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, � ���, :;, � ' #.�wr '��. '� '�.�„��.3r�t„yi.r� 3e�'�:ei�� ��b :F'��"� ka�' �'���`a ���' �, 'a '�4 :a � � � �. . n hon Insurante� � �� ������A��� � ����������������RMIT � �... � ,. sure c+r a cert£cate of.Wg kers Com e sa �C Sf7(REV 10/87""^ � � ' • n �.F, x�c � InhenebtiFei1Ro�R�}�O Q�EeS�AYI��NDaPLofco se f to self,, .. .. ...... �.. ...�..,._,.,._ .,.,. . . . - ;.».< , . . . ...._ . ,. 5,.- . .. r qr u ce py�here f(Sec 380�`I.a C) COUNTY QF;I.OS ANG�LES BUItDING.ANO SAFETY .,,..,,,._ . � , �7���q�' .... _.� _..._.�. �.�,�ti ._,.m��.,. .# „ ," �7� `T_' � 'Po�cv No. ... ,e.. ..._ompanY .. :.;..�:., . ... .. .,.�.. . .. �,: _ ,. ...,:.. ." _ ... . . . � Cert fied mpy is.hereby furn�shed � ����� �� - FJ��(����F���F�qDDRE55 � ��� FOR APPLICANT FO FiLI IN jPRiNT OR TYPE) � �,�"j' . C� � Cenified copy"is filed w�h,the iounty buiiding nspec-��. - � ���n "'"�""" �1 n depa�fine�q�1. � ��`,��rry L>i y��' NUMBER HXTURE OR ITEM _� �'`d'� FEE T'�� �� , � BUILDING � ,,: � IOCAIITY, , ��C�r.!.J k,, , ..-,�' G`7 i` a s��� WATERCLOSEi � ... . ppte Appl canf �� �� � � NEARES ..,. „ „ .: - . . .,_ .°' � - CROSS 57, � �; � CERTI�I�ATE C3F E�CEI'viP'(I¢N fROM WORICERS ;; � eAip 1U0 - �� - �--�---�� ��� —� ` .. C'OMPEN5,C'�Cb1�T(NSURANCE "� . .. ..; �..� - OWNER. .J .• Ih erterm�?at�n�theeerfo ma�nc�e Ofrhe work fo@which�h s lAVA1ER - ���- SHO`N (Th�s sactiog need nof bo complefed tf 1�e work Invotvec�by w . Mqll � � � � P - _ ( ) ORY F.DDRE55� ��+ ,jp _ . .. .._... /,...._, j., �pE�rmi�s��ssued�,I�shall no1 employ�any person vr��any�monne[ �� SINK ': " � -�� �. ��tY � l�/V 1�✓� � p / so cs5 to become,sub�ect�o the Workers'Compensahon Laws. �" ' '"�"'"" � "`,��yW4�°" . �^� . �� � ' D�SHWASHER J CONYRACTOR � ��� � \� '� � ���! ���5 l���'� �CLOTHES WASHER...._ ,.�F . A�DRESS�: `� �`��, ��i J'N/'G.��f-�..., � � PPLwm - t,...a.. ..�.„ � . .�.� - . ..... TIPE TO RPPLICANT'lf aHer making fbis CerYficate of SWIMMINGPODL�R�C�.PTOR � .V�rv`. . "'� A -" `""" ��subecr�to Yhe Workers` ._: . CiTY ��f�� . TE- ���`��j n tion, you should�.6e�,omQ.,,,__� .... ._.m � �wmperisa±ion provisions�of�he Labor Code,you must forih- �;qWN�SPRINKLER SvSTEM . ,-. .. ;wrth Comply wrth Su<h.,provisians or ih 5 pe�fiN sholl be � �' . � STATE ',-y g V�� " ���-�� ���'�:�-. �,,, "'^ LICENSE NO J JJ C� CLA55 � ked WAJER HEATER' , . � . .,, ..«,.�, ......,,.......... . IYhereb Q�{��'ENS�$D CdNTRA�'�ORS�ECCARATION " � . ; �n. .. 