Loading...
HomeMy WebLinkAbout1217 PORTO GRANDE (9) WORKERS'CO.MPENSATION DECLARAiION � I hereby offirm �ha�I ho�r.n certiFicate o�consent to self APPLICATION FOR BUILDING PERMIT Insure,or a teriifica�e of 1Yorkers'Compr,nsotion Insu�ance, or a ceriified copy�hereof(Sec.3800,Lob.C.) . vOcyNo.121832-$ Com�o�y Plission Ins. COUNTY OF LOS ANGELES BUILDING AND SAFETY pv v FOR APPLICANT TO FILL IN nooacss Ccrlified co is hereb (urnishrd. �� �G1...CJ'�'• � Cenified copy is filed with the co�nty building inspec- OUitDiNG lion dr.parlmenl. ADCR[55 1217 Porto Grande Dr. iocnurr .�; �rt�v AEAREST oa,e 6/30/83 nPP�;�o�i C.�DeI1�se aTv Diamond Bar z�v cRoss sr. CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. n55ESSOR COAIPENSATION INSURANCE SiZE OF�pT NOw ov�Oi fnnv BOOK PnGE PARCEL (This secrion need nor be cempteied if thr.permit is for one u5E �.^aP ����,�� hundred dollars(5100)or less.� TRACT 42536 BIOCK LOT NO. ��� NO. TEL, $PECIAL I cerlify thol in the pnrformance of�he work for whith Ihis OY/Nf2 Presle Of 50. Cd�.1f.No. 540-05 �/�"�� CONDITiONS �u� �'r�'3 ti ermil is issued,1 sholl noi em lo an erson in an mannM DISTRICT GkOU7 TYVE FIRE PROCESSED BY � P P Y YP Y ADD2E55 P.O. I30X ZZOO CONSj,� 2�NE V so as to becomn s�bjr.tt lo thc Workers'Compensaiion laws. /0 �� � �� C ciTv [Jet rt I3each z�P 926G3 � Date' Applicant STATISTIG4LCLASS�FiGn110N A7T. CONDO. F- ARCHITCCT 04 TEL• O ,l V NOTICE TO APPLICANT: li, aRer makinp this Ccrtificate of ENGINEER F�nil Benes r,o838-6680 CIASS NO. 3 DWELL.UNITS�T � �+ Exempiion, you should becomo subject �o �hr LYorkeri a- Compensation provisions of ihe lebor Code,you mus�forth- p����cc 1q081 Yorb�i, $. 232� TUSt.1I1 ,,::•..4.•.•A" � s^ with comply wi�h such provisions or Ihis pr.rmit sholl be ? deemed revoked. TF�' gK, p�, VALI�ATION CONTRACTOR Sl7iK' r]S OWI'leI' NO. LICENSED CONTRAC10R5�ECLARATION liC. I here6y aifirm that I am licensed undcr provisions of Chapter 9 A�DRESS No. 289274 yp�UATION ;j 0„�]j",, (commencing with Sr.ction 7000)of Division 3 of the Business ond LIC. ��� �� ProFeseionz Code,and my licertse is in full{orce and effect. C�TY G�7� C�A55 �3-1 S+�.��-T"�" . H � . ��,- SO.ii. NO.OF NO OF CHECK � !�� litense N�mber 2892�4 Lit.Closs ��' SI2E , ST07'FS Z fAMIliES � ONE � .�5�7 � I •C 0 a C: //Mc. Nnv � s � O� co���oco�Presley of So CADO1e 6�30�83 OESCRIPTIO40FWORK IIld . i�r100 � , _ ,�^ AD9 � n i%Q.r V::�: �I am ezemp�undcr Sec. �ya��CUIL1tS 511-514 ALTER � FINAL / �']�� � —��: B.&P.C.for this reason REVAiR � �ATE o2 ��1' �� Dafe: F%STING 9LDG. DFNAI ❑ BY A!