Loading...
HomeMy WebLinkAbout1586A 1587A (9) . , . , ,. .. ._.__..._ ._ . .__. ... _._ - ---.._. ._ ..._ _... ._..._ . .... . .,.. _. _ _ _---.. _ ' WORKERS'COMPENSAiION OECLARATION � .. � ��- . � , � ���- � 1 he�eby affirm iha�I ha�e�o�e�„f,�o�e of�a�=e�,,o=e�F - - ----�-�-qpp��CATION��F4R����BU1lDING� PERMIT�� ��� �, insure,or o cerlilicote of Workers'Compensotion Insvrance, ; or a cerh(ied co ihereof�(Sec.3800,Lab.Q) -�� ��:� � � - -"- �- � � �"� - ---�-� - � � -• � � WCP6��5241 � • GreaC American Plan 3C COUNTY OF LOS ANCrEIES BUILDING ANp SAFETY Polityldo.� �Company� .... . . . . . � �Ce�tified[o is hereb furnished. • i�� �' 9UILDING ❑' PY Y FOR APPLICANT TO FILL IN aooeess c�O�D� �� � � �' Certified topy is filed with the county 6uilding inspea � BUUDWG , - tion'deportment.'� ' ADORESS 20808 East Boulder Lane . 12=22-86 • ' ' The.Wm.' Lyon Co: Walnue 91789 ' Date ' Applicant � CITv ZIP �OCAtI7Y � � ' �CERTIFICATE OF EXEMPTION FROM WORKERS'� -�- - -- � - NO OF eLDGS � �- NEAREST ._.. . ....,... _.. .. ..; • _ _. . :_,. � - � � ����•`COMPENSATION INSURANCE'�' ��� ��� SiZE OF LOT 3,aoo-sF riin.NOW ON toi 0 CRO55 SL . ' ITcertify�hm n he perfo�mar+ce of rhe wo k for which,this o�'�'N R T IE6WILLIAM KLYONDCO. �No 83393600_ us�zoNe �P � �� PARc�� h's sect on need not be com leted if the ermit is for one ASSESSOR hundred dolla s $100 or less MAP BOOK � PAGE permif is issued,I shall not employ any person m ony monner i - � � � SPECIAL� �-- - �----�-� --�--�-� .. '0. . so as to become su6jec�to�he Worken'Compensotiori Laws. /DDRE55 S9-COr OTBCQ P18Z8- -- -- CONDITIONS 'O DdieOTIPE 70 YPPLICANT: If, o(te moki'ng 1h� � CIrY . NOWE)OtC Beach, CA 92660 _ .. .. _. :_. _.... . . _ � �� �.v '� ' Applicant . . . ; __.. . -. . - .ZiP. . _ ___ i .. - -_ . _.- -OC 5 Cerfificqta of ARCHITECTOR H81C5-L2R StOri TE�' rjli���8(7 OISiRICT__ .GROUP TyPE. _. .. .�fIRE . Vk0 ESSEDBY � Q ENGINEER � NO. � ��+m Yon, ou should become sub-ecr�o tha Workers' -�----- CONsi. �ZONe ����j � .mpenwiion provisions of fhe Labor Code,yo�must forth- qooaE55777 S. Main $C.� $C2. 10$� Ot8(1 .p2.._ � .__ pw. wi�h-comply-wifh such�prorisions or �his permii sholl be -- ... TEI. N fleEmC(J ffvOktd. � � � ' ' . , ....�..,.. ,;.,...'. CONTRACTOR Same As Owner NO �� $TATISTIG4�QASSIFICATION ' A . ." �',7, LICENSED WNTRACTORS DECLARATION• :.. . .. . -� ---- � -----... . ._._..._.._ . ... . .. ----�JD:.. �- _ �'� . _._ ... ..._ � -UC.--� CLA55 NO. DWELL.UNITS 1 hereby aifirm ihal I om licensed under provisions of Chopfer 9 ADDRE55 � ryp. � (commencing with Section 70001 af Division 3 of Ihe Business and ..__ ...._ . . . .