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��� . ��s�,�-� ?` "`,hy��,�`F--"`g.� ig �- � R`°F- - ';rn•,g;'_'a%T,�; ._ .:. �� t .. ._�� �- £ ' "�'`��.� '�' -�,�*�'"�` ,�"�" �.''�-T � �,� a�,,T�,€�„�a-�„-,g „'. �'�`.`��'-fs•d" ��.. ��++ � .;��` � �''����:_..�.�.rb.ti'1 .t,�`�`t,,�"�r��W6R�R.e�C IvlP�7{Yf6i�TD"�'CLJ{�fi3:Ti N:..��-�. �.....��,.-..k �.�„�..�NP L � ���^ � 11�lG ��� ��,.��. f I�iere�by a�fi�m that�a�ve a cerii�flicai'e��enY fo self 76A657A ' :�� nsU-e or cx Ce t f cate�f Warke s Compensqt�on lnsurvnce, CE 877(REV 10/811 ' �� - ' - � x '���b�'r�a cert f ed�copy thereof(�c 3806,Lob C j� � - � � � : ,_..__ . .� � � a.,e.� ,a ����-�,��.,i,���,��r����,OUNTY OP LOS AfYGELES BUILDfIVG AIVD 5/�FETT ' ';�� �� � Compony ' . .�� - Y _: � ��� _ � ._._.. � Ce t f ed copy s he eby tu n shed _ - �- --� � .^-.�� �, ^-- ��-.�- �. a.� _ � ����"�'����`��'' �" ^-��^"`- fORAPPUCANTTOFil�IN(PRIP:ITOHTVPE� - BUILDNG �� ��� • = _,w�Cert fied copy is tiled w�ih ihe munty 6uilding inspec �- � .� - -��- � ADDRESS �� -�1 on depariment. _ �. � ' � UREOR ITEM Ld FEE -� q � � � _ - NUMBER FIXT LOCALITV - ' afe� '- A li ant ���� - ` : YJATER QOSET �. . ^ :,� - - � -= pp-S y � NEA¢EST t ,. .. - BATH TUB-� CRO55 ST lZ�-� ;,� r� `�`�e �k`��iv�`��'s��"� S ss��^ �." g�{)xIP�A�I�I�S[�TR�C.E 4 . �O`NP1ER _ . SHOWER � ,:��,�( s sact�on nea nof�be'c'dmpfef i �f�ie work mvo ved by � r t.- � � � � ��the-permrt is for one hundrod��d,z„�ollars(S10D}or less) �qvatoaY� r�A�� � ,�'� �CD��, � ADDRESS -'� cer�t�'y thai n ihe per�fo�manee n�it e�work for wG+c�t�i�s� �� - ��rri t s'ssued,..l shall not employ any perian i any manner SINK � - CITY �i Gl� ���s TEL.NO�L'jG• /�. :�f3bs`"to�bemme�-sub�ecF b fhe Wo ke s�Compensahon La s .� � .,, , � -� . �_ . - fl = �' -•--.� -M-E -r - - ,..- - DISHLVASHER CONTR CTOR� >� 5/,�1� - i.,, �..ti,bi „ a ate � PPlicant��" ~�-���"��P C�OTHES`NASRER ' �. r . . ���3� N�$TIC TO APPIIC/>NT If,-after making ihis CerFfimie af � �� ADDR SS G . - .��'-'�" '° -- � ' -- SWl7v1MiNG POOI RECEPTOR -� ,; �E empi o , you s�ould�became sobjeci to tNe;1(Jorkers' -� . CITY� � . , � 6" -F,� :. C'om ensation � � - '� � - ,: t p psovisians of-fhe Lal�9r Code,qou must fortF� � �. -�- ��. Q L�,- 1EL NO. ���CJ -�� - CAWN$PRFNKLERSYSTEM � O �t Fih.comply with such prqvaiotrs or this permrt-sholl be - �- � ��- deemed revoked � � -STATE � �7` [,,� F �-'UC -. >-�EN����.���AT�Q��� �... WA7ER tiEh7FR . LICENSE NO�..5 '� ! F� :�.CLA55 - : %�. t . ��, �, ,�,�,�,,,�y, D15TRICTNO PROCESSEDBV .. - I e,�eYiy a irm t at I am i tensed� der pro is ons of Chapfer 9 - � � GAS SYSTEM -�OUTLEfS � - l �� - - �x �c4�"i.m�nang wiih Sect on 7600)of U v sion 3 of the,Bus ness OUTLETS OVER � `� �� Y '�,�¢� d P ofess ons Code and myY�¢ense rs inlu}�#o�ce ond effect 5 PER 5VS7EM --F�NA� . � � � �� - '�� �•�� � �.� � . �; � �� oATE VACID/1TION _ � „_� L ce'nre�ber� � Lic Class �� ��s"� +.��'.���s��' " -. :�_ aCo�"�rjo'M � - (tf. .�f>n�2 --�7 �r�� �- F�NAL � . ate � BY . �.. '���� I nm exempt under Sec � � � . �� .. . �- . �.... -.