HomeMy Public PortalAbout9445 1/2 LAS TUNAS DR_Miscellaneous_9/17/2002_occupancy inspection Honey Bee Bakery i WORKERS' C:UMYI✓NJAl1ULV llCI.LHKAl1VLV 20-0063OPW,2/90 - l�l��`I•�'+.1.�+1.��'�.l�l._.,v�+� .f�.I""t'"L.l'L.f-�1 iCJI�
I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING:AND SAFETY DIVISION
-insure,or a certificate of,Wdekers'Compensation Insurance, or
a certified copy thereof (Sec.3800, Lab.C.) " .
Policy No. Company FOR APPLICANT TO FILL IN BUILDING
BUILDING ADDRESS ADDRESS
❑ Certified copy.is.hereby'furnished. X, 4.4 5 �2 L�g TUNAS DT�_, LOCALITY
❑ Certified copy is fileCwtth the county building inspectio CITY ZIP
department. T&, I lib OA !1 NEAREST,
lJ CROSS ST.
Date - Applicant SIZE OF LOT NO.OF BLOCS.NOW ON LOT DISTRICT NO, I GROUP TYPEPROCESSED BY
CERTIFICATE OF EXEMPTION FROM WORKERS- TRACT BLOCK coIJST. O
Lor
I COMPENSATION INSURANCE
)
permit.is issued:I shall not employ any person in any mann C�x
soas to. become subject to the Workers' Compensation Laws. aooREss
PIMUN OCCUPANCY GROUP Z
Date Applicant . CITY Al
zIP �/ ���� '—
NOTICE TO APPLICANT: If; after making this Certificate OCCUPANT LOAD
of Exemption. you should become subject to the Workers' APPLICATION FOR
Compensation provisions of the Labor Code.you must forthwith EXIT HARDWARE:
comply with such provisions or this permit shall be deemed TRAILER USED GEOLOGY INSPECTION❑
No Spec.Kncwl. ❑
revoked.
LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION[J Panic Devices
El
I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT❑ (LIST ITEMS BELOW) ,❑
9(commencing with Section 7000)of Division 3 of the Business �e o us mess NO.OF EXITS
and Professions Code,and my license is in full force and effect._:. .
PARKING• REO'D PROVIDED
i License Number Lic. Class �, 1� �aL SPACES
I
Contractor Date LIMITED TIME USE
El4 I am exempt from the licensing re uirements as I am a DATE DATE
FROM: TO:
licensed architect or a registered professional engineer
acting in my professional capacity (Section 7051,Business SIZE
OI F BLDG. S.O ES INS EC T R'S
and Professions Code).
LIC. Or Reg. NO. Date PRESENT USE OF BUILDING FINAL APPROVAL
HOME OWNER-BUILDER DECLARATION NO.OF EXISTING BUILDINGS
I ON LOT AND USE
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and
Professions Code): - NO:PARKING -
SPACES PROVIDED -
❑ I, as owner of the property, will do the work and the
structure is not intended or offered for sale(Section 7044,1 PROPOSED USE OF BUILDING
i 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.).
PROPOSED MAX.OCC.
Lender's Name PPLICANT(PRINT)/+ \- TEL NO
Lender's Address DDRESS /�1� { p
I certify that I have read this application and state that the v d�u15u- c 0
above information is correct. I agree to comply with all County PERMIT FEE
ordinances and State laws relating to buildingconstruction,and III
hereby authorize representatives of this County to enter upon ISSUANCE FEE
the above-mentioned property for inspection purposes.
t .TOTAL FEE
X t O'L\)SEE REVERSE FOR EXPLANATORY LANGUAGE
Siem ur of Permittee Date
t