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Home My Public Portal About6029 LOMA AVE_Plumbing__ 76A667 CE#817 5=61 - APPLICATION FOR ..PLUIV! ING PERMIT COUNTY OF LOS ANGELES DEPARTMENT,OF COUNTY ENGINEER .BUILDING AB JOHN ANE cY ENGINEER FETYDMSON BUILDING ADDRESS Q WILLIAM A. JENSEN, SUPT OF BUILDING - LOCALITY FOR APPLICANT TO FILL IN HOSS S. NUMBER FIXTURE OR ITEM OWNER r WATER CLOSET MalL BATH TUB ADDRESS SHOWER CITY — TEL NO. CONTRACTOR LAVATORY SINK ADDRESS 7 DISHWASHER CITY CONTRACTOR'S STATE ❑ LAUNDRY TUB REGISTRATION NO. O L�Lj� rp COUNTY' ❑ CLOTHES WASHER. DISTRICT NO. GROUP ZONE P SEED BY WATER HEATER INDUSTRIAL�'D�,1I- 0 GAS SYSTEM 0 WASTE APPROVAL INSPECTION RECORD ce uia N - Z $1.00 PER ITEM OR FIXTURE $ 1 APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2100 UNDER SLAB WORK TOTAL FEE ROUGH PLUMBING GAS PIPING ' 1HEREBY 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 PLUMBING.:. HOT WATER HEATER 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES L'CENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL oWNiA OF THE /SHOVE GAS TEST _ DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED- SIGNATURE OF PERMITTEEFINAL ^D ^ . �/ /l.fa /0 LDATION ROBERT A. WOOD � c M.0. CASH SUPERVISING MECHANICAL ENG'R �. to 7 3 6 Z !�? JAN 2 4 5. 0 3,0 0 �� '—D.§-.'17'25M SETS 12-43 APPLICATION FOR SnHdIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF,LOS ANGELES WM. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP rO E PERMIT /PcLQU. ROUGH FIXTURES COMPLETE HEATER CESSPOOL ,I—I SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED �pv�{ FIRSTIN/S/PECTIION GAS MISCELLANEOUS � 9 `'7 �`I44 1?—/5 11�4 APPLICANT FILL IN HEA V OUTLINED PORTION ONLYJOB pt s E - NAME � ADDRESS �Z3 g ADDRESS '» LOCALITY D 1 NEAREST LJL CITY �TEL�2ty�:. �1O.0 CROSS ST. COUNTY CERT.No. NAME EXPIRES.P� 8, LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL,� 3 ADD$ 88 4 / NORTH O CITY..", � TEL.No. I AM THeoOILEGAL POSSESbOR OF_ THE ABOVE LOS ANGELES COUNTY CERTIFICA,-rE-'F U��TIOp 1 PLUM13ER 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. ° a OWNER '1 CORRECTIONS SOUTH J DESCRIPTION OF WORK _i BATH TUB FURNACE _ 2 SHOWER DISHWASHER LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I I METER GAS SODA FOUNTAIN OUTL GAS PIPING ., GAS VENT ( 1 CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK I I T ICESSPOOI SEPTICTANK a SEWER $ �q UTILITY CO.NOTIFIED TOTAL FEE L/ FINAL WORKERS'COMPENSATION DEC of con I pt 78A8 17A APPLICATION ; I=O R PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self ce e�7 (z-eo) insure, or a certificate of Workers'Compensation Insura.c:ce;or a certified cgpy thereof(Sec 8 0 Lab.C.) .Dop J051 �.9 � � COUNTY OF LOS,ANGELES BUILDING AND SAFETY Policy No. Company. "Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ADDRESS De� LOMA Certified'copy is filed with'the county building inspection NUMBER' FIXTURE OR ITEM • FEE dep rtme t. LOCALITY A,,/ WATER CLOSET Dater$ ApplicantA� 1?k— ,PLl.t4QrN NEAREST. I TY BATH'TUB CROSS ST. Q CERTIFICATE OF EXEMPTION FROM WORKERS' / COMPENSATION INSURANCE SHOWER 0 OWNER 1C ORY MAIL (This section need not be completed if the work involved LAVATORY ADDRESS GL -by -the 'permit is for one hundred dollars ($100) or less.) SINK' Q CITY G TEL.NO. / I certify that in the performance of the work for which this DISHWASHER CONTRACTOR O permit is issued, I.shall not employ any person in any manner so.as to become subject to the Workers' Compensation Laws. CLOTHES WASHERADDRESS All /,Z./ V C )Lr v. Date Applicant SWIMMING POOL RECEPTOR ! W ANT: If, after making this Certificate of L D � TEL.NO. d NOTICE TO 4PPLICCITY Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE n LIC. Compensation provisionsofthe Labor Code, you must forth- LICENSE NO. �} "�� CLASS 3 with comply with such provisions or this permit shall be WATER HEATER deemed revoked. DISTRICT NO. , P OCESSED BY GAS SYSTEM OUTLETS �. LICENSED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that 1 am licensed under provisions of Chapter5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINAL ness and Professions Code,,and my license is in full force and DATE �- VALIDATION. effect. Q FINAL o�3 License Number�2S_9� Lic.Class // BY Contractor� Date I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Lic.or Reg.No. Date Plan check applicant ' HOME OWNER-BUILDER DECLARATION Name 9 5;7 1,.0 A I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section.7031.5, Busi- City Tel.No. # o .oho o o 5 ness and Professions Code): //�� ! - 0 I, as owner of the property, am exclusively contracting (i° ° 24,5 0 with'licensed contractors to construct thero ect x p 1 0 0 0 24,50.0 (Section 7044, Business and Professions Code). 