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Home My Public Portal About8827-29-31 LAS TUNAS DR_Miscellaneous__ NOR7riERS'COMPENSATION DECLARATION CE 875 111-84) MISCELLANEOUS APPLICATION CE 875 1 hereby affirm that 1 have a certificate of consent self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION insUrurC,,cr a certificate of Workers'Compensation Insurance, e,or a certiPfed copy thereof(Sec. 3800,Lab. C.). Policy No. Company FOR APPLICANT TO FILL IN BUILDING 2 ADDRESS Certified copy is hereby furnished. BUILDING LAS —ruouts DOREss J LOCALITY Certified copy is filed with the county building inspection LOCALITY NEAREST department. CROSS ST. Date Applicant NEAREST /� DISTRI NO. GR UP TYPE PROCP$SE BY pp CRoss sr. I lti� rI coNsr.� CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL V UU COMPENSATION INSURANCE DESCRIPTION LOT No. eLocK . iDrvwA rvOv IclwC l¢I STATE MAJOR $EC D LOCAL NO. OP 0 LDG9. (This section perm need not be completed If the Work involved TRACT NOW ON LOT USE ZONE SPECIAL CONDITIONS by the permit is for one hundred dollars (S100) or less.) - Use of SIZE OF LOT EXISTING BLDG. I 2 1 certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner LAME RThIlmas fikoi \ v so as to become subject to the Workers' Compensation Laws. Jv ,`,OCC�UP�AN�CY�'GxR�\OUlP MAIL AORE53 II) W 0a wcA iv1� All' Date Applicant - mO LU NOTICE TO APPLICANT: If, after making this Certificate of clrY U. no O. 4 1 OCCUPANT LOAD o– N 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 ❑ GEO OGY INSPECTION ❑ No Spec. Knowl. El deemed revoked. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTIOIT Panic Devices 1 hereby affirm that I am licensed under provisions of Chapter El SAFETY PERMrt 9 (commencing with Section 7000) of Division 3 of the Busi- 1 (LIST Ire Ms BELOW) NO. OF EXITS ness and Professions Code,and my license is in full force and effect. PARKING REO'O PROVID6p eAA CES RKIN License Number Lie. Class LIMITED TIME USE Contractor Date DATE DATE I am exempt from the licensing requirements as 1 am a P¢DM: licensed architect or a registered professional engineer SIZE of No. DF INSPECTOR'S acting in my professional capacity (Section 7051, Bus- (STING BLDG. sroRlEs SIG ATURE iness and Professions Code). FINAL APPROVAL PRESENT USE OF BUILDING J �. Lie.or Reg.No. Date C/ HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS ON LOT AND US 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 I, as owner of the property, will do the work and the SP CES PROVIDED 130,8A structure is not intended or offered for sale (Section 7044,Business and Professions Code). ^ H s'e e • k R In �d o e se Y Y N CONSTRUCTION LENDING AGENCY PROPOSED USE OF BUILDING I hereby affirm that there is a construction lending agency ( 213788 for the performance of the work for which this permit is issuedSec. 3097,Civ.Q. c� Lender's Name PROPOSED MAX. OCC 1/ Lender's Address , d U I certify that I have read this application and state that the PERMIT FEE above information is correct. 