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HomeMy WebLinkAbout0908A (4) T)_"... . _.. .._._'"...__.,---.._...-., �.,.-.._....v �.-..-_. ..�.��...�_�.�� . I... I� . . . .. _ _._. ....._ .. . ___...� , ....._.._. . s ._ . . _...._�-..._._._.._...._. .r.._.__. _......_._ I / '. . . � ' ��� �_` . . ' . . . ...i , WORKERS'C6MPENSATION DECLARATION � - � � '�� � I laroby ulfirm�ihat I have�a�<erlifieate of�consent to If ' ....� � ��. � ��. .intuie,'orccertlfimteofWorkan'�om���f�o�,�,�ro��. - ��. � - �.APPLICATt�N�����0����BUIL�ING _PERMIT i- - � -or�o eerlifidd t ahereof(Set.3800,lab.C.) n LO$ANGELES ,' ��.; . .BUILDING AN�SAFETY � '� `ponovi ce�ed��b�furn�aha5 d.�� �^{.�!u y . �FOR APPLICANT 70 FILL W ..-..._. . .= nooae� �0 3�, . „: �'�'L�K-0G. � ❑ � Q' �-CerHfied topy Ys filed wllh fhe tounty 6vllding insp t- BULL0ING � '� � . ! : fro dep rmenr. r ' nooaess 3b3- ... C. ,: �ocaurr 14hOti1 (3-Q- � ;_ ��` ,��, �f NEAREST - � Dale��� APplieanf - —� arv N f0 R.- ZIP �. CROSSST. � . , ERTIF. TE QF.FXEMFfION FROM WORKERS' , �. , 52E OF LOT � � . . .NOW ON t0T . \ ���. MA�r BOOic � �PAGE anRCEI �� � , COMPENSATION INSURANCE •(This eecHon need-noi 6e completed if th6 permit Isfo�one � � � ' �SE Z�NE N"AP ' ,, . - , - h4�dred dollon(E100)or leds.) . TRAtt eioac ior nro «, nro. _ own�e i�d�� . _rec , .. : sa�cu.� ; Y� I�ertify that fn:}he performance of ibe wolk for which 1 Is NO � CONDiilONS ' �d � � ermM ii iuUed,�ahall nof em lo an erson in�an maM � n.i.�.J DISTRIC7 GROUP�TYPE :fIRE PROCESSED BV �Q -io os to beeome wbjecl lo ihe WorkenPCompensahan Lo a. �� A��� C`�� L � 1� .GONSL �ZONE �� �V � NOiICE.�O APPLICANT: ff,�aher makinp rh . ��. .... . _.. . ........ _._ ...... n �7O _�.. 3 .�...� ,. . ' .� Dare � . . . i�^C f�'� Zia .,._ . � ilplicant . . ��� . " ARCHITECTOR TEl .. STATISTICA4CtASSIFI�ION_ .,.... APT. C�NDQ.; . ._V Is Certlficafe f ':'> NGINEER ..'. �..-.. ..� `NO. :,..�' � ClASS Np.�DWEII.UNITS_ i. 'Exemption,�you �hould become sub�en�ta Hro Worke ` �� d ApDR � �Com n Pi�on rovieions Pt the La6or Code,P ou.musYforlh- � �" E� . ..__.. .� .._..,.._ . .._......�. . � SEWER MnP �� . _.__.. , I Z with.com wiTh-auch rovisions or.this erm�t shdll e -� /�,p� �c VALIDATION � ����-'^ deemed tevoked.�-. ��'�-� � . � ` CdNI'Ik.a OR �. . NO. . '^=s-�� ...� BK._._.. .PG ..... .. � � . . . .... UCENSED COWTRACTORS OECLARAiION. -� ' �," :. ,.��ef c.. .uC.