Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
1713A
..._ ._.._ ___.� ..�.,.___ .�_. ,_ .---..__.___ _. .... ___.. �..--. _ .._.__._ ._ nvaallONDECIA.RATION .. �� � � APPLICRlTfON FQR PlUMBiNG PERMIT `���,��. ��� i '1 he eby offirm Ihar�l hove a cerr f caie-of consent to se14 76.4667a ��� �� ' - � - �. � s re o�o certrficale of Workers'Compensdiion Ins�rpnce, CE 817{REV 10/Si) � �� . � ���or��g��ied �+}��'eof(Sec.3s0o �oh C.� ` COUM7Y OF l0S AR'GEt�S „ ,,: BUILDING AND3AFETY r � r �V o '�oi c � '� Compan .- "�t� .. ,, , :., � '... �.�.. L�. � ,�� � Cert f ed copy s he e6y fumished � .. . �..:. �.�.. . . .. .��:. ��. ` ^. ��' e �.:.. .. �^s_ '.-. . . . �' Certified[Opy�s f led fh the counfy bu�ld ng irSpeG;'_,,: �FORAPPI CANTTO FILL IN(PRIN'ORTYPE) qDDR�55' �s��� `��4 ��'�/—�lC� ��� _ < ���-' � NUMBcR FIXTURE OR�7EM k�y..d�,dBParimenf.� ,xr,::�....��sa�net�...a�.....�.. @. FEE . LOCkL{TY ^! �, �� �;�„ y ) r�r+a �WATER CLOSET �Date Appl canf.... , ._� .. NEAREST. i � � . .� � ������ ERTIFICATE�OFEXEfvIPT10N FROM WORKERS'� BATH7U0 , :. .��� CROSSSY� ' �'-'^�'+�y � '� COMPENSATION INSURANCE � � SH��� - . OWNE f ' � ,� � �/.• � ,-a^(Th s sect�on need not be compiaTed if the work imolved by � � . rI f,��;�iho perm t is for one hundred dollors(5100)or,less:) . �qyqTpqy � � AODR S ` ��� �� � tA����j '*+1�1 c hfy that�in�the per4ormonce bf the work for wnich�his � . � ,�pe mi�5 issued,I ghall not employ�any oerson in any mqnner' � SINK � CITY t . � .NO. � �-to a to�bemme sub�ecf to the Workers Compensation,Lows. �- � -�� � ; + I ;Fv� �,�'���"��'f�.�"'�,T�h:t"�.;KF�' n'....:., .. - DISHWASHER_ � CONTRACTOR L ,`��1e . �, ,. APPh.pnt . .�,_.:.:..:. rLGTHES WASHER .�..:. ... AD�RES � � � .. � �. � ,,�7710E TO APPLICANT !f �o(ter makiny thia Ce�t ficafe of 5`NiMMING POoL RECEPTOR �� � � �� mp on,, you should_become suhject to the.Workers' , � . . � Ci'Y � TEL N . • or51P�'nsdtion provisions of 1he Lobor Code,ybu�most forth- �- � ,t "�� � LAWN�SFRINKLERSYSTEM � � ', : - � � � x"§w ih comply w ih such p o�s'ons or this pe m'r shall be � STAiE � ' tIC. �a�,�.:deemed levoked .„ , .-.,.:^.'- .•..... .... . WATER HEATER � ... LICENSE NQ. . C[A55 � �110EN5ED��CONTRACTORS DECLARATION� . � ` � DI57RICi�NO�. PR BY �' GAS SYSTEM OUTLETS� �j+� �� erAby aifirm thol I am Lcensed under provisions of Chapter.9- n,,_ C ����commencing w th Section 7p0�)�.of�vision 3 of the Business� OUTl,ETS OVER, � . � , �v�'- >` 1� .q�and Profeuw s,Code,a d my lic nse is in foll forc ond effe t. 5 PER SVSTE�.n � FINAL � � ,� ��r n � � oATE VALIDATtON � ��� ���'�"�' .���� rse Numb � � Lic.Closs E ry, '��'� J�� / '(Yg � � PINAL 4�����o:».►C��� 1 �+ f�L�.� �� y f? BY � � .�,p,,.rO I om exempt nde Sec � � . � �iw roF'�°�"�§r �^sw . � # s,r B BP.0 for this reason � �r '� ��.,,�s Plan check fee � 1,�s.. �� �: � Dar�� � . -. � .: r�,:� �` ' � - � �FLUlNBING PERMR ISSUtNG FEE 5 � � � - � Sa nt � � � . '. e .