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Home My WebLink About1337A w°RK�s•co^^�N�,T�o�°E��,w�Ti°N APPLICATION FOR PLUMBING PERMIT � ; I hereby affirm tFqt I Aove o cenifimte of consarrt to self� ��y�yy�p , iMore,or a cMificofe of Wmkera'CompenuAion Inwrance, CF Bn(REv.1oiB1) �. . . . . � . or a cerrified copy thereof(Sec.380p,lob.C.) COUNTY OF LOS ANGELES BUILDING AND SAPETIf �' Policy No. ..�TGompaqy � � .. . � ❑ CerHfied copy is heroby fumished. � � �. � . fOR APPLKlWT TO FILL M�PRIM OR iYPE) BUA�� Certified copy o fited with the couNy bu�tdirg inapec- .� fio�dlptlPlT9n1. - . NUMBER FIMUREQRiTFM � � i{E ��`m � � WAiERCLOSE� . i Da�s ..--_-_-APPlir,ant � h1FARE5f � CERTIflCA7E OF E%EMPIION FRQM WORKERY enTH 7U8 ��• -� COMP�NSATION INSUR/W.C� ... SHOWER . �� . � � (Thtf�Mion nNd not M rn�nplN�d.ff fRe�woric invel��d by . . i tha portnB is toT ono hundnd dellerr(;16tl)ae Ins.} �pyp7O�y �� I eenify that in tFre performa�rce of tha work fbr whirh this . - ? � permN is fuued,f shall not emptoy a�ry pm'son in any monoer� Smnc � � CIiY� iF1.NO. so o�fo hemme subject o fhe YVuken' fonlowa. �� . � A! . . . ORHW/ASIftR � �pp � . Oate��J��irnnt U07ME5 W0.5MER � - � + �� 9 NOTICE itJ APPLICANT: If, aHer matting ihis CaAiti� �e of S,w�� U j Ezempti�n, you shor�id bacome subjaet ro the W ken . �y �, { Competrsation proviaiqns ef the Lohvr COde,.you m�af foAh- �qWIVSPRINK1fRSYSfEM .� �with mmpiy with sach provisiont or thia permit=MqYI be SiA7E LK. � � deemed reroked. � - � � WAtFR HEnYE�t � � -� � �� g . IiCENSED CONTRACTORS�CIARATlON . WStR�C� . 8v IherobyaflirmMiWlamlicat�sed�rnlMAroyiiiq�ofGwp�ar9 - ��GASSYSiEM - OV1lkT5 � !?O � �`Q (mmmenang wi�h Senion 75100)of�[�kisinn 3 of tha Business ptntEiS . . � 1 and Profesaiom{o�e.Qnd mV Ikeme is In full forte_and effecl. �R 5� .FINAL A vau�anoN � •` p O DAlE � �A�'� litenae Nv r � '.Cless�� . . �� Ot � + �� FINAi /-� O Gontractw Oate . - BY C G OvW� � I am eaempf un ar Sec. - 4' � B.BP.C.fm this raoson � . .. . . .. .. . � � z I Plctn che�k fee. � oarB: � v�uneswG a�an+�T issu�wc r�a ,�D signotuie � � . - TOTAIFEE q9 d � � i .... . . Plan check appYiwn� .. . r�� 3,']A _ i . SINGLE fAMttY �. #� � • �5 i HOAAE OWNER-BUIlOER Ofq,ARAiION� Name - � I • •2250 ` I hereby affirm thar I am exempt fiom�ha CoMrotfor's Ucense pd�s . law for the 4ollowing remon(Sedion 7031.5,Busines�a� � � �2 2 5 d� Rofessions Code}: � City �Tei.Na � - - . ? . ❑ I,m owner of the propMy,w�ll do ihe work a�the . � ► 0�n� �8 4 � shucture is not intended w offered for wle(Sacrion � . 