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HomeMy Public PortalAbout6015 ENCINITA AVE_Building__ DIVISION OF BUILDING AND SAFETY MIND ,� Department of County Engineer County of Los Angeles DONU WM. J. FOX, COUNTY ENGINEER APPLICATION FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY T DISTRICT HM PUN Cc. OR RED.No: PERMIT NO. ILDINGGOI Sr -Antit.ei nAwI.(✓ 7 1_,Mk2_F1 ADORE98 RECEIVED BY DATE OF APPL DATE ISSUED y LOCALITY p/ NEAREBY I19y, J DRDBB 9T. BUILDING o n ,n � ♦ ,f ADDRESS G A OWNER MAIL c r LOCALITY ADDRESS Q YS � (' yU.,„�Jy NEAREST !(�� Lin , ,�}. CROSS ST. CITY c94, 4v_c l.Lin NOLLU G 7� FIRE I NO.DF TYPE •UP ZONE PLANS ARCHITECT OR TEL ENGINEER NO. BLDG. ORD. NO. SETBACK LINE ADDRESS USE APPROVED /�.., TEL ZONE BY DATE CONTRACTOR^^ IVT/, ,,.� nN D.G}L1117 HOUSE NUMBERING ADDRESS C/JiYw(•rQ�i I i-f.0 IV MAP NUMBER NO. ASSIGNED BY LEGAL CORRECTIONS DESCRIPTION LOT NO. BLOCK TRACT NO. OF BLOTS& SIZE OF LOT NOW ON LOT USE DF NO. OF EXISTING BLDG. FAM I LIEN DESCRIPTION OF WORK a v NEW ALTERATION ADDITION D r REPAIR DEMOLITION BO.FT. NO.OF SIZE ROOMS STORIES EXT.WALL ROOF COVERING COVERING USE OF STRUCTUR�nj /.% E �I1 �d 7,01n l LU u-4 L uwuau INSPECTION FOR APPROVALS OCCUPANCYAS INSPECTOR'S SIGNATURE DATE FOUNDATION: LOCATION FORMS, MATERIALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRESTOPB, CORRECT. BRACING, BOLTS I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION. OAS VENT, DUCTS SIGNATURE OF 71✓J ly + ��y1 2 f� LATH, INT. PERMITTEES Al ,f� ..11.�.. W.1/AA 1C ADDRESS 4J/YYVh.QI_ 0 t . LATH, EXT. AUTHORIZED AOT. CLOU u /✓A/. PLASTER. INT. 000— PLASTER, EXT. $ FEE � p�100 HOUSENUMBERCOR- RECT AND POSTED VALUATION ®FEE FINAL Q•Z9'(tij 96A636A 095 3 1-52 V COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUILDIN ADDRESS F� „1111• - or a certificate of Workers'Compensation Insurance,or a certified f 0-11:6 ` G�Ct NG• Copy.thereof(See.3800,Lab.C.) Cf /-` ZIP 9 '-f('q LOCALI em l NV pLc C Policy No. Company SIZE OF L NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. look .1 83 1 Z NEAREST CROSS ST. ❑ Certified copy IS filed with the county building inspection TRACT J-1 O� BLOCK LOT NO. 380 USEZONE MAP NO. department. ` ASSESSORMAPSOOK PAGE PARCEL 53 Data-Applicant Q O 5 I SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER ' V 1 TEL.NO.p YES NO COMPENSATION INSURANCE AYI `' 11 /A '" WITHIN 1WO FT.OF SCHOOL? n1 ADDRESS (This section need not be completed if the permit is for one hundred �0 J(. N• / DISTRICT GROUP TYPE CONST.'IFIREZONE PROCE ED BY dollars($100)or less.) CITY ZIP pp � p I certify that in the performance work f whi this pe Jr-, 7O o J/o0 ' is l.Slled, shall not employ y BFSO i0 ny pl B! as AgCHITEC OR NG NEER TEL.NO. become -SS'uuy�bjecct�t to^the Workers Den. III L As SU STATISTICAL CLASSIFICATION APT C NDO DatApplicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT: If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST OR TEL.NO. Exemption, you ShOUItl become subject t0 the Workers' CONTRACTC � SETBACK YARD HWV PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith JFRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC,NO. PL LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS SIDE PL d C) I hereby affirm that I am licensed under provisions�of Chapter 9 SEWER MAP - - - (commencing with Section 7000)of Division 3 If the Business and SQ. SI NO.OF STORES NO.OF FAMILIES C Professions Code,and my license is in full force and effect. NEW BK PG - D _ D License Number Lic.Class DES PTI OF WOK ADD VALUA ION 1 W s.. n b0 . a a: Contractor Date ' - ALTER ❑' -' - Y{_:T.a ti Z b Gk Y e . REPAIR ❑ 1 i 7 „�•lili El am exempt under Sec. - _ - BAP.C.for this reason DEMOL ❑" Z I(t'M - � USE OF EXISTING BLDG. - LDMA P/C N Date: URM ❑ _-; _ IIIiA`� S - 00 Signature APPLICANT PRINT) TEL.NO. LDMA Perm# .Z ` ' 1_.TIEL.K _ ,l_h! ❑ I, as owner of theproperty, or m employees with wages as I - - - Y .. --;0 ...3:r!Ci!'