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HomeMy Public PortalAbout9750 CRAIGLEE ST_Plumbing__ /per p Iqy�./gyp B I I I fWP 78A89 BA CE#803-9.60 AP LRCAT1 ®� LL ,V R V Y is l 1� �� COUNTY OF LOS ANGELES BUILDI w' ADDRESS... _;. _ ..�.: -- DEPARTMENT OF COUNTY ENGINEER j BUILDING. AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM.A. JENSEN .SUPT OF.BUILDING - CROSS ST! ., DISTRICT NO. I GROUP, ypE _ ESSED BY FOR APPLICANT T X14 IN CONST. BUILDING.. " _ STATISTICAL CLASSIFICATION WER MAP ADDRES _..-- CLASS.No. DWELL.'UNITSj__I LOT:NO. BLOCK. MAP STATE YES O - _ `.NUMBER -T. s F1WY.' .. ,TRACT. - - USE ZONE, SPECIAL e - • NO. / 6 Y OF BLDGS. CONDITIONS SIZE OF LOT /� /'Z .I NOW ON LOT - USE OF ` EXISTING'BLDG. BUILDING' '•'EXIST. TEL.- I `SETBACK YARD HWY_ TF}E NAME • •;WIDTH . OWNER ', 'NO �/ FRR�ONT ' .s. L. �. ADDRESS' '� -•'' '` =L. , '=SIDE. t ARCHITEC.r"ORs ,-� TENGINEER • N4 INSPECTION.RECORD ADDRESS '(L TEL. � ,J ..11. -�. t ,'rte•. ,$', � �-Ti .� .0 "CONTRACTOR( / _'. NO. ' y. ADDRESS'.. .. I -. '. r ... -•'- O DESCRIPTION OF'WORK �t 'earE+. E tie '�' W O_ NEW HADD -;ALTER'... REPAIR DEMOLISH ..,� ` L '. SC.FT NO.O.F NO.OFt.Zi rS A ',s6 ;t—Ae"� c...�"S� �1 ..✓S�N/��:'. — . SIZE ?/' .I., -STORIES. .FA IL Sys fr I USE.OF'.e �.. .9�i,..e. sai;.. v- :STRUCT.URE . AL � f IGNQTU OF' P • - APPLI NT VALUATION$, '�� ,0, APPROVALS. .DATE?°. INSPECTOR)S SIGNA TUR E ' ...< P C - /q _ FOUNDATION: LOCATION PMT, "+ :'.' FEE $i `�r I FEE -$ `� FORMS. MATERIALS ',rl /. ..,.. �a:� ,,eS•. • •FRAME: FIRE STOPS,HEREBY ACKNOWLEDGE AC`KNOWL'EDGE THAT I'HAVE'READ THIS APPLICATION BRACING, BOLTS' AND STATE THAT'THE,ABOVE15 CORRECT AND AGREE.TO,COMPLY FUE;NACE: LOCATION, WITH ALL COUNTY `ORDI.NANCES AND STATE LAWS REGULATING GAS VENT DUCTS �� BUILDING CONSTRUCTION..I CERTIFY THAT IN THE PERFORMANCEOF THE WORK FOR WHICH THIS .PERMIT IS ISSUED I SHALL NOT. LATH, INT. EMPLOY ANY PERSON IN ANY MANNER SO AS TO�BECOME SUBUECT TO THE WORKMEN'S COMPENSATION' LAWS OF CALIFORNIA. LATH, EXT. // SIGNATURE O HOUSE RECTAND POS POSTED PER4f:fl.,.j MITTE ADDRESS FINAL CLYDE N. DIRLAMf PRINCIPAL ST C RAL:ENGINEER PLAN CHECK VALIDATION'; lcK. M.O. CASH PERMIT VALIDATION CK.. M.O. CASH Uic'o d o" 7 9:- JUL 172 3 D f ,�.�. ii? 1 ,2 8 A.JG 7 i u 6 01.0 0 2: ,C,!4 WORKERS' COMPENSATION DECLARATION I Hereby affirm that I have a certificate of consent to self D O � D O M O D nn �( insure, or a certificate of Workers'Compenstion Insurance,or A P I L Q%CT�O O D D U V G IPE RLI V UO LI a-certified coop/y thereof.(Sec.3800; Lab. C.) COUI�ITY OF L05 AN 5 BUILDING AND SAFETY '.- Policy N'.v-_L, mpany F BUILDING ` .Certified copy is hereby furnished: "' FOR APPLICANT TO FILL+ IN ADDRESS /Certified copy,is filedwiih the counfy,building inspec- BUILDING tio department., ADDRESS iG Ple LOCALITY ��r�,�.,, �� � t /� T . NEAREST Date Applicant U� 1 w✓ CITY " I e- 'l,-i J ZIP CROSS ST. C RTIFICATE OF EXEMPTION'FROMWORKERS' NO. OF BLDGS. ASSESSOR -COMPENSATION.INSURANCE SIZE OF LO T-- NOW ON LOT MAP BOOK PAGE IPARCEL, (This'section;heed not be completed if the permit is for one USE ZONE MAP /l�Q hundred"dollars ($100) or less.) - i TRACT BLOCK LOT NO. NO. } TEL..rr�� , SPECIAL I certify that . ir the performance of the work for which this OWNER L C NO.i���u �' CONDITIONS Q permit is issued, Ishan not employ any person in any manner. DISTRICT GROUP TYPE FIRE C D BY V so as to become subject to.the Workers'Compensation Laws.. CDDRESS C ! _ r CONST. Z19 Date Applicant Y / �� ZIP STATISTICAL CLASSIF TIONi APT,' CONDO. V . NOTICE TO APPLICANT: If, -after `making this 'Certificate of ARCHITECT OR, TEL. W Exemption,; you''should become subject to the Workers' ENGINEERNO. CLASS NO. / DWELL. UNITS N Compensation provisions of the labor Code, you must forth-. ADDRESS SEWER MAP Z with comply with sucH provisions or.this permit shall be -y�, // _ n!y deemed revoked: CONTRACTOR J. E: Z04,U "�r&J NO. 4^�C1 Y321 BK. PG, VALIDATION, LICENSED CONTRACTORS-DECLARATION - LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ,ADDRESS C'7 •AJ a.1'<)4f ' NO. ` pf%- VALUATION' (commencing'with Section,7000)of::Division 3 of the Business and LIC. / Professions Code, and my license'is:in full force and effect. CITY F�7J. �(�! -CLASS C." / $ �X _ G SQ. FT. NO. OF NO.OF CHECK - - - License Number 3 3`1 Lic.Class C.-�/ SIZE STORIES FAMILIES. ONE" 7 ,r / DESCRIPTION OF WORK C�dD L-f� (C NEW $ Contractor • &f J O lNs /d�� Date 7 / -- r ADD -❑ ❑ I am exempt from the I.icensing,requirements'as•I am a, licensed-architect'or a registered professional engineer ALTER ❑ FINALiOv DATE r I "acting in my professional.capacity' (Section 7051,. REPAIR ❑ 'Business-and Professions Code). USE OF EXISTING BLDG. - DEMOL ❑ - B NAL Y �- Lic or Reg. No. - _Date APPLICANT. TEL. — OWNER=BUILDER DECLARATION (PRINT) NO. hereby affirm that I'am exempt from the Contractor's License -' Law for the following reason'(Section 7031.5, Business and ADDRESS z 0'3.3,2 A 9 . Professions Code) PRESENT ❑. - 'BUILDING °,°.o 8:6-1 I, as owner of. the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the'structuee is-not intended or offereclJor sale(Section LOCALITY J2,o'-,4 3,,0 Q 7044, Business and Professions Code). MOVING TEL. _ ❑ CONTRACTOR NO. ° ° .3 O O v I, as owner of the property, am contracting with licensed contractors to construct the project (Sec- . ADDRESS. . Q'7,..� tL'-8 tion 7044, Business and Professions Code). �` REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD. HW Y' PROP. LINE, WIDTH 1-hereby affirm that there is a construction lending-agency for FRONT the performance of the work for which this permit is issued P.L. (Sec.•.3097, Civ. C.). SIDE P.I. Lender's Name m Lender's:Address P.C. Fee$ , Permit Fee r &zef .. > 1 certify that I have-read this application and state that the Issuance Fee r C above information is correct. I agree`to comply with.all County Investigailon Fee M ordinances and State laws relating to building construction,. �.