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HomeMy WebLinkAbout0865A 0997A _. __ � - _ �._ _ . __ �. _. _� ._ . . ,� _ ;�,� _ __.�_ .. _ -_ .__.. . _ ;;_. 54bk1FEk5�t�AP�A"sRtTBt��GU�1tTbt�`� — _ _ . � I herebw�aff�rrlrPhot I hav(a certifimte of;onseni ro self �.. ppp�iCATION FOR COMBIN � � � : �msure�or o cm�ificote of Worker5 Compensotlon�,��,a��a, � A�'ION �SWIMMf NG�..POOL PERMIT � or a certified co Y Ihereof Sec.3800,tab.'C. � .bqpg ._. , �. ._` ;.•. ,, �. . ,....., _ .- . :.,. :.. ..� . " " � � 'CE�87501/Bi) . . . � . . . . . Policy No. . Company �RE��C COUNTY OF LOS ANGELES BUILDING AND SAFETY � Cerlified copy isfiere6y.furnished: _.. . _ . . ... ` . .� . " :'''`� . . ..'{ ' Certified cvpy.is fJed��with the co�nty bu4lding inspec- -.-�- ��FOR ARPLICANT.TQ FILI��IN.� � .. q�p�Eu ;..a��—{.` tion IdOaparfinent. Y BVIIDING l'� (� ^�/� { � Q,.,�,�++ � , . Qate �`"t`v`�' APP�itant'�IR�`4JlVU V^�-3....1�. . AODRESS ,.-G�O 1�- � -EL.)(�`R .�S . ... .�. l4CALITY ..�'1..7�.7�1 � � � - _ ' NEAREST ._._.. �., .-` , . . _ arr b ziP 9���D� caoss sr . , �� . GEkTIFICATE OF,EXEMPTION FROM WORKERS' , � SIZE OF � . � ASS�SSpR � . ' : .. COMPENSATION WSURANCE . . . . .� �. A�{� .. . ��� NO.� " . � , �..Np � .'.� . . �` (Tht:��edion noad nof be eomplafod if 1he p�rmH is for one - TR�Ci LOT L�`NO. - MAPZQOOk �P PAGE PAR (�undred dollars(S10Q)or Ias�.) �., . � . -� OwNeR H) .. � � - �"- � ���- � ' . ,I��certify Ihat�In.�he performance�of the work for�which fkis...,. � . . � � . . .. SPEpAI . ��' . . . . .... . . . . � permit is issved,t shail no1 employ ony person in any manner . ADDRE55 �� � ��' �. CONDITIONS. � .�ao as b become subjeat.to the.Workers'Compensafion Lows. - -� � - OISTRICT, �.�STAASTIUL CLASS TYPE . . pROCE55E0 8Y � � . �. - � . �. �. � . CITY . �� � � 21P , � +' � ST ���ate � APPlicani-�� ... . . ... : . ... ARCHIiECT� iFk' /� �GIASS A10.- tfn � � . . �NOTICE TO AP7LICANT: tf, aftarmaking thiz Certificare of� ENGINEER . NO..� I�V ��,. �rn � � -�ExemptiAn,�-yod:ahould 6ecomC sybiect fa.Jbe .Worken' � - t ^^_C � � p / /� � �YALU�TION '�� - � �� , � � ' . .Compensation provisions of.the Labor Code,yoanlUst forth- � A�URESS�lOPp� G•� G ` t7'l7� v . �� . �. witb comply with such proviaions or tbis�permit shall be �p�� TFL.� ('�^7p�/� _ �{ '�(�� . � VAUDATION. .. . � deemed revoked.� � �..CONTRACtOR Q ��[�.��:NO. -O�!7 7�J 'V .J`.�./ � . .. . - � LIGENSED CONTRAC70RS DECIARATION �.�� ']�]^� r , ��.5[1'��� . � . . . . AOORE55 f p1 1 -3l '� '� � � I hera6y affirm}hot I am iicensed�nder provisrons Of C{�aptet 4 . lIC S'." ,' . .... ...... , ." � .. .. � (commencing with Section 700p)of Diwsion 3 of the Business �. ' . � �,j� � � "• � ° . �� �� and Professions Code,and myiicense Is m fulbforce and effect � GiTY � �� � CIA55 � .. ., .1 ,.