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HomeMy WebLinkAbout0824A (4) � ' . ..-�' .. .. ... .... .. ... ... � ....:._ _....:....�.. ._..... � .. .. ..'..:.. . _I.. .- .. ..._ ... .. .. ..., ., . . . ._... ... :.. .. .�. `I � . . ....._. .._... .. � - -WORKERS'"COMPENSATIONbECIARATION � � �.s-:c : ��- + ' ' � � �, ( � -- � " �,' � ..Y . . . ( _. � „.-�' �..._. .. ' ,. . � _. ms�rebor�a{certif co'fe of Workersr1Com ensahon Ins'�se1i .COUNTY OF LOS ANGELES � .BUID'�� .����I� . � . ' or a certiiied co '�hercof Sec.3800,Lob. � � � p urance 73WC005-1��79-0�m6a� N� ,_, � - - 1/B- _ _ AP LI 'B IL DING AND SAFETY ' �� FolityNo.- p y ationwide __. ' � ' . . O .Certified copy is hereby furnished. . FOR APPLICANT TO FILL W i BuuowG � AWRESS ���:�Certified copy'is filed wGh�the counry 6wldmg inspeo- �• � -� BWiDwG - �"� ' -��"� � ' -�-'��' . �` � � ro�dePo.�meor. . •.:,, ; . , - ,,, nooaess _ 24250 Gem Place i . ,,� � ,, .,. . , , . , ., .,. . . : .... . _ - _,__. . . ....... ...:......._ .. _ _ �� paie��8IS��H7�� qPPlimnt THE�ANDEN��GROUP � arvDiamond Bar�� � � z�v - ' �oenurv Diamond-Ba - - � � � �.__. . . NO.OF BLDGS. . ' . ......:.. NFAREST , . . '�' '�LERTIFICATE OF EXEMPTION FROM WORKERS'.'��" '-�- -' -�-��--�� �--- � -- � t ' . � . ��� ��� �'����-���COMPENSATIONINSURANCE - SizEOF�Ot � nIOwONIOT cRosssT.Diamond��:�Bar':�Blvd"���&��Golden-�S rings -�Thiz section need not be complefed if Ihe permil is for.one .�-....: . . ' ��� :..J ASSESSOR ."- �..:-..�.. . .. . . . . � . . �,hundred dollars(E100)or less.) .�... � . '."� TRACT�Z r'J$0""�..BIOCK.�.�. :..�l0T NO.''.'�4 3 /�qP BOOK.' � � ,•-��' . PAGE .:PARfFL�.. . . . - , .•..: . , . . . iEt. , . USE ZO� - N� . . . I tertify�ihot In Ihe performante�oi the work'for which Ihis ������ OWNER�--� -� � � NO � — /� �I �� � I j(:j�,3 - ' permit is issued,I sholl no�employ any person in ony manner - ! � �^"-,.,,' . SVECiAL _.... _ ._ _._ . ... .. . so os�o�become subject to Iha Workers'Compensafion laws. .' ADDaE55-P•�•BOx 3329 avrv�.� CONDtrIONS- � 0 ,... ?; ,, :. ..__.. arv Covina. iiv 91722 _ !; c) �a A li[tlnt - - � ARCMITECf OR � �7EL � DISTRICI GROUP, iYPE I FIRE %20�SSED BY �� � \ ' OTICE�TO APPLICAM Pf,'ofler making�this Certifitate of ' � ENGMEER� D1V2� $Z3I1 p11A� n,o.445-4073� / � eoNsr. - �zon,e- - �� � � �Exem tion,' ou i should'become sub'ect.lo tha��Workers .:� . . ... ... . . . ........... �..,7EL . i... S7AiI5TICAl C1A5! . .: , .: ., � � Com ensa�ti�n rov�sionsPf,�he lobor Code,P ou most.forth � jg � ( � � . � � W wlnc �om I �with such rovisions or,this ermit shail ba COP77Ra.ttOR . - � � N . . .