Loading...
HomeMy WebLinkAbout1591A (9) , ,�a . '< >.+R�'�€�n , ax-;zNs.�:, �** - ' -' - - �-- .__. .._._, �.�= rs-+c.w!.'..... . . . . �,., �. . _ . �; � : �� ..: :._ :.. .. . , . :, ., .- � . ... ..... _ ..._._ �\10RK�RS'COh1PF�S.r�"CYbN C5F"C�L��7YC�° ,,.� P �E 808(D2 801, � � A�P L�4��"f"I b IV���'�O R PE R M'1 T ... . � . ... . -; . . . .._, � I hereby affirm (hat C have a cer[it'icate of consent to sr�r � � . SEWER—SEWA��E"C�f�QSAL�� �� nsur�.or a cerii ficate o f�l Vor kecs'Compensacion insurance,or � � � a cett�fied,�y_�h�r�; 3soo,�ab.c. . COUNTY 9F LOS ANGELES BUILDING AND SAFE7Y '�— -' �� .e•°,l v.s r3�e.�l�9n%� .. . . ... _. . ;�. ���. �" PolicY'No. iai_ ynv ....... .._. ,..; . � � ''���/. FORAPPLICANTTOFIZL.W CONNECTION;DP�TA ' Cer[fted copy s nere6Y fumishtd � .. � .....'. ."." "'- ... .. ,. , .... ...,. '.:�..� . ��'�:�. � , .�.- , �" BUtLO1NL ,/'� .� - �1 �+ STATiON DEPT 'C �.er[�f�ed co�� .. .. g 1�..p �r aooxess�� CC'.rJ,� �. . ... �.L,_ c.�C"3G- . ...., ... C p}•is P�ted w�ith the�county buildin ns ect�on - -`�� � uPvee MANHOLEREKEKENCE � {,OWEI3, dzpurtment. ,. , toeaurv . fi�}Y✓lb�/ND � " . . . . ._ ..._. .-. Date �APPl�cane�. ... -: rvewRest .... .�../...�}..�+..y. .�. . . ,,! rrae oF�Corvwe�cr 8F� ..... �sr3'i'CY'k^ri'ol�Y"...�.:•::-- . .... ` ` � �+ �- "�: CRO55 ST �[%iy.Jc:.-/ � �����/'I'� v cuRe .20 P.L . . CCFTICICA.TE OF'E�-'�.ti �nV F'Rb�1 NaFt[CfsItS � '�-"-- . .., COR'1PFS7S�Ti(3N'i`�1S[IYCA'.J�L` � �',••_�. ���_�bn y—� /� . ....... r.c.�v . . .._. .. �:. �. � .g.., .t. , -: OWNER " ���( �/7�� G.�� CO.�MP.NO. J06-Nb_ . } $Thes sechon n^ed not be cor� leced �S the woik � � �� �//�..�A � '"""'�� `' ..< .. ,.. � . . ` � P � IIVOIVe(I AbORE55 �� w.�Ti-/� ,. TRVNK PEftM'- R�� ERM Y'ND��" `� by the perm�t es fo one hu dred dollars (5100) o� less.) ' r /!�`/ �F,p,,,,, ,,,E sE„E �o.,p., s�R.N o,r� tJ , . ..:, ..' �::� ��.:1:. ...-�,. . .:. - CITY' TEL O.. .4J�;1��/IU v'> . p ♦ a en Wr ne o . . :. . .:.. .. . . . � .'., .. �.;' ..�..... ....... .... . ....... _... 3� ]certify [hat in�the performance of the work foi w�hich this� �eGa� , . .. . . o� per nit is issued.I sba�l.noc employ ana person in any manner'�` oescw�vswN �or no. ' � - ��� .. ...... . ._. . . .. -.-� - -����� ���� NWY.OR ST.WIDENIN� " so as"'to be�o�me-iub]ect tn the�4orkers'Compensation Lau�s. . � „ _,.�,___> ..- il .,.__.. „.,,,. , ';;: '. ".: � ..:.. •: .�-�... 6lOCK � � TR0.CT .,._ . ... STATE ENCROACHN(EAT �,ej ,�: r.'>. :.: :� .: . . . ... ...�. ".�.�� PERMITNO. Date ApPhcant . . rv oF e� s ... ....... .._._..,.. ._.• t� e..�,-.,. . .,n. ' •-.-^�' ._•. SIZE OF LOT ..... , ... _ 1 W ON..L�T ^IOTIC'f.TO 9PPY.7CA�V1'.`�If,'after making th�x Cetiificate of��-� �"'� �"'�"� - . " u5E oF' ._ .., ... ...