HomeMy WebLinkAbout1568A , _ ,��„�•�^^�N�,.�o�oE«^�T�oN - q��LI�ATI�J:N FC�►� PL�LIMBIN�G PERM�T ss r/a �,
I hereby atfirm�hor I fiwa o certiflwte oi conaan�to�atT ypqbpTa
•imure,or o te�lN/eate of Wq�ken'GmltpeMpllon lrqurpn[Q. Q 81T(REV.tp/81)
. . or o cerufted mpp rhereu4(See.9800;#C4.C.) CORNTY OF LQS�ANGELES BUILDING AND$AFET'ff
Pordh��.7],1.�14.7 ca�o�i��rt�� �d
OCer�Uted�eopy b hembT fu�nifked. . � ._ � -- - � .
� FaR avaic�wr ro Fiu�N i�n oR rrve� ��2�86�7 C� Ut7i.ts 29�-.300
CauN�ed�ar is flteek wifh�he aDanty bqiWing�imPe�- fiXTUf�Ors imt p �t
nandeponmenl. UOCau1`�j}j.�iCl �2Y'
� - MfA1E(tt145ET � ._ ._. _ -
Date3IA/RL. _. -APA�rn _ `' P
���iu�vsn��noc�usv���eS; ' �b"10� _ ��T.Diamond Bar Blvd/GYactd Ave.
� � Presl of So. Cal3f.
(Th4.s�cttan���dneib�eompTirad�(�t�v�prkl��ealvodby
�hr-p�rmx tr ierae�hortdn8 doU3N(��bOl�erl��r,1 uwvnromr aa�.000ie�sss 460d Dr'i e
.00�
. 1 ce�ify fhnl in tFe perfDTmonee of I}ts worlc far vieAich ihia � . . .
� permiR ia is3�$d:t ahall�Ot amP�t�WqnY penOminqoy manner � atr 7Et.taQ _
ea m w W►rnms aubjec+ro rhe Workarx'Compen�ar�oa lav� p���
� CONYRACtOR R.C.R. , Il�ICt, INC.
oar, ePplicaM C1OTM�w"s'� ' �Eu 12785 li8 Ave.
r'hnte ro nveur,cwT: rt; ane�maim,o m�cerrir+��e�
. . jmpnon, yvu strautd bnmme �u�'�r�a rhe,Wn.ken ���"�°��°�
�ompenxe:cn�aavisiuey o4 ihe tabor�de.�tw must farM- ��S���M CITY gyvez'side 'E` 110�371-5000
, witb mmply wifA soctt pmvbiony of fhis pprmit tholl be STu�E�, 3 b'(�2$ �5�.+�36
deemed�+6rokp�l: wnmt MiFA1FR --
uCENSED C+ONiRnCtpRS CECIARATION '� oarcicr�uo. er
' I heroM aHlcm�hpT�am Ifcensed�ualeDA�isiona of Chap�er 9 �tta5 s�ar�nn � oul�rs
' (cumenendnq.v�lBr Sacrton�OOQ1 of�Olsdsion 9 ai the Busineu GtEiutS 4VER O -- - �
� an{�Rok�3liiaM C'Ode,a1fTl'+nY hilf�3��in fu114qL�.aKleffec�. S PER�SY37FM FINAL �
q ` VALIDATION O
License Number 336�.428 i;�.G� C�36 - °A� '�, ��� �
�2C[t.Plw�in�_Tric�,,, 2/6�184 n�` � �. �' .,� �
Cartran
❑ W
I am exempf und7�r 4ec. . y�
Z
e.av.c.�o.�n�s rocao.� :Plarccheck fee
Date: RIIMBIMR oERMIi�SSUIN6 FEE t � r
._� ..�a�
; Signo+u.e 70iA1 FEE � � D.0 0 . � . .
p, .. .5
�. vra��che�t aaauco,u �
$ING1E fAMILV 1 •3 9 0 G 0
HO1NE OWNER-BUIlDER DECkARAT10N Mcme �
� �peby a4firm�Fwi I ain e:empl iram 1he Canhador i License • •3�U����
� .w for tl�n followin romon eriyu 7IXi1.5;Busieess and ��� '-
9 �O 1� v e215-84
PrpfessYo�n Code): Eiry y�],�' ''y('� iel.No. ,3]],�500D
�� ❑ I,aa awner of the properly,witl do IAe wark ond ihe
, sMMure is not irrtendeC�or ofie�ed 4or sole(Secnon �
' 7044,Buauieas and Protessions Gade).
