HomeMy Public PortalAbout6050 AGNES AVE_Building__ 76A838A CE#803 9 87 1 ���
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APPLICATION FO UILDIN ERMIT
COUNTY OF LOS ANGELES /
DEPARTMErlt OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY /
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUP T OF BUILDING NEAREST `
CROSS ST �}
FOR APPLICANT TO FILL IN DISTRICT N GROUP TYPE ---PRO SSED Y
CONS
(Print ort pe only) �10
[BUILDING t STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS ,� I C > CLASS NO=�DWELLL UNITS —� L PG
LOT NO—�jp l , C� E U ZONE NO
C�
TRACT 4 SPECIAL
NO OF BLDGS CONDITIONS
SIZE OF LOT SC/ 3 c NOW ON LOT J
USE OF ,o
EXISTING BLDG G( ` BLDG SETBACK FROM
TEL FRONT PROP LINE OF (STREET)
OWNER 7 1 OdzL TYPE OF EXISTING SETBACK JYGHWAY + YARD = TOTAL
ADDRESS
HIG WAY WIDTH FROM C L
1,� G� C �S
CITY ♦ /' v +
ARCHITECT OR TEL BLDG SETBACK FROM (STREET)
ENGINEER NO SIDE PROP LINE OF
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
TEL _
CONTRACTO N + CL.
L O
ADDRESS N CORNER CUTOFF YES ❑ ��NO U
LIC
CITY CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK �; a
CURB;GUTTER DRIVEWAY APPROACH, e t z
LEADD ALTER REPAIR DEMOLISH AND PARKWAI TP' tiDEOUI t t 1�
NO OF NO OF 37 l STORIES FAMILIES 1 r Nbip Potm A fe `�I},I.., PIY v approach n
RE %jAjk#1®Rs should h , 1 I A t� a
1, - R Id
a leng'hy deley S,. y ' G Is not start d
RE OF 'NT un 1 erml a been s u a 3) L ar„w y ti9 perm) aON $ Olt-
� � �G Cl I ,�
FOUNDATION/�} (( APPROVALS DATE INSPECTOR 5 SIGNATURE
FEE S FEE $ / .�N� FORMS MATERIAALS !
FRAME FIRE STOPS ��9
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY Ulu
FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT LATH INT
ING TO WORKMEN S COMPENSATION INSURANCE //
�.� LATH EXT U lZ V
SIGNATURE �
O HOUSE NUMBER COR
PERMITTEE /7 RECT AND POSTED
ADDRESS - FINAL L S �9
JOHN F LEWIS PRINCIPAL ST URAL ENGINEER
PLAN CHECK VALIDATION CK M o CASH
PERMIT VALIDATION CK M O CASH
L&O3 6 4 V�8 AAR19 1 D 1 -725, Nq
7!lA638A CEitSO3 9 67
APPLICATION F R BUILD G PERMIT
COUNT,Y OF LOS ANGELES BUILDING / 4C
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUP T OF BUILDING NEAREST
CROSS ST r T
FOR APPLICANT TO FILL IN DISTRICT ROUP TYPE PROCESSE Y
Print ort a only) �� � CONST
BUILDING _ T� STATISTICAL CLASSIFICATION SEWER M
ADDRESS i� �f / / CLASS NO_�0_DWELL UNITS ':BK
LOT NGFd !� [� L�6ff�J USE E MAP /j ,} `
O `" v
TRACT �J CONDITIONS
SPECIAL
NO OF SLOGS
[EXISTING
IZE OF LOTy NOW ON LOT
SE OF
BLDG - BLDG SETBACK FROM
TEL FRONT PROP LINE OF (STREET)
OWNER k4a 4"94 NO i TYPE OF EXISTING SETBACK /HWAY } YARD = TOTAL
ADDRESS (y//pp i HIGHWAY WIDTH FROM C L
CITY l �
BLDG SETBACK FROM
ARCHITECT OR TE SIDEPROP LINEOF (STREET)
ENGINEER NO
TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
CONTRAC O NO
Lic
ADDRESS ✓ NO CORNER CUTOFF YES ❑ NO U
CITY CLASS SEE REVERSE SIDE FOR SPECIAL APP OVALS o
DESCRIPTION OF WORK N
NEW ADD ALTER REPAIR DEMOLISH �� ,A�l�d�'
SQ FT NO OF N �N
SIZE 2 STORIES FAMILIES
USE OF
STRUCTURE
SIGNATURE Gq
APPLICANT
VALUATION $ /'eq�V
G� APPROVALS DATE INSPECTOR S SIGNATURE
P C PMT d FOUNDATION LOCATION
FEE $ FEE $ FORMS MATERIALS a
FRAME FIRE STOPS f
