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HomeMy WebLinkAbout1558A 1559A W ... . __ .. . .. __ .._._. . . ..... .... ,. __... . ..___.....� ,., .. � ... _...." _ ' I here6 aF RKERS'COMPENSATION�ECLARATION : "" ' ��, ':�:: r.-. � �- -„- _ , � Y fi.m iha�I have o�e,��F,�o,e oF consenf lo,e�f - � � APPLICATION �F4R BUILDING PERMIT —�� insure,or a certifica�e of Workeri Compensa+ion Insurance, or o celtified cop y iheieof�Sec:3800,4ab:�C.)�� .�.. .__... _._. . _ . . _ . _ _ _ . WCP6155241 Great American Plan lAR COUNTY OF LOS ANGELES BUILDING AND SAFETY �� � ' PolicyNo.-� - Company - � . � Cerrified topy is hereby turnished. _ •;,, '� FOR APPUCANT TO FILL IN eunoiN� D�,�/ c. ADD2ESS C �'�Certified copy�s fJed wi�h the couny building inspen "- - gw�DwG i . , �lion�deparfinen�. ' � � AODRESS 20811 East Boulder Lane � . ""12-22-86 �" ' The Wm: Lyon Co: "Sdalnut ` 91789 Qafe � ' Appli�ont � C�TY ZIF �OCALITY , '� CERTIFICATE OF EXEMPTION FROM WORKERS' � �� -� -' - NO OF BLDGS. rdE.4RE57..__-._.�,. • , . � •��COMPENSATION INSURANCE � '", � 5¢E OF lOT 3,800 SF Min.Na,w oN ior 0 CRO55 57. � � (This�seflion need naf be mmpleted i(Ihe permit is for o�e - - -- - - , �ESSOR � . � � --- ����.-:, hundred dollors(5100)oi less.J.. . ianci�- 43760 BLOCK 2�$�� LOT NO. �E � Mqp gppK' '' ' PAGE PARCEI � SIIE WILLIAM LYON.C0. TE`•833-3600.. use zoNe n�wP 1 certify tho�in the perlormanta af the�work�1or which this �'M'�EF NO. NO. ; /IJo2-� '} permit is issued,I sholl no�employ 6ny person in ony�manner qpDRESS 19-COrpOTBtE:-P�18Z8 -- � -� � - - �EpAL � �- - ---� -- - - � �Q- '� --" " � CONDITIONS �v so os fo become subjed fo the Work¢ri Compensofion laws. C'TY Newport Beach, CA Z�P gZf1(70 . _._ . _ _ Dme'. ...�� ..:APPlicant' - �, �. . � . ARCH1IECT OR.... � .. . TEI, _-- ' � .. --_ _- .. . _ . __ :� TICE TO A7PUCANT: If,'olter making'this Cer�ificate o� tlales-Langston 547-086 DIS7RICf GROUP TYPE � FIRE. G2 SSEDBY ��nphon 'you should become sobject lo�1ha'�Workers' �--�� �/ ENGINEER ND. CONST :ZON ' .npanwtion prov slons of ihe lobor Code,you musf fonh- pooaess 777 S. AI81n St.� Ste. 105� Oran � OC _ � . _ � �'a wuh compty wiih such provis�ons or �h s,permn.shall be - �- Same As Owner TE�� STATISTICAL ClASSIfICATION AVT. CO ' Z� deemed revoked.'., �.� '� ' . ' .. .. � ' �ONTRACfOR NO. ,�1 � LICENSED CONTRACTORS DECLARATION � ��. - �- - - - � -- � �� � ---� -� -� ���_- --- � ---, CvSS NO.� ���/ -DwElt.UNIiS� � �' I hereby affirm tbai I om licensed onder provisions of Chapte�9 ADDRESS NO. SEWER MAP (mmmencing with Section 7000)of Oivision 3 of the Business and .._..__ ..