HomeMy WebLinkAbout0966A .._ __ �.�_..__._...�_.�„_.._._......_.v..__..___�.�._�.-^_."'_...._'._ •
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, woe�as connvp�csai�aw oEc�nw�noµ � APP�.iCAT1:�1�1;F�R�'L�U,f1ABIMG P�ERMIT
, I hare6y afhrm�ha+i hars o earnficme of mme o si '
'� inaum,w a ceniAc6re af W cker�Compq�natlQtt.f _� c6� CE �lREv.�aet)
i�' o�o centt�eci copy�►rereoE�eo e�tab C) �Q111�(Ta1(0�105�NCs�4ES BUILDINC'r.AND SAFETY
'., ��aYc��if����iUt thCt e�ounfyObuiYding�ms���--� - - .. _.�_ . ..- - --- - ---_ --- . - . ._: _ . •. '
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Gardtil�d eopry.ts her.6J�y nlID3hed. - -
WK aDVL�GWT 1QflLL rt�h fPRINr OR NPEI �� . _ �1.C�
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� t�OTdJppf,IHngll� . MOIV�EQ f17RLREORl7FM � #kF ��- .
, D9�e �QI�..App11�1 ' -��`.:' :�. WATFIt'Clt15Ef M ' � I�' - .
CFariFlcaxF dF E�MP�amt FRa�n woRr�es' aanr rua / — - �T' �
ca�nt�Nsntror,��uw� � s� � — � Pres.le af Sm. Ca.
{Thls��etto���d neT b�.Cory�pi+i�d it•h��+'orkinrotwd by
�hrp�rmltl�oronrfiuKd��d�do]faes•(31d0).orl�ts.� Cl UVATEAfY - A�ppµkEyg j
, I ceniiy flwt in fi0�¢y`rfa[rtt4nce ct"rha work fpr which rhis .
. �permM ia issvad.I ihdltnotenePrQY�7MOorson irvany mGnner � smix � _ arv ia.rr0.
so aT ip bamfcle iaf,fjOc�fo Yhe NCQf,kers'C`OmpeMaHan Lows. p�W0.SNER - -
I �p "'" (MRRACIOR
? ome.,., �,,T..n�ueoor J a°TMt�w"'s"ea " noo¢�s 12785 Ma noli� Ave. �
i- NOTICE TQ�APPitCANT: IP, pRer makinQ�A+�s�ertHieo�e of
EkgmPtian, you ahould'dpGm+l�aubMOe�'re iha 1A!arlcers' S�`������� . '
. �.penwu�m v�0sicn:ai��he tA6or Cade.vw m,m ionh- uvm svaw�.flr svs�n c'"'River id m.No. _
ns�
� ,r complp witA tpch {7�qvisiGni ar ffiis pekmi� ahnll be �fniE - IIC.� . .
anamed rErG�cOd 'WAIER HEAlE4 LIQNSE NO.
�'CrINiR2CTQB4.QECIARAT�Qlst D1STW[TNO $Y
I I herobTf.G�Irm tkqtY4�11t4[760L����RO�R�a�qOf ChCPter 9 Cih5+6Y51FM OUlltfS
� (mmmancinp-wriM 59Ctlon 7Q0p/bf� viaion 9 oF the Bfusiness puilEiS pVFR . d
ane vrofeaY�om Cnde.0�1CI'IYA�I IiC�liy�!i5 ill FYII fpt[E 01KJ'dHBti. S PER SYS7FM F�rvn� VALIDATION O
-_- DA�E � _� lJ
}��Nn�.. 3�364� ;�.c��C-36
� �
! R.�.R. P tmnli �n� i0/7/85 F�NaE o
j, Gonrracror Ca s BY F.
�C9h.,F, �
❑ I am exempt ande.See. �
1�� &&P.G 4or this reason �, o � • • •;. Z
Plon chetk fee
� oare: 1 � 1 C q,=L
FLUM9ING iEKM1T i55U�NS3 FEE 9 � �� D
I� SiOnaMe - c c � v� �U 23
.TOTALfEE -�
'� � Qlan check applican� �� �����- '`�.
