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Home My Public Portal About9156 LAS TUNAS DR_Miscellaneous__ WORKERS'COMPENSATION DECLARATION CE 875 MISCELLANEOUS APPLICATION CE 875 (11-84) - insureby affirm that I have a certificate of consent to c 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 LICANTTO FILL IN BUILDING ADDRESS Certified copy is hereby furnished. BDUILDDREING ASS LocwLlrY Certified copy is filed with the county building inspectionV LOCALITY NEAREST department. Q CROSS ST. Date Applicant ` . NEAREST DISTRICT1NQQ GR P TYPE j PRO SED BY V CROSS ST. 1(/ , CONST. i/ - CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL (�0 V COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK MAP HIGHWAY NO, (CIRCLE) STATE MAJOR SEC D LOCAL NO, OF BLDGS. (This' section need not be completed if the work involved TRACT J 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. }, 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-"16 OWNER f. so as to become subject to the Workers' Compensation Laws. p MAIL ADDRES OCCUPANCY GROUP V O Date Applicant �� , c`— NOTICE TO APPLICANT: If, after making this Certificate of V CITY NO. OCCUPANT LOAD uW�i Exemption, you should become subject to the Workers' z Compensation provisions of the Labor Code, you must forth PLICATION FOR EXIT HARDWARE,: "— 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 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 D PROVIDED D SPACES License Number Lie. 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 INSPECTOR'S acting in my professional capacity (Section 7051, Bus- EXISTING BLDG. STORIES SI {NATURE iness and Professions Code). FINAL APPROVAL Lie.or Reg.No. Date PRESENT USE OF BUILDING HOME OWNER-BUILDER DECLARATION NO. OF EXI TING 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 , #'•e'e e • I, as owner of the property, will do,the work and the •, SPACES PROVIDED • o•o o•o o•• z' structure is not-.intended or offered for sale (Section 6 T2 7 t 8 7044,Business and Professions Code). ` V - 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.). LTJ ^ Lender's Name Lender's Address 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, h an reby authorize repres tative o this County to enter TOTAL. FEE up n above-mentioned o erty o inspection VurpoiS. 1 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permit e DA I WORKERS'COMPENSATION DECLARATION a CE 875(11-84) \M ISGE- LA kANEOUS APPLICATION �E 87 (� `I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION hlsure, 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 9i�� ADDRESS Certified copy is hereby-furnished. BUILDING q�56 <</S �GCAAS LOcaLITY XX ADDRESS I/ J 0 Certified copy is filed with the county building inspection LOCALITY NEAREST department. }try, T_ CROSS ST. Date Applicant NEAREST - DISTRI T NO. G�yypUP TYPE CESSED BY v CROSS ST. �).- CONST. CERTIPICATF.OF EXEMPTION FROM WORKERS' LEGAL /17 COMPENSATION INSURANCE DESCRIPTION I LOT NO. BLOCK MAP HIGHWAY No. (CIRCLE) 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 (5100) or less.) USE OF SIZE OF.LOT EXISTING BLDG. ' •`j Or I certify that in the performance of the work for which this o permit is issued, I shall not employ any person in any manne3[X OWNER of builain S%k Cti%gv Sly so as to become subject to the Workers' Compensation Laws. MAIL �j ��++ ^^ OCCUPANCY GROUP Date, Applicant ADORES$ re .Yw L.&g Z85 OCCUPANT LOAD NOTICE TO APPLICANT: If, after making this Certificate of CITY e No. (O� a O��S y 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 slrall be. TRAILER USE GEOLOGY INSPECTION El No Spec. Knowl. deemed revoked. Panic Devices LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION El I-hereby affinn.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 ani "fix Name of business PARKING SPACES REO"D 1 1 PROVIDED License Number Lic. Class /�r L_J LIMITED TIME USE Contractor-__ Date DATE DATE FROM: TO: 1 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 sle TORE iness and Professions Code). FINAL APPROVAL a+� PRESENT USE OF BUILDING � / Lic.or Reg.No. Date !