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1301 GLENTHORPE DRIVE (14)
__ws __. .rr_ �_,. _-� . �; - � � �.�-� � �x� � ,��,� ;�`�� , f '� � � A P��� A /� _",� W612TCLRS CON"CPEN�SAT�1�N '.:A7"I" N ��`" :.76A64�D � ��/y...m�y N,�,�,P'4V y�{ PE��R M IT ^_ q�. F CB 808(2-8QI Y s sysw�s � ��.._� �t�-' �.���:� �`*����..�� � �� �� �� " a�'� �IEWER-SEWA�E DISPOSAL "»hereby afFirm tha C ha e a cgrf f�ca e o ;�consent to�se��f z .: .�„'., . �. ,. , .._. v.�.�,�� ��� , � �.,,��, �,,,,,�r. "�4sure o"r'�ce 4t�fica te o Y V`�or kers"C o m p�n s a t i o'n I n s u x a n c e,o r COUNTY OF I.OS ANGELE$ , B U I L D I N G A N D S A F E S ;ceit f e�d c�o�pv t_ hereof(Sec 3800 Lah C) ���n ' � �- w''- , L� ,�` �..J'A�� Jc,�d� �o�pany _ L'Omm. . �m .,.,:.. .. . . ' � " ' ' "' '` �" � 7R CpNNECTI�N DATA� 7 � �.� � . �' se. ,,.z�,e.�s.a�., �wgxr„�....,'r ,..:; FOR APPLICANT TO F(�-��. .��,: ,�',� Certified copy�s herebv furmsAed � .au��ninc �� �z q ury '�}'�"""�'"" '�"'��^ �- �.-Y �'¢ .. �. ., . �:._m..V x +• _...._��.k .;� ., �._. ADDRESS �JO 1 V��rT�.IXOS�Q�.P/1.�A TION � ` ' TH M '. _ STA DE � '� Cert�Fied copy u P}ed wijh S�e county�w'�dmg msp8ct�on . . . . � tt�% � a AQpNtIREt1S (� " �r ,{ y y� �v .40CALITY ' J . HOLE REFEPPNCE �_ �� M,qN i..�'13SE ���.��A.4�PC�rICflnSGSBO♦ Q� �.4e'S4 W,UOA ... ......<_�_, __.x-..-....:=�«.p;.-Hmanamaa:rm�aasa.+�rx... °rnn TYP50FCOf�NECTm LENGTHRRO��O .,» „ _ � � NEARESS . -' CRO55 ST. , Y.. CC1RB P L M.L TO P L' ,� CERTTFIC4TE OF�EXEMPTION FROM WOIiKERS . -._,......,.- ,��.,�„.,..„..r,�,,,. � , . - .c.no. t :; CC5'NPEN5 TION�N���� �.. ownen �OT6(:S �� � - � co.in+ o ...._ tlF oe No � ��� �:-�� � �����9& �r��y�S'�'�'.�"�'an9$`y�a�l - 't . . "»"" . . , .... ...,.aw�....F��aa�,x�.rrea � ^:y ...MAIL - . Y �T�IIS $0CU01.1 �eed not,�e CO111p LCtCl4 lf t�2 WOIK I�1VO�Y�Q AOpKESB ' � �' � � TAUN PER[dIT.NO ROAO PERMIT N� ow'iE .... ._ . �v� oy the pecmrt.v�is� foi�otnne hundred dollars($100)ox legs) ; "' """'""'""'"'"""'""""`""'"�`"�"""*'°� . � 0.�� � ""- v r o V wwNE P ,I: ��P <in�33-�.+�'� S �� .'� "F td'� � .: ITV ..'. . ...., TEL.NO. I U I certify that in the per£ormance o4 the wor�tt,for w��ch this �y; �e�nr. ' � �--- �"`"" o£SCRIPT[ON 40T N,O � aa[aAc+',90 . � permrt�s�s5u�d Y shali not employ.any�Erstln m anY manner , �� •�- --•- �� �-- HwY.oR sr.w�oe � ,. Q s'o as to become Sub�ect to the Workers ComDensation Laws � � �� ¢�'� �� � .• 4 � � ti� yy . 8{.OGK � TRACT �TNpRO�' - .... � ;. ;� ,�;���,�x a�vu 1� Pr�S 3� � : STAT AGXM'E�51' M1l0 fY'P"8LGG9. „".�""- 'PERM y�bate PPGcant „.�. ...,. . � .._ ___. �.. p�, ,F N�T�CE T� l�PY.