__... . q�, ' � ' � . _ .._- _ .. ..___. Professions Code,and my license is in full force and eHect. cliY Cin55 - BX --� - -- � - --- ---�-��VALiDAT10N�-� , Z�6HOI $-S SQ.FT. NO.OF NO.OF CHECK - . �� , , License Number � Lic.Class � SiZ 7 �1 SiORIES fAMiuES� ONE�- -� - � , , , . . �* . . ___'. OESC21Pf10NOFWORK- �" ADD SAI�I� OVD� -___'.._ .. _. _._.__.._ ._� THe Wm. L 'on Co. , 12-22-86 _. Cnntractar � � - �ate � � ' .� : .�. . Sin le.famil home constructio � NEW- ❑1 am exempt under Sec. , ` � � _... AITER . ..• ' ,.. B.BP.C,lor ihis reason� . . REVAiR � S... . _ _ __ . . . �.�5 5$a . , ._ .__._ .. . . _ -.. Date: -' USE OF ' � t� r� ' ... EXIStING OtDG. �EMOL __..'_' _ .tt• •.�._•G� ""--SignoFure � ' ... .-..'-- " . -. . .. � . APPUGLNT TEL RNA .� PRINT TIIE William L on Co.No. 833-3600' pAT[ �� OWNER-BUILDERDECLARATION ,� • .�' �.�-2?.�.� ,. _ _ .. __. _... . _ _ _ _ . . _. .. . . ___. -I here6y affirm Ihat I om exemp7 from the Gontraaor's License � � Law fot the following reason(SeCtion 7031.5,Business pnd /+DDRE55 FINAI � � ' -� ' •2 2 3 8�� ? '.ProtessianzCode):_ . . ._. _ . ._._ _ .. _ , .gr .. . . .. :-..,.,.' . . _ _ . - BUILDING ' � . : �2 3� -a 6�� 1, as owner of Ihe preperly, or my emptoyees with ADDRE55 � .��. � � � ' ._ . . ._ ._.. . __.. . .. .. _ _ . . . . . . wages as iheir sole compensafion,will do the work and tOfl.tltY � , � ' "-r'-�J�5 9.F rhe srrocture is nor(nrended or offered for sale(Sec�ion �� � - �'�� 7044,Business�and PrafessionsCode). � � � '-` MOVING- -- �--- � - TEt.� � -- -- - - �— �� � - � � � - -� � I,us owner of fhe properly,om ezclusively controcting CON7RACfOR NO. ' . . •. � �.� � ��� • - with-licented contraCmrs to construct the project(Seo- - . . � . . .. ... .. .. . - -� �-. -- � - - �- . ..... . . fion 70dA,Business ond Profestions Code). ADORESS � i .,,� r; I •.3 9 Q Q� ,� �-� ' CONSTRUCTION IENDING-AGENCY �-- '" "SE1gq��C� - VARD HWV' - TOlA�QPB�CNE wiorH� � - -� � �� � } ��-�• '-J�9 O.O.O u - 1 hereby affirm ihar the�e is a constrouion lending agency for FRONT '-�� �-- 'r`� - � �' � ' "��' ' 'S'" _'_1.23tr_8b -the performance of Ihe work for which Ihis permif ie iseued � ��v.L: �- � � � � - � - - -- - - - �--- - �' ` .� ` , • (Sec.3097,Civ.C.). SIDE -' � i� �'�!�; � . P.L. . ._ . i V:. . ... ie�de:sNome Continental Illinois Bank - � - �-� , ,�b �„�Re�.. ' — - ..-_ P.0 Fae S . �ermit Fee -' "-'—-- ..- -...`_.'. lender'sAddress_23S So. La Salle St.. Chicago /y � , _ - .1 certify Ihat.l have reod fhis opplication and siate ihot.fhe . Issuonce Fee •SV LOMA v/C N � ,� �— - - - �� � . . ___._ ._ . obove infprmarion is corr gree to comply wi�h oli County Invesriga�ion fee /� � ' noncas on , aws rel g�o buHd��g cons+rocnon, rom�Fe� � -� - - "� '� ah au . ..