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HomeMy WebLinkAbout1711A (10) -. -„v.q-Kra� �cx! +"�.°§�' r Z � � ���� �a�.:'� ����� .����� y�.'y . ,�� �� � � �,�- � , .�w �� �'"'�,�,".� �d'� x „ti:� ,�a x�'S}�..d ^, �'.� g�.�,t7�. 5�°��"d�+�F r' ` .�s,`.,r t a"���s.tz."J'»3z:.�`�`:�.. e�; ��, � 6 K s C('�"" ,SA�Y '�C fd .�: , ,.« .., ���1$� � �� � �� � ��5fy`-j �� ���� Y hereby�'affrm that�l hove a certiiimle oi cansent to�-self w�7fiA667A � ., "�i�"� fn5u e��or o cerhfimte of Workers'Compensat on Insuronce, -CE 817�REV.�10/61; � - � � � � � � �� - - � � r'"�rGa'c�-rfed copy i(i eof(Sec:'..3800,"Lab.C.) � � . . . .-��.� .-.�-.. ..�. ���� .75asso_cY.� COUN7Y OF LOS ANGELES _ 6UIlDINC AND SAFETY Lo.T �/ .� �A�ol ty No Co pa y "�Y97�F /rYJN.G7 . � � . . . . . . . . _. . 7�n Cert f ed copy is hereby furnished � ��- --��� �: � y..�..�. ssr ..e.�. ..v.:.s ur.cx .ro.. ,.n: .. . ' BUILDING Cert f ed Copy is f led �, � P �OR APPLICANT TO FILL IY(PRINT OR TYPE� c ifh ihe coun 6u Id n ins ec �DDRESS a, . a z / ���n',:. i y.� tion deporlmenf NUMBER. fIXTURE OR ITEM ' - ' (� FEE � LOC,ALITY f��+ n '�"�'.�is+���k�^�.�,�'.. , A � � .'����'k'i��ec,�u'��S WATER CLDSET ' � '"/I�'i/i(r� .. . - , . �.�,� .. PP 4a t . . . NEIiREST .,.. ... � � ... '�f����,'y`�s'°���"'c�Iz�I�A,T�FES�E`M"°f�t�r�Fz6nn'��f+o�`R�S�"�. ' snrH�rus . .. . cRosssr. ayq c.�' ....o.� .� `CO(V1F'FNSI�`I'IOIV�INSUR/Sf.1C�E' �OWNER 4�������`b�wt Yd�'a&+��.s�. �y .�� ew.��:�. �SHOWER � � .C�+C9 �< .C�S�" --���.. . This setTion neeC not�e complefed if Th wor�c mvalved by a,�;,"ihe perm i is for one hundred dollmc(5100)ar less) � iAVATORY � � � � MA��- aooREss 3/.Si eK ca .9ir._ u� �d, r � T"�cer�t��,y�fhat 1heT�pe�ormance o�t'X'ie:wor(c foi`�;v1i�i'ch�this�� � - � " .. . . . . "� SiNK � CITY L NO. -'�"�`eim�i is issued fshall not employ any person in ony manner � G" . :y � S O 3b�as fo become sub�eU to the Wo ke s Compensation La s — � �.,'��.�;"^Es�,a �.. 'A`P �-s� a �'r`rt c s � � DISHWASHER. � '' . . . g'.�. ��s� � +;�ycr 4,X^!� �k.. 5 � Fs YR �.Y �+:4� COMRACTOR .. .. . . �'� � 'w". k,�w�f�,�[���'.fw.,ux`� ..�..�:�� .. .�i`•Y., .': . . .. . . . � /�'.� . �[.��ate_.,_�_Appl<6nt CLOTHE5INASHER ADDRESS �....S�J�YIC��TfS AS�C�ICA�IT If, after mak ng_Phis Cerhficafe of ��' � � 9�. - x e`mpion you shoold become subjeci to ihe�Workers'�� �� SWIMMING,POOLRECEPTOR . � . . t otn'p�'rl'S'ahon provision's of ihe Labor Code,you musl forth- �, , � � G7Y �.�.,,�.t.