Loading...
HomeMy WebLinkAbout1482A - --. �..P, ��, ._ _. _. � � >.., �.. _ _._.��w _ _ . i . ...... . .._ . _ WORKERS'COMPENSATION"YSECCiiRICTION�� . I hereby off�rm �hor I hove a cenrf mte of mnseni to self �- --���� -� � � � � msure,ar a cerfifimte ot Workers'Compensar�on Insurance,or��.� � �6°bd20 � , _. , .. >._ .�-.� . 6�tertifiedc� r Sec.3600,L �., CEBOB�(REISeiBll� �� � �pp�rCA�`ION �C3R ��It�ill��`T - Policy No. ���/�o_mpany �'�• �''lITld . ....,_,...,_..�s p . . . .� . . ❑Certifi....e8 o�y�fidfeby 4ornished: _ . . . SEW�R • SEWAGE DYSPO�AL .� .. _... . .. .._ COUMTY OF LOS AIJ��LES " � BUILDING AND SICFBTY ,. �Certified copy is filed with the county building irspection . ��.:de orimeN .. .._ ... .... .. .. _.�. .. .: ... �...,. :-��k.u .,::� -� . �� � '.vsarnv., :,. ._ . . . . .._.... Daie �I2� �6 Applicant Fl�"9BIC1d.Y1 FOR APPLICAMT TO FICL 11�1����� �u��� CONNECTION DKTA �� �� �� ,. .: _> ..,..:.�: . _ .... .._ _. . . � CERTIFI'Ci1TE(7F E��lvt�PTfdN fh0/v'�"1�76'R'R�"12.�'°p� - � ,, ... , ... ., ... eU!toiNG '�.. C7 � T�. STAflON DEaTH � �'� '�.CObA�P�NSATION INSUI2Al�CE " � ncoaess J _._.... � (This sen on eed not be mmpieted if ihe work Involved by rhe � awNr�p.E REVEREt�ce �- � �" '�'" ����� � uPv�R permii is for ane hundred doilors(E100)or less.)� ux.Au�v .„ _.. _ � �owea ryEq�51 TYDE OF C7�hNE!'TION �hGTN FROM � I certiiy Yhat In ihe performance af the�work for which this [aosssr � y v. Nae a.t. ,^n.i.roP.�. . permil is issued,I shall nof employ any person in qny manner � � �� " � �� � sb'as�ro become sub�eU to�he Workers'Com enwtion laws. . � -•---- -�-��"' ac no (�`y� , . ;. . ., � .,.. . . P . . . UWNER . . ...._........... .. .. CO.IMP.NO. JOB.NO ��YQ a. ...�� �: . � � � MAIL TRIJNk PERMIT NO ROAO GERMIT NO.� ..... • .• Date - � APPl�cant ,., , � . aooee55 . . ,.,_...... ., Nd710E�TO APPLfC}i�NY �, P�Iff ffla�Ci119�FIt 5 Certificale O� ��Y _�,ry (Y (� AFFIDAVI' WAIVER EASEMENT RKORp INSiR.NO. DATE VOV�T�tS TEL.NO.8 p � ,,;f�mplion,�yao sho�ld become su6ject to the Workers' �E�A� �pensation provisions of the Labor code,you most forthwith oeSckiPrioN �OrNO. Hwv Oa51.wroeNwc .n�ply with such provisions or this permit shall be deemed 2 - �,-�---��--��— ^� ..:IevOked. BIOCK TRACT 'J � STATE ENCROACl7iiAFNY..'.•�..•....�.'�...�..... '� .,-:. .. . .. ... , � � ..;.:•.'•`:•:x•: NO OFBlDGS - PERMJTNO. . ' �s.:....,., uceHs�'o caNTkkcTb'ks"a�ci7��dn�` _._._ . ' � SIZFOFlOT NOWONLOT � I hereby aff rm�that I om I censed under prov sions of Chapter use oF .._ a. � - ommencing wirh Section 7000)��of�Division `�Ot�he BVsi- BOILDINGS CHARGES: �,_„�.