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Home My WebLink About1370A � �� s .,�.— ,..,� :..�_ .::`.... .. .<-.z. ,.,_..t�sa �,:z' �, `,Y�s_, .�'t S.s.=.,r.�:'-., �..-sl:tt-'p�.r Far_':.xc'+.",�-`f� ,�_? .... .. . . . -. - :.�.= �, vsc=�-- .x;T t.. f -�. �---_ ._:._� _ _:.. _:,� s ..,, _. � ,.;..�.; , > -� - =�k- \VORKERS'COMPE`vSAT[ON➢ECLARATION -- �swez>a � �P�L I C A T�O I V F O R P L U M B I N y P E R M IT I heretiy affirm that I 6ave a certit`icate'of conseJif`to self ��ce e� (z-eo� � . __ __ _..� , ,: �.� msare,or a certificate of V4ock�es Compensanon Insw'snce,or �� - - ' - a cert�fied copy ther.eof(Sec 3807f,�Lab.C.) - - : COUNTY OF LO$ANGELES BUtLDtNG qND SAPET�Y�.Fr _ -- :� � = .. -- ��: _ �.._ .�: . ; = �� v __ _..� _... - �� .a.. ,.. Policy No. �Company . - ^-�- �.3 '• ..� . ._ .:. . . -. � Certif�ed copy is hereby furmshed. � FOR APPLICANTTO FILC IN fPRINT OR TVPE) BUILOING'-��/ �j � -� � _ I � '_:`_ „ '.; . � -.: .; ; t"�. .. . l . . ._. AODRESS 7o�ZZ .�� L`-� � . Cert�fied copy s filed with�the Coanty building insp"eCtion - NUM6ER FIXTURE OR ITEM • -FEE o�sa dePartmenL - � � .. . .. . . . . LOCALITY_.O/ ...6�/(�� vl�:-- � .WATEIi CLOSET - Date' ` �APPlmant .- `�. -.. , .� „ . �fVEAREST-. ' . . .. .7 . ''- .,; ��. .,:: �, ` - � BATH TIJe .. .. :CROSS ST.�' 11J�7 f�� ... �i6'��=j I%'1'� CERTIFICATE OF`EXEniPTION FROEA W ORKERS «,��, n � - � � � � � �-- -- �-"- �-� --� .- COtiiPENSATICIlVTNS�JRlCrYCE.�'�:-.. SH6WER. . . ��..j � OWNER �`/�Jl/ ,ZL.i�--.T�i�-E�� -�AVATbRV MAIL - . .- � . - (Th�s sechon need�not 6e completed if�fhe wpxk imolv_ed �� - � nooRess ��` - ,� - . } by the pexmd �s fox one hund:ed dollaxs (5100)or less.) SiNK ' . ,. .. , .:� . .- :, �..� , � CITY .. . �TEL.NO,_. "'��.7'` �� I certify that in the peiformartce of Yfi�work for,w}jich this � 61SHWASHER -.�i - � � - permit is�ssued I shall not ert��toy any person m anymannet - - - � �CONTRACTOR so as to become su6�ect to t e Wo kers'Compensatio � � . .. _ . � ,. _ r ppp CLOTHESWASHER:.: , � --� O , , �y �-�AODRESS� � . .. . Date � �Appt�cant a1 �� r,��' SWIMMING POOL RECEPTOR� - F �-� �� - �' � _t _' "'. _ -. ... .. . . NOTICE 7`6.�FFLTC.�.NT I�;after maTiing t`hts CertiTicate of . - . - ' . CI7v - Tel..NO: . � W - Eiczmfion . Y_s �. . � ' . .. . .. . a . p you hautd become su6�ect to the'Workers' -. � �AWN.SPRINKLERSYSTEM .:! STATE ,_ UC. � Compensat�on prui�ision5 of the C,abQr�C9d0 you`must fqrth „_ . : � � - { .LICENSE NO. � �C�A35 - � �`— wtth Comply with�such pro�iswns or [li�s permit shali be `NATER:HEATER - , -� - - � deemed re oked .r GAS