'CONSTRUCTION LENDING AGENCY 1 8;—8 2 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- en ' d property f s tion purposes. Sig ure.of Permittee Date WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT hereby affirm 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 they '(Sec. 3800, Lab'. C. J ` �•� /J COUNTY OF LOS ANGELES / � o BUILDING AND SAFETY . Policy No. Company Certified copy is hereby furnished. QFOR APPLICANT TO FILL IN(PRINT OR TYPE)- BUILDING f' Certified 'opy,' filed with th cou y b 'ldin i pec- ADDRESS tion.de rtm 1.',. / NUMBER' FIXTURE OR ITEM' FEE LOCALITY Date �✓ Applicant / WATER CLOSET' NEAREST T. ®� ClRTIFI ATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. �. COMPENSATION INSURANCE OWNER (This section need not be completed if the work involved by SHOWER /nC MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY, ADDRESS ^+YT I certify that in the perfor'once of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL. NO. � so as to become subject to.the Workers'Compensation Laws. DISHWASHER CONTRACTOR �.�� i✓�/`'�4r77� Date Applicant CLOTHES WASHER _ NOTICE TO APPLICANT If, after,making this Certificate of ADDRESS Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR n Compensation provisions of,the Labor Code; you must forth- LAWN SPRINKLER SYSTEM CITY r WfLk7 L. NO. 7 �/ with comply with such provisions' or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO.3�16f-1 S C LASS SSS/ FJ LICENSED CONTRACTORS DECLARATION DISTRICT NO. PR ESSED I hereby affirm that I am licensed under provisions of Chapter 9'" GAS SYSTEM• OUTLETS r/ (commencing with Section 7000) of Division 3 of the BusinessOUTLETS OVER d and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL i DATE VALIDATION O License Number 5 4q,� Lic. Class n' '�Z� U FINAL = Contractor Date BY LU I am exempt under Sec. B.&P.C. for this reason Plpn.check fee Date: • PLUMBING PERMIT ISSUING FEE$ Q 0 Signature TOTAL FEE Plan check applicant' 1. 1 IL 8'A SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name Wo 0.0 0 0-1�7 I hereby affirm that I am exempt from the Contractor's License' Law for the following reason.(Section 7031.5,.Business and Address 2 -'-.3 0,'5 0 Professions Code): City Tel. No. FT30,50 I, as owner of the property, will do the work and the �. I structure is not intended or offered for sale (Section 7044, Business and Professions Code). 511 ,1 8�4. CONSTRUCTION LENDING AGENCY I hereby affirm.tha{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 auth rize representatives of this County to enter u on the a o -m do roperty or,inspection purp ses. _ SEE REVERSE FOR.EXPLANATORY LANGUAGE gna 're of Permittee ate i y COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0908100015 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 DUPLICATE PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID 1 BUILDING ADDRESS: ITR: 5904 LT: 349 I 6029 LOMA AV I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917801926 I (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 1 15384-014-021 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, Cl 1 151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 1 (TENANT: I TOTAL FEES 43.95 (ISSUED ON: PROCESSED BY: PLAN BY: I I 108/10/09 SR (OWNER: TEL. NO: (FINAL DAT BY: CODE: 1 IZUO P. WANG (626) 29271151- I I I 16029 LOMA AV I I I PIRED ITEMP 917801926 1 IDESCRIPTION OF WORK 1 IGAS LINE FOR HVAC SYSTEM 1 (APPLICANT: TEL. NO: I I 1 ITHIRD GENERATION. & CONSTRUCTION (818) 533-6722- 1 I 112101 OLIVOS RD. I ISPECIAL CONDITIONS: - 1 ISYLMAR, CA 91342 1 1 I I I I I I I I I ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE ITHIRD GENERATION CONSTRUCTION, INC. (818) 533-6722- 1 1 1 113469 LOS OLIVOS ROAD LIC. NO (UNDER SLAB WORK 1 I I ISYLMAR, CA 91342 893694 1 I I I I IWATER SERVICE I I I I I IPLASTIC Y/N METAL Y/N 1 I I (ARCHITECT OR ENGINEER: TEL. NO: I I I I 1 I IROUGH PLUMBING I I LIC. NO: I 1 11 1 _ IGAS PIPING I I I I I I I IGAS VENT I I I I I I I IHOT WATER HEATER I I I I I I (PLUMBING FIXTURES I I 1 1 (LAWN SPRINKLERS 1 1 I I I I I I I I IGAS TEST I I I 1 11 1 I (UTILITY COMPANY NOTIFIEDI I I I I I I I I cWv I. I I (GRAY WATER SYSTEM I I I I I I I I I I I I I I I f I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I f I I I I I IREPORT ID: DPR263 ROUTE TO: BS0508 ' I I I_