�/ HOME:OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS O ��/ L t 1' ON LOT AND USEt��,It-I!:"�!},,,I hereby affirm that I am exempt from the Contractor's % IL '} License Law for the following reason (Section 7031.5, Busi- nes 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). CONST RUCTION LENDING AGENCY PROPOS ED USE OF BUILDING 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 MAJt.'OCC. Lender's Address.— _ PERMIT FEE25. 00 - 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, le above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE � X� —XX ( Ci�.nalii r „(1't•rinilt � I1,!tc WORKERS'COMPENSATION DECLARATION CE 674(tt-ea) MISCELLANEOUS .APPLICATION 1 hereby affirm that 1 have a certificate of consent c 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 DDR ESSS GS ADDR �j 74 A Certified copy is hereby furnished. BUILDING -r � ADDRESS �., , ..Q LOCALITY Certified copy is filed with the county building inspection LOCALITY NEAREST department. ][}{ CROSS ST. -------------- Date Applicant NEAREST DISTRICT NO. GROUP TYPE ROCE SEED BY CROSS ST. CONST CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL ' COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK Mwv HIGHWAY ND. - (CIRCLE) STATE MAJOR SECOND LOCAL _ NO. OF SLOGS. (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. 1 certify that in the performance of the work for which this - permit is issued, I shall not employ any person in any mannetk-X OWNER of buliuinK _ =' SO as to become subject to the Workers' Compensation Laws. MAIL OCCUPANCY GROUP c�J Date Applicant ADDRESS PP TEL OCCUPANT LOAD ul NOTICE TO APPLICANT: If, after making this Certificate of CITY U NO, v3 Exemption, you should become subject .to the Workers APPLIC 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 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 an X effect. Name of business PARKING REQ' 1 — 1 PROVIDED SPAC68 L_ 1 1 J -r License Number Lic. Class `"( t/t��r �V LIMITED TIME USt(is"•-` Contractor — Date—. DATE I' DATE 1-f' am exempt from the licensing requirements as I am a PROM. TD. 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). FINAL APPROVAL PRESENT USE OF BUILDING Lic.or Reg.No._ — _ Date 0 s HOMEOWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS �'•��' ON LOT AND U86 I hereby affirm that I am exempt from the Contractor's f License Law for the following reason (Section 7031.5, Busi• 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 USS OF BUILDING 1 hereby affirmthat 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 25.00 I certify that I 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, and hereby authorize representatives of this County to enter TOTAL FEE 25.00 upon the abodve�-mentioned property for inspection purposes: XX ` ./�1 ��;,y� `f XX ,, 0 f,, E REVERSE FOR EXPLANATORY LANGUAGE ► \\ORI:ERS'( ONIPEVSATION DECLARATION 'tE 875 1 1 341 CE ?5 MISCELLANEOUS APPLICATION /� I hereby affirm that 1 have a certificate of consent to self COUNTY OF LOS .ANGELES BUILDING :IND SAFETY DIVISION insure. or a certificate of\\orkers'Compensation Insurance,or a certified cony t,iwreof ISec. 3,800. Lab.C.I. `r ,.,.I• Policy Ni)._ —Conivany FOR APPLICANT TO FILL IN BUILDING / ADDRESS !G ❑ Ce'rtifie'd copy is hereby furnished. v BUILD ING� �� ' S -�w A ADORESS `� IM, LC CA CITY I Certified copy is tiled with the count- buildin_ inspection LOCALITYNEAREST department. Temple City CROSS ST. Date .\pnhcant NEAREST - �/� /^1 DISTRICT N G UP TYPE OC ESSED BY CROSS ST. O C� { tel" �� CON CERFIPIC._\TE OF ENENIPTION FROM '.\ORKERS LEGAL t— ! I C0�IPLNS:\TI0N' INSL RA �. DESCRIPTION LOT NO. BLOCK !�"�� 1G Hw AY ]TATE MAJOR SECOND LOCAL C. ICIRCL.'I - NO. OF SLOGS. (This section need not he completed if the %%ork involved {{ RACT NO'N ON LOT rE ?:ONE SPECIAL CONDITION] by the permit is for one hundred dollars +SIO01 or less.) t usE DF t SI:E OF LOT I EXISTING L.G.7 I ertify that in :he performance of -he .\.r!: ',; •vilich -his, � -- permit is issued. I shall :lo[ e ! employ any :le-son !n ny manner O'NNE-R— PCJ- 1 �1 �� a /J so as to become subject :o the l\'orkers' (.)nloehsation I.a\vs• OCCUPANCY 3ROUP � — °aIL - aDDRESj I�'-I L0.