�r�C .___...._SSSS ,1111 their sole compensation, will do the work and the structure is A DRESS not intended or offered for sale (Section 7044, Business and D _ t . - .F FINALDATEJ • — C Y� 1f 7gd � - / Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANTHANDLEAH RDOUSMATMIAL y O I�, R�C)/• , { 1 I 1 (' OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN .4 O'VI 1 7/i9/911 ❑ I, as owner Of the property, am exclusively contracting with THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors<to construct the project.(Section 7044, YES El NO,, J - 'i21 HIS 7'�i Business and Professions Code.) I '1 1 WILL THE INTENDED USE MI THE CONSTRUCTION BY THE APPLICANT IO FUTURE BUILDING OCCUPANT REQUIRE APERMITFOR CONSTRUCTIONOMDI SEI PERMITTING THESOUTH CONSTRUCTION LENDING AGENCY COAST AIR DUALITY MANAGEMENT DISTRICT(sCA/MDl.EE PERMITTING CHECKLIST "• FOR GUIDELINES. ' I hereby affirm that there is a construction lending agency for YEs❑ NO -• the performance Of the Wolk for which this permit IS Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MT REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE_TITLE 2,CHAPTER 2.0)SECTIONS 220.100 TH ROUGH 220.1•e CONCERNIN I Lender's Name HAZARDOUS MATERIALS REPORTING AND FORDBTAININGA PERMIT FROMTHESCAQMD. Lenders Address oY'.+,Im oR.anrt o I certify that I have read this application and state that the above R fOf short i. Correct ag fee to Comply With 811 COUnty P.C.FEE PERMIT FEE AN a ortlin n and I w rel ting building construction,and `U of !BP SQ to &4 -this County l0 ante!Upon - ISSUANCE FEE 3 1 /� O e a I Boned r/ a I. nspection purpoie� i� 9�1 1. v - U INVESTIGATION FEE TOTAL FEE olAMb,twAps,l om L SEE REVERSE FOR EXPLANATORYLANGUAGE. WORKERS' COMPENSATION DECLARATION I hereby al4imn that I have d certificate of consent to self insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab..C.) - COUNTY OF LOS ANGELES BUILDING AND SAFETY" Poligy'No Company t - - , BUILDING- �S ❑ CeNified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS /V. EN C/ltll T/4 ❑ Certified copy is filed with the count-Y' B Pec-buildin ins BUILDING 1 ` - - - C tion department. '. ADDRESS J 2 CITY T y�L 1. CA zi; � ' LOCAL" _;k Date 'Applicant - _ .NO. OF BL0G5., NEAREST ' CERTIFICATE OF EXEMPTION FROM WORKERS' - SIZE OF LOT NOW ON LOT CROSS ST. WOODR r COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK I LOT NO. MAP BOOK. PAGE P RCEL hundred dollars ($100) or less.) TEL. OWNER I ` NO. USE.ZONE.. MAP certify that in the perform of th work for hich this / ' NO. J• CO +.� . . / SPECIAL permit is issued, shall note pla any rs matlner ADDRESS - GGG "' f CONDITIONS - so as to become sub'ect tot ker e a ion ws - �r,r� - O / C « ZIP 17V U P /'9/�Q (� ,iD� CITY Date�PPlica nt ""`�_ ARCHITECT'OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY 0 NOTICE TC AP LICANT: If, after making this Cert icate of ENGINEER F(F NO. CONS ZONE Exemption, you should become subject to the .Workers' tUy Compensation provisions of the Labor Code, you must forth- ADDRESS `J/O ✓ 0- with comply with .such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATIQ . - APT.. CONDO. Z deemed revoked. CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION LIC. CLASS No. DWELL. UNITS — LICENSED I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS `� SEWER MAP (commencing with Section 7000)of,Division 3 of the Business LIC. CLASS ,and