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Home My Public Portal About5359 LOMA AVE_Plumbing__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer �� I� DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR APPLICANT TO FILL IN -b-MTRIMT NO. GROUP ZON E PERMIT'5-- s-)O 2 � PLUMBS RECEIVED BY READY FOR DATE ISSUED ADDRESS / — _ FIRST INSPECTION - �•` BUILDING CITY TEL. Na, 3 ADDRESS COUNTY -?0-1s� LOCALITY ' LICENSE NO. EXPIRES V NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER _ MAIL WATER CLOSET(TOILET) 0.50 >8 �� ADDRESS _ J 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 1 AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK 0.50 AND STATE LAWS REGULAT PLUMBING. 1 CERTIFY THAT I THE ABOVE VALID LOS LAUNDRY TUB OR TRAY 0.50 ANGELES COUNTY LI N I AM THE LEGAL O ER OF THE RESIDENT DESCRIBED ABOV GAS SYSTEM-..�OUTLETS 0.50 SIGNATURE OF WATER HEATER 0.50 Q PERMITT SLOP BINK Q O.SD INSPECTION RECORD FLOOR SINK Q 0.50 _ FLOOR DRAIN 0 0.50 � r DISHWASHER 0 0.50 L_'J/�/ C.�IMI-T / 6 117.SL014:3.v DRINKING FOUNTAIN 0 0.50 c:1--v +� c�'7� �a'�Tb..cS.G..o (:9.42 URINAL O.SD ,� J a HOUSE SEWER 0.60 / p✓R' v.��BCa �,�c MISCELLANEOUS 2 v O APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING ZS GAS PIPING 3JZf OAS VENT CESSPOOL 1,00 CESSPOOL ] , t SEPTIC TANK: SEPTIC TANK! 'I' Ali �� .........• DRAIN ( ) PIT ( ) @ 1.00 HEWER PERMIT . . 1.00 1 GAS TEST TOTAL FEE TILITY CO.NOTIFIED � U O 76A667 DBS#17 6-52 FINAL.� / WORKER'S COMPENSATION DECLARATION 20-0026 DPW 9189 (� 7) I hereby affirm th2t'14have a 6ertificate of consent to self insure, 76A667A Aft PLICA7ION FOR PLUMBING PERMIT IL1) or a certificate of Workers Compensation Insurance, or a certified copy thereof(Sec 3800 Lab C) i COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. ,k Policy No Company _ r El ; Certified copy is hereby furnished � FOR APPLICANT TO FILL IN(PRINT OR TYPE) - BUILDING ❑ Certified copy is filed with the county building inspection ADDRESS [,�Q department NUMBER FIXTURE OR ITEM @ CFEE LOCALITY I r Date Applicant WATER CLOSET j �( 0 G CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS' � BATH TUB C) COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the work involved by the SHOWER MAP BOOK��'��Aff PAGE PARCEL permit is for one hundred dollars($100)or less.) OWNER w, C C e. I certify that in the performance of the work for which this permit LAVATORY o2Jy' Q ' I is issued, I shall not employ any person in an SINK ADDRESS manner so as to MAIL � ) become subject to the Workers' Compensation Laws _ DISWASHER CITY -► TEL NO Date Applicant CLOTHES WASHER NOTICE TO APPLICANT If, after making this Certificate of CONTRACTOR Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such ADDRESS provisions or this permit shall be deemed revoked LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL NO I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER / Q_ (commencing with Section 7000) of Division 3 of the Business and STATE LIC Q GAS SYSTEM OUTLES Professions Code,and my license is in full force and effect, _ ` LICENSE NO CLASS V OUTLETS OVER - DISTRICTO� PROCESSED BY 0 5 PER SYSTEM O License Number Lic Class V �oSE j� O FINAL VALIDATION