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HomeMy WebLinkAbout1582A 1583A , . _ _ __. ,_._ .. _. _. _ .._ . ._._ _. _, . ,... I hereb offirm that I hove o certi(�pECLARATION - � -' � r.'.� ,���� �. ' � �� -��-��' • -__ . __ ... WORKERS'COMPENSATION - `' mle of�onsenf lo self � � ;�=��e,o ocert�fimteofWorkers'Compensafion��5�,a��e, - -�- APPLICATION FQR BUILDING PERMIT --�1, or o cenified copy'Ihereof(Sea�3800.Lob.C.) �' ----. ..._ .. . . . .. .. .. ; . ..- - _---- ,_-- -.. WCP6255241 Great American Plan 3B COUNTY OF LOS ANGELES BUILDING AND SAFETY PolicyNo.� Company ._. - . � �.�CertiRed copy�s he�eby furnished. FOR APPLICANT TO fILL IN BUILDING � aooaess oZ(��o2d �. Certified'copy is/iled wilh Ihe county building inspeo- eUit�iNG fion departmenL � ` ADDRESS � . , pa�e ,.12-22-86�ApPi;�,,,� The Wm. Lyon Co. aTr Walnut Z�P 91789 -' �ocauTr i Lu�; ��� CERTIFICAiE OF EXEMPTION FROM WORKERS' � � � -� -- --NO.OF BtDGS. - - �- --� NEAREST_..--_.. . _ ......_. _ ' __ .._ _. . _ " � " COMPENSATIONINSURANCE SrzEOFLOT 3 H�O SF Min.NowONlOT O CROSSST. .[� j�_� (This sec�ion need nol�be�completed if ihe permit is fo�one :-- TRACT � BIOCK l0T NO. �ESSOR,,,, � ---� -- .� � . hundred dollars(SI00)or less.) .,. , , �, M47 gOOK- ' �" ' VAGE PARCEL owNea THE WILLIAM LYON C0. nio`'.833-3600 use zor+e n+a.a I,certify thaf in the performance of the wark for which this NO. �07� 02- �� ��� �} permif is issued,1 shall nol employ ony person in ony monner __ qOORESS ' ' --- �ECIAL�. -- --- - -� � - -- - R so as to become subjeci to Ihe Workers'Compenmtion laws. � � -" CONDITIONS 'i v . , ., aTr Newport Bcach, CA zir. . 92660 _ , _ . _- -- . . . �� Dafe'. , .. •..,- AppNtont � -� . . , - - .. � . _'__._„__'i . rvOTICE TO�APPLICANT: If;oiter making this Cenificofe of ARCHiTECi OR tEL _OISTRICT G OUF NPE _ . FIRE _ PROCESSE�BY _ _.'o EN�iN¢ER Fiales—Lan ston No. 547-0862 r mpiion; you should become subjecl to the Workeri CONST. 20yE V �mpensation provisions of the Labor Code,you mus�fonh• ADDRE55 p2.. �� �� �ti with wmply with such provisions ar Ihis permii,shall 6e - - - " � in deemedrevoked. . .� . � �pMRACTOR Same n5 Owner N� STATISTICAI CLASSIFICATION ' APT. C �Dp..' �� IICENSED CONTRACTORS DECLARATION-�� • � -- --- - � � - ���,--- ., ttA55 NO. �0O �DIVELI.UNiTSt'/ � I hereby afiirm.thot I am licensed under p�ovisions of Chapter 9 qDDRE55 No. i (mmmenting wirh Section 7000)of Division 3 of 7he Business and _ _ . _ ._ _ ___ ��� .. _ SEWER M.4P � . . �' ._ _. _ .. _ .