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Home My Public Portal About5529 NOEL DR_Building_12/13/1988_house additionWWRKERS' COMPENSATION DECLARATION I her y` epy`bffirmthat I have a certificate of consent to self ina��,. or a ier(ificate of Workers' Compensation Insurance, or a eit fief dopy thereof (Sec. 3800, Lab. C.) Policy No. Compony ❑ Certified copy is hereby furnished. Certified copy is filed with the county building inspec- tlon 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.) 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 to become subject to the Workers' Compensation- Lows. Date �lT —Applicant �� C 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 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 Business and Professions Code, and my license is in full force and effect. License Number Lic. Class Contractor Dote I am exempt under Sec. B.BP.C. for this reason Date: OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Low for the following reason (Section 7031.5, Business and Professions Code): F1I, 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). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec- tion 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 I Lender's Address Fib A In&IL D(Z.-- 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 L obove-mgntioned �roperty/for inspection purposes. / Signature of AplWcant or Agent Date APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY IN 1BUILDING I II I AnnRFSS ',f•2A - : 2 SIZE OF LOT L NO. OF SLOGS. NOW ON LOT NEAREST CROSS ST. .//, ei & lt LASS ASSESSOR VALIDATION NO. OF NO. OF TRACT SSS STORIES BLOCK LOT NO. FAMILIES MAP BOOK VALUATION JP4E PARCEL OWNER ). C 91tJ NO. - USE NEMAPIAL / / NO. L fQ- ADDRESS � ) OSI- D+- �1 %��•Yv SP EC CONDITIONS n, ..! w1/Inl Z i.I T Y 71P MIL E&P g� rTEL: CONST. / I LtJE [tea /LIC. �.._ .. LASS BK 6 VALIDATION NO. OF NO. OF CHECK STORIES FAMILIES ONE VALUATION WORK NEW ❑ ADD $ 99 - �1 %��•Yv ALTER IREPAIRs DEMOL >J � d 94U= 1° 4 37,97 MIL E&P g� rTEL: ; DATE/Z__ iF • • ° ° 3 FIN ET I • • °S73 ' • . • .573 08.08-88 TEL. NO. r03&1A #..00.1 YARD HWY TOTAL SETBACK PROP. LINE WIDTH WMA Ref. If 1. 5 3 2 5 0 a/7a.a_r� r Permit Fee s • 53Z50= V 5-,-7 I Issuance Feer WMA P/C If Total Fee r WMA Perm. M SEE REVERSE FOR EXPLANATORY LANGUAGE M OWNER -BUILDER DECLARALIWN I hereby offirm that I am exempt lroo',the44 Cni �la(iC t License Low for the following Feason r$ec'. -71031 h) Business and Projessinns Code: An y cityf�I nu nJ,4 �Ne- I requires a permit o, ,a,etrucL aFter;' unpi(rre, demnlis/t, or repair any .ctrucdlre, plrinr to its issuance, also requires the applicant toe such permnl to file a signed .statement that be is licensed pursuant to rlre prol-ewons of tiro Con- tno lnr's Lieense 1.au• /Chapter 9/ /eommem iqQ with 1 cc. lion 700(1) of Uirisioa 3 of the Business and Professors Cade/ or that be is exempt therefeare and the hasis for He alleged exemphos. Any otolatian of .Section 7131.5 by ant' applicaet fora permit subjects the applicant to a civil penalty of Drat mom than fire hundred dollars 1550111.1: - I, as owner of he property. or my employ nes wiw wages as their sole compeosoeon, will do the .,wortand the structure is not intended or offered for sole (Sec. 7044) Business and Professions Code: Tire Contractor's license Lau- does not apply to an owner of property who builds nr irnpronea thtero., and u=be does such sunk binuelf ur Nsrough his ou-n employees. praridod that such ire• prooemeats are not intended or offered for sale. /f, bou•erer, the building or improvement is sold uithin one Year of completions, the owner -builder xoill have the harden of praning that he did not build or improve fnr the purpose of s./e1. ;. L. as owner of the property, am exclusively contras Zing with licensed comroctors to consrruc, the proleo (Sec 70441 Business and Profacsion.s Code: TGa Confracfr)r's License lau,daes not apple' in an sumer rf properlt, u hn builds nr improves thereon, and ubr contracts fur such prap[tits with a couiractmfsj licenser) pursuant to the Contra.Yur's License batt). Date I am exempt under Sec. B.BP.C. for ih s INSPECTOR'S NOTES PLANS TO APPLICANT INSPECTOR'S NOTES To: Returned Approved r No. Date No. Dote __ze Approvals 'Required Date Received or Approved Yu No V.'a'e, cure . Health Deportment Fire Department Grodng Geologtcol Pedestrian Protection IF=nce)jConopy) Spec�crl Inspection IConec) (Masonry) (Welding) -- Lot promoge Po, -king Approvals Date Inspector's Signature Loco',a, - fSelhacl B Wards) - FoundaYons Slab Frome bull Endlgy Mseloeon lock' II— nt iia O Loth-ExteFror t` House Number C oneci 8 Posted Wflq I/V Final Enter at Front 2 7� . `et Q M OWNER -BUILDER DECLARALIWN I hereby offirm that I am exempt lroo',the44 Cni �la(iC t License Low for the following Feason r$ec'. -71031 h) Business and Projessinns Code: An y cityf�I nu nJ,4 �Ne- I requires a permit o, ,a,etrucL aFter;' unpi(rre, demnlis/t, or repair any .ctrucdlre, plrinr to its issuance, also requires the applicant toe such permnl to file a signed .statement that be is licensed pursuant to rlre prol-ewons of tiro Con- tno lnr's Lieense 1.au• /Chapter 9/ /eommem iqQ with 1 cc. lion 700(1) of Uirisioa 3 of the Business and Professors Cade/ or that be is exempt therefeare and the hasis for He alleged exemphos. Any otolatian of .Section 7131.5 by ant' applicaet fora permit subjects the applicant to a civil penalty of Drat mom than fire hundred dollars 1550111.1: - I, as owner of he property. or my employ nes wiw wages as their sole compeosoeon, will do the .,wortand the structure is not intended or offered for sole (Sec. 7044) Business and Professions Code: Tire Contractor's license Lau- does not apply to an owner of property who builds nr irnpronea thtero., and u=be does such sunk binuelf ur Nsrough his ou-n employees. praridod that such ire• prooemeats are not intended or offered for sale. /f, bou•erer, the building or improvement is sold uithin one Year of completions, the owner -builder xoill have the harden of praning that he did not build or improve fnr the purpose of s./e1. ;. L. as owner of the property, am exclusively contras Zing with licensed comroctors to consrruc, the proleo (Sec 70441 Business and Profacsion.s Code: TGa Confracfr)r's License lau,daes not apple' in an sumer rf properlt, u hn builds nr improves thereon, and ubr contracts fur such prap[tits with a couiractmfsj licenser) pursuant to the Contra.Yur's License batt). Date I am exempt under Sec. B.BP.C. for ih s INSPECTOR'S NOTES