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Home My Public Portal About9085 WOOLLEY ST_Plumbing__ D.S. » asM sera ,a-aa APPLICATION FOR PERMIT' ; DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES �L� �� WM.J. FOX,CHIEF ENGINEER NATURE OF INSTALLATION DISTRI No. rlR�OU O E P R IT NO. ROUGH. FIXTURES COMPLETE -.4"- . v. '. t HEATER CESSPOOL SEPTIC TANK RECEIVED BY READY FOR FIRST INSPECTION DAT ISSUED � GAS- MISCELLANEOU O APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB 0 NAME/! a� _ ADDRESS o 10 m ADDRESS LOCALITY E .DI NEAREST d _ CITY TEL.No. CROSS 8T CO N 2 A CERT.No. L� EXPIRES Al L NAME LOCATION OF SEP'T'IC TANK,-OR CESSPOOL z MAIL 3 ADDRESS NORTH O CITY • EL.No. 1 AM THE LEGAL POSSESS R OF THE ABOVE LOS ANGELES COUNTY CERTIFICAT F gAL�I ATION. PLUMB I AM THE LEGAL OWNER OF THE PROP DESCRIBED ABOVE. N OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK _Z BATH TUB FURNACE O ROWER DISHWASHER 13 -LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS _WATER CLOSET DRINKING FOUNTAINDATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I I ETER GAS SODA FOUNTAIN OUTL AS PIPING GAS VENT . CESSPOOL I TOTAL NUMBER OF FIXTURES SEPTIC TANK I I CESSPOOl OEPTIC-TANK SEWER UTILITY CO.NOTIFIED TOTAL FEE �+ FINAL DEPARTMENT OF COUNTY ENGINEER PLUMBING DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES BUILDING WILLIAM J. FOX, COUNTY ENGINEER ADDRESS FOR APPLICANT TOFI LOCALITY BUILDING //yy NEAREST ADDRESS LIQ _" CROSS ST. LOCALITY DISTRICT NO. GROUP /ZON PERMIT NO. - NEAREST CROSS ST. RE EIVED BY Ready fa n paction DATE J9SU.ED 0 W N E R C71�C/Je'�-' MAILWASTE P ROVAL ! ADDRESS CITY' TEL.No. INSPECTION RECORD f PLUMBER r/ ADDRESS _ CITY TEL.NO-4f ATE LICENSE No. U COUNTY J ERMIT FEES z VUMBER TYPE OF FIXTURE OR ITEM FEE 0 WATER CLOSET(TOILET) @ 0.80 $ 0: O BATH TUB @ 0.80 SHOWER @ 0.80 LAVATORY(WASH BASIN) @ 0.60 . KITCHEN SINK @ 0.80 LAUNDRY TUB OR TRAY @ 0.80 SLOP SINK @ 0.80 FLOORSINK @ 0.80 FLOOR DRAIN @ 0.80 DISHWASHER @ 0.80 DRINKING FOUNTAIN @ 0.80 URINAL @ 0.80 GAS SYSTEM••..._•_...••OUTLETS @ 1.00 WATER HEATER @ 100 M($QI:LdwE@US/ APPROVALS / DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING TOTAL FEE 00 GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GAS VENT CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES 1 HEREBY CERTIFY THAT 1 AM PROPS13LY1 REGISTERED AND/OR LICENSED AS REQUIRED BY OSANGLES COUNTY GAS TEST AND STATE OF CALIFORNIA,pR T T AM THE€LEGAL OWN- ER OF THE ABOV RIBED-R 1 TIAL No TY. UTILITY CO.NOTIFIED SIGNATURE c OF PERMITT _.._...•.. _.. •....._..... ....•... . -.._.... FINAL �� 7_�'SZ. / 7r."�lyt.I�.f+!f 76A667-DBS 17 1/53 D.B.S.17 28M BETS 12.44 APPLICATION FOR PE' RMI - IMPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES �L Wm.J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ' Z/OTE. PER�MIT ROUGH FIXTURES COMPLETE I • 1 O 9t HEATER CESSPOOL 1-1 SEPTIC TANK RECD D BY READY FOR DATE ISSUED r FIRST INSPECTION A. p e GAS ' MiSCELLANE0U8- APPLICANT FILL IN HEAVILY OUTLINED PORTION / � PORTION ONLY ADDRE86NAME dIc . ems, A- ADDRESS LOCALITY fv24 • NEAREST � OJ. CITY TEL.No. �j�,1# a CR ST. 1 1� Y COU i!� > CERT.No. 1 EXPIRES LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL 3 ADDRESS NORTH O CITY TEL.No. IAM THE LEGAL POSSESSOR OF THE ABOVE LOS zi - _ •• ANGELES COUNTY CERTIFICA�F�t PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. OWNER i I CORRECTIONS � I J '��ylg A f� 1�J ��..