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Home My Public Portal About4916 ENCINITA AVE_Miscellaneous__ WUKnctt3--cnvlrrn�HrnnN—uC( 17\KVI )N 1,1,,, M151.1=.LL—AINtVULJS At`t L—It.AI IVIN I hereb\ affirm that I hd\L a LLI111ILdIL u1 L01hL11I III ,LII COLIN 1Y OF 10S ANGII V5 BUILDING AND SAFETY DIVISION . Il noure til a LCI III R atL of Will kLIS (unlPul,duon 111,111 I LL 111 .I certll led u)P) Ihereol (Sec 1800 l ah ( ) Policy No C onlpally FOR APPLICANT TO FILL IN BUILDING BUILD ADP RESS /y�� ADDRESS ❑ (LrtillLd Lop) IS hulh\ IllllllSIILd Il0 X1 1�1r ^(V�j LOCALITY i J ❑ Certil led copy Is I IILd with thL Laxnu\ hulldlne UI p-Lunn CIr n ZIP �� '"�/� V't-- NEAREST department lid//� / O CROSS ST Date _ AppllLdnl SIZE OF LOT NO OF SLOGS NOW ON LOT DISTRICT NO GROUP TYPE I PROCESSED BY CONST (I Rill R All_ Of IXI_MPIION I IMM \\ORhI IV, ntAcr etocK LOT NO COMPLNSAI[ON INSIJRAN(L MAY HIGHWAY NO ICIRCLEI STATE MAJOR SECOND LOCAL (THIS tiLlllon nLLd Bol FIC LOI)1PILICd l ASSESSOR MAP BOOK PAGE PARCEL If IIIL NUIk 111%Ohe (- by (ill' pernllt 11 for one hlllldied doll.111 1,-,11)0) Ill IL%%) USE ZONE SPECIAL CONDITIONS 1 LLrtily that In IIIL pLrlolnlaIILL of (hl \\1111 11,1 \\IIILII ihls OW / )IQ�q kTELNo fin( I t pLrnllt IS ISSULd 1 shall nut LInplu\ dn) PLISnn IIItil) n drinLl — 1 /"16 cA0 1 SO aS to become SllbleLt to the Wolkcn ( on7pLn1JIn)II I I\v1 ADORES � ( OCCUPANCY GROUP I„ Date AppIlLanl CITY zIP /�� NOTICE TO APPI ICA N1 If alto nlakulg INS ( Liu IL Ile OCCUPANT LOAD of Exemption \OLI should become Sub)eLt to the \\'191LiS APPLICATION FOR Compensation pro\Islons of the Labul (odL you nnlst II)I11WIth rr�� EXIT HARDWARE 1 conlpl) With Such pro\Islons 0r (IIIS pLlilllt SIId11 bL Lh Lnlld TRAILER USE LJ GEOLOGY INSPECTION❑ No Spec Knowl ❑ revoked OCCUPANCY INSPECTIONK Panic Devices ❑ LIC ENSLD CON FRAC IORS DI ( I AR \1 10N r� I hereb) all irnl that I tin IILL@1ed Lind--r pill\ISIonh of ( IIdplLI SAFETY PERMIT O (LIST ITEMS BELOW) 9(COmnie11L1119 W1111SeLllon 7000)of DI\ISIon 1 of the BusineSS 110 OF EXITS s and Protesslons CodL and nl) IIculse Is til lull IOILL and (ILLI A A f L3� L-.Itics,> PARKING REO D E= PROVIDED LicenseNumbLl l IL ( I.Is1 X �r �T/j�nj,ef— �41 r SPACES (UlltiaLlol DdIL Jn�(�C�( LIMITED TIME USE DATE DATE _ El am a\empt front IIIL IILenSing rLlttlll LIl1LIIIS d1 I dill d FROM TO IlLensed architect or a reglsterLd p1uILSSu)ndl Lllomet-r actio In Ill 10ILSMOnal La Jlll (tiLLllon 7011 1{IISIIILSS SIZE OF NO OF IN ECTOR S g P p EXIS TING BLDG STORIES I ATURE �) and PIOILSSIOIIS (odLl —y ,( -� ---- LIc or Reg No DatL PRESENT USE OF BUILDING �01[� ` FINAL APPROVAL '. 1 I 110!\11_ OWNI K Bllll DI It DI ( l AR \1ION ON or I BUILDINGS �]\1 ON I_UT AN D USE \^\'.JIC_J \�V 11 IlLreby allUm th 1I 1 Int L\Lllll)t 110111 IIIL ( 01111dL101 S I LI IISL I Law for IIIL following reason (SLI-tion 7011 � BuslnLI, and e,\ Professions (ode) NO PARKING v SPACES PROVIDED as o\\nlr of IIIL propLll\ \Lill LIu thL 1\.nk wkI IIIL — SIII1LItuL IS nut InlLlldLl UI olklk.d 101 SAIL ( )LLIILII /111 I PROPOSI n USE OF BOILDING ACL}i7 V•ter �� BLISIIIe SS and PI OleSSIOiIS (O(IL) ---- r CONSTRIJ(TION I I NDING AGI N( ) hen.h) 11111111 111,11 IhuL IS a COOSIIIlul011 lulllutP WI-110 Illi — -- ----- —the perlormalILL 111 IIIL \\011, fol \\IIILII 11115 pLrnllt IS ISSIILLI I (SCL 3097 (Iv ( J PROPOSED MAX OCC ` l I Lenders Name _ X APPLICANT( NT) 1 TEL NO C//� rel/ Lenders Add rLSS AD SS I I certify that I have ILad this aPpIlLation .Ind slalL III II IIIL L1iY0-XQV