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HomeMy WebLinkAbout1074A 1071A ... . . . , .... ....___.._.__ _.__.�.,___.___. .._._.___._.___.._...----, .- Y ..__.__......__._._.._,_ . ATIONDECIARATION , � :i'T,t�,-�:7?.•J•^ .,. ...;�... -:....,. .,.._._..._..__,._..... _.__.._.. . mwre,or aOceKEfica eOorf Wo k�. . . . . . .....--�'-.-"-' _ _ � . .. . . , . . ` . . 't ,�. � . ' � � I hereb affirm that I hava aers'�CompensaHon��;�,a�aF APPLICATION���FOR-��BUILDING �-PERMIT����-����--�� or'a certified copy�theieof(Sec:3800,lob;�G)', : . .---- ..__ __.__-. _ ._ .._ . . _... . .----. .. . .- - --_-'-.. ' "' • 30/B. COUNTY OF LOS ANGElES ' BUILDING AND SAFETY . . voi�cyr7�WC005-279���y.Nationwide' � "•"' � "' _.... _. _ ._. ... -- - - - ' � Cenified copy is hereby(urnished. `� BVit�iNG � ',�'� FOR APPLICANT TO FILL IN ADDRE55 773 N. Featherwood Drive � ,Certifled copy is fi�ed wlih�t6e tounfy huilding Inspec- -' - BURDWG � " i , , - ��fi8ndeparlmenl. �� � - ADDRE55 773 N. Featherwood Drive' � `• ', , ' ' --- - _. _...... ..._ _ ` ' ! 6/19/86.�. � TH� ANDEN GROUP . .. .-- ' oa+e' Applicam aTr Diamond Bar ZiP 91765 ; i�,�iTY Diamond Bar ; ' �.'� CERTIFICATE OF EXEMPiION FROM WORKERS"� "°. -"" ' "---'------��--'----''Na�OF BlDGS.------ - -�-• n�iaeST__...,�_ � � .', _. .. . . _..... . . .. ,..----..... .. � � � �-'COMPENSATION INSURANCE ""�•' ��• SiZE OF LOT NOW ON�07 CRO55 ST, xl Knob &.Golden SpYlrigS . ,. � (This section need nor be completed if Ihe permit'is for'ona .. .. ... ---------. -------�---�-- -'----- ---� ' n55ES50R .. --- - -� .-: • - . hundred dollar5(SI00)or less.) . , , . . TRAR BIOCK LOT NO. Mqp BOOIt��" � � PAGE� � PARCEL I certify that in�he performance of��h � •• .. �.,.. ---- owrvca ------'--- u5�ZONE �P e work(or whith this THE ANDEN'GROUP—-� -ruo967-9541-� /� No �,Z3,-3 �permit is�ssued,I shall not employ any person in any manner __ . ; •"���--- SPECiAI�-�- -- � - �- -����- � � ���� ����Or„ I so os to 6etome sub'e'cl to the Workers'Compensation Laws. ��- ADDRESS - - - -�--�---�-- �) CONDITIONS ;Q !te , ,. ., . App�icant`1� ' � .� ., �_. .�, . . ... cin_ Covina---- ..------zir__91722---- . .. .._.... _. 1._. _. . .._._ . _ .�� . v ` �m �7TICE TO APPIICAN7:•If, ofter-making Ihin Cerlificole of ARCHITECT OR � TEL. .DISTRIQ . _GROUP TYPE � FlRE PROCESSED BV. '� I ENGINEER Dave Szan AIA r�o.445-4073 � - -+t- �emptlon,��yov should become subjett'to•the�Workers' � �- 2 CONST.�l ' Z .V Compensotion pravisions of the labor Code;yoo mvsf forth- qpDRE55 � .-.1 t�_- -J .�- �l/ - . � .�pW„ with comply with such provisions or'�Ihis permit shall be .�--- "-- - �-' deemed revoked.. ,.• coNrRncroe THE ANDEN GROUP `c ; riorv / nar. coNoo. , 1 Z ,�. , . ... .. ,.: � � NO. . _- _._�..__. . LICENSED CONTRACTORS DEQARATION� � -• � - � �---� �-�-"��--- ----� SS NO. I I A,...-OWEII.UNITS . . ' ' _'_.'_._...._.. ._._.... _._. . .._.'___. . I hereby oifirm thot I om litensed under provisions of Chaprer 9 A�DRE55 � OVe ' N0.3]Z SO (commencing with Secfion 7000)of Division 3 of the Business ond ........ .__.__ ���_ _. SEWER MAP , . , . � Professions Code.and my license Is in full force ond effetf. C�N�-�---� --- �--'---�- '....�--��- �q� -.._ '�- --- - � --.- -- ----- � .. , , . . . , , �: :.. . . :__ ; U ON � B'� -- - - : ... . . . VA DATI � ;, . 371580 : . ,. .� $: .' __. _ 5f].FT. NO.OF NO.OF.._1_._.. __�HECK BK. 7G. ; I license N�mber � Lic.Class SIZE 1�]HG� $10RIES FAMIl�ES ONE , . � :� O 7 O A _• . .,��,�.,, � � " " ' ' ' � � __VALUATION ..-- - ---. . con+rocror THE ANDEN GROUPoore G��.9IHE) '"- DESCRIPTtONOFWORK-- in le-Famil - - "'�'--� = 65,320 ' ��' • '••2•� ADD � � ' ❑lomexemptunderSec. ----- - -�-GaYa e---445--SF--- _--- - ._ ___O ,; � . .. . .... . "" Al7ER , I_��6"8 6-5 -, -; - - -- B.BP.C.for ihis reason ' REPAtR_Q _._j_._.