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Home My Public Portal About9550, 9548 LAS TUNAS DR_Miscellaneous__ WORKERS'COMPENSATION DECLARATION 76M444 CE 875 (t, 84) M ISCELLANEOUS APPLI"CATION I hereby affirm; that 1 have a certificate of consent to self COUNTY OF LOS ANGELES 13UILDING AND SAFETY DIVISION } insure,,jr a certificate of Workers'Compensation Insurance,or i a certified copy thereof(Sec. 3800,Lab.C.). / Policy No. ('ompany -- - - FOR APPLICANT TO FILL IN BUILDING AQ DR ESS cG1r �j Certified copy is hereby furnished. BUILDING ADDRESS ,A.D '�lfet ,s LOCALITY 0 Certified copy is filed with the county building inspection LOCALITY NEAREST department. CROSS ST. Date Applicant NEAREST DI Tr G" RO I P TYPE P ESSED BY CROSS ST. ,1 G CONST, CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL ��D COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK MAP HIGHWAY NO.NO. F BLDGS. (CIRCLE) STATE MAJOR SECOND LOCAL (This section need not be completed if the work involved TRACT NOWOON LOT USE ZONESPECIAL CONDITIONS by the permit is for one hundred dollars ($100) or less.) USE OF SIZE OF LOT .G. I certify that in the performance of the work for which this I -` f permit is issued, I shall not employ any person in any manner OWNER l M �{ `. G U I C(i so as to become subject to the Workers' Compensation Laws. - -MAIL OCCUPANCY GROUP Date Applicant ADOR ESS rTEL�6& c. OCCUPANT LOAD NOTICE TO APPLICANT: If, after making this Certificate of �r CITY � r� NO. 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 beTRAILER USE E]' GEOLOGY revoked. GEOLOGY INSPECTION ❑ No Spec. Knowl. 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 PARKING[/I�/// /yJ effect. /" SPACES REQ'D PROVIDED License Number Lic. Class LIMITED TIME USE Contractor Date DATE DATE ❑ I 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- 0 EXISTING BLDG. STORIES M. To: SIGNATURE iness and Professions Code). FINAL APPROVAL �`/� /1 D PRESENT USE OF BUILDING � j} 177 Lic.or Reg.No. — Date— HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS ;, gn�r ON LOT AND USE //I $r`—I�T— �"'iV M-9-3 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 1 SPACES PROVIDED El 1, as owner of the property, will do the work and the structure is not intended or offered for sale (Section 7044,Business and Professions Code). --------------------------- - -- PROPOSED USE OF BUILDING CONSTRUCTION LENDING AGLNCI' -- 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 "Cl 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 tate laws relating to buildin construction, and hereby t rize representat' s of th' unty to enter TOTAL FEE eG� upon the iov,mentione r for in do urposes. 5 I ItFVIsRSL FOR EXPLANATORY LANGUAGE, ature mit Date • e� ION DECLARATION WORKERS' COMPENSAT � 20-0063DPW12/90 MISCELLANEOUS APPLICATION, �I hereby affirm that'I have a certificate of consent to self COUNTY OF LOS ANGELES. " BUILDING AND SAFETY DIVISION ll + insure,or a certificate of Workers'Compensation Insurance, or 11 a certified copy thereof (Sec. 3800, Lab. C.) 1 Policy No. Company FOR APPLICANT TO FILL IN 6taILDINc - - BUILDING ADDREqSS� p.� y�Qe ADDRESS El Certified copy is hereby furnished.:.. —ru wi•e> Vf— LOCALITY I ❑ Certified copy is filed with the county building inspection CITY ZIPV department: N Le C T y NEAREST CROSS ST. j Date_ Applicant -• SIZE OF LOT NO.OF BLDGS.NOW ON LOT DISTR N GR CTYPE ONST. ESSED BY CERTIFICATE OF EXEMPTION FROM WORKERS' �� TRACT BLOCK LOT NO. MAP .. .. HIGHWAY - - j I COMPENSATION INSURANCE NO. (CIRCLE) STATE MAJOR.SECOND LOCAL (This section need not be completed if the work involved ASSESSOR MAP BOOK PAGE PARCEL DeE ZONE SPECIAL CONDITIONS qby the permit is for one hundred dollars (S100) or less.) I