No preview available
HomeMy WebLinkAbout1641A � , � _. 33 .X ,., .a .:. ,uw� ..:,. . k r % .�N/t�RICEkS Cl7MPENSA7'7p'N`tlECLA�2A71aN . - `�:T�:. m ��4 C .�Y*. �I hereby aff rm` t'6at`�i. have a c'e,ri�itate'of cg,nsent�'1''a se 9E�e�oaW 3 e; "�.�� ,, fi � y �. .- _ . � , .. . . «..�'�.�.t,.w �aaan2o . . .. . . rn6ure or o certifmata of WorkeB�CompBnsat�on Insurance or ' �' ' - 'p�� ' ' �. ,...,�, ,� ,,, _,, _ ._,_, �„ _. ,.. � ,-. 'acertfied,cpythereo (S�c,38�0,Ca C) �.� � . ` . . .�. ,�pP���p+����N���a� ,P����� �.u. � :�Pol cy�`1 -Compqny_��.,fl-,'t_�..IC'�/�6.°� �is ' C �1 �[ y . . . ��Cert�fied copy�s hareby furnish,, . .�_., ��_: . . .��:' �cWER ':.S�W~G� ��S,�QSA'}.�� , ... �� Genified copy is(71ed with e co ty b�{ildln '�napepion .� . . .;,-. -, � -- , .y.,� � TY �� . . COUIVTY dP tt?3/[FfGELES BUI DING,AND A E ��dePart ent. �.� - � o . .� , .. -. . ,. � . - , �, . __.. ,.W.��.. .. .P.,�...:: ,�bare,,/���!R�.4pPl c� � �=f�!i�«�6�.���'� F�J�APRLI�ANT TO�I�.G IN � GOMNECT�CSW DATA � ": CE fIFICA'[E OF E�EMPTIO�IV�FROM WORKERS e�itoiraG�. I �� � sr.anoN � oevrr+ - �* GOk+IpEfySA�f6N�TFT�`,URA,�C�' . ' Aoorz�55 , {?, .. .,°",*` � �,.�., � ' ✓ ,.�(This sectiqn ne�d�4l:be comple�ecf f the wrzrk tnvolv�c�C�y rha� . ia`A�in, - �� rowNHo�#neFeReNCE °�'�` ., �owER'- x'p�rYn t s for one I7undred dollors{$100)or Iezs) hEARE51,�.. �� � � ' � � '�"'� tvpepFCkNNEcrla�7'""""'""" �. i�NGTH F 'M � .� -�e'rm�it�is issued,I�sha I nor em io��an ersok for h�p}�'+h�s „ cRoss sr, � � ��� v. .cuze e� �. M�To P u�.� f � Q the wo �. � - p � - P Y Y p n in any manner �,.�.:, . ,.,..,... .,..,.,x ...�.�»Mw�„�.mo„�.�; . . a.c r�o ��C� ,, .' ��;so ag to become sub�ed to the Wnrkers Compensavor+laws _ owNea� � �� � co iMp No.�� �os rvo � � "�. .sw'a"• �; �`FS' kt�.�s ••s K :;. �.. �'-.k ,;�-�d ;: � �.'�. Mnu-. ,.. .._ _.p��- . . _ _.,_ .._,� . , �. ��J _ ,..q y,'�,;". .;� �, � ,/. . � �TRUNK PERMIT Np . ROA�PERMIT ND'. .� . . . ... :`� AD�RE55'. .�. . . . , �. � . �bate "�APPI cant . . . x�xem +"on, ou "should iiecom'e sub'e9t to the Woi { � a � d��onvit' wa�vee �e.nse�seNT REcoRo iNsre No� oare�� ' ..h N�OrICE'1'O APPLICANT If�after makin ths �er(ifrcate of pTy . set:uo � . ,.... _ . .. ' p _.. Y p ...., I t?_. - . , �.�,�... . .. � �.with s�ch Q i d ...,._ ��cAt. �_ �,. � .._., _...., _�.