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HomeMy WebLinkAbout1556A 1557A , . , .. . . . _ . _.._ . _ _ .. _ _ __ _ .. . _ _ ... _._ . � WORKERS'COMPENSATION DECLARATION , � --- � ' �"�7 �` , �. - � � ���-� ��� �' , .. . . .. . _....- ; , ,� :- : .� �. ,;.. 1 hereby affirm Ihat I have a cenificme of.�o�=e�„o Se�t � qpp��CAT10N �FOR �BUIL�DtNG PERMIT ����,- insure,o�o cenificate oi Workers'Compensotion Insuronce, ; or a certified copy��thereof(Sec.3B00.'Lab.C.) � ' . .. . .. . . . . .. . .. . ... . . ..... ... . ' WCP6255241 �` Great•Amer3can Plan 2CR COUNTY OF LOS ANGELES BUILDING ANO SAFETY Polity No.:. . Compony -. - � Cerrified copy is here6y furncshed. .- FOR APPLICANT TO flll IN nooeesi �D�O � . (� Cedified tapy�is filed�with�the tounfy building�inspet• - - BURDING �� _ � L� 'tion deparlmenL � � �� � � ADDRESS QD Q pa�e. 12-22-86 APP�;�a„�.,..The.Wm. Lyon Co. arv Walnut ziP 91789 ��,iiTv ; ' �CERTIFICATE OF EXEMPTION fROM WORKERS'� �� "- �" �" "� �' � NO.OF BLDGS. - - �- Nfp.REST �.-'7 ._ .__ __ �_ ..._.. �� -��COM7EN5.4ilON 1NSURANCE' �� -` � S¢E OF LOi 3�HOO SF MliI.NOW ON LOT O � CRO55 5T. f , :� �,. . , ..` ' .. (This section naed nof be completed ii Ihe permif is forone .- .. .. _ . .. . . --. . . .. _... quESSOR. . - ... ..;�. h�nd ad doll s(E700)a les ) . .. TRA�T flIOCK LOT NO. � Mqp 6ppK' ' . � VAGE VARCEL owNeu THE WILLIAM LYON C0. No,833-3600 us�zoNe No D 3 r I cert fy Ihat in Ihe perfo ma c f tfie work for which Ihia ` � ' � permu I Is u d,I shall t mpl y any person in any manner �� � �-- SGEQAL- --- -- - - - -� d so as to become suki�ect�o iha Workers'Compensation laws. ' ADORESS S9 Cor orate-Plaza� � � mn�moHs � • . . u , ., .,. , . Newport Beach, CA zia 92660 — -.: _._. ___ -m CItY Dafe•. , � ' ' -''��APPIi[ont. �. ' � . , . . ARCHITECf OR . . . TE4 OISiRICI. GROUP. TYPE. ., 'FIRE_ PR SSED BY _ :O j�ICE TO`APPLICANT: If, afte-making this Ceruf�caie of Hales-Lan ston 547-086 conisT. � zo ��� { ption,'�you-should become-subject ro ffie Workers' - fNGwEER f�' NO. � - . �,.�ipansotion provisions o/the Labof COde,you mu5f IOIIh- qDDRE55 7�7 5. Main St. Ste. 105 Oran �-� �✓� - W � ith-camply�wiih such pravisions ar�this permi�sholl be � - � deemed revoked. - , S8m2 AS Owner TEL STATISTICAL CLASSIFlCATION , APi. CO . � � UCENSED CON C�NTRACTOR NO. �7� � �) � . TRACTORSDECIARATION� � . . _ -_.. - . . ._ _. . - LIC.. .. .- . _� �CLASSNO.. . . _ _.