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HomeMy WebLinkAbout1240A 1666A ,.� .. _ ... . .. . ... . , _. __,.. � WORKERS'COMPENSATION"Y3ECLAI2Ta710N���� .. . . � � �� I hereby affirm that I hove o te rificote of consent ro sel( /► " insure,o�a certifica�e of Workers Compensaiion Insurance," � �- /"OPPLICATION��OR��COMB(NATION�SWIII�lIII�II�G POd�L�����T��V������ ���� o.a cer!'ied moy Ihereof(Sec.38C0.Lab.C.) 7. . . � . . . . .. .. .: . , ' � cE7 e:3:8'; ._� . .. Po�icy�vo company COUNTY bF LOS'ANGELES BUILDING AND SAFETY �� Cerl�fied copy is herebY tu nished -. .. � � � . . . . .... .,. _ .>....,.-,:,�., , .,w....;. ...,,..,,;. ,�.,y,w., ,,...�^ :,. . ....•::�..� � FOR APPIICANT TO FILI IN no�REss �-�- �l� �`-�`'�� w� Certified copy is filed with!he cooNy building inspec- . tion deparfinent. , BUILDING C ��� AODP.E55' LOCAIITY Do�e Applicant . �-[ { NEAREST . , CERTIFICATE�OFEXE'(J�PTfON�FROlv1C�ORYZERS' � ��� ��TY ��`-' � ZiP �� ,J CROSSST. ... - � � COMPENSQTION INSrJhANCE ��"."�.�� '�-'� , Size OF y ASSESSOR . , ,. �.,... TRACT� � LOT l0T NO. 1Z MAP BOOK . PAGE PARCEL (This section need not be�completed if the permit is for one� 7E�. / uSe zoNe rm.av ,.. �.�hundred dollors�(S��)or less.) OwNea' ?J =(,.�NO. j- 1Q,.^:j No. l r �' ��� �I certify�hot in the performonce of the work for which this� m[�' . y Z SPECIAL . permit is issued,I sholl not employ any person in any mnnner� ADDRESS . L„�.�i V��_JU COND�TIONS ....... so as to become su6jec�fo t rkers'Compenso�ion Laws. � f1 �ISTRI�'f STATISi�CAI CCA55��-��� T�'PE � � vROCE55ED BY� �"� CITY S�� Z�P ���v CLASS NO. ' � CQNST. / ��ate� �� ��pPlimn� � ARCHITECT O . . .. . . � TEL T �, r� -)�. �... � (�7,i NOiICE TO APP ICANT: 14, after ma ng Ihis Cer�ifica�e of, ENGWfER N�� � Exemption, you should become s�bjecl to fhe Workers' 1 1 �. � D • VALUATION - � Compensation prvvisions�of ihe Lobor Code,you�musf torih- ADURESS 1 { /� VqLIDATION winc �omply with such provisions ar ihis permir sholl be �ONTRA�iOR ,N�__r 3� s deemed revoked. LICENSED CONTRAC70R5 DECLARATION-�-������ �� ���' G'S � . � � AD�RE55� � N�� Pp'r'T ' � ' I hereby offi�m that I am licensed u der pro�isions of Chapter 9 / S � . � y� �,(commenc ng with Section 7000)of Dlvision 3 of the Business CITV �� LC f4 53 QO `-j ��.U'� 1 CLASS ond Profzssio�s Code,and y license is in full force and effecf. DESCRiFTION OF WORK �l, . +1C � �'� FINAL fl�.�:., �'1f" o�m c�'s'��'. License Numbe��� � r ^' Lic Class=a,� SWIMMING POOL ��--y DATE —'-�t � a COa� $"'F3� e � 'Z SPA� L� FINAL — i �%C37Sy U Contrl am e em� � �r SQ. t. . BV F "- �.. ..._,_ ° �(;.J/sj. �. ��.-� � x pt under Sec. �� . SIZE " � -'. .-. \ ----__...---"'� O s ar.c.ro�,h�s,eoso� eiecrRica� �-�.-/ � �,��;-.;9 W 1��7 � .. Dare: �7( 'i .�S� sl '_y �- Si nature Steel 8 Conduit Bonding �—�r � _ 5 5.6 a � 9 Conduits,Conducrors,Equipmem t '�I � � z . . . . .�.. �� � SINGLE FqMiLY� � ��_m g a �,3 HOMEOWNER-BUILDERbECLARATIbN���� ���� - PLUMBING I hereby affirm thnt I om,exempt from the Contracio(s license ► �X l�. ,jC/�4. - �� � -i.�rj�,�(�' Law for+he following reason fSec�ion�031-.5. Bus�ness and P_T�aP ���'�tl; � Profess ons�Codel.