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Home My Public Portal About8811-13 LAS TUNAS DR_Miscellaneous__ TEMCCS.Des 75 12-54 MISCELLANEOUS APPLICATION 1 DIVISION OF BUILDING AND SAFETY OCCUPANCY-SAFETY-TRAILERS Department of County Engineer County of Los ADgoles WM.J. FOX, COUNTY ENGINEERBUILDING G CASSATT D. GRIFFIN, SUI-T of Bu aoiva ADDRESS n J LOCALITY ^1 U A-AS V U FO APPLIfAIYT TqF_ILL IN NEAREST w✓ OWNER I / 9Nr �(]J A� t—.TL�IT�f CRO55 ST. MAIL O' 3 I� L` / -�� -- ADDRESS - �} a.�."��l�p• }- � DISTRICTj� /a GROUP TYPE CONST. CITY / {/I ICIO� I-C�/ NOL�� /� _%� I -Y .Jf QW?q p O TEL. `•I NU®ER �D Ot SHWY YES NO CONTRACTOR /MVV G,\ NO - I USE ZONE SPECIAL CONDITIONS ADDRESS LEGAL Jf DESCRIPTION LOT NO.� (atl0 BLOCK BUILDING EXIST. NO. OF SLOGS. YARD HWY STREET NAME ? SETBACK /•� WIDTH TRACT 7 ��at-3 p NOW ON LOT FRONT '] S/ qX -,k ISq I USE OF P. L. /f7 C Ci 4-NQ�J .7' SIZE OF LOT EXISTING BLDG SIDE _ APPLICATION FOR P L OCCUPANCY `/ INSPECTION RECORD INSPECTION '1S I SAFETY PERMIT VGVT�VC!- ................. ............................. TRAILER TRAILER USE LIMITED TIME USE DATE ......,u.�.... .._...................... ..........._. _ ............_.... FROM: TO' USE OF STRUCTURES OR DEVICES .(`��... .I~•_Rr.!. .Y ...._.e�...aS.._L-,o c.!.5,... ........1.........._................... e-.ST �4 6 X1 e- . M fl -,I, . IDG C Cs L.j 19 /Y?-'C .........._3p......._Aw..,_.....�.rT...-........._............................L................................... Nr-1— R�yul R I t4�; ,.... ..._A..!-4......P.._I-�.._.�'_.....;: ... ._ ..._ 1 .............._............... TI ��_p co.._ ..._V .uTQ a........_...t......................_............. nihliS� � A / - K'esTf AAn/?� .� 4I. sPl.naa tJNS a ¢ uf2 .rl(o $ 0 5G2titct'`- APPROVALS W.f.ur�-•— INSPECT DATE I IX pECTOR'S SIGNATURE OCCUPANCY AS— OCCUPANCY OCCUPANCY APPROVAL I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GROUP Y OGc.LOAD$� '2 SS _ APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES TRAILER USE AND -STATE LAWS REGULATING BUILDING CONSTRUC- TION. SAFETY PERMIT SIGNATURE OF PERMITTEE TEMPORARY - STRUCTURE APPROVED ADDRESS TEMPORARY v STRUCTURE REMOVED FINALAPPROVAL I LD )" ST lI - WILLIAM J. FOX- COUNTY ENGINEER VALIDATION _AC 6 5 3 5.0 AUG 11 1 8 5.0 0 e in " f;,y � 2 ? CCT 2'7 18 n BY / BY J(;.nigY �I/.unDEPUTY WORKERS'COMPENSATIONDECLARATION CE 875 (2-801 MISCELLANEOUS APPLICATION CE 875 I hereby affirm that I have certificate of consent to'self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION insure, or a certificate of Workers'Compensation Insurance,,or a certified copy thereof(Sec. 3800, Lab.C.) Policy No. CompanyFOR APPLICANT TO FILL IN BUILDING O' AODREss Q ❑ Certified copy is hereby furnished. avuolNG 1� LOCALITY ADDRESS T Certified copy is filed with the county building inspectionNEAREST department. LOCALITY -FCi-,f\6 t r cROSS ST. Date Applicant 1. WREST DISTRICT NO. UP TYPE PROCESSED BY CROSS ST. Se.M CONST. l CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL v COMPENSATION INSURANCE' DESCRIPTION LOT No. BLOCK /meq n o.� �ppp (e..CLE) STATE MAJOR SECOND LOCAL a 'f�his section need not be completed if the work involved I NO. OF LOT USE ZONE SPECIAL CONDITIONS Q ( p TRACT NOW r LOT by the permit is for one hundred dollars ($100) or less.) U USE TI SIZE OF LOT EXISTING BLDG. � t'C e 'I certify that in the performance of the work for which this v 0 permit is issued, 1 shall not employ any person in any manner NER � I— so as to become subject to the Workers' Compensation Laws. AIL OCCUPANCY GROUP W ADDRESS S a Date Applicant Z TEL.CNID NOTICE TO APPLICANT: If, after making this Certificate of CITY` V t NO. - OCCUPANT LOAD Exemption, you should become subject to the Workers' APPLICATION FOR EXIT HARDWARE: Compensation provisions of the Labor Code, you must forth- with comply with such provisions Or this permit Shall be TRAILER USE❑ GEOLOGY INSPECTION❑ No Spec. Knowl. ❑ deemed revoked. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTIONPanic Devices ❑ I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT q (LIST ITEMS BELOW) Q (commencing with Section 7000)of Division 3 of the Busi- No. of Exlrs ness and Professions Code, and my license is in full force and PARKING effect. SPACES REO'O D I PROVIDED D License Number Lie.Class ' LIMITED TIME USE . Contractor Date DATE ..T. ❑ I am exempt from the licensing requirements as I am a. licensed architect or a registered professional engineer SIZE OF rvo. OF IN SPEC .K. acting In my professional capacity (Section 7051, Bus- EXISTING BLDG. STORIES SIGNATURE iness and Professions Code). FINAL APPROVAL v ESENT USE OF BUILDING a J- Lie.or Reg.No. Date HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS ON LOT AND USE / O I hereby affirm that- I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Busi- ness and Professions Code): NO. PARKING , SPACES PROVIDED ❑ I, as owner of theproperty, will do the work and the 1 , structure is not intended or offered for sale (SectionO'S 7044, Business and Professions Code). , ROPOSEO USE OF BUILDING CONSTRUCTION LENDING AGENCY L.ILY- I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec:3097,Civ.C.). - Lender's Name PROPOSED MAX. OCC. Lender's Address PERMIT FEE ' I certify that 1 have read this application and state that the above information is correct. 1 agree to comply with all County ISSUANCE FEE ordinances and State laws relating to building construction, TOTAL FEE and hereby authorize representatives of this County to enter upot he above-mentioned roperty for in cti purpose . SEE REVERSE FOR EXPLANATORY LANGUAGE - Signature of Permittee Da e1 WORKERS'COMPENSATION DECLARATION 8 CE 875MISCELLANEOUSMISCELLAEOUS APPLICATION CE 75 I hereby affirm that 1 have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN Bu1LDlN / ADORES ❑ Certified copy is hereby furnished. u1LDINe 1\ _ .� LOCALITY 111, ADDRESS J',,\-r � !� ❑ Certified copy is filed with the county building inspection NEAREST department. - o ALITY IS ;I ( ; 't CROSS ST. Uate Applicant EAREST / - OISTRICT_NO. GROVP TYPE PR sSED BY CICAR ST. IU 2 (I\ • T CONST. CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL COMPENSATION INSURANCE DEsc RlPn ory 1D1 NO. eLocKNA, .,..WA Np,,,0� (CIRCLE) STATE MAJOR SECOND LOCAL This section need not be com leted if the work involved NO. OF BLDGS. USE ZONE SPECIAL CONDITION$ (L ( p TRACT NOW ON LOT p by the permit is for one hundred dollars (SI00) or less.) 0 USE OF SIZE OF LOT EXISTING BLDG. I certify that in the performance of the work for which this 0 permit is issued. 1 shall not employ.any person in any manner i, eWNER I . _ I- so as IG become subject to the Workers' Compensation Laws. MAIL OCCUPANCY GROUP U ADDRESS `� I ` a Date Applicant U) TEL. NOTICE TO APPLICANT: If. after making this Certificate of eITY \-{ A NO. G O !�� OCCUPANT LOAD Z Exemption, you should become subject to the Workers' APPLICATION FOR EXIT HARDWARE: Compensation provisions of the Labor Code, you must forth- with comply with Such provisions or this permit Shall be TRAILER USEGEOLOGY INSPECTION ❑ Cl No Spec. Knowl. deemed revoked. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION Panic Devices ❑ I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT ❑ (LIST ITEMS BELOW) NO. OF EXITS 91(commencing with Section 7000) of Division 3 of the Busi- ness and Professions Code, and my license is in full force and PARKING effect. SPACES REO'O t� PROVIDED License Number Lie.Class LIMITED TIME USE Contractor Date DATE DATE To: ElI -in exempt from the licensing requirements as I am a � rOR'S icensed architect or a registered professional engineer SIZE OF NO. OF Q4..z`7 G[A, t IrvsPEC acting In my professional capacity (Section 7051, Bus- EXISTING BLDG. STORIES i ST iness and Professions Code). FINAL,APPROVAL /J _ SENT USE OF BUILDING Lie.or Reg.No. Date �( o HOME OWNER-BUILDER DECLARATION No.OF Extsnrvc eU.LDINGs ON LOT AND USE I hereby affirm that Vam exempt from the Contractor's License Law for the following reason (Section 7031.5, Busi- -90 1.9A ness and Professions Code): NO. PARKING SPACES PROVIDED ❑ 1, as owner of the property, will do the work and the eise 8 8 structure is not intended or offered for sale (Section ' 7044, Business and Professions Code)- in ZROPOSED USE OF BUILDING ` I 2e CONSTRUCTION LENDING AGENCY 0.2 1 6-84 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097,Civ.C.). Lenders Name PROPOSED MAX. OCC. Lender's Address PERMIT FEE I certify that I have read this application and state that the above information is correct. I agree to comply with all County ISSUANCE FEE ordinances and State laws relating to building construction, and hereby authorize representatives of this County to enter roraL Fee upon the above-mentioned property for inspectpur )ses. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Dae r I COMPENSATION DECLARATION CE 875 (280) MISCELLANEOUS APPLICATION A<= CE 875 Insure, y affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab.C.) Policy No. Company BUILOING //�� FOR APPLICANT TO FILL IN /J ADDRESS 3/ 1 J04 ❑ Certified copy is hereby furnished. ..R.55'UILDING p / i J-R574N'fIF LOCALITY ❑ - ADDRESS O Certified copy u tiled with the county building inspection NEAREST department. oCwury E� JLE `r CROSSST. Date Applicant ARrisr DISTRIc'''((r O. G OUP TYPE PROc D By CRO55 ST. O E L [�j) _] CONST. CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL .J((� {/ COMPENSATION INSURANCE BESCRIPT ION LOT NO. I-LOCK HIGHWAY y perm OF LOGS. Ne. IEIRCLEI STATE MAJOR SEGO LOCAL d NO. (This section need not be completed if the work involved TRACT NOW ONBLOT USE ZONE SPECIAL CONDITIONS U by the ppermit is for one hundred dollars ($I00) or less.) USE OF SIZE OF LOT EXISTING BLDG. Q I ceitify that in the performance of the work for which thisO permit is issued, I shall not employ any person in any manner � ^NER f u C ltE e U so as to become subject to the Workers' Compensation Laws. IL /, Q OCCUPANCY GROUP ��Z W DDRE55 8 /J R' �vl N'i a Date Applicant W NOTICE TO APPLICANT: If, after making this Certificate of d< E/Y� 1 rvo�a — 64jq,3 OCCUPANT LOAD Z Exemption, you should become subject to the Workers' APPLICATION FOR EXIT HARDWARE: Compensation provisions of the Labor Code, you must forth- with comply with Such provisions or this permit Shall be TRAILER USE❑ GEOLOGY INSPECTION ❑ deemed revoked. ❑ NOSpec. KnOWI. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION Do Panic Devices ❑ I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT q (LIST ITEMS BELOW) NO. OF EXITS 9 (commencing with Section 7000) of Division 3 of the Busi- ness and Professions Code, and my license is in full force and PARKING.RKING• effect. SPACES REO'B D PROVIOEO License Number Lie.Class LIMITED TIME USE Contractor Date DATE DATE ❑ 1 am exempt from the licensing requirements as I am a licensed architect or a registered professional engineer SIZE OF No. of NasP eTO R'S acting In mV professional Ca3J'acity (Section 7051, Bus- EXIS ING BLDD. STORIES S NATVRJV iness and Professions Code). FINAL APPROVAL PRESENT VSE OF BUILDING Lie.or Reg.No. Date - L HOME OWNER-BUILDER DECLARATION NO.OF EXISTING BUILDINGS ON LOT AND USE I hereby affirm that- I am exempt from the Contractor's License Law for the following reason (Section 7031.5. Busi- ness and Professions Code): NO. PARKING SPACES PROVIDED ❑ 1, as owner of the property, will re the walk and the �t\ I\� Z 2 7 �,Q A structure is not intended or offered for sale Section v \ `V 7044, Business and Professions Code). S # s e o 0 8 8 ' OPOSED USE OF BVILDING CONSTRUCTION LENDING AGENCY I ,` p �� • s e e e o e z 1 herebv affirm that there is a construction lending agency K) 0 RR LM -QADi for the performance of the work for which this permit is Q a22-85 issued (Sec. 3097,Civ.C.). Lender's Name PROPOSED MAX. OCC. Lender's Address PERMIT FEE - I certify that I have read this application and state that the above information is correct.I agree to Comply with all County ISSUANCE FEE Ordinances and State laws relating to building construction, TOTAL FEE - and hereby authorize representatives of this County to enter apo a 7n e-mentioned property for inspect; n purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE � Ze �8-a/-gs Signature of Permittee Date \40RKERS'COMYENSATION DECLARATION CE 875 (2-80) MISCELLANEOUS APPLICATION {J CE 875 L J I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab. C.) Policy No. - Company' FOR APPLICANT TO FILL IN BUILDING / ADDRESS ot/J/ ❑ Certified copy is hereby furnished. BUILDING LOCALITY ADDRESS ('—I�j �• LASWA Certified copy is filed with the county building inspection LOCALITY } NEAREST department. gfyk E Cil` CROSS ST. Date Applicant AREST DISTRICT NO. GROUP [TYPE - PROC SEO V CROSS sT. ll COrvST� CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL YJ COMPENSATION INSURANCE DESCRIPTION oP LOT NO. BLOCK STATE MAJOR SECOND LOCAL NO. OF SLOGS. rM+ Cvr.��o jc lv ael a (This section need not be completed if the work involved TRACT now ON Lor USE ZONE ff77DITIONS O by the permit is for one hundred dollars ($100) or less.) 3 U USE 512E OF LOT EXISTING BLDG. {/..' 0 I certify that in the performance of the work for which this o permit is issued, I shall not employ any person in any manner NER so as to become subject to the Workers' Compensation Laws. IL JETZ OCCUPANCY GROUP a V I' AADO REss `1 C—.I.AS 'LU�IAS yQ W Date Applicant C NOTICE TO APPLICANT: If, after making this Certificate of OiGGeiet [-k- TELNo. 26-1-9c100 OCCUPANT LOAD 2 Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- APPLICATION FOR EXIT HARDWARE: with comply with such provisions Or this permit shall be TRAILER USE GEOLOGY INSPECTION❑ No Spec. Knowl. ❑ deemed revoked. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION Panic Devices ❑ I hereby affirm that 1 am licensed under provisions of Chapter SAFETY PERMIT q (LIST ITEMS BELOW) 9 (commencing with Section 7000) of Division 3 of the Bus!