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Home My WebLink About1155 SOUTH DIAMOND BAR BLVD (154) or d certif ed 3oER5herOeMf ESec 3800 D'a6LACATION . ..._. . _ .. . _. . .. �. . . ...� . .. . ..... . . - . ._.._. . . .. .: . I hereb affirmP�at I hav(a cerhfiwte of;onsent,fo self . �p�`�e��A�1`I�N �O�R��_:,B�IJILDI�NG� PERMIT � , msur.,or o c tifi<ote of Workers'Com ensation Insurpnce, � . . .. . .. . _....,�. . .. •^ ,�7� � COUNTY OF LOS ANGELES BUILDING AND SAFETY P�oI1cyNQ�Z�Compony_Sf/V-�.��/'!Bd/� - . ....... . .. _.,. ._. ._ Ce�tifi d copy is hereby furnished. FOR APPLICANT TO FlLL IN ' Bu��D�Nc� ADDRESS !� � � Certified copy is filed with-the county building inspec- � BUiLDING ,r �, � � tiort department. ADDRESS Date ' Applicant � .� CITY P IOCALITV CERTIFICATE O�EXEMPTION FROM WORKERS' �NO.OF BLDGS. NEARESi - COMPENSATION INSURANCE � SIZE OF LOT NOW ON LOT CRO55 57. Q� (This sectian need not be completed if the permit is for one ASSESSOR � b�ndred dollars($100)or I,ess.) TRACT BLOIX LOT NO._ MAP 600K 'PAGE PARCEL .Y P , . � .i. / USE ZONE '�P I �'"�"� } 1 cerlit thot in ihe erformon<e of ihe work for whicf�this OWNEa O. NO. � permit is issued,1 shdll not employ any person in any manner qDORESS ��r� �ECIAL' 1L so as to become subjeU to the Workers'Compensafion Laws. CONDITIONS o .. � Date Applicant . . .. _. CiiV ZIP � NOTICE TO APPLICANT: If, after making this-Certifimte of ARCHITECT OR TEL� DISTRICT GROUP TYPE FIRE PROCESSED BY � Exemp}ian, you should become subjecf to the Workers' ENGINEER NO. CONST. � � Compenwtion provisions of the Labor Code,yau must forth- , f � with [omply p P ADDRE55 ' with such rovisions or this ermit shall be �• - - -�.--� �-��- ( TE� - �� - vai deemed revoked. CONTRACTOR L�'�NO. $TATISTICAL ClASSI ATION APT. CONDO. � LICENSED CONTRACTORS DECLAR.4TION �� CLA55 NO.�DWELL UNITS I hereby atfirm that I om licensed under provisions of Chapter�9 ADDRESS NO. �y,�R MAP (commencing with Section 7000)of Division 3 of the Business and . �� , Professions Code,and my li<ense is in full force and effect. CITY � f� ClASS �i" , BK � VALIDATION ' ' Sq.FT, NO.OF NO.OF CHECN �+'� SIZE STORIES FAMILIES ONE license Numbe � . Lic.Clqss� VALUATION �,p }��4 F ' ��Date_L,� �� ESCRIPTION OF WORK NE�N ❑ S ,� 6btZ � �''` 0 � �2`�' Confracror O �, �'� �. A�D �I am exempt under Se ptTER ❑ i � r 2 7,6 3 B.BP.C.for this rea � r' � USE OF / REPAIR ❑ s �7.6 3� m s e" � EXISTING BLDG. EMOL ❑ ' Q � ��b �Signature APPLICANT� FINAL OWNE - CL TION PRINT) NO. DATE I hereby affirm ihat I am xempt fro ihe Contracror's License �^ Low for the followin eoson(Sec�ion 7031.5,Business and ADDRESS J fINAL Professions Code): RE Enl BY � I, os owner of ihe ert or BUILOING prop y, my employees with ADDRE55 .. ..... . .. ........'_____.._... .. ._... wages as their sole compensation,will do rhe work and �OG4uiv � the structure is not intended or offered for sale(Section 7044,Business and Professions Code).' MOVING 7EL ` �� {�1 7,1 A � IW os owner of ihe CONTRACTOR NO. � properiy,am exclusively contracting l� �th licensed contratlors ro construct the project(Sec- 1`) q e tion 7044,Business and Professions Code�. ADDRE55 r� � h a ° °� RE�UIRED iOTA�SETBACK FR I T. ��G CONSTRUCTION LENDING AGENCV - �7 gq�K VARD HWY pROP.LINE WIDTH ' �I � '��"4� I here6y affirm ihat ihere is o constructio��ending agency for PRONT � ihe performance of the work for which this permit is issued P.L. e a a(;,h��O� �Sec.3097,Civ.C.