HomeMy WebLinkAbout81952\"Uq)9
WORKER'S COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self insur,
or a certificate of Workers' Compensation Insurance, or a certifl6.
copy thereof (Sec. 3800, Lab. C.)
Policy No. Company
❑ Certified copy is hereby furnished.
❑ Certified copy is filed with the county building Inspection
department.
Date Applicant
CERTIFICATE OF EXEMPTION FROM WORKERS'
\ COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred
dollars ($100) or less.)
t certify that in the performance of the work for which this permit
\ D issued, I shall not employ any person in any manner so as to
become subject to the Workers' Compensation Laws.
Date Applicant
NOTICE TO APPLICANT. If, after making this Certificate of
Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
LICENSED CONTRACTORS DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and
Professions Code, and my license is in full force and effect.
License Number Lic. Class
Contractor Date
❑ I am exempt under Sec.
B.&RC. for this reason
Date:
Signature
I, as owner of the property, or my employees with wages as
their sole compensation, will do the work and the structure is
not intended or offered for sale (Section 7044, Business and
%Professions Code.)
U I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Section 7044,
Business and Professions Code.)
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec.
3097, Civ. C.).
Lender's Name
ILender's Address
o I certify that I have read this applicati d state that the above
g Information is correct, I agre o com ly with all county
3 ordinances and State laws rel Ing to build' g construction, and
hereby a r¢e represent iv of this ounty to enter upon
abone prope t r ins p tion purposes.
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BOIL DDRES/
BUILDING ADDRESS , / / `/ 7
-W- Ace �- 4 4- ,-1
(,-- . N
SIZE OF LOT
TRACT BLOCI
ASSESSOR AP BOOK
OWgER
13f tEizo 501,4-_,
ADDRESS �@ 1
CITY
RC I TECT OR ENGINEER
#I
ADDRESS
) ty , Zr
CONTRACTOR
ADDRESS
CITY
NO. OF BLDGS. NOW ON LOT
PAGE i PARCEL
USE ZONE I MAP NO.
SPECIAL CONDITIONS
WITHIN 1000 FT. OF SCHOOL? I YES I NO
DISTRICT I GROUP I TYPE CONST'l FIRE ZONE I PROC
—1 `
TEL. NO.
STATISTI
CLASS NO.
fZe,
TEL. NO. REQUIRED
DESCRIPTION OF WORK
r-( i� ,bt tJ1 i,, t, W b 1 L,
±Ala Q A Z 0 1 i :z t
USE OF EXISTING BLDG.
SET BACK
FRONT
PL
SIDE
S
PL
SEWER MAP
NEW
BK
ADD
❑
VALUATION
ALTEREl`S
REPAIR
❑
DEMOL
❑
LOMAP/C #
URM
❑
DDRESS—
WILLTHE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL
OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN
THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE?
YES ❑ NO ❑
WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH
COAST AIR QUALITY MANAGEMENT DISTRICT (SCAQMD) SEE PERMITTING CHECKLIST
FOR GUIDELINES.
YES ❑ NO ❑
I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD
PERMITTING CHECKLIST. I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES
OWNER OR AGENT
P.C. FEE C
PERMIT
i
TION FEE TOTAL FE ,/
SEE REVERSE FOR EXPLANATORY LANGUAGE,
I
4� w
IFICATION APT
— DWELL UNITS
TOTAL SETBACK FROM EXIST
YARD HWY PROP LINE WIDTH
C.3
PG
44
a
LDMA Perm #
FINA ATE
FIN I Y mw,
177
CK
TL
r D
04* 81952
819,52 'U'h
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61,715;
01-04�94
6
AVORKERTCOMPENSATION DECLAMATION
I hereby affixin that I have a certificate of consent to self
insure, or a certificate of Workers' Compensation Insurance, or
a certified copy thereof (See. 3800, Lab. C.).
Policy
1:1 Certified copy is hereby furnished.
Certified copy is filed with thv county building inspection
department.
Date Appfl cant
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if tire work involved
by the permit is for one hundred dollars ($100) or less.)
I certify that in the performance of the work for which this
permit is issued, I shall not employ any person in any manner
so as fo- become subject to the Workers' Compensation Laws,
Dat
NOTICE TO APPLICANT: lf, aftcr making this Certificate of
Exemption, you should becorne, subject to the Workers'
Compensation provisions of the Labor Code, you must forth-
with comply with such provisions or this permit shall be
deemed revoked.
