Loading...
HomeMy WebLinkAbout0926A 0927A __...... -- -.__... _.... . .. .....__... ..._.. ...- - --..__.._.... .. . . WORKERS'COMPENSATION DECLARATION �-- ' � ���-'-� �� � � � � � � � '-� , .. 2� � I he�eb af{irm tha�I have a rertificate of consent�o self . . _ . _.. . . . . insure,orocertificaieolWorkeriCompensafion��,�,a��e, �����- APPLICATION� FOR�BUILDING PERMIT��- or o cerfiiied copy thereof(Sec.3800,Lab.C.) . . , .. ... .-. . -. . -. . .� . . - - . �� � -. .. . - ,- Poi;�,,N�.IWETX7993 com��Y Hartford Grouo COUNTY OF LOS ANGELES BUILDING AND SAFETY � Ce.ti(ied copy is here6y furnrshed. ., FOR APPLICANT TO FILL IN qooRcss -2 � � it.t.�•c(Y'�v f . .r1 Ceitified capy is filed with the county building i spec- "�� g�iIDING ; �� , �W tion�departme r. nooRess 24441 East Thunder Tr ' � . _. . ...' - . -'.. ..._ .. . ._.. . Dote � ApplimM���1'2��� CITV ' ZIP LOCALITY ' � � .. . ..' ___ . � CERTIFICATE F ExEMPTION FROM WORKERS' ' ' ' - -� NO.Of BLDGS. --- � � NEARE51 . SiZE OF LOT : NOW ON LOT CRO55 ST. . COMPENSATION MSl1RANCE ' - (This sed�on need no�be completed if the permi�is for ane �-- iRACi \'BLOCK LOT NO.� AUE550R . . hundred dollors�S100)or less.) , N✓+P BOOK ' PAGE PARCEI TFL U ZONE �P �I .. , _. . .. . .... _ . . .. _ 1 cerfify that in the performance of ihe work for which this OwNER • • n10. _ P� �,p. } permit is issued,I sholl not employ any person in any manner , , � - -�- SVECIAL- - � � � � �n. so;as to become su6ject ta Ihe Workeri Compensation Laws. AD�RE55� � � � ��Q CONDITIONS � � . .��... . .. �... .. CITY _ .. ZIP _ ....� .. . .. . . . .. . ... .. .... .. Date� APPlicanl ' ' � ' .. � ICE 70 APPLICANT: If, after making�ihis Cerlilicore of nRCHITE f R TE�. 'o I FNGINEER NO. DISTRICT GROUP NPE., FIRE PROCESSE�BY � �nption, you should become subjecl to 7he Wo�keri �� - /D /f CONST,I ZONE W Compensation provisions of�he Lo6or Code,you must forth• qpoQE55 "�-3 � a. with comply wi�h such p�ovis�ons o� thh permit shall ba • -- � - - � - - � deemed revoked. � . , . TE�� SiniiSiiCni M55iFIC1�TION � APT. CONDp, Z CONTRACTOR NO. __ ��� .�.!_ UCENSEU CONTRACTORS DECIARATION -. - -- - ---���, ----- - -- � C1A35 NO. OWEIL.UNIiS I hereby olfirm ihot I am I�censed under provisions of Chapter9 qDORE55 3151 A' No. . (commencing with$ection 7000)of Division J of the Business and _ _ _ ___ __���,_ . ._ SEWER M'4� • " Professions Code,and my lirense is in(ull iorce ond�effect. Cliv �1A55 �"BK.� � ' � ' - �- VALIDATION- - `I SQ.FT. NO.OF NO.OF CF7EIX ' � � cense Number rlpg(al�� �u�.aa��- �g��' �� s�ze - 5 STORIE$ �2 FAMILIES �� ONE � � - -- ; �p• , . {'� �a��Ar�oN :-a 9 z.b a ' ' '" DESCRIP110N OF WORK"-'"pLA ' � N� �yj� 7�' /yl 1 ' ' Contracror Rramalda�CalifDare App � f ,y a�v �, ��• °GI �I am exempt under Sec. - � � -- ' - - � - � ALiER B.BP.C.for rhis reason � N2W Construction REPAiR.