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.��++•-,�w,�x �- �=�v°-g��-€; �^� "—"`" --� �-" : : � �-�r- �;=-- -�,,r���.a h �;��,�°� �x� � � ,� � �a � t t''-� �...,F3� -:n�,��+�,..y�.-�r:�. � �'� �RK�S�O/Ji�ENS��c��Fk A ATI�N �'����.{��� .:. .s��, "_ �. �-'�m �. ��x: �„a:s,:��'.�;. � � I�,b�(��IN��R �'�h� � � �r �,. ���.��..�...��.��M.ry�,�,����.,�:�:�� � ereby ait rm ihat I�'ave a cerl f<ote,of can e t tp sel� �pq«,7q . _._ . - . . . . `�� u e o crre i f te af Workers'Compensation Insurance, � CE 817{REV.70f6:' -. � .�. - � . � 'o a ce t€e-�copv�e eof 3ec'3SCio ❑b c;_. /� Jf COUNTY QF LOS ANGECEs B�IL�ING Ai�D SAF`E�Y'�"���" ������ '�. Pol cy No 7�s �' �'o pany�� s'N�l]�+ � y . .._._ .. .._ . . .�. , . _ _ . ..� _ __ _ ... � . C rt fied mpy s h by tumished � , � � - - - - BUIL�ING } �- -`- ' .,.�.,-. ,_.. �,.._...ss�,. F:-.�..�-x-s�.�. �•.��.-: �"' '���.�-�^+ FOR APPIICAfJr70 fICL IN(pR�NTOk TVPE}... } C:' � � • .. �'❑ 4� ^ '. :I' � e tif ed cop�y�s f.led wi1N�iNe coonty bwldin �nspec � �. - AOORE55 �v'�) J _.ru! � - ; t department:.: ' Le��.C�' �'� NIJry,BER �.: FIXTU1tE:OR 17EM , t3� �-.- ��E- LOCA!ITV � AL����,`:, .�-_� . `� + �� �'"'��� ��� �� � WATER CLOSEi � � � D APP�San;S �., NEARESY . � ,�- C ��T}�Ct�i f�E�k�,hTl � FROM WORKERS' - Bair+rUe � CRO55 5T _ ' v x � ` ��t�/iRPEN$ATION-,INSURANCC - � - ��� � OWNER--- . �' �,�',�M'�€�z.t�.�'��x+�_�� r� ,� �s,-.<;:•mz � SH��YEk - .. j7h s secfion n6ed not,be completed if t�ie work mvo�ed 6y- . .� ��- - MAa. � � � � fha pe if s for one b ndred dolf s(�1D0}or less) .:� IAVAiORY qDDRE55 - � ? ___,,,c.�. »s.,.�s.�� w._._. ... .. . �"( ert Fy i�iar n the perFormanae.o�ihe wbrlc�o wFu<h jhis - -� . . , ' '`- " _� ' : ,r`'pe m 1 s issued,I shpll no'employ any person,�ln.onqmonner - S���K . ��T�' � . TEL NO. �`�' `sd c�s to bec b�ec�fo rf e Wo kers Compensat on Laws - - . ' �� "'' ' �� � � Y ���,�„���� � ,,,Y �.���,y������ v DISHWASHER . CONIRACTS7R e ���� ; -t p �^ �4-a'� ��.`3sc�} �sa� sw„#�.:� _. �.. � �.�af������pp�icani � CLOTHESW.4SHEk:'. , . . ... . ��NC7f Gc'�1�O�T ff f e'mo q �h=_Ce�f�co�e--01 - AD�RESS � � � .�'E m ton, ou hauld F�ecome s 'o t t�:the Workers' -SWiMMINGPOOL.RECEPTOR . yj - ,�%' . ..._ Y I : . ... ... .. . Cf7Y -�. ... + .�.:. TEL:NO P �Ce pensa�on provision o� he La6cr�ode,you mus�forfF- � �qyyNSPRINKifR5Y5TEM '� � -� -. �'r�� . �"`w t4 comply wifh such proa sions or this;pertnit sholl��be - - � STA7E.