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HomeMy Public PortalAbout9428, 9426 LAS TUNAS DR_Miscellaneous__ 76M444 DEIS 75 12-54 M0SCE LL9- NdOUSA9 Y LICATI ON ; DIVISION OF BUILDING-AND SAFETY ' OCCUPANCY-SAFETY-TRAILERS Department of County Engineer. County of Loa Angeles* B U I LDI N WM.J. FOX, COUNTY ENGINEER ADDRESS &" �V q�, CASSATT D. GRIFFIN, SUPT OF BUILDING FOR APPLI AN TO FILL IN LOCALITY �f /�E'My���� NEAREST' OWNER f�'(J.TTT(��®E�Q '.. L�"F/YC.G�UL-�D/P/Pi)/>•• 'CROSS ST: . MAIL DISTRICT O. G OUP TY'•CONST. ADDRESS7i�.%t� �C � n TEL./,4 y{, I Z/ �f'M p� .�� � NO. CITY / � //_@ +17 _ MAP STATE YES, O, • TEL. . NUMBER Q HWY CONTRACTOR' NO. USE ZONE SPECIAL _ - CONDITIONS'• ' ADDRESS � � //� � _ LEGAL 'y DESCRIPTION 'I LOT NO. L4). BLOCK - BUILDING - EXIST. YARD HWY STREET NAME i' NO. OF BCDGS. SETBACK - WIDTH TRACT 6 6 SO I I NOW ON LOT .,1 SIZE OF LOT 6'Q X �V I EXISTOING'BLDG.S" SIDET S• TUJI/�J APPLICATION FOR P. L. OCCUPANCY INSPECTION,RECORD , - � INSPECTION, I SAFETY PERMIT ' .TRAILER USE I. LIMITED TIME USE. ' .......................:i........................................... ........................................................I.................................... " ........................I....................................................................................................I................................... . DATE. .. DATE ....:...................I:.................................................................................................i...............I..................... FROM: TO: ' USE-OF STRUCTURES,OR- DEVICES ................:.....I.....................,.:.......:................;...............................................:.I..................................... ......................L.....,...........................................................................................I..................................... ....................I..................................................................................................I..................................... .................:...I.:........._............................... ......................................................................................................................L.......,..............:............. 'APPROVALS INSPECTION FOR _ I DATE• I INSPECTOR'S SIGNATURE OCCUPANCY AS _ OCCUPANCY APPROVAL - HEREBY ACKNOWLEDGE 'THAT 1 HAVE RETHIS� GROUP 'OCC. LOAD'. APPLICATION AND STATE THAT THE ABOVE IS:CORRECT - AND AGREE TO COMPLY. WITH ALL COUNTY ORDINANCES TRAILER USE AND 'STATE. LAWS REGULATING 'BUILDING- CONSTRUC- TION. SAFETY PERMIT ' SIGNATURE PERMIT /!i�.- TEMPORARY - `TTC � `O STRUCTURE APPROVED ADDRESS+' � "� -^®"�• � ^ :TEMPO"RARY v STRUCTURE REMOVED INAL A ROVAL /// /�y ���"�A• WILLIAM J. FOX, COUNTY ENGINEER Ar0 6 1 7 Olt'3 MAY 5 2 : 2 A 5.G u - BY 2 6.2,a;.- P;IOU 1 .0 4_.8 A. . A .. DEPUTY DEPUTK 76M444-CE #8754-67 MISCELLANEOUS APP ICATIO 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BADo EISSSS BUILDING AND SAFETY DIVISION JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY COLEMAN W. JENKINS, SUPT. OF BUILDING NEAREST CROSS ST. FOR APPLICANT TO FILL IN o CT�NCI., GROUP TYPEP D;BY G CONST.BUILDING ` I 7 /�-S�` MAP HIGHWAY ADDRESS _ N0. 0 (CIRCLE) STATE MAJOR SECOND LOCAL LOC ALIT y__.,7 USE ZONE SPECIAL CONDITIONS NEAREST ,I� C, CROSS sr.. (�/ LEGAL �f,t�c/0 /120 REQUIRED YARD HWY STREET NAME EXIST. SETBACK DESCRIPTION LOT NO. /"/ BLOCK WIDTH _ FRONT NO. OF BLOGS. P.L. TRACT NOW ON LOT ' SIDE USE OF P.L. SIZE OF LOT EXISTING BLDG. OWNER MAIL V ~ ADDRESS TEL. r } CITY NO. d O APPLIC TION FOR ` v OCCUPANCY c> O INSPECTION SAFETY PERMIT !— v s 41 TRAILER USE CL Cn USE OF STRUCTURES OR DEVICES I Z LIMITED TIME USE DATE DATE FROM: TO: INSPECTOR'S APPROVALS DATE SIGNATURE OCCUPANCY APPROVAL I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GROUP OCC. LOAD APPLICATION AND STATE THAT THE ABOVE IS COR- RECT AND AGREE TO COMPLY WITH ALL COUNTY TRAILER USE ORDINANCES AND STATE LAWS REGULATING SUCH WORK AS INDICATED HEREON. SIGNATURE OF �f SAFETY PERMIT PERMITTEE TEMPORARY STRUCTURE APPROVED ADDRESS Z/ f TEMPORARY If STRUCTURE REMOVED FEE rj t� y�; FINAL APPROVAL 1, ! G' '� APPLICATION VALIDATIONJOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER (NOT A PERMIT) CK. m.0. CASH PERMIT VALIDATION CK. M.0. CASH L 0 4 8:7.;6-\ MAY 31.2 2 D 15.00- WORKERS'COMPENSATION.DECLARATION 76M44 CE 875 (2-80) MISCELLANEOUS AP'PL'ICATION I hereby. affirm.that I.have a certificate'of consent to"self Insure'or'.a certificate of Wotkers'`Compensation Insurance,or COUNTY'of'LAS ANGtLES BUILDING AND SAFETY DIVISION N a certified copy thereof.