�IC� If afte�making tYi�Cect3fiCate of '? size oF�or _ rvow aN�or� � v� .....,�„�_. .,�..-F.�. . 3..,i:.'5�.,,w.�-� .,. ,,,... ... . . ,. .._ .,,.....,,m»�.w..e.w Z f�xemPt�on,- you shou�`becorrie_subJec�"fo �be �i�orkers use oF . ,�., �� BUILOIN.65� .� . - .. C�OIII�PRSLt10R[ICOVISIORS OP YIIC,LfihOi CQCI2a YOU I1lIl5Y FnILIl �., -�:�--.. .- .�. � � CONNE4TION CHARGE FEE "�ri�it6 complv vfth such provistoqs or th s..permtt shall�be _: eorvrewcrae OII - - — �deejned re�oked � _. . . . "^"`°"`"""""'"'"""`"""°:�`� '��'i � �'�.tCE�N"SFD�CO�I�'T��AC'I�ORS d'�CtiAAATYOtY "' �� woor.Ess_� �{ba �OT22"lS& £3"�:� .:.. g ❑R5e � , .. ss . ,. ,... _ ,....... . ,. , a er`no.� ,I hereby al'tirm f�iat�i'am ficensed un er prov'�sioas of G�apter � G�ry �����Q��� t,�� a ���j��y�� /� REI ENT E6 , . � ....«, , o�r� Ro P —......», oc�.�,.�a§'v� ., ..-._.:._ aw / �(, � 9 (commencing with�.9ect�on 70,�0)of➢rv�sion 3 of Che Bus7 . . . . _ .__., „..,,..,,�,,.. .„,���,.�.�.�. � -� � �� .. , STATE +7 p `R r;nes6'a15U Prq�ess�otts Code and my�cense is in full fo5ce�gnd ,,,y ��cE�rs�'.e:,�To��`1' � `•�fl �' �2 __ _ _. ,,,. - ..-.-.-. - P. `� a �'` '� � V�'� Finw�. �, VALID ION effect - � .rvo besCtt7aT�oN6x'wcrtt�z K��" .. ..��we car �� c ro - . _ . _ ..._...._....... ��License�iui;?ber 76�,a��_, Ltc Class .�� _��_ " �1 �o RATE l'25�� � �.,. Y �dSe� +k :'� {°�,�g' "�4'rt'i+�rs: i 4 .c E"�M1C%v`"L-�dtk O° ' . _ '" ' 8— �0 � ! F �Contractor �ate - . FiNA� ���� -, H"`+rv` Ng�#,*'"4''?Ek`i, "�,{'X/' UBE. 4i R O N tb � BY ���� .. ...;->y.w,'`Ti.�d,%� .��'..:.�,� .kst.�'.�-^'�" r is s s n. ., . . , . . . __ I am exempt $om the licensing requirements a`s�T,am�,`,a„ ," � r 7 eensed azchdec£Ox a re@�stered professional angineer � o s'e�r: � , . acting::in my pro°t�essional capacAty (Seck�on 7051 �Bus g �'�'�'�T"�`�� "�`� . T E M1fRN'ti �.-�� lIICSSSIIaP��C5510�8�OdC1 V E .� iYA4 aU�MYiO .. . _ . f R e ' s�wE.w r , .. �. --F:Lec o �Leg��Mo�•hd r5"��.a„ k t'� � �ate Y . . . . . ' r t�z � 1 s . .�� �,^�,��a.'�"�' 'E . � . .,- . � . . _ H�MEO�WNE`�R�BIJI[-�fk�'�ECT.ARATIq'�� �� ���. ^. . . � . �„ ���` �f;�g".� ���'� '���t'.�� ��' � OWNER S.�. Permit.. s � �� �AI hereby affirm that 'f am exempY from i e �'ontvae#or s _ , � �L�cenae Law for the fo�owmg re9son (Sectio� 7031.5.Bus� .i AUTHQRIZATION TOTAL.F�E �. � , � 'ness and Prgfesstons Code�` � �� ' '�- ` - �� '1Q- � . .,ry uz.��:, .. . -k:. .�,k. ,A< r m �,�-�.,���,���"�w� c 4 3 --'�'� I, as�owner of fhe properry,wiit do.t6e workeand,the ���,� o rNe au,e.�.io ,w„ "r,,: . .._..