1 agree to comply with all County ISSUANCE FEE ordinances and State laws relating to building construction, TO - and,hereby authorize representatives of this County to enter TAL FEE , n the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE , Signature of Permittee Date WORKERS'COMPENSATION DECLARATION MISCELLANEOUS CE 875 U S APPLICATION �I CE 875(11-84) L ' I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION IILII' 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 Certified copy is hereby furnished. wv UILIG Mq Lao []Y aJ -Tuvw/3 N. "T. C({ LO CA UTY DRDENss O ElCertified copy is filed with the county budding inspection LOCALITY NEAREST department. cRoss sr. Date Applicant AREST -T ��1/, -L CJ O�t,/1„e!,f� DISTRICT Mpg G@pUP TYPE P SSEO BY CRO55 ST. I.0(S I(,(r'{A,� 1 '\ °�[M/� „Z',-`//y rL CONST. CERTIFICATE OF EXEMPTION FROM WORKERS' LEGwL V v(J U— I/ COMPENSATION INSURANCE DESCRIPTION Lor No. BLocK ho.�.�� jl HIGHWAY =Lt7 STATE MAJOR sECON LOCAL NO. OF BLDGS. (This section need not be completed if the work involved TRACT NOW ON LOT USE ZONE SPECIAL CONDITIONS by the permit is for one hundred dollars (5100) or less.) USE OF SIZE OF LOT EXISTING BLDG. C 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 OWNER fns--1 SA—MSA-M s-D so as to become subject to the Workers' Compensation Laws. AIL ESS OCCUPANCY GROUP �o �j/ ` raj'j-.� V Date ADDR Applicant LLI NOTICE TO APPLICANT: If, after making this Certificate of Y CITY — NO.TELJg 11,1q- .'L q'AlOCCUPANT LOAD Exemption, you should become subject to the Workers APPLICA ION 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 INSPECTION Panic Devices I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT ❑ (LIST ITEMS BELOW) 9 (commencing with Section 7000) of Division 3 of the Busi- NO. OF EXITS ness and Professions Code,and my license is in full force and effect. PARKING REO'D I� PROVIDED SPACES License Number Lic. Class LIMITED TIME USE Contractor Date ..T. DATE ElI am exempt from the licensing requirements as I am a FROM: TO. licensed architect or a registered professional engineer SIZE OFrvo. oP INSPECTOR'S acting in my professional capacity (Section 7051, Bus- EXIsn NG BLDG. STORIES SIGNATURE iness and Professions Code). WPRESENT USE OF BUILDING 1 FINAL APPROVAL Lic.or Reg.No. Date HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS ON LOT AND USE I hereby affirm that 1 am exempt from the Contractors t License Law for the following reason (Section 7031.5, Busi- ness and Professions Code): + NO. PARKING El1, as owner of the property, willydo the work and the ''Aces PROVIDEDf/ y' .96 3 7.6 A structure is not intended or offered for sale (Section - # o e e • 3 U 7044,Business and Professions Code). - ROPOSEO USE OF BUILDING f, / ��, O O O O O`O O Z CONSTRUCTION LENDING AGENCY p 1 I hereby affirm that there is a cbnstmction lending agency Sk\N 4jO:l,l l' Jll,`b 01.21 =87 for the performance of the work for which this permit is 1 - issued(Sec. 3097,Civ.C.). Lender's Name PROPOSED MAX. OCC. Lender's Address PERMIT FEE —I-certify-that-l-have-read-this-application and state that the above information is correct.I agreFto comply with all County ISSUANCE FEE ordinances and State laws relating to building construction, and hereby authorize representatives of this County to enter TOTAL FEE upon 1e above-mentioned property for inspecti purposes. e SEE REVERSE FOR EXPLANATORY LANGUAGE �\ Sig iture ofEerrITITt Date �" t WGIfirm atIhavSATIONDECLARATION 761V875 MISCELLANEOUSAPPLICATION {� 76 44 (11-84) LJ I hereby (firm that I Workers' 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 BU ILDING ANDRE ED Certified copy is hereby furnished. BUILDING CSO-&q Lao i Iwao .