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Home My Public Portal About10663 LORA ST_Plumbing__ 7GAGG7 (O6-11117) - 1/75 .. APPLICATION FOR PLUMBING -PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ' BUILDING MAKE CHECKS PAYABLE TO: '- ADDRESS' /0646.9 '1,ae HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY �„�: FOR APPLICANT TO FILL IN (PRINT.OR TYPE) NEAREST / NUMBER FIXTURE OR ITEM ® FEE CROSS ST. Gr WATER CLOSET 2.00 OWNER r 'GiS BATH TUB 2.00 ADDRESS Z XC)" � SHOWER 2.00 CITY �~ 1 J� . N '.O�;U LAVATORY 2.00 CONTRA CTOR SINK 2.00 ADDRESS r DISHWASHER 2.00 CITY Ali TEL. N0. CLOTHES WASHER 2.00 STATE LIC LICENSE NO.' 'CLASS SWIMMING POOL RECEPTOR 2.0.0 DIST ICTNO.IGROUPI ZONE PROCESSED BY LAWN SPRINKLER SYSTEM 2.00 +^ O / 0 WATER HEATER 000 3 017 INDUSTRIAL o WASTE APPROVAL 67 GAS SYSTEM OUTLETS -OvO ' '' G Q7. INSPECTION RECORD OUTLETS OVER u.. 5 PER SYSTEM .30 CD an check fee See Reverse. PLUMBING PERMIT ISSUING FEE S TOTAL FEE (} (7 check applicant .APPROVALS _ DATE INB PECTOR'9'SIGNATURE / yUNDER SLAB WORK e r 3 1/... ROUGH PLUMBING eSS/o GAS'PIPING el. No Q GAS VENT HOT WATER HEATER HEREBY ACKN LEDGE THAT I AVE THIS APPLICATION TATE THAT HE ABOVE IE CORRECT AND EE TO COMPLY PLUMBING FIXTURES L COUNTY ORDINANCES AND STATE LA REGULATING GAS TEST EREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED ED .AS REQUIRED BY LOS ANGELES COUNTY AND STAT OF RNIA OR THAT 1 AM THE LEGAL OWNER OF, AND fATETO ' IN THE ABOVE DESCRIBED61151DE TIAL PAO.PERTY. FINAL TU RE ERMITTEE -PERMIT VALIDATION CK.' M.O: CASH, ECK VALIDATION CK. M.G. CASH _ 5 76AES7 DBS» 11-so APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES L - WILLIAM .I. FOX, CHIEF ENGINEER FORA 6- DISTRI;rNO. Ci OUP Z ERM PIO. PLUMBER l U IVI a I RE IVSD BY READY FOR DATE ISSUED S 2 ® FIRST INSPECTION 3 ADDRESS 1� 1� 7 PfIR®ft AVE. BUILDING SA*Ig'AgRjEL . ADDRESS CITY 07 /o COUNTY _Cz LOCALITY /(� ZY LICENSE NO. EXPIRES L Of NEAREST PERMIT FEES CROSS ST. NUMBER TYPE of FIXTURE OR ITEM FEE OWNER .37Vi/ MAIL WATER CLOSET(TOILET) 0.50 6 ADDRESS a BATH TUB 0.50 CITY TEL No. SHOWER 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 APPLIGAT113N AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK 0.50 AND STATE LAWS REGULATING PLUMBING. ICERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER OF THE RESIDENTIAL "ROPERT—lYPEBORIBEDAOVE. GAS SYSTEM OUTLETS @ 0.50 BIBNATURE OF WATER HEATER @ 0.50 PERMITTE SLOP SINK @ 0.50 INSPECTION RECOR FLOOR SINK 0 0.50 _�y FLOOR DRAIN @ 0.50 N DISHWASHER @ 0:50 /% 7c'e �� 7'0 f-4 "q � DRINKING FOUNTAIN @ 0.5 G ' URINAL O.•5O Q HOUSE SEWER @ 0.50 �l U ,�v z MISCELLANEOUS CIO 'q �re'4ie +T r vtoe ci, O APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 1.130 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ) PIT C ) @ 1.00 SEWER PERMIT I 1.130 GAS TEST ��U�TILITYC13.NOTIFIED TOTAL FEE---7 7- Lam- �► c bG�a►:.+s�s�. 7GA337,(CE-S17) - 1/75 APPLICATION FOR PLUMBING' PERMIT , COUNTY OF LOS ANGELES .' . DEPARTMENT OF COUNTY:ENGINEER ,BUILDING AND SAFETY DIVISION BUILDING � MAKE CHECKS PAYABLE TO: , ADDRESS . HARVEY T. BRANDT, COU-N.