Loading...
HomeMy WebLinkAbout1233A 1234A � , . WORKERS'COMPENSATIONDEPIARATION ..... . - ._.._.._ .. ...,._ ..... .."- ....._-" '-.... . .._.._.. . _ _.._ .. _,. :._ .. .... .. . - . . .. ;�5��ebo�°a`�e„F�a',eofwoke5�'�om'ee�5o;o���s�:a�e" � u- - �APPLICATION FOR BUILDING PERMIT -�>: or a cenified copy thereof(Sec.3800,Lab.C.) COUNTY OP LOS ANGELES BUIIDING AND AFETY Poi�cyNoCP6255241 com��y'Great"American _ Plan 3CR QCenifed copy is here6y furn�shed. FOR APPLICANT TO FILL IN ew�ow�� . - '�. ADDRESS �� Cerlified copy is filed with the co�nty boilding inspeo- - BURDiNG tion deporlmenL � � ADDRE55 Date^�12'2—$6 � Applicont�� The Wm. .Lyon Co. aTv Walnut ZiP 91789 ���n. , ' �:� ' �CERTIFICATE OF EXEMPTION FROM WORKERS' ' SREOf tOT3 �$00 SF Mlit. NOW ON�OTS O � ' CROSS SL � - � ^ �"COMPENSATION INSURANCE (Tfiis section need nm be�completed if the permit is for one � - -- -- - -� � - AUEu�R , ; � " .h�ndred dollars(EI00)or less.) ,, , TRqCt B�OGK LOT NO. µqp Bpqc PAGE PARCEL owNea THE WILLIAM LYON C0:-N�33=3600 us�zoNe nna.P I.certify Ihat�in'the performance of iha work for which this Na� Y �` manner �. . SPEC�AL ^ � - - v permit is issued,I shoil not employ any person in any - ADDRES - � - - - so as to become 4ubject to the Workers'Compensation Laws. CONOITIONS � aTr Newport Beach, CA 21P 92660 -- - � Dale..`�� •'; .�. . APPlicont . .� . . ARCHRECTO TEL �� ��OTICE'TO XtPPIICAM: If, after making this Certificate of ENGir�ER �-lales-Lan ston NO. $47-OS62 DISTRIR GROUP TYPE. FIRE SSED BY smpiion,"you should become subjeet fo�Ihe�Workeri - � �a�� .ompensalion provisions of Ihe Labor Code,yau must forih- pD�RE �] ' � - - - 0- ith mmply with such provisions or�ihis permit sholl be - ti deemed revoked.� � � � , . Same As Owner TE�' STATISTICAL CLA i ioN A T. CONDO. .Z � CON7RACTOR NO. LICENSED CONTRACTORS DECLARATION � ' -- -� - - -- - -- - ���,- � - ---- -- CtA55 NO. DWELL.UNITS I here6y aHirm that I om licensed onder provisions of Chapter 9 ADDRESS NO. ��R�p , . (commencing with Settion 7000)of Division 3 of the Business ond .,.. _. ... . __ . LIC. � Professians Cpde,and my license is in iull forte ond effeU. CITY QASS " BK � -�:- � "-- - VqLI0AT10N - � . , , �. _..... SQ.FT. . .._. NO.OF.. ._._ NO.OF . CHECK . LitenseNumber2�6SO1 �iC.C�O13B-1� � 51 STORIES FAMILIES ONE . . � � The Wm. LYOil'CO � IZ-2-HG " DESCRIPTIONOFWORK �, V ATID7N�Y�7� Controctor Da�e N� S �l�t�!✓ "---�-��- . �I am exempt under Sea . - _ ADD , .._ _ : , nit�u ❑ -�1 2 3.3 Fl B.BP.C.for this ieason . . • RE7AiR .❑ - ; ._ . -. . ... . . " - � . . .__ ....___'. _.__" .' '_ . USEOF �• • • •`Z� I . . Dafe: E%ISTING BI�G. DEMa .. . . _ � Signature ��' . . -- - -- � -�-- - APttICANT 7Et. � FINAL � •2 7 6 6 8 OWNER-BUILDER DECLARATION PRIM NO. _ DATE�C�� � -I hereby affirm�hai I am exempt irom the Contractor's license . • •2!�t b$_ Law for�he following reason(Setlion 7031.5,Business ond AooRess p�Np�J _ '. - � - • �' 'Professions Code):�" -'. . "... .. . .. ` �..�. g td By V`--• � .- � . . 