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Home My Public Portal About9124 LAS TUNAS DR_Miscellaneous__ r— WOi2'KERS'COMPENSATION DECLARATION CE 8754(2-80) MISCELLANEOUS APPLICATION I h(preby 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 - ADDRIESS. ❑ Certified copy is hereby'furnished. B"LPING LOCALITY ADDRESS `..a. . �$. �.WI��S •-' r j(/�- _ Certified copy is.filed with the county building inspection NEAREST co department. L wLITv �. 4,- CROs ST. Date' "Applicant - EA`REST - DIS RIC 0. GS2 UP TYPE PRO SED BY CROSS ST. �'. � ., Cor�Sq. CERTIFICATE OF EXEMPTION FROM WORKERS' LEGALV DESCRIPTION LOT NO. BLOCK MAP HIGHwAv COMPENSATION INSURANCE - NO, (CIRCLE) STATE MAJOR Seco D co'cwL a (This section need not be completed if the work involved NO..of BLDGs.. p 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 cc I certify that in the.performance of the work for which this `r 0 permit is issued, I shall not employ any person in any manner OWNER -a J o U so as to become subject to the Workers' Compensation Laws. AIL W OCCUPANCY GROUP �' /� Date Applicant w DREss O`; ,ISO 7Z 0- �' a NOTICE TO APPLICANT: If, after making 4his•Certificate of CITY tC'J, No� v1- _9 YET J OCCUPANT LOAD z 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 occuewwcY INSPECTION Panic DOVICeS ❑ I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT q, ' (LIST ITEMS"BELOW) a NO. OF EXITS 1 9 (commencing with Section 7000) of Division 3 of the Busi= Hess and.Professions Code, andmy license is in full force and ffeCt. PARKING SREq•D PACES PRO..... �. icense Number Lic.Class LIMITED TIME USE ntractor 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 j SIGNATURE ^s Code), LNAi APPROVAL I RESENT USE OF BUILDING ,•./ �� Date HOME OWNER-BUILDER DECLARATION'. No. of Eicls ON LOT AND USE USETING BUILDINGS 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 l,'as owner of the,property,-will do the work and the ;2 4 ej 5.6 A structure is not intended or offered„for sale (Section 7044, Business and-Professions Code). # e • • o.8 8 ROPOSEO USE.OF BUILDING CONSTRUCTION`LENDING AGENCY r o d ote ® o o I hereby affirm that there is a construction lending agency t C for.the performance of the work for.which this permit is , U,30_$.6 issued(Sec.3097,Civ.C.). L'ender's NamelJ 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 CountyISSUANCE FEE ordinances and St a laws relating to building construction, ' TOTAL FEE. and hereby aut ize repr entatives of.this,County to enter upon the abo rrien n . property for inspection p rpos s: SEE REVERSE FOR EXPLANATORY LANGUAGE n Sig ature of P rmittee Date WORKE-RS'COMPENSATION DECLARATION CE8454(ir-84) MISCELLANEOUS APPLICATION I heraby'a€firm 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 APP LI CANT TO FILL IN BUILDING ADDRESS Certified copy is hereby furnished. BUILDING I 'L 1 �; C Y LOCALITY ADDRESS FCertified copy is filed with the county building inspection LOCALITY — r I "�( �. NEAREST department. r CROSS ST. Date Applicant NEAREST DISTRI N(Qy_ GROUP TYPE P CE ISED BY CROSS ST. �j � or CONSTj. CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL v/ COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK MAP HIGHWAY NO. (CIRCLE) STATE MAJOR SECOND LOCAL NOOF BLDGS. (This Section need not be completed if the work involved TRACT I NO.W ON LOT USE ZONE SPECIAL CONDITIONS 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 o permit is issued, I shall not employ any person in any manner OWNER y w Rli JN C�i�.l OCCUPANCY GROUP so as to become subject to the Workers' Compensation Laws. MAIL _ p�' o ADDRESS ' �f. 04` S'_ - I-- Date 3 Date Applicant %E`' OCCUPANT LOAD LU NOTICE TO APPLICANT: If, after making this Certificate of clrY 9 — oo "- Exemption, you should become subject to the Workers' z Compensation provisions of the Labor