Professions Code,and my license is in full force and effect. CITY' 9K PG� J VALIDATION -• SO. FT. NO. OF NO. OF CHECK License Number Lia Class - SIZE STORIES ( FAMILIES ONE VALUATION /(O• Cdniractor Date DESCRIPTION OF WORK NEW ❑ -// - ❑ LO ADD am exempt under Sec. - e/ D ALTER ❑ B.BP.C. for this reason S 5 REPAIR ❑. $ Date - USE OF : EXISTING BLDG. rG5/ Q/G C°� DEMOL ❑ PICANT' � L. Signature APL // // TE2 �^ (PRINT) VI,� �V� O. iQ 7� FINAL �3 OWNER-BUILDER DECLARATION, DATE - I hereby affirm that I am exempt from the Contractor's License - f ' Law for the following reason (Section 7031.5; Business and ADDRE o/S/,vl1E /'/ ZLIT_ e, FINAL 1 Professions Code): - PRESENT - - - By - pinjlBUILDING \ A`L`T• ' I, as owner of the,property, ormy*employees with ADDRESS dQ wages as their sole compensation,will do the work and .. 7 v7rrw the structure isnot intended or offered for sale(Section LOCALITY D t 7044, Business and Professions Code.) - MOVING - TEL. - ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. Y - EMS �•A, 1 IT ' with licensed contractors to construct the project (Sec- ADDRESS TOTAL 87...38 tion 7044, Business and Professions Code.) REQUIRED TOTAL SETBACK FROM 'EXIST. 87. 0. CONSTRUCTION LENDING AGENCY SET BACK YARD Hwy PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT _ � .00the performance of the work for which this permit is issued P.L. - (Sec. 3097, Civ. C.). P.SIDE L. Lender's Name. 'vP-WOl 6/22/89 o - -LDMA Ref. # m - P.C. Fee E _ Permit Fee r 4121 ASE S:5 Lenders Address - 121 F9t f! . 2 I certify that have read this application and state that the Issuance Fee U LDMA P/C 4 D ;nd vmfor alio s correctagree to comply with all County Investigation Fee21/� `\1 nTotal Fee .J LDMA Perm. q refs t o ze 5 n fives of this County to enter[eIn bov ed perty for inspection purposes. t p O SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Dat -)WORKERS' COMPENSATION DECLARATION I HeIreby affirm that I have a.certificote of consent to self insure, or o certificate of Workers' Compensation Insurance, or a certified copy thereof (Sac. 3800, Lab. C.) _ COUNTY OF LOS ANGELES _ BUILDING AND SAFETY Policy NoCompany j ❑11, r`fied copy is hereby furnished. FOR APPLICANT TO FILL IN - ADDRE55 Q r Certified copy is filed with the county building inspec- BuaowG 7� e tion deportment. ADDRESS C,it 17 Date Applicant CITY P _ ZIPS V LOCALITY LC ( 1, ,, O NO. OFN LOT.' NEAREST ,.. IC) Fr CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE of L07 7< D ' NOW F B LOT - "" CROSS ST. V Mn i COMPENSATION INSURANCE - /-,� •'� - (This section need not be completed if the permit is for one TRACT BLOCK COT NO J 90 MAP BOOK _ PAGE PARCEL hundred dollars ($100) or less.) TEL USE ZON MAP OWNEd V Init� AICk No. 297— n J NO / 'I certify that in the performance of the work for which this SPECIAL — - Y permit is issued, sholl not emp y a person in any m er ADDRESS 'O j r C - CONDITIONS a so as to become subject to the rke s' Co pe `io L S 7. c CITY e ZIP '7 (7 Date , �Q Applicant ARCHITECT OR �'(\ TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY K NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER t' NO. n CONST. 1 / 7�4�IE - o Exemption, you should become subject Co to the Workers- \ CR r 3 V J 9 Vw Compensation provisions of the Labor.Coda, you must forth- ADDRESS v I\ J a ' with comply with such provisions or this permit shall be ./C TEL. STATISTICAL CIASSIFI ATION - APT. CONDO. Z deemed revoked. , CONTRACTOR ��/ L NO. LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL UNITS_ I hereby affirm that I am licensed under provisions of Chapter9 ADDRESS NO. SEWER MAP (commencing with Section 7000)of,'Division 3 of the Business LIC. and Professions Code,and my license is in full force and effect, CITY- CLASS BK F PJ VALIDATION SO. FT. N0. OF NO. OF CHECK License Number Lic. Class SIZE ' STORIES FAMILIES ( ONE 7 - - - VALUATION4c) Contractor - -.Date DESCRIPTION OF WORK �Z1L Y` 2 NEW Elv ...ADD ® c. D ❑I am exempt under Sec. _ � , - B.BP.C. for this reason ALTER ❑REPAIR ❑ $ Doles USE OF t - EXISTING BLDG. res d ej DEMOL ❑ - Signature APPLICANT , TEL r-r q r.FINAL - (PRINT) V i L. A.I L 4- NO. Z9/ .. ....