Loading...
HomeMy WebLinkAbout1390A � . WORKERS'C0�1PENSATIOND-ECG.XR.�'1'l�Kf.............�.�...-reaae�aA,,.. ...,....w..�.,,...w.m...,..p..z....a....�........�„»... . . ,�.v„..+_.._..... i hereby ajfirm that I have a certificate of conset�t to self ceanlz-eo) APPLiCe4T101�1 FORFFLU�N`1B�1��1"� PEF�M fT� �insure,or a certificate ef Workem'Compensa[ion Insurance,or � L� a eert'fied.copy.hereof Sec.3800, aS.G) �^- -^ "`' _.... �y;C�f .��:� z •-.� f COUNTY OF LOS ANGELES BUILDIN�AND SAFETY' �Poticy No. Com�any ' ' �t i��� ��;` . . . . . .,. . .. � .. � . . .._....__ .... . , , . . . . a,...�._.. ' �' �Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRIfY'Y OR"f``�P�������� BUILDING � ` � Certified cupy is filed with the county building inspection NUMeER FIXTURE OR"ITENI����� • FEE AD�RESS � �4'Y l�t �y� department. � WATER CLOSET � - �� LOCALITY ��� Date Applicant ���� �-�������-• " -� �� --- -•� NEARESY ' � � ' SATH TUB � CROSS�ST. �CLR'IIFIC.4TE�Of`"EXE67P'I'IUIV�F'i�OM VJ('sR'�1,"K�S�"'�rr������ � � . COAIPPNSATIO:V INSURAN'CE �� �� . SHOWER OWNER . �. , . � � . � LAVATORY MAIL (This.section need not be completed iP the work involved I ADDRESS ��IVf � by the permit is for one hundred dotlazs (9100)�or less.) SiNK � �, . � . � � � - CITY TEL.NO. � 7 certiPy that ir.thz performznce ot"the work for which this DISHWASHER '� ,{• � 'permit is issued,1 shall not employ any person in any mannet CONTRACTOFt 'so as to 6ecome sut�ect to the Wnrkers'Com ensation Laws. � � � 7 P . CLOTHESWA�HER � qDDRESS O ➢ate� APPi�cant ..- .�. � K . � ,. ... . . ,, :. ,. SWIMMING�POOL�FlE�EPYbR j ' , 'NOTICE I`O APPLICAN7:�If,aPter makin�thzs Cer[ficate of � � �` CITY � TE�.NO.,���'-��'�. I,Uci Ezemption, You should ,become subjec? [o the Workers' LAWNSPRINKLERS�YSTEM'� STATE .E [� LIC. U�8 Compensation provisions of the Labcr Code,you must forth- I.ICENSE NO..p1�J 35� ,,,C�AS '� � with com ly -��� OUTL TS VER OUTLETS �I � � p with such provisions or [his permit shall be I . . deemed revnked. DISTRiCT NO. � PROCESSED eY a ��,ti Licens�D can^ra.ac'riins n�'CL.aRai'i2i�P�'"°," �'Ei ,�J Q,c�.'�-� I hereby affirm�that I um licensed under procisions of Chapter 5 PER SVSTEM � �- ��� � � "" '����"` 9 (commxncing with Section 7000)of Division 3 of the Busi- � � ` FINAL VALIDATIO�I ness and Professions Code,and my license is in full fo«e and '��` 7✓ `������ DATE � _'7 9 �',�J effect.� LC 7 � FINAL LicenseNumber 3���k`'`��l Lic.Class. ���5� BY i— ]- t_ i� �r � , r Contcactor�������Q��Daee� � I am exempt from the licensing requirements as I am a Plan check fee , licensed architect or a registered professional engi.neer pLUMBING PERMIT fSSUlNG K�E��$``��� / ' acting-in my professional eapaci[y (Section 7051, Bus- .... ..._.,.