- m Total Fee _ and hereby authorize representatives this County to enter aupo�nt �Zentioned property for inspectio purposes. ` + SEE REVERSE`FOR EXPLANATORY LANGUAGE ^ _ Signature of Applicant orAgent .Dote - - - ©s U P P U C AM O ll V .Ll O.R "B U I L O IJ C9 G P E LI f!N T COUNTY'OF,LOS,ANGELES _ BUILDING AND SAFETY.,. WORKER'S COMPENSATION DECLARATION > FOR'APPLICANT'TO FILL IN BUILDINGADDRESS I hereby affirm that I,have a certificate of consent to self Insure, BUILDING ADDRESS . jj or a certificate of Workers' Compensation Insurance'or c rtifled' copy there-f-( •3 0,L .C.) CITY i .-> ZIP - LOCALITY 0. Company - / Policy N - Cany.j N i C/__ - - SIZE OF LOT � NO.OF BLDGS:NOW ON LOT El Gertifi py'Is eRE'reby'furnished. N ST CRO ertified copy Is fil� with the county,building inspeC - TRACT =' - - - BLOCK. - LOT NO, de USE ZONE 'MAPN O - - rtm - - Date pplicant A_SSESSOR MAP BOOK- PAGE PARCEL _ `SPECIAL CONDITIONS fir, CERTI KATE OF EXEMPTION FROM WORKERS' OWNER TE COMPENSATION INSURANCE wlTiw l000 FT.OF SCH06C? • vEs No This section.nee'd not be com leted'if the permit is for one hundred ADDRESS / ( p p. - - ? C (...C Lam,. DISTRICT 11 .GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars ($1'00)or less.) CITY ZIP I certify that in the performance' of'the work,for which this permit i mARCHITECTORENGINEER TELN /J _ s issued I:shall not employ any,'person in any manner so as to O. becoe subject to�the Workers'Compensation Laws. - - - STATISTICAL CLASSIFICATION '' APT CONDO ' Date ".Applicant ADDRESS CLASS NO.. 'DWELL UNITS NOTICE TO APPLICANT.—If,'after making' this"Certificate of - j' REQUIRED TOTAL SETBACK.FROM EXIST'. Exemption, you. should' become '.subject to the Workers"- CONTRAGTOB•_.. - L % SET BACK PROP LINE WIDTH Compensation provisions of the.4Labor Code, �A_/t(�"JL! YARD HwY: p p you must forthwith � J'`��1 i�.`� 4 FRONT comply with-such provisions or-this,permit•shall be deemed revoked; ADDRESS /i �'- LIG L" _ SIDE.. - LICENSED CONTRACTORS DECLARATION clrY LIC.CLASS PL I.hereby affirm that I am licensed underprovislons of Chapter 9 .. SEWER MAP (commencing with Section'7000)of Division 3 of the Business and, SQ FT:SIZE r O.OF STORIES NO.OF FAMILIES Professions Code nd m Ijcens is In iull'force and'effect. NEW ❑ BK PG X� a `j S DESCRIPTION OF WORK 1 .- ADD .. ❑ VALUATION - �' Q License Numbe LIc.Glass �• )�j/� (-,rte C7 Contractorf� ALTER ❑ �F �7 6 1 -> G �. REPAIR - - 0. E].I,am exempt,under•Sec: 1 _ $ �. BAP C.for this reason r p Q I DEMOL ❑ LDMA P/C.# W USE O EXISTING BLDG. - Date:.. URM ❑ _ _ Signature i - APPLICANT.(RR1NT)•, V C - �' .LDMA Perm# "• ; -. i }Z ❑ I,.as owner of the..property, or.-my employees,with wages'as Z ADDRESS ' .their sole,compensation, will doahe work and the structure,is. lJ not.intended or'offered for sale (Section 7044, Business and - A/ FINAL DATE Q � : Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ''LI3^i 7 ` OR AMIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE. `� - '••`""`E J i• ❑ I, as owner of the property, am exclusively'contracting with- AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION"GUIDE? FINAL'BY ' licensed contractors to construct the project (Section 7044, \Y Business and Professions Code.) YES❑ No❑ - { - \, WILL THE INTENDED USE OF THE BUIDLNG,BY THE APPLICANT OR FUTURE'BUILDING _ OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION BLENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR - GUIDELINES. ii''- _t_; I hereby. affirm that there is a construction lending agency for YES❑ NO❑ ,1 the performance Of the Work for Which this permit IS Issued(Sec. jHAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING - i •".S" " 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY_CODE, TITLE 2,CHAPTER 2.20.SECTIONS 2,20.100 THROUGH 2.20.140 CONCERNING,HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. a• Lender's Address o� O OWNER OR AGENT _ I certify that I have read this, application and state under penalty of per' that the above information is Correct.I agree t0 comply .P.C..FEE - - - PERMIT FEE; W all ounty ordinances and tate laws relating to building / / m onstru Ion, and hereby autho representatives.of this County ISSUANCE FEE m to este up e b -mentio property for inspection urposes. ` pC �O•U a - 9 l 'INVESTIGATION FEE- TOTAL FEE - - Sgn 2 0l A nt or Agent Date _ SL 1 ' SEE REVERSE FOR EXPLANATORY LANGUAGE WORKERS COMPENSATION DECLARATION 5P M e. nsureboraafcerti'f cane of Worke-s't bmtpsensat on ensuran elf Lf11 �L/11�.�O-LI I �:O�Y � �D GSI C p C G3 uG�]i 0 or a certified copy ItHeIrof (Sera 3800 La C ' COUNTY OF LOS ANGELES i BUILDINGA'ND SAFETY. , Policy No - Certsfied.copy is herebytfu coshed t', FOR APPLICANT TO FILL IN BUILDING Certified copy ss.M id with'iThe co ty building mspec-' BUILDING AD tion d'eparime ADD ' r •'.' a'. 1',�— ,Ch1 ,'- _ _ ...• _ _ - . - _' f _ ._.., + _ .. RESS Date' CITY G �G. ZIP LOCALITY. 1 ' CER FICATE OF EXEMPTION FROM`WORKERS ' " COMPENSATION`'INSURANCE SIZE OF LOT NOW ON LOT CROSSSST: (This'"section-need�'n,'ot�be'completed if k,.1permit is=for one' - r �• _ - �• ASSESSOR hundred dollars($1;00)or,less ) , TRACT BLOCK LOT NO MAP:BOOK A. PAGE PARCEL TEL. C/ �S,- i USE Z NE MAP I cer)ify:that sn `the performance of the warkYfor.which-this OWNER NO.�Ob" NO. S 9� f? ' 1-1 U6 I not employ any person in any manner. _. i,' SPECIAL ermit is issued I shat t so'as to become'suble'ct,to the;Wo`rkers"Compen0'tio'n'L°aws. ADDRESS -' S�1 vn CONDITIONS.' V e _ CITY _ '•. .'ZIP Date Applicant '. ARCHITECT OR TEL' DISTRICT -GROUP TYPE ,FIRE _PRO ESSED,BY.._ . NOTICE`TO`APPLICANT:'.If after>making.this Cerificdte of ENGINEER NO- _ CONST.s ZONE ' U Ezemptionr• ou--should become subject to,`*e Workers. Compensation provisions,of the Labor Code 'youcmust'.forih ... ADDRESS S `� " F with 4comoly„with su(fh.provisioHs or this permit shail,'be um- - TEL. deemed reyoked ;. CONTRACTOR' i' /&/” 3S STATISTICAL C N APT. C DO LICENSED CONTRACTORS DECLARATION ` -- - N� 7,0- I STCLASS NO. TIODWELL,UNITS- LICENSED r , / / } SSIFICA i hereby�.affirm that I am licensed under provisions of Chapter 9 ADDRESS :0'( L't �0 ( O l L� 4 SEWERMAP i u. i • (commenangwsTh SecTion7000)ofDrvislon 3 of the Business and .__. .� -.- - _._� �C: 6 Professions Code, and' Icense`is'mzfull force and.effect. CITY.