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HomeMy WebLinkAbout1575A 1 _. . _ � ..._, . . _ . _._ _ , _ . � . .. t � � E .ATION bECLARATION ��aearw � � � � t he�eby�fe,� that I have s ceniCcata pP����to�« �a.,.�a-.o, -APPLICA?10N F4R PLUMBING PERM#T��" � insure or re cettificate bf Worke[e`CompensaHon Insutance,or �,� �. , � � � , �. ,� .�,- ."� a sert�fied sopy thereoY(Sec.3800,Lab.C.) -. � � � � � po���y N�4�—���"� GmAm� �mm �n� COUNTX OF l4S ANCBI.E& BUIL�►NG AND SqFETY� myanY � .. . . . i 4 � Cartified copy is liareby furnished. � ���-Fpp AppLICAIVT TQ FIC.4�IN(PRINT OR 7YPEI �� BUIL,OIN6 �� ' � " 4 AooaEss 2dQ3 CHS$1'NtTt CREEK AD.1 , _`. �Certified copy k Ned with the county buLding inspecHon NUMBER -� FlXTUFE OR ITEM.. �• .. F6E,�� � . � �� .,�le art A . ..� . :�iTUDY�K�lLP� . . WATERCLOSET� .. LOCAL�TY� DIAMOND BAR� �CA. "9IIES I � . ���� ��Date ""� , pplicank� . � N AREST . . . .. . � . � k ,.� .. , . , . . .. . . ... ... . . ... � .�BATH TUB. .. � . � CROSS 6L �. . _... , ,�. � CERTIFiCAT£OP EXEMPTION FAOM WORKERS' -� . : - �.�s �COMPENSATIQN3NSllRANCE � - -� -� ��� 6HOWER . �-���. �- � �� " �WNER '�.. WALTER 7'tiRASH . , ! .� pe d I ) ) S NKATORY AOo DIAMOND BAR . ISL4 S � (This secGon need not be eom leted if the work involved SA1�fE I, :6y Yho vnit fs Pw one hnn red dotlars 5300 or less. O � � � .' CITM .�7EL..NO, g . I certify that-in the�performance"of-the work forwhich�this CONTRACTOP� AIR�KTNG ING. � 'parmit is lssued,1 shari not emptoy any peraon ln any tnanner DISHWASHER � � � . 5.'� O 3�� so as to beeome aubiect to ihe Workero'Compensation Laws. . �CLOTHES WASHER � ����� ' �� ADDRESS� � 1 ~ � 1d744 ::ARMIiITA 5'S. , v . Date�` � 'APPlicant . . .. �. ` . . .., . . . � 4! .. SWIMMING PDOL RECEPTOR � ��NO?ICE TO APPLICANS:ti,-after making this Certi�cate of - ��T�' VAN NI1YS. �CA qi��'E�.�Na.219)89� �� ExempHon,�.you�should became'su6ject�fo�tfie Workers' � � LAWN$PRINKLERSY6TFM. - � STATE.� �. LIC. � Z � �.��Compensation proyislona bf the Labor Code,yov muat forifi- - � �..� CICENSE NO. �7�9� .CLASS ��'"4 F�� WATER NEATER�. ' � � � with��cbmply�wfth-auch provlsions or this permFt shall be .. , {, ,deemedrevoked. '�� �� � � � �, .;�� . - DI6TRICT.NO.� .-. PRO ESSEDBV ��. � . � � � � � ' � ��GAS SYSTEM OUTLETS 6 � � '�� LiCENSEDCpNTRACTQRS➢EC6ARAT10N .� -� � OU7LETS OVER � . � _ �� � Qt.d.l.�/ � � 4� �I hereby atfirm that I em licensed under provlsions of Chapter ' �� 8 PE YSTEM� � . � ' 9(commencing with Section 7000)of Divfsion 3 of the Busi- ��� ' � �- FINAL � �-�' . �-��, d0 onte i�ATiON : i'. neas end RaPessions Coda,pnd mX Iicense i:in full�force and � :� �-� � � ��� , - �,effeet. . . , _.. .. .� '� . , . . . ,._ � . . . . . . i , Licenee Number 2�Q�Q$ Lic�.�Class ��'�� . F�� . ' I. . . � . . �. .-. ' BY . . . �1 i Contrectoi�sIR KING TNC.D�ie 1/28/$2 ' S _ i � 1 am exempt from tht licensing�requirements ae 5 am�a Pf8t1 ChBCk f¢0 ' . _ � ��� . ��:� -, . �� �. ��! �. �, liCensed siChiteCt or e feglstered Qrofessional engineer �.