- No. of Exlrs , ness and Professions Code, and my license is in full force and PARKING. effect SPACES REG'D E= PROVIDED License Number Lic.Class LIMITED TIME USE Contractor Date P.TE DATE I am exempt from the licensing requirements as I am a licensed architect or a registered professional engineer SIZE OF - INSPECTOR'S acting in my professional capacity (Section 7051, Bus- Exlsn Ne BLOB. ND. OFs SIGNATURE No. OF iness and Professions Code). FINAL APPROVAL �r ESENT USE OF BUILDING Lic.or Reg.No. Date pat V4-1t I OfF7LEr HOME OWNER-BUILDER DECLARATION No. OF Ex ISTING BUILDINGS ON LOT AND USE OK`C I hereby affirm that• I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Busi- ness;and Professions Code): NO. PARKING PACES PROVIDED ❑ L as owner of the property, will do the work and the # e e a.e 8 8 structure is not intended or offered for sale (Section '- 7044, Business and Professions Code). POSED USE OF BUILDING O O O ..a O O CONSTRUCTION LENDING AGENCY p�,Cfc'c s 01. 1 9—8 2 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec. 3097,Civ.C.). Lender's Name PROPOSED MAX. OCC. Lender's Address PERMIT FEE _ I certify that 1 have read this application and state that the ISSUANCE FEE above information is correct. I agree to comply with all County - ordinances and State laws relating to building construction, TOTAL FEE aC�� and her authorize represenjat!ves of this County to enter upon above-mentioned operty for _inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE r ✓ f��0 �t7 1- Si nature f Permitte Date ' ' WORKERS'COMPENSATION DECLARATION 7610444 CE 875(2-80) MISCELLANEOUS APPLICATION I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION insure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN BDDRESe � 7 7 ❑ Certified copy is hereby furnished. SUILDINe Locwurr FCORES S ❑ Certified copy is filed with the county building inspection NEAREST department. LOCALITY CROSS ST. Date Applicant , NEAREST DISTRICT NO. GROUP fi PROCESSED BY CROss ST. CO T. d CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL L. COMPENSATION INSURANCE DesCRIPT1Ory LOT No. eLocX MAP ICRwwv U (....L3i STA E MAJOR SECOND LOCAL This section need not be completed if the Work mVO1Ved NO. OF BLOG3. U9E ZONE SPECIAL CONDITIONS LU ( p TRACT Now Ory LOT by the permit is for one hundred dollars (SI00) or less.) J USE OF 1 certifythat in the SIZE OF LOT EXISTING BLDG. LL performance of the work for which this } permit is issued, I shall not employ any person in any manner dBNER > so as to become subject to the Workers' Compensation Laws. MAIL OCCUPANCY GROUP r� Q ADDRESS tr Date Applicant O NOTICE TO APPLICANT: If, after making this Certificate of ITY No. OCCUPANT LOAD 2 Exemption, you should become subject to the Workers' APPLICATION FOR EXIT HARDWARE: W Compensation provisions of the Labor Code, you must forth- i— �' With Comply with such provisions or this permit shall be TRAILER USE❑ GEOLOGY INSPECTION O No Spec. KnowL ❑ deemed revoked. LICENSED CONTRACTORS DECLARATION occurwncr INSPECTION Panic D¢VIC¢5 ❑ I hereby affirm that 1 am licensed under provisions of Chapter SAFETY PERMIT q (LIST ITEMS BELOW) 9 (commencing with Section 7000)of Division 3 of the Bust- No. of fixers ness and Professions Code, and my license is in full force and effect PARKING: SPACES Rfi0'D E= PROVIDED D License Number Lie.Class LIMITED TIME USE Contractor Date PATE PATS ❑ GROM: I am exempt from the licensing requirements as I am a licensed architect or a registered professional engineer SIZE oPNo. of INSPECTOR'S acting in my professional capacity (Section 7051, Bus- EXISTING BLDG. STORIES SIGNATURE iness and Professions Code). � FINAL APPROVAL PRESENT USE OF BUILDING Lic,or Reg.No. Date