�-w'-"vw��'`� v�"k�-'�,�v-�22��.v�,`�'���,R-z`� T�"%Y �C«K'S�'`"� . . . . . c I��:.�i�J�`. -� � . 8 P C pr th s reason- � ��- - � . --� � `� - ��` � are ���� Plan check fee � y�o F �4: - '��s� � � �' - - PLUM6ING PERMIT tSSUING 6EE 3� ��i - � '," �� �.�gnafure� .�- .. . : � . � � . . � ,e e. I � �. � ��� _�' � : TOTAt PEE � - - . - - :r ,�.�� ��� ' .- � _ F�� Plan check app�ican[- � . . _�� c,..,�;%� ... ;��� .� x ..�O �k`'��15E��-0LEl:�`T�Z5K1`.. - ._ Name -� . . _ ,..- ��•::G /�23 f`...�; � z .�-:�.,,OS�� O� �.'.���I h�reby a irm t�iat I am exempf from�t e-Contratfnr s License � . ,_.__ ' , __ .. �=��-�.�-Law�o the followiog reaso»(Section 7031�,.,Bu`sine`ss and"__:. Address�. - .' _: _ � . .. . X �Professions Code} . � _ C ry � Tel.No � �����f`. `�LJ I as o ner of ihe praperty wili do the work-and 16e _ - A , �- :. � ������.�� _ _ _ _ ��u����}rucfi�re s not mtended o offered for safe-;.(Sect on . _.. � _, ; - � � � � �" .�7�4 �"usrness and Pro essions,Co�el � : �-. �... f��������E�'*�:S-�-�s� -s :f� ,wa-rt�'�� � �-ab,."�a.�,v -� �- ��: ,f4� :� .�,� ^x«� :x ����� ~�con�s a ro i i �.��.�. �� � ,��.-., .__> ,._ - _ _ ...._ �s_r� ,...�.::��_ .,_�t..� . � e eby�o Y�'iat tYiere is a con t udion lend ng oge cy for . } - - � ;���� the pa formo <e of the_o k for whrch'ihis perm 9._is ssued ... � • -.. . � � �Sec 30=f7 C':�) ` ._ - > _ . # � � m � � .�-�z a. � � � �. � r����-�� .� . � _ , �� aa.�"��'����t�..�����F:*� �`� __ lender s Name -� � � _- - - ; � _ _ � � � � ��'�'���s:�","�`�_�.��,i�a��a'���� -e�` ��'�����,�,�=c`'��'���r z�`��"'�'�,�.�".�""�"�"'����`'���.��..¢��"��'���-���'r,�'� �';'��'�?}`�'��'� _ -,�`"',�- enders Add e3s� � _ � _ . ��, ceri�y t�iot I�iave reo�th s applvmt on an8 state�.f{iaf rhe` ' - - .-, _ . �_ _. , - s�r„,c'�obo e format on a corre t i agree to comply �h oll Coonty . . w,��or""�d �ances a c��tate�'aws egulohng Plumb ng ond here6y - - . - .._,..,.. _ ��� au4fior¢e represe iot ves of-rhis Couniy Yo�eriter upon ihe � - � � � � - � .u�f ' a�owe- enLoned proPert-�fbr inspect on purposes=. � . ' .> , ,....:_., _ _.._, i.-.._ ._.:: . ��� � � SEE REVERSE F�R�EXP[ANATORY L"ANGOAGE _ ' _ � ignoture of Perm tfee ` �` � Dqt� --." ' , •.. ._ . , - _._ . ._. . . _ -. . . _ �'��� s=�:�����:v�'�"`.z,�.'`���a 3._y� �� a� _� �d��;:-��'.� ���" ��'r. ����z��,'�= a� ��. � .: ':.. ;f - ..r�.;�'..�,..�. �`N_.,�' •��"� �'����r�"`� ��-- "`' �.�.� � �`��� � '� ' . .,._._� . .... .,.... ... . .. .s ._ -; x . .. .::^ '����,�'a� t.� �: �X � �APPRGVALS � DATE INSPcCTOR'S SIGNAYURE - � �NS�ECTQ�S NCSfc�S��� � �OWN�R-BU�LD�R D�.�RR�'`� f �� .. ,__ _ . .�_� __ . _.__. ._ _ . _ , . .... . UNDERSIA3`NORK� � � - � . � � �. - . ;�tiere6y affirm thct I�am exemp?;r m the Con�r�clor's� 0 .: ROUGHPiUM81NG-......-. . . . .-.. . . .. . .-..".". , ` "".'.._`" "`."` .,."`.:" License Law. for ihe ro1lo�Hing r2ason�!Sec:ion 7031.c. - .�.. .--...--- � . . . . .. . . . BusinessandPofessiorCod�)::inyc±tyor.cour.ty.,v✓nic'r, 6A5 PIPiIVG . ... . .. . . . - GAS VE.hT -��� .. ... ... . . . � - . . . �..� - �..-:' ' '.'��..LL.��Y�'�-�`��.� �....