The URL can be used to link to this page

Home My Public Portal About5708 OAK AVE_Building_1/8/1982_w WORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self nsure, or a certificate of Workers' Compenstion Insurance, or r certified copy thereof (Sec. 3800, Lab. C.) 'olicy N� Company Certified copy is hereby furnished. ] Certified copy is filed with the county building inspec- tion department. )ate Applicant CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE This section need not be completed if the permit is for one iundred dollars ($100) or less.) certify that in the performance of the work for which this termit is issued, I shall not employ any person in any manner o as to become subject to the Workers' Compensation Laws. )ate Applicant JOTICE TO APPLICANT: If, after making this Certificate of Ixemption, you should become subject to the Workers' :ompensation provisions of the Labor Code, you must forth- vith comply with such provisions or this permit shall be leemed revoked. LICENSED CONTRACTORS DECLARATION hereby affirm that I am licensed under provisions of Chapter 9 commencing with Section 7000) of Division 3 of the Business and 'rofessions Code, and my license is in full force and effect. icense Number I ic. Clo=y :ontractor note I am exempt from the licensing requirements as I am a licensed architect or a registered professional engineer acting in my professional capacity (Section 7051, Business and Professions Code). ic. or Reg, No. Dat - OWNER -BUILDER DECLARATION hereby affirm that I am exempt from the Contractor's License aw for the following reason (Section 7031.5, Business and 'rof ions Code): I, as owner of the property, or my employees with wages as their sole compensation, will clothe work and the structure is not intended or offered for sale (Section 7044, Business and Professions Code). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY hereby affirm that there is a construction lending agency for he performance of the work for which this permit is issued Sec.. 3097, Civ. C.). L a APPLICATION FO�BUILDING PERMIT COUNTY OF LOS ANGELS. / e, BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDING �� /y /fj ADDRESS ie /L ioccai BUILDING ry .! /J� ` ADDR.ESSSS}..�/O� /V• /�A //WCi LOCALITY -CITY I CMP -E /TSI. CA. ZIP 7W NEAREST �f A/ //d CROSSNEAREST ST. �/ J ./! rt ` / NO. OF BLDGS. h ASSESSOR SIZE OF LOT�T7 e. ( X 13O NOW ON LOT scv MAP B ) I PAGE PARCEL TRAC7�nJ (O I W9GK y17M /Jzs4 � NO fJC i I > / TEL /��(Q,Qs�/� SPECIAL I OWNER15;iIIF0,PGE Q rREfA fyr& LW7-2431F // I:..DIT- ,ONS "ADDRESS%�/�% �_ L�iys AAi / tlx/ STRICT GROUP TYPE I E _?� CONST.. / � aTvTEYhPGEG! f 7� CAzIP 9/7,?o � �� f72 v � o ARCHITECT Ofd ,7.' TEL. STATISTICAL 111 ION COND 'II V ENGINEER PAIVIP V. LE•E �/N6�-'2(,�siV-3%:11 CLASS NO. -DWELL. DWELL. UNITS I I I a ADDRESS 7 ,Jv y-� 5% iTt144Ln9eA0_ SEWER MAP Z •+CONTRACTOR pip, BK. PG, VALIDATION ADDRESS i �j/ - ' C� C VALUATION LIC. =CITY CLASS S q_a,DOO ' SO. FL r? ! rZ INC. STORIIEES I FAMILIES I CHECK '=SIZE ,�LL Ls�� = DESCRIPTION OF WORK /T///J/ Tl ONS Or- NEW L -IR �Ip I ADD %IASTrIP gmr�0/!M /iiVA'bATl{. ALTER ❑ FINAL - FAFhi LL! a OM U -n L f T� FOOM I REPAIR ❑ DATE USE OF / - - FINAL DE OL B EXISTING BLDG. 5 iAfL1. E � Ercr i � EA/C� ❑r y APPLICANT/ TEL. '44'7 7-430s- fPRINT4_Tf'O.�.L '� �QEM/7TA'�D i_ ADDRESS r=PRESENT/JIj BUILDING LZ Cam,/ _ ADDRESS _ LOCALITY /Jr . a d q _ 5 ?, MOVING TEL. OS _CONTRACTOR NO.to `O s = e - ADDRESS Td QL)'RED TZ)TAL SETB�+L�C FROM EXIST, I n SET BACK )'ARD HWY I L PROP. IyE I WIDTH FRONT I��ITTO i%`P. L - - P. L.cz SIDE- P.L. ender's Name ender's Address P.C. Fee S Permit - certify that I have read this application and state that the IssuanceFee bove information is correct. I agree to comply with all County t -investigation Fee / /!l romances and State lows relating to building construction, ■ �{fO nd hereby authorize representatives of this County to enter r ITotol FeAJ p the above-mentione property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signa re of Applicant or Agent j yy �� Os PLANS TO APPLICANT To: Returned Approved No.I Date No. Date I Required I Date Rocoivod Approvals I Yos No or Approved I Water Certificate Health Department Fire Department Grading Geological Pedestrian Protection (Fence) (Canopy) Special Inspection (Cont.) (Masonry) (Welding) Lot Drainage Parking Approvals I Date I Inspector's Signaturo Location— (Setback & Yards) ` Foundations Slab Frame Energy Insulation Loth/Drywall---- Interior Lath - Exterior House Number Correct & Posted Final— Enter on Front INSPECTOR'S NOTES OWNER -BUILDER DECLARATION'- I hereby affirm that I am exempt from the Contractc License Law for the following reason. (Sec. 7031 Business and Professions Code: Any city or county whi requires a permit to construct, alter, improve, demon or repair any structure, prior to its issuance, also requi, the applicant for such permit to file a signed stateme that he is licensed pursuant to the provisions of the Cc tractor's License Law (Chapter 9) (commencing with S tion 7000) of Division 3 of the Business and Professic Code) or that he is exempt therefrom and the basis for t alleged exemption. Any violation of Section 7031.5 any applicant for a permit subjects the applicant to a ci penalt of not more than five hundred dollars (,5500) 1, as owner of the property, or my employees w wages as their sole compensation, will do the work, c the structure is not intended or offered for sole (Sec. 70. Business and Professions Code: The Contractor's Lice$ Law does not apply to an owner of property wbo bui or improves thereon, and who does such work himself through his own employees, provided that such i provements are not intended or offered for sale. however, the building or improvement is sold within c year of completion, the owner -builder will have i burden of proving that he did not build or improve, the purpose of sale). ❑ I, as owner of the property, am exclusively contri ting with licensed contractors to construct the project (S' 7044) Business and Professions Code: The Contractc License Lau, does not apply to an owner of property u builds or improves thereon, and who contracts for sr. projects with a contractor(s) licensed pursuant to i Contractor's License Law). 1 am exempt under Sec. B.&P.C. for reason Date/�QtC - `/ J7 Owner INSPECTOR'S NOTES