� .._ ._ _. ._ _. �r `� -tDMAverm.N- ' � � '. � GlM1� x represe ves of lhis Counfy to eNer , . up n he u e-i tioned � ay for inspectien purposes. .f 7t—�y r_me—�, _ _. . _ ._ {� . . . __��,-v�r . .._. '��-v 6/ _ _ . .. __.._._.. . _ _ _... �L'L�y SFE NEVERSE FOR EJ(PIANATORY IANGUAGE ' �, -�-' S�gnotura ol Ap 1 conr or A9en1- .. . pote-. .. .... . . . .. .. � . - . . __ . ._ ' __ _'_' _ ' .00i PLANS TO APPLICANT INSPECTOR'S NOTES �O�VNF.R-6UILDP:tc uca,..,,.....__. I hereby affirm�lhol I om exempf,from the�Contractor's Te: ' Ratum�d � � ' � . ' �� License Low�for �he�following:reason:�(Sec. 7031.5j ' � �' ' ` �Approved Du:incas�ondProfessionsCode:�inycityortountytubicb, No. Dote � Mo.� �' .�pef�'.. '�-. , �. . � . . ...-.. :� I ��J', r,�^.reqaires a pern�il fn rnnsJrucf,alter.'irnfrrnuc.demnlisG, . , , _..nr ref,airuxystr¢cture,frior to ies usuance,qlso rcyuires ' �'. .\..`. . . , . �„ . ; _,� . .-. � tl�e applicant Jor surL permit to Jife a aigned seatement , lbuz be is ficrnsed pursuaat to tueproc�isions oJ,!!e Con-. i� .. ;. , -,,� �,.. �;;:... . !�'.::'. , .��.�.. fracfor'sl.icrnseLaw(Clapter9J(commancing.witb5ec- - - -� - ....._. . ..� I -, i - ; - -- . �ion7000JoJDirision3oJlGeQusinessandProJessioes , � ',-�.. '. . �` '`..� _._'._' __ ._.. .....'i_ .-_ _'.. .. _ . . _ . __. . ... CoJeJor(ldt5eis¢xempttlerefromandtLebaiisfnrtbe ._ ___..._.__�__._._ . . _ .- . ' ' _ aflrgeJ rxemption.An,Y i'��falion af Sertion J031.5 b,y � __. _-.�..� -'' -=RoquGad ' pataRacrirad � ---�- - ...�� . .�.- .. . .--�.--. aqyapplicantfnrufe>mittabjertst7eaJ�(�Irranematiri! . Approvali �� or Approvad�� , � . pena7ly of not mnrc ehan Jire GunJred do(lsrs(SSOOJ.I: ; � , .Yes -No . .. . ...,.. � . ��� _____._ _.. '. .' __ _ .' . . - ' -� -- - - ❑ I,as owner of Ihe propeny,or my employees wi�h' .. Woter Cenificale , - . __._ ,_. .._ _.... _. __. _. _ .. .. . . wages os their sole compensation,will do the work,and . - -- - - � '. �lhe slrutlure is not iMended or oFfered�for sa�e(Sec.7044} � HeahhDepar�menl. _ _ _ ... _.._ . _.: � �.'�.'_�' _ .. ..: �-�--„---�- � - � -- --� - -�- -- .-. . . ➢usinessandPrafessinnsCoJe:TGeConeracfor'sLicense .... ._, ._ �... _. ..� � I.nu doca nol apply In an oumer oJpmf�crty u•Go bui�Js . ... � .,..., � ,�. , i� Fire Depariment __. . . .._, . __ ... .. _ , �-- �- -- - - �, - -- or inipraves 1Le>ron,and u�bn does su work�imse Jor cG ! . ".',�'-.\ r.�� .. .-�. . . - - . tJ�mugfi his-oum empJoyees,:prorided,tlne-sucL imc , Grading � " � �� - � ���pmvemenls arr not intenQed or offcreff for sale."