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HomeMy WebLinkAbout1742A (10) ��f� 3R "Ty� n�- �'���.,'" Y'' ���`��u.�...°.�5�"'S �.. � � .;��'''f`°.�'».'iw�i'�s"-',��.��/ �'ik�'��.�r..g e`�"' ��,x.- ^�j.. . .. �,.�`�i�.�i�"k , 3 � ��s^3�u,.laas,Y. ''� : �'"3a^ks."'� .u. ��, r �, ,,..WORICE��tO/JiP�SA1�N P��L7ikA710N� /`iP�L��A4 A' p e'�A r��rp� . . ' _.� ��.'�I here6y affi m thpt I have�a certifimie of mnsen�to self "•t"` ,."'""""" ��", � Yinsure or o cerirf cote of Wo ke 5 Compensai on Insu ance �5A667A ,;y .- ` p��s• ��� �4 � ceet���ev �orei( '�'� , • ` " . . . :. W�YI BI,YV �� R1�A��' �" t ;;�or o cerfif ed copy thereof(Sec�38D0 Lab'�C� �� � ' � 9 .._.. ,.�.�: Y ..a. ......,:T'.1 .., ..n.. ..: :._ , .� '_ j� �� � C mpanyFramnnt Tnt3amnit,� M.., .:.`., ....... .. ... ..r _ - BUILdINGA1�TD�AF"E�"'V";"`: Poi�� ""'"" °' COUNT'Y[5F LA�AN�ELES y ''� Certified copy is he eb furn shed �. . . - ... ...�. .. .. . .,. ` Cert f ed copy s f led ih the munfy bui ng' peo- FOR APFLICAN7Y0 FICL IN(PRI�t OR TYPE) �4 �gUILDING.. �,. ?°a1w"�p 1 on depa imenf � �ns � _...., . . .,..�. ADDRE55 . . j _..,.._. � n NUM6ER FXTURE OR fYEM��- �� � � ;an�".tE',��`xT"-W�!'e'�".�+., �as�+�!u�'r�.-�`83ssE s �,��,r•�� f ..... Dote ti/lQ/RS � 1# ' � - � !�M —vr�s--- Applcant � �J'� WATERCLOSEY i F ���'4L�N Diamond. Bar ���� � ..:�� '�s`CE�TIF'fCATE'yO��X�kMP71 9�y `.,"" "�•.,� ,•s•.< . .. �.:. -�: I tYEE..-� �JEAREST ' � -.. - � y. '�x+, �`FR�I "�NOR�CE72S BATHTUR ' + ��. ... ..,.$ +x ���`�"� �- �� �__. ceosssr 60/Ph1111ps Ran . 3.a.��i,c�,:,�✓� COMPENSATION��INSURANCE - � ..-... ,_..... .... C � �This secl�on need not be completed i{fhe`work involved by SHOWER�� ��� �� - OwNER � -� ; fhe pe mtt�s fo ons huntlred dollors.,(;L00)o�lass.) � -� � . �"". `•� "`".:-..._. . LAVATORY... ... � {� MA1L South Cavntr Cor -�cert fy that n the,performance of the'work for which this .�., � � ,g � ADDRESS` '"'`'*`` ' "`-'�" '- ..?: ..__� .. � ,, Fi`�rm 1 5 issued I shall nof employ pny person�in any manner �� f SINK � - so as io become sub�ec�to rhe N/orke s Compensat on Laws � � � �-°--��-•�-°��• " CIT1' _M pv�t�+ A ryrJ53�„�p,u r . � . . ;'�a a d`5„5� .f yF,`i�,��y."'�,�s" � .,..�Y�+`i��. ��� L CLOTHES HER _ DISHWAS .- � ' , TEL. O N ' �a�e � n -.. ... . ,�-: �(p _ . coNrRacroe I�..,C R P�Iuuibin PP��mnt. VJASHFR .:..,.' ,.... f NC. � T���b A�PL(C�'ANT, If afre makmg th's Certificote af � I .z, ,,........, -"_ ADDRE55 �.:.. -._. „� �p�on you should be�ome �sub�ecf to the Workers' SWiMMING o00L RECEPTOR'' '�� 12�78 Ma. �nolia Av . � :. � mp'�'YisoT oo pr.ovisions of the Lobor,Code,you must forih- --� -' "" � � � ' wlh comply with�,such provisions or�fhis permii sholl be �AwNSPRI�KLER5Y5TEM����-- �� ��T�� ' �' � �TELNO �- -`��. dea.