�� Gas System . ;� � � � '+ � 1 C�G50� I,as owner of the properry,will do the plumbing and Ami-Syphon �y �,,��7 , plectrical work.I,or my employees wilh woges as iheir sole compensatioq or o Iicensed coniroclor will do all MECHANICAL . �. � . � other work ond the s�ructure is nol intended or offered � � � for sale(Sed�ion 7D4d B8P Code). Swimming Pool H`he�a�e,,r.C � � � CONSiRUCTION LENDING�AGENCV���� �� � �� . `�'TR,W ���i� � I hereby affirm 7hoi fhe�a is a construcrion lending ogency for APPLICANi . � TEL� � the performonce of th Hork for which this permit is issued (PRINT) _ �F hlp — ,3Q , (Sec.3097;L'i�� '` ��9� 9/��/J� �v ���j/� Lender'sNomz— ..___.,_ ADDRE55 Z���f�/AY C/ • l//G��'�+ Lender's Address , p.0 Fee S Permu fee r� . I ce,rtlfy thot I hove reod Ihis opplimtlon and sta�e Iho��he above information is correct.I agree�o comply with alI County Issua�<e Fee 1d �� ord�nances anti Sia!e laws re�mir.g ro buiiding, electricol. . mechan�col and piumbing construciion,ond hereby authorize Im.esngarion Fee � � - (� repre n�atives f .his County to en�er upon the above- io�olFee J , . pr p y Inspecflon purp�ses. � ent o e t o y�- � �.� r S 19 8� _ _ _.. s�9�a+,.e��faPorc���o.q9e�i oa+c ^� SEE�NE4ERSEFdR�€XPC"AIiAI'C3RQ-IAP�t,1�S��E���-�� . . ... ....�. .�r.+�,.��a�..�.+ - ----- —a' . . .. ...«..... ,. ��- .�".�PCANS�TO�APPLGbN7.�..-... ' � . .".. �.. "..INSPEGTOR'S�NOTES.� ....... . . . . r ...--.......----- . �. . . - '..�.`—... .'��+•:•,:"'....'.'�.�.• OWNER-BUILDER DEClARA710N � .. .. .---...---.-...•�-.....-m^�-u,�.=..-..:.....:-.I hereby affirm�haf I am exempi from thz Con^racfor's To: . Returned . . Llcense Law for :he following reason (Sec. 7031..5 -- Approved � . .--........... ......._,..,_ ,...:....,,_..,.,,,...,,,gusinessondProlessionsCode Anycity ��r�counry�which �No. Dote No. Date �. � . requires a permit ro mnsfrucL oller,Improve,demolis6. . -. • . . ._ _ . .. :-... _.• � - ..�.c .:-1=�or srru<+vre, or ro rts issuancc, alzo re- . . .. -....- ��-•.��, repair any pri '� � � � - � � � quires the appli<aot!or such permit�0 4ile a sigr.ed state- '� - .� � • � - . �' ' '���-� �����"'ry �Q�•+� ��--'"�-""���� �� meni thaf he is ficensed pursuant fo fhe provisions ol 1he � � � � Contrattor's License Low(Chapfer 9)(commencing with . �. - �. -,-�.:� �..���-��:�^-��,��µ.•�. .:-�::.-Sec/ion 7000)of Division 3 of�he Business and Profes- —_ � sions Code)or ihat be rs exempt therefrom and ihe basis . . . . ..- .._. _..._._..__ ........._. _:._..._,., . �::'__.��__,_,,..,,,,,..._,.,.,.,.,,,,,.�,,..t.,„,R,,,,,;,,,,,�„ �: w,.,_,„,.�,y for.fhe.alleged exempiion. Any violaTion cf:5ection ' I - i � � 7031.5 by ony applicont!or a pe�mit subjects fha appli. � INSPECTION DATE� INSPECTOR � ~ ,__ , - �� � � �� ��-.,�� cant to a ciyil penalty o�not more than fivs Mundred LL�CATION ' r/i ,. � . . � � . doll❑r:(5500).): i _ ..., � ,. -� � �� � - � ���---� - m:•�.,:, ❑I,as owner of ihe property,or my employees wlih STEE:B FORMS � � - � - woges as iheir so!e compensatior,will do ihe w,ork,and � � /y `�� I - � -��--�--�-- � �-� the sfrucfure is nbt intended�or offered for sole,(Sec 70a41 LIGHT GONOl11T� I ) � � - � ' � i �� � ,�J � � � Business and P�nlessions Code:ihe Contrcdor's License �sOnfoiNc � � � "��� '-�-��'�""" "'_"-�`"`"'" Law does not opply to an owner of property who builds or . � � �mAroves thereon,ond who daes such wo�k himself or � I � � -� .