�.�,,,.� _„ riess'Bnd Pr�fessions Code,and my I�cense is in full force ond � . � � � - 9 c � COf1C�. . . . . . CONTRAC,OR .. .. ...'. �...•.. � . � . ..." ' CONNECTION CHARG � � a E FEE effenseNumber 474887���.�ias5 C34 . A�RE55 $`�2 �f3BC�"1WOQC7. DY'. REinnBURSE/t[Nr.=FE' .. .. .. � .�,�_ � Gre ,... ,. . _..�:. �. , . . .._ . ._..,... . . � � 'frac�o Y'P2II13ri � Oafe $,�7f1/RF � oisTaicrNo. ceouv� Mav Paoc�sseoev� � �.,� �-� Alta I,oma �E��o. BK � z � ❑�I am exem t under5ec.� of fhe L.A.Co. sare � uc 1�} O P . . � I:CENSE NO. CIASS � f;, P" � " � � ' No. DESCRIPTION OF GVOpK FEE V lum6mg Code and/or Sec. � of fhe � � . �..�::,._,... _-_......-...'-. ... ..-, FiNn�- . w ' � � �' ' � '�� � .�.� - HWSESEWERCONNECrti�JGYO DFTE V/ �� VALIDATION� ....N � �� 8.&P.Code for ihe followinq reason . � .. - � �. viceoc s�wea / ;3 - ..__ ........ . � SEP?IC IANK,Sf[PAGE PIT OR Z . ,. �DOfE. ..• . . -�. . . P'S ANO!OR[IRAINflEL�� FINAI , . .: �..:...... ... . HOJSE�'�.'ER CONNECTING�10 BY ' , . � . ' . - � ' PR�VAtE�ISPO:J+L"5YS7EA1' � $�9/101U f � � -�� � . �� , �_� C�NNER AODI ONAI BL�G.OR' � ► � '� `�� � OWNER-BUiL6�R DECL`ARAl�O1J � `�� � - � �' woeK ro,;euse sK�ea OVERf�OW SEEGAGE PIT,DRAiNFIELJ I hereby affvm that I am exempt from the Contractor's�litense ��.� exrN.ce55Pocn�evwEu./AaN!foie� � � � �La'w'�for the following-reason(SeC100 7O$1.5,BUi5nCS5 anCJ Pf0- ALTE2,dEPAIR OR ABAN�GN HOUSE � �sions Code): SE'�vER OR o�5ro5nL 5'�SYEM � _ � �. _ I,os owner of ihe properfy,or my employees with wages as , ,-�j /'.�L p ..� their sole compensotion,will do the wark pnd the.structure -�� .'� is not intended or offered for iale(Section 7Q44,Business pe�mit 5 :j!.e e ri c j C � 'and Professions Code). OWNER'$ � ❑I,os owner of the property,am exclusively comracting with HUTHQRIIA'fION TQTAL FEE ' .J ±e ;;�7,;�� '. IiCen52d Conf�aCiplS fo COnSfNCf ihC�JIo�ECf($eC�iOh 7�A4, �,HAVE AT TN75 DATE A CONTPACf WIiH`HE NEREM'NAME'J CONTRACTOR TO Bus�ness ond Profe s ons Code) NNNECt TNE ABOVE DESCRIqEb"EX157Yh1G�D�ff'.IING�'fO�if7i�PG'BY�C$EWER`. � .-`_.'f,�,�4 ` � '� GONSTf�UCYIZSN LENDIIV�G:4G�1�"CC' "� I hareby off m�that ihe e is a constr�ction lending�agenty W a� SIGNE�THIS �� DAY OF�' -� 79� ► u L ,y d�� O'MNER OR for the performonce of ihe wvrk.for which.,ihis permit s OwrveRSnGevi �� � � fssued(Sec.3097,Civ.C.). ' � �.�� /��'+ t � . ,. . :. � - A'Y�nE55 n���G• Lender's Name ..�� �"�" ` - '�'� ` �" ""�"` � Lender'sAddress � . . ,. .. � . . � ;- .� . .- ,....« .. . . , � . ._...:,......a...........,,....................�............