-Tem � � ADDRESS VV OO LOCALITY E] Certified copy is filed with the county building inspection LOCALITY NEAREST department, cN oss sT.- Date Applicant NEARESTDISTRICT NO. GROUP TYPE O s5E0 BY CROSS ST. RO�CL�'t CONST CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL y COMPENSATION INSURANCE oESCRIPnoN LOT rvo. BLocK ODWw NOP 3I(CIRCLE) STATE MAJOR SECOND LOCAL NO. OF BLOGS. (This section need not be completed If the work involved TRACT NOW ON LOT USE ZONESPECIAL CO NOIT IO NS by the permit is for one hundred dollars ($100) or less.) - USE OF I certify that in the performance of the work for which this SIZE of LOT EXISTING BLDG. C 3 0 permit is issued, I shall not employ any person in any mannerOWNER TOlt7✓r^.� FG3.N``I C so as to become subject to the Workers' Compensation Laws. MAIL r. ' OCCUPANY GROUP_; o AOOR Ess C10.VUC sldire_ loo Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of clrY Yu.OGJ pUArE\ NE. v_u�,S 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 oI this permit shall be TRAILER USE ❑ GEOLOGY INSPECTION ❑ No Spec. Knowl. deemed revoked. ' LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION - Panic Devices - I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7006) of Division 3 of the Busi- SAFETY PERMI ❑ (LIST ITEMS BELOW) NO. OF EXITS ness and Professions Code,and my license is in full force and effect. PARKING SPACES REO'D PROVIDED License Number Lic. Class LIMITED TIME USE Contractor Date DATE DATE EJI am exempt from the licensing requirements as I am a licensed architect or a registered professional engineer SIZE OFno. OF INSPECTON'S acting in my professional capacity (Section 7051, Bus- ExIsrING SLOG. STORIES sic TURE iness and Professions Code). PRESENT USE OF BUILDING CCiU SrAID✓\ FINAL APPROVAL Lic.or Reg.No. Date i HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS ON LOT AND USE Ali_�.,'aT I hereby affirm that I am exempt from the Contractor's - _ License Law for the following reason (Section 7031.5, Busi- NICI FEE ness and Professions Code): NO. PARKING I, as owner of the property, will do the work and the SPACES PROVIDED - structure is not intended or offered for sale (Section 1/213,'K 7044,Business and Professions CodeL - CONSTRUCTION LENDING AGENCY PROPOSED USE of BUILDING BuL�T Sath '��1,64 1 Art 8:74 I hereby affirm that there is a construction,lending agency u x ext.U.b4Cly y) for the performance of the work for which this permit is {/y issued(Sec. 3097,Civ.C.). r �Q Lender's Name PROPOSED MAX. OCC. V Lender's Address PERMIT FEE I certify that I have read this application and state that the above information is correct. I agrecro comply with all County ISSUANCE FEE ordinances and State laws relating to building construction, and hereby authorize representatives of this County to enter TOTAL FEE on the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date f WORKERS CO:NIPENS.ATION DECLARATION 200063DPW.: MISCELLANEOUS APPLK.;AIIUIV G-n06U3u [� 'i I pc:eb} affirm that 1 have a certificate of consent m self COUNPY OF LOS ANGELES BUILDING AND SAFETY DIVISION IIIL'lll insure.or a certificate of Workers' Compensation Insurance or a certified copy thereof (Sec. 3500. Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN eur_DINc -7 ;-7 BUILDING ADDRESS ADDRESS LJ Certified cop) is hereby furnished. p y� p �I p. � � "'� W{- � LOCALITY l IJ Certified copy is filed with the county huildine inspection CAT ! , ZIP/'' /� /�) NEAREST department. (,(j V 9 Q '� ceoss ST. Dale Applicant SIZE OF L I NO.OF SLOGS.NOW ON LOT c�;.LJT�ICT r GR P TYPE P EssED By O Dir /� CONST. !I - CERTIFICATE OF EXEMPTION FROM WORKERS' TRACT (BLOCK )LOT NO. (/ "CC ! COMPENSATION INSURANCE TIG"WAY 1 r:^w uwCLp STATE MAJOR SECOND LOCAL i (This tiCC11Un need not be completed if II1C n'Ork iIR'D11'Cd ASSESSOR MAP 900K (PAGE PARCEL USE ZONE SPECIAL coNOrtloNs b, the permit is for one hundred dollars (5100) or Icss.) '! "' ---t-'4604 � f ! I rniii ifthat in the performance of rite work for s. OWNER TEL NO�hick this DTOpercN p,� i � b rermil s issued. 1 shall net emplgv any person in am tn ;n:uer so as to become subieci to the \\'orkerc" Cmrpensanen Latvs. 'ADDRESS p p OCCUPANCY GROUP I Date .Applicant CITY r�fX t ZIP NOTICE TO APPLICANT: II after making this Cer:rI t!e I Or a, C 0s, OCCUPANT LOAD of Exemption. you should become sabieci to :hz \fp;kers spDIICATIJK FOR Com;ersa[ior Provisions of the Labor Code.ooli:nus: EiiIT HARDWARE oomph P'liii such pro'i Torii Or IIt15 p:rmli mall Oe oe ricd TRAILER DSE uEJLOGY WSPECTrON_I res.ked. No Spec.Know.]. LIC'LASED CONTK.ACTORS DECLAI:ATIO`; Py.ni^ Device=_ ❑ 1 herb:: afl Irni that I am it _ns.' tine'r pAT:jlonj Oi Cnallte: 5<:_TY�ERA{IT� :LIST"EMS 9ELJ'.V. i p Icom:nen_in,with Section ,000i of Division ?of It Buslress No.OF_XICS and Proie=cions Code.and ni license is in Iilll force and _ Si R.1_ RECO PROVIDED I . LIC2nse \iiia Per LIC CLss r ,..,1,cLIMITED TI ❑tME LISE - o t ._,. Dat: �_ - DOTE DATE I ani exempt from Or licensinc -. eCui^menls :s a t it F'Dlt TO: a licensed architrcl o- :I r:,'int.r-d '+rois:iona! ^n Ei;tezr __ INs=EETOP's actin, In. nt, irO 2SlOn:11 capacn, iSCciion iJ.`I. Btlsio CS> slc=o' GOOF sIGN ATURE _x Is T INC 6LJ.. STORIES v and aHessians Code;. _Z1.1, Lic. n; R2^_,. Ne. _ Dal: wR Esc NT USE r-aul_DIVGFINAL APPROVAL HOME ON',\"ER-RG!LDEF: DECLARATION NS. IUcaululNcs d^, on LOO AD T nUSE A I hercbr affirm that 1 ant esernpi from the Contractor's Lic^nsc V 1. LtA for the following reason (Section 70315. Business and ! Trnn'J :ssions Code): .PARKING �' f 1. as owner of the properro. still SPACES PROVIDED do the stork and the�+ v structure is not imenaed m offered for sale(Section d)T4X PROPOSED USE OF BUILDING Business and Professions Code), f CONSTRUCTION LENDING AGENCY _ I hereby affirm that there is a construction lendin^_ a,ena' for the performance of the work for which this permit is issued (Sec. 3097. CI%'. C.). PROPOSED MAX.OCC. Lender's Name _ APPLICANT iM:NTt I TEL NO. Lender', ,Adorers __ ADDRESS ! 1 cerci(, that I have read this application and state that the above information is correct. I agree to comply with all County PERMIT FEE ordinances and State laws relating to buildin_construction...ind I i hereby authorize representatives of this Coumc to enter upon ISsuANCE FEE the above-mentioned property for inspection purposes. TOTAL FEE x ?j0 OJ SEE REVERSE FOR EXPLANATORY LANGUAGE 6 _— w iene rurr of Permiuee Due c ! WORKERS that I have a certificate DECLARATION CE 875 MISCELLANEOUS APPLICATION CE 675(2-80) LJ 1 nurebo s(cert that I have a certificate of consem 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.) e �/ 1 ✓ Policy Nn. Company FOR