__ Professions Code,ond m license is in full force and effect. Ctiv cin55 -'�'- ��� �`` ' t- - -' - �- VALI�ATION- Y .. � .. � .. , � SQ.Fi. NO.OF NO.OF 'CHEIX BK. PG. ' . _ � License Number 276801 ����;Class B�1' ' SIZ STORIES �FAMILIES ONE �- , . �� , �� � . � ..;�I am exe .. ... . , . . ., VAWATION . .' -- � - - - --. ' �� 'TtlE�.wOl.-�Lyon CO. � . 12-ZZ-SG " �" DESCRI7TION OF WORK '- ' - �- NEW S -�-� - -- - �: Commc�or � Date �� � ❑ . .. ADD . _ . mpl under Set. . . . . al7ER ❑ I . �i 5 8 2 A .. __ 6.8P.C.for ihis reason REVAtR_ � s �-- -- - - . . - .. ' �, . �. . � . - - ' USE OF •. �• •�• •C� .- . .. .. .... . . ...'DOte: ' - EXISTING HIDG. DEMOI ❑ . .. : .. ... _ . ._ , . �.'---SignatUra . . . .... ". - . ''. APPLICANT TEL FINAL 2 7 Q 6 8 ; OWNER•BUILDER DECLARATION GRIM 7• • NO. : ' • • _ .._ . . . _._ ._. ... .. . ._. ._ . ..PATE �.L� .._._.._ .__... ._ • �27'�.'bHcS.>... -�I here6y affirm 7hat I am exempt from 7ha Coniractor's License � , , Law(o�the fallowing reason(Setlion 7031.5, Business and ADDRESS p�Np` � �� �" � •�-" � -�• - ' I 'Professions Code):. . . -'..... ... - aE N BY. � �. — -- � !2 3,1 -a 6� '(,"', � BUIl01NG . . .. . -.. �. � __ .. . � � �� I, as owner of the property, or my employees wi�h A�DRE55 �V . �'� 58�p wages as thert sole compensahon,will do fhe work ond , � � Ihe s�ructure is nol imended or affered for sole(Secfion tOCAIiTv , , {�� . . � i, • t -- --- 7044,Business and Professions Code�.. ... . . . .--- MOVING . . . . _. .'._ .- �-'��TEL- -.. ' .. ._..... -_ . _. . . . _ __ .._. � I,os owner of the o ert am exc�usivel conlro[fin CONTRAGSOR NO. _ -, � P�P Y. Y 9 , ' ,`: ..���• ���' '. I •A I�S�.. 'wiih I�censed conrracfors to construct the project(Sec- ..... .. . . . . . . . . . . . .. - __._ _. .. . . _� _.. � . � .._.. _. - . _ ADDRE55 .-.. � � tion 7D4a,Business and Pro(essions Code). ��J. i�.. ? � � •[�%I'y 5�� REQUIRED TOiAI SETBACK � -� ' '" CONSTRUCiION CENDING AGENCY�---�-� - � s�i gACK ��vAttD� HWY pROF.LINE wiorri�� - �"" � � � - � I hereby affirm tho��here is a construction lending ogenty for FRONT ��'� +Z J'� -8 6'' ' , I:+ � �the performance of the work for which�this permi�is issued � --� -�v.t. --�"�- ,- -' � ' . ... .._. ..__ . _._ _ . ._.. __ . . .. .--- -. . (Sec.3097,Civ.C.). SiDE � . �. l _� • ' '_' . P.. _. _ _. . . . __ -.'....' i_ .. .._.._�'��.. .. lender i Name �nnt inental T�I l II67S R'^U LDMA Ref.M �. � . ' � lender's Address P.0 fee S -Permit Fee -- �- - �-- -- -�- ��t Se ba Sa��e S� � 6l��-cago /��� _I certify ihot I.have read this applicmion ond state ihot the ._ . ._.__._. . .• . lie�anee Fee �- Q.