HomeMy WebLinkAbout0766A ' """"r"S""°"°�"AR"T'°" AppLICATION FOR PLUMBING PERMIT
I hereby„offirm�that 1 ho3e o cerrificote of consenr ro sel£in- 7�"��7ADPW 4/87 J�
sore,or a cenifimre of Workers'Compensotion Insuronte,o�o CE el7(RfV.Bie6) �� �
cer+ified copy iheroof{Sec.38Q0,Lab.C.J � � . � � L�
Pdl�cy t�o.7�WC005047�}(�(}�1J�IATIONWIDE COUNiY OP LOS ANGELES DEPT.QF PUBLIC WORKS
� Certified�copy is here6y fornished. , . , LATI7 2 ' -T�CT �
FOR APPLICANT TO FiLL IN(PRINT OR TYPE) 9UILDING
� Cerlified copy is filed wilh fhe counfy building inspection ADORE55 Z1�ZQQ $A$T SRYN`�AT$YN WAY
daparfinent. . � � � NUMBER FIXTURE OR ITFM � FEE �
9-1-88 �NEW PLUMBING 3 wAreR aoser�roner� 6 18 1O���TY DIAMOND BAR -
Da�e Applimn NEARESt
. �CERTIFICATE OF EXEMPiION�FROM WORKERS� � Z BATH TUB � 12 caoss sr. GRAND AVE.
- - COMPENSATION INSURANCE 2 � SHOWER � ' 1.� OIVNER ggp�LEA�LIMITED. �
(Thi�wctien n��d nof b�comp4Nd N fh�werk Inrolr�d br MAiI
}h�p�rmlf is br on�bundnd dollan(5100)ot{�ss.) (AVAiORY � 'j(� - qpDRESS 3151 AIRWAY AVE. SUITE N �
. I certify Ihoi in the performance of the work far which Ihis per- S�NK
mil is Issoed,I sholl nol employ any person in any manner so 2 12 [irv . COSTA MESA TEL.NO.8SO—I.00I �
as lo bacome subject to the Worke�s'Compensalion LbWS. 1 OISHWASHER (
coNreacTo�EW PLUMBING CONTECACTORS, INC.
Data �� Applitont ' 1 CLOTHES WASNER 6 AODRE55
�r""TICE TO APPLICANT:If,afrer making Ihis Cenificate of Ex- ?iGI. S. DUPONT DRIVE �
.tion,you should become subject ro the Workers'Compen- SWIMM�NG v00t RECEVTOR
� sa�ion provisions of Ihe labor Code,you musl forlhwifh comp� ��TY EINAHIEM TE��No�937-3972
.ly with s�th pr0�is�on5 0�ihis permit sholl.be deemed revok• �WN SDRINK�ER SYSTEM � .
STATE �IC.
ed. � . � ' 1 WATER HEATER 6 uceNse n,o.426109 C1A55 C-36 �
- � LICENSED CON7RACTORS DECIARATION � � Di57ki[7 n10. aROCE55E�BV .
� I hereby affirm Ihpfi om licensed under provisions of Chop�er 1 GAS SYSTEM 6 OUilETS 6 f D
9(commencing with Section 7000)of Division 3 of 7he Business ouitEis ovFR 1
ond Grofession5 Code,ond my license is in ful i farce and ef� 1 5 PER SYS7EM � 1 $� DA E� � �( LIDATLON a
fett.
License Number 4261Q9 � tic.Class C-3fi . V
� � � FINAL �� ¢
Cont.dcror NEW PLUMBING Dare $-31-88 eY
O
❑ ~
1 om exempl unde�Sec. w
� B.SP.C,for this reason -
Plan check fee �0 7 6 6 A Z
� Date: .pLUMBING PERMIT ISSUING FEE$ LO SO � #�� ° " ° °5
. Signature �- TOTAI fEE - �
114 00 I • 11 G.00
SINGLE FAMILY � Plon chack a I¢ant -
, HOME OWNER-BUILDER DECIARAiION PP � � � ° 1 j L'-U G�
I hereby offirm thpt 1 am exempi fiom the Conlroctor's License Nome • �
� ,�"`�.Tor�he follawing reoson(Section 7031.5,8usiness and ' - ��','� �—�s
- essians Cade]: � Address �
� I,os owner of�he propeny,will�do the work ond Ihe Gy Tel.No. � �
� stroUureisno�intendedorotferediorsole(Seclion7044. . .