CONSFRUCTIRN kENpIN(3 AGERICY
�� I hereby aHi.m that�Aero ia o wnsmu�Ion lendh+y apa��x(o�
� the performonce of the wro.k for whicA�h:s permi�is iesoed
. (Sec.9U9�.Civ.C.).
�� Lender's Name.�2 �m • -�51.4+'�:�Sc.e�R"- •
Lender i Fy�dress N"r� B��� � �
' I cenify�hof i heve�ead thi��pYfedflqn�abre thn+�be � .
� ahove iniprmation is corree.Iag roe t4 mmply.wiik016Cauery .
ordirwncm and S�ate law�re0alati�Plbmbin9.aetd horebp
' aun�o.��s�eprosemm�yes oi iF�is cqnnry ro emer upen ilue
� above•memtuned pr�perry far inspeaion pwrposes. "
�E�•�F,SC�$;�•FP&�XP-4�HA'ti�R1C tASN�1IAGE
' R.C.R. bv:�c,.��l�,/ - 2 6 84
�. Sipnature of Permittee " DoM . .
� .
AP7ROVALS DnT¢ � in75cKiOQ'S iGNniUe¢ �NSPECTOR'S NOiES O'd/NER-BUILDER DECLARATION •
UNDER SlA6 WORK �"� I hereby ofiirm lhar I om eaempi{rom the Contrc Ucr's
ROUGH PLUMBMG License Law for Ihe following reason (Section 7031.5.
GAS PIPING � � Boslness and Prolass�ons CodeJ:Any cify or county which
GAS VENT � raqWres o permi�to tonstruc/,olMr,Improvc,demollsh,
' HOT WATER HEATER or repolr any sfructure, prior to ils issuance, a/so re-
, qvires Ihe oppficanl lor sv[b permll�o fi/e o slg�cd sfafo-
i PLUMBING FIMURES � � � - mont fhot hvls Ilccnsedpursuan!to fbe provlstons ol lhe
�'� GAS TEST � ContraUor's Llcenso Law(Chapler 9(rommencing with
i� UTIUTY GO.NOTIFlED Section 7000)of Ofvlsion 3 of the 8vslness ond Pro(es-
, , slons Code)ar lhaf he fe exemp�fherefrom ond Ihe basis
P � � for iho olleged exempt7on. Any v1olanon ol Secuon
FlNnL � GIx(rr on �ron( � ' 7031.5 by ony applfcaN lor a permit sub(ens�hc appli-
� , cant fo v dvil penalfy o(not more fhan Ave hund�ed
doua�s(ssoa�.:
INDUSTRIAI - . ❑I,os owner of Iho property wiil do rhe wark,and
l� WASTe AP7ROVn� - � ' �he sirodure is not in�ended or offered for sole. � —
i (Sec.70�4,Basiness ond Pro�en�ons Code� The Co '��-
i . � . � ior's Llcense Law dovs nof apply to an owner of properfy
�, � - who buflds or lmproves fhereon, and who does such
� � . - � work hlmsaff provlded fhat such improvements ore noi
� lnlend�d or a!lered{or safe.ff,hov�ever,1he 6uilding or
� - . ImprovemeM!s sofd wlthln one yccr o!mmple��on,Ihe
' owner-6ulfdar wlll Fove the 6urden af provfn�1601 he did
� . not buffd or lmprove(or tho pvrpose of scfe.J +
I, . �I am exempt under Sec. ,
I
j B&P.C.for ihis reason
Date
Owner
INSPfCTOR'S NOTES � �
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