� � Exem�[wn, yuu should beeome subject te the lVurkers' . _�,�e,�f��lVE"C MnrscEs �� " ,. . M ,C�mpensation prov�sions oC the Labur Code,you mus[fnrth- � ew[orrvcs - . ,,. �� � �.�-.�� � •� . ..._ . ,. .... . with compiy with suNi, pro��isions or this permit sfial� be CONTRACTOR �I�G�r�,. ��,y,� � CONN£CT1ON CHARGE ee deemedrevotced. � .�_ � - -� � -� � -- � .�. � �', � �,;:_,� .r REIMBUR9EMENT FEE . _ , �.. .ti., G 7� cL.��-.���. ' ...LIC:FI�ST.�'C�?�7�'R�CTOIi�DL_l`L'A�'t.'�`'Il�h woowEss ..-. ._ . � . . _.. _�./ 'j- "_. oisr�+icr�run�. �aoor Mn= PWocesseo ev'... I hereti5 aCf�rm tliat I am licensed.under provisians of Chapter t�rr �l/VTZ-s�.A'(� .ret.ruo:��-(l�/`/I�f e" '� 9 (rnmmencm with Section 7p00)of Di�ision�3 of the Ausi- �� - ness 8nd Profevsions Code,and my licenet is in ful]fome and �� sT^�E ��'"�`ry ,� ric. � � �� ,� �a �.; ������ .... LIGENSE NO. �!�[ /G��J CLA55 /J � • eF7'¢cI. ::�. . .� - �� Na OE5CRIPTION OF WORK C�E � � � ... . � yy _ __, .._....._ F�Nn� VALIDATION � {-� wCk L�cense Number����'�� Lic.Ctass J � � -owre . �u . . �... /,�'// `C� ' .��1.�[`�- / sE " H�5 h?l+"n .. . .. � . _ ... �COilttaC�Of '��`�, �,-`ULt¢ '� f �� r�- / .. � FINAL � ,..r.� nouse seWew. cri'uG 4 "" '"� ❑�.-�. . . :�. ..,�..� . . ..:..... Ira ..�r M .... .. - BY � 1 am ezempt from the licensing requ�rements xs I am a o�-�yeLp�,oq , licensed architect or a qegistered professfonal�engirt�er � ��s��•�R t� ym�✓ -`2ctii�g�in��ny Crofessional capacity (Sec[ior. 705t, Bus- oGoRP�ow Ec .o� � . r �.�iness and Yrofes�ons C`ode) ... . � . EF .. vW�..� � �� - � . . . . .. , _ . '. � n� " N A s�'Y6�...J ., ," . I - ' ' "� ' sEN n oR n15PO5wL ' ' ... _ . _ ' �'. .. . ....>. f,ia or Rzg.No. �� � Da[e -- i � . � �j - ` :.. �159.1A ,�� HOMC Ol4NTR'�t7'i�D"ER D"$CL'4R"'A.TION� , .... . . ........_:.. ! O,� ,1 : OWNER'S Perm+t t ;�U ` '�0 � �- i hereby affirm tha[ I um �e�empt from the Contractor s �� License Law'for the following reason (Secti�n 7031:5,Bus��' ���� A�,ITHORIZATI�3N TDTAL FEE � f�� t:� �.a.o'�G,�C� ness and Professions Code): � , . . „E ���y.� �ykx-y W�rw^rr+t NEa�irv�a'a�ea tow�- ' . . . .... .... . .. ... . ... . . .... . .. ...�. . .. escpr9ti �x�sYfW'e�r��uc e � T, as o�vner of[he propert},wiil do tfie work and the .a rve r�ec�e sewea.t��`,�"'�. ' $' °.° • 7 � � struclure is not in[ended or offered_,for sale (Sec[ion sicN¢oTH�s �� onYOF -� ' � � ��� +5.�_ ,�! .a e 1 �,JO '7044 Business and Professions Code). � � � � ��. � � _ . . .� . . . _.... . ns�c,EwY ' . . . .... _.. covsraucri`orvt,i;n"nYfa�";ictx�`.'."�".,,""'"°:- � ^ � 1 7.5G� . AooRe�s _..., ,�._.._ 1 h�erehy�uffirm tFiat [here is x cons[ruc[ion Ientling 8gency � � ���--�•���� �• - • '� -- � tur�ihe performanre bf the wbrk for which this permit is . �2,I .Pi"8 G � issued(Sec.3Q97:'Civ.CJ. � . �� �Leniler�sName .. . _.. _,,.,,,,,.._,- _ __.,....�,....U,.