HomeMy WebLinkAbout1781A (10) i . _ _-_..__-_ _'. ..._�,_._._..__.. ...'_._ ..._.... ,,._...........-...�.......__._.._..... _ _..... �
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""°�•`°'�°�'""0N°�"'�" APPL�IC�4T#;�NJ �OR PLUMBING PERMIT �
� I hereby offirm �hm 1 hu,�e o centflmta of cons�m ro wlf �y��q
�rouro,ar o cenM�cata ot Workers'Compensanon irnurarrce, c�a�7�Rtv.�wa�� � � �
' a.a centfied cvp�rhq�eof�ea 98A.4.Lab.C.� CCfUN1'Y OF LOS ANGELES BUILDING AND� AFETIf
; PoUeyjr���$�;qmpa�,,,�"ramnny�TnApmn���r
� ❑ 011ttlfled[9PY'V�*OrEbVfum4hed. . � �
� fOR i4PPLIC4NT TO fql IN(illMT OR 1YiE) ��� ,
C,er�n�eA oopy a Med wc�h Me munry bu� IrtQ insDea ADDR q�
�lan-dePanme'ne. x � pxittREocnFM O � iocntm �1.8.�011i1 BST
DOtR.,.�a.�,�,.�AppGiVns . .. • � WALERCI6SET ...
� c�cnre oF ok.FQonn+ruoei.�es• �enxH�ue .— �sr. 6 0 f Ph�i 1 i s Ranch
co+u�v��n�uruNCF � � sou.th Gbun,t co
' (This��dW�na`d nn 7+�<elt+pl�iid�1�F�nork Inrolwd 6y
iF�p�rm7f tr#br en+�undinW d41Can(ftbb)er I��s.) uwroar "1A°
� 1 eenify�hpr ie��he peAormpnee eF�he work for which rhis
�oort�
qe�m�r a+�avad,r:halP.w�aMa�w 4m aeno���ar�y�,o�.�., � Crcr TEi.
' co as a Eiemme aubjecr io�t�wai�ers'Campe�,sor�rn,Laws. �
��R CON"tACTORR.C.R. P 1Lmmhin INc..
j. �
Date =PPpcMt C10tt#5 W�S�iErt �
� Nonc�ro arec�,nns: ns a+ra� Takr�a�ce�i�Kme � aoo�ss 12 8 Ma noI a. A
�'-pmp�ron. rm, .hould bnmme mbjecc fe �he WorkMa' swwunmic v�ooi eECEvro�
't CQmpe�raatiun Yxaviaitms af•tha loppr�Code,you a�at fonh- C�Tv . . hl.Np. •
.IAriN SPRMKIflt SYSIEM
�, ..�wieh QpnOplg y¢ith'sVCh q,orisionS q IFria permit�ahall be LIC.
� aeomed�eYoksd. WA,�*E„�R u��No. 336l+28 � C-36
i 61(�NSEp CON7RAGTORS DECIARAT�ON —.
I here�y!QNirm 1ko1 I Cm UcenSAd ta$19r pravhioni ot ChaPtar 9 �6A5 arSTEM OUrlE75 � DISiRI[T NO. 7ROC�SSEU Bv
C (sommpek�inp vnth Sac��on Ifpp)otOlv�si+C[ti 3 of�he Bueiness �
s'
i and PrafQfaioM•Cade.Ond my Iicen30 4 in lull fpcs a�effxt. ����R FlNAL ' �
� �� ly�/�I�)' V LIDATION �
iLicenae Numher�.ic.Cloas�_ �
RCIZ. Plumbin;� F'"'"`�y�
I� Cantrapor . . . ppetr.6,,,�1•�85 B� !�v V
❑ W
I om eiempt under Sec. N
I . B.6P.C.ior Ibis roosoa z
� Ptan chedc fea ► �1 7 8 1 A
I oc�e:
I SqraNre VIUMBING PERMIT ISSLiING fEE E a ��� ��� }.r7
�� TOTA�� '71�5 b i . .�6 5 0
- P�m��hed�apPUca�, U
s�NGi.E Fa�nur �• • • •7 6 5 p�
= HOME OWNFR-9�IIl'pER OECIARATION Nome� � � O��C�''"8 Jr"
�� �':sreby aN+rm�hai I am e:emp�from the Comroc�or's L�cerae Adtue�s '
' b'w far�he fallow;ng reasan(Secuon 7031.5, Bua�nast ond
� -Profe»�am Code): �;� Tel.N
[ ❑ I,as owna�oi tha p.op�rty,will do rhe wo.k and the - . '
; slrucNre is not iMendOd o�plfe�ed ior�ole(Sae�fon � ,
704a.Bwineas ard Vrofeafona Co4ej. . .
