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HomeMy WebLinkAbout1205A 1206A (6) „ . --.. ._ _ _._._ _ ,_ _._ . __. __ .. .-.__. . _ ..__..._ . ._ . _ _ . --- - --- -- WORKER$'COMPENSATION�DECLARATION '� ���?��-��'�' '� ' � �'� ��� ' -�-�': � .�. . . . . . . _..,. .__ . . . ��e,eeY affirm that I have a cerlificate of�o�se�;,o se�f qPPLICATIQN F�R ..BUILDING PERMIT � ` insure,or a certificote of Warkeri Compensation Insuronce, . . .. . .. _ . . , _.. . . . .._._ .. _ ._._ :.. or a ceriified mpy lheroo (5ec:3BOo,�a .C.)� � COUNTY OP LOS ANGELES BUILDING�AND 5 FETY WCF6255241 ” Great American Plan lA ' P❑ollcyNo. Company� - � - - � - CertHied copy is hereby fumished. � FOR APPLICANT TO FILL IN noosess / � ,Cerlitied topy is tiled with ihe county�building inspec- gURoiNG �� � '�tion departmenf. " � AD�RE55 . .. � .. � � . -. : .., � ,: . . _ __ . . .. . _ . .. . ... ' Date .,1Z�-Z-H6 ..�Applimnt�.TI10 Wm.� Lyon.Co.- o7r Walnut 21P 91789 ; i�i�n, . '� ��'CERT�FICATE OF EXEMPTION fROM WORKERS' ` � � '� �-�-NO.OF e�DGS.-� -��--��, r7EqRE5T. � �� �---� . --��- �,, ,. � 512E OF LOT3 SOO SF Mlil. NOW ON lOT 0 caoss st � � ��COMPENSATION INSURANCE��' �� (Thii section need not�6e mmpleted if the permit is for ane � � - � � - �--� - - --- �ESSOR _ �' ��- " � �� hundred dollars(E100)or less.) � . ,.,, . TRAC7 BLOCK LOT NO. MAG BOOK�� � iAGE PARCEL ' • ' - owNeaTHE WILLIAM LYON C0. N�33-3600 ' usezoNe nnnP I.ceriify�that in�he pertormance ot�he work for which ihis �� ' "�� .Y permit is issued,I shall no�employ any person�in dny manner . - �-- SrECiAt � � so as to betome suhject to 1he Workers'Compens6fion Laws. � � ADDRE5�9 COT OTH[0 p 18Za� - �� CON�ITIONS ,V �, � , arv Newport Beach, CA _na 92660 `, _ - _ _ _ " ec Oate. .-. .� -. .;APPliwnt � . ._�.,. . - , ...._ . _.. . . .. .: ' ' �O �PTICE TO APPLICANT; If, after makin this Certificate of ARCNITECf O TE�� .O(STRICt . GROUP TYPE ._.._... � FIftE _ . O SED BY 9 ENciNEER 'Hales-Langston No. 547-0862 - - f ;mpr on,•you"should become subjeu to'the�Workers' - � �� CONST ampeneatian provisions of ihe lobor�Code�you must forth• . qDDRE5577� S. Main St. StO. 105 Oran C - wilh mmply witB such provisions or this,permit shall 6e -� iEL. �. STA715TKAL F TION _ _L/ _APT. CON�O .2 deemed revoked. � . . � -.•� �„-� ,-. - .� , . �ONTRACTOR$ame t�5 Owner NO. � _'_ _ ' , '__. .. . . ...___ ... _�� IICENSE�CONTRACTORS DECLARATION�� �"� -�-- �- - -- - - - - --- - � �--��C:- -� -- aA55 NO. � DWELL:UNrtS � (hereby atfirm Ihat 1 om licensed under provisions of Chapter 9 ADDRE55 � NO. -� Icommencing wi�h Secfion 7000)of Divislon 3 af�he Business and . _._ . _. _.. _ i�� . . .. ��'�FR MAv ', '- '-". - �� Professions Code,and my litense is In fuli force ond efiec7. CITY CtASS BK:-�-� �� �"��� ��- � -� ��� -� -��YAL�DATION ��-�-�-- . , .