(Sec.3800;Lab.`C.) Policy.No. Company FOR'APPLICANT.TO FILL-IN wooeEss o? �- Certified copy is'hereby furnished. BUILDING LOCALITY UILDIN LOCAL ..}. - - a .Certified copy is filed vbith,the county building inspection" : NEAREST d : 1�sc� LOCALITY • department.- ," , 'cRoss'sr Date - Appllc ant' Pm NEAREST .. DISTRICT�' GROUP TYPE PROC SED.BY x - CROSS ST. ! D CON{yQ�T/ CERTIFICATE OF EXEMPTION FROM'WORKERS' ' f LEGAL �D ESCRIPTION .LOT NO BLOCK MA HIGHWAY. COMPENSATION.INSURANCE - ��6 7 - NO OF BLDG NO. - (CIRCLE)- S - , TATE MAJOR SECONDLOCAL d - (This section .need'not"lie completed if th'e work''involved TRACT.." Now ON LOT'S USE ZONE SPECIAL CONDITIONS " " , 0 .. by the permit-is for ohe hundred 'dollars',{$100) or less.) USE OF - - SIZE,OF LOT - EXISTING BLDG I certify that in;the.performance of.the work for which this V V O." permit is issued, I shall not employ any person In any manner OWNER of b.uad U so as to become subject to the Workers 'Compensation Laws: OCCUPANCY GROUP- uJ _ MAIL _ _ y{� ` .. D-DRESS 9/ _ V'- LL S „� (,�-Pt/t 7.. CL Date Applicant NOTICE TO-APPLICANT;_If,.after'_ -making.this Certificate of IrY ` g.. len, �., t NOl - OCCUPANT LOAD Q "s '�..® Z . Exemption, you-should":.become subject to.`the,Workers' APPL CATION 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❑ .. deemed revoked. . NO $peC`YKnoWl. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPEC11 TION _ Panic Devices I hereby.affirm that.I am licensed under provisions of Chapter. SAFETY PERMIT L I (LIs-r ITEMS^BELOW)' NO. OF.EXITS ' 9 .(commencing with Section,7000) of Division 3 of the Busl ':•' ne'ss and Professions Code; and my,license is in^full force and - PARKING..' .TT'� . .effect. - - • REO'D_ 'PROVIDED, -- PARKING.- SPACES �� - License Number :Lic.Class ,LIMITED-TIME USE' Contractor Date DATE DAT E. - - ...• - - FROM: TO: ElI am exempt from.the licensing requirements as I am a: licensed architect.,or a registered' professional engineer SIZE OF No. of rrvseEcroR's acting in my,professional capacity. 7051, Bus- EXISTING BLDG .,,3p X. a" a ltf�%� t•, roRIES mess and Profe`ssionsCode). FINAL APPROVAL SIGNATURE - - RESENT,USE OF BUILDING - tLic.or'Reg.No. Date' / r /Z'e,S'1`&K HOME OWNER-R`BUILDER DECLARATION, NO. OF EXISTING BUILDINGS • ,. - ON:LOT AND USE - hereby affirm that, I am-exempt from the Contractor's icense' Law for the following'reason (Sectiorr,7031:5 Busi- . ss and Professions Code):. NO. PARKING .'s.. - '. SPA CES PROVIDED. I, as owner of the property, will do the.work and the structure is not ,intended or offered for'sale.'(Section oe .7044,Business and Professions Code).,' - 0.4 Q i - - ROPOS ED USE OF BUI-LDING C,G O CONSTRUCTION LENDING AGENCY u o I hereby affirm that there is a construction'lending agency t�5 ��i. .r�.M't for -the performance;of the-work for wJlich-this permit is issued(Sec. 3097,Civ.C.): Lender's'Name PROPOSED ntwic..occ.`' Lender's Address' .:"PERMIT FEE. - r .. •t' .. I certify. that I have read this application and state that.the. -above information is correct.-I agree to.COmplywith all County ,Issues NCE FEE - ordinances' and:State laws relating'to building construction,. TOTwL'i EE and hereby authorize' ,pesentatives of this County to.enter pon the above-menti ed .property for inspection' purposes. SEE REVERSE YOREXPLANXTORY.LANGUAGE Signature of Per ittee Date Yr ORKERS'COMPENSATION DECLARATION '- — ',76M444. /A� pp '' APPLICATION AA ®p /� T N r. —z CE 875 (2=80), ISCE'.LL6'°i��®4.JS. /'irf��.�/'1 1 �01V hereby affirm'that- I have, a certificate of.consent•to se ; insure, or-a certificate of Workers'Compensation Insurance,,or, ETY:DIVISION :,.: . .. a certified copy thereof(Sec:38OO;,Lab.,C.)> COUNTY OF LOS ANGELES BUILDING AND'SAF. Policy No.' _ CompanyFOR APPLICANT TO FILL IN BUILDING_ ADD RESS �"• - - . py'. . • - UILDING.. 4� 4,,45 rVl)A.5 �� T Certlfied'co Is hereby furnished., -LO LI Y' ADDRESS Certified copy is filed with the county building inspection. NEAREST, � • LOCALITY, Imo.{;S.'• V/v'I✓ �!''� P4Y vI .,[JT "depaltment. - - TCROSS ST.. Date Applicant EAREST �/ �'^ DISTRICT NO. .J.�OtJj�TYPEROCES D BY . CROSS'ST. G tom- S/• -:CERTIFICATE-OF EXEMPTION FROM WORKERS LeGAL ~ DESCRIPTION LOTNO.; • BLOCK' - MAP 'HIGHWAY C T COMPENSATION-INSURANCE .. NO .