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HomeMy WebLinkAbout1081A 1082A , � . . --- •�--•- -.._ ...._..�.._.._.__-- - �-�--�---- -� tnsure,or o certificate of Workers'�DECLARATION .. �.,,„ ... , .. ,...^-__.,-.._.._._._....W„_. .. .. ... . _. _, .-'-"...... ........ .. ....__ �T>'•,... .�WORKERS'COMPENSAiION . .,_:;• �, , .:,-..: , . .. •-.._........_'___. I heie6 affirm that.l have a terlificate.o�.consant�to,self ompensation��t�,a��e, APPLICATION �FQR��.BU.ILDING PERMIT �-�� � or'o cer�ified copY�rheieof(Sec.3800,Lob.�C.� � " ��-'---���--- - �- '- -� �� ' � � �-� -- - •• " • 73WCU05-2�9-0004 Natioriwi.de 30/C COUNTY OF LOS ANGELES BUILDING AND SAFETY � r:: • Policy No. , - ompany . .. .. _"_'..__' . ___ . ... . -:. '._ _.. .._.._. : Certified co �is hereb fumished:' ��� BUIIDING ❑, PY Y FOR APPLICANT TO FILL IN ADDRESS � I � Cerlifled copy is filed with Ihe tounty building fnspec- -�� gU1lDING ��tiori department. � � �� ' "' ' ADDRESS 705.N. FeathelZ+t�od DZ'ive ' oa,e 6-19-86. . aPPi��o,,,TE� ANDEN GR�(JP _ _- arr D�tnorrl Bax Z1P 41765 iocaun Diamo , .: .�CERTIFICATE OF E%EMPTION FROM�WORKERS'� ' .. �. - -' -��-�- '-� - � --'�- �---NO:OF BlOGS:-�------ ----' n�o,REST.._.,.._. . .__-..".- '..,--'_ -'. _ ...._... �� � � � COMPENSATION INSURANCE �� . � SIZE Oi LOi NOW ON LOT CRO55 5T. ( ' ' . -.; ASSESSOR�., . ._-.. ( p . . .+p it is for one _ _.._ _.. ...__ _ __. .. .. . ._.... __ _ •... � , ti��ded�aano:esioo aeless. Ietediffhe erm TRA 3S�JF)�. BLOCK 2 MqpBOOK �� PAGE PARCEI � TE� 967- usy�or� nwa q I certif rhat m th� . .., .,. . � , . • � �.. -- � Y . P , - _ _ ._. OWNER'. . . "_'. _ � ' IK��^ . � e eriormance of 1he work for whic6 Ihis N�� K permtt is issued,I shall riot employ vny person in any manner �j �� - SPECIAL � ��- - �---�---- �����- - � '""" ADDRE55' •O.Box-�3329------- --�--�----- �ira ;.. ..�0 so aslo become sobjett lo tFie Woikeis'Compensation Lows. CONDITIONS � .. . PP ��, g . Zdl�� .2 90 445-4073 .. . o TRICi _ GROUP NPE . , .,.. . . ..., ., ,,. .. ... _ .0 - e , .. . ' , .,,A licbnt • ... .�., .,....�., ,. -�--- Citt-- -CAVlI1d --- -- iP. � �- -� -- -- -. _ .. . � - TICE TO APPLICANT: If, ofler makin"Ihid'Cerfiiicafe of ARCHITECT ORD3V0 S T FlRE._ ..PROCESSED BY.'. �� I ENGINEER �F mption, you should becoma 3ubjecl�to'�1he�Workeri ""- CONST._ � � _ �� . w Compensation provisions of ihe Lobar Code;��you mus�forth• ADDRESS 314 N. F]YSt� �'CdGll.d ��.��6 ____.___._ .�-j. ._ � PY P s permil shall be'----' � - Yi - -- . �a ' � ��+ ANDII`� C�T� NO. • S7ATISTICAL QASSIFICATION � � APT. CONOp; I Z I hereb y affirm that I am litensed�nder pro CONiRnCtOR . wit com wif 's�t rovisions or"1hi deemed revoked. ,'•• '• . •�'. . . _. � , _. . ..... . � - � - - - - - . IICENSEDCONTRACTORSDECLARATION.�.�, ... '---- - -. ..... ---�--� ��Ve�---'-"-....I�C.�-3�15$O . �s5N0. � DwEIL UNiTS� - - . ; visions a(Ch o pt er 9 A D D R E 5 5 N O. (commencing with Secrion 7000)of Division 3 of the Basiness and --.--. _...._- -.-_'_-. ._ ��C.--- SEWER MAV . ..,. ., „� _"_'' "'"'_ ' Pro essions Code,and my license is in iull force ond effecf. Ciiv CIASS B '---� - - - - -- --- � - ------ �--�-� __ . , ,. SO.Fi.17H6 . NO.OF." . .. NO.OP_.. _... _CHECK_� BK. �. � I DATION VALI . . . _ '___ DESCRIPTION OF WORK-' �-�l.e t�IU.�.Y'"" NEyy-- _n.