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HomeMy WebLinkAbout1346A 3951A . ..,_—. _._ .....___._..�.� , i _� . . . . . --._ .__�-- ._._�f _..._y.___..._-- �....._._�. ......_�--..,,,,,, ...._.....__�..�._-�.,.._._.. ... . . . .,_„__. .--'. - APPLI�AT��7►�V���' � WORKERS'COMPENSATION DECLARATION i � I fieroby affirm thatl hove a�-cernficate of.rnnsent to self ���;g�,J�N������� pERMIT � iaaurp,or'a certifimte of Workers Cnmpenso�ioo Insurance, - . o�y-r!rflfied copy thereof�(Sec.3800,1a6.t.) � � � � � .-CpUNTY OF..LOS-AN.GEI.ES ; � r•.-�. ,.,..•.,BUILDING AND��SAFETY � � i. _. � Paollcy No: � � . .�Compcny . .... .. ... � . .... . . .. . .. . . Certified co ia hereb furnished.� BuitoinlG • , PY v ���.� .FOR APPItCANT TO�FILL IN--.-.-.-- I� �ooaess ...,.�:��ZO:. .'.�-�-G� ��� Certified copy is filed-.with the county bvilding inspeo- � BUItDING �1 /�.y/1�.� ; � : �. - � :. � lion departmenl.�- .. . .. .. . � . .. A�DRE55 .. Z�d�' .�.CJ�!K. _ �'...._, . .....' IOCAt17Y _ _. .. �. .Date, � . . . . .. . .... . . CITY��MaND �(�'`� ' NEARESt . __..- ,. .. ... . ApplimM � 21P � �� CROS55T... :-.CERTIfICATE OF EXEMPTION#ROM WORIfERS• � . . . NO.OF BLDGS. �: ASSESSOR . . � .COMPENSATIQN INSURANCE � � � . . � Si2E OF tOT � �hiOw ON toT I Mnp BOOK PnGe PARCEL � ' (fhis�ettion nebd rlot kie eemplered.�f the parmit.is for one � � � � �� � . - ' ��" USE Z NE MA7 D� � hundred doUan(:to0)a less.> owniek � l�S O(2-�`_`o� 1"''O v a �v,J . ��^T f�p "3 3 7 ' tcertify.that in the-performante of ahe.yrsrk for�which thia � , . ,. �'M;.. D I S T R I C f G R O U P I�T v a E �� ��ZONE � 'O Pe ' P Y. Yg �n�tY manner . .: . . 57AT�1�GL CLA�IUTION F I R E P R O C E S S E D B N � ;so cs i�be�w�me^bub�'ect to the Wo[kers Com Ion lnw�. � ADDRE55 �3-ZC) VL"� �[ONSL . ' � �. . ��,}�OTICE TO�APPLICANT:�licafte makin this ert f , ... . CITY��` ���IG':l� �� .ZIP� �O�' ' �. N�., ��Q . �. rmit is iuue ,I� I not.em lo an 6non In an � "" .. ENGINEER N 'Nd.��f C�•�1�� . ..... ....... . . �. 'Exem tfon, 9 C ific of ANCHI7EC(OR 7e�. ( 2 .... �. . . V . p you sbould�bec e eubjetl ta.1he�Wo ers' � }�� �wER�P �' � I W :Compensatlon provisions�of the iabor Code,You muat fonh- . . AODRE55.=2 f L7.1'-c•-7...�. � . �. ..-,� . . . � y ��'. CLASS NO. DWEIt.UNRS � , . � �i wfth comply with such provislona or this permlt��halh be ' � � ��� - �� 2 deemed�reroked. .. . . . � . � . • � �L. ..3 ... . ..., ..�...�_ .;...�.. ..YALIDATION . � . . . ... COMRAC[OR �OI/�h� � r NO.. J" D�H ��DK. � VG, � �� . IIGENSED GONTRACTORS DECLARAiION�� � " . . . � ' i heroby affirm that I am licensed onder provisions of Chapter 9 ADDRE55 S 5.�� O. � "VALUAAON ��" � � ''' � ' � � ' . (commencing wifh Sedion 7000)of Divislof�3 of the Busines and - . . . LIC.�. t`. e r ��/ `, . .. .. . � �% Professions Coda,Ond my license h in full force and effed.- CI7y. (y� p CU5,5 ' ; s EQ (fs�! ►. , . ,�r . � -,. 'l ,.. �+� ir � . �.. SQ:FT.� NO.OF �- NO.OF C1NKK , . _ . . .