„..._...._. ,. ..�� .! .S� iness and Professions Code). TOTAL FEE J�_��� Lic.ui Reg.No. Date ?lan check applicant , . . .. .. .... . �� HOME 044N�&R-BUILDER DECLARATI�ON-'��� ���������` " %`�ame �1 �9,G A Adtl ress I hereby affirm that I am exentpt from [he Con4rAc[or's ,�,+o � a • •Jr" . ... ..... .... .... License Law for the Yollowing reason (Section 7031.5, 6Usi- City Tel.No. ne9s and Profession;Code): - �) o o '� E+.��, � S,as owner of the property,am exclusively wnGacting , �vith licensed contractors fo c,onstruct ihe project s a o � (�,rj Q� (Section 904A,Business and Professions Code). . �� - ..,..,v.....�.,.... �, , �,,.... . . ..>_...�,...,.x,.w..... _ ..,...d,..,..a .(1 1.2�'8 C , . ,._._a, . � . - �_. _ . . ... . . . ...... . CONSTRUCTfON LEN6��N'��AG�L`NCY�'�::.",:..����,c��.�..�� . . . i here6y�s£firin��thpt�there is a construction lending agency fo_ Ihe performance�of the work for which this permit is .. issued(Sec.309'7,Cic.C.). . ..,...,..,.. .a.,.� - _ - .....,.�-.,....,,.....,....._.�.,...�,»,�...._ Lender s Name. ... _ _ ...�.....,...�...-..,.,....,,..w .. ..�,-,,,.,........... _ _........,.,,,....,....,............ . . . . Lender'sAddress .,...�w...,,,..,.�...-.,«... .,,,,.e..._.,...._�...__...»..,..... . . ,.. .,:,,..� �. . � ....-,_ ,.,............ ._J_._ ..._....,.�.... �v;..��;pP�� .........................._........... .. -....._.. .. ....._.... .,.,..,_.... .. . . . . I certify thui`"��h�ave read this d I'C8~ ..•.,.,.,,� , ,.. . ..., � �� � tion und state that the , �,,,rt�,x w.,,.t. a6ove infarmation is correct.]�gree to comply i��ith all Coun[�� SEL REVERSE FOR C�XPI.ANAtd'KS'LA7�1'��1AG�'���'�'�"'��������������W u�µ�����p��4 �ordinances and St�te laws regulating Vlumhing, znd hereby authorize represe Futives of this Coun[y to enter upon the abore-me e propurty£er inspection purposes. /' - � ��:f7i'�L�J+� L^'f�/B _. . ... . �gnature of Permittee Date � . . .. .,,..:. ,.... ,,..�...,. „���,_..,�...,. ,�.x.�...-�. ,�:,....�:�r-m�, ,�Y�iw� +.��'r,� �-��:�� �,_ �t<ws.�. -�'� �r" - � .°;3+i'�,� -��.-'�'. �,a����—_���-�+�-�-:',..-�--e- ,�,�,n- ,,,�r �.'_'_.,aF �TOR 5 ti�T�S; �' , O'�"`dER i3lJILDER S3EC.Lis12A i1Q3'�' APPRCVALS oATE� INSPECTOFi'S$1GtV;4'fU�iE` �� � �� .., , . . .. � ' � � � __... ...�_ .._�._. . . ... .,- . , . . . . . . ,...,.,,� r,.,.� U�JtiER S�AB UVORK ^ � � � � � � ;•He by affirm ihaz 7 a�:`k ,�1Of fx6in he C015CCa t [�5� . .. � . . __._ . . � .,. . � ' FtOUGH Pw� '' . '. .. . . . .. • �`�Gcenu ..� �cx hz w3lo�im c�s^n JSectron 7�di �, -�r- �� --�,y�G� ,��tainess r.nd Proless;oees Code/ 4n; ai} or cc�n:Y GAS PIPING ����!