� � � �. � _.. . ... ,.. . . . . �. �'i 1 ���bowc:�cr,!be b�aiJJing orimprovemertt iaiofd utitbin.. -. Geological ,� ,- '�. �� , . , . , , , ,,, , � ,Ycar nJ mnoj�letinn, U e"awnen6uilder wilf bnve�tl e , -• i � . • ���^' � � �; � ' � �' . , burden o/pmring tlat be Jid not buifd nr improne fnr � , . _._.._ _ ._ _ . .. .. _ ._ ..._ .___ ' Pedeslrion Profeclion. . . . -. �- . t!c purhose'nf saleJ.� � • ..• . . (Fencej ICanoPY) . . -...--. -- .-- . - - ' -- --- - ---- •..� � '1,at owner of the properry,om exclusiJely conlrac- � ling with licensed conrrdctors to conitrud Ihe projeci{Sec. " �"' " � �---� -� - -- - �- 7044 Ousixess and Pro essrons'Code:TJe CanfratMr's SPeciol Inspection- �� . - - .. -: ..'-� � . .. -- �-� � - �- � -.:� ) � (Conc.)(MaaonrY)SWelding) . .��' � . - ..,. . .. _ c. ��:�_}i:._i. l.itcnseLaudnesnotapplytoanbuneroffrorertyu�bn � "- - � -� � --" -�-buifJs�or improres tLrreon�"and u�bo aontrdets'Jor s�<cG Lot Oroinage . :"'}',;�, c'•. , ' . .^ . _,.^ _... __f ..._ �rojetts u�itl a cnntraclnr(sl 7irrnr�d pursuant tn,tfie ` � � _ .. � . . .. . -_..___ _. -- ontratlnrs icc . -_ - _.. ._ � ' . "C Parking • � � . . . ..' , .., ' L' lau'�'_.. : � , . '�.. . fo� " � - t] I om exem I under Sec B 8P C \ .. .. _`. . p r'ihis , . � � � reason . ' . .. Dafe - �---� �_��Owner'�'_��. , , . ,. , . ; _ _ . , . .. � . . � , . . �,. . . ---- .. . _ . _ ._ _ .. . � i i_�';,: �.i i i i . � � . - , .. .. . . ...... . - Approvols . � Date Infpecter's Signefun . . . . . .. . :..._ . . . � . . � �. INSPECTOR'S NOTES ' � - Loco�ion-_ � � _____ _ _ _ _ _ . . . ISe�back 8 Yaids) •� ' - � � - - - - ---.. .._.. _ _. _ . � ,. . Foundatlons i .. rf" . ' . . �..� . . �. . � � . Slab� ° � . .. .. . . �/ �i��-^� ._._ _ . � . . .. " ._ Fwme , . , '.�'�'�� .. . . . . . � � , . . ,. . .. , . Energylnsolation , ��O l/�� . - �- . . � : .. � .. { 'U .. .... '___•__ _ . .__ __ , .. ,. �. . . , . . ... . . .. , Lath/Drywoll- . � �' __-__., _.__._. _.__ __ ..._. '. . _.._- . - . . Inlerior - - � ---�� �' , , , ' lath-Exlerior . � � � ' `. .. . . . - '__._�. . � .;� �, � .� :. �.,�,_[:." _ . ,.. ._ � _ ` ._'_ _.._. .. House Number- . . . - .. ._. ...._ ' . _ ._ _' -_ _. . . . .__. .. : � . i. � . . . . . .,�. . . . . . _. . ... . , . Correct 8 Posted . . . .• '"-r � � •:.- '�' '� ��...•�� . Final- _.� __.�._ .. ._. . ... ..__..__� ._ _. . . . , . .__..._. . ___... . EMer an Front - � 4:' � � , , • . . . - . _, . .. . • ... . . . . � ��. , � . . .. .. . . . .� . . . .. ...-'.. �'. .. . . . . .,i � �1 . . � _. . . , . . . . .. . . 1 y .___-"a'�, . . -1 /'? ! . - � !� .