�� 4n�. ��t-�l !1✓��frm. SOUTH �f DESCRIPTION OF WORK BATH TUB' FURNACE os WER DISHWASHER LAVATORY REFRIGERATOR KITCHEN BINK WATER SOFTENER FLOOR RINK AND TRAP GLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS-\ ]y�TER CLOSET DRINKING FOUNTAIN DATE /INSPECTOR'S NAME WATER HgATER DENTACLAVATORY ROUGH PLUMBING METEr+ GAS RODA FOUNTAIN GAS PIPING OUTL GAS VENT CESSPOOL I I TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOL REPTIC TANK SEWER I 8 UTILITY CC.NOTiF1ED: I TOTAL FEE 1 ct>,vI I/ GGfL/G'v D.B.S.17 25M SETS 12.44_ - '+ - APPLICATION FOR PERT - DEPARTMENT OF BUILDING AND SAFETY-1- q COUNTY OF LOS ANGELES r. L Wm.J. FOX.CHIEF ENGINEER 4• NATURE OF INSTALLATIO DISTRICT NO. GROUP ZONE . PERMIT-NO. ROUGH FIXTURES COMPLETE HEATER CESSPOOL I—I SEPTIC TANK RECEIVED BREADt F-OR DATE FIRTINSPEION GAS �� ' II SUED ,A MISCELLANEOUS APPLICANT/F-pI}LtL IN HEAVILY OUTLINED PORTION ONL yYJOB / C NAME= //f � �it._i<6e'Lf6.s?. �r. ADDRESB 7=1 d.s11 ADDRESSI �l'.� f6 _ `^�C y� - .I LOCALITYNEAREST 4 dCITY CRO68 ST. T'� rP COUI CERT . EXPIRES 0 NAME LOCATION OF SEPTIC TANK,-OR CESSPOOL{. 3 ADAIL DRESS :5� y NORTH O CESSPOOL!, CITY TEL.No: I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY_CERTIFIC E QUAL IFIC. ION PLU— B�— j 1 AM THE LEGAL OWNER OF THQPROPERTY DESCRIBED ABOVE. ( aWHER f CORRECTIONS -• = rte- SOUTH (DESCRIPTION OF WORK ATH TUB FURNACE —SHOWER DISHWASHER LAVATORY REFRIGERATOR ITCHEN SINK- WATER SOFTENER FLOOR SINK . SAND TRAP '-----SLOP SINK FLOOR DRAIN WASH TRAY URINAL - APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPBCTOR'6 NAMB 111 11111011 WATER HEATER DENTAL LAVATORY '. ROUGH PLUMBING I ' METER—GAS SODA FOUNTAIN0A8 PIPINm. I I OUTL GAS VENT -CESSPOOL TOTAL NUMBER OF FIXTURE13 SEPTIC TANK ESSPOOL SEPTIC TANK / SEWER I I TOTAL FEE UTILITY CO.NOTIFIED I' I WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT �y ' 6 DPW 4/87 r%. �,hereby, crKr{iYw that I Have a certificate of consent to self in- 76A6676A667A ,stare,or ci certificate of Workers'Compensation Insurance,or a CE 817(REV.8/86) certified copy thereof(S,ec. 3800, Lab. C.) Policy No. Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS ❑ Certified copy is hereby furnished. �r- ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS Lu�L 1 department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant WATER CLOSET(TOILET) ot/ NEAREST UB ^ CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TV COMPENSATION INSURANCE SHOWER + OWNER C (This section need not be completed if the work involved by ,_.�s/��j//�� / the permit Is for one hundred dollars ($100)or less.) LAVATORY DDRESS �j A). -5rQZ A V I -T4 I certify that in the performance of the work for which this per- ''') SINK mit is issued, I shall not employ any person in any manner so tX Z, CITY/1-�(j� �pmk TEL. NO. `� as to become subje to the Workers'Compensation Laws. DISHWASHER IF} �// CONTRACTOR Date Applicarm- �,v� CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of Ex- ADDRESS emption,you should become subject to the Workers'Compen- SWIMMING POOL RECEPTOR CITY TEL. NO. sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO P CESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS m 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER (� fand e Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL v �� VALIDATION DATE O License Number Lic. Class y FINA cc Contractor Date BY O I am exempt under Sec. W a B.&P.C. for this reason Plan check fee # 0 0 a 0 0 5 Date: PLUMBING PERMIT ISSUING FEE.$ d! lo - 40,50 Signature TOTAL FEE SINGLE FAMILY 0 0 0 0 0 0 0 HOME OWNER-BUILDER DECLARATION Plan check applicant o - 21 6,50'5 1 hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and Professions Code): Address I, as owner of the property, will do the work and the City Tel. No. 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 representatives of this County to enter upon the above-mentioned roperty for ins ection purposes. �� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date