certify that in the performance of the work for which this _ Opropy iLLt,AV✓1 �� U TEL NO. ert I, permit is issued..I shall not employ any person in any manner , ADORES so as to become subject to ti e W ers' Com ensati n Laws. �1-7 S Ltd I-L I-I� �'j- OCCUPANCY GROUP f Date �� Vpplicant �( __,- ` CITY ZIP MIJNOTICE TO APPLICANT: If, after making this Certificate OCCUPANT LOAD ,• of Exemption. you should become subject to the Workers' APPLICATION FOR EXIT HARDWARE: I Compensation provisions of the Labor Code.you must forthwith comply with such provisions or this permit shall be deemed TRAILER USE GEOLOGY INSPECTION NO Spec.Knowl. ❑ revoked. LICENSED CONTRACTORS DECLARATION s occuPANcv INSPECTION Panic Devices--- ] El I hereby affirin that I am licensed under provisions of Chapter ' SAFETY PERMIT❑ (LIST ITEMS BELOW) F__1 I 9(cotnmencing with Section 7000)of Dision 3 of the Business No.of EXITS iv and Professions Code.and my license is in full force and effect. PARKING• r � REO'D PROVIDED ! License Number Lic. Class SPACES LL�� Contractor Date __ LIMITED TIME USE DATE DATE ❑ 1 am exempt from the licensing requirements as I am a -ROM: TO: licensed architect or a registered professional engineer INSPECTOR'S NO.OF t acting to m}' professional Capacity (Section 7051, Business SIZE OF EXISTING BLDG- STORIES SIGNATURE s =3 and Professions Code). `g r "e PRESENT USE OF BUILDING I—t 1�! ,� Ti FINAL APPROVAL Lie. or Reg. No. DateI I {I N-d NL' Tut i I HOME OWNER-BUILDER DECLARATION NO.OF EXISTING BUILDINGS �� A I ON LOT AND USE I hereby affirm that I am exempt from the Contractors License U :'law for the following reason (Section 7031.5, Business and h I Frofessions Code): NO.PARKING' \\i SPACES PROVIDED )'\\ ❑ L as owner of the property, will do the work and the - (1 structure is not intended of offered for sale(Section 7044X PROPOSED USE OF BUILDING j Business and Professions.Code). } 0l1W LP_ C, CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for se\/i �i the performance of the work for which this permit is issued PROPOSED MAX.OCC. ' s, (Sec. 3097, Civ. C.). s Lender's Name APPLICANT(PRINT) TEL NO. NCIaLL M. ( E-2F tG Lender's Address — ADDRESS Av I certify that I have read this application and state.that the C c,,6) LiA t! - I tC lZ i1 above information is correct. I agree to comply with all County ,I PERMIT FEE i! ordinances and State laws relating to building construction.and herebyauthorize representatives of this County to enter upon �auP I ISSUANCE FEE iii the above-mentioned property for inspection purposes. li II ? TOTAL FEE � $ SEE REVERSE FOR EXPLANATORY LANGUAGE I w Signature of Permittee Date 1 is j 1 WORKERS'COMPENSATION DECLARATION 76M444 M I SC E L LA N E�U S APPLICATION certificate 1 hereby affirm that I have a certificate of consent tsell CE 875 (11-84)COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION � insure, or a certificate of Workers'Compensation Insurance, e,or a certified copy thereof(Sec. 3800,Lab.C.). ,7 Policy No. Company FOR APPLICANT TO FILL IN ADDRESS '''/ / .•�� f�/G y��i7 Certified copy is hereby furni hed. XX BUILDING ADDRESS C1 C , LA-S T UN(+S Dr I-Q LOCALITY !r• 7�X / [�/«<///LLL�' Certified copy is filed with the county building inspection LOCALITY yyC t NEAREST department. xy -'�`) 'Q `( CROSS ST. Date Applicant NEAREST k DISTRICT NO. GR UP TYPE PR-0CE SSED BY pp CROSS ST. P C'I,rnr^o S Z T C• QI v d �. , CONST. CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL G 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 ($100) or less.) USE OF I certify that in the performance of the work for which this SIZE OF LOT EXISTING BLDG. /V o 1 D_ permit is issued, 1 shall not employ any person in any manneXX OWNER Of building; �r1E NNeAH G6SS `) so as to become subject to the Workers' Compensation Laws. MAIL y� (�A i, OCCUPANCY GROUP 0:: ADDRESS S F}S r�r�aV Q/ Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of CITY sm1w RS A g0vz- No 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 provisions or this permit shall be TRAILER USE ❑ GEOLOGY INSPECTION ❑ No Spec. Knowl. deemed revoked. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION USI Panic Devices I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT r❑ (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 ariX effect. Mille of business PARKING SPACES REp�D D PROVIDED D License Number Lic. Class ES (� h A` 1 CS LIMITED TIME USE Contractor Date DATE =I DTE E ElI am exempt from the licensing requirements as I am a F R�'JM: 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 _I j'I r5{r iness and Professions Code). �• ,I II�� PRESENT USE OF BUILDING It`l' S�1"�f e_. wI FINAL APPROVAL Lic.or Reg.No. Date It °y•= Q�I�� P�in7 Seru'sCeS v Cop�eS 'q HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS /� n 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 1 hereby affirm that there is a construction lending agenby 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 1 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 authorize represe tatives of this County to enter TOTAL FEE 25.00 upo thea ve-Inentioi ed p �fo, ion purposes. XX J_I � ` SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WORKERS'COMPENSATION DECLARATION CE 8754(2-80) MISCELLANEOUS APPLICATION 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 f ADDRESS ,L8° ❑ Certified copy is hereby furnished. uILDi /' LOCALITY A DRENG Ss ❑ Certified copy is filed with the county building inspection NEAREST department. LOCALITY CROSS ST.' Date - Applicant - NEAREST. - DISTRICT NO. G 6UP TYP PRO ESSED BY CROSS ST. -CON CERTIFICATE OF EXEMPTION FROM WORKERS', LEGAL DESCRIPTION LOT NO. BLOCK MAP MIGMWA. COMPENSATION INSURANCE No. (CIRCLE) STATE MAJOR SECOND LOCAL d NO. OF BLDGS. (This section need not be completed if the work Involved TRACT. NOW ON LOT USE ZONE SPECIAL CONDITIONS 0 by the permit is for one hundred dollars ($100) or less.) USE J � SIZE OF LOT EXISTING BLDG. 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 �R,am ON C9eACQr11& 1— so as to become subject to the Workers' Compensation Laws. OCCUPANCY GROUP �b V Date Applicant MAD LU ORESs a 1 SI �OCy V1��C3 ;. NOTICE TO APPLICANT: If, after making this Certificate of I T Y a NOL !Y7 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 USE GEOLOGY INSPECTION deemed revoked. ❑ No Spec. Knowl. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION❑ Panic Devices ❑ I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT ❑ (LIST ITEMS BELOW) ❑ No. of EXITS 9 (commencing with Section,7000) of Division 3 of the Busi- ness and Professions Code, and my license is in full force and PARKING effect. SPACES REQ'D PROVIDED 11—ense Number Lic.Class LIMITED TIME USE Contractor Date DATE DATE I FROM: - TO: I 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 SIGNATURE iness and Professions Code). ( FINAL APPROVAL RESENT USE OF BUILDING --_ y y.��j(�- �r -vt�/.Q Lic.or Reg.No. Date `w` 'l?r` 4w+ fff✓✓✓ VVV HOME OWNER-BUILDER DECLARATION No.of EXISTING BUILDINGS ON LOT AND USE Z.6 O O..71A 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 SPACES PROVIDED ❑ I, as owner of the property, will do the 'work and the o 0 0 0 0 0 02 structure is not intended or offered for sale (Section O,•1 4 -83 7044, Business and Professions Code). PROPOSED USE OF BUILDING }T+II•i.