❑ f �� -' -- - � - _ � °.�P�.� � _' . - pa� USE OF DEMOL ❑ • �.���.� U u / E%ISTING BIDG. . , ` ^� - -_ '- Si�nnlure / '�/(�� . . ' APPLI('p,NT iEL FINAL p � O NE -Bl11LDER OECLARATION PRiN7 NO. H�JO-� DATE�d e'LO�g�J-- - ; �`"��.-��_ I hereby affirm thar I om ezempt from Ihe Contraclar's license ._. , . � Law foi ihe following reoson(Section 7031.5,0usiness and ADDRESS � FINAL�� � � . 'Professions Code): � ' -'- " � - PRESENi BY '«� - - � �. � BU�LDING I, os owner of fhe prope�iy, or my empioyees wiih aDDRE55 . _ . _.. � ��. '. . : . - woges os their sole compensotion,�d✓ill do�he work and � ='C�'.'C,7 I�, the slrucfure is not infended or offered far sole(Section ����TY � � � 7044,6osiness ond Professlons Code). �� MOVING --- -� �- �- -- -- -- 7Elr - - � -- , � - �� - • �, +��• a�e � . I,as owner af the properly,om ezdusively coMrading CONiRACTOR NO. � '� ; �. i � - with licensed conlractors to constrvct the project(Sec- - -� qDDRE55 '� � �`��-� � "'� '- I ^��,.C� tion 7044,Business and Pro�essions Code). ` ' � ' CONSTRURION LENDING AGENCY""" �-� SEQaaCK � �YakD- HWY "T�TO'pgoP LCNEFR WiDiH' �- "--�- �' � � - . ' � ��j� C J T � I hereby aifirm�hot there is a tonstrutflon lending agency for FRONT �� r '� -ihe perlormanca of Ihe work for which this permil is issued -- P.L- - - - -- - - � � � � � - �c��2���'�7 (Sec.3097,Civ.C.). 9oE � � � ^ . _, ... . ... . . __ �� _ _ - . . .. 0 Toronto Domininn Rank P�� �� � lender's Name �j� � ; • � $ 144 Sansome $t.� Su i te 700 P.c.F«s �cg/•IO � Permir Fee G�C/ �°"'°'R`i.x - Lender's Address " � , ' � � W an �;�"�1�45 �,W_ �„�o�«Fee jo•�b ' � I certify that I have read t app i o� d a st t i ihe . . .- -- - -.-` iDhtA PiC N �. -... . _ ¢ obove in(ormation is mrrect.1 agrea to mmply with all Coun�y Inves�igation Fee / � � � . ordinonces and Siate laws relating�o building tonsfrvtlion, - To�ol Fea -f0'S-J,�d� IDMn Perm.p --- � � � � ._- �- - -�--- .._ . ._ . u and heieby auihorize represemotives of this Coumy to enter t�, `,�i �� � rc�� - � � Upon Ihe o ov -meN ned ro e y for inspection purposes. _ . .. ... .__ , _ _ __ __ '__. .... . `....-- ._..' .' _ _ '_ - .... .. .__. _.____. _ ' ' "_ ' .... �S . , a ' SEE REVERSE POR EXPLANATONY UNGUAGE � � � � 1���. -� 5� re f I� A .' . pa�e ... _. '._... ._... . _. .. _._.. _ .. __._.. _ . _ .._'.___ .-. .._.. _ . _'._ . _ .. ' " '_ _. ... :pO� m-n n S m �+ tn „ In Or � r tn ^'a' ",� _G1 _ 2 . . _ .._ 2 � � .