HomeMy WebLinkAbout0806A (4) � , � , n � , �� ;WORKEI�S Cf�biPEMSA'FION�DF�C�CARl�`Z'I�N � �s�se�a �:. �� �'��^' ��' :�. �,: '� ��� . . . $ t I hereby a�firm��,�1Yha�e a cei��ifmpa�te�of c�se�i"�o self c�i�a-ao�""'�''A�'F�1L1C��`C'���N FC�F� f�LU�NIBING PE��GI T tnsure or a ceYti�Ca eaf�oS�eTs o ensaftonZnSuranC;,oT ' �'���' "� '� � �� ��'.� �y"`�` '�' ���� ����. � � _� 3 ��"��k"je� ai�rxie�ea oo�r t7tereof(seo saroo"Lab.c.> '_.' �� " " ; . ": , ' . �v/d�G �� /e,30�z' COUNTY OF_40S QNGELES � , Bt�i I,DING A �SAFETY' o�cy No Company . � '' � � �: ,.s �.- . ,�. : _�y ,_ F. ,. �;. .. �, .. .: ���`�._�� E� Certifi �Lpy is hereby furnished. � � FOR APPL,ICANTTO FI4C IN(PRINT OR TYPE) BUILOIN(� �J �+ y � r �„ " ' . .:. A�DRESS. OC(J' / �7�/�.��+{f,1,l,Y Certi�:�Y�Pi[ed tuith the c,o;unty�ng Snsp�ctidn NUMBER FfXTURE qR 17Et], ;, �' FEE � , �� - �-�n.->.�•- .. � -� ,�;�de artment � � �J � "� LOCALI'TV /v (�.(!'.� WAFER'CLtlSET o}-G. '-,. :.- �date�Applmaat - . � , .,; _. . ., . :.:, _ NEAflES7, .; . . . ` t a+l� � r h � �` t�" ,k, jc :. y . . ' eATli TUB �•d CRf3S5`.ST. ." . `� CE�TTF((.'ATE O�E�b7'�'�'I���FROIvf'WC�RKE 5 � " � SHOWER ..- OWNER , , �^� ci�'�iP�Ns�Tto"Y.*�r7srztta�ic'� , �', . .__:.,�,_ , "� n" a �,,., �' �� r:�. nnait _ � LAVATOAY �+ �h�s sgcllon need not li'e completed�i the wp�k��yolved , � O�FJ qoARESS f � —l�i�a.v �n'-t.�-e-� by�.tfie permU �s Pqx one hundred dollars (ElpO)or less) �� S W K �� �- . . : ;a ., ; ciTv ;�2.2.a.. ��� Y��-/ rEi.�`vr�.:S„i97/'Y�D-� �O � t ertify tfiai�in the perfoxmartce�q�f"�Yhe work�¢r which�di(i�`� �_.� Di$N.��ASHER `� � � . U '�e'��}t ts]ssnQd,I shall noi employ°any p�craon in a�ny mann;c ,. �✓� CONTI�ACTOR � so�s to become sub�ect to the Wor�Cets Contpen�a'2�on La�vs� �� CIOTHES WAS�IER ;�- � Ly^U AD�R�ESS "�� � � L, � Ilat� � � �PD��cantm, :�:r ,� '� ,. �r . ' , . .���� �. �-��-✓ �.ef_;�.• E— .� -�.—y-i� �, ��. � � SW�NIMING`p00'L RECEP'i`OR � `" - V �ro�rYe�Td ApPL"I�n��v�'Yt�"a1`ter mak�ag fn�s Cert��cate o'r`," ci-rv reL.No. d--�v/ � �xempt�on yov shoa��becom.S.su�r ect ta trte Woxkers' LAWN SPti11VK�'ER SYSTEM � � py C�mPOnsation� � Z�� � � , � STATE�,� . -y �iC.". �j �p ov�sions-oP 4he a �C�ode Yo�ti must fortli : . . � � ..- � " . �/,� - (,_ � � �v�t�i comply with such .prbVreipns or T�h�s perinrt s6alt be"�� WA7ER HEATER LICENSE MO. �� CLASS � � deemed revoked � , GP:S.SYSTENt�! OUTLETS �� DISTRiCT N0. . PROCES5ED BY; � , , Lr�ErY��D�or�ri�nc�oR [7� �,nnk rr - � � G�� ��w � OUTLETS OVER I heieby afficni that 1 an?L�ce'hse��'�e�prqy�a�on�f Cfiaptee " - � 5 PER SY37EM" �°"� � . . - 9(commeficmg w�th Sectidn 9�f08)of Drvision 3bf the Bus3� , � � �� � FiNAI , �' VALIDATI�N � 'h8ss artd Profesa�on Code.,and y y censews m fu11 Foroe and � DATE .-:��—(S'y� � �- -� � ,En 1 _ e£feFt � . � . � . � - /Y FINAL�.�- �` Lxcense Number����Lic CiassT�-"�„�.� � � � gV �� � . .g,.-.,. »..�� . Contl am�exem t fro,m tti Ice�n�stqg��������� : , � .