- LV GYLNC( CLASSC 3 /' VALIDATION. SQ. FT: NO. OF_ NO ,OF CHECK b a _ ._ BK PG. ZU } s SIZE STORIES FAMILIES ONE License Nuri r• Lc.Llass s �. zt ,.... VALUATIONu. j DESCRIPTION OF WORK �'F,0- (J" - NEW Contract Date ADD D $ x _ . I am exempt under Sec .D. r_ ALTER }, > � 1 6 T 1'A B&P C for this reason REPAIR y Date -- USE OF DEMOL~Q # o c e o •o. 1, j ' EX STING B DG _ L APPLICANT TEL o i "Signature' FINAL 1 1 5'J�0 Y WNER-BUILDER DECLARATION ., _ - PRINT).. N- _: -,DAT ' �A Law for the.irmo shot 1-am.exempt from the:Contractor s,lice.nse 4hereb afficmOowsrig "r'ea'son;(Section 7031.`5, Business and ADDRESS FINAL—` `''`" sta 1�1 5 Q v „..- _ 'Profes`sions,Code) PRESENT' _ By,.. a a 5 BUILDING ! O a- 1, as owner of the property or my employees with ADDRESS. X12 85 wages as their sole compensation,will do the vrork and. the,structure is not intended oroffered for sale(Section ' LOCALITY ) 7044; Business and'Prof essians Code): r MOVING`"- ''" TEL. .D . 1, as owner of the.property, am exclusively contracting CONTRACTOR NO; : - -with licensed contractors to construct the project (Sec ADDRESS tion'7044,'Business,and Prof essionsoCode). F ^ REQUIRED,.:_.` TOTAL SETBACK FROM... I CONSTRUCTION LENDING-AGENCY SET BACK YARD" HWY' PROP. LINE" WIDTH; ? .I hereby affirm that there is a construction lending agency for FRONT -•the-performonce=of-the work-for which:this permit-is-issued - -P:L. T. .. . (Sec. 3097, Civ. C.). SIDE :s Lender's Name `� ,. m - -•. _. . �. _.. ._-- -....-. P:C',.Fee$ -_ ... -' Permit-Fee - •-,-:Q�-�C/ - ... `l LDMA Ref. # Lender's Address CJ ''(( Lcertify-that_F.have_cead thiaapplication and-.state that:the. �__. tssuanceFee fV PLDMA P/C#Fr 1Z above information,is correct. I agree to comply with all County' Investigation fee m _ordinances and'State,laws relating to building construction, - :_. _ a Total Fee ^" LDMA Perm. u and hereby authorize representatives of this County to enter �� t- d < un the above oned property for inspection purposes. 1 (�{/Glic� _ EE REVERSE FOR EXPLANATORY LANGUAGE " Signature'of•Applicant.or-Agent. _ ._� _..Dat - ,.._._ _. ... ... ..-.•��_._.,_ ..- - ._ _ _ ._ _ _ _ .-_-- •. - 76A667-CE817 6-60 'y L u,, PLUMBING PERMIT-- APPLICATION FOR _ �.,. COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING - - ''_ �' •�-�I� JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM OWNER WATER CLOSET.. MAIL ADDRESS BATH TUB CITY TEL. NO. SHOWER LAVATORY CONTRACTOR e, - SINK ADDRESS 2 low DISHWASHER CITY -r TEL. CONTRACTOR'S STATE LAUNDRY TUB REGISTRATION NO. COUNTY ❑ CLOTHES WASHER DISTRICT NO. GRQUP— 3;9NE PR CESSED BY WATER HEATERGAS SYSTEM SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD N - a O U O e F U w a rn 4 r ® OR FIXTURE $ I /-/— L APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK TOTAL FEE ROUGH PLUMBING -- GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES CE LINSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST - CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. �.—.