__ _ OWNER-BUILDER DECLARATION - f DATE I hereby affirm that I am exempt from the Contractor's License ADDRESS G A e r - Law for the following reason (Section'7031.5; Business and FINAL Prof sions Code): PRESENT _ -_ .. By BUILDING �p I, as owner o4 the property, or my employees with ADDRESS , , ,. --(- „ :AGCT.V wages as their sole compensation,will'do the work and - - - - - the structure is not intended or offered for sale(Section LOCALITY D _ o"i.W 49.w- 7044, Business and Professions Code.) .- - MOVING - TEL. I El1, as owner of the property, am exclusively contracting CONTRACTOR NO. 'LL1 ITEM& ppQ with licensed contractors to construct the project (Sec- ADDRESS y ....:T�TnC'- ,,� .�a O'O tion 7044, Business and Professions Code.) IST. _ _ - CONSTRUCTION LENDING AGENCY 5ETOeACKD YARD HWY TOTALSETBACK OPi NEFROM WIDTH I I hereby affirm that there is a construction lending agency for FRONTMom the performance of the work for which this permit is issued - P.I. - (Sec. 3097, Civ. C.). SIDE P.L. . . .-(�(� Lender's Name LDMA Ref. q. --� """j 6/22/sq P.C..Fee S Permit Fee [s•yL I Ay I Lender's Address p�C - ?iCV NT O J aI certify that I have read this application and state that the Issuance Fee D LDMA P/C N D 0 P.� ve info anon is corre I agree to.comPly with all County Irrvasrgoron Fee nane s nd 5 at I -re la' g touilding construction, Total Fee LDMA Perm, p aIter b orizeseiveIh isnth b e-me io ed p pe 9or inspection purposes. _ SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of App want or Agent Date L( COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0205070034 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 5904 LT: 380 SQ. FT STORIES TYPE 6015 ENCINITA AV STRUCTURE: VN TEMP CA 917801935 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: WOODRUFF 5384-013-024 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY TENANT: - EXIST BLDG USE: RESIU'- U E ZONE: R--T-- ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 05/07/02 JK 11/03/02 OWNER: � TEL. WU:� SLOGS. NOW ON LUT: VALUATION: FINAL DATE FINAL BY: CODE: VAN LEER;BRIAN & TERRY (626) 285-2031- 400 6015 ENCINITA AV - i7 TEMP 917801935 FEES PAID DESCRIPTION OF-90-RK C/O 2 WINDOWS FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. N0: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION ,REBID 400.00 VAL 0.50 SPECIAL CONDITIONS: 02 PERMIT W/OEN-HC_ 400.00 VAL 43.65 _ -.TOTAL FEES 71.90 CONTRACTOR: TEL. NO: ;�j� � � r' APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO / ��� LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: i FOUNDATION/TRENCH FORMS ; LIC. NO: / --i - ' J- ;l SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION X 3 01 FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/CO D: STAT CLASS: __ _ NO 21 ' - - _ % ROOF SHEATHING SCHOOL WITHIN HAZARDOUS / ' SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO '�. - � FRAME INSPECTION REQUIRED ---TOTAL SETBACK FRO E IS �V(; FIR SPRINKLER H GERS SET BACK YARD: HWY: PROP LINE: WIDTH: �' FRONT PL- INSULATION/ FATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CASSEM. RATED WALL ASSEMBLIES - RATED SHAFTS/OPENINGS--- T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILD G D Es \ I I hereby tthat I have B certificate of consent to self insure, BUILDING ADDRESSr A\O0 S �, c��i� r� or a certificate of Workers'Compensation Insurance,or a certified 017Y ` nP copy thereof(Sec.3800,Lab.C.) ^ 9/ �' O LOCALITY Policy NO. Company 511ZELOJF L-01T 1-_1••' 1 _ N�rOF BLDGS.NOW ON LOT I ❑ Certified copy is hereby furnished. A© D 3• , Ada NEARJSTJCROSB SST. {�-r TR�ZO BLOCK LOT NO. ✓`� o 7 i w ❑ Certified copy is filed with the county building inspection S 77 USE ZONE Mare NO. department.' .. 