LICENSED CONTRACTORS DECLARATION
I hereby affirm that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Busi-
ness and Profession,; Code, and my license is in full force and
effect.
License Number __ Lic. Class
Contractor-- —_-____ --- --- Date_
I am exempt from the licensing requirements as I Ian a
licensed architect or a registered professional engineer
g1leer
acting in my professional capacity (Section 70151, Bu-s-
iness and Professions Code).
Lic. or Reg. No. Date
HOME OWNER -BUILDER DECLARATION
I heyeby affirm that I arnexempt from the Contractor's
License Law for the following reason (Sceti6n 7031.5, Busi-
ness and Professions Code):
1, as owner of the, property, will do the work and the
structure is not intended or offered for sale (Section
7044, Business and Professions Code).
CONSTRUCTION LJENDING AGENCY
I hereby affirm that there, is a construction lending agency
for the performance of the work for which this permit is
issued (Sec. 3097, Civ. C.),
Lender's
I certify that I have, read this application and state that the
above information is correct. I agree, to comply with all County
ordinances and State laws relating to budding construction,
and hereby authorize representatives of this County to enter
upon the above -mentioned property for inspection purposes.
76M444
CE 875 (11-84) M I
WtINTY OF LOS
ELLANEOUS APPLICATION
GELES BUILDINGAND SAFETY DIVISION
BURLD
F_ FOR APPLICANT TO FILL IN ADDRESS �NG
BUWLDING
ADDRESS LOCALiT
EARDST
CROSS ST.
LOCAL,VVY U
NEAR EST q1 C NO,L
GROUP
TCyOrNSS
, PROCESSED -Y
CROSS S-1
I-8GAL
..SCRPT€ON LOT NO, BLOCK: OFAHiGHWAY
STATE MAJOR SECOND LOCAL
LUGS,
ON , OT USE ZONESPE c¢AL COND9TIONS
/4
-S-01'
siza or LOT __LEXISLING BI-Dr—
OWNER OCCUPANCY GROUP
MAIL A. 960 0 .'TL) 1pI
ADDR 0 1 —
TEL
C - I Y &R& U_+
APPUCATION FOR
TrAHLSR USD❑ GEOLOGY uNSPECTION ❑
OCCUPANCY SNSPSCNON ❑
SA55TY PERMIT (msr iTams B5LOW)
OCCUPANT LOAD
EXlT HARDWARE:
No Spec, Knowl.
Panic Devices
NO. Car ErxVrs
FA R K I N G
REQ'D i
I PROVIDED
SPACES
— LIMITED TIME USE
9 9 7 -W,55 ATF DATE
INSPECTOR'S
SXZE or N 0 SIGNATURE
EXR3VNG BLDG, STORIeS
FINAL APPROVAL
PR,5SFNT USF OF BUILD�NG
NO, C>;; EXZSTING B_U6LWNGS
ON LOT AND USE
NO, PARK�NG
SPACES PROVID51D
pRoposED USE OF BUYI-DING
PROFOSED MAX. OCC, og-
TOT FEE
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date
County of Los Angeles
Department of Public Works
Building and Safety / Land Development
WORKER'S COMPENSATION DECLARATION
1 hereby affirm that I have a certificate ofconsentto self insure, ore certificate of Workers'
Compensation insurance, or a certified copy thereof (Sec. 3800, Lab. C.).
Policy No. Company
Certified copy Is hereby furnished.
Certified copy is filed with the county building Inspection department.
Date Applicant
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed If the pemutis forone hundred dollars ($100) orless.)
I certify that In the performance of the work for which this pem6tds issued, i shall not employ
v person In any manner so as to become subjecttb the Workers' Compensation Laws.
-ate Applicant I
f
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should became
subject to the Workers' Compensation provisions ofithe labor Code, you must forthwith comply
with such provisions or this permit shall be deemed revoked.
LICENSED CONTRACTORS DECLARATION
i hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)
of Division 3 of the Iusiness and Professions Code, and my license Is In full force and effect.
License Number j Ncg Class
Contractor ' Data
❑ 1 am exempt under Sec.
