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0803A (4)
-'M: . s . a�n g: � �. �. a :. as,z:.n5 k�x '� .' ��::�.,.*^.,� 's:t- �._ rv{ ,, : � -' �"�'�' '� p���zr .a I � � '4"wr_: ,a�w z�.y;..:z �rR"�' ;�y t` .�,�3 '�*r s".„a-"x* x d�,.: ""��"§ :.W a�'�,c.� `�, �:. ' Y � WOIF[�R9 C,6Nt7��r�A+i]ON'pE"C'�ZARe� 'b � e � �"'�.y `/►w j�{ y�' �+c '�^y^7 - - � Y hereby et'firm that�T fiave�a cert�Ficate o��"cb��'�se� `��c�ai�ja eoj �"�1���"'L 14 P1��4J��� 1".�. �V ��IYI 1� �. ..�,, ,w...,, _, ,._„�.._ ..._r ,�_ . �a._ ,.. �,...,_ �...,. �� . ' msure ox`g cert�ficateof`�tvor�rs�omp'ensayYon InsuFance,or � �� �COUNTY QF L0S;r4NGELES BUILDtN AND SA/F.F�/ � � � a eprhfied,`copy t�heDr�eo4'($'ec 38bd`�"Y,ab C.} ; � " �� ;. o mY N� "'ro�C�pan� . _�r;.E :.6�a��� / k7Y__ . _.. ._.. ..._.... � � �� �uildin ms ection FOR�APPLICANTTO�FILL:{N,{PAINT„OH7YPE)� ��p� �„ ❑ Cert;fied copy is�.filedwith[he�county b ' �. MUMe�� PIXTURE O ITEM � FEE LU�IL�ING ",.y�-�� � r � Certitted co y is heeebY f¢rfushed 6, pRE55 ,/ P g p OCALlTY �i'„����Q_;�y�f�� ,t�tmen ���. � �.WATER'CC03ET .�bate, ��Apphcant � �+-j'�-� .�. . �. ; , � :'�'� N !AAEST . . '. . . . `.�+Sf CERT�Y�FTC�`jA°I�OF�X�MP'E�Y���6���'IfTCE S . �gAYH TUB�-� '` � �� A'`-U CROSS ST. ;; y, � �G`6'I�k'��Se1T1�O�1�T�TSU �Cb' �� ._,,. .SHOWEF :; ' _ ":�. � OyVNER . .� � .. ;r`F,; t�-N ��� t t -',�.�..$ t.#54"�'te-e.�. .�,,.�. � �.��AVATO,RY � �w•'V ADORESS�" .�eX�-r'-✓ d �., (Th�e secGon need �ot'be coynpleted iP ffie tyark anvo�ved r��. � by the p!ezrmt �s t`ax one hu�rdred dollazs($100) or,tess.) .`SiNK ,�t I, �� ��-'� ��� .�y�. O�� ,_ �i �n. ^��- �ry`"` .�.. �3,�i�� � �. , �: � ��^--V� CITV �� � �1- .�TEL.NO�'"� � � (� �. . T'cert�fy'}hatin fhe;performanCe of tttE�yoik C91 wfi�a,h t]lts .' .�_DISHWA$HEF � - � .� '- �f8rm�t�s issae� �shatl not empto'y anY persvn in any mannzr �--� CONTRACT(7R � e� -, o . -' so as io liecome sub�ect to the�'V�orTcerg Gampensation;�aws." - ��.�CI,OTHES:WASHEq { ` �.�d��� � - f v ; a � S �� � .,, r�. ; . �.. ADDRESS _ , -. ` .� � U '� Dgte Applecant ' � � ��SWIMMING,POOL RECEPTOR�.� � ��� � W� . � :: 'Ss. ` S+e��' ,�r s -z•' �' - R NOl'YC`�Ttl A�PP`L'P��"T It�at'�e"�r mak�ng th�s Cert ficate of ` . . ' CITV �.