APPLICANT TO FILL IN -u,,-:-- Certified oo rsess ❑ Certified copy is hereby furnished. U BUILDING YN� p DDRESS aADDRESS Y J Certified copy is filed with the county building inspection L /r department. LOCALITY j3O CROSS ST. Date Applicant I NEAREST DISTRICT(N� R P TYPE PROCESSED BY CROSS sT. QS Ph1 P<g� . .ly COrvST. CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL —��I COMPENSATION INSURANCE • BESCRIPTION LOT No. BLOCK P a ,GHW (This section need not be completed If the Wolk involved Icon CLe) STATE MAJOR SECOND LOCAL NO. OF OLDGS. �. rvn p' a TRACT NOW ON LOT USE ZONE SPECIAL CONDITIONS O by the permit is for one hundred dollars (5100) or less.) U USE OF I certifythat in the slzE OF LOT ExlsTlrvo DLDG. cc performance of the work for which this permit is issued, 1 shall not employ any person in any manner OWNER Comer t.'�N9 FO V so as to become subject to the Workers' Compensation Laws. OCCUPANCY GROUP �' U L ADMA DRESS/ F/ � � �,�..9i�b 11 LU Date Applicant n to TEL. z NOTICE TO APPLICANT: If, after making this Certificate of ��Q� OCCUPANT LOAD Exemption, you should become subject to the --- Compensation provisions of the Labor Code, you must forth- APPLI ATION FOR EXIT HARDWARE: with comply with such provisions or this permit shall be TRAILER USE E) GEOLOGY INSPECTION No Spec. Knowl. ❑ deemed revoked. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION 0 Panic Devices ❑ I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT q (LIST ITEMS BKLOWI NO. OF EXITS 9 (commencing with.Section 7000)pf Division 3 of the Busi- ness and Professions Code, and my license is in full force and PARKING. effect. . SPACES REG'D E= PROVIDED License Number Lie.Class ' LIMITED TIME USE Contractor - Date D.re G.re ❑ PAG.: I am exempt from licensing requirements as I am a licensed architect or a registered professional engineer slzE OF rvo. of INSPECTOR'. acting in my professional capacity (Section 7051, Bus- EXISTING BLDG. STORIES sIGNAru RE Ines$and Professions Code). L. PRESENT USE OF BUILDING FINAL APPROVAL rs Lie,or Reg.No. Date A / /J 1 /� HOME OWNER-BUILDER DECLARATION r+o. of Exlsn NG 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 0 0 2 2 9.6 A 1 G El 1, as owner of the property, will do the work and the SPACES PROVIDED structure is not 'intended or offered for sale (Section # e o 1.:-'8 8 '7044, Business and Professions Code). V rRoaos ED USE OF BUILDING I y z e e s e e e a CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency izloAl elly I for the performance of the work for which this permit is .1-21 ,4 -8 issued (Sec. 3097,Civ.C.). Lender's Name PROPOSED MAX. Oce. Lender's Address PERMIT FEE 1 certify that 1 have read this application and state that the. above information is correct. I agree to comply with all Countv ISSUANCE FEE ordinances and State laws relating to building construction, TOTAL FEE and hereby authorize representatives of this County to enter , up the above-mentioned p operty for inspection p rpo SEE REVERSE FOR EXPLANATORY LANGUAGE - i Sig6ture of Permittee Dvrdt 1VORKERS'COSIPENSATION DECLARATION CE 875(11-84) ' MISCELLANEOUS APPLICATION I hereby CE e]5 affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION insure, or a certificate of work-,rs'Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab'C.). Policy No. Company FOR APPLICANT TO FI LL IN BUILDING / ADDRESS Certified copy is hereby furnished. -A'DUILDDRE5ING /-. 