� � s� .4�. El.NO.vr��� ""��� �}h com I wifh suth�- rovisions or fhis'� eemif�sholl he �AWNSPRINK�FRSYSTEM� « p Y P P � STA7E . � lic. ��k1ee ed re o ed � - ,. � WATER HEATER. . �. - . LICENSE NO. CLASS ��`��" L�I�� S�E[S CO�fC�T�TS���L�p��b�J � . DISTRICi'N/�O.�, � OCESSED 8Y �'���'�`''t� '"K '"n�'"''7""�` „aC�"k"�rx"tP"G GASSYSTEM � OUTLETS � . � l3 --.�-v� �p,. I�he ek�y o�f m t�pl�l om I cense�,unde provisro s of C�apte 9 ' - � s�,,��commencmg iih Secton 7000)of Drvsion�3 of the Business - OUiLETS�OVER - ������ � .. _ � �y„ nd�ofe s ons Code,�and my I cense is i fu)I force and effect 5 PER SYS7E.M�� FINAL ,r� a*e'��'�' �:�rw'- :5tra�.�s;F�s,:��?x,�::: VALIDATION +� DATE e3 r �.�.r�'t � (� �j . . � '� �1tl�-1� LIC CIO55 ��� . . . .. .... . .� y � um er icevnse N �'+�/'�9/C'�sa9��C-4asOSG'�t, .� -.�......, ._. . FINAt � �`;��,y�ont actor y . ,* . �Date 9"� �C . . gY . � � . , � - I am exempi under Sec �. ��'Jb �F�k���'?�k�3 aarac'±r'•oa��56+�STf� �d. , � � �8 a t s reaso �k�+ ,� r a,kr :r s � plqn chetk fee ���, ��'��'`�'^ ''�"�''����ate�'� �� `'� t.�,.�'�` r.� ,'�,�n`�t ,�.� <��`,y -. 'Y *"�� �x �7; 4 PLUMBING PERMIT ISSUING FEE 5 ?���r S gnofu e '"�r`°��'`x,.�s��-�� �1 :,� �°r�ri '� 'y°' ��3'r-��^''t„� .. �� ��� iOTALFEE - . ��s���`�'���,��� s�'��c v �r,�.'�''J,� er'z�-�''�'.�P,w��`� H,i> ,.S Plan check applimm � . . . . � v �y� ,�'� §1N�1��'AMA�CY �: '-�� e s'`��^s�I�AE�1�M'EQ�t�I�b�R b�CLA`RATION � " Name � � � � ��l�`"''eYe�y affi�m't�iat�'om exempt from the Cont octo's Lieanse � qddress � � � --� � '.•� �. . � �for ihe following reasdn(Sect o 7D31.5, B�s ness�dnd� � ` P ofess o s Co�e� LL .�� �� Gty Tel,No. . � � `� " � $ - � I as ow e of the p operty w II do the work ond the � .� � � � . � � , , „ . . _ .� � G-rj!i _ � 5�{,y,.y'�'� shucfu e is hoi intended or offe ed for sale (Secf o . � - � :,�4��, "7`pdq �bs ness a d��rro�essfons�ode)-� - �- � � '�.. .��i c'�+%`�k-���� T���A k a a� ��ts< c'4i�:; � n 3`: ,� �� . �F e�� 4) . �,r h �e�� i ;s:.'z s.�>.: .e�.� .`r..,.....,. .... r� �S R CT O LE ��E�1�'CG".,, ,>., v. ��„ . ., _, _ _ . , ti � #� ....� ....,.�.,....fx�.. .u, . ._ ;- ,.,.,.. :.. ,. . .. ...,� . ._. ,,��:_ r-.a..,,. _.,..,. F ��, he�af irf�m t�at t�iere is a consiruuion lend ng agenty fo � � � � ��- �3-t �/" . � "fhe erfor once of the ork fo wh ch this � �� � � - �i - � , p pe mrt is ssued . . , �Sec 3'697 C C) �� .. . . . . .. . . . . . �.��� �if, '�� 2w^ r� (�r : �.,,�6 �� `an ':�, Y+ �-�F`k #�-�,n �.. : 3 :pr F`a �. �' -s£'� �,� � �/ :�..i% S ���`v-z�`� :k ��r`u�,�' r�#°-A,'�'.