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Home My Public Portal About5030 WILLMONTE AVE_Plumbing__ 7614887-CE#817 10-82 APPLICATION FOR PLUMBING PERMIT " COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS. U C1 WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. T NUMBER FIXTURE OR ITEM EACH FEE - WATER CLOSET $1.25 OWNERMAIL _ BATH TUB 1.25 ADDRESS &_5 , SHOWER 1.25 CITY TEL. NO.0.- -03 r LAVATORY 1.25 CONTRACTOR ADDRESS y SINE 1.25 �s�` DISHWASHER 1.25 CITY �" 1 TEL. NO j LAUNDRY TUB 1.25 CONTRACTOR'S r?/O / � STATE REGISTRATION NO. G"r (� COUNTY CLOTHES WASHER 1.25 DISTRICT N GROUP ZONE PR SED BY WATER HEATER 1.50 per, GAS SYSTEMOUTLETS 1.50 INDUSTRIALWASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD u Om fid W d N .� APP•ft_,J,AQS DA TE INSPECIWO SI,G4A gh PERMIT S 2 00 1� UNDER199"WORK 64X3 ROUGH PLUMBING f r TOTAL FEE .;� ' GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. _HOT WATER HEATER 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES ��II. - , � r T LICENSED AS REQUIRED BY LOS GELES COUNTY AND STATE OF i .�- CALIFORNIA OR THAT I AM THE AL OWNER O ANO INTEND TO GAS TEST - 1 _�1• RESIDE IN,THE ABOVE DESCRI D ESIDENTIAL P ERTYUTILITY CO.NOTIFIED .•�: J� I SIGNATURE OF PERMITTEE r FINAL DP/t/l3 ALIDATION ROBERT A.WOOD CK. M.O. CASH SUPERVISING MECHANICAL ENG'R LAAO 5 4 3 5 IMINE 3 1 5 D 1 5.0 C WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT, 1 reby of that I have a certificate of consent to self 76A667A '1R nsure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) _ o a cert,j,f�ed copy thereof (Sec. 3800, Lob. ) , ,� COUNTY OF LOS ANGELES BUILDING AND SAFETY \ `Policy No. CL ��, Compony�'� ' -S � � Z ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ADDRESS t Certified copy is filed with the county building inspec- tion department. NUMBER FIXTURE OR ITEM C") FEE LOCALITY Date - Applicants . WATER CLOSET NEAREST ' CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. J COMPENSATION INSURANCE OWNER SHOWER (This section need not be completed if the work involved by r AIL the permit is for one hundred dollars ($100)or less.) LAVATORY MADDRESS h f I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY - TE so as to become subject to the Workers Compensation Laws. DISHWASHER (�1�,,.(�1�n,� CONTRACTOR _?0� Date 1� Applicant � JC` y CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS , ' 9 SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY Compensation provisions of the Labor Code, you must forth- 7E =-7 LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. E� deemed revoked. WATER HEATER / •r LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION lP DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS 7?1�`� " (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER Y, 0' and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL-7 06,ff VALIDATION v 7 _! / DATE ,� A License Number- Lic. Class ( i - _ Z Lir Z FINAL Contractor Date _ BY LU ❑ I am exempt under Sec. —J ' r� ` 1 O �� y B.&P.C. for this reason G i i� ► Z Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE Plan check applicant f SINGLE FAMILY -- HOME OWNER-BUILDER DECLARATION Name _ I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. ❑ I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section 11011",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 representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE a Signature of Permittee Date WORKERS'COMPENSATION DECLARATIdN 76AG97A ,yy�� I hereby affirm that i have a•Certificate of consent to self ;ce et7•?.-eo) P P L I.0 A T I O N FO R PLUMBING PERMIT in 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 Certified copy is:hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ( '❑ Certified copy Is filed with the county building inspection NUMBER FIXTURE OR ITEM • F E ADDRESS O o�� f�V FJQ Pb department. LOCALITY F G+ITY Date Applicant WATER CLOSET NEAREST 'LL CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB ROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved :I LAVATORY MAIL ADDRESS WJ LOU)Fd2 klo. } by the permit is for one hundred dollars ($100) or less.) BINK CL �� ITY L& Ci TEL.NO.Alyce I certify that in the performance of the work for which this DISHWASHER V permit is issued, I shall not employ any person in any manner CONTRACTOR 0C so as to become subject to the Workers'Compensation Laws. CLOTHES WASHER0 � ADDRESS Date Applicant SWIMMING POOL RECEPTOR W NOTICE TO APPLICANT: If, after making this Certificate of CITY TEL.NO. Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. N Compensation provisions of the Labor Code,you must forth- LICENSE NO. CLASS with comply with such provisions or this permit shall be WATER HEATER deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. O. CESSED BY LICENSED CONTRACTORS DECLARATION 'I OUTLETS OVER 1 hereby affirm that I am licensed under provisions of Chapter I 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL VALIDATION ness and Professions Code, and my license is in full force and DATE '"" effect. - I AL License Number BY Lic.Glass BY � Contractor Date F1 I am exempt from the licensing requirements as I am a FPlancheck fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ JI- acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Lic,or Reg.No. Date i Plan check applicant 0 6 3 Q 7 A HOME OWNER-BUILDER DECLARATION Name # x'00005 I' hereby affirm that I am exempt from the Contractor's Address . License Law for the following reason (Section.7031.5, Busi- City Tel.No. 2 - 20,50 ness and Professions Code): l I, as owner of the property, am exclusively contracting ° ° °:2 Q.5 0 u with licensed contractors to construct the project (Section 7044,Business and Professions Code). 0 9, 1 7-82 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 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 Staid laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the 1 above-mentioned property for inspection purposes. Signature o erniittee Date ;I WORKERS'COMPENSATION DECLARATION '76Ae67A I hereby affirm-that I have a• certificate of consent to self cm e» (z-ao) APPLICATION FOR PLUMBING PERMIT insure,or a certificate of Workers'Compensation Insurance,or a certified c6py thereof(Sec.3800,Lab.C.) I 44.2586 State Fund COUNTY OF LOS ANGELES BUILDING AND SAFETY 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 NUMBER FIXTURE OR ITEM O FEE ADDRESS 10906 Wildflower Road department. WATER CLOSET LOCALITY Tem 1e Cit Date77.41 h1_UApplicant AAA Cond. Air, Inc. NEAREST BATH TUB CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE I SHOWER OWNER Ma yo U (This section need not be completed if the work involved ILAVATORY MAIL >_ r�r• a. by the permit is for one hundred dollars ($100) or less.) SINK CITY TEL.NO. U 4793 DISHWASHER I certify that in the performance of the work.for which this I dd— OR 0 permit is issued, I shall not employ any person in any manner CONTRACTAAA conditioned A.Zr, Inc. O so as,to become subject to the Workers'Compensation Laws. CLOTHES WASHER ADDRESS 70790 R_ D V Date Applicant SWIMMING POOL RECEPTOR a NOTICE TO APPLICANT: If, after making this Certificate of CITY F, TEL.NO 9— R rn Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. Compensation provisions of the Labor Code,you must forth- LICENSE NO. 293529 CLASS.:C20 with comply with such provisions or this permit shall be WATER HEATER deemed revoked. GAS SYSTEM OUTLETS ' DISTRICT'NO. PROCESSED BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that I am licensed under provisions of'Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- , FINAL VALIDATION ness and Professions Code, and my license is in full force and I DATE effect. FINAL License Number 2.93529 Lic.Class x720 j BY Contractor AAA Cond. Ai ate 12/16/82 F1 I am exempt from the licensing requirements as I am a I Plan check fee licensed architect dr a registered professional engineer PLUMBING PERMIT ISSUING FEE$ ` acting in my professional capacity (Section 7051, Bus- on - iness and Professions Code). TOTAL FEEJU Lic,or Reg.No. Date l Plan check applicant t - 8'4 3 6 F, HOME OWNER-BUILDER DECLARATION Name ��-p� _� V j n d c a 0 r l I hereby affirm that I am exempt from the Contractor's Address �� `=�'��\�• License Law for the following reason (Section 7031.5, Busi- City Tel.No. o o 1 6 5 C ness and Professions Code): r I, as owner of the, property, am exclusively contracting with licensed contractors to construct the project (Section 7044,Business and Professions Code). ' 1 z. 1 7-R2 CONSTRUCTION LENDING AGENCY �� w I hereby affirm that there is a construction lending agency for the performance of the work for which this permit isFay^ F� C"dC P issued(Sec.3097,Civ.C.). ' Lender's Name Lender's Address � I certify that I have read this,application and state that the r�r 4� •,�V ��,; above information is correct.I agree to comply,with all County { SEE REVERSE FOR EXPLANATORY LANGUAGE - e ordinances and State laws regulating Plumbing, and hereby I y - �i authorize representatives of this Count. to enter upon the ff %'�� +a g� 1•� above-mentioned prop y for inspection purposes. p L � �`c"r p'` �C® ! ° David Cos 2 Z6 2 rY Signature of Perm tee ate J