>��vtaS Or ! I Date---- \pnlicant — -- -EL. OCCUPAN- LOC NOTICE To APPLI(ANT: If. iif:er mukin_ ;;care ,r gj`:IT" IPevr�� +.._ No.(�Z�-�A+ .C�iy s Exemption. vuu ;hoold become iubiecr o the V\'I,rkers , — I .A DL!CATIC�! =�F _X'�- HA R CI.vdPE Compensation r.rmisions .,i rhe Labor`. )dc. you !Wrist not rh- I _ } with coni:11v '`\'It it .uch nrovisi,ni -. his ''ernm illall he -RAILER 'J -+EOLOGY :N=P ?:CN (`lo Spec _ deemed -e, l-ke,i. . 1CCJPANCY ;N3PEC"ION� - I':311iC CQ`i'N;S I LI(.ENSED( ON I RACTORS U I Ile-ebv _l[!Irm :hat I am !icensedundo-pro\isions` l.(haoter ' ' SAFETY PERMIT (LIST ITEMS BELO /l 9 le(1n11:enell' ,\!ti Section -000) f LI\inion : 1i :he Busi- NO. OF EXITS ness and P:"I'csswn< Coda. mid ulv license i in :I:il :orr:.tnd � — Clilet. PARKING.ES REO'D U PROVIDE.DED SPA U License Numi er Lic. Cass o — ; LIMITED TIME USE LL • ( miractnr .._.._._...--------.___.-.._. I):are---- I SAT: In ._---_-_._..._._—.. W � Z ❑ i O: tam cm exempt o :he :icensine require:nen[s :is I ain .I 9 I licensed archirecr Or a -e lsterld nrniessional :neineerI ?IZE OF I NO, Or INSPECTOR'S z actin-, in :m' prrte•:.ional Ira ir. .. i?:1 I'`i. Ru•: IEx IS TING BLD,. ;-oR I 9 inesiantiPruiessic;n.i-:xlel. �- - �-- .. I--ESENT -SE-0F BUILDING FINAL ROYAL 7 ' Lic.or Rec. NI,.. -------- ---- D.i:`--------- --- 2 I e _.. F EP IIO`•IE O\1 NI R-Ii I. ILDER DF:L-I..\RAI'Ii)N E NO. OF EXISTING BUILDINGS OH G i1',�'�•+�+�'4 �• }j ON LOT AND USE 1 ' " '^e-13^il!,;, W-1; aFI.]'v1' l herebv .tt:ant that I :un exempt front the Contractors I License Law for the followin(_ reason I Section -o:l Busi- ness and Pmfessions Code): NO. PARKING '/�• ❑ I. as ,,M'ile'r of the property. will do !hc work :inn the PACES PROVIDED structure is not intended or offered tor :ale ISectiun l 7044. liusiness and Professions Code). p CONST RUCTION LENDING AGENCY PROPOSED USE OF BUILDING 1 hereby affirm that there is a construction lending :wenc)' Ip�je for the performance of the ,.cork bar \\'hich this permit is s issued ISec. 3097.Civ.C.). Lender's Name.___------------------.-.. --- )'. PROPOSED MAX. OCC. Lender's Address----- 1 1 certify that f have read this application and ;tate that the PERMIT FEE 25900 -- above information is-correct. I asree to comply with all Cowry ISSUANCE FEE ordinances and Spate/,laws relative to building construction. — and hereby authe(riz-e representatives of this County to enter ' TOTAL FEE 25.UU ! I upon the above 'enti3nCd property for inspection purposes. YI" SEE REVERSE FOR EXPLANATORY LANGUAGE Sienat'u'rc of 9rririttee l� Date WORKERS'COMPENSATION DECLARATION 75M444 RAI CE 875 (11-84) �r�s LA N EG�� APPLICATION I hereby.affirm that ! have a certificate of consent to self i�t�i `.:—� COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION insdie, or a certificate of workers'Compensation Insurance,or �r ,I a certified copy thereof(Sec. 3800,Lab.C.). Policy No. Company FOR APPLICANT TO FILL IN BUILDING / i3 ADDRESS Certified copy is hereby furnished. wcoReSS -lit �Cr� �AS IS LOCALITY Certified copy is filed with the county building inspection LOCALITY NEAREST department. Temple City CROSS ST, Date Applicant NEAREST A DIST T pfD GRy�yUP TYPE P ESSED BY CROSS ST. L4.! �J I/ Ijt CONST. CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK MAP MIGMWAY No. (CIRCLE) STATE MAJOR SECOND LOCAL NO. OF BLD GS. (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 1 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 OWNER S'jCH14.p S1 so as to become subject to the workers' Compensation Laws. OCCUPANCY GROUP MAIL ADDR / { l �•\/J[�- 'J ESS I Date .Applicant NOTICE TO APPLICANT: If, after making this Certificate of CITY ( NO` 3 ,(�- OCCUPANT LOAD = Exemption, you should become subject to the Workers- AppLl ATION FOR EX IT HARDWARE: —� Compensation provisions of the Labor Code. you must forth ( with comply revoked.with such pIOVlsions Or tn1S permit shall be deemed TRAILER USE GEOLOGY INSPE--BION _ No Spec. Knowl �--; _ . I� OCCUPANCY INSPECTION:EX Yan;c Devices - LICENSED CONTRACTORS DECLARATIONL. 1 hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT — (LIST ITEMS BELOW)1 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. SPACES REO'O I i I PROVIDED 00, License Number Lic. Mass LIMITED TIME USE I Contractor Date GATE DATE TO: 1 am exempt from the iicensing :eouirements as I am _ 1 licensed architect or a registered pro*essiona_l en, iaee: INSPECTCR•S SIZE OF �NC. OF I acting in my professional capacin (Jet tlOn 0.1. Bus- EXISTING BLDG. STORIES SIG A7URE c iness and Professions Code). PRESENT USE OF BUILDING 7 1FINAL APPROVAL � Lie.or Ree.No. Date I HOME OWNER-BUILDER DECL.�RATION NO. OF EXISTING BUILDINGS ON LOT AND USE 1,1 I hereby affirm that I am exempt from the Contractor's 1 €o o—i_o 1 License Law for the follow'ine reason (Section '031.5, Busi- ,`!71f-II � ness and Professions Code): No. PARKING =' 'l 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 g PROPOSED USE OF BUILDING I hereby affirm that there is a construction lending agency t l for the performance of the work for w'hichrthis 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 25.00 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 2S.UU t.•I f upon the abo - entioned prope y for ins ection purposes. i SEE REVERSE FOR EXPLANATORY LANGUAGE ' SignatureT Permitte Date WORKERS' CUMYhNJA11UlV 1JCl:LHKAiIUiV 20-0063DPW!2/90 idlA�L..G,.L.L..HI�A1:;V[.J� H1'"d"LA�:..HIt iL,Jill. I hereby affirmthat I havea 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-T.0-FILL IN BUILDING WILDING ADgRESS - ❑ Certified copy.is hereby furnished. 6 6 L m r' LOCALITY r ❑ Certified copy is filed with the county building inspectio arY zIP //))�nj NEAREST. ' department: - �LV CW V (J CROSS ST. Date Applicant SIZE OF LOT NO.OF BLOGS.NOW ON LOT DISTRICT NO. GROUP TYPE PROCESSED BY CERTIFICATE OF EXEMPTION FROM WORKERS' CONST. CI I COMPENSATION INSURANCE - TRACT 'BLOCK LOT NO. MAP - HIGHWAY V - NO. (CIRCLE) STATE MAJOR SECOND LOCAL.. (This section need not be completed.if the work involved ASSESSOR MAP BOOK PAGE PARCELW_ by the permit is.for one hundred dollars ($100) or less.) usE zoNE SPECIAL CONDITIONS TEL No. a I certifythat in the performance.of the work for which thi r)q�l2rfy er permit is issued. I shall not employ any person in any rnann UJ so as to become subject to the Workers' Compensation Laws. ADDRESS g OCCUPANCY GROUP Date Applicant,. CITY ZIP NOTICE TO APPLICANT: If, after making this Certificate OCCUPANT LOAD of Exemption, you should become subject to the Workers' % APPLICATION FOR Compensation provisions of the.Labor Code.you must forthwith EXIT HARDWARE: comply with such provisions OI this permit shall be deemed. 'TRAILER USE❑ GEOLOGY INSPECTION❑' revoked. No Spec.Knowl. ❑ I LICENSED. CONTRACTORS DECLARATION occuPANcv INSPECTION Panic Devices ❑ I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT❑ .(LIST ITEMS BELOW) 1� 9(commencing with Section 7000)of Division 3 of the BusineNO.OF EXITS and Professions Code,and my license is in full force and effe r ame o - us loess I— G• REO'D I ❑ PROVIDED SPACEPARKI License Number Lic. Class �D I�r► sPAces i Contractor Date �J LIMITED. TIME USE ElI am exempt from the licensing requirements as I am a DATE DATE FROM: TO: licensed architect or a registered professional engineer acting in my professional capacity (Section 7051,Business SIZE OF NO.OF INSPECTOR'S ! - ' and Professions Code). EXISTING BLDG_ STORIES SIGNATURE LIG. or Reg. No. Date PRESENT USE OF BUILDING .FINAL APPROVAL 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, Business 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, OPOSED USE OF BUILDING Business and Professions Code). 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.). PROPOSED MAX.OCC. Lender's Name LICANT(PRINT) TEL NO. Lender's Address DDREss I certify that I have read this application and state that the above information is correct. I agree to comply with all County PER FEE ordinances and State laws relating to building construction,and hereby authorize representatives.of this County to enter upon ISSUANCE FEE ` the above-mentioned property for inspection purposes. TOTAL FEE X� 6Z, SEE REVERSE'FOR EXPLANATORY LANGUAGE Signature of Permitt T— Date S