SVSTEfVI OUT�ETS- � �-�� DISTRICT N4��-_ �PRO SSED BY �:. ;'. LPCFNSEDCONTR�CTORS DECLARATiON' � - � OUTLETS 6VER . -- - lQ - •�G.t-�<rC/ - T here6y affirm�that-I ain licensed under piovisions oTGhapter �"� 5 PER��SYSTEM � -�- - - � � � � - � � 9 (commencing wifEi Section"7tioo)of Drv�s�on 3 of the Bu'si "" . F�H"''� VALIDATION ness atid Pro7essions Code,and�my license is m full fot�e and - � - �DATE -��".�- _ - -�: . .. , ..,,. ._,.:, � _ .: .._ .. . . . � . . effect:-� - - . - - - . . _. .... ... _. .. . . FINAL � LicensxNumber -��-L�c Class�� BV_ �- - - � - - _, . _.. , � . .. . . . ... . . . a.- ;,-.. ,.-:,, =:. . . . .. _.. _... . _ . . . . Contractor � Date �- � - � . -__ . _ ; ,__ ... .-. ,� '� t am exempt from the licersing requirements as T am a ' PIBn ChCCk f@@- � - � - - � - � hcensed architect or.a_„K„egistered profess�onal_engmeer . pLU.MBING-PE�RMiT ISSUING FEE$ -- � ��'� � - .:.,. ,. _ _....__ .. .:,. . "'ac4ingin my-professi4nal�capaeity�{Section'f`�b1,�8us- -- � iness and RqfeSsions Code). - � TOTAL FEE- � ' _j� - Lic,or Reg I�o � �➢ate � s�� Plan check applicant � �- - � � - __ .. _ _ __.. � : _.<- - ; �137.OA -�HO�+fE OWNER BUILbER DECL�I�ATION��- -�� Nsme. - � ,. . _ , #?e •:• •5 I hereti}� affuin tfiat I am ei[empt from The Contiactor,s " Atldcess - . � - - License�Law for the�follaiving�reason (Section 7031.5, Busi City - - Tel:�rVo, �� -�� . r�,a e � 2,5 O ness'and`P�ofessions,Code� - �� -_ - � � �... ._ -..: ❑, �.. _ . ,.. . ...:. :: . . . ,�. . . ... , ,. s o m � .. .., _ ... I,9s owner of the pLaperty,am exclus�vety conttacting - - _ _ 25Q� with licensed contractors:to,construct ,the .project - -� �- --�1.C�8`8'� ' (Section 9044,-Busine3s and Professinns_Code). - �� - � � � � � � � - - ' - � ��- - - -� - � - CdNSTRYi'CTIOI3�LENDINGAGENCY ' �� `. _ _ _ _. _ __ _ -APPRGVALS `DA7t IN�PECT6R5SIGNATURE� -�. . � ..rINSPGC`VR'S�NOTES�`�� .. - . Q ,�1��-�TJ`�I,DEI�DE,�LAIL�ITION UN�JE-ft SLRB�WQRK :::i:'vT=:..�_ . ,.:-..-.,...,..; .... ,-;d . ��:: . . , .:, ;�� _ _. - ..- , __ ,_ _.� . , .., ., t. - ....-.. . ._- .. . .,� ._ �- ,�.. ._ _ - " -- ` "``��•�' � -� � � �-.�-i hereby affixm 3ha4 I am exsmpf faom the Con4Faciar's ROUGH P�UMBING � . �-.-LL'acense��Iac• foz Thc fo[lowing scason(Sectier. 703:5. GAS PIP�C2G ":: �..... �_:�.. .... ..:� . " ,.-' , ..' . , ;.. . _ . . _ _ - Business artd Pr�fessions CodeJ:. f3tty.city.or eaan:y eqs:�e�7 ` �=.:. . -:. ,_. -__.. , . ._:�, .-:: . „ ..: .. ._,.:. .:::, _ .�.,_� . . which :rqv.i,es a perrrti:ro-construct�-¢Ifer;:imardve, .:_ ..�� - - ' �.� .�- ': .