�pLUM61NG PERPAfT ISSUING FEE 16 �j'� � � . � � t "� acting in my professionat capactty(Section 7QSt,�Bus•. � . � � _ � � . � ��� tness and ProPesslona Code).' - � �� . FOTAL FEE `�Q �$Q .�. . �� . - . �� � �. Lic.or Reg.No. . .. . ....... Date� � Pian check appunnt - � .. . . .� .. � �i . �� �HOME OWNER-6UILDER I]ECLARATION' � -' Neme . . . � ' . � . � '� . a.dd,es: . �i 5 7 5 A ', '�I here6y affvm that I am�exempt,from the ContractoPs � C` .License Law-tor the following reeson(Section.7031:S.Busi- ��City��� �--� � �Tal.No. � �� � � � � � � .. #��������-�J ��. - � f� ness and Prafeaslons Code);� . � � � . , - �. . � ', ' �. � � , �� � 1,as ownar oi the proporty,am.ezclusively conlneting -�� � � . � ��� � � �� �� � . �- ��.�-�'��4�J�Q `� �� . with llcenaed conlractora�to�conatruct � the �projeci , � . � , � �� . � , � � �� . . - t . � (Section 7044,Buslness and frofessions CoQe). . .. . ... , . . . . ' � -. . .. •�����.1�J�Q�i�'' . . �.. �'� � CONSTRUCTION LEND[NG�AGENCY .. ��,. ..: .'. ��. ._. . � � .'.� . . �. . . � � . ..� �. Q�L.��`g:2 �{.. ��� -� p� 7�hereby�affirm that there is a.conatrucNon�lending agency � . � � � . � � . � � � . � . . � . 1 {'� for the performance oP the work.tor whFch thia permft is� , ` �- . „� � � � � . _ , �� . � , ' z issued(Sec.3097.Civ.C.). . � . ., '� ' ' ' . ' 6 .Lender's Neme � ���,:.. . . ' . . . . .. .� . . . .i�.. . n, . . . , .. __ . . , .. . . . . � _ � .r.�Lender's AAdress� � � � � � . . . . . .: � . :� � . .� � � � � '� �� 1 certify�that I have tead th3s application and�atate{ltai the ' �. �'�.� .� �� . � � � � � -� � �- . � �, � above informadon is correct.I agree to complY with a11�County S&E REVERSE FO&EXPLANqTORY LANGUAGE � � -� � � � ' �; ordinances and Siate law�reguiating.Plumbing,�end Aereby� -. . � � . , � � � � . � - � � . . '���. auth ize repraaentatives of this Couniy to enter upon�the�� �. � ��� ., , - � . - � � � � . � � bbo -mentioned prop�or inspecHa�pu;poseQs.���� � -� - �� -� � � � : �� . - ;�� I �"�b - 0�"'_ � � natureo Permittae � . � Dafe.� . � � � . � ..�. � � .. , . . .- � � . ... �_ . __ _ _ -._ - -- - -- - __ — - ;,a , . . , .. ,. .,,.. .- �' � „"�... � , APPROVAL$� 3 DATE INSPECTORSSIGNATURE ��NSPECYOftS�NOTES �" ' �' � ��lE];_�]��"��,���� �� UNOERSLABWORK� ..._ i':,.�. ..y. ,._y. .,., ,._ . . .� .. ..,i . . . ..�.,.. �, . J._�� t�... , .;:..: �� Rou�rt P�unneiNc� � -� . ��� ` � � I.hecQby aFf4rm;Rhat I am exemptftom tliaCpntractor's .. . , � . .-�,� � •'�����-GicOnse LaM•-for-the�[oltowing teaeori(Settiorc�7031.5, ` GaSP�PiµG ...,..:. _....,...;... .,., .,..._��:. ,o .,,..,.... .._. .,_. ., ..._...,d...,,�. . .......... . . .:....�.,. , ...._,... .,,.. � Businesa and Prolessions.CodeJ: Any.ctty,o�.,county I � � cas'�veNT�.'��:. : ,�.'; '.�.;, ' ,s�:J .�.'.::�. :"' . ::`. _ .': .:..:.... ..:..' ,.�_.�..—__._�. whtch requtres a-permit�o construc't��a7ter, imp�nve.� . , .. . .. .. '.' :.. . .' f ,,�, ..,.. � ;��. .�� '�.. ` � , .., .demolish:,oc repair anY arrueiure�.Prior.ro 1ts issuunce. ' HOT WATER HEA7EP.. .,. . ,..,. ,. ;,-_.. .. � . . _ . .. �� . ' - � � PLUMBHVGFIX7URE5- .:�..._ .. ...