(CIRCLE) - TAE:MAJOR SECOND CAL Q.NO. OF . (This section need not be:completed if the-work involVed TRACT 'NOW ONBLOT S USE ZONE SPECIAL CONDITIONS by the permit is for one hundred dollars ($100), of less:) TO .. - USE OF'... I _ - - SIZE OF LOT - EXISTING BLDG.., //'•�' .. .. ✓ 2 I certify that in th`e.performance of the work•for'which this �/ _ O permit`is issued, I,shall not employ any.person in any manner wryER 2O7'Df.' ' ,� 6WAn!j�?,/T/�! j' U .so 'as to become subject to, the'Workers Compensation Laws. AIL. OCCUPlANCY GROUP _ W " 3 ADDRESS a Date' Applicant TEL. �p��dd I p� O OCCUPANT LOAD ? NOTICE'TO APPLICANT`-'If, after_ making this Certificate of cITY �?7 �Jf�1 nio �' Zd l 9�j Exemption, you should .become subject to :the .Workers' Corrlpensation provisions,of the Labor Code,`you mustforth- APPLICATION FOR EXIT HARDWARE: ,,with comply With such ,provisions or"this permit shall be - TRAILER.USEGEOLOGY INSPECTION O NO Spec. KnON/F:.❑ - deemed revoked. LICENSED CONTRACTORS DECLARATION, - OCCUPANCY INSPECTION PanIC'peVICeS El - I hereby affirm that I'am licensed under provisions of Chapter _ .sw FEry PERMIT V (LIST,ITEMS BELOW( NO. OF EXITS 9 (commencing with Section 7000) of Division'3 of the Busl- ness and Professions Code, and my.license is in,full force and'" effect. PARKING., REO D PROVIDED. . - - SPACES License Number_ Lic.Class Contractor' - LIMITE:D TIME USE _ Contractor, Date DATE DATE FROM: TO.: ' ❑. I am exempt fro m'the licensing requirements as.I am a I licensed architect o.r'a. registered ,professional engineer SIZE OF _ NO:OF NSPECTOR s SIG MATURE acting in'my professional.capacity (Section '7051,.Bus= Exisrlplc,BLDG sroRIES iness and'Professions Code}:; d�� Dmf A,v - P SENT--USE,,OF BUILDING O�F�7��L M 10 FINAL APPROVAL' LLc.or;Reg.No Date 770 NO.OF EXISTING BUILDINGS- e HOME OWNER-BUILDER DECLARATION ON LOT AND USE �} `u� y affirm that I, ani exempt -from the Contractor's:' t , License_.Law-for the following`reason (Section;7031.5,_Busi, $4 4 A ness and Professions Code). NO-. PARkING:,`, # o e ,.y. - 'SPA.CES PROVIDED ' .0'.O er structurent 'is- nothntendedty,'will do the work,and tor offered for sale (Section o-o ® o a o_o z p h 7.044, Business and Professions Code) ��/ � y>r� V��e/ p (l 1--5-­8 5 .i. _ OPOSE.D USE OF,BUILDING /I '� _ , 'CONSTRUCTION LENDING.- AGENCY 1•,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 _. PERMIT FEE I certify that I have read_.this.,application and state that the - - 'above informationis correct.I agre' eto comply with all•County. ISSUANCE FEE prdinances and State laws relating'to building construction, and hereby authorize:representatives of this County to enter -TOTAL_FEE up I the above-me, tinned.property for inspection,pilrposesr SEE REVERSE FOR EXPLANATORY LANGUAGE Si tune of Permitt ! i/ ... 1 ee Date WORKERS'COMPENSATION.DECLARATION ' ' CE 84542-80) M.JSC E L A N EO IC. A PPI ICAT I®_A1 . I 'hereby.a'ceiti that .I have a ,certificate at'n Inset to self COUNTY OF.LOS ANGELES I�9 V"•7BUIPL9DINGLA_ND.SAFET.Y IDVIVISION insure, or-a'certificate of Workers'Compensation'Insurance;or '. , -.a•certified'6opy thereof(Sec. 3800,Lab,. C-.) Policy No. Company FOR'APPLICANT TO FILL IN BUILDING - _ ADDRESS,..' Certified copy is.herebyfurnished:' r3ilaLplty; ' / n/AS b, �G t-�[AS �.0 LOC ALIT,Y. C.�[.: • •, - i -. ., •-... ADDRESS `,. - ❑ Certified Copy is..filed With the county building inspection - ;-. .y - NEAREST :department. LOCALITY �M-f�C CITY. CROSS ST. Dqg ate Applicant— OFIEXEM PTION.yFROM WOR RAREST d J DISTRICT NO.`, jROP° TYPE PRO SSED B pp - : - CROSS'S 1G �. (/ry'/ CONSTI KERS LEGAL DES CRIPTION- LOT•NO BLOCK NP RIGHw Ay COMPENSATION INSURANCE U' STA T E MAJOR SECOND LOCAL >• �' •: .. NO'.�OF BLDGS, .N O. Z�© (CIRCLE-) ®. (This section need not b&•completed-if, the work"Involved TRACT NOW ON LOT.' USE.ZONE SPECIAL CONDITIONS•' �' by the;:permitisfor one'hundred•dollars-($100)•or less.) „ USE SIZE OF LOT. EX STOING BLDG / / Y I certify that m the performance of the work,for which this permit is issued, I shall not employ, any person in any manner owNER ��(� jzf• /�yfe E , Er 'so as to become subject'to the Workers' Compensation Laws. alp= OCCUPANCY GROUP: - 1 h ADDRESS '•�.0-v .,e_',444 7 I�SGA - _ U.1 . Date -.. Applicant-' s. D t?'P N -NOTICE TO APPLICANT: If,:after making#his Certificate of "Ty CE C/T No O 3 OCCUPANT LOAD g Y-. ;' 9 Exemption, you-should. become..subject' to the',Wo kers' APPLICATION FOR EXIT HARDWARE: 'Compensation provisions of the Labor'Code;`you must forth with comply' with such provisions or this' permit.