� . �'� ... . . . . .. . , , . . .. . ... _�. � - . , _ - . . p �g .requireme�ts as[am a Paar��eh„e�k feej �� � �= ticensed,archtecf or�a reg�atQred professi4oal enginzei �pGUM61N',Ca PBRMIT PSSUWG PE�E,$ sf�' . � "?acfmg m`��rny�rofessional capaqity (Section�.40`St Bus�rt „ , , .. � � _ . �� mes9 and�ofess�ons Co�le) � � T07RL-FEE .� � �` �'�'�'��' � .:� �:"t�+ , � - ��- . . . ,»� �i� a`„: � i . C �te.-or Reg No, Date � - Plan,qheck applicant, ��� . .��f.��s o,c:.a,,� � _.;.: .., +. �. ,a� .r ..;�-,�-. . , . . _ . HOME OWh[ER B"C7TL13ER D`E`CY.��AT'{O'N Neme . . . .. � . , .:I.c m�;9,�'.� . -: ; ' = .,� „ " . �- . - . - ,._. ' , �,- :` ,� , . � �p....� ` I�}ierzby af$rm t5at"T ain exempt`from"i'he�ConEFactor y Aaaress � . � � � V �� u, , Licens@Law��`or tf�e following rea�sbn.=(Seq�toli 770'31�,Bus,�= „ City' ' Tel,`No. � � � � � � �n�57`s s�d Professions C"ode): �� , U � `. :. . �a ...:, �. . - •t wi 4 1 cerr ,,,� �$ � .., ,. ; .. �C as oLvnee of the property am�exclus�vely.contracti ' ����� �'�� S p sed co�trac�to�s��t�o,co�struct the prn7ect: �(Section 7U�C4 $us�ness and Profega+qns Code) � '� � f , -. . . 7 �.'j �� CO1�ST[Y?�CTION X,EfJbl1`IG e�`uENCY �� � �� �"'` ''� I}ierel�y affirm �ha( t�here ie a congtruct�on len`�mg ageney ` ` ' r �" � �" - �" . _. ,H. ....� , .. , . . . ...» .w .. . fo'r;'Yhe peri'o"rma�nce"af`ffie �vork"for"wh�ch`tHis�,petmrt is , ..� , ' ;"" -� v '` '� �' . �seu�eyd"�Sec 3tf47 Crv C) � Lender s 1Q��ne', _ �� ' :, ._ -� �. ,, �. �s �,.,�s��� ..�- ..�� s; ,y,r ^r �+t h^-w�::r _� u � � Lender s Address � -� � � � - t � �`� � � � .... ..• "� ' '6 v. �,.., ��'...�� ...�.a,M.„�� at ,.�. ,.,�. „°. �' s,F,��-«! s, i z` � �- . � . F - ._.�,>.� _ _. .;, ..,..,. .�� . �, . :". abi{ve information s correc} I a ree"}o ��n gnd skate tfiat`the � , , : , : � . _ � � T cert�fy that T have rea3�his appl�ib . ' - �, g "�comply with all County 5FE ft��@RSE F.`OR EXPLA,P7la.Ti3RY(�,ANGTYQGE.�� � � oidinances znd $tate laws regulatmg-PSu hmg��.and hereby � � . - - --��� .a w-...,,�_. W .. ...,.�... ,._. ..�. ..-. ............._ �,, ,_... ., w, _ . .�.,.._. _„_.,. �. . . .,.... _. ,.....�... _ ...,..: ._._�. .... �,. au{�os7za rep"'r'esentatives;0'�'tffis"�ou"nty�o"`2n`fi�npon"`tfie � ` ` ""� ' " ' _. �- 9bo�e me tion.ad pr rty for mspeetioa purposesr - ' - - � - 7��� .�[.l.tti?u..C,@-�'� G�' �/ - � . � . ...�s9igna"kure af"Permaitee'.� . ..,,.,.�"�a£e....�..,. ...,...... .,_,,......z�., ,,..,.K....,.w. ..�..�«,�� ,...� ti..,... .....,_ e . a.�...a._ .-„�.�.,,.� . ......... . .....�.,�,,._ .. ,<. - . , . ., . . ,.. ,... , . .._ .. . . ..: r ._. . , . t . � . . , .. �„� ._ . , , ,.. ,. . . . .., . . . : . .� . ��. . ��, � .. . ., _;� ,.,. �.�.� . _ . . . .. � . - . - . � � -����.� �.;.;k _.. � � - � ; � � �� : ��.�.u__._______�_�_�____ .�..�._,____ _._.__._.. fySPECTOR'S NOTES :��QW1QiE]$$ LDE,IL�DECL.�$�A��OIV APPRO�lAlS nATE i S C OFSSiGNATURE .:: .......:.. ,... .._...� .. . ..:.._� '�. ��UNl'�El�5LA8 WORK .