above Information Is Lorreu I agrLe to LOIllply Wufl all County PERMIT FEE ordinances and State laws relating to building(. nntruLloll and hereby autllorlle IeprLSelllall\LS of 11115 CoBnt) 10 LlItLl Upon ISSUANCE FEE the above-mentlon(d property for InlpLluon Pu1POSL1 — �f I TOTAL FEE y a I c X SCC RCVLRSL FOR EXPLANATORY LANGUAGE '0 Signature Of Peril)IUL DIIL L I \VORKLRS COMPENSATION DECLARATIGN CE 875 111 84) MISCELLANEOUS APPLICATION � CE 875 i hereby affirm that ► have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION insuresure,, or a certificate of Workers'ComCompensation Insurance,or a certified copy thereof(Sec 3800,Lab C) BUILDINGPolic No —Company FOR APPLICANT TO FILL IN ACESS �J i Certified copy is hereby furnished BUILDING - ! /J XX ADDRESS G LOCALITY Certified copy is filed with the county building inspection LOCALITY NEAREST department -3tY„ 6 CROS. sT Date Applicant NEARESTwZv141TYPg.1/— .J DISTRICT NO GROUP ESS CED BY CRO C CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL COMPENSATION INSURANCE DESCRIPTION LOT N / BLOCK MAP RICRW AY NO (CIRCLE) STATE MAJOR SECOND LOCAL NO OF BLD65 (This section need not be completed if the work involved TRACT, NOW ON LOT USE ZONE SPECIAL CONDITIONS by the permit is for one hundred dollars ($100) (,r less) usE of I certify that in file performance of the work for which this SIZE of LOT SD�( EXISTING DG `(}6 5 hN o permit is issued, I shall not employ any person in any mannerkg _OWNER of buildin m vff so as to become subject to the Workers' Compensation LawsAia OCCUPANCY GROUPLA_J rY AA06 n C3 ADDIRESS Date Applicant LLI NOTICE TO APPLICANT If, after making this Certificate of CITrT ITVE OCCUPANT LOAD Exemption, you should become subject to the Workers' APPLICA ION FOR EXIT HARDWARE Compensation provisions of the Labor Code, you mu,t forth with comply with such provisions or this permit ',hall be TRAILER USE ❑ GEOLOGY INSPECTION ❑ No Spec Knowl deemed revoked El LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION ❑ Panic Devices 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 Busi i No of EXITS ness and Professions Code, and my license is in full farce anix efteut Name of business SOAKING SPACESREQ D PROVIDED License Number Lic Class T LIMITED TIME USE Contr ILtor Date DATE DATE 1 am exempt from the licensing requirements a'. I am a FROM TO licensed architect or a registered professional ;ngineer SIZE OF NO of INSPECTOR S acting in my professional capacity (Section 70')1, Bus- EXISTING BLDG STORIES ' SIGNATURE mess and Professions Code) FINAL APPROVAL 2_2<�� _T PRESENT USE OF BUILDING J Lic or Reg No Date HOME OWNER-BUILDER DECLARATION No OF EXISTING UILDINGS ON LOT AND USE I hereby affirm that 1 ani exempt from the ContraLtor's ,J� LILen%e l aw for the following reason (Section 7031 5, Busi- �? N� ness and Professions Code) No PARKING Q N` ( Pn 1, as owner of [he property, will do the work and the SPACES PROVIDED structure is not intended or offered for sale (Section 7044,Business and Professions Code) r IQ id (ONS IRIK IION LLNDING AGINCY PROPOSED USE of BUILDING > t� 1 hereby affirm that there is a construction lending agencyi L for the performance of the work for which this permit is _ issued(Sec 3097,Civ C) — Lender's Name PROPOSED MAX OCC I� Lender's Address PERMIT FEE I certify that I have read this application and state that the above information is Lorrect I agree to comply with all County ISSUANCE FEE ordinances and State last s relating to building construction, and