HomeMy WebLinkAbout1787A (17) �RKERS•�o^^�N�,i�°N°K�^R^T�°N APPLICATION FOR PI.UMBING PERMIT � �i
I hereby affirm thot I ha�a a certifica�e of consent�o self 76qyy�q +7_ i
inso�e,or a cer�ificote of Workm'Compe�wtion Insuronce, CE 817(kfiV.IOiBI) - OCJ
or o cert�fiad copy therooi(5ec.3800,lab.C.) COUNTY OF LOS ANGELES BUILDING RND SAF �
Q����°'"f+o�Y FrPmnnt, Tnriomrtity � . ,.a.A I
Cxlified copy ia hereby furnished. BUfLDING
� . FON APiLICAM TO RLL M(GRINt OR TYPE) �� � ��,
Certified copy is filed wilh the county 6ui 'ng insppc-
fiondEpartmanf. NUMBER FIXTUREpRITENI � � ,pc,�ar Diamond Bar �
Dare G��Appli�pn� wniER[LOSET • — �� . .
c��iFicnh oF ex�u+pnon�FaoM woaicEas• enn+rua r ..� a�osssr. 60/Philli s Ranch
COMPENSATION INSIfRANCE �R � South Countr . Cor .
(ThM s�efton naad iwf bs eempt�f�d tf ihr werk InvoM�d by ii
th�p�enit Is Ior on�hundred detlen(f100)or Ian.) � IAVAiOav � qp17RE55
I tertily thof in the performpnce ofi the wwk for which this I - �
pprmit q issved,I shatl nof employ any penon in.arry manner �K C�r . , hi'
ao ns�o become subject�01f�e Wakers'Compensot�on Laws. � ' �
� OISHWASHER -- ��TORR.C.R. Pl�mmbin INc.
Dnle nppliceM C10TNE5 WASHER �� . '.
� ' �CE TO APPLiL`NM: If, afte�making this Cerri#Imre of 5�������� 1 �8 O�.� — �,
4. ��p�ion, ryw shoald beeome su6jeee m the NYorken' �ry �,Np.
Cctmpensqlion potiaiony o4�he Labor Code,you mua�forlM � �
IAWN SPRINKtER SYSTFM ,
with mmp�y wi�h s�{xoviaio�P or �his permit shatl ba ��,,�. 336428 � C-36 !
deemed rBrOked. WAIERHEAIER �
iJCD95ED cOHrRA4�OR5 O�GIARAriON wsta�tr tao. amc�sSED BY j
IhereMaHlrmthat�aml�eemed+mdnprwisi4m^PfLhoP�9 c,a,ssvsr�nn oun�s — � } +
(cQmmencirg with$ectfon 7p0p)Df Oirisie��of the Businesa OIlilE150YER . - . d
arnlRofasiornCode,ond�plicpmpipinfylYforceerdeffec�. S�PErtSVSfFM "� FINAL / VA DATION � '
DAIE j� �'f ��j
License Nvmber��-ua CIos3�.�,_ . � '�
f�NAI � i
c��.��« �CR Plimibin��„6l19/85 �` �+ �
� I om exemp�under Sec. N �
� i
B.BP.C.for thn mmon p�an check fee� �
Dcte: p�UMB WG PERMIT ISSUING fEE E Q � . �1 7 8 7 A �
Sigrrohne �
TOTALfEE �Jp�� �r • • .•J� �
�
Pfan check applicanr
sir�ct�fmm�r I • +7 G 5 0
�} HOME OWNER•BUILDER OECLARATION n��e R.C�:R. PLtJMBING, INC.. •
� ,_ hrcby affmm thar I am exempt from�he Connadw's Licease agno 1$ Ve.' � �7�5�" '
Jl6w for�ha follow�ng reeaon(Secrioa 7031.5.Business and Addrass - i
Profenions Code): Ciiy Tel.N ��.2 G �5
D ;
I,as owner of rhe propeny,will do tho wrnk orn1 the ►
ahucNre is�rot inMnded or offered for SCIB (Sarlion .
