Loading...
HomeMy Public PortalAbout5314 LOMA AVE_Plumbing__ O 76A667A ♦♦ " GE 8171REV 6/78) , O S � gg PERMIT� p APPLICATION FOR ll®9eUMBING ■ _ERMIT COUNTY OF LOS ANGELES ,BUILDING AND SAFETY FOR APPLICANT TO FILL IN IPRINT OR TYPE). BUILDING _ 41 ADDRESS NUMBER FIXTURE OR ITEM ® FEE LOCALITY 57 WATER CLOSET NEAREST BATH TUB CROSS ST SHOWER OWNER LAVATORY MAIL'ADDRESS ADDRESS SINK CITY TEL NO DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR CITY � TEL NO LAWN SPRINKLER SYSTEM STATE LIC WATER HEATER LICENSE NO _ CLASS GAS SYSTEM OUTLETS „ '` APPROVALS DATE INSPECTOR S SIGNATURE OUTLETS OVER (J CJ UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING a. GAS VENT @S HOT WATER HEATER PLUMBING FIXTUR f GAS TEST Plan check fee UTILITYCO NOTIFIED 1�� PLUMBING PERMIT ISSUING FEE$ TOTAL FEE FINAL Plan check applicant PLAN CHECK VALIDATIO Name Cv 9�®(✓' ,� 95 - 642— Address Q��� City Tel No I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE �l ��L �(1 /� I1 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES (J U LF A AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION _ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS # O O O O O 5 REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE r� LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL e L O O 1 300 PROPERTY o 0 0 1 3 0 Q v SIGNATURE OF PERMITTEE 0 9. 1 4-79 RIC DISTT NO PROCE D BY J INDUSTRIAL WASTE APPROVAL 76A667A d$1817(REV 6/78) ' �5 ' ®y APPLICATION FOR PLUMBING MBING PERM (T COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE( BUILDING DRESS 5 AD314 N. Loma Ave.Temple C ty NUMBER FIXTURE OR ITEM ® FEE LOCALITY _ WATER CLOSET NEAREST BATHTUB 5 60 CROSS ST live SHOWER OWNER JO Ce geed - MAIL LAVATORY ADDRESS 531 4.,N. Loma Ave. SINK CITY Tem le Ci I ty TEL NO 285-5722't DISHWASHER CONTRACTOR Owner/Builder CLOTHES WASHER, ADDRESS SWIMMING POOL RECEPTOR, CITY � - TEL NO LAWN SPRINKLER SYSTEM STATE LIC WATER HEATER LICENSE NO CLASS GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING GAS VENT �i HOT WATER HEATER ® PLUMBING FIXTURES GAS TEST tR Plan check fee ` UTILITY CO NOTIFIED PLUMBING PERMIT ISSUING FEE$ TOTAL FEE FINAL Plan check applicant PLAN CHECK VALIDAT ON Name „f'o Address��i N CItyT� L� t Tel No oVds� a - 26'65.7A I HEREBY ACKNOWLEDGE AT I HAVE READ THIS APPLICATION AND STATE r'- THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES # O O O O O 5 AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION , .I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS rj O O 1 f1 O O REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE L 7, LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL (� PROPERTY 0 0.0 1 9,Q 01'-, SIGNATURE 09. 13-79 OF PERMITTEE DISTRICT NO PRO S D BY INDUSTRIAL WASTE APPROVAL 76 A 667 — CE 817 7-69 / APPLICATION FOR 1. LU SING PER IT n y COUNTY OF LOS ANGELES - DEPARTMENT OF-COUNTY ENGINEER BUILDING_ AND SAFETY DMSION nnn RESS JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W JENKINS. SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL INPR NT OR TYPE) NEAREST CROSS ST. Winsia NUMBER FIXTURE OR ITEM EACH FEE OWNER ' WATER CLOSET 1.50 G, TAA nA MALL' BATH TUB 1.50 ADDRESS SHOWER 1.50 CITY C• TEL. NO. LAVATORY 1 50 CONTRACTOR- - SINK 1 50 'ADDR'MS. _10920-Eo Grand' Ave, " DISHWASHER , 1.50 CITY• City- _ TEL. NO. 4)42_7070 7 CLOTHES WASHER STATE LIC 1 50 LICENSE NO 211898CLASS C-20 , SWIMMING POOL RECEPTOR 1.50 DISTRICT NO.. GROU NE D _1 LAWN SPRINKLER SYSTEM 2.00 e ��d I' WATER HEATER- - 1 50 0 INDUSTRIAL gp ovAL ' a• O GAS SYSTEM OUTLETS 1.50 