HomeMy WebLinkAbout1219A 1220A _ -- --- _._ ___ _. _ -- _. __ _ . ._.__ _ . ._ . _ . . _ ___ _.__. . _. WORKERS'COMPENSATION DECLARATION '' � ��� '` � � " � '�� ...,,. . .. ,. . . . . -�. . . . . ,. . , . .. . . _....._ � . _ . . . . ._ 1 hereby affirm thot.l.have a certificote of consent(o self APPLICATION� F�OR-.BUILDING��PERMIT-�� � inaure,or a certifimte of Workers'Compensaiion Insorance, . or a certified copy thereof(Set.3800;tab.C.J'' ' � � �' �-���� �� -- - � �' � �� -WCP625524T "' Great American Plan 3B COUNTY OF LOS ANGELES BUILDING AND S FETY a�Y.No. � Campany - ... ., _ ..,_ _ . Certified copy is hereby furnished: FOR APPUCANT TO FILL IN � Bu��owG aooaess � � Certified topy�is filed with Ihe county boilding inspec- � gUiIDiNG , � ; � 'tion deparlmenl. ' --t'�' - A�DRE55 2 �y Date 12-2-86 Applkant The Wm.. Lyon,Co. �iT� Walnut Z1P 91789 � ��iitv � CERTIFICATE OF EXEMPTION FROM WORKERS'' �` - � � '�-� �-� � � No.OF BLo�S.� - -� �. n�aRE57 ' _. _ _ ._. .. ._ . . .. � - � - �COMPENSATION INSURANCE'� "� ��� SIZE OF lOT3 800 SF Mifl. NOw ON LO7 0 � CROSS ST. ! (This�seclion need not be compleled if the permit is�for one - - - n55E550R ' � � "- �- -" �'�"� �. . .-. TRACT�--- eLOCK LOT NO. ...�'� ...� MAP BOOK •.... ' . PAGE PARCEI ( ) �. � ,... .. . - - . . . hundred dollors 5100 or less. owNeaTHE WILLIAM LYON CO.--N�33-3600—' usezoNe �.+F+P . P P Y he work for which th's � �� ��a so aslto be�come subjettoo t'he Worker Pefson in any manner .. ' -- - � Saeanl-- -� - P ermit is issued,�shall not am lo an -�- noozes�9 Cor orate Plaza- - coNoirioNs � s'Compensation Laws. �.V arv__Newport Beach, CA Z1P_ 92660 – _ _ _. -- __ _ . , _ _ _ _ Date� ' :'., APPliconf � . . � ,.. � . . . .. . . FIRE . D BY O ARCNITECT O ��• _DISTRICT. . OUP TYPE . /�TICE TO APPItCANT: If, affer�making this�Certificate of ENGINEER �ales–Langston No. 547-0862 1 '�mption,'�you�should bemme�subjecl to�fha Workers' ""��-� ^ CON i.i : . :�V � penwtion provisions of Ihe Lobor Code,you mus�forih• qDORE55��� S. Main St. Ste. 10S OrBn �T- - -� � � �- - - - wllh tomply with such�provisions or this permih shall be --- TEL , STA715TICAL ClA ION , APT. CONDO.' '_ deemedrevoked. � .�.. .... . . ... . .. � ..._ mrvTRncToaSame As �WTIEr NO. __' �. __. . _� . . .. . .. � . ��� C1A55 NO. OWELI.UNITS • LICENSED CONTRACTORS DECLARATION•��-��. ��� - ---�-� �--- �� - � - -- - - � liC. � � :: I hereby aiFirm thoi I am licensed under provisions of Chapter 9 ADDRE55 NO. (commencing with Section 7000)of Oivision 3 of the Business and _ . . _ ���. . SEwER MAv � : Professions Code,�and my Jicense is in fuli force and efiect. ciiv c�A55 � � -BK ----� �� ��-� �' �; �-��'ypLIDATION � ��� '�� � �� � � � � � . . 5C7.F7.__ NO.OF _ __ NO.OF _ _.. . CHEIX . � - � � LicenseNum6erZ�68�1 �� 'Lic.ClassB_1� SI STORIES FAMILIES ONE �. ...