�' ..; - p l'I` �,/'��� -DESCRIFrION OF WORK �FINAL L �Q$Q 5�� t cense Nomber.�`��"�"�� Uc.Closs-52v`�v "SWiMMiNG PpOt �... . . ` � _� DA " . , . � . U . . . 3�lStl�L1v��3JC�`� ^�DJ � .. .� ... � ... #• •�� �`�7�� C Contractor , Date , . .�A � .�.. eY ` ... _ .. . �.�'+���l Q�4 .� � Q. , . . .S(i.FT. ��l.am erempt vndar Sec� � � . . � SIZE ...:� . .- _ _. ..�. . . . . . ... . . .... .. .. . . . . . . �. . -' 6.8P.C.'fo��this reason�... .. . . . . , �� .� � •�•��4 9�Q 9 L�i � � y � ������A� . P.S�.Q,�... , _,-, / Z . oa�e: D b�1 9—8 5(. � � S�eel&Condwt Bondmg � . Q- � � , Signature � - �� � � .�Condw�}.Condutlors.Eqaipmant -... � .. .� as.Q��. •`` � � . . � . . SINGLEFAMItY,. . . � - .��. . . ..... ....HOME OWNER=BUILDER DECIARhTION -� . PIUMBING `� �..�.. . .. ..� .... �..:-' . . - .- �� ?' , -�. .� � � �� I hereby.affirm that I am exempt from tha Contratlpr's License : � � ' � � ;� ' � �� � ! Low�for the follawing reoson(Section 7D3L5,-B�siness and ' � - "' "` . . ����9,7 p _ . . . Professions Code): , .�..�� P•Trap . �� . � . � : .. . ,:-Gd9.5yEtem . .�,. ' �$f�-a.� • •3�� , �, ��� I,os owner ot tbe ro e� . .-. , .. � ..-� _._... . ,, p P ty,wlll do the plumbing ond Antl.Syphon �. ... .. . ' . ' •_,� ,7 S 5 O_ _ ; alechital wprk.1,or my employees with wagesbs Iheir �-. , . .,,__ _ � �- ! ' �'- sole coinpensotion,or�a llcensed coniroctor will-do all � MECHANICAL -� � � '��` � .��`� "`� �� . � ^�� . •��� 7 ra .Jr O�. , other work ond ihe struc(ure is not imended or offered . � � p ,. , . .,, . . . . � . - : � for sale�Secnan 7044 88P Code�. � � . . � . � Sw�mming poof Heater, .. .'. . - � {��2']...$�j�.. � .CONSTRUCTION IENDING AGENCY � ,;"( ' 'P � � N� '��-' .. ��� � � -- - - 1 here6y affirm that-thare is o tonstruction Iendiag ogancy for � ��� ""' � � ' � � . Ihe performonce of fhe work for which this permit Is iesued �y�,` � p �/'� - �� � � � � �+ � "� � � � . AVPLPRINTT�{ `'�vQ.. K 0�.�O�t747 , . . �^}^y�Q,, {',,� �yy yy n 1 �-t}� � , � (Sec.73G97,-Civ.C.).� . . ... . . _. . . . . . . �„ ... ...�. _ . ...�. � ,. . � 4ender's Name ��ADDRE55�{p�a f.71eQ.��lJ11 V��.-R��r�ln,n�J�,\� � � ' � � tender'p Address . �.. . � ��� . .... 'P.G.FaeY ._ ..1.7� � Peimk Fee':���V�'�� -- • .�...,... ��.. . _.:. . ' ��-, • . " . � 1�cartify�hat I�have�eod this application and sta�e ttwt the . . . � O � �� - � ���;� � above information is conect Lagree to camply wtth all Co�nty� � �,r. ._. . '_ . . .. � y�.:: .-..-- : ... ...- �.. . � ordfnances ond Slate lows��relating.to buflding, electtical, � ��dssua�eefee ���� �� � � � , � � . - � .�. . � mechanical ond plumbing cansiructioa,and here6y uufhorize �^�esrigallon Fee � . � �: . _�. ._ . . . .. ._,'. �. � _ _. ._ ! .$^r„�id _. representa�i es of this'County�to emar-upon�ihe above, � towi FQe� � � � ' me 'r ro y for spection porposea. . _�- � . ����� . � � � �-� . 