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1272A (6)
� a'ORI:1'It5'CC)'.fl'['V5.4TIOtiDI:L'1..4HA7IOY �saae�w APPLICATION FOR PLUMBING PERMIT � I1 herrhy affirm ih�t 1 have ii eertifieair nf eons�t to self ce en I='s°) . insure,or a certi(inte nF H'nrkers'Compencation(nsurancr,or � a certi(ied copy tLereof(Sec.1800,l.ah.C.) . � COUNTY OF LOS ANGELES BUI LDING AND SAFETY � 1'nlicY`n. Compiny. i � Certific•.1 enpy is herrby furnisheA. FOR APPUCANT TO FILL IN IPRINT OR TYPE) BUILDING A�DRESS �� ��+ Cer�ified cnp>•is filed w�ich t nwitv)iui�Qing inspecti�m NUMBER FIXTURE OR ITEM • FEE i ❑ ,1eP � � � P; LOCALITY � _ _ ___ /��Q` ��„r �Fn�i a�� WATERCLOSFT NEAREST �)"����'•y BATH TUB CflOSS ST. l�C+L � • C}iRTII'ICAT13 OP F.XI[MYTIOH FROM VNORKI?RS' CO!•1PICVSATIQN IK5URAVCIi ISHOWER OWNER � �'j�L,�Gt u r (7�1i.5 92Ch011 IICCIi fl0[ {M C(MiV�Oftld ��l�l¢ WOf�f 111V0��'C1� LAVJ\TORY MAIL A�DRESS } M}' the P2IIIlit IS �O� On¢ hUn�fO� �f111af4 (Sln�)Oi le55.) SINK I CITY TEL.N SD73 O f tertify tlu+t in ihc prrfnrmanre of Ihr wnrk fnr�tihich t.his �ISHWASHER `J� V 7 CONTRACTOR permit is ir.cueJ.1�h�ll nnt empiny any p^rsnn in an}•manncr L!-c'.t�� �` � sn;is m//J7�e/c�{}e subject tn thc s' p�n�atinn La�rs. CLOTHES WASHER I ADDRESS f� �y� O I7a1c�,e.��L-Applicent�� SWIMMING POOL RECEPTOR I � U ?10TICt:TO AYf'LIG\tiT:If,�flcr akinY.�his Crrtificatc nf CI7V � — ,� � TEL.NOSIsJ�,,D' W F;ermptinn, ynu shnalJ hccnmc suhjrct tn thc N'orkers' LnWNSPRINKLERSVSTEM I STA7E b LIC. C� Compens+ninn prncisinn5 n(Ihr L�hnr Co:le.ynu musl(arth- I I LICENSE NO. /"�/ CLASS �'� 7 uith comply u�ilh such pro�'isinns nr Ihis permil }h.^.II he WATER HF.ATER — �etmrii recoAc,1. CAS SYSTEM OUTLETS I DISTRICT NO. PHQFESSF.O 6V IJCF\$liD CO`77RACTORS DGCLARATIOY OUTLETS OVER I lO \\� f hrrrby�t{irm that I:im IicenseJ undar prnrisions of Cheptrr 5 PER SVSTEM 9 (cnmmrncing u�ifh$�r�io:i�000)��r u���������3 of thc Rusi� FINAL �i VALIDATION nc<.s 2nd Pmtessinns Codc.and my licPnsr i5 in full forcc and I �ATE /�,�(9 � effrct. I . ���¢C/ F I N A�i==/y�''�/L� I.icensr!�umFc�+�L/• �— I.ic.Claes���6 BY � /�� � / Cnntnetor(��"�� Date�L�!„//�_� � 1 am exempt Gom thc licencine rcquirrmenH�s 1 im� Plan check fee licrnxed �rchi�ect or a re�istercd pmfeasinnal enpineer pLUMBING PERMI715SUIYG FF.E S ,S aclin�in m}• pmfescional c�pocily (Section '051, Bu5- iner.c and Prnfesxions Cnde). TOTAL FEE �a S l.ic.nr NeR.Nn. ❑ate Plnn chnck enplic,nt f H041fi OR'NIiN�RL'II.DF.R bLC1.ARATIOti Name 1 hcrchy affirm Ih:�l 1 vm e�rmpt trnm t!�e Cnntnctor's Aaltlress Licenqc I.au�(nr thc R�I!o�sinF�rasun (Sc:tinn :OJI.S, H�ixi• City TeI,No. nets and Prnfescinns Cnd±): � 1,as nw-ner nf tlie property.:im exclusi�'eiy rnntrac[ing u�ith licensed enntractors tn rnnxtrvet Ihe prnjec[ (Srrlinn 704a,B��si^esc an;l Prntccsions C�dr). 'r-�� G 7.2 n COtiSTRUCTION LL:vnItiG,�C1itiCY �,� � � � �`� 1 hcrcby affirm Ihat Ihcre is :�constructiqn IeuJinR�genry ' � � ' G�� � fur thr perfonnancc ot thc u•ork !or u�hirh this prrmit ia itsurd(Src.307',.Ci�•.C.). Lendcr's Namr • • •� 2 5�l u LenJer's,1�Jress ��,� 4—$2 I certify that 1 h���e mad thix aI'plic�tinn nnd state�h�l the abore i�dnrm��ion is mrract.I a¢re^tn cnmCly���ith:dl County SIiE RI;VI;RS[FOR F.XYLAVATORY I,ANGUAGI; orAinanres anA Stare law�s reRul.ating F9umbin�, snA hrrchy , � authnrire rrprcuntitirts nf this Cnunly to rnler upun Ihe aboer-m• Fymrd pmperty for insprction pvrpn rs. I .�� ./>��. IT natur f Permittee Uate r ,C��r,C' ���`�\�G\\r\'�: �/\ \���T.\���\��1'4�i�r\'�i �' � Y. � \ � f '�\L�p\ �^�`?\.(�r\O .���; � �\\ {�'\,`.`\\C�`!J'\�\CI``C 4. :,. � � �.`'��;- ..,?, .i::;� `� � \ \,v\\ ,� G\�a!' ,\� \:C:\`'\ �%1 :.�\ � \�'� � 1�'�.\ \ 7, . 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