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HomeMy WebLinkAbout1530A 1531A (8) i . ,. . . . ... . . .... �. ... .w . .... .. ...�, .. ,_. ,.��. �.., . � - WORKERS'COMPENSATIbN DECLARATION .. . ...: . � �. _. .. . . . . . .. . .. . . �. ._ . .._ .a _ _ . . .. . . '. _� .. I hereby affirm ihot I hove a ce ificate of consenf to=e�f ��qp-p`fCqgp�Nf���FC�R���:B�J���LDII�G I��ERMI�T� insure,oi a certificate of Worke�s'Compensafion Insuronce, oratertifled mpy�thereofi(Sea 3800,Lab�.�C.) - � - � - �-- � � � � � - - - ��- . . ... ..__ _ . _ COUNTY OF LOS ANGELES BUILDING AND SAFETY PolicyNo.��ompany P�r TnAomnittr . .. �._...... ......=.,.:�.. .-.=-,.....---..' . . .,. .. ............ .............__. . . _...._, � Certified copy is hereby furn�shed. FOR APPLICANT T0 FILL W su���iNc� Z�.7. �.� ADORE55 �'1 Certified copy is�filed with�fhe covnty 6uilding inspec- BUILDING La eway DY. B g. �.�� �ion�depprfinenf. ADDRE55 (�t oare a,PpUcanr S.McGinnis, arv zia 91765 iocaurv CERTfFICATE OF EXENiPTION-KROMIIJOkIC�RS' � NO.oF 0ioG5. - NEartEST ... .. __,. .. - SIZE OF LOT NOW ON LOT O CROSS 57. � � �� COMPENSATION INSURANCE � (This section need not be complered if the permi�is for one 7RAC7 36346 BLOCK l0T NO. /+SSESSOR ���'� � hundred dollars(�y100)o less.) . MAP BOOK PAGE PARCEL OWNER Ahmanson �2V. N�Z881�F�1..)Z USEZONE �P J/�/ � � } I certify ihat in ihe performanca of ihe work for which rhis NO. ! Y' permit is iss�ed,I shall not employ dny person in ony mdnner 1001 Commerce DT. SPECIAL � �d sb as fo become sub�ect to 7he Workers'Compensalion-Laws. -� � A�ORE55� CONDITIONS V Irwindale 9170 � . GITY _ .ZIP. . ... ......... _ OC Dqte �� ApplicaM ARCHITEC70R TEL � � � NOTICE TO APPLICANT: If, after maki'ng'fhis Cerfificale of ENGINEER B&E En . No2132545134 DISTRiCT GROUP ryPE FIRE PROCESSED BY„ H Ezemptio�,�you should become sobject 10 the Workers' - CONST. ZONE W Competisotion�provisions of ihe Lo6or Code,you must forth- ADDRE55 sZ5 Colorado Blvd. LA 90041 /� y with-comply with such provisipns or ihis permii shall be � - � � TEL � ���'� ��-'��� STATISiICALCLAS5IFICATlO APT. CONDO.' � deemed revoked. ' � CONTRACTOR Ahmanson Dev. No7148371279 LICENSED CONTRACTORS DECLARATION �i�. C1A55 NO.�DWEL�.UNiTS I hereby affirm ihot I om licensed under provisions of Chapter 9 ADDRE55 23861 El Toro N0465�788G$C commencin ��ih Secfion 7000�of Dibision 3 of the Business and SEINER MAP' Professions Code,dnd�my license is in full force and effect. GTY EZ TOYO C ASS B-1 sK � VALIDATION ,.. 465688GBC g-1 SQ.FT. NO.OF NO.OF CHECK License Nomber u�:tia size $�� sroeies Fnnnwes 4 ONE I ��� �� - - � -�� CBYpoY'ts NEW � VAtUA,�T—^ION Ahmanson D2V. DESCRIPTION OF WORK V (p Ll O Caniraclai- Dote ADD S �I am exempt under Sec , `��'y ""r�'� ALTER B.&P.C.for�his reason ' . . . . .. REPAIR s �' �. ��"�.. . 'Dafe: � USE OF DEMOL � �, EXISTING BL�G. �%V.4'.4 . " Signafure APP���ANT S.MCG1S1R7.5 7EL� JI�FS61Z31 FINAL �7 OWNER-BUILDER DECLARATION PRiNt) NO. DATE �'� f - V.�l r,*u I hereby affirm that I om exempt from the Contrac�or's License 22900 Golden $PTltlgS Diamond Ba .^v _ �.(, low for 1he following reason(Secfion 7031 5, Business and ADDRE55 .. ._._. ..... FINpL � ( . Q � ��."��� � Professions Code): .. . . . . . ."'"...... '. ... ESEM .. . . . BY �\-(��✓'-�`—". . � I, ds owner of the o er y P y gUIL�ING pr p ty, or m em lo ees wiih ADDRE55 wages as iheir sole compensation,will do fhe work ond , fhe shucture is not intended or offered for sale(Seciion LOCALITY . , � . . 7044,Bu5ine5s and ProfeSsionS Code). MOVING ' " � TEL. - �- � � I,as owner of fhe properfy,om exclusively confracting CON7RAGTOR NO. �_j �;�,1'���-: wifh licensed coniracfors to consiruct ihe projed(Sec- qDDRE55 tion 7044,Business and Professions Cade). - fi`.c e c c c � . . REOUIRED iOTAL SETOA K I � � CONSTRUCTION LENDING AGENCY - - sEi anCK YAR� Hwv pROP.LiNE WioTri j o �h�,�� . I hereby affirm thai there is a construction lending agency for FRONT . the performonce of the work for which this permit is issued P.L � ��n:��,��?,� (Sec.3097,Civ.C.). . SIDE ' s P.L. � Lender's Name n,qAQ 7�(�._�� � y� � LDMA Ref.R - Lender's Address � � � � � � P.0 Fee 5 v�` Permit Fee � +-� ' I�ertify that I have reod ihis applicotion and stote that the issuance Fee �e r `5� LDMA P/C k x above information is correc�.I agree io comply wifh oll County Investigation Fee / —7 ordinonces and State Ipws reloting to building construction, Toral Fee �!' /� LDMn aerm.ii - - ��� and hereby ouihorize representa�ives of ihis Counry to enter . � upon th ve meroione propert r inspectio purp s. . . . -� . . _ /J � ' SEE REVERSE FOR EXPIANATORY LANGUAGE — '"6 ��'-- _ . ? ..