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HomeMy Public PortalAbout8756 HERMOSA DR_Building__ �OA6itlAeBf�ygAPPLICATION FOR BUILDING PERMIT : DIVISION OF BUILDING AND SAFETY BUILDING 8 �-� ADDRESS Deportment of County Engineer County of Los Angeles LOCALITY WM.J. FOX, COUNTY ENGINEER NEARESTG r y� CA99Att D. GRIFFIN, SUPT of BUILDING CROSS ST. DISTRICT NO, GROUP TYPESEWEyR,� MAP FOR APPLICANT TO FILL IN ! I oNar. >,) /t9 BUILDING- MAP // STATE .�. ADDRESS NUMBER 994 HWY LOT NO. IJ Ip' CK U3/JZONE SPECIAL CONDITIONS TRACT .> /�\-J/�h` NO. OF BLOG8. BUILDING EXIST. SIZE OF LOT I W ON LOT � SETBACK YARD HWY STREET NAME WIDTH USE OF L FRONT X101 EXISTING / P.R L.N /� - b OWNER Zi SP.IDL. _ E MAIL4zta ADD O TRACT DWELL. 1 UNIT 5 INDUSTRIAL TEL. t DWELL. 1 UNIT CITY NO. 8 PUBLIC eLDG. ARCHITECT OR TEL. 2 DUPLEX I UNIT ADDN.. ALT.. ETC. ENGINEER NO. 3 APT. _UNITS B M19CEL. ADDRESS 4 COMMERCIAL L INSPECTION RECORD ADDRESS �'✓I ��/ ��J-'�,Y�f';• & ' OF 'rY f A -C/2F_ DESCRIPTION OF WORK NEW ADDP"� ALTER REPAIR DEMOLISH ✓IOL'.S DRQ /PO F� F(v 15'1 •1 SO. FT. f NO. OF NO. OF L SIZE �-�S K STORIES FAMILIES USE OF 9=TIS- T R ✓ 4 - a/ 91GNATU RE OF APPLICANT APPROVALS ADDRESS DATE INSPECTOR'S SIGNATURE FOUNDATION: $ P. C. 8 FORMS. LOCATIONN FORMS. - //- /t FEE FRAME: FIRE STOPS, q,T VALUATION �tJ f /J BRACING, BOLTS FURNACE: LOCATION. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT,DUCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO GOA LY WITH ALL COUNTY ORDINANCES LATH. INT. AND STATE LAW EGU TING BUILDING CONBTRUC- ' TION. LATH, EXT. BI GNATURE OF v2� HOUSE NUMBER COR- RECT AND POSTED ADDRESS FINAL WM.J. FO ,COUNTY ENGINEER VALIDATION C. N. DIRLAM. CHIEF BLDG. INSPECTOR v `C9 3 3 41n CCT25 1 /J 2.00 N 7aA° °98AOB38 -APPLICATION FCS-F '"BUILDING PERMIT - DIVISION OF BUILDING AND SAFETY BUILDING ADDRESS Deportment of County Engineer County of Los Angeles LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST. L FOR APPLICANT TO FILL IN DISTRyT No. CROUP TYPE SEWER MAP �� BK PG CONST BUILDING (�/ pAM^ .�__/ ,<CL� NUMBER HWY ADDRESS r) (� ((y K //� - w�'+�il. /V `� YES O l. LOT NO. (/I/I_ . ' _ SL L� �, BLOCK USE ZONE SPECIAL � CONDITIONS TRACT :2 a (/ NO. OF BLDGS. �J SIZE OF LOT NOW ON L 2 BUILDING YARD HWY STREET NAME EXIST. SETBACK WIDTH" USE OF EXISTING G. FRONT OWNER SIDE O TRACT DW UNIT TEL. 5 INDUSTRIAL CITY O. — I DWELL. b 1 UNIT 6 PUBLIC BLDG. ARCHITECT OR TEL. 2 DUPLEX 2 UNITS ENGINEER NO. 7 ADDN..ALT.. ETC. 3 APT. UNITS 8 MISCEL. ADDRESS 4 COMMERCIAL CONTRACTOR TEL ' —/ INSPECTION RECORD ADDRESS ' `j (f) 4L;; -DESCWPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH SO. FT-77� NO. OF NO. OF SIZE Q TORIES F MILIES USE OF STRUCTURE� 64I SIGNATURE OF APPLICANT APPROVALS ADDRESS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION $ /JDO FEE $ FORMS, MATERIALS FRAME: FIRE STOPS. VALUATION $ BRACING. BOLTS .. FEE FURNACE: LOCATION, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT. DUCTS -/ APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT. AND STATE LA EGU ING SUILDI G CONSTRUC- TION. LATH, EXT. SIGNATURE OF /� HOUSE NUMBER COR- PERMITT EE RECT AND POSTED ADDRESS '��� FINAL JOHN A. BIE. COUNTY ENGINEER ,�{LIDATION CLYDE N. DIRLAM, CHIEF BLDG. INSPECTOR I UMO CASH 7 4 4-0 JUL 31 1 8.0 0 n 1 M:WORKERS' COMPENSATION DECLARATION rreib, affirm that I havecertificate of consent to self APPLICATION FOR BUILDING PERMIT -` insure, or a certificate of Workers' Compensation Insurance, - �or a ceilFfied copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY .._. Policy No.' - ' Company - ❑ Certified copy is hrebeFOR APPLICANT TO FILL IN BUILDING �/(Q p-M Y•furnished. ADDRESS J 1 ❑, Certified copy is filed with the county building inspec- BUILDIN 7/-7�& �7✓�M �A JTt , - tion department. : Date Applicant CITY I GM PW C- ZIP LOCALITY NO. ON LOT OF LOT NEAREST LQ, CERTIFICATE OF EXEMPTION FROM WORKERS' ' SIZE OF LOT NOw - ''" CROSS ST. T - COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK I LOT NO. MAP BOOK PAGE PARCF- hundred dollars ($100) or less.) TEL' �7 USE ZONE MAP OWNER I I-)1/I y.J NO.