�r �.�5`.r�.'� ��r�;'�r.��"�c r:�.� .r�3`�'�?+h'���r�'w.r'e*�� F=ia�'�3" 9 `wl,�[u'' "'+�,k�SF�3`��, ��-� 'x .�' 'u+Fz�Av�F�". ��c.`��.`.^�F�`r�`ac.�`�k'�{�1'.r�Y' �:`.�.:.�"'r.. «u� '_ Len e s Na e . � +�$.d� �.'�, �,` '� '.�„sx :er�et^�k�.:��.r��«,W�.�v`,�;�.i�".,��m�r��Ua.a�.GN.,..�s...,,,sw�-M.�S.��^° N,.�� _'�..0::�.4sr'a'.4��5d°�:Sa��+N�'�, F:. �r'"tir...�z,,::. ��der�s�dr�s���'�ut�c�'��.���a�k� .w ? d�"'�`}: �''� �'Vra`*"'��`�'e�.,ca��,����3�` �' .uY � , . .......�., .. .__. .............. .,,_. ....... . ......, ._ ,.. ..� _ . , . .....�. ,. .. ..... ..... ........ . ...,.. .,_._.. . .. ..... . . ... �,. I ce t fy that I have re d tb s appl c t on and state iFo�the � . � - � ��� ��'-" �- � - e�o e nfo mat on s�co eci i ogree to comply with all,Counry � ' - ��� � Y+R""""rd n n es a d Srate la s eg �or ng Plumbing,and here6y � y,��rfar° .. . . . . . ( a t�ho ze epreseniaives o��-this Coy�ty�io�enter upon the ��� . � � � '"'�,�.�;a6o e me t oned� �roperty fo��nsped o �purposes.. _ � . � � ,��4.����/f �=� . . 5EE�R55/ERSE FOR EXPLIONATORV jANGUAGE .._ . . . . ..�-.� . . .. ���� -�-S''--�'.t _ ����Signofure of Perm t ee Dpfe � � : � � �� ' � a�k'�s� ,�, �ses,� '��'a 4 '`.k,�"�a`,�,c� r � i u ;� , v'- �. �"a ��'<�' r ��ar`"�r�'�-"�s ,z� �,t _�'� r��i..,��t F .� � �,�n :� ..���. - .s�:�fl��"�'�{.�...,�„e:t$"�..,s�".�`�.,...��.. ..��� ���' �i^°��'�,r p"�a�'�I' .. � ���.T 1 &:� -�, t i? PS y ,{ 5y. " tJ:a u��n'��'f" .;& W Y . .. :- i�: �:: 'i . ..n. " . .�. _ , ..� „ �; b s �.. .. .... ,,. . . .�... . .. � :.. . .. �: . , ,.. ..�::.:� .:., . .�-:... .. . , ; .... . ..... ...: .. , ......�:.�..�,.;,:n,- ,..:.:.. ........ ; . .. . ,..... . .._r., 7�: ;:: ... � ' : � .. ... APFROVA�S . . DA7E I�SPECTOR'SSIGNA7t1RE ' ���� INSPECTOR'S'P1�YE$� �� �� O�NNER-BUIi�ER DECLARA ION � � UNDER SLAB WORK y . ^ ; hereby affirm ihat i am exempt 4ror the Cor�,rddor's � -.°.�� ROUGHPLUMBING� �� � � � , -- � License Law�for-?fio�foliowing reoson�(Setfren ?G3LS. . GAS PIPING � � � � � Business ortd Professions.Coda�:Any cify or couniy wbich GAS VENT . . . . .. . � - � � �� �. � � � _ requires a permit fo corts7ucf,aker,imprave demol�s�. , , . , � � � - or repair ar.y structure,prtor fo its issuance, also re- H07 WATER�HEATER � � � . � � quiras tbe applicant for svch permif to 7ife o signed s;aPe- ?LUAABING FIXTURES � �� � � � � - - � � ' �� � - � � menP that ha-is licensed pursoanf 4o ihe provtsrons o{!hc GAS TEST . � . � ��� � � - - � Contro[9o.s L cer.sc-Cnw(Chapier.9(commenainc wirh � UTILITYCO.NOiIFIED� �� �� � -� � � Section 7QOC)o°Qivision 3 of the Eusiness and Profes- . . . . � . . - � sions Codej o;iF.ct he is exempt tBeref.