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Home My Public Portal About9085 LAS TUNAS DR_Miscellaneous__ `eVORKERS'COMPENSATION DECLARATION CE 875(2-80) MISCELLANEOUS APPLICATI®1 tl 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 Insurancnce,'or a certified copy thereof(Sec 3800, Lab C) Policy No CompanyBUILDING 7"7i / FOR APPLICANT TO FILL IN ADDRESS 7 LC IG! ❑ Certified copy is hereby furnished ILDING / LOCALITY TADDRESSa �' F-1Certified copy Is filed with the county building inspection NEAREST department + CALIT CROSS ST Date Applicant N •AREST DISTRICT N GfIOUP TYPE / PROC S B ROSS ST. \� L '�� L�� CONST.'/ CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL 'J �/VV/ COMPENSATION INSURANCE DESCRIPTION LOT NO BLOCK MAP nlGr wnv No (CIRCLE) STATE MAJOR SEGO D LOCAL a, This section need not be completed if the work involved NO OF BLDGS US ZONE SPECIAL CONDITIONS 0 ( p TRACT NOW ON LOT t, by the permit is for one hundred dollars ($100) or less.) USE OF SIZE OF LOT EXISTING BLDG. I certify that in the performance of the work for which this 0 permit is issued, I shall not employ any person in any manner WNERAjH so as to become subject to the Workers' Compensation Laws IL t OCCUPANCY GROUPE� W AD DRESS 3z« / 5(0 S-- IL Date Applicant TEL. NOTICE TO APPLICANT If, after making this Certificate of 04TY NO. —�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 or this permit shall be TRAILER USE O GEOLOGY INSPECTION deemed revoked NO Spec. Knowl. ❑ Panic Devices ❑ • LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION.' 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 effect SPACES REq'D PROVIDED License Number Lic Class 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 FROM INSPECTORS acting in my,professional capacity (Section 7051, Bus- EXISTING BLDG STORIES SIGNATURE mess and Professions Code). FINAL APPROVAL SENT USE OF BUILDING v--lg Lic,or Reg No Date C HOME OWNER-BUILDER DECLARATION NO.OF EXISTING BUILDINGS ON LOT AND USE I hereby affirm that 1 am exempt from the Contractor's # 0 0 o D 8 8- License Law for the following reason (Section 7031 5, Busi- ness and Professions Code) PARKING 0 0 0 0 0 0 0 SPACES PROVIDED ❑ I, as owner of the property, will do the work and the �, -8 Jr structure is not intended or offered for sale (Section 7044, Business and Professions Code) A-IfUPOSED USE of BUILDING CONSTRUCTION LENDING AGENCY I'hereby affirm that there is a construction lending agency ( L L,O 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 t O and hereby authorize representatives of this County to enter X` ugh a ab a ion property for Inspec ion purposes SEE REVERSE FOR EXPLANATORY LANGUAGE U Signature of Permittee Date WOR KERS'COMPENSATION DECLARATION CE 875 (2-80) MISCELLANEOUS AP®LOCATIO 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 n� ADDRESS ❑ �3p Certified copy Is hereby furnished BUILDING / nC 'g�y�< �p� ( ADDRESS LOCALITY ❑ ell Certified copy is filed with the county building Inspection •�' NEAREST department LOCALITY / CROSS ST Date Applicant AREST ( yJ DISTRICT NO GROUP TYPE 1PROC CROSS ST. SU�T/q� /`� CON11 STt/ CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL COMPENSATION INSURANCE DESCRIPTION LOT NO. LOCK MAP HIGHWAY N0 Q (CIRCLE) STATE MAJOR SECOND LOCAL } (This section need not be completed if the work involved TRACT NONOW ON LOT OF S USE ZONE S ECTAL CONDITIONS 0 by the permit is for one hundred dollars( $100) or less.) USE OF GiZ U SIZE OF LOT EXISTING BLDG I certify that in the performance of the work for which this permit Is Issued, I shall not employ any person in any manner WNER 0 so as to become subject to the Workers' Compensation Laws ,IMAILESS4ii W a�7 / �O CUPA'�VCY GROUP — V 40 ADDR /�•✓ Date Applicant to TEL OCCUPANT LOAD Z NOTICE TO APPLICANT If, after making this Certificate of CITY No. Exemption, you should become subject to the Workers'• ON FOR EXIT HARDWARE OR 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 Panic D8VIC8S ❑ LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION❑ I hereby affirm that I am licensed under provislons.