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HomeMy WebLinkAbout1586A 1587A (9) , __ _._ _. . .._ _. WORKER$'COMPENSATION DECLARATION �� �. � � I`hereby oifirm that 1 hava a ceriificate of�o�,e�,�o.e�f . - � �APPLICATION �FOR��BUILDING�PERMIT �I insure,or o certificate of Workers'Compeneation Insurance, . or o cerrified copy thereof(Sec.3800,lab.C.) CpUNTY OP LOS ANGELES BUILDING AND SAFETY coi��YNo.�3wc005-2��m�Q�6 NATIONWIDE 31 B � Cerrified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRE55 23704 E. Goldrush Drive � Certified wpy ii filed with the county building inspea BUitDiNG Z , , tion depattmenl. ' ' - ADDRE55 3704 E. Goldrush Drive Dale 6-3O-HJ ., �qPP���a�} TAE ANDEN GROUP CITV DIAMOND BAR nv91765 � �ocauTv DIAMOND BAR , CERTIFICATE OF EXEMPTION FROM WORKERS' � - NO.OF 0LDG5. - � � NEnREST 'COMPENSATION INSURANCE SRE OF l0T Now oN�oT ' caoss stDIAMOND BAR BL{1D. + GOLDE (This secfion need no1 6e completed if the permil Is for one TRAn 43435 BLO�K LOT NO.3$ � AUES50R �, - AMP BOOK PAGE PARCEI hundred dallars(5100)ar le�s.) - .� , ' � TEL. U ZONE P / �3 r 1 cartify that In ihe performance of the work for which this owraeaTHE ANDEN GROUP- � -- No.967-9541 f NO. J permit is issued,I shall noi employ any person in any manner qD�aESSP.�. BOX 3329 �p J� �ECIAL � � - - � � CONDITIONS so�as to become aubjed to fhe Workeri Compensotion laws. O urr COVINA . zia 91722 v Daie Applfcant � ' �' ' � � ARCHITECi OR TE�. �ISTRICT GROUP TYPE fIRE 7ROCESSED BY O �r'�'NOTICE TO APPIICANT: If, after mak{ng�this Certiflcafe of ENGiNEER DAVE SZANY AIA No.445-4073 ' eoruT. z F- � �xemption, you�should bacome sub�ed to ihe'Worken' "- �I� V Compansatian provisiona of fhe Labar Code,you musi fonh• no�rtes5314 N. FIR /V ``'_ '� W with comply wi�h svch provisions or lhis permit shail be - . 0-' daemed ravoked. . . � - TE�� �� SinnSiiG4t CL45SiFlC TiON APL N00. (n cornanaoa�'HE ANDEN GROIIP No. ( Z LICENSED CONTRACTORS DECLARAT�ON ' - - - �K, CL455 NO. � � DWELL UNITS� , I herehy aHirm that�am�icensed�nder provisions of Chaple�9 ADDRESSAS ABOVE NO.S lOS6O (tommencing with Secfion J000)of Division 3 of the Businass and � _ . . - . UC. . ��R�P', � Pro(essions Code,and my license is in full(orte ond eNect. G�TY cwSS BK � � � VAIIDATION � ___. SO.FT. NO.Of NO.OF CHECK , � LiCenseNumber�10560� �i�.eio:3B S12E 1�86�- STORIES± � fAA41tIE5 1 ONE �� VALUATION; ,THE ANDEN GROUP 6-30-87 �ESCRIPTION OF WORK SINGLE FAMILY N� � Connccto Da�e App S $9�000', �� 5�.6 A ❑I am exempt onder Sec. GARAGE 445 SF AUER � , �r• •• •2� B.