� ,,, -- �-- '� c n ��{ ,, strucfure is �ot,mtended;or offered,£or SB�C �SCCI1011 SIGN6q'THIS �A?'�P � �9�— .. . . f. " ��-_��� oo4a`BuamessanA hro�easions�de) ww �� � I ;h�8 �J # , P �'coN�ricrtc'rro�r�t��tfvc a�G`��rc�r` �.-�.�....,_...�..,.� � � � � �I herebvJaff�rm that"there 3 s„pon�uct�on lan�dmg agenc � �,� _�����.�� ;. �„��,.gxi�,.- -. -.. �?�,�t�.��.�..�,y�___.p .�for the performance of the work foc�hch,th�s perm�t �5, � '� � � ' ti�ssued(9ec.;309"j.Civ:,C). . ,.:.. . �__,_ � � ....�, :�- - . . .. . ,;. .: �4� ���'�{�i "�Lende�s Name �` . � - ���� �,s4a'"+� ' ' .> � �:��.�,'����� y4 h h L.. � a t . " �e '`".a�'�' °'' . � ,. „°�:±�."� ., ,'' ,-: : `.�-.'Lendec s Add ess � � , �.�� �' . . :.. .' .' . ' " r ,_' _,.�, "� .�, �r�t� :swz�r�+�, `"�`�"�':��-`"���`;�'-e*��;" w�y'�'�..^,�„^rx �.r�^.�' «�.,.,�+^ �wt^. �. . n �.I cert�Py that 1 have_read[k�s,_application��d sta$e hat Y�„e � � ��� ����� � ,r ��„ ., ..z.� .,,..,.., .�.. .. . ,..9.«,: ,.-.,m,...w .,�, ,e.�„��.-.r.a. .....,. -above informat on�s corre�t I a�ree to comply w�th aI1.C�ur,tv `�N+*'����iwh��M��'..'� .����.�.�� �.�����LL �M��. �_�.� � .'��.�' . ��'ani1,hereby auiho���e�represenfateves ofrth btion ur osWers, � �� � ' � ` �-� " � � - � ' g m and Se , � �, .,.. , . _ . .. . . . . _County io enter _ : . , - , �„ ., ., �S . . ,-tipon Che abo e-me tione�properl}Sor mspec, p P �g@E REVERSE FOR EXPLANP,�,TQ�.RY LANG�GE � � ������-� �"'a'�' �O . �_.., .t, � :� ��� ����........�..n Signature of Pecm�ttee Date - - .,t...�&'4 a., f ; i , 3y��_�� 't�a . _ ., . . . I _ . . .. _ � � �.�a 3"r�-',�'�.'"-�'� ��'�T. `:-�'a����"-��'° �E3 �?�4i.`�.C,'°;[ �i'�.� �."� t `� . ,s� . �� 3 , 0 � ' .:. =,�.+ ....,r,.r.x ..�ze,�u»ri.n� .«an,�:a:��,� .-,.:.� �Y'���»'°��r��'�� »��',''�'"s "��'� «..+, :aa. g ' 1111SPEC'fOEi'S NOTES,_, „ .. . . . . . . .. . . � wx.,�.=-.a��Okk7V�I2-BUILDEIt DECLARAqI�N �' �' AF�PROVALS �:�' �ATE�-���INSPECTpRSSIGNATtJRE '�-- �'' � ' � . � � ,�- -��-,-- ..�- . --- ._. - .�. ;: � , � � . l hexeb af�;p}�that d arn-exemp�,fao�n,ihe Contrac4oi'� Y � License�I`aw for CC�e.fotlowing ee�aso`ii'y NEWHOMESEWER ., *... .,:" . ... . .. � .. . . . - ' /$2EPiO�F�7b3�1.S � AN r/DOki�DNK EOEP P#,�5) ..i' 1�i*.�-_ h =} .';i. �..,, .... n (_ �'` .<.�.., .. . . . �d�riiolish,qor ere aa'e�Panymstrucnere S prior t01�t O uSuO/3Cre � v ' ,r.. atsq.PeQPatement �t#tlt tie ers [cerrsed p umit zo file, ALTEA REPqiR S WER OR _ - `'`� t ~a �� �- � y �� � ea�6nS OJ�tN¢ COlftlYlCtOi'S L�Cett�s�e'LpStf(PTdt t0 tl7i �,#� _ CESSf�08't'"'l5�']RY ELL�❑ � "" � P -- - provi.r� . �iv�)ChaPter 1 SEWAGE DISPOSAL SVSTEM '"�" �C6)tlril2nCirtg WIf51 SeCtEoi3 7000 o Ddvision 3 of rhE DISCONNECT'PLUG AND � ' � �' 846iytEss attd PrOf¢SSl0718 COd¢f OY Yhat he is¢x¢rVtp� �'AaqNooN HouSE sEweR' �"`�' �--� ����� --��"'.