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HomeMy WebLinkAbout0792A 0862A . .._ . . ..._. M - ._. _ _ ._. . ,,.. �.� ' WORKERS'COMPENSATION�ECLARATION � � � � ' � �' - ' `- �� � , � �� � ��e�eeY affirm Iho1 I hova a certificate of�o�5e�,�o Se�f APPLICATION �OR COAABINATION SWIMMING POOL PERI�91T in ,ar a rtificate oi�Wor ers'Co naation Insuronce, i � . oa ' e r f(Se 38 La .C.) 7e ae� . � .�. �- .�_.� � ._. . .. . .. ..: �.. ...�... . . . . � � 'C 76(3/B4� �� aa�y COUNTY OF LOS ANGELES BUILDING AND SAFETY Certified copy(s h reby furnished. � � �` � - � � � � O � _. FOR APPUCANT TO fILL IN suuoiNc � ti n e rt enf PP -fhe c nt uil i g inspeo ADDRE55 ��� � Certi'ed co is filed ith 'BUItDING n ^/f •�,i{"\ �� . ADDRE55 �J� !!!' l0[AUTY� IW_J Date liconf' � NEAREST ' -� CERTIPICATE OF EXEMPTION FROM WORKERS' - �CI7Y 2�P � �GRO55 St � . - COMPENSATION INSURANCE � . SiZF OF � e.55ES50R . ,TRACT t0T LOT NO. MAP 800K PAGE PARCEI (This secTion�need nof ba complated if fhe parmit is fer ene� � EL USE ZONE MAP . . . ...... . . _. . . �hundred deilarc(SIDO)or IescJ � � . OwNER NO. � � � I tertify��hat In Ihe performance of the work for whith lfiis $PECIAI . . , . .. . . permit is issued,I Sholl not employ ony person in ony manne• ADOBE55 � CONDITIONS . so as to become suble�t�o the Workers'�Compensation laws.� � OiSTRICf 5TATISTICAL CL455 � TY7E PRpCES$E�BY : � . � . . Cltt �ZI � CONSL � . �nte APPliton� � . .ARCHITECT OR, 1 .�`' . TEL� I'd I� . CU55 NO. ,' .NOTICE TO APPLICANT: {f,�after maki�g this Certifimte of �ENGINEER 1(� Y . '. Exemption, you should �6ecome suhject to Jhe Workers'� � � � � - V�IUATION - � � -�� - � � � � � Compenwtion provisions of�he lobor Code,you�must forth•-. sADOftES ' � � �� with comply wil� suck provisions or this permit ahall ba�� - iE�. f�.�1 � �C5V�-'' �- � . YALIDATION . i . � deemed revoked.� ' � . [ONtRnC � NO. � b �. • .LICEN5ED CONTRACTORS DECLARATION � LiC. �� -�� "'��"�O 7�J.2;A � � . ' ADDRE .. ' . NO.-� . .• � . . . 1 hereby affirm that I am licensed under proyisions of Chap�er 9 ��� ���� - �� - - � . � �#�� � �'��� : ,�(tommencing with Section 7000)of�Ivisian 3 of fheBusiness � CITY �� ��" " � � ' CU95 "'� - � � ` - - �anil Profassions ode y ice e i i�full for f �. 'DESCRIPTIO F R � � J�.� •4 4.0 9 � � � .. . . FINA � � y . - L'r[ense N�mbe Lit:Clds 1-'.� SWIMMING � "' Z, - DA7E �' • 4.4,0 9�� �d �.,`.. � Contr tor .. . . . at . �5[).Ff. ���� �Y A ��� Pl-8�J�.., V �• � � f am ezempt under5ec. . ��� 512E . . ..- .. . . ..... . ... . .. . . � (L� ; . . . �. ' 1� � . . 6.8P.C.for this reason � � � � �t EIECTRICAI ... .. .� . . .. . . -. . ... S�QN`P�Q�:--��. " ". ' � ' � Date: '! � � �[� ' .. ���6aO . . . . . . . � � 'a. � Si noture . � � . . � .Steel 8 Condoil Bondin - .. . . }�.{ • 1 ' � . � - ; N : 9 � �,- Conduits,Conducton,Equipmeat V�ll ��-. � � -��;. � � ! � SINGLE FAMILY �' � � '^� � �- � : Z � HOME�WNER•BUILDER�ECIARATION pLUMBING .� - � - � �q�Q.11{�.'��'� �' '. -� - I hereby affirm iha�'1 am exempt from 1he CoMractor's Licenae P ., . . „ . , . ., „ . —�� �_ (�� '� �' '- � . . ; �low.for rhe followFn reoson Secfion 7031.5,�B�siness and ���� � , � � �] � ' ��. � � �:. • •2 A '�-� ' Prafessions Code):� g � �-( P T�� S�-`-�' � a$� ..Gas Svarem . . . . _ . � . ..3 �. I O sole'coml ensaYwn oma li en ed Sontroc ala esli�do ol MECHANICAL hon ..._. ..... .... . X� . . . . .. . .; . . ..,'.: ... .... ' ,7� �.. P P Y P 9 YP � , . .Y. P Y 9 . . .. � - �S� P other work ond the struc�ure Is oot intended or offered ' � - : .. . .