� '�J - _—__.__ "'___ ____ _ .. ' riSrYnv�, w}+ich re;u�res a r,ermir YO .�nSb+.c[ irer, ' . .. GAS VENT � QEn50Zi5:h,61'�e'�'[lV Q14�� SF)1:CttIIY.P/iOT ZO f!S iSSi1GKCE, � �...... .. .. ...... . ..�_...-_..—_ ..._..» ypTWq'(EFHEATEF ' �`�'�� '" ""-"-' - ' ' "'-' ' -" ' ffl.e0 +'2Q:ii�'ei FhA A�Ulltant f.^.Y sllch permi: fo fi7¢ C PWIV�SING FIXTURES � ^/`'�'^' _,_„_ S�gned �ate�ttE t 1hIIs he is fiCet25elJ p:J=SUt�l17 t� the GASTEST �/�' � .�8� . . .. . ..., .�.• -. . �....• " ,.7YOVYS!(ln3 .)j rix COY-�CtO."F ftCens� LQi='(C�apte3'� f��7 ---- - . .. , . . . . .. `...,..., — ... .' �ran�nemr�8 x>>. �cc.zan 7s001,�f�D;via�ion 3 r,J[he UTILITY L'O.NOTIFIED - � ' �1(slYtecS alYd'.�YafY£s'i0?1s t;e�eJ or tiMt he iS Pxem�� . - � �� - ' � � therefrc.n cnd?he bca�s fnr�r.e mleged exernp:ion.:tr?� r � .�_. :� .. .._.-c.---?.. . , �::.,._ _ .. .. . � w,..a .. . - � �7 ��. :.��,. -�. , v;oFSt�Sr�.oj Sectecn 70�7.5 by n�y ep2fican7f�ra yerrs?et FiNa�:.-: . �.��f,�?�:p�y�g�,PJaLC . ... su��ec�.�r'ne C��l t'li..[!J U LtYit j)etfG;7�i GJ`i:Ot?1iJY2 tFQli .. .. ,.� . __ .; -. :.., _ .... �. -.�—._ ..,—._.. . ,_:_....... � .. --� - fi��ehundwzddoltnrs($SGOj,:. . ... — � .— � . .._ -. . .. y V. . . . u l,as ov,ne:ci the.paopectp wi3!:iu d�e t.•o•k,and iNo�sTaia� ,� � - . -- - . - — - hes ctar :3rtntis�er.dedaxtztfere5`orsai � WASTE APPROVAL_� . . .. . .: . . , . `. . ..' . '.."' t .tiU = �--e-' . . . .__� -� .-:�-.�.->«.�--w....«��..-•t+ . ..,-_:..,:x:.��n:.......... .._ �. . ._ ... .. ,.:- lSec �64a,�Susirtess and Professinrts Ccd�: 7Fe Caa- . '..: -, ;, �. . — .....,—... ......... . ........ . . .. . . .. - ewrir o . . troctnr e Lfcense-Law�d"oes r+et applp v6 uia ^ J ' . � - � prnnerto.v,dto bui7da o=improve�therrara,enG who dozs _ " _ . .. �. �� . — .. . . . � .. , .. ., . :. sueh wurk Mnns�iJ.C�'�ol�ed.Ihut stteh :tnJ?racemrnts � �:..'. . . . .�. � ' � are rw� i;a.*endeu r.,o,f,:erfd fo:sele.7f, ho�%es'er�.�the . . .. ., . .� . . .. , ......_.__�.___._.. �....,. ...... .nw,..a�-�.r-..,�.,.,,.-, ._,...�..,... � � � Y'ear n � � btaitdir,,q cr err.�royernenl u .rold w��nin nre J � � . enmpfetinre, Fke c�vrzr-buildc+- wiii have ake b.srden . �_�_�.__'-----'---' - .. . . .. ... .. ._ ._�-_,........,.•....•,�......... ....., .� ..... of A"nvE.rrg sryat he d[d r.or t�tuld or iy,prode fer rne � ' p�.-�n�e af scie.l. �. , . . . ' . _. ..._.......:. ..... _... .:. ...�................:... .. �_.._...�. . ...., ., ., � � � . . . - � . � ��c1":��k2T:3�.u..i21?tiE:fi 9�Q:�R . ___.-- — � . . ..-.,_.,._ ... ......�. _�,.:_......>-.:.�..._<:..�.r. - �.t . . .. . .. . _.� _:..... .. ..�. � .wr..-..� ,n ......;„. � ��'d,�..