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HomeMy WebLinkAbout1226A (6) ; _ . ,_�.. ...., . , ,_., , _.:r._ � . - R S�,+alloe��r,�ATEON � , APPLICATION=FIpR PWMBING:PERMIT - � 1 hereby affirm 7hat.t bove o certlficate of��oonsent�o selF �bq�y�q . � - �i�� , , Insure,or a certificate�of Workers`fompensation insurance, CE 817(REV t0/8t)� -��- . - , "� � ' .� . � or a ca.ris�ed copy rhereof{sec:3eoo,•tab.c.�' rCpUNTY OF LOS ANGELES 6UIl01NG AND SAFETY .� �,p�olicy.No.� ' Company � - �. �.�. �.��,. ' ,.. . .. � Cer�ified rnpy is�here6y fumished _. :- � . � ..Q � � � FOR ACPLICANT TO F1LL IN{PRINT OR TVPE) � �SL]IIDING f - �Certiffed copy is�filed with the totlnty buildrng inapea AppRESS ���� r ����� � c,. �. ����- A ifon�deportment : �, �..;-. NUMBER �:. FlMURE OR 1TEM QA FEE � �tOCALITY �� � ��Date �. ' �APPli4ant � . WATER.CtOSET �. , �.. ���l 4�-� NEAREST . � . � �CERTIRCATF OF EXEMPTION-FROF+I WORKERS' _ ��.,'3 &4TH TUe d �Ct�qsS ST.� ;,���. - ��� ���COMPENSAT�ON fNSURAMCE --����- �3 �� 3HOWER (f O�'��eR M�GN � IN1 f KAS.t- .� : � �(Thls seetion es�d noi 6s compldt�d H ih�work tnvolvad by . p�'' .� � ��IhePfy hat nothe��a�maa eo'of heswork fo�which this �� ��� InYATORY �� �U �� A�WRE55��t 32✓O[�j�� (�1.k�Moyp r�.}� ��„Yja . ',permtt is iasued,i�eboli no��employ-ony peraonJn ony manner ��.�L SiNK� . � QQ�.CtTY�.� ,��� �� �::� iEL NO.C'�j//���,/.:E,Cf �� � �. .. xo as to become sub�ect fo ihe Workers'Compensafion taws. �,��. _. DISHWASHER ����� � � � � ' � . . � �.rV� d,u.+.���/t.�-[ O!J COMRACTOR �OW �E.C. � ��-Date � �Applican ��J CCOTHESWASHER...�. d . ADORE55. �.',.�.�4/�..6Gt.- .NOTI �Tp'"PPLICANT IF qfier makmg 1h�s CerhfiCate oF SWIMMING POOI RECEPTOR ��� Exemption,�you�sfiould�6ecpme�sub�aet to�.ihe Workers � �� �i7y��� � i0..NO.� � g � .Compensation prOviSionS of.fhe Lahor Code,yoV mVsf�.forth- kAWN SPRINKLER$YSTFM � y wi�h comply wilh s�ch.pravisions or this permif shall be , - �� SfATE _. � �tC.�� F .deemed reJoked. � WATfR HEATER �� i1CRNSE Nq. � CL4SS�� �� .�.LICENSED CONTRACTOR$DECLARAT�QN - � ' �� � piSTRICi Np. Pe SSED BY ; � �(hereby affirm fhar t am Iicensed dnder provistons,af Chop�er 9 GAS SVSiEnn � OU7�E7S�. , fQ - ��� � ��mmmencin w ih Section 7000 of Division 9 of��be Business pp�� -�' � .{ p ) . OUFlETS OVER � �pnd Professions Code,pnd my liceqse��"s in full 4orce and effecl. � - 3 PER SYSTEM ��ffNAC � . , : ua7e : VAIiDATION � � License Number ��Lic.Closs� � �- . ��� ' " ..�� � . FINAL � . ..� � $Y �-Conirperor,� - � �Da�e W . ❑ d 1 om Exempt under Sec. y B.&P,C.for Ihis reason � �� � � ��: .� Z. ..�. Plan check.fee . .."Dote: � . PIUMBING PERMIT ISSUING REE$ ��fO O� � ��� Z L b A��'; � � . 5ignature . ; . . , . . ` ,iA7AL FEE � -.�01� Sl� , . ��l���-� � � ���5'. . . �- '� Plan check ppplicaN � � :SINCaIE FAMfLV �.� .� .. . . ..�- (���� 2 G.S Q� � ��� � � ' 'WOMEDWNER-BUILDER DECIARATION � � Nome �' � �� � � � � - . ' - : 1 hareby affirm fhat f am ezempt from the Contractor's Lice�se � �� ' � •�'��.�2 A+5 0���� � ' � Law�for ihe fotlowing reason(Section 7031 5;8uvness and Addrefs _- . � ; � [P�rof-e�sysi ns Code):�. , . , � .: ..: City . Tet.No a t���`a 4�' � L"J I,�as owner of the property;�wili do the Work ond the `- , ' . '�� � . �'strutture�ia nbt infended�Qr_offered for�sale(Section � , ��► , ,, �, - 7044,Businass and Prvfessionz Code}.��� � � � , � ; .ggg�. - � � � ��CONSTRUCTION LENDMG AGENCY�- � . .��� � �� �.. .�. . � �.��. "� ....�,_ , � �. � ,.; . � � �, �� ,� ��hereby offirm that there is a construction lend��g ogency for the performanre of the work for which this peimir is Issoed� j5ea�3097,Civ.C.J. . . . , .. . . �:... . � .., ... ; � � .......�,' .�.�; . .. .. .. .. .. ..�..�.�..: . ��. � � Lsnder`xNttma �...