�_:-,_..,z � s�e7G�qTer.s�eqj'Eft - - -_ _ - -devno!ish,�or-repair:Anysrrucrure,�prra;toe?s dssuance, � :°LUN1�Ii�fG FIXTLRES'� �![.3o reqGires th applieanP for such perrrifi /o file-�a - - _��- - _�- �sigr.ed�si�tement tha:-he is licensed pue'seca�te to�.�he Gas�a EST___ �:� :-- • .:..� . __ �.::.- � ��' � ' � . . , " . . . . provisio-sts:of ehe Conarccter's License Law(ChaPrer 9 .... . _ -�._ _ _ .�:.� __ -_ _ - - . U7�L��YCO.NOTIFtE[� . � ..:" ��- . - ..'.: :.�:. � .`.._ ._�. ...�. .° -.�('com»vrnci:'ig with Sec,>on 70Q0/of Dr;isrer.'s of t3te-' ..::. . -._�. .--_ �,`� :...... ..._;. .. ..:, ...__ .,.:- -.._.'- _ - 3usiness-and�Projersions Cod2/� ar-!hat fie-ia exemat ;; �.. - „ , ;... -therefrarii rsnd the basts for.rhe a:leged exenFtior Rr.y- F NA�- --�'v��e--ass �2ayti?�� . , .� _ `.� :�. - ... . .:.� ... .. �✓iolation of.Sectior, 7031.5 bY any d��.trrnnt jora nerm.ir :::. -�� .:� �.:-. -�. �;...- -.� ._. :.. . . _ ._. . . � „„ � �.:. _-� - � �---.subjects 2he apptic�nX fo�a civif_nenaity of not more tlian - irvo�Trtia� �� -� �� . _. .� ._..__ �.. :� . �:� _' frvehundrzdaotlqr,/.��00)-: . . - � . . WaStE,4PPi?ovaL � - -�--- - - - - -- �� C 1,as oumer et t,e prQ�erty-�t71fl do khe u�ork;��d . ,:' ' . - -_�_� - �� _,�� - � .� - _ - -'the stractur��; no mtended or otfeied'ioz sale:.- ` : ` .'::. ��... . --^.-: . �. :;Sec. 70�8,�&usiness cna Pro;essiens �o�e: The�'on- ;;._ _... _ _:_ __ _.... . _ .. . �. ,- . .. . `.. .--,- �:-.:. .. � . . .. . � .�. :�rractar'r Licensc Iaw�does nqt apply to an ownar...oj. :;. _ _...... '�� . . -_:_. . ,.. . :� ,` ' � .. . . .�... -: '� ' -property`.w#o b rdds�qr��:mprc�es[li�ereon,and,wha ades ,_ . . �.� .;.- . - - � � - .- . , .. . -... . . .. .�,N ,: ; . .. . -�- -.:� `.' ..such worrc��hiraiself..yrovideli vhar�.such :mp..�verrterits - :.-. .:;, .. ,.. .,.._�-.- . -.. ,. : - . -..:�: � _,'. . .` :.-nra no.��:�:[eadnd�r�offrre�l;or sade.��:-If, harxver,-. the .>.,_. . - . . :.., ..., . . s ._ . . . . _ _ � u�_.r : �i . . _ . . _ �- � '� � -�� _- � -buildi.yg�nr irr.provement is sald w�t}nn one.y2¢r c; ... � � � - cempleeion... the,awner-Bu:Eder wi/l.hQve�,7{te burden... ;_ ` ._-�..� L�_ . .__:.�_ � ., --. . ..>: ., � .. ' .: . �� ... oJ p�'nyitz,��Clzct,he 3;d.not buifd�or improve.jor.eke . � � � ' ..1.�. . . _ .. - ;, . .. . . , .,_ � ..-: . _. .. _ .. . _. ... .-.� . _... ;purpose�ojsqie./ . . _ _, '" I am exempt under Sec. , , , - __ B&P.C,for�3tis reason _ - -- : --- ' D3fe _ _ , _ _ -.; _. 43wner _,- . . . �'. '; : ::: ,_ . _ _: ;. . _ - � r. __ . . ' ��.:s a ,INSE'�CT�R'S.NOTES. . ' � . .,:- . �� . . '-_ .. � . . ... _. .___.