-therefrorn and the hqsis for fhe alleged exemption:Any sAcKFi��"s'€PTiCrAr3k5'a"-�-'� ' " � - �,� �- � -���- �- ���- � � .. �v/otationofSectiox7031,S�.by�anyapplicantfoiapernri� �SEEP,PIT(S) q CF.SSraoLS O � �� � �-�_��� subjects ehe applrcant ro a civi!penalty ojnot more than ., �_ �.._._. _ _:.. �_ . . .. . �� ��.r z �� . c,L�;. z : ':; five hundred dollais $S00).: . . .. � �� ,., � � .�-- -- . .—.... ' �.., '` `�� �^> �'.^P,O;1,as ownerbf thepxope[ty wi11 do ttie��work,and �� � 3 ` , � �; �„, _, the s8mcture ie noi in[ended�ox ofiered[or sale. . --� ^�- - �= � fSec.�7044, Business and Profersions Code: The Com �. _.. .. T.,.. , ,_ , � � �� . . . ..- x .: � ,r.i ��� � � EracYo rzse n wn� _ __, ; �_ .� �._� ,., - �, r� Lzce � w does irot a'pfy to¢ o er-of �i � P -� - . ��' �� „�Yv�erty who bui/ds or improves therean;and wha does , .._............. .._.. _ ____ .� . �,� -._ . _.�-. �, �� � such Work himsel ' : � - �� � = —_-- . f provtded thnt SucH emprovements - - �-` ' � � '�"are`n6z intended�or o ered�or s¢le. 7,�kowever;'the�� __..__._.� _ .__.:., �_ .__ -..,. { p I ,. .,— �..._..J .f"'a'h.7, V'o-{ L f/. J f � � . : � � -� �' s� �� - ' . .. _ � building or iruprovement is sold within_one year oj� � • � „` �� completeorx the owner buttder witJ haye the burdere, '�-t+^' bd._ .m � �� ��� b �. � �. � M� b� ��. � - � oj provang that he drd`nor build or improve,for t:re � � - .:., .- . S ���,s' �"v� i z:3 � �fi, ��1 � �.r. � -, � purpose oj sale) _: � s �� �9 � x; .. � �,��� ��y y ,i. _ -,. ��T am exempe under Sec. __,. _.� " . . - --�- !-_._ '�> �k e,,,, v�'e+`< :� �.. �r r - , -� �.�. . . �� -� , .: ,.. ..; ,:,:... n'. �&P.C:for th�s reason�' ; Ta.y � � .:za `s> .�:r w� �„r?�,..;ek;�€sk��,t_,.s:.- - :,r�^ _ ��.....� _ . �.� ._.� ... _._:.. ,,� . : � r; t c � � � " . . , _. �_ - - �... ,� , _ . ... ,...4 _ . < r.,a-. ..�;,.,_u, . _ �. �, 'i 1 ��ete . J � . , . ,. .c -� r-_._.� . _��.. _.,.� �. .. . . .. � . �' , . .�.�. ,_ .. .,.;ti„. .�,:,:. ,»�,.x,.,,U,y«„�..w�w.3.»��, . .- ,. Y�..._, _ .:_ ; _ , : __ _... . .'. Owner .� �.. .., . _. �,. . ....., .�. _,�_ :.._._.,.�.:.._ __.�>.....� >_.._.._.�., � IMSPEC70R'S NOTES � . . �� . ..., . .... .... . . . . . . . . .� . ,. ...:�.. 3... . ,. .. .,.:.. ..� - L;.v .�:t;;.w.a�..�.i.r�{x�,:�. xr.�.ra�..;s�t.�=��sc'r...�=�.€i�-.. .,:;::.:�, , ,. . . 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