___ . __ . _. . - UC. -. SEWER NJ1P � . ,. . � �i Professions Code,and my license is in Full force and effect. GTr CtASS ' - �--��� '---� ' -- �' ' �-Vp��DAT10N ' '' . . ... . BK. PG. �. � . Z�GSOS ... . . �. �$•1.,. .� 54.FT. NO.OF NO.OF CHECK .. . SIZ STORIE$ �� -FAMILIES � - ' Litense Number� -Lic.Closs� ]�� �On�E ,, � . . � , 1 am exem t under Sec. I � e 12-22=86 vnwnnoN ._ _- - .. y . .. ... �ESCRIFTION OF WpRN...._. .�.'. . . NEW- .. _ noo � s �J�d�d She Wm. L on Co. Contractor Dat P - - - Sin le famil home.constructio ` - � _ . , ALTER I �� . � 6.8P.C.fo�this reoson �Date �. � � USE Of OEMOt -�s�_.... . ._�����. . .'� '��'������� � �- r�� 5 8�6�� �' •.. _-.. _._ .._ . ..... . ..._ ,.. .. '. ' EXISiING BIDG. " '_Signafure... ... ... . ...'___._._._ .__- �� APPLICANT TEL. I . _' ' . ' " '" . ._- �_" . vaiNr The William L on Co.No. 833-3600 F�N^� �J J �� �2 ! OWNER-BUILDER DECLARATION DA�E�'(��( � -�—'� - - � � '��-0 2�h 6II" � �.I hereby offirm�hai I am exempt from Iha Coniractor's Llcense -- ��- � � � �� - � - � �-- � �-�-�-�-��� ' low for fhe foilowing reason(Setfion 7091 5 Business ond ADDRESS ' FINAL/� �' ' `�� "'� �� � � Y (/LJ 'Professions Code): . .. ... . _. ...._._... _... R i �0 � �.... . .-. . _ - • .�7���:c=., , �^ BU401NG � � : r��1 I, as owner oF the propeny, or my employees with AODRE55 . � �.-.��. '• . �2•3��� R 6�� � ' wages�as Iheir sole compe�satioe,will do the work and � ��� � �L1TV - � �" '� �� - � `' � ' �_.- the s7rucWre is nof intended or of(ered for sale(Secrion � �� '��� s,� � � -. . .7044,-Business ond Protessions Gade).. .- -- '- MOVING ..-.. .. -. --- - TEI.--. - - -. -. . - ... . - ._ . -. . � '- � I,as owner of the o ert am exdusively contracting CONiRACTOR NO. � . . ,., > -_�. r'� 7', P�P Y. .- _ .:.. �. . S H. . _,� -wifh�licensed coniractars to construct the pro�en(Sec• .. . .... .. ..... .. ... ... . .- . . . . _ . - . . .. ..._ _ __ _... . tion 7044,Business ond Professions Code). ADDRE55 � , I ' •4 7�5 O`__� �---� - � �CON57RUCTIONLENDINGAGENCY '`�" ' "� - - SE�BnGc YARD' 'HWY � ��iApRppliNE WIDTH � � �� �� � - � � �' I heteby offirm�hot there is a consiruction lending ogency for Y FRONi i • °r1-/rj,,rj Q u' ' �the performance-oF 1he work for which Ihis permi��is issved � -v.L---�� � - -� -- �-� . .. . ..._ .__..... ..._!. ..__ __ .._..._.. (Sec.3097,Civ.C.I� SIDE ' ' `, I 2 3 1�-fi 6.�, ' - .-,, .. _ . . P.L. � ..�. � . �'i.� .''. ... teoder•sriome Continental Illinoi's $ank y ' �" ';— -tender i Address 931 Rn.�-f.a Sa 1 1 a S . �i cago P'C Fce E / . Pe.mu Fe� ionnr.aet x � .; � •� �� .J certify_that.l.have read ihis appiicntion ond state 7hat iha _ . _._ ._._... IssuanmFea-f�-',� �� �Onnn PiGM ./���... - ,..'