HOME OWNER-BUILDER DECLARATION NO.OF EXISTING BUILDINGS ON LOT AND USE 1 I hereby affirm that I am exempt from the Contractor's I License Law for the following reason (Section 7031.5, Busi. ness and Professions Code): NO.PARKING ❑ SPACES PROVIDED I, as owner of the property, will do the work and the -: structure is not intended or offered for sale (Section 7044, Business and Professions Code). • • • • OPOSED USE OF BUILDING CONSTRUCTION LENDING AGENCY • • e , e • I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec. 3097,Civ.C.). Lender's Name PROPOSED MAX. OCC. Lender's Address PERMIT FEE I certify that I have read this application and state that the above information is correct.I agree to comply with all County ISSUANCE FEE ordinances and State laws relating to building construction, TOTAL FEE and hereby authorize representatives of this County to enter ! upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WORKERS'COAIPENSATION DECLARATION CE 875(2-801 MISCELLANEOUS APPLICATION • CE 875 I hereby affirm that 1 have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION Iinsure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN BwUDRE`SS 3 DREV r� ❑ Certified copy is hereby furnished. BUILDING LOCALITY F] u wooREss 8811-13 E . Las Tunas Dr ' Certified copy filed with the county building inspection N11 T department. LOCALITY Temple City CEARES ROSS S liT. DdIC Applicant EwREST DISTRICT`NO. G OUP TYPE / PR SEO BY CROSS ST. Muscatel I/IV i - CONST.V CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL Vo II COMPENSATION INSURANCE DESCRIPTION I LOT rvo. BLOCK M,)50 q/ Ie.,w. ry 'GD (CIRCLE) STATE MAJOR S ONO LOCAL (L NO. OF OLDGS. (This section need not be completed if the work involved TRACT NOW ON LOT USE ZONE SPECIAL CONDITIONS O by the permit is for one hundred dollars ($100) or less.) USE OF SIZE OF LOT EXISTING BLDG. - tr 1 certify that in the performance of the work for which thisO permit is issued, I shall not employ any person in any manner W'NER Ralph Almeida et al F_ so as to become subject to the Workers' Compensation Laws. AIL OCCUPANCY GROUPL. . W Dale Applicant AD RESS 811 Revere Avenue a N NOTICE 7'O APPLICANT: If, after making this Certificate of ii<rrY Montebello Y-" (213)7222464 OCCUPANT LOAD z Exemption, you should become subject to the Workers' APPLICATION FOR EXIT HARDWARE: Compensationprovisions of the Labor Code, you must forth- with complywith such provisions or this permit shall be TRAILER USE❑ GEOLOGY INSPECTION❑ No Spec. Knowl. ❑ deemed revoked. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION Panic Devices ❑ 1 hereby affirm that 1 am licensed under provisions of Chapter SAFETY PERMIT q (LIST ITEMS BELOW) NO. OF EXITS 9 (commencing with Section 7000) of Division 3 of the Busi- ness and Professions Code, and my license is in full force and PARKING. effect. SPACES REO'D E�= PROVIDE. License Number Lic.Class LIMITED TIME USE Contractor Date DATE ..TE ❑ I am exempt from the licensing requirements as I am a licensed architect or a registered professional engineer SIZE OF NO. OF INSPECTOR'S acting in my professional capacity (Section 7051, Bus- EXISTING BLDG. STORIES SIG ATURE iness and Professions Code). FINAL APPROVAL _ SENT USE OF BUILDING Lic.or Reg.No. Date Law Offices Facial NO. OF EXISTING Bu1L.IrvGs HOME OWNER-BUILDER DECLARATION ON LOT AND USE I hereby affirm that- I am exempt from the 031.5, Busi- ness - License Law for the following reason (Section 7031.5. Busi- ness and Professions Code): NO. PARKING SPACES PROVIDED ❑ 1, as owner of the property, will do the work and the `yr' structure is not intended or offered for sale (Section4 6 6 9 A 7044, Business and Professions Code). OP `.