8 � ) L' rJO �JO A/ TU It/ '3R . LOCALITY 5 / L� I Certified copy is filed with the county building inspection LOCALITYT �� CJ TY NEAREST department. / CROSS ST. I7lte Applicant EARE9T Mi4 a C j DIST$��'T GRQQQIU TYPE / PR C}SSEO BY DRDs33T. eI1�sC/I�L/-• \ /{— CONST.V / / CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL V I v t/� COMPENSATION INSURANCE DESCRIPTION Lor NO. BLOC A HIGHWAY N. I"CIRCL6) STATE MAIOR SE ND LOCAL NO. OF BLDG.. (This section need not be completed if the work involved TRACT NOW ON LOT USE ZONE SPECIAL CONDITIONS by the permit is for one hundred dollars (S100) or less.) 7 U.E OF I'certify that in the performance.of the work for which this 2- SIZE OF Lor 7 EEIST'I"N,ettB '� CM permit is issued, I shall not employ any person in Say mariner OWNER 6EP9 E e/. WIN 6 Sr so as to become subject to the Workers' Compensation Laws. MAIL ` OCCUPANCY GROUP '� o Date Applicant ADORE E. QTY j.AJ ZuIJA6 DR. /L///PLE Q f Y TEL.�/ �f-0��J3 W NOTICE TO APPLICANT: If, after makingthis Certcate of clTv 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 , deemed revoked. ❑ ❑ No Spec. Knowl. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION Panic Devices ❑ I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT ❑ (LIST ITEMS BELOW) 9 (commencing with Section 7000) of Division 3 of the Busi- No. of EXITS ness and Professions Code, and my license is in full force and effect. PARKING SPACES REO.O PROVIDED License Number Lie. Class `� LIMITED TIME USE Contractor Date L FROMt DATA ..T. DI am exempt from the licensing requirements as I am a - licensed architect or a registered professional engineer SIZE OF ND. OF INSPECTOR'S acting in my,professional capacity (Section 7051, Bus- E (STING BLOO. STORIES SIGNATURE iness and Professions Code). PRESENT U.E OF BUILDING FINAL APPROVAL Lie.or Reg.No. Date HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS ON LOT AND USE 1 hereby affirm that I am exempt from the Contractor's . :2664,3A License Law for the following reason (Section 7031.5, Busi- ness and Professions Code): NO. PARKING # e • • • 88 F1I, as owner of the property, will do the work and the SPACES PROVIDED h. structure is not intended or offered for sale (Section r •,• • e • e • z 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY t / PROPOSEO USE OF BUILDING O O - 0'309-870 3 0 9_8 I hereby affirm that there is a construction lending agency CNPEL ALjG ! for the performance of the work for which this permit c, !' `V issued(Sec.3097,Civ.Q. '✓ / T Lender's Name I / ` PROPOSED MAX. Dec. / Lender's Address PERMIT FEE 1/ 1 certify that I have read this application and state that the I� above information is correct. 1 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 TOTAL FEE \\ up7n tl above-mentioned propMy for ins'p�e.tion purposes. C�� /?—&_ Q SEE REVERSE FOR EXPLANATORY LANGUAGE Signa[ re ermittee J Date J 1 "oa Llcs c °y1PhNSAT1°" DLtL,I:""" E87As t� sal CMISCELLANEOUS APPLICATION e ar y 1 hereby affirm that I have a certificate of consent :o self I �— insure. or a certificate )i Rmc urkers Compensation Insur < or COUNTY OF LAS .-ANGELES BUILDING .AND SAFETY DIVISION a Certified copy thereof Sec. 3800. Lab, C.t.-- — 'rniiC)' No.