INSPECTION REC - U OUTLETS OVER' ' 5 PER SYSTEM _ 30 7 TC, O T _ ul D. - •e z Plan check fee 25% of'above. See reverse. PLUMBING PERMIT ISSUING FEE 8 2 00 TOTAL FEE APPROVALS :DATE •` INSPECTOR'S SIGNATURE Plan check appllcani- UNDER SLAB WORK 's Name - ROUGH PLUMBING Address GAS PIPING GAS VENT' '- City Tel. No HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION , - AND STATE'THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST _ PLUMBING I HEREBY CERTIFY THAT I'AM PROPERLY REGISTERED AN IOR UTILITY CO'NOTIFIED LICENSED AS REQUIRED,BY L ANGELES,COUNTY AND STAT OF CALIFORNIA OR THAT I AM E L GAL•OWNER OF,AND INTE TO RESIDE IN,THE ABOVE DESC IBE IDE L PROPERTY FINAL e' SIGNATURE JACK R. ALLEN, SUPER ISINGHANICAL ENG'R OF PERMITTEE C ` PERMIT VALIDATION cK M O CASH PLAN CHECK VALIDATION CK M O CASH � . D - WOR 'COMPENSATION DECLARATION A I hereby affirm that I have a certificate of consent to self CE 817 (2-80) A z-eo) APPL6CAT9® eF®R` P L U M B.B N G PERMIT insure, or a certificate of Workers'Compensation insurance,or a certified copy thereof(Sec 3800,Lab C) STh'i'o� F'�FNi M COUNTY OF LOS ANGELES � WING AND SAFETY Flo—34763 f - • `Policy No Company ` O Certified copy is hereby furnished �© / FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDINGx, L��A dCertified co is filed with the count buildm NUMBER FIXTURE OR ITEM O FEE ADDRESS copy y g ins ection ie��a�rt��T�en,t,, I�'•��tavW Zvi = S G- LOCALITY Dated Applicant—l" WATER CLOSET NEAREST '' 1) BATH TUB CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER .IO C=V_ �� ® -(This section need not be completed if the work involved LAVATORY MAIL by the permit is for one hundred dollars ($100) or less.) SINK 31`{- �' L ��0� O ADDRESS S CITY � —H� <=11—N TEL NO 2-J 4 ��� U I certify that in the performance of the work for which this DISHWASHER CONTRACTOR ��3 Cr permit is r`ssued, I shall not employ any person in any manner r��44:1R W P. I 0 so as to become subject to the Workers' Compensation Laws CLOTHES WASHER ADDRESS W Date Applicant SWIMMING POOL RECEPTOR G. NOTICE TO APPLICANT If, after making this Certificate of CITY TEL NO.33 t7 Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC z Compensation provisions of the Labor Code, you'must forth- LICENSE NO CLASS with comply with such provisions or this permit shall be WATER HEATER deemed revoked ' GAS SYSTEM ,Z OUTLETS i DIS ICT NO R SED BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- RMLC%,\TP_' (ROSE FINAL VALIDATION ness and Professions Code, and my license is in full force and DATE effect FINAL License Number Lie Class BY IZialisavw t3V1l,pIl.r� 7 ov, ,P, Contractor Date 0 I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ - acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Lie or Reg.No. Date Plan check applicant � _ •,�„� HOME OWNER-BUILDER DECLARATION Name �TF�I�' - J�'[>s;�( CL d ( Address C I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031 5, Busi- City Tel No Qb9- ness and Professions Code) O 3 O A I, as owner of the property, am exclusively contracting with licensed contractors to construct the project # o'o•o o'0 5 (Section 7044, Business and Professions Code) I 2 o�o l 300 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency o o;o 1 3,O O for the performance of the work for which this permit is issued(Sec 3097,Civ C) Lender's Name i7, .5 8 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 authorize representatives of this County to enter upon the above-mentioned property for in ect puposes nature—Sifof Permittee Date IF WORKERS' 6A6 COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT �1 - 26 DPW 4/87 I hereby,.