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS �p
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION 1 CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN S COMPENSATION INSURANCE rt�
LATH EXT J�7
SIGNATURE O �J� I HOUSE NUMBER COR
PERMITTEE RECT AND POSTED
ADDRESS FINAL
JOHN F LEWIS PRINCIPAL ST URAL ENGINEER
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M O CASH
"t,r
,f n
3 ri"4 0\ eM 19 D 6.0 0 a
Y
i
. L4 CATION FOR LC NTY OF LOS ANGELES
ARTMENT OF COUNTY
,BUILDING PERM 1T D UILD NG AND SAFETY DIVISION ENGINEER
BUILDING
-- FOR APPLICANT TO FILL IN ADDRESS'
BUILDING c
ADDRESS Q J i N LOCALIi.�" _
//t�
NEAREST
�j &
CITY 0-0C 617 ZIP CROSS ST
NO OF BLDGS ASSESSOR
SIZE OF LOT O 1 NOW ON LOT MAP BOOK PAGE PARCEL
TRACT �(li BLOCK L NO S DISTRICT GROUP TYPE FIRE CE D BY
TEL 5`� (� CONST Z
OWNER NO
6 �L S CLASS NO DWELL UNITS BK
STATISTICAL CLASSIFICATION t SEW MAP
ADDRESS Q S0 /Vle
T
CITY / C1 ZIP USE ZONE MAP
ARCHITECT OR TEL /GNO 1 /
ENGINEER NO SPECIAL /
C DITIONS -
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES [:] NO ❑
� -
CONTRALTO �j� TEL NO Zg BLDG SETBACK FROM
l �j 7 r FRONT PROP LINE OF (STREET)
ADDRESS57�i S CJj IO v�� HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
cc�,.+ LIC FRONT PROP LINE HIGHWAY WIDTH
CITY moi&' CLASS
CONSTRUCTION LENDER`
NAME AND BRANCH BLDG SETBACK FROM ^ UU
ADDRESS CITY SIDE PROP LINE OF (STREET) c
O
SQ FT13NO OF NO OF CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING U
2 SIDE PROP LINE - HIGHWAY WIDTH w
SIZE STORIES FAMILIES ONE ti
DESCRIPTION OF WORK JE /V NEW ❑ t
—
r4fxg
L oO g (, ADD CORNER CUTOFF YES ❑ NO ❑ j 1 1
f ALTER IN OPEN SPACE YES ❑ NO ❑ }
` REPAIR ❑
USE OF /� IN COASTAL PERMIT ZONE YES ❑ NO'-[]--
EXISTING BLDG (� DEMOL
APPLICANT Q� TEL
Zy� v
L $
(PR I NT)pO5 E,D7�0 �7 O
ti
BY(SIGNATURE)
LSS PEBY A KNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE d J�
E ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
WS REGULATING BUILDING CONSTRUCTION CERTIFY THAT IN DOING THE P h 1
UTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF a E t
OR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM
ION INSURANCE 1
C l f
l
URE OF FINAL BY
TEEZ�� DATE
SS Z ` v li
/ �\ NOC Fee$ Permit FeeIssuance Fee
TION� O �// /� ` " l
✓� Total Fee .�
PLAN CHECK VALI ATION CK M o CASH PERMIT VALIDATION CK w M o CASH
,
eq-� 04 1 e'-t�tnt 2 .1U 1 1 J 0 U 4'4
Y t
(5S 76A638A CE#803A 8/77
RS COM�6NSATION DEC
Y insurA bar a cute of Workers have a rtificate of Compensat,on ensuian ent to self APPLICATION" 'F O R" A U I L D I N G, PERMIT ♦
or a certified copy thereof (Sec 3800 Lab C ) - - ' - - `
4 ,r 1 LL// s P , .,COUNTY OF LOS ANGELES ` BUILDING AND SAFETY
BUILDING
Polite No f-j� ofnpanY 27�r J`J
' ❑M Certified copy is hereby furnished A vN' t, - 3 FOR APPLICANT TO FILL IN } ADDRESS _ a
ds
Certified copy is filed with the county building inspec: BUILDING / /�� r
tion departme`nT F t'' t 3 "K` c ADDRESS 60 V
Date Z'�J+ �'8 'r Applicant a tc w i CITY rt ✓y -�f f ZIP - 7 LOCALITY` 4
CERTIFICATE OF EXEMPTlq5WWVOR Sa +t"� '" - ` NO-OF BLDGS - NEAREST
COMPENSATION�INSURANCE
` , SIZE OF LOT NOW ON LOT CROSS ST
�� �!
