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HomeMy WebLinkAbout0924A (5) W°RKERS-�°^^'E"�,T'°"°��"RAT'°" APPLICATION F�R PLUMBING PERMIT � � I heceby,aff�rm that I hove a certificate af consem�o self yq�g�q , � �. insure,or a cerfificare of Wakers'Compensation Insurante, CE 817(REV.B/88J , -� . .�. . � - . � . . -- � �� � � - � . -or o tertifed copY thereof(Sx.3800,La6.C.) .. . . . � . , QcyNo�B��comPo�y�A�'C FU/!�I COUNTY OF LOS ANGELES �PT. OF�PUBUC WOR Certified copy is hereby fumished. � : � FOR APiIICJINT TO FILL IN(PRINT pR TYPF) BUIIUMG t + Certified copy is filed with the county buildinq inspet- �E`'� ' lion dRPOltmenl. . Nl1MBER FIXTURE OR ITEM � �FEf �«��N � -- �, Q����,� (�-� � WA1fkClOSFT ... . . , � �o�eSL�LMP1iSonr f � � .:� . . � CRO55 Si. 1 U� . . CERTIFICATE OF EKEMDTION FROM WORKERS . � BatH tuB � COMVENSATION WSURANCE . - ��R OwNER � � - � � � � ..(TAb��cflon nnd not b�compbt�d if th�wo.k in�olwd 6r . . . � 1h�p�rmit�t for on�hundr�d doqors(:100)m Ina.) LAVATORV �II . . O 00 nonrtEss rt � I canify Iha�in�he perfamonce of Ihe wo�k fa which this /l , . . pe�mif is iuued,I shali not emplay any penon In any manner 5i� ��TM `,�V� �p S , so os to become sublec��o the Workers'Compensalion Lows. ' D�SHWASHER � � - � � CONIAACTOR �� - � i he If3 �. A�olicanl -' CLOIHESWASNER � d�� AOOkESS ..1 a (�t ,�j��.��, . i.✓TICE TO APPLICANT: If, aNa� moking thia Certiiicate o/ SwUvwltdGPOOIRECEVTOR E�emp�ion, you should 6etome subjxt to 7he Workers' CITY �'��,elf� �OUE-' =ID —oZD Compenm�ion provisions of�he Labor Code,you mVsf forlh- �qyyNSVRINKlER5Y5TEM � - with [omply wi�h Such provisions o� fhis permil sholl be STA7E /� ���. .G3� ' deemed revoked. � � � WATfRHEATER . LKENSE NO. �3OU3 CU155 � ' � UCENSED CONTRACTORS DECLARATION DrsraiCT►l0. � VCOCESSED BY �I hereby offirm tho�I am licensed unde�p�ovisions of Chaprer 9 GAS SVSTEM � OUTLETS � ' (commenciap wi�h Section 70W)of Division 3 of N+e Busmeu . . ou7iEi5oveR . ' � �''� ond Roiessions Code,and mypliceme Is in full fwce and effed. 5 PEa SvSTFM DA�L n � VAIIDATION v license Number �ti 3�a�] Lic.Closa� � �� C/�J nq FINAI j�;j�J, � Cantraclor F �'P . pu�e O�rV� BY ��G""G't U OW 1 am eKempt under 5ac. p N B.BP.C.fw this reoson � � y Plan check fae Do�e: PLUMBING PERMIT ISSUING FEE S� � Signororo ��9 2�p . - TOTAL fEE � ..�. . . . . . � . Plan check opPlicaN �+• •• • •5 � SINGLE FAMILY - �� + HOME OWNFR-BUILDER DECIARATION Nome � � �� � , � � -- � .