HomeMy WebLinkAbout1123 FLINTLOCK RD (2) _..e._.___. _�___�._____�. ___._._,_.,._T_..___,__.__.... _..__ ...._ ..._ ...._...__.�_.._..._____..�_..,..��_.�_._.._.�_.__._..�___._.____._.�,
f� wo��s"c�w�sA*'°"°Ec�'R"n°" A�pLa.�/�►11p:N FOR PLUMBING PERMIT � �
� � I Fereby.affum thdt I hove o nn�El�eq�e af eonsear�o�etf � �y�� . . �
inu,re,ar a cemftm�e cf workec+•Coe�pemenan imurance. CE e�s cREv.w�m 1
or a cen st c tpheuagf�a�9406�. h.C,. �OUNfi�ff�i1FL�S ANGELES BUILDING AND SAfETY
� Pol ..�..-�_�'tl�af��Y � _.-- �I. . - --- �
h GeRifiedCQPYii�.I�bIDbY•EDrnifhSd: � . �.�.. .
f ❑ � FOR AEPj�`AL11'tO FUl ml WRINtCR lYkFl �pQ��� .
C-errNJed e9py ia lildd�wRM the eAvmy bviTdiap�i�uPeo-
C . nomtlepaRAwenR � . . U nulltt6,�[i sCttORf�RSTFM� � �E ��tt
iDsrte--�....��.,.APPIfGanr � - wl[�ItG1� . � �Qa6R8 St. �
� CERnFlCATE 9E�11.9N FRONG WqRKERS' ea7H ni8
GOMFFN �PINSURANC6 . �R . °� f' !/
(�(�1�qNi3n eNd rto(�6i. TpiN�d 1Enh�wbrk li�+rolwd br � �
� ll�irp�rm(f'ir(o7 bn�liqrt�.a.�onor,tsioox�.�.,..j �„ATaR„ ��
�� � I epnify ti8it in�htr p6rf4rmetl�e of rhe wwR fo.whieh rh�a .
1 PetrtRi�43ued,I.shdtkrmraMDtoYanYPPrsoninmrq�,manner STVK� [rtr ' ,��.No. S96�3�/
1: amo:ra6remne cub�ee�o�hD Wodmrs'Campensatlon laws. a�� �
- . CONTRACI'OR
� Ocro-� - � - °PCYspet� � qo�sNEswASh�ER .
NQ710E TO�AP%lQANT: If, cfflar mOking rhfa Gerttfieeta o1 ���� , U �E
� EXBttlpTion, yap �11oYk1�68Q�ine snb►ert Ib rha Warke�a' SmMMINti°ao��t0�
CCMRaA�Q1i0ryA�viSiGtID[ff IIiO�tqbOr.60de�►�mYA�forlh. UVVNSiRINKIERSVSTEM CITI - - 7F1.NQ��S�I�'�
wi� met�pYy wtt16 atrSb.p7ovl3}Rn! Gt �bis p6rmit thoil be S��� S l�� -/ f�
� daem4d ternkad wntER HFnTnc
� UCENSER GGNTRA�RS{)E(�LARATION . DISTRICT NO. PRIXISSED BY
I hQtDkEy 4Htlm thPW aelfiCRniqQ'wOd?tprDvi�p n4oiChaPte�V OASSr57EM OU7lES5 �a 6
�, (comm.4�RYpB�r�Ib SaU1C�70pQ�•�of(1�vieion�$of�thp�$usineas a�ACROVER .
andOrof6sf.�p�s�f7g,4nSImrll�neebiu+fuDforeacrideffea. svEasYssFM
q �� VALIDIITION �
Ucenee Number���-��-'3�'�- �+c.c�ms 'S� .� � � a
� WnnxforrAtsl.•i �+► �� pqre ��S� � . . g� - - V
O W
� 1 am e:empr under Sec. h
8.8P.C.fw this reaso Z
Plan check fee
� �a� PLUMflING4ERNIC�ISSIjiNG FEE E i0 ` .
Signpture-
IDTAtFEE
p � �� Plan eheck applicam � �
i;, SMGIE FAMIIY . . .
