HomeMy Public PortalAbout5130 BALDWIN AVE_Building__ (2) APPLICATION FOR BUILDING PERMIT
F05\APPLICANT TO FILL IN (Print or type only) 6' /��
BUI LCnNG COUNTY OF LOS ANGELES
A!DD Ess DEPARTMENT OF COUNTY ENGINEER
I ' -3 SAFETY BUILDING AND SAFETY D ISION -
CITY ZIP n
NO OF BLDGS , BUILDING ^
SIZE OF LO NOW ON LOT ADDRESS s —tw—D
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TRACT B O LOT NO LOCALITY
TE NEAREST _ y
OWN NO CROSS ST
ASSESSOR
ADDR SS _ MAP BOOK PAGE PARCEL
DISTRICTGROUP TYPE FIRE PROCES BY
CITY ZIP //� �' CON ZONE
ARCHITECT OR TEL �
ENGINEER NO _
STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS CLASS NO DWELL UNITS B PG1
CONTRACTO SE ZONE MAP
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NO
:240 0
ADDRESS NO yS ZSPECIAL
LIC ✓ CONDITIONS
CIT C LASS
ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CO RUCTION LENDER
NAME AND BRANCH BLDG SETBACK FROM
F T PROP LI NE OF (STREET) a
ADDRESS CITY HIGHWA t YARD TOTAL SETBACK FROM TYPE OF EXISTING CC_'.
SQ-FT NO OF NO OF CHECK FRONT PROP LINE HIGHWAY WIDTH
SIZE STORIES FAMILIES ONE
t C
DESRIPTIC OF WORK NEW ❑ G~.',
ADD ❑ BLDG SETBACK FROM 'd
SIDE PROP LINEOF (STREET) V:
ALTER ❑ Z
HIGHWAY t YARD = TOTAL SETBACK FROM E OF EXISTING
REPAIR[:]
USE
PROP LINE HIG Y WIDTH
USE OF t =
EXISTING BLD DEMOL ❑
APPLICANT TE CORNER CUTOFF YES ❑ NO ❑
(PRINT) NO
IN OPEN SPACE YES ❑ NO
BY (SIGNATURE) ❑
IN COASTAL ZONE YES ❑ NO ❑
VALUATION D�
CATEGORICAL EXEMPTION YES❑ NO ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE)
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON
STRUCTION I CERTIFY_ THAT IN DOING THE WORK AUTHORIZED IMPACT REPO T ROCES SED (DATE)
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF TH
LABOR CODE OF TATE OF LIFOR NIA IN RELATING T i <�
WORKMEN S COM NSATI N INSURA
SIGNATURE O • t
PERMITTEE
ADDRESS
FINAL BY
EL
CITY NO DATE
PC 111hF ( 1/1 ( KS 131) 1131L 10 FEE � FEE
HARVEY T BRANDY COUNTY ENGINEER
PLAN CHECK VALIDATION — cK M o TCASH _ - PERMIT VALIDATION 2 M 0 CASH r
I �'r 396,3 JUL 24 s D 3525®
76A638A CE#803 12/72
76A638A CFn803 5 65 APPLICATION FOR BUILDI G PERM'li7--'
COUNTY OF LOS ANGELES BUILDING /y
DEPARTMENT OF COUNTY ENGINEER ADDRESS C/
BUILDING AND SAFETY DIVISION LOC A L I T Y
JOHN A LAMBIE COUNTY ENGINEER NEAREST _
COLEMAN W JENKINS SUP T OF BUILDING CROSS STESE /
- DISTRICT NOR U TYPE
FOR APPLICANT TO FILL IN sj� CONST
FADoR
G / Y STATISTICAL ICATION SEWER MAP
v CLASS NO DIWELL UNITS RK��G�
BLOCK I USE ZONE MAP fj
`^ NO
�J SPECIAL
r NO OF BLDGS CONDITIONS
LOT Q^1 NOW ON LOT
} BLDG SETBACK FROM
TEL FRONT PROP LINE OF — (STREET)
NO TYPE OF EXISTING (SETBACK- HIGHWAY + YARD — TOTAL
HIGHWAY WIDTH FROM C L
CITYµ
ARCHITECT Of TEL BLDG SETBACK FROM -
ENGINEER NO SIDE PROP LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
TEL + _
CONTRACTOR NO O
LIC
ADDRESS NO CORNER CUTOFF YES NOLC
V
CITY CILASS SEE REVERSE SIDE FOR SPECIAL APPROVALS O
DESCRIPTION OF WORK - I ti
a
NEW ADD 2 ALTER REPAIR s DEMOLISH
SO FT NO OF NO OF
SIZE STORIES FAMILIFS
USE OF
STRUCTURE (,(:
SIGNATURE OF
APPLICANT
VALUATION G G
APPROVALS