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Home My Public Portal About9803 LAS TUNAS DR_Miscellaneous__ DEPARTMENT OF COUNTY ENGINEER DIVISION OF BUILDING AND SAFETY MISCELLANEOUS COUNTY OF LOS ANGELES OCCUPANCY SAFETY TRAILERS WILLIAM J. FOX, COUNTY ENGINEER CASSATT D. GRIFFIN, SUPT OF BUILDING APPLICATION FOR APPLICANT TO FIL IN BUILDING BUILDING ADDRESS ./�.._? ADDRESS LOCALITY LOCALITY A�Evv' NEAREST NEAREST CROSS ST. . L /- CROSS ST. DISTRICT NO. PLAN CK.OR REC.NO. PERMIT NO. OWNE MAIL RECEIVED BY DATE OF APPL. DATE ISSUED ADD S CITY No ' USE ZONE ( MAP N I TYPE I GROUP I FIRE'ZONE CONTRACTOR NOL. 7 � ZONING DATED ADDRESS APPROVED Br_- - - 07q. TLEGAL DESCRIPTION LOT NO.74u9(7rI BLOCK SETBA KLINE: APPROVED DATE TRACT µOW ON LOTS O By: HOUSE NO. DATE USE OF _SIZE OF LOT /_J x�j?O I EXISTING BLDG O SIGNED BY APPLICATION FOR CORRECTIONS OCCUPANCY DATE INSPECTOR INSPECTION I SAFETY PERMI .......... ..............—•••-••--••^--_.._.._.._...........------.---------------.... MISCELLANEOUS .-1,,-..« L/,.''.''..11.3.,1��Xyy-../``1''r 1.--$..-:l L -----•-------- TRAILER USE I LIMITED TIME USE��!/� ) ---•--...C..--(J.A:__...i1.f.1!::�C..__Y�s !�'� ..�------ / f J� FROM: Ll I ��t/ TO- ��'D/_� -------------------•-----^-•-----...••---•------._.._ _.. .T....................-- USM OF STRUCTURES DEY CES ............ ................. ...................................................-----•--------------------.. l --------------i------------------ ------------------•--------•------------------ ---------------------------- ---------------- -------- --------------------------- ---------------- -------- -------------------------•------------ ------------------------ t -1---------------------------------------------------------------------i ------------------------- L G>� fi INSPECTIONFOR ................1--_...----------------_.--------------------------------------------------------------------.. OCCUPANCY AS .................................................................................................................... I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS _ ............... CORRECT. .-.—... ------------------------------------- 1. I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES .I--------------1-------...----................................------......-.-.-.....)------------------..-.....- AND STATE LAWS REGULATING BUILDING CONSTRUCTION. APPROVALS SI GNATUF2t LJF' LW INSPECTOR'S SIGNATURE DATE PERMITTEE �_ OCCUPANCY APPROVAL N GROUP OcC.LOAD N r ADDRESS in TRAILER USE I, In AUTHORIZED AST. SAFETY PERMIT O STRUCTURE APPROVED MISCELLANEOUS FEE I $ TEMPORARY TEMPORARY - m STRUCTURE REMOVED PERMIT FEE $; FINAL APPROVAL I i WORKERS'COMPENSATION DECLARATION ""'""" id ISCELLl�;�t�cgUt:� APPL,.IIL-Al �VI�I 20-0063DPW12/20 1 -� I hereby affirm that 1 have a certificate of concent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION �- l 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 1 l BUILDING ADDRESS ADDRESS ❑ Certified copy is hereby furnished. Q LOCALITY 91 ElCertified copy is filed with the county building inspection CIT /) ZIP NEAREST department. P.fn (r t� CROSS ST. i I Date Applicant SIZE OF LOTI NO.OF BLDGS.NOW ON LOT DISTRICT NO. GROUP TYPE PROCESSED BY CONST. CERTIFICATE OF EXEMPTION FROM WORKERS' TRACT BLOCK LOT NO. t ) 1 HWAY COMPENSATION INSURANCE NO..ON(CIRCLE) NO. STATE MAJOR SECOND LOCAL ' (This section need not be completed if the wor) involved ASSESSOR MAP BOOK PAGE PARCEL USE'LONE SPECIAL CONDITIONS by the permit is for one hundred dollars (S 100) or less.) i OWNER I TEL NO. } I certify that in the performance of the work for which this I property permit is issued. I shall not employ any person in any' manner so as to become subject to the Workers' Compensation Laws. ADDRESS OCCUPANCY GROUP } Date Applicant _ CITY ZIP NOTICE TO APPLICANT: If. after making this Certiiic:::e _ OCCUPANT LOAD of Exemption, you should become subiect to t11: Workers' APPLICATION FOR EXIT HARDWARE: i Compensation provisions of the Labor Code.you mu-1 forth%%ith comply with such pro%istons or this permit shall oe deerPed TRAILER USE L_I GEOLOGY INSPECTION J No Spec.Knowl. ' revoked. 0Panic Devices I .;^.UPANCV'INSPECTION� LICENSED CONTRACTORS DELL.ARATI()\ I hereb} affirm that I am licensed under provisions of Chapter SAFETY PERMIT (LIST ITEMS BELOV/ 9(commencing%%ith Section -10%10sU I of Division 3 of the Busin-:sNo.of-EXITS and Professions Code.and my license is it full force and effect• PARKING• RCG'D I I I PROVIDED € License Number _._ Lic. Class _-__ SPACES Contractor — Date _—.—__..— LIMITED TIME USE DATE DATE I am exempt from the licensing regUirenlelns':l} I Lit' .j FROM. TO: I licensed architect or a registered profession a, er,=;n:-:; INSPECTOR*S acting in ni% rofes�ivnaal ca .jelly(SeCllon 7tr,;. BUfll':�: cIZE OF I NO.O� SIGNATURE � 'i 1 and Professions Code). p EXISTING BLD:. ;STORIES PRESEN-USE O"BUILDING FIN'_APPROVAL �3•a�0 Lic. or Reg. No. __. Date--..---- ' HOME OWNER-BUILDER DECLARATION NO.OF EXISTING BUILDINGS (�a ON LOT AND USE `fl I hereby affirm that 1 am exempt from the Contracim's Licen.-e �., Las for the following reason (Section 7031.1. Bu.iness and 1 Professions Code): I NO.PARKING � SPACES PROVIDED ❑ 1. as owner of the property. will do the work and ibe structure is not intended or offered for sale(Section 7044AX PROPOSED USE OF BUILDING I. Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending Igenc%fe: the performance of the work for which this pei;lj is issue i PROPOSED MAX.OCC (Sec 3097. Civ. C..). I Lender's Name _. APPLICANT;FR:M i TEL NO. Lender's Address ADDRESS } I certify that I have read this application and star? that the above information is correct. I agree to comply with'ill County PERMIT FEE ordinances and State laws relating to building constrvedon.and l hereby authorize representatives of this County to enter upon IISSUANCE FEE y the above-mentioned property for inspection purposes. ! TOTAL FEE % - � — SEE REVERSE FOR EXPLANATORY LANGUAGE Signatu of Permit ree [?ate I