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HomeMy Public PortalAbout5111 FARAGO AVE_Miscellaneous__ pugs WORKS COUNTY OF LOS ANGELES ;Sr i DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY DIVISION 532 South Vermont, Los Angeles, CA 90020 (213) 738-2135 OWNER-BUILDER VERIFICATION Attention Property Owner: An "Owner-builder" building permit has been applied for in your name and bearing your signature at 5"ii/ 4e. T l- e '� Please complete and return this information in the envel a provided at• your earliest opportunity to avoid unnecessary delay in processing and Issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) heave signed an application for a building permit for proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of the work, but I have hired the following per- son to coordinate, supervise, and provide the major work: Name ChAr`-�, (f. /70 Address 22oo 5, 4-ve- city A korv+,hy� Phone f5)t- 3ve—©e2-0 Contractors License No. 5 ��3rZ 5. I will provide some of the work but I have contracted (hired) th'e following persons to provide the work indicated: Name Address Phone Type of Work Sed &'Z4 4 41 5- e_relL At, 3zz rd G W-rad ( -L -o Signed: Return Form to Address Below Property Owner J 14 � Social Security Number Date: ' Ja,e- 4 1� -, Reference: Sectio6 1 511 Chapter 9 o mart 3 of division B of the State Health and Safety Code. DISK1/AM30.13