�..._, , f hW)fh �ESCRIPTION ��Tryp �� N1VY ORST.WIDENING � .,,b p. ;..���plYnsation rovprdv'sfornshor.PForPer�mit sha I befde@�I?S. . .. .'.�. .. . .. . � .. ._.... ' CVOkG'C� . �� BLOIX TRACi" , . SiATC ENCRaACHMENT �,� ` �', Y ' � _� " " . '- NO OP�LO,GS ' ' � PERMIT NQ �:;TICENSED CONT�A�"T'OR�DECCAkATIQN � � size oF ior Now oN,c_i �- �� - � ` � '� � F" ;I hereby df4irm thot'�I:qm liceasec��„u Y(er provisions of C�aptar ��oF'� ` """"""`"'"'""""'"""""' �"" ~"` ��� � , , _ . ,i,9�commen<ing with 5edion 7p00)of Oroisi�n 3 of ihe4Bus . eu��oiNCS '' �- � � �. '' � � �� ainkGes' ` . effect. Profess�ons'Co�e,pnsi my I�cense is:in fytl forc�e and.,,, . �� --_.d�- - _�-� � - -� y � � ' �- ' --"'�-' .,�ne�es a`nN . . �� .."` , . . - . . . .. .�. CON':RACTOR' ,., H`�'R CONNECr�ON;C GE FEE� . . ,x : ;, ' . . .�' . . .. . _ ._ .. ,.�,. _ ..,,w.»_.. Y ,��L censeNumbe. . lic.Class �� �� Apb�SS ' . . - ItEIMBURSEMENT FEE � � O • �:.� . ° _ .r . <,�, - , ', -�. , DISTR7CTN0. GROVP MAP �. �PRCCESSEDBY'� � Contracl r Date � - CIrY ' � �rv0 �� ' `�' � . STATE' ' � ' � - CLY55 "- � �.., ��� �y r 'yy�7� � U BK, �'}vG � O , ❑I am exempt under Sec � of the L A Co -, �.iCENSe�No'""' � . �� f, ,. , h fallowin�� � . ,„�. ._y •.' _-_., " -.` " � . V. - B�&Pi�,Co odfoa t'i : � ' �` No � 6ESCRIP(0(J dF W01�K fEE" � . ' !�/orS�c " ofthe . .-. � FlNAt . " �r9 -. ' � HOUSESEN1ERCtiNNEC'i(3Gib'' " DAiE � � VACIDATION a'� ; 9 fEO50n ��PUBlC3EMlER .. � � �� �, �a�� � . - � ..-. ..»} F:- ,�+ :,, 'SEPi�CTANK,SEEPAGEPIT4�R '.�.. ".' . � , '�� ��PIT$ANb/OR.'pRAih'fIFLp .: . . ... . FINAL. �'. Z ' �q� . . HOf7Sf SEWER-CONNECTING TO_' � B� � y _._ _ " ;• � � � � �� �' .-':PItIVA7P➢I$P SALSYSI" " � """'� ��` ��I he�eb��a� .�u,u.. �,..�«.. . . .. r C�ontraCtor'g��L'C, � WORkTdHOU5E5EWER � . . �....�.. .^.� _. ... .�.... _� .�... g u - ���NF7NECTADUI710p L'�'6DG'O_ � .. - . -. " y'_ OWNER BUILDE�DECLARATION � -:,. , � �o„,+-_,.,. OVERFLOW SEEPAGE PIT.D2AM'IE0 y ifvm iha�i,J`am eze,mpt firom the � , .i�en,se �EkrN cE5sa6�t bkvwEti,nn.ewHoie � ._ �. � Cow for tlie following`ieason(Sec(on 7031;S,-Bu sness pnd Pro` _ ��a�rers'aevA�K�"ottn9r+ia�oh�F+o ;!�"r'""""'" , _, � . r'fess�o�s Code)� � � seweR oe oispo�nt sws�,u" ��9 �4;1�A� .,.: , . _ _ ._ �� - ❑i,as owner of ihe�property,or�my employees with wages as , � . � . ��•m e c.