� '�/ NO. I certify that in the performance of.the work for which this //�� IIM,YJ NO, AL } permit is issued, I shall not employ any person in any manner ADDRESS V.� Cl ri l Mc?2A -J - CONDITIONS a so as to become subject to the Workers' CC ensation Laws. ryT FL L' O f CITY '1 W ZIP' U Date 'S�� Applicant ARCHITECT OR TEL. D TRICT GROUP TYPE FIRE PROCESSED BY IY NOTICE TO APPL CANT: If, after making t is Certificate of ENGINEER NO. _n CONST. ZONE Exemption, you should become subjectto the Workers' yU S U Compensation provisions of the Labor Code, you must forth- ADDRESS - a - with comply with such provisions or this permit shall be TEL STATISTICAL CL4SSIFI([�ATION APT. COND deemed revoked. CONTRACTOR NO. O. Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NG DWELL. UNITS- - I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. LIC. SEWE MAP (commencing with Section 7000)ofDivision3 of the Business ' and Professions Code,and my license is in full force and effect. CITY CLASS BK 1 �) VALIDATION SO. FT.'pp NO. OF NO. OF CHECK License Number- - Lia Class SIZE /� STORIES FAMILIES ONE VALUATION - Contractor Date DESCRIPTION OF WORK ' NEW ❑ $ ,^ ❑I am exempt under Sec. /��Lyl�wo 11- yy� P P IaP�L ADD ® Q/ 7 ALTER , B.BP.C. for this reason Cfa/^ IWA&E E REPAIR $ n ' Date: USE OF �I//ff�� ` LL..�� - EXISTING BLDG. I'�i/`71 l9 DEMOL �- Signature APPLICANT TENiFINAL ¢ OWNER-BUILDER DECLARATION (PRINT//)r��r,,'�I l / r Ul�1 Z0 O. "r t. DATE t L 3 U 1 hereby affirm that g r exempt from the Contractor's License ADDRESS' (JCY G� C*tk 'fr Law for the following reason (Section 7031.5, Business and { " FINAL11-^// 1 , Professions Code): PRESENT / . �By�l/V-V ACCT.+ . ® 1, as owner of theproperty, or m em to employees with BUILDING I L.ry � ..ACCT •T Y P Y ADDRESS {-� _ wa es as their sole compensation,will do the work and thestructureis not intended or offered for sale(Section LOCALITYPLE , t yL'•` t L 3307 , <e7.J8 7044, Business and Professions Code.) - MOVING TEL ^- 'I ITEMS ❑ - I, as owner of the property, am exclusively contracting CONTRACTOR NO. x\ l \• � x'• 'sC'•-: with licensed contractors to construct the project (Sec- - - �� L 1 v'S �l y TOTAL 23-7.38 tion 7044, Business and Professions Code.) - ADDRESS c ,` `.s, ;,ruCnV 237 38 REQUIRED TOTAL SETBACK FROM EXIST. CHuEAC`R� L CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH - Cfll'4�C. I hereby affirm that there is a construction lending agency for FRONT � � , .t -- HANE the performance of the work for which this permit is'issued P.L. (Sec. 3097, Civ. C.). SIDE, ' Lender's Name / _ PL, 0000-OMI 7/q 7/89 9 - LDMA Ref. # 1 AI I 8:35 Q�h� F�^ i � 51 �IIYYW GY' P.C. Fee$ Permit Fee 3 Lender's Address " /� , o I certify that I have read this application and state that the Issuance Fee V �. LDMA P/C# ' 8 above information is correct. agree to comply with all County Investigation Fee R ordinances and Siate laws relating to building construction, Total Fee I LDMA Perm. # ' a and hereby authorize representatives of this County to enter ' m upon the above-mentioned property for inspe<tioo.posQS. _ JL dP/ SEE REVERSE FOR EXPLANATORY LANGUAGE n Signature of(Applicant or Agent Date - � .Z I WORKERS' COMPENSATION DECLARATION - .