&P.C.for this reoson . REPAIR s i � y 2 9 Q�7 USE OF Date: E%iSTWG 6LDG. DEMOL ' Signature - APPLICANT TEL. FINAL ••2 9 Q O I� OWNER•BUILDER DECLARATION vRnvi THE ANDEN GROUP NO. DATE . /�/� . _ �I hereby aifirm�hat I am exempi from the Contractor's Licensa � �9.� �_&7 low for the following reason(Sectian 7031.5, Business and AD�RE55 AS ABOVE FINAL //+�/�f Pro�essions Code): - -' � " " 8Y //���� �� . . BUIIDING � � I, as owner of the property, or my employeas wlfh ADDRE55 wages as Iheir sole compensotion,will do the work and ip�p,�ITY ' �r��� �• �� , �� :� J��7 A the strucNre li not Imended or offered for sole(Saction � , - 7044,Business and Professions Code). � MOviNG ` S - '' . TE�' � '� � I,as owne�of Iha praperfy,am excluiively COMracting CONTRACfOR NO. � �� � � � �� with I�censed tonvoaors to constroci the pro�ect(Sec- qDoa¢55 ' � I ^fl 5�,Jr� tion 7044,Business and Proiessions Code). f-� !�� RE(]UIRED TOTAL SETBA _ �"..,• !�'�"'' �� � CONSTRUCTION LENDING AGENCY - � S�T gq�K YARD HWY PROP.LWE wi�iN , � °ll.�Z�O� I hereby affirm that ihere is a convruUion lend�ng agenry for FaONi - � 4'_;_f the performance of the work(or which this parmit is iewed - � R�. ,�;'1'� • �� • 0 9.1 1 �$7 (Sec.3097,Civ.C.). 5ioe �' ' �• CITISANK P.�. f i-!'"� Lender's Name LOMA Re1.N ' �.�,i � ' � Lender's Addres:444 S. FLOWER, LA 90071 � o.c.F�e s 290.07 v�.m�r Fes 447.00 � . ��� '- , � 1�.50 I certify that I have read fhis opplication and srate�hoi the - iasua�ce Fee ��M.4 7/C M o above informofi torretl.I ogree lo mmply with oll County InvesYgo�ion Fee 457.5� � q ordinances o ate laws relating to building consirvction, ,. iow�fee IDMq perm.71 �' and hereb a orize representatives of this County to enler ^ upon th e nlioned property for inspection� . � v LDMA $75 $35 p SEE REVEIISE fOR fXtUNAiORY IANGUAGE SfgnaNre oh ApPlicanf or Agen� pote - . . . . -. . . � . . � PLANS TO APPUCANT INSPECTOR'S NOTES ..U�1'NF.K-11UII.URK,UCCI.AHAI'10\ .. � : �. : . ' � , .. . . . . � , ,. , I h 6y c'f rn�•ho�I n c enpi 1 n ihP Con.� ' ' Y l . .. i . . . . , ; � ..'. �; i ' , �� , � I ��' � j' li[rnse� Low tur �he inllow ng re or (Sec. 70���5; To: w�. .. ,. �i. Returned � . .. . iA� roved .�. . :. . ' , . . , .- � .. . . .. ,.� :� ,. . PP � [Jonrrrc�r�nJl4�,lrsii��ns(,ad��.An��at�.nrruunhii�l,itb No. Data No: �.�...Dafe �. .� . -. . • . ... �..-� , \ I rcyuir��u prrnirf!��nnnfrurL alt��r.inr��r��rr,drmnlisb, � , .. . . . __ur rupui�.iriti'tiructu�e:priur tu ils i.esii.irs.r,dls�.n yuirr� - : j � ., „. ., ;.i_i� .. . .