6/9 �S' . . ,.._ ��:' �g�awre o Applicani or pgen� oore .. � SEE REVERSE FOR EXPLANATORY IANGl7AGE '"`"�� . � " � - - , / . ,. .. . � ' . . . , . . .. . . . . . .� . . � . . \•� __ _ - - -'S,r -�,...5t►ik ���+ 1 � .,i..�:� �.,,4... - . .� -,� " . .. i � � ' ., .��. '"-'- �" - PlANST�APPLICANT'�-.� . . . .�� a�... � ..". '. - INSPECTOR'S NOTES`.' .� `. .� . ' `'' O�iVNER-PUILDER.DECLARATION, ' ; r_ , „ . . � �� I}rereby.affirm.ahat I am exampt from�fhe Confrdctor's To: . -.-•�, iCafumod � �;:; s ,'- �, L.:: �x -,- � � - _ LicBnse�ldw ftir�the following_reason�[Sec. 7031;3) - , _ . ,�.,.,. ' "���A roved - ' . , �. . pP . ... .,. :.,.._..,.--'-,-rt_,,,._ . _ .... BualnessondProfess�ons.�ode:.Anyp�ty:or:counryui'iikh � No. ....�.. Date� � Ne. ' .�Do10. , .a: :� ..... ...._.... . .... • alter.dmprove,demoh�h. . .... . .:.._ . .�... .i�.�..,.. . ...:� . ,.`. :; ; ;�.� ,��:��� .i�. .,'...-.- qulres he ppf cant fo esucb�fo,Ns lisubnte,�also..rq- � � rmtt Io file a slgned stote- .. ....� .... _„ .....�.,.-..,.. ...__.. .___�. .......___. ....�.�. .___.. . � .. _ . :�. .. �mbnt ih6!!aa Is�f#c�n$ed pursuGnt�o fhe'pr9vlstqns P.f�the � ' �'.- .A. .y:.,; ;! �� .... -' ... .�Contrallor`s Llcense Law(Chupier 9J(commencin8 wt�h � ':,.-. . -.-.. . . ..� �. „ .��' .:�.. . , � . SeNlon�7'lf00)'o/Dlvlsbn�3`.ef'-�he BubfMess oBd Rrofes- , � � �,,{ r�,�; � � -�•i� -�! " slons CodeJ or fhal he IS exer4ipl7R'ere�'rom and fbe bos7s ... . .- . . ..-. .. .�..; .. ,,. �. ', , . . ... � ; ..•'for-fAe aJleged exarrip}fan:�Any�Jlolofion:01�Saeflon� � -...-INSP@CTION - �- ---�D14TE �.--.. �lNSPE TOR � '�' .�:�� "` "'� . , t.��:, �. � 70.?1.5 by any appl7can/dor v pArmit subjecla eM1e�nppl(- ' �, A . � : . . �. . � a- .�'-tvni fo o�clvll�penhlty ol�rro!moredhan'�iiva bundr6d- iocnTioN...:_.__ _ ___ _ . .. _' _ __ _�! doqo�s(Esao).): .�, , , . ,i.� �. SYEEL i FORNI�� ...�. ..,•: . . . ... . . . � . . . � �"����9j Ss owner of the"�ropery,or my employeas with 5 1 ' i. i-.. � ,� . ;: �....:._..,-. .____.._`-�- -.._._. ... . __... .��...' wages as Their sole compensation,will do the wak,and� r � �, �:. � „ , - ��� � . ., , ��the sirudura Is nor infendad or offered for aole(Sec:-7044) LIGHitONDU - . ." � ._ . .. :... ,... . f��,.., ._.. ,.�...... ._:,...:.,._ ..,� . ..... ' .:.-� -- : ��� .,,�, ' � .., .r.� .`�. _�.� . �'oner`acroYs L1ten"se ' . � +- �.'.,:. '.�. p� � . . ..:...�,• f .-,_..,.� .,r... -��'Ba'wdoesnofapplyf�oano,w�er�ofpropei/yulhcburldsor lONDING . ��; � `�� 1 r. -: . . . . .�� . ���... ,. .. , � ..... .. .. .. .._.. . _ :, . ., � �wrk 6n e 'r �. , _ improves�hereon,: nd who does sbe �o h s 1/o . . .-'.:. ;......:.,.. �' :". , . ., .. ..��:. i : v, .�..� . . 'lhraugh his own�employees, provld,ed;fhat euch��Im- �.., . �.... .��.-._. . ... �.�..�` _ .....: ��:1 provem,g�ls ore not.Iqiended or pf(ered�,lor sale. IL �. �. � :���. . - .