HomeMy WebLinkAbout0981A (5) _._.. ._ _. ...�..._.�__ __. ...___.___.-, ---_.._ _._._.__.
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� WdRRERS COMPENSAqON OECIARRTION A�P�P!(�ATIUM F�.R-P�4UMBf N.G PERAAIT
' I he.aby offbm �hc�I hcre o aeniflmte ot cp[pern tb selt �
i insure.or o cenifl�yro at Wwkerr LpmpO�s91�On Infurtl�q. �(REV.IOiel:l ..
o.o can�ned�copy tfiereoe gx.3BIXk ucb.c.► GOUNTY pF CO5 ANGELES BUILOIIVG ANDSAFETY
� Q�. -CenN�r�ro l,�u�hed. . �.� i� � . . - . �� �� .
Fa+avRiuwr ro ciu w lvamn aa rr�� �� — _ .
f � Cenifled rnpy K iNed w��6 Me cavnty bnlGding naPec- ._ - �Q.
2 �ton depanmem. i�tnNeev F�xn�at i7� � � ��rcY
to
� Da�e : APDtRa Et�f������ . WAYER�CLOSE7 ..
i c.�w��o�r�r� waws�as � e�.n,�e �� y c�s s',.
c�nnraas,ot�oK uasu c� �+ �Q Pres 1�}r f S'�. Ca.
� (Tht�a�HIQn nNdeot B�eomptyM lEyhe,�wotk lnvolr�d 6y a ��u
� �F�a�Ymif Is lor on�fiandt�d dolron{��DOj orl�ss.} �a,U�y
' I cenily�hpi in/h9 perfqm7nnce of ih¢�yark Iar which th��
� permit is is5ued,FfhpU rwtempltry onypenon in ony manner � � 6 [ITY . - � 7�,�,��- �
�o m ro bemmb subfeet ro tde WakarY Gampenw�ion tows.
�` ' I ���� � -- CONiQACfOR . -
p Dofe apPlippn� t CLOTf1E5 W0.SNER � . �� .
� niOn�70 qPRK�IWt: �f, aRer�king ihis GerrMrcofe oi ��u 12785 Ma oli� A�e.
� �"�Tpnon, ya� ihoutd�hesnme a�b�sn ro rbn iYorke� ����� �
- ,pe�sat�an prorisipmpi iRe Whuo Gods.you mwr fonh- cnr � �y,p�p.
w�.�i com I witl��uch L��N�'1 SORmGCLER S751FM
1 a v A�ieiceis w ehis Fermit �MU be 5in - .
deemed rewked. �
� uC,ENSED GONTRAetoft5�OECtARnnGw J 'wnr0e�.n1�+ (p -- {���-. osr -
a I hereby aFktrm Mpf V am hmnsed undar{xwuimrz af paP�er 9 f ��� oVr�TS _
(� (eommencing wkh$�,�etlon Y000)of pirision 3 oi the 8usiriass p�
ass
� and A'ofessions Code.wd my liceroe ia in fuN farca ondeHM. p!� FINAL p�,
d ��,.. VAUDATION 0
iLleense Number�_Lic.Elosa� � �A� "� � �
r� Con�rodor� �r' Z �r����'n7.^��} - � -� BY�` 0
� � I am exemp�undm Sec. � W
�r r d
� B.bP.C.fw Ihis Reoson • - - � �
� Plan cherk fea ► ; < < e .,,
�t�� PiUM@ING VERMVi I$$UING FEE E Q . .
$ipnoruro �� _ � r I.�,�,'
�, �TOTAt F� �� � .
I� SWGIE FAMIGY Plon chett applieant � *� " � C 1,^��'T . �
� HOME C77NNER-6ULLUER�DECIRRi4ilON Na.pe 1 I ,,:�,,^,�.�
r+�reby oHl.m thot F om axamp+hvm the Canhoctor's Lice�yv �d��
�fa r1�e foltowing reoaon(SeClan 7a##1.5.8minem ond .
j ,aasions Code):
O Ciry Ye.Nn �
� I,a�ow�r a£f�n propprty,will do tt�s vyprk ond tAe .-.. . .. - . � . � .