� � , � �, , __ SQ.FT._ __ ._ .NO.OF . NO.OF , CHECK ' U[BnSeNumberZ�68�1 . .. ���:eioSSB-1 . s� STORIES � FAMIL�ES ONE . • � ' , �. The .Wm. Lyon Co. 1Z-Z-SG' ' OESC2IPTIONOFWORK VA��oN. .. _. ._. _ __ _ _ . .. . ....- NEW--. � .. Conlra[tor Dafa � � - ' �-- APD �I am exemp�under Sec. -- , , � z� Q Q S�1 ... ... ; . .,�. . . � , � ALTER � ,� .. : B.BP.C.for this reason . REVA�R ❑ .S .. . .. .. .-- - -� - -� �r • • •2� .. i � • ' � ' liSE OF � ' � . .._ 9 ._._. _ _. .._ .. . Da1e' � EXISTING BIDG. DEMOL . ' ' _ ._' •n n�S.�_. ;. -'..-Si natVfO . . ... ...... . . . � ' - - APPUCANT . TEL FINAL � c c OWNER-BVILDERDECLARATION _ vRiN t• NO. . __. . . .DATE /�� -- '� ..- -'--'- •-•�L'25,�E��-�.'�: -1 hereby aifirm that I am exempt(rom Ihe Conlractor's Licanse , , ., . „ . taw for the following reason(Section 7031.5,Business and . ADDRE55 � FINAI � ��� " - B __ ,_ 1219-86 ; •.ProfessionsCode): .. ... . .-` . . ... `..'. .... -_ R Y� ..-.-` . . . � BUIIDING '. �•� � I, as owner of ihe properry, or my employees with ._ _ nooaeSS � .. � ;. - � '.. �-_. ,. .; -..�.� 2 Q O A_.- wages as their sole compensation,will do the work and i�i�TY '� , - . Ihe strocture is not intended or offered for aale(SeUian � ' �,�.: � ij • .��.�� "�.�' 7044,Business and Professions Code): .._ .... - - - MOVING .. .... ._ .. ..."�TEL - . .. . .. ..._ � . .. .: . .- CONTRACTOR NO. �" 1`� a 1,os owner oi the properry,om exdusively contracting � . �' � � •3 9 Q 0 0 _ �� - with licensed conrroctors to construtt the project(Seo- '� - - "'��'� "-' ' "� ` � � -�` ` � ��� ' � tion 7044,Business and Professions Code). AODaE55 ��" �'-; 3 9 Q���, _'_' • • "_-......_ .. .REOUIRED . .TOTALSETBACK ....-'-. . .. . .�' . .-. ..- '-- - "�' "CONSTRUCTION LENDING AGENCY �" `� ser eneK Yneo- HWv pROF.IINE WIDTH I hereby affirm fhat there is a conshutlion lending agency for fRONT � _. ��L 1 �J^S 6 � ' �the performance of�he wvrk for which�hiz permi�-is issued -� - v.i.-- - --� � - � --���-- ��- ��' -� � �� '�� ��- �`--�� - - - (Sec.3097,Civ.C.). Sioe '. � - � ' m _ .. . ..._. . .. ._.._ . .. ..._. .. . P.l: . _. - '� . � lender'sName f` tinnnral Tllinnic Rank . � � � - ' WMA Re(,N �. .,.-i . S . .. . __. .._' "_._. . . .. . .. _ ' P.GFeeE� � Permitf¢e - ��d. . ,'._.._ . . . . = Lender's Address 2�,�g,—�.' �3-1 l^.�.�,;.�,�gg0 . � - '" � . I certify thot I have read this opplication and state Ihat the .. . Iszuance Fec -... O� Q �,� l�r.w v/C R. . -- --.. . _.. . .._ . .._ . .