� Si�re o�APpI a 1 or gen . . ... . Data . . . . . . _.... .... . . . `p1� - PLANS TO APPLICANT INSPECTOR'S NOTES OWNF..R-BUILDHR�ICLARATION . .: .,. ... . . .. .. . ._ . ..,.. .. ,..,-,,....,_� . . . I hereby affirm fhat I am exempi from�ihe Coniroctor's �� � � �+' �����license�Law'��for the�following- ( ) Ta � Relurned � reason. Sec. 7031.5 - - � � � Approved - ])usiness a�u{Professiuns Cnde:Any city or cnunty w5ich No. Do}e �No. Dote �� r�quirea aQermit Eo rnastrucy after,dm�rove,�lemolish, .. _... _ . . .._. . . .. :....,, ,.:......n- .,:.:„.„,,,, .:. .or repair nny stracture,prinr to ets usuuxce,aTso reyuirer - � - tba applicant for sucb pernsii to file¢.signed statement . _._. ....__... . .._ . ;;... � „,,,., ,; dGa_the s licensed pmrsunnt to.the prnvisdnns of tAe Con- � �� ���� � � - � � . tructor's License Luw/CSapter 9)(comireeacinq wiafi.Sec- .,, tinn 7D00/of Division 3 of tGe Dusinass and Profassrone � � � ' Code)or tFi'az be u exempt dfiere{rom rexd tbe basis f m,tbe � � a[legerl exemption.Any violation n(Sestion 70315 hv Required Dafe Received � � � � � � �� .. any applicunt fnr a permit su8jects the applicant to a civil qpprovpls or Approved __. . - _ . penalty of not more thun J¢ve bundre(d dollqrs(5500/.J: Yes No - � - � � . � ❑ I,as owner of the property,or my employees wilh Woter Certifiwte � ' . � ��-����..� wages as their sole wmpensation,will do ihe work,and 1he strucwre is no)intended or offe�ed for sale(Sec.7044) Heal}h Department .. .. �� Bu ixess arzd P_f ssi ns Cade:The C tructor's I_erexse . ._ . I,am dnes not upply to an owner of property w5o builds Fire Deportment �� � - -� ��� - nr i�wf r�ves tbemon,and wbo does sazch wnrk bimself nr . . _ . . tfrrriuq! hu.own employerts, procide�( tbat sucLr em- Grading � ,. yravemends ara.nnt intend�d or ffered for sole. I(, �� � � , . . hnwever,the buifding or impmvement rs soJd mifhin one Geological,. � . � . . _ . year of rnmpletron, t!e awner-builder will bac•e tbe . " � � fiurden nJ proving thul J�e did not builJ ar�improve fru Pedestrian Profecfion . . . . . . .. . � �- . � .,. e purpose of safeJ.- - . �-.: . . .. .. . t (Fence}(Canopy) � - � �� - �� '� �.asowner of the property,am exc�usively confrac- �� ��-. � .. . �ting with licensed coniractors�o consirucl fhe��proiect(Sec. Special Inspection�� � � � � � � 70441 8usiness axid Professions Code: The Cnntractnr's (Conc.)(Masonry)(Welding) - - ��� - �� -�.�.,: Licenae I.uw does not apfilg�to¢n ouner of praperty u�bo . builds or imf>riwes tberenn,and who mntructs(nr surh Lot Drainpge � . � ��� . prajects witb a cnndractnr(sJ licensed purseanE tn tbe � � Cnntraclors License I.qu�J. Parkin 9 � � � � ❑ I am exempt under Sec. ,B.&P.C.for this " - reason . � � -.,...-�.. - �..: . .....:....„� Da1e Owner ApProvals Date Inspedor'sSignafure . . �. ' ." - . . �.�. . � �� �.. �..... � .. .. .. .... � -� �- INSPECTOR'S NOTES Lomlion— .. . . . . ... .. . (Setback 8 Yards) - Foundations � � p/ `R (� . . . . �._..:.. .:::�.� ... . � �EC A`F �i�'� J�'•`Y' . . .�..,. .. .. . _, . Slab - . . .. . . . . . . .. . ... .... .. . . . .. ... ..:.............. . Frome Energy Insulotion .. ...�..� . .. .,.::. .�. . .,.�....:.... . Lath/Drywoll— �� . . . ' � .. .. . ..��.` . . � . . . . .. Interior ... .. ... �.., ....:..� . .. . . . . .. . , ,. . ,.... ,. ...,. Lath--Exterior .. � .. . . , .. House Number..._ . . :.� ....�`..'. . Correct 8 Posted � final-- .. . . � � . . - ... . .. . .. . ... . ,. .... . - En�e�on fronl �. ' � /� � . ' . ... .,. ..... . ... . . .._ . . . . . - .- . . . 1� �ll�� • v � ��iLlLa '� l'�.. . . . _ _ ..