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Home My Public Portal About9082 LAS TUNAS DR_Plumbing__ J c 76A667-MI7 M9 \_l] APPLICATION FOR PLUMBIN PERMIT, COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, Count Engineer ADDRESS /i/ I J CASSATT D. GRIFFIN, Sup t of Building LOCALITY '^ FOR APPLICANT TO FILL IN NEAREST ROSS ST. S U L:—r 6,t /T NUMBER FIXTURE OR ITEM OWNER WATER CLOSET MAIL BATH TUB ADDRESS CITY TEL NO. SHOWER CONTRACTOR MONTr-Rf_Y PARK PLUMBING CO. LAVATORY LAVADDRESS 410 SO. GARFIELD • AT 2-2604 SINK F� CITY N E" „PW CALIFORNIA DISHWASHER CONTRACTOR'SLL ,�` STATE LAUNDRY TUB REGISTRATION NO. 1 J COUNTY CLOTHES WASHER DISTRICT GROUP ZONE ROC ED Y WATER HEATER GAS SYSTEM INDUSTRIAL ``'' WASTE APPROV L 9 O N 41 INSPECTION RECORD 12 /9 7-WMf /'-- D - / /�41 o$IXTURE $ I Qp D- 6o FIIV/9Z, 9-4, D0Ge'N y APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2100 UNDER SLAB WORK TOTAL FEE O ROUGH PLUMBING GAS PIPING WP 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _ 61' W WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER Z' `r'P7 PLUMBING. ^I I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF .Y CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE GAS TEST DESCRIBED RESIDENTIAL PROPERTY. . UTILITY CO.NOTIFIED i a SIGNATURE OF PERMITTEE FINAL OF AMATION ROBERT A.WOOD, cK. B.0. CASH SUPERVISING MECHANICAL, ENCG'R Q . 9 4 0 5 DEC 2 5 0 7.C� t3 - e F i 76A667A(CE817A) - 8/75 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUIADDRESS HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST , CROSS ST. NUMBER FIXTURE OR ITEM @ FEE OWNER WATER CLOSET MAIL BATH TUB ADDRESS SHOWER CITY TEL:NO. LAVATORY CONTRACTOR SINK -e ADDRESS DISHWASHER j CITY ;rr TEL. NO. CLOTHES WASHER STATE ! = A / LIC LICENSE NO.' CLASS SWIMMING POOL RECEPTOR DISTRICT N0. GROUP ZONE FROCESSED BY LAWN SPRINKLER SYSTEM WATER HEATER INDUSTRIAL �- WASTE APPROVAL C. GAS SYSTEM OUTLETS INSPECTION RECORD O V OUTLETS OVER W 5 PER SYSTEM -+ Ix C: Q 0 C. uj W Plan check fee See Reverse ~ PLUMBING PERMIT ISSUING FEE S ✓` �; TOTAL FEE APPROVALS DATE INSPECTOR 5 sicNAruRL 'Ian check applicant UNDER SLAB WORK ame ROUGH PLUMBING dress GAS PIPING ty Tel. NO. GAS VENT HOT WATER HEATER HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST BI NG. HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED SED AS REOUI RED BY LOS ANGELES COUNTY AND STATE OF 1RNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO . IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL TUR E PERMITTEE r PERMIT VALIDATION CK. M.O. CASH 'HECK VALIDATION CK. M.O. CASH �! '..✓ �+Ems-!4� it r1 19 .� :�� ; 76A667 (CE-817)-4/72 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING #'` ADDRESS - •. y HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY l.�";• s fl6 FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST Y r CROSS ST. NUMBER FIXTURE OR ITEM @ FEE OWNER WATER CLOSET 1,75 � MAIL BATH TUB 1,75 ADDRESS SHOWER 1,75 CITY TEL. NO. LAVATORY 1,75 CONTRACTOR; �.. SINK 1.75 ADDRESS ✓i :;> („ DISHWASHER 1.75 CITY ` TE.L.;-NO.l� CLOTHES WASHER 1,75 STATE LIC LICENSE NO. ' CLA!S_„" SWIMMING POOL RECEPTOR 1,75 DISTRICT NO. GROUP ZONE FRQCESSED BV LAWN SPRINKLER SYSTEM 1,75 77, WATER HEATER 1.75 INDUSTRIAL p WASTE APPROVAL C.;0 GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD OUTLETS OVER 30 5 PER SYSTEM 4� OG O a W 1� Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan Check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALI FORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL SIGNATURE OF PERMITTEE PERMIT VALIDATION CK. M.O. LASH PLAN CHECK VALIDATION CK. M.O. CASH f 5 I 7SA%7-CES17-11-57 APPLICATION FOR PLUMBING PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer ADDRESS CASSATT D. GRIFFIN, Sup't of Building LOCALITY j FOR APPLICANT TO FILL IN NEAREST T. , NUMBER FIXTURE OR ITEM WATER CLOSET OWNER IL BATH TUB ADDRESS SHOWER CITY A, TEU NO. LAVATORY CONTRACTOR , IV .... SING ADDRESS cc DISHWASHER CITY TEL. NOY .;1 ,;-9 LAUNDRY TUB CON CT 'S A �- STATE REGISTRATION NO. D oY49 COUNTY 01 CLOTHES WASHER DISTRICT NO. GROUP ZONE READY FOR INSPECTION WATER HEATER GAS SYSTEM INDUSTRIAL ,� Q a WASTE APPROVAL k SP TION RECORD -i APPROVALS PER ITEM r L-'-'c-rr 5 I IL DATE INSPECT_ URE OR FD{TURE 5 S UNDER SLAB WORK hC PERMIT $ 00 ROUGH PLUMBING 14 TOTALFEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES 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 THE LEG_4L OWNER OF HE ABOVE UTILITY CO. NOTIFIED DESCRIBED RESIDENTIAL PROPERTY _, SIGNATURE I ✓ FINAL OF PERMITTEE- ROBERT A.WOOD. OF VALIDATION SUPERVISING MECHANICAL ENG'R CK. M.0. CASH LAO2564 iBl $ 5 A 7.00 76A667A ICE 8178)-11/76 APPLICATION FOR PLUMBING PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADIDRESS Petrillo, 9082 Las Tunas Dr NUMBER FIXTURE OR ITEM ® FEE WATER CLOSET LOCALITY Temple City BATHTUB NEARESTSultana CROSS ST ' SHOWER OWNER Petrillo Angelo LAVATORY MAIL ADDRESS as shove �J SINK CITY TEL NO 286-4747 DISHWASHER CONTRACTOR W E. Graham CLOTHES WASHER ADDRESS 9127 Las Tunas Dr SWIMMING POOL RECEPTOR LAWN SPRINKLER SYSTEM CITY Temple City TEL N0286-9293 E LIC WATER HEATERr e lace 3 0 LICENSEN0104466 CLASS C-36 GAS SYSTEM OUTLETS DISTRICT NO GP ZONE PROCESSED BY t OUTLETS OVER � Z )- 5 PER SYSTEM INDUSTRIAL IL WASTE APPROVAL O INSPECTION RECORD U �C Gr V W A. Vl Z Plan check fee PLUMBING PERMIT ISSUING FEE$ 4 50 TOTAL FEE 7 50 Plan check applicant APPROVALS DATE INSPECTOR'S SIGNATURE Name UNDER SLAB WORK Address ROUGH PLUMBING City Tel No GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE GAS VENT THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES `A�, t 1 AND STATE LAWS REGULATING PLUMBING HOT WATER HEATER 6�- I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITYCO NOTIFIED SIGNATURE OF PERMITTEE FINAL PLAN CHECK VALIDATION CK Mo CASH PERMIT VALIDATIONcK mo CASH 5 7 0-SEP 2 5 9 7, s 5 7,0hSEP 2 5 D 7.5 0 Bpi. ®s 76A667 (CE-817)-4/72 � � a� MBING APPLICATIO FOR PL PERMIT {� COUNTY OF LOS ANGELES �J DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LDING MAKE CHECKS PAYABLE TO A DDRESS Q 2 A HARVEY T. BRANDT, COUNTY ENGINEER OCALITY L- FOR APPLICANT TO FILL IN (PRINT OR TYPE) EAREST ROSS ST. NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET 1,75 OWNER MAIL BATH TUB 1.75 ADDRESS SHOWER 1.75 C L E LAVATORY 1.75 CONTRACTOR Yf SINK 1.75 ADDRESS Njgs DISHWASHER 1.75 C CLOTHES WASHER 1.75 STATE ` ` LIC CD LICENSE NO Q p CLASS SWIMMING POOL RECEPTOR 1.75 DISTRICT NO GROUP ZONE FRO ESSED BY LAWN SPRINKLER SYSTEM 1.75 �l WATER HEATER 1.75 I WASTE APPROVAL a GAS SYSTEM OUTLETS 1.75 �` INSPECTION RECORD C.