1 2 1 9—S 6 BUILDING � _I, as owner ot the properry, ar my employees Wi�h _ ADDRE55 - . , , -�1 2�4 A ' wages uslheirsole mmpensafion,will do Ihe work ond � � :- �,•' . the atrocture is no1 intended or offered(or sale(Section ����T� ' �• •,• • • .� � ----7044,8usiness and Professions Code). � �- -�- MOwNG - ��--- � � -� -� iEL. � - � -- - -- � � � I,us owner of Ihe prpperfy,pm exclusiVely Conllacting �ONTRACTOR NO. _ - ' - - `,I •4 7-5 5 0�� � wiih Iicensed conrractors to construci the projecr(Sec- .. . a�ozE55 . . .. -_ . . . . �. .. . . . . . . - . . - � . tion 7044,Business and Professions Code). ,.,_.�" �� _ '•,�; '� �.: :, _ ' �� -��� CONSTRUC710N LEN�ING AGENCY -� '- �� REOUIRED� yqRD' HWY iUTAL SETBACK .. . ,. __ _ �� • •4 7 5 5 0 c� $ET BACK PROP.LINE WIDTH� I hereby affirm that there is o conslruUion lending ogency for FRONT - . ' • �2� 9-$6 � Ihe performance of the work for which this permit-is issued � --- v.L � - � ��� ---- -� -� ' - � �����-- � � . (Sec.3097.Civ.C.). SIDE - � -.� .'� ' .. m __ .. ._.. . . . _.... __ ___ _ .._ ..__ . P.L. , �-. _� ... � . . , � � lander'sNoma rr+r+r��cx�t'Ll I��_7's101c R�.,k , , , � $ _ LDMA Ref.M � lender's Address�7 t G i.. c..1 1„ c. rl,;�a Q P.C.Fee t `� Permi�Fee , ' - - _ - i . � � ..1 terlify Ahot 1 hava reod this applimtion and state tha�the �g - -� - -- Insoanca Fee�-- -� � IDMA P/C k -- �- - - � -� � above informaflon is wrrect.I agree to comply wifh all County in�esugm�oo F�e ' � � g _ordinonces ond State laws relaling to building construction, _ . . S•S' . . -. . - � �. �. . u and hereby authorize representalives of Ihis Couny�o emer � -� �- �"" " To�ol fee 7 a- tDMA Perm.M ��� �- � - � � opon ihe ohove-mentioned property for inspection purposes. 7 5"_._ ._. 't.�,S-�_ . . ` -�,.t� �.'�; _ � _ _ _ ,� SEE REYFRSE FON E%PLANATORY LANGUAGE � . � - - 5 9norure ol Applicont or Agenl - .. ta-- ._ . _ - . . . . .-'-.. . . . � . .' ' - . . .� .' ' ' - -. . . .- p� I PLANS TO APPLICANT INSPEROR'S NOTES ,.-OVV'NF:R-OUILDER,DCCLARATION . I hereby affirm Ihat I am ezemp�(rom the Convac�or's To: ' ' RNurnod � � � . � � " ' License Low toi ihe�,following�re6san: (Sec'��7031.5) � ' - ' � ' Approved ��fJuainessanJProJessioniCnJe:Anycil}orrountyu•lich �;,. . . . .., . .. No. � Date � No. DaN .. � �.'.`���-�!: : . .• .."-.� ..��� _; ;,- reguirrt a/rernrit to ronttruct,allcr,1mj�rorc,demofisb, , �.'..or repair un y;3iructure,priar 10 its isrud nce,afso�requrres . � , ", . �` ". �' ,_, . . tJ e applicartl jor such Qermif to file a signed statement fbal be is lrcenseJ pursaant to tbepronisinns o/tbe Cun- � � - � , . lractor's l.icente Lau•(CGaJ�ter 9J(conomrncing udlG Sea : ; __ •.-�..i_ �-_.' --' 000 D' ' b II ' dP . _, .... ....... .. � '.� . . tron 7 J of muron 3 a/t e ur�ness an rofessiorts �' •'-'� ' ���-� ��� ��� - • ��CoJeJ or tbat Ge rs exenrpt tberefrom and 15e basis for tbe � �_ . . . ' ...-._ '�"' ' .. �._"- �. �- � . ...-' -' - "� - - -- -�- - � alfeged exem/rtinn.Any,s�inlation nf Seclion 7031.5 by ' __ � ' -Requirod � " Dc1�Ree�iwd��' - .- . . - .