Loading...
HomeMy WebLinkAbout1554A 1555A , . . . . _. _ ._ _ . . -. . _.. - - -. .... ..._ _ ._=- _ ._ .._ .. .__ _ __ . ._ ' WORKERS"COMPENSATION DECLARATION � ' ' ""�. - ... ' I hereby afiirm thar��o�e a certificate of tonsenf l0 5e�� -�- - �.�-��� �- APPLICATION FOR�BUILDING PERMIT � � �-�'� insure,or a cerlificale of Workeri Compensafion Insuronca, , or n certified copy Ihereoi(Sec.3800,'lab.C.) ' ' ' -- �� �� - � � . , WCP6255241 Great American Plan 3SR COUNTY OF l05 ANGELES � BUILOING AND SAFETY ,.... Poiicy No. Compony � Cenified copy is hereby furnished. FOR APPLICANT TO FILL IN BUIl91NG �'D�-o3 �': �� /J�/ � ADDRES$ f�U K-c.(t{-/L_ � Certified topy i9 filed with the coonry building inspec- - � BUILDWG � � � fiondeparimenl.�� � � � ADDRE55 Date S?—ZZ—Sb APPlicant � Tk10�Wfil..Lyon Co. nrr Walnut ziP 91789 i�,iin - ' � � CERTIFICATE OF EXEMPTION FROM WORKERS' -� ' - - NO.OF BLDGS. - -', NFAREST -. ' SIZE OF LOT O � NOW ON LOT '� CROSS ST. ��•, '. ._.: — �..��.. ....�� � .. ...COMPENSATION INSURANCE ' .�. .. ... _ . _. . _: ASSESSOR . . ,, .—. '.. (This settion need not be-completed if the permit is for one - TRACT etOCK LOT NO. µqp gppK � pqGE�' PARCEL ' hundred doflars(E100)or less.) , .., �� - TEL. USE ZONE h1AP I certify thot in the performonce of,the work/or which this OwtdeR-TEIE--WILLIAM LYON�CO. No.833 3600�� r„o. �: /Q�-,3 • � � 'a permii is iesued,I sholl nol employ any person in any manner � �� - -- SPECIAL�- - - --- - --- - � so as m 6ecome subjeU fa Ihe Worker5'Compensotion Laws. - /DDRESS -' " CONDITIONS ;V � urr Newport Beach�. QA _nv _ - 92660 , - ; .. _ - � Oate'. . . . APPlimnt :. ..� ..� �_�� ARCMiTECTOR 7EL. ...G 2�ICE TO APPLICANT: If, afler making th s Certificole of . ENGWEER Hales—I.8❑ SCOri No. 547-0862 OISTRICT. .G UP_ TYPE ..._ .. . FIRE",� PR $SEDBY. f �ption, you should become subjec� ro the Workers' - C��T �,h� �� � �a `_.�pensation provisions of the lobor Code,you must forlh- ADDRE55 ' �. - ��. . -.-�--- / - � ith comply wilh such provisions or ihis permit shafl be -- iEL S7ATISi1�AL C1A551FICATION APT. C DO.-� deemed revolced. �' ' ,�-�.� � � � � - CONTRACTOR Same As OWiIEL NO. . . . - LICENSED CONTRACTORS�ECLARATION � -- - - �� -�- -� �- -�-- —----uC.� - � - - MS$�NO. Q�� DwELL.Unu75�� � 1 hereby aHirm thal I am licensed under provisions of Chapter 9 AooRE55 NO. � (commencing wilh Sectfon 7000)af Divisivn 3 0!the Business and .. ���, -. ��R�''�'P � �� � Professions Code,ond my license is in ful�forte ond effecl. a7Y CtA55 - -'--BK � � --� - - " ""-VALIOATION -" � - ' Sq.FT. NO.OF NO.OF CHECK ' ' .� . UcenseNumber Z�ba�l� � ��'LiG.Class B_1 SR � STORIES FAMILIES ONE ,' � . , . ; � ��� � VALUATIOfN Contractorhe Wfil. Lyon (�.0.� pa�e1L—ZZ—Sb �- - OESCRIPTIONOFVJORK ' ' —""""' ADD � s �y DOO 't''155liF � V ,�I om exempf under Se[. - AITER � � . �• • • •'Z�� . ' B.BP.C.for fhi5 rea5on .. . REPAIR s - �- - "-- � -'����- � .2/6 6 8 - USE OF � . . " � � " "--� Da1e: � DEMOt � ' ExI57ING eLDG. - - . --' " Signature . . .. _ .. � ...- APVLICANt TEL FINAL , •L 1 Q b Ft��.. . � OWNER-BUILDER DECIARATION .... .. PRiNT • • NO... . . _.DATE. .:"—' .�. _..._ .. .I 2 J� —�G'-.� -I hareby ai(irm that 1 am exempf from the Contracror's License qookeSS FINA � � � -' � � Law for the following��eason(Section 7031.5,Business and . � -�-j 5$.5 A. �� �Professions�Code: '�-'-� � ' -- - - RE N �BY � ._'_ � . . .