� �l LIC. . -'� . � �d mei�revoked � � � WqTER HEATER�-' �- UCENSE NO J�7 �� CLAS5 � � v�' �'""���' � �DISiRICT NO._ � - P ESSED BY�� � � � "'"�.l��C�I��C,�SN`�`k�Z7RS'D��i.�R.4'fC0't� �: . -._. � � � „ }'� ,� GAS SVSTEM OUTlF.TS - 7 '/I 1 reby aff m tha�I am I censed under prov s ons af Chapter 9 r{z -��r�E� � �',g.,.4,�,_„ .�} Iyf c me c'ng witb Sect on 70001 of�Drvivon 3 of the Bus ness OUTLETS OVER �� ����� . - - - - -p;�� S PER SYSTEM J t��l�d P ofess o is Code,aad my hcense s n�ulf force and effeci. _ - - FINY+L j� f �j \//\[�p/�T�QrJ � �,.� � �� p,�;{y. ,b«._.. .. . . ` .s-. j�i L �se N�hmk e�r__���GL�L c Closs� . � �'Yr�G �.�-4c aiE� 2`�"(� DATE.. j�j��-} . . .. .._ ,. . � �J 3 :'a'.,���'`._r . �'�x�i,'8Xi $• �iNSF;U-#.�:�F'" «'�.°7� 7 . OG FINAL�,� � � ,F ��_C t o ror.� .:. Date I�� `���'�i . . . . BY ..d.;i�F r.�.i�9��'_. _ .V t � LJI ri e e npt unc 5 � ��� �,�� � �n '�e&'� o �h r as�on Plan ch�ck'fee -�� � � � - � �,T�"u'a.�'r�'�'n�� �6oi��u'`':� �1rt`''� A- . . .��. .._ �- � �: . - . � � � - ���r.:��-.��p��?-�.�;.s� �5y';� . PLUMBING PERATIT ISSUING FEE S � �t ��i�(�i - . . . �"F y Q 3. ��"' '�-�„�� .. . TUTAL�:FEE ✓'fi SC� - .. � . . _ � �t x.a � 3 �,��#� �, �.;' ��; ,;� «... -�fi =� �t^"r�r�`,s � " �„ �'��'�` Plan check apPlicant � . . �.O 7�.�A. . f-�.w-'3��' �un1n�E��fSKI�"�C7'�bg`��C'�P,"�2'aYRSF-i' �""` Name �� � � � •,_, '<�I he eL c,ff r�-Yh$at I om e empt fr�m the Confraclo's Ccense - �- " �. - � }�,.e o o .o -�j � Address � ��O ��L fo � e f lo ng_�reaxon ($ecnon 703L5;Business qnd � - � `P('ro''�fess ons C de) � � , ,. . Gty � Tel No � - _-7 � •�il�� . - ,L_l I as�o e of the prope ty, II do ih wo k and the ._ -._ -: �' . -- . - m s � � VOSOt e"3 {sf ctu ou: re ded nr_offe ed for�ote�Section , � .. - - � � 70�4 B s s o�F oiess o s Codej ;� `a�,�- �.a''�-K�� R � e'� �, 'S�- .s+�-�}a� �i.�^ �^ �- Au �'a ��� t }�h4�.��'��z x+« -�� aYw -� L 29 ..�5�J __ .. _ c'�'�-'�"CO�S7fFGCY�C�i��C� . _ . . .: � _..s, . .. - _. .. reby 4ff m tho�fhe s o conslruc�ien lending gency,fo M "`- ?-tlie pertormo ice of iFe o k for.whuh fh s permrt is wsued _ �•-- �� - � t 5 c 3047, C --;x. � � ��- � �.v� .� � � ���s-�&�€�.� � �,�,�a����s��'% �`� S� ��`�`� � �� ��-��''�� ���`e�a� .+� :L de s harie � ,�_�.,. � � ``�f � � s"�'�. � '^e=;"�,. a s. -ys �:.;t C' , ,. �' �� �'��'����"..b�:�c������.��'-x��-a��m�,'�.��..� '�,.�._.'