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Home My Public Portal About10546 LIVE OAK AVE_Plumbing__ WORKER'S COMPENSATION DECLARATION 76A66P' 7A 6DPW9/89 PPUCATIO �1 FOR PLUMBNG PERMIT 76A66JJ I hereby.affirrp'thato have a certihcate'of consent to self insure, or a certificate of Worker's Compensation Insurance, or a certified J copy thereof(Sec'3800 Lab C) Policy No 3641-93 Company State Fund COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT. OF PUBLIC WORKS DIV. ❑ Certified copy is hereby furnished —� BUILDING ^f ` ® FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS 10546 Live Oak , Certified copy is filed with the county building inspection department ABPP INC./ / NUMBER FIXTURE OR ITEM ® FEE LOCALITY TeM le Cit � Date 3/16/93 Applicant Progressive Plba. WATER CLOSET "c OSS ST El Monte Ave. CERTIFICATE OF EXEMPTION FROM WORKERS' 3' BATH TUB ' COMPENSATION INSURANCE ASSESSOR p� (This section,need not be completed If the work involved by the SHOWER MAP BOOK Jia(v PAGE�� PARCe_9____7, permit is for one hundred dollars($100)or less.) LAVATORY OWNER Starts International Calif. Inc I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as toMAIL / SINK ADDRESS 601 S. Figueroa St. #4650 become subject to the Workers'Compensation Laws / DISWASHER f CITY Los Angeles TEL NO Date Applicant CLOTHES WASHER �� NOTICE TO APPLICANT if, after:makin this Certificate of CONTRACTOR D s Progressive Plumbing _ Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such ADDRESS 4257 Auction Ave. #F provisions or,this permit shall be deemed revoked LAWN SPRINKLER SYSTEM CITY Baldwin Pails TEL NO LICENSED CONTRACTORS DECLARATION 962-2428 �- I hereby affirm that I am licensed under provisions of Chapter 9STATE LIC WATER HEATER d (commencing with Section 7000) of Division 3 of the Business and GAS SYSTEM OUTLETS LICENSE NO 478794 CLASS C-36 0 Professions Code, and my license is in full force and effect OUTLETS OVER DISTRICT NO PROCESSED BY 5 PER SYSTEM License Number 478794 Lic Class C-36 �v �C'� "�'`� FINAL T U ' DATE VALIDATION a Progressive 3/16/93Contractor g.Date ❑ I am exempt under SecY AL ACCT.a, Z qq�fo' c B&P C for this reason 31307 1V■ice: Date Plan check fee _ ® _ ITEMy Signature PLUMBING PERMIT ISSUING FEE$ TOTAL FEE TOTAL 3 JLG® 65 Plan check applicant C" C HE CK' 310.65 SINGLE FAMILY l:rlt GE ■� ) HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031 5, Business and Professions Address Code) ❑ City Tel No / '1310100-13001 3J/17/9-15 f 9-15 1,as owner of the property,will do the work and the structure 7Si is not intended or offered for sale (Section 7044, Business 1 and Professions Code) -- CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097, Civ C) i Lender's Name Lender's Address I certify that I have read this application and state that the above information is correct I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned ;pro�perlinspect purposes SEE REVERSE FOR EXPLANATORY LANGUAGE 3/16/93 Signature of ermlRee Date 4 ` ` ' WORKER'S COMPENSATION.DECLARATION 20-0026 DPW 9/89 76A667A APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self insure, �or a certificate of Worker's Compensation Insurance, or a certified ` copy thereof(Sec 3800 Lab C•) Policy No( Z`1 CompanySTP.-t 'L E-taran COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS DEPT. OF PUBLIC WORKS DIV. ❑ Certified copy is hereby furnishedBUILDING ' FOR APPLICANT TO FILL IN(PRINT OR TYPE)MV I ADDRESS OSo -LIv E jai Ceihfied copy is filed with the county building inspection department NUMBER FIXTURE OR ITEM @ FEE _ - - , LOCALITY -•r`_ Date Z 3 Applicant_rekTof`-- G0+1 i_T WATER CLOSET' NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' 'BATH TUB CROSS ST � I COMPENSATION INSURANCE' ASSESSOR (This section need not be completed if the work involved by the SHOWER MAP BOOK '$S$6 PAGE 12— PARCEL21 permit is for one hundred dollars($100)or less.) LAVATORY OWNER I certify that in the performance of the work for which this permit ` MAIL is issued, I shall not employ any person in any manner so as to SINK ADDRESS$$Q$ VAIC,Sl0N become subject to the Workers'Compensation`Laws DISWASHER CITY �oS�c �ap i TEL NO-8 ?50q 55 Date Applicant CLOTHES WASHER NOTICE TO APPLICANT If, after making this Certificate of - CONTRACTOR — xT C-0 Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such ADDRESS ��3 s. �i�+J GIUEI✓ provisions or„this permit shall be deemed revoked i LAWN-SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY f TEL NO g Jy(p�D >' I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER I IZ (commencing with Section 7000) of Division 3 of the Business and LICENSE NO a CLASS (STATEO Professions Code, and my license is in full force and effect GAS SYSTEM OUTLETS OUTLETS OVER DISTRICT NOAp PROCESSED BY 11:5 PER SYSTEM ��U /i J . O License Number S�d ` l7� Lic Class FINALV i' DATE VALIDATION' LV _ a ContractorTE'k-UbP-J CV^'1e'T Date -T 27 fn ❑ I am exempt under Sec ) BY FINAL i Z B&P C for this reason Plan check fee Date pop- PLUMBING PERMIT ISSUING-FEE$ Signature ❑ TOTAL FEE /a Plan check applicant r c SINGLE FAMILY -�•i a � HOME OWNER-BUILDER DECLARATION Name"[a -ror.4' c,otl& t n"` ''r / q I hereby affirm that'I am exempt from the Contractor's License Law j3�In 1= for the following reason (Section 7031-5, Business and Professions Address«03 S oN S, G ASa4S-L, ` Code) City S�r�+ G o.t3R t�'L- Tel No IS '1,,ve(cc)°,p r � �i i�_i= ❑ I, as owner of the property,will do the work and the structure TI)I Ai_ 41 _FE35 is not intended or offered for sale (Section 7044, Business r and Professions Code) K _ _'HEIC, 41.;7.5 CONSTRUCTION LENDING AGENCYC.L ih1 jE I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097, Civ C) f Lender's Name .j?3 All ' L Lender's Address I certify that I have read this application and state that the above - information is correct I agree to comply with all County ordmances and State laws re ula ng PI bang, and hereby authorize representatives i unty nter upon the above-mentioned proper i cti os 7 Z SEE REVERSE FOR EXPLANATORY LANGUAGE ig ture of Permittee ate 5