-affirm thd�`I have•c,certificate of consent to self in-- 76A667A sure,-dr a certificate of Workers'Compensation Insurance,or a CE 817(REV. 8%86) certi#ied copy thereof (Sec. 3800, Lab,C. . Policy No. Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Certified copy is hereby furnished. 1 FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING -3 I�7/ -hj 119vE' Certified copy is filed with the county building inspection ADDRESS NUMBER FIXTURE OR ITEM . LOCALITY e department. @ FEE J WATER CLOSET (TOILET) O aSy Date' Applicant NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE �y OWNER SHOWER V Gl (This section need not be completed if the work involved by MAIL -31q ) �J the permit is for one hundred dollars ($100)or Jess.) LAVATORY 11 O ADDRESS 5 31 I certify that in the performance of the work for'which this per- n mit is issued, I shall not employ any person in any manner so SINK. - CITY / TEL. NO. as to,become subject to the Workers'Compensation Laws. DISHWASHER / ��"iii•��� V C, - CONTRACTOR f Date Zto `' ` Applicant .(r.'.• ..may CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making t is Certificate of Ex- SWIMMING POOL RECEPTOR emption, you should become subject to the Workers'Compen- 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 r.DgST T JCE#D I hereby'affirm that I am licensed under provisions of Chapter GAS SYSTEM . OUTLETS ,►/� 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL V LIDATION feet. DATE License Number Lic. Class U FINAL f� Contractor Date BY oiA1 I am exempt under Sec. IA1 B.&P.C. for this reason Plan check fee ► ! g Date: PLUMBING PERMIT ISSUING FEE $ O Signaturep� TOTAL SINGLE FAMILY FEE t.! Plan check applicant HOME OWNER-BUILDER DECLARATION '. -,+�n� 7�vc I hereby affirm that I am exempt from the Contractor's License Name ,x}301. +. o•_1� Law for the following reason (Section 7031.5, Business and 1 ITEMS Professions Code): Address ' as owner of the property, will do the work and the City Tel. No. TOTAL �`8 @ 50 r' �ructure is not intended or offered for sale(Section 7044, CHECK - 28.50 Business and Professions Code). Poo. CHANGE e100 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 =_.Of 1 9/26/89 (Sec. 3097, Civ. C.). Cr 5904 1 PM12- 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 Signature a Permittee Date WORKERS'COMPENSATION DECLARATION 76A667A APPLICATION p ,//�'� p� I hereby affirm that I have a certificate of consent to self ce a17 (z-60) A P P IL 8`>,.�A T V®1 tl F®R PLUMBING PERMIT. insure, or a certificate of Workers'Compensation Insurance,or a certif�ec'c py thereof(Sec. 3800,Lab C) I�ls'� COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No &`ii 1 Z Company tAiff.5 j 0A1-r4,t1 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING 2 /� ADDRESS Certified copy is filed with the county budding inspection NUMBER FIXTURE OR ITEM O FEE Vy , , LOCALITY L�( �$t �/Q 57VM 44r—y WATER CLOSET Date Applicant NEAREST BATH TUB CROSS ST G �/ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER r,Q (This section' need not be completed if the work involved LAVATORY MAIL �V� } by the permit is for one hundred dollars ($100) or less.) SINK ADDRESS CITY TEL NO I certify that in the performance of the work for which this DISHWASHER TO n U. permit is issued, I shall not employ any person in any manner CONTRACTOR / /f� so as to become subject to the Workers' Compensation Laws CLOTHES WASHER 0 ADDRESS Date Applicant - � ��� N. Q � SWIMMING POOL