Loading...
HomeMy WebLinkAbout0964A 0965A - � � � ... . .<.. . .. .. .... . ... ... . .-�.._ . . .._._. .._w.__._�_" __" .'_.. .. ... _ . ., � . . . . .... __._.. _. _.._._ � insure,or a certifimte at Workers'Cam enso TION -. ".. .,:�•.- ..:.. ... _ . ..��. �•T- .. .. -- ' '-- .. .. WORKERS'COMPENSATION DECLARA .. . . , . .. � ._.._._._ , . •I here6y affirm tha�I have a cerhhcat�e of:;o�;�s��o,��'� - -� �- �� APPLICATION -FOR:BUILDING PERMIT� ���� �� 3 =. - �- ---� - - _ - __ _ . or a ceifi(ied copy thereof�Sec.3800.Lab.C.J'�:'. ' - . . . . . : . .'. -.- "-" ' -_ ' 61WETX799� 'Hartford G'rou �OUNTY OF LOS ANGELES � BUILbING AND SAFETY ;,- � ; , P Pol cy No, ompony .-. .. / O � Py y � FOR APPLICANT TO FILL IN AODRESS 4 I�o (�• (trp�,,i-� �.Certified m is hereb fvrnished.�� � CertiFied'cbpy is filed with tFe ounfy�bu'Idi` inipe- -- BUROiNG � 'tion d artme : � •��- � ' � ' '� "� ADDRE55 1016 South Lon VIeW . ' ..� � .. .'1 �'. .. .� - �,,, . ."_____ '. _ _ . _ '___. ._ . ____.._-____... __ .- _ Dofe � � Applicbnt CIN Diamond Bar z�P � . �oc�urv '' �� CERTIFICATE OF EXEMPTION FROM WORKERS '�'"-"� --'._- -- ------_. . ._.: .__ _..iv0.OF BLDGS:--` --- -�--' nlEn.REST'-"-' � •— -'- . �--.'- ..._..---'''. __ � � � � � ��COMPENSATION INSURANCE�'��• �.. SIZE OF lOT / NOW ON lOT CROSS ST... . , . , ,... .: : (Thia setlion�need nol be eompleted if the pe�mif is for'one ----- �(�2568�� ..-j/_ ASSESSOR _� ---- � --�'� � �.-. . , .., TRACT BtOCK-� �-��---- �lOTNO.�--37� . MqPBOd(� ' i ��.• �...PAGE' PARCEI � .hund�ed dollon�E100�or less� ,;:. .,. . :, � . - ` TEL. . ,..• . ,.. . ---- owr�R- Bram l e - •m• ._. -- No. _ e z N P i 3 I US E � �/� �1 certify that m the performonte of tha work for which�thn � �� NO. , ��� T � ' permit is issved,I shall not employ any peison�in any m6nner . � . ��-�--� SVEGiat---���--.--- ��- -��--- - - � � �� 'G�. - ' '-'__ ADDRESS---�3��J�- Al l'W 'AV .-._.. _.'_- ' Z�O so as-fo betome sobjecf lo the Workers Corripensotiori laws. � d 0 CONDITIONS � :Q -- oare .�.. ., ... naa�co�i'., ,' ,.,, __ . an _... .COsta Mesd,. CA_ zir _ 92626. _ . `. --_. . __ ---.. __._ ._ :. ' I�E T�APP�IG4NT: If affer'makmg ihis`Certificaie Of ARCHITECiOR . TEI. ! DISTRICT._ GROUP� TYPE , ,._ _FIRE _ , PROCESSEDBY ,� � �nptlon,.yau should�hetome sub�ect�to'the Workers' --� � ENGin7EER Aram Bassenian NO. -� �l � ppN�.. 20NE . �rj I l'ompensotion p�ovisions of the La6oi Code,You�must for�h• ADDRE55 ' � -_��...__. '`_� ._ �_ ,_ � _ ._ ;y with�comply with su[h provisions or;1his permit sha11 be ---�_. .. � TE�, . STnTISTICAt QASSIFICATION : APT. CONDO. -� �Z deemed�evoked.: .,�., -.., ..•. ,��. ... CONTRACfOR � NO. � . . _ ���/�.,,,��� � ..--.` .. " LICENSED CONTRACTOR$DFCIARATION .',-'�: .