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Home My Public Portal About9822 RICHMOND WAY_Building__ WORKERS'COMPENSATION DECLARATION hereby affirm a I have certificate of consent uta self APPLICATION FOR -B U,I L D I N G P E RM I T � insure, or a certificate of Workers' Compensation Insurance, ' or a certified copy theieof Sec. 3800, Lab. C.) ' A�jr —oa7�5— COUNTY OF LOS ANGELES ;�_,..BU ILDING AND�SAFETY Policy�N�o. ompany 1i S F t,G / BUILDING El Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS' Z ' /LJO/ 44/✓l/l -lf Certified copy is•filed with the county building inspec- BUILDING L t tion department. ADDRESS ciTY Temp 1 e City Zip 91780 LOCALITY Z� Datt -23-8'9 APPlica NO.OFBLDGS. NEAREST. CERTIFICATE OF EXEMPTION F96m RK ' SIZE OF LOT 8 7 0 0 0 NOW ON LOT0 CROSS ST. COMPENSATION INSURANCE' ,• ASSESSOR (This section need.not be completed if the permit is for one TRACT BLOCK LOT NO. 5 MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) . ' TEL. J OWNER Westco land ,Inc. No,2.86-3636 USE ONE MAAP / /t J, NO I certify that in the•performance of the,work for'•which this 1 "f -permit is issued, I shall not employ any,person in-any manner ADDRESS 1425 Melanie Lane 1N Ja CONDITIONS so as to become subject to the Workers'Compensation Laws. O. CITY Arcadia ZIP 91006 O Date Applicant ARCHITECT OR TEL. ne NOTICE TO APPLICANT: If, after•makin this .Certificate of ENGINEER Same NO DIST GROUP TYPE FIRE PROCESSED BY. 0 9 . ,/ `� I) A CONST. [ / ZONE / uJ Exemption, you should become subject to.the.Workers' ] K S Y 3 uJ Compensation provisions of the Labor Code, you must forth- ADDRESS , CL with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. W . deemed revoked. '' ' CONTRACTOR NO. , _-� / Z , LICENSED CONTRACTORS DECLARATION LIC. CIA--..-.'DWELL. UNITS , ADDRESS NO. 265864 I hereby affirm that I am licensed under provisions of Chapter 9- SEWER MAP (commencing with Section 7000)of Division 3 of the Business CITY LIC. B ' and Professions Code,and my license is in full force and effect. _ BK. PG. VALIDATION SIZE 230 STORIES FAMILLIIES ONE License Numbe� Lic. Class -. VALUATION DESCRIPTION OF WORK Single" F am i l y 'NEW ®. - Contrp o Date 114-7 ❑I ADD $ ❑ ► -- �` j:v: am exempt un sec. Residential attached ALTER ❑ I`I ''•� _: B.BP.C. for this reason rq g P I REP �� AIR ❑ $ i } f USE OF l r_r v •_] Date:' EXISTING BLDG. Sing 1 e Family Res' dEMOL ❑ Signature APPLICANT TEL. rj a: l�' (PRINT)- G e o r. e W i e• and NO.2 8 6•-3 6.3 6 FINAL OWNER-BUILDER DECLARATION DATE :' -- I hereby affirm that I am exempt fr6m the Contractor's License ADDRESS a Arcadia a - Law for the following reason (Section 7031.5; Business and FINAL Professions Code):. PRESENT Ry • BUILDING ;_�.,_;.`_i_�;,. .-.: ir:,:.r.• ❑ " I, as owner of the"property; or my employees with ADDRESS " '..' wages as their sole.compensation,will do the work and ; �r. ?. LOCALITY '' the structure is not intended or offered for sale(Section �. ' - •" ` 7044, Business and Professions Code.) MOVING TEL. ,e`0 ❑ I, as owner of the property,am'exclusively contracting CONTRACTOR NO. i ` " �� ACCTA with licensed contractors to construct the project (Sec- ' \ ., tion 7044, Business and Professions Code.) ADDRESS I } p 3307 . 2-7.70 REQUIRED TOTAL SETBACK FROM EXIST. ' v j`''U CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH t I hereby affirm that there is a construction lending agency for FRONT i 'the performance of the work for which this permit is issued P.L. r ;. , ;ACCT.4 (Sec. 3097, Civ. C.). SIDE 307 980o2 P.L. Lender's Name f3 R H M n r t g a•E e 7 LDMA Ref.# 2 ITEMS Lender's Address8 S R W i l.a h i a Beverly Hill P•C. Fees Permit Fee , Tt�TAL 111709 I certify that I have read this - • . O J Q application and state that the Issuance Fee LDMA P/C# CHECK 1117n9 above information!s correct.-I agree to comply with all County Investigotion Fe r 3 ordinances and State laws relating to building construction, Total Fee dam. J LDMA Perm. # CHANGE .00 and hereby authorize representatives of this County to enter ' upon the above-mentioned ropert 'for inspect! n Pur ses ; SEE REVERSE FOR EXPLANATORY LANGUAGE Signa of Ap icant r;HgPg at UQVU-LtVLti 8/ 1/89 f� 4792 1 ASI x.99 COUNTY OF LOS ANGELES TEMPLE CITY it 05081 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS RESIDENTIAL ADD BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9706250016 PHONE: (818) 285-0488 EXT: LEGAL ID: NO. OF CONST W BUILDING SS: TR: 43136 LT: 1 UN: 5 SQ. FT STORIES TYPE OCCUP GROUP 9822 RICHMOND WY STRUCTURE: 0 1 VN R3 TEMP CA 917803966 B ASSESSOR INFORMATIONGARAGE: NEAREST CROSS STREET: GOLDEN WEST 8589-020-083 OTHER: THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY S G S SE0 S CS 8 S0 : EXIST OCC GRP: 06/25/97 . TC 06/25/98 OWNER:- TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: WILLIAM (818) 451-0938- 1 2,200 9822 RICH 9822 RICHMOND CT. C1 TEMP 917803966 FEES PAID DESCRIPTION OWOR OPEN LATTICE PATIO COVER(ATTACHED) EXISTING SLAB APPLICT: TEL. NO: FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 2200.00 VAL 0.50 SPECIAL CONDITIONS- AX O DI IO S:AX BUILDING REVIEW FEE , 54.70 D2 PERMIT W/O;EN,HC" `2200:00 VAL 99.15 TOTAL FEE$; -� 182.10 CONTRACTOR: TEL. N0: v ,.'•,� APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO ' LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: 0: +�, 0 D IO / C FORMS LIC. NO: SLAB/UNDER FLOOR RAISED00 G MAP 0: SEWER MAP BOOK: AGE: FIREONE: CMP01 UNDERFLOOR INSULATION IST LEVEL FLOOR SHEUW- 0. 0 L S: CLAN-. - NO 21 2ND LEVEL FLOOR SHEATH SCHOOL ' SHEATHING AIR QUALITY: 1000 FEET MATERIALS NO NO NO FIRE DEPT. FRAME INSPECT REQUIRED SETBACK STBLDG DEPT. FRAME INSPECT SET BACK YARD: HWY: PROP LINE: WIDTH: V'4�7 FRONT PL- +,:•.', -"`�; ,• SNEA PANELS SIDE PL- ~? S 0 R STRI INTERIOR LATH/DRYWALL EXTERIOR LOT DRAINAGE SMOKE E CES IRE DEPARTMENT APPROVAL REPORT ID: DPR261 ROUTE TO: BS0508