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Home My Public Portal About9151 LAS TUNAS DR_Miscellaneous__ TEMPLE CITYj�/s5, 76M444-DBS 7511.55 MISCELLANEOUS APPLICATION DIVISION OF BUILDING AND SAFETY OCCUPANCY-SAFETY-TRAILERS -Department of County Engineer County of Los Angeles BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY A x7 FOR WANT TO FILL IN NEAREST OWNER k,Q CROSS ST. MAILDIST ICT NO. I GROUP I TYPn�ST. - ADDRESS I 1�� - TEL. ,•J[,� CITY �� NO. Z MAP ,( "ySTATE TEL. NUMBER V y/ HWY YES IVO CONTRACTOR NO. USE ZONE SPECIAL CONDITIONS ADDRESS 'LEGAL I DESCRIPTION I LOT NO. EXIST..BLOCK BUILDING SETBACK YARDT NI HWY I SIRE E: I WIDTH NO.OF BLDGS. TRACT - NOW ON LOT FRONT �] I• I I /�,�y USE OF ?hl-�' R�+/' P L. SIZE OF LOT I EXISTING BLDG. SIDE P.L. OCCUPANCY APPLICATION FOR INSPECTION RECORD INSPECTION 1�. SAFETY PERMIT TRAILER USE I LIMITED TIME USE -771 'Ir .._I..:..._._........._._.._.... DATE DATE //•-'�� - FROM: TO: •, .(5a r- n 0 -/,V. USE OF STRUCTURES OR DEVICES ....................... INSPECTION FOR OCCUPANCY AS I.._._ ._.......___.._.......................__._:...I.................._............ .. APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS DATE INSPECTOR'S SIGNATURE APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES OCCUPANCY APPROVAL AND STATE LAWS REGUL�zz�z CONSTRUC- GROUP OCC.LOAD TION. SIGNATURE,OF TRAILER USE PERMITTEE ADDRESS v •Qq--Z SAFETY PERMIT TEMPORARY STRUCTURE APPROVED TEMPORARY STRUCTURE REMOVED FINAL APPROVAL. _dui L_ IFEE S '� ;rpt . JOHN A. LAMBIE. COUNTY ENGINEER ,VA,.IDATION CLYDE N. DIRLAM.CHIEF BLDG. INSPECTOR CK MO. CASH WORKERS'COMPENSATION DECLARATION CE 875 (11-84) MISCELLANEOUS APPLICATION CE 875 I hereby. affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUI DING AND SAFETY DIVISIONfl 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 ADDRESS Certified copy is hereby furnished. BUILDING rl ADDRESS LOCALITY FCertified copy is filed with the county building inspection LOCALITY /n� ,, NEAREST department. mP l CROSS ST. Data Applicant NEAREST � DISTRICT NO. GR UP TYPE OCES5ED BY CROSS ST. O D� CONST. CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL ^� COMPENSATION INSURANCE DESCRIPTION LOT NO. �{� I BLOCK MAP HIGHWAY No, (CIRCLE) STATE MAJOR SECOND LOCAL NO. OF BLDGS. (This section need not be completed if the work involved TRACT a NOW ON LOT /' USE ZONE SPECIAL CONDITIONS by the permit is for one hundred dollars (5100) or less.) USE OF YhM SIZE OF LOT EXISTING BLDG. - L 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 sJ so.as to become subject to the Workers' Compensation Laws. OCCUPANCY GROUP, � MAIL O Date Applicant ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of clrY� TNoD� OCCUPANT 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� SPACES effect. GGa.✓ PARKING REQ'D PROVIDED - d LL��JJ License Number Lic. Class LIMITED TIME USE Contractor Date DATE DATE FI am exempt from the licensing requirements as I am a PRDM• TO: 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.andProfessionsCode). 630 4�il D /" FINAL APPROVAL f �z- PRESENT USE OF BUILDING /�,.+ FI' I• Lic.or Reg.No. Date SCJ b HOME OWNER-BUILDER DECLARATION NO.OF EXISTING BUILDINGS ON LOT AND USE I hereby affirm that I am exempt from the Contractor's /,y �✓ t "_:l '?"Y`` ' License Law for the following,reason (Section 7031.5, Busi- ness usi ness and Professions Code): NO. PARKING 0 1, 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 0 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 dCJ - 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 3orffland Sta ws relating to building construction, hor' esentatives of this County to enter TOTAL FEE me prope y for inspectionAur o s. E REVERSE FOR EXPLANATORY LANGUAGE o of P mittee Date i WORKERS'COMPENSATION DECLARATION E 875 (11-84) CE MISCE LLANEOUS APPLICATION i C 875 I heretyaffirm that I have a certificate of consent teat£ COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION � insure; or or a certificate of Workers'Compensation Insurancc e.or a certified copy,thereof(Sec. 3800,Lab.C.). Policy No. Company — FOR APPLICANT TO FILL IN AUDRess G Certified copy is hereby furnished. / LOCALITY UILDIN ` Q� �- j ABDDRESSG � (J• G 1 Certified