�.�:#�ar�inis�re2sa�i � ' � .._ ____..,......_-. ,..... . ._..:_.," ,,;a, - <3�_y! . ��• .,.-�-.; .�. . � . ,�Sate — — f3v,y�)er,._ — � :iNS?ECTOR'S�NOTES -....... ..-.�........w.r:_................ . _ ........... -. �, .... ....,,.,_ .. .. �M. . .._......._.,..,.�. .�T...W:w. .,,......::..,,c.,;,.�:��,aW�:o,. �:.�i...�.�.._..�.....� r: -> ;� .. . „ ,� , , . � . ._ _.......--.--'_'.. . ....,...>;,=r:�....-..-�..,.«�....,...,'_..�:..>-.r.�.. ..,.:.v..�.��r�.,.aa.. �_�:.a.rx..kv.,»�.i.�aWSI�.w.,i�-�..x.�::�.�,y-,..�sdanrrxsAu3.ra+e5amer+n,. b.taEiriier...'�«-"�ka�w1... ,�dr��aa6'}.: . . a : . . . .... .... _.. ..._�.,. .. ..y, ., ,...... ....... .. -.T-S.>w+..-:..:-_...:�'.-f,�::•:d�.:;'x.�.o.a.�"r..w.�., . .��-.�....:' ,. ,.._,....., ,.....: . .�..,*L"�s;7...�..._...as., .aii_aa.:� . :.. . . .. .,. .... ...,.... ......,...............:..........- _. .;... .....�._..�::n.. ._:.:._,; .i,. -v..:_...:«.......�:..�..�.:5-.:`k.r.-. .v.-...K.t'YJffl��iRfy3tL.r�s.kYSYS9RYJt5�KfifFL.`:`WI�'6bMLL�h.�"."�L3i..< �_ .. . . ,,...... ... :..�.,"-�r+e++�..:... �...:.r..,.:�.,.---v� �:..Levba.,.sr�°. '.:.sM.1ww":'t.`.^b("-k�..,�:f.'::.m�r5».•:n"'xc: ,• . ,.. .. , .v -.a�R.s.,�..b`La+k1S`..NKI.�.nSYav'vL::a�i'�5P'Wcan^+:.�'+Sk.w:. �C.A�+^3�c(;. . .. ... ..... ........,..+m:. .......�.r...... ,..�.... .-. ��.�-.... -n'__.....�, '.,_,.-+....,._e:.,.�. ::.,.,,, ..'..Y... _ ..B:.ISu.Ca"Y.T'.�4S:Fie?+I?nyn,Sb:�4�1'!Lh.�.a.�',Y...:..];_�.�`�.�^.:.w'•'�.`+M-`r . . ... ..... . .......�e:..._.....�_n..r...N..ez. mu�,aWu'.T-i•...-,_,w... -�..-,sr.,�....:awx.ar.�,K'�n�.c.v:�i'-+..�"zS�+Yae+:d.CsBlID'�E3W<k�.:.,na�Yu�`�xe�saa..ne...qa-�xl.a.n..-..%R+ti.,c..vR..aS.x.�+�-.,�exanr.iVra-+rv.u�w+wt-'.v.'uti w,w ... ..„ . . ..,.........r...�,........ ,...--r.,._ ,...:..,... .r..,.-,.m..,...�,m.+..�:-:,;.,:wvr�_<:s�w,,:s,...s:�u�n<,.r„w.:s;�»6:x.srsrc,,,m..:.t�m'nea�',.�:.�s.r�.aa,m'§»+:wr��'�`.w,.wc�+er:�eNm'rsAtw..R.��6[c�e:r '- . . ... �..... -.....,..�..,....,...n�.....w,.«.m.,.x.,.:..:,:�:,.m-r�....:.�...m.�:.�....w.�..r.w.,ww.-a.ms+uwm.m.., . �� ' -.. .. .......... .. . .. : . — .. .. . ............ .�...,......_......, r,....,..,:.,.._....,...,_..a,:..v.e,a.a'-� _.-._,a-,:7'r�..:.,.�*..�...,.�...n'.K.K,r..:.�--.r:.wr,WN�+A°u;,'�asw...a.as,w ,,..35���..:..�F. .7n.ra....fn.2w.u.,,�*?4'se'-ieUN2}wsx:lx�.. - . ....,. .�>�.a.,:-..___" , ,.. rv..� x �,-..n'. s,..�.:�..,_.-n �r�_.:.:-_ .x .c.......'.hr .�,...�... ,.1.......0 . .n,�N- ��d�wrwg`+Paa . . . . . ..__. _...,..�w�.,,...:.e..w�.s..�:..»,-_ :....«._.............:e...,.s>....._.,�..ww..-;...,--.�,n,aa:m�:.,.w...,x:..:z>,.u.:.as-w.T.».�.a„�a�,�....z,�«a;,ri+es:v+��,...:-,,....:N�w„���� a;N....