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Home My Public Portal About9625 OLIVE ST_Plumbing__ 76A867-CF-0817 5169 City of Temple City o0193 e ,r tl-.�laaLjl� �•• ' � � APPLICATION FOR PLUMBING PERMHT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS 9625 E. Olive JOHN A. LAMBIE. COUNTY ENGINEER WILLIAM A.JENSEN, SUPT of BUILDING LOCALITY Tem. 1e Cit FOR APPLICANT TO FILL IN CROSS ST. Temple Cl t NUMBER FIXTURE OR ITEM EACH FEE WATER CLOSET $l.as OWNER J• R. McDonald BATH TUB 1.25 MAIL SS Same SHOWER 1.25 CITY TEL. NO. LAVATORY 1.25 CONTRACTOR General Installation Co. SINK 1.25 ADDRESS 6558 West Blvd. DISHWASHER 1.35 CITY Los Angeles TEL. NO. PL 3-2541 LAUNDRY TUB 1.25 neGI AYION NO. C-36 151839 787 COUNAiTTYY CLOTHES WASHER 1.25 DISTRICT G NE P y ,E.SSED BY WATER HEATER 1.50 J C(��f/ } 1.50 INDUSTRIAL a GAS SYSTEM.-OUTLETS- WASTE APPROVAL 0 OUTLETS OVER 5 PER SYSTEM .90 INSPECTION RECORD 1 Water Softener 1 50 .. Ready for Inspection Now O a h _ Z APPROVALS DA�JEN INSPECTOR'SSIGf ATURE PERMIT $ 2 00 UNDER SLAB WORK 4 TOTAL FEE 3 50 ROUGH PLUMBING � GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 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 PLUMBING. HOT WATER HEATER I 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,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESIDE�L JjQ �� UTILITY CO.NOTIFIED SIGNATURE OF PERMITTEE = FINAL ALIDATION ROBERT A''WOOD CK. M.0. CASH SUPERVISING MECHANICAL ENG'R Lt 1%.Jc7 Llr•:; ru'Z 17 5 D 3.5 0 `• 76LL A 6.67—CE 817 8/68 APPLICATION FOR P`LU /&NG RMIT. COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER , 01iVe FA DING BUILDING AND SAFETY DIVISION RESS, JOHN A. LAMBIE, COUNTY ENGINEER 6 E a COLEMAN W. JENKINS. SUPT. OF BUILDING ALITY TleCitFOR APPLICANT TO FILL IN PRNT OR TYPE) SS ST. Temple City' Blvd. NUMBER FIXTURE OR ITEM EACH FEE ' WATER CLOSET 1.50 O1 MR Jesse Me Donald MAIL BATH TUB 1.50 ADDRESS Same SHOWER 1.50 CITY TEL. NO. I LAVATORY 1.50 CONTRACTOR Pacific Installers SINK 1.50 ADDRESS 10920 E. Grand Ave. DISHWASHER 1.50 CITY Tem le City TEL. NO. 112-7Q7Q CLOTHES WASHER 1.50 StATE LIC LICENSE NO. 211$98 CLASS 0-20 SWIMMING POOL RECEPTOR 1.50 IDIS CT NO. GBAUP N SSED BY LAWN SPRINKLER SYSTEM 2.00 r D d CD WATER HEATER 1.50 1,50 I 6USTRI•AL O %TASTE APPROVAL GAS SYSTEM OUTLETS 1.50 // �I{N'SPECCTION RD v OUTLETS OVE 55 PER YSTTEMR .30 �l � h l/V(r, Plan check fee 25%.of above. See reverse. PLUMBING PERMIT ISSUING FEE S 2 00 TOTAL FEE 3-50 APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant U.kDER SLAB WORK Name ROUGH PLUMBING Address G S PIPING City GAS VENT Tel. No. H' T WATER HEATER 1 HEREBY-ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING G S TEST PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED LICE44 NSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL'OWNER OF,AND INT6'ND TO i;p R f®P RESIDE IN,THE ABOVE DESCRIBE7ENTIA ROPERTY. FINAL SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICAL EN•G'R. OF PERMITTEE PERMIT VALIDATION CK. M.O. CASH PLAN CHECK.VALIDATION CK. M.O. CASH �, 1 Arm3 2 2 4 eo DEC 31 5 0 3.5•Q i ,617 APPLICATION FOR PLUMBING PERMIT :1 CE 8I�8-BUMDDiG AND SAFETY DIVISION Department of County Engineer County of Los Angeles BUILDING �y ,•'- JOHNA.L.AMBIE,COUNTYENGINEER ADDRESS CASSATT 0.GRIFFIN,SUPT of BUILDING � LOCALITY— FOR APPLICANT TO FILL IN I CROSS3ST. OWNER � DIST ro. GROUP I ZONE I READY FOR INSPECTION MAIL ADDRESS �n,��a�4'/(_ �.�X TEL.NO. INDUSTRIAL CITY - - WASTE APPROVAL IS PLUMBER E r,, c, INSPECTION RECORD ' � ADDRESS CITY)�Q>:?__LJ l.irtC,C// ..