- ..,, .� �� TION I�. � A7r. CON�O. , deemedrevoked.� , ��� �-A5. dl'J V@ z P D � Y ADORE55 314 N. First Arcad� LICENSED CONTRACTORS DEQARATION �� �� .... ClASS NO SiFI A OWEIt.-UMTS "� - �- - � -�" "" �� UC " � I hereby aff�rm that I om I¢ensed under provrsions oi Chaprer 9 �� ADDRE55 � O - �No.51�5 6 Q . (commencing with Sec�ion 7000)of Division 3 of the Business aed �.�. � �� '� _LIC. .B �` �..��R�i . � � . �� . .-`� �. . �. _. ____.,. . .-- - __... ___.�_ .. .._.. _-.. Professions Code,and my.litense h in full(oFce and effecL ; � Cii�' � � � �CtA55 �� � -�BK ----� --- i�- - � --VAUDATION � � 510560 . : B __ SOEFTt1535. s"roR�s 2_ ia°ii°Es 1 -oN� . � Ucense Number Lic:Clan � ' � . � � eon�rocro�THE ANDEN,.GRO(��e' 8/5/8 7 : oescaivrioN oF woeK ' • New__ s A7 8 0 9 I _. _- ' ._ . .i . ...�.,. . �ADO ��' �.. - I am exempt�nder Sec. ' - �- ' �_ . airea ❑ ,� -.. :�0824A B.BP.C.for�his reason �. SLAB ONLY '' 'aEVAiR. ❑ .-S I� .. ..._._ . _. ._. . .#.. ;-y, ..�_ . ......... . . . � USE OF . � � . . - � � � Date � ��.. :; � EXISTINGBIDG. - DEN10L � � . , � .� 3lgnature ��-.. . . . -_ _ .�... . . . ..-_- aFPtICAM ... ., ' :'TEI. . . .l. FINAL� . . _ 4,2�J � . PRINi � I •,7 OWNERBUILDERDECLARATION ,_,DATE,.{/�J �:_l � _. :_.� ♦.'].(�. � ._I hereby afhrm Ihat I am enempl from the CaMractor s License -�-"' �"�' � "� ' --AS dbOV e � ! � � - w for the following reason(Sec�ion 7031 5 Buvness and ADORE55 �� BINAL"'' �` . �':/� ��� � ' ��fessions CodeJ:... . ..:......_. _ ._...... ......._._._.. _.:._ R . . . . ._ . ;... . _ .. y . .�.oR� , .., - -.8,1 7�.�8 7 U. . � ' BUILDING �. . � , t,�as owner o(ihe properfy, or my employees with ADDRE55� _.. �I ,�. . � ;, ,� : � ��' wages as their sole compensation,will do the work and `... . .-....-... . _.� _ . . ...__. . ... . . „_„_ . . O. � � the s�rucfure is not lotended or offered for sale(Section � ��`��Ty � � ' � � i� . . , �� � . --- .:7044,Bu3inass ond Grofessions Code). .-_.-.-.. -.......-` MOVING -. ...-... -.-_--.- .I 7EL. ' . . -, . . -. { - --" . -� . � ❑ � � CONTRACTOR- � .,NO. �; . � j I . .•. . . 1,as owner of Ihe ro en,om exdusivclPc inirai tin pooRE55 � � � � �� '�� - �- � � ` .' � . .with IicCONSTRUCTIONrLENDING'AGENCY.:ro ecf Sec -..- _�7 BnCK . ... . VROv.�uNE �� Wi�iH' . . .. - 'I. :�._ . ..'... �.. .� . .... ..� . � P P Y Y 9 , - � . rion 7044,Business ond Professions Code. � . , . �� .. ...__ _...;._.... RE�UIRED : YARD� ..HWY.. ..TOTALSEiBACK .. : . � '� . ... .. .. _.: .. ._..