HomeMy Public PortalAbout10511 FREER ST_Miscellaneous__ PUBUC 'NOAKSI COUNTY OF LOS ANGELES
WOMMEMM
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 'Fr4wr CT. k 04,
•
Please complete and return this information in the envelopt provided at
your earliest opportunity to avoid unnecessary delay in processing and
issuing your building permit. No building permit will be issued until
...is verification s receivea.
1. I personally plan to provide the major labor and materials for construction
of the proposed property improvement (yes or no) �� J
2. I (have/have not) (Lv signed an application for a building permit
for proposed work.
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
Address City
Phone Contractors License No.
5. 1 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
„igneo: Return Form to Address Below
Property Owner
Social Security Number
Date: 7 --? - Y f
Reference: Section 19877hapter 9 of FaFt
3 of division B of the State
Health and Safety Code.
DISK1/AM30.13
o��GELES COGy��
COUNTY OF LOS ANGELES
PUBLIC WORKS DEPARTMENT OF PUBLIC WORKS
G6�c
BUILDING AND SAFETY DIVISION
ServiceQ�
OWNER-BUILDER VERIFICATION
Attention Property Owner,
An "Owner Builder" building permit has been applied for in your name and bearing your signature
at i os l l t=(Z��rZ S7. (e yr,le If c ; 4 y GiH 9 0 Please complete
and return this information in the envelope provided 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. 1 personally plan to provide the major labor and materials for construction of the proposed
property improvement (yes or no _�e-S
2. 1 (have/have not) h a V"-o signed an application for a building permit for proposed work.
3. 1 have contracted with the following person (firm)to provide the proposed construction:
Name
Address City
Phone Contractors License No.
4. 1 plan to provide portions of the work but I have hired the following person to coordinate,
supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. 1 will provide some of the work but I have contracted (hired) the following persons to provide the
work indicated:
Name Address Phone Type of Work
Signed: 1i „ rZo L`LIL Return Form to Address Below
Property Owner
Date 10 —t- - D 6
04/19/04