// TEL.NO.69 / d (((,I!C LICENSE NO. NUMBER TYPE OF FIXTURE OR ITEM FEE 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 @ SI.00 CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 i GAS.SYSTEM @ $1.00 Ain ti F a A A A—%.1 . APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ I [ 00 ROUGH PLUMBING GAS PIPING TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT VVATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES 1 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 OWNER OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED REBID TIAL ROPERTYf f ' / SOF PERMI- _ 2�./ 4R FINAL - i� C-% - �~ ROBERT A. OOD, JOHN A.LAMBIE,COUNT ENGINEER VALIDATION SUPERVISING MECHANICAL ENG'R cic. M.o. `01 1 1 1 1 aUG 1 q. 3 2.00 �• RS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I herjej affirm that I have a certificate of consent to self in- 20-0026 DPW a/B7 affirmWORK sure,or o certificate of Workers'Compensation Insurance,ora CE 817(REV. 8/86) certified copy thereof(Sec. 3800, Lab.-C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC,W.ORKS Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM ADDRESS department. @ FEE LOCALITY Date Applicant ` WATER CLOSET(TOILET) bloNEAREST T CERTIFICATE OF EXEMPTION FROM WORKERS'. BATH TUB CROSS ST. / l AJ U COMPENSATION INSURANCE SHOWER OWNER gHVP' (This section need not be completed if the work involved by MAIL [ the permit is for one hundred dollars($100)or less.) LAVATORY V ADDRESS ROa Q I certify that in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so CITY`�lJhs e TEL. NO. as to b&I m subj ct td the Workers'Compensation Laws. � DISHWASHER Date v °2` �� CONTRALTO Applicant "� CLOTHES WASHER ADDRESS NOTICE OAP LICANT: If, aft ,makir g this C icate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY TEL. NO. sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM ly with,such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER fed,Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALID DATE /Z a License Number Lic. Class O FINA V Contractor Date BY ccO ' H ' I..am exempt under Sec. W �991L8A n. B.'6P.C. for this reason W ' Plan check fee • 0 5 - � Date: '' PLUMBING PERMIT ISSUING FEE$ # 0 0 0 0 Signature TOTAL FEE 10 1 o °2 8,5 O SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant o -,o28,505 I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and 0 621 -88 Professions Code): Address In 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 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 ounty to enter up n the above-mentioned property for' ction purp es. C SEE REVERSE FOR EXPLANATORY LANGUAGE Sign�Per Date i Z,: -4vORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I+hereby affirm fhat.,l have &certificate of consent to self 20-0026 DPW 6/87 G 1 insure, or a certificate of Workers'Compensation Insurance, 76A667A IILIII or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS I Policy No. Company Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADD ESS BUILDINGI l U s Certified copy is filed with the county building inspec- NUMBER FIXTURE OR ITEM / p tion department. FEE LOCALITYT� 1, �J¢- �l Zp 0 Date Appli4ant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER � ti� T W OWNER W1J2)0 4 '�,� T (This section need not be completed If the work Involved by the permit is for one hundred dollars($100)or less.) LAVATORY MAIL ADDRESS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner SINK �L� - CITY TEL.NO.,Z�� so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR 4�,fi/,iyl�7 Date Applicant ' CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY TEL.NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked.• WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby off irm.•that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER vv and Professions Code,and my license is in full force and effect. i 5 PER SYSTEM FINAL VALIDATION DATE 2 oe License Number Lic. Class I FINAL Ilk Contractor Date BY ❑ I am exempt under Sec. i B.