� . � .... ..... .... BWLDING � �, �� I, os owner of the property, or my employees with q�DRE55 ,. . , . - . '_�.T_�_� � .' ��-. . w6ges as their sble compensotion,will do the work dnd � ' �he strotture is no�iNended or offered for sole(Section ��iO�Y � I •Ll 7 5.Jr 0 704E,Business and Proiessions Code). .. . - �- MOVING-' . . . .. . . .. TEL - —.. .__ .. ._.__ . ...'_ _ _ __. . _ . � I,as awner af the properfy,am exclusively tontra[ting CONTRACfOR NO. ' , '' ! ' �' ' ' , • 5��_ - wilh licensed coNractors to constroct�he project(Seo- . . _ _... _.... . -_. ._ .__ . _ � _. ..i ' . _ __ __ _ _ . 1iOn 7044,Builneis and Professions Code). P.DDRE55 . � � „, :' I 2.J� 8 G:. . . ; .. �r REIXIIRED TOIAL SEiBACK . . . . .. . . ._._. __ ;..� . ._ ... . . �-' -�" ' �- CONSTRUCTION LENDING�AGENCY-- -- - � � Ser encK- YAR� HK'Y PROP.LINE wiorH - . I hereby affirm Ihat ihere is a tonstruction lending ogency for FRONT ' � ��'�� " ��� ` ' --�he perfo�mance ofihe work(or-which ihis permit is issued � � -P.�. � ' � � � -�� � ' - ;-" �." ,. (Sec.3097,Civ.C.). SIDE . j�r ���. .. . • . i � m —"' .. _.. _.__. .. _.' "' _"... _. .._ _ P.L. ' _. . . ... _. _ _ _ . . .. _._ � Lender'sName ('nnYinnntal Tllinnic Rank �j ' . � $-- . _ /�.� _L/ �/� LDh1N Ref.N ___ ' ' '. .. .. . . ._ . ... . . .._ P.C.iea S Permil Fee l C./ _ ... _ . __ ' - Lende�sAddress231 Sa Ia Sa11e St , Chicago � 'k _.I cenify fhat I have read this applicotion and sfate that the ��- - - i,sua�cs Fee ��•� LDhM P/G A ����� '-- -�- - _ � a va information is corr o o comply wi�h all County inve:tiga�ion Fee I/�y��D _�a , g ar " s an ws relming building mnstruuion, ___ _ -- io�al Pee�-7' / � LDMA Perm.-M �� �'� - -"' --- - . u n here6 tho' presanrati a(this County to enler � upo the o ��n ti ed prop � for(nspec7ion purposes. 5•00 . f�SOD � �-�- _ _ _ . . __ ... _ .._ _ _ . . a ���y� SEE REVFRSE FOR EXPIANATORY LANGUAGE � — n ' � � ---'"' ignat�rc o Applic nr or geni. ... - - --�Dare . . . .. " " ' - . . .. . ' . . ..---' / . . .O� r PLANS TO APPIICAN7 INSPECTOR'S NOTES OINNLR-BUILDER DECLARATION � � I hereby affirm�hat I om ezempt from ihe Conlroctor's � To: ' � R�turn�d'.. : � ' � - � , ', r. ,' ' .. � 'License law far_the��:followin9 redson"'(Sec. 7031.5) . -� ' ' � ��� ' � Approvad ' �Busrness and Professions Code:Any city orrounry u•bicG No. Oate �� No: -� ' Dato- � � . - � • -� �- � � � � � .reguires npem�it lu tonxtract,alter,imprave,demofisl, _ _.orrepairanyieruciure,J�riorinitsusuance,alsoreguires �, � . , �� , - � '-. � � ;,, �, � tGe applicartt fnr sucl permit to file a aigned statement , t�at Le is[icensed pursuant ta 1Lc pma�isions of fLe Co+i- � , __'., , ' ,,.'.I::.'. .,. ,. . ,. � Jrartnr'sLicenseLau�(Clafter9f(rornmencittgwitl5ec-� , , �"" -� � ""��' ' "'"��"" ��' '����"�' ' tinn 7000J nf Dirrsion 3 nf tGe➢usiness and Profestions •__ _' _'._____.__ '. _ '_ ''. :�.".i�_j�. \'"_. .... . .,� �. ._.._._' �' _. . .. _ � ' _ _ ___ -'���������� �`• CoJcJortbutLeisexemptlGereJromandtbebasrsJnrlLr � afle,reJ exemJ+lion.Any niokfian of Sertion 7031.5 by �. '� ` _;'_ _ Rrquired � ' ����..DateRecoivad-: - - � -=-�....-....� ; -�-- .,.. - -- � ` - � . -. an.Yanfli�antforaprrmiteubjectslleapplicanttoacrui! , � APProvdls :-Yos No or Approwd � � , .. . , . , ��� . -fenalty of not nmre tban five bundrrJ do!lars(d500J.1: - . .. .