-. ;, .,.. � . : .� � : �. hawever;fhe bullding or Improvemeni Is'soCd witMM one � ,._ , _. :: __ _ , . . . . „ , . .., ; `. '��. ' ' . , : � year.ol'.�.cPmple�(on,.}he,owner-6ullder wilf R6ve 1f�e ' CONOUii - �; s;�j �; - � . _ .. . ,,:,.. ,.�_„_ ,,,,. . burden oi prqving Ihat M1e d)d no�balld or Improve�or�he GGAS LINE � .� .�.. .r � �4 �'� ',�.h ' ` � ..- . � - '.. !� '._:: � �.. �. . pYrpose of sale). I I'i.:� ._ . ... . , ..'� .�� � .. , � � ., �. �, . . ,^•, �_�`I,as owner of 1lieaarOpe[ty,.am mztl�sively tqn- WATER LINE , , . '�.- � ,.. ._... _...'',. ... . ;'�" � � � � IroUing.with licensed Contracfors to wnstruct fha proiect t. . �� � , � ��t 4 , �� � �- � . � . . . ._. . .. . (Sec.7044)Buslness,and Proles9lans�05/6�:�7he.Corltrqc- `: S�R . ' ' � ..� ,� .."+"�i,•. •- � . .i ��.� �� � ���.. —....,.�for's Llcense Gow does not apply to an owner of propeSlY '� .,,.>.,,.,..: . ,_.,,,:+F.t..... ...... ..... .. . ..._... .._ . .:. _ �_.. _. .... .: - ---.who builds-or 7mproves lkerebri;�bnd wba�confrac�s/or , ' � '�'"' - � � sue6 projeNs w�ih a controcfor(s,).licensed pursuani to . ;, . ' • �- __ .... �.:�.�:.�-� '�` , ...;' ;�. .�..' } . . . _ � . -fhe Conlrodors L7Censa Law). . . , : , .. . .... _: .. . '_... . __.. . ..____.. ._._ � ANTI-SVPHON VAl {` % , � c ��, , _[]I am exempt underSec.�_ . ,$.&p.G.for tMis '�� � ELERRIC WIRES � � � reoaon �� -.,n�.. ��- ..� . .,.. . i,.7 i FENtE(WEIGH� � ., . .. . � . ..� . . . � . �. RatA-�.. �... Owner - '�'. .�,..., SELF.CLOSI � ; l... �� � , •.�,.... . . � . . . .� . .GATFS. .�SELF.IATGHING� � . '. ' . .. . � .- ��,, . .. . INSPECTOR�S NOTES:; .�. ; ."", , '. . . . . :, . ..�- .. �. .�. ,..,.. � . • ... � . . . �.:� . .�..� u,�- . �._-�� . .� I . . . _ . ... ., . .. . ROUGHWIRING�;��. � �� ..c. ...n , . , _ . � — . . , . '-. ' , . . ._ - , 1':;� __ . ' fINAL ELELTRIG� ' _..... . . . . - .. ' '. . .. .� . � _ .�_ . �r _ .. � r ..., ,, .. . . __ . . ._ ... . . ._... ._...._. . ... . . . . . �- . I �� � � , � ,.,. �� �.__ .... . . _ ... �. ...,.�.... ....,;.... . . HEATER(LOCATION i VENi} � ;: . � � ' \ . � .... �� ;�,! r � +�nt��r' � l .� ,-,�, ... ._ ._.... ..... - GASLINETEST . ., y _.VS...�_ _ ....._._� .�.'.....`.... ��.....�._.. : ..-. .� . � , ..;I ,o-. r'i , � ,. .� ,:. - -, ,. .. .'.. , ..... ..., POOt DRAINAGE' ' � .,. •,,�... , �� , . " . ' . � .�� L.�. .,i � �.:��,. .. .. . .__.. .. . ..... . ..__._ ._ , . , . - , �� .\':. � � ::� ' _ P•TRAP� � . � _ - _ — . , � . .~�a . .... . � . . �. . . �. � -� , . �� ... ..,-..'.... ,_..�,_._... ...... . .._,,.. ... .....__. ..,... � � . . . , . . � . ,a .�i.•_ , � . � . - ... � �. 1 y .,� ��. -.. �. ��. , . . .. _ �,. ::,_.__ .._:.,.:.� _. ..•� , s__ . ��� . , � � ,c ��.. . ..,. ,..�...,. .. - ....��...; .,. .. .. , .. . . .... , .. ...�. . t