-shall be TRAILER USEo GEOLOGY INSP.ECTION.a S'peC deemed revoked: ` OC CUPANCY.INSPECTION - No . Knowl Panic Devices :'❑ LICENSED CONTRACTORS DECLARATION El I hereby affirm that.I am.liiensed under provisions of Chapter``. SA FETY•PERMIT (LisT.ITEnns BE�ow) a- 9.r' mmencing with Section 7000)of Division-A'of the,Busi- o XI N OF E TS ' ne s and Professions Code,'-and my license is in full force and PARKING effect. , _ REO'D C� PROVIDED .. License Numbei_ ' •- - Lic.-Class SPACES LIMITED. TIME, USE Contractor 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 r /- - =.NO. OF _ - INSPECTOR'S 'J-�Xf �NL SIGNATURE acting in MY-:professional :capacity (Section 7051, Bus- EXISTING BLDG! STORIES �1 mess'andPTofession.sCode) FINAL APPROVAL �.•� Lic'.or Reg.No. Date _ ESENT USE'OF BUILD ING �`.res rrryff� ''., ..i NO. OF EXISTING BUILDINGS - _ -. •r' HOME OWNER DECLARATION •- s.. ON LOT AND USE. - 1. 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 - • SPAcESPROVIDED - O I;.as owner .of the property,•will_ do the..work•and the z 3 5 (l jA,- .. structure is -not intended or�offere'd :for sale (Section #r 7044,•Business and Professions Code). `, • OPOSED.'USE OF,BUILDING /2�s74VA e e e g g CONSTRUCTION LENDING-AGENCY o a o"o eio`o':z -I hereby;affirm.that there is a construction lending-agency for'the' performance, of-the'work for,which this permit is G,0`5,-82 issued(Sec. 3097,-Civ.C:),.=' L'ender's Name g'RoaoseD Maic. oce.' Lender's Address 'PERM-IT 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 ordinances and State laws.relating'to,building construction, i TOTAL FEE J 40,0 �© and hereby authorize'represe�at�ves of Phis County to enterupon the above mentiope vfor inspection'purposes. SEE REVERSE FOR EXPLANATORY'LANGUAGE V001,312 , '82. 41 Signature of P.ermitt Date i:15'e V RS'COMPENSATION DECLARATION 76M444 MISCELLANEOUS APPLICATION • CE 875(11-84) I her y m 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 J ADDRESS (0 Certified copy is hereby furnished. BUILDING q y2 f `AE 1UN1�'� �� ADDRESS!/��/ (✓ J LOCALITY Certified copy is filed with the county building inspection LOCALITY NEAREST department. 0 CROSS ST. Date - 1 . Applicant NEAREST DISTR (1Nff��. G OUP TYPE P•e}�-ESSED BY CROSS ST. • n 1/ - CONST. (� s CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL 'd (((��� t[�(•6/J COMP NSATION INSURANCE DESCRIPTION Ir NO. BLOCK MAP HIGHWAY ` NO. (.CIRCLE) STATE MAJOR SECOND LOCAL NO. OF BLDGS. (This section need n t 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 i SIZE OF LOT EXISTING BLDG. - ' I certify-that in the p formance of the work for which this permit is issued, I shall of employ any person in any manner OWNERf j67-4; to/1 44 0_x so as to become subject to the Workers' Compensation Laws. MAIL OCCUPANCY GR UP tz / r Date Apph ant AD DR ESS (j C'. AS jv )P,• NOTICE TO APPLICANT. If, after making this Certificate of CITY• ��( j CC=CIvo gl& 2�7-�� OCCUPANT LO D Exemption, you should ecome subject to the Workers' z Compensation provisions o the Labor Code,you must forth- APPLI ATION FOR EXIT HARDWARE: _ With comply with suchp visions or this permit shall be TRAILER USE E] GEOLOGY INSPECTION E] No Spec. Kno �• deemed revoked. LICENSED CONTRA TORS DECLARATION OCCUPANCY INSPECTION ❑ Panic Devices I hereby affirm that I am lice ed under provisions of Chapter SAFETY PERMIT ❑ (LIST ITEMS BELOW) 9 (commencing with Section 7 00) of Division 3 of the Busi- NO. OF EXITS ness and Professions Code,and y license is in full force and -30 ••M, a (n`l effect. - 3a/� I r"1 `v S �GPARKING SPACES REQ•D PROVIDED License Number ic. Class 759www LIMITED TI E USE Contractor to D A•f E DATE I am exempt from the licensrequirements as I am a licensed architect or a registe ed professional engineer SIZE OF NO. OF PROM• TD• INSPECTOR S acting in my professional capa ity (Section 7051, Bus-, EXISTING BLDG. STORIES SIGNATURE inessand Professions Code). FINAL APPROVAL 3/' �• 9/ PRESENT USE OF BUILDING t. C�r- ✓ Lic.or Reg.No._4 Date HOME OWNER-BUILDER DEC ARATION NO. OF EXISTING BUILDINGS ON LOT AND USE I hereby affirm that I am exempt fro the Contractor's - -- -l-!J- - -- License Law for the following reason (Se ion 7031.5, Busi- ness and Professions Code): No. PARKING =2'=`I' ❑ 1, as owner of the property, will do t e work and the SPACES PROVIDED structure is not intended or offered r sale (Section O / 7044,Business and Professions Code). ' CONSTRUCTION LENDING AGENCY PROPOSED USE OF BUILDING I hereby affirm that there is 'a construction lending agency A E-S TA L, )kA J,/ 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 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 p?