-, '. 11 e�Jrp/i:mif/nr;suc!prrnnf!n/ilr,a si.qneJ s(dleuirr�l ' -„!1 a!ibp is LcensrJ/�urn�m�t fri 1be J�rnr n�inn.u/Ihr Cun• . t `�- "� !`��.:: - � � tro:tnr'sl.inm�crf..�u�l(%l`�pter'Jllimirnrennn,tttill,li� '_ __... .__ _ .._ _ _ _..____... . ... .. ... . ' '."_._ . .. .::' . :' ". :'..�.�..__" ___._ . .":'.-.. finn 760UJ n/Un ivnn 3 nllhr l7usinrn¢nd Pn�/�•n„�ns � ; :.. � . .�.• ' . .�•.•-. � � :���,'.' . �'(�Ne/iirtlwlle �pe![er�J manJl6rFriiie/ur11�r , .. '1 _ . ("', . ."'` '.rrn �� ' ___ _.. _._' _"__- ___._ . . . . __ " .; "_ _.. _. . _'"_. _...".': __ '.. _. . . . .... __" _" _ . ,__ ... •y . . . ,., , , . .. . ; .: ...... .r '_ _ , onrt�rJ lr wnt .i ia.Arnri�,<vh ti�lr t/r aea7�ni�trn a Sirr! ,�,� . �� . . '�'.i _.'.Raquirod'.�� DateR coivod -�--�'------ .. .. �--.'_�.. _..-.. ___ .. ..__ PP f P� l�'� . /'P�a�rt ApOrovals .,Yat No or Appwved,�� , . ,.,.,�� ,.� ,. , fennitv ol nr t,mnn lhun/'e l�undn-J J��!lars/55(IUJ.y ": _ � _..._"".__-'..'. _ . _'__. __.: ._i. ,._, . . . . � � . � , � � . .___ ._ _ ____.. �_� I,az owner oF the p�operfy,o.my empbyePs'wuh - Wo+er Cern6core l���•� '� �\ � � ., t�- � .� _ .:�� .. ._. . ..__._ ._..__.� waqes as�herc sole co�ensanon,w II do�hr.wor4.and • . _�_� _ _ � . _ „ . . , '... . -. ._ ... . -�-��--�-� - -... _� ' ^. ' the shoc�ure is noi inien ed or o}ie�red lo:sc�l'e(Scc 7044) Hcolih Dep�rtment._._'___.. �. '�.�- � -_ � � ..-.--'---.-- ----�-- - -----.. . --- -- . �.�Uusinrss unJ P /.asii.re!(�Jr:T�Lc'G ierdrfnr'i l.i:��nse .. ------- -- --- � ,. ,. �I.mi•�Jnrs nnlapplv 1n av r�u•nrr o/pr+ipertl'irb��huilJs " , �.. '.� .` or iuiprorrs 11�crrnn,and evbn Jna�v suoG u�urJ.ivra��rlf.�r Fire Departmeni .., . . . . . . -. ` .. . .. .. -- , ... .. . ._ _ . ._. __ . _ ._.... . __. ._ .. � - -- � " . � �brriuRL-L�is m�rn einplr�,l'v�'s. prnrrJed;lL�rt ivib=i�n+�--. Gr�dinq . � i -� ( � _ '. � _ - .:..(�rnt�ernenls.� _-n�l rrst�•nded ur�n/ferrJ fnr snlc. !/� i �-�/� � . , . . . . . ..�� y(rn�rerrr,lbeluilJinkori�rcprr�rnmen7rn'u1Jtr�ifLrnnnc ...__ . . _. _._ _ .. �. .. _ �.__ . . ' ._._ _ _ _ !'.: . .: � � � Geoloyical� - � • ... . . � ,.'leur o/rnrnp/ctrnx, tle nunrrvh��ilJnr u�if!hc�r tLe , i '�. � �.� �:.� -. : .�......, ; '�. -_. �.., ':. .�. fiurdrn ril f�rnrirc,�fbnl he did nnf GrrilJ rir imhmrr/nr ___ _..._ __._ . . . '.. . ... , , . .. .. .. .. .._ .__ - ' tJ r pu�usc n/talcJ. ' � Pedestrian Pro�echon > � i� -�-� ( � �� I; . . -.. �.. _ . . ' .' , �Fence)(CnnoPYl . . . .