7'3 /f �- C ,— Q ASSESSOR MAP BOOK PAGE PARCEL Date Applicant SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' Ow ER - to��` n� TEL.NO. YES No COMPENSATION INSURANCE ✓/�N� rr.fC 8148AS7o�l337 SS WITHIN 1000 FT.OF SCHOOL? X (This section need not be completed if the perm it is for one h u ndred LREj A �,w Trl RMA- Ci DISTRICT -"GROUP TYPE CO ST.' FIRE ZONE PROCESSED BY dollars($100)or less.) L ..� /• ,ZI �7 8`0 1� I cergfy that in the performance of the work for which this permit bm E 6 CA / / O 0 Is issued, I shall not employ any person in any manner So as to ARCHITECT OR ENGINEER TEL NO. become subject t0 the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NCL pa��—DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate ofREQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject f0 the Workers' CONT ACTS OR �_ TEL.NO. SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith (�(�aJ ��1� FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION CITY LIC.cuss BIDE y PL 1 I Ll I hereby affirm that I am licensed under provisions of Chapter 9SEWER MAP U (commencing with Section 7000)of Division 3 of the Business and SO �' Z�i NO.OF STORES NO.OF FAMILIES Professions Code,and my license is in full force and effect. (O NEIN ❑ SK PG U DESCRIPTIONOF RK ADD ❑ License Number Lic.Class _ VALUATION �� y Contractor Date ALTER ' ❑ ❑ I am exempt under Sec. REPAIR El $ BARC.for this reason DEMOL ❑ LOMA P/C It Date: USE OF EXISTING BLDG. URM ❑ Signature APPLICANT(PRINT) TEL NO. LOMA Parm s Z ❑ as owner of the property, or my employees with wages as O Itheif sole compensation,will do the work and the structure is ADDRESS FINAL DATE,. Q ipt intended or offered for sale (Section 7044, Business and O Professions Coda.) WILLTHEAPPLICANr ORFUTUREBUILMNOOGfUPANr HANOLEA HAZARDOUS WE"' AL S���IZ J GQ a4. OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR REATER THAN , as owner of the property, em exclusively contracting with THE AMOUNTS SPECIFIED ON THE H DOUS MATERIALS INFORMATION GUIDE? FINAL By 7 licensed contractors to construct the project.(SeGbon 7044, YES❑ No❑ N Business and Professions Code.) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING OCCUPANTREQUIREAPERMITFOR CONSTRUCTION OR MODIFICATION FROMTHESOUTH p CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST 3 �O. 75 ,. FOR GUIDELINES. I hereby affirm that them is a construction lending agency for YES Cl No❑ the performance of the work for which this permit Is Issued(SBC. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD 3097,Civ.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY LADE.TITLE;CHAPTER ZaISECTIONSZat.tODTHROUGH 2A.MBCONCERNING Lender's Name HAZARDOUSMATERIALS REPORTING AND FOR OBTAINING A PFAMIT FROM THE SCAONp. Lenders Address o' I certify that I have read this application and state that the above q Ion 19 Correct. 109fee Omply with 911 County P.C.FEE PERMIT FEE F3i ordi99ean BE and State la' g t ui 'c traction,end �� �� q herfby uthon4e re t es t oun to enter Upon ISSUANCE FEE t `e e-menti ed o f in rposes. �J"/•J a INVESTIGATION FEE TOTAL FEE p �� 1/�-(— SEE REVERSE FOR EXPLANATORY LANGUAGE,