� upon the ab e-me tioned property for inspection purposes. �jlit'�� � / E REVERSE FOR EXPLANATORY LANGUAGE Signature of RI55—mittee Date :>W,QWERS'COMPENSATION DECLARATION CE 875 (11-84) MISCELLANEOUS APPLICATION • CE 875 I hereby affirm that i have a certificate of consent to sett' 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 Certified coy is hereby furnished. BUILDING / p ADDRESS � ; —_ � v �S LOCALITY Certified copy is filed with the county building inspection LOCALITY ._.� ' NEAREST department. �_vA_ to 1� �� CROSS ST. Date Applicant NEAREST DISTRICT GR UP TYPE PROCESSED BY CROSS ST. � �/ CONST. CC:: CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK MAP HIC Hw AY - -_ rvo. (clRctE) STATE MAJOR S CO ND LOCAL ' NO. OF BLDGS. (This section need not be completed if the work involved TRACT NOW ON LOT I USE ZONESPECIAL CONDITIONS by the permit is for one hundred dollars ($100) or less.) USE OF 5 E OF LOT EXISTING BLDG. �./ I certify that in the performance of the work for which this CD permit is issued, I shall not employ any person in any manner OWNER S U VA DE Q4 06V.SU i3 y so as to become subject to the Workers' Compensation Laws. _ OCCUPANCY GROUP• Date Applicant DOREssq Lf 2 I—�S .( [�(VA� DP-, - o� ER�� C.3 TEL g(g) 2c5�_`��ySD OCCUPANT LOAD NOTICE TO APPLICANT:'If, after making this Certificate of CITY PLE O( LO No. c"i, Exemption, you should become subject to the Workers' z Compensation provisions of the Labor Code,you must forth- APPLI ATION FOR EXIT HARDWARE: with comply'with such provisions or this permit shall be TRAILERUSE ❑ 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 PERM I ❑ (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 SPACES REQ'D D PROVIDED D License Number Lic. Class LIMITED TIME USE Contractor Date DATE DATE ElI am exempt from the licensing requirements as I am a FROM: TO: licensed architect or a registered professional engineer SIZE OF NO. OF INSPECTOR'S acting in my professional capacity.(Section 7051, Bus- E TING BLDG. STORIES SIG ATURE iness and Professions Code). Lic.or Reg.No. Date PRESENT USE OF BUILDING ecJ.• - �(� FINAL APPROVAL �Z7,., HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS ON LOT AND USE I hereby .affirm that I am exempt from the Contractor's `f # ® ® ° o B License Law for the following reason (Section 7031.5, Busi- N ness and Professions Code): NO. PARKING ° ❑ I, as owner of the property, will do the work and the SPACES PROVIDED structure is not intended or offered for sale (Section0 3 1 b 8;. 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 " above information is correct.I agree to comply with all County ISSUANCE FEE ordinances and State laws relating to building construction, _ anher authorize representatives of this County to enter TOTAL, FEE u o die an ue-me tioned' roperty for inspection purposes. /� �c�i2 SEE REVERSE FOR EXPLANATORY LANGUAGE C1 Signature of Permittee Date WORKERS'COMPENSATION DECLARATION76M444 . CE 875 (11-84) MISCELLANEOUS APPLICATION I ere, o3afcert that I have a certificate of coInsur nc self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION inswre, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab.C.). Policy No. Company FOR APPLICANT TO FILL INBUILDING �a� ADDRESS �" F7 Certified copy is hereby furnished. Bu,LDING idyl ^ eo ADDRES .S �2 C: �. f� LOPCA LITY Certified copy is filed with the county building inspectionLocwLlry NEAREST department. CROSS ST. Date Applicant NEAREST DISTRICT NO GROUP TYPE P ESSED BY PP CROSS ST.' ��)C r,J�,S �� corvsr.�/ CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL. - Y C� COMPENSATION INSURANCE DE SCR IPT[ON LOT NO. BLOCK MAP HIGHWAY _ NO. (CIRCLE) _ ,STATE MAJOR SECOND LOCAL NO. OF SLOGS. - (This section need not be completed if the work Involved TRACT NOW ON LOT USE�ZO NE 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. a permit is issued; I shall not employ any person in any manner o OWNER so as,to become subject to the Workers' Compensation Laws.: . Y OCCUPANCY GROUP MAIL o Date ApplicantADDRESS p �_ Pcr3 TEL. Ul NOTICE TO APPLICANT: If, after makingthis Certificate of CITY '� 9 No. OCCUPANT LOAD z 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 provisions or this permit shall be TRAILER USEGEOLOGY INSPECTION Eldeemed revoked. ❑ ❑ No Spec. Knowl. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION E] 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- 11,,�,, --.. -- \ NO. of EXITS ness and Professions Code,and my license is in full force and 4X l PARKING SPACES -I effect. h&N REQ'D PROVIDEDLicense Number • Lic. Class (L-& S 0 Ttlij 1 eu IS. N& LIMITED TIME USE Contractor Date AS SUN S- R- DATE DATE I am exempt from the licensing requirements as I am a Te us o 1ry, ofA q i FROM: To: licensed architect of a registered professional engineer SIZE OF NO. OFINSPECTOR'S acting in my professional capacity (Section 7051, BUS- EXISTING BLDG: STORIES SI ATURE iness and Professions Code). FINAL APPROVAL H -TD ' 1 Lic.or Reg.No. Date PRESENT USE OF BUILDING 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, Busi- ness and Professions Code):. NO. PARKING I, 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 TV ) &=, t ' /emy 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 - 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 FEt ordinances and State laws relating to building construction, and hereby authorize representatives of this County to enter TOTAL FEE upoUthbove-mentioned pro erty forinspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee v/ Date WORKERS'COMPENSATION DECLARATION 76Iv1444 CE 875 (2-80) .,.:MISCELL NEO.US_.-A®pL'ICp T ION ,py af�;;m that I have a certificate of consent-to self, insureor a certificate of,Workers'Compensation Insurance,or COUNTY OF LOS ANGELES. ` . BUILDING:AND S"AFETY;DIVISION a certified copy thereof(Sec. 3800,Lab,C.). PolicyNo. ,Com any BUILDING- " P FOR APPLICANT TO,FI'LL IN - - � .,. _ ADDRESS � �/ .: Certified copy is hereby furnished. " AU'DRess / <. LocaLITY - ;t I Certified co e ' py is filed with the county building inspection' department.. LOCALITY ` NEAREST ' CROSS Date Applicant NEAREST., _ DISTRICT NO. ' G UP TYPE / PRO E SED BY + - - CROSS ST,. tO� 7 CONST_ E / •. CERTIFICATE OF EXEMPTION FROM WORKERS .-,LEGAL V/ DESCRIPTIONS LOT NO BLOCK`- MAP MIGMwAv. � COMPENSATION-INSURANCE no: (cRc�E) LOCAL d' ' s -- , • -NO.'OF BLD GS0. (This section need. not`be completed if-the Work Involved TRACT NOW ON LOT. USE ZONE SPECIAL CONDITIONS TA by the permit is' for .one.hundied` dollars ($100),or less:) D TE MAJOR SEC .. -. SIZE'OF'LOT... EXIES TO NG`BLDG. .. f I certify that in the performance of the work for'which.this 0' permit is..issued, I shall not'employ any person in-any manner" O iv Rp• / /�_ �� -U"' so as to become subject.to the Workers' Compensation-Laws. OCCUPANCY GROUP W ADDRESS 'J• �j, -/ J �F�lil/A7 VX V) Date Applicant NOTICE TO APPLICANT:.If; after.making,this,Certificate`of clry y ',CJ r - rrio�. ! OCCUPANT LOAD Exemption', you should b'ecorne subject .to the Workers' Compensation provisions of-the.Laboi Code, you must forth- 0 orth- A PL EXIT,HARDWARE: . With comply with. such provisions, or this permit shall.be 'TRAILER USE.O GEOLOGY INSPECTION,a deemed revoked No SpeC.'Knowl. ❑ LICENSED CONTRACTORS DECLARATION.' occuPArvcv INSPecriorv. Panic Devices: ❑. I hereby affirm that.I am licensed under provisions of Chapter sAFErr'PERnarr Q (LIST ITEMS eELOW) " 4. 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 PARKING effect. REq D;� PROVIDED-'- r te SPACES License Number Lic. Class _ - - 'LIMITED TIME� 'USE - COntractor' Date DATE DATE, ❑ --.. ,. .. FROM.: �� TO I am'exempt from the licensing,requirements as-I am ii . , licensed'architect or a registered profession dl engineer SIZE OF NO 'OF INSPECTOR'S acting in-my professional capacity (Secfiorf'.:7051', Bus- EXIs .B OG STORIES _ sI ATURE ' iness:and Professions Code). RESENT usE:oF BUDDING FINAL:"APPROVAL' Lic.or Reg.No. Date h�� a uw,l HOME OWNER-BUILDER DECLARATION NO. of E7C(s USE Bu11 OIIVGs I hereby affirm that, I am .exempt,, from: the, Contractor's ON LOT AND USE' '. License Law for the following reason '(Section 7031.5;'Busi- � ness and Professions Code): NO. PARKING- -, - - ' SPACES PROVIDED '❑ I; as"'owrier-of the;property, will do the,work and',the structure 'is not intended or offered for sale (Section RoPOSED.0 SE OF BUILDING /• - 7044, Business and Professions Code ✓ ' CONSTRUCTION LENDING AGENCY` I hereby affirm that there is a consttuction'lending agency : for the performance of'the,.work for which this permit is '- 24955A- issued 2 4 9 5 5 A issued(Sec. 3097,•Civ.C.). o # o"'c 0,0Z Q F Lender's Name PROPOSED MAX. OCC O. O O O "O U P. Lender's Address PERMIT FEE " I certify that I have read this application' and state that the; above information