- �.' � � � �_ The Wm: L on Co 12-2-86 _ vnw TION� _ _ _ Y ���� . -�- DESCRIMION OF WORK '"" "� -�' '-''� "�""-" NEW Contmctor Date noo � s �1 2 1.9 A �I am exempt under Set. �il le �fami 1 e co i i ,.. � ._ ALTER � s , , I '_ #• • • •2� �� . -. .� _ �... :. � . ._ _ .___'. ._.: .. I.. ._"_ .. ._ .. B.BP.C.for this reason . O RE7AIR . - �� USE OF � , I I •2 I C16 H ._..._._..'__. ._... ._ _--_-_ Datei- � �- DEMOL E%ISTING BIDG. � -- --- -� - ---' -I herebnotff im thal 1 am exem 1 trom the Contractor'S Lic � � „ -. . .. ....- ' "-'- ' -- APPIICANT TEL. ....' • •Z 7�}�J a� . . FINAL OWNER-BUIIDER DECLARATION ... . ... .. PRiN .. . NO. - �DATE �. . . ....-. .- - - -..... .___; y p ense � . _ . ., I�L�9-.II G - Low for the following reason{Section 703L5,Business and ADDRE55 �FINAL�' - � . ._"____."'._._. �_._... _ . .... .. 'Professions Code)i�-� " -"�-` � � " R �BY ��� �� -� -� - � BUIIDING : , � <�.2 Z.O Fl, ..: I, as owner of tha property, or my employees with _ , nDoaE55 . _. ._ :_�._ .. _ . �. _ _.. -. woges as Iheir sole compensation,will do the work and . � ' _ the s�rocture is not intended or oTfered for sale(Section ����TY � �� �� ��� � � � ��I . . --7044,-Business and Professions Code). ..... .. . . . MOVING -- --"._ . .. . -.. . . . - �TEL... -. - �. .._. , '. . . .. � . . . . � I,os owner of the property,am ezclusivety coNracting CONTRACTOR NO. . .�-. : '. . � •4 7 5 5 0�� _: . .with-Iicensed confroctors to construcf Ihe�projeU(Set- -..`". . . . . ..---� -��-". ... .. .. .. .. .. ... .._.... . .. '�'-- . �- � • •�4 7 5 5 0 c=i � ADDRE55 ' � ,. tion 7044,8usiness and Professions Code). i `�J t .1%,`' �1� ' . ___.'. _ _.. _REOUIRED . TOTAL SETOACK . -. __. .... _. . _ . _. . L .- -�" � �CONSTRUCTION LENDING-AGENCY----�- � ' Ser encK YAR�� �Hwv FROP.UNE W�DTH� ' , �2� 9�II V ,-� I hereby affirm Ihaf Ihere is a mnstruttion lending aqenty for FRONT ��-""'�' ' �'4 � ' . - i-.. -the performance o(the�work for which-this permit is-issued . .-- .P.L .-- ---_. . _. . ___ . . _._� . ._ .....'.� .. __.. _."_ . _ . . ._ . . _.. .___.. (Sec.3097,Civ.C.). � SIDE ' �j('•�'�; . . ., ^m ... _ _. _ . .. ._ _. ._ ... ._._ . _.._._. P.L. . . _ .. _ _ ._ _ '__. .. . .. _. _ .._ : lender'sName Continental Illinois Bank �/ �/� 'V� � _ ....... .. . ....-._ __ _ _ _ _ ' '_ _. g... P.CFeef '/ S.IJV . . ._ '_ ..��. LDMA Ref.N Permll Fee , � i - - Lender'sAddress��1 Sn. I.a Fa11P Rt_� r.h,ra O � • " ' ' �/� i � .1 cerlify ihat.l.have read ihis�applicption and slate lhat the - -- Issuance Fee ��i J�� IOMA P/C N - -- -- - - � above Informalion is mrrecl.I agree b tomply wilh all Coumy Inves�iga�ion Fce -f . � � , g _ordinances and Slafa_lows reloting to building construcfion, ___ ... .. -� � - Totol Fee /S•��- �lDA1A Perm.N - --- � � `� ._ . . .._._ __ . ...__.