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HomeMy WebLinkAbout1193A ,, ,... .:. �. , y�` ¢ � ;p�. `�rs.�*,��"z@'�' �;�,�,. .,..<..w , ,.,,�,.,�>... ,.. ,.. . . , >, F, .. ...,,. -. ,_.. �. �. �r�r , \40RKLRS'CO'1�PENSaTION DECLARATION ��> � � + � t hereby aff�rm thae I ha�e,.a c�rufaate of consent to setf een(zaol APPLI.CAT101`1 FGR P,,,�,�J,M,¢,,�NG...PERMIT � �nsure,or a cettiftcate of Wo�kers Compensat�On In�urance or , .a��,y, „+,�;:;,xw,a,.,..v,>.�.-:���. �•w"�"'"-'`""°"^'�'�""�� � � � �~�� � a Certified coPY ffieze f(Sec.3600.Lab.C.} :"`."^'�'"�`."••""'�•.. '�•:-.. �.' ��. `��. .:.� ¢�+C-b85 'f�a� G COUNTY OF LQS ANGELES ,�U�,���LV„C'a,�MD_&AFETY PolicY?JQ.: . _�a�'tl ,,.;.. > ' .�,w»...�.,-.-.�.rc„+w w, ..rx.m. � ' . . � � , �.o.�....+� ..a�.r.w„sr<.ro.��ar..c.�:.we� � ���.e� . . . . '. .. .. , .,.: , . . . . :' ' '1_. � . .., „ � -ur-,nN... � .....� ......m,..�..�_,. ...., . .� ... . .. .....,..,a � �Certifiad copy is hereby furnislied. FOR APPLICANT TO FILL IN(PRINT OR 7VPE1 6UILOING �p��1 . � - NUMBER .FIXTUFE OR ITEM � FEE '4DOPESS � f �1/ �' Cer[�ReA copy s f�led with the county bu(dmg inspection - �� •"^'""` ""' "' '" LOCALITY . , tle art en[ / ��' N�ATEBCLOSET A Q,� ,,,,,... � ' - .,Dat��APPhcnnt .�,G1+c_��-{�yi� . .. .._ NEAREST�'/� . � . . ...,-. -•--��- ��'� BATH TUB CROSS ST. G�.t7LQ $P /h/GR � - CERTTFICaTE OF EXEMP;{IO,N I,ROiv(WORBERS' -'"'�+'., ��� _^�^•^-" """"`". "...."'. .. ; 1 �..,.. <.�...... .. . � ,,,GQh1Y,EhS�710,N.lIsSURANCE SHpWER I i OWNER , .,...,........ .. � ..a,..,, . ._ . .�.,'._.... ' MAIL (17us section need not be comgleted.if,th.e wo;k.imolveci S'NK RY ' ADDRE55,rZ��� eS � S � �, � by the permit �s for ane hundred dollaza ($100) oi less.) �AVRTO � -^: _........._., . . m.___. . � - CITV /',,�m�� EL. O.�C � .. .-.,.. . .. v 1 certify that in[he performance,p�.She„H�ork for which this DISHWASHEF � ' " "� "" V� i CONTRACTOR �- r 40 permit is issued,1-shaH no.t employ any person in any manner z..�,E , , „ ,.__ . ' i7 , � ' ,.so.as to become snbjec,tto.[he K'oskers'Compensation Laws. CI,,,OTHES WASHER �� �"'��-���� ��- ' ' � .. ..._...-.„-.. � . �: ADORESSG -r �'-- Date A p]icanC ��� � ���� � � ...._.-r..�,.a�mas..ac�:r:vc,ewra+ .. - §'ry,SM.MING POOL RECEPTOR _,_..,....,+.H:.+w ,.,,,>,, . ... ., . . . . V . NOT7CE 70 APYLICAN7:If,after making ihis C:ereiPicate of � .. . .._ .. CITY �v—� EL, O.,Yy�_HD7 ;yi Exempt3on, you.shuuld become subjxct to [he 15'orkets' �„�N,�1�SP.R,INKLER SYSTEM ��••���-�- � -��� -��� A' . Com ensation oyisions of,the Labor�Code, o .must furth- _. .. .. . STATE � UG 4^. �.,d � p p pr }' y. WATER HEATER ; L�CENSE NO. yC7L�r7/ CLASS G.-��� � with comply with such pravistons_or Ihis pe�mit,shal] be "�r�- �- OIST,RICT NO. � �PROCESSED eV � deemed revoked �: : `� .. .. . ' ......„'. .. . . - . GA�S SYSTEM OUTLETS � I L�(J(/ /] C . LICEr.Stll CO'QTR�,,,,C,�4.R,S.DLCL�RA710N OU7LETS Ovc `"� -"- � l�7+/'���a ,._.. ._�,�,.