-TY ENGINEER' LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST J � ' CROSS ST. L NUMBER FIXTURE OR ITEM@ FEE- WATER EE WATER CLOSET 2.00 OWNER-MAIL WNER ,MAIL , @(� r. " BATHTUB 2:00 ADDRESS-.��j�ij .SHOWER 2.00 CITY - NO E!! :9 LAVATORY 2.00 CONTRACTOR. SINK 2.00 -ADDRESS '✓n DISHWASHER 2.00 CITY / TEL. NO. CLOTHES-WASHER 2.00 STATE / LIC ' LICENSE'N0.' CLASS• SWIMMING POOL RECEPTOR 2.00 DISTRICT!40.[G ROUP ZONE PROCESSED'BY LAWN SPRINKLER SYSTEM 2.00 WATER HEATER t e2r66' S INDUSTRIAL -WASTE APPROVAL, GAS SYSTEM OUTLETS 2.66" Q 0 INSPECTION RECORD a ':OUTLETS OVERCD 5 PER SYSTEM • -.30 v O ' v y Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ ,,tr-- TOTAL FEE (' sa.� Plan check applicant APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB'WORK Name <5, ROUGH PLUMBING Address �. � � GAS PIPING City �� GAS.VENT.. el:'Np. oe HOT,WATER HEATER 1 HEREBY ACKNO LEDSE THAT 1 VE �AGREE APPLI'CA TI ON - AND STATE THAT E ABOVE I'S,CORRECT TO COMPLY PLUMBING•FIXTURES - WITH ALL COUNTY ORDINANCES- AND STAREGULATLN•G, s GAS TEST.' PLUMBING. - ' I HER EBY.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 AAA. THE LEGAL OWNER OF, AND.fA 7'E TO o " RESIDE IN. THE ABOVE DESCRIBED R IGEN)IAL + FINAL SIGNATURE �� •- ' OF PERMIT-EE PERMIT VALIDATION CKI. 'I M.O; ASH•.:. PLAN CHECK VALIDATION• CK.' " M.O. CASH ' SEP.26; , :D. 1'0.5 0.A5$ 76AG67C (C6-8178) -9/75 APPLICATION FOR PLUMBING PERMIT. BUILDING AND SAFETY DIVISION ' FOR APPLICANT TO FILL IN_(PRINT OR TYPE) ADDRESS / b LO ►� S� r NUMBER FIXTURE OR ITEM_ @ FEE WATER CLOSET LOCALITY e r BATH TUB NEAREST CROSS ST. SHOWER OWNER �1 LAVATORY MAIL ADDRESS O fo 3 L� r ig5--� SINK CITY' e Ce TEL.JVO. _ 0307 DISHWASHER CONTRACTOR If PDO C O CLOTHES WASHER ADDRESS ., f V G SWIMMING POOL RECEPTOR LAWN SPRINKLER SYSTEM CITY �-� TEL. NO. STATE LIC y WATER HEATER LICENSE NO. Q CLASS DISTRICT NO. GROUP ONE OC D BY v GAS SYSTEM OUTLETS �� CD CD OUTLETS OVER 5 PER SYSTEM INDUSTRIAL W 1 WASTE APPROVAL y �� 1r INSPECTION RECORD e..-7L Plan check fee PLUMBING PERMIT ISSUING FEE $ • TOTAL FEE Plan check applicant Name APPROVALS DATE INs TOR' s•�G�gTURE 6 Q/S ` d UNDER SLAB WORK !'. .f+'1 - u Address / C� G a(��N S /-r1 ROUGH PLUMBING City tAl jq- / f"-:IIL- Tel. No (� _l2/j" GAS PIPING I 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. I HEREBY CERTIFY THAT I AM PROPERLY'REGISTERED AND/OR PLUMBING FIXTURES i7 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS'TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO r RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED - SIGNATURE e OF PERMITTEE �f, FINAL PLAN CHECK VALIDATION CK. M.o. CASH PERMIT VALIDA 10 cK. 0. CASH " , -dc,/.� •rid /S' � 76%607 17 U-so 0, APPLICATION FOR PERMIT . DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERtAIT NO. /,may `r3 � �I� s 1�+.la +J•', PLUMBE �/�• „ 1F RECEIVED BY READY FOR DATE ISSUED �. FIRST INSPECTION ADDRESS.-lJI �- �? ``��I,r. �✓'? s y t. '`' q BUILDING r OO� CI �_ �� C'.>• `j TEL. NO �O(�v,J ADDRES Ye-7, , .H L CENSE O. i EXPIRES LOCOUNTY ALITY .1L' ,,^r •r �% NEAREST PERMIT FEES CROSS ST. o,A NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER Aut�Q� .