HomeMy WebLinkAbout0777A (4) �.....:......___._. ......_.........�..�....__._..-..,.�...--,.._..�-..�.._.........��. ,-».._�....._._..,...-..�_ . ._...�..�...�._.___-.....-.._..-.�. .� � '"°R';�'�"�°1�,°�'T�" APPL1�ATlO:N ��R P�.UaVIBIN.+G P�ERMIT � I hMe6y CffUm fltat i M�e o c8ltNieqja Of GGRMfii 10 Mlf �yby�q . .. Y. +.aure,w acsreN�mte of Warkeq Gcmpenso�tan Nrsurance, c#ai�tREv.iaat) M w o csef�ftpd , t ��pfN�s�.�� b•C.> COUNTY OF LOS ANGELE$ BUILDIMG AND SAFETY y Polky � �-.: ` -:� � :, , . . , � . . , � � terirflsd eopy i�tper�p�fumuhed: ! . . led `!y il f�IbCI w}!h Qf CO If11 �in3P0[- fOR APftICANYtO flLL IN(pRINT OR iYPE) ADCRESS �315 � � � � d -_��� - . .. . . ' �utmnsFR rixttmeoR rc[na ' � �. L���,- . , . pQ� �' �1F9 ' _ �W61ERG.OSE1 �R� „ , CERTI IfXtE 0F EXFMPfRlH FROM W01t "��� 8A'YH nJ8 �cROSS�ST. 4 czsnn�tasaYior�uusua� o„� � (This��ctfonn�sdi�eF4itom�-pf�t�dlf�h��rtirhlnvolr�d4y 6�C�vER � � fh�p�rmlC9s 1ot�+a-na+l�undr�d8opar��(1100j ot l�rs� uvaraev �R� r f cee�ify�Fa»in�Be�p0�od'menae�af�Ptp wwk fa whfcf+rhis .. . . - - �. 4 Perma�is isiued�.1 shqll'aoremplQy qnY��lpnoein a11y manner - �K e�T'r �rEt.No. i �o qs�o bornme snbiep ia rhe iNcrkea tompanaa!!an ta�. - �DISHWASIER � EOate� � e0piimnt -- qOTNES WASI�R _ : I., NOTft�YQ APPUGA�Nt !G O/M�rtrolfin�.thli CppPficate vi � � �. � Exsmption, yw ahavtd�beeome�uk�� ru�i1+e.WVorken' g'^n^�"^'N°°oq.u�c�vraR , '�.j'C// Gsmpsn�anan pro+rlsio�rlrof�he:iabvn pde,}rou tnusr fonh- an �� � wi1M compty vey6 iuelr prox1i10n3�ar �his-pe[mii aholF be ����SVRiN�ERSK'�EM y�A� `K. d/�3 ' � deemed rnvokad wn�HFatflt t�Et�nrD. I UCF�Y�ED GONTRAGKPRS OEfitAWCALlN. uaTa�ct►io. vR e � I hqro!]Y 4�flrtn Ihql�YwOD�fiiC�}Ci��Otpr4v�titm4f�{�Pter 9 GA4 SYSTFM OU44E75 . ; � � lsctmtrt4netrffi=v�1b 5aetlap�oGa3 eE NvAia��;oi�1.@wiReu yyER d � arMaa�es►iara4`od�t�pffi•px esaiq:u,hdristr qnpe � �� q� .�/�,�� ALiDA710N � �licerroe Mum r 't.C4u,s . � � �, � - � � fIHPJ. 0 Conrractor � � � Doie �� - - fly � . � ❑ V 1 qm e:empl under Seu � - d N �' e.av.c.for u��.eow� Plcn check fee � Z pry � �t�� �L.UMBING iERMYT ISStJMG fEE E .� r Siprorore � . .. . G TO7ALfEE . . . Plan check opplicCm . . � . � �' �' SINGIE fAMILY . . � � � Nonn�owriea�euno�r oEcuw+naN r+a�„ :_O i"r,7 F. . I hereby of{trm thar I om exnmp��from ths CRttttoCiOr't Licprqe pddress � � � � 1:�• • • •� Law for�he(cltowcng reawn(Se�mon 703t.5.9usinen and � Wofeasiann Codet Ciry Tel.No. � . ' .;� , �i,-�� � ❑ 1,ea owner of ihe propery,wi►I do tl�e work and tF�e � �� � � � struaure is rwf inrendetl or offerqd for�le(Senfon ► � �. ��F =^ 7044.Bus�nesn an�J Prufessions�CodeF . . . . _. . . . , Il L.2!