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HomeMy WebLinkAbout1600A 1601A J i ... . � : .. .. � . ... . ._. .._.. _, . ... . . . . ...... .. .. ..._ .... .... .. .. ___ . _'_.. _'"_ .__ ' _ _ '_. WORKERS'COMPENSATION DECLARATION �: '. ' � � '�." �� .�• � I hereby affrm that I have a ceriificate ot�o�5e��,o se�f -� � - APPLICATI4N� Ft�R �BUIL�DING� PERMIT -�� ����. insure,o a ce tlficole of Workeri Compensation Insuronce, oro'cerrified cop ihereof(Sec.3800,Lab:C.) ��' - � ' - " � "� - � - - - . . . -. .__ . . � WCP62�5241' Great American Plan 2AR COUNTY Of LOS ANGELES BUILDING AND SAFETY PolicyNo. � Company - - -� � Certified mpy is hereby iurnished. . � FOR APPLICANT TO FILL IN eut�D�NG �ya� `i aooReu � Certified copy�is filed with the covnty building inipec- �" BUIIDING �fion deportment.� � ' ADDRESS 20825 East Can on Rid e Road ome• .12-22=86.APP���a��, The Wm.,Lyon Co. arv walnut - Z1P 91789 i�i�rr '�'CERTIFICATE OF EXEMPTION fROM WORKERS' �' $iZE OF LOi 3�BOO SF�Min.NO.OF 6LDG5. NEAREST - - .- - • �- � �� COMPENSATION INSURANCE -�-•� � NOW ON LOT � CRO5557. (This sedlon need not 6e�completed if 1he permit is for one -- -� 7RAR 43760� � eiocK 20800 lOT NO. 99 �ESSOR . - � : • . hundred dollars(5100)or less.) . , . , , � NJ�P B�aC PAGE: PARCEL THE WILLIAM LYON C0. TE`833-3600- us�zoNe tiwP Ltertify that:in the performante of ihe work for which�ihis OWNER N0. � D ��'�. � ��„ permit is'issued,I shail not employ ony person in any manner qDDRE5519 COT orate P laza � � $°E��"` � � -� '� ' a �" " "" -" "' CONDITIONS � V so as to become subject to tha Workeri Compensation laws. � - ' " . aTY Newport Beach, CA Z1P 92660 � Dofe. .� � '.. 'Applicant. ... , . . ARCHI7ECTOR TEL. - � ' '�' - " . ... � �OTICE TO APPIICANT: If,after making this Certificate ot ENGINEER Hales-Langston No 547-0862 DISTRICT GROUP �NST.� 'IDE_ PROCESSEDBy__ F mption, you-'shouid hecame subjeu to the Workers' - , Q W ' ,mpensation p�ovisions of�ihe Labor Code,��you musf fo�fh- qDDRE55��� S. Main St.� Ste. 1�`J, Oran C �. �.J � - -N with comply wiih such•provis�ons or �his,permif Shall be �- TEI. STATISTICAI CLASSIfICATION � APT, C Z deemed revoked.. Same A5 Owner - -�' CONTRACTOR NO. _ _ ,_,ry�'� . _ �_ ,�/ LICENSED CONTRACTORS DECLARATION�•. � -- � - -------- - � � - - ���, - C1A55 NO.—�DWELI:UNiTS� � I hereby aNirm 1ha1 I om licensed under provisions of Chapter 9 ADDRE55 n10. (commendng with Section 7000)of Division 3 of the Business and .. .- . _.. . p�. .. ��R�`P � .� ' ' Professions Code,and my license is,in full forte onil�efiect. CITV C�A55 ' � � BK ' ' �;--� -� �� �, -�' -VALIDATION �-� . � Z�GSOS . ' $-1 _ 50.FT. NO.OF NO.OF CHECK � � � . ,. License Numbei � lic.Class' " �'� Si STORIES FAMILIES ONE ' ,. �� , ' The_Wm.,Lyon Co.., 12-22-86 oEscairrioN oF woaK - NEW vawaTioN _- . - ' .. , Confrocfor pote App � j � DO ' ❑Iamexemptonder5ec. ln le famil .horne �construction ---- , : - - "� � �� ; -'� . AUER' B.&P.C.for this reason -- , � .S - . -.... .. .. --__ . _ .. . . � . - - -- Date: ' USE OF REPAIR ' �� �]O.O F DEMOL EXISTING BIDG. . -�'.� � � �,�,� . . ' APPIICANT TEI, � -S�gnawra veirrr he William L on Co.No. 833-3600 FINAL ��� __ -- I •2 4 Z 2 J . OWNER-BUILDER DECIARATION _ __ _ ,_ _ _ __,__ _ .. _ _ ���DATE -- ' --1 here6y afFirm that 1 am exempt from the Contwctor's Litensa . � . Law for Ihe following reoson(Section 7031.5,Business and ADDRESS FINA � ' � , � ' '�-_ � �Professions Code): '-..". .. ............ . ... . _ R - SY . . . . . � �•L�i i.�O<� � BUILDING � � 1,as owner of the property,or my employees wifh _ A�DRESS _�: � ..�, � � 2 3'� -8 6- ' wages as lheit sole mmpensation,will do ihe work and -�� - - � ��` � � � the slrutture is not inlended or offered for sale(Secfian ����T� ' �=� (�Q�� f{ � �. � �� 7044,Business and Prafessions CodeJ. --� --- -' ' hnOVMG - `--� �� ' �- '"'-� � tet:-�� - � - - �- � --- � - - � [OMRACiOR NO. � ;-_,, I,os owner of Ihe property,am exdusively coNmcfing � . - ��• . •, ..� .wiih licensed tontractors to�construc�the project(Sec- ...... ...` . .� . . . _ . . ..� �. ::�.: ��' '��•�-•' . � --•..•.• •1 ... ADDRESS �� � tion 7044,Bosiness and Professions Code). �- � . '; �� I •4 L��� � ..._...._ REOUIRED ._..TOTAL SETBACk . . . . . _ . . ..' . .'. , ' _ _ ' CONSTRUGTION LENDING�AGENCY -��- �T gq�K YARD HWY pROP.LINE WIDTH , � • O U I hereby affirm thm there is a construction lending agency for FRONT � ��� ` ��� � .- ..., _: •4 2 � ,:. ,..,c ,c' the performance af Ihe work for which thia permit is issued �—� - -P.L - -�- �- � - �- -� � �� �- - - . +��- -�-- -- � (Set.3097,a,,.e.�. s,oE - - .. I 2 3 1 -8 6 �� P.�. . � , ...- - - Lender's Name Cont�nEnt81 I111i1O1S Bank � �� , � ,, $" / -- LDMA Ref.k ' '- � _ . . .. . . . ._ , .. -. G.C.Fee S Vermil fee '-."_.. . ._ . ..._ = lender'sAddress 231 So. I.a Salle St.� Ch�cago /'' �7 4 � -I certify lhat 1 have read fhfs applicotion and state thaf ihe . issoonce Fee � ��(/' iOMA C/C M --��oC , ---- - �� --� � - - ¢ above informolion is torrett.I agree lo tomply with all County invesi�go�ion Fee � � r manc , d5tat fin tobuild�n consirutlion, _� ... ...._ . TmolFea � �LD1�Mverm.N ��J�w� � --- - �- -'-- ---- '� � �C 9 9 ___ .. . _ . and h re6y au3h ze represe 1 �ves of ihis Coonty to enter � , opa ih ab e ntioned p ry for inspection purposes. y��✓/"�D �,�C(� . _ ' ' ' . _. _ ' _ . ._ _. ._ _. J _ _ . . .__ _' � �LZ� SEE REVFRSE FOR E%PLANATORY IANCWGE � � 'O I _....SiqnaNre of �P i or Agent'_. _.._.. _. Date.. __ . . . __.. . . . _. ._ .. . . . .. . . . . . . � _ . ' _ . ,r i I _ .__. .�.'_" ' ._' PLANS TO APPLIGANT INSPECTOR'S NOTES �,�.O�VNIiR-BUILDER U@CLARATION , I hereby oifirm thai 1 am exempt from the Contractor's So: � � � Roturn:d . � � � � - ' - license low'for� the following reason.';(Sec."7031.SJ �"-" � " ' " �- � Approved � Qusiness and Pr%ssions Code:Any eity ortounty ieJ�itl� No. Dafe �� No.`� ��Dati . . � .. . .� ' . •� . " . . .� i:i�; . r.:requires a f�ermi!fo rnnstruct,a�ter,irrrprove,denrnlisl, I � ___or repairanYstructure;/�rior tn its issvanre,aLcn reqaires `�� . .. - . . � , r, . . . .., 1Le apJ�licant for surb permit to fi(e a signed ttatemenl , tbaf bc is Jicensed pursuant to tGe f�snni.vinns of the Con- , . . ., , '� �� trndor's I.icense I.aw(CbaQter 9J(conrmencinq witl Sec- i - � - -�� ��-- �� -" �� � - --� �� � , ernn 7000J n/Dii�rsinn 9 nf!be Basiness and Pr%ssions . . , � . - �.�;� , � . � " � ''� � ' � � �"� '� CnJrf or[bae Ge is exemptlbcrefrom and[hr basisfor tGe . , ,�� .._ �,_ . .. - �' _ _ . . ____ .' _._ __ ._. ._ _ � -. � � � �� - �- allegrd exemf�lion.Any t�iolalion njSertion 7031•5 by _._"_ , ._ '��Rsqulred � - _ . . � � - � ' . ._, _-�. �_. _ � . an�'°hhfiranljnrapernritsubjec7slheapJ�licantloaaiei! �� Approrcls�� � � DateRoeeivod� . nJt emom'tLan GundreJdallarr SSDOJ. . . . :Yai No or Approv�d�. . . . . . .