� etrucruro n no�in�ended o.oNered fw wte fSeNfon - � ►
i7MA,Bu�linn�s 4nd P�ofeesiona Cade). . .
, CONSTRl1G11ON{ENDMG AGQVCY
I hetaby offirm�hot rhere ia o conshuGion lendinp agency io. • .
fl�e perlpmpnts of the wark for which 1ho permir ia iawed
i (Sec.3Q9).Cit.C.). � �
� lenQers Name
G lender's Address �. �
I cenifp rMt I hore reqd Mua opDhcdrion ar�d state rhp�the � S
� abwe i�orrr�l�ii wnx�.haqree�o coo�plp rv:�oll Cwnry � .
ardirqnces and�StWs lows repbfo�ing PluTbing,a�hene�y .
awhorize.epFese�rorhPes of�R�s Cw�ry ro emer upon iha � . �
abore-mentrmeNd prcpe�ty{or im�ed�on yrcpoyps 6EE REV�RSE��R�#XPLf►N1liORY� NG AGE
ttCR B3i:���_�-�� 10/�185 � �
S�gno+u.s of Perminee Da�e . .
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aP720vnt5 DAlE �� WSP€CTOR'SSK'iNAT e INSPECTOR'SNOTES Oti"JN[R-6UILDER UECLARA110N
�I UNDEF SIAB VlORK � I hereby offirm that I am emni from�he Conrrcc�o�'s '
'� ROUGH PtUMBING � . License Law for Ihe followi�g reason (Section 703i.5,
GAS PIPING � / . Buslnesx and Pro(esslans Ledej�Any city or counly which
' GAS VENT , requirQs o permil�o consiruct,olter,Improve,demolish,
' or repair crty slruclure,prior lo ils Issuonce, also re�
� HO7 WATER HEATER - �- , . � qufres The applicanl lor such permil b iile a signed sfale-
. FIUfhBtNG FI%TURES � manf Iho�ho is ficensod pursuaN to ihe provfslons o(Ihe�
GASTEST - � j.�idC' . Controdor's Limnse La•.v(Chapfer 9(commendng wilh
UTILINCO.NOTIFIED � Setllon 7000J of Dlvlsion 3 of Ihe 6uslness ond Proles�
stans Cade)of 1ho}he fs ezempf ffierefrom trnd f6e bosls
c7 �- � � � !or Ihe aflegod exemption. Any violalion of Secfion
, FlNaI - '��(�r nn ..Yronf ' � � . ' 7031.5 by any opplican�!or a permif subJects 1he oppli-
' cant}o a civll prnally af nof morc?han INc hundred
� dollars(5500).:
IINDUSiRIAI ' ' ' �� '�;.� . � � ❑I,as ownsr of Ihe property will do Ihe work,ond '
� WASTE/+vPROVAI � the structurc is no±inlended or ofiered for sale.
i , (Sec.7044,BusinvssondProfessionsCode: TheC��'7c-
� . . � � . ior's Llcense Low does not apply lo an owncr of p !ry
� � ' . who builds or Improvss tBcrcon, and who does such
_ � � -. . . . . work hlmseff provlded thaf sucb Improvements are nvl
� � � lnfended or o(Fered(or sofe Il,boweveq the building or
I, ' ' � . . Improvemenf(s so(d urRhin one yeor o1 completion.1he
�� ��� " � � -- , ownervbu(fderwillhavetheburdenofprovingtholhedld
� . - not bvrld or Improve!or the purpose ol sale.)
'. � ' , � i, I am exempi undcr Sec.' ,
� `v . 6 E P.C.for ihis reason
Date
', � , . Owner
� INSPfCTOR'S NOTES "k
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