✓�� MAIL WATER CLOSET (TOILET) @ 0.50 S ADDRESS BATH TUB @ 0.50 I 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 AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ 0.50 STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY Q 0.50 ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER OF THE RESIDEOPERTY QUCRIBED ABOVE. GAS SYSTEM-- OUTLETS @ 0.50 SIGNATURE OF �.�Cr�`a=6`-a��. WATER HEATER @ 0.50 PERMITTE SLOP SINK 0 o.5o INSPECTION RECORD FLOOR SINK @ O.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50 DRINKING FOUNTAIN @ 0.50 URINAL @ 0.50 a -J O I HOUSE SEWER @ O.SO .lam Q Z_ MISCELLANEOUS UI Q: O I APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 1.00 CESSPOOL r' SEPTIC TANK: i SEPTIC TANK ;a DRAIN ( ) PIT ( ) @ 1.00 SEWER /•.�' PERMIT . 1.00 GAS TEST , i _ UTILITY CO. NOTIFIED TOTAL FEE FINAL F APPLICATION FOR PERM DEPARTMENT 'OF BUILDING ARID SAFETY COUNTY OF'LOS ANGELES -p ELIUMBING, I WILLIAM J. FOX, CHIEF ENGINEER FOR. APPLICANT TO FILL IN DISTRICT-.L140. GROUPI ZONE PERMIT NO.-- " -2 .3. .. PLUMBER . . RETE D E FIRST NSP� TI - 6 ASS . V . � BUILDING CITY i TEL..NO. ADDRE39 ex _ COUNTY g z LICENSE EXPIRES LOCALITY I NEARlsj EST PERMIT FEES CROSS Sr.- NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL A/ WATER.CLOSET (TOILET) @ 0.50 >6 ADDRESS (J BATH TU.9 0.50 CIrY TEL. NO.. + SHOWER: @ O.SO _ -1 HERE Y ACKNO LEDGE THAT i HAVE READ 'THIS- ' I LAVATORY•(WASH BASIN)` 0.s0' ' APPLICATION AND.STATE THAT•'THE ABOVE.IS CORRECT AND AGREE TO.-COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK 0.50. STATE LAWS REGULATING PLUMBING. I .CERTIFY THAT 1 POSSESS THE ;ABOVE JVALID LOS LAUNDRY TUB OR.TRAY @ O.SOS - ANGELES COUNTY 'LI LNSE, OR I AM THE L 'AL OWNER OF THE RESIDEN-Y 1 OPER. DESC OVE.: ��xts sxs�EM,w- cv a=FX6 @ O.so SIGNATURE OF . WATER HEATER @ 0.50 PERMITT -SLOP SINK a o.no.INSPECTION RECORD FLOOR SINK Q 6.901 _ - FLOOR DRAIN @ 0.50 I ey4 DISHWASHER 0.901 r Y >s t✓�rJ' �+'/�' DRINKING-FOUNTAIN Q 0.901 URINAL Q 0.50 I ,rs A!b.7- 7•Yf fel iu'.�/•y?'Li' HOUSESEWER @ O.SO.'.. a� � �!. �� < MISCELLANEOUS APPROVALS DATE INSPECT'OR'S NAME. ROUGH PLUMBING -GAS PIPING ! ., GAS VENT CESSPOOL @ 1.001 CESSPOOL SEPTIC TANK.- •'SEPTIC.TANK = ' DRAIN ( ) PIT ( ) @ 1..00.. :SEWER _ f PERMIT . 1.00 GAS TEST ' TOTAL FEE •7• �' ,` UTILITY CO'. NOTIFIED V�v V FINAL I J�.YrG��r-, ✓1 I WORKERS'C.OMPENSATION.DEC.I.ARATION l 176AS67A • - I hereby a firm thai I have g ceitiPicate of ¢onse4it to self cr e17(a-eoj'> A P P L,.LC A T I N FOR PLUMBING PERMIT % or dl�rtificate of Workers'Compensation Insurance,or a'4 ertified`copy thereof(Sec.3800,Lab.C.) T COUNTY OF LOS ANGELES T r BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FNUMBER R APPLICANT TO FILL IN (PRINT OR TYPE.) BUILDING ADDRESS Certified copy is filed with the county building inspection FIXTURE OR ITEM FEE �� department. LOCALITY Date Applicant ! WATER CLOSET NEAREST BATH TUB CROSSST. CERTIFICATE OF EXEMPTION FROM WORKERS' O5 -14 COMPENSATION INSURANCE SHOWER OWNER /� LAVATORY' MAIL 0� � 1OR4 5 ' } (This section need not be completed if the work involved ADDRESS 6. d by the permit is foi one hundred dollars ($100) or less.) SINK CITY �� TEL.NO '03 I certify that in the performance of the work for which this DISHWASHER M permit is issued, 1 shall not employ any son in any manner CONTRACTOR 0 so as..t+�oo�become-sub] t to the W rkerq n ensation Law CLOTHES WASHER ADDRESS Datej _Qicant SWIMMING POOL RECEPTOR �� LU NOTICE TO APPLICANT: If, after making this Certificate of CITY TEL.N "�. N Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. 