�,___ " � .. .. '.,., . . ' . .,.,. . . � � .-:.� . . tendel'sAddress"� . .. -�'.� ..���. �'.� . ..� . 1 certify�that I have reod fhi�epplicafion and store that ihe �,� �� �� �� . a6ove information is correct.I agres fo comply.whh pll County - � �. . -ordinonces and Stare laws regolo�fag Plumbing,.and here6y � , . � : o�thorize representotives.of fhfs County to-eMer upon the' . . � a6ove-mentioned proparfy forinspethon�pdrpo;es ' ' �. ' � � � EXPLANATQRY iANGGl4GE � � ���� ' r�� SEE REYERSE FQR � Signatvre.ofPerml�tee � . . .. � Qate . .� . � �. . -'��,�_ ;,�� � � { �'� � . �. � �� � . .� � . . � ��INSPECTORS NOTES : .. .. , . . .... . ..��..OWNERi8l31LDER bECLARATIOM��� '' � �APPROVALS �DAtE � �� IN$ 651C5NAWRE � . . �, UNDERSLABWORK � � . - � � � � � "� i hereby aHirm thot�(am exempt''hom�the Coniroctor's - !: ROUGHPIUMBING �;�. "" �- � . � . � � . - Li[ense Law for Ihe following reason�{Set}!on 7031.5, � GAS PIPING � �-^; „:. ' �.�� � � � - � �, ��� . �. 8uslnessand Prolesslona Code):Any clfy or countywhlcfi GAS VEM , requires a permH fo mnstruN,alter,impfove,demolish.- �� HOT WA7ER HE4TER��� � ' ' � ' � � -,- e�r�apclr ony strucfure, prlor to lis fasuonce, also re• , ;} � .-. � -. . . _.. _ _.. �- � � -�-qukes fhs applicont tor such permit lo fNe'v-algned slofe- - � �PLUMBINGFIXTURES � � � � ' . . � �mbnl}hot;he1s17censvdpvrsuanffatheprovlslonsofibe ' t° GASiEST ' � - . � � � Contracfor's Ucerise Low-(Chapter 9(commencing wilh ��� UTILItt�CO.NOTIPoEp' � � � � � � .�.Settion.7000J;of Divislon 3 of�ihe�Buslness qnd Profes- �- E . , �, ..1 . . - slons�CodeJ er Thol Ra fs exeMpf�herofrom ond/Ae 6as1s� ,. ��n � c7 �� � -� ' �� � � /or ihq allgged exempfion. Any vlolatlon pf SEC}Ib❑ � � FINA�' �. '..�•Gnler-on 9rorat. '�. � � ' ` '.� . '� . �' ..�� . -; . . ..7031.Sby any applicanf�or a parmft fubJech tbe appli- . C. . . . , . . . . - ��� caef fo�a tivlf penafty�of not�more�1hon#7ve�hundred � ` lars($500).: _, �� . WDUSTRtAI . .... . ;.. . .. . .. .... � �. , . . . ._�� .�SB,�1.as owneY oi the�property will dq The work,and ; aor WASTF APPROVAt � struUure is not intended�or pffered.fnr xale:�.'� � . t ��r � � � � ' ' � � c.70M,8us7nessandBrofessfonsCode: Thetontmc-� � . `. ..__.. .. . ..... . .._ .. . ... . , . . . . .. . . - ior`s License L6w does nof'opply to an.owner of property � �� . ' � ' �`��� ���who�bullds'ar�tmproves�fhereon,�and who tloes such p� . �... �,.. � -. � '.... � ...�.�... . .. � . .. . : work h7mself ptovlded ihot such Improvemenis are�not � . ! . ..� .. � � ..;' . '.. . . ��.' `..�.. . � .- ` . . . ' .. ...� .... Intend�d w offered for aalA.If,howe�er,lhe butld�ng ar� . ,i . _.. , `.� . �� , ^`t .. . . .:. : . . . . - '�Improvement is aold wfihin one yebrbf completfon;Ifie � i: owner-bulfder wlll have'the 6urden of proving tho}he did j' . .' . . .. `. . . . . . .... . . ... . - - ; : . . ��not buitd or Improve ior Ihe purpbse o/Eals.) ' .. G � � . . � � �� � ._._ ,.; � „ .;.. " ' I am exempf under Sec. � . _ e&P.C.for this reason _ ' , � f _ : . _ . _ _ � ' .; - Dota _ g; , , r� _ Owner E � ` '' `INSPECTOR'S NOTES � � s � ^�-y- r �,, �� �e i-�, . (�^`b ��h�c�T•5 c��� . . � .. � . . . , . .. �� '. `^(1,!.�,f� O li r C!!4CSfa,rn� ��e �ti . . . . . � - . .. � � , . . . . . �: ' ' 1%-f��� . . u� .. . - . . . . . . . .._. .� .. � ', ? . ' ' � . . � - . - . . . , .. . . . � . ., .. .. . . �. � � �� . . � .." . . . � � ' _ ' _ � .. .... ._ . � . ' � ; �:�. .. .. . . .. . . � . . . . i.. ' . . . . .� . � , . , � . . � .,� . � . . , . . . , . . . .. . . . . .._ . . . _ . . � . . . . .. .; . . - . � . � .. . , -' �,... . , �i �, .. ' .. , . . . .. � � , � � � � ` . _ . ,.. � _ . ' _ .. . . i' . - � . . � � . . . , . . . . ... .. ... .