` I .hEreFip afF`vm that I'have a certificate of consent to self _ nsurance, APPLICATION FOR BUILDING PERMIT f Y nsure,ror{o certificate of Workers' Compensation I - or a cer$ad copy thereof (Sec. 3800, Lab. C.) - ' •'- - - - COUNTY'OF LOS ANGELES - BUILDING AND SAFETY � _Policy No. Company BUILDING ❑ CertiFkd.copy is hereby furnished. . . _ FOR APPLICANT TO PILL IN ADDRESS El'- Certified copy is filed with the county building inspec- BUaowG //� �• pp r tion department. ADDRESS % (-! E�2 Cu. )�✓ Date Applicant CITY ��/ l+G G) I ZIP LOCALITY NO. OF BLDGS. I NEAREST J I CERTIFICATE OF COMPENSATION IN FROM WORKERS' SIZE OF LOT NOW ON LOT LI j L CROSS ST. df COMPENSATION INSURANCE _ _ POR O ASSESSOR (This'section need not be completed if the permit is for one TRACT BLOCK LOT NO. 2 MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) �j� TEL / /' OWNER UC'1"�t/ NO. ". . USE ZO MAP certify that in the performance of the work for which thisr' NO. permit is issued, I shall not employ any person in any manner - ADDRESS P;-713&E (Z r - SPECIAL - CONDITIONS .so as to become subject to the Wo ers'Compensation Laws. / '` p �j�� r �- O r/l' CITY 7 /�+ l�nJ'�4GL' C ZIP ° U X Datek. Applicant ARCHITECT OR - TEL O NOTICE ATO PPLICANT: If,. ter makingthis ertificate of ENGINEER NO - DISTRICT GROUP TYPE FIRE PROCESSED 8V C p CONSL ZONE '� n p Exemption, you should be ome subjet to the Workers' y7 f 3. / ? r w Compensation provisions of the Labor Code, you must forth- ADDRESS V !� J / J O_ with comply with such provisions or this permit shall be TEl STATISTICAL CLASSIFICATION APT. CONDO. NZ deemed revoked. CONTRACTOR NO. _ -- LICENSED CONTRACTORSDECLARATIONUC. - CLASS NO. DWELL. UNITS_ I hereby affirm that I am licensed under provisions of Chapter 9 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 S VALIDATION • qrd SO. FT. NO. OF NO. OF CHECK BK. PG. License Number Lic. Class / SIZE STORIES FAMILIES ONE - ��� - VALUATION Contractor Date DESCRIPTLLI��ON OF WORK / q pp yyff�� NEW ❑ $ c ar^ . -EJT cim exempt under Sec E�fjT� D V �•©� `-' �'\.��N� /bqL ADD ® �� ALTER EJB.&P.C. for this reason V CIL REPAIR 1:1 $ DateF , - - EXISTING BLDG. DEMOL ❑ APPLICANT FINAL Signature TEL. .._....._ OWNER-BUILDER DECLARATION (PRINT) NO. DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL/ 1 Professions Code): PRESENT - /ey ' y I, as owner of the property, or my employees with BU ADDRESS ACCT 33 LDING wages as their sole compensation,will do the work and , > - - 3.�'i0�- __. ... . _ the structure is not intended or offered for sale(Section LOCALITY - M -7044, Business and Professions Code.) MOVING TEL. El -I, as owner of the property, am exclusively contracting CONTRACTOR NO. - 1 ITEMS 1p S with l icensed�contractors to construct the project (Sec- - _ TOTAL `09. 25 tion 7044, Business and Professions Code.) ADDRESS •. ., -. -. REQUIRED TOTAL SETBACK FROM EXIST. `./ "' T• -CHECK 209.25 CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for . FRONT 'CHANGE v the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.).. - SIDE - PL. 0000-0001 6/ b/,39 Lender's Name. ' LDMA Ref. M. 31+1.5.0 1 AM 10:14 P.C. Fee$ Permit Fee 3 Lender's Address , o I certify that I have read this application and state that the Issuance Fee t l LDMA P/C k 8 above information is correct. I agree to comply with all County Investigation Fee ('� , R ordinances and State laws relating to building construction, Total Fe V 6? LDMA Perm. li _ a and hereby authorize representatives of this County to enter m d property for inspection purposes. upon the abov�entione 'a 4--CO , � S�'�QCj SEE REVERSE FOR EXPLANATORY LANGUAGE / Signature oftApplicanl or Agent APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS BUILDING A DRE55 I hereby affirm that I have a certificate of consent to self insure, or a certificate of 3800,L•Compensation Insurence,or a certified -7,5(o 9WT14M bpi copy No. (Sec.3800.Lab.C.) CITY ZIP� zIP /7 S LOCALITY.