•--��s�.����^z� �'�z�'�r:.�'�,��''�,._���"��r- ..�fz��:s ,�:^a.�.� �.3���"� . ,,,s-. �;� de s..Add ess � _,..:. . - _ >� . . . - ., _ . . _ . � w 1 tifq ihot I I o e reod ihis appl cafwn ood state tMaf ihe , ��� _ . � .,.=. E _ nforn n�o,s<o e<t I agree to mmply ��h oll Co.uniy - i� o ances a d Sta+el s,k�egutohng Plumbi��g,�ond�Fiereby -. - � - . . - -- -� - . - - ,i dLfho ze�represenTotives nf rhis�County to-enier upnn-�ihe � � - -- � - - � � - � � . - - -�a�o�e�menficne� Prepe�fo+mspec'icn purposes , ���� - - .-.-.-.. . , . .- .-- , ' ... ...... . .. � SEE REV£RSE FOR EXPLANATOQY IANGUAGE-'- �� � �-��� � �� X �Cf �� � ,�3�i � � : ,�'� $ �7 e o mi Date . � � �� $ _ � �� -r-�����n _ _ .� -- � �-� k..;� ar.W s%�� e =Yr'�4-:i�.,..�;ti�>. �.r�.�w��..-�s�:^.;�`- � % -. _..__ . s��..a�.:e���_w,m.�...,� �� � � , � ,� �, , .� -� , :�� -��� � � �� r ���: � r� .� � � � �; . , - - = . , �... . � ,. . .. . , � _ . ; � ,, . � . -> < �_ ; .. ._ ,. , - � r �.� � � �� pPQRGVALS OAiE ` INSPE[70RSSIGNATqRe � ,�1NSPEQOR'S��IOFES' _ � �_ y ,_ - CVJiVER 31,iL6ERF�D�CrLARA'�UN .e .. . ..r,.,._ . _,..._ ...v ,..,._„_ ....�._. .. � Ut9DER SLA@ WORK � - - - . . - I�hsreby-aff rm:h t I on�exempt from�th�Con�rdc,or's ` RbUCH�PLOBi1BiA!G'�....'... ... .. �. ....-... . . . ..."�"' ...' '."._.:. ' .,..`: ` ..:License Caw for�ihe follow�ing rzason��Section 7G37.5. � � GASPiPiNG - � � -� - - -- - � - - 8usiness-ord.Profa-sionsCode):Anycl9ynrcounfywhich � . . . _.__ �.� . . - . . . .. . . . .. . __ . .__.�._._.. _.,,._, . __..�..,-'.....,. rBquiresap"ermierocor,struct,alter,improve.demolrsn. � GAS VEN7 � - � - � : , � � � - � r repair any sfructu:e,prior fo its i;suance, also�e- �HOT WF�TER-HFATER ... . ... .. . . .. ..,.. _...._...-.._. � �� .. _. . . - - . . quires�ihepppUcont for soch permit�o file a signed srcte- . . PLUMBING FiXTURES �-. - -� - � � ' ment rhot he is iicensz�!pursuant Po Yhe�provisions of!ha —. - '�-_ �._.: ...... . __� .-.____ „ .-�... ,...... .....-.,-.-,. ..,..:,.., --. Cantrac"or's License Law(Chopter 9(commencirt�wiih ; GAS TES7 ..... . . . UTILITYCO.NOTIFIED �� - �-�� Secf7nn 7000)-ot�Divislon 3 of fhe Business pnd.Protes- - - - � -- '�" . '- "�� " ���-"' siOns�Cade)or�5l;ot hz rs exempf therefrom ond the bosis �- ' . . _. -., — ...__ . . . . . . �. � - �. . �. . - � . `or-tha a(leged exempticn. Ary vlciaflon o4 Ssctior, ��n �-7 ' ' "- " "-�--"` "-�-�-�� '-'� "�` 703I.5 6 an o -Lconf for a erm�ifsub ects ihe a oli- - .FINAL � � .