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Home My Public Portal About5084 SERENO DR_Building__ ! APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES - BUILDING AND SAFETY FOR APPLICANTTO FILL IN BUILDING ADDRESS WORKER'S COMPENSATION DECLARATION ' I hereby ethrm that I have a certificate of convent to wit mnsure BUILDI D Q or a certificate of Yorkers Compensation Insurence,or a certified �, ' zIP OO 0 copy thereoll(Sac 3800,Lab C) /�` �� compery O SIZE , NO OF eLDGS NOW ON LOT L Lli ❑ Certified copy Is hereby fumndletl NEAREST CROSS Br ❑ Certifled copy le filed with the county building Inspecdon TRACE BLOCK - LOT NO department USE ZONE MAP NO Dale-Applicant ASSESSOR NAP Bode PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EKEMPTION FROM WORMS' 1 �� TEL �p� COMPENSATION INSURANCE JOv �� —N 1000 FT OF SCHOOL? YES NO (This Notion road not be Completed H the pemdt le for oro hundred ZAl � � DISTRICT GROl1P TYPE CONST FlRE ZONESESSEDBY dollen($100)or 10e) CITY C ZIP y,,/ I certify that In the perfo n"of the work for which this Permit {, 41-wk I ✓, 3 U 3 In Issued, I shell not employ any Person In any manner eo as to ITE OR IN NO baCOMBUMBCltoths Workere COmperoetfent. W STATISTICAL FiCATON APT CONDO Date Applicant ADDR µ CUSS NO DWELL WdTS NOTICE TO APPLICANT If attar making this Certllwete 01 CW A/ WE Z AA VVE �I REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to Me Vforken' CONTRACTOR 4P1 SETBACK YARD HVN PROP LINE WIDTH Compensation provislorn of the Labor Code, you must fortlnwdn campy with such provisions or this permit shell be deemed revoked ADDRESS !O G SPL�3 2- � LICENSED CONTRACTORS DECLARATION ,� cm ALC case &DE '`a PL p I hereby affircrow with I em licensed under prvNsl the o1 messChapter 9 gEypgl MAP C1 (commenml9ng with SechOn 7000)of Dtwalon 301 the Business amid p ,.80No BT NO OF FAMILIES Proamal«ro code and my hearse b In fun force and effect ./ NEW BK PG 10, TOTAL 676 _J LCenMNumber U, DESCRI ON OF WORKADD 0 Contractor Date JALTER ❑ $ ?low o11 ! CHECK 676.3 ❑ 1 em exempt udder Sec REPAIR ❑ 2P550% CHAPI15EI 4-3i 0 B BPC for this reason DEMOL ❑ Ded USE OF E]dSDNG BLDG - - URM - ❑ ILDMA P/Ca OQ�-yyyl .l! 1/%,Signature 7 LOW Fw a ,'9226 1 AM10:44 10 ThE ❑ 1, as heiowner of the property or my employees with wages m ?'O their sole cOmpensetlon,will do the work and the atrucWre m ra nterded or offered /or eels (section Toa Business and G D rdrALDA G ACCT.: Profession Code) - - WLLTIEIPRJCAIrTCRFUTx1EBUlxnm+BocclarrrHWDIEAMArAiDpl9MAreeAi y 17.7�� ❑ I as ci m of the property, am ex oonbuctl with A LIBnURE CCNtNNImD A IwAROCIA LL1i611AL WIUL ro Cn OgElnEin TVI! licensed contractors to contruct the project (SWUM 704/ TI@AYOUMaePECEFD ON Tm141NIA1�o116 YATEAMl9 afoRWTION OUIDPI Pa1AL aY r 4 - '` 1 ITEMS l3ulness and Professions Code) `�❑ W❑ / WtLL TIE IMENo®IIeI aP TE euaovro er lie APN1CVnt oR RTUE euuOaD TOTAL 817 . 78 CONSTRUCTION LENDING AGENCY CONY'r AmvAnAlTamRr nrenrvcr MCAMM eaPmLarrwo` C EcxueT •CHECK 817.73 7 1 hereby affirm that there Is a construction lending agency for res❑ Ko❑ the performance of the work for which thu permit Is fssl,ed(sec ' I NWe 11EAm TIE IWARDg1a WITAIMa NFOnMT enllee AID THE SCAOLD 3087,GY (i) PelaaTfaq CLECglBI I nDERBrALD W�UWIZFI THE LCB AWELES COmW,YCCDE.tmLc;C«APt�ex�ea�„oNa�ra,O/„�m«,aN.,n taIlNa 1.erldefs NameMAZAmDOUB1W61MlDRFPORTINO/Jalfpl oeTAapeA Ppaen NDYT1E 8CA0YD Ler dors Andre11000-0001 7120790 v 1960 1 AM 10:4a I eery filet I haus read title application to c end stale that the above Information ncisI end! correct I agree to comply when all