Code, you must forth— with comply with Such provisions or this permit shall be TRAILER USE GEOLOGY INSPECTIONEldeemed revoked. No Spec. Know]. occurwNCY INSPECTION Panic Devices LICENSED CONTRACTORS DECLARATION 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. N. tis PARKING SPACES RSQ'D E� PROVIDED License Number Lic. Class 1 t- q LIMITED TIME USE Contractor Date G-- N Ss>k DATE DATE I I i^� R FROM: TO: I am exempt from the licensing requirements as I am a Lam! licensed architect ora registered professional engineer SIZE o NO. OF INSPECTOR'S acting m my professional capacity (Section 7051, BUS EXISTING BLDG. STORIES SIGN RE iness and Professions Code). PRESENT USE OF BUILDING {l I- � FINAL APPROVAL J �� &J— Lie.or Reg.No. DateJ HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS s 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 usi ness and Professions Code): NO. PARKING SPACES PROVIDED 0 I, as owner of the property, will do the work and the -�- structure is not intended or offered for sale (Section E D ^t 7044,Business and Professions Code). �I CONSTRUCTION LENDING AGENCY PROPOSED USE of BUILDING Al S P- 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 I .certify that I have read this application and state that the PERMIT FEE 6a 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 Bd upon the ab ve-meritio d pro, erty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE . _i Sig ure of Permittee Date WORKERS' COMPENSATION ION DECLAllA'1'lON 761v875 (11-84) MISCELLANEOUS APPLICATION o ' I hereby- affirm that 1 have a certificate of consent to sett' CE 675COUNTY 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 BUILD ING• / ADDRESS -7 - Certified copy is hereby furnished. BUILDING ADDRESS - 2 - �� ' �� LOCALITY Certified copy is fffinspection the county building $pectlUn NEAREST LOCALITY l department. "ter ,5:. Gyp /) CROSS ST. Date Applicant NEAREST // //� r DISTRICT No. GRq UP TYPE P ESSED BY CROSS ST. L.OA IA , 11C r// CO CERTIFICATE OF EXEMPTION FROM WORKERS' - LEGAL COMPENSATION INSURANCE DESCRIPTION TL.1 NO, BLOCK MAP HIGHWAY NO. F BLDGS. NO. (CIRCLE) STATE MAJOR SECOND LOCAL ' (This Section need not be completed if the work involved TRACT NOWOON 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 EXISTING BLDG. ^, permit is issued, I shall not employ any person in any manner OWNER 5/1yQ-9jSL- MAIL so as to become subject to the Workers' Compensation Laws. — / OCCUPANCY GROUP ADDRESS Ise✓%�' CrJ�- .A1Y 'IDate Applicant O TEL' OCCUPANT LOAD NOTICE TO APPLICANT: If, after making this Certificate of X c:rY = �6 2�� - No. Exemption, you should become subject to the Workers' ? Compensation provisions of the Labor Code, you must forth Q(_6_aPPLI ATION FOR EXIT HARDWARE: with comply with such provisions or this permit shall be TF,AILER 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 (commencine with Section 7000) of Division 3 of the Busi- 140. OF EXITS ness and Professions Code, and my license is in full force and Ir effect. PARKING SPACES REO'D PROVIDED D License Number Lic. Class LIMITED TIME USE Contractor Date DATE DATE FROM: TO: F1 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 SI ATU E iness and Professions Code). FINAL APPROVAL PRESENT USE OF BUILDING Lic.or Reg.No. Date HOME OWNER-BUILDER DECLARATION N-1. O= EXISTING BUILDINGS 1 l;l Ks ON LOT AND USE 1 hereby affirm that I am exempt front the Contractors License Law for the following reason (Section 7031.5. Busi- ness and Professions Code). NO. PARKING 17 1, as owner of the property, wiL do the work andthe SPACES PROVIDED structure is not intended or offered for sale (Section 7044.Business and Professions Code). CONSTRUCTION LENDING AGENCY X PROPOSED USE OF BUILDING 1 hereby affirm that there is a construction lending agency w��- ��- I^ 1'�l'Iv �i•C— for the performance of the work for which this permit is issued(Sec. 3097.Civ. C:). i Lender's Name PROPOSED MAX. OCC. Lender's Address PERMIT FEE 25.00 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 25.00 upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WORKLRS' COfvfPENS,'JION DLCLARM-ION MISCELLANEOUS APPLICATION 20-6CIb.;iIPW 1 2'9U hereby affirm that I have it certificate of co-ent U. �eh' COUN'I'Y OF LOS ANGELES BUILDING AND SAFETY DIVISION insure;or a certificate of Workers' Compensation Incur,n::C. Or a certified copy thereof (Sec. 3800. Lah. C.) a Policy No.