�-,.--����•-�-'-�. tbrough his own emp!oyee>, �rovided thot such im- _ _... I ._ . , . ._.. . }" provemenfs ore noT infended or offered for sale. If, I - �i " /=-� . � "�� ""--��> �� -'-°���'��'��� . ��'"�"•��' �-"� however,the Suildinq or improvemeM�is sofd within one_ �CONDUIi � 'U • ' ��'' � year of compl�hon �he ownenbq fder will have the I � �^� ��� ' � � � " � '-^ ' ����-•.^- •_�• �-�--�•= ' '� burden o/proving thof he did not build or'rmprore for IFe GAS LINE . '� ' ' .purpose of saleJ. .- �, � , �- ���-�- - :----- �� ��-�•^- L��I as own r of ihe propeny,am exclusively con- �,WATER LIhE ,'�'-'3� � �✓J'f`I tract ng �.th I�c. .ed con`r�ctors�o construct the projec� �- � • -- �-- ��-- --- � -.=a:::,-=.--.. i5ec.7044;�'Susines,s ond P�o{essio�s Code:7he Coni�ao- 'SEWER ' tor�s License Law does not oppfy ro an owner ol property � - . . . � � .--- ..��'-."�,.�-• ..=:=r.� -�.���: who burlds ar improves thereon,ond who confrocTs for - such projects w�fM a contractor(s;(icensed pursuani ta . '�� - � � .� � � � � .. . . !he Conlractor-s Licenso Low,l. ��j AN7I�SYPHON VALVE � .�.�.......,•..�. .�--.v.,.:.,�v�,.� �.. .�:..r ......::..❑I am exe��p!under Sec. .B.&P.C.ior Ih'�s ; _ _ ',ELECTRIG WIRES � •eason ....... ........,.. ,-_�, .,:..,,_....-...... <.::,..�.wti�:,:....w..wwws�n., �-. . °' .s,,:;, FENCE�HEIGHT) ' . _ . Dale �Owner � � . . ........ .,._,., .... . . �� , ... . .......... .....:..,. ..... ,........s.. ..u:... . ...�.. .. � SEIF-CLOSING � ' � � � ��-- '�.GATES. �SELF•LATLHING� IN$PECTOR'S NOTES � . . _.: . . . . . _..,.._. 7,.Y;_,,:. .,...:....,�.-+.,..... .., .: t .w.,....�a R.�n;:�:u.+� n++�k-,��.::: :h, &OUGH WIRING .'..'. .:.`. .':.�. "... ��^��"+�+_ . 36d7.x FINAL ELECTRIC = ..- ..... ....._, ._ .�_:_._..� . : ._...�., . �.�n:�..;�YJ,.-._�..:�.::t..s�.�a�ta.y».�J;...u.s._.,' i ; ' . , - . .. ., .__..... ...r._..... . � � .. I .___.. . . . . .�- . ..._ . �..... -.,� .:���_•r �C:�t F�;+:z'9'4't'., .t!V^.'.;>,.....:, ' ,. _. ., � .,.._....�� . :�:-_..-_ F......,Es _.,.�.,�.. _...:..,;r e....�..�.,,,,....M..,.�....�r_,...,, , , _... -. -....... .. �. _ . ... . �HEATER(LOCATiOP!3 VFM) ' , i . . .. ..... ... -......,..-..� ...,>......�,,.�w.�.,.,,..�,..... ....�..�,»,.., �x,....m�...,.:.. . GAS LINf YEST . . . . �.,-.....a.sa�..a..a..w�..w...an�..ru..+.o..s,a...,..,.,.�...,,. ,PQOLDRA!NAGE ... . . . . ., ..: �, ...,.— v-�m�•:: .s.:.,,,, - ,.�,..._ - ... . r ' '"..�... ........._: . w...,......:: ..,.,.,�......: ....:..:,..,.. ........,:n-...w�m�...f:3:�iai... ,. . _,...,�i-�.at�..,; p-TRAA . . . .. . ...._ .. . .......... .,...«.,-,.. ....�„..,..�., ...,... ... .,._......,,....,.. . ...._, .. .,..�... ...... .. .. '. _ .,�,:.._..- . .�.....,.. ....tm_:...... ,.,n,»,J•...,�.t,,.�.: . .. __ ,,,,._..... ..........�..:.:.r. ,.:...:. ....;*«—.....,suw::av+n.��wxs.��'�+�.imsa.ue:nr,�'rae.�a'saPrawi.:1�'� s.:....�.