Y
B.&P.C, for this reason
f Date
Signature
SINGLE FAMILY
HOME OWNER -BUILDER DECLARATION� S
1 hereby affirm that I am exempt from the Contractors License Law for the following reason
(Section 7031.6, Business and Professions Cade) f
_ 1, as owner of the property, will do the work gild the'structure is not intended or offered for
sale (Section 7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for
which this permit is Issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
I certify that I have read this application and state that the above information is correct. I agree
to comply with all county ordinances and State laws relating to building construction, and hereby
authorize representatives of this County to enterupon the above-rnentioned property for inspection
purposes.
'Signature of Applicant or Agent Date
PLUMBING PERMIT
PL 0200 9503010026
DUPLICATE
BUILDING ADDRESS:
44478 TRACT
LCNT CA 91789
LOCALITY:
DIAMOND BAR (WALNUT)
NEAREST CROSS STREET:
ALIAS:
LEGAL ID:
TR: 44478
ASSR INFO NBR:
OWNER:
TEL. NO:
TAYLOR WOODROW HOMES
CONTRACTOR:
TEL. NO:
TAYLOR WOODROW HOMES CALIF., LTD
(714) 581-2626 EXT: 247
24461 RIDGE ROUTE DRIVE
LIC. NO:
LAGUNA HILLS, CA 92653
352047/B-1
APPLICANT: TEL. NO:
TAYLOR WOODROW HOMES CALIF., LTD (714) 581-2626 EXT: 247
24461 RIDGE ROUTE DRIVE
LAGUNA HILLS, CA 92653
DESCRIPTION OF WORK:
IRRIG. SYS. F/TR 44478 LOT(S) 10-14 & 58-63
LA PUENTE # 0200
16005 CENTRAL AVENUE
LA PUENTE CA
Phone: (818) 961-9611 Ext:
) ON: PROCESSED BY: EXPIRES ON:
FINAL DATE
FEES PAID -
FEE DESCRIPTION:
01 PERMIT ISSUANCE FEE
37 SPRINGER BF DEWS)
r�
QUANTITY: UOM: AMOUNT:
17.90
55.00 SPRKDEV 577.50
TOTAL FEES 595.40
County of Los Angeles
Department of Public Works
Building and Safety /,,ha a' Development
WORKER'S COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of consentto self Insure, or a certificate of Workers'
Compensation insurance, or a certified copy thereof (Sec. 3800, Lab. C.).
Policy No. Company
Certified copy is hereby furnished.
Certified copy is filed with the county building Inspection department.
Date Applicant
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the pemtitis forms hundred dollars ($100) orless.)
-1 certify that In the performance of the work for which this permitis Issued, I shall not employ
-- •.person in any manner so as to become subject to the Workers' Compensation Laws.
-mate Applicant
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply
with such provisions or this permit shall be deemed revoked.
LICENSED CONTRACTORS DECLARATION
I m hereby affirm that I am licensed under provisions of Chapter 9 (comendng with Section 7000)
of Division 3 of the Business and Professions Code, and my license is In full force and effect.
U—se Number Uc. Class
Contractor Date
I am exempt under Sec.
B.&P.C. for this reason
Data
Signature
SINGLE FAMILY
HOME OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law forthe following reason
(Section 7031.E Business and Professions Cade):
1, as owner of the property, will do the work and the structure is not Intended or offered for
safe (Section 7044, Business and Professions Code).
--' CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction fencing agency for the performance of the work for
which this permit Is Issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
I certify that I have read this application and state thatthe above Information is correct. I agree
to comply with all county ordinances and State laws relating to building construction, and hereby
authorize representatives of this County to enterupon the above -mentioned property for Inspection
purposes.
Signature of Applicant or Agent Date
ELECTRICAL PERMIT
EL 0200 9602150009
BUILDING ADDRESS:
20525 U CRESTLINE DR E
LCNT CA 91789
LOCALITY:
WALNUT
NEAREST CROSS STREET:
WENTIFF CT
ALIAS:
LLUAL IIJ:
TR: 44478
ASSRINFOI
OWNER:
TAYLOR WOODROW HOMES
24461 RIDGE ROUTE DR
LACUNA HILLS, CA
CONTRACTOR:
