HomeMy WebLinkAbout0799A saTioNoectaenrioN qpp��CATIL111� FOR PLUMBING PERIWT
I he ehy,affirm thar I hove a certifimre of consent to self im �-�26 DPW 4%87 �
suf,or a ce'iificote of Workers'Com ensation Insurance,or o �6A6e7a
P CE BI7(REV.8�86J
�ertified copy thereof(Sec.360q lob.C.) CpUNTY Of LOS ANGElES
Policy�vo.73WC005047�mNATIOI�WIDE DEPT.OF RUBLIC WpRKS
� Cer+ified copy is ha�eby furnished. 48 TRACT42$78
� , FOR APPLICAN7 TO HLL IN(PR�NT OR iVPE) dUILOING
Ceitlfiled copy Is flled wlth the counry bullding inspecf�oo neoaess Z Z EAST BARKER DRIVE
deporfinenf. NUP,ABER FixruRE oR ire,� �a FEE icca.���Tv DIAMON➢ SAR
Dare 9-1-88 qpplican�EW PLUMBIIdG 3 waTee c�oser pouer� b 1& NEARpst
CERTIFICAiE OF EXEMPTION FROM WORKERS' 2 e/+TH Tue 12 ceoss sT. GRAND AVE.
COMPENSATION INSURANCE StiOWER 1Z O�`'NER $RLiHALEA LIMITED'�� "
(This a�ctbe n�ed�rot be compirted if ihe work Involwd by
1be psrmif i�for ona hurtdred dollora(S10DJ or I��s.) �qvnrORv MA��
ZG aooeess 1 1 AIRWAY AVE. SUITE N
I certify lhat in the performance of Yhe work fer which this per SINK
mit is issued,I shall not employ any person in ony manner so 2 12 I cliv COSTA M�SA iEL NO.85�-1��1
as to 6ecome subject to rhe Workers'Compensation Lows. 1 pISHWASFER (�
conTaacro�EW PLUMBING CONTRACTORS, INC
Doie Applicant CLO7HE5 wASHER
NOTICE TO APPIICANT:If,after making this Certificate of En- 6 Ao�aess Z1(yl S. DUPONT DRIVE
emplion,yau should 6ecome subject to the Workers'Compen- SWIMMING POOL RECEPiOR
satlon provislons of ihe Labor Code,you must fonhwith comp- CiTY �T�jIEM TEL NO.f337-39]2
I with Such P� LAWN 57RINKLER SVSTEM
y provlsions or Ihis mlt shall be deemed revok- S7A7E
UC.
ed. 1 wnreR Henree 6�� �iceNse No.426109 ciass C-36
LICENSfD CONTRACTORS DECLARAiION DISTRIQ NO. PROGESSED Bv
I hereb affirm ihal l om licensed under '� GAS SYS7EM OUTlETS /n `
y provisions of Chop�er (> 6' V
9(rommencing wilh Secfion 7D00)of Division 3 of fhe 8us�ness oUilE75 OVER 1 5�
ond Professions Code,ond my license is in full force and ef- 1 5 PER SYS7EM FlNAL 'r^1' �` VAtIDAT10N }
Sec+.
DATE ��:� b 0
tf<ense Number 42b104 Lic Class C-36 V
FlNAL " �
Conrracior NEW PLUMBING Dare 8-31-88 BY p
h
� I pm exempt under Sec �i�
[�
6.6P.C.for Ihis reason � ��
Plan check fee
oQte a�uMsiNc a�RMir issuiN�FEE s 1D 50
Signature _ ,� �,z,.
T07AL FEE 114 �� `.C � " "
SWGLE FAMILY Plan check o I canr -
HOME OWNER-BUIIDER DECLARATION PP' S��� �� R� ' ;.
I hereby offirm fhqr 1 om exempt from tho Cantra<tor's License Name � � � j �
law for ihe following reason (Secfion 7031.5, Business and ���-
Professions Code): Address
E. c � I =. . , _
� I,os owner of ihe property, will dp the work and the Cify Tel.No.
structure is not intended o�offered for sale(Sedion 7044, �'�- � � —�. --
Business and Professions Code�. �
CONSTRUCTION IENDING AGENCY �
I hereby affirm thal there is a constructian lending ogenry for � -
the performance of the work for which this permit is isaved
(Sec.3097,Civ.C.).
�Y's 14mf� _ . ..
Lendm's Rda�ress - - �
I cerfify thnt I hove read this opplication oad s�oie�hat�he �
abova informarion is correct I aqree to comply wi�h oll Counry
ordinances pnd State Ipws reguloting Plumbing,and hereby
aulhorize represen�a�ives of this Caunry to enrer upon the
obove-meMionad propany for inspxtion purposes.
����� �_�� ��_ SEE REVBRSE FOR EJ(PLANA70RY LAFiGUAC`,.E
re of Parmi e Date
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,
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�, .,,.., I �� i 0;' .P O7E5
0.PPROVALE OATE INSR€C70R'S SIOtIkiUFE ' �
�uvoEa s�ns wo�c _ - � ^.� � � I herWy aHirm thBt I aan eocaiepe hom tha CwdrroM'a
�ROUGH PLUf.f31NG Uf1BMB l�W }Or 1{if fOIbW(flg fBB8W1 ($6Gf10/7 7031.5.
� _.-_.. � �� � qofesabns Code). RrtY dty or counlY
�CA�P�P��'r' which re�uires s permiF to consEr�et, alter. improw,
�_casvENr � / �i demdlsd9 or repetr any structure,Rrior ro its issuance,
�HOTV7ATcRNEA7ER �.� ---- - alsorequUesiheappllcan�iorsuchpermtitofifeasrgrred
a�ur:+sir;!:Fixrur.ss ; statement thaf he rs licensetl pursuant to the provisions
� � —____._____�r.�.. oftheContractor'sLicerrseLaw(Chapta�J(commencirg
cas resr with Sectkn 7�00)ot DivJsfon 3 ot the Business and Pro-
UP.UTY LO.NOTIfIED M .._.____..—..�. �BBSlORS CO�@}O(fI18f IMB/8 6XBf7fA�tharefrom and the
besis for ihe allegetl exemptian.Any vioiaFion of Sectinn
� 7031.5 try anY appl�anr tbr a permi�sufijeCta tfr�appli-
�:FINAL s�
[„nfw•ow.�ront csnt to a civN peneky of rroi ma-re ther,�ive hundred
�. __�. dale�s l�oo!
�t INDUSTRIAL ❑1,A9 OW/qf Of tlN pMpB�ly wIG de ihf MOik,eM tha
�wnsre rwr�vai � sfruciwe la noE Interxletl or offeiad tor ade.
(s�c.7044,eusfness aAei Wofessians code:rhe Coahec
_��_ ror's Llcense l.aw doas rrot apply m an ownar of property
who buikis or impraves thbreon,and wha abes suCh N�rrk
____.�.r_ him�K provided thet suClr 7mprcivements ars rrot intead-
etl a offered for ssle.16,howerer,tfie buNdaig a im-
.--__-- provement la sokf withM one yeer of c�mpleFton, fhe
awner-builder will h9ve the burckn of proring thef he did
� not buih�or ir»prova�tb�tM1e pwpase of sele.)
� I 8fY!8%8filpt UI1Q8f S9C.
�� B 8 P.C.for thie reason
.___..�r.-_w____.^, DBte
���.___,____� Owner
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