� � � ' � . �hereby�rm that I�am I'censed under provieions of Chapter 9 � AD�RE55�� P���Yl� NQ � ".VAI.UATION `��� "�� � �` � �� (rnmmendrq wl�h Seoion 700D)of Divislon 3 of Ihe Husiness a d 'i -1� � u�, �r} n R . � � �� f . Profassiom�Code,and myq�licerise ls in full force ond effecl. �� • CRV���- � �{/N F� �. C1.p,55�U'� S �� Q v; . � - � �f�.V�� .. .. a r-. ._.. SQ.FT. �, NO OF . .. ND OF. . . ..CHECK .�. . . . e � � ..,.., �i _.., � - Llcense Number Lic:Ctass . �, SiZE"' J Z STORIES� L cpMILiES � � ONE ��; - 'W�STt�3i'"ttJ9y'�h".^ + . . ., __ ___ ..... ....... ... y '' Confraator �. �A3-7'"l D - Oete � .. �, F�ESGR�TION OF WORK L(`..dS � NEW Q . . . .... . - .� . ❑I om e:empr vnder Sec.���. '' ^:�.5'� /IS� . .O�0 RJ_...�-�6�� ��D . ._. .� �. _. . . , . . � . � . AITER Q ..-FINAL �.. _ .,.. ._ _n . .. . .I � . � . B.SP.C.for ihis reason� � . . .._�. .. :->r __............ ._..,,........._.,.._.. . . .. _.._� _.DATE � � .. . , . . , . :,. : ', �� Use'oF � � .,. _. _:.__. s DE�nOs .:dY{k�. _,. � .. ._ ' , ... SignatVro ' . �..�� �. � . A PPCAM DG ,._.vI� . . ..ND. l.'�f�..! � rX r � I� -�OW(VER-BUIL�ERDKIARA7IQN "� �', v .. � I � I bereby offirm that I am exempt from the Contwctor's Licena - :�I . � � - � 1 Law 1or the followinp rowan�(5ectlon Z031.5,�Business an . ..,. Aoo�if35_ . � �_. .:�--...����3�,#.��:.p.i4 � ...-. ... . ,.f.�. . � . Wofesaiona Code): �-. .' ... ... . . " . . PR N , ' " � � ' ' � � � _ . euuoiac . _ �{�4 0.8 A . -.I.�us�ownar�of�he property, or�my emptayee3 with ....-.� AooRE55.. �---. .. -•...... . ......_. -.' .....'- .. + ..��� � � wapes as their fole eompensotion,will do the work an . .. .°.. : . . � �I ' . . #��.•:•,� .� ' � -the structure is not intended or oHerod for wle(Senio .-..... �oG4tttt � . .. ......,. ...,... . �_,, :.._,. ... ._... ... ..,. , �: , . .� � 7044.8usiness and Pmfessions Code). � � �.. MOVING � �� TEI. �� � . �� • �4.�J.a h . ��. i . � ..1.os owner.of the property,�am exelusively confractin aAROR . . . . . . nt0. � ; , . .. . '. - . .T� . . ' ' -.... ..._. . a • • with Iicenaed contrenors ro tonstroa the pro�ect"(Sa- ` ��'` . . � 1�3,Q�J� � ' ADDRESS �tion 7044,Business ond Profeuions�CodaL.;. _,�,.. .. _._:. _... ..,.... ._._ ._....�...... : �:,..- �. . ..i _. � ,, .... . . . . . ` REQ IRED YARD HWY TOTAL SETBACK FROM EXIST. ► ..�..