TEMPORARY UTILITY SERVICES
2720 REGAL PARK DR.
ANAHEIM, CA 92806
TEMPORARY UTILITY SERVICES
2720 REGAL PARK DR.
ANAHEIM, CA 928D6
DESCRIPTION OF WORK:
METER PEDASTAL FOR IRRIGATION
TEL. NO:
(714) 581-2626 EXT: 247
TEL. NO:
(714) 764-0020
LIC. NO:
523596C-10
(714) 764-0000
LA PUENTE # 0200
16005 CENTRAL AVENUE
LA PUENTE CA
Phone: (818) 961-�9611 Ext:
ISSUED ON: PROCESSED BY: EXPIRES ON:
FINAL DATE. A4 B�':
/5 l
FEE DESCRIPTION
Al PERMIT ISSUANCE FEE
LA 100 AMP PANELS, MCC
QUANTITY: UOM: AMOUNT:
18.20
1.00 PANELS 25.50
TOTAL FEES 43.70
County of Los Angeles
Department of Public Works
Building and Safety / Land Development
WORKER'S COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consentto self Insure, are certificate of Worker's
Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C.).
Policy No. Company
Cardfled copy is hereby furnished.
Certified copy Is filed with the county building inspection department.
Date Applicant
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the pormitis forma hundred dollars ($100) oriess.)
I certify that in the performance of the work forwNch this pennitis issued, I shall not employ any
rson In any manner so as to become subject Lathe Workers' Compensation Laws.
.ate Applicant
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply
with such provisions or this permitshail be deemed revoked.
LICENSED CONTRACTORS DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 0 (commencing with Section 7000)
of Division 3 of the Business and Professions Code, and my license Is In full force and effect.
License Number He. Class
Contractor Date
I am exempt from the licensing requirements as I am a licensed architect or a registered
professional engineer acting In my professional capacity (Section 7081, Business and
Professions Cade).
He. or Reg. No. Date
HOME OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following reason
(Section 7031 .8, Business and Professions Code):
1, as owner of the property, will do the work and the structure is not intended or offered for
sale (Section 7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY
preby affirm that there is a construction lending agency for the performance of the work for
.nich this permit is Issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
I certify that I have read this application and state that the above Information is correct. I agree
to comply with all county ordinances and State laws relating to building construction, and hereby
authorize representatives of this County to enter upon the above-mendoned property for Inspection
purposes.
Signature of Applicant or Agent Date
MISCELLANEOUS PERMIT
MP 0200 9408230002
DUPLICATE
BUILDING ADDRESS:
44478 TRACT
LCNT CA 91789
LOCALITY:
BREA CANYON CUT OFF ROAD
NEAREST CROSS STREET:
LEGAL ID:
TR: 44478
ASSR INFO NBR:
OWNER:
TAYLOR WOODROW HONES
CONTRACTOR:
TEL. NO:
TAYLOR WOODROW HOMES CALIF., LTD
(714) 581-2626 EXT: 247
24461 RIDGE ROUTE DRIVE
LIC. NO:
LAGUNA HILLS, CA 92653
352047/B-1
APPLICANT:
TEL. NO:
TAYLOR WOODROW HOMES CALIF., LTD
(714) 581-2626 EXT: 247
24461 RIDGE ROUTE DRIVE
LAGUNA HILLS, CA 92653
APPLICATION FOR:
LANDSCAPING PLANCHECK
LIST ITEMS:
USE OF EXISTING BLDG:
RESIDENTIAL TRACT 44478
DESCRIPTION OF WORK:
LANDSCAPING/IRRIGATION
OCCUP. LOAD- OLD: NEW: NBR OF STORIES: SO. FT SIZE:
0 0
BLDGS NBR OF
LOT SIZE: ON LOT: EXITS: EXIT TYPE:
0 X 0 0
OCCUP GROUP- CONSTRUCTION TYPE:
EXIST: R3 NEW: R3 I
MAP NO: HIGHWAY TYPE:
LA PUENTE
# 0200
16005 CENTRAL AVENUE
LA PUENTE CA
Phone: (818) 961-9611
Ext:
ISSUED ON: PROCESSED BY:
EXPIRES ON:
03/01/95 SH
01/08/22
FINAL DATE: F Al'BY:
z r
/
PARKING SPACES
USE ZONE: REQUIRED:
PROVIDED:
R-A
FEES PAID -
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
34 LANDSCAPE PLANCHECK 348378.00 SQ FT 3,860.00
OA PERMIT ISSUANCE 17.90
39 LANDSCAPE PERMIT 3583.20 DOLLARS 3,583.20
TOTAL FEES 7,461.10