� �i LlcetMe Nomber �7 �S� Lf0.CIOS /s�z,__ � SRE� n STORIES �� FAMILIES N�E�� S �. . . . . '�� 3�I,b a -� l � �^ -I.L,rer��mafe Lf �5-+7'k __. _ , .. _.. ___ ❑ COntraclor�.4 h. � DESCRIPTION OF WORK � . . , , , _ _ ._. DATE.- � .r'���.- . � I ADD. .Q ���a� a� �I am�exempt under 5ec.� � '��. ��„ . . . � �1 ALTEk � fINAI -� ( �,�b�g� , . I B.&P.C.for this reason � .. �� �iV 5�-�B�l"{C'01" .• ..�... . �: . ..8 pGl 4 ,,:'. , .... . ••.• �' .� - -�_�. _ .. Date: . .. FlbE OF � REPAIR ..,Fly A4-. J . '.-. 6 G.H�2tii. . � A exisnrresinc: .K�t?5�• _. neMo� �J Sfpnafu�e . .. . ,_ ,.. , . APPLPRIM �� N'1_�R ��`�YMO. �/ ��,.�L ,�+� � o a��.���7 �. . � OWNER-BUILDER DKLARATiON ' , I I hereby affirm that I am eaempifrom�ha Conhactor'a Ucense � ��- � '1j � �/� ' low for the following reason(SecFion 7031:5,Business O�d , AO�RE55 '?- 3 �,J r ���• Q _ �(ie{�O/`�..-. � � -ProfeulomCede�: � �. .. . ...�. .-� . . . p N . ,y� • � ,',' , II Q . . ..� . . - . .OUIID�NG �� : . . .� .�'�/�'�`-s�o . .�.. .. � . 1 ,` �1,��as owner of the property, or my employees with� ADDRE53- - ' '��� ' " � ' [•. �3 9�S,��,p � . �wage3 as their aole eompensotiort,wlil do the work and � �-�� �� � . q , � I . .the structura is eoT IMended a offamd for sale�Section LOCALRv � - .... . 6 //��..�/ � ^� . �� . . . ... •,• •s ♦ ')04d,Business ond Profeasions Code).� .- � MWING - iEL � �{ _,. � � . � .. (,ps owner of fbe o � . . . ... RAROR � :. NO. � ._ . .�..,'�,, � ..�, i pr perty,om exefunWelytonfroding . . -. . _. . . ':►�8 Q,7� , with lieensad eantractors�to aonsnucf the pro�act(Seo- � A�DRE55 � � � � � ' ' �� � tian 7044.Bueineas nnd Professions Code1. :.� . .... , ( . _,���� ` i,• • � , �� REGIUIRED TOTAI SETBACK FROM �XIST. S G�J� � \ ����� CONSTRUCf10N IENDING AGENCY ��� . ��T gq�K YARD HWv pROP.uN � Yvi07H � _� �- � � 1 ', � I hereby affirm thot there fa a bonatroation lending ogency for , _ F�tOnii .. . . .. ..... . _ ... ...- _ ` .,..�, f/�yiD. . -:�'�,�JY.�S'� . ; the performance of the work for whith thia permif Is issued . V.. � f . ^ �Sea�9pq7�Civ.G.)• - SIDE.:. . . .- , �y;� �,,� . . i .. . . , . � . ._... .'G.l. � . .... ... . . .... ._... . -. .. .. . ... .. , _.� j '�y lsnder'i Nome� � . � ti . .. . , . . . . �. ... . ... .. � ,. � � . . . _ . . . . :.. ...._._. ...,.. � � P.C.fee S Permit F�s � � �lender'sAddross � � , ' � �..�Vil, :�.� . - c. ,� . ..� � , ...: ....._._.. . _ _.. `, . .�. . � -,cetlify�1hW I have�mad this applicatlon�and��tcte tbaf�he �� - hsuonca Fee . .�... .�..�. . i .�.. 'bave infoimatlon is torroct..i agree to tomply with.all Couny Inrsauqollon Fee � ,I� �'7r � � �� � '� ' i tdinances and�Stete laws relating io bollding conshuttion. - .. . .... ..�.iotal Fee� .. -�W' /�l....�. . ......-. ._. ._,.. .- . .. . ._.. . ,. . � +d here6y authorize represemarives of�hb County ro�-eMer , � � . � � 'on fhe above-mentioned property-far fnspactlon puiposes. ... .-._ .. .. ...._....:..... . ......... ... ..,...,..._, ._ ......,.., ...'