--- ' . �. ..�., ob w ' is . ree fo mmply wi�h all Counry i vavige�ion Fce � . � � rdinonces and St lows relaf g to building mnsiroction, -.idal Fee � LOMA Perm.M���3 � - ---� � �� -� � nd hereby auth ize represen es of ihis County�o eNer � � � � ���--�� ��- - on 1�60 - e ioned pr p r y for Inspecfion pwposes. ?,e.�SQD . , . --�, O�'O6 ... . . � _ __ ._ _ _ . . . _._ ._.. .'._ _.' . _ pC ..___ _- .� _ . . . � ..'_..._. .._. _ .. .....,.. ..., . ?j-Z- SEE REVERSE FOR ExPLAHATORY LANGUAGE , �Signafvre of APP canr or Agenr _.. .. ._ pple . ..... . . ..- .. . _. . ... . .._ _,... _ .. . .._ .. '_.._ .. ... . . .. .. ...O I PLANS 70 APPtICANT INSPECtOR'S NOTES .-OWNCR•DUILDER DECLARATION , i hereby oFfirm tha�i nm-ezempt,from the Cantroclor's To: � R�furn�d � � ` � � • � - �� Litense Law�for the-,following�reasoa�(Se2.`7031�.5) -� � - - � � 'Approved Duriness�anJProfesrionsCodc:AnycrtywcouqtywbicG No. Dofe '� No.' - �Dot�"� �- � -� �� � �. �� ��� •� ' (�t: r.,�,'.� ,•cre4uires a permit 10 rnnstruct,alle�,lmprove,drmolisG, i . -_..or refairanysHucture,prior to its issuance,uknTequires . � . . . , ,, ,. � tl e applicanf for sac!fermit to Jilr a si,qned atatement . tl�ne lre is firensedpursuant to t!e provisions oJ i/e Con- . _ !�i�� trncfor'a l,irense Law(C!apter 9J(comn�enoing mitl�SeN - �� - -„����� . finn 7000/of Dinirion 3 of tuc Uusiness and�'rofetsions " . �_pP._ . _ Yes9uireNo_ ``� vP �z .�. _'_. -_.. . ___.' .�_ . � �. ..��ae�PP�Jbr'�f n e tfi x`'cejcfinndred Jr!!ab`isjoetbr , .-- 031.5 bv . t- ' � A rovals . �. . ...Dafs RecAved - ....- . -.. - .��- `�. .. .� ca s pp ta a cirr! . ; orA rovva h v !n� I fssoo/.): ' _._.. . . . �. 'f�._ .. . ._ .-�.:i.. _.,_. - , ❑ I,as owner of the propery,or my employees with Water Cerlificale �` . `... -'�. _�. .,... . .. ' __.. . _ .�.... � . �.. _ . ...._ _ . . � , wages os Iheir sole compensation,will do the work,and .__._ . , .. . . - -����- --�--�-��--'- ''��' ����� �-�� ,;,iha s�ructure is not�imended or oifered for sole(Sec.70a4� '�, Hea11h.Deportmenl_.._._. ____ _ _ . _�..� . _. .�� .._: ______ _..._.. ....._'.__.. . ..____��_ __. . .Qu ne d Pr%ssi . 's ir ase si is an on.s Code Tbe Con�ractor L e ' � . _. . . ..._, . �. _ .. ., f.au�does not app(y to an owncr of profcrry wbo builds , .. .. .. . ..,.,, � . F�re.Deportmenl ..,.__.__..-.__ .... .._ ..._.__ _... . .-- . .. . .. . - . . ���� ur in�/�rones tbrrcon,and wbo does aucG work bimsclJor - � . � �°�:� . "`.�� . ...�i.:.� .� :;,,. . �.�...I_:-,.1: ,: �- � :: ', lurnug5-Gis ou�n cnployccs,�provided tbat surl�im� Grading � � ; . � - � . . � �proremcnls�are no1 ineended or,ffcred./or.sale..