\ pen y of nn five .. , (, /: �, .._.. : �__. . �.__ __ � ❑ I,as owner of the property,or my employees wi�h .. Water Certifica+e - - � - � ` ` � �� � ___ wages as their sole compensation,will do the work,ond �. . . ... .'. __ _ _ ._..._ ... .._ .. . . .. . �-----�-� --��- -- � - ' ��--" �- ' �� "�the sfructure is not intended oi olfered for sale(Sec.7044) Heolth Departmenf ._ _ . . _ . . - -_ .-� . - . . - --- ---� - -- - �-� ._-_ .. _ � - BusineasandProfessionsCade:TGeConeractur'sLrcense ._ .� „ ,_, _. . � , Lau�dors not aA(�!y tn an owncr of proJ�crty�a�Gn baiGls �� FireDepartment _ _..._ ___._ � �� � � ' .� � �- ---� . , ��� - orimproneslbercon,onJu�hoJocssntbu�orkGimtelfor . -.� ' . ,, i;,.�_, . .. .. tGrough bis.own employecs, hroi,iJerl:thaf�iurb ini�. � Groding • -.. � � . � , . prorcmenfs arc ttot intcndcJ or offercd/or sale.� - - . . � . � ! . . . . ..... ' �\�� . bowerer,1Le btiilJingor irnprovrment ir sald u�ilGin u. . - Geo�ogi[al ' - . �. . . - -_ -� � � -� . . .. , .. . , ... . . . }'eal'nf tomJ�lclion. 1Lc ownenburJder�u�i!!Gaoc !bc ' ', _ . _ ___... _ _... _.. .__ . � � burden nJ/�rnving tl at br drd no!baild or improve fnr Pedestrian Proteclion - . . � � . thr parpose of salef.�: � • ,I�';: � ..-7.� ;._ .,. . � :. .. `� (FenceJ(Canopy) � �..� _ , -�--- - -- � � -��--- �� - � - �- - _.�❑ I,asowneroflhepropeny,amexclvsive�y�onlrao -,�, . � �ling wifh Ifcensed controcto�s Io�constrvd the'project(Sec. . . ��.:_ . � . .�R $pecial Inspec�ion . . . �-' '- � . .� .- ... ....... � ' . . . . -.- . 7044)Uusiness and Prn est'otts�Code•7" Cnrttrattors j � /e y (Conc.)(Masonry)(Welding) . - - ' � , . . �y;.,, , I,ironscLau�docsnnlapflylncn'o¢•ncrnf�m/rerlyu�lo --� � � - - � �- � - -�buiGls or imJ,rm�ei'1Grrenn,and u�bo aonlruclt for sucl� lo�Drainage � � �' �� � � . __ projecli�urtb a contractnr(aJ licenaed pursuaxt to !Le ., �..�'. ,, -,." � _ _. . '_ . ".. ' . . ^ '. . - .- .. ,, • � ... ' 'Cnntractnr's�l.rcrnsc Law).�--- --------- � - ,. , . Parking . . , _ _ _. . ._..' ._. ... _' ._ _ . ._ . .,�. . � . .., . .:...; , Q I am exempi onder�5et. ,B.BP.C.for�his . � reason - ._ . _ __._..� .. � , � . ' . . ' _ . . . _ . . - .. .._..._" � • ' �• � � Daie Owner . , .., n _ � . . ........... . . — � -- - � ,. . . Approvals Dafe � �Inspedor's Slgnafure. . . . �! � INSPECTOR'S NOTES � � Locolion— . . . - . (Setback 8 Yards) ��, _. .- . . .'._.. . � : � Foundaiions i � . � • .. . ; ' .� '" �, � . Slob� . , ,. _ .y f�, � _ :: ..� . _ .. . ... . , . . Frame . � �""_ _�- � . . . . . . .. .. , , . .�.. .. � .� .. �,. Energy Insulatiod `71J�C � �..'.. .�_ _ .. . __.._.__. _'...__. . , . . . . . .. - ,.,• � - .-.. Lath/Drywall—. � � ��Vl . .. ..� __ . .._._ . . ..,. . ._,__._. .. . . � . INerior -� -- - -- --�-- . � :. . . Lalh—Exlerior �� � . . � � . . . . . . .-' .'' � t' . . . .._.__ . � i , ' � -� ,'��� . .,C .. . House Number— . , ' . _ __. _' __ " .. ' '" , _.' . .. .. __. � . ' . _, . _ . . Correct 8 Posted ' � - ' ��'.\ � . ` '� Finol— __.. . .... . . _ . . _ _`- __. _. .__ .. __ --.. . , _ . , .. . . . Enter on Fron� � 1\ : \:-, � " �� � �,� � . �� . . . - . . . . . . . . _ .. �.r.", i.� _ . � ' .. .. ' . , .