copy is filed with the county buildinginspection LOCALITY NEAREST ' department. CROSS ST. Date Applicant NEAREST DISTRICT NO. GROUP ITYPE CESSED BY .I CROSS ST. /� �j /1 CONS i CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL .16 1 Q 1 COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK NOP (cGIRCL Y STATE MAJOR SECOND 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 (SI00) or less.) USE OF I SIZE of Lor I certify that in the performance of the work for which this EXA OTING BLDG. P permit is issued, I shall not employ any person in any mannerOWNER -. i so as to become subject to the Workers' Compensation Laws. OCCUPANCY GROUP — MAIL ADDR ! Date Applicant _ TEL. y OCCUPANT LOAD NOTICE TO APPLICANT: If, after making this Certificate of CITY No. $� -- Exemption, you should become subject to the Workers' APP CATION FOR EXIT HARDWARE: Compensation provisions of the Labor Code, you must forth 1 with comply with such provisions oI this permit shall be CTION I-RAILER USE I GEOLOGY INSPE1 1 No K ❑ Spec. nowl. I deemed revoked. Panic Devices LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT (LIST ITEMS BELOW) I 9 (commencing with Section 7000) of Division 3 of the Busi- NO. OF EXITS ness and Professions Code,and my license is in fill force and effect. /7PARKING N SPACES REO•D D PROVIDED I 1 s License Number Lic. Class � < LIMITED TIME USE N ' Contractor Date _. DATE DATE N y I TD- I am exempt from the licensing requirements as I am a «Dm. INSPECTOR'S licensed architect or a registered professional engineer sNO. OF SIGNATURE acting in my professional capacity (Section 7051lzE of , Bus- � EXISTING BLDG. STORIES iness and Professions Code). C' PRESENT USE OF BUILDING FINAL APPROVAL ' Lic.or Ree. No. Date - LL HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS _ ON LOT .AND USE ✓/,' I hereby affirm that I am exempt from the Contractor's 1. i License Law for the following reason (Section 7031.5. Busi- ness usi ness and Professions Code): NO. PARKING V "1 I, as owner of the property. will do the work and the SPACES PROVIDED structure is not intended or offered for sale (Section j 7044,Business and Professions Code). I CONSTRUCTION LENDING AGENCY PROPOSED USE of BUILDING 1 hereby affirm that there is a construction lending agency 1 I for the performance of the work for which this permit is issued(Sec. 3097,Civ.C.). Lender's Name PROPOSED MAX. OCC. Lender's Adiiress 5 t I certify that I have read this application and state that the PERMIT FEE 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 upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE i`nature of Per to Date V, 11'0RK1':RS'CON11'f:NSATION DECLARATIONE 875 11184) CC4 MISCELLANEOUS APPLICATION E 87 • + I �iereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION in lire, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab.C.). Policy No. FOR APPLICANT TO FILL IN BUILDING ADDRESS G• � ��2�� Certified copy is hereby furnished. BUILDING Q I �/�� I l XX ADDRESS —1 I �T LOCALITY G=am FJCertified copy is filed with the county building inspection LOCALITY /e. •^/ NEAREST department. Xy Lam. 0/ / CROSS ST. Date.-__ _--Applicant—_-_____ NEARESTJ /yl DISTRICT NO. GROUP TYPE CESSED BY CROSS ST. L// - CONST. CERTIFICA11'OF EXEMPTION FROM WORKERS' w LEGAL COMPLNSAr10NINSURANCE' DESCRIPTION LOT NO. BLOCK MAP HIGHWAY NO. (CIw CLE) STATE MAJOR SECOND LOCAL NO. OF BLOCS. (This section need no( be completed if the work involved TRACT NOW ON LOT USE ZONE SPECIAL CONDITIONS by the permit is for one hundred dollars ($100) or less.) usE OF SIZE OF LOT EXISTING BLDG• p certify that in the performance of the work for which this y/ Aj/ D- permi( is issued, I shall not employ any person in any manneSCX OWNER Of buildin 1 f� �,VC9' —Mm so as to become suhjccl to the Workers Compensation l..a\Ys. MAIL OCCUPANCY GROUP c� _ ,ADDRESS BID 0 a[ �z U Date ----- -- Applicant---- — Y L. "I NOTICE r0 APPLICANT: If, after making this Certificate of CITY NO. Q 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 provisl(ins or this permit shall be TRAILER USE ❑ GEOLOGY INSPECTION ❑ No Spec. Knowl. deemed revoked. OCCUPANCY INSPECTION. Panic Devices LI('I::NSf:U CON'l RAC7ORS DECLARATION EJ I hereby afflTI11 that I ani 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 anix effect. Name Of business PARKING REWO E= PROVIDED I 1 SPACES 1..