� TEL.IVO��y vy. �pn � ; Exemptisn you y�to�Y�'d�Y��come suTJect-Yo the VYorkecs -_ � -LAN1N SPRfNKLERSC;STEM��� � ' STATE ,+ r�-�� CI0. ""/�` � Crompehsaf�on prov�nons oi'tfie T.a6or Code�ou must fprt� .yyqYER HE7aTER � � �. LI,CENSE NO..! -d�4? CLASS, [.T--' �- . ylnth comply tv7th suc�i provisrpns ot fh"fs perm��sha"�`Y�"�e � l� - . - deeme�rGvoke� . � � � �� � DISTRICT O. � PROCESS� BY : � r �, ;� � .��GASS�'STEM �,f`'�p�,lTLETS � �� _���� � ' L�E'��Eb C`d'T�P'1'�A�'T'dT,��'b"E�T."�A"�Y.A''�R7'°�' . ,:� . " ,,r� ,�' , �OUTCETS OVER' � �- � " '�,��� � V^ �1$ere'6y aff''�'vm that'I�'am lAcense�'unc'Cer pcovis�Ions of��hap{er � .��5 PER SYSTEM ' .� � � � -9 (commeilcmg w�th��`eclion''f(��111)pf Div�slon 3 of t,h'@:�usy-, ' FINAL ��-�� VALIDATI�N � rtes3 an3 Profession$�Code anei my LCense is'm fuU€prce vid �. � - DA?E `�;.a-;(S�� . .. _ .. .. . -effect : ... _.,�. , .� . . . ., . ... _. . . . : . . - ._... . . � /��Cy r�l /�. —� FINAL / . �T.icense Numtier" � /`�l� Lic.Class �—`� - - BY-� (9¢�"�,��. .r � 3 y,e���.�, �� /�, . .. : . _ . . . .. . �Contract r%h�G''2_2�S_4� Date'�^ i7� . - .._ � . �� [am-exempt from th t�eensmg requirements as I�am a _ � P�Bn ChECk fe0� .: �� � � . - `> l�censed are.h�t,�c� or a registered professional engmeer pLUMBING PEptvIIT tSSUING FEE$ � ��`�{) � � �' act�ng an mY proPess�onal �apacify (�echon 9�}§t�Bus- . , . � � � messand Professions�ode) � � � � � 70TA�FEE .�'„�� � �� � + ' a�, ..,; •p � :, rq . � . . . - . l '�lic o[Poe"�Nfo . Date�� ��, ; Plan check,appt cant'.:. , . : .- - � � - �:. _ . , �, a � . .. . � HOME t)WN�it gIIYLD'E.k D�CT.ARA1`XQL� � Name - � � a � r � : <=0$Ct�11 , ' "^...� Address . � .. .�� �� i �ereby'a�'L'�vm thaf t am exempt tYaY� ihe Confra,cfor s � � :.L aense,Gaw T'or S1}e ioIIowmg�reason(Sectiqn 70�1.5,�"Busi- ,:.� CitY . .. ��Te1.No. . . � � . . � � �' ��'��.� °� .. ... i ➢ress�artd Pi�ofessions G�ode} � ���� � ' . � .,❑ :r�•. ...r,. .,. .,.. ,.„. . . . ._ . . .. . , � ..., _, w .�. . ,� .:�. , a..,�_ ,. _,a;.� .,._...._ 1,as,oumec of the property,am aXclusively contracting '� ' e��'`�'� � - wrth�ltcensed contractor,s t� conatruct the pro7ect . . � ' (S�ct�pn 7044 $osmess and Professfons Code) � �� � ����` . �: - � . `' L �. �:� ; :. � s'� � � :w s 5 y� � ;CONS�['�t�',C'�'�C�N L�Nl�I�dG AG�TTCY � '. - � � .�: k� ���'"` �V CI�. ��I hereby`affirm tha£_t'here Is a aanSYructwn lenr�iag 2gency �� � ._, .. �.,,,. .._.,... .. .,., _.,._, �. �r .. _ . .- +�* . for the,performanGe.of t�ie W,or`�c for wh�c:h th�s pErmit is '�.• � ' ... .., .,._. .e.. . . . , ..<. , .� _�. _.. : s .. .. .r.:. .