����Y�,�- �� �`�'.�,,, *�.� �*i xn''"'`',�.�s,'� `Yr. _._ . TOTAL FEE � . � t�°' S � ���< , �� �� . � fi r�a`z��`. �-� � s .� , . Plan check opp6canl � ' ,� ��� ��5. LE FAM�LY � a,�.�� t�`'�`'�HOINEOWNER-6UIlDEKDECLRRATION - � � Name � oy aH��m thar i am ezempt from the Conrrncror's License Add ess �` ' ' t� for the fol�nwing reason (Section 7031.5,Business ond. � � � �- . Yt��"ofeu�ons Code} . � Ciry _ �.: `Tel�Na . . _ . . . . .. � ❑ I qs'owner of the propery,wJl do�he work a�d the � - � � � � ���� �- � � ' � �� � � � � � 7� ✓�'h„st �Wre is not ntended or,offeretl�for sole (Section �- �, � � � ' �� " ']�.�� .r �;i�� 6,�7�44�Bus nes{.a d Professio,n�s Code). .. .�� � � � � .�. � �u+�4. . . . . . . j B���v�-, NSTRUCTION LENb1NG RGENCY . � �� ,<6�P�t^���'�``�"��a�"��v�� �' e�� ��hereby affirm ihot Ihere is a consirucl on lending agency for ,:.X ,.� .���,r�„w�:5'.3'� "�',�^'`�'� �'�'������'� ,.� ,� � �, � �tl performon<e of the ork fo wh ch ihis pe m f s ssued �„�.�.,�,t Y„s��`r���"^ � � � . � a;�)/Sec 3o97 C v C) r � s��:7 +.n,++,• .. � . � w�F.4�c'�'.�f',r.E:�t�it',;5,?5'S�„J�i7 . . s b .. �� Y�z �,'+�:*'.�'.'�, k^v�'� .. ��, .;�, . ';.:�' . r.�. �,� � ..,�- s� .��s�`� _ . ...,. ..,..: . . _ _ . . l dcr s Name .,,.� . ' -. . .., . . . , . . . . � . � .,.✓U�"'i!�;;� . . � �t,�'��`�'YiY7R5'r.z ':,, .. .. .�, : .� . � � . .. -.. Le de_s Add ess �..�: .'. .... , �: . . � '. . . � ° 'f��1 cer ify that I have read th s oppl cation and slate that rhe� � � � � . � � � �f�}"'h'b roe,informotion is wrrecf I agree io comply wrth pll County � � �` �'�"rd nonces and State laws regulating Pl�mbing,and hereby � � �� � �� � "�""'�iho ze rep esentatives of th's Cou ty to.enier upon the - .�� wa'bo e ment oned property fo � specn purdbse. � ' - �;����y ��� � ��;r � SEE REYfRSE FOR fXPLANATORY IANGUAGE „ � , x � "` � �"�€++1���e':s���"��<[��s`�. � ( � � � F +A q.s. $ignolure of Pe miNee s � Date �� . ,. :'r :<•.: .:... , .•... y . • ?, o .: :,; _ .,,. . �� `, , .�. e ,. > ,,>,r, , n. r� , .. . . ' ..qc'." � .,� _ . ,; - k .... �;;�,.: .�... ,...."� :x. � #;-� ,�.'+ ir�,cti:� m �+% � .e�'. � v�"'^a^s s , , .,. � .. . . ���„ ..... _, , . ,.�.. ..... .� , �.,.� ..5'Yq'...'" -��"�,t �..��`'. - r. � 3 �2 �' - �� -� �-- '��'� .��..�. . . � �'��i°s[ ��a����':�.�H� . , .. :: ; .•n * .`,� ,�'��'u� wy„# a- - " xsi..�'�`�`�•� �=b s'�s`�"�x"�OV�/Nwc�P.BUIL�CFR�bECIARATION �'. ' ' .,:x .." . '.. �. �.--�_._"" � ' � " _----"—' `�— INSP�CTdR'S�nOTES ____,_---�-- ' .: "��� ��� � ' � nerehy afi�rm�roi I am exemp�from the Cort�acta%' :� . . . .' .. ......i, ...: .,.,:-. ..�.:.... .. . . � . , ' ,. '"�� . �.:� � �..�:.