�. . .. ..._.. . _._ ... . i . �1 hereby affirm that there is a construction lending agency for�� . .fRONi : . � � �_� � ���� - � � �� �. � �� - � � � .��( pe ) e work for which this permit is issuad -. __. -..v.�..-...: _ � �� ._. . . . :_ ..,._ . ...- _ .._ . ._. .' . _ .._. . _ ... � the rformance of�h _ . ._ Sec.3097,Civ.C.. � � � � � ' �. SIDE �� . � � � lender's Nome C-'l ` P.l. '' � � '�� . - . ...� __. tibank._ _ : .. .___-. _ . �. _ ( _ . ae.mu Fee ;,6"3.75,:' ;' �nu est.M l ._ _ ' ' m 444 S. Flower: L.A: 90071 v.c.rees _,. _. ._. _ . __ �� - � � Lendefs Addross � . � '- �� � _ . ' ._ � . � . i, .,� . � . �,. I tertify that I.have read.this opplication and.a�ate that ihe_..-_'-_ .._ �._. - Is�uanca Fae-10.5�� ;� iDMA�P/CM �I �i ._��'. .. ? �obove iniormetion Is eorroet.I agree to eomply wirh all Counly � Inrase�qa+ion r•a � � � � � �� � � � . � � - �- � $ ' ordinances a State laws relafinp to building construClion, ' ..._....iotol ha�.`.-. � ;� IDMA Perm.M I� -._-..:..I .. .. . . ... ....__ '_. _.�...-...... .. . . .. : . .. R . -�end hereb harize�reprosentalives of this Counry to enror-�� � � _ ' . � vpon Ihe v - e tioned property for Inspectlan pvrpesee. � . � . � : � . I ! � ' ..._. . ...._. .._.. __ .. _.. ...._. _._. _ ..- ._. , . . . ._ _ . ,_��. __: ., i� _ n ��� � SEE REVERSE FOR EX►LANATORY.LANGUAGE � . . f I ' . .... .. . . . . � _. 'Siqnor o ppliconrorApe� - . �e � _ ._ . _._.. .�,. . .... _._ �.i:. ..:�,. . . . _. �� _. .. . __ . . � .... _. �. . , � - - � � . . � . . .. � � � , � . . . . . .. . . �. i�..� PLANS TO APPLICANT ' . . INSPECTOR'S NOTES ��U15'�11 R fSUI);I)!�2!)!(l.r\H 11.IU� , i, �I hr eby�rf m thoi�l am eMemp��o ihe Coni a tor's ',I �` p �� F . . „ �.�„; 7+ " .'.. A. p t� jl� p� p l �,"., i �{d: . Lce s �L fo 1Fi'�ollowin�q rrnor� �Sec 7U7� 5� . r' � To: s� ,F ei r.C.r '4 �Itewrnod 6.1 �'. '�k �.�.� L G� t ';_ ' G S'` h� u t:C�-C. ,e� �.: , . • . � Approved � fli�srrs�<s�nd,l�f es�un;(od (1n1t tt rr� untt vl.i G . No. Deto � Na"•: "•'Date"".� �:i i_:-�:�L?1:i�� a�}45�i��1�7r �'�� r� uirr��u crn�relutonslr Et alt r;rrc/ �i'L�ie7uh�/; ' ' t' ' Y P 1 ! � ' - � ._. ..___... . . .._ ._ . ...._. _..... _ iirtr�nrun� �rdth �:' ..�t t-��wruu.++Lrirvy i.�•. tui �: l•llJ)I1GT iVl JIIi9A.J; _ _ �i, T Pl� / h� /� fi I � y A��"' � 4 1Lc o ! ,�n� �<urh u�tn !r u ti nrJ se 1 t __ ��C1E.'C `37-.�-LS.�-`-�-'-"- � — ------ .�..:{bat�L�,tfli,.cns<J/iur.su.;�[tetl�J�r ui ns �/.t! G�ne- � �.. E.�.' � c�Jts�4 f�')c7 UC�.,.r'� � 3 t�n��� tra! rslirens l,ua•(CIdfN r�/(oo enntl.4»Itl 1 e� i �'--_—. .- ._ .—.— �-'-----�' — ' � t+ n 7U0 1 n Ui�r. �n 3 1l1 lisste £, inJ{'r. v s. � L._ f`j_�>(IC3"1�,.5( r�.l._r ._���n !