____..__'... '____! ____.._._______.a_-C�7-[:.f)J�c=i � __ � ��'• USEOF _._._. _ _. .-.. . Date: _. ' DEMOL �' ' E%ISTING BLDG. ❑ .__. "_ ��f�2G'�86 -. . .. -. - �- .. �: APPII(/aNi TEI. "- :. .•-�..Signafure .. . . .. - -- FINAL , � 7RINT THE ANDEN GROUP No. -�'� - OWNER-BUII�ER�ECLARATION . --.UATE--�L�. .- � . . _,_.___ -.1 here6y affirm that I am exempt from the Controctor's license �-��- - �--- '--�� �- �---- -------- -.. .." ..'-" -'..... .___._ .........--'� : .Law for the following reasan-�Sectlon 7031.5,Business and A�DRE55 � FINAL � ^� � �'`�-'� '` ; ! fesslons Code): .. _ . . _ -'--"' . ..._ PkE NT --By-- - -- - . -.. „ . . , , , . � I, as owner of the properry, o� my employees wifh ADDRE55 " � �'"'�' �� •-•�� •'' I � �� �� �_A� ' . ._._. . . _.. __._ .._. . . I - wa�es es th>ir�ol�compe^�a!�,;n,liill do tFe wcrk cnd • - „ ' ' . the strvc�ore is not iMended ar offered for wle(SeUion ��`��TY �-" •' '� - :�•A • ' -�}� � ir• • • • •� � i ' .__._-704d,-Business and Professions Code).. � ._� .. _ ." MOVING.-...__ _ -_._- . -,.-, . .�..TEL.. -. •.._. . ..._ __.__.___ - _' _..____." '... ._.. I � 1,as owner of rha ro er y 9 CONTRACTOR NO. � � , p p ly,am exdosivel confractin � ; •.J 9�,�Q� ` with licensed controctors ro constructthe pro�ect(Set- �'--�- •- '..._....-.. .. . ---�----------' ---.. .__..._._......, -- _---'- . -__--.-- . --._.-.-_. .'--.._ .... - - Iion 7044,Business ond Professions Code). ADORESS � '--�:_�. c- : �., � , � e e J 9 a Q��.�� . .. REQl/1RE�_ _i0iAL5EiBAIXFR M._ %I """"��'� ���'� ' "'��y•��I' .. . . _--'_'''_ N TRUCTIONIENDING�AGENCY'��--�" `- -rnao- �Hwr �-. y- � .-- -- - - - - - --�-, SET BA CK P R O P.L I N E W�D T N' �,�--_ , � _ 1 hereby affirm�hal thera is a conslruc�ion lending agency for feONi r`�;�:;,�;�` ',�`��i�;'�,: ' � -�he per(ormance of the work for whith this permif is issued '-'� - P.L. �"" -'---- - -.. -.----- --- -'--- �� , --�- -... . .. ` . .. . .. __ ._ . � (Set.3097,Civ.C.). SIDE � •� 1 +\ ���1 ��� . � . �ff ��`•�i! . � 2 - - ---- - Continental Illinois�-- - - P.� . _ '.``.,`t , ,�+{.. '.. . .i Lender'sName --- �lUiJ .I f • ',� . � ' LDMA Rei.A - -- - 231 5. LaSalle--Chica o�' IL -- Pc.F�es --- �.R+i�F«- -379.50 ._._� ; ;.!f ___ " Lender's Address � g �; " � _ �''', _I tertif thot.l have read this a litation and.stole that the60693 10.)ro-. ' � _ - ' Y PP _--..- -_.'-�.___.._._ .._._... '-.'- lesuance Fee---' --�� -IDMA P/C N - -•- -._ .. . . .._.... . � ok#ove information is cortecf.I agree to[omply wilh all Counly Invesrigarion Fee � � � _ordinances and laws relming to_boilding mnsiruttion, _ - Toiol Fee---�39O.OD -�'- LDMA Perm.M � --�-�- - ------ --�------ � �'�� -'�-{ and hereby o'e representatives of�his County to enter - � �- � � � � � � ���� ��� ` "�---' vPon�he v nedpropertyforinspect f�p°�es. LDMA---r.. • 1 $']rJ � -- -- •. $3rJ�___. ._ .. .--..-'-_. ' '- . --._.._.- -- _-- .----'---_; --�� - .. . .. . ... / � ...__ . / SEE RFYERSE FOR F)(PIANATORY LANGUAGE ' -7R�.'.'___.'. .".'."___".._."_"'.'.'__.. .__._ . .._._�.._'_`.._�._'__-__ _. ..__'.....__. . ! . .. ....-Signalure of Applicon�o�Agenr--- --'-- '-pare-- ' '.-' -_!' '._ _ . _ -___ �.Q i ` - -- o I� yT- s- � _.._�..... - 0 • �_ -c�- -c�- " ° � ;I � p nv m Q ol o � fl :m t ... .� N T N O j� 7 �, n`N O � �v 7 C1 � I ' � R' o � ^ o .`^J o c:^ to ,p v O cp y' m T f1 S o � c�D � ? j � ip °. o ^ ° � _. v' �� � - > > o o =. T 3 a n o a > >�. n� o o -' a" o .. m o � � � co o � � v c �� , o,a "3 .� _ o ce � I 'o < � v �o °v _ ' - ? 3 ° � ' s' O I -� K �K � j Q°I O � O n; �� ' ry N O Z � �C 7 �+ � a°c � o f � N � o o, �� ., - 0 o m o i Q a G �� , o _,_ � � ? = o � � � � .. m _ �• D a� � � / ' 1•.. . 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