� �NSPK=TOR'S�SiGNANRE ------` -- . License La�M for �hQ iolbwino�reason lSedUon'��W��c' '�qn c•4 o u y h , APPROVALS � DATE . , . . � . . . . . _ . . � . . � Business and ProEess'ons Ccde Y Y � .. UNDE2 SLAB WORK � .... . . ' .. . . .. . , .. _� requires o permif to consY��lor�loe�i� iss�anc=_a��s°�ra. ... . . . � ' ... ��.. . ___-�- -� .... - .,...� . . ..:..... or repoir any siructure, P - ROUGH�?CUMBING . � � . . � . �quires ihe app�iconf for soch�permif fo i fe a signed atata �qs p�p�MG � � � . �- � r�,ent ihat he is licensed pursuont fo ihe provlsio�=�f!he � Cha ter 4(cemm=ncing wi . ;ASVENT' .. . .. � � - �. '- - _ ' Conlracfo�s Licanse I.ow( A . . ... . . -- . . .. . h0?WATER HEATER � � , ,. ---- �.. .$ection 7000j of Divis�on 3.of the Ausiness and Pro�es- � � __-�.----.—"-'� or thct h�is exempT ti7ere�f fam ar��hs bO�n p�UN,BIt3G FIX'URFS � ----'- —�-----�-� sion5 CodB� for }he afleged exem,olion ,4ny PP�'" GASTES? . . .. . . � � � 7031.5 by anY apPlicant lor o permit sub�ecfs tne a �. U71i1TYCO.�NOTIFIED� � .--- � - � � �� � � .. cont to a oivi(penalty of no3 more than five Furdrnd ,_. .., .. dolfars(55U0).. -� . ... c-p'�ryt �� ' . . � '�]I,us owner of the proper9y will do!he�++ork �r�� pINAL�� ���+.eer osi -1� . � . . . - .� .. . .the strucltare is nat intended o�offered for sae. .� �._...... � -' � � : ��..- � . . � .. - -�—�: � . .. "�(Sac.7Q44.�BusinossandProfessionsCode: TheCc . . . ... ... - � . . .,:,_. .... �. ...._.. �� . . . . .: � I ta an owrer of property . : - . ... . . . . . .. . . . . � �� - � � - tor's Li�ense La+v dQes no7 apP Y INDUSYRIAC . . . �. � . � . .. . ..�who buiids ar improves thereort, und'.vho-does such .VJASTEl+�PROVAL „m,s,�s . ' . ' . � .. �. ���: y,�p�-k�(nssslf rorided that such improver4ienis are not � ,:- ' '�� � ' � �-�� �-� � intendedorafPedforsole.7f.however,thebuildingor . ^.•�.� ":; ..': ' � ^.' ^" ' • .:�----�-- �� ... .. .. .. . .. emenf is sold wf4hin�one Year of compfei �'d ..:�.� �'� '�: ',,. .::� = .:���. �,'!_ '"' . . . . akP�e�builder wilf have the burden of proving tha ; d::� ,.. .- _ ..,. ., .:; '.` -.� .. �.V . . ... ion,��e rho " °?`� - � not bvlfd or improve for fhe p++�Pose of sale.; , •, . _ t under Sec. _. _. ._ .. ............. . . .�. .,c. :,..„ , .: ��. : . . . 1 am exemp ,., . .. ... . �,, . ... �'. - .� � .....� - . . . . , .. .:��: ........:�.. , ..� -:. . , ... . . . . ...:�..-. � ._: . . .. . ..,... .. . ... ,.. �;,�.�. .,. ' ., , �• e&P.C.for this.easort � _—__— , , � . � ,; . _. . . ,.�,� � �:._ -�. �. ., ., • :�:�.. ',�. _-___._-.--�- . .�� ..; - . . . .Date .. . . . ,.4 . . . .. .. . . . . . . � . ,.. .., . . ... :,,... .. . .., . ' . " ,, . . Owner , . . . .. . . _ _. !NSPECTOR'S N?7E5 _ , , ..: .-.:. . _--�------'—" __—.._...__--_ , ;. ...... ; , _ . _:_. >,. ,:: . ` -..-_____�'-._._-------- , - ;. _. ___.----------- : ;. _-------="""'"__,_____._._..—,__ �-------�—�—'—``----`