�..,.._......:_............�.,.....-. .-...,......_...� . . . ......, .. ._.....v�.....,w.w..�.....,�...�........,..... ....._..,.�.....,_.......d...�-... ..... I�ceriify ihot�I�have read �his application and state thot��he _ , . � . �- � - . � . � above informatio�.is wrrect.I qgree!o mmply w�th all County � , . 'ordinonces and S1afe laws regulating Pl�mbing and Sewers, , . � � � anil hereby au�horize represenrafives of th�s Couniy to enter � , , . �upon ihe above-mentioned properry for inspection purposes. � � c�c�,,.. �.e_a�.n rn.- �-9-5�"� _ �.,:„�,....,.,,...,..,.._., �...... ...�.., ..a., ..,., � ... . ignafureo ermiftee Do}e SEERFVER5�FORE)TPYA�NXYdRV'C"3lf�CUA��"'"" ��"'����-���µ� p . . . . . ... -.:'...<�... - ' --,. . �.,.:e. ... _ _ _ -_ rrr.�� .... . . -:,.:; .':..:...:.: . ...�:; r.:, �.,,.n.�.�.-.�...�.p . '..,�. ..-.;'�_.. . �.:. _,�....,:,r" ...�,� . ._ - -- -______,�_..---,..-_-.___w.--- - -- _ _ _ _ _ __ _ _ - .. , ;;:--��: lAJSPEtTOR's�YES _ £�3�WIdEIt-33Y3I�.��2�BC�.:A�TnUP1 , . _ ;.. ,_ .:� .. .. .. , : .. .. �k� ;,,. . .<,� w x ,�PAR�IBALS oa� IPI6PECTORS SIGNAtIIRE T Rikff3P}8$iIYlQ P�fiY I8•Yi EAF�iYfY SStAi112}3@ Cqdl4f8C$�Ofl"�S ---� ., .'—..._,..�..�--. .. '� .., Licenae Law�'oY t�ee followin�reasan g'3ec'�or,743I.S, �vEw�+ouse s:xr�� �,�� � �� � � Businsu axd Profzssrcras CodeJ: Asxy reey ur;eounty ._ . __.. ... . .._.......................�.:. . �: -. ��� w&ich r-aqxerras re,¢eams'e to ronsErucd altav,sreaprn-ve, ., CONNECT AObITIONlLL . ,� . BUIIDING OR WORK .. �� dBflGOP7PIJ,nr,re�sia�an,y sasaesta�,e.-f�?ar..lo fiSs iss�rwxre, . .. ' .... . . _. . sevric rnraK,seeP,vi'r�5>.._..._ .. .. ..�,._..... . .-_ . _.... . _. . . _:y. . . ... .._-._.-,.._ �Rso requsra.� :dse:t35p?icare8,1'or•saach�eraaa38 ac.f'Ze u .. ANO/ORORA14fIELD sig�zed s,agemens tnat be!s.'bcem.scrl pursv.an3aaa to tbe -: .... ...,._� _,� . � cessrooi❑ ortvw«i❑ � .. . . . ......� •���. ..,...:...... ..,�,.�::....,:..� us.>.�.'- ._.�.:.,-t-.�pruuisror.s�j ibe�aa:trattor's Licemse Zaw(CF,apeer 9 �. ALTE�.REPAI&,SEWER OR . .. .• . ,.... . ..... . �COi95BDS61dd'6f1g'f)sP.�J 3¢C:iOfl.rdiOOJ GJ�d�82JeSf��6,f 3dTE - SEWAGE DISPOSAL SYSTEM � . $t[.v'B1LPd4 S1Sld..�9'd�8&SeORF E�OlLBJ O?2`..^kS.J7E%%2X'E9M�lA ' - . .' . .. ihee�e rosu a+w'dbe 8asis for 33'i�nZdeg¢d.�xzrnptdar Any pSCONNECT PLW ANG IT—^. . ' -- � ,x�r . ,......�.,. .. .,_,.,..r,.......... ....,. : aarwooniwouses�wea . ..._. .�..,_,.._�:._...... -. ....._._..;:•.:. yioJaeeos:ofSee:rosa73331.�5yun9�ptPiscaatJord�ee°nsda "� RApCFILL SEPTiC TANXS�'. � �sbjects sba ap 1u�xt sc a cirlal�eaa8s+y.sf ra?