�emed re oked r� ���� •" �'���^ STA7E � ���� '"�yrt����"1'ICE�iSfD C�NTRAC70RS QEC`LRRA�Y16f�`�� `�� "" s �� waTER HEn7ER �.� - ' - __ uceNservo �3642$ ' . �a�. �. ...,. ._ .. _,.� . _. . — _... uc:: .. , anss C .36..._ �d I�e eby�ff m Ihof I am licensed�nde provisians of Chapier 9 � GAS SYSTEM�.. � OUTLE'S l p��R��r� PROCESSED BY�� -. �commenc,ng w (�SeBion 7000)bf Drv sion 3 of the Bvsiness � C.n `-����� � d'nd P o4essions�Code�and�y Iicense s in full fo ce ond effect OU7LET5 OVER� � �E�i�"�"+'r41 v{t�'�� f� n�:� wYv[ S:�:'�` � ��_:�,r:� . 5 PER SYS'EM . .. . . . � , . . ��: ' ....... . '�' . . ,- FINAL � �. ��,, �ens�Number�-�_�c Class��_ - �. _ , DA7E J,;jz/�s�- VAUDATION ��.: � ;�'`�x��z���'�. ..,, r, / �� , .h, :: ,� � .��... : � Contractor� ��UII1�71T1 pate6/�-���8,rj - -..., . FINAL � � _ .. av �,+�,*.�, ,/ z I am e empt u der Sec � '"" }a:4i�.''�2.�"�r.t�`�'au3-.3} �'o-,:r$ars Y a ;:.:.a �� � -��� . .. S k sz'�xa B C�for m s eason . � �., ., � �., '��'-��a"�:�.ursh4�� �,.� . ' � ,r: , ��a x �h y��"��„�>�r'�'�.���a e r�r � , � Plan check fee � � � r�.���, a�-.,� a.�..� � x .r s . . .... � ... - .�,, ��� � {�r'a, 5 gnature ,__ � PWMBING PERMIT ISSUING��FEE$ � F;^n�"}"x xv"*4.,g.^s-•*$'4. ?t.:�;s '�YA`� .,;� .�i �..G � � . , . y�,,�s ' . . -.. . . .. .. TOTAL FEE � L.'r' 4.�y,�,gr7 $� y���� �'�"�l�:�a r r �..`"'i�`x z � �` . . .. ! -I,c . . ' }£, �,��,� °�„ '$INC�`lE FAMILY '.°�' Plan check oppl can . . � . . .. 1 i A. . . �� . . .�., .�, '� �"}.c nl '4 C � HO/v�E dVJNER BUILDER DECLARATION � � Name R•C P i]MBING� INC. ��by aff rm thot I am exempt from the Conhc ctor's lic�nse ` 4 0 v '� fo ihe following reason (Section 7037.8,'Buiiness and �� �ddress�� a�y O 1 V2 f- t�t��i, � - � � 5 P ofessions Code). �,� ;��3 ,�_ ,� '� City - �.:�el No � . . . . . � . �_ `J C x . , ,r. I as owner qf the prope[ty,will do the work ond the � • • �"T �. strociure is not ntended o offered for�sole (Sec(on � � � � �� - � �G��-"O rJ. 4� �7044,Bus�ness qnd Pr�ofess ons Code) � � � � ` .e. i ;..,;,� , �' :`"�"� ty�-�,,�„-;�'CS�ISTRUCiION LENDING AGENCY F���' � �-- - �- " ���� ` .'I he eby offirm�hat there is a consiruc�on le ding pgenty for � . � - _ . � �:�tl�e.performance of Ihe work for which lhis permit is issued � � �- � � � � � b(Sec��3097 Cv.'C.�.., ... . . . __.. . .. ... . _... �....�. . �..... , _. . . �_. .... . . . .. . . ... .. . �_ 1c E'1'T ..,.Ark" :IiY. 5.'4' `G ^S;h � . .�k .. ��,R r+a � ' s:' e -..: ��:s� n>. �, ..., �� „a � F,t ..:,�S�r��3"�t��.�'.�'�"�'��',�-�r1 �.� i a-- �: ,�" "�:.