hereby authorize represen atives o this County to enter TOTAL FEE 25 ,QQ upon the above-meoned perty f inspection purposes I SEE REVERSE FOR EXPLANATORY LANGUAGE XX }{X- Signature of 'ennnt Date If WORKERS'COMPENSATION DECLARATION CE 875 111-841 MISCELLANEOUS APPLICATION •� CE 875 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 Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab.C.). BUILDING Policy No. Company FOR APPLICANT TO FILL IN ADDRESS '/ ;�rI4 Certified copy is hereby furnished. XX. wooaess / LOCALITY �Z EJCertified copy is filed with the county building inspection LOCALITY NEAREST department. XX / ^L 8a CROSS ST. Date Applicant NEAREST ^ DISTRICT NO. GROUP TYPE rr• P CESSED BY 1. CROSS ST. Cr CONST. CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL j COMPENSATION INSURANCE DESCRIPTION I LOT NO. BLOCK MAP HIGHWAY rvo. (CIRCLE) STATE MAJOR SECOND LOCAL NO. OF BLDGS. (This section need not be completed if the work involved TRACT NOW ON LOT USE ZONE SPECIAL CONDITIONS by the permit is for one hundred dollars ($100) or less.) USE OF I certify that in the performance of the work for which this SIZE OF LOT EXISTING BLDG. n permit is issued, I shall not employ any person in any manneXX OWNER of building �LGe dL�ixi o' so as to become subject to the Workers' Compensation MAIL C �^ye / OCCUPANCY GROUP ILt� � �� ADDRESS [:Z:l J f V r Date Applicant �(J 4 NOTITO APPLICANT: If, after making this Certificate of CITY TE CE OCCUPANT LOAD Exemption, you should become subject to the Workers' APPLICATION FOR EXIT HARDWARE: Compensation provisions of the Labor Code, you must forth with comply with such provisions or this permit shall be TRAILER USE ❑ GEOLOGY INSPECTION ❑ No Spec. Knowl. deemed revoked. Panic Devices LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION I hereby affirm that 1 am licensed under provisions of Chapter SAFETY PERMIT ❑ (LIST ITEMS BELOW) 9 (commencing with Section 7000) of Division 3 of the Busi- NO. OF EXITS ness and Professions Code, and my license is in full force anX effect. Name of business PARKING _ _ T SPACES READ I PROVIDED License Number Lic. Class �^ / LIMITED TIME USE Contractor Date DATE DATE 1 am exempt from the licensing requirements as I am a licensed architect or a registered professional engineer SIZE OF NO. OF FROM. TO. INSPECTOR'S acting in my professional capacity (Section 7051, Bus- EXISTING BLDG. STORIES/ SIGNATUR iness and Professions Code). FINAL APPROVAL PRESENT USE OF BUILDING r� Lic.or Reg.No. — Date �{� Jr...y .;._... .. 110MEQWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS U •-" j�--'^- ON LOT AND USE �1 I hereby affirm that I ani exempt from the Contractor's G7�/ License Law for the following reason (Section 7031.5, Busi .t`i - i I i ness t (d Professions Code): NO. PARKING 1 as owner of the property, will do the work and the SPACES PROVIDED 'Z., structure is not intended or offered for sale (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY PROPOSED USE OF BUILDING 1 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 PROPOSED MAX. OCC. Lender's Address _ 1 certify that 1 have read this application and state that the PERMIT FEE 25 - 00 apove information is correct. 1 agree to comply with all County ISSUANCE FEE *oMinances and State laws relating to building construction, and hereby authorize representatives of this County to enter TOTAL FEE 25 -00 i upon theabov ;mention property for inspection purposes. XX SEE REVERSE FOR EXPLANATORY LANGUAGE X� Q Signature of Pennillce Date