- � • 1 1 ��J� -�- I he�eby oftirm thot 1 am�xampt from the Connador's Llcenae . . . . . " _ . . . ��o, x . Low for tbe followinp reoaon(SeUion 7031.5,Basinet�and Address- � O��'I � S 8 L1 0 Wofeuions Codel: . Ciy. � Tel.No. � �� _- . � � ❑ I,os owner of ihe properfy,will do fhe work ond 1hs � � � . . � strocturo ia not infended or of(e�ad fa wis(Secfion � � �- - � � ��- � � � � � � � - � � 7044,Buainesa and Vrofessions Code�. - . CONSTRUCTION LENOING AGENCY - � � � � � - � � � - - � � � I heroby offirm thot Ihere is o conehuction lendinp oqency for � ' � � Ihe performonce o/the work for which fhis permit b i�sued � ' -�- � - ' � � � .. (Sec.3097.Civ.C.). . � lender's Name � � Lender�Address - . . . . . � � . . I certily thnt I hove reod Ihis applicmion ond t�afe tbol Ihe .. . � . . . . . . -. . . � . - .. . obove I molion Is co�rocf.I pgrae to comply with oi�Counly �. ordina ond Stoie lows requla�ing Plumbinp,and hereby . . . , . . . . . . . . _ _ .. ou�hw e r ro�ento �s of f b CouNy ro enror upon Ihe . � � -abo i ne ert�fo mpecflon purpoaes. ' . . . _ . . . . �� �j, SEE REVERSE fOR EXPLANATORY IANGUAGE 'YT Signa�uro of Permmes Da�e , � , , i ' .....,, . . , , ..��,� , �.� �,f' �,1 E', . 'r _ ..... ..�,. • .. ,v �.� -1 � . . . �., ,� 1 '. � .�� v l.i�\r' r.. .. I : . !.L.l... '. .,�_ ..'. . �. ... ,. . .. . . . �<,...„�.,�' . � , . . . . . . .i.. .. .. . , . ., . . . .��I I � � � . � 1NSPcCTOR'S NOTES '"" . "�„-'.-��� `.� '�..•"��., O�'.lJFf�GUfLC'E�D'ti l� C i���;.� . .. . AVFROVA;S CATE INSP�CTOR'S SiGNATURE ( � � - .� - :� �� U^I�ER.,tAB�V:Oak /�' ���j�� � ._ . ��•� . � r ,.�1i. � � � F to .�'_:C c�t-rs Y.7 �`�`� 1}c �J!'.s3f t I a. .-ROUGHClU:131N - ��_ . -!s��-j�.���� . ___�..- ... ..._. . ._.�..�."'_.'. .-.�. Lc . . La f �h f I � r�o (Sect 1031.5. �'GAS PIP?.G ' .{,- r_�� �" � ' � Rusiness c d F ro(assi s Codc!�Any c fy o�co y h,Ch - -. .�. . � . � ._ ...._�-c--_ �� ...'--�---- �-._.-._-�. =>— ���� .. . - - Fcr rtd lo canshucl.'a'fo � ve d r'otish. GAS VEfrt ^� � �� . � . �� '•. -___. '' , �'- -.'�-'�.-"'--.. . ._ '_ _ ' r any�struU�re. pno�fo t ❑nc also rc� _ _�_. _.: ' . . ...,- . f 4 HOTV1RiERHEATER......_. . � -. � F P ... .....1�. . ...._ . , \ ..� _-. . - . , � .., , qu�as�h�cppl rlo.such pe�n,r r f�l.o sig RU�L?�hGF�xTU,`5 . ,..•i � . . -: �. . i . ����-."� .�. :-.. .; --'-"--'��-- •'_^- ..�_ ��'- n+iiid�h -fcc�nsrApursua6i� rFeprovision:olrh� --..___._.-.--_-..� .�._._,� :_.— . . G�SlE57--� � : /, .,�--'� . !-�^ --=----- -----. �- -_...� ___:: .._: Conf.=eclorsticens�e Law(Chapie�9(�ommencing wnh - � ' i � �� !• -� Sectlon 7C00J�01 Dfvis on 3 ofYfie Ousiness and{'ro(es� UTILITY CO..�JOi1FIED_".' _-__-_ ' _.�.:.` _�.._.._.. . ' L - t":.�.�s�ons --- -- • �-�- - -- Coce)cr Ihtl�i�/s k�mpf?hc i or»and IFe bosis . . .. .__' _____.'