__ _ ._ ..._. u and hereby a�thorize representalives of Ihis Counly to enter ,� opon the above-mentioned prDperty for inspection purposes. t 91J' _ _ . �..3 JC.--_- __�. . . _�J . .... __ . ._ .._ . ._. ..._._. � ��a / ln„__�/ • � � � �,Z-�S'S� SEE REVERSE FOR E%PLANATORY LANGU�GE . . ... .._.. _ _.._ _ ' . _- -_- - -. .__ `n LYJ'J�liQ�' . . �-- �' Signa�ure of Appli<am or Agem--.. . -- - ��Doie... ._ . - . ...." . - . .'. .. I . ._ __ . _ _. .. .._.._ . ._.. . ., _. . .__. ._.pi - PLANS TO APPIICANT INSPECTOR'S NOTES 01VNGR-DUILDEN DECLARATION . , . I hereby affiim Ihai fam�ezempt fwm�he CoMraUor's � Licenie��low'for��Ihe�,followin reason.' Sec.`7031.5 To: ' � . �. .. � „ R�}umed � .� � ' �: ' "�' [. , ,.�'. .' .. . . � . ' � ' ' A c 1 ` � ' Approred ' ' Qusinees and Profestions Code: rsy city or oun[y wbicG No. Dnfe �.� No.' . ..=�Ua}e . - ' <.-.. ,. . _.. .. i t�... ' ", �:: �. ;.r¢qaires a Jrermit to rnnstrecJ,alter.�rnafrooe,demolish, .. _ .� . _ . .. . _._�.�orrepairanystructure,priorloiesissuanre,almrrquires . ��.j �; ' �� . , . . . . . � fGe af�pliran!f ir surG permit to/ile a signed slatrment , . 1Gat be i.a IicenseJpursuant to tGepronis;ons of fGe Con- I ��, �. �. . : .,. ; �,�..� :. ,.c ;,�•.�, �� � Jrattor's Lrcensc Lau�(CLaptcr 9J(canen�encing u•rti Sec- . , . Jrox 7000J o,/Uii�ision j of the tiusrness anJ Profersiont � �'. • `. '�. - ' �:�-- ,' �." . ' `� �-�"" , • ''CnCeJorlGutic�riesemf�tlGerefromartdtlebarisfortGe . _ .___ . . .. � . . _ _ . _ _ ._._ . .._. -. ._ . - . ..- . . ..-.allegeJ exemfNion.Any t�inlation nf Section 7031.5 by ' . . �. .: q � . , �... . . . .,.., , .. . . .. Re uirod . _. -`DatoRacalvad- -- -- � --' -- --- � - ...: =_ ... -___'_. ..�. � an,Yapplicantf raprrnriftubjertstheaJ�plirantJnacivif _ ._. ,, A rovals � a�Approv�d ' . . . , .., . . . .. � � ��.fenalty ojnnt mnre tbart fire Gssndred dnflars(8500J.J: � vP: - , � Yec .No �..���. . . . _____. S _. .:...__ _._.... _ _ �:� . .. �., - � -�- . ❑ I,os owner o(Ihe properly,or my employees wilh - Water Certificofe ' , -� � - ', ���:! � ` . �- _ � -. �� - ���� ������ � ��� wa9es as Iheir sole compensa�ion,will do the work,and .__.. ... .. . ......._. ___ -.._ . _. __ _ .. . . . . '��--"-� ��� ` "� -�--�� � . -�the structure is noYintended or offered for sale,($ec.7044) . . Heahh Depariment � ��\ �� �'' ; '' _�.._._� _.___ . '.. ----._. .-..--�- �-. -�.'.�.�. :. ..' .. .._ �.._ �_. ._ . �IIusinrrs arsd Professinns�Coile:Tbe Contraclor's Lirense . � , .�,�;, ;. '. �Lau!docs no1 apply to an owrtcr of property�u.•Go bur(ds . , . Flre Deparlmenl,_, .. . � -����- - - -� �- ��-�- -� - �-- - - --�� . or inrhroncs t!ereon,and u�bo does sutb urork Gimseljor . -.. �. . .. �i-�. .. __ � �. � - � - .. [Grougl��Lis nu•n...employees, pmvWed.tGat sNch.inrz r Gradin9 -.�".._ � �"'� ' '\ ; � --. �:.. . � . .. - ..