� �b�g'� � � � �CONSiRUCTION tENDING AGENCY� � � seT�anc RiOP.lIN � WIDTH � � I hereby cfflrm iho+there ia a aonatroetion lendinp ageney for ...... pp _. .... .._. ....... , ._ _._. . �__ . ;,.. .._ . „ . '�: ���the performonce of Ihe�work for whith Ihis permk.ta iuue p t��- � ' � � � ! tSec 3097.Civ.C.). � SIDE.�. . -� . ...�. .` 1 . . . . .. ... ... ,_ .._._ . ,.. . __.. . ..... _.. ,.._ _..._..�.. .... ._ ..... . . _ .a,_.., p . . . . . . . : � � . . . �'P.t.'. ..... . : , lendePa Name . � � .��..�� . ; . . a _ _ � _ _ . . _ : _ �. a _ _ . Lender'i Addresa � � r.C.Fae t rermu he - . . , : - � . . _ .:... . .._ .. ___ .. .__.. :__ /t . . .�_ ..�:.. .. � .. .,. . .. Y ...I esrtify lhet�I hove raad Ihis cpplimtlori and stata fhai the �� - � � Iuuanc�iea- lJ�.... . ' . �' l c obove lnformation h corrccl.I aproe ro comply witkall County - Inrasnqatb�Fea - � .. �r.. �..� '. � ordtnances and Stote lawa relating ro�buliding ConslrvcNon �...' ..,.--.� - . �. ._:._ ..... _. ,.'. .._.__.,. ___ , .. , ... . . . , � 6nd haroby authoriza reprosentatWu of this Counry ta.ente � `�� Totol Fw ��� � � � . upon iM�e above-mentio e properry�tor.inspec0on. s .. . . - . .... , .. __.._ ....,-_ _ ..._.,. ......,.__. . ......_ .... . ' ._.._.. . .. _.'. ... S... ,.. � '.. . � ,', . .' �. ' . . . �' � �SEE REVERSE fON E%PLANATORY tANGUAGE,.__,_, ,,„.�,,, _: . ..„�. �� . �- ..., ' ! _ ...�... . _ _. ... . SiqnaNrtof MP icani or A9ent ..� te . .�. .,.... � . . �. � .. � . � . ..._.,0s �.. . . . . . . . ... . . . ....., .._:.._.._ � ' .. _... .". , �,_.._. _... , ._ . .{_ : . !. ...._ . ._._ .. . _.�. .._... ... . _....�,... _. . . . . .:�.._.. '_.__.__._'__ _'._.._..: . . .. � .� _ I ' .... '� __ ._ . . . . � � � .���r:�., ,� a �.. -...;I h ��N����r; , . ,<<, . . . � � , .. . ,.�. . , .. , � t .; I,D�R.DFCGARATION.. ....;e� � ;,: :�.: .^�tANl�TO AVPLICANT .� r. , .. �:. .� ,:.� ., ,° ' ��INSPECTOR`S NQT@5.��. ,, - . eroby P ;om exetrrpt,Jrom the,Gontrocror'a to: �y : , .��,,. .R}otum�d,. . �, .. .. � .A.. ,,.� .�� . .. .. . . . , Llcense LWW fb[ ih¢-#oUowih9 ea4 n.; 5e�, 7A31�5) e v: ...� ..A._ ... •�,6 � i�1..�. .::.'.r�,. .,..._. . ,. er e�er�,e�,�ucbMr,�ru I�a�r;u�c v�d�u,bicb :. .,n. .....� ��--orrepair¢nyad c re;p iuito'i�ist an e,c �o . No: - --..--DBM�...__�_No ,.:"�ah�,�.-�- . ^ g � p' p � eqeoY'isFi`f pproWtl - . EufixssaaildPra taion.rCade A' a nr�qun 'req�rires __ _ ...._ ,.._._..... ..... ... . .._.- ..__.. .._ __ . . _ _ _ ; .. .. � . ., .... ..� �, ,�': --Ybe.cppt'rcahtfor:such�p¢rmftldfi7e�a��si�nedntdte�nd ..._.. _..