�. a abore information is carrect.I agree to comply with all Coumy imes�igar,o�fee ' � � ordinonces and S�oie laws relotinq lo,building constroction, ._ ..,. - Taral iee- � �. -- lDhw ve�m.M � � � � . _._... . .... .._. .. . .._ _. u and hereby authorize represemo�ives of this County to emer � $ upan�he obove-mentioned propeny for inspection purposes. ��, - ' � ���'�.�' .. _- __ - _ -- _ _. i_ _ � _ _o a l.Z�,'�j�{ SFE REVERSE FOR EXPLANA70RY LANGUAGE ' � �� .�__..SignamreafAppl�mmorA9em .... . . _�aie . . . _... ... . .. _ _ .._ . .__'_ . "' . .__ '� _.. . .-_.- ._ ..___. _ _ •i � _ PLANS TO APPLICANT INSPECTOR'S NOTES ., Olh'NF.R-BUILDER UECLARATION 1 bereby af(irm thal 1 am exempl,from Ihe CoMracror's - To: � � � RNurn•d � � . � - - �. �' �License-low'for-the� iollowing�reason."(Sea'7031:5) ��� � � �� � � �AVP�o�ed � �� DusinessandProf:slo�:Cod�ifl�y�+tyor�ouneya�birb No. � Uafe �•� No. �' � �Data�� .--... : . . � „ :. . � - , �;; � ,requires apermi!tn tonstrutt,a11cr;improve,den�olisl, _ � . , , .___orrcrairanysbucturc,j�rJartoilsisivant'e,a(soreguirer � . • , i,,�, , , , , , ., , fhe applrcant fnr sacG permil to/'Ic a�rrgned slueement - , . 1Gae bc it licenscd partuamt eo ebe prorisinns nf t!c Con- �i , . � � � � traclnr'a License Lau�(Cbapler 9J(commrnting wi1!Sec-' - �� � - tron 7000J nf Dirisrrmn 3 of tbe Uusirsess and Professinna , , ' ,, .. ��'� � � ' .. - � ' ., • '��''CndeJnrtlatGci.fezera(�OfGereJromandlGebasis�orlGe � . _� . __... ..�_._'._ _ .._.. ..._... .... __.. .�.�__ .. _. . . . . . . ... .-��.... .. ......... ..-... . . . affegeJ eseinption.Anv<�iolalion of Sertion 7031.5 by . `. ...� . ''Req�G�d � �DaleR�coiwd ..._. :r'. ....... �. � •'.��- � � --. . . anYap(�Iicantfnrayernritsubjectatheapplicanlmaciri! `� Approvcls :�,Yas � No °�A�P�OV°d •� .�� � i.,.- � � ��- . . h�nalry of ttnt morc lGan firc GunJred dof!¢rs(SSOOJ.J: �� �. ', .. .. .._'__. _.__. . .. .. _..�� • �-.... .- -. ❑ 1,as owner of the property,or my emploYees wilh , . .... . . .. .. .. . . Warer Certificate.. ._ . � ','•� �� ��. .. .. . .._._..: . __ .. : . .. : ... :�. _ . ,.wages as iheir sale compensation,will do the work,and ..: . .... . , ' �� --- '- '-�-�- - - ��the strucfure is not intended or offered for sale(Sec:7044) � eahh Departmem .�` i , _..- .__.�.. .- ..::.i.__..._... ----- �- -�- - -- ._ ' .- .. ' . - . ... �. Uusines.r ond Prnf�ssions Code:Tbe Coi+troclor's Licente H ' . Lp¢�does nol�aJ�J�,y!n an oa.mer of rroQe�ty u�bo builds F . ,..: .::'.' .�': :�.�.,�_ �� �., �. : � ire Department _. _.___ _ .... _ _ _ . . . � �- -- - - - - ----�� - � � - -� or improi�es d�erron,onJ u�bo Joct sucb u�ork bimse!