�roccnren[s am�.nol intend¢d or nffcrcd jor sule.;,� . _ � ,r':i ��i:�., �,C - � �ti'et'er,1!e baildin,q or ini(rronement is so u�itLin o.. � , i � Geological ,��'..-, ... _ . ..... ;. . . � -. , ....� . ���'�� •'� " �• ..'year of mmJilefinn. Sbe o¢�rterv6uilder.a•il!fiavc tbe ' •� ' � �-� ' ���� �-"�� - -��� � ' burJen oJ/rmvrng 1Gat Ge did no!build nr imJ+roneJnr i -� ,... ..__.__ ___ ._.. . . . - � -. Pedestrian Protection .'�--� �-:". � .. .. '. " . .�. . � �- _ �- � 7Ge/'urJ�use of saleJ. �.�..,�:. ; • �i�..; (Fente)(ConoPY)-. . . . . � ..�.� -.-... - ..-.- .-_--- . .- ...... .---.-.. .-- -..-...' . . , ❑ I,asowneroi the properry,6m exdusivelycontrac ting with licensed comroctors to construtt the project($et. Special�Inspection��- ��. -=-..-_ -` . .....:��- ��-- . . ..... .�-� - . � ----��-�::-� � 7044)IIusiness arsd Pr�fessions�Cade:TLe Controctor's �Conc.)�MasonrYl(Welding) -.� .- :� �. . . . , ., � . �: .,:�;,.. "�'.i.__ , l,irenseLau�docsnntapflyloanou�nerofpmpertYu�bo � LolDrainage �. . .:. ., � .. .-� �. . � � � . '.. __. .__ ..�_. .. _. �ojdata�u�il��a�rn�tra�tor(sJ l�enacd parsu�ant�M�tG/e / _ .. .__ , ..... -`� . - .. �.. .. . ...� • � �- � . .. nrttraotor's Licrnsr I.nuJ.. . ..- - �----�-� , � Parking , . „ . .': . " .. ._�.._. .. _.. . � ,. ,.. ... .. __ _ . . . .. .. . . � � � � � , ❑ I om ezempt under Set. ,B.BP,G for fhis I , . . -. . __ _. .__ ... .. . ...___. .. .., . •�., .�. '-; '. . �.;; , �. : �,: �� , . � reason . _-__ __... _�_..__ _. _"'.w__-. .--. . � ' - . . Dale O ner � � . . �. . ., ..., . . . ,. ;, . .. ., , . . , ., . ___. _ .. .. _ _ __ __ _ .. . . ,. . ., � , ! � .. ..I. _.. .. . _. . � _ __ .-P_ . 9. �._: _. . __�. � _ •.. _ . ; .,_..:. ..�: '.-.�-..�, � pp Data Ins eNor':SS n � �� ' � A rovals: : afure '� ' . INSPECTOR'S NOTES.i '�. �. �� Location-, . ...._ . . . . , .: .. � . .. . (Selback 8 Yards) "- - - � " " - .. , . .� Foundotionv o , ,' `ff . . . ,,_„ � �< �-��. � . _ . . �. . A .. ... ..�. .. __'___...._... ....... .._., .. ..__ ._..__. . 5�06 .:�.'1 ',; ,. � ,�i . . . .. .., � . . .. , . Frcme � � � ° N l'1, '� �� ' . ._ . .. �. . . .. . . . � .. ... ... . . .; . ..� ' ,. Energy Insulation � �� }' �. . - .-- ,. ,. . . � . . . , .. . � .� . . . . . . r ... . , Loth/Drywall- � _.... _ . .__.. ____.- . :... . . , .-_�. .. ._:__._. ..� . _ _.�.._ � Inte�ior __ __ .� _._. '� � i -- .�.� �.; . . .. Lath-Exterior � ._ ._. ..� . ._: . � �_ - -. .,: � " . . .. . .. � _. ' , , . . . ... ._ ___I.' .. . . . _. . . . . . -�-.•.� ... . � _ House Num6er- .. ' _____. •. . _. �.�.�..� . ._ . ... . . y . ,. �__ ___ . _ _... .. , :. . , . . . Correct&Posted ' . . � . - . - .-..,.. ._. .._.. . _ _.. ... . . . .. Fina�-- ..__.____.. .__..__ _. .._._,.. � ..: , . _ :.. ._..._._.. ___.._.__ . ._ __.. ._. Enter on Frant ' � � .. ' . � . .. . . . . . . '. .' " .-.. � ... . � : .