__ _—t,nn pan)' _— FOR APPLICANT TO FILL IN SCORE c DDRESS8827A E. Las Tunas Dr Certified copy is hereby turnished. BUILDING Tunas Dr LOCALITY Temple City X ADDRESS 8827A E. Lam y I 1 I Certified copy is tiled ,with the coming 'ouiidino inspection LOCALITY '+IE AR EST department. Temple City CROSS ST. Rosemead Blvd., Date —.\nnllc311t �� NEAREST Rosemead Blvd DISTRICT N GR P TYPE OCES]ED BY CR05S ST. CONST. CER Fit ICA fE OF ENE>IPTION FROM 'W R6ERSS LEGAL L I l-MIPFNS:\TION !NSC R.ISC!i DEscwlPr:ov LOT No, BLCCX """"" Sr Ar MA�oR sEcorvo LOCAL YO. OF 3LOGc, aV ICI CL=I (This section need not he completed if the :cork involved I-RAe- rm's oN LOT rl SE -ONE SPECIAL_ CONDITIONS by the permit is lir otic hundred dollar, 51001 or less.) r SOSE D 1 151,. •]F LOT EISTIF YG PLC-, �3 I -entity that in rhe performance of !le :yo:S: io: chich '.his Fr _ permit is Isevai. I ;hall tot ample} Jr., oaaua is anT manner OWNER T ,. I _ SO as to hecnnte iu biec: :o ;Ice '.\'Orke:s l ,:n-ensation !.a"s. � ,,1z11 OCCJP APIC" CROUP AD DR E55 8835 E. Las Tunas Dr Date_ .\pnlican: NOTICE I.O .\PPLICAN'T: IL zi'e: mak!n_ ::.. `:- ii icam ,1 $�cI: oL. Temale City 626 ?ft5 9�6� occuP,Iv- LOA E\en- , m :iu,di become u_ieC s 11 \\ krtii lompensrl- . >n rni m:is1 liI_:tbr T o mm ont toeh I APOUCA'I n DF =v -IaprI,,;Ir_ e'idt willv 1 "id) rml int tit. '-.r til di,il he I L-w ISE [ -•Eowr.v :N r _ .,. _ deemed :c,•,Kea. NO Steen. < ,C LR`NSLD( ONI R,\CTORS DFI L,\RA i10': Jc carANCY IrvsPE ccloN gE I P]nlC Cev ms u ' I he:eby affirm :ha: I am !icepsed undo:pre,'i,tuns of L3avler SAFETY ACRIIT _ (LIST ITE:as BEwvll 1 9 (colnn:cncine ,0ih Sectinn 7000) of Division ➢ .,f;he Bust- — No. OF EXIT, C - ness and I'-„Icxil,n, Code and ❑, liao,a n :n :i:!1 :orc:.md - 4 7777 l'I;l't:. V AFNESG gEp'D QFC'/IOEJ - License Nulty Ler _ Lie C!.ts._ L LL LIMITED TIME USE z I vn \cp pt •;Om h mmL ',uuaL ., t. s t n: 1 = I lice;.' d A list, 1 e-iu r .tit -nr I n 'neer .rsE aw G- IN SPE cro q's,l Z ,1lrm_ .n ,:ll pre i 'SII\I1:11 ::I r'.1-. i....l„ - 1`I, I}II\ a 3L.--•. +I O'Jv c SIG TVRE FINAL APPROVAL _ - - nq cc E.lT VSE OF pUILJING LICr Rt••. NI'. --------- D.i:c 2 I HOME O\lNi'It-151'ILDL1i UFPL.\;:AIl1iN' NO. OF EXISTING OUILDINGS ON LOT Ai10 USE L / E I hereby _ftvm that I ani exempt final dee Contractors (/V/ I''-5 i }- � License La, far C;e follo,cima reason IScrtion -'lila. B / usi- ice.--o ness and P-oiessmrss Codel: No. PARKIN'. � ✓ Ilt_Ill�-illli!1 :jf :. ❑ SPACES PROvm Eo ;3 I-' I. as n,c ntr ,I the propertc. ,y do : dee ,cork aims the _c;""41 AN 11%1' structure is not intended Or oi,crcd lift .ale ISeaion I 7044. Busine,s aad Praic,sions Codei. . - i3ONSI'RL'CTION LENDING .\GI`.N( g PROPOSED USE OF BUILDING I hereby aifinu that there is a construction lending agency Travel agency selling ail- tickEt 1 for the perlormance of the •.cork Gar MIMI :his permit is issued lSec. 3097.(-ic. I*, Cruise & Ogler travel elated business,, PROPOSED MAX. OCC. Leader's Address 1 I CCr UtI' [118) I have read this application and ila lL` that IIIc PERMIT FEE 25.00 aho,'C lniorniation is correct. I aarce to compl\\1'Ith allCount% ISSUANCE FEE ordinances and State la,cs relating to building I:o struclio and hereby authoriLe representatives of this County to enter TorAL. Fee 25.DD upon the above-mentioned property' for inspection purposes. I SEE REVERSE FOR EXPLANATORY LANGUAGE Sienanre of i'cnnirtee Date t