�,+'u a'� s3 v�, ,..�= �; ,_ -Lender s Name � � > �'�q 8w i ry .� r� � xwa .ne.�aar�.sva '� � - w sk�,�ov�z+�as�ra-. � m��na.�e.u��. r . 3'�e r�.ra.?:..:5..a.,.3'�k � .�.�.ut;�a.�,t.M.a.*. k;,u.+..o.� ,tt.ss�,., x�., �.,,a.� .3.,s.�,.m F�.,�t;�:.a�.�.,i...#�xw�,a�:�a'�.s...i-��:� , .,,.a�,.W.aMf�:f ,.,,a.�� .,�4�r 4 <`:�a�...an.4..w��..�... m..... . �LendernsAddress . . . �r:.mw��e��� � ..,�-.. . .� . .. �aw.�-w.+.w�.,^aa�;�sa��w�r�� -,:.sarma�a.:s:.rw��rr:a�mu.w,u:u.��.v�;eew+�.:.:.:� � �..�4°I ce i�fy�tl'iai I hove reod this�applicahan and state ihat the � � � � � � - �y`t��above nformot�or�iscorreU.Logree�to comply with all Couniy . . . . . . � �.o d nances a d Stote.Iaws�regulating Plumbing,ond hereby� � � � ,�,.�a thor ze,rep esentatives of ihis County ±o enter upon ihe �� �- � � � � � � � � � above ment�oned pp@perty for insp,ection purposes�� �� � � ��- � � � � � � � �^*�'� ��r�'�'R"� t f SEE REVERSE FOR;EXVL/(NI(70RY LANGYI`i1GE"' ;. ,. ., , .,:,� . , r:... . ...:::..:: . ~�g ature of Per Utee `'�/� � . .. . . �:� • . .�..�:�.....��:.. x BV � C � � . .. . .... � . �.. .,, �Date � . . � - . . ... . ... , . s. 1= _"_..-...,w _ .�,�o.wy .a., .i t .-,.,� i` .x.� x ,.. �� ....;. _:. ,:, .��, .. .. , . .. . . ._ _ ' ..z.�,.m.,.�.'......a..�.,.,,:y,r, . ... .. . �.. :... r,. ,�. . . :.: �y ,� S"�. � a r' � .. , , . . ..'r.. . , v , . . , ._ ,.. IN�9PECTORrS'�YES...„ .. .... �,'.• �:: , . ,. . ....e O'vNNER-BL LD°R DECLAR/ai iO�i' .�... . - �::: .... ,.. , .,... . . ,,,- RPPROVAlS � � ..��DATE"..,.,�I�v�P�CY��'gl�'T5A4UkE .....:...,,, ..,....;... ,-. ..:::.,a.. .��:.-�.�.: ,. T:::;..° _ -.••:•: ':` 1 a eM e�ay oF(m iK l� ��pt�` �� UNDER StAB WORK �"'��„�,?/' ;� �:.: �'�°"`""""' . .- L ar e Lo or h,:�`ollo nc� ..a n (Se., ., � � . .._._....... . . . . � ro �° r�31 s o t' r 5, : ROUGH PLURABING�"�"� �����r ' �,�'a� . �..�..: - ...,� .•:.•...,>. .✓ .:�:•:.: �...,. . ... �_. 6 s`ness�p,a Pro(esslons Codo?:�, y ah�c cour y h't: �` GAS P,PING � � ,,e�f,/,,P���� � .+�:�� . . requires a permi!ro consfruci,olte mprove demvL..h '��- .. .. .� ... � -�' .� . ..... ' �..���. �.��� .. ar repoir any strucfure, prior}o t i sumu� a o re � GAS VEN7 � � �-� -� � --- �-�� -^—��-���� �. ,.< .�m,r.�...;.,r,.sm.,,_..Nm�.z...,.�+„i'e� .auires tbe oppiicanf°or suth permd to f� ❑signed cte _ ,.._...._.._. �.�. -.:c.-r...«r ...�. � HOT WAi.R HfATEk� � �-�- �� merrt thaf hc is licensed pursuon}'o the prc�is. ns� r �c . �� .- . .. . ,.. ..,:�.. - merc a wi,n .. ..._. . . . . . PLUMBINGFIXTU2 5 � � � .,,........_. ...:.:,.,�.._ _. .y.;_.. , _,_ .:,,n;. . .- �, ,,,.��:.. .Contracfcrs Licensa Law(Chapfe, 9(com . ... .... ���:, . . .