__. _ �_L_fL_OWELL LINITSLL � I hereby offirm Ihat I pm licensed under provisions of Choprer 9 ADDRESS NO. ��R�P (commencing wirh Secfio�7000)of Division 3 of the Business and . . . _ . .. ._. . . � - UG - � � � � Professions tode,and my I�cense is in full for�e ond effen. CiTv Ctass � eK: � � -� � -VALIDA710N -- . �, - ' - 50.FT. NO.OF NO.OF CHEIX . � � � � - ' '� �� 512E STORIES � � FAMIL�ES� ONE �� � License Number Lia Class . � � ' ' ; � . - .,VALUATION, ' � The Wm76Loon Co 12B22-86 oescaicnoNofwoaK NEw " '' Contracior ' y �Dale .... .� '-.. � .. ADD � s �� �Q� ... . . . .. ' ' "' �'_ . ' _' ❑IamexemprunderSec. Sin le famil home-constructio AiTER � , . ,. ., 8.8P.C.for this reoson . . . .... REGAIR S.. . .-�. .�.. . . .- -. - .�1 5ra b A- - �� � . _. . . ._.-_.__ ____Dote:..._�.._ . . USE Of DEMOi ##• .• •-2� � EX1511NG BLDG. � - - -� � '���� -�� APPUCANT TEL. � ._..Signofnre � .....-_.. .__--_ .._'__. _' FINAL � . OWNER-BWLDER DECLARATION _ yRwT _ W'1 .NO. . . .. . ..OATE� , - . -..- . . .. . --'��'�.'Z Q.�],2''� �I hereby offirm that 1 am exempt from the Confranori license _ . � � Law for the fallowing reason�(Section 7031.5.Business ond ADDRE55 FINA '. ��- ' _ ' , -,. . ,. . ,. -------- • •247,23� ..1�P�rofessions Code):..`...._. .. ... . . . N By. �.. . . - .� r �_1, as ownei of iha properly,or my employees witb nD�DRE55 _ . . _ .. . .. .. . , � (2�3�'-8 6_ . t �wages ds Iheir solo compensation,will do ihe work 6nd - ''. � � p � tha structore is not iNended or o4fered for sala(Section ��`��T� , � � �-�J�5.7 fl�� . ..""- 7044,Busine5s-ond Proiessions Code). .. -. . . � � MOVING .. . - � ' .-_.-.._` TE[. - -.. . . . . . . . �.. • -... .. . . -� 1,as owner of Ihe properly,am eaclusively coMrocting CONTRACfOR NO. ' ''� � � .-�- - �t• • • • •� . with licansed�mnhactors to conatruct the project(Seo- .. �.. . .. .- .. . ... . _. ..__ ._. ._._. .. _. . . . ._ . . . . ' , _ �. tion 7044,6usiness and Pro/essions Code�. ADDRE55 ' � _ �,.�(-!,; � •�1 L�i�Q , ...-'_... ._ ......_ .REQUIRED _ 101At SETBACK . .. ._ . . . ._ ._ �. �_ � �"CONSTRUCTION LENDING-AGENCY - �--- SET BACK 'YARD HWY' PROP.LME Wi07H �. �� •��•4 2 G O O� I here6y offirm Ihoi ihere is a conslruUion lending agency for FRON7 "- �.� •"� � � �� � � Ihe�performan<e of the work for which thu permif�is issued . ... v.L . - . - ... . - . . . .-.- - .. .- .- . .-�:�',. .�2.�J.1."8 6 ... (Sec.3097,Civ.C.). 51oE ' �\•��.��_•j;" � ._.. .._ . . . _ ..... . ._..._. . . F.L. _ . . , . � ..._ . _ __. . .. .. ' lende'sNome Continental.�Tllinois Bank ' . . �� . mnu aet.a - o.�.F�e t a Pe,m,�Fas rs - Lender'sAddress �'i7 Sn l.a Aa11n-.�',r_� Chica�o /' ` ' , � � _Lcertify.lhal 1 have read tbis opplimtion and aiote ihot the ._... Imuonce Fee -�V•.J tDMA P/C k ����- - - � - � . . __. . obo ' ion is co . ee�o comply with all Couniy i�.esr9a�co�Fee � r inancas and aws relati to building consfruction, _ ., . _ ._ . � �-- Taol Fee-� r LDMA Perm.