� SIDE Lender's Name �f"e—' P` �y �t--� f C%��b P.G Fee$ �\�� Permit Fee �L-� V �DMA Ref.k _ - Lender's Address r ' � I certify thot I have read this appiicotio and state that rhe Issoance Fee J 4-�� DMA PiC# ¢ above informption is correct.I aqree to c' p�y with all County Invesrigorio�Fee � ordinances a tate laws relal' g to uilding construcfion, To+al Fee �'�� L�MA Perm.# and here6y ut orize represe ives f this Coumy to eMer " .._.. ....�..-.... ...,_...,_... ._ . g upon the a ove mentioned pr rty f inspe<iion pur oses. �� - " - �' � -� ' ' -�� - � . - � f Q SEE REVERSE FOR EXPLANATORY LANGIIAGE ^ Sign r� nt o A en� � . . ' �� I ' ON'YER-BUILll13R DECLARATION PLANS TO APPLICANT INSPECTOR'S NOTES 1 hereby offirm that I om exempt from the Contranor's To: Retarned Ucense Law for 1he following reason. (Sec. 7031.5) Approved 8usinrss and Professioar Code:tIny city tii coienty ic•bicb No. Date No. Date regmims a permit to constriaot,alter,improve;�derxolish, . � . 'ns,reparr any structure,prmr en rts essuance,afsn regua . � - tfie applicant fnr sucb per»ait tn jile a sr,qned stutement . tbat fie is lfcexsed pursazust to tbe pm:�isions qj tfie Can- , _ � trac6nr's License l,uu�(Cbapter 91(cnmmencemg with Se<�- tinn 7000/o/Uirision 3 of the Buriness und Prrfessinns �, . Cod�J nr t8ut be is rxempt tl�ervfrom und tl�e bu.au for the nlTeged e.zemption.A�1'violution nJ Se�tion 7031.5 by Required Dafe Received - . . uny applicunt/or a pernslt suhjects the apf ltcant tn a cir�i[ Approvals or Approved � penulty f�ot more tlan jtve hr.,,dred doUa>.5�(SSOOJ.I� Ves No - � �I. I,os owner of fhe properfy,or my employees wilh Woter Cerhificate � , wages as thelr sole<ompensotion,will do the work and � the structore is not intended or offered for sale(Sec.7044) Healrh Department " � IJrasine.�s und Prujessions Cnde:7'he Contractr r's`I.rcexse !au�does xot¢ppfy tn an nwmvr of prnperty u�ho builds Fire Department . . .. - nr imyrnves ahereon.�nJ uiho does svcb mnrk bin:seljnr tfirougG bis own empinyeas, pmvided tbat such rm- Groding � pmvements are nnd ixtended nr r�/fered jor sule. If. hore•ever,tbc building or improvement is.rod�d u�itbin nne Geological . ' year of rompletron, tbe nwner-huilder wrld hare tbe � . . , � burden o/pmr•ing tbut he did not build or rmprore for Pedesvian Prmeuion � tbv pnrpose nf salej. - . (Fence)(CanopyJ � � - � � � � � • - ' - C' �,as ownerof Ihe property,�am ezduslvely comroc- '�'"ting with licensed contro<tors to<onstruct�he projec�(Sec. Spe<iol Inspection 7044)Business and Prafessions Code: Tbe Coxtrartor's (Conc.)(Masonry)(Welding) License Law does nnt apyly to an owner ofQroperty wbo � �� builds or imQroves 6herenx,and who�contracts for such Lo�Drainage �projects u:iEh a cantrac[or(sJ licensed�ursuant ro the Contractor's License I,aw/. Parking � I om exempr under Sec. .B.&P.C.foi iFis .� _..__---..... ._ . . . :. . ..�. .,.. . . . reasan — Date Owner Approvals Dafe Inspecfor's Signature INSPECTOR'S NOTES Location--� (Setback&Yords) Poundations . , Slab Frame Energy Insulation . Larh/Drywoll-- - � IMerior Lath--Ezterior House Number-- � Correct 8 Posfed final— Enfer on Front