__.... . �.--- -- _.. .�...�. � _ ' - -� . _. .._._,- ' , ��=hax be�licensed ursuant to lbe�prbvirlont tbe-�ea=., _ _. - P ��� - . , . . :� , ., irncipr's icenaeLa.y , hapter9J(commsncts �u�ithSen .... ._._.._.. �... ., �` . �.� . �� '��� °' " �. ...�.:%�oe�70(�OJ oJ IS.zrsio�3 bf the'��.<sixes5 o»d P►ofesslti�'s � . ...,,,,,� � . ; . .... . . , ._,-':.,„i � .� �:'.i n,�o-�...� � ' . CodeJ'a�tbat�^&b.i�bipldb�frdrndir�l6e�b a�ortbe �-�-'-AT9rowls......_._.._. Y�s9 --M4 erfA�owd +_r`.: �.�.,;� . _,` i �. Pele�Y J�ot ���9.�oJ� .. ddoson ,��1r10fb1 �q e on�o,F 7 S i Ra uind ..._..._ ...._...._...._.._._.__.._..... };..: .��_....�...� � ..� (..f.un�l.. {'AsoWne+bf�p�QA�j��mYo�� yP� W�� ' ): �rh .� Vya�er'Certifiaale -. ', � �. ` E .....:�::j � "�' � . � .�>�:�.rwog�s�aaaheiraale�compqnsationl!+�✓�II!db-the��rworfp-�nnd ;-�:�': �.. iz. ..� � ,. . ,� 1 ��_�.; .! '`�.,� % _ �....,._, " ���t . .rv�nNe�sirucroro-ts��nol=ln+en!led�orm'fferedforeate�(SeC�704�) ; , :_.. ._ ,.... ..:. _.. � � _��p'h"��a� m�,l. ` , . "'�.,-� , c�„�r'% � 9 . . y� �,��� ... Eusiness and Professions Code:Tbe Co�Lracdor's Licens¢ i ; , ..,, , . �y .. . .� � ,...r`. „ ._�_...- -._... .. __.'_.., . ... ..... t _,'...., -�,. ....�_lam�oas.ttaL.apPly.ia-an�osJaer.ofprop¢rtywbo..bu3ldc �I I Fire Deparfine;o� � � , , �.:�, .��' � :,,:,. ..• �.�� ..___. ..�� •-'rtih�rooes there'as;'us3d wbo doq's'SutB tnork-hinfseff or ' ..._�__.-- , .. .., - ._...- _ --.._ . _..:- ..{8lau�5'bu o?�x e 'loye¢s �rovxded tbai�'tdtb r'- _ , ,. Gradi n .. . ..� ....:�°,'�.. - ..�. � " '�o�we er Ebe baal��o'r improoeme�f red�o��am�e,�� g . _— ._ �....,- - � . n �� . '� ._�:_.c� ,.. ' }..,_ ` �,, �, , . �� . '� xtEaso sus�i�itti . ea Gealoqicol . ... �, .,... ' -�,- �:; - . ; ;):, , ,� ear of i omy�leho� fhe ou ner ba:lder utell baue tbe _ .Y � i O• ='�" c,, p�rdea��rouin���nD,� d.d x E bu11d or;lm,proi e Jpr , � s: „�.. � � 5'��' • '' -' e urpare�o,r`sqleJ , . .r ,.. Pedeetrian Prorection' - ��h � ` . �,�i,���. " .. „ '` � - .�- n > . _ :.�. :. (Fence)(CanoPY) „ �' L .' . « �� , •� ;�,� _ .. ..). �' 4 �' . '�>-:'C�..I:,�owneraf.th�e:properly;amexclusive4yrnntmc' �' ... ' _ --. '�"4 .. 3 � ttrg wvth Ilcenead conir�ctqn t0.con{tru�ct the project(Sec. � � ..1.__ `', ._ZR44)@'ustees.vmud.ProJBsssonf�'olle T�ie.GaMeractor_"s " Speciallnspection '�� � (Conc.)(Masonry)(Welding) � � „ . ,���L+texs�f,�(+�doeinotopp!