�M ��- - � - � �- � . _... . ..__ .. o her. auth "e represen s of this Coumy�o enrer '� � up n t e o o - ioned pr per for inzpection purposes. ..�. �r��� . ...7t.?5�O . .. . � ._._ i . _.__ _ . .. . .. ... . . .. ...._ . _ . .. . / W . . _.. .. . _ . . ...... .__ _ _... L^L�� SEE REVERSE FOR E](PIANAtORY IANGUAGF �: . ��. '�'-- -$ignmure of A �cant or Agenl �' - "-� " � ' pote .. .,.. ... '"- '--"- " .- . � . . " � - -'-- . ---"� . OIVNER•F3UlLDER DECLARATION PLANS TO APPUCANT � INSPEttOR'S NOTES I here6y affirm�ihat 1 am eaempt from the Controcror's . Te: � ��. RNurn�d ' � " ' . � ' . � �', Ucense�law for �he}ollowing reason: (Sec. 7031.5j � . � � � - ' � � �Appravad � l3u:iness and ProJcssions Code:Any city or county whicb . No. Date �� No: � OaN�-• -� -� • � �- �� � .� ,I' �, .eqairesp herrait to ronstrurt,aker,�imProve,�demoluh, �. ,. . , . .. . . •...�. ... . or rc(�ai>anystructurq J�rior to it:i.ssuance,ulso requires �, ' � ... . .. . . ., tl e applirane Jor sucb per.nit ro fife.a signed statemcnt tLat Ge is Jrcensed pursuant to 1l�eprovisrorts f eGe Con- ' � . � . , . tractor's Lrcense l..aw(Cbapter 9/(comn�rnci�g a•itG Ser- , . � ,�.�i ,. . . . .. . "-� ���- ---� . i, , fmn 7000J nJUieifion 3 J�Ge IIusiness anJ Yrnfessions , ^ , � ,:- �. •, � ;� - ' .._` . ..__ ..... .. .. __�__ __ .:.' •... CnJefor'elatG'cise.remptfGere/rumandifi¢bdsisfnrtbe � . ._ .. , � �,' _ ,_Roqutrod�_.� . .Dal�Rac�iwd - -. .- --... ... ..�'. . ._�__ ' _ . ._. ' avyaphlcaneJnrapernYitsubjecesf!>eappliro t�tna.ai�if j � �Approvals �.Yas �No orApptowd .- . .,�. � , , . �penalryo/notmnrelLanJive/undreQJolfu.s(SSOOJ.): _.11. ... ._ ._ .. . -\;: . _:_ . . , ❑ I,as owner of the propeny,or my employees wilh ' � "��- ' �' - �� �� �� �� wages as�heir sole compenso�ion,will do the work,and .� Warer Gertificate �'-' ,�. - ��. � ... .. . ..� '.. _ _ ._. . '.:_ . .___� , . . , . . ,. ., . ��-- --� - � - � '_ �� ���- � , th�e strutture is not intended or�otfered ior sale(Sec;7044) Health Deponmenl._ ._ ��� _ � . � . . . Business end Professions Codc:TUe Contrattor's Lice�� .. ;� � . ._ . ._._. . _ .... :' �. _._ . nse . . _ _ _ . . . _ . �•� - La�u does not apply m an owner of proper�y wGo builds � Fire Departmeni ._,..__ � � - � � � � f- � or improves tGrreon,and u�Go docs sucG work Gimseff or ' ' .. :- . . _ .... .-. . ..�... � ... _. . �. � ' ' �._, tGrvugb�l�is��.ou.n employces.provideJ tlat adc/.%-�- . Groding - • � ��. ' � � ;.