/or ' . .. . .:-� -` - . : �,,-� . � . ..�. . . 1GrougG-lu nu�n.erxf�loyces,�ProriJed t{3t such�im= Groding - . �prnnerxenlr are nnt intenJed or offered Jor sole.: � �� '. �� � ' �: ; �' . \ .'' '. .. . � . . .. bme�c��er,lbe bsifdrng orimproucment is snld witbrn a.. . . , ..�..... .� . , :._.. � .1.. _ . � ,�� . Geo16g cal_.�' _ ... �,ycar of romJ�letion, !be nwner•burlder wrlf bavc�tGe .. .� : ' "�,. .� :.� •...:�,�. burJen of Qrnring tliat be JiJ nnt build rir impmve for __.___..__ _._ _. __._ _._. _.�_� tbe te a sale.. � Pedestrian Protection .' .- .. .. . nu pn f J . • .... .. .� (Fence)(ConoPY) - . ... . �� "�:�.�..�:.,. - . ---- .-..- .-. .-. --.-.- . . . - ' .. , �❑��I,as owner of the propertY�'om�exdusively coNrac- . . � �ing wilh licensed controctors b�onslruc�Ihe project(Sec: ' ' '�"� �` " --��-- -� --��"-��-- �� - ----��� - 704dJ Buainesr nnJ Pmfessinns Codei T!c Contrac[nr} Special Inspeclion ` � � - � � - � - � . , , (Cone�(Masonry)(Welding� � � - � �� ���� - � r � � � - .�,::�,j-�.-; � I-icense Law does nnt apply lo an ba�ner nf Jmoperry u��� �L '� � ��-- ---"' �� - - --�- �- � � � � -�builds or-imprnrrs�lGrrrnn,and u!n conlr¢ctsfnrsurb v �,.` . a�c1s-u�ilb a contrucro s,lracnsed. ersuamt M t!c .` lot�roinage . � ...,:.. _ .' .� ___..__...... _ ... __ - -� -� � . P�l� �(1 . ? . ,,.. -: ���� �� -� -� �•- Cnntracror's Licensc l.au).- -'�'�"'- Parking����. i . - � . .__ .. : . - _. . ...... .. ... . .. __. . . ..- .. . . .. _. �-. . . . �❑ I om exempt under Sec. ,B.BP.C.for this , . � • ,� . � � reason _. _ . . � . . � � . ,..� . _ . __ _._. � . ._._ . ... . ...__ __ � � � � • �� ' ' -Date Owner � i .. , � i� . _ . ._ . ;_ ___ _, __.' .. Approvals Dola ���Inipeclor'�Sfgndturo� � � . . � .� INSPECTOR'S NOTES� ' Locot�on— ' � � (Set6ock 8 Yards� . �------ . . -�. . ' . . . .. � -- Foundatians � . .. �. � . . . . . � " . � ,� . . , . ... .�. . . _._ _.. _._ . _. _. . . . Slab- � . . , , /� ` ._. `.-', . . . .., � . . _. . Frome . . . , � ' M�� � ... ... .. . . . . . . , � . . ., . . Energy Insulation. � ��� � ' .._._;._... _'__... �.... . .._ . .. .:_ _. _.r_..� �__ . . - ..�. . . lath/Drywoll— _'__. ,.__.. ... _ __.. . . _ . _ .._�' _ . ,. � . Inlerior .. .. _ . . ... � . . .. Loth—Eaterior . . . �. . . � . . . . . . _� . . � . .'� . .'. . ._ . House Number— ._� .-., ,.-,._.. _ _._. ...��.�-.��. . . . . . . . . , Correct&Posted '�- �... • . _ _ .. . .�.�._. .,,.�� ..-. . -,'. ,:.: . '.�:� i Fina�— _.. ___._ __.. ._.._ ... ___... -...^.�.._._.'._ . _. ... . . . . .. .. . . . Enrer on Front . ' � �� �� � � ' ' . � .. �� . � . . .. 7:� . .. ,. ....:.. . � - .r... - � .. � • � . .1