- - --.----- ---- -. --- ..-.-.-- .-��C- - -__--....-: CLA35 NO.�DwELL UNiTS� . � I hereby oi(irm that I oin licensed under provisions of Chapter 9 ADDRE55 Np, ��R�P (mmmenting with Settiori 7000)of Division 3 of tNe Business and _ • � �liC.�� � ' " ' ��� �� � ' '.' --- '._. ._..._ .. . ' -..-- _. .. . . Rofessionz Code and my license ii m full force and efiec�. Cltt ' Rq$S r -�--------��- -.- �� - ' .� . . ,� . .,.. . .. . � �, � ,_. ,. BK. A9. : �VALIDATION� - SQ R. NO.OF NO.OF CHECK , � ; ... . ���� l�tense Nomber' 4096�O . , l�c C�ass t B' - SIZE �884 STORiES 2"" FAMILtES '��_ - ONE��� • `�'0 9'b 4 A � . , , ., . , . .. . . . .. .,... . . � Cortlr6tlor BPaflld�2d� Ga�lf' �De1e '. .. "•.�. - � -- DESGRIPTtONOFWpRK-'- - '.I -. ._.._._ NEW- . - VA UATI�_�, .._.... .��-' ' s n ' " ADD � S ID � ' �t• � •'2� �.: I ❑I am exempt under Set. . -- ._ • _ • _ • -_ _ - AtiEa ❑ ,; -I +3 2 Q 1G 1 ' � " NEW CONSTRUCTION - ._.. . - B.BP.C.for thrs reasan -S ------�-�----� -. - - -. REPAIR_Q - --.-... _ . " . - __ ..__ . . _ '. __ _ __ ... ,. "..... USEOF ..e_^-vry�ILl� r=+ � - Dafe:- � - exiSnNG etDG. N0►12 DEMOI � .'DA EL.-.�---.... ; ' ' . ._.Si�nnl��rn�.., .. . _ . __'__" APPLICANi TEI. � � "�-�_". L;7 2�/�`J '�'�: OW�ER-BUIt�ER E ARATION PRIM Geor e Vedell NO. 85�-�00�: � t i ---' - --..--'... _.._...._..— ---'-----... ..._ .._...'.-"._- -. ._..---. . .... _ . . �T� �-�I hereby affirm thot 1 am exempt from ihe Contratfor's License pDORE55 31�51 Ai rway Ave. N-��Costa Mesa � � - Law for�he fallowing reason�(Section 7031.5,Bosiness and ' ' flNAL�"'���' '' . �� ' - " • ' ' "Pro(essions CodeJ: -.._.........._.._--.._._.....__..,.-.___. ....--- PkeSeNi --..0y. _. .__. . _ ..._. ... �.,.... � _ - . - -n_. . _....:._-. . . .. .. � BUIIDING �. . .... � .-�.0.9�C�Jr,., I, as owner of the properly, or my employees with aoDkESS J wogesasthei�sofecompensa�ion.�willdo�heworkond- --._ ... . _ . . . � ._ ._., _. _'-- --_- _ . -- - __ . .. � � ihe slruUura ie nm imended or offered for sale(Seciion ��'��T� � i:• • - 7044.Business and Professions Code).� - ..... _ -... .. MOViNG'-'"".._.. .__.. ..._. ... _ _...TEI: ..-.__...__.._. _. .'_. _'.... . _.___ .. ..__ . _ __ _ � I,as owner of the property,am axclusively coMracting COMenCTOR NO. - , ; � �S 4 9.0 0 � � .. with Iicensed tontrocton ro tonstrott the project(Seo----- ---- ----- �--- --.. ... .. . ..._.. .---....-..-" ' -"-� -�--..-. ..__.._. : . -.. -_-_ ... . . _ .. _ tion 7044,Businesi and Professions Coda). ADDRE55 �i e„J(��,���.� __.. . � REQUIRED.. . ..TOTALSETBACKFR M_. ._XI . ._..____...__ -._ ....__._ �:."'.'_"_ � . ""���" "CONSTRUCTION LENDING AGENCY- "----� � -�- �SET BnCK �YAR� HINY� PROF,LINE wiDiH. � � D A.L O`.�.6.