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Home My Public Portal About9000 GARIBALDI AVE_Plumbing__ heFet>� niTlrtnthat:[heve a wiUtlo to of tato,salt Insure, &°°'A�B/� APPLICATION FOR PLUMBING PERMIT or■wr1HZ..Gf Workers Compensatton Insurance, or a certified oripy the (Seo 3600 Lab.C.) PokyCOUNTY OF LOS ANGELES. DET. OFrPUBLJC WORKS DEPT. OF PUBLIC WOR" DIV. ❑ Ce flM1ed copy is hereby fum.Wod FOR APPLX.ANr TO w..L IN(MNT OR TYPE) ABs Cert W copy M fled wkh the county bulldnp a //f/�)/ (depert:rrony //M/� Hll►IBER FDCTURE OR ITEM F� J Dale Afff�aMG.�LBL �s+� WATER CLOBEr T 4 v RCOEOMb CMT1flC.ATE OF EXEM"ON FROM WORKEi8 CAOSB$T. COMPENSATION INSURANCE BATH TUB l ABfaEseoR (This section need not be corapiet d H th*work Imrotved by the %`OWE`R MAP BOOK( PACE P perm Ft to for one hundr d dollars($1 DO)or less.) OWHER l I�oerdty that In the pefformanoe of the work for which this permit LAVATORY Is Issued, I shall not employ any person In any manner so as to 83NK YAL become sub)eof to the Workers'Compensation Laws. Vv DELL DISWA%JEFt CITY Date APpk-a CLOTHES WA9hEF1 MM NOTICE TO APPLICANT: If, otter making this Certificate ofPLA rn- ExertKprion,you should become aub)eot to the Workers' Compensa9w SWIMMING POOL RECTOR . provision of the Labor Code, you must forthrrtth comply with such prwWons or this permit 4hafl be deemed revbkod. LAWN SPRRiKLEA SYSTEM LICENSED CONTRACTORS DECLARATIONit I hereby affirm that I am licensed under provisions of Chapter 7 STATE U& WATl3� � (oommenoing with Section 7000) of DMalon 3 of She Business and JCI9 Profession Code,and my license la In full forts and effect OUTLETS OVER DW7JC'F GAS SYSTEM OUTLETSLIC8i8E NO. (XAHB 6 PER SYSTEMNO. PRO(�88ED HY Lloer»e Number I j Lk,c,,. FINAL oArE V T10N iI r D� 1 ITECf, ❑ am wwrnpt under Sec. BY TOTAL 293 10 BAP.C.far this reason Plan check fee , �#$ k: ?93.11) Deice Sligrahe PLUMBINo PERmrr lssulNG FES>t .0] ❑ TOTAL FEE &HOLE FAAULY Piin ofleok aPPillowrt ' t1 two tl_R 1 f 94 J hereby aMrmHOME OWNER43JJIL that I am exampt E the DECLARATION Cicero se Law Nears 474 1 AM 9:71 for the following reason (Section 7031.6, Business and Professions Address ❑ CFty TeL No. I,as owner of the property,will do the work end the structure is not Intended or offered for sale (Seotlon 7044, BUslness and Profesak)m Code). , CONSTFILK, (LENDING AGENCY I hereby affirm that there is a oonstnuadon lending agency for the performance of the work for whish this permtt Is Issued (Seo. 3077, CtV.C.) Lenders Name Landers Address I certify that I hav'e read this applloatlon and stats that the above Information M oomoct I agree to comply wtth all County ordinances Pol- and end State I s regulatl bing, and hereby authorize rep of my to nter upon the above-mentioned SEE REVERSE FOR EXPLANATORY LANGUAGE Lf— 14--.7 If of Dde 8CO1i1PENSA"0"° 'A"°" °P"°'°° APPLICATION FOR PLUMBING PERMIT I here" nMrm that I have a certificate of consent to eef} Insure, or a oetttfloate of Worker's Componsatfon Insurance, or a o"ed F reof(Seo.3800 Lab.C.)reoZ�(sS00 L rGo� COUNTY OF LOS ANGE_ES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. ❑ cert►f4d Dopy hereby runs had- FOR APPtx".ANT TO FILL BulLooro IN(KANT OR TYPES - ADI � �. F-1Certtffed copy Is fled wm the oou dy -NUMBER FDRURE OR ITEM FEE LOCALITY Data I( ( Apooarrt WATER CLOSET NEAREST CAO88-ST. CERTIRCATE OF EXEMPT:INSURANCE j:FLA�rk BATH TUB COMPENSAT}ON(fhI*Yaat$— nand nt be oomplewotnvo the %K WE3R MAP BOOK PAGE PARCf3 parmft Is for one hundrid dollars($100)or 1ess.). LAVATORY OWNER I cerdty that In the performance of the work for which this permtt NAL Is Issued, I shall not employ any person In any manner io ae to 83W ADDRE68 become subject to the Worker'Compensabon Laws. DISWASHr�R CITY Ta.NO. Date APpboard CLOTI -8 WABFE�R CONTRAOTOR NOTICE TO APPLICANT: If, after making this Certificate of Exorrrptlon,you should become subject to the Workers'Comperwt1cn SWIHdNO POOL RECE17TOIR provfslons of the Labor Code,you must forthwith compty wfth suoh Alm provisions or this permit shall be deemed revoked. LAWN 8PA21KLEFI SYSTEM d16 LICENSED CONTRACTORS DECLARATION CITYTg W_ (L I hereby sfflrm that I ■m licensed under provisions of Chapter B WATER � (commencing wfth Seotlgn 700b)of Division 3 of the 13uslns" and am SYSTEM OLITLET8 NO. � S� CL,913 G �i8 Professlons Code,ind my Iloense Is In full force and effeoL DIBTFOCT NO X88®6Y a: Lloorw Number Ll._ aeee G �� J .T Contractor FINAL V AT10N W Com" u I DATE 1 —' `�.3C1 a.. ❑ ,.m exempt under ta.a 1 ITF�lS z 7 .30 B.SP.G.fpr this reason TOTAL �: � Pian check fee CWX }7.31] • PLUMSJN(3 l'EAMIT 188U1NQ FEE>t 2v ► DlAL E .00 ❑ TOTAL FEE - a'� 81NOLE FMIfLY Pian oheakappeout 0000-"1 111 1194 r� HOME OWNER�UILDER DECLARATION Name 7512 [�1 rf f 2:al I hereby aMrm that I am exempt from the Contractof'a License Law for the folkrOng reason (Section 7037.6, Business and Profseslons Address Code): F-11, TeL No. I,as owner of the property,"I do the work and the stnioture R not Intended or offered for sale (Section 7044, Business and Profeeskmu Code). , CON87RUCT1014 LENDING AGENCY I hereby affirm that there Is a oonstruotlon lending agency for tAe performance of the work for wt0oh this permft Is hsued (Seo.3097, Cts. c.) Lenders Name Leaders Addle I o4rtlfy that I have road this applioation and state that the above , Information Is correct I agree to oompfy with all County ordinances and Siate laws regulatingbing, and hereby authorize repreeenU of th my o nter upon the above-mentloned property P SM REYERSE FOR EXPLANATORY LANGUAGE Swatun of Pwffkw4r-j D66