� ^CL;��7IIp:lCt�� J�;' �iUI���CiJcfnrtf.+JtLP.v4rcniftfGerrfr�marllh�.hhn�[�r1br . i t �— � �c . ' ---- _ �- " . . . u!l�Erd,csto+f!�rn7lnrlt�labnrs:nf 5ei( �n,-JQ3f.5 b� �g�('I�.�.;c. i�.7.�tvc� .�, uv! "�Ra ir'od."'i �""'L `:.�• . � �'�� l .7�n�•. _ t�i � 3:�'.� yrty�/�Ii:m�!/iYrtJrcrnn[Ynh�cels7(etfjhcunitnuiiei! ^'-- - � - .9� --Date Rocvivod � i ,y � A o ols . ,'_"� �_�--- ^���frna!V'n(�not mnri��ihun�Jrrclnindn dullars(SSpD1.7: � PP -, � or Approved�. � .� _,;� n,..-r ��i o. , _No '-'- .1��� '�� -� r� i .rn���:� ,._� �.� '---- -'--�.:��.L.__.._._ '_Nos � . . __. <---- .- '-_.. .� _... .__. . .��,; . r. �_ I,as owner of the p operp,�:a�my employcFs wif . ... .. . ,. ` . . ...i. .. -_ .-._�_'_ . ', .^. .,.,_.�,.._�..�.e.._ c i a.wP9Ps Qs,t�y- }qle.c�m e so�on.w Il�do.lhe�}.�oSY and . lVo!:r_Cr.rGticore._.�_�'C..- 1` - .�.� \ ✓�.. -"-" . r.:� S �`'n� •.. y: ,..;,ifje st�NCWr��s nqt�nlended ornffered fo safe�Se5 704J1 . �� 17ec+:»rDeponmenF---— �7 L�..�! J�� . ��- ., __T___ _� ^r • � �zv:cl3asrrsrst.und Pr/a sr�nf�Je i7Gc Ga i;r�,t irp! nri� `_l.__'- "-'__' ., -. V � �CC�f? f�fT.LVO:� �+, l.ae<dcsnrtuhfhlian unero//+rfirhul Furlds ',� •,� �C)e �mem- - i ' _-�. :�� �. <� u :. � •..R, o i J u i v tl r�p,pndµ! Jo s c 1 u rk hmi�c/!�� '�� f-� ��� �c�°�. .,'7"� ���;�_� 3"n St;G':i I p.,t�.:v t� �p. t,•• � r I�' !. tc �flr�uqlqLis.oun.�,rmp! t ��IJ�ryi.Jed.tL�t,isurhfr?. � .�J: C����-C:^ Filt. Yl'[ .2 �: C6(_ y . �� C: �i�omrt J t .•�J{�... ��1 y r,�-' . . . ` . � :,aJ�r (emeulrtarr nit infrnJ 7!dro�f/ereJ Jor inlr;,JJ. . . I �eolo rcbl .•n.�.� � �_':._ � .1�rD3.. �..��`Ll`T .�j7���1�. . 7 •q..: '�ny�mr�er lI.>PLiII�(tt,QU�fIM�YJrFtrtYM(IC( (itrrt/�i n G� � � _ � ' 'J. � b� . ' ---------- ----_._._ ._. ___ . . ^_' .. __ e �{rLr L�f eimJifeti�� -�lbr iu7ncfbn 1 v ��all'! e�..th• . i �'j {- ry.•.7i .i�iA �C .��i�l„�f�.�,- � i�[tt,i �_a�Q C. �"` h�)� _� ..��-'. fiuJnul >rr�n dulLeddn rF�.l,l� ili m�r%nr i� ... � I I C _ ��� �.:iz� :�__;{.'..1_.__' �., tJ /+ur(S �4/�n/J ?^G� �,')i 0 � 1.n . Pede'siRb"ri�Profeclion_� .. . .. UC[li c�.".1 .�V(:Ci., �:1�� 13 ,1-y.� G�otc ,1 tcr��r � ..�F Ir�� l pi ��L�.r ..<�'I. � ...... .�... '. '.�:,,� .. . � ..... . _.. - . , . (Fence)(Canapy) ii '4.15... . "-- -,� `-'-` „ �.,�„ L)i I.asQ nerortfir,p operfY OmeSc�us-.elXro Irac- II . ....._ .... � :_�� . .. � ��� - ..+ p �.._ i .3„�--7---_ (1 O't� r.i.0 a •; � Ti+ '�.� 044)Il ' Special Inspechon ` :: .... x -.. . .,� ' I ', � (Canc1(M1tasonr Weldin ) � �.... _.... . .. _. . .... � �l t cclL�rdeinP�'aPf;�o�coqs�ruc �f�/ertt�`Nh� . lt 1! , Y1l 9 b ..