� ' : _ _.. . c _._ on_yapplicantfnrapernriese�bjectsthe.applicaneMacie�il �Appiovals\� � . n ft nnt mnrc t1�an oe 1 undrnd dalfars S 00�� j .. , Yos No ar Approrsd . - �, . .. , .,.. . �� ^,. . /'e ° Y°{ �' (S /l� ... . . . —��..�. ... :..;.. . _. _ ._ . . .. 1 .. , . . ❑ I,as owner of the property,or�riiy employees wirh Water Certifim�e;�-„_-� • , � ��,� :.::. � .�. .� _ •. � .�.:_ •.- .�__t__�.�_._ �_.. .�_� wp9es os their sole compensaGon,will do the work,and --� - - - -� 'the struUore is not in�ended or offered for sale(Sec.7044J - Heolih Department. :_. � . _ ..' � _ _`_- .. . - -- . - -- -• �-�- - -�� . . . Duainess and Prnjessinns CoJe:TGe CortlrnctorS Lireese , l.au�doet no!apply to on owner of property wha builds Fire�epartment_ _, . . . . _ - -- -- � -- - --- or inrprnnes t6emon,anJ u�bo does sucb u+ork bimself or � - lbrougL bis ou�n erripJoyces, provided tbat suc5-im._ � Groding ' . � ' � .� frovcmenes orr nnt intended or oj/rrcd fnr.safe.:� ' � �. bo¢rveqtGebuildrngori>nprooe�nentisaoldudtlinor. _ i��� Geological �, - ��� ' , � � . . , Ycar o/rompJcliom, !bc nuwrr-buifdcr u�ilf bavc iGc � ' �� � ���� � � burJen of prot�ing tbat I e did not bvild or imprnve Jnr P� . . . . - _. ..- - - --� - - -� , edeslrion Pwtection �- . ' � _., tbe purpose ojJalef.�.. . �� _ (Fence)(CanoPY) � . � :� . � . .- -... - . . .---- --._ .. .--- � ,� ❑� I.ds ownerof ihe praperly,�am extlusfvely contrac- � - . . � ling with licensed contra[fors lo conslruct the project(Sec.' Special Inspection �7044)Uusiness and Prnfessions Code:TGe Caniraclora � (Conc.)(MasonrY)�Welding) , � � " __ __ ,__,_ . .. . ._ _ ___ .`` '.;r: . l.irense La¢�docs nnt aQfly lo an oa�ner of proprrty ubn , .. "builds or inrproecs lJ crcon,and u�/n tnntracft for iucl lot Droinage '-- � �'� . . . . - ._ .-_- - . -_. . . � � /+mjert.c�u�ith a cnntractrir{sJ:lirerised'pursuant tn tLe � �� �� Contractor's�Licenscl.au).- Parkinq . .. � . _ . _,.:_..... .._... _. . .. ., ... . . _ . P :. . ,, . ,. _ . .I , , . . ,- � . _ � ❑ I am eaem f under Sec. ,B.BP.C.for�his -� a . . � - � �eason ' � : , .. . __ _ _. _ . . ... -- - -----_.__ . . .. - ., i . , . , Date .... . . Owner . , . .. ,... _ . , . . ,,.. . , _ .. _. . - — . ..._�.,.-._, .. _ ._. .i.-;...:_� .i � ,. . •.:". � . _. � • . -• , � Approvals ' Date Inspaclor'a Signotura.� � . � - INSPECTOR'S NOTES ' � locafion— � � . . (Se�back 8 Yards) - � � - -- - � Foundotions /� ! ' ' . � � Slab � , . . . . � � . � � •" ' --' --.. -- --.... ._._.._ ... ._ _ � , - -. . . i . Frame � �� ....� . . . . - . ,. � , Energylnsulmion /`L __ - ________. . . . _ . .._--'. .._ _ . .. . . . _ .. ` , i�� . Laihi�er oall—� � .. ..._...'_.__._ ___._ __ . " ._..' . _ .. _....... ' . Y . � . . _.. � � �. "' " ���- . , ., , . Lalh—Exterior , . . � � . � . . _ . - ._... �... ,..... �.. ......._.. .. �_ • . - .. �. House Number-- . . __. . • .. .. .. '_ '- ' .. _ � ' , . . . . . . � Correct 8 Posted . r��.�'�- . ..� ° � — .. . • � � • Final-- -. .._. . _ . . ._ ._ _1-�.. �. , . - ,. . , . . . . . Enfer on Front - --c � . .._..-. .. -. � . .� � .. � ' _ ,. . . . . �� . .\,_ .. _ _ . ... . .. .