HomeMy Public PortalAbout9422 GARIBALDI AVE_Miscellaneous__ .� COUNTY OF LOS ANGELES
DEPARTMENT OF PUBLIC WORKS
BUILDING AND'WETY 0[118(014
OWNER-BUILDER VERIFICATION
Attentlon Property Owner,
An 'Ow r ullder' bulldf p r 4 as. en a Iled r in your name and bearing your signature
at A V Please complete
and return this Information In the envelope provided at your earliest opportunity to avoid unnecessary
delay.ln 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 la or and materials for constructlon of the proposed
property Improvement ( yes or no ) yi
2. 1 (have have not) signed an application for a building permit for proposed work.
3. 1 have contracted with the following person (ilrm) to provide the proposed construction:
lC
Name �l/� apTk A
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 wor9c
Name
Address city
Phone . Contractore License No.
6. I will provide some of the work but I have contracted (hlred) the following persona to provide the
work indlcatpd:
Name
� n Q y„�j"��Addreas Phone Type of Work
81gned: Return Form to Address Below
Propefty Owner
:1.�
Date
I •
0411 M4