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Home My Public Portal About6411 LOMA AVE_Plumbing__ 76A667-CE817 3-69 APPLICATION FOR PLUMBING PERMIT ^= COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING J JOHN A. LAMBIE,.County Engineer ADDRESS 2 D C / CASSAT P D. GRIFFIN, Sup't of Building LOCALITY FOR APPLICANT TO.FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM OWNER WATER CLOSET SIL BATH TUB ADDRESS " CITY TEL. NO,--.,• SHOWER CONTRACTOR , v r LAVATORY SINK ' ADDRESS DISHWASHER CITY TEL. NO. CON ACTOR'S ( i STATE / LAUNDRY TUB REGISTRATION NO. / _3.5 COUNTY ❑ CLOTHES WASHER' DISTRICT NO. GROUP ZONE / WATER HEATER GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD Xie s �° __/z/? @ $1.00 PER ITEM I �f d — lam/ 1v7 / /� � OR FIXTURE $ / APPROVALS DATE, INSPECTOR'S SIGNATURE PERMIT $ 2100 UNDER SLAB WORK TOTAL FEE (j0- ROUGH PLUMBING GAS PIPING I HEREBY ACKNOWLEDGE THAT 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 -Op'aQl r ;, _ 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURESL ICE CALIFORNIA NSED SORE THAT DIB THE LEGAL OO;"P 7HE STATEOF OF GAS TEST %V I9L,. DESCRIBED RESIDENiIA PR PERTY.. UTILITY CO. NOTIFIEDSIGNATURE ,% OF PERM ITTE - FINAL a ®e. \TALIDATION ROBERT A. WOOD, CK. 11 m,O. CASH SUPERVISING MECHANICAL ENG'R -844 2 _ /�y�2�/Y✓Yl' r WORKERS'COMPENSATION DECLARATION - 20.0026DPW4/87. APPLICATION_ F®R PLUMING PERMIT I m hereby, affi 'that I'have a'certificote of consent to self in- ,76A667A' sure,or.a certificate- Porkers'Compensation Insurance,or a ,CE 817(REV. 8/86) certified copy9;hereof.( ec: 3800, Lab C COUNTY OF-,LOS.ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is'here6y furnished Certified copy is filed with the•county building inspection TY ADIDRESS ❑•:-department. NUMBER R APPLICANT ETOR ITEM' FE (PRINT OR @PE) FEE' LOCALITY FO T /19 11 ��f, Date- Applica NEAREST _ WATER CLOSET(TOILET') r CERTIFICATE OF EXEMPTION FRM WORKERS' BATH TUB cROss'Sr. ,COMPENSATION-INSURANCE• SHOWER OWNER C—A (This 'section need'not be completed-if the.work involved by the term MAIL fy t f cer it is for one.hundred dollcrs•($I00)or less.) LAVATORY - ADDRESS at in'the per`focmance of'the work for which this per- _ mit is'issued,.l'shall not employ dgy person in any manner so SINK CITY TEL. NO. as,to become subject to`the•Workers" Compensotion Laws. DISHWASHER - CONTRACTOR _ Q� Date - - Applicant - - .CLOTHES WASHER - NOTICE TO APPLIADDRES CANT: If,'after'makin'g`this Certificate of Ex. SWIMMING POOL RECEPTOR emotion,you ' should become subject to the Workers'Compen- CITY t T sation.provisions of the Labor Code, you Aust forthwith comp- LAWWSPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC. WATER HEATER LICENSE NO: CLASS LICENSED CONTRACTORS DECLARATION', GAS SYSTEM DISTRICT NO. �/\ CESSED BY I hereby affirm that I alicensed.under provisions of,Chopter OUTLETS m U (� 9(commencing with Section 7000)'of Division'3 of the Business OUTLETS OVER (J and Professions Code, and my license is in-full force•ond ef- 5 PER SYSTEM FINAL VALIDATIO >' fect DATE d License Number il Lic. Class�/,� O FIN U Contract _ 9 e r f BYO xem O I.am pt under'Sec. W B BP.0 for this reason ,. Plan check:fee.; - - - Date: , ; PLUMBIN PERMIT ISSUING FEE$ Signature ;. TOTAL FEE /_ 1�D SINGLE FAMILY f� HOMEOWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that lam exempt from the Contractor's License Name Law,for the following reason (Section'7,031.5, Business and Professions Code): - ` - Address s. . Q I,.