� _ Policy N0. Company SIZE OF LOT NO.OF BLDGS.NOW ON LOT - / L L- ❑ Certified Copy is hereby furnished. I NEAREBT CROSS ST. ❑ Certified copy Is filed wit the—ce 1 builtling inspection TRACT BLOCK LOT NO./� USEZONE MAP NO. de rtme(nt. Date "'�` ASSESSOR MAP BOO PAGE PARCEL I Dpl 5-3 !C:2 1 \ SPECIAL CONDITIONS CEpTIFICATE OF EXEMPT N FROM WO RS' OWNER TEL NO. VES NO COMPENSATION INSURANCE oS� 1N� A'LIIfJ G ' �� WITHIN 1000 FT.OF SCHOOL? �y1,r (This Section need not be Completed if the permit is for one hundred ADDRESS 7 L /I;yO v YkW. A_ D7/L 1 DISTRICT "'GROUP TYPE CONST.' FIRE ZONE OCE BY dollars($100)n less.) cm .ZIP AO n� � 3 / I I certify that in the performance of the work for which this permit T�7 / 7� /v0y //\�is issued.issued, I Shell 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 C O Dale Applicant ADDRESS CLASSNO, DWELL UNITS NOTICE TO APPLICANT: If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIBT Exemption, you should become subject t0 the Workers' CONTRACTOR TEL.NO. SETBACK YARD MWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION CITY LIC.CtABs AIDE OO� I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP U TOR OF OSES NO.OF FA SIZE MILIES FT. N . --(commencing with Section 700(1)Of Division 3 of the Business and SO. NEW ❑ BK PG O Professions Code,and my license is in full force and effect. - � License Number Lit.class D CRIPTION OF KP15-Mo ILI�O © C ADD ❑ 45 J VALUATION Contractor Date ALTER ❑ $ z ❑ I am exempt under Sec. REPAIR ❑ $ BARC.for this reason DEMOL LDMA P/C 0 Date: USE OF EXISTING BLDG. ._URI ❑ ' Signature APP CANT(PRINT) TEL.NO. LDMA Perm N 1 I, as owner of the property, or my employees with Wages as 6 -7 Arf �— G =7/ their sole compensation,will do the work and the structure is AODRE Ss� _ 0 ACCT.ay not intended or offered for sale (Section 7004, Business and nT�fE Q� . /�1/ �j FINAL DATE < pp 1 Professions Code.) G 3307 83.h) MULTHEAPPLICANT OR FUTURE BUILDINGOCCUPANTHANDLEAHAS RDWIS MATERIAL „ ; ITEMS ❑ I, a$ owner of theproperty, am a%CIUSIVBI COOtreCtln with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN , '•1 Y 9 THE AMOUNTS SPEOIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FI a'�, liCensedtcontractom to construct the project.(Section 7044, rEs❑ NQ❑ - TOTAL $S e ❑O Business and Professions Code.) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING 1, �/ }1, OCCUPANT REOUIREA PERMITFOR CONSTRUCTIONOR MODIFICATION FROM THESOUTH CHECK 38.100 CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT SCAQMD)SEE PEAMITTINO CHECKLIST /��J� L �'1 FOR GUIDELINES CHAT?GE .0[1 I hereby affirm that there is a construction leriding agency for YES❑ No❑ the performance of the work for which this permit is Issued(Sec. 3097,CIV.C,). I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAGMD ' ,'1 [ 111, p� PERMITTING CHECKUST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES I]OOO—I]OO1 4/Z.1! ]V Lenders Name COUNTYCODETITLEZ,CHAPTER ZM SECTIONS 1ID.100THROUGH 220.1 W CONCERNING C) Lenders Address HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. 0309 1 AN 7.90 D awtw aA.Orxr I certify that I have read this application and state that the above P.C.FEE PERMIT FEE information is correct. I agree to comply with all county `? O ces and State laws relating to building construction,and —f' hereby orize representatives of this County to enter upon ISSUANCE FEE O the Boo e- entiOned o for inspection pu oses. I INVESTIGATION FEE TOTAL FEE d Pql wp 1' SEE REVERSE FOR EXPLANATORY LANGUAGE, APPLICATION FOR: BUILDING PERMIT r COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION BUIFOR APPLICANT TO FILL IN BUILDI LD NGA fl SS #� I hereby affirm that I have a certificate of consent to self insure, W( v� or a certificate of Workers'Compensation Insurance,or a Certified �7 copy thereof(Sec.3800,Lab.C.) CITY P nP 7 f / LOCALITY Policy No. Company SIZE OF LOT NO.OF SLOGS,NOW ON LOT ❑ Certified copy is hereby furnished. NEARES ❑ Certified copy is filed with the County building inspection TRACT 2-1, BLOCK LOT NO. department. 