._ . ..- ._. . ..'..I '..-=. � .. � / , .._ . __ __. . . ��.. , ,� . y?�jj'� l,�� � �L'�_�', �(rY,�s��-(� - fEE REVERSE FOR EXPUNATORY LAFIGUAGE�_�_. ...;�..�... , _.._.. . ..._..�' ' �P ` � -' ' '/� . Ipnamm oi Applicam or Apent �- pyro � . -� . . . . �.. .. . .� ' ..mc. /..� �.,. . . � _ : � ... . . .. . .•. ... ""......... _..»...._.. , , ...�... . . ._.... .. , .., .... .. . . . . .� ,..! ,._ _ __ _ _ _ ____-. — —_ _ _ _ __ -- ___--.. _ __-___ - - _ _--- � � � � � 7;��, � ' " 'i 1 �. iNSFEGiOH'6 NOTES ,.:c i •,C�WiNER,�UILALA,H�C[.ARA.�'ION.,.... .. , � a : ; ; �,. ; � ` . .. . _. ,. . . ..� " '� . . .. . � . . .. . ,�,:I,�tereby aff��m that I;am excmpt.droH�ahe Contractqr's '. . To: 1: Y �,.R�}u�P�d� � . . ..,�.._ ._,. . � - litenae Lmw for'fhe�.�followiRg��reason,�>�Setv a031.5) ......:^�Y .t�i...: c'�- . :. , .. �... .1 �AP�►�Yed � Busi�ess and ProJusioxs Code:,Any city or county wbtcb" � No..._. Dati .. .. ,_ .._. �.:.. ,, .�.; ,,J�c� . �' .. ,-�,xfiepppl�tant,�orsarbpern�ltto�,�filsasegvr¢ddemoli.i 4...Na Oat! . . _._. .....__._...._.,__.-' '--.____� �•' .._ " 't re¢Ge7'as i p�r�n�to ronstruct �i[c,��:�Cou�_ . �, . , _ ,. . _ „ _ _ � p a yst ci r prro t t k an alsarequ'vet _ � � � � -= .stat¢NEeri� . _..__.____. ...... _,__ � —__—__--- -.. . thatbeulxcensedpursannttotbeprovesions'df�theCe3a'- � _ . . .:.;'•'' . .t-�:•;1,�,"' �r:.. ....... =;�1,. , •j; .F ,c � tractor's License Law(ChapSer 9J(commeecing witb Sec- . . � .' ` ; 4 . : . . , .-_tion�7000/-o F)r�rsson�� th¢Busiroess and Profesr� >•.. ,. ,....r<�3 -.... r .'� '�.''; .,,;�a . Code)owteia?helsE.keiif��ereJrarri�andili�basisforebe _ _ _ ` � .,`�rt�9ulnd c��r, _ aky�hIttaieif�re}r'enrle�ssbjecis`tbe�tG�a�3eqr,� . ___.-i1 rovah -- 9a4•RauJv�d _.._., - - . . . �._ � . ' �r�Approwd ,�� Ir�� -'� � � ,� ,� . .. penalty oJnaf ntarc than�„e b�xd.e�dat�>s'�Soo).i Y�s No -" .� . , . - _.:. --- --_.' . �__ _.._ . _l._ :_�. - _ ; �:�.:I d�:,. 6;bs.o�++n4rrbf,thFProPariv,ermyemPloyebs!!.tith ;; ;.- ,. _ , ' -�', Woferterfifi[ate ���.v; � T>� ;'. , . �I.�. •. r:� , .• ..-�7 „�,- �' wagms salq�wm��pan i , � �� , ill zioibe�Wotk;�and , ' � i -� � � � � 0'� i . ._......�..�. ._,..... . .,..,_ �. ..�,:',. ` �__.....'. :._':: . xn-:th�iwr'f[ture'isnor�ini�n'ed�YtAffetedFor�sCle���(Ser.�904d) i � �, � .W artmrni. . --- �--_--.- �-`_ `' �.... • < � -.i-. ,i'�� � � .t E.usixe 3 ridPr;fetqruns Code:Tbe ConEracto%Lrceaae v � p P y.. ., . �..� , �..� . _; � }.,. _-.._ .... - ��''LbuY�dhe mdCappYy taaH oumer"of propertyu�bo�bailds � � F e Da arlmorl .� �. � �F : �':�� � �. ��.�� _... _... _ .. l��m�!'ove's•2fi4YAd�,a+ul wiiotdd'Es aret�wur,E�bimseljor t , �_..... . ._. ._... . , . .� ., - � . , �� . . .. - . -- . `r.. s~' .a.. ' t rbuge,,b& dv.e e�Ploqers�rdv�ded lhaf'aueh em}- ��, , Groding � � .... .z :�'. " + � ` ., .. _... , t._,_ . .,:. � {`bowever,theabssi�n'Iritended a+'�,`h.r.fered�or'a¢le�.7l� � ���� �� ._: �' � ` r�, l ��or[mQrBveme»f .tot�.