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HomeMy WebLinkAbout1509A (8)- I kereby t'' •- •• r I have a certificate of consent' +o seii.nsy/�'`.j�+'p - of ...:,, .ndazo�, ser 4ef Sac �• /+ 808;RF.V 8/811GPob:y ltA Pohry Noompo� s7�r• nnshed,r^und 1 �Va : MPO SEWER S ISPOSiAL r .f�Zv.loyIFleaae f • Cemif:r-d copy Is Alod wick -rte courny ou:lding .nspect:on COUNTY OF LOS ANGELES BUILDING AND SAFETY aepar• g .. ... - ... .: •... ..A-, '#i Wit^ %4:`:,'^ , ;": ,.: .. •. Date 8/.20 �*::cant �� FOR APPLICAIIT TO FILL IN — • - • -- CONNECTION DATA CERTIFICATE OF FX°.'%`':h r7^.': :'.';7(; is COMPF-NSA T •:'. '" 5.��5:.:.'.: ,Jn-- •• J.+e„�X s , S� '—' i•n' J\ chrr". ?res secilon need ro' be completed d -he work Involves! by the !! ,:rrvR "r•41GI=QF oam,it '� ., :•r�)'.I,: ,. 5'001 or loss.t ' "h't� F3EKF .,TJ,EF ! r .. pe,m., ...,^.F �• the wort for ••-vh!ch •h:s person ri any manner P ,::. \L:.QEc- �,a� / ._ CA5%S_�31!_1Gr- - — —rr^::.-7\\-: t1^N 3.N^ir•'<:NAwuuw, r C'..R3 ' '.• I -C. . 1 tr aec0 me sum ec• to !h. tgor4)ny 1 en' Corn OenSahof• La WS pg�T �,} „':,\_R_ i1LY y.1LL V`14C :^ V:1 r:,p V^, Dale-- -Appl:cant--- A' TF. J'JK 7Rtnn r10 '^ - II NU NOTICE TO APPLICANT 'If,' aftor making fl, : I, 1:..OV1— 1.6 CA'.11 :.A 1FK ay�OV3PE ;:r•ntpinn. you should become subiec: :perso-inn prov,Inns of the too., code. ::, .,. . �.... ,, '• Lt =AI DESCR rr C•\ ,O-\;7 '� ., .....,. .._,_.__-._.....,.....•......,., - .»...... ,..... . .,oke Wi!f1 Sl'Ch p•OVI4iOn5 Or •n`S prrinl• �' •.'.; n.-•:•,."^ - �l^'-r54 _- — HWY OR ST. WID8NfN6`"" - •. ..-, _ .-. revoked G a:x iRA; - �, ....,. ,. .. s-:: C -N: aOAcrFAE'NT LICENSED CONTRACTORS DFCLARATICftJ ----'-_-`--••_`---�^'`=--AWA-"•^ •+� I hereby affirm that I am licensee ..oder provls�ons of Chapter .s:,- :rT �.-A ;- 9 ;conlmercing will, Sect-on 70001 of Davis-on 3 of Inc Bus:- �T =nL=\+: S n a Res. ---'—L-c-IAa�a" ^ess and Professions Coo. and my license -s in full forre arte - nffPc•- T��',T�q�j,T :;)\'3Af TOR F1i}J1'.!i•llili CONST. r,^.\\•f'rn C­,PCI :iE L•c.rse Number4 ___rr.�L�Y,8_Q7_Ic C.ass01 ACDF:'.5R.-`.`tt,iSrMr\-rfi Cowroc1or _FT_ q_ M& L ___L a. 8120/86_J.i "'-_1iYe7 la4_1Aa N�jS4$�4— F@"_ NO illi- •/s: aR: Cre57 ev S.T I m , :Orli O%epl UI1dt`I' Sec..___- __of ''le L A. Co. __ .�A l \ 'Af5 r'1 z p V lY AC PG I a* P.urnb•ng Code and. or Secof the \U JFSCB'PTiCN OF WORK n- .� _t N1. .—_. a•• f•) B 8 P Code for the fo'Iowmg censor—� -<i.liF $e::Fi: M3 70 j r..4: [ ,purl,":. .}-,. AN< •.•• I:.: i __ — VALI ATION_, _• ,..-_._._ rL' p ^ 1 •AA\ t,.4•JRA'l'IF.c \r• _I S.gnalun)'---"— —'--- .. . - .......,, OWNER•BUIIDFR DECLARATION „,.,z• \r. •,. ;:)In^i.�, a cr.:iF -� -- � "_T4 I hereby affirm tl,ot I am exempt from the Contractor's License •;_Qr ^n Er-°ncF .,\r r,c hR^, ;: $S�Ja. �Rv,4t' vnh,-t?.: !ow f-• •!' : '.:"owing reason (Secion 7031.5, Buisness and Pro- _ A ••Q ru R ?Q neA•.•^,a:. raa$[ :! 'j cJ (}, g a I os owner o/ the property, or my employees with wages as —�—t e A ° i o th.