3G Ix USEZONE MAP NO. ASSESSOR MA PA PARCEL `1 Date Applicant SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. -7 YES NO COMPENSATION INSURANCE �u� 2��7 / (THIN 1000 FT.OF SCHOOL'! A$R6G N (This section need not be completed if the permit is for one hundred MOSA y/\/VG DISTRI 'GROUP TYPE ST.' FIRE ZONE R ESSED BY dollars($100)or less.) 1 Certify that in the performance of the work for which this perm iL Gt /_,/ is issued, I shall not employ any person in any manner so O ARCHITECT OR ENGINEER TEL NO. (/// •,(44J/� become syl)ject to the Workers CO Laws. ATISTICALC IFICATION CONDO Dat ((e�' .._a VApplicamt✓ ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT: If, er making this Certificate Of REQUIRED TOTAL SETBACK FROM E%IST Exemption, you should become Subject to the Workers CONTRACTOR TEL NO. SETBACK YARD HM PROP LINE WIDTH Compensation provisions Of the Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS _ SIDE I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP (Commencing With Section TOW)of Division 3 of the Business and SQ. Z NO.OF STORES NO.OF FAMILIES � ❑ , O Professions Code,and my license is in full force and effect. NEW BK PG DESCRIPTION OF WORK ADD DA1QO n J� OL License Number Lic.Class Q /k. Q fXJ `/ Contractor Date r ALTER ❑ Z ❑ I am exempt under Sec. REPAIR ❑ B.&P.C.for this reason F' DEMOL LOMA PIC# Date: USE OF EXISTINGIBLDG. URM ❑ j Signature APPLICANT(PRINT) TEL.NO.b. 7 LOMA Porn# = i I, as owner of the property, or my employees with wages as . eWN S Al O Z60�ZJ t/ 'O their sole compensation;will do the Work and the structure is ADV not intended Or offered for sale (Section 7044. Business and YS7,66 pie., ! FINAL Q vj�7 "327.90 PTOfeSSIORS Code.) WILLTHEAPPLIOANTORFUTUREBUILDINGOCCUPANTHANDLEAHAZARDOUSWTERIAL j { ITEMS ❑ 1, as owner of theproperty, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN Q S F g THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? Y licensed Contractors to construct the project.(Section 7044, YES❑ NO❑ TOTAL 327 - 90 Business and Professions Code.) - WILL THE INTENDED USE OF THE BUILDING BY THE APPUCANT OR FUTURE BUILDING CHECK 321.911 OCCUPANT REQUIREA PERMIT FOR CONSTRUCTION OR MODIFICATION FROMTHESOUTH ( `HECK CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST l FDRGUIDELINES CHANGE �' .Ou I hereby affirm that there is a construction lending agency for YEE❑ No El (j (I/ , the performance of the work for which this permit is issued(Sec. Imo'^ 3097,CIV.C.). - I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD C p PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES 0000-10-1001r#!15I]�I Lender's Name COUNTYCODETITLEZ,CHAMMZMSECTIONS21.lW0 R000H2M.1i WNCERNINGy Lenders Address HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SGAGMD. 0303 f AIN 7.58 O GANERp1 AGEM I certify that I have read this application and state that the above P.C.FEE PERMIT FEE information is correct. I agree to comply with all county ;,q' O ordinances and State laws Tale g to building construction,and C� hereby authorize representatl as of this County to enter upon ISSUANCE FEE the a ove-mentioned propert for inspection purpo�± 3, {y (Y n 9D INVESTIGATION FEE TOTAL FEE MpAanrwAtn� SEE REVERSE FOR EXPLANATORY LANGUAGE -