7044,Buainess ond Prnfessiwn Code). . . . � � - CONSTRUCTION LENDING AGENCV. . . . . . . � I hereby aifirm rhar rhme is a corrsh�xtion lending agency for . rha pedormance of ihe woric tor which rhis perma if iuued . . . � � � � - � (Sec.3097.C'w.C.).. � . . Lendx's Name- . . . ... . . . � . � � . . �J Lendx's Address ' � � I ce.tify that I have reod this opplimtion and sfate fhol fhe - . �, . . obove infprmotion is[Orced.I pgree to comply wilh all County , ordirwnces o�Stata hws reguloting Plumbing,and hereby � au�horixe re reaeo�a�ive• f his CouNy�o eMer�pon Ihe . � � - � �� re-m io ed proper�y r inspetlion purpoeex. . . '. . . . . SEE REVERSE FOR EXPIANATORY LANGUAGE � Signa Per �inee are .. . . � Gt � q Z _._. ,a 2 y 9 G �, N _ � ,,, � �, � � � y Z u� qe ` y o z' � N 4� > "� G� � � p ,N'.�„N � O �' � � O ➢ ./��I . q� � G *�` � x crn -- � .- �� m '�N _ O o u' _ r . _ . -' ,�,� i � , ^` � � l � � . , . . . . . �,,n N . .�� ' '. � ' ' � � � � . �� z ` � �- � � N � c� � � � o �, � � p a N m a 2 � � � N � q a � �. , � J '� , � . � `; O � '�, O `` N � � �:` C G � � � � � � p . 4 �� ': N v+C�3�° ��o w o m Q 4 ' ¢n o° � ^..?.� Nv a� � 'c P, NS o �w, v p o 3.sa n Q p o p �� . £ ^ 4e a �,� fp�� ^.. o ,� � � _ � � � , 0 3 0 3� M� �Q� O 'd O'O O.. f1.p�.� Q �'�.� � �� JC Q� 4 �Ov� q�.�G� � �3 m � +� � n O�: � � � O �N ;3 0 � p � 3 �W m �i.3�w�.o ° `�«W4` o,� �o � � m° � \ Q o -o X a.c � o �Q � N ,� £�,n.,� � caW N " co � op G ' '; 7 � � 3 ^ a'"�"o ^ � n�.�..� o�os�� ca-� ° '�"-n° co p - � o �o � g '" i0 a 3 c.a ?°. � 3 a � �c �'6 � °ci7"c, � v ma < a � -u m s ^. m ; � � w o a� �� Qa� �o � � �Q Q �o 'o D �� N t�o.. W £� N °�'a'° ye v 'a �.3 ° 'm � o "' � �4 . �, � . � .. ' O ,(P � T?q�..S''�6 O�� 3 7 m �^ o � v' ^ e'' > > p"� . - . - . ',� (4 . .7 O � y� �'6 � �(0 3 "G A O��O 3�' �K � . . 7 � � ��?S$o��S �3 0 ��o� Q q o o^� � � ,�.< o nho-� s� ti° �, 3o oc`0000 ,0 3 � � 3'a � a o cr 3 �, a N� � �> > � . , . ' .. . . .. . - . � N �� <O fL 0 0'Q-� rt N 7 � Q � 3 l0 ..l p , . � . . � . O,'O .0..� C t,7� '^ S � O a'2�-'.7 6.D��t W 9 °j ' ° ^� 3 s° '�� „''3' ' '" ° °_' ' �- . u� C O 3' O S .6r £'_ 7.� N�p 'a tA O Q� ;n ' tn N � - .. , . ' � �,D � ? d"'� O C Q n' lT� �' ?. � f� T �. . _' . . . ' . . . � --.S Q �'" n C 3 . -'` �-v_O N' " �' ' r'./�i � N P m _, 7 . � � � . �O �" �p 7 d , °�p . . , ' ' . . . �S> > n C -�. O p. M . _ - '. . , _ . , a-?p O.S j n N , . , . , . , . p-� i� � � � � �z . 1 , +� � �