• - �DMa v/C M ,- ��-- ��---�� =� � -� above informaiion is cor ecf.1 agree to comply with oll Coonry Invesiiga�ion iee `l�y,c, q � � ' �rdmances and Sr e lows lating ro building construction, .__ .... .__ _ . ioia�Fee �7-/V•� tDMA Perm.N �$$.../ -- -- --�--�- - - � and hereby o 1 rize represe �,Vrves of this Caunty to en�er , po t e ova entioned r6pLrry(or inspedion purposes. � f."��PU _ �.�5 ; _ ._._.._. _ _ _� .__.. .._.. . . .__.' . . ... . . _ _.. . . ._ I � -1� SEE REVERSE FpR E%PGANATORY LANGUAGE ' ' ._ $ignatvre of pp vr Agenl """ _ . ' Date ..._. _ _. .... ""' _ _ _ . ... _ . . . ._ . . _ .. _... . _ _.".' '___ ._ .. . _OQ 1 PLANS TO APPUCANT INSPEttOR'S NOTES ,.01VNF.R•6UILDGI2 DECLARAT'ION . "- . , I hereby aifirm ihof I om e.empt from the Con�raUor's To: � Rvturnvd�; . � . � License Low ior Ihe.followinq reasan.��(Sec.`7031.5) ` � � � " � Approv6d ➢uriacsxanJProJcesionsCodc:AnycityoroossntywGicb No. Dafe No.� � Dafe � ' �-- � � •� � -- - � ,rrqaires a/�ermit tm m�strucl.alter,imrrooe,demn(is7, . . . .or rcJ�airan�•stracturc,f�rior to its usuancc,a&o requims � � � � � t/e applicanf fur suaG ycrmit to file a signed statement , ' �'t �. 'L.� �` � - . � . ... .. . . ..� , ' tbat Le is licensedpursuan0!0 1Lepiorisions nJJfir Coti- � tractor's I.icense Law(Clapter 9J(mmniencing uit!Ser- ; , ` � �''�'� � � �� "�� � � ��'-- ��� �- tinn 7000f jDit�isinn 3 of the Dusiness anJ ProJessions � .�. �.:� '; �;, '. � � '- . , , � ' . ___ _ _ _ . _ ", • '' CoJeJortGotG"riscrempttberrJromonJLhrbasisfortbr ._. .. . ._._._ ...._._ . __..__ ._ .... .__ _ . . _. . _ - , allegrd rxemption.Any,i�iolation of Section 7031.5 by '___ , ,.__ ` �' �' � . Raqutred'_� .�.�DafePPcvtvod-� .-- .. .� . . . � � ' � . anY�J�licanlforapernritsubjectstbea�plicanttoacinrf � Approvals� or A rovad: .., pena ey oJnnt�norc tl an fice bundred o[lars($S00/./:. , -� :�Yos No ,� . .. .. .- � . , . .». ._._ ... _ - ... _. . .. � . . - ❑ I,as owner of ihe � property,o�my employees with � Woter CeAificate � - �.--�. �� � '�� � - ' -.._�.�.__ •. ' -:._ _... .�.�_ '_.. :_. wages as iheir soie compensa�ion,will do Ihe work,ond "�-'� � - � - � � �' --�- -��-�- � -" �-• � �the struUure is not intended or offered for saie(Sec 7044) � '.� ' Dusiness and Pm essiorts�Codef Tbc Contraator's Lrrense - HeolthDePartmem - - -_ . __... ---'-.. ..-�=�_�-=--- ----�� .._._.. . . .. ._ . . . .._ .� _ . • . . .. f . . . . � . ` � �, , ���, . , � �I.aa�doet not applY tn un oumer of yroperly u•Lo bui� F ire Depanment __�_ _ . _ _ .. __,_ . - - , - - or im/novrs!!ereun,and wbo does sucL u.�ork bimse%or , � , . .' . .'.. ., : . ..