�. I here6y affirm�hm there is a construction lending agency for FRONi � ; . � --1ha per(ormance o(the work Ior which this pmmil is issued - ._. ..v.l--- ...._.. . ._...- .-_._- .. _....- -.. . .. ....:. .... . _.._... __._.. ._..'---_...._._..._-.,.--._ ._ _._ (Sec.3097.Civ.C.). SIDE . . . '.. . .. � ' ___... ...._ P.L. : . ,.. : �e�de:sName-Tnrnnf.n f]ninininn Rank- - -- --_- - ------ - - -.:._... ..._. __.. ._ : • 7 'l 7e .... IDMA Ref.# �: '-� '•' . - - - -144�Sansome St.-y-SU�tQ /OO ---- P.C:FeeE ��D�'7' - PermitFee 5.20. � - � - lender'a Address rqnC C y �7 � . '.-� J certify.that I hov .areo thT'6ppl�a'I�A and s t 1 a ihe _�_- dO,K7,�...__/S"lJ�. . IssuanceFee---/O-`S�.-.' .LDMA P/GM__ , ' .. �. �" . . . _'"" .... _....' ' ..'._' ' '_ " above Information is correct.I agree to comply with oll Covnly Investigmion Fee � ', � . . __ordinonces and Slate laws relating to 6uilding wnstruclion. . . Total Fee�--- - ��� � ' �LDMA Perm..M... �' .�„' � -�;�� .. ._.._'._.__..____'_'.. . ....._.__.- and hereby authoriza representatives thi County to enter -�-�-�- � � ' � -���� -����-� upon ihe o e- tion d p operty f ed7on pur oses. l � , -- � - - - ._... .--� - -�[/� ---- -�� '� �J .. .._._.___.-'------... . _-- - ! _ .,__ _..-._'-..--�--- ;.. � � � SfE REVFRSE FOR E7CPLANATORY LANGUAGE� ` � ' _.. .._ . .Uc/_"_".' i ..... . ..." '_""... ........ , ...... .� Sign rur of Applicom n ..--._...pO1e. _..__.__'__.'._..'_. '__.'_. _. . ._.-_.._'_.._. __"_'.._'_._' ..... ..._�". .. _'___'._._..._ ...._ .......... _.._.._.._ _..._ ..._...__. OO� � � . , mT C1= r r m T (n T r v -r. N' ^'e_ _�' _Gl. _.T.. ..__ _ _ ._ Z � > > o o ° ° � o o � m° ° ° o c�o fD Wa `D i o c'e �' o 0 0 N O � C S S 7 � �� � �� � � � ° 07 e �'o ° ^ ° � �= �° m � � �n � wZ �`� � 'r � • � " �o ^ v m �+ �3 m' o o ° oo I � 3„'. ' o� fl ° � _ D � . ] O � � _ � "' { c N N� ' �.v . �3 O = `��. - '^ �p I � O O . O � �. O.O' tD � �n . M O O; �D O a � � (D � � �7 '� I- O a� � � � � �� " � `-' _.' , ro Im . o• . o .. vO' � � i ...M" , O .. � '• � .... • i ! � k � . 1 ' � I - 'O 7 ' ! � r � i� ' . ' ' � �� ' _ � • O � � � � -t ' � Z � 1 . f • I I !1• M � I ' O �0 � . F I � I i. ". i'� � � � ',- o o > j' i i w i ' i• '� � � ' i � -a 2 'O: � � I m -.. n. i . I . i N: ` _ . • _ ` � . •_ �-' '�'_ - o n ' .. �.� . � � i � ' . . � " 1 y e i D, . i � 'o� ' , ; t� 'o t 'o v i o � :C . .. �/ r• . . t � I � ' � �: " ( . ' ... � . . .d� • a,. . 1 . . ... i . . . y i _ ._ .1. '' ' - . 1 � ,�i . r �� . . � 1 ' - . . � •'� � . - '^ , i . � , _. i . �.. � i . I: � ,. , i' . . i , . i - _ I i _ � i , � � ' ': i i i . � i _ � • .. i : �^ '_ L i� � i 1 - '- � � . � . �. . , i � _ . , � , , ' � - � ' . _ . . � .. .._. .