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HomeMy WebLinkAbout1112A �•__. ' _ . . . .:.._ _ .___ ... . . �' _ ".._ _ . WORKERs�oM�N�,TioN��ARanoN APPLICATION FOR PLUMBING PERMIT �- ' � J 6ereby,aHirm thol I hove a certifica�e of comenr to self 7�887A � � , � �.. _• insurs,w a carlificate of Wor4eri Compenwtion Insuronca, CE B17(REV.8/88) �� - -- � � - . . or a certified copy rher�of Set.3800,Lob.C.) . . . . . ' ' . D78 39QP"�� S�AfC'_ FU/2� COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS ', PQolicy No. ompony . . � . . . . ,�., . .._.� .3 .3.5 � � , .. Cen"rfied copy is hera6y furnished. . � - � �� FOR APPIICANT i0 FILI IN(oRINT OR 7YPE) . �����' . � Ce�lified eopy Is filed with the co�ofy building tnspec- �O� �� � � �• . j"I�oa deportment. NUMBER Fi%TURE OR ttEM Q ffE ��u�, , �. �-j �/,, f�'�� � a WAT[RCLOSET' - O � .. ' ' Dote3-C=�.s:.i�-.APPliqonf `S�f NEAREST I . CERTIFICATE OF E%EMPTION PROM WORKERS' BniN TUB . CR065 Si. LtC7� � � .. � , COMPENSATION INSURANCE ��R OWNER . , � . . . . � .. (This�M�en n��d not 6�cempi�f�d 0 Ih�work Inralwd by � �it . . . . . . . . '� , th�pvmN h for on�E�ndr�d dallan(i100)ar bu.I t�v�toRv da ,�ppREgs ' '�, I.ce�tify tbat In ihe performance of.the wwk for which Ihis . �� permN is issued,I shall not employ ony person ie ony mannar SINK UTY � , � �Jr j _ � 50 as�o bOcoms sublect to ihe Wwkers'Compenwlion laws. DISHWASHER � .. .. CDMRACTOR ISC � � Dois � ePPlicant � CIOTHES WASHER .. . . A�E� . . . . NOTICE TO APPIICANT: If, aher makinq this Certiiicole of SWIMMINGPOOLRKEVT04 O n D � �F f'^�mption, you_ahould bemma aubjecl 10 �the Workers' CITY y ipemotion pfovisioas of�he Labor Code,yoa must forth- LAWN SPRINKLERSYSTEM � �n ��vP �� . ` wrth comply wifh Soch�povisio�s or this permif sholl be STAIE r� llC. deemed ravoked. � - � WATEM HEATER UCENSE NO. JD CIA55� �� IICENSED CONTRACipRS DKLARATION ' D�STRtCi r.p. PROCESSED BV � � 1 hereby offrm thol I am licenaed under p.ovisions of Chapter 9 ' - GAS SvSiEM pUTlETS � y (tommencinp wi�h$e�fio�7000)of Division 3 of thc Buaineu WTtET50VER .. ... � G a ; and Professiona Code,and my Ikeme is In fvll force ond effect. ' S vER SvSTEM FINAL �� VALIDATION � �� LicenseNumber 313083 �_ \ �AT� S'3-�jY V Lic.Closs � I� . . Q ����Q'� FINAI G3� d � Coniraetor •Dote 1,L.�L BY l W i ❑ I am eRempt under Sec. - a N i B.BP.C.ta this�eason ., � . ? � Plan check fee � , , �'�'� . PlUM81NG PERMIT ISSUWG FFE S . IO � i Sigrwi�re r^1 1 1.2 A . , TOTALFEE . - . ! . . . . . - Plon check applicam ' � - tt. o e e •�j . ' SINGLE PAMILY . . � o o�,t�j,S� E HOME OWNER-BUIIDER DECLARATION Nama � --� : � . - � � � ,�re6y offirm Itrot I om e.empt from the Co�tractw's License � , . , � �. � .' • a �p u.j Q� .for.the following�eaaon(Saction 7031.5,Busineea and - Addrou � � . , �. fessioas Code): �ity Tel.No. � O f?2 I�H% � ❑ I,as owner of(bs property,.will do the work ond�he '� � a�rociu�e ia not tNended or offered for wle (Section ... .. , . �, , �� - � - - � - - 7WI,Busioess ond Pro4euions Code). - '� . • CONSTRUCTION IENDING AGENCY � �-' -��� � - - � I � ' � � � - � � � ''�, I hereby affirm that Ihere is a construction le�ding aqency for . �� ' Ihe performance of the work for which this permit Is issued � � � -- �- � � � � �� � � -, ' (Sec.3097,Civ.C.). . , . .