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Home My Public Portal About5327 LOMA AVE_Plumbing__ 7BA667-CEU7 M9 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEP=ARTMENT OF COUNTY ENGINEER / BUMIDING AND SAFETY DIVISION ADD ESS JOHN A. LAMBIE, County Engineer CASSATT D. GRIFFIN, Sup't of Building LOCALITY ' FOR APPLICANT TO FILL IN y NEAREST L �`v CROSS ST. NUMBER FIXTURE OR ITEM OWNER G WATER CLOSET MAIL BATH TUB / ADDRESS h SHOWER O g �• CITY TEL. NO. 7 LAVATORY CONTRACTOR SINS ADDRESS --2 DISHWASHER CITY TEL NO. T6 2 7312 CONTRACTOR'S STATE ❑ LAUNDRY TUB REGISTRATION NO. COUNTY ❑ o y CLOTHES WASHER DISTRICT NO. GROUP 7ONE c P CESSED BY WATER HEATER GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD S { r / !I a $1.00 PER ITEM $ OR FIXTURE APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT S I 2 100 UNDER SLAB WORK TOTAL FEE (.T ROUGH PLUMBING �(py / GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. /.I 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES L2� LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE r DESCRIBEDRESIDENTIA PROPERTY. UTILITY CO.NOTIFIED v SIGNATURE OF PERM TTE �— FINAL OF VALIDATION ROBERT A. WOOD, cs M.O. CASH SUPERVISING MECHANICAL ENG'R LACO 749 2'�O• ttAR 9 5 A 9.0 0 r I/I k661-CE817'12%59 -T MPLEi CITY APPLICATION FOR PLUMBING PERMI`T'. � ' COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY QIVISION 'BUILDING JOHN A. LAMBI OUNTY NGINEER ADDRESS WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST v CROSS ST. NUMBER FIXTURE OR ITEM tADD ER WATER CLOSET FeaBATH TUBSHOWER TEL N0.TRACTOR LAVATORY SINS ADDRESS DISHWASHER CITY TEL. NO. 2- CONTRACTOR'S CONTRACTOR'S STATE ❑ LAUNDRY TUB REGISTRATION NO. COUNTY ❑ low CLOTHES WASHER DISTRICT NO.I; GROUP ZONE PROCE E&l BY WATER HEATER GAS SYSTEM INDU TRLRL WASTE APPROVAL INSPECTION RECORD y P. 0 U PC 0 F - U W - a / $1.00 PER ITEM OR FIXTURE $ APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT- $ 2100 UNDER SLAB WORK —H TOTAL-FEE l ROUGH PLUMBING C�� GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE-TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. _ 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND.STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTE FINAL ®P • VALIDATIoBERT A. WOOD, O. " cesR UPERVISING MECHANICAL ENG'R T � � 2'6 4 1 FEB 1 5 5 0 - 3.0 Q 7T67 APPLICATION FOR PLUMBING PERMIT DBS-17 DIVISION OF BUILDING'AND SAFETY Deportment of County Engineer County of LOS-Angeles BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ' ADDRESS CASSATT D. GRIFFIN,SUPT OF BUILDING _7'�- LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. OWNER - DISTRIC�0'. GROUP ZONE I READY FOR INSPECTION MAIL ADDRESS2.:ji . INDUSTRIAL CITY TEL. NO WASTE APPROVAL PLUMBER l"ld L U S p INSPECTION RECORD ADDRESS CITY C TEL. N 0 /j LICENSE NO. ( 2=Q 3 - NUMBER TYPE OF FIXTU.REfOR ITEM FEE ' I 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 @ $1.00 GAS SYSTEM @ .$I.00 07 APPROVALS DATE INSPECTORS SIGNATURE _ UNDER SLAB WORK PERMIT 7 00$ ROUGH PLUMBING GAS PIPING TOTAL FEE it) GAS VENT ,I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ' 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 LEGAL 1,0Y NER OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTI PROP TY. SIGNATURE OF PERMITTEE FINAL JOHN A. LAMBIE. COUNTY ENGINEER }TALIDATION ROBERT A.WOOD, CHIEF PLBG INSPECTOR cm. M.0. CASH LAC0 6 7 4 3 w, JUUN�. '% 5 2'.0 v '�. WORKERS'COMPENSATION DECLARATION .�'Prl"L P% ION FOR PLUMBING PERMIT I,hereby, affirm-that I have a certificate of consent to self in- 20-0026 DPW 4/90 UU �8tltl Rte® 76A667A sure,or a certificate of Workers'Compensation Irisurance,or a 4ertified copy thereof (Sec. 3800, Lab. C.) COUNTY OF.LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company � � e ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING r� ' ^ Certified copy is filed with the county building inspection ADDRESS 3Ci c.-f��LI� department. NUMBER FIXTURE OR ITEM @ FEE ' LOCALITY Date Applicant WATER CLOSET(TOILET) PP 'NEAREST_ , � � CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. •- \;` •� COMPENSATION INSURANCE OWNER ��/ SHOWER (This section need not be completed if-the work Involved by the AD permit is for one hundred dollars (5100)or�less.) LAVATORY DRESS 3�-'7 L DsrAR" I certify that in the performance of the work for which tht per- SINK mit is issued, I shall not employ any person in any ma er so CITY GL TEL. NO as to becosubject to the War mpensation ws. DISHWASHER CONTRACTOR t-G&v Date Applicant CLOTHES WASHER ADDRESS .yy�� NOTICE TO APPL CANT. If, after maki is Certific to of Ex- 3 (/ Gf�'! �emption,you should become subject the orkers'Compen- SWIMMING POOL RECEPTOR sation provisions of the Lab- ,Coee, u m t forthwith comp- LAWN SPRINKLER SYSTEMS CITY G1 TEL NO. 7ry?� 6 7 ly with such provisions or this permit be deemed revok- STATE � � CLASS !�1 ed WATER HEATER LICENSE NO . LICENSED CONTRACTORS DECLARATION * DISTRICT NO. PROCESSED BY 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 _ dh and Professions Code, and my license is in full force•and ef- 5 PER SYSTEM FINAL IDATION fect. j HOSE BIB DATE l Z/" o } License Number fVW / Lic Class ` ' a O /� ��r��l �n FINAL AC T.Ir Contractort,•fes• Arr�l"eu-o Q. /S q`f'. BY 303 109.509 I am exempt under Sec. 1 ITEMS B.BP.0 for this reasonW Plan.check fee. ® TOTAL � �'� v -_ � Date: PLUMBING PERMIT ISSUING FEE$ a CHECK 109.502 Signature TOTAL FEE Q CHANGE �� SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Name 0000-0001 7/15/96 Law for'the following reason (Section 7031.5, Business and Professions Code): Address 7430 1 AM 9:e6 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 re this application and state that the above information is orre I agree to comply with all County - ordinances and Stat law reguldtmg Plumbing, and hereby ize representa ve of this County to enter upon the above- ntio ed pro ty for inspection purpose . SEE REVERSE FOR EXPLANATORY LANGUAGE X Signatu of Permit Do e