Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
1275A 8891 (6)
o t,OMPENSATION�ECLARATION � � I hereby affirm�fhpt�have a cer�ificate of con:e�t ro self � insure,or a certificaie of Worke�s'Compensotion��s�,en�e, � APPUCAtION FOR COMBINATION SWIMMING POOL PERMIT - or o certified copy thereof(Sec.3800,Lab.C.) . 7a42oB � � . .. . CE-875(�I l81 V . . . Aoucy No. Compony COIJNTY OF LOS ANGELES BUILDINCa ANR SAFETY � Certified copy is hereby furnished. � � - � � �� � POR APPIICANT TO Fill IN BURO�NG �a�� �,�`�� L� . Cenified copy is filed with the counly building inspeo- aDDRE55 fion departmeM. BU�LO�NG (� } �� ., AODRE55 � 4�� �LP � LOCAUTY G-<e.✓ Dote App�imnl � � . NEAREST /� � CERTIfICATE Of E%EMPTION FROM WORKERS' CtTV N� ZIP CRO55 ST, p.er� �J'���L ' , COMPENSA710N INSURANCE 5¢EOF ASSESSOR TRA�T LOT l07 NO. MAP BOOK PAGE PAR[EL �(this a�ctton nwd not M comploNd I!the p�rmit It for oe� tEL USE ZQNE MAP n hund��d dollan(S100J or lo .) � � OWNER lL° ( NQ ��07C�p / NO, y�-'3? I<er�tfy thot in rhe perfo��ca oF e k for which this 2 � _ � � 51'ECIAI . . � - permit is issued,i shali no�'mploy a perso in any manner ADDRE55 'J '��'"��p,� ��� �r� CONDITIONS , 5�as to 1JGCOm SubjeCl lo ihe : n ENCMEER NO.... ...�. �Q: � ��NO'p'%, t, �0 BY � rke Co fnsotio Laws. DISTRI�i STATISTICALQH55 7YPE PROCE � GItY O✓. IP COt15i. Da�O � Z Applic ARCHITECiOR � TEL � ' .NOTICE TO A LICANT: If, otler making this Certificale:.f � ��"a'�� Ezempiion, you should become wbject ro �he Workers - � - � - ' � VALUAaION `�. '� ' , - Compensofion provisions of tha La6or Code,you�must forth- ADoaESS �- � . wi�h comply ��h such provisions or fhis permit shall ba � 7FL s� � VAUDATION deemed revoked. ' CONTRACtOR NO. � �' ����r . LICENSE�CONTRACTORS OECLARATION�� � . (�'" ���• � I ADDRE55 -t'OpT1�ltN0,�( Z � �. I hereby oHirm ihot 1 am licensed bnder provisions ot Chopier 9 ��C. - f �. - (co "g wifh Secrion 7000}of Division 3 of the Business ��n, �4 . ���',-�j`3 . Y an PrOfe55i0(�5 Co ond my(icEnsC i5��fUll IorcC ond eife[�, pESCRIPiION OF WORK . Q /� �-� FIN�L V Li nsa Numbe ' Lic.C�ass�2= SWWJ.IING FOOL �usrp�.�poo�P�i�,+aP� DATE ��-�6 �E F(�c �e Llis[�!L E�s`r,a-t� ► o COnIrP �aie � 3 SPA flNAl � � � ❑ so.Fr. er �om ezempt under Sea 5¢E .d N B.BP.C.for this reason EIECTR1CAt . . � � ? oo�e: � @�.���u,s�c�. Signoture � � � . Steei 8 Conduit Bonding -�� � Condaits,Conduc�ors,Eqv�pment ���.,4�� SINGLE FAMILY f's� . HOMEOWNER•BWLDERDECLARATION PLUMBING -���f 91 � I herehy offirm thol I om ezempt from the ControUor's License � w�� � ' Law for the fo��owing reoson(Sec<ion 1031.5,Bus�ness and - - - , �� � � , �r y � � � Professions Code): � � � P•Trop Gos Syslem � 1,as owner af tha properry,wiil do tbe�plumbing and Anti-Syphon ,�,q-�2 7,5{� . eleclricol work.1,or my emp�oyees witb woges as Iheir . . . �sole campensolion,or a lice�sed conrrocror wil)do all MECHANICAL � � � .� �� e� . ��3 other work ond ihe struc�ura it not intended or offered . . . ' ��. for sala(Section 704A B&P Code). � Swimminq Pool Heater � � �� � � e a j��j,Q� . • CONSTRUCTION LENDING AGENCY � -- � � 1 hereby affirm ihal there is a tqnsnucrion lending agency for . , . • 'b�Q�c�i �he performance of the work for which�his permil is issued APapR 7� TEL �� �seo.309�,c�.c.