coumy PC FEE ( 3 PERMrr FEE ardlnanme and Stets teas reletlrq to building Caotivetiorn and �O ' hereby aWndm repp we t Ja upon ISSUANCEFEE 3 0 the abor led �ect]on purposts R / �.a�n O INVEsnGATICN FEE TOTAL FEE ,. BEE REVEME FOR WI PLANATORY LANGIIAQC APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO Fol IN BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self Insure SUILDM ADDRESS n w a certificate of VAMUre Compensation Insurance or a certified E D ei V tzV L copy thereof(Sec 38110 Lab C) 1 E LP LOCALITY / Policy No t••OmDany, 81ZE OF LOT NO OF SLOGS NOW ON LOT ❑ Certified copy Is hereby furnished NEMEST CROSS ST ❑ Certified copy Is filed with the county building Inrpectim TRACT BLOCK NO department -M4kLISEO E MAP NO DamApplicarH AB9tB90P MAP BOOK PAGE PARCELSPECIAL CONDITIONS CERTIFICATE OF EIIEMPTION FROM WORKERS' n 1 y ' N idol Fr OF SCHOOL? YES NO COMPENSATION INSURANCE ADOFthss(This extion reed not be corrlPletedHthe permttbM pie hlaudred E' U-16 CT DROl1P TYPECONST FlRE2 BY I ceare(i7i m)or Ise) ciivILP ^� D�( / /A 3I certiN const In tire Ilerfomwlce o1 the work for eduktl this psmltt IL / U KrJ s Issued. I shat not employ any person In any manner so s to MCIa7E ETq become subject to the%l rkers Compensebon Laws , STATISTICAL CLASSIFICATION NDO Dots Applfcerrt ADDRESS CLASS NO DWELL L*M NOTICE TO APPLICANT If after making this Certifcata of 00 REOIJMED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' SET BACK( vMD HWY PROP UNE WIDTH CompensationCompensan provisions of the Lab67or Code you must forthwith V comply with such provisioro or Oils permit shall be deemed revoked 1 DE LICENSED CONTRACTORS DECLARATION �' v 1. c� I hereby affirm that I am licensed under provisions of Chapter 9 C l p ` SEWER LDAP lj (cornrlerlcblg with Section 7000)of Division 3 of the Business and NO OF STORES I/O OF FAMILK Profesbna Code.and my license 13 TR I®in full force and effect NEW ❑ BK PG PON. Licemse Number Lic Cos DE5CN1 OF VAxtK ADD ❑ rAwAT d 94 Cuxltractp Data a ALTER ❑ ❑ I am exempt under Sec REPAIR ❑ B BPC for theresson DEMOL LOMA P/C0 Date USE of ETasnNG eLoa URM ❑ 'r pp I�� signature APPLICANT(PRINT) TEL NO TDMA Penm I 3307 83.0D ❑ I ea owner of the prop" or my employes whin Wages as O 1 ITEMS sob compensation WIII do the work and the hu e stnucre Is A F not Intended or offered for sale (Section 7014 Business and FU"L TOTAL $$.OO Prafessiom;Code) WILL�1�NRICNITdINMCaunnrleoCpMIITINNOIl AIWiVa)OUBY�fInML /�LI�/�I/ ❑ I s owner of the un O%CI with aR A YOtTIAE CONTApaq A NAUAOCV9 WT6nNL r.•, ro OR OREAT61 THNI l.LI�E�CyK- �. property ushmly Contracting TIEAYOIAfre ePBprm oil TXE IMTEANLa IaraRNATgN ouuET FILIAL BY > I.1"v111Tt>< .0I 00 licensed contractors to construct the project (Secdon 7014 , ❑ No❑ Business and Professions Code) Wl1 Tera MBmm ere!a TIG!eunnruo eY Tia APR1611lr t>R RrIIRi euanrue OT1a9UMEAPDOrr Id1lXXRRICT IsCterwoCIml® YOpilGTic11 TROYTIf eOlfnil CONSTRUCTION LENDING AGENCY PDIFI OAST Am auAum Mwucomrr DISTRICTrr3mr*po aEON.sr rl hereby affrnl that mere Is a corobrK.roan landing agency for veep❑ 0000-0001 5/23/90 the p1Rlomgrlro of the work fa which this Permit Is Isued(Sec I RNE READ TIE HATAAaps Wreuua INrpaIATKIN ouoe AHo TIE auwouo 0391 1 Ali 9:5,t 3097,CN C) 9V Ladder's Name WBREPoRti o aerA lvac+A PvYQr�nllpai TE LWXW%Addres p1a1 el.mlf • I certify that I have reed this application and state that the above Information bow*correct I agree tow* with all county Pc FEE I'6UIffFEE �i O ordinances and State laws relating m building coFgmcmm,end rMprpe9rlm f Of Hda Courtty� ISSUANCE FEE Md