{or sate(Secfion 7044 88P Codel� .. ... . .�. . Swimming(oo �eofer -..... ". . . �' � �1�'�� � _ . CONSTRUCTION LENDING AGENCY „ . . . .. ., , � '� � � O Cl� S.^S J-� � I hereby off�rm�hat�here is a construcrion lending agency for ._. . .. .. . .. .. ' .. � the perfor ance of the work for which this permit ia iseued �.AVP�pR NT N �� � "'., �se�.sov�:��_f� ., � . Lender'a Name �� --�"-L- � � ADORE • . . .. .. ,. .. �'..... _ � . ... . .. . ... ��... � � lender i Address u`l _. .1 S"�,.a . �� . � � ' '.C.Fee S {�� Permu fee � � - . . . . .. .' I cerlify that I have read Ihis applicotion and slaie ihol the -'" � ' ' � - - obove informotion is correct I agree ro comply wilh oft Gounry . . . ._.. . luuance Pee.... �Q . . . ., .. .. � . � . , o�dinances and Stat ws retating to building, elecfrical, � �' � mechonicol and plumbin construclion,ond hereby.puthorize �nvestiga�ion Fae � -� - �� � � �� � - � �- j-� � repr en "ves f this ounly �o enter upan �he above- Toml Fea �. � � - ' m tioned op rty4or� spection porpos�� � ��� � � � �� -� � ��� �� ' Siqnoture of Applimnf or Age �oie . SEE REVERSE FOR EXPIANATORY LANGU{CGE � '� i ..._ „. , , � ... . . .. . . .., , __ w-y _ _- . ,: ; �� ,.'. '. . PIANS TO A►PLICANT - . . � p1VECTpR't f�TFS . . .. .... NER BUIIDER�ECiARATION �. �..' . .. OR licbnse Low�yf . To: . Refumod PP ' •.8usirtesa a drPr thpt I'a'm Axempt 4rom�he Conhahlor's . " s' .„;z ^ .�� or.1he�„£alfo�i�ng �Baeon�l SSec. �091;5) '„ _ A ror�d � ���orcount� whtch __ . ._. . . _ ._�.. . ... . . ,.. , ....,,, . ,. _. P . Y .Y Y oleaslo s Code An N� � No. -��ba�e-� � Nm ....�Deta . . ..-.� requlres 4 ParmN la cvns/ruct,alter,Improve,demoli:fi, � .., , • �. � ,. ,.�.'.�..... . � � . ._- . .... .:. . ..:.. .. ..._, _ . .. .__. .._ �..... .._ .. _ . - - ,., . , ... . . . . . `,. ., ` ' 'po(pp , �ri:� . o�its��lsauonce, olse re clr e'ny sfrutiure, prlbr f � - ,E .�"�� �f.;.. q rea ths.appbtohf�or such permlt fo 111s a sJgned afa�e- � . -..- - .-..�.•�.�� - -� ��-�. . .� � �. �. .-.. . ...,.- .�...= � .. .. . ... ..;. . . . .��. ...... menl}6at be 7s Ncvnsed pursuont to ihe provisions o/Ihe , . . . �� . �. • � .�y1,-.t ��.. ,. � , � - - . � .;;. � _� '�,.� '� . ...� ...COnlr6tiorL llcense Law(Chcpier 9)(commencing wUh ..;: - . .:�. . . . ..� � . , .. ... �, ....... . � SACRon'700Q)af Oivlslon 3 offhB��Bualnass��Orfd Prolss- � � � � - alons CodeJor'tha66e Is'exemp/therefrom and ihs 6osfa tNSPEC7 N�� .--. . IIATE::- . lN3PECTOR��:��, ��� � . � . ._-� Ior�:the.afleged,exampNon„Any vlolatlonroi Sec�lon .r.., .. �•'-� . ,��,�'.i , �, � �:.. .;;,�� � . : 703L5 6y ony appLconrylar o perml�sub�ects the'appli• �.� � , � � - t � _ � � � r . � penaHy�oi mon thpn ilve hundnd > . io 5�11 nof � LOCATION._._ . � ��.'� .. . ' i . ., ,� , ._... . ., , . �. . - � eanh , ._,�. > '..;._ .� ...-....' .. . . .��..'`_ ,,.��doflan(S ).):�., ,;... . .. .. . . ........ ._.: ._.,._ . _.�.