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HomeMy Public PortalAbout5317 LOMA AVE_Plumbing__ D.B. 17 25r.1"SETS*12-43 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING • .COUNTY OF LOS ANGELES WM. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE _ HEATER CESSPOOL II SEPTIC TANK FIRST INSPECTION RECEIVED BY READY FOR DATE ISSUED GAS MISCELLANEOUS _l_ APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB 1 K NAME ADDRESS W ® ADDRESS LOCALITY rE D NEAREST ", B. CITY TEL.No. CROSS ST. COUNTY CERT.NO. EXPIRES K NAME W LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL 3 ADDRESS NORTH O CITY TEL.NO. I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED j ABOVE. W D V OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK z BATH TUB FURNACE SHOWER DISHWASHER O LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN G. WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTORS NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER GAS SODA FOUNTAIN GAS PIPING OUTL k GAS VENT CESeSPOOL I I TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOI SEPTIC TANK SEWER UTILITY CO.NOTIFIED TOTAL FEE FINAL J D.B. 17 25M BETH 17-43 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES WM.J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT . GROUP o —PERMIT . 1-1 _ - X314 ROUGH FIXTURES COMPLETE RECEIVED BY READY FOR DATE ISSUED HEATER CESSPOOL SEPTIC TANK �� FIRST INSPECTION 0/ .�/, AS MISCELLANEOUS ^� APPLICANT FILL IN HEAVILY OUTLINED /�PORTION ONLY JOBD NAME DRE 38 i�(j�n-1-4 S / /► , _ Lam. 0 V'! )® III ADDRESS LOCALITY NEAREST 6J. CITY TEL.NO. C OBS 8T. ( / �1/ ��/ A��J+ COUNTY CERT.No. EXPIRES W l7 NAME /7 &)9-C LOCATION OF SEPTIC TANS, OR CESSPOOL Z MAIL 0 ADDRESS NORTH Z � �)2r CITY J'�f-TQ 1V/T 4 TEL.No I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY,DESCRIBED m ABOVE. �C-, ,/� _A <OWNER�/"1N' CORRECTIONS SOUTH U J DESCRIPTION OF WORK _.BATH TUB FURNACE SHOWER DISHWASHER /LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP GLOP SINK FLOOR DRAIN / WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I, METER l-' GAS SODA FOUNTAIN OUTL r- GAS IPING ENTOOL `� TOTAL NUMBER OF FIXTURES TANK r CESSPOOl SEPTIC TANK SEWER / 17 TOTAL FEE UTILITY CO.NOTIFIED Z11 FINAL / 76 A867FC EtF✓3l7 10-67 `vA� �� //���/ .. ..... APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING !- JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS J COLEMAN W. JENKINS. SUPT, OF BUILDING LOCALITY FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 1.50 MAIL BATH TUB 1.50 ADDRESS SHOWER 1.50 CITY TEL. NO. a&17,__,5 LAVATORY 1.50 CONTRACTO SINK 1.50 ADDRESS DISHWASHER 1.50 CITY r TEL. NO. §9,9423t CLOTHES WASHER 1.50 STATE LIC LICENSE NO. CLASS SWIMMING POOL RECEPTOR 1.50 DISTRICT NO, GROU NE PRI,CESSE BY LAWN SPRINKLER SYSTEM 2.00 Z WATER HEATER 1.50 INDUSTRIAL V WASTE APPROVAL D= GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD U OUTLETS OVER W 5 PER SYSTEM .30 CL Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE 8 2 00 TOTAL FEE �L 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. 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED 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 IEGGRIBED RESIDENTIAL PRO FINAL / (i SIGNATURE �j JACK R. ALLEN, SU PERVISIN M HANICAL ENG'R. OF PERMITTEE PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATIO CK. M.O. CASH LA 7,63�3 2:� JAN 2 5 D � �'� WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate'of-consent to self 20-0026 DPW6/87 insure, or a certificate of Workers' Compensation.InsuTonce,` � 7*--;667A or o certified copy thereof (Sec. 3800, lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING 17 y n ,p & Certified copy is filed with the county building inspec- ADDRESS J. ©A/ 6t - tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant ca WATER CLOSET NEAREST Ito L' CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB -79 CROSS ST.--6 6 COMPENSATION INSURANCEOWNER (This section need not be completed if the work involved by SHOWER 0,5 the permit is for one hundred dollars ($100)or less.) LAVATORY MAIL ADDRESS c a q e AL W I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL. NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS `� NOTICE TO APPLICANT: If, after making this Certificate of a V Q bO C Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR CITY TEL. NO. 7 7`� Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM 4 7s3 with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION GAS SYSTEM OUTLETS DICT PR ED BY I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER ° and Professions Code,and my license is in full force and effect. A 5 PER SYSTEM FINAL � DATE ��'9� 1A" ` TION License Number Lic. Class ®. FINAL /a C� Contractor Date BY ❑ 0 I am exempt under Sec. � M' B.BP.C. for this reason Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ 3 Signature TOTAL FEE SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name n I hereby affirm that I am exempt from the Contractor's License ACCT Law for the following reason (Section 7031.5, Business and Address _ l x )it I Professions Code): City Tel. No. 3330-7 103" ❑ I, as owner of the property, will do the work and the 1 ITEMS structure is not intended or offered for sale (Section ® TOTAL 103 - 00 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY CHECK 103.OLD I hereby affirm that there is a construction lending agency for CHANGE a01J the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name 0013DI—0Iy11 83/ 4/90 Lender's Address 2554 1 AM 7:41 1 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 Sig ature of Permitte'61 Date ` COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMB;I:NG-PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS �PL'"05'08a'0'00'`/05'0002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING-ADQRESS: TR: 11218 LT: 10 BL: E 5317..„LOMA AU' FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: T.EMP'CA..9,1`7803002) ASSESSOR INFORMATION NUMBER: (NEST—CROSS STREET: OLIVE 5388-007-010 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 04/05/00 UT 10/02/00 OWNER: TEL. NO: FINAL D T FINAL BY: CODE: LOPEZ ALBERT J;MARTHA J (626) 287-7338- �i� 5317 LOMA AV // yJ TEMP 917803002 DE IP ION OF WORK GAS LINE FOR RESIDENCE APPLICANT: TEL. NO: LUIS MOTA (626) 806-6876- 542 N. SUNSET AVE. SPECIAL CONDITIONS: AZUSA, CA 91702 LUISRMCMOTA GENERAL CONTRACTOR 818969283 ®� ��9� APPROVALS DATE INSPECTOR SIGNATURE 542 N SUNSET AVE LIC. NO UNDER SLAB WORK AZUSA, CA 91702 623955 B WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. N0: I _ ROUGH PLUMBING LIC. N'; _ - --- 1111111 � GAS PIPING GAS VENT HOT WATER HEATER UUU--�J J IIIJJJ UUU v�J PLUMBING FIXTURES Ir LAWN SPRINKLERS 0 ❑ r�l._, GAS TEST UTILITY COMPANY NOTIFIED @�® �Oo _ cwv GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508