HomeMy Public PortalAbout10545 FREER ST_Miscellaneous__ gpELEB coG '
s COUNTY OF LOS ANGELES
PueucwoRKs DEPARTMENT OF PUBLIC WORKS
BUILDING AND SAFETY DIVISION
OWNER-BUILDER VERIFICATION
Attention Property Owner:
An "Owner Builder" building permit has ben applied for in your name and bearing your signature
at /0-55 5 i�2��� 57• T-e�.dl�P C'� C�3 �1 ��y Please complete
and return this information in the envelopd 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. 1 personally plan to provide the major labor and materials for construction of the proposed
property improvement ( yes or no _�S
2. (have/ ave not) 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: ` Return Form to Address Below
Property Owner
Dat - -2005
04/19/04