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Home My Public Portal About5710 RIO HONDO AVE_Miscellaneous__ COUNTY OF LOS ANGELES � t + DEPARTMENT OF PUBLIC WORKS . MICROFILM INFORMATION Record Search Building Address 57/v Locality e Tract No. Lot No. Lot Size '*Building Permit # Issue Date V-V-30KFinal Date -/3 t Description of work Sq. Ft. Building Permit # Issue Date Final Date Description of work Sq. Ft.� Building Permit # Issue Date Final Date Description of work Sq. Ft._ Building Permit # Issue Date Final Date Description of work Sq. Ft.� Building Permit # Issue Date Final Date Description of work Note: The information given is taken from Building Permit Records. Unless an Oceupancy Inspection is requested and the fee for this inspection is paid, no investigation of the property will be made by this Department. Sewer Permit # Issue Date Connected to sewer in street: Inspection Date l9� Senior Clerk WORKERS'COMPENSATION DECLARATION 76M444DPW12/90 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 certifivate of Workers'Compensation insurance, or a certified copy tKereof (Sec. 3800, Lab.C.) Policy No. Company — _ FOR APPLICANT TO FILL IN ADDRESS f Z BU ING ADDRF�S ❑ Certified copy is hereby furnished. � U `, LOCALITY ❑ Certified copy is filed with the county building inspection clry n - zle/� ��`' department. `, NEAREST YY 1. CROSS ST. Date _Applicant_ _ SIZE F T NO.OF BLDGS.NOW ON LOT DIS T No.. G UTYPE OCESSED BY CERTIFICATE OF EXEMPTION FROM WORKERS' f Q �/. �1�f' , _:P5 CONST. _ JL COMPENSATION INSURANCE TRACT BLOCK LOT NO. MAP HIGHWAY L !% NO. (CIRCLE) STATE MAJOR SECOND LOCAL (This section need not be completed if the work involved ASSESSOR MAP BOOK PAGE PARCEL NO. SPECIAL CONDITIONS by the permit is for one hundred dollars ($100) or less.) Q I certify that in the performance of the work for which this �r �JUJI permit is issued, I shall not employ any person in any manner o R �� TEL ,7 J Its so as to become subject to the Workers' Compensation Laws. ADDRE_SDSS D OCCUPANCY GROUP _ U) Date_ __ Applicant _ CI ZIP b NOTICE TO APPLICANT: If, after making this Certificate OCCUPANT LOAD of Exemption• you should become subject to the Workers' APPLI ATION 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.Knowl. ❑ revoked. ❑ OCCUPANCY INSPECTION❑ Panic Devices LICENSED CONTRACTORS DECLARATION I hereby affirm that 1 am licensed under provisions of Chapter SAFETY PERMIT❑ (LIST ITEMS BELOW) 9(commencing with Section 7000)of Division 3 of the Business I - NO.OF EXITS and Professions Code,and my license is in full force and effect. , PARKING• License Number _—_ — Lic.Class `.� 1&' 2t r �, SPACES REWD E= PROVIDED Contractor ---___ Date ____ _ K [ C`y LIMITED TIME USE DATE DATE F1 am exempt from the licensing requirements as I am a FROM: TO: licensed architect oi• a registered professional engineer acting in my professional capacity (Section 7051, Business SIZE OF NO.OF INSp NATO'S and Professions Code). EXISTING BLDG. STORIES Lic. or Reg.No. Date __ PRESENT USE OF BUILDING FINAL APPROVAL HOME OWNER-BUILDER DECLARATION NO.OF EXISTING BUILDINGS 3303 �4e7 ON LOT AND USE I hereby affirm that I am exempt from the Contractor's License 1 ITEMS for the following reason (Section 7031.5, Business and Professions Code): NO.PARKING p ❑ I, as owner of the property, will do the work and the SPACES PROVIDED TOTAL 242.70 structure is not intended or offered for sale(Section 7044, PROPOSED USE OF BUILDING CHECK 242.70 Business and Professions Code). CHANGE .00 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for .01 the performance of the work for which this permit is issued (Sec. 3097, Civ.C. . PROPOSED MAX.OCC —�vv 1 1I 3/96 Lender's Name APPLICANT(PRINT) TEL NO. 4054 1 M 9e41 Lender's Address _ _ _- — -- ADDRESS 71 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 15— Gf o ordinances and State laws relating to building construction,and hereby authorize representatives of this County to enter upon ISSUANCE FEE , �0 the above-mentioned property for inspection purposes. y""""� ////`^ Q TOTAL FEE �( " /�- O L ( SEE REVERSE✓1FOR c�EXPLANATORY LANGUAGE Signature of Per 'tee Date