�/�mrcments are not intenJed or.oJfcreJ for sab � , �,� , , ���� : bnwcrer,tbe buifding or improvement issofd u�ilGin�.e . . . . , ,.- •. � , ,:. , ,��, . � . '. . -. . .- .. . : . . . `. • . ��- year f eomfferinn, !1 e n�anrr-builder u�iJJ.l ave tGe � . . Geologicol� �. . . ,_ -..-�_ . ,. . , . . � � � - "-� � � 6urJen oJ pron�in,�fl at be drd not build or improoe fo� , , . .... __ . ___ . ___ - ' __ ._. PedestrianProSec�wn ..�'-..-. . �.�: ' . � tbepurpose'o/sal J.:::..... . .... .�...- . (Fence)�CanoPY) �..� . . . .. - . .���. . ....... .. . ... . -. --..�. � ❑ I,as owner of the proPerty,'am exdusively comrac- . �� linq wilh li<ensed contmclors to consfruct Ihe'projecl(Sec. i -' �-" � �----- � � -��- -- - 7044)IIusiness anJ Prnfessions Codei TI e Cnntroctnr's Special Inspeclion- . . . . .. .. � ' (Conc.)�MasonrY)(Weldin9) � � � _.. i. _ .... __ . \\:�.�,:,. . . . Lirensc f.au Jnes not aphly tNan owner of fnoperty u�bn " � builds or irnprours f!erenn,-unJ u�Go ionlroct{for tuM Lot Drainage • i�• •. "' � •'��' . � . , . _ . . . _pmjecla uiifi a ranfrdcior(sf licrnstd fursuan!tn tl�c �., ... _ ... . _ ._..._ ._. . .._ .. Coneractor'sf.iorn'seLau�/:- �- -' . � Parking . . . . ., . . �� � � �...- � -" ��- -- . •.. �.. ..- � -- -❑��-Iamexemptunder�Sec'.���� '.. .B.BP.C.�1or�th'is V . . .. . .._ _ ___._-___..__'__ ... ,. ..:-.._ . . � reason . � „ � .. ; _. ., .... . . _ . . ..._.__.. . _.____.__.--._--.._ ...__..... � -� Date Owner PP . ,. ... . ..p�� ��- ignatura_. .. :, � . . . ...,� .:.,.�INSPEC70R'S NOTES � . A rovals Dafa Ins ector'�S , Locaiion- . . .. . .. . � .. . .. . . .__.. ..._ _- . (Se�bock 8 Yards) i � � - ' � ���� .' ' �� ' . . ,.. :. ....,.�.�. � , .. �� .'_. . . . ., Foundo�ions i . . . .___._._..�._. .---��---�--_._._..._..__._....._. �--.. � . . .. .. _ :.�..�.,;. � s�ob r � , � , 2'b`T l-�'?'' __---- -— - ___ _ . , , ,, . , -- F�ame ` ' ?�Ir� Energy Insulmion � ��\ , .�_...__..__ �._._..._:__._'..____ ,. _.._._'._. .. .'. - .. . .. , . . Lath/Drywoll- . , ��r .._- ._..._..__. .____._ __. _ _..._ __ __. . Inlerior - " . , . . . ... . . . �� Lath-Exterior .,. � , .. .. . . ..: . . . ,�� ��� i . I --,��.L� + �_...__... �. . . ...I � -.�` i - _. .. _ . . . --.. • , . �-. .-.•. House Number- . � .... . � �. . _._.__...:. � �_.,��, . . �. . � .. . t . i i�. . , . , .... . . .. Correcl&Posted . '. . • ,.•-. (..� . . . . .. _ _ __ . ..,..... . _ . .. Final- ._ .,.'. ... _ _ :� . .. .._ _ . . ��.� .. _... _.._ .__ .. . _ En�er on Froni � ;"� � - � - , . _ � ,- . . . . -. - . , . . . . . -� _ . - , :� ,. . .,., ,;f.. . r — _ � c �z � � � � " � -�_�. ,