< . .r. ��seued(Sec 3p9� Civ"C)• '�, Lender s Name ' ' � ' �. :-� -' �' " ' .�� � i �_� z`9 -.,' 3'�. �.; y £ x 4:. "u1 '�""'f� F. �'y,4 t'C N',�vc. 42 N�- 1 ' � . � `� r�, s� c*�'��,s 1 .�� s� �: s� �' '1 e t c " LenQer s Ad�ress �� ' �� �. . ; .. � :� � t3 i.,,`�- v�. -:. s �:: x5r c`�,�"�.� �� ��.3c�,�.^r ^� vi' ��5 . r: '�x -..' �... e t . . ....� �.: ; f ceFtifx fhat I have iead tY"Fiis applica�"ion aiid s"ta�e t$a`ithe A ; . . ` � ' � � . . . 2, ..,. a,.�....- N.,._., .a...-: ,,.. .�..: .,... .. »� ...� , ., � _.ti . - . - .�-above n t`oimation is cbire�agree to comply wit'h aYl�oun�ty �� ,.�.gFE REV ERSE FOR EXPLANe�TTqRY J,ANGUAGE ' � � �� 'oTd�nances and State�laws regulat�ng PCumli ng and.hereby � ... ,. w,. .,,:. . a .::.> .W„„__.:�.�. _.,,�.„....�.„- ,..._.,,...:>. .... �.;.-. „ ,_.,.....-. ,. . ._ .. ,.:. °aufhortze�rapres2ntdfipes of tliis,-�"ouufy ta''en[�r�p'qd £he�'��� � � , . �� ' " ` -°- �.' -;���giention� ed operty for iris@ectinn purposes. '` '` = �=��- " � �« � ' ', . . r . -. � .�,. .. ��c�v �— �—t}�T . ���tureofPermittee � ISate-" " . . . �� . , .. . . . '`:: .� - � . . �. � � �p „ � �s�� �* .� �', o„ � _ ,,� .� AarRov�a;is DPcTE i�v oa�ssicNa-rur� �wSP�Ct`OR•S�voTEs _. , f3,W�lERBUILDERIDECLPeRATPON -- UN4ERSLA64MOR1 . : " ."— . � �.: .' " �I.�. . �.—_ ';y q.. _s^ ., '. ;. .f. ., . . ����.ROU.�w Pwnna�rv� �� ' . ' � . � I herei�y a£fitm tdaE.P am gxem�t�from Yhe.Contcac"to.r's'��� � �� ��-�License Law for i7ie"follawing ieason($ection 7031:5, .GAS;�,prPiM17G•�- " � �Bu;ineas"and Prafesaiorc� CodeJr�Any city��,dr eoupry � .. '. ... .. ,, ,. ,,,`. . . �qs;�!�n�T , �; �� ,, . �.; . ,_�. 'i _.: '� �eyui� a perm to onstrucr, al e`r, imPr4o&; ._._.- ._ _ .' . .._ "W; �which es ie c t HOT`,JttrER HEdTEt7 : '� - ���" •'I��demolish,or repair,arty stn(c;uXe.�prior to�,iPs issuance, PLu�'e�N��txFUREs'� � also requires the appiicani.jor such permiE.to fi1e�'a - - ,'�;s�ned�statemer.t aHai;he is�lieensed p�tCsuGnt l;4,the GaB�-„esT � _ _ � � - ` :=provistons of the Comtractor's Lic¢nse,Law(�'ha'pter 9� u'ri��Y'Y co.N�TiFrs6�. � �'} ��/comrYdp+rc(rig�with Section�7d60j�oj DivisJon 3'of ti�e ' -- - _:�� ,, - .. Busfness.and �rofe.osions �Code)��or thp1.he is exempr . FI��t - '_ ..�±herefromapd the basis for the n[leged exemption.Aray , . . � . : .�,. _ ; . . ;. ..:_ .. .._ . . ... : - �',ra�Q/t-vat,'�2r�./r.� - - - ��vinlenon,of`�S�ction'7�J31,5 by any applican�jor a�per�iYt a.