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HomeMy WebLinkAbout1231A 1232A (6) _ --- - _ . .. ___ ... _ _. _ . __ _._ .. _. _ __ _ _ __ . .. ... . ._. or 6 ceniUed co �hereof Sec.3800,Lob,C TION � . .���, -� � � �_. �.�-� -� - � , WORKERS'COMPENSATION DECLARA I hereby afiirm tbar� �ove a�e,,�t��o�e of�o�5e�<<o,e�� --� --�- �- -qpp��CATIO�N FOR .BUILDING�PERMIT-� ��---��� insure,or�a certificate of Workers Compensation Insvrance, . PY � � COUNTY OF LOS ANGEtES BUILDING AND S FETY vou�yNoCP6255241 ComPa�y Great American Plan 2AR � Certified copy is here6y furnished:. FOR APPLICANT TO FILL IN BU�tDING ADDRFSS � CerNfied copy�is filed with the,coun�y�6uilding inspeo- �-"- gU�LDwG �, '�ion department. ' � ADDRESS � ..... . ., - � . . , � . - .� . . . . . . ..___. . . _ . Dote 12-2-$6 Applican� The Wm. Lyon Co. �i1Y Walnut ZiP 91789 i�irv �'�'� CERTIFICATE OF EXEMPTION FROM WORKERS'� ' � - - - � � NO.�OF BiDGS. - NEnkeST _ . -.. - . .:.. - �' � -COMPENSATION INSURANCE- � . SIZE OF LOi 3 BOO SF Min.NOW ON LOT O CRO55 57. / � (This seaion need nm be completed if the permit is for one - ��� - -�� - - � --- �- -� - - � -�-� � n55E550a . � • ��- . -: �.��. h�ndred dollar:(E100)or�eSS.) � � . TRAR BLOCK LOT NO. µqP Bpq(� ' � AGE' PAR�EI ovmrea THE-WILLIAM LYON C0.-No$33-3600 use zoNe r.v+P - I certify that in��he periormonce of the work far which�his td0. — } permit I5 issued,I shdll nof emp�py ony per50n in any monner . qDDRE5SI9 COi OT'ai2'PIc32d '" � ' - '--'' SPECIAL �- � - -� - n. so as to become subjecf to fhe Workers'Compensation Laws. �� '�� ' � CONDITIONS � V , arr _Newport Beach, CA nr _92660 _� _._ . - _ __ Date ... ..�� � .ApplicoM -' . .. ...� � : ARCHITECTOR . . . TEL. . ..._._ G j�OTICE TO�APPLICANT; If, after moking ihis Certificote of ENGINEER Hales-Lan Ston No. 547-0862 DiSTRiCf . O ttvE .FiRE__ Plt SSEoeY - 'rmption, you�shovld become subjec���o the Warkers' " - � COni57� Z N ampensationprovisionsofthelaborCode,yOVmuslforth- qDDRE55]]] S. MA3n t. e. lOS T'flil � - s permit sholl be TEL. � S7ATISTiG4l C TION APT CON�O. � 2 de medRreiICENSEDCONTRACTORSDECLAR � � COMRACiORSdI11e AS �Wi1CP NQ _ PY P '� . -�-I _ .._ ...-.--'-' " ATION.. . ---- .- -.- ... ... . .. . -. . L�. .-- - CLASS NO. DWELL UNITS 1 here6y offirm thot�am licensed under provisions of Chapter 9 ADORESS NO. , (commencing with Section 7000)oi Division 3 of the Business and �_ . . ��� SEWER MAP �� . � � �, . . ._. .. .. _____'.. _ ...._ . . -i Professions Code,and my license is in full force and effect. C�TY Q.455 � ' B� - �,- - -- - . -�� �: --� `VALIDATION -� -� ' �. .. .ZJ6HO1. ... : .B�l. . . .. SQ.FT. NO.OF NO.OF ... CHECK ' ' . . . '�'� License Nvmber � lic.Class - � - SiZ $TORIES FAMILtES ONE . ,. . �. ' � � . , The Wm.:Lyon Co. iZ-Z-HG ". OES[RIPTIONOFWORK' ' � VAL ATI N _ _ . CoNraqor Date ...... ...._ � A p Q S � . . r . ' , 1231A . . . LTER � . , . -___ �• • • •'2.