�� $ignalUre A7i'LIUNT TEL. OWNER-BUIIDER DECLARATION PRINT Charles DeRose no. 540-0500 � I hereby aifirm ihal 1 am eKemp�fram�hr.Contrattor's License qDD2E55 96�� US Dr. T7L-S rt Beach ► law for ihe following reoson(Sr.ciion 7031.5,Businese ond Pro�esslons Code�: F4t cn ❑ 9U::D:VG r'J(1(�?i1. I, as owner of the prope�ly, or my employees wiih ADCRE55 wagns os iheir sole compensaiion,will do th�work or.d � „ � � e � , Iha structure is no�inlended or ofiered for sale(Sr.ction ����TY �'' 7044,Business and Professions Cade). MOVING TEI. � I,as owner o{Ihr.property,am e.clusively conlracting COVTRAROF NO. � e�j�j,(�� wilh Ilcensed tontrociors lo construct�he projett(Sec- qDCRE55 ' • e!�� �ion 7044,B�siness and Professions Code). � �•���-= RECU!RED TOiAL SET6ACK FRO.h1 EXISi. ' CONSiRUCTION LENDING AGENCY 5[l ancK Yp'R� HNn p2CP.LINE WiDiti ► C l,� '',—F i I hereby aflirm 1ha1 Ihere is a conslruction lendint�agency for FROvf � ihe periormancr.of the work for which ihis permi�is issued P.l. �Sec.3097,Civ.C.). SIDE P.l. Lender i Name 11T1}CT1C7I'7l1 o /} P.C.Fee E .� G6 Permii Fee /7 , S� Lender's Address 1 cenify that I have rr,ad ihis opplica�ion and stote that the issuance Fee /'V. �d obove i ation' c rrect.�a�ree io comply wiih oll Couny t�ves��garo�Pee p Ordin ces nd te Iaws relafing to 6uilding construclion, Toial Fee J 7. �� ond re out rix representalives of Ihis County io enter �pon f a me iioned properly for inspettio=purpose SEE REVERSE FOR F7IPLANATOMY IANGUACE �gnar�re ol . A9e�� �oie � � �s . .� � . _- ` ,. ��. � -� c� � �' � � � . � tn +,� � p e s:_ � • O � O 1�C -.�j L- C P. p . ::- . ` T (!� p �n T� � h ti +u V 3 �� `) � �. f r- � j Q O c. L O , a G `-� " (1 �, t> :, ti C1 �,� n �; o o �- � ° 3 °, '. � o � ?' i :� ^'� +;1 `� r` *� c `;' � 1." L) � � y.'�. �: .. U �-7 .L. (N".'S .. "?. G ' 1 C I �C. C, �? (l � � l: � I n' % ,� N C' � � o 'j .ii � . � �•�,� T F>�J � c) �i. � �, ' �µ �� . S . - � � 1:' , N` �; `; �. C� �:. ,� I� 1 I, `- `, `� �,] r �s � � �• �1 i '1 I ���, ,�' ��C(�' f "" � �' I '- _ _ I� ' ` Cl, �`�` - �� 1'., ��t 1 �-- 'I .�- - ' _� r < � 1����4.f �. :.�� . --"--_'�_�\ 1`�. S` � �V "�` :': �, `�.1_ _ •. �` ` a ri � j! ,i+ �, � �J � .� - � ` I c ` n 1 ` ' •,• `� ����J 'i� �:..,��. � I . ��.�.�— -- "� �r :� C i� ^�ti (�,� �,` �C� ` - i\1 ,�. F ' \ �e ;� .� ^� � 1., y{_ ,�,_.._— ` :� �. �``-�. � �c � - -1w�-�,� . �� ` _l._ ---�- -- . �' -� � � � � `{ � ; " -- .:,— �--�-�'—-,.-i � j � o _��- -;��-:.�.--- � � � � � ,�,��` ;;� . ; ; ! 'I _ --j =�: ! ��� ' �� � �;� ' r I r'�.� ;, � � .� „ i � ' ," �� � � � N , r" �'".