is correct. I agree io comply with all County` i§suAnlce..FEE 0 ,0.3 86 ordinances and State ,laws relating to building construction',.. TOTAL,FEe,'' and herpoy authorize representatives,of this, ounty to enter u"on a above-men one pro e ty for ins ction purposes. SEE-REV FOR�EXPLANATORY LANGUAGE L-15ignatu of Permittee Date i WORKERS'COMPENSATION DECLARATION 5 (11-84) CE 87MISCELLANEOUS APPLICATION ' CE 875 - I litreby affirm that I have 'a certificate of consent to self COUNTY OF LOS ANGELS BUILDING AND SAFETY DIVISION 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 co is hereby furnished. BUILDIN DDRESG y16 TUNA!?copy y S / LOCALITY Certified copy is filed with the county building inspection LOCALITYNEAREST / department. I6M (�L1G' G'r'T CRoes ST. Date Applicant - NEAREST �� UQ - DISTRICT NO G UP TYPE IPR SSED BY CROSS ST. e c�oj1 `] CONST. CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL WA COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK NO. (CIRCLE) STATE MAJOR SECOND LOCAL NO. OF BL-DGS. (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 D_ OF I certify that in-the performance of the work for which this s1iE of Lor EXISTING BLDG. r J permit is issued, I shall not employ any person in any manner WNER 1!( O ! ` �} I��R I la In so as to become subject to the Workers' Compensation Laws. MAIL / r ^ ,�/^ D�7 OCCUPANCY GROUP o ADDRESS - (� LA v/"/, �" • "— Date Applicant uul NOTICE TO APPLICANT: If, after making this Certificate of 9--ITY -MF1 L5' (gl ty NOL 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. 0 deemed revoked. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION Panic Devices E 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 �Sf/�C.i�I PARKING effect. O REq'D PROVIDED 1 I �1 V ON SPACES License Number Lic. Class LIMITED TIME USE Contractor Date DATE DATE 0 I am exempt from the licensing requirements as I am a FROM: 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 SIGNATURE iness and Professions Code). FINAL APPROVAL .Q? PRESENT USE F BUILDING Lic.or Reg.No. Date _ NO IE HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS ON LOT AND USE _ I hereby affirm that I am exempt from the Contractor's I" �;,.; License Law for the following reason (Section 7031.5, Busi- f �• li ii l, —hs_3_s� a; 4PP? ness and Professions Code): NO. PARKING c s=. ('_ '- SPACES PROVIDED - 4s�52116 AN 10 13 I, as owner of the property, will do the work and the fP structure is not intended or offered for sale (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY ROPOSED USE OF BUILDING I hereby affirm that.there is a construction lending agency TITYA it'T )� 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' 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 Signature of Permittee I Date WORKERS' CUMY>✓CVJ:uIU[V LCLLHKH11Uly 20-0063DPW12/90 L+G,.L..L..Alvr-%juz AI'11_.1<..Hl- [iJIN I hereby 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 ,I `> BUILDING ADDRESS qq�� `/p ADDRESS ❑ Certified copy.is hereby;furnished.. g 2b 'I--V�4 TUKAy DRh[� LOCALITY ❑ Certified copy is filed'with the county building inspection cITY�.Em�L� �? zIP�a' department. ( 7 NEAREST CROSS ST. Date Applicant SIZE OF LOT I �'�B���� NO.OF BLDGS.NOW ON LOT DISTRICT NO. GROUP TYPE PROCESSED BY CERTIFICATE OF EXEMPTION FROM WORKERS' consT. I COMPENSATION INSURANCE - TRACT BLOCK LOT NO. O MAP HIGHWAY NO. (CIRCLE) STATE MAJOR SECOND LOCAL.. (This section need not be.completed if the work involved ASSESSOR MAP BOOK PAGE PARCEL !� by the permit is for one hundred dollars ($100) or less.) usE zoNE SPECIAL CONDITIONS I certify that in the performance.of the work for which this _roper y r� �wiN+�zMInf� � lt�L 2 U permit is issued.I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws. ADDRESS 1 D I (,A-It rZ V/EW DIP-I vie OCCUPANCY GROUP Z Date 6 ®2 Applicant . 