� �I am exempf under Sec. - -� � � � � � -� � � ' B.BP.C.for�his reasan .� . � .._._ � . S . - .. - . - . ..--� -•-' --.- .. . REPAIR .. _ . ._.._.. _ � . USEOF . ! I •PLl7.Z.3 � ��- Date: -�� � E%ISTINGBLDG. DEMOI ' � " APPUCANT TEL. � . ._� �.�.• . . . ..... .. . -..Signature ...-. "._ - ... . .-.... . � . . FINAL � �L�l 7.�G J c=i OWNER-BUILDER DEQARATION PRiM NO. _ -OATE- --� � -��- '-•--� -� -�--�- -I hereby affi�m Ihat I am exempt from the Contratlor'z license � � �-- � � � -� � � ,, _ �.��r�2 t v-s 6 Law for the following reason(Seaion 7031.5,Business ond ADDRESS FINAL - � �'�' .,ProfessionsCode):-- -- . _.... ._... ._. . ......___. . _. R N By ....�.� �- ./." ._ ` _�"v� 2�J.�2R. � euuoiN� � I, os owner oi Ihe properry, or my employees with . qDDRESS __ ._, , _ � � �� � � � . wages os their sole compensotion,will do the work and `�i TY � . '- 1� . �.� Ihe strucWre is not intended or offered(or sale(Section ; '� � " � � " �7044,-Bu5ine5s and ProfeSSionS Code).' ' '-' "' ' MOVING -'�"' -- '-' ' - " " '' TEL � --' - " -- ' � -i - -- I � °Q 2 Et�� � CONTRACTOR NO. - �� '-" - O I,os owner of the property,am exclvsively taniracfing --� .. . '-, - 0 U -with licensed tomracrors to mnstrou the projecr(Sec• ._. . - -- -... . .. . . . .. ..'...-.... ... .'-.-- . - . .; . ... . • •�=L�� tion 7044,Business and Professions CodeJ. /+DDaESS � `- � 1",,._�... � �.�.;�. 1.219-8b .. ._ . REQUIRED .TOTAL SETBACK ' � ' -'CONSTRUCTION IENDING AGENCY� � -� "� seT eaCK YARD� HwY vROv.uNE wiDTH � ��� � "� - �- �� ' � '�-� ' � - 1 hereby affirm that�here is a consirouion lending agencyfor prtONr __ -- . 1:>� ��'r'. '� � � the performance of the work for which this permit is issued �- v.i. �- � �� - -- -� � --� '� ���-- � �- � ��^� �-�'- �- ; �� --- � � � , (Sec.3097,Civ.C.). SIDE � � t l � �'_� : m .__..__.__. ._ _ _.. _ . _. . P.L. -...- i' , � Lender'sName- CnnYinontal 711innic Rank .. . . _.- . . . ' � ... . . �..� --._. - .. ..-. .-. ' �� IDMA ReE N � � � .. . . ._ . ....._ . ..._ .._. . � '.. . .. _... _. -. . . . -�- P.C.FeeS - i a .. . PermliFee.. .5.• �' . . . .�� - Lender'sAddress 23S So i a Salle St , Chicago , � . , � �-I tertif that I have read this a liwtion and state tha�7he '__ _ . . . �.