�. ..-:..-, � . I hereby affi:m that I am 1 censed under provisions of Chapter 5 PE R$YSTEM �'--"-��� � .•+�. -��^^ - �" � ��, 9 (commencing with Sectio�z 7000)of�ivi�ion 3 of[he Busi- "'""� ��� FINAL . � �i,�` ''ri'� DATE !l (_ � VALI,,,,,�D_ATION. ..> � .�2".r/' ,.,,., . .. .. . . ness and Yrofessions Code and my,�icep,Sg ls_i�Lfull fOrce and 1 � f � .._,._.............e- .. .._.. . ef£ect.� �-��-'�� � �7 " FINAL r ��. � � �..� � � L�cense Nuq�i,}_.._.DO�I,5..,L�,c.,CWss�.. �'�5.7 .. .. ._...... BY � . . . . . . ..�. ,.z„. .. . � . Contracto�� �Q�6 Dat�I-�'�tl�. , t. .. ... . .......w.� _ . .. . . , . '3. .-...... . .w:.e.rcr .�+.r,,..« ...�.... � -.... _. . . . . � I am exemp[,from the licensing requirements as I am a Plan cheCk fee �-�� . Ii,censeJ architect or x registered professional engi.neer � •°'� ` �-'-""�"'��'" � �� " . . . �,� . aCtin6 �� n�Y ProPessional capacity (SectiVn 7Q51, Sus- p!-UMBIIyG PERMIT ISSUING FEE$ � � � . � � . iness and Profegsions Codz). TCTAL FEE ,� .SQ . � . � � � � �, e.�.:�. ,�.. .,., ._... . . .. � . . ]C�orw��tl NO .. .::..... �3T2 ._..�_ Plancfieck PPliGantk ' � �� - . '.. .. . . . rtr� � . .: ..:t' :.:. .:.�.,,..... . . . .. , . .. .... . . ,._ , .: .,..,, , HO�SE,O�Y,a.{�R�B,U,ILDEJ2 DECLARATIQN Nari�e - '- � �� � ��-.�-� ' �� � � ;,.:..�..:n�..,. ... � . .s..- ..,.. . . � . .. � I here6y affirm that 1 am exemp(,f[.q.S9.[1l�.ContractoPa AdNdress '� . �. . � � ' � ...,... ..,...... _ -• ., L�cense Law foi the foi]owinR reason (Section.,7031.5, Busi- Citv�'� ' ' � �"� � �� Tei No. � � -��� � � . nessandProfessionsCode): .`� , „�� � ,.,,,,,, . - - . . '� � � .- -,::.._:•� ._ ...._. ' ❑� . . .., ,�.,.�,.r» „�ssy:u��;.� �+n'y:��»x�� , :,,,.. - ...... - -, � � . [,as'olvner of the property,am exclusively contractmg . � � �� ' � � � "� ' " � with licensed,c.ontractors [o cbnstruct the ptojecl . , - � . � ' � ' � ' � . � � � (Section 7044,H4Sine5S aPd PcuFession5 Code). : ,� .��� . -.�. ��, � ��� .� . . . �.' . �.. ..'. �. ....�..... � .,.. .. y _ �Ely[D1NG AUENCY _ � .,� � . ., � . �. ". � ... .,�..... . _. .�.. :. ... ,_. . . �.� ...,., .. y V.� � . CON$�'RLC'tIQN '��� .� i hereb aff�tm.�hat there,.is.,a..consjruction lending ugency . � " " ' ' for fhe performance of the�wo;k„f,�r,whic6 ihis permit is � � � � � issued(Sec.3097,Civ,CJ. . . � . � . . � ���.o;r . e.�j" . Lendec's Name � ` � ....._. � . .. . � � �� � m�0 7 �J Q'. ..Lender's Atidress . . . ... ' . '. . . � . . . . . , . .. ... .. . ........._.._,-. . . _ . . � ' o,,no ? E',J{�.c:..� icertify that I have reud this application�nd state that [he -� � . - , ' � � � aknve.jn[orn�etion.is correci.7 agree to complv wi[h all C>untv � � �.� � � � - ' � ' ��,[1(j�-�G . uidinances and State la�a's regulating Ylumbing, and herebv =��.��,cV,£R�.F�yrQj,�,L'XYL�,INA7;012Y LANGUAGE , � ' , . ...,�"r�' ..�4.:�...,.,...� . , .. .. � : , � . . authorize representacives of tt�is County to znte���upon Ch'e .