__ ___ _ _ Company FOR APPLICANT TO FILL IN BUILDING BUILDING ADDRESS ADDRESS El Certified copy is hereby furnished. QIZTV �rS - _, - _�— �2t LOCALITY ❑ Certified copy is filed with the county huildme inspection CITY �rr �I ZIP �� uC NEAREST .- department. CROSS ST. Date _ _ Applicant SIZE OF LOT NO.OF BLDGS.NOW ON LOT DISTRICT NO. GROUP TYPEPROCESSED BY CONST. I" CERTIFICNII OF EXEMPTION FROM \\'ORKI.RS C I COMPENSATION INSURANCE TRACT BLOCK LOT NO. MAP RlGrtwnr L..; ./ NO. ICIRCLEI STATE MAJOR SECOND LOCAL (Lhls sec(iml need not be compllia If the "mi, in-lied ASSESSOR MAP BOOK PAGE PARCEL USE ZONE SPECIAL CONDITIONS r,i by the permit is for one hundred dollars IS11111) or `ess.) (l t I certify that. in the performance Of the work for \whirl• this OWNER TEL NO. permit is issued. I shall not1110 y any person in any' nlanncr ' so LIS to hrrOulc subject JO Thr \\'nrkcrs' ( nnlpcn.;Ition I.;I\\s. ADDRESS OCCUPANCY GROUP 1�El tri Date Applicant CITY ZIP NOTICE TO APPLICANT: II', after making this ( eltilirate OCCUPANT LOAD 01' FXenlption, you Should become subject to the Wo kers APPLICATION FOR Compensation pro\'isions Of'the Labor Code.you must fortimillt 1 EXIT HARDWARE: I comply with such provisions lir this permit sIEIIl he dC-,Illc•d TRAILER USE❑ GEOLOGY INSPECI ION –I No Spec.Knowl. ❑ revoked. — OCCUPANCY INSPECTIONN Panic Devices ❑ LICENSED CONTRACTORS DECLAkAFION _ hereby affirm that I alt( licensed Under provisions of (h:ipter SAFETY PERMIT O tLIST ITEMS BELOW I M1i 9(commencing with Section 7000)of Division 3 of the BLI41Ile SS NO.OF EXITS and Professions Code.and my license is in full force Lind cifect. PARKING• REO'D E= PROVIDED �. i License Number Lic. (lass SPACES ' I C'ontractot Date LIMITED TIME USE DATE DATE - ❑ I am exempt front the licensing requirements as I -till a FROM: TO: licensed architect or it registered professional engineer acting in Illy professional capacity (SeCtlon 701 1, Bu';IIICSS SIZEOF NO.OF INSPECTOR'S EXISTING BLDG. STORIES _ – SIGNATURE and Professions ('ode). Lie. or Re'. No. Datl PRESENT USE OF BUILDING 6 C��FI�F =1NAL APPROVAL 2 - I F[t/2) IIOML-OWNER BtIILDFIt DI:( LAItAIION NO.Of"IXIS IINGBUILDINGS �fl� ON LOT AND USE hereby affirm that I am exempt from the Contractor's Lit:ense Gj \, Law for the following reason (Section 70315. Business and _ Professions Code):): NO.PARKING SPACES PROVIDED ❑ 1, as owner of the property, kill do the „oik ant( the — -----� Sil-LIChlIC 1S Hot intended ill- olicled lot \IIIc• (SccIloll 7044, PROPOSED USE OF BUILDING Business and Professions Code). CONSTRUCTION LENDING AGENCY hereby affirm that there is :t construction lendinL' LiCCnC; for the perfl)rmanc•e of the Wolk for \%hlch this perllit IS I'-sucd PROPOSED MAX.OCC I (Sec. 3097,Civ. C.). Lender's Name APPLICANT PHI."JT) TEL NO. X C" 2� 11�/ti)SU lc26-34Y—y40 Lender's Address . ____ ADDRESS certify that I have read this application and state that the above information is correct. I agree to comply with all CO:mty PERMIT FEE ordinances and State laws relating to building construction,and hereby authorize representatives of this County to enterIpon ISSUANCE FEE the above-mentioned property far inspection purposes. ' TOTAL FEE SEE! REVE=RSE FOR EXPLANATORY LANGUAGE ignature of Permittee Dale _ t