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, and my license Is in full force and PARKING effect. SPACES REO'D PROVIDED License Number Lic Class ��JJ LIMITED TIME USE Contractor Date DATE DATE ❑ FROM TO 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 SIGNATURE iness and Professions Code) E ^L FINAL APPROVAL ' RESENT USE: OF BUILDING T �C Lic.or,Reg No Date HOME OWNER-BUILDER DECLARATION NO.OF EXISTING Buii D rvGs ON LOT AND USE I hereby affirm that, I am.exempt from the Contractor's License Law for the'followmg 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 # o .o 0 0 o88 I structure is not Intended or offered for sale (Section } 7044, Business and Professions Code) e 010 0 0 0 0 0 ROPOSED USE OF BUILDING l d + CONSTRUCTION LENDING AGENCY '1,2 27 8 2 I hereby affirm that there is a construction lending agency W /�- 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 �rl� above information is correct I agree to comply with all County ISSUANCE FEE SVy,ances and State laws relating to building construction, TOTAL FEE - and hereby authorize representatives of this County to enter 00 ' upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature J Permittee Date WORKERS'COMPENSATION DECLARATION 76M444 CE 875 (2-80) MISCELLANEOUS APPLICATION I herel3y 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 P35712 Company Zenith FOR APPLICANT TO FILL IN BUILDING ADDRESS ❑ Certified copy is hereby furnished BUILDING Or LOCALITY ADDRESS Temple City, Ca.91780 Certified copy is filed with the county building Inspection NEAREST department LOCALITY Temple City, Ca. 91780 CROSS ST Sultana Date 14-1 5-85 Applicant Greaves & Atkins Inc. NEAREST DISTRICT��pp G UP TYPE JPR SSED BY CROSS ST Sultana +S'/l�/ 2 CONS CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL VO COMPENSATION INSURANCE DESCRIPTION LOT NO BLocK MAP HIGHWAY _ rvo D (CIRCLE) STATE MAJOR SEC D LOCAL a (This section need not be completed if the work involved No OF BLDGS. USE ZONEFCIAL CONDITIONS 0 P TRACT NOW ON LOT by the permit is for one hundred dollars ($100) or less.) USE OF • /f / SIZE OF LOT EXISTING BLDGO f f. &S t O I certify that In the performance of the work for which this F"— permit is Issued, I shall not employ any person in any manner owNER7Uar Coni lic,so as to become subject to the Workers' Compensation Laws MAIL M OCCUPANCY GROUPLU Date Applicant AOOREss 3216k Division St. d TEL. Z NOTICE TO APPLICANT If, after making this Certificate of CITYAngeles. Ca. NO- 213-221-6536 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 N ❑ deemed revoked. El O Spec. Knowl. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTIONR Panic Devices ❑ I 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 BusiEZ - ness and Professions Code, and my license is In full force and PARKING. effect SPACES ' REQ'D D PROVIDED O License Numb464306 LIc Class Bl C36 LIMITED TIME USE Contractor Greaves & AtkjMS& 4-15-85 DATE DATE FROM TO 0 I•am exempt from the licensing requirements as I am a licensed architect or a registered professional engineer SIZE OF NO. OF INSPECTO R',S acting in my professional capacity (Section 705I, Bus- EXISTING BLDG. STORIES 1 GNATURE iness and Professions Code) FINAL APPROVAL PRESENT USE OF BUILDING Office & Storage N.W 0 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 License Law for the following reason (Section 7031 5, Busi- ness and Professions Code) NO. PARKING SPACES PROVIDED 3 F1I, as owner of the property, will do the work and the # 0 0 0 0,88 structure Is not intended or offered for sale (Section 0 0 0 0,0 0 0 2 7044, Business and Professions Code). FROPOSED USE OF BUILDING Office & Storage 04. 16±85 CONSTRUCTION LENDING AGENCY 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) NONE Lender's Name PROPOSED MAX OCC 3 Lender's Address PERMIT FEE I certify that I ad this application and state that the above Informat /ct I agree to comply with all County ISSUANCE FEE ordinances a relating to building construction, TOTAL FEE and here utsentative of this County to enterupon t o y r inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE 4-15-85 S fna C errlattte�Ns Date -VV6RKERS'COMPENSATION DECLARATION CE 875(2-80) MISCELLANEOUS APPLICATIO V I'•f4eby'^3>1irm 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 ❑ Certified