� : . �� ,�' �, ' _ � ' � '�'�subleca.e,�the�pFic¢ez{�Fo�u civii penalty of not��more than-: ��� ' ' - ���,five hundred oFtars l�'S00J.: � � � 'IN�Gt�STRIdG ' � , � - . . � , �, �, . . . �: :: . :. . .�.,. .. x ��, . n ._. ... .,. -. :_ �s=. „ _ wasTE Rt'RRovRL ' -- ' -'��- -�- . ' '- �� .� '� - ❑4,as,owmer of_flte ptoper4y�.n�lt do thc:wosk,and .: : . _. � ,.�..,, � . . ..,. .,.._� _„� . ;: ' ::t_ .w_<:. _ _ ��� _,-.. . ... ..; .; - � _ ���Yhs stxuctuie f§n¢i intended oi offesed for sale: - .� - , -: . . . � i „ .y ... .., � .: ,�.,, . ,.,_ . .__.., . <.-. ., :.:; � -_ . -�" , .�. . ,_ .�rractor'.��L'ic�se�nLriw�doe��t aPPFy�io 6�n owner�of. �,.y - - - --�,,,_ ..,�properfy�.who buiids or improves�thereon,and whp does .. _ _ _.,. . .. . � . _ .�:, ��' ' . .:... . . .....�- : ,�� . .�.,...�, ,_ ...:_:. . ':_. . - _ , . � . - � --- �-- ,�.'such wqrk- hemse3f:prmvided��chat'such imDrovements �� i: ..�x �,� -�•:. .•�. --k. ..< .-�::�. . .:..: .....��. �. . ,. � „are.not intended or..ojfered.for,sa�e. If,.hcwever,.:ehe , 4.: '-. -� buildirrg�or intproveosient is sold wiPhin-orse year oj. ._. . .. . .... ,. . .; , ., - _:�, � . ,�.. ` �. . .. . , . . _ � -- � � -• --- - --� �-� �� � �" � �-comgletiori; ttee, owner bu C�Jer,�,we/1 hava ��the 8urden���, ,..,. , . . � . �'�� . :_..: . ��.�` . `._..:::�....._.:..�..�__.. . .:_.. ,,;., _. . ._? `_ .... mprcre far qf:e.. ... , . , . ��.,.,, ., 'of provi,ng thp5 h'e��did not bui(tt or t �.. , , �. . . ; .._:, _ �_..: .. :;_.._�. .:_ . .�.... ........,y . . .. . �� .,..purposeofs6le./' �. ,�.. .,..... . ,:�;- ., .�.:. � , .� �, . � . _ .�-:� . �. ,. ,_._. . ._= , _:' _� . :. _�� ����� ��°` I atn e�einp8 under�'ec. � , ,, _. .; _._�:; �. :..: _ ..�..:�_. , _ . ` : ` . ," i ' ' _ �..B&P'_� fe� �h'as,reason ' ''' • - " -- �. .....,s__� .,._:. . ._. .._ �`.. , � .. � , , ,,, . ' .. _ ,'�{ — '. .�� �_. .�`r} ! . . §� �BtC � i , ': • ::�... � � . �.. � . �� , , y, . ..., ,:: .-,� � .� _ �;_ __ ... -_.. .. _.. _ ._.._,�. _ . __.. . -_--. . �WricC'.: ',. , .. � . -.�. . � :. �, . ,.,: .. r.� . .. . ; „ ..,..,INSPBCTOR'5 N�p�'ES , , ' _ . __ ��, . . .�. .. �_ ,,. _.._ �.,_ , >,-.- . ..,«_. _ ... . .. .�_ ..,,.. ..,, . ' - �. .. ' .` � ..;: - ,�,. ' � ,, r .'��.. - - - - - ,} .. .. . .. . � _._ .. _ ; . _.,.. . , .. �._ . . .. . .. ...: , . . ., . � ... . . , . :� ., `r � r :.; '..;..� . ._ ,. , -� � � -