Business ond Proiessions Code). ' �� � � � . , � �
, - CONSTRUCTION LEN�ING AGENCY ' - � � - � - -
1 here6y alfirm Iha�fhere is a construUian lending agenty for ' . . �
tha performance of the work for which Ihis permit is-issued _ � � � � � � �
� (Sec.3097,{iv.C.). . . . � . .
Lender's Name � .
lender's Address ' � �
� t cenffy thot I�hove read this oppfico�ion and stote thaf the ; , � ► � , �
� above information is correcL I ogree ro wmply with ail CouMy �
ordinonces ond Stafe laws reguloring Plumbing,and he�eby �- - � �� � �
aWho�ize rapresenrotives of rhis Co��ty lo enter opon Ihe , �
a6 e-menli ed property far inspection purposes. � � � � � - � �
���/..� g.3,�x SEE REVERSE FOR EXPIANATORY LANGUAGE
�b+`
Signotore of Permittee Dete � � ,
APGPOVALS DATE INSPECTOR'S SIGNATUFE v INSPECTOR'S No7ES � OWNE3i BUIIDER DECLARA'fION
UNOERSLA6WORK - .- . 1 h6fB6y afN(m tMtt 1 art1 Bxi'iipt kdn ltN COMfeCtofB
Lfcense law fw,tM tollowfnp reafon{Secllon 70,z1.5,
ROUGH PLUMBING � 811510@55 and Pro�esslons Code). Any c/ty or county
cnsPiawc- � - � ' � whlch requires a perm7t to consVuct�alier, improve.
cas veur ���. ' � , demo7ish or repalr any structure,prbr to its issuance,
Horwe.reFl HeareR - also rBqulres the appllcant lor sucn permlf to tile a sfgnetl
PWAIBiNG F7xiuflEs - � ' � : St8t6RiBnt th8t h87s IiCBn58tl pulSuBnf to 1h@ prOvlslOns
ot 1he Contracior's Lcense Law(Chapiar 9(commencing
cns resr � wfih Seciion 7000)of Oivtsbn 3 0!the Business and Pro•
UTILYTY CO.NOTIFIED fessfons Code)or that he Is exempt lherefrom and the
� - � . � � _ , basis lor fhe a!leged exsmpflon.Any vio/aflon o/Sectton
7031.5 by any appficant for a permli subjecis ihe appfi-
FiNA� � �n(ar on��ronf � � � -- - cant.to a c1N1 pertalty of not more than live hundreU
dolla�s(8500).:
INOUSTRIAL . � . . ❑�,es owrwr ot the proparty wui do fne w«k,w,d tno
WASTE APPROYAL ' � ' � SSNCtUte 16�Ot 11128I1tlBd Ot O�IBfBd}Of 981@.
[Sec.>044,Buslness andPro%sslons Cotle:The Contrao-
tor's Ucense Law does nai apply ro an owner of pro^4rty
_ whobulMsorfmprovesthereon.andwhodoessuc. tk
� - � , - himse!l prov(detl fhat such ImA�ovemsnfs a�e not In<ond-
- � , _ - - - ed or oflered for sale.!f,however,ihe bullding or fm-
provemenr!s solU wlthin one yeai ol complefion, the
' �- - " , owne�-builder wlll have the burclen o�proving thaf he did
- ' • not bu!!d or lmp+ove lor the purpose ot sale.) .
1 am exempt under Sec.
,. , , - 8&P.C.forthle reason
� _.
DBte
Owner
INSPECTOR'S NOTES
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