5VAA&IT' fUPPAIcITZIP _ — NOTICE TO APPLICANT: If; after making this Certificate Pr�`-t'�D bea eA q.3ss I 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 or-this permit shalt be deemed TRAILER USE❑ GEOLOGY INSPECTION❑ No Spec.Knowl. ❑ revoked. ❑ OCCUPANCY INSPECTION[ Panic Devices LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT❑ (LIST ITEMS BELOW) a 9(commencing with Section 7000)of Division 3 of the BusinessNO.OF EXITS and Professions Code,and my license is in full force and effect. ame 0 ._ usluess E�EN 71441 1.51 NE PARKING• REO'D I I PROVIDED License Number Lic. Class sPAces Contractor Date LIMITED TIME USE ❑ I 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 EXISTING BLDG. ��{ FSE STORIES I IN SIGNATURE. and Professions Code). LIC. Or Reg. NO. '"' Dale PRESENT USE OF BUILDING S T#4JA WM T ' FINAL APPROVAL 2J Ol HOME OWNER-BUILDER DECLARATION NO.OF EXISTING BUILDINGS I 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 �j structure is not intended or offered for sale (Section 7044, PROPOSED USE OF BUILDING IRI SS- AU RAN'T Business and Professions Code). I - 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 I (Sec. 3097, Civ. C.). PROPOSED MAX.OCC., Lender's Name APPLICANT(PRINT) TEL NO. SU,RASJ T PLIDPA-1 �1I6 Lender's Address ADDR I certify that I have read this application and state that the S CIss S- P-0S'15/n� � � P/� DE�� C d' ' above information is correct. I agree to comply with all County PERMIT FEE ordinances and State laws relating to building construction,and hereby authorize representatives.of this County to enter upon ISSUANCE FEE I the above-mentioned property for inspection purposes. TOTAL FEE - I�� 3' p" SEE REVERSE FOR EXPLANATORY LANGUAGE Sienature of Permittee Date i «,1r.`Lns PENS A?ION D[CL.rR.%T!0;: C��33-15 ((1 t-gal M I-SCELLANEOUS APPLICATION ; t . hereby affirm that I have certificate of consent to self. COUNTY OF LOS .-ANGELES_ BUILDING AND SAFETY DIVISION ' insure. or a c_raftcate of Workers* rs'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab.C.). : Policy No. Company FOR APPLICANT TO FLLL IN BUDOR4ss Certified :oov is he-ebv furnished. pp BUILDING�j/ ` 1 A A❑DR 55,=/ �(J [� S - LOCALITY - 1 Certified copy is:'Hed •vith,hecountv.,buddine inspectior. %[Loci ITY C +E AA EST department. 7 fj���G C CROSS ST. Date Applicant NEAREST I 715 TR IC O GR P TYPE C=55E7 3Y CROSS ST., - (/// CONST.J/ CERTIFIC:ATE OF EXE�IPT!ON FROM. •1OR1:E.RS' f - LEGAL. - - COIIPE`,SATION' iNSI.Rn L esciIPT10N LOT uo. �s�ocx ' J � NOv IClw c_cI STATE .•AA:OR SECOND LOCAL i ' (This vection.neednot hwork lom'vieted If the nrk Involveded -RACT- ,NO. OFSLOGS. NOW ON LOT J'JSE _ONE SPECIAL CONDITIONS s ; by [lie Permit IS ,tr me 'wridired .lolLirs IS 100) or less,) _ USE OF .i•.e ' ; S1.__ OF _O EC15.TING 3L7�.. :!cal '.n :ne oe :rmar f rs cn 'us _ permit is issued. i mailnut m-lct art nescn n uny manne, XR (fJ /J� /°��jNA I/ I r- 7'::'SE // !" / as 'o necome ;urleCr 'o,:he -,l.)rK .S- .JmCensa liCR Laws.— so - - g '•,,,,,L //�^ I w�1 �J CCC.;PaNCY GRQUP AD CR Z,_ ,��/6�1 //fir r NGTiCL TO a'�' C �\i:'lt, zr Eakin_ !tis ^Sic re u -.� 41-v /Q� �Y No -/O29 2�G OCCUPaIVT LOap E':emptton fou- .noula become >ubfec: •o :he \Vor ers C moensa inn ? otistens )t he Labor Code ou must :ortli- ' APPLICATION FCF i .X,' HAnC'rV n' :till cmni': t,tl< .c_.. ns n ,ita[l 'e — ,aiCuNo spec. Kala A. I tC_NSED(.01'TR.,C'1-ORS DE 1it.1.!l,' :CCJ.Pa>IC'. INSPE-T;oN g. 1 ~ariC De+iiCeS n 1 'te-eov ai`irm :ha I m iicensed under erovinons of Cl=tc., SAFETY PE.R.M IT IL;S rE.'As 3ELOw mr, Section 9 icomecme-tuh ec ton 10001 of Ditision of 'he 3usi- ( No. of EXITS Hess arid P-ai.rlhns Cod- and me license s .n ..11 .',tree And EO"7 r--- I . SPACES RL I PRO V,ID EO � - _ License `iu:nber — Li:. ;.ass - LIMITED TIME USE I I .in e: lie 'ireasine s u re:ne [s ., 1 rolession:f 7F NSPECTD R'S _rl :71V pr JICSSIO-IUI _..pa_.,_ .�,e�::ti 11 )51L. IJLI,- =X:S-"!G SLOG. 77P!E3 i - SIG TUR bless ami PmitessiCRs l.Udel. .LiL. ..lr•Rce V,, -- '_-- _-- ----- _3'E :SE pF 3u1L71vc jFINAL APPROVAL I{Q 11[Otti�ER-3CILDE:R DECL.aR ,,FIC11, No OF EXISTING BUILDINGS i D ICA SEE :N L AND USE I hereby at it t :Iiat I im e,.emm '-nm :Le Contr_c:or'i )• License L" t -it he C Ile .ins reason 'SeL:iun I? 1 _. 3u,i- ��� - ,4-� C NO. PARKING ness and ProiessidnsCodel. 3 4'��` `ti ��— C. IL�I 1, as "'.%ner ,i[ Ica.orh 'r<: . . till 10 :he n coLnu !;e st;ar-tare is ao: miendo_ed •Jr u[tz:cd :u• die Sz gens -1)44. 3u;iness:ind Proiessiunsl odei. ? OPOSEO USE OF BUILDING c.ONSTRI CT10\ LENDINGBOE:�i 1- , I lmebt aliirm th2v the-e is :t constniction lendins ;Lens: I` for. the performance.of Elle work for tchich this cernttt is issued (Sec. 30°`.Civ.(-.I. ., PROPOSED MAX. OCC. ' Len er's.lddress 2500 - PERMIT . .IT FES - I Certify that I have read this application and Eta to h'a: :hC above ini:ormation is correct. l acres to comply tcith all County Issu Anes FEE ordutances and State laces. ela'Limi to building construction, ` and herebv authorize representatives of this County to enier TOTAL FEE 25.00 ' upon tli bove-mentioned property for inspection purposes. I X x f g SEE REVERSE FOR EXPLANATORY LANGUAGE