�..,....�.�..-,.,�...�.,.+-�.,........�:�..,_...... ................ . ..... . ......- �...��.,..::,.....>..�,..�.,w,.W,..n..�....�..r..�.�...-.�.o...�..,,«-•-... .. . .,. .. .....,....:. -...�_ . . �.,.. . ,.�. .. .. .. . � ., . . . . .�, ....', . . . ,. . Lender'&Addre55 . ..._. . .. . ...,,�,:.r. .«�........-�,d,.e... ..�.,...,.,..,o..w�..�..w,,,..�.,,.,,.....,�..�.Y.�..>. .. .. . . . . . ' � . ,� . �... ,.... , ,.c . ..:. . . . - '� ' . ..:. , � .,.. _. . . . . . )�cerxiFy that I ha�e read th�ia apPlica4ion and s[a[t�chat [he- � � , � . . .. . . � �� � � � � abirve��nfarmution is�wrrect.I xgree tu compLy u�ith ull Cour.ty . . . .. - � � - - " �� orUi�ances and State laws.regulnting Plumbing�and See�ers, . � .� . . : � ��,�. ��- � � � � � - ��and lierebv authorize representatiaes oF ch s C��unfy�to en(e} � � . Lpon fh�e�b ove-mentioned propertl fui msp ec[ion purposus � � . .......... .. .......... :_ ___. ..... ... . ...-.,.:_.. ... ._. ��,/,/'�� /J ,,.�m^!),t SE^r,REVHRSE FnR EXPL�.4N.4T(SRIj"--I.4NL'Y'.AG�'��' h%' /r I �� C � . � /��t.L�(i � Si�na[ure of Permiitee �ate " � _ , ..., ...� �.��,.. ��..:�. • �, .��....�� .._ ' �x:��� 4f�+�= ':�'��"aw-�:'..-�i;�;.v�+ax^s�r.z7��,xr. . ....:,; ."�A.-,agr�.+a�t � ' . . . _ ._ nar:,>. _. __ _. , . � � �. r_ - _ sa � .° ��°.., , _ ' , ., s. iNSPSCTor?•s�sor�s dD`th'NEit BUI�.�EIt DECLP,RATI�N � : � , . . .. .- ;...,, _. <.-, . .__ , . .;.; , � APPROVALS . . oaTE•�. �NsaECroassicNnluac � •" `. �... " . rvEvd NOME ssav�a .-. .... ,.�: �,a �...: ..A , V.;. .m ,.--� �Bus:ne b�a d fP•of¢es oam'exe�r,pt Fiom ine ontrac rr's . . . . � _ ... !'ollowing xessu�(Sec'o„ 70 .i, �s eoaeJ: a�y crty nr c urry — CONNECTaooiTiOUac � ��— � - �� . � � � :vh.rrt reGe.�reS a Aerm�e to �nnstruct, ql.er, e.nprove, BUILDING OR WORK � : I"..' '� ��-� . � ' . �. � � d�ritOild'h.O/'i'C�7tli3'Qi1j"Ftd'M'Cd'lif�,[7I40Y?D iis e5'SUGnCe, - ......._.. .__.. _....... - ' .--P._�_ . �-: .��, � SEFTIC T7iN.K5EEP�:FfT(Sl , .. _..... .. . .- . . . . _ . - .� AND/OR DRA�NFIELD � - �� - ,,_ a150 !'PQif7Ye5 tlZP ¢�pficarzt for such permi[ ro ji:e [t � _— .._.......... __..._._�.._._.._. . .. �`• -� —_.-- ... ._-_ . , srg eC staaemertr tFaa he is iicerue� p.e ruaxr :o :Fe cessroo�❑ nRYwe�L��" � � . . .. • • . . � � � Fporaseof.s of�rre Conrraczar's Lic�ense Law(Chapter 9 .._...._.. ... ......'.. ._. �. _......__.. . .�� ..�. .. . . . . .,. . lcom,venring avith 3acr:or. ;auo� of D�v.�=.ai 3 of the ALTER,REPAIR,SEWER OR � �� �� ,,, `�Pt SESMAGC�ISPOSAL5'vSTEM� �� . ��� ' �� . : E:Asrn2ss ^'td Pr6fes.flortd�Co�eJ or tFlat fle is exe� _ . . ....... .,.;. .. ...... __.. ._._... . .. . . � . . ._ --� � - �--� - � :heref�m:n arr3 fhe ba:is for thr alieged exempr�o^.. ny D{SCONNECT PLUG AN� . . . . —'--..'