-om and fbe 6asis � - c} � � � � for fbe alfeged zxemp9ion. Any violetion o/ Sc-ction - FINAL . � ...�'nter�on �} . - . . ... ... . 7031.5 by ony appliconf for a permit subjed>rhe appli- ' �,. . '���`f�, ,` ...canY!o¢civil penolry of not mor=tHan five nondred _ .. deflors(SSOpJ.i � INDL'STP.!AC � � ----� �����-- -�� �--� �� ��� �� � � ❑I,as owner of ihe property w'll do�he worK,ond ' `PJASTE'APPRO`✓AL � . .� . . . -' .- . . . .. .. .-. . . . � .. . . �� �ihe structure is not inPended cr�offered lor-s&te.,. �_;....�. � �(Sec.7044,Business arrd Proiessions Code: 7he{ar � c tar's ticense Law does not apply fo on ewner af prop�.,y'� � ;.., ,�.-. , :. _.- .' ,'�. - � - � .� ���:. �� :,�- -'�. :�- .�':: . ,a.; ;...;,, :� who builds or improGee fhereon, and who doc-s such � a . work himseJf p.ravidsd tHa,�,such improvemen s�ara not : ._:� .�. , . .,.. ... . �., :' :� . _ •_ .:: ,� .... �� ^ ` � ,'' .��> '�i .`- .... : �- , .. .` , :�-. : .': , - nfended oroffered-far safe.It,howeve„ine bmlding o `�'��- ��:;�; � :�.�� -'!'.` . i�.` ' -.�� :�.:� .�;, ., iihirt orte�yecr�of�completion�,�;he. . ,`' ,.,:= . -��.:: ; �;,..:: .-'- .., �" �.�., : �...�� : �" awnpr-bulderwtlnavetheburdenofprovingthathed;d . �;. ' -; ' . ..,._, , t . . . ,[1.a .�.�. , .:., < .:. ... :.,' ,.,': .� - ,�� �., ,, , .._ . , ;; .. :: �-`.�-- ��� naf 6uifd ar im�reve for the purpose af sale.J � I am exempf under Sec. � , ..::. -:. �.�. ' -� �.: ,,.. :, ., �_. _. - .. .. ,.: - �. :. . .:- . . .. " ..... ... -. - _. � .- . - ' B&P C.for ihis reason . :. � . �. � .� �r ..C:. �_ .�.` :��. .. ,, -,:,.:. �.. . �.:: :'. ..' • ..�. , : . . ... .:�.�: : . - . ,. ;..: . � ��.: :_.:.,.. , c�. ,� - . . +. � % ' _ . . ..� .. . . . �"�i - Dae .. . . . . - . � ... . �.,. . -- ..:� ,.:�. ..� .. .. ., .. �: ,;.;,. .... . -..r ' � . ..._ :.::. :��,�. ::� :,.� . ,.: ;..' ', '� ��� 1..�:.� ,. • .:: � . : .�: . . � �.'.: .- ,- ._.. ^._.� .,.: .� ' . . .. . . .. ._ . . , . �', .. . .-.. ...._ . .. . - �Wn@f::. . . . , , , ....,. ... ... .:; . ,. , • .,,-� , .��::�� . .: . :.: .. .:+:.. . . .. .:- ...�� ,.�� . ; . -. . , ... ,,.� � .., .. ,,. ,.,.,. .,.: �. 1NSPECTOR'S NOTES _, _. , __ . . . : _.,..,,.: � G.' _,s ";^ -. ... . .. . .... ' , :.. . .r. ,.r, . ,,,. . .-:. � . ,.�,. i` ,.. . . . .. . -,- . . .,-, _� . . . �