� Q,.. ' � '�'''�their sole compensafion,will-dn ihe work.and the sfructure - ' �,-����� ���.��.-.-w��,.� is not-ntended or�,of(ered fo�sale(Section.7044„B�sinesg � pe�mlt . $ �y ,�',� .�:�°���rj� . .� and Professions�pde) OWNER'S v .._.� [�I as owner of the property am exclusiv,ely cantract ng with AUYHOR�ZATiON TO'TAL FEE m , s e m 2'7,rj Q� licensed confraclors fo co�,nx�sfyYuct the projecl(Seclion:7044;'" �'� �HAVE�AT THiS OA7E A CON7RACr'WirH iHE PEREIN NqMFO COfJY2ACTOR?0 , �� .. �u51nE'S5 OnC�Prof255 Or15 I.OP�} CONNECT 1HE ABOV�pESCRfBE�EXISTIN6�yWE7L1YJG Tb TH�Pl1'Bl(C S;�IpJEi� r„ ;' , .t Q,'Z�..-���. . , �� CON5TI2C1C7101J'�ENpIN�A'U'��t�CV' � � - • � � � . . .�� I f�ere�y a�firm�"��at�ihere'�is��a.�consiruc�#lor,v._kend�ng�agertcy � SIGN�D 7Hi$ �� DAY qF �� �� 19��.- , ,;.fo1' ihe erformance:of the�wo(k for which th s� ermif is " Owr�Eq�ors 9� � .. , = �ssued�-(Sec.3b97,CiS�C�) ,�... .`.:""".` p..- . owNeaS nC,�vr ' . . . ', „ _ _ - �. � AOORE55 "` Lande s fJamz � � � � „ ,. , . „ . . . -. � m M :' :£ {"'i ayYrvz",�`$' :�,y�mf;, . .. �. . .. .. _.. .... .,tBflf�Ef 6�.QC�(�IC83 � e .�. . . . � . , . . P.-.-,.. _. _,.. .. g P Y ...... .�, ._ , ,;. K_W ; . rdinances and S,tate laws re olat VIum6 n and Se'the � � � � ��� � I,ce y t t I hqve read lhis appl cafrorc and siote iha , , _ .,, ' and,here�r ation is'�c�r ec4.'16 ree`fo ro1� I wtth ali Caunry � � � - ve Pnfo � . . . 9 . 9 __ 9 wers � � .. . . . '%- ❑ufhonze�.represe�ntqt�v�s nf"this Couniy fb�enler"' �"'"" "" ` � - "' �" "" "- �� ' "' " �� �" ` ' -" " �-- - . .. ... . .__. ... . _ � upon th a6ove-menti d pr .etR/ or in5peciion p�rposes ' ' ` `�`f �'' �' � . - � � - � �- } � � ' Sig� Perm�tfee , _,,, 6tl�1�3�/' �<<�� �� . .' . SE6R�VENSEFORE�CPLANf(iORY.IANGUAGE�, � , . ..;. ;.., . . : -�:�.� . . ,,. .. ... , _. _. _ __. __ _ __ �� e�. z' - � -� � . � �. ;' ��.r '� ,�: ''�' .:r R:' IPdSiWEL.YCD�"S PI�TE& '.,�.....�:..._.a..._.. .'. .�:. .. �. �: . . ,., > za.�.»-�t,-r ...�:...,.�,,.r.� _ OWNFIZ�.LTIL.I7ET�33ECLi#��I(Jl� . �_ _. .. , - , ,,.,.,._ �PPR��ALS onre orusrenoas si�Nnr'uxe _ _ , _ ..�. .. ......,Y hereby afa:em rhar 3 am e.e2aispt ftomt6e Gonaiactor's-. NEW FiOU�SEWEk � ..�, , � .. .