��ssore+�x . �'. SEE7.Pli(5)❑ CESSP004S�s —.— - . .. , ..._ . ...,.. ._..7... 1 ��.-..�emea.vu�.�-�- �.. �•-•�: . • • '+usn4. .. ,.•••:•�f08 u�"8Yi8dK�b tB9�idPS 3�.��DI�•Y , ,.. :..:... ... . .._.. ..n:3f«« +ti�..n}w..'h.,,, ..� .i.:, . .n (� � ., . � . . . ... `°`"��,'� -.3.�. •. � - ❑I,as the awn�of fSae Paas�es[y rvaF".�o Else�svter;c,aatc3 �.. . . ., .. .. . ._.. '.-... ....._.�. . ,.. . . . . � • . - . ....--_ �:he saroc[sire_s not inter.ded aa oifercd fo�sale. . � . : . :,. � .. . .. � :: w.�_... .,_, . '� � � ' � .._^��::.� .. ��..'�.-�� .<.3 . .... ~,. • . , : /Sec. 70�4.i3u3amess cxcl Pvofessfons�ndcr ��-�.'orr .;. . ._ .._, . �,. .__..: � . .._... .� ... .. ..... . ... . .... .. ,; . ..„ .,.,...,-. --,...�...«F.,�,»��,ar......,.. ...,�..<r,.�.n; dracSoe's Tac•erus La¢a�c¢s»�t:.ypd�3o ars�a. �of .� . . . . ;.._.., . ... . ,._ _. . . . ' ..., . .- • �. ..,.- . . ..�� � .���ro¢erty atilr�buldds or�spxar:�.s aher+zoss,tt�wBa does , __ , . .. .. ... ._. . . . . . ... ��.,:". . ......-------. .:. .�:...�. �., -" �,;h vo�rk ?�ssx.celjproajided�l�ma x�cb ampros:ern¢n# - - '� � . . ., . . �.. „. �.. .. . . „--..._._._.,�..„. -� .. . . . , _ ... .., . . ,. ' � - ase�not»x8eai3ed a,�6ffere�jor saze,T�, hmuever, S,be � - ,.. , .. . �. ..�'�,_.,,...., ..�......�. �. .......� -. �:..._._..� .�i:�x,;» bufldfasg ar�spirnvesnews is saYd uriPkfir,sr.es yexr af , . . . ... .. . . .. . ... .._ .. .,�a i� .2_!.:..<.'. . mrn�le8uos, :be assmawSmiYc%er avs�',!bmxse ske 3ra e� �- ... .. . . . . , _... .. .. _._ .. .:. . . . . . -_.- . ,__.... ...._...... . ....:,....... .�a..,..:,.... . .�..... ,.. . (rrrar�1 er sb� ; . . � �:�_°�^�^-�"'�af prova+a��bua 7ae!Fad not Smidd��sas , �:�.. .,-. '". ' �- ""r' r�? ' !. �': ' �w aseoyf.s:e�s.9 . . � ... . ... . ... . � . : _.. ... _ _. ...._ _... _ ._ .. .�„_ .. . � . . . .. .. . . . , , . . _ .. _ .. n.;. - ,�,;. - ,}c ..... - - . ._ . .. , _ . . . . �� .. _ �w�-- ....�. ` _ _ .. ... .._ .�_;.� �..���. . .. ._ � . ,�., � - - . $�� � � --� ._.. .... - .:-� . : � ' ' '. . . -ti�`.,�-1� .:—. C� . � . ....e»va..�.> 1_A�s.R-nR rM.lrw.....�. .r-�....+...,;,yj�C,y'o+.`ik!fili�5{-V.� :.i1,� a�.'"y.<. r ....... ,.... ,.._ , .. . . �(YR `a°li� D - . : � .�'..�=°a' _';. '.' . � ,..., . . .- .. . .... , . . .. . _ .. ��C�.�i.�GEkff't�IY�1'�C�Af1�.J .... . . � , -.., . � .�" ' . _ ,. ..;.. .._ ._.._.� .s..r. �. _,.�__ ..._....._.,. . ... .. ... . ..... . . ....� . . ... : .. , ; � . , . ., _. ._ ...... ,. ... . .. , . ..�.ur..:....,.. , x,«..� , x, , , , . ... � , .. . .. . . . . .. _ -�� `� . . . .