�'7e._ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for wAich 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 FEE ordinances and State laws relating to building construction, TOTAL FEE and hereby authorize representatives of this County to enter oq the above-mentioned property r Inspection purposes. ' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date _ - WORKERS'COMPENSATION DECLARATION CE 875 (11-84) MISCELLANEOUS APPLICATION !'1 CE 875 I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES IIPUILDJNG 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 copy is hereby furnished. BU'I DING LOCALITY IxADDRESS�; 0 Certified copy is filed with the county building inspection LOCALITY NEAREST department. CROSS ST. Date Applicant NEAREST DISTR CT ISO. CSO ITYPE P ESSED BY CROSS ST. C/f'1(/r Jf}— CONST. CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL COMPENSATION INSURANCE DESCRIPTION LOT NO. HLO CK 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 ($100) or less.) USE OF SIZE OF LOT EXISTING BLDG. I certify that in the performance of the work for which this. i -3(J t�( \r�� C IIsi® y permit is issued, I shall not employ any person in any manner OWNER so as to become subject to the Workers' Compensation Laws. MAIL /_ OCCUPANCY GROUP o AMD DR ESS L. w 1 � I" Date Applicant _ C3 TEL W NOTICE TO APPLICANT: If, after making this Certificate of aIryy- Y No. OCCUPANT LOAD z Exemption, you should become subject to the Workers' APPLICATION FO 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. El deemed revoked. .LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION gel Panic Devices El I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT 0 (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 /f &f—IQss PARKING effect. ,f t5- REQ'D PROVIDED �� License Number Lie. Class 1 SPACES T1 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 �7� NO. OF INSPECTOR'S acting in my professional capacity (Section 7051, Bus EXISTING BLDG. STORIES SIGNATURE iness and Professions Code). FINAL APPROVAL 3_�_�' � : 1 PRESENT USE OF BUILDING ` IV Lie.or Reg.No. Date �j1 c HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILGS �(/ ��`J/ £ I hereby affirm that I am exempt from the Contractor's ON LOT AND USE AI 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 't •IIT ri sem€ structure is not intended or offered for sale (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY PROPOSED USE OF BUILDING Y. I hereby affirm that there is a construction lending agency ` �� 97O `M-471,j (J�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 a upon the above-m ntioned property for inspection purposes. V SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date " 1 i WORKERS*COMPENSATION DECLARATION 8a CE (11-841 MISCELLANEOUS APPLICATION • i CE 87 • I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES I;UILDING AND SAFETY DIVISION �. insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800.Lab.C.). _! p y FOR APPLICANT TO FILL IN BUILDING 'Policy No. Coman f. ADDRESS Certified copy is hereby furnished. BUILDING Sc-�(��e ��/ e LOCALITY ADDRESS 9 �.(/v/�((/S , se JL L s 1 Certified copy is tiled with the county building inspection LOCALITY / NEAREST Trr�A/� , department. !G ,`915 Q ( CROSS ST.. Date Applicant NEAREST DISTRICT NO. GROUP TYPE / Pe CESSED BY CROSS ST. CONST: •✓ i CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL 1 r a f /& COMPENSATION INSURANCE DESCRIPTION LOT NO. bJ BLOCK MAP^ MIGX 1 NO. (CIRCLE) STATE MAJOR SECOND LOCAL NO. OF BLOGS. (This section need not be completed if the work involved TRACTNOW ON LOT USE ZONE SPECIAL CONDITIONS by the permit is for one hundred dollars (S 100) or less.