copy is hereby furnished ILDINGRESS �/•-C LOCALITY ADD2 tvE Certified copy is flied with the county building Inspection _,� NEAREST department OCALITY �. CROSS ST Date Applicant N REST DISTRICT NO G O P TYPE / PRO C D BY ROSS ST. su-�Ti4/Y �� CONST CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL L/ /V✓ COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK MAP RIGR AY STATE MAJOR SECO LOCAL Q„ J NO OF BLDGS. NO (CIRCLE) (This SCCtIOn need not be completed if the work involved TRACT NOW USE ZONE 0 ON LOT SPECIAL CONDITIONS V by the permit is for one hundred dollars ($100) or less.) USE OF SIZE OF LOT EXISTING BLDG O I certify that In the performance of the work foi which this permit is issued, I shall not employ any person in any manner 6 OWNER dEC[L o so as to become subject to the Workers' Compensation Laws (� OCCUPANCY GROUP 6,i W ADDRESS j"1 d `~�� N Date Applicant `.� /✓' TEL. O(�J OCCUPANT LOAD Z NOTICE TO APPLICANT If, after making this Certificate of Y No. J �- Exemption, you,should become subject to the Workers' AP KATION 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 INSPECTIONCl 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 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 + REQ'D O PROVIDED D I License Number Lic Class LIMITED TIME USE Contractor Date DATE DATE FROM T I am exempt from the licensing requirements as I am licensed architect or a registered professional engineer SIZE OF a NO OF INSPECTOR'S acting in my professional capacity (Section 7051, Bus- EXISTING BLDG STORIES SI NATURE ( iness and Professions Code). SENT USE OF BUILDING FINAL APPROVAL iLle nor Reg No Date e 04 G �I `HOME OWNER-BUILDER DECLARATION NO OF EXISTING BUILDINGSON LOT AND USE hereby affirm that I am exempt from the Contractor's [ Y,4 CA A�)` cense Law for the following reason (Section 7031 5, Busi- JF.3 O a 1 R ass and Professions Code) NO PARKING ��/ ) ACES PROVIDED / I, as owner of the property, will do the work and the E /r/ # D0o088 structure isnot intended or offered for sale (Section s ee 7044, Business and Professions Code) o 0 0 o e o o m OPOSED USE OF BUILDING 2 CONSTRUCTION LENDING AGENCY 0 8,•2 5-8 5 IJ l/issued affirm that there is a construction lending agency Lam' S,4Lo or the performance of the work for which this permit is M1 (Sec 3097,Civ C) Lender's Name PROPOSED MAX. OCC Lender's Address PERMIT FEE \ V� 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 ent upon the abov -mentioned ppe Iy for nspection purposes SEES REVERSE FOR EXPLANATORY LANGUAGE Signature f Permittee Date 7VORKERS'COMPENSATION DECLARATION 76 44 (2-SO) M U SC E L LA tl�7 EO U S A P P l� CAT I®1� I hereby affirm that I have a certificate of consent Self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION Insure, or a certificate of Workers'Compensation Insurance, e,or a certified copy thereof(Sec 3800,Lab C.) Policy No Company FOR APPLICANT TO FILL IN BUILDING ❑ . ADDRESS Certified copy Is hereby furnished BUILDING LOCALITY En?�GL- ADDRE33 Certified copy is filed with the county building Inspection NEAREST department L CALITY CROSS ST LTAWA 1 Date Applicant NEAREST DISTRICT NO, GROUP TYPE IPROZXD BY CROSS ST. �\ CONST CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL t V COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK MAP y1�7/• HIGHWAY } NO [[JJ 24,1 (CIRCLE) STATE MAJOR SEC D LOCAL a NO OF BLDGS (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 •V 1c I certify that in the performance of the work for which this Q permit Is issued, I shall not employ any person in any manner 15WNER U so as to become subject to the Workers' Compensation Laws. AIL .� OCCUPANCY GROUPF lL y, AD ESS P.