6�5YhICt Nb." �ROCESSEtl'Bv`"""` "' d'eemed revo ��C ::c �s* �� K� ' GASSYSTEM OUTLETS � y m thpt f am(�cengpd under}7rovrs�otis pf Ch�pter 9 � • � ��� , _ } (commencng wrth Secqpn 7000)of Drviswn 3 of the 8vsmess � OUttET56VER . �" ��,�' - � � tind Professm�s C ode and my license is m f�ll,fo�ce ond effect 5 PER��SVSiEM FINAI� �i ..,... . . .....__ ,.....�: DATE .. � 4 . - VA- qT10N at�- ,. . .,. � € ° ticense N�m6er ����c Class ���,,,.� � ' �-" "" . ' . ..�' . CJ � . ,*" t ,t, 'p^�»,,...eA.:,.����� FINAL � - � f � n r•- BY Controc(or ���/�� Date . .:' ��� . .. . . . � .....: _,.�-_.,.._,_.....-..�,w.......�,...._:,,..,...�.-._...-.._,_,...�- >,.. _... ., _ .. .._. w. p �.._......�P-. � � I om�ezempt under 5ec _ ��� � W 6&P C fo�this reason ,� � .� p�qR G�1BCk f�,y �. . .- � , �" �' :; ..'. .�-bpe . �.. . . ._..._ ,... .:..», � . �u N - ��+��w�„, PLUMBING PERMI;f ISSUIN�PEE$ �'� . . z ` Signat'ure � . . _._ _�.._.�.._ _. ..- . ,.. ., „ . . .. � ` .�. . .. .� J.. .. .. �� y TOTAL FEE � .3Y . . .+�w .,n.w�,.xwmaWwta, , , . . : ' . �'-. . .._ ,wy.e,u„v. . �- Plpn check dpplicanl , , � i . `� siNCL�Fnnni�v ' w�m���,;� �i �(.t�2 A HOM�"OWN�R BUILDEk DECLARATION " ' Name - .� � . _ - �� r 4 ; � �:. . ..�-..wa..,,.�.�.�,_�.�».��..�e� � ��eby a#firm iFat f am e�rerript from rFe Controctor s_licens,e�, Address � � � � � . o for the,follow ng reqson jSectipn 7031 5,BusineSs qntt , �„ ,,,�,,,, ,,,,,,,,�.,:�.y,„,,,�.„,,,ur��� � f m m�fx��. , -', rofessionsCode): -_ � Crty � � Tel No °� � ❑ I,os owner of ihe property,w II do ihe....work and ihe, � ... ., µ ,����s����� ����������e�����.�3�.�.��w��.�u� � j N +,, � .j d� �. shuclure s not i tended or,offered for„sale (�S,edion . . � � - � .:. -. .._ . �. ,.. , �. . Ya - -rr .. , � 7644,��Bus ness an�Professions Co�e) � - � � -- � ` ��' ONSTRUCtIbN fPNDING AGENCY ���� ��`� '� � � � �� � � � a,� r rw +M��».a:��..,�«..a�+�..�_� � ,..m,.,.,...� .:.-»...�w ,._�,. ...�..-- - e, � a..�. ,.,,a �.n n.�.,�,Gw+r.x->..,. . —m �,w,rW.�n.,.��.�,., ��"-..�,�r...�...� o�mw:-.0 a.,... ,,..�,- ,._.�.. I hereby affirm iTiaf t�rere s a eonsirucllan len�ng�agency�or ' , �� ��� �- the�perfarYtrance�of th�e;wark for vth e,h this pe'rmit i5 issu,ed ,a;,, , ,,,p„, � - „ , . � . _ ... „»__. �.. .. .,,-�_ .._r.,s .. . ..... . .. .. . ...... .. ::.'(Sen�.�-3097,�Civ.C.J.. �� ... , . . . ._ _.,. ..._ ..... . .! ���. r�s'r : s xv ; J , "< ' ��: � -. Lende s Nnme �, �, � ��,�.��,�,�,,, . . s � . �'�^^;,: N��:�?� ; ..: ': � � � �.