� ._ ..._.. ....,r,,,. , ❑,,-baow�erof,n .. . , . ... � " � � ' 'e praperty,�or my amployaea wi�h �. YEEL f FORMS � I . E - '� ��. wapes os fheir sale compensoflon,wlll do ihe work,cnd " ' ' ;�-_ ,�,' ��� . ...;��ti . . ..��, j :, -- �ihe�tructure[s not intmnded er effered 4or�ab j5ec.70dd) . � GHiCOND1hY��. ;�,'.-. -. ,..;;.� ..,.,....� ..,, .� . 1. . `- ,... ' • • -. � . ..� -. ..8uelnass end Prof�ssfone Code:�ibe Cantractor's tfcenss . . ...._.... .. . .. . . . _ .... _' �' sONCiNG .. . - „ � � ��� ' � ����� � L .�' ' .;�'.' ; :' , '�� ' '. m rova3�hereony andRw�erof property who bulfda�or ,; � � � � �-- ��� —�� � ��� � --� � �d ns'svcF work fmse f or _ � . , .. b n � ; . ..� ' ` ." .�,.,. � ..-..�� �.,. . , .. . , .;�� . ���hrough`�hfs own employeer, prevlded.rhol.suefi'fm- , ..._..�._....... , ._� ...�...- .� -.. ..:. ,..- �.�.'. " - . , . " � - "�"` proveman�s.ere nm intended„or plfered"lor sc%: �f, , ,- . !' ; �- . '�� ' ++ . � . �.. . . � ��. � .,:-•.. ' however,ihe bufldlnq or fmproverirenlls sold wllhln one . . . ..., . _ ._._... . . .., , . � ,: _._:.'. ..., .. � � N I .' ' � "� .. � � �.., year oi�complevlon,,Ifie`owner-budder wkl have f�e.�. �� • .. r ;� , . . . . . - . . . . ,. . . , ..._.. .. _... _ ,� .. ..�. , , , .._.. ; � .�..bvrden af proving�fhot he dld not bulld or Improve forYAe 6A5 t e � � +" -" .�".. _ � . . � . .purpose ol sbleJ. � ` �. . �. �' . � iNE . � . '� � . .` ,, :... ,';�-�' `', ;.�...;-.i_ ",���..r �, ��:. �.:� 'fraciinO�g�'wah liee sed�cb�ractorsrto consVuct the projed .- ,�, ., , . , � � ,�,.,,.. � � "{SeE.7044}�80slness ond Profa3slons�Gode:Jh�c Gon�roc• .:�- ,__.__... _ .__ ._. _ . . . . �� � :r" '�tor';Licen'se!6w-�des i+ot upply fo an owOed o(properly �, . '- � � �� � ' , . . . . � . ...... ... �.. _ .. .... ... _ ...__ . _._.__ � ..__.. ., ....� ..�.. ..._._who b�fldx oc Impcovet lherem,and who contweh for , :. � - � ' . such projects wlfh a controcior(s),litensed punuant�io � : .. ...-.. ,..-� . � .., � � ..... .."Ihe Coniroctor's Cicense�Lriw}. -.' ..� . ... —.____. .... ..._.�.�.��.; _ .._..,_ _ _.. _.._. . . �,�� �, b HbNVAIVe. '� '-.��� , � ❑Iamexemplunder5ec ,B,.�,P.C�torihis �� . , ... i.�.�:� .___.�.__ . _._.._. __ . .. _ , �. . ELF � WIRES . ��. . � � �� � . . . . � reason 1 � . ' `„', .-r`1^ ' ,.�t -.� : , ENCE(MEIGHT) .. . � � ' � ,.:;7afe Owner . ATES (setF•ClOsutG } ...,.�. .. > - �,.._... n. .•-�.� ; ' ''�' � � INSPECTOB'S NOTES � � �SELF-UTCMING J : ..� . .. � j ' _... . . .. .. . .� _, � . ,.. . . � �. .f>._ ,. ._, , �U. . ,. .. � ROUGH WIRING � . : �: �..��:. - �:,,. . .�..�.�.- .. ;,.. . �, . . ...:., . . , �. . � . FINAL ELECTRlC �' . , � . � .. ' .� :�..: • . ... .� .. , ,. , ,. , � .. , " .. �.�.. � � _ � �, , e. ...i. ,..._. •c � ,�. .. . . . . ...... ._.. .. .. . ._...r„ . ...._.. _... � .. ...._. . �:� �.. :��.. . . . ' ...' ,...... .-. .:..... -..,..;. ...�...,. ' . . . � HEATER{COtAT10N R VENTJ � . �� � � � � i 4 ` GAS LINE TEST � ' '�7'.'~ . .t,7 r ..:� ,^,.� i �� ... ' . , ..�... ..__ ...... . .( _._.. - POOLDRAINAGE.� ' � � �� ': �::•�..� . ,� . . . .. . E ' . . .+ ,... ... , . . . . � ..,. . .�ir... ►.TRAP � ,. ._. ,: . � ., � ..1:. " , , ,i� r:" .i �, ., - . � . .. ..,..�...,. .. .:.:,..�.,. .-......,_.�.. ..�.... .....,.........�. '� , �� � - . .. . ' �1i .. � '� . �