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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 2U 1, r z 96.3353 , ?2�6 125`92 4 ''d 1.8: 7 2 z , > 21 79 Y U I- 2 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