__..', _.... : : � " - i,. . fl . i i � . � = _ _ � i. '- � ' : , - -_ - . � • � .. I � : .. r�, . � �. _ _ ' , � i ' �� . - . . 1 ' ' ' � I 1 , . � I -- _ .. 1. I: - �, _ . 1 �- . ' ' � O '� ' . - I' ` .. . . . i �� � � ti ( - __ � � . , � . � ' _ _ . _ ( . _ �- � _" _ _ ; '" ��I � .. .. � ; `t 1 ' 1 �' � , I � f• .I ' � •' � . � I . 1 . '. . . ! . � �. _ � . � � , � • � � • . � ' �� • � " . , ���• . '_ i.' ,. ' , .' � ; . 1 `, :: : , _ _ - , � ;'" ; - ...v � I � oo-c�� , a;e c b 'o t��-.f 'tr a a!n;.� c.�ti �..- - �' •c 'fl , ooe ;�'a� • c� � � eti,ticc:m� �< m�a � � '° �'° w m's - -- ���'a , �. `m•C a � �+r C� n e z•�.�` a � N � �z� ` o��a,�.�.� .�'m ' ` - . - !i � � n N '^ A ��� . � a�� �ov b p M.c t�p',r.•C C'' �y c..� u � m'. I_,�.' _ _' . _ . �: C l �� S•-0 , ���•� N M'� O C .��lrCt^��Z.`ry-�^ M' '•� � �' ; _ ` _ - ; • 3; ., � _.L s.,,..N. .'� Q ��'°''�° a � ,� s N � z .� .�o[�,r�'�� � o o.O '. t .' - . . � �� �"t'� O� F V 4� M J �< O n ry ' .H', �'iy .(p CC .0 3'_ +A e�.?�,�.,�C ;•C�.,f.�C � � •�.� � � • K� � l �M N C `1+1 Q`1 C��Ll b.��� G �b•V N ��~_� ti � - ' 3� n ° � M A o:.m: c a•�. � �o:���b o 'o_�o �'�c ` � .o..`°,O":� i �... � .0 3..�' - .- � y _' ' ' i v_i M ' ^= �. �o c`..:` � A b ti `o c � H �'C„ �..�,�, ., _ , �..a C^ .o'` s �a . .°�e�'-..:�c Y � :' *s x O ,'", TC � _ 2 ct o a o o a•c:,�,� �.��n o A� k o� _ � a T.o. c' � a+ �� � i� `0= �'`„ oo I o o'co o �''� a ��', �'�'^ ^ c' � _.G 'O � �.^,��`o cc ��� �-ti a'�,��°s:'^.av �p a �'�rb�'''�cz.b� w N o� O ;. ' � : _ _ .. . � - - N� `-c � 'e G.° o _" ., `a'a� E c�o a�� �'" � \� � ` `o'� c.,0 3 �' . ,-. . . O -: ; �� '��� �•Hv . C�'e C�_t� .qo o C-r o'C-.. �.ti n C .�u�x , �' � , -� �o � i i�c.''c•� m � e H�c � A o v �`o-�ry ��,p �. o_. � f•m 0 '- . a' i.��°a `" n� ' a y c �+s Cti.. o•o '� �,'n" `o';�`C, � �"'wm�3 r • ! '; _ • ' ., n° - : o '� c ti `n_ � cm.�:` � a a �,N .�m`� a v C� ' � O ,'; ,; "� � c N �' �'� , �;��o.^• ^b "� ' r ,.'l �:; ' m . � _ - :'^ �'a'�,� 3 ' c=_��ti'- ��.na.F$ ��~'a �'O,o �e ~ � o'0 9 5.�� . ' � ' ' 1- • v+ :i0; _ �� � �o�' = � ,�c,i �':�'°"5�s ° a� ��J ^:��^ .�p.M�l^ tt5`t � 3 > � �l- 'i f . � �x a ��.N u n � A � o m c'S,.. a o•oo'n ti:ry • ` - � ; ;_m:: :-w ib° �. . , i E �0.�� � � o � 3 •r^.�•,�.a-n a � c �.. � ► -- ; a,- : � �:� n�.�. .. z•�A?ti',��„�:c `° �v a �:�io-b�v�o c�.��.�-�,n•Z .-� _ - .� ' - : .'v� � M� �'o.-c ^a L F•� � �C N•�^f ,� � O� � `M ° Cr w-^:7 - . - . '- . -- i ' n ' ��� � ^ o o � l:,e�.•��„ o.'�^-�N '�"c ',�"'`o����ne�.�0c ``4``� 0 i . p _ '�c �:� ^ '�' � �° 3 m Cm e.� v� O� �n.�''^ �'' ? t � � ��n . 1 . . . __ _ , ; . �! -t � Z F O.��. � 0�1.`�.��A�O f ` . w �'�C'i �.;�•�•C.'-�.p ' N ,C-n_�`� �.� c C- .c c. a � • �^ O-L`a ,•,.s.a�� �� ,V . � l0 �"O F` l �0 �0 .'l ti R'v d S ' .�r'�' �'i N - N �."`� 1 .