2 Compensation provisions of.the Labor Code, you must forth- WATER HEATER LICENSE NO. `e_ CLASS _4___with comply with such provisions or this permit. shall be deemed revoked. DISTRICT NO. PRO BE BY GAS SYSTEM OUTLETS ,r LICENSED CONTRACTORS DECLARATION OUTLETS OVE..R E7 t Qe I hereby affirm that 1 am licensed under provisions of Chapter 5 PER SYSTEM FINAL 9 (commencing with Section 7000)of Division 3 of the Busi- VALIDATION ness and Professions Code, and my license is in full force and DATE _ al / e effect. FINAL License Number Lic.Class BY Contractor. Date 0 I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Lic.or Reg.No. Date Plan check applicant o a o a o r- HOME OWNER-BUILDER DECLARATION Name u u 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 r C. ' ness and Professions Code): I, as owner of the property, am exclusively contracting ii 2'3 with licensed contractors to construct the project (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 read this application and state that the above information is correct.I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE ordinanc tate laws regulating Plumbing, and hereby ` Naut ri a repr tatives of thi County to enter upon the io property for i action purposes. r" �V Signature of Permittee Date . �V1IOhIcERS�COMPENSATION DECLARATION �� APPLICATION OOR PLUMBING PERMIT I hereby a'IFfirm thW I have a certificate of consent to self 76A667A - ing,um, or certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) �� or a certified copy thereof (Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES, BUILDING AND SAFETY - Policy No. Compan ❑ y Certified copy is hereby furnished. BUILDING a `` ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS I®6(3.3 �� ® $ Certified copy is filed with the county building inspec- tion department. 1 NUMBER FIXTURE OR ITEM @ FEE LOCALITY J �/ j Date Applicant ( WATER CLOSET NEAREST �O CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS S7. COMPENSATION INSURANCE I SHOWER WNER V'lJ ,fes I. (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) r LAVATORY ADDRESS ov I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL.NO. �sO as to become subject to the W rke Compensation ws. I DISHWASHER 1 CONTRACTOR Date - pplicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of 1 SWIMMING POOL RECEPTORon Exemption, you should become subject to the Workers' CITY TEL.NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY GAS SYSTEM OUTLETS I hereby affirm that I am licensed under provisions of Chapter 9 I r (commencing.with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. . i 5 PER SYSTEM FINALA VALIDATION O License Number Lic. Class TE 2-/2-1 IN FINAL O Contractor Date Y U