� - - - ,. , , . ,_, �._��.�� , , \�;;,. r', bawe��er,tbe burldin,q or improvcmc�a is sold mieGin o, .: Cjeologital. ... '. --' "�--- � - .. . ...-. =. . . � 1���: .� ..�� • , �� .. .. . . , � �Yrar o�-completion, tbe owxer.buiWer willJ�ava'tbe ' � � - " '� 6urden o/prnring tbat be did not 6uild or improve Jni , � . ,,. . � � _____-.. _.'.�. _ .__.._._. . .._ .. _._ ': . ''_� _ _ Pedevrian Pro�ea�on "-��- -. -. .. -.��.`. . tbc pury,osc"af saleJ....:��. •' . ",�...�.C.�'.:- (Fence)(CanoPY). . ,. ��.�. ..�.�.. ..� :,. � ---._._ _.. _ ���.__ . . ___ _ _ __..__._____-_ .. ,,�. ...❑ 1.6sowner�ofihepropeny.'amezdusiJelycontroc- - ting with licensed controcrors ro mnstruct ihe�project(Sec. �... ,..•. ., . � .-. -......-. �-...- -- .-...-� ..��.--.-- . .-. 7D44j�Uasiness and Professinna C�de:.TGe Canlractori Special Inspeciion�"� � -- ' � . . . � .. �Conc.)(MasonrY)lWeiding) �. .. ....:.� - � ___ _ _'_. ..' ... .__ ___�'_'....;,; .��.'.�.,y i . , Limnee"fau�docanntap/�!)'toanowncrof/�mfertYud�o � buifJs or in�prones 1fie•eon,anJ wbo runeracts for autJ� �h9 ;� 1��1' .�. , '-�.. � .,��. - � _-,..�, . . .. ._ _..-__ . ._ . . . - - -- n lraca r's/LrrensctlauJ._. ..._, _.' nt to,the lot Draino e _ p*�� a o,(sJ ficrnsed j�uraua �� - C n � Porking . . . . . ' ...___... _._.� . _'._. _--�. ...�_..-'-��- - -�- ----�- .�.__. - _. --- .... � , :_.i a � � ❑ I am eaempt under Sec. �,8.8P,C.fo ihii . . ' . . reason .. � _.. .._.__.__ ... �.'__._. __ _..._ ___. . i � " : ' . ' �� Date Owner Approvals Da1e --�Inipictor's�5ignnturo,� � . . - � �� ����� �� INSPECTOR'S NOTES.' � Location- . . .. .. .. ._.--_..__ __. . . . ISeiback 3 Yards) �� � � � �`� .__. ._ _..._. . . . _ . , . . ,� Foundaiions: a . � . . � � .... . .. . - .:: � ,. , __-_ ._.__ . _ .. _. __. _._ � . . � . Slob- .. , , . . � /�7 .� � . _ .. . .. . � . .. . . � . � Frame� . . . < 'I ����7 � .. . . . . _ _ '__ - , . .. . . ,. .. . � � � � .. . �. � , . , . _ . Energy Insulavion �. ___ � .._.._.- __. .. _�_ .. ._ ._._,_.. __... ._. .. � . � � ... � ... . . � ..,, Lath/Drywall-. � � ___ ...___._.... __..._ , . ___._..___.. '_, .� . , .. IMerior � .. . _..__._...__ ... .__. ��. � i . . �. � I . . ,.�.., 11 -.�. . ' "� ' . .�.. , i: ..,�:.:,.. Loth-Exterior . . . .. � --__ � ..- - - . � . .. . ..,. r1 C7- `- ' v, ,�. � . . House Number- ,.., . ._;.. .�:._. . •..__. _`;�.. ..�.s___.__._..-- . ' �:.:� �� ._�_ ... ., . . ... .. - ... . , Correcr 8 Posted -- ��-;- ��.�. � � �� Final- ._ _ ..._ �. _. ._��-- _ _. . . _.___. ._-� __.__. . __-_- ._.._- . . . EMer on Front . ..,.--.., . �, -,.n�j� � .....�.. .__..., .,.,- .... . , , . ,. . . _ r��:,. _� . _ _. _ ,