•�. . .. : . � . � ..'�'�.8C0U9C'a:'aW gOY 4�It�01�8Wit9�zC850A��5¢CSiOPY�QS��,J�✓..�.. ,, _ . .. ... _ _�/�`- ' . , . � - _ �,.$aessn¢ss:r�asd Profe.rs�aoaa G'adeJ:.fsay olty:or.eoaenty -� _.. 'cnniNEcrnnoiiidrd`ai" .:�,. , �,� .. � ..� :-d�besFr re u9res a eems¢ta cos�mrasct, mF�Po s , ' BUIIDINGORWORK � ' . � ' '.:.' '. Y � �.14�yYDSB>� .sepr�c rnr�K,�er.:.oifrs) -- .� � .—`---�-,_..,Y._. .�demsolish,os rsjxear,¢:iy struc usor,._,grtior,�'m,dEs..�rua.ace, �:. �.aHQioaoaawFiFio �, ::,. '� � ..= i 's....: ' . ' .. � �-' '., slso reqissrea t�s a¢&(scceus�}'�r.;c�k7fTerm{t:.co f!!e a . . _ :.s . . . __ ...__ ._. ... �= -........;.. ...._. . .. . s4 ed st¢tememc 83rdt�be as"8eesiase� ursuxaat Eo�Ebe . e�ssrooe❑ "..p�vw�.i❑ �. �.� 6'+s . �: . .� . . . - _ - .. '�rbr�eslox3'of tl�a.Coaz6eac uT's Ldtbaum.T�u���bu�iier�9'. = ♦ _'-. . . :.y .,> ro- 1 f A1TEk�RFPAIR SEVJER OR , .. � �.. .,_, .. . .._L .�:�--r�--W-�-----.... . �COtii3➢3EAC9A�9(lE&I!S86EROOL �OOOJ�O�D8QMf19'9X 3 O�$AC�. . � .SEWAGeDISV65ALSYSThi - . ' ' —'--'—` -- " . . . , .-, ,. . .. �issdetasa'�l�rofasa%m+as CodeJ�or tbat 8�s.;�a mxeaaa.pa�� � DISC6IJMFCfPLUGAND� .. .� . . ...�.-. . . . .. ' , . ,,. . .Ae3woont tsouse 5twFa .: . . ._._ �.. . aberefro-ra rgoad abe bssss for ahe�Shcgrsd n..xamepE£rava.Any �. .Uncrcsin sevne rsNKs❑ ... .-' -. � - . �.. '.= , " .`�'� .. ...viadatRmrs of Sestion 7���,5 by¢aay app85eanijoz`zayreeraaaia ,seer,rrc�sY❑.-ce55a0as Ll�::�. ,° �.�:+.. - .,� -�_� .....:'. = .�:. .. . saz8jectx tbe ap,n8rcamzB.to m clve8pexal;y uf�a8 sr.oee.Tian�:. . � ' � y.� :� ::��'svehwssd+�ddotlurs{$S00%: ... -- . .. . _ ,... . _ .. .., . � .�. o� -� >s. . , . ., �� .,.,.� - � .__ � � � ', � .., kf •.�: `� ` ,,. -�.. &� .��`' `�4°� �::,v____'_y_� Q I�as the awner�£the P�P�s'��vi71�r7o'the��a�or����d' . , . . ., ... .:.. , ..,,_.�..._ _ .....,. . . :: . . ..:.� .; . � . . . . . . , .� . �.. . . � � .'. ��2k�e strvcmre�s�oz i¢;endkd cx oHered far saSe. . .. ._�..� � � :��'� " �. � �:,. ; ,�., �. . . . . . �::- . . . .._ ,.. .. .-: .'.;:;_ .:,, � .-i, � . .�:- , ,,... I.�.'�tracEar��Trisaaas�e�"Lsw��does�oes;s"ans��;�avner rzf�. .. d..�; �.�.... � �DP � _ AroPerty wbo beee8ds ar.saxjorovz.thes^2osa,�syut avbo does�. '. .... .. ...... �� ,. .. .