N Honne rnvNEQ.sunG�x uEcurunoN Name �7 8 2 9 A
,F � Ihere6yaffirmAptbumexemptframt4eContractor'alicense �drau ' •
& taw for ihe following.Qason{$pcnqn 7031.y Busineu and N• •,• • •$
I Vrofessions.Codtr�- Ciry Tel.No. , .
� ❑ I,ai owner o{the�propOrry,wUV do�he work qnd ihe , � � I • •3 0.5 0 �
structuro h not inCCnded or offpred for�ole(5«tion � � . ��. . . .. � •,• •.�Q,J��_
7044,BusmOss and Profbssiort�Gode}. � � � U �
� CONSTRUCfION LENDING AGENCY � . , . � O�.O 5��3
� I hereby affirm t}wt Ihero is e coraWcqon Idnding agancy fw � �
t ihe performanee of�hs tvo�k for wbxb thia pe+�mi�iy i.sued - . . �
(See.3W7,Civ.C.). • . '
k
�� Lender i Name � � , �. - � .
� leader_'�Addre�e . . .
I eenify t�qr I tqfe rocd�hia appUcption an�.stoes�ho�the ►
abave i�dOrmm�on is cQrteM�9�ceR rQ�.pmql�C wi�h aI1 Coumy
- ard�ncness a 5mre brvs rogv�onng�Plumhieg a��l�erepy � . . �
� aufhorize �� rei4tirqt ... lfiis Cq[�fy to�Odter upon fhn . . . . .
above�anp �trneeC y fae tns ennn pvrpase�. SEE REVERS�'FGB£XP.�i4NA74�RY lAMGIJAfsE
� �� �
igrMtu f Permiifee Oate
i • INSPEC70R'S NOTES OWNER-BUILDER DECLARATION
AGPROVALS DATE INSi'ECTOR'S SIGNATURE �
i UNDER SIAB WOFK - I haraby�affirm Ihat I am ezempl 4rom�lhe�Conlractor's
� ROUGNPLUMBING � . License �aw for'the following reason (Sedion 703L5,
j� GAS P�PING . � - 8uslnsss and Pro�essfons CadeJ:Arty Ufy or counly whicb
GAS VENT � . . requlres a permil fo[onslruct,aflar,7mprova,demolish.
' or repalr any structure,prlor to!is Issuvnca, also rc-
I HOT WA7ER HEATER . . . � � qolros The opplitant(or such pe�mlf}o Ale o s7gnedstafo-
I FLUMBING FIMURES � msnf lhal he Is Ilcensed pursuanf�o Ihe provfsions allhe
Y GASTEST � . , Confroctor�s l(Censo Law(Chapfor 9(commenUng wi�h
UTILIN CO.NOTIFIED � Sec7lon 70P0)o(Div�slon 3 of fhe Buslness and Protes-
I' . slons Coda)o�IBaI he ls sxempf fherakom and fhe basls
. ' � �c7 - . (or fhe alfeged exemptlon Any vfo�ofion o�Set}!on
I. FINnI. � ���[�r o�i yronl � , 7031.5 by ony applicanf ior a permif svb/ech fhe oppli�
� canf ta a civ71 penolty o/not more Ihon live hundred
i daua�s(ssoo�.:
INDUSTRIAL �" � � ❑I,as owner of ihe properly will do ihe_work,and ,
IWASTE APPROVAL � � � �he Stfutture IS nOt intended or offered for Sale.
J (Sec.7044,8uslness and Professlons Code: iha Confroc-
i
i . - . � , � for's Licenss Cow does nof apply to an owner af properfy �
� _ , who(wllds or 7mprovss�fhereon, and wfio does sucb
. , ,. � work h7meelf provlded}(�a�such Imp�ovemenls are nor
7ntertded w oHered for sole.If,however,ihe 6ulld�ng or �
- - Improvam�nf Is sold wlthln one year ol completlon,1he
I . � . � � � ' �- " - - ownervbuilde�wlll have lhe hurden of proving lha}hc did
p ' nof bulfd or Improve for}he purpose ol sale.) �
� .
F , '
,, , ,� ' _ . I am exempt under Sec. ,
I� � � � � B&P.C.for this reason
i •
I�� . ' . Date ' . .
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�: Owner
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� INSPECTOR'S NOTES
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