( USE OF I SIZE OF LOT EXISTING BLDG. / >- I certify that in the performance of the work for which this �L^� permit is issued. I shall not employ any person in any manner OWNER ` (� so as to become subject to the WO'rkers' Compensation Laws. MAIL G2� OCCUPANCY GROUP _ �c ADDRESS e,¢ T �� Date Applicant 7 e•�' TEL' OCCUPANT LOAD NOTICE TO APPLICANT: If, after making his Certificate of � CITY pmt No. -- Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- APPLI ATION FOR EXIT HARDWARE: with comply with Such provisions or this Dermit shall be TRAILER USE GEOLOGY INSPECTION 1 NO Spec. Knoivl. deemed revoked. LICENSED CONTRACTORS DECLARATION' OCCUPANCY INSPECTION� Panic Devices I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT E] (LIST ITEMS BELOW) a 9 (commencing with Section 7000) of Division 3 of the Busi- NO. OF EXITS ness and Professions Code, and my iicense is in full force and effect. PARKING Re0'D 1 PROVIDED spi ' / ces License Number Lie, Class G •'�` '� Allz -l' LIMITED TIME is3E Contractor Date DATE DATE FROM: TO: lam exempt from -lie licensing requirements as I am a i licensed architect or a resistered professional engineer SIZE OF NO. OF INSPECTOR'S acting in my professional capacit} ;Section( 0-1, Bus- EXIST ING BLDG. STORIES SIGNATURE iness and Professions Code). FINAL APPROVAL PRESENT USE OF BUILDING Lie. or Res. No. Date -� - I HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS ON LOT AND USE I hereby affirm that t ani exempt from the Contractor's 1 License Law for the folio«ins reason I Section 70:1.5. Busi- ness ness and Professions Code): _ NO. PARKING (/I SPACES PROVIDED I, as owner of the property.w ill do the work and the � structure is not intended or offered for sale (Section ( f! 7044.Business and Professions Code). tj 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 - PERMIT FEE I certify that I have read this application and state that the above informa n is correct. I asree to comply with all County ISSUANCE FEE C a State laws relating to building construction. and hereby ihorize represent ives of this County to enter TOTAL FEE 25. co upon t e ove m tinned pro,e for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE r Hire of P :.t iaee Datz J COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MISCELLANEOUS PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS MP 0508 9703200005 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: NO. OF CONST NEW BUILDING AD RESS: TR: 6561 LT: 638 BL: .001 SQ. FT STORIES TYPE OCCUP GROUP 9548 LAS TUNAS DR STRUCTURE: 1 V B TEMP CA 917802106 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8587-015-019 EXIST BLDG USE: COMME THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY EXIST OCC GRP: B USE.ZONE: C-2 TENANT: ISSUED ON: PROCESSED BY: EXPIRES ON: �BLDGS. NOW ON LOT: VALUATION: 03/20/97 TC 03/20/98 2 0 OWNER: TEL. NO: i FINAL DATE FINAL BY: CODE: GOSS KENNETH D;KAREN B (810) 661-6993- LIST ITEMS: /]f/1e ) 5415 POND BLUFF DR. -C1 ��` WEST BLOOMFIELD, MI DESCRIPTION OF WORK TO INSPECT EXISTING BUILDING (BUILT W/O PERMIT) APPROX. 700 IOCCUP LOAD EXIST: SQ., FT. APPLICANT: TEL. NO: iOCCUP LOAD NEW: SAME AS OWNER - E yPARKING SPACES REQUIRED: SPECIAL CONDITIONS: PARKING SPACES PROVIDED::. ,EXIT HARDWARE:, CONTRACTOR: TEL. N0: ` ,` - LIMITED TIME USE SAME AS OWNER - INBR OF EXITS:,.'- FROM TO LIC. NO I i FEES PAID APPROVALS DATE INSPECTOR SIGNATURE FEE DESCRIP.TION ` -QUANTITY:`UOM AMOUNT: ARCHITECT OR ENGINEER: TEL. NO: ' TRAILER USE OA PERMIT ISSUANCE 27.75 . _ LIC. NO: �01 R/M OCC/USE INSPECT 145.95 SAFETY PERMIT —_ TOTAL FEES" " 173.70 TEMP. STRUCT. APPROVED MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: TEMP. STRUCT.. REMOVED NO. OF FAMILIES: DWELLING UNITS: APT/CO D: STAT CLASS: NO SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS _ NO NO N0. REQUIRED TOTAL SETBACK FROM EXIST - SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- SIDE PL- REPORT ID: DPR267 ROUTE TO: BS0508