� SINl3LE FAMILY
won+�owr�ea-euim�BEcu+rrarioH No,� R.C.R. 1
I haroby aNirm thaf 1 pm e:empt Opm tha Condpctor i 6icense . -
f�-`far the follrnving rapson ESpttFpn 7031.5,9uiinps7 and Addrees
��,''. I �' p�''o^S�O'1: Ciey iel.Na �
' L�� I,a�owne�04 the properly;will do the work ond ihe �
� aMuctu�e is nut intanded or offered ior wle(Section �
T044,Businesycnd Pep}esaiona Code). '
�. CDNS1f�1CFION LENDIM6 AGENCV
h I hareby 4ff4m thoT Ifiero is o wn5lryction kndinq aeency for '
j �M pCrFormonce af fha.w�k for x�luch fhie permit is ist�ad .
'i� (Sec.3047.Civ.C.).
, lerdar's Nqme _
LerdOr'�A�lrea �
I ceetty ihaR 1 hwa read+his oPRl�mrinn and rtWe LLw!ihe . �
�. a6ore inforinq�lon o�eoven.I agtlpe�v eor�ly with all Cvun^« .
, o.dieances o�d Srme Icnys regutating plwn6���and herebt �
outhor'rze re(�esantprivn of�his C,Sounly io entsr upqn the
� aRiov4+Al0n�0�P1LIPA�Y frn inspprtion purposea�
` ��R BY:� �, 10I7I85 SE_E REy�RS��PR��RPLANA76RY IAC�f�UAC�
�
' SignaWrs of mitlee po�e ' �
L
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I APPROVALS �niE MSPECiOR'S SiGnu7Urte INSPECTOR'S NOTES OWNE2-6UIlDER DECLARATION
iUNDER SlA6 WORK I here6y aifirm that I om exempt from tho Comrocici s
i ROU6HMUM8lIJG License Law fer the following reoson (Seclion 70J1.5,
GAS PlPING B�siness ond Proless�ons Code):Any ci�y or covnfy whlch
� GAS VENT requlres o permif�o conslrucl,ol�er,improve,demolish.
' or repair any strutlure,prlor fo ils issvance, also re�
� HOT WATER HEATER - . � • -qvires�he applicvnh(or such permll fo/ile a slgned sfafe-
i PWMBING FI%TURES � � � men�that he fs lic:nsad p�rsuant fo thc provisions ol f!i3
� GAS TfST �y'' Confroclor's Llcense Law(Chapfer 9(commencing wifh '
UTIUTYCO.NOTIFlED ' Sedlon 7C00)o/DiWslon 3 0l Ihe Busfness and�Profes�
� . , slans Code)ar Ihat he Is exempf fherel�om and IRe basJs
I. [� (or �he ellegad exemp�ion. Any vfolalion ol Soction ,
FINAL [nler nn �ron( . 7031.5 by any oppliconf/or o permlt subJetls Ihe appli-
cant to a ciWf penaliy o/no>more t6ort/ive hundmd �.
� do!lars(5500J.:
INDUSiRIAL - . - •� � �� ❑I,as owner oF the proper�y will do tho wark,end
NlASTE APPRO'JAl � � ihe sirucfure is nof infended or of(ered for sale.
! (Sec.70M,6usiness ond Pro/esslons Code: 7he Con�rvo
j � fo�'s Ltcense!aw does not apply to en owner af p� --fy
i who bullds or 7mproves }hereon, ond who do. ;ch
; ' . . work himsel/provlded tha�such Improvomenrs aro no1
, � � inlended or oNered/or sale.If,however,/he building or
� . . . �mprovemeM ls sold wllhln one year of comple�)on,thc
i � � owner-bWlder wtlf bave fhe burden of proving fhof ho d�d
� � not 6utld or tmprove for fhe purpose of sale.J
j I pm exempt under Sec. ,
� � B&P.C.for ihis reason
Daie
O�vner
�NSPECTOR'S NOTES '
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