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Home My Public Portal About8848 GARIBALDI AVE_Plumbing__ WOR ION I hemby of mR�t I have 9 certificate Of OOm=tato self . Cli:`7(2-.e) APPLICATION FOR PLUMBING PERMIT insure,or a cerdficsito of workers'Compensation Insurance,or a certified co tbf(Sec.3800,Lab. COUNTY OF LOS GE LES BUILDING AND SAFETY AICl ❑ � cop l~Is h? 7 FOR APPLICANT TO FILL IN (PRINT OR TYPE) OUILDING � ADDRESS Certlfied copy is filed with the cbunty building lntpectlon NUMIX BER FTURE OR ITEM • FEE F� LOCALITY Nte� A lia]Stl �� y(flf7Cf �u WATER CLOSET N AR Q BATH TUB CR088 8T. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER R 2) T-Z, (T'bfs section need not beOCIMPfeted tf the wort[ hivotved LAVATORY MAIL A D D R EBS YINk by the perm t Is for one hundred dollart ($100) or lett.) SINK CITY TEL.NO.IAll"Ir) I cortlfy that in the performance of the work for which this DISHWASHERpermit Is Issued, I chap not employ any person in any manner CONTRACTOR b as to become subject.to the•Workers' Compensation.Laws. CLOTH Ea WASHER /ADDRE" IV.� 3fl v Date Applieamt SWIMMING POOL RECEPTORNOTICE,TO APPLICANTv If, after making thIs Certificate of CITY �tA0 TEL. No, Exemption, yoU should become subject to the Workers' LAWN SPRINKLER SYSTEM TATE LIC. Z Compensation prevlalons of the Labor Code, you mutt forth- WATER HEATER LICENSE NO. C.L with comply with such provisions or this permit shall be tASS deemed revoked. DISTRICT NO. PR ESS D 11Y OAB SYSTEM OUTLET'S LICENSED CONTRACTORS DECLARATION OUTLETS OVffl I hereby affirm that I am licensed under provislods of Chapter 15 PER SYSTEM 9 (commencing with Section 7000) of Dhrlslon 3 of the Busi- FINAL/& noes and Professions Code, and my license Is in full force and -DATE G �y —4?0 ATION effect. J-FINAL License Numiber�l'�LSG— Lii .Claes ✓nk1C BY CodtrYtto,,��i��i� EX�►', � to I am exempt from the licensing requirements as I am ■ Plefl check fee licensed architect or a reostered professional engineer pLUM13ING PERMIT ISSUING FEE; 1-7 acHA& in my professional capacity (Section 7051, Bus- 'I Iness and Professions Code). TOTAL FEE01 Lie.or Re*.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section-7031.5, Bud- city Tel.No. ;212'6 E1 9 A nen and Professions Code): I,ss owner of the property, am exclusively contracting # o o o 0 o 5 with licensed contractors to construct the project (Section 7044, Bikoness and Professions Code). 2 o 0 1 (10 O CONSTRUCTION LENDINd AGENCY 0 0 0 1 Cl 0 0 I hereby affirm that there Is a construction lending agency for the performimce .of the work for which this permit is 1 7—80 Issued(Sec. 3097,Civ.C.). Lender's Name Lender's Address I certify that I he" read this application and state that the above information Is correct.I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances an State laws • L umMng, and hereby a tativea un to a er n the tore of Permittee f Date I he,,e��Mb�r�°tNtDECLARATION to a4,f CIC:;;;a-8e, APPLICATION FQF PLUMBING PERMIT insure, or a.certificate of Workers'Compensation Insurance,or a certifled copy thereof(Sec.3800,Lab.C.) /" C r COUNTY OF LOS ANGELES BUILDING AND SAFETY ,Pollcy No---------- Company Cart lfied copy'Is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING , Md iflad copy is filed with the county building inspection NUMBER FIXTUREOR ffEJM FEE ADDRESS � DataAdepartmant. WATER CLOSET LOCALITY ILg Applicant CERTIFICATE OF-EXEMPTION FROM WORKERS' BATH TUB CROSSPT. COMPENSATION INSURANCE 6HOWER OWNER LAVATORY MAIL (This section abed not be compl6tdd if the work tmotred ADDRESS by the permit is for one hundred doom (;100) or len) SINK CITY TEL.NO. CL I certify that In the performance of work for which this DISHWASHER permit b Issued, I shall not empl p n In any manner CONTRACTOR u t be a subject to the ass' tion Laws. CLOTHES WASHER a GL Q f, ADDRESS to 0 Applicant SWIMMING POOL RECEPTOR O CE O APPLICANT: If, atter making the Certificate of. CITY TEL.NO. 4W F emption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. 0+ mparaation provisions of the Labor Code, you must forth- LICENSE NO. LIC. Z h comply with such provisions or thi#,perm.1t ahall be WATER HEATER med revoked GAS SYSTEM OUTLETS DISTRICT NO. Q� PR EsetD H LICENSED CONTRACTORS DECLARATION OUTLETS OVER OO by affirm that I am licensedµndar provisions of Chapter 6 PER SYSTEM mmancing with Section 7000)of Dtiislon 3 of the Buri- FINAL and Professions Code, and my license Is in full force and DATE ect- ��'�' FINAL Llcense Number sip_ 3 Lic.Class 1 BY Cddtrict J*V1r3 C O*' Data I am exempt from the licensing requirements u I am f Plan check fee license¢ architect or a ragI terad professional engineer PLUMBING PERMIT ISSUING FEE>f acting in m7 professional capacity (Section 7051, Bus mess and Professions Code}. TOTAL FEE Llc.or ReQ..No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Nam* I hereby affirm that I am exempt from the Contractor's Address License )aw for the following reason (Section.7031.5, Bust- oFty T41.No. nass and Professions Code): 1 3 a 4 A I, u owner of the property, am exclusively contracting with licensed contractors to construct the project # o 0 o o 0 5 (Section 704-4,Buafneu and Professions Code). 2 - - 1600 CONSTRUCTION LENDING AGENCY I hereby of Irm that there Is a construction lending agency o'0 0 1 6, 005 for the performance of the work for which this- permit is • issued(Sac.3097,Civ.C.). 07 2 3,—8 0 Lender's Name Landers Address Icer ify that read this application and state that the above info tion correct.I agree to comply with all County ordtnan and t laws resulating Plumbing, and hereby SEE REVERSE FOR EXPLANATORY LANGUAGE auth re pt of this County tq enter aeon the ab men ed perry for ins tion Purposes. ti d ' tare of ttee` Date