UA ❑ I am exempt Under Sec. 0.CA B,BP.C. for this reason Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ Signature i TOTAL FEE SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. (Lr�l I, as owner of the property, will do the work and the 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 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 aboventioned�property inspection purposes. �d _ o SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date . WORICERS'tOhave a4TION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby.affirrti that'l have a certificate of Consent to self 764667A n insure; or.a certificate of Workers'Compensation Insurance, CE817(REV. 10/81) K` o rt'fi t ereof (Sec, 3800, Lab. C.) COUNTY OF LOS ANGELES / BUILDING AND SAFETY bSC � 'C A Policy No.. Company Aetna Casualty & Surety Certified copy is hereby furnished. BUILDING ® FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS 10663 E. Lora Certified copy is filed with the county building inspec• NUMBER FIXTURE OR ITEM C� FEE tion department. SERVAMATIC SOLAR LOCALITY Tem le Cit Date-9/16/83 Appli4ant SYSTEMS. .INC. WATER CLOSET NEAREST ,e CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB CROSS ST. COMPENSATION INSURANCESHOWER OWNER MOSCAL, WALTER .& MARY (This section need not be completed If the work involved by MAIL the permit is for one hundred dollars($1'00)or less.) LAVATORY ADDRESS SAME I certify that in the performance of the .work for which this permit is,issued,I shall not employ an person in an manner SINK CITY TEL.NO. p. P Y Y P Y 448-0307 so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR SERVAMATIC SOLAR SYSTEMS Date Applicant CLOTHES WASHER ADDRESS 20290 E. Caere Road NOTICE TO APPLICANT: If, after making this Certificate of y Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY Walnut 91789 TEL.NO'595-7433 with comply with such provisions or this permit shall be STATE LIC. deemed revoked. 1 WATER HEATER solar 20 loo LICENSE NO. 390645 CLASS C3.6 S.C44 LICENSED CONTRACTORS DECLARATION DISTRICT NO.• OCES.SFD B I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS ,n r/ (commencing with Section. 7000)of Division 3 of the Business OUTLETS OVER d .and Professions Code,and my license is in full force and effect. 5 PER SYSTEM - FINAL � VALIDATION O License Number 590645 Lic.,Class C36 SC44 DATE J�� Z. cc SERVAMATIC SOLAR .SYSTEMS. 9/16/83 FINAL 0 ` Contractor Date W ❑ I am exempt under Sec., !>L B.&P.C. for this reason. �/Q . Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ 10 5.0 ) Signature 30 50 TOTAL.FEE , Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name sa5 4 4 6 A I hereby affirm that I am exempt from the Contractor's License Address c o 0 0 0 Law for the following reason (Section 7031.5, Business.and Professions Code): City❑ Tel. No. 6��. ° wt r;•�� t5 I, as owner of the property, will do the work and the .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.), LendNONE er'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 ove-mentioned:pro erty f inspecti purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE /16/83 Signature of Per itte Date '\, 't