7p14.Business a�d P.afeuions Coda).
CANSTRUC710N LENDING AGENCY �
I here6y offirm rhoe rhme is o conshuctfon Imdi�g agencY for
�be performance of the wode for which rhis permit is isaued -
(Set.3W7.Civ.C.).
Lender's Nama �
lender'a Address �
I cert�fy�hnt I Mve revd this opplicolion ond atole thol�he , ,
abova informotion is mrrect.I ogrea lo tomply wilh all Coualy ,
ordinances and Slo�e laws regulufing Pl�mbing,ond he�eby ,
authorize represeMatives of�his Counly fo enler upo�the
obove-menfioned p pe��y for in fion purposes.
nI �n SEE REVERSE FOR EXPLANATORY LANGUAGE
R-�=R= B�1l.�Js�'.6/19J85
Signoiu�e of PermiHee Do�e � �
. Nv Z =' D C O N N � Z
c D = � 3 v
. m�^ .0 r~n m L� � � = 7p
. . ' ' D� n f^ 2 > 2 �7 � �n
. , v,.D.. Q ~ � m /�j �
� ' � . . A T A y `�' C �
I . • ... . O � c � Z A D
� O N A � � N
I - '�
iZ . . . ;J .
�
� ! ,
� o ; �+' r � n
� �
� i� . a � .� �
y � a v h
� Z �
O ]
� ' � Z .
C �„
`� � �
, ,
_ A
� � N
. �
. �
I • . C
A
I '
I
F - ' -" "_ � '
I
Z
• N
• rn
�
� O
A
liN
i Z
_ �
m
. cn
�
� o a� v « v,n .ao � e,,-
� o W _O � ° F3 � o �-� �m °� w� � � � m � '�° � ^ S
� N �' 4 1.C
. � t� � �.� _ P;o Q��c-��� ❑o-- �7« o o a �o � N �-� .
. . (p . c N S C n O� e' Q � �1� � T � N � �
. ' � � � � p C � O � 4� �'c � U O�0 4 v O A m� Q ❑ O�
o �� '+ 'a y � �" � m c� ° $�. � ��$N-n� �m a,� o, O
�� �
s e v3F.N �o � � � a � � v-Ooa�-°o -roH3p ° 3•' Z
�
rt � �o � 'c ' N
• �a m m q a�a� �� � o 'o�x 'r< � � � � o � c�° p
� ` m3too �o �
� , p o m F.H 4 0 7 4 7 S � �b N o � a� n j � o� C .
_ . � � ?zo3-'" oroao o, _ n � Fv � � � -3 �
'. �� ��� o' a.v oo` xw-�� .,� � n� �
-. , ac� «c �� � °v � ° ? 3 +on� ° ' '�� � �
a,p �7�,�N o a � Db sb ! � o .. 3 0
�� a ' o' a n'� o � 'c sm m o 3 ° o �Q a . n
. . � � � a .� � m -� � .
� ' m �� �b � � n a- W � � m ��o S�.N n o o A
� ' � °.� °,�o o a o q_.,— 3� o �,i, m :,N � � � �, y
� o ° o , � E � ° � ° � ;�0 3 � 3 0 0'o o� �T,. � .
, m� 3 m� a� y o � ;N � o " 3 5'N 'n m ^ " � 'L
' b o'' a°.�° `m o 2a � ":w �o ' °c o 0
�o m_ N o.D f s�, a�. � m ' �> >
,� n-.o �-,� 3- � o �
.�. o a c ,� o ,F. c H m ro� a 3 '� `�n
�� � cecv . �av � S'o � °�ppO. fwo
�o n � .'o _ N n` �
�
_ am° ° �t ? 'a a�• � - N s�?m' o �-�.v��,
� -� .