\ (This section need not be completed if the permit isifor one - ��- 6 ASSESSOR ; -t r z '♦
hundred dollars ($100)or less ) TRACT r BLOCK_ LOT NO MAP BOOK ♦ t PAGE PARCEL
♦� t rr t /lC�� �- E TEL "����J U E O - MAP
9n vY r �t't e ri OWNER / ✓►'!/ `"" NO"` ✓ s♦ r
I certify that in the performance of the work for which this NO a
permit is issued I shall not employ any'person in any manner `1 SPECIAL- T t
so$s'to become`subject to the Workers`Compensation Laws ADDRESS 605-0 ,4", `' CONDITIONS i O
ti , r j ..;yC Ori , = 8°�' , : t t / (� _• .r ._ '_ ' t -
" t S♦ �, ' ♦ t t CITY / Gr £ ZIP �/7G7�..-+- _ " t - , ., i,�
Date ^ Applicant ' - f ,OC
NOTICE TO APPLICANT filf after rrakin this Certificate of r ARCHITECT OR', 1� TEL DISTRICT GROUP TYPE FIRE PR ESSED BY
Exemption youN'should `become subject`to) the Workers r ENGINEER e NO �^ I f_' ��„/ /I CONST £ ZONE W
Compensation provisions of�the Labor Code youtmust forth ADDRESS �JVC L �uuXX !/J - -
with comply with such tprovisions or this'permit shall be - -t ---- -
TEL ` rD � � i STATISTICAL CLASSIF CATION APT _ C DO �
deemed revoked,% i * t tt ,+�v�,- F + CONTRACTOR e +r [ t..v NO y�2-�Jy� J
YI
LICENSED CONTRACTORS DECLARATION, , tE w —_ p� -, LlC - t -C-LASS-NO _DWELL UNITS ti
I hereby affirm tfiat l tam licensed under provisions of Chapter 9 ADDRESS 7 7 ^ �'f L Gt���L'! NC J�rJ3�W t SEWER MAP T t
(commencing with Section 7000)of Division 3 of the Business and _ _ _ LIC - t
Professions Code and my license is iii full force'and effect CITY Y CLA55 + �X1 1 ; " VALIDATION
S �t an..+.y, q`Js*♦ BK PG
se d € 5
e ° SQ F NO OF NO OF ICHECK
V Li%nse Number',x K �t Lic Class j° SIZE STORIES 2 - FAMILIES ONE
tit t ❑ VALUATION I
__ _ NEW-
+ " >> '' � DESCRIPTION OF WORK 2-3
j
'Contractor;Te '/�v ke' -'1 Date Z-`C S�� s - 06) ` !
v ADD G/ 'j # e o ° e 2-`7�
F-1I ami exempt under Sec Y } -' " �� C�� -' ALTER ❑ } e {
a7
r l 20&79
B&P C for this reason REPAIRr 0 $ "
e - _ > na USE OF RC1/ or trCY DEMOL ❑ _ ° ° 20a79U l
EXISTING BLDG r
' Sig`n'ature t ✓�� i - APPLICANT TEL ,s FINAL , 0 1 2 5-85
PRINT "! NO 7 y
ECLARATION _ _ - -DAT -r I
I hereby a it am a mpT from the Contractor s License I G ~ -
Law for the follow'mg reason (Section 7031 5 'Business and ADDRESS / ( �.✓!lVe e_ FIN �///' /�/(�1
Professions Code) m PRESENT By -J7J k� " r't " L 1 5 1-6 Ac
BUILDING
❑- I as owner of the property or my employees with ADDRESS ✓ # • °-O ° 2 3
w wages as`their`sole compensation will do the work and '+}_ `'��-• 1 1^2 5 1 ,
the structure is not intended or offered for sale(Section LOCALITY 1 t }
_ `
7044 Business and Professions Code)' "^ MOVING r TEL - x - - ° •"1 T1 2 5 1 v
CONTRACTOR NO ` f r 0 2, 1,2-85
I as owner of the property am exclusively contracting
$ e with licensed contractors to construct the project (Sec - ADDRESS f } u�( '~W " r} 1 5 3.5 A `
tion 7044 Business and Professions Code) tt 6 v i k ?
- CONSTRUCTION LENDING AGENCY" ' ` - REQUIRED YARD -HWY -TOTAL SETBACK � a fxt � _ , � 1 ��
SET BACK PROP LINE WIDTH I y rt r t #T° o e ° e'1
I hereby affirm that there is a construction lending agency for ' FRONT x c� t ��' +' ' 4
-the performance of the work forrwhich This permit is issued P L - - - �` - }- t r '' `� '
(sec 3097 Civ C ) SIDE , x _ I—I-'3 8 8;�5 0
m 3 gig,5�0=_ ,
Q Lenderrs Name
u a LDMA Ref # _ +" r f
P C Fee$
`� ♦ ? '^ Permit Fee '- l V - °�' ! `{
Lender s Address t 0 2 1 5-8 5-,
ll 7' f
��I_certify thart_I have read this application and state that the r ? �� I v Issuance Feed n N LDMA P/C-# �T
a above information is correct I agree to comply with all County Investigation Fee
ordinances and State laws relating to building construction Total Fee LDMA Perm #
u and hereby a 1tho ize re resentatives of this County to enter
upon the ab., enti ed property for inspection purposes t y
j 4 SEE REVERSE FOR EXPLANATORY LANGUAGE
�
n r o
uf Applicant or Agent'- Y"" Date � — � --- � o- - "-- + ♦ � _ ��,,._. ._ � __- _• _ r