> OUTLETS OVER 30 O 5 PER SYSTEM F- U W a N Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR 5 SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel NO GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE I5 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING GAS TEST -G 7 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED S LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL SIGNATU RE OF PERMITTEE74"- 10 PERMIT VALIDATION cK M,o CASH PLAN CHECK VALIDATION CK M D CASH OA�DfC 4 5 U 1+.7 5 ,,1 78 B CE 81717 B-56 APPLICATION FOR PLUMBING PERMIT 1 BUILDING AND SAFETY DIVISION Department of County Engineer County of Los Angeles BUILDING 0.17 JOHN A.LAMBIE,COUNTY ENGINEER ADDRESS X10,61 4c."�2 CASSATT D GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST 001 CROSS ST. OWNER DISTRIIC MAIL t —7 R CTT NO. GROUP ZONE EADY FOR INSPECTION ADDRESS I /'�' i 0O G INDUSTRIAL CITY TEL. N O WASTE APPROVAL PLUMBER - INSPECTION RECORD ADDRESS hl CITY TEL. LICENSE NO. /6 00 NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 BATH TUB @ $1 00 SHOWER @ $1.00 LAVATORY (WASH BASIN) @ $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 INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ I 00 ROUGH PLUMBING 1 GAS PIPING TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES 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 THE LEGAL OWNER OF T E ABOVE UTILITY CO.NOTIFIED TY DESCRIBED RESIDENTIAL PROPER , SIGNATURE OF PERMITTEE FINAL JOHN A LAMBIE. COUNTY ENGINEER VALIDATIONiiiiij /ROE3ERTA.WOOD, SUPERVISING MECHANICALENG'R Lt-G-3 3 15H4 ;' , � 12 5 A 3.0 0 �9 7GA667 17 s-49 ® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING ��' � � 1 COUNTY OF LOS ANGELES WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. PLUMBER -1 If 13 I- AI RECEIVED BY READY FOR DATE ISSUED °� FIRST INSPECTION ADDRESS Q/ ///1 O !i/� CITY J Ci lh r // / TEL NO �V (J / BUILDING / /p ADDRESS 1 e LIOUNTY CENSE NO. A9(717 EXPIRES si/JV-51 LOCALITY P NEAREST PERMIT FEES CROSS ST. a yr ot, NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET (TOILET) @ 0.50 $ ADDRESS BATH TUB @ 0.50 CITY TEL. NO. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL MOUNTY ORDINANCES AND KITCHEN SINK @ 0.50 STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR i AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. GAS SYSTEM_—/—OUTLETS @ O.50 SIGNATURE OF WATER HEATER @ 0.50 PERMITTE �- SLOP SINK 0.50 INSPECTION REC FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50I DRINKING FOUNTAIN @ 0.50 URINAL @ 0.50 J HOUSESEWER @ 0.50 Z MISCELLANEOUS (9 O lo I F7 APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT C POOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK I DRAIN ( ) PIT ( ) @ I.00 SEWER PERMIT 1.00 GAS TEST I TOTAL FEE UTILITY CO. NOTIFIED $ FINAL 76k4-57' C'R 7 5/70 `APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W. JENKINS. SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN PR NT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM E CH FEE OWNER WATER CLOSET 1.po MAIL BATH TUB 1 50 ADDREjS air < SHOWER 1.50 CI TEL. NO. &- LAVATORY 1 0 CONTRACT SINK 1 so ADDRESSzo DISHWASHER 40 cm, � / TEL. NO. J 41 CLOTHES WASHER 1 50 LIC LIATECENSE NO <(00 y� CLASS d— yo SWIMMING POOL RECEPTOR 1 50 DISTRICT NO U QNE P O S D B GIRD Y LAWN SPRINKLER