-O • Q I t1 Date Applicant Z NOTICE TO APPLICANT If, after making this Certificate of CITY e--- TEL: No. 5_ OCCUPANT LOAD Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth PLICATION FOR EXIT HARDWARE with comply with such provisions or this permit shall be TRAILER USE GEOLOGY INSPECTION deemed revoked a• NO Spec. Knowl. ❑ Panic D@VIC@S ElLICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT i (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 o PROVIDED License Number Lic Class LIMITED TIME USE Contractor Date DATE DATE FROM TO 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 SI NATURE inessand Professions Code) SFINAL APPROVAL (� ENT USE OF BUILDING r L�� Lic or Reg No DateV/ Ala-�-- 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 417.2 ' � + /� A � �J,2 A El 1, as owner of the property, will do the work and the 4 SPACES PROVIDED structure is not intended or offered for sale (Section °o 7044, Business and Professions Code) OPOSIi D USE OF BUILDING i CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency G r for the performance of the work for which this permit Is_ Issued (Sec 3097,Civ C) !!q 12,r,; 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 ab Ne-mentione •opert y for Inspects purposes SEE REVERSE FOR EXPLANATORY LANGUAGE gnature of Permittee Date WORKERS'COMPENSATION DECLARATION CE 875(11-84) M 4 SC E L LA N E®U S APPLICATION PPLICATION 1 hereby affirm that I have a certificate of consent tself COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION insure, or a certificate of Workers'Compensation Insurance, e,or a certified copy thereof(Sec. 3800,Lab C). Policy No. Company FOR APPLICANT TO FI LL BUILDING ADDRESS 90676- A g TLj N(if Certified copy is hereby furnished BUILDING p LOCALITY N. / ADDRESS 70 FS A,1 FJ-17e, Tom / e `v ,i Certified copy is filed with the county building inspection LOCALITY NEAREST . department. oke e, / L G� q / Q cRoss sr. �)ff ClPii Date Applicant NEAREST / DISTRICT NO. GROUP TYPE PROCESSED BY CROSS ST. S(,7`t G/J 4 /'•+�Q _I CONST. CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL COMPENSATION INSURANCE DESCRIPTION LOT NO. tj 3 BLo-- MAP HIGHWAY NO. OF BLD 63. NO (CIRCLE) STATE MAJOR SECOND LOCAL (This section need not be completed if the work involved TRACT ,� {n ) , NOW ON LOT USE ZONE SPECIAL CONDITIONS by the permit is for one hundred dollars ($100) or less.) USe OF I certify that in the performance of the work for which this SIZE OF LOT �' �( H p EXISTING BLDG. Vge4 J•1 F a� permit is issued, I shall not employ any person in any manner OWNER J p HW E. HA V A)L/4-�'�� s> so as to become subject to the Workers' Compensation Laws. OCCUPANCY GROUP 0:_1 �!'i^ 1�n f7� ADDRMAIL ESS 33 o 9 7's Q b-4/ �� Date our✓ 6 Applicant I„ TEL OCCUPANT LOAD NOTICE TO APPLICANT: If, ter making this Certificate of CITY• j� - NO.'a,`� •aa/ 6 S3 (bCn Exemption, you should become subject to the Workers' z Compensation provisions of the Labor Code,you must forth- APPLICATION FOR EXIT HARDWARE with comply with such provisions oI this permit shall be TRAILER USE ❑ GEOLOGY INSPECTION ❑ No Spec. Knowl. deemed revoked. Panic Devices LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION El I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT ❑ (LIST ITEMS BELOW) 9 (commencing with Section 7000) of Division 3 of the Busi- NO. OF EXITS ness and Professions Code, and my license is in full force and effect PARKING REQ•D I PROVIDED SPACES License Number Lic. Class LIMITED TIME USE Contractor Date DATE - DATE I am exempt'from the licensing requirements as I am a PROM: TO licensed architect or a registered professional engineer SIZE OF No OF INSPECTORS acting in my professional capacity (Section 7051, Bus- EXISTING BLDG STORIES SIGNATURE mess and Professions Code). FINAL. APPROVAL PRESENT USE OF BUILDING -f- Lic.or Reg.No. Date " 1 HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS @ L/i ON LOT AND USE I hereby affirm that I am exempt from the Contractor'sIl�;1!t-E)I,I_E 2r 1}'CE9 License Law for the following reason (Section 7031 5, Busi- No. PARKING ly' ! ness and Professions Code). I, as owner of the property, will do the work and the SPACES PROVIDED structure is not intended or offered for sale (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY PROPOSED USE of BUILDING R$ f CII J 4140 g 1 hereby affirm that there is a construction lending agenc g o✓v� -i "1 for the performance of the work for which this permit is ll issued(Sec. 3097,Civ.C) Lender's Name A PROPOSED MAX. OCC. Lender's Address PERMIT FEE a d 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 TOTAL FEE Oa u7 the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE atS J6h Q7 ignature of Permittee Date