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w•okx�tksco�irrvs,�T�o�ntsct.ax:�nov "•'•'^ APPLICATION FOR PLUMBING PERMIT � • 1 hrrel+y a(Pirm ll�at 1 have a'crrfi(icate of mns�:Ot tn sdt cE sn(z-ao� insure,or a certificeie of R'nrketc'ComDensation Insurancr,or a certificd coD1'���ereof(Sec.JB00,l.ali.C.) COUNTY Of LOS ANGELES BUILDING AND SAFETY ♦1 Poiicy tinn �3�'�L�mp�ny��l71e�� . . � CcrtifirJ rnp3'�s herrby furnixhed. FOR APPUCANT TO FILL IN(PRINT OR TVPE) BUILOING ' ADDRESS ,� `I� 5'r�eFLCc%.is _ Lv��� � Certified cnpy is filed w�ith�6e county building inspeclim� NUMeF.R FIXTURE OR I7EM � FEE , deperime t. � WqTER CLOSET ` �G� LOCALITY n,�elf/`�-�l .�pp�icant���7, ,f�L,,v�Cnr�.a�q NEAREST n / � S� BATH TUB �p CROSS ST. I'/�y�FINCIe� r � CF:RTII'ICATI;OF'F.%F.SIPTIONPROMN'URKI•:RS' gHOwER �(/ OWNER � [,�j� cnuvr,tis�no.i,suK,��cs '� � ��g�t3Ns��•� �7 LAVATORY MAIL • � � (Thix aectiun need not Ix completed if the work inw�lved �6 i�� C� AooREsS � by the permit is fm one hundred dollers (S11N11 or leas.l SINK � �/ Q �' Z r (, CITV DI��1�?C.'�H Q�? TEL.NO. O I trrtify that in ihe perfnrman[^of the u•ork fnr�d�ich this DISHWASHER I V permit is ir.aued,1 shall ont cmploy any penon In�ny m�nncr COYTRACTOR l���A ! ����;r sn ac tn hecmne sub'rct lo theµ'nrAerS'Cnm ensation Lawc. �� v� � � 7 F` � CLOTHESWASHER I I�'U ADDRESS !"+�:f ��L�/jL � f)a[e applicant SNIIMMING POOL RECEPTOR I I U CITY� TEL.NO. t+.� W NOi1ClC'I'O APPIJCAti1':lf,aftcr makinN Iliis Cetlific�te of � �f E'�V 4- -�G J �� y ICzemption. 5'�u shoulJ 1•rrmnc suhjrct [o the �Snrkers' LAWN SPRINKLER SVSTEM 5TATE �I LIC. U7 Com�rnsation prrn�isinna nf the Lahor Cnde,ynu mvst furth- yyqTER HEATER I � I I LICENSE NO. 31�� l CLA45 �'�3G Z �vilh tnmply uith such pru�'isinns or thic permi[ thall I�e OISTRICTNO. PROQESSEDBV dremrd re��okrJ. � GAS SYSTEM C OUTLETS � �U LICi:\SIfU COtiTR:1CTOR5 UIfC1.ARATION OUTLETS OVER 6U l�� ��'«t'�–� 1 hrrrhy affirm thet 1 am licen�r:l undrr prmisions nf Chaptrr 5 PER SYSTEM 9 (commentinN w�ith Srctinn 7000)of Divisinn 7 of If�e Busi- FINAL /C/ r^/�Jy VALIDATION ness:�nJ Frnfessionc Cnde,snd my Iirensc is in full fnrcc and I oATE � effeet. • �(/�� � FINAL Liccnsc Numh:r_`�--�–�— Lic.Class `� 6�' ��Li.��:7t.�-- CnnlractnY'���1���9.. Date J{_2��� !J � � Plan check fee f am exempt from the licensing reyuiremrnts as 1 am a licensed archilcre nr a reµistrred pro(cssiunal enainerr . pLUM81NG PEPMIT ISSUING FEE S � scting in my prof�csional capacity(Srclinn 7051, Aus� iness and Yrnfessinn5 Cnde). TOTAL FEE ��� JQ . Lic.or IteR.��. [7�te Plan check a�plic»nt FIO.`dL 0�1'NPR-HIIILf)LR f1iCCLANATl01 Name .. _,('�i I:C!. nAAress 1 hrrrby affirm th�[ I am esempt trnm the Contr+rtor's ' . e . •� l.iren�e Law fnr the fnllnuing reacon(Section 70J1.5,Busi- City 7e1.No. �' • nrss nn�Protessions C'n.ia): I • � ��i v 0 � f,as owner of Ihe properly,:+m ezclusively oontracting �eith licrncrd cnnlroctorc ro consirurt ihe prnl�c[ � • a � ((''�� (Srrtinn 7041,Rusinr.<t�nJ Pmfetsions Cnde). I 1.��-31 COVSTRL'CTION LLNDINC AGIC!VCY 7 herehy affirm tlwt lhere is a[nnstruction Icnding apency for Ih^ perfnnnanc^ of�hr�cnrk for �rl�ich this prrmi[ is issucd(Sec.3097.Civ.C.). I.ender's Name � Lender's AJdress 1 crr�ity�hat 1 hsrc rcad Ihit applitation and statc that Ihc aborr informnlion is cr�rrec[.I agree to comply u�ith all Cnunty SFF.RF.VF:RSF FOR iiXYf.ANATORS'I.ANGUAGF: ' � nrdinanres und St:rte lau�s r2qulating I'lumbine, :mA hcrcby � euthori�e rrpresentalices of thix County to enter upon Iha ahnce-mentinnrd roperty fnr in�pectinn purpnars. �� � r mittee Date , ;,.�.���,;��i Iv1o'�1 ,� ,. �.L� ,y c -+1`�' ,��T �;: " �.' z 'S>. ����1�:`1:..�,,t i..��:i l,� ==o� �� �=, .. ,:�t7 1 � r o ,,,_ �a �Q � ��'i.;`.i'� r� -' C.1 C 1?'G ; ���� � _ �4y� C_ �`�� :,'�1 ,��`� �y��,�`*1 1'L1.C�'� ;.. � =�.��,31 n;� ��:. j ,��r; �- :� �,� � 1;'� , ��. .ti � (� � O Q . T �i � ; � ��:�� � � r �.. c 1 �. � �L f '.v C'a,o�_.: "'�1 ���'�+� `�!�1�:� 1 1! . h)� ;.. �,:a . ��,R`C��` '-��,,,�,, '`1 � . � �, ��,,,r�r . �.� ` �'� C7 ,��'��,,. 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