a DATE Contractor Date N ❑ FINAL Z I am exempt under Sec BY B&P C for this reason Date Plan check fee /�� a1':`- ^'v PLUMBING PERMIT ISSUING FEE,$ j� ® J9I+ 7Li ~� e t•_ Signature , TOTAL FEE I ITEM Plan check applicant TOTAL- 170 = 25 SINGLE FAMILY CHECK HOME OWNER-BUILDER DECLARATION Name + CHE K 171_25 I hereby affirm that I am exempt from the Contractor's License Law �.r7H __ for the following reason (Section 7031 5, Business and Professions Address _•_ t3L e)�_I Code) , - - City Tel,No - I,as owner of the property,will do the work and the structure t t� t r is not intended or offered for sale (Section 7044, Business ' 4 00130 -0001 - Q/12,rf" and Professions Code) ' 55 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 props ty for inspection purposes ,v SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Perm ttee JDate ° �K�RS',Ct%jMPENSATIOIV DECLARATION APPLOCl�il ll �®Il'KI FOR IrL�IUJMMMIG, PERM 67 hereb 1 firm that ,1 have a certificate of consent to self 76A667A nsure,ter a certificate of Workers' Compensation Insurance, CE 817(REV 10/81) or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDINGf• Certified copy is filed with the county building mspec_ ADDRESSS 6. W tion departmentNUMBER FIXTURE OR ITEM @ FEE LOCALITY DateV4.4 Appl,4 t WATER CLOSET NEAREST CER IFICATE OF EXEMPTIO FROM ORKERS' f BATH TUB CROSS ST COMPENSATION INSURANCE OWNER (This section need not be completed if,the work involved by SHOWER + the permit is for one hundred dollars ($100)or less.) LAVATORY / �{ MAIL �J (/ ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK O a CITY TEL NO so as to become subject to the Workers'Compensation Laws / DISHWASHER7 00 CONTRACTO L i Date Applicant CLOTHES WASHER ADDRESJ;F Q Q (�� ~ NOTICE TO APPLICANT If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY TEL NO Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STA E ,Ypr�g LIC C 20 -e,7 deemed revoked. WATER HEATER LICENSE NO OO e� CL S B LICENSED CONTRACTORS DECLARATION Q o DISTRICT NO `/ ROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS a� �' /,� (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER v and Professions Code,and my license is to full force and effect 5 PE YSTEM FINAL V (DATION Nim / O (f24_47:2o I DATE 0 License b O Lic Class /�o FIN U Contractor ate / B 4' F-1Ion xempt u der rec U B 8P C for this reason W Plan check fee Do., Date N PLUMBING PERMIT ISSUING FEE$ Z Signature TOTAL FEE SINGLE FAMILY Plan check applicant ;2443. 1 A HOME OWNER-BUILDER DECLARATION Name # o o o o 0 5 1 hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031 5, Business and ( o•o 7•Q 5 0 Professions Code) City Tel No ❑ 1, as owner of-the property,',will do the work and the o 0 - 7(15 Q 5structure is not intended or offered for sale (Section D 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY 4 1 4-786 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 ha e r d this application and state that the above informati is rrect I agree to comply with all County ordinances an St laws regulating Plumbing, and hereby , authorize re e n tives of this County to enter upon the ve-m coon puoses p los SEE REVERSE FOR EXPLANATORY LANGUAGE Signatur,15 of Permittee late