�r sale compensation, will dr' `, `. •'•r s'r,, tura rr Is -lot Inie :deo or offered for '.:: , . .. ..: B,,siress I ,y P,afess,ons Cone OWNER'S Permit S 10 ej© a 27 r Iand IJ I, as owner of the property, are exclusively contracting with - AUTHORIZATION TOTAL FEE ? p , ,.. 5 n hCCntied c.Ontror•Or8 to ronsirutt ,he project .Seclion 7044, 1 wAVF AT T S " F A'-,^,N-R4:- AIT- *-! --rRF YA.'.'=:`- Businessand Professo-Co,io:. :::N'.rc''•I�aeOSF Yrd'Qs[n•xS �c�v.r iN;:r. car=.:G �: FF,,,. t'• +, C; CONSTRUCTION I ENDING AG}TdCY ) I hereby nffi— :ha is a con,tmErion 'a cfinq og.,iyi•G\FD roc be 1rR,5 7AvJ':? _I _ %wN-s :Is tea— oerfo•manre of the work for vm:cn :his pPrrtllt S . �_„ �� N; Rb A;•: h't~_`{__ .1!{F+��rr `-[%"� issued f$ec 3097, CIv (_ —✓.L� _. A';L`RF55 L.cler'a Address— .. .., .. .•.•. >u •. m° :.,.ew4,:s.o-.+.r.,..,r.-a-....v.:....acn..�,.r,.r+w^.-e.+o ....,... ..,-r,.r. I.,n,,, ,,,., r....m-»-.. ,..<. ,.. .-. ,,,.,.. .s .,, 1 certify -hot I have repo lois opphcanon and state !hot the aboveInf.r,nafiw, Is cwrrect- I agree •o comply wrh ali County ord!rances and Sate jaws regu.curg Pit—loviq and Sewers, and hereby outhar— rrpresorow-vas of !ills Counlq !o entor upon -lie above-mennonod properly `or ­pec—:on ourooses. Slana•ur,• I Pcrmn:ao Dole SEE REVERSE FOR EXPLANATORY LANtiUAGE-• APPROVALS _tATEp� INSPECT ORS SIGNATUREm NEW NOUSE StWER CONN C1 A001TIONAI---_--��Y.-_'�'��—�_— BUI; DING OR WORK ------ SFPTIC TAN",- m(((I AND/OR DRAINEICLD CESSPOOL 0 DPYWELL kni REPAIR. S-WFR OR --_--"- SEWAGE 7 SP.^,=AL SYSTEM I D SroNA KT PIUG AND _ j- -- AINANDC• N HOUSE YWER L c T,.NKS G srrrZ, Plrl11sl n c�w�ss'.+ool s ❑ �.�..:e. . INSPECTOR'S NOTEr INSPECTOR'S NOTES UT Y?�TER-B�JI�.i3rk DECLA-R 4' ION' ---- Umns; S.•.:. `u .Fw iAlowi.g reasor. (Settlor. 7031.5, '-----.—'---.'--usiness and ProferiDns Grde,: Any ;xn�� or courty, -----------'--- uB.h;C4;c , permit to construct, alter, improve, 4R1./Iiir::�:", r•ZNlS any SPFSrtLra, ftior t. tts iseuruce, V aieo raguirc, the applies.; fe.r Ai rb permit to file a Sc'gned statemewe that he is &tensed pursuant to the provisions Irf sax C( r2. n ids * a,. /, 'ar r 7 lcmemeucing with F ra : r 'r > h+ Business and prrRJ:..;Jr;ar ',s,R F ap! therefrom and the r 'sir :re:r,pa:.r...^wy r _ vio1atiouof5ectio» sub• jests the applicant to a cavil penalty of not mora than � = five hundred dollars ($500,:: -_ • _ `. f :. - ❑ 1. aa it c- owner of the property will do the work, and • the Structure is not intended or offered for sale. lSec. 70¢$. Business and Professions Code: 77 `"'bw tractor's License Low does not apply to an of of property wl n builds or improver eberco t, and who doss such worle bhroetf peouidea that such imgrnvLmete are not iotevdad ar + fsra for sate. If, however, the -,,_•y; ._.. butldaug a:• ,~.provmxamt is sold trnitbiv one year of completion, tine owne.-b-0 v ki have she burden of proving that na u..r .,.E build or improve for the p et io!e of sole., - v ..' �. ,1 . .. . . .. 1B & P.C. for ffis reason