prop" for hgpepbn per � WVESTgAT10N FEE TOTAL FEE d syn � BEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION FOR BUILDING PERMIT t COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I have a certificate of consent to sen msure or a certificate of Vkfken'Compensation Iroumnm or■wtilled a � copy thereof(Sec 3800 Lab C S ZIP Poles'NO Company SIZE O LOT OF SLOGS NOW ON LOT LOCALITY --r YJ� ElCertilled Copy IS hereby furnished NEAREST CROSS ST ❑ Certified Copy is filed with the County building Inspection TRACT BLOCK LOT NO department USEZO�E MAPNO ASSESSOR MAP BOOK PAGE PINCal SPECIAL CONDITIONS Date Applrrant_ CERTIFICATE OF EIQiMPTION FROM WORKERS' TEL'NO yES NO COMPENSATION INSURANCE wrTNIN 1DDD FT OF SV,1OOU (This section need not be completed d the permit m for One huddled A009E93 V DISTRICT GROUP TYPE �:YE PR m dollars($100)or lea) I certify that in the performance of the work for which this permit cm LP m lolled I shall not empty my Person in any 60 a.to ARCHITECT OR ENGINEER 'TEL NO O K J Neconviubject Ilp the Workers M Llan STATISTCAL CLASSIFICATION APT Cpr�O Date Applicant % ADDRESS MASS 0 DIVELLUNITS NOTI TO APPLICANT If e r g this Certificate of LSIOE IRED TOTAL SETBACK FROM EXIST Exemption, you should beco a eu act to the Workers TEL iAC1( YARD If1Ay PROP UNE WIDTH Compersatlorn proweian of the Labor Code you must forthwith _ DanPb wrdr such ProealOna or this pemut shell be deemed revoked AD V LIC IID _ ai�44ni _ )•LICENSED CONTRACTORS DECLARATION c I hereby affimn that I am licensed under provisions of Chapter 9 `''� G �6 - MAP (commecing with Section 7000)of Drvsuon 3 of the ammeae and Sa FT SIZE NO OF STORES NO OF FAMILIES ® - � a Professions Code and my I n NII faNEW BK PG IE-M-ce and L 1 L.cerue Number Cl / TION OF WORK , ADD ❑ VALLIATION ,Cl hL. 117 30E / _ Contracto Date ;.Kc - _ .G E.'-G ALTER ❑ S ^®� •_fit. , ..7.� z Q tamfto Sec REPAIR ❑ S/ I ' ;431W,s •-I- Cis reason DEMOL ❑ Date USE OF EXISTBO URM Cl lD1IA EXISTINGL D Signature AP019ANT( NT) ❑ 1 as LDMA Pmm e owner of the property or my employees with wages as �� _ �.C..'_ 1 Aft G•�_ their win canpambon wdl do the work and the structure m F dOt Intarded Or Offered for sale (Section 7044, Buerress add ►INIAL ATC t P1OfeQp10A°COQ) wu.LT�Awl.rvrtaaarruuaanorooaasrwr AnwARoamMArauAL ' 2 S� __ _. _ ❑ I as owner W the property am exclusively _ oA A Nlm�m CafrtAMA3 A HAZNnaa MATFA eeuAL To CR MIU ER THAN Iceaetl corntracbre b construct the PrWeLY (Section 7014 TIr,ANowresReaTlm ata nelwARooua MA INi7xOlAl%]M asoeT MAL YT / {Y 13mmeas end Professiaro Code) res❑ dD❑ y�G/�" I TOTAL 151 - 95. Nu Tse nrtea¢n vee aF TI¢euanlw err THe Awuowr oat FunAs euluKa _ CONSTRUCTION LENDING AGENCY COOART�s AaiALmAi irr as 'WAQI MOOi'�1A0"TweauTN Ci�t h m I&'"o'ml sea Fenernn0 a.aausr FOR oui0en 1 hereby atfinn that there Is a construction lending agency for Yea❑ ❑ LYfi14l7t . _I_ the Pedoreance Of the work for which this P&Md m issued(Sec I HAvc aGo TIs NAxiuoam s�aRUATnarr GUIDE ANo TAE aCAap 3097 CW C) RESnarTeo oerximr I uNonsrN Mr Rwuinpnema roa TNs Noe Amass cora+rrcooe TmszouPraram Cnoassm lmTHR oHszlrocoNrAwmro TT 'hl-_ Lender's Weise • 11AIMiDD mTorLosuamNo elasr rROMTls erworo 053 =r� iJ��t/- �a o I ABY that I have read thisapplicadw and state that the above PC FEE D PQiMIT FEE /191F��/ information Is correct I agree b comply with al: county / Ordbrences and Stats taws,relating to building Cormtnuction,add S hereby authorize repfalentatVes of this County to enter upon ISSUANCE FEE $Yj thea ova-mentlone Mop" inspectionoee.((�� / �7X/ INVESTIGATION FEE TOTAL FEE L