�y � r �� . �t ! . `� 'n i' � � � 4• I `� `i\`� �Y( ��1' �.: . ! � i . ..i � ' �, t=r � C —_� '.� \\ I 1 � ` ` w. I I � r. � . , I 1 �' --1 --'� �_. � i � I ' �' `.' y .' �. � !� � ` ! ... -'- ; � j ' �� .' ,l li i � i� � I� . l. ' ,_ ; ; I ..-, . , �..I � ' I; � '► � � � � I ��. y _ _ _�__..` '- �.s , , � • � I ` � � , ` 1 ' - - . , �I + ��, i i � � r . , . � . � � � � `. I � � � �� I�� � ��- � � � � _ _ ..1 ; � � ; 1 ; � , � � . ; . ; � � , . ��� �i � . I � � `� ; ; ; i� :l, I� , � ���, , I �. ,� _ � � ���' : ; ; � � �,. :, ; -; I ' � � � � �� � - . � � � � ::� � � �� � � , �� i : , _ ; � ; �� � . . ; I, . � : ; i ; 't,; �! 'I • ` � � � � . ' � ' ' �� � � � 1 � ``'',� � � � I ,I ; 1 � ! � ; ' - I .I ' i -� � �� . 1 ' j . ' I • ' � l � _, . � • ` I',I ! • ' � I 1 �: � 1 � I , � / .I _ ` • I ' ; 1 . I , 1 I ` . I � � '' . . _ ,� ,' ' . I } , I ,�� { . . I ; � , i I. , } ! . . � . � � � � 1 , i . �. ` �� , ', �i '` , .'� I i � i � � � �� 1 ' � ; � i � . � � , - � � � �i . . 1 , � i . � 1 � 1 � �:' ;1 y . I ,� . � � ` ,, . � ► � � � � � � ; � � i � + , ` � 1 � �, � � , � � � _ . _ R: .. . � _ � .. �.- � � � . . __ _ = �- . } _. � :,� . �� ,: � _ I I I , � . � _ ' _ �.(: ' _ , , „ ' •�Y N '� ^' ,'' � r" .�i � . . ' � �_- ' �. y f� C � � �.� - t" . �. l � , . 1 ' t ' � . . � � � c. ^ `".1 ' _ '.�.. _ . ', . 1 � �4 . i i . ` " „ _ ,. , � — , :' _ ...,• ,,, : • 'I' 1 !� ` '. 1 1 � � I� � r. ._ , "� , � e _ (- � - ' ^`':�•+ ';t ` - (e. '. •, { I . ` . 1 1 ' , ' � . , `, . ' . ,. �. _ _ c ;' ,^i ' _, ' 3 v � 'Y ,` ...i'�; I , � ' � � ' .1 , •I . . � -_"' _ t. � y - t' � _ c � � ` { � i : i ; � `� . ; � _ �' ' _ • ;,, , � �; i! � �� , . � i = � ' 1 , `= ' � - - :: :. � �� _ �_�- ��� .= _ ` � I II �' : � 1 �.� .t^ _ �� . . r, n�.(: F _}' ^ _ 'ti ^`T ..: •� . i . � ` � � I '1�' ., . _ r� :. _ ._ , � _ c, ' _ _ �.`• - a ;,: i• � i , � . � ' ! ' ,I ; '� . � . r�� �� ,,4_ ' : `, - ' _' :.._ �, a �. - = r �.. � ; . � � �': 4 i I :. - ; - ._ -� _ ° ;r;� �;,.;^ z _ -..�i;��; � ; o �. � , ,� � _ 1 . � � ...� .. _ � - ~ � ' �- � `` _ L='e-" ` �. ' �'n•f �R � i . .. ' . t - "- ^ :- �= `; °- :s `� '�^: �-�^y� ' c ',�i ` . � ' � � � �•, �� I . I� y 'i.` Y ` ^, C R Z" ...1�- y �w~ v � • .. � � _ � ` ��. f . � ' _`�.~�!••', Q N ^� r..` r � .� � �� � ' � �Y :`�a F -i''e v,•7 w `'•:'n � �. O`? c� . e. •.-r � �'� =c �-�.^ : e,r� �.. •:.N � w �� , ' -� . . � .�' � y.^ i�"f. :�; .J .^' .,,.�.F (+•1 I^i 7' � O� �� O ,n�• w� � .^. �'^/,• � ' Cl- -•`:r^i � r� 4 � � �� - '� � , U(1 f :`_., �"'3 � s •`.:�� , . , v �'r ^`^� , ^ � '•``,N_ p µ � . 1`r. m . . I . o : ` v ,c`� m c `� 1 ,,' . N N� �=�\" • . �