� ' � oo ° ° � o o � mn ° ° o� fDma �0 o m �D .o 0 0 mo � c T \ � 3 � � �o 'r o � n nN ° a ° ;m o ' �� � ' o `c � o � o D � a •" o �- �° � � T C C' � ' Z x m� �� v � � o � � � � �fl � C� � .,, �c e� o f � N m� o � �' o� 0 8 � fD D ��� ° a- o ' O o o „ � � � � � 3 0 � v . a i � o a ' � � a � 3 ° � a � ``o'. � � m o, o � ? m n� � `,� _ � � � � � � 11� �\ a , , � .- `� -� � R ' N� ti v �o � . a L N V 0 N �,,� �� on o,� �, �,�, � ° m o o � o 1 � � � � m ° � � � � � � � f' � n � , o °' _ ° e D � � w � S � � � , . o a -� m } o • � N __ 1 O N D O m ' � . 9 O ! � i O' ' . " � - � n _ 9 C � O O • • O '� O d O < d O • d i ' - � - i ' - _ J _ � ! ' . , i ' • _ - N ' ' . _. ' . ' ' ' .- • T .. � � i N .. • ' Q ' . ' - V1 . _ -- • z , ' . .' . . ' . m - . H ., � ' I ' • ' . . � o � ! n^aatr�+= - o-'ec�'"� �.�sf bc �n.. .. o:ti � � . � ° ��:."'� r'�p �o ti c � c �;' ° H.��p °a'e "C: c'�m �-c � - �- - - �u ? . ❑ } � NM� � ❑� m� � nej �$'= N �1jn ` ` ..1�'0 �•:� 7�m c o � � � a�m ��vtioM�� 'e4 �e0'',�b ° � N �mm . . . . � .`�. � i ti� 7- b C � � �O � a ^'O _ +' • C'" y''^ M Q' ' .. , ; � ' , f � 3 ; � .�. .n N "=C 1� �r' a � � O �•� n C``�,r.p �•A � O � ' . '- _ ' N.�..`S fi �i! l: F.�n fD S V .s w i� "J CJ ' - m �,^..p h � o ti m ° �_. mp p Z � '�.n .�.'� nCf.wi -- '° �-z c �" m � M�.�e n �"�p ��'� � ��b.� C7m �",i.`- � 0 3 t' 3 v n P`. �^ ..� d� 1= � �"J�O O fD ^ 1 C M F-� .�• ..H � - � � m a y a C e o �.A � a� r_ �cc N �' m o, �� � � b e fi c M T G - . � � �� �..., y.� s a'a° '�`� s c ^•rn o ti ,� a ��', �'� ^ o' �� C _, ` -- � '. ' n I� '� ^ ^ '°���-�o C�� � o`4 a "' a� c� � =�e��'"�c b b a '^ o o v - ' ' „'� ' ! N `C .r.`C� O t0 �'��t n d N'O �� y O A ^ � w .� n 3 rr, . - O m '�- �v° �C�b c,F c� �o � o' c•� a'�~� � � � � ° r� n. � oo ^ .`a o ° m . m o � ;� o v n�,��n o,n fi „.� f � � . �� cho c:acC' m o � '� o ' � � ` ^ c' '�mC ; n'�` :� ' � �' � � ^.s o ti ,.o �^ o'ry�`�^ .�,�0 3 :r. - Z ^ � c n� o ° o-� y � ' c ���< � H a c.c �°`fi s � C� - � ' - ,�„ p.,F �= 3 0,� m c � M�`� m.£ o y��� �.eb �F'ti^ � .. � H . � �^ n ' ' x �.�4"''n n C O �-3�C A y?.N � � C p .. . O O�r'C r_ � � :b � � ": ^ C:� ,'ti C�^a � � cL< C� � C'h ;� &•� a�� � 3 Y � � • - . _ �`C=�-N � �, � � ��i � � �'�,• c � o•A`',^'-� ti ',..t tu � N i� " rn _ � � 0 0.� ^ p 3 ^.�•�a ` F z o = 7' e � � <' _.::c:�� ''�e �u �'� z n a C � L ,� in fD C - � ' � � � �^,�JOO � � ^'F.IF��FIN� O �wV�, ;�•��O {r'-' np� .`S .< � � ` • n �ti m n e a a e �'p M � o m M^ �N��.Lw`-� � �� � ? _ o o c c c n h N �^` `� � n � � ' •- .o � N V n ^�� � n s��C'� �n`'.�x- C° +•; 4 V A A� c E �O ^ ¢ �w- r- •n p c,n, �n � (�� ?C� - ' N Cn �.:� n o. �.�° .�-•� a � f. `�.o,� ",�.+o n ��N•� -p ' ' ' . � � 'a �� u�•n n � e� ie '`f �m�a 7' ' ��C n i�., �i,� � F -�`' L`��v