COUP Y OF LOS ANGELES 'TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS - - PL 0508 1302120020 , BUILDING AND SAFETY / LAND DEVELOPMENT -TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT ILEGAL ID - I FEES PAID 1 BUILDING ADDRESS I ITR- 11218 LT 3 BL- E _� I _ 5359 LOMA AV I I _ IFEE DESCRIPTION - QUANTITY UOM AMOUNT TEMP CA 917803002 (ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET- OLIVE - 15388-007-003 101 PERMIT ISSUANCE FEE •27 80 1 THOMAS PAGE 596 GRID H4 LOCALITY TEMPLE CITY CAI 1 151 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20' 1 ITENANT 1 TOTAL FEES 44 00 (ISSUED ON PROCESSED BY PLAN BY 102/12/13 SR _ I 1 I I (OWNER TEL, NO FIJJAL DATE FINAL CODE 1 INGO, TRACY - - _ I _ 15359 LOMA AV I - I 1 ITEMP;917803002 1 - IftSZRIPtION OF WORK I IGAS LINE TO FAU UNIT 1 (APPLICANT TEL NO. I I INGUYEN, DUNG I (626) 582-8046- I I I 14216 •RICHMOND AVE 1 ISPECIAL CONDITIONS •1• IEL MONTE CA 91732 I _ - I •_ I - I 1CONTRACTOR TEL NO I 1APPROVALS DATE INSPECTOR SIGNATURE 1DT AIR & HEATING (626) 582-8046- 1 - 1- 14218 14218 RICHWOOD AVENUE LIC NO (UNDER SLAB WORK I I 1 1EL MONTE CA 91732 874333 I 1 - - 1 1 IWATER SERVICE 1 1 1 IPLASTIC Y/N METAL Y/N 1 (ARCHITECT OR ENGINEER TEL NO 1 - IROUGH PLUMBING 1 LIC NO I IGAS FIPING - I I IGAS VENT I I I I _ IHOT WATER HEATER 1 I• I IPLUMBING FIXTURES 1 ILAWN SPRINKLERS I 1 I I I IGAS TEST I I I I I I 1 1 - 1UTILITY COMPANY NOTIFIEDI. I - I I ICWV I I I I I I I I I I IGRAY WATER SYSTEM 1 I I I I I I I (REPORT ID DPR263 ROUTE TO BS0508 I I I I I I • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT =DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1301170013 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE- (626) 285-0488 EXT ILEGAL ID. FEES PAID BUILDING ADDRESS ITR: 11218 LT. 3 BL E 5359 LAMA AV I IFEE DESCRIPTION- QUANTITY UOM- AMOUNT TEMP CA 917803002 (ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET OLIVE 15388-007-003 101 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID H4 LOCALITY TEMPLE CITY CAI 1 107 BATHTUBS/SHOWERS 1 00 FIX 16 20 1 ITENANT 113 DISHWASHER(S) 1 00 FIX 16.20 JISSUED ON PROCESSED BY PLAN BY 1 125 LAVATORIES/SINKS 2 00 FIX 32 40 101/17/13 SR 145 WATER CLOSET/URINAL 2.00 FIX 32 40 1 (OWNER TEL NO 147 WATER HEATER(S) 1 00 WTH 16 20 FI AL QATE FINAL BY CODE INGO, TRACY - 151 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20 1 15359 LOMA AV I TOTAL FEES 157 40 ITEMP 917803002 1 IDESCRIP ION OF WORK SHOWER, DISHWASHER, LAVATOR E, SINK, 2 WASTER CLOSETS, WATER HEATER AND GAS LINE 1APPLICANT. TEL NO IVAN, VICTOR (714) 724-3681- 1 110391 BONNIE DR GSPECIAL CONDITIONS ARDEN GROVE 92843 I I I CONTRACTOR TEL NO 1APPROVALS DATE INSPECTOR SIGNATURE INGHIA VAN VICTOR (714) 724-3681- 1 110391 BONNIE DR LIC NO 1 1UNDER SLAB WORK I GARDEN GROVE CA 92843 562136 11 - IWATER SERVICE 1 I IPLASTIC Y/N METAL Y/N 1 1 1ARCHITECT OR ENGINEER TEL NO I 1 1 - I TROUGH PLUMBING w LIC NOIGAS PIPING 1 1 IGAS VENT I _ I I I IHOT WATER HEATER 1 IPLUMBING FIXTURES I I I 1 I ILAWN SPRINKLERS I 1 1 1 i IGAS TEST I I I 1 1UTILITY COMPANY NOTIFIEDI jCWV I I I IGRAY WATER SYSTEM I I* ADDITIONAL DATA ON FILE I I I I I I IREPORT ID DPR263 ROUTE TO BS0508 I i I I I I