�'`e9uires�a permrt so cens9ruct,eiter,imprave.demoiish, _ � or�epair any strudure, orior�o its issyance, also re- � . HOT VJRTER HEATER�..' � ��� � � . . _. ... .--. --._. ...--_..-�--.. �-----'--�.�-�.�--.-- _�.---�ruires the.c�pGcon'r for�suChpermil to frle a signe�sYv's- . PLUMBING PIXTURES _ ..._,__..� � - � - � - - �ment fhct ne is ficensed-pursuoni 7o fh �p o•isians of:nz -�'- _.�. . . .. __. . _ . . ... _._...: ._.____..�.__..v_Y_....__,..,_„_..,..;,.,.. .--..._-_- ::---�Coriradcrs�Gtense lcw�.(Chapter 9(rommencing wrth ^vA$TEST "- . . . - �. .. . UTILITY�CO.NOTIFIED-. - - � - -- �. - - . �: .: SectiQn 7060j-of Divlslon�3.of fhe-Bus"rness;and Prdfes- . � . � ."�-�"' ' '""'""" """„��" " '"s7ons Code)or that he isexempt There£rom and th=-bcsts - � . � . -' -.. .. .. . ��.... . � . . � �.� - . for ihe alleged �x=mpPion.�Any violvaron of-Sectron � ..._ .. ..._..._....:___. � . . . . . . . . • . .. . . . .. .,.�,..._.. _ ,,._.,.__ ...__4v_., �._ 7031 5 byany.applican9�for.a permi!subjec;s.the appli-..� fMAL � -�nf¢�ors �ron{. . ... . . . . . .. . . - ._. ,. - .-,._ � - -cant-i¢q civii.penalty of not more ihan 4ive hundred �:.__ _ _.. .. _�.._:.. ....,...�_ . -,..,:._ -.._,_ .' .-dofiars{S560).: _._.. . . _. .. . . ..... ... ....;.. ._._.::..,-...-_-•. . .-.ENDUS7R;Al ..�- . . ... � .. . .. . . . . . . .. �..�t:es owr.er-o4 ihe properTy vi(I;do ih�aiork,ond- . WASTE-APPROVAL �'- - �' �� � � � �� - � ` �- ' --" "- ' ' �"�"' thesir�cfu�e is no1-int�nded cr offeced for sale.-- '- ..� ;. . .:' _ .�. ,.. �;. ..,, . . .._ - , ,�, -_ . .', _ -.= ' S 2 - `>_� �-;=-x �`''. "; ...:� :.'- ..' -. -,c� . L � _ ' �to�s L aense taw doss noY apply fo an�ov✓rer oi proper.y . - _ _ `who builds or improVes`tnereon, ond-wh6�does-such, - .. .; ...�> .: r _--. `r .,.n., . . " - ."wo k h'mself prvvided fhat suc6 lmprovements-are�nof _ '>'` ` . ,. • ' a_-�,_ � " �� : . •= � . - „ _ '- in}ended or olfered for sdfe H,however the bu.lding or'- , , , : ..." , ' r: ,_� ' ;.' ,. .,:: _ _ ,--.�.:,,�.. �- -� �� r ������ -"x . _�� mprovemen9-7s sold wilhitt one year`of complefioFr,tFe . "..:� t.__, <.:. , �_ . -; _.:: .._..:�� � � �' ' �' - :'owrier buil3er wi}f hove ihe burden of proving f5af he�did ' �. ': :^:.,� : , ' - � :='�: , -: . -.: ... :'""T'�° ""�"ibt 6uild or improve for�fha purpose of sala.j .... ... _ :.. '� :, ..-r _ _ �'t_am exerrpt under Sec._�� .T - - " - r--- -. ..... . , . -_� -. �;. � `. �.: ' '_ ` s: _ - . 8�&A C for`this reason _ � . , ... :_ , 1�. � Date '� . . ; . _ , . . _ . . -: . . _. . ___.-� '_ `-� ,-. ��,.� - � .s . - .flWt76r .- ._ _ INSPECTOR'S�N01'�S , ._ � . � A.�., �, _ � .< n,_ � -�...4 -,.. Y . .. �.F _� � t. - , ��-� ��� �ne , .. , sn� ..�..r ., :� .,_.::,_. , �.-t ,.a..�.:»��Y_�n.�,,���--�.»���>;�, . m� ��,,.� �.�+ .�a•n .�.�,.��^.�.,�«p„r�.. - - ���.;,..��.��,=µ� ��... �-�_<...;:: _ _ ti,���� _ � ' ' - �sw���,c+�-�m�o,��:v...�.e.��-_�-.�. ='.a , ::. ':.�' _ ...�. . ..:�. ......'�. > :;-.. .,.. .�: ..a,,.*�� �....xu�.c� �:a.z-+-.,�� ���v.r _ :. ., �...: :._ .. ,� ,: , . . .,�_ .. , -_ .. . �:: . �rxm=,�..:,F� �.�.,�, g.D"-�� ..-_, _ " � _ „�w.-�:r.�,.+w+�a.,..,.