_ 'Y-.._.. ._ . fc7 .... _ � � � �� Iof`Ihc'allegcd�o mp�fon �Any vIo aho���o� Snc��on Fir n� i ��., � C nlv r-_irr � .. . .. � . . y � � � �� - .�.,� f 703�.5'by en�t pf c -�pbr b�eci e� PP�'� ,, o fo 1 ' �h '?7_. " .__: -_._ . ._�.'. . .__.- _ .:. .. -� � �_.._____._-'_. _.__.__ _ c�n o c cvl.P;nrifty'of'no!nio th n�Y�v fi��ared , ... ' ". �... • . I 1 ! � --�_ ` O�IOrS��SS�J) . . . _ . -,. . �� ..' INDUSTRLS�.__.__...____.. . . _" ,..�" '�-� ' _.___._ '._._.- .. .-_ .... _ ,.....-..__.__,.___...._..._ ._._. .__ _ _. ___ ❑I,ai o.vncr cf tF.c proFeny will da ihe wor�^�nd t b¢ASTEV.GFROVnI ';-- L -.. . . " ; ,.�.Y' -.. _� .-- ------the�slructurc is nei intend^d cr ofFmed{or3vlc.... �.___ _ .._,. ._�__ ._.. � �-/.' .,...___ I ___I�_ . .-.- .. _ _..__ �e 70'�I zro.11m5rovdProhl�P cons�c���.„TheC /roc� 5 c •,Y, t .�. . 1 r [i�cen c Cc v doe ror I f a o nci (�o crfy - ` -� --- -- -= t . , .. .I w6o bui d p o dc,s sbch � �. .�i ' �' �. .� _. °' . ... ' � � � � • ' . .�___ ? in�ended seloile�nd�(,o�rsel�;ll�howevo�c'm�enls arc noi � -. .�.. � I .. '�. 1 ' . s�,: .�.' 1 F P . c......... .... ._ . .__.._ _.._:.�_._ .�_ . . , - � qr ��he bullding oi ,,. . . .. . : -- --' - -- - . . . ..- ' -'' . . . ... �:.. '� '., . -'. : ;. -,�,: . .. . - -. .� 4- �,. .imPravnment Is so;d wilhln onc yeor o�romrlcrlon,thc ^ .� i ,' ,,..j . : . i :-.._ . �_._: ... . ---- - ---_ _ _._ ... ..�„mc�nhu;ldcrvqflhovoihe6urdcnolp�oo�n�lharb9dd � . ; 1 .; ..�. _�_.. ..._.. ' '___.- _,.___ _� .._.._ _ _.` ,� . - , - , ,. .�, �, - � ��. � ��i __ ..., �nof t�uild oe Irnprove fe•Inn��urpose cl,scla I � .,�... : . ., .. . .___ .._'_.i _ . _.._�. ...__. _ �.,. _.. , _.._ __ , � � ,\ � _ , . -- �.�c f _.._-I,--� i---.�_�-. _:.:_ _ _._ .+_-_:_,_` _.. am exemp'ondarSc - ' � . . ' . . ` , _,�. - `-_---- ---. _ � � j � --- a6 E�'.0 for Ihis7eason •_ __._... , ;' __ _.,_ �_ --'- - _ -- . � �_- ,�__.-1 - ,,,. i ,. � �._ - _--- ---__ , i i - ---1 . . �--- --- _.-_ _ i -- _ ; . :. - r---. .'.^c_-----r'�;,- --- . .___ .. .. .. __ _._. . . �_. ___ .__ _i , - . i �. � . ..,. .. � _"' .._'___.. _.�__'_ .._'_..."___._. __" �_.1r - -1 -'-'--�--- -� Dtit�__— _ '�; -�. :-' ._.-- �r-- ----- ----� . , . . . . -`- .:..,......,. .. . � . . . . , .-..--."----. .... -.-- .._ . . , �i � � . ---- ---.., .��� _-_ .. . --------.. . O,vn e r �'� . � �NSPECTOR'S NOTES ' . � , �� ::. � ..��. .�.�.• . . . � � . ��------------�---------�----�- ---- �' .., ". .. . � . � . .. ,,. ,�..; .. . . �� , .. . . , .. . ... ; . . � ... _ �... . ... .., ,�.' . , „ �,. ... .. � � - � . _,__ . ,.... .,.� �._ „.:� _ r_t i,. ., , ..-_ ,,, . . ._.._----�---------------...__.._._---�---------' '. ,.� - . 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