�{�nf¢r on�..tranE � .� .... . _ . .. . � �� Y Y FP� P ! P.. . _, cant`to a civi(penolly of ncf more thon'five hundred ` _ _,._,. . . ____. dolfars(S500J.: �__. ;:, _,_._,m,.,. � INDUSTRIAC -- --� '�� - � -- � - � � - ��Cf li.as owner of ihe properiy will do ihework,.and ; NJAS7E.APPROVAL - .- . . ... � . . -� . . .. ' . ' . �-�:. -"..... .�._.."", rhe struc}ure is not intended or offered.for sola �� - � �� .. - *�r ���_' `:�° �-'_ '. °� - ;�`,' (Ser.7444,Business and Pro€essions Code: TheConirac ` z .. :._ ,s y�; , - " tor's Lirense Law.�oes not apply ta an owner of property F _ , �- riho builds cr�mprovas 4hereon, and-who doas such �' '- ; !. : '§� - ,. , .�, ..�. _ _ ,,.�: �.:� ,..- .,.r_ y- � .;_ �. � � .. - .,' �'" �- PYark h�mself provided tha4 such improvements-a-e-not.. . . : . . , -- . ... .� ., .�: ; - - �_ .�; -�--. .-. ,`.�� : '.�, �= - iniended or o feied for sale.7f,however,tfie b�i(dirsg or� . ' �: � �:., ,, .�.. .: ' _ _ - menf s so wilhin-one year f�com �e'ior,,f4e ... �- . . . .. _.,..; �'� _� -." .--,�.- -�._-: " �� - �i� 'A- ' ' ��- „ ,;�' � :; - v6w(derwJlfi,avetheburdenofprov�ngrhdthedid- � impro � ' ` ' -= ` , ._--' ��' � -.�= - - � 7'iotnbui/d or improve.or the�purpose ot sale.J � � _ _ i am Vexempt onder Sec,f.:N � �-�� , ----' : �`- r �4� .-: - : `'�---^«-+•� .-�.-���: �r"- . , _.. , � , � _ , . _.._.. ,: ..,� : ... � . � ason ..,.... -�.-�.-�;� ..,.j - � - - �� _ ,� ,.: , � ., _,_y •.; - - . -: B&P C ror This re 6c�e Owner� �� q1N5PECTOR`$NO7E3 = _ �-,..n..«.� �. -e-,- __ . Y, _ _ . ��.�_. . .' '.,..:�. ._ .,- t '...-. _. ... :w �--.�-°� ,�.�:,,�, ,.:"s..�aw--�..- »�_w�.uw-����-�vsw�.r`. `- _ - - _ _ _ *.-s;>�:� '�*s„�"",�r'�r�-•.¢��;,�'� - - _ ��.. � - � �"�--.� - �.�v..�-�.»�-,..-.��www��,..�s..�,�„�,.xx»�:, - � ; t,. " - : � � .�'��:�,,��..-�.,�.,� . , . . � �� = � :: . , �r ,. , , ,r ,r.. -� _ . , - _ _ „�` . - .; -,, - z__ :�; -�, ,,_ ,. .-. :=_.� - ;� .' ' - e. �. �f _ - �:.ti ' - - _ - - - { r ; ' _ e'� z,-�. , _ " y-'�.t" " - � �-:� 4 f €,�_��. � - "xCYs-r .,»rn...'�e •mir�_S'f` _ _ _ _ 'c = +��T'� , _ y.S. � aka �s� '4s �"�'°s� �. °� "uya�aaey� _ - �a �' ...�§� s�-� �� - _ _ � ^..`9.-x.,x :c.n�..c�Nu �»*_�Y�N'�x.'N'.Gu .. ` . . . � .: _ -.' _. s' _: . . ,. _-. _ _r _ . ..�.� e,. '.�. . . . -. , '... , ,:.. ; .. . . �-_ • - ' '-: � •, .�-f