� .. �. � . . � � � � �.. . ,� � � � � a6ove-mention�ed,pf operty for inspection purposes �' � . ' � � � � � ' � � ' � � .��/�� /-N S�� S�gnature of Permi[tee`�� " ,Date � � � �� � � � . .. . . . , . ' . . - �.. .r ;.. g i',. ,4. , :,> --- .. _ , z. ,. . . .... -- _._ .... t.... �;�-�,� � � ,..,:{• ' . . . . . .. . -- . —. , . . , — ._._ F, a a x ' . . . . - .... . -. . . . . _... _ .. , ---- � i:�:^ti, -,...:. : ; . ' " I --._.....:... ...:.._..._.:_..... , _ � � - ' . � ' '� � � S310N S.�01�3dSN1 � ' '�" � � � _____�__._.._.M. ... . . . ,_.> ..,,;.. . ---aaump -- .,. �.. ... . , ;1, _, . =a;Q _ . . .,,<<., --- �T — . .' . . .�,.. .. ...:..:... .. . . . r. ,. , ' . ,.'..'... ._'_.___. .,....,, . . � � . . ... . . . . � .- . . . ..,.,.:.... � . ""..t,.c.,,,.ys ,AOSk2a5:.y;XD3 .����Q .-' .___ .__ : - ...� ...., . .y... ..,.. .,,.t.,. ... ..R.�,-._:...... .... . ...... .......... ' ... .. ' , __'__, �� — �ag.�apu�i ld:�:aaa we g.. �. ., .. _ ,,., ,... 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F..•,..� �� . .a`es ioj pai�33o.�o p��uaic:zou F�3n7�nY�s�y� � . .. , ,. . . . . .-. ..� . .� . . . ��b'n0liddb 31SVM pue'�icea a4't�P llsh.taaa3oid aqz.dc�iat+•.a se°I C3� . 4.� '—' - .. . . . �. � ' ldialS�an�l � ' :•lO�Sxi s.rnt,:o�pa.enuny�an�f. .. . . `-- — . . _ _.,�.,..�_. .— 51..::a. . _... _,,.. unr�,a.rotu!ou f�Tti�uaci irn�s o o:1u.ns,Eddo aN�rr�afyns . .— . . . . �.• � tzewaad�aoJ�::,�ayddb�,fuo F9 S':£OL uo �aS!e;u�FJn;ais . . . . . . . . . . . ..,..�1?�$�+' Bf?,'�2�? ^b'Ntd - ,Cvr�,�r,rtUt.�zxa paHtpa ayz aof.srsct�ar,;pun�u�{I.�<au; .. ... . . . „ _� .i�tivaxa st ay ;nyt .�o f��J sunrssa,lo.r� p,�� ssaursng �... �� . . . . .. .. . , . a±�710 F rm�st,ir�Jc /OOf� unl�ay :ri^:s�'rerivat+�:t:o:, . . . �.. ��- �. � , . ____ ..,_____...... .. ... � � � .. aa1�110N'O��i.1��11� .� g sa:�mf71 :uc7 asuaa(g t,.roi�a.�ls�o� au�jo sur�ternwd .. � . ' ' . �,�`�_�/^., Z.� 153iS�C� - aya O: �itiDr:slJ+fi CasUa�t; i�� �G(,'.lot=J, apdu a10F�' `ttat�' � - . � � � . . . . , _ . . .--_— 537if1 iXlj'JNIBl1llld D dj!� 01 9(IkArTd ?j�:fe Ja;'JGb�t�7}:jD dN alir%13:1 OS(`v... .. . . . ., . ... . _. 'aJidnnsSr�sPt o7 dcud'a.�:U:ir•,e:s:[rdo'.1r.�llad �ri�'�.r?;cwaQ - � � --�- . .- .. . � • . . a31V3H F131VIvilOH ' 'JAOAL114t 2ljU .'.)(ul�'IfOJ OI titdldf/ SdJ/ltlldl ijJfUM1I � � . .. .� . ' � '' ' 1N3/\SV�J .�ru;����xo�ai?� rCup� :la,oa�7 s�ci�sa;o.r3 p.rs �sdzrsr;� "' - . , .,� .�`T��$�-�._. —r'— ^ ---- 'S'7£OL .rou ai;uaseaa 8a�xr[i=�.i a�a.� g ie��asua��� � - . .. ..• ..".•�-'�. .. -� _�y� S�. � �nic�aSv� �..r s aoi�sflh��i"es"i�wc>a3.ldu�axa�,:z f;a.{ u�ie;y�s b(q�a:y t — —____ - —� . � .. 9Ncew�ld HJ�Oti ... ..:er.-.. ..' . . ._�. , . . � •.. .. ',�"` . . . >I7jOM9VlSH30NlT �(933.t'2i'c'�3�Q 2��LL"CSII�-2i3`,'«1C+ . — -- -'"-� adnlvrv��ssao�a dsNi 31va s'ivnoaadv: . . ... .. . .,__._._..-� . 5310N S,�lO:.J3d5nIi ��� ..' � ._.. . ��:��.��..a�::<