-iEbinane , _ _ _..._.�_ . ,_,_._.. !....._ .,. t . ��. : �,� .{, -,.v;� . . ' 6er e eam leti�a...Lbe o¢m_n wilder tuill��eve 66e ! c.oloqical : ,. .. � � . � .,, .v f f' . if� . `�,� ` ••� � �� i ,burff�n of�'rvvxn tbat b drd r 2;''bc,lld or im�roue�or Pedestrian Prorection ,. i � : � ' ----- ,4r�-_i � ,.the purfiosg.of sa}ef,. �:, , • ! (Fence)(Canopy) �r f "� �,\ _,,�„ �.`A �� ����lpasowrferlof the property,am ezcfusi'v!lywntroc- IP p . . � ...� . . �, .„, �_ _..�__.. -��4.__ ,�-��..�f - bu tds'}siuessznve,�'t,hroje�s�s ons�'C iru�t the projed(Sec. I .. .. _ _ _ .:�:_ _...^ �: �_-�o )A �n �.ate.\Thc.Eunaacenrr S etia�Ins adion (Cont.)�(�ulasonry)(Walding) _ .,L:ceotse Lam does nod�pj�ply to an ou�ner ofQroperty who . - 'a:�htf,EvtEtracts for:sutb �� LoiDralnaga � ''"-', , .. . . .�- ..�� ' �-�.; � '..._ ' � Q>ojects witL a cnntrutoo{sJ.licensad,pursuaxt,tq4tbe ; . �, . . . ,,.; :...�.. . ..., � � . � .H;Lx .._..__... ...._ .. _. . �,. __ ` _.._.�.,. �_._(°nntrattnrYF,'tc¢lu¢�f.auSJ,- � = . ..: __ ; . ., . ' �, {,., . _�., . ,.., . ...,r.. G...._..._,. � .-.. ...' �' � _ .�, Parking , °4 � . . � �z..-:�,: .-rt r� :?.'.7=' ._..—_ -,3 _... .._- ._._... . .. ._... ._ _..._..__.._. . � . , _ _ ..._ ��—I am exempt under Sec ,B.d►.C.for this � ,. . ��� 'i� t::i�;��e. ..:.. , , .. ... ,... � „'.. . .. ..�� '_.._.__.�._._._.-._.� .._.___.r... _..�__. .._..._.._._..,_.... ... � ... _,.. -_ .'.�, µ ... _. .� . . .._.__ � . .... _ - _ .. ._ . ._ .._..... ._— .) '.� y�l r�.�.. ..: j �yA �,)i ' � .__ _ . ..,. -' " rcoson , . ., .:. � . . , _..._.__.._�_.. _._ . ,... , .. ..._.. . � .�.> _. ' ._�� ._� '.� .• �,,. ., ��� ... �� . ..�_. . �'. . , .. . . '..'.v Date �. , .,.- ,:� :�,�Awner �:� . . � ., ... ,. , . ..� .. � .J .".4.� � ., � �.�, ._.. . . - �.�� ���,_ - . . "� 'c..J Yor -. ri�� � �-}o{a .- , , .t r �.� �� . .,.,, . .. , . ,. .�. � - �,,,�.. �.�. '..ff, " �..,, .� ,,�. ,.-. i U. .i��� .,icl v.,'. '� Approrats DaT� ..��,. -1nkp�rirs.EighNur� . ."�". . � . . ..: -. .' '. - . �... .... . ' : � + .�..�, . • ,' . ItdSPECTOR'S NOTE3� �-�..... �. -y... � < - �' location-., . _ , .. ....__ __.__ _.._. ....__ . ___. ._ ..__..... �.. . ., <_.... r �Seib'ack&Yarda) - . .. �� . t :ti� t - .- �. .i 4� �. ..^.ti- + . . � Fou�datP�ns - - � , s'- Y� . . � o,: o . ,. .����.�� �,;,� �� ,., � r"'? ��. 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HouseNumber— . �� � '.._i , ,. . - ��i u �„ c,'�, .,.: e Y . .,; � Correci&Posted G. .—.�__ .._':._-_ __ ..."_ _..__._..._ _...,. __'�. y.,r:=_ L� �.�.,r. .�.t.�..•,oln ��.o:( � (G � Final— � �, � � . m._ , ., .;� ., � . .,. , .. , � Enreron Front .3�;' . . ..y ot r r c �� _ , > . . . ,.,,.. , _ . ,..... ,.� , � � i�. . , . .._ .��.. . �, .: z,. . .::'.. ..., .. .,......�_.. .� . .'. ' ., roUS�L►k'l.a - � �.,. ,_ „ . 4. ``�, {, -. � .. , ,..,:.., ;, ..• -. : ar_ � �'�� � � � , • �: , :; '� .. _..._....""""". ..._....� . ,..__ . . . ' � . � � . . ..j_.