__ . .._�.. '. '.: . _ , .. . ,.. , `. -.,� . - _ .. . . . . au,sb cuor���drev`�asedj"�proueded tbat saecB�f�3�?a(rr'ooemewRc .. � .. . � .:�� . . :.'- �.__.,:1._ ._.. �..�._._ . _." _.;: ' . ,.-.,: - . .� .._. .. �,.. . ��:. �•�mre aaot"i�4eudgd Or�ojfere�for s�de.''�friitvener,.8he" �. . �... .��.. ._ , �..:. __�__:,. " �...::.,.. _ .(.,__ . :'t' -. :'.:-__y_ .._=. ... :��. . . _._,.r:-. .. .._:, . . ,dudjdusg'or can¢raeieistesea 4s sotd.svatbio�arae ye�cr of�.. ,� _ � . - '-� .'Covn,pdeisosi, Ybe ofun�e»beafkler"taradl P�auo'�i1s�e bilydea��. ' - . y ��-"' - 03`piavdsag tkas be�did osoP bac¢&t or.%mjrrove fov dbe�. . .. __ _.. � .._ . _ ._ .: ._ . ., .. ' purpose ojsaleJ , • � � _ _ _ , .. : . : _ � � .� ,� , - �� :, ,� ;�i � � � ; 'd��eau�ua3�r��c. ,...,..�,;, h .:. ,. . ..;-.s _- ` _.. . ,. ..,'_. .._ ._ '_. ..�. `y ' ; _� �.�.for xhi�eeaaori., � _ .• . �� � , �, ., . _. , ��. . , , � � , , ,.,, ,, ,:_. , . _ � , � � , _ ` , e "" Da2e. ,�,,.. , � " ��� �, _ ��, w _ ,. . . _. .F � , , � ,�r-, ., . _ _ �.st ,� a.,._ ._. __ _ _, -- __ , � f.�4wt1�" �� ,._.. _.. .. __,�. _..,w._ .,, - _ ,. _. .._ . .. .� . ��. _ .. �;�.; ;a 5. ';` iN3�EC'dOR'S 5d6SES _. -..w :. .� ..- ,. ..,_ . s � . ...:". . ;:. _, . :. . . ,.. , .� , , ��.._.,«.. .___._� . . . . . ._.. „ . ...... . . , , �:�� , . ��:s � �. � . _.: .:..- ' ;�. ::� `� .�: .. . , , �... , �..,.. � '� .�..�..:��:.� ' .� � -. _ .. . . .� � , . _.._ _ . . , . _ .__,.,,...:,- ..,H�.,.,.:..a,....�..,._.wc�:m. �.�..::w . . . . ,_... . . _.,-..» .,.., �,.: .;a-� y � � �' � � _ � �.. ,.., . � _, -� ' .�„ � _. . _ _ ._ ...,.. ._.._ . ...... '..�,a�-.r......�+�-�-�.+ , _ � ,'. .. & a�;., - � � � .,.'$. ' � � y ... . , , . n - . ', . ., r � . r . . . .'. . .. . ..., , , � � .� ^ � .:. . ......w.. .. .. . �,� , .� ,.._. ..�:.�. 7 _- ..,._.,.:.. .. _,_.,:'_..,u... , . :: �,,µ.q . � ,..r „ . _ _ _ :.. ,-.._.. .. . . : � ,� � �� . .; :p, ,... . .�. , � .r o - . �. . �.5. ' , , . , ._; _ _. .., .. .. w_ ? ' c' ,s: �4e�' V � S` , . .._ > � -.. .:-s .. ' -�: ' �.�.'�.�. ��e%���, �+3.�''�C-� .. i S.�a.�: 4 ,� � . . ... � ,. � � '. . ,�..� . .. . � ..... _ .,.,M....,;«w. .. . . .� ..�.' . , d,.._...,.»,,.., .,..�4.�.,.,,..., -.� ,«,..e..r-+:-.:w...4....�.,<..�. . . . . ,.. ,., . � '... � . �. . .. .., ��; , ,v .;.. . _ ..c`.� � ^ ' .