�::. . .,.„ �'�� Section��7D00)of Divis od�ot the 8uslness ard Frofes � GAS TE57 ... ��'� .� . �,� -,,,,,,y, . � � � ' � � . . -. 'j.,:���-. �, �"!.,s otts CodeJ or ihat he exempt iherefrom�and the bnsls .� UTILITYCO.NOTIffED'�. . .- ..... . .,,�:.::.�,. _..,�..._ ._... ,�.:::. ., „ . . . � for +he alle'ged-�exem��;ion. Any violaPio,� Scchon . ._.. ...._. ,. .�. ,... � � c.7 . . - . �_.. .__,....: .:,:::,: :�::: ...4��..: :,:..�.�p - f d d . ` _,h. 31.5 by ony apaiicant for a permrt suojeds the ap��i- - FiNAL � , �is(er on � ' , �� cant to a civi(penalty ol nct more fhar, ive fiun ra J ortf ,. � . ._..:-..... . �..:..... .a�, ..x.».: .�,+,s�:�.u.�::w,.».w+'m*�t��.'�: ... . . . ..� .�.dollars Si00).: d .. _..._ ._... . ..�...;.:.-. . ..._;_.. ,. ,...,:�....,. ... ��� ❑I,as owner of ihe properry vJl do'he work an � . :.. , ...,,..., ._....��:=w . .,.+-z,s�. .,. ;��:.�� . � . .. . . . . � . INDUSif21AL �- ... •-4 _ �_ �•„,,,;p;�,��he truc�re�s nes�Qnnded or��fere^fo�r salce '� ` WASTE�APPftO`JAL � .., .. ( �,.�. .,,.. .'+, >^ '.�� :•-:� �^ ...�. ., .•. .^:. ' �.. _ forsLi�C2nsoCdwdaesnofaf plytosono•r�nerofproport� ��� ,� .'. �- :�: �:� �.. . ���•. ..�'�� s"or lm��ores fhereon,.an v✓fic does sucl ���+: � .. who buifd P . . .. ... . t _ r, �„,�,��,,,,,�,.�, � �,,,;�, � work 6 msalf provided that.such improvements�are,pot „ ,.. .,,, ,.. �� .. . . �� , ,,,:_ . .; , �.,-,�' �:�� . '��. i � ;:�. inten�edorofferetl-farsofe.if,�-however,tSe'duildingor �-' ,' �. " � ;� '� ' `.:.. . ..<`�� ... �.. �- ' .. �-� d within orie year of complefion,the ,,�.. , ". :.. . � .�; .... ,..,,; �. �q,s�... x re +�7�^e�r�tr�*��.i�.6 �e;�.-z.<R'prov at he ..� ��� ..;,.., :. � - - -.. - _..:,.. __ . ; . �e`ment is so! „,. ..,. ,. ,„ . � , . '�. • . ', � �.. �, . oivner-bwtdar w71(have the 5urden of proving th did . .:__ � . , �. -� � . .. .� :..�. P �:..', . �::�.., . .�-.._ . ... .,::., -,.�.�.�„,.. ..;,,.. _.,..,:.:�.. >.F:k.�:rw noi�ul�d or inprove 7or iNe.,u�po4e o4 sale.? ... . ..:�,. .... . _. . . . . . . . . . ., --:.. .���.. . � , �... ..,.. . _. . _�� �.: . .,... �«;. ..���.-:�r.,:- �� �._ . .:.... :_: . . , �.- �:a�n exempt under Sec �;re�.�w�� -.w�w .^.�+:a, �"..,�k,..,.ix�,�&�.C.{orihis'reason_ ..,�_. .. . ... . w' _ -r,H ..' .. . ;. .'.. .,. _. . . . . . _ . w.3 `,;+.°..� . 'e "�rw""'�"�^.. . � ` '.... -.. , .� . ,,,. ��., , c a I .,�... '.:. .. .....:. ...... .,.. . �... .- -.:.-. �.... _:�- ........ .......y,,. ..... ....... .. .. ,n rar. "�.. .,.,: . .. . .. � �. .,- . � . Date . ,..., . . r,'�=., Cwner �;... : .. � . ' .. .�. ,>., ;; � . ,:i _ 4. ;, . 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