�,���-' '., ,� �Licensa Number .,-�_ Date { S f ADD � '-VA ��'� ` �71SBO Li[.Class B SIZE STORIES FAMILIES 1 ONE , . , ; . � _ LUATION_ � � co�i.acio:'�i_F. NhEN 1d�L� 6-19'86 s 65 32� � - • - �.a_..-1 �I am exempl onder Set. ----- ..-...._..Gdr e 445._SF-_._--._ ..._. � ---,�rr e�-•-G-� .-�.• . . . . . ' _ _' AITER ' i ': �1. ' 8.8P.C.f0�1Mi3 reoson ' •.. '___ . REPAIR a . .s . .._ . ,. . � . ...- I ��2 6-8 6 5-.-: - ' " USE OF ' � � .._... ...____ . _, _..... . . . _ . . . _ ale:- E%IS71NG BLDG. DEMa Q � i . ._• o.L(j&fj 5� . ... . . _., __._.__. "'._..,..__ , $ignafufe . . '__. '__ ....__'" ' _' .' APPIICANT�� �.� � NO. FINAI OWNER-BUILOER DECLARATION PRiNT � ' " � � I he�eby affirm thot I om e.empt from the Conhactor's License � - -- --- -DATE�--Z.�2(l- ��._�� ..... . ....__�.e.�L��.8 5_. ' _.AS a170V2 . _ �nw for rhe following reason(Seclion 7031.5,Business ond ADDRE55 �Np�� � _ .. � . .. � ' �(¢SSionS Code):. ... .. __' _' '_ _" """'_." -....- PRE ENT BY - ' - .. ' . .-'.' . ' BUILDING ' ' ' ' ' ' ' I, as owner of Ihe property, or my employeez with ._ ADDRESS � : : � ' � wages es fheir salc compenw�ion,will do�he work ond� � .. �"��--� - -��--� -�' - � -� � - - the svucrore is not inlended or oftered for sale(Section _ ��`��t� � � � � ' ; : _ -' 7044,Busine55ondRo(essionsCode). -- -� --- ' MONNG' - �--- - �--��---� � - �-��7E�,- - - � - ---�-- : --�-� � - - - �.1. . 2 __ �Qi � � 1,as owner of tha property,am e.clusively contracting �ONiRAttOR i�' I , Np.-- , i ' �r• e • • •��. � ... ,` ., � ' -with�licensed controctors roYonsirucr Ihe�projett(Sec-._._._ ___. ...-_ - _...�- t.' .-- "'�;'��_. ---. -.---_. - - /�, . tion 70a4,Business and Professions Code). ADDRESS:. . ' ' . �.. : i i - -!, 1 - .�y. ._`."-�'--- -���a 3 9 R 0 0 , . \�. _..-.. .-.." - RE�UIRED, . . TOTAlSETBAIXiROM.. ___'"_ -�i�'`,�.•+%� �•/�•:�� � CONSTRUCTION LENDING�AGENCY��' � � SET BACK YARD- .HWY� ��� pgOP.lWE WIDTH �- � v�'�G I hereby aifirm Ihot ihere is a conshuction lendin g a genc y for F R O N I . _.....r_,�i.l%1 I �:��r �,��..� ; �, . .. �. G�'"�. �I, �-the periormonte of tha work for which fhis permit is�issoed --�-- -v.L.�--� ' (. l :; ` __ _ __ . _.'-'- --- ----- -_'-.._ --- -- . . ... ., '-' , ` ;. �s«.sos�.Civ.C.I• SI D E ,< ��2 2. 8.6. .. ..__ . . P.L. � __ ..._�!•t�� ![^r' ' i � � lender'sName C'AS1t1.II2Iltd�. I1.�.1t]D1S_ .. .__.... _.- -- -- - ----._. . _ . _ _ 1:.._`•!• -- -. .... ... _.-i .. .�.. , 232 S. IxlSc�.1.2�CYL1C�1C�0 IL_ .__ P.C.Fee 5'ZF)H.65 --- P�,m��Fee-379.50_. lDM4 Rel.k , . �\.i � . � :.,,;; lender'sAddress 0693 .... ._ ... --'.....- .-'-'- ----i -I certify thot I.have reod this opplimtion and stote Iha�.fhe �.0.5� ' '_ _'� � � � , .��:r;� .._ _ ... . .___' __._"_'' Issoence Fee. .. _- ' lDM4 P/C N........_...'-- - .._ _ obove informati is correct.I agree 10 comply with all Counry invesrigoiion Fee � � _ordinances a fine Iaws rela�ing�o boilding consiroction, __._._ 390.�0.. .' ' � •, a .. , . ' '. '_._.___ _.. .. .....-.._ To1alFea.._ .._ LDMAPerm.N... -... . �- _. _ __._..__ .. ,.... __ : and hereb o ize representotives of this Coonty lo ente� . ---- � upon th - tioned property for inspection p rpose/s. � _ , � � O� - � $75 ----- ` - $35 ; .. _. . - -- - - - _ . -- -�--- - - SEE REVERSE FOR EXPLANATORV LANGUAGE - - Signo�uro�olApplimmorAgenl --- �---- poe-� - � ......' 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