.. ,-..' . ... ' P'7Y�t ... � _ . -. -�� . , vioeatacn ef Secrian 70.s'/.5 by'a"++1'aA'iidcans for a p-� ABANDONHOUSESEWEF i . � � � � . ..,., ., ,.,-,:.. ...,,:,...,_ ..,..^,,. _ .�..... ev�,ect;t`r.e apPlicani to n civi7 esenatiy ef no:rrore trax BACKFILL EPTIC7A�IKS� -� - - -� „ - � sEEa:a�T(sl� c[ssabo�s o�� � ... . . '. ,�ve hundred doJu��S530J.: . :._ . ......__...�..__ _ ._�.:`_ _._...._ .. �...,._._,..,_-.,.....-..,,..�.�.,a. . .... .... . ....... .,_:-,. N,�.>>.:•,.,...,n �n..,. ..�r��3w,•4,,, � . ,s^<* - [}al;as�o.�aec aF ti�e psupec4y w111 do thc wox�,and � . � - ;��,. =..,.:. ,;� . ._...._. . ..�... .___.. _ ......_ . . . . - ._, . ...__._..... ............_..... :__.�.: . ...._. ;. . . __ ����'�¢he st.-uc£iixc is not�irttended ar-oifered for sa9e. � . � ������ _�... :... , ' . . , . '�. _ ...:. '.�. � :�.:'.. , (Sec.� 7,�i44, Rvsines�and Profe.esions Code: 7'h.a Cor.- . -�. . . _....... ...._ ........ ._ . �.'�_:_ � . � �:.::.. ..,.. . ... -. trcc!or's License F,m+�daes"nat aPPjY zr, cn orqnar of . .___...._ ..... . . '�- - � ._. _... :.. ..� .. ...� :� � , f ' [h reat� and�x�ho e'eos5 , - - � .'property iuho Furl,s ar,rn roves e .. ;.__. ._.___-.:._......_ ,._..,. _ ._.. ...... ..._. .._ .. ..:'.r .�.:-. . .,. ;..... .: . ,�>o>id rhar siech 'mproonm.ents _ .... . "' •� � c�f . . . . ._ _. ...__ . . .,. . sueh svo k nr,s . �:�.... ..- .--..- .__. ._ _ .. .. . . . . ..,. ,:-..>. ;:-. .-; .'...-.. .�� �- ' . . . .. are no ��iii,4tlde.!�or o}'Jered�p'or.sale.�:f. hoeoever, the � -.: ., �._,. ��. �--,�—. � ;.... . _ ..� . ...�,�� uudding nr ;rroprae•zm2n£ rs sol� wiihin �ne "rear of - :....__._ ...__......_ .__ _ ,:. , . . . .-, <... ��� �,_; ...... � omoi r nn, fhe ow.ne:-}x;ef.ae; w�:l have rire uurdera �. ...__ _...,_.._.._ ._......... �-. '- �..; . . . -....� -,.�- � -- - :�. :._�.�� �f P�octng��hat ]Te..did��noi b�ild or impr�ve fo� t;he . . :.,�.,,: , ...: �. .. , .. -:�,.... . ,.,.. . .... �.. , : , . . . �� ..,_ -.. �- - � - . . ,.. .. . ., .. . .�-�:.�...;.... ��. �. .� . . ..:. ... . Pu>pose¢f sate.J . ,; , ,.,;� , ; <_',.. t ,.::' ,_.\. _ I am exempt under Sec.�� ....... __ � _ _._ , ,,. ..:_ .. _ . . ,Ts&P.C.far 8}ds.eason'• .. :: , , � , _ _ ,_ ..._. _.. ; Dafe _... .,. —; _ __._ _. _ _ Osunar --- -.�4.,�..�� _....._ : .,.�. - It�7SFEC7:1R'SNGTES . . .. . . . � . ....... ..:...�: ., _ ... ...._ �. . ._�. � � .a,m.. -- . .. —. .. . . ,_ ; ;� . . . . . . ._ ..� � . . .. - . .i g �. c' . . . ' �_.. . . . � � . , . . . ,. ... . . .. � � „� ;��.. .� .. _. . , _ .. . _ . .... ..,� .,. ..:� . .. . . . _ .... . . ..� .,. �,. ., , ........ , „ . . . . . � . ....<......_., , _W..,.._.:.. ................ .... .....�........��....,..... ..., ...,..,.._ _ ....,... ........... ._ � .,........ ,...... . � � �. � � . . . . ............ ...._.,._ _,,,..'.:..�.._ .� . ....... .... ...,.�.