� UTILITY CO. NOTIFIED - SIGNATURE OF PERMITTEEt FINAL ATION ROBERT A. WOOD, / C[. R O CASH SUPERVISING MECHANICAL ENG-Ft `WORKERS COMPENSATION DECLARATION,` � 0 Pp (1�Vn U'L� �� pE 6 hereby:affirm that I have a'certificdte of consent to.self 76'A667A .1���©9` O , (���n LL PERM �j L� nsure;.or`a certificate ofiWorkers Compensation.,lhsurdnce, CE 8.1,7•(REV,10/81) oYa certified`'copy'thereof-(Sec. 3800 Lab. C ) w ' COUNTY OF LOS ANGELES BUILDING AND' SAFETY Policy No Company C �` Certified copy s hereby furnished. u ih In unt'building ins ec- FOR APPLICANT TO FILL IM(PRINT OR`TYPE) / Certified copy is filed wi co - ADDRESS BUILDI Tion riment y 9 P NUMBER FIXTURE,OR ITEM n @ FEE E f` PP ITY LOCAL WATER CLOSET x Date i' A li' nT tJEAREST ;„ yCERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUBz, v CROSS ST ( ;, C COMPENSATION IN ` ( SHOWER,.a t OWNER,; This"section need not be'com Ieted if"th'e fork involved-,by Y 'MAIL` } YJ (Thi P P � ) Y LAVATORY-w .y • a' ADDRESS the ermif is':for,one hundred dollars $T00 or less. ,, r ;. I certif, that in the erformanee.of the work for„which this, u y t P SINK 3N CITY ' TEL. NO. permit-is issued, I shall not=employ any person m any,manner y .,, - r' t 'So as to:lbecome sublect to the'Workers'Compensation Laws.;, , - DISHWASHER ;CONTRACTOR Date Applicant' WASH HER . r NOTICE T6APPLICANT”,If+rafter making ,this Certificate of i (a ADDRESS r r M ,: SWIMMING,POOLRECEPTOR come sub ect to the Workers _: t Exemption,..you should ,be I_ CITY, TEL. NO. H, Compensation provisions of'the Labor'Code, you must forth LAWN SPRINKLER SYSTEM Y 'with 'comply. with' such prowsions or This permit shall .be° STATE LIC• deemed revoked, " WATER HEATER NO GLASS 'LICENSED CONTRACTORS DECLARATION SE DISTRICT NO - PROCESSED BY GAS'SYSTE/J} OUTLETS _ ? p'y LICENSE I hereby affirm that I am licensed under provisions of Chapter,9' (commencing with Section(A7000).of'Division.3,of the Business, OUTLETS OVER rand Professions Code and'my license is in full.force and effect.:` 5 PER SYSTEM r; FINAL p r t® Y 4;: DATE x: VALIDATION v License.Number-• Lic. Class J w r $ J Controctor Date, M,., = ` s r _ .. ., .. FIN I am exempt under Sec. - r E n B:'&P.C'. for this reason ` V • ... 'J Plan cheek fee a - is ,- L Date: s- LAA °PL'UMBING PERMIT'ISSUING FEE$ �t. r v Signature f £ TOTAL FEE . h sED Plan check applicant`l SINGLE FAMILY r HOME OWNERKBgUILDER DECLARATION' '> Name k T r {to,p E w• R L hereby affi{m that I am ezempf from the Contractor's License. z t•r Y" aaa , Address v ,. •. t ., g nd' ,Professions Code): tion 7031:5, Business a' Cii T ( ,t; Tel No. x Law for the followm reason Sec a y ar I,'as owner of the properly, will do the work and.the' structure'is not intended oc offered for sale,(Section - 7044;`Business and.Professions Code). a 1 ,CONSTRUCTION LEN DING'AGENCY t hereby affirm that there is.:a construction lending agency for x 4 The performance of the:work for which this permit is issued: d f (Sec 3097,iciv: C.) 4 L l �ILender`xName Lender s,Address y -f -T =I certify,that I have read`.this application'and,state••that the- t ` above information is correct. I agree to comply with..all:County. ,• Z -: ordinances and State laws regulating Plumbing, and hereby , authorize"representatives'-of, this County to enter upon:the ) :.above mentioned property for inspection purposes. N :: pp SEE REVERSE FOR:EXPLANATORY;LANGUAGE. le :Signature of Permittee Date f >v