&P.C. for this reason 'Date: Plan check fee ® � PLUMBING PERMIT ISSUING FEE$ o? Signature TOTAL FEE ' Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name. I hereby affirm that I am exempt from the Contractor's License ' °=a _ Law for the following reason (Section 7031.5, Business and i Address ,��_It• may, Professions Code): I City Tel. No. ' 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). i c I _ 5n a CONSTRUCTION LENDING AGENCY i CHOCK I hereby affirm that there is a construction lending agency fori _•1-! '�;� 1-, the performance of the work for which this permit is Issued =�- (Sec. 3097,Civ. C.). Lender's Name _ ,. . Lender's Address I �s� s s N ,.T a 5' 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'property spection purp ses. I SEE REVERSE FOR EXPLANATORY LANGUAGE Ad gr o, S' nature ermitfee Date + WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 20-0026 DPW 6/87 insure-; ora certificate of Workers'Compensation Insurance, 76A667A ILjI tif led copy thereof(Sec. 3800, ob. C.) COUNTY OF•LOS ANGELES 'DEPT.OF PUBLIC WORKS / e� Com an ed ram Y2 5 Polity No: p y El Certified copy is hereby fun iishe . FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING /&C� d h v� ,�/5Certified copy is filed with the county building inspec- ADDRESS (� �. tion department. /� ar NUMBER FIXTURE OR ITEM FEE LOCALITY �s pate —91� Appli4ant I`I�N�4J�� WATER CLOSET ■ NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB CROSS ST. COMPENSATION INSURANCE OWNER .R0°�- (This section need not be completed If the work Involved by SHOWER the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS s OL , VJgE- I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner SINK CITY TEL.NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date applicant CLOTHES WASHER N`..d ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ira > Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR CITY ^d TEL. NO. 4�1� Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM G �L j/�0��( '"�� with comply with such provisions or this permit shall be STATE LIC deemed revoked. WATER HEATER LICENSE NO. LICENSED CONTRACTORS DECLARATION t 1.�, DIST CT NO, ROCESSED BY I f ® `� I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS CJ r (commencing with Section 70b0)df Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full�f��nd effect. 5 PER SYSTEM- FINAL jam( LIDATION JW DATE License Number d3 �+ Lic. Class �� C.a Contractor P 11SAW10 IfDcit �0 T/ BY AL ❑ I am exempt under Sec. W BAP.C. for this reason �� " Plan check fee � Date: P PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE O Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address AG0T A Law for the following reason (Section 7031.5, Business and ��•� Professions Code): City Tel. No. 34t7 16.50 ❑ I, as owner of the property, will do the work and the 1 ITEMS structure is not intended or offered for sale (Section O1•A�. � , � 7044, Business and Professions Code). o CONSTRUCTION-LENDING AGENCY CHECK, 16.50 1 hereby affirm that there is a construction lending agency for ��'y the•performance of the work for which this permit is issued CHAKE .00 (Sec. 3097, Civ. C.). Lender's Name 0000-0001 10/24/89 Lender's Address 6395 f AM11:53 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 repre'sen.tatives of this County to enter upon the ?bove' ned prop for inspectn purposes. D^ Z wy? SEE REVERSE FOR EXPLANATORY LANGUAGE de. "&n-'VSignature of Permit e� Date leAlN�2 ��2 VJORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT !;I herehj$kaffirm 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 thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy cy No. Company ; Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- RE OR ITEM ADDRESS V i tion department. NUMBER FIXTURE FEE �( LOCALITY Date Applicant WATER CLOSET V NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. E/{ F „Gry COMPENSATION INSURANCE11 OWNER#gk, (This section need not be completed If the work involved by SHOWER V the permit is for one hundred dollars($100)or less.) LAVATORY / MAIL ` Q ADDRESS p. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner , SINK CITY"7fj �/ TEL.NO. so as to becom subject to the Workers'Compensation Laws.M Date• , DISHWASHER CONTRACTOR Applicant. &OWI=1�1i CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of I 01-y SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY TEL. NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. _PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS 151, (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER U and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL +7 VAL ATION License Number Lic. Class Q FINAL U Contractor Date BY a ❑ I am exempt under Sec. Q B.aP.c. for this reason Plan check fee ® CrCIL Date: Signature PLUMBING PERMIT ISSUING FEE$ Q S� Z • TOTAL FEE ^O Plan check applicant SINGLE FAMILY 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 Prgfessions Code): City Tel. No. AN4 8 7 8 A ' IICL�J I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section ® # 0 0 0 0 0 5 7044, Business and Professions Code). I ° °2 5 O CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for o o o 2 a 55 05 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 thi County to enter upon the above-mentioned property r' Pection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Sign• re of Pe ittee Date 'WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT `j,, lereby,affirm that I have a certificate of consent to self 20-0026 DPW 6/87 insure, or a certificate of Workers'Compensation Insurance, 76AS67A or a certified copy thereof(Sec. 38.00, Lab. C.). COUNTY OF LOS ANGELES DEPT.•OF PUBLIC WORKS l Policy No. Compony Certified copy is hereby furnished. BUILDING D ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS 8111 ' Certified copy is filed with the county building inspe ITEM NUMBER FIXTURE OR tion epa ment. CSD FEE LOCALITY WATER CLOSET EH Date ApplIq;nt - NEAREST CERTIFICATE OF EXEMN OM WORKERS' BATH TUB �- H a O CROSS ST, t9i� e I COMPENSATION INSURANCE OWNER (This section need not be completed If the work Involved by SHOWER /J DO /U'Cfr�f21 y'I� MAIL 2mlp-- the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this J - permit is issued,I shall not employ any person in any manner SINK CITY T p' 7 TEL. NO. . �G"� so as to be o7An bject to the Workers'Compensation Law DISHWASHER CONTRACTOR Date �a3 � plicant � CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: if, er king't Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY TEL. NO. ` Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. P ESSED BY I hereby affirm-that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS \/, /ti 4 (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER J V O grid Professions Code,and my license Win full force and effect. 5 PER SYSTEM FINA67 �� VALIDATION DAT License Number Lic. Class V FINAL Contractor Date BY Q ❑ 1 am exempt under Sec. LLL BAP.C. for this reason Plan check fee G Date: PLUMBING PERMIT ISSUING FEE$ Signature f �� 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 AC�°'� Law for the following reason (Section 7031.5, Business and ., Professions Code): City Tel. No. 3307 16050 fur I, as owner of-the property, will do the work and the 1 ITEM structure is not Intended or offered for sale (Section 7044, Business and Professions Code). ® TOTAL 146.50 CONSTRUCTION LENDING AGENCY OE K 16.50 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued .00 (Sec. 3097, Civ. C.). Lender's Name -OM1 5/24/89 Lender's Address 1 AN 80-08 1 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'property faction purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Sign re of P ittee Date