SYSTEM 2 00 - t d WATER HEATER 1150 WASTE PP.ROVAL GAS SYSTEM OUTLETS 1 50 / INSPECTION jpECOIpV OUTLETS OVER 30 ¢ Z 5 PER SYSTEM O O. N Z Plan check fee 2557o of above. See reverse. PLUMBING PERMIT ISSUING FEE 8 00 TOTAL FEE APPROVALS DATE INSPECTOR S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT City Tel. No HOT WATER HEATER 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. i HEREBY CERTIFY THAT 1 AM PROPERLY REGI RED AND/OR UTILITY CO NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNT NO STATE OFcr CALIFORNIA O AM THE LEGAL O !R D INTEND TO RESIDE IN, THE O RIBlD RESID AL OP RTY FINAL L SIGNATURE , JACK R. ALLEN S PERGISIN E ANICAL EN G'R OF PERM ITT PERMIT VA ATION cK o CASH PLAN CHECK VALIDATION CK M O CASH LA0 7 8 rD MAY 2 D 4.75 w " WGkKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT , I hereby, affirm that I have'a certificate of consent to self in- 7bA66�A PW;4/87 sure,or a certificate of Workers'Compensation Insurance,ora CE 817(REV 8/86) certified copy thereof (Sec 3800, Lab C )'j- Policy No 0800,rn�paL COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS ❑ ;:" Certified copy is hereby furnished _ FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ' Certified copy is filed with the county building inspection@ FEE ADDRESS department NUMBER FIXTURE OR ITEM LOCALITY bbe77pa-- K �? Date 07 7 Applicant WATER CLOSET(TOILET) NEAREST42 V ~ CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST , COMPENSATION INSURANCE SHOWER OWNER R '(This section need not be completed if the work involved by MAIL _ the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS 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 CITY n..r ` TEL NO , as to become subject to the Workers'Compensation Laws DISHWASHER r CONTRACTOR y /- , Date Applicant CLOTHES WASHER L ') NOTICE TO APPLICANT If, after making this Certificate of Ex- ADDRESS f s w L IJ1G emption, you should become subject to the Workers'Compen- SWIMMING POOL RECEPTOR / CITY,G14i11� .o G T ' 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 srs / LIC' edWATER HEATER LICENSE NO �J/ �6 CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS000- 9.(commencmg with Section 7000)of Division 3 of the Business OUTLETS OVER J and Pfofessions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION fect DATE Z'10— 2 C License Number �)~l'�s6 Lic Class /, L3 h y -V rr _ FINAL 1c Contractor ` Date r/f?- f, BY O ❑ Lam exempt under Sec W f B&P C for this reason N Plan check fee ate PLUMBING PERMIT ISSUING FEE $ Q(J t Signature"" TOTAL FEE SINGLE FAMILY aec h c Flan k licant HOME OWNER-BUILDER DECLARATION PP .E I hereby affirm that I am exempt from the Contractor's License Name +T Law for,the following reason (Section 7031 5, Business ands'' ' "g _ Professions Code) Address 7 i _ , r �0e_ I, as owrier of the property, will do the work and the City Tel No 1 Iy ENEE'. structure is not intended or offered for sale(Section 7044, Business and Professions Code) - i;.= f ,,''��_+� a 50 CONSTRUCTION LENDING AGENCY r- ' - - CHECK 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 ij 1 iil v �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 auth�19 resentativ of this County to enter upon the abov. n d pr ry for i ction purposes �^`� g� SEE REVERSE FOR EXPLANATORY LANGUAGE Sign a of Permittee Date