�,�� �- 4 � . . . Lende s Adclress � rv,,.� .� ; � .' �� - � . . . ,�I ce t fy i��'ot I have read th s_app��cat on on �st te t�iat t e , _,. .� . . , w ..� . ° above nf4rmat o 5 5ar�ed,I ogree to wmp�y�w th alI Counry � . . , � � brdinances;,opd`State ipws reg�loting Plombing,and hereby � � - � � � . . . , - - . . . �.�� '"author.iz �representat�ves of t�is Coun(y to enter upon�fhe .� :-- . ,.„ ,. - - abo e m nt ane prope t ius�e t� n ourposes SEE REVERSE PPR EXPLANATORY LAI�jGUAGE < � ' �s ---�'i . �. , , . _ � -__ ,._..,. _ _ ��Si t�re of Pe mittee:;- ' 'Date ..� ��� .� . .. .. ,., .. ._�., .. . _..: � ... , ._._.. _ _ .... . . ._ .. ... _ , .., _._ _a.. e_� , ._. -.. _� , . ;�� . . - . . .. , .�. �. ,. .�: .,. +. .. , . , � ,. , .v , ,�� ... : �� :�� ,�.. . _ _ � ,. , � ,_. ,. _� _ . � . � ,..� ,�,��..�.��,�..;:._..�n:,.,. � . _,. _. _. .r r„��.., __ .. . �. . _.._ _ �.. . '�AGPROVALS ATe�� rNSP'`ORSS�NA'R7Rf � .���NSPfCTOR'S IvOTES � O�NNEt2 BL�ILDtR;DECI�RAil01�(� . . JNDER SLAB WOQK � ��� - „ � ! hereby otflrm tho'I cm er,empf from ine C�nirr��or"; � " _ ..�. ROUGH PCUM9.VG �� �� � �� L c�nse Lnw fo���ihe follo --�a son (S r 7G 1..5, � CAS F PI'VG��v "�': '- � ' - � .Bus'nc cnd Proless o C d�� A y city o c ��y H`�i.�ch �--� � .� equ'rres permit to consVucf,alfer,impro e,d_molish. . GASVENT „.;.v...-. : . -.._ . . .. . �� .'. . , . . . . . . �. , - ' � ��,�o�;�„repair any sfructure, prior fo }s'issua c��. Isu re� � - WOT Wq7ER'rlEATEA � . ..... . . � -- - quiras the appficont for�such�perm�t to-file o signed�sfnse- P,.UMBING-Hk7URt5 ���� , �� � -�`��%�- '��- �� � �-��. me�t}'r�at he,�s llcensed porsua t o t!e pr vi o of:he eee���--- ....,w GAS TEST-� � f�`� � C nfrc i rs 1 cens Law�Chapt 9. com nc �,�ih � �UTILITY{C�.hOT.FIED� ��;;�,,.,,,,,.Sy�ec7'yo�,7000)of Division J o/the 6usiness nd,Yrofes- _---- -. .. � �" . ���-�. .;- , - -`..... s ions�Code)or iha�he r.�exema'therefrom'ond the basis .�.... �"- � . � �_.. ' ..- . .. .. . , � for tha �of(ege�d exornpiion- Any.vfolarion or.Section � FihA� p.. - , .�... , .;n, . -- . _ . �,,...:,..��•�.�--�-'03.�a.,.�....,. _ �� � t� �rmKf � " . �. � _.. . . � . 1.5 by ony applicanl for.a permit subjects th�oppfi- _-n�er dn . �. . . . . - :� � _�M��, ca�n ,i.to�a c✓!penalt/ef not more than five�hundred � . �. °_- , � ... . . .:_._ � 500 - .. �� � dol ars $ -�._ � �, ..<_. Y,. ,.. �.. .. ' ...' .` -.:..". '...... fhe�stryeture�s not mtended oo riy w II do Yha work.and� ��NDuSTrz�AL ��`, �'[7 I as_ownsr of tl�e ro �wasT�.