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0780A
. WORKERS'COMPENSATION DECLARAiION p pp1 1/`A TI/1I►1 CA� �1 1 lAADIRI/� �C�AAIT r I hereby,o€firm thnt I hnve a r.ertificate of consenr to self In- jbAbb�A"�'"""•o' ����j��i iV i� i V� i Li�iYi�ii�fiS i��7iiii i [:� i wre,or a certifica?e af Worked CompensaLon Ins�rante,or� CE£:17 i,RFV.Sie6J i ' � :er.iified ropy ihereo.'(Sec.3800,Lab.C.) �-� � Policy No73WC005047��(}�,�IATIONWIDE COUNTY Of LOS ANGELES DEPT.AF PUBLIC WORKS � � CP�tified co -hereby t���ished. LOT PLAN �+ TRt1CT av�� FCR AI'FLI�ANT TO FIL!.;�\��P2•NT OR TVFfI Ii:ING Certified mpy is fi�ed with the coun�y building inspection �--'A��.%4t`,`; 91$ SUUTH LEYLt�ND DRI�1$ y nr �� � � d rme�,�. . . . . Nur�nata FixTURE ok iren� �- F�F _.—_. - _. , PP�' ---. __ � �io:n�nr DIAMO D BAR � Uate9-1-88 APPI.icanR,�"�T PI.�BIN(�i 3 '�^lAIEKCiOStI;TI�!.FI�__ __. .�.6....__I 18�._._�V�i\kFS,... N _ _'_'-_—_- � ' �Kcsssr G12ANll AVE. CER7IPICATE OF FXFMPTION FROM WORKERS' 2 RATh Tl�n �I � 12� SNOWeR _-._-.._ �__-_� i .. ._—_ ._ i COMPENSATION WSURANCE - ��'N'��R RRAMALEA LIMITED ' (This section need nof be completed if The work involved by 2 � __ 1 Z�. f N;ql, __ _ _ ... �a the permif is for one hundred dollars(5100)or less.) rj �ava�0ev 30� nnoRess 3151 AIRWAY AV�. SUITE N ---- — - - I certify thot in ihe performance of ihe work for which�his per- ������� � ��������� �-_-_ mit is rssued,I sholl not empiny any persort in any manner so 1 5'NK (� � 'I CiivCUS'j[� ME'SE1 T��� N�'$5U-1��1 ' asio become su6jecl to fhe Workers'Compensaiion laws. �- i�_._.._ S 1 oisr;wasHtk _ I 6 i�cniknr.r��Ebd PLUMBING CONTRACTORS, Ii�C. --r---__... -------- --- --- Uotc. Applitun+ 1 C�DTHCS WASHCR fl I A�L i`, ' ���C�70 AFFLICAN7:k,utier maK�ing inis i:errilicate of Ex ;' ���____ ZL!+1 S. 4UPONT DRIVE _ . xion, ou shouid becomo sup�etl to rhe Workers'Com en- I 5'/✓�MMING POO!RKEFioR ; I v � � ---- - _--- =-�or�ANAH�IM, rr� �:0.937-3972 ;: sa�ion provisions of}hc Labor Code,you must forthwith mmp- �AWN SPR�NaIER SVSTEM � � .-___.. _-_- _.t...-=---- ---�_'_�-' ,� ly with such.provisions or!h�s permi'sh.^,il bE.deamed revok .--..__..._. '4iF !'.0 ed. 1 „vnr-R�+enr�a u�ehse No 4'L6109 aass C-36 i i10ENS�D CONfkACTORS DECiARATION -- --------�----- - -- Ui5"I:ILi NU.` P�OCiSifD 3v � I hereby affirm ihoi 1 am Lcensed under provisions of Chqpter i GAS SVSTf+n G _CUf�..r?5 + (� ,�, I � 9(<�ommeodng wi�h Sect�on 70�0!of Dieis;an 3 of the Bus:ness 1 OUr:tiS OVER } ! 1' S� �. and Pro7ession5 Codc,and roy lirense is in full lorce ond ei- 9 PER SYSTFM I ' FINAL � � + Pect. � VAlIDATION 426109 C-36 _� oATE ` �, , `� cs ? License Number Lic.Class ---�----�-""""-- � ; -- 4„7 j FINAL ' � ' Connano� NEW Pi,UMBING___Dat=_-8-31-88 ---- - -- � BY �:,��� p ? � � ---+-- � s.a i am exempt undar Sec e! ..--"- - G.� �. B.&P.C.for ihis reason . � .- - �� � Plan check fee � - � � otl1e Pwnnew�PeRMir issuiN�FeE s 10' S0 •' _ _ '. - Signarure riOTAL FEE ' �� l l�f� �� , " i � 4.�.,:: � ' SWGIE hAM�LY ------"'""�' { Plac-heck appli ... HqM'r.OJJNER-Bilii.DER DfCIARATION - �°"' � _ , : , g I hr:reby affirm that I om exempt Yrom ihc Coniroctor's License Name � i for fhe following reason jSedion 7031.i, Rusiness ond �:;=� , ,� „ ,. 1 ,:ssions Codej: Address � I, as ownei of 1he property, will du!he v.r>rk and rhe City Tc� No. �� siructure is no�in+ended or otfered for sale(Section 7044, ! Business and Professions CodeJ. � i � CONSTRUCTION LEN�WG AGENCY � I hereby afffrm that rhere is a mnslructinn lendiny agen.ry for � + ihe performance of Ihe work fnr whicn this permir is issued (Sec 3097,Civ.C.). � Lendar's Name I ` Lender's Address_,__.___ � I certify that I have read �his onplimt�on and stnte rhat the f{ above informotian is mmect.I agree to comply with all Counry � j ordinances and Stafe laws regulatiny Plumbing, and here6y ` authorize representatives of this County to enter upon�the i a ve-me iioned property for inspectio purposes. . 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