� - - -.. .. ---.. _ ..._'i : .:_.'.. ._._-.f_ � :ti 91with I ce sedreo{niro�o s to y'�nm eKclusivelyconiroc� 1 ��'�� '� conslruct Ihe.�p�olPd(Sec. . .. , __ _ .". ._ ___ _ - _.. . .. _ _ ,. . Special Inspection ; . �.__ .. _._ . ..� ,, � - : - �-.: 0 4 a'nnss anJ(r i� a � de• ! (.orslr.r e m's 7 e )U r C� . bc � , � (Cenc.l(MosonrY)IWelding) �. � .� ... �__..-�. � _ �i._. _.-.. . , ..•� � l.ire �.(.��vJ rsn>��ppl1 t a u�•nr'tifPrr�pr�t�u�hn • �" - �-- " "'"'hu�7dfur nnf�su:•rs��lhrreun;and u�bn innfruclsJnr�su.b Lot Droinoge .., . .. •, � � �. ,.. •. . �..,. . _. ..... . rrlccts,u�it� a con ra�in a i� i f , �, p 1 t r(.cJ!�r� cA�frrrruanl t� /r ;: �. : � '-_ -- . - �. . . ._. � , - ' p�,�:.I .. -Cnntrncfor's I.icrnsr lau•J... _ . ..- . , Pnrking . �. . . _ . �'� � .._......_'_'__.' ......�_ _.�... . ..____'_ .__ ____ ._ .. . � � � �� '�i ❑ I am exempt�nder Sec. '.8.8P.C.Ior�h�i � ___... .'. .'_ _ ._ ._._._....�� . . ' reason .'I . ' ' _. " "__ � . ___. ._ ' __.._..._ � . . �Dnte Owner _, ., ..� . . , , �.. , ., . , . . _ , . �_ . � . . _... ._._..._.__ _ _ _. _.__ _ .._ ' .� . .. _ . •,'�., � � ,..�,. .. :t. . '. ... . „ �+PProvals Dofe •Infpecfor's5iqnafuro ! ; ' ..��;. ,. � . _ . � ... . � _-� . , �r_7 ItRSPECTOR'S NOTES '. . Loca�ian- , , _ . � . _'-- —- - - - . ._ ., . .. . fSeiback 8 Yords) .. . .. - .--'� . __ . ._ __ _.. . ._ ,� . . . .�.. .,. .. . . i , _ ...;. . ., .. Foundations � .:- .�Lk�� H�. (/_3a_yl__.. ��� __. __ ''_. -' • .., ,. �.� ..., �„ ,- .. �. , Slab� , , .. . ,i . .. . . � __.._ _ _ _ _.._ _-_-__'__._._ ' . _ ._._.. _. . . __ � .. . ,.,, , , , ,_ .. Frame ', , A�� .. , . .. . - � , � . .; . . � . . . � , . , . �J EneraY Insulation _., r,�. n �. ..__ . _ . _ .. . __ � _ ' .. _.: . -, . , , , . . . . . —� LAn` f . ... .' _ . � , ,. '. lath:Drywall-- n . . _ .. _ ."......—.." _ . _ . . . •. ..� .. __. � . . Interio. Z �Q. ___Y:l�r�.. .._... .__�, i ',, ; -. . . O ���' larh-Exierlor . � - - . . `� .' � . . . ... -. _,,. ..� . ,� , 2_ ' + . , . _,. , - „ , , . � � ,,,, HouseNumher-- ' . . �„ ' _ _ _'_ :. ..._...___._.r _._ ._ . _ .. _"._�....._ ;� .��.: ,• . .:... , �: . , . , . .. Correc�&Posied y . ic..,'. .. ._ .. .-... - . _ - _ _ , . i finnl.. . -.__ . _ .__. ., . _._ __ . ___.. __ .'___._ _ ...__. .. .'._._'. _' _ . � . , ' Ente. . �. �� �� . . . or Froni .1�,• � . , • . . .. -�. � '� �.\. . . . , . . . . . . , . . . . �. .. , . � ; .. , . �.`�\, . � . . _ .. � ' � . � . .. `\1r' ,� `,.. \CL ,._ �� .�_:� ,.,... .,,.- - �