� OSEO USE OF BUILDING CONSTRUCTION LENDING AGENCY # a 0 a 88 I hereby affirm that there is a construction lending agency Law Offices e e o o e e 012 for the performance of the work for which this permit is issued(Sec. 3097,Civ.C:). - O S 2.O'8 b Lender's Name PROPOSE. MAX. Oce Lender's Address PERMIT FEE I certify that 1 have read this application and state that the above information is correct. 1 agree to comply with all County ISSUANCE FEE ordinances and State laws relating to building construction, TOTAL FEE and 1 reby authorire representatives of this County to enter u o above-men ' ed property for insp on purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WORKERS'COMPENSATION DECLARATION 7610444 /7 CE 875(2-80) MISCELLANEOUS APPLICATION Shill I hereb}'affirm that 1 have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION iT: rte, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN BUILDING p g OGRESS F-1Certifiedcopy is hereby' furnished. uuDING 8R �/ f 4d 5 i9/IAf San (n,2/ LOCALITY ❑ ADDRESS Certified copy is filed with the county building inspection r NEAREST department Loe LITY /CF1n� C''J CROSS ST. Date Applicant EAREST B3 Y II V DISTRICT�N/p1'y/ GR UP TYPE PROC SEC BY CROSS ST. I/ ` V V CONST- CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL Q t/ COMPENSATION INSURANCE DEsc RIPTrON LOT No. BLOCK ^ �e „IGN-A. NO. W ICIRCIEI STATE MAJOR SE NO LOCAL a NO. OF BLDG$. f ('1'111$ 5¢CflOn need not be completed if the work involved TRACT NOW ON LOT / USE ZONE SPECIAL CONDITIONS O by the permit is for one hundred dollars (SI00) or less.) USE OF n /} SIZE OF LOT EXISTING BLDG. /)QCY� 1 certify that in the performance of the work for which this NER permit is issued, 1 shall not employ any person in any manner U so as to become subject to the Workers' Compensation Laws. ,^ ( OCCUPANCY GROUP UJ AA R $$2 a 1At ll% / - M Date Applicant I TEL. 20 Z NOTICE TO APPLICANT: If, after making this Certificate of ITY vy�b Tri �� no. 3�$ OCCUPANT LOAD Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- APPLICATION FOR EXIT HARDWARE: With Comply with Such provisions or this permit shall be TRAILER USE GEOLOGY INSPECTION No Spec. Know[. ❑ deemed revoked. LICENSED CONTRACTORS DECLARATION occurwxcY INSPECTIONPanic Devices ❑ 1 hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT q (LIST ITEMS BELOW) NO. OF EXITS _ 9 (commencing with Section 7000) of Division 3 of the Busi- ness and Professions Code, and my license is in full force and . PARKING. effect SPACES ' REDID E= PROVIDED License Number Lic. Class JT ` LIMITED TIME USE Contractor Date DATE DATE ❑ I am exempt from the licensing requirements as I am a licensed, architect or a registered professional engineer SIZE OF. No. OF INSPECTOR . acting in my professional capacity (Section 7051, Bus EXISTING BLDG. STORIES SRaNATURE iness and Professions Code). _/ • FINAL APPROVAL SENT USE OF BUILDING er<� r Avt wQ) Q ` Lic.or Keg.No. Date S, HOME OWNER-BUILDER DECLARATION NO. OF EXISTING Bm LDINcs ON LOT AND USE I hereby affirm that. I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Busi- ness and Professions Code): No. PARKING SPACES PROVIDED ❑ 1, as owner of the property, will do the work and the structure is not intended or offered for sale (Section 7044, Business and Professions Code). /I oPOSED usE OF BUILDING KCf�✓� {L{� / CONSTRUCTION LENDING AGENCY 4 X 2 9 9' I p 1 hereby, affirm that there is a construction lending agency 9 # e e e e $8 for the performance of the work for which this permit is e e e e e o e issued (Sec. 3097,Civ.C.). ' Lender's Name PROPOSED MAX. DDG. o9.24- • /IVORKERS'COMPENSATION DECLARATION 76M444 -MISCELLANEOUS APPLICATION CE 875 (2 80) 1 hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN BUILDIrvG q ADDRESSIt ❑ Certified copy is hereby furnished. ADDESS .O- /3 I—A S T�f I�`S 0 t LOCALITY Certified copy is filed with the county building inspection �/ department. LOCALITY j/SIA Z6 eRoss sT. �..�� Date Applicant tEAREST l G� /hT .J� DISTRICT N GRR .V TYPE PROLE O BY CROSS ST. Marc/'/ ( 0L &V f 'j— CONST. CERTIFICATE OF 17XEMPTION FROM WORKERS' LEGAL JqQ v COMPENSATION INSURANCE - DESCRIPTION LOT no. BLocK MO P/L ,o,.wA. CL (C IRCLEI STATE MAJOR $ECON OC AL a NO. OF BLOCS. O (This section need not be completed if the work involved TRACT NOW ON LOT USE ZONE sPEC1AL CONDITION$ U by the permit is for one hundred dollars (S100) or less.) USE OF a. SIZE OF LOT EXISTING BLDG. I certify that in the performance Of the work for which this T� 17 permit is issued, I shall not employ any person in any manner WNER uG�C G� U so as to become subject to the Workers' Compensation Laws. AIL D OCCUPANCY GROUP �- Y W ADDRESS g�N (�� M VVV a Date Applicant l/ TT 111^^^ fn NOTICE; TO APPLICANT: If, after making this Certificate of 17 CITY Gs�[� civ rvoL OCCUPANT LOAD Exemption, you should become subject to the Workers' I APPLICATION FOR EXIT HARDWARE: Compensation provisions of the Labor Code, you must forth- with comply with such provisions or this permit shall be TRAILER USE GEOLOGY INSPECTION Cl No Spec. Knowl. IJdeemed revoked. / OCCUPANCY INSPECTION Panic DQVICe$ ❑ LICENSED CONTRACTORS DECLARATION 1 hereby affirm that I am licensed under provisions Of Chapter SAFETY PERMIT (LIST ITEMS BELOW) NO. OF EXITS 9 (commencing with Section:7000) of Division 3 of the Busi- ness and Professions Code, rand my license is in full force and PARKIrvG effect. 1 SPACES REO'O PROVIDED License Number 1 Lic. Class LIMITED TIME USE Contractor Date DATE DATE ❑ 1 am exempt from the licensing requirements as I am a licensed architect or a registered professional engineer SIZE OF ST OF Iry CTOR'S acting in my professional capacity (Section 7051, Bus- Exlsn a BLDG. sro RlEs IGNATURR mess and Professions Code). ESENT VSE OF BUILDING FINAL APPROVAL _ Lic.or Reg.No. Date ^'"q-ft c,^ ec 1�/^'r ' O HOME OWNER-BUILDER DON LOT ANOD USE NO. OF EXBu uDlNos SE I hereby affirm that• 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5, Busi- ness and Professions Code): NO. PARKING � 2 Q B r1 I� SPACES PROVIDED L ❑ 1, as owner of the property, will do the work and the # e e e - 88 structure is not intended or offered for sale (Section 7044, Business and Professions Code). yl OPOSED USE OF BUILDING O O O O O O O Z CONSTRUCTION LENDING AGENCY Q 606—8 5 I hereby affirm that there is a construction lending agency Yr >/v L- for the performance of the work for which this permit is issued (Sec. 3097,Civ.C.). Lender's Name PROPOSED MAX. Dec. Lender's Address PERMIT FEE I certify that 1 have read this application and stare that the above information is correct. I agree to comply with all County ISSUANCE FEE ordinances and State laws relating to building construction, TOTAL FEE and hereby authorize representatives of this County to enter app he +bo• -mention d pro erty for inspecT SEF. REVERSE FOR EXPLANATORY LANGUAGE V/ ignatu of P rmittee Date '