~ liUur�.UTAV i . �� _� `� -�� huilds nnf� retflere- sn3u•li �fnlraclsJ sr , ' vr ,I__''=� .. ..._ . � c- \ r� - ' ��. lot Droinape f r7 e Q p i� % .• ��� +..-.•--"-- --- �._ P�^IG���u�itb,��inlruZ rj�1 t�teru�J�pi�tivant t tl c `� ...,.'__ __ ' ' - � ..,,._.....-„.,.'�_"'. ...�.-._r, �i .-., n i �.-.:.r .�'� r. �lrAilni'x I.icrnsr l.auJ . . . ..�.7 ,, . ,.., , .. . _.��_� .c tc . .::�m;l(J .. Fa��C��rt3� -''�-� � ':' � r � y n"'. . .-.. � c' '{•• ❑ I am exempl unde Sec 8.8P C for-�h�s � ¢ '. ��' ' � �i z:r.G-.:I �L�iT:� �.'. f,_c, 1.�; n,_.r.. _ . .7.�.:i.b . I �, . .. .. _ . . t __�—_� � c .� .. . ' t. � '�_���� { reason- _' '"'_'____. . ' ir... ' _ ,. , ` _ _ ."? O e � �_. , � - � ��: J H' '. 1, � Doie ._. �_. � ' .-' t � 7�� ' �L��2.:�LS!',IL`? � —,: v, ia.,.»: _a�.ue�� „� , -.�. .PP..� 1 � �. P� -,. 9' ..�.'.�� ... .,st v j� . r. . ,^.,.,i INSPFCTOH'S�NOTES�I.:} .. ..+wY1, _ � , �. i .. .. ,A rovals Doto �- Ins ecfor's SS nature ..�. �� .,_. . .,..,. . b.r.:z.-rf.�.f .i,.ICC,n '. � Locn�lon.— L— — --_-- v•� �I�' . . . � � ISethac4&Yardsl p/��� . w I y . � L �' di�a x t �a.n y o . . o , 1 � l � �'�I � /�ti 6no„ Foundmions +�,�F _ _il_—�.r� n:�i�:�_, ..,. ,.:1 ?1_�-cl�� ����or.0 . t. Slob� t7 y�,(x t '_� ti�7 �:': �.�;Uoii,�o�Yls.�a I,a... .r.Yi��ao.a ari:to . . �:z�.i n ' p �'�U � '. _ _ �,� , � Frome � .�:.-r ,,.�.r .. ... ..,. ....,..� � » . ` _ . .c�r:,�.1.� �u .. ....., .u.. „non . � � k� -�nf i 37 '7 ' � .., e ,. .. .� .. ,.,. �� � , � �' � . Energy Inwla�ion _. �.. �y '� »#y�roen pr•, � �I�u :.�o . -�:.i t v nv,�-n �j...-�.•; - �:- -�^.��_�------�-=- :.� t, II loth;Drywail_. '_— . -_ I� �� _ _ ..._'__- ,i c, z .,.. � . �--- -- { � f-1 � i � ,, �.� �, i�,P��o, a: �, _..... ... ......... t hIL IIA.'. 1 41 t' �J Loth-Ektenor '� a :q�:� ._.._ .� . ... `.,.:c-.' _..S',� _ . ' ?f C" � Ncuse Number_ +(y. >. —�'. � �`�e •r..u_.1,.-. . �t i. :..xl+.bna. ' � Correct 8 Posted r`.: U,G.�.L-_�� dl .;�. .,d�. .h.� ,��.�� ...+�� ,.1�, _ ; '.�.: ..� � .-.. ... +� _ Fmol. _-__"'-"_. .. .. ._ ._- "____.'_..-..-. .. .,.. �n En1er on Fronr �': h. c-:(�1.9,n1p.� Y'ru�7 I p({ ��V y.- 01 e i, o I 1 .1J) Ilc�Or .J C � E1�-' .� •,r 1 ,nclr ��trnc�o�;�L u J r�n�Y�_ 01 0. nlF;o i . .... ... . .-. . ..... .:'.. .z i'�+... � .. at y�nu�J t n iiiC 2 �li�n � .;..�, . ..5 ,. . . �' �.y ::: .._ ..._. ._._. .... .. ..:���. _ -..�:.. n.�..:',.�''....�. ..:...L.. .�..i....... ..�._�.� � . e �� :: . _. . .r.cca�un ro.u�._�n��ol yi�n.,�iq t .., �.�:.� .�.r no:,�; ' eaF t;r..,.�i i:,oTnvr. r��:;e a�.,,,�,,�a.., �R4.�^..i�� =>> >'��� ��-- - r �