-. _ v Pa _. __.._ .. i»�a„�s c��_ /�.5l7- -� ior.0 aic M _. � above information is correct.I agree lo comply with oll Counry i,„,esi�gauon Fea � . g _ordinances and Siete laws reloting to build�ng construci�on. ._. . . - --. tarai Fe�- r�d. � --' �mMa pa«,,.A .. . . . - -- __.. .. � :�. _ ._. � v s-r� and here6y authoNze represenfatives of this County fo enter ' , � upon Ihe above-menfiane property for inspeclian purposes. . . �JS. . - . �3S.v!/ . . _. . _ . ._. . . _. .__ . .. . ....... . . . � a �,4�� � � SFE REVERSE FOR E%PLANATORY LANGUAGE � ' � � . ......Signal�re of Applicon�or Agenr._ . ... ..._ �a .. . .. ... . .. � . . . .. . . .._ . .. ... .'. _. ._..' " ' '. ._� ._ . _ . .. . __ Q.i 1 PLANS TO APPIICANT INSPECTOR'S NOTES . 0�9NER•OUILDER DECLARATION - I hereby affirm that I am exempt 4rom�the Contractor's To: R�turn�d ' ' � � � �� License Ldw�for ihe fallowing reason: (Sec.`7091.5J ' ` -' �-� - � � Approved Dusrnest and ProJcasions Codc:Any rity orrours!}�tabicb No. Date ��• No. '..: Date .., ....;. :..:„. ..:.._ .. '. :':,.. , � :. ��., � �egu„�s ar�..,,,�t���n��.��r,ar,�r.;,,r�o���,Jemnlul, , ., , . __.or reparr any structurc,priur to i1s iisuanic,alsa rcguircs , . , � -, _ , , , � tGe af�plirant f r rurL permit�o J'!e u rrgned statemrnt tGat Lc is licensrd pursuan t to lbe pronisions of 1Gc Con- '. � � � - � tractnr's f.irease l.aw/Cbnnfer 9Il�ommrncin,q a�itl�Sec- I � - . .�... . . . ... ' . 'l�l . _� �•i ;�.��, tioa 7000J n/Uirisinn 3 of 1Ge Businrss and Professinns � � ' � . . . �� � ' _ _ _ _ �. • � CndeJ or t!at Ge is exempl 1Gerefrom arsJ tGe basii/or 1Le �� -- � - �� �� � � � � ¢lfgqed exemptinn.Any riolation of Section 7031.5 by �.._��. -�-A `rova . ...-•.. "�Raqulred.'_. '-,.DofeR�eoived ._-- ..�� .....'. ..�. �� '-�.'.� ..�����- �c.� ._ _ . anya/�/�fi�antJraJ�erneits¢bjectstlea/ip[icaneloacini! P� �s or Approvad - f enalty of not rnore tban jine Gundred dollars(SSOOJJ:� � . � Yos�. No �.,,, ._. . �... . � . . �. . . .. .. �".� '----:.. ` --.�.. ..�`� - ❑ I,as owner of Ihe property,or my employees�with Waier Cenificafel_ . � '- � � - �� .. .. . ' � . ��� � �-- - wages os�heir sole compensa�ion,will do the work,and . . _ � _ . .._ . . .._ . .�.._—_. ._� . . . „ , - - — - - � � . the strutture-is nof intended or ofFered for sale(Set:7044� . Health Departmen� _..- -'=�--� �- -_� �.. . _ __ . .-.- .. . .-_ . .— - . '� .. . --._-��. ... _. : .Duiinett and Professiorts Code:TGc Contractar's Lracnse , Laa�does not oQply to an o¢mer of fisoferty wbo bullds ,� Gre DeparimeM. _ . . .__ . ._.. ._. . - - � �---� - �� �- - or rn�roces tbrrcon,and u�bo does isscb work b'mse�or Fi � � ' � lbra b liu own em/�lnyees,.provrded,tGal tretG�n _ � ,rading � , - � � � ' � prnvenicn�s are nn! inlended or o/fered jnr,sa!¢.� r• � ' - — " . , -� t , �\,,•`.. . � ..homee�er,tbe building or im/�rovement u sofd u�ilGm m. �. G . . _.._ .._ .. .._... . � .