-__� _. ..._._.... . ;.,��. .i�.. .: � .., - . „�...' elso r¢qKiKes.the Op�JlcOnt jor BtlCh pECn7it��tO���e G� ,.., _ slpned atdteinenr rhdr he:.is tkensed'purcuanr to.the caS;resT � "a� � � � � . � � � � provisions oj rhe Confinetor's Lfeenae law/Ciwprer 9. i . . . _ . . .c' . . . . �- t ; . . ` UTILf''iY CO.NOTIPIED �::,' .: ''..'�.�.. �' �.`.. , ..... .. ..... .�.. . ....... .' . �'(commeneixg�wlth'-Seetioa'7000/�u�'�Divisibri�3�bj tHe ,._�,_ ......___ _._._ ..... __. ....._.-_. :: .y,:. . . �` . . . � Buaineu�and�Aojessioies Code/ or-ebdt h¢fs exempe f �-� �';. :..,.� --,_ _-._..._ �.-. . ._ . . � �h � ���� �� ( I „ 'fiVeerehrom and the.bas�s jor the alleged exemption.Any � - ... .. . . . .. .,:: ro++of��r;on 7031.5 6Y amy aPPticanr Jora permir I F1NL . . : ,,... , .+-....-,.`. .. . e❑ - ... .` . . . ..�6'ects'�the�epplicant to a civil penalry of not more tNan � ' iNo sraiA� 1. undreddollars/SSOOJ.;.; � j A3�fl�a.RaRov,qt � �.. . � �I,as owner.of the piopecty..will do the wock,�and "� � "�� . ucNt¢�is twt intended oa offe�ed foe sale. � . 'r ..... ,:x,�� ,., ', , . . ' .�t. ��. ._ � ..- :.. .� (See.�7044, Business and Pcofersioros Cade: The.Con- __ __ � e : ,; , .. , , ' , �rrsctor s Licenae Law doe¢not apply to nn ownee..oj , ;- , ,:. �, � ,:;,�, _ .._.... �. ._ . _..: .:_ . .. ..... . ... .� ... . . . � . ,property�who buwlda or�rmproves thereon.mtd who does . . .�� ..�r i; _. ''��..; . ..... . -_�,.�... � .... .. .. .__-.. _..�� ', ._�suc work�.,ktmselj provdded�that�such,,tmProvemeNts � . h �... ...�. ��.,,:.. .. �.,`. .. ... . .'� . �.... . , .. : � . . .am��nat intended�.or olf�far su�le.Xf�howeuer, ihe � ;:�,. r.�..._ .i�,..... _.t . �.-... .. ... . __ .... _ . . . ... . . � � .. . � _ � � . _ . butlding or tmprovement is sofd withiq nne�ytar of . :,. . , �. ..,., �...� , . ; -' ..-�; '.� � . -,� . .�" �. . , . , . ....� completion. the..�owner-builder..wi11,have �ihe burdett .;.. ,".�.�_' " , ._:.. . _:...�. ...__... _.+;, � '� . . .. .� • .- . . �' � . .,.of�.proving.jhat he did,.not buil¢.or.improve jor the , . '�. ....... ,.... . ,.... . . � � - � � ,. I w ���.. ., ', ' � ,�Purpose of sa1e:�... . . . .. � . ,� .- . . .� , � - :., . � .::. ; , ...;. ' � ...�-.. . , :.; . , . .. , � . _ . , �. ,� . .. i _ _ _, _ _, _ I am ezempt under Sec. � c. ,:., ._ __. _ _. _ _ ,.._..._. . . , . ; B&"P.C.fpr this reason�^�, .__._. .. ._ . __ . � ; � � _ ,,. , :.. , ' . • � \�, �,� � , , � , , . , . ,._, _ . _ . • . . �te . , � __. ._. _, ; . , ; ^ , ,. , _:. , _ _ _ _ . _._.. Owmer • " _ . _ - �;;.. ,. _ , � __ _. _ __ - ., t �� . �INSPECTOR'S NOTES � ,� . � � . . � � .... ... ., . �_ . . . . . �,. � .. �� . . . .. � �-_ ...._.. .._.. . ., . ._._._.._._.,.._.. : .� �. � ' . , . .. i ' � -? . .4 f � , .�.. tt ,. . . ' ...:�I ; ' � .......r. . .. ... ...... . . :.... ....» ...,....�.,:...._ . .. , � . . j . .. .� . . . .. . .... � . . . . ., � "p-.��-�-=G . .... � �. ., 1'+�fi. . ¢. f _ ��., . C;�-�f.Cfl - . ; I . , , ' a , _ � . � . .� . . . _._._. . _. . ��._.. ..-.� _r_. . . ._. ; . , . � .. � .. ... �. . . �. ......�. , .! I