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Home My Public Portal About10203 LOWER AZUSA RD_Miscellaneous__ 76M444.DBS 7512.54.` t ,..,'CYYISO/,E.LLd-'ltl tlE�®V S' AY PLI�V Y�1'T•'..O�9 - DIVISION OF.BUILDING AND .SAFETY OCCUPANCY--SAFETY-TRAILERS �. Department of Courity, Engineer Count'y of Los Angeles WM.J. F.OX;.COUNTY, ENGINEER BUILDING (� _ ADDRESS (f CASSATT,D. GRIFFIN, SUPT.OF.BuIL'DING FOR.APPLICANT TO FILL IN, LOCALITYNEAR EST (/ , OWNER 'Axel RO.d1 Es.SiI----..'. � - � :CROSS T. MAIL .ADDRESS ' Y8QQ �%�l..li.6itni:i;� � t,- DIST�Cr�10..: I GF��O�IP.,, TYPE CONST. CITY Temple , G ty,� Vc�1.oNO.. . none' MAP 'D/•D STATE YES, `NO TEL. NUMBER - HWY CONTRACTOR -.OW. Xler NO, - - - USE ZONE CSPECIAL' .- - I CONDITIONS 'ADDRESS-• '1 .. LEGAL I �w gqt9. DESCRIPTION LOT NO BLOCK - - BUILDING' YARD HWY STREET NAME EXIST. . NO. OF!BLDGS:-` SETBACK WIDTH _TRACT �� I NOW'ON LOT,:. 1. „• "FRONT' . � 80_ x. 230- USE OF .P.-L. - SIZE OF LOT I EXISTINGBLDG. SIDE.. - APPLICATION-FQR P. L. OCCUPANCY INSPECTION RECORD INSPECTION - I- SAFETY.PERMIT ................ ..... t I . - �l TRAILER USE I -LIMITED TIME USE -- . .:.... ........I..................... ......................................................._..:....I... ..,.1.......... .. To live in,-.while. remodeling � • - - . DAT .... FROM: 'ye'bo I5,, *55To_t]!�-y. T5'yAT�55 :.C: ................................L:......:.........:...._..... ..... USE ,OF STRUCTURES OR` DEVICES .... .I......... ..................................................................... .:............................... --------------------- ..... ........... ..........................__....................... ...................... .....I............... ...................K � I .. ..... ht[tp 1 t :...:...z: I.:................::.. 1 ................. .. ....................... d ..............L . .............:...................................... ... APPROVALS INSPECTION FOR - - ',DATE I INSPECTOR'S SIGNATURE OCCUPANCY AS- OCCUPANCY APPROVAL 1 HEREBY" ACKNOWLEDGE; THAT, i)HAVE READ ,THIS,._ GROUP •'occ. :oaD ' 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 OF / . �(/J� Q •TEMPORARY PERMITTEEr (L1ti'L STRUCTURE APPROVED ADDRESS - - ';TEMPORARY • - STRUCTURE REMOVED' " FI'NATAL APPROVAL WILLIAM J.iFOX, COUNT Y-ENGINEER VALIDATION ` o -12,1`2-1 s`- 7 .2' a e'2;1ID BY BY DEPUTY _ DEPUTY r ! WORKERS' COMPENSATION DECLARATION' tbM444 MIJCLs6rLAl�lEOUS APPLICATION 20-0063DPW',2/90 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 t- a certified copy thereof (Sec.`3800; Lab. C.)' Policy No. Company FOR APPLICANT TO FILL IN TADDRESS ' - BUILDING ADDRESS Certified copy.is.hereby furnished. I X uses RdY Certified copy is filed with the county building inspection 'CITY zip 71 {`[[�� nn,, T. department' `C.. C.� T. Date0= Applicant SIZEOFLO NO.O'F BL�GS.NOW ON LOTT NO. GROUP TYPE PROCESSED BY CONST. CERTIFICATE OF EXEMPTION FROM WORKERS' TRACT sLocl< LOT No. COMPENSATION.INSURANCE MAP HIGHWAY No. (CIRCLE) STATE MAJOR SECOND LOCAL.. (This section need not be completed`if. the work involved •ASSESSOR MAP BOOK PAGE PARCEL USE ZONE SPECIAL CONDITIONS' by the permit is for one hundred dollars ($100) or less.) rfy wffer - TEL NO. s, I certify that in the performance.of the work for which this 6 46-33 3 I permit is issued.I shall not employ any person in any manner ADDRESS OCCUPANCY GROUP so as to become subject to the Workers' Compensation Laws. s neS' Y. { Date Applicant CITY ZIP NOTICE,TO APPLICANT: If, after making this Certificate 1,e ( -70 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 shall be deemed TRAILER USE❑ GEOLOGY INSPECTION❑ NO Spec.Know]. ❑ revoked. LICENSED CONTRACTORS DECLARATION occuPANcv INSPECTION EX Panic Devices ElI hereby affirm that I am licensed under provisions Of Chapter SAFETY PERMIT O (LIST ITEMS BELOW) �. F ) 9(commencing with Section 7000)of Division 3 of the Business_ - NO.OF EXITS and Professions Code•and my license is in full force and effect. ame o uslness PARKING• REO'D PROVIDED �. License.Number Lie. Class I,N VvW C SPACES ��JJ ( ! Contractor Date LIMITED TIME USE m ❑ I am exempt from the licensing requirements as I am a - DATE DATE Q FROM: TO: licensed architect or a registered professional engineer acting in my professional capacity(Section 7051, Business SIZE NO.OF INSPECTOR'S n I ! EXISTINNG BLDG. STORIES and Professions Code). - - SIGNATURE. Lie. or Reg. No. Date PRESENT USE OF BUILDING FINAL APPROVAL Zd� Z- 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, PROPOSED USE OF BUILDING Business and Professions Code). CONSTRUCTION LENDING AGENCY o I hereby affirm that there is a construction.lending agency for vi''}( —� 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. �16J 4�6 ti333j Lender's Address ADDRESS t I certify that I have read this application and state that the 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 - - the,above-mentioned property for inspection purposes. ` Y - TOTAL FEE - X l3, 07 SEE REVERSE FOR EXPLANATORY LANGUAGE v Signature ennitoee Date