��—r'�:��T CDNS7RUCTION 4ENQING AGENCv ; 1 1+e.eby aff'wm�hor+F�ers b-c minvunlon lendlnp vge�for - . the peAwmance of rha wur4 tor whieh thh�pennir is�ued . . � � �Sac.309�,Cw.C.). � . . . . . � lender's Name - � .. � � � � I; LOnde_r'��trea� _ . . . . . . . � I cernly�hqr F hwe�.ead.rKis aPplimi�a».qnd.�tnin Hwr Me . � �, � ,, � abave�ntc nna+is car.xr.1 ayrarw mmPty wifls WI C,ouny . . . . . . . ordinan� Siere 7avn`pyyievnp vfnmf7`inq 4�d M1tebY aulllMiz �r 7 IiYBa of t�1i!Cponty q a�er UpOt1 ihis i a6o. , e 3, fpr�rrs�edkan rP�[e� S�E R�]tSE'�OR EXPiANATORY.'iAlISSUAG� •�_ �; ��' � S�grwturs of Perminee ute � ' � y � aopAOva[5 DATE. � INSPECTOR'S SIGNATURE INSPECTOR'S NOTES OWNER-BUILDER DECLARATION� � � � � UNDERSLAB\VORK � I hereby affirm�lhat I om exempr from rhe Conira<lor's j. ROUGHPLOMBING Lice�se Law for Ihe failowinc� reason (SeOion 70J1.5, GAS PIPING - - - -� � �� 8uslness and Profe3slon3 Code):Any d!y or county wbrch '' requires a permlf fo tonsfruc/,aheq Improve,demollsh, 4 GASVENT � � or rapoir ony s�ruclure, prlor fo(fs Issuanco, olso rc� NOT WATER HEA7ER - � � . . . quires fhe oppfi[anl for suth perm/f�o lile a slgned efafc- P�UMBtHG FutiUReS - � man�thot he is llcensed pursuonr to�he prov�s�ons a�fhe � GAS 7E5T Conlracfor's L7censo Low(Chapfer 9(commencing wilh UTILRYCO.NOTIFlED . Sedlon 7000J of Dlvlslon 3_a(fbe Suslness and Proles� i � slo�Code)or t6o�ha Is exempf tbe�efrom and�6e bcsis , '� � � - - !or fhe aileged exemptlon. Any vlolallon ol SecOon f FlnlAt �(�r on �roni . � . - 7031.5 6y any oppllcanl lor a perml!subjet}s fhe appli- - . cool fo a dvil penalty of not more�han�Ove hund�ed � � - � � . . . doflrns(5500).: INDUSTRIAL � _ � � ❑1,as owner of Iha properry wiil do�ho work,pnd �� YlASTE aPPROVAI � -� �� . Iha sfrucfure is no�Inlended ar offered for sole. - � , � , � - (Sec.TON,Bustrross and Prolesstons Coda �Jhe Contrac- � � , ' - ' �, , . � - . for'a Lkenss Law do+s no�opply fo an owner ol properry . � who bvlfda or lmproves fharean, and who does such ' . ' � , � :. . . . � �. . �. � wark hfmself provlded fbal sucb improvements am not Ij� _ � , � Mbnded or ofhred/or sole.!f,-however,ffie butlding ar , . . , .. Improvemenl Is soFd wH67n one year ol compfa�ron;�he - � � -� � ownerbullder wtll have fhe burden o1 proving thot he.did ,Y , .. � _ . , � . nol bulid or Improve for the purpose of sole.) � � . �� . . , • � 1 am exempi under Sec. . � �i . . . _ . .. . , . .. . � 6 8 P.C.for ffiis reason I.� _ . . . . � . . . . ; . � � Date� � . . . � . . R � Owner � INSPECTOR'S NOTES I' .. II r' � � 1 i i 4 , � .