�_ - . .. . . . . . . .. . . . ... . : .. .. , � �, . . �».... .;;.,....s«..-..�.._ »:..,..:a<a:-; p`18'$�__. , _ , , , , t. � � _ . .:.,:, � �,;..,., :�,,.�.. ..�_._.,—� C�vmez :, __. _.._.__ _ . .,.. . . .....� .;...... ,. ., o..�.,_�... ..,:a.... , �,!r�•�. � ...,v�..x. �.u-t.,,..nn. . :u,...:�,.. .yi �� . . .. __—_.a.....,....e:e,,.. _� , . . . :.. . . .. ..._:aa_..,_. .,...w.- ..-.-,,,.-�..... ,-:....,,.., �„-. .�.,.�.,. .. .,y... .. �._w,,... ..,....N ..r. .. . � 9NSPEC40R'S€d07'ES . . . . . . ,. � . .. � �K� � � . ... ,.. ...:......., ..,...,...:.,.wv.,..,_.,,-,.,.,< _:.,,.,.�K..�..»......;..,....,,,,,.�.. ,.-�..;.;:.�_,..��-.;,-;.;: ..h,.:��� , .�.. y.�4� *,r x r. �� �? . , ,.�. ' ...,...,.- �,,......._.k..'i-!�."E1�.__.u...::»...a�..,wn.e�. ':�:..,�.� »w,3"'3.nww.»,...0.:Bs��,; ��,:. .� .,„ , ...._�.� . ....�._.,..� . — . _��� ..�.� - .'��.,........,n...... ....,_.::� . ',�.�mrc n.�w^+.�'S�'rWG"Y3dqiV'_dA'M+'.. ' .:t.;�:. �s.tits'4A... ,.,sYr� . tl ........ .. ..... 'µ' -,.jp,. ,�.,�.h�.,... . , .:. ... . .. . . . . _--_.—. . ' '' . . .n.s . . . .... ;,...._. . .�.-,. v ,�:�*.�.r�ua ,.. . .F�.{�f. . -:��: ,�e°�".: . ... i -.'Mti�i:i/"#bCtsNntJViY�wf.C . . .,, ,. : . .. . . . '. : . - . _ _ . . _ ,,,��,y�y�� . . . .. . ,.. . .w�.�e.� . . . .�!`RSllAM�"S^a"T'^'�'1r.. .'?�:Mt'�i...+-.. . .-.?4�.--.k:�irv/A+x..u'TA-i: r..� ;w. . . . . `�^'S^''FM�,'^' ... ._. . ---�� . . . .._.........-.� . .��-e�+.-w,x�sx i:s�>�zt���as �".;�"����:a-�.3y,�3B.`.:a - .„ . ...__,,._,.......�...:s.�.:�ar,c .,:�-.r.t:...... �. .,. ,..,::a . . m . ...,. . .... _ .. . ., ,. . . .. , . r . ,., .�.,_ .. _tl...: .: ... , .._. ......,... „o»,...,, .-., w._....w..«.,�.�..z,•�ou-��'...�:w1a;:u�,:.a.na.p.r:.-..�,:�'�u.w:;.tw.�.�..a�.. . .,,w.:..., '�,+.�.=h.�a�am..r,�nwnr.rc•�'a"t='=�'c-��..:.w�`,w,.us a.u.s:rxiw.n *Pro�c;..,,5>., -. ,� � _ _ —._._. ......., .., ,�....,w..r...�. �.��.�a�., .-.:-.. r .�..:�.<. ,,., "dutt�e:«�•t ��4'.': �'a'>>- . , . • :^�:»,. � . . .. .. ., .. _.r . .m..:...•..-, .,.' ',u. . '�e :.�.: ):' 'dY ,. .. . . ., ..e.r .vveezw .;,n..��,-,ea x........� ��.. ..�.. �.: — .. .. . .... .. ,.....,,......«.............. ........r,..... . .. . ; ' ,. ',P.X,U54��' '�+t4'Nr..>a+ba@6'dt,v.N�'a4""�f'.'+a'?, '�+tY,.. Y+Y'Y. ^CN9'� .. .... � ,_.... ...... ..:.._..:..... .. ._:�� .-;.,...',:. .:.:..;...,. ,:.;.e.. .L..,. ww:... w..c.wux'�"'.x�...��. , ._«Wl. 4'.`�.. , . .. .. ... ...........:.�....,.:,.�.....:x,:.� ,:6...,:.r e�.mJ.. ,.�.;�8�w-T �...,t 4:d.+'v�v"e�`,-.;..:��"u":.':"1^e:�^' ,,. .�F'.'"Yi'n";..��. .,... � � -s'�'�f•`�..`.�'�f .�,.`�"�Wk-_,. ."""��A'^k'M9^�`�"{..�'....: