HomeMy Public PortalAbout9239, 9241 LAS TUNAS DR_Miscellaneous__ WORi,LRS ('01IMPI.NSIMION DE( LARN1101,! -,t.11
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I I MISCELLANEOLJS APPLICATION
I
hereby affirm thal I have it ceiiil'iCilie 1110011—im Io sell Ot'-z3-1 COUNTY OF FOS ANGFIES Bt-111-DING AND SAFETY DIVISION
insure.or a ccitilicit[c of, Wolkels,( ollipcil.'ai I w hi'lif mcc. or
it :ertihed cop) thercol' (Sec- 3800, Lah. ( A 11
J Policy No. Company FOR APPLICANT TO FILL IN BUILDING
ADDRESS
0 Certified copy is hCrehY furnished. BUILDING ADDRESS LOCALITY
❑ Certified CoPY is Idled with the C01111h hLIIIdIII2 Ill')OCCIIIIII CITY ZIP
department. C
I Aql-Tf 0 NEAREST
Uk � I CROSS ST.
Date Applicant SIZE OF LOT 0 NO.OF BLDGS.NOW ON LOT DISTRICT NO. GROUP TYPE PROCESSED BY
CONST.
LRI IFICAI L OF I XENIPI ION IAMNI \VORKLI.S*
TRACT BLOCK LOT NO.
NS HUN INSURAN( HIGHWAY
ONI I'L A (CIRCLE) STATE MAJOR SECOND LOCAL
(This seclion need not be completed If Ilic "oik ir%ohe(1 —ASSESSOR MAP BOOK PAGE PARCEL 'ISE ZONE SPECIAL CONDITIONS
by the permil is for one litindred dollars (S 111111 or less.)
TEL NO.
p _--
so
--- ___L
I
certify that it) the performance III the \wtk III[ Mi,,_11 this OWNER
ermil is issued, I shall not cmplo\ illi� pCimm III :111\ ILIHI)el
so its to become subject to the "Iwkcis' ( oiilpcw,mml( Lab's. ADDRESS OCCUPANCY GROUP
Date----- Applicant CITY ZIP
NOTICE TO APPLICANT: If. abler makim-, 1.1
this ( C111kale OCCUPANT LOAD
of Exemption, you Should become Subjectto the Workers' APPLICATION FOR
Compensation provisions ol'the Labor Code,you filtist Ioi thwith EXIT HARDWARE:
comply with stich provisioiis or this penuit sh;,11 he 15ccmetf TR .(LER t,,E El GECILUG Y INSPEC MON No Spec.Know(. ❑0
revoked.
LICENSED CONTRAC'MRS DI:('I ARAI I()\' OCCUPANCY INSPECTIONN Panic Devices
I hereby afTirm that I ain licensed under provn
isioN III ( haptcr
SAFETY PERMIT F1 LIST ITEMS BELOW,
9(commencing with Section 7000)of'Di\ision 3 of'the Business NO.OF EXITS
and Prol'essions Code.and my license is lit I'till force and effect.
PARKING REQ'D PROVIDED
License NLIIIIher Lic. Uljss SPACES
Colillaclor Dale LIMITED TIME USE
❑ DATE DATE
I am exempt Irbil) the licensing requirements as 1 am it
licensed architect or it reListered professional ciwitwcr FROM: TO:
acting in ni) professional capiicity (Section 70il, li:isiilcs, SIZE OF NO.01 INSPECTOR'S
and Prolcssions Goda RESENT USE OF BUILDSlORILti S!�GGATUPE
'y PING
Lie. of Reg. No. Dale FINAL APPROVAL
01;;t_6 VV%C_y If" Offl�� 6e_–�AL LIS I
I ION4 L OW N 1:R-lit I 11.DI:R OL( I A RA 110 N t4l, OF CXV�I ING BUILDINGS off )
IN LOT AND USE
----------- C
licich) al,I)IIII 111;11 1 ;1111 cwIIII)l IwIll Illi' Colill'ItIol" I Ir cllw
law )-0I the toll,milig reason (Section /Oij,". lftlsillcs> and
Professions Code): NO.PARKING
SP,\CE-,PROVIDED
❑ I. its 0WA1cr of the property. \\ill d" the 11,Iik :olid lit,-
slilicillic is not intended 01 )It,c1cd I"I sale(SCcIIk;.,j -/oil. PROPOSED(ISE OF BUILDING
Business and P101'ession's Codcl.
CONSIRUCTION I-I INDING AGEM
I hereby zill'irm that ilicic is it cotistiuctim, clidiiiii W0;C\ lot
the performance of [lie work tot which This pcill-lit 'is issued
(Sec. 3097, 0\. PROPOSED MAX.OCC.
Lendcr's Name APPLICANT(PHI'll I TEL NO.
LJ,4 f.JA L-4 A
Lender's Address ADDFdESS
I certify that I have lead this application and stale LI-jil the I C—- M4 K A-4 Jp-r. -re.Ie_ &t 7
above inl')rmation is correct. I agree to comply with all CIILIIIIy PERMIT FEE --r—I �)
ordinances and State laws relating to building COI]Strticti n,and
hereby authorize iepresentati\cs of this Collim,
' to enter Upon ISSUANCE FEE
the above-nient ionedpro oem� 111SI)CC11011 purposes.
TOTAL FEE
SIA Rl-\'LRSL FOR EXPLANATORY LANGUAGE
I'� Signature of nuuLL 14t, I