�� ._ _ ._ ..... , - .,_ i. '�::- . ❑ 1,os owner of�he properry,or my employees wiih . Water Certiiimte ��`_ ��- � � ' � � � �-�� •� • •����� �" -�� •� �� � � „!Na9es os their sole compensation,will do the work,and � . : .. . .. . - -- �---- . ._ _ . .--- - --.. .__. . . --- --�-�-� - ��- -- - --- �--��- "._the�structure is not iroended or offered for sole(Set.7044) HeahhDepprlmenl_ . . .__-. _.__:� ._._��. __ . _.. � -- � � -� - - - �-��- ��-- - -- �� ��-���� ��- � _IlusinestandPrfessionsCoJe:TbeContractor'sLrcrnse " . , . I,aw Jors rsol a/>p!y to an oumrr o/proprrty u�bo buikls ..� _-. .. . �-... � �� ��� � ���� � � � � � or inr rores lbrrcon,and ud�o dnes sucb work Gimse!or Fire Deparlment_'__. _ .. __ . _ . .._. . _ ._ . - . - - . .. "- _ /'- . . _. � . , ' � . �,I�, �� - - ,- tGmegb-Gu pa�n employees, /rroeided tbat ssscb�m- , Grading � " . ' ,.prnvemenfs are not.intended or of�ereQ for sa( � � . ��.;1 _ � bou•crer,fl�e burfding or im(�rovemenJ ia sold u�itbin. .: . . Geolog�cal�-1- � .. � . �.. .. . .'� year nf tompletion, tbe�owner-buildcr wi!!bace�tGc � � � � . burden aJproning t5a!bc did nnt build or inrprovc fnr � i .� . � - . ._. ....__' _._'' ..'.. .._ � __ Pedestrian Protection � " - � � - 1!e purpose nf salef.�.�. . , . . . (Fence)(CanoPY) �.�.�. I� ..� . . . '.-'.�� .-. . - -- - - - -- -- -- .... .. .. ... ���'�❑ I,asownerof the proper�y,'am�ecdusively controc= ling with licensed tonlractors b consfrutl the project(Sec. � ' ` " �� -�-��--� ���� - -----�-- - � � �-- - - �-� � 7044)Dasiness¢nd Professions�Code:TGe Contrattnr's Special InspeUion�'" -- �-��- � �� � (Conc.)(MasonrY)(Welding) , �� .� . .-.- � - .:.. ;_ ;_.._-:-'_ �'.�-'-:'_ . .', "�, -i C I . l.irenie Lau�Joes no�a/,/�Jy fo an onvlcrof j�roferty u�hn .. , ' � . �"�builds-or rm/+rtie�es�lLerenn,-und u�l o cantraclt fnr sucb LotDrainage�. ' !�'�•,� '•��'`.+`.... . � , _.____ _._.._ _ projects��uv1G a tontraator(sJ'lir¢nreJ/�ursuant fo!be t�A . . `. � :. •.:�. , .. . , .. . . .... . _ .. _. . -- - Con[ractnr's Licensc L.auJ.-_.__ .._ ._. _ •'- V __. .P... _ � � � . � Porking- ,. �. , , . . - _ ' .. i._..,-"-� -- �---__. .-_-.._ .. _ ..� . " .._ . , , ❑ 1 am exem 1 under Sec. 8.8P.C.for this , � , . , . _._.__ .__. .._. ._.. __ . . . ._. reason . � : . � . � . . . __...._. . .. --- .__ _. � � - �ate Owner.�.. . i ' ' � ..._ .___. _ _ . _. _ � .-. � . , . . � . . . o,. . .. .. 1.'.._. ... .._ .:..1...C....... .. .1 _. � �- .:.� , Approvols Date � Insputlor'a Signoture� � _ . . . . . � . INSPECTOR'S NOTES ��. Lo[at�on- � � ISetbock 8 Yards) � � ��� -- � - -� - � - . .^' 1 � ., � Foundations. . . ; � �� � � . ' _ __'_ ... .__... ... . _ .. ...___ .. ... . . . . , . SIa6 - - ,. ��'� �1� , ,.. . � ,. � ... .. �.. Frame " � �. �.�� v�� — .... . . . . , � � ..- . . � : � , . .. Energy Insufation � 3'�� f.:...__. ,._ _ ... I._. ._.'...._...' . .-'c'._�_. .� . . . ,� .� , . lmh/Drywall- � -- ��-- --- ... . _ ..._. _ .. � .. . IMerior � vU� � � ..__. . __ . . . . i Lalh-Exterior � . � . - � ` - . . � � . � ... � . �- . . '\�'.,•� ,�. . - . _.. .. �_f.C_.�_,. _il _:..� ...__. ..__ ' i(�.. ���� House Number- • __: _ . _ _ _ ._._ . .- . . . _. � - ,. . . . :. ' - '� . . . Correct&Posted - .\J � . . . � . , .. . . . . , . . Final- _. ' . _ _ _ . �� _ . . . ... _ ." '_'_... _.......__. , . .. � . Enler on Froni - • •�%. . � .. . . � . - .. ' ' .. i . . . . - - .� , ... , C'--.2" � • . � . .- ,,. : � . � ... . . � _' - . _•� � . _ . . f i.