� License NIII11bCT-_- —, Lic. Class_ 6 LIMITED TIME USE Contractor---.--__-�__-.__.—_ Date DATE DATE ElI ani exempt from the licensing requirements as I am a FROM: TO: licensed architect or a registered professional engineer SIZE OF NO. OF / INSPECTORS acting in my professional capacity (Section 7051, Bus- EXISTING BLDG. D STORIES SI ATURE_ iness and Professions Code). PRESENT USE OF B ILDING J 0 FINAL APPROVAL 1+. -•�; - Lic.or Reg.No._._.__.__...-------.—__--- Date ftt4 *of HOME OWNER-RUILDER DECLARATION NO. OF EXISTING BUILDINGS ON LOT AND USE V Aye �` 3i{•,it•il "•-�i1,'e!'_ •_":,-'` ,'. - hereby affirm that "1 and exempt from the Contractor's License Law for the following reason (Section 7031.5, Busi- ness usi(less and Professions('ode): - NO..PARKING Y\ 1, 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). 33 y � CONS]RUCTION LENDING AGENCY PROPOSED USE OF BUILDING ��L'` M 0I I hereby affirm that there is a construction lending agency �i{ , for the performance of the work for which this permit is issued(Sec. 3097,('iv.C.). Lender's Name PROPOSED MAX'OCC. Lender's Address.—---_--.----------- -------_-- 25 . 00 1 certify that I have read this application and stale that the PERMIT FEE above information is correct. I agree to coniply with all County ISSUANCE FEE ordinances and State lairs relating to building construction, and hereby authorize representatives of this County to enter TOTAL FEE 25.00 upon the above-mentioned properly for inspection purposes. _ SEE REVERSE FOR EXPLANATORY LANGUAGE XX �—/ WORKERS'COMPENSATION DECLARATION CE 875(1 1-84) M I SC `A N EO U S APPLICATION 1 hereby affirm that I have a certificate o£ 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 j ADDRESS Certified copyis hereby furnished. BUILDING & /V� XX ADDRESS LOCALITY 7G DCertified copy is filed with the county building inspection LOCALITY ! NEAREST department. yy. �, CROSS ST. Date Applicant NEAREST DISTRICT NO. GR UP TYPE P ESSED BY CROSS ST. �/j� CONST CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK MAP HIGHWAY No. (CIRCLE) STATE MAJOR SECOND LOCAL NO. OF BLDG3. (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 ($100) or less.) USE of SIZE OF LOT EXISTING BLDG, 0 I certify that in the performance of the work for which this C-3 permit is issued, I shall not employ any person in any manne3[X OWNER of buildin /yy// • so as to become subject to the Workers' Compensation Laws. MAILq Q OCCUPANCY GROUP a ADDRESS �, . '�.► / G U Date Applicant rEL. 8/ NOTICE TO APPLICANT: If, after making this Certificate of CITNO. OCCUPANT LOAD Exemption, you should become subject to the Workers' �� 1 .��d��a �� 7 Compensation provisions of the Labor Code,you must forth- `�/O 4iV APPLIC ION FOR EXIT HARDWARE: with comply with such provisions or this permit shall be TRAILER USE ❑ GEOLOGY INSPECTION ❑ No Spec, Knowl. deemed revoked. 1 Panic Devices LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION 1 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 anX d effect. pName of business PA12KING R9Q'D PROVIDED SPACES IL��JJ License Number Lie. Class LIMITED TIME USE Contractor Date DATE DATE FROM: TO: El I am exempt from the licensing requirements as I am a licensed architect or a registered professional engineer SIZE OFNO. OF // INSPECTOR'S acting in my professional capacity (Section 7051,.Bus- 'EXISTING BLDG. 3(� STORIES / NATURE iness and Professions Code). - FINAL APPROVAL 11 /_ S PRESENT USE OF BUILDING [[ Lie.or Reg.No. Date 11 ..�� IC HOME OWNER BUILDER DECLARATION NO. of EXISTI G BUILDINGS U3E ON LOT AND I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Busi- fn ness and Professions Code): No. PARKING 1, 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 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 25.0(1 above information is correct. I agree to comply with all County ISSUANCE FEE ordinances and State laws relating to building construction, and hereby authorize repre ntati es of this County to enter TOTAL FEE 25. 00 upon th ove-ment' roe y fo ins ection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE XX X Signature of Permittee Date