� � Lender's Nome � � - � lendei s Addreu . . ..... . � . . ... . . . � I certify that I have read this applicotion and atote�ha�ifie . . . . - - . . � -, � -� : � �� �� � � � - abave informolion is corrat.I oqree Io comply wllh ali County � � . � . � ordinance�ond Srore lawi reguloting P1umb�nq,ond hereby . . _ _ ., . _ . . . . . , outhorize represenlo�ives of this Counly to enler upon the , � . above-men�ioned property for inapection pwposes. � � � SEE REVERSE FOR EXPLANATORY LANGWGE �� �-r��pv8-a�8� ` Siqnoturo o! ermit�ee Date ' , � � �" , .,.. ` ...�.. . . _.� .i. ; r�. �.,�.. �.:... . .. i.�. . ... . . . .., . ._ u a i.., i i ... � i.. .�. �. � .. . . .. _I .,_ .. ... . ;. ..-.,. � �� �, .. � '� ct;�.,.; .�.:.r ,,.. _, :. ,,...�,......� .,....., � ._. , - . - A7CROVA.S .. PATF it�.SPECTOa 5 5iG'.'Ai,�y..E � INSPECTOR S NOTES . .. .•'�.����-i:-.. �' " OJiI �6 GUjL�� R L I LF "� i� ���„.; 'UN7ER SLAB 14�2K �. r- -. I 1'� . . 1 ' , � � .: _.. f�Q _ 9--�^�-' . ihcLb uf i J i e A P � �Sef �i�� ' � FOUGHFlUh1 1N:.-".: . �j(( ..f���;-.-^-._. . ...._ ._._ _-_.- » - . ._w �..._._..... IiCC 5 - f f f� n JI S GAS CIP:NG�.,. . .�f-�Z .1 .^ . 1 � � y^.'I ' ..'�;!�, . ". '.'•1: C . .��.",',.. „I . -.•f 8us rt zsLcnrl Pr ( csrons Cn/�'Any clty r J�f/which � GAS VEh7� . . r� . ," . �.-. . � r; -, I �eq -is rctm � ons rucf oi :imp o ,: no . HOTIVATEFHE%.ifR._ - -'.-_\ ` -1 .,-.'� -.-. ._.__ __ ..;..__ _._...1... ' '__.� or repa ony slruclure.fprio r el.s'�rzsJ ce?also�rc � q � _-_ . ..._ � ;- i � "�' .._t � ._"____ ,,___ 'i l,��tyi�es Ihrappfi ntio. uch Fe�7 Fo file o s��nad s ro!e� . PLUh59R:G FIXTJc..S-✓� '�� � ..��, - �,t �. � �.�. I � �-, w�ih t hc n! s Apur� I fo�ihe p slon5 ol�nc� GAS T[5T ��J�..�` j4 r�i , � .�' "_'_' .___ .____�_'._ li.._ .. - Cor.�rocio(s TI'�c taN(Chapt 9(co cncing wi!h I Sed on 7000 oJ Div�sion�3 of Ihc GGsln ss ond Proles- 11TILITYCO.NOi.FIiD-. -._..__.__ __ .__ -" ��-� ,_:I �.'--_, _-'�.` - .. l�� Ih' a,fe)oJ np�on An�'v�ciulinn`o/'Sec � f ��.i � ---- --�-�- fo'r Coo'- cr}hc�he�isexrrcptt� re6a q dibe6asis Hhat i \ ,"( ��.v�x iron/ _ . .� :_i�-j .��, � ��� ; '�703i�bl anY uJ�P mn;'for a�7 m"(s� � ci�r 'cppl�n � � 1- � � ' ' � ,conl fo .�cin7 p nalty,el,no�m rb 1}r�Lvo,hundred ,_- ..._'_ . .. _1-"-1�._ - �.__ _.__� -___.___ .__ _ ; �, t_, , , ,- rr :_ .. . do ., .. _. vousrn;ai-- t--'' � . �- - _ _1- • ' �s ISsao).: IIo ::ASiET�F60bA.-- _ '_ "'- �_ ... . .-. _.�.. _ti._�_ � os oain of Ihe p c(' �y���ill a�he �ork,nnd ..� .." �_ � .. i '-' . ._ . ' ____i_._ _'- � � nr,- v-� isnc ��clednr crcdfo � .:-"..� �„ ._ ..._ .� ..� r , �� ' 1 .�, :' ,-�•., � �� �._•1 � . ._:_. _', _-_� _ , �...— - : - ,_... - . for's C censE lan dc s ncii,�F�y ns n�y. crb/�on acY i' ...-- - --- - - V ' i ,.who�bw(ds.or lmr�ovus Ihe aon, on'd r.n� doc>,:,,fcb f 1 �, . � -- �'� ' � ' ... � � � ' ' � ;:;;, •„� � ark hfin e!i prov drd Ih�f'such Improvemepts crc nor ..•�. V. �.- �� ..• _ . �. �. - - ___ -- infenAcdorolforndlorsaf^-.��l,ho�ycver fhebuildfn�oi � '�� � --� � �, -- ' ..!m ro rmcnf is so�d w fhin onc ar oI com 1- �n.�he .;. .., � . � � I : -._:_.:. .-�:.� �� , P. ... 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