�. c � "o. , 0 1.2 7—8 4 . Lender's Nome ADDRE55 � der's A ss � 7.C.Fee L " Permu Fee -;,���Sa or erfify tha�ra reo this opplication ond slo�e fhm�he !, � � . above in(orm �io is corc ;t.I agree to comply wnh oil County �� isaoo�<e Fea� (J.,s`�V dinances o d a�e�a z relaring to buildinq, elec�riml, � - mechonimi a pl mbin conslruOion,and hereby outhodze ���esiigalion Fee . �� - . seor rives af ihis ounly�io eNer upon the obove• ToialFea .�� �`U � �en1 n rop ' speUion purposes. . .. . . . . � Gmre or ngem t Do� � SEE REVERSE FOR EXPLANATORY IANGUAGE � ._ _._ . . ddxi�d . . :�� � .� . � ,. ...� ' . :.. - � . .. �, -_. ._ �� � � � - � � 3'JtlNltlHa100d � , ' ,'. . ,. . ' . . .. � . _ . : `'�)1 � �`` � n� C 15313Ni7 Stl9 � � '"' � ' �� � �� (1N3A�NOILY]Ol�$]1tl3H , .. . . . .�. � � . �I711�3171VN13 . � � 7�1181MH'Jf10Z . .. . / /ONIH71tl1'3135` ' - -5310N S,NOl�]dSNI �" � � ^:���." \ 7Ni5D77�135I 531V'� . . 13U+✓�0 a�oQ � ` .� r�Y~ �1N913H)3Jt333 . . uosoai _ • . � � 53HIM�IYU313 � siy��o+���dg�8' �as�apu�ldwaiawoi� .. . . � . . . . -' .. . . 9n1VANOttdASI1Ntl .. � �(mo�esuwi7 s�o�3o»uo��y� � . � ... � o��uons�nd'posuaoq(s)ao��n��uoo o ypm spalo�d y�ns � � �' � j ros}��o�luo�oyro�puo�uoa�oy!sano�dwi�o sp��nq oynn � " . .- ... _ . ' 1 A�ladoid�o Jaumo ua o�6�ddo�ou saop^no7 osuw��s�aa E ao�luo)oy�:epo5 suolssa�o�d puo ssauisnp j660L`�nSl� . �. , . . . .. .... . , . . b3hV5 I �aalo�d oy��on�isuo�oi voioo�iuo�posua���yqM 6uipoii . I 3Np 7t31VM � -uoo�A�onisn�>za wo•A�iodo�d oy�`�o��umo so'��n._;. . ' � ��-�� ��� ' --�/�. .. .(a�os}o asod�nd'`� ._.. � �lll,\i 3NI7 SV9 ayi.iolano�dw��op�!nqJouplP°4toyj8u+no�d�ouopmq- � . .. . .- .- . � v� �'� ey� onoy �pm �appnq-�oumo�ey� 'uoiys�d:uo�jo�oo,( - . .-.. � 11t1aN0� , auo u�ypm p�os sj�uaaraeo�dw�Jo fiu�p��np ay�'�onamoy' •�i'. _ . , . �. .,..;,.,,�.- , ,. �. � '�� •a�oz�o!po�aJlo�o papuoiui'�ou o�o :�uawano�d . � �- —_.-- .�,.::. .--�._. .. . , -w! yms ioyl Papino�d 'sa36o�dwa urao siy y6no�y! � . .. , � .; �; � � �.. . .-.� .. ���; ._ . -�C . i . � �o��asm14 K�wn y�ns saop oym puo.'uou�oyt sono�dw� � _.. . ' ` ' _ . .. �-� ' . ....� �o sp�inq oy'n Ey�ado�d�o�aumo uo o�.(�ddo�ou saop�o� � � JNIONOe esua���s�o�nnquo)oyl:apo�suo�sse�o�d puo ssau�mg . �- -.,� - � � - � � �. . �.. .... . .. . _ _.._ - (vVOL'�aq)u�os�o�poiay;o�o popuo�u��ou s�,ainpn��s oyi. � � "l�nd��o�tu�il puo'�ioi..ayi�op��i.n'uoi�osuadwm o�osSlay�m sa6om�� - � �--� � SWa03 513315 . ya�m saaAo�dwa Aw�o'At+adoid'oy�30�au'no io'��. ' � , : � . �� : �:f'(oosSl vopop._ � --'� . . .. - ';,�_ ..� . -.�t,.. � -' : � . . _�.� . ._.. ._.._ .. NOuv7ol pe�puny enp uoy�e�ow�ou;o,�qoued�in»o ap�um , - -��ddo eyi si�alqns��iw�od o�o;auoo��ddo Auo Aq 5'1£OL , � - . , . , - ' 801.93dSNt � - 91tla � ��� H011�3dSNi`- . uoipog�o vo�Zo�o�n Auy •uopdwaxo pa6a��o ay� �oj -. � f �' �� � s�seq ey�puo wo��a�ay��dwaxa:�ay�oy��a(apa�suv�s �. . - � . � . -se�oid puo sseu�me ny�yo g uois�n�p jo(OOOL uo1Aa$ � - yllm 6u�ouawwoo)(6�oldo4�)n�c�asua�l7 s�o��o�Juo� _ .. . -. , . . � . ,, .�. � � ,. oy��o suolsrna�d oy�o��uonvnd pasua�ll st uy�oy1 ryaw " '� � � � � � . _ .. .. . . _ . ___. .. . -eiols pou6�s u a���o��!wiad y�ns�o���o�i�dHo oy{sa�inb . . „ , . ._ ' - ' ' . �e��oslo (o�uonsst s71.�!�a�d.'a�nlon�7s 6uo���do��o , , � ... � . _ .. _._- .: •ys�rowap•ono�dw�'�a��o'l�n»suo�oy��w�odo�sa��nba� � � - � � � � �oyo a �o 0 yo�4n+6�unw�o.��p Auy-:apo�suo�sse�w�puo ssau�sng . .. .. - .. . �.... .. ..._ _. .. .� poeo�ddy. : -. . Q_-_.. ' N . . � ❑.�. __ '_AJ (5'tEOL '�ag) uosoai"6uimo1l°S.�oy� �o}�mo��osu�oi� - . . ... . � , .�pou�n;oy .. ;ol s�opwNo�ay�wwy�dwaxo wo�iay�wn�yo 6qaioy� � • 5310NS.H01�3dSN1 . iNV7l7ddtlO151JV1d,�� . � NOIlt/8Vl'�30 213011(19-2J3NM0 , �