RECEPTOR U NOTICE TO APPLICANT. If, after making this Certificate of CITY /�/� TEL NO. W Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC to Compensation provisions of the Labor Code, you must forth- LICENSE NO CLASS z with comply with such provisions or this permit shall be WATER HEATER deemed revoked GAS SYSTEM OUTLETS DISTICT NO PROCESSED BY LICENSED CONTRACTORS DECLARATION OUTLETS-OVER" / I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL�� «bSl� ��— VALIDATION —ness and Professions Code, and my license is in full force and �C DATE effect License Number 17f'41-1-6 Lic Classy �"rt� BY AL ContractorkVP T0/7 & Date I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ — acting in my professional capacity (Section 7051, Bus- iness and Professions Code). I TOTAL FEE Q :Po Lic,or Reg.No Date Plan check applicant ' HOME OWNER-BUILDER DECLARATION Name 2 0 67.O A I hereby affirm that I am exempt from the Contractor's Address # 0,'0 0.0 o5 License Law for the following reason (Section,7031 5, Busi- City Tel No. 2 0 0 Q.00 ness and Professions Code) ❑ I, as owner of the property, am exclusively contracting o 0 0Q O'O U with licensed contractors to construct the project (Section 7044, Business and Professions Code). oaoT—s1 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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned erty for inspection purposes. gna —u mittee Date WORKERS'COMPENSA.ION DECLARATION Ao o P�UC�A�DOO N FOR PLUMMMIG, PERMT 1-1-hereby `dffirm that I have a certificate of consent to self 76A667A insure, or a Certificate of Workers' Compensation Insurance, CE 817(REV 10/81) or a certified copy thereof (Sec 3800, Lob 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 inspec- ADDRESS 3f 4 0I#,7 �F tion department NUMBER FIXTURE OR ITEM @ FEE LOCALITY y. WATER CLOSET V h1 P/_-V 9-117- Date Applicant NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST V COMPENSATION INSURANCE SHOWER OWNER �-pw �� O7 J'✓ (This section need not be completed if the work Involved by MAIL the permit Is for one hundred dollars($100)or less.) LAVATORY ADDRESS Q ndl I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY L TEL NO so as to be m subject to the Wo s Co nsatio L w DISHWASHER C L CONTRACTOR a.J Date pplica t CLOTHES WASHER ADDRESS NOTICETO APPLICANT If, a r a ,ng s ertificate of SWIMMING POOL RECEPTOR Exemption, you should bec0 suble' to the Workers' CITY TEL NO Compensation provisions of t abor Code, you must forth- ' orth- LAWN SPRINKLER SYSTEM with comply with such pro ions or this permit shall be STATE LIC deemed revoked WATER HEATER LtCENSE�NO CLASS LICENSED CONTRACTORS DECLARATION DIS(//�(O(T NO- ESS BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect 5 PER SYSTEM FINAL VA ATION DAT A _'� 0-1License Number Lic Class Q FINA U Contractor Date BY W ❑ I am exempt under Sec V B&P C for this reason W Plan check fee D CLI Date PLUMBING PERMIT ISSUING FEE$ D ' Signature ' TOTAL FEE Plan check applicant R 4 3 9,4 A SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name ,TD#PJ D 7-7—gW # 0 0 o o 0 5 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031 5, Business and Address D M ( ­ 2250 Professions Code t ) City r` i�?IJL� Cil Tel No lG 0 0'0 = ❑ 1, as owner of the property, will do the work and the 2 2 5 0 structureis not intended or offered for sale (Section 0 10$-$6 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 4be ze rep esentotives of this County to enter upon the men a oper r inspection p rposSEE REVERSE FOR EXPLANATORY LANGUAGE re of P rmittee Date