-- ._. .� . .� :"�. .. � / P!t fh b 'fd 1!b G eologicaL �i � ��. .. . .-� ,Year n com e ian, e or�ner-ui cr wi , ave t e � 4.. � � ��� � - � � burden ofQmving tbn[be did not build or rmp�ove Jnr � t , . . -__._ _ .. . . . _ . . .._. ..._. - -.: � PedestrianProrection --... ..'� - � � -.� thepurpoe-oJsa(eJ. . '. ,. �':.. :� (Fence)(CanoPY) .� . .�., �,. � .--. - ...__� .. _ _.... .. _. . ...._. . .. ' ;❑ I,os owner af Ihe propeny,am exdusiJely conlrao . 'ling with licensed contraclois lo conslrucl Ihe projecl(Sec. � Special Inspeclion-- ' � -� "� -- "--- �--�"� � ����-- �� - 044)Business and Profcisioni�Code:The Contraclnr's � 7 _ � '-�- Lit¢nte Lam dnes ant a t m an ouner o ro er! u�bn (Conc J(MasonrY)(Welding) - .. . . - � - _. . . .. . ' ��.�:. ;i. . . PP)' /0 0 3' ' - - . -'-- ""- - "- � ' ---buifJs nr improocs tl errnn;and u�hn conlracts for sacG lot Drainoge-� � �� �� � � ' - � � p�olects.u�itfi a matracmr/sJ.licensed pursuant to !!e .. , �:. . .. .__......_.___�__._. .._�_... �..:. . . , ., . � �. ` : .. � -- � -Cnntraclor's Licensc l,aa�J. -..��_ �� •� . Parking .. � . .. �.� . ... . . . . .. .._...._,.. .__. .. ....... . _... .. _ . _ . . . �. '1� i..._ J � ' . . ❑ I om eaempl under5ec. ,B.&P.C.forfhis , ..�. . . ....... ... ..,,:,. _. .. _ _ ,, .-: ., � : i - .. . . � �reason . .. .. . _ _ __ . . � _ _. �. . ._.._. _. �_._ . _ _.. . -- e . . . . , . Dare Owner ��� ��'� - . : .• _ ..' ., . . . _ -'_ .._. .. . ..-- - -- .. ��: _,. .,:. : 'I.. Approvali ' � Date Inspactor'a Slgnoturo -�- - � . � INSPECTOR'S NOTES �� • � � localiOn— ' �- � ' _____.._ . _ , (Setbock 8 Yards) .. � -� � � � � � � � Foundotions �� . ,. � ., � �� .. . .. � � .. _ .._ . � . Slab �jf'l/L� , . ..- . . . . - . . Frame . . � "�W' ��/ . . . .. ... . . . .. .. � . � . . . , - . , .. . � �. , .. Energylnsulation Fln.�. ��� •_"..;... .. _ . ... _. .-- .-� _--_�.. __ i . . . . �,. . . .- ... . ����� . . , .. � . - . . .. laih/Drywoll— S ..____� _ ..._. ... . ._.. .._ _.. . . ._� ... . - .. Interior � `��U^' -._.. ..___ ' . . .,� . " laih—Exferior : . .. . . ,i . . .� � �� . . . � .� i i �. . . .. �-� �� -.: .. , �..�, _.____. .__ . . . ._._ . ,.. House Number_ , ___.. -..._ _.�__'_ . _ .. . __... . .... ... .. . . , _ ..'.. ... . . ,. � . . � . . ,.. . .. . . - Correct 8 Posted � ' ' . „�-, ���. . . . . - . _ . _.. _.__.---- �--- �----' , .. . . . . ,. . . . . Finol— _._ __ . . . ...__ _._ .. - _ . -._ . . , . . . , . Enler on Front �. . . . . . . . , " - '. ..., .. . . . . . . .,, �� � ., .... . . . , � . . . .' ._. �_..-_:,-< . . .. . ..�.�.. ,. . L. �.� ' - ..... .. '. , �.�.. .