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HomeMy WebLinkAbout1795A N'ORF:I:NS�costri;�s.1T[OtinFC1.AR.�rioti �b�d��A � qpPLICATION FOR PLUMBING PERMIT � 1 herrhy a(firm thot 1 ha�•e a certificate uf consent tn srlf �c etv Iz-eo insure,or a certificate nt N'nrkers'Cnmpensatinn�n511f811CC,O� a certified copy thereof(�c.J800,G6.C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY . PolitY No. ComVan)• � Ceriifie�.l c��py ic hrreh)•furnished. FOR APPIICANT TO FILL IN(PRINT OR TYPE) BUILDING � Certified copy Ls filed with Ihe county huildin4 incpection NUMdER FIXTURE OR ITEM � FEE ADORESS � �.{'� deparlment. WqTER CLOS[T LOCALITV � Datr Applicant NEAREST' BATH TUB CROSS ST. CGR'!11'ICATL OP IiXF.ti1PTION I�RON W'ORKIiR$' - I COSiPF15AT10N 1:ti5UNAhCIi SHOWER OWNER S< LAVATORV MAIL (This xcrion nced not be crnnplefed if the work involved � � � � nooRESS by the permit is for onc hundral dollars (5100)or less.) SINK � a CITY �� TEL.NO.�jsl�> -]6 O 1 rerfify O�al in Ihe prrtnrmance of the�vurk for�vhich thie DISHWASHFR V pennit is usued,1 shall nM empin5'iny p� on in any manncr I I I CONTRACTOR � xn as tn ncj�me suhjrCt In the crs', �mpens�l'r Lsn•s. CLOTHES WASH[R I O ��/�� ADDRESS I)ate( .�pFticant� .-� � ' 'J1' F ISri1MMING POOL RECEPTOR I U ^�OT CI.TU API'LIC.\1T:If,afier makini;this Certifinte of CITY � EL.NO --5 — r.��,ru��, >•o,� shuuld becumt �uM1ject In thr 1A'ofkers' LAWNSPRINKlERSYSTEM I I ST T LI0. N Cnrnpcnsatinn prm�isinna nt[ht Lal�or CoJe,pnu must fnrth- ��ith comply u•ith vich prm�isions or �hix permit sLall hr �'�'ATGR HEATER I p� LICENSE NO. CLA35 r ifeemed reanked. GAS SYSTFM OUTLETS I DISTRICT NO. CESSED BY LiCF.1SEDCOVTRACTORSDfiCI.ARATiO4 OUTLETSOVER I \� \Q. I herel+y affi�m th;rt 1 am licentrd unJer prnvisions of Chspter 5 PER SYSTF.M � (cn�mnencinq wilh Sectiun'000)nt Uicision J ot Ihe Rusi- 1 1� �\ FINAL neac;inJ Vr�fessinns Cn�r,�nd my license is in Cull tnrcr sn� 1 �\ `C DATE ,�j /�A �'� VALIDAT{ON effect. I.icrnsr!dumh�r �J� Li[.Clscc--� F�NA BY Contnrt������)a�e_���� � 1 am evempt frnm the licrnsing reyuiremrnts:�s 1 am a Plan cheek�20 IicenuJ architect or a reF���rrcd profrcxinnsl enpinrrr :ictinq in my �nifexci�nal capacity (Sectinn 7051,B�is- FLUMBING FERMIT ISSUING FEE S � inecs and 14n(excinns C�de). TOTAL FEE I.ic.ur Rrg.tin. llsir plan chock epPlicant 110}fl;O«'YICR�RUII.DGR 1)F.C1.:1RAT101 N"�P I hercby affvm that 1 om erempt frnm thr CnntnrMr'x A`���'ess Lirrnae I.aw for Ihc fnlinw-inF rra�nn (Sectinn 70J1.5,Ausb Ciry Tei.No. � � C� 7�.5�1 � nrss and Yrnfrtisinns CoJt): � � �j;• .• • •;. , I,as navner nf Ihe prnperty,am rxclusi��ely contncting �cith licensed cuntractors to ronshucl [he project , � ' (Sectinn 7044,Buciness an:l 1'rofessions Code). ' � ° � � ��J G • • • � F.r)�{.1- COtiSTRUCTlO\LG�DIVG AGLNCY � . i hrrrhy affirm that therr is a cnnatnictiun Irnding aycncy O�C y,�II 2 tnr the performance ot the �smk fnr�chich this permil is issueA(�c.3097,Civ.CJ. Lendet'S Vamr Lendcr's Addrrss 1 certify tha[ 1 h��ce rrwd �his application end sL•�fr that fhe � ahnre informalinn is correcL[aRrec tn comply w�ith:i!I County Stdli RF.VF.RSIi FOR GSPI,ANATORY I.A1(:IJAGIi ordin;�ncrs and S�ate lau�s re^utating I9umbing, anA hrrtby aut nri�c rrprr rntatiees ot Ihis Coun�y to entrr upmt [he �h � icr.ti property fnr in. tinn pmpnrrs. � ' Sipnature of etmittre Dat 1 . �- , ' �1:���v'�°��1`. �':.\r � c��o.1� :.� , 1 ,���,�� ;,,1 F�-� ` �w . <^°�, ,I; i `�1���', .''�.j.\�?r' �, G �y� �' \ .y•;�� ;'`i��1-�1 n'�G �:� r:� � ` ,7� ' 1.c;+`•1 i.; . � � C;.•, .� `•�,'�G� �'.�.� tV1 ,���\ \ � 1 F'�',�' a l. \ �T 1 , C ` ` ,,f.1 `i'1�� �' �. ��, ;�1 �` �.�� ; ` C' �'�_ - � \ ,�..`�1 �1� �`. � 5 ` =,• � V�� � 1 ��, • � � � �� . �� � i � ��` 1 1 '�, ;` •, �'` � Z �, �o � ` � 1 1 -',-�' '4. , JC O �J `"� ,. —^1.� . ,�i '� ` ' ».. �'1 G `� � � ,`. � .,'� � '� ,1� �•. . . � � �,. , 1 �^ . o � �, ���, '1 �� � � �; - c� o � ` , � � ,'i � !. ..� :� ` `ti � � :; cn ` , 1 t c � �. 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