�'- ' � ,..: .., �. . . . �+'�� �T��� ' ""- ' `"" " [hexeby affirm thaf H am exemp4 fram�the Conttactpr's" � RouGH P�vttna�rvc -- � ` II (S 03T5 e . .s� . . °- : Licepsse Law.for'Ylie fo owting r^ason craon 7 ' . , ca iatNo yy Business aru� Proyessians C9deJ Any crty o counry ���.G.aS� E'nli�' �� � - � - � � whrch�reqaire.s�a-permit�tp�conatniet,�a7ter;.�improve,'� �..�HO7�VA'S'ER HEA'TER'.'. . � :, �� ._•..._ . ....._. "�. �- '. . '�: .,�; � � ... -P¢F?4FY:tlily 5ti14CCU7'¢,PYiOI�t0[t3 tSSt[R7t2C. demalish,ar -�a�,uMBiNG:��X'ruaes�-- ' alsv,reqazirea the,nppliccn:for such permit to,fiie a �;sDgned.sPatemerJ that h��ia�licensed pursuant [o:iMe - '��GaSA-EST�� �J— � - - provisians oj ihe��Contracdor°s License Law(Chapf2r 4 �� F, ___. . _._.._, _.._�.. , _.._: .. . . a . : . .. ,, :�_�_ r.�...._.._,". � ___� . " ...,_ _ .... . .,. , ,,. . . , . _ . - U7iLc'fi'x.co.No71Fi,E�,;' ." `�� . � ' . _.: - /commpncing with'Sec!ion"7600J of��l7rviston�--3�of tke- . - `' ��� � „:.-.: ��� � ...., ::.,_ , - Busirae�s and'Yrofessioxs�CodeJ�or�thQt he is�ezempt-- "_ __, ._ °' �- . _ __..._.... . _. _ . � � ""��� � - ther,epY:om ant�,tF{e basts for.the alleged.exempaion...�A.�'y �� , .� . . � �� � .: . .. .a, ,, :.�__,�_: . }� .� �g ,. .. :;, . .,.. �.' . , -�- ' � Pi�A_L_ � t�4Y�Plt rT�s :tR.44t� ..>. ' �- .'�,��: . .. .�.�.::, , .. - . vi�et?' - ox pJ Seetron 703_1,.3 by¢ny app,licarxf jor a pennYt .,c , su J cts the applicant to a csvil penqlty of noi rnare Jliun ' , ��4! fiye huadred dolliirs($SOOJ.�. . �. � Inlot�ST,ftCPo O,I,as ownex�of the properCy wiil�d,o the�otk�;and _-- . _._ ,�_. . � . ,� . , : : ...,. -. . - AS'TE%3PP��A1 '-�: ..�. -. . .;., , " ... ' . ... . ' - - � � � �� +� � � '-•��' �-� tl�e"sttucture�isxox intended�or offeied-foS sale. ::.. � �� � " � - (See. -�7044, Buszness and Prapessions Code: The�Con•�� .4 ,. . , _ .�.. ._ � . �, >,-- �.��,, ,.r '� : a ".,� �^ �, ', tractoi's License-Zaw does.?roe apPly�t�,an owne:-of .... .: - 'r... �.. . : .�_.� . ..:. .� � �-� suehework�hims.etf providedYthatesuch m'proeinens - i t . ,•^•.�;s. � .,.�:•, ,_° '�w .,•. ,. �� . .�� .. �" .�� ar of,�red or sale-ff Aaw er�the • �. , , ��^ `.c. . __.�_ . . �. .. _ � _. . y. � � are.noi infended`. f .. ., €v ... �'�"'� "'' ` ' '� " � burldrreg or improvement�rs-sold wirhin one.year�oj . � . - ,_� ,, :.� ,�. ` ' � �,- ,.. '� v �. '�' `� ` ' � - � � � . cogppterion, the;..owner-nuilder will��ha�� rhe,tiurden . . ._� ...._ ,_... ._ ... . . ,�_.. . .y, . .. ;�, . .. . �: . . .. . . . I..:. :._ _ .:t..__, _ .___ .__. .. - . . , ,. . . . � - � �- ��, o,�provrrrg that;�7e did,rao.{��bujl¢or,:iry�prove for.t,lJe � . . . �� ..���. .,�__ ; . : . : •� . � - purgoseoJsale./�,.. , . � ..� , «._:_��.. ' .. ..- , .. . -...,� � . ... .:.: . ,. ., _ . . ; ' : :$am ezempt under Sec. ...� _: ,_ , ' ,' . _ , �B&.R:G.for,thes r�asan:; ,.. _., -._ ..��_..._ ._.._ _. _ _ ._, _ __..._ . ,. .._ .�.. _._ �_. _... . : _ : � , „ . � Date ; ; � _ s, ' � � '. <�_ "._,., _ __; O�€mer , �,, . , �� a ,�..a � � � :.�; � .; . .,�� . „ .. .fLV,SPECTOR'S NOTES, • , � � �. � . . .: , :� :.:� � ..-:' . .. . ... .t: „�-:. . .` .. . � �..r..a ..> >,: .:�, _.. _ . . , _. .. t t .