� COMSTRUCTION�IENDINGAGENCY
I 1 hereby afii.m�her�here is-o-rnrntr�ction lend+nq-agancy Sor
�� �he pedormonro o4�he wah tw wh�ch rhia permu ia inued
(Sec.309f.G..C.). . �
�
Lsnder'�Nome
- Lendor's l�drs.ss
' I certlfy Iha�1-hqvp rpvd ti�is appllmtion Ond a�ote�ho+�he ,
i� above inlarrr�Ypn ia eonect.1 aqree W cannph vrith atl Caumy :
ordinonc9f ond Sroro Ipwa rOBulaliny Plumb'v�q,and heteby
, aorhwize rep.es0�+atwss o1�hia Gounry te entar upon tha
i adove-mennoned erh 1�ins°��o��p�,.pose�. SE�$EYqR;E FDR RXPLANATQRY�NGUAf%E
� R.C.R. Bv�a � �,J�'t, �,,�1, iRa
S�prw�vro oI Pe.m troe , Doro
�� INSPECTOR'S NOTES OWN'cR-6UILDER DECLARATION
APPROVALS � DATE INSPfROR'S SIGNATURE , ,
UNDERSL48 WORK '� j S LJ ' I hcreby offirm thot I om e.empl�irom the Con'roctor's
ROIJGHPLUMBING fD w y License Lmv fo� fhn following rcason (Seclion 70JJ.5,
', GASFIPING � BusinessendProfcss%onsCode;:AnyUlyorcoun�ywhich
requires a permi�fo consVucf,a17er,improve,demolish.
GASVENT � or iepair ony sfruclure, prior fo Ils Issuance, also re�
�� HOT WATER NEATER . qvires Ihe opplimnf!or such perm7!lo lifo o sfgnrd s!clo-
' FLU'l,BfNG FlXTUR[5 ' � � - � menf Ihaf he is limnsed pursuaN lo fhc provisians o�fhc
GASTEST � ti r+�' �#.�, Canlrector's Llcense Law(Chopier S(commencfng witl��
, UTILITYCO.NOTIFIED � ! Serflon 7000J of Dlvislon 3 0�(hv 6usiness and Proles-
. - slor,s Code)or Ibcl he!s ezempl fhere(rom and 1hc bcsls
� . � � !or the alleged exempfion. Any viofclion of Seclion
. FWAI � r rtfar oa Jror�l � 7031.5 by any applicenf for a permil subjects�he oppli�
cant fo o eivif penally of nof more than five Fundred
� -� dollars(SSOOj.:
- W�USTRfFI ' ❑I,as owncr of iho property will do the work,nnd
� 1VASTE AFPFpVAI - � the sfructure is not INended or offered for cole.
� (Sec.7044,6usinvu nnd P�ofess(ons Coda: The Cor'" 1
' � - - � � tor's License Law does nof apply fo an owner o/prope..,
�, - �, � - � . � '. ' who bvilds or fmproves ihereon; end who does svch
� � � � � � , work hfmself provided ffiat such improvements are not
i , inlended or olfered for salv.!f,however,ihe building or
, , lmprovemenf Is sold wlthln one year o!compfefion,�hc
� awner-butlder will have}�e burden ol proving fha�hc drd
� not buifd or lmprovo for IBe p�rpose af salc.)
I am exempt under Sec. .
� 6 8 P.C.for ihis reason
. Datc
Owner
INSPECTOR'S NOTES •