}Lohs�own9rofpropgr2yitwhn � . ': �u(fd,s or i+kfrwrts theredn,l'andw�._�or�Fro�tsfnrrnec6 ; Lot Drainoge �, .:� . �". `-�:��. ' : r,._ . ,' ��, rojee6s with n rontracto bceros .: .t�ft5e . _._. .___`. �sJr,u�'�'� ursua G_ F � -��- + . � J, ."-�`a5tral o�zempt un�e�ec. ��p,B.&P. L�� �I. Parking ,._....... . :�.,.,.,. �._ ., :. ;_• _�_ _ ..i: _ ._ .._.. --.--_-. n C.forihis � . .._.: �,. .� ., ' . � . . ., .... .. . � �,- , q � . _ _.__. .... ._.... ._...._. ____ ...___ . . .,, � ._._. ._._ ."' '__--_.. �_ �� �____._ ....._ . ._._ .�., i,. ... _ �: � � reason . �, , . _ , �,,� j � � t-.�� � . ...__. .'_ _ �. ... . .. . .. Date - ;'; .. : . - OWner �. - (""� _� .. .,,, .Y_. � r� ,>Yir.ltr uH�:. :��i�� . . i= iL�. I fl�2 tla. '1 . �F}.nl ".1 9���,�, �. ,�/►p�r�vols D�to Inapetor's fipn�fun - -' .' . ,..', �� '. ... '. . . . .�;.! :'� , . �IRISPECTOR'S�lOTES ��y���- ��--, , :, � Lacation- .�� --._ .,..._._.-__'--�._._._ ._.T.._.___ .___.....__. i�., .� _ . � __.. (SatbackWBMe'rds)'�i b�.;! .obl• _�� � .. . ,. . .. , .... . r i . ��. n:r;.= � ..-a i.._ ,...., ,... ,,..�.,, � --�. �.. Fou�iddHQn3 : o � � . :��,�. � ,. :• � ..(� �,.:��.os,c.�,,... ..;,d��n.; . _ . �.. ._... . , � � . ��, ,. .: ..,, . ,.�t„ r_`' .. ,,.. _:, ,� .... SIq6,;1 i ;, , . „ ° �.?; �. sd��� > ,;t » .���, _.._ fi . . � , ..._... _�.'__'._"_`___._. .._ _.._.—` _-- (..�c,J� . �POi=l r �ia ..f� n�`, � t. I fra�ie�_,•��� p 3 . ,i5 ,,� `r ;.. .._ v . i U�. -1? �;�4 , ,; V �J. ,.. _._ ,�__ .__._._ _ ;_.._.:: _:._; ,.�; ��.,,. ,,:.�._ , , �..,.. .. «. ..i� ,b, . ,,. �.._C _. _ , . `. 6sauzc �n,.,,.. � :.,.c .�,. ,.I..r .� � Energy I�sulation . . ....._ . .. '.'.. .'. ':: , . , �___ ...._.._. . ._.__._.i_ .. _..'_' ' ' .,. ' > C.,' , . , ; ,. _ . . .. . .,� � Lath/Drywall- . .,. ,.I .... ....:.. � . .'... � _.m .. ,..�.. Interior ' � � . �` - � � 6 ,.��.,.. . . � :.: . ..... ,. , .... :� . . '. . .,..��izi ..) a Lalh-Exterlor � ��.._.� ._ .�._..:C: � "�� ' r ..��; . .,.,.. - , ,,,�_"_ '.:.__ ___.._" ___.._._._ _;� _ ,�`�I�,A; :'�n=t I House Nomber- ". ._�«�..R-a....:�__ .-,' r�. rlt r. � �..knr > -. c. ,' . .. Corrett&Posted ' - _.._.__:,�.._�'_"' -�..,` t-�s�..-;?I o r.:�.�yl�, ,v oi,,.•pa I n �.ro z n .�.-r.c�. t <, , s Pinal- ..��: �.,-�1+ .U_ ( :no V���-.a�z . . .. . '�. � Enter on Front ,. „ '..� .. . .... . ,,..,, ', :'.� ,� �,rc , , ,•zc � r i . � ., -- , � � , . ,. ..,. ,,��� :�. . �n,.,.,.�t� ..., . ,_. . ;� �` . ., . 4 , . --- �,,. , ,