE 1 PEOTOR'B AME ROUGH PLUMBING GAS PIPING p 'j GAS VENT if CESSPOOL @ 1.00 ®c, CE99POOL SEPTIC TANK' SEPTIC TANK //�� DRAIN ( ) PIT ( ) @ 1.00 SEWER t/ 6v PERMIT 1.00 GAB TEST 0 UTILITY 00.NOTIFIED TOTAL FEE is DU FINAL __ 7GA667 DBS#17 6-58 WORKERS'COMPENSATION DECLAR41QN n •.76A667A.i i I hereby affirm that I have a• certificate of consent,t6.self cE en(4-601 APPLICATION FOR PLUMBING PERMIT insure,or a certificate of Workers'Compensation Insurance,or a certified copy.thereof(Sec.3800,Lab.C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company j Certified copy is.,hereby furnished. I ? FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING /� ❑ ADpRESS. °1 ,�99•� Certified copy-is filed with the county building inspection. NUMBER FIXTURE OR ITEM ® F E a department. LOCALITY Date Applicaht WATER CLOSET —� NEAREST G Q �n CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB OSS ST. COMPENSATION INSURANCE SHOWER OWNER Ll/ (This, section need not be completed if the work involved LAVATORY MAIL ADDRESS eY by the permit is for one hundred dollars ($100) or less.) SINK CITY L/ TEL.NO.W W. 9L /L�// I certify that in the performance of the work for which this DISHWASHER U permit is issued, I shall not employ any person in any manner ONTRACTORGJ e, so as to become subject to the Workers'Compensation Laws. yy p ADDRESS Date Applicant S IMMING POOL RECEPTOR W NOTICE TO APPLICANT:•If, after making this Certificate of I CITY � O. D. Exemption, you should become subject to the Workers.' LAWN SPRINKLER SYSTEM s to -Compensation provisions of the Labor Code,you must forth- ' STATE LIC. Z with comply with such provisions or this permit shall be I WATER HEATER LICENSE NO. CLASS deemed revoked. DISTRICT NO. PROCESSED BY ' GAS SYSTEM , OUTLETS LICENSED CONTRACTORS DECLARATION + OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL nes .and Professions Code,and my license is in full force and DATE 4 ly -OP VALIDATION efferc't. License Number Lic.Class FINALBY (• Contractor Date I am exempt from the licensing requirements as I am a Plan Check fee , licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). 'TOTAL FEE Lic.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address '6 2 5 G A License Law for the following reason (Section,7031.5, Busi- City Tel.No. ness and Professions Code): ( o 0'0 0 o 5 1, as owner of the property,'am exclusively contracting f with licensed contractors to construct the project ° ° 2 P_5 0 (Section 7044,Business and Professions Code). s , o ° 0 22,50• CONSTRUCTION LENDING AGENCY O 9. 15-82 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 SEE REVERSE FOR EXPLANATORY LANGUAGE 'ordinances and State laws regulating Plumbing, and hereby 4 authorize representatives of this County to enter upon the above-me t. no propZY12p ctipurposes. VIn Signature of Permittee Date WORKERS'COMPENSATION DECLARATION �j1� �p [�� I hereby affirm that I have a certificate "PconienF'to self' 76A667A :1"'' AI!'Lf'UCAVON FOR PLUMBONG PER • OT insure, or a certificate of Workers'Compensation Insurance, CE 817(REV.10/81) or a certified copy thereof(Sec. 38.00, Lab. C.) COUNTY OF LOS ANGELES ✓ ('r (BUILDING AND SAFETY Policy No. Company El Certified copy is hereby furnished..❑ BUILDING FOR APPLICANT TO FILL IN(PR TYPE) ADDRESS Certified copy is filed with the county building inspec-� ^^ tion department, NUMBER FIXTURE OR ITEM (� FEE LOCALITY Date Appli.qant• &9 . WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. IpiQr COMPENSATION INSURANCE i; OWNER (This section need not be completed if the work involved by SHOWER MAIL. the permit Is for one hundred dollars($900)or less.) I; LAVATORY ADDRESS I certify that in the performance of the work for which thi�syy permit is issued, I shall not employ any person in any manned• SINK �� CITY TEC. . so as to become subject to the Workers.'Compensation Laws.i DISHWASHER CONTRACTOR Date ) plican CLOTHES WASHER ADDRESS NOTI E TO AP. ICANT: If,'dfIermaking this:Certificate o;, , Exemption, you should become subject to the Workers" SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY TEL.'NO. with comply with:such provisions or this permit shall. b� LAWN SPRINKLER SYSTEM STATE LIC. deemed revoked. +, WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION 11 DISTRICT NO. CESSED BY . I hereby affirm that I'am licensed under provisions of Chapter 91, GAS SYSTEM OUTLETS (commencing with Section 7000`)of Division 3 of the Business) OUTLETS OVER :and Professions Code,and my license is in full force and effect. 5 PER SYSTEMFINAL VAL9®ATO®IN9 License Number Lic. Class 9 Fl A Contractor Da.te.. ❑ IL I am exempT.under Sec: - �' �� IL BARC. for this reason �' g Plan check fee Date: 1 PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE Plan check applicant • SINGLE FAMILY o HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License, Address Law for the fbll'owing reason (Section 7031.5., Business and r 7 2 Professions Code): 1 . City Tel. No.' 1 1, as'owner of the property, will do the work and the �? o .0 0 0 0 structure is not intended or offered for sale (Section 7044, Business and Professions Code). D 2 ° ° 1 .650 CONSTRUCTION LENDING AGENCY t r �' ° E).5 C u I hereby affirm that.there is a construction lending agency for, the performance of the work for which this permit is issued P P I 029—F G. Ci (See. 3097, v. C.). Lender's Name Lender's Address I certify that 1 have read this application and state that the above i6formation 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-mean ioned.property for'i. 'pec.Non purposes. ) SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date I , RKERS'COMPENSATION DECLARATION APPLICI�TION FOR PLUMBING PERMIT I he—re-by1.irm that 1, have a certificate of consent to self 76A667q insure, or a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) or a certified copy thereof (Sec. 3800, Lob. C.)�)a�qq COUNTY OF LOS ANGELES BUILDING AND SAFETY �ic I�o2A1'��O ComponY 1--W5i&0_A_T' Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS r Certified copy is filed with the county building inspec- NUMBER FIXTURE OR ITEM FEE lE tion department. n/'� 1 LOCALITY Date 1 !Appligan` �� ° Le / WATER CLOSET NEAREST i&-R; LAX*0 a CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER Ll t- t (This section need not be completed if the work involved by the permit is for one hundred dollars $100 or less. MAIL P ( ) ) LAVATORY ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL.NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR 1404A&= I Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of �SWIMMING POOL RECEPTOR X Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- CITY 16 A TEL.NO. ` with comply with such provisions or this permit shall be LAWN SPRINKLER SYSTEM STATE 1/V� A LIC. deemed revoked. WATER HEATER LICENSE NO. S 6 CLASS LICENSED CONTRACTORS DECLARATION DIST_RIQT NOP ESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER 5.-or and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL f -•7 ~" ' VALI TION DATE License NumberYt.; 44 Lic. Class _ ��' / MnDe torte " JC`r AJ Date FI 0 ❑ I am exempt under Sec. B.BP.C. for this reason Plan check fee ® 22410 A Date: Signature PLUMBING PERMIT ISSUING FEE$ of # 0 0 o 0 0 5 TOTAL FEEWko I o - 30,50 Plan check applica t SINGLE FAMILY � o o,0 30.506 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address 0 7, 12-85 Law for the following reason (Section 7031.5, Business and Q- Professions Code): City HA Tel. No. ❑ I, as owner of the property, will do the work and the 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 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 repre t ry s of this County to enter upon the o e-mentis ed o r or inspection purposes. r SEE REVERSE FOR EXPLANATORY LANGUAGE gnature Permitte Date