-as.ownerof•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 ® 29.2 I hereby of irm',that there is a construction lending agency-for _ the performance of the'work for which this-permit'is issued 1 o'o (Sec. 3097; Civ. C.). 0'329-egg Lender's,Name Lender's Address I certify that I;,have'read this application and stcdte'that the above information is correct.I agree to comply with all County ® . ordinances and tate laws regulating Plumbing,'and hereby authorize re sentative' of'this.;C to'enIer upon the above me, 'oned pi ty for ins on purposes. - SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Dat F • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1305020025 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: FEES PAID I BUILDING ADDRESS: ITR: 5904 LT: 350 1 I 6021 LOMA AV I I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917801926 1 (ASSESSOR INFORMATION NUMBER: II NEAREST CROSS STREET: 15384-014-022 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY CAI 1 _151 LOW PRS GAS S OUTLET -' 1.00 SYS 16.20 1. I (TENANT: I TOTAL FEES 44.00 (ISSUED ON: PROCESSED BY: PLAN BY: I 105/02/13 SR 1 (OWNER: TEL. NO: 1 IFINAL DATE FINAL BY: CODE: 1 ILO (626) 689-5883- I 1�l'fj�/�/►L - I 16019 LOMA AV I ITEMP 917801926 _ 1 ID SCS RIPTION OF WORK v1 I I IGAS LINE (APPLICANT: TEL. NO: I I IRAMIREZ, CONNIE (626) 815-1632- 1 1 I 11017 W FOOTHILL BLVD 1 - ISPECIAL CONDITIONS: I IAZUSA CA 91702 I I I I I I I ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1 ICOMFORT CLIMATE CONTROL INC (626) 815-1632-- I I I 11017 W FOOTHILL BLVD LIC. NO I (UNDER SLAB WORK I I I IAZUSA CA 91702 641060 1 1 I I I IWATER SERVICE I I IPLASTIC Y/N METAL Y/N I I (ARCHITECT OR ENGINEER: TEL. NO: I I I I I I - I (ROUGH PLUMBING 1 LIC. NO: 1 I IGAS PIPING I i i i I I I I I I 1 IGAS VENT I I I I I IHOT WATER HEATER I I I I I I I (PLUMBING FIXTURES I I I I I I I I I I ILAWN SPRINKLERS I I I IGAS TEST I I I I I I I (UTILITY COMPANY NOTIFIEDI I I I I 1-1 CWV I IGRAY WATER SYSTEM 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 1 (REPORT ID: DPR263 ROUTE TO: BS0508 I I� COUNTY OF LOS ANGELES TEMPLE CITY' # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL 0508 9704170002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 5904 LT: 350 6021 LOMA AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801926 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: ROSEMEAD 5384-014-022 01 PERMIT ISSUANCE FEE .27.75THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, 47 WATER HEATER(S) 1.00 WTH 16.35 TENANT: TOTAL FEES 44.10 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 04/17/97 TC 04/17/98 OWNER: TEL. NO: FINAL. DATE FINAL BY: , CODE: HSU DAVID (818)1291-2128- 6019 LOMA AV TEMP 917801926 DESCRIPTION OF WORK CHANGE OUT OF WATER HEATER PPLICANT; TEL. N0: ORANGE COUNTY SERVICES (909) 444-1844- ++ SPECIAL CONDITIONS: CONTRACTOR: TEL. N0: = _` J APPROVALS DATE INSPECTOR SIGNATURE ORANGE COUNTY SERVICES, INC. (909) 444-1844- /J DBA: GEORGE BRAZIL PLBG,HTG. LIC. NO j \` UNDER SLAB WORK A 154 UNIVERSITY PKWY 679898/C20 ` , �, POMONA, CA 91768 /r �` //' '� / WATER SERVICE PLASTIC YIN METAL YIN ARCHITECT OR ENGINEER: TEL. NO: 1 �r:�. l �/ \�� ROUGH PLUMBING LIC. NO: { _ intra GAS PIPING GAS /ENT /C HOT ,47 NATER HEATER 71 / PLUMBING FIXTURES LAWN SPRINKLERS �j GASTEST - ��j- UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTEM * ADDITIONAL DATA ON FILE REPORT ID: DPR263 ROUTE TO: BS0508