� � . lbrnugb-1 is oan-crnployees,provided 1Gaa.rucb iin,� � Grading , ��- � �, ' � -- r. � �prnvrmenes arc not intended or ojfered.for,sale.; - � Geolog�cal._���j ,. _-. ..-..� .. �_ . ....:_ . -;-r � .. . . r'ery rconinle[ : �.� �-� bo ldrng or ineproucmcnt is sold udthin m. - yea mn, �/e nwnervbuifdcr u�ill,bave tGe - � � ' � � � burJc of Qr ving tbat!e diJ not build nr irnprove fnr PedestrianProtec�ion '" � ' ._.: � � .. ._. -._ . . �� ' .� � . �'- �- �. tbepurposebJsalel.. ..-...; •'.. ' � . (Fence)(ConoPY) . ' ,-� � .-.-. . --._.. - - _..- -'-. . . ... . -..-.. � �, ❑ I.as owner of Ihe properly,am exdusively contmc- '�ling with licensed mntmctors to mnstrud the projec�(Sec. ' �"� " "'� ' ' � � � � - -- -- 70a4)IJusiness and ProJessions Code:TLe Conlraclnri _..-_.._ _ _ . . . Speciol Inspedion -- �--- .. ._. � " - '" Lrrenie Lau�docs not a [ to dn owncr o m er( ml a �Conc.)(Masonry)�Welding) � -� � ` ._..._. ,_ , . � + - . . .- _ _ , 'f�:-� -�-buiWs-or improvcs tGerrnn,-rsnJ u�Ga conlrarls/or surb Lot Drainoge • - __ _ . _ . . . ... Projects u�itl a mntraator{sl IirenseJ pursuan� to tGe .. �j�• '�) ��� ��'.. , -'-Cnn�ractar's I.iocnse l.amJ.�--- -... . .-' . " . . . � ... . � _. -' � . . . . , . . � Parking .. � . . . ,.... ..... ......_ . ..._ . .. � - _ . . . . . .._ . . . � ,..,, ' �, . _ ..__ . ..... . . _ P ' : . _ . ' �� ❑ 1 am exem t under Sec. B BP.C.for�this , � . . E reason . . , _.. ,. � �, . . _ .. ____ .._ .._ _____ ._ _. _.._ ..... . � � � Date Owner . , i _ � ___ ..__"'_ ': . _.. . Approval: pafe Inspector's Slgnaturo : . . INSPECTOR'S NOTES � . i ..,, . ,.. . .. . . , Location- �7 �"l,� - - . . . ISe�back 8 Yards) ^C."t�� .-.. �6� � . ..._� . . -- �: .,. .. , , r , :... ... . . . ,..� . . . Faundotions .. . . �-----._._.- -��--�--.__.--�---- -------�---. -'.._.. ,.� � :.. . . .... . .. ... .. .. Siob , , G : . . . ._ . . . .� . !t i -___..___ ..-_...._._... -'-__ .. ----- " � . . . ... . . . , .. Frame � .. � .. ._. . ... . . _. . .. , � . . . � .. , � _ , .� Energylnsulmton: �l 5=7E- '_--'..�- --- : ' ._-_. ,___._'�.. _. - . . .. . . .� ; � . ., , � � . toth/Drywall- ---- -. -- . ..-.._.__ .__.� . ., - --�- . '" . . __. __. IMerior --�- -- �---- �--- �. , , , . . Loth-Exlerior � . ' . . _' . .. . � � ., .. ...... . . �.....,. . . .. __ . .. . „ _ \� Hoose Number- J. . - • --.-,. .- -- - - '-� -. -. � � . ... � .. -. I f . _ . . . Correu 8 Pasted � ;`c-. -..` i '' -'- � . • .. a . � __ , , ._. Final, . . -_> _ . .. . . .. � . ._.___._ .__ ' . ._ .. . . .. _ _ -__ __.__- _. _-_._ . EnleronFront �.,\•_ . � , �., � . . . . - .. . . . . ., . , y, �= . . . ' ' . .. � . . '., . .� .