�P,P�tov�'� . �� . - �r offered for sale '''�'. � " � � � � � � ,�;,(See.7P94,BosinessandProfessiortsCode: 7heG�� �- . .�. , .. .. ,t � , . � . � �� � tor's Lieense Low does not apply to an owner of prupsrty �., � , ' � _ � i � �� �ho 6u1ds or.improves thereon,�and who does such _ . , . ., . . ;�. . . . ...,:: ,�� �.:�.: u...,....x .»... . . . ._. . . -- � � - - work himseff proviiled�}hai such improvements are noi .. ��,.:�. A ,.� : . � .� :-'. :-�.. �.:��.. ...-: .-.. . ` .. ..... lntended or offered for safe:ff,however,the buHding or . . . . _ ' . .._._. .._...., _ . �� � � �� . � - `, � . .. „;. .:�.. .._..,, , ,.:_. �.; � improvemeni is sold within�one yevY of compleir�2��he � �`��� "'� - � -' �'" -������-� ' ' - " ` „�,,,;;o,,,,�,,_oWnervbu Ider wi,ll hove the 6urden of proving thoi he dirl ::� . . � ��,'.,^ � �.- . . . .' . ... . .. ..�.. � . ... . . .' not 6ui(d or.improve for ihe purpose of sa(a.; .. � � . . <" . . � � , k,_.�.r..�.::u ..a.,_.,.:I,:::.�.,.+,�.x_,�.s..�w_.a. ��... . r_.:. . . ., _ � .. . . . _.. , _ _ _i_ � . .. .. . . ....... ... ..... w � � .... . . !: t am exemp?vnder Sec: :..,,. ,. ..,.3 , . : ;, _.. r ,-.: . . . .�. . . . . ... . : .:.:�. �.... . :��. � �� � � 8&�P.0 fo-tnis�reason ., .. �..,-:..w.:.a.:,.� . . � . .,.: .. � �. _ ._ . ..� _ . __. __. . . . � � . ' . .. , �,�...�: Ddte � . . . . �,: � , . .:.,.. . ,.:-. ._. .�.�v::.,,. Owner . . . , ,_ .. . . ._. . .,.. , . . . .�, . _. . - ... -., .._- ;..:�.,� INSPFCTOR'S NOFES �� � _ � � � .;w. _..�...:.....��� ..�_.��_..:� n � . �...::; '� �.:�.arMz��'r��::.r,�::�:a�,.�:. ....:�.._... , _. �..., xz��s�r-�::.'v�a,s»,r«.,. . . . . . � . . . . :.. � .... . ; �. . , .,-,: � ' . -.. . � .:..- . ,;.:.: . .:.-:. .. . �.'.: . . .; .,.u,�. _ __....._r, f.::., . ��:::: .,«... . ..i ,.. .�-. .. ..,. _ .«, . ,,.s,m,r.��,,.... . '. .. � . ��� . . �. . . � . , ..�M �,r "'�.�w�t.�e�.�.w;..-t.c.,� ,.#z�s.�.w,�w. 9:�.mtu,�.�,w,,.�:�^.�.-.�r,:wr.'w!�'�e-,�ss.u,:.aa � . . . . . . , _ . . . . . :._ ........ ... ... � .__ .i„ ........... .....+:... �..t.u..ac ...,.: � '.. ., p.:.. _., . .:. .. :�... .. . -�.. .� . , ,. .���. y...�. .,.. .�',+�+ .�. �..v �.ue.. ..u..s ai� �::� ..•�. ,�,.. y+ �.,: ._ �.-. . ...,.e .. „�t-,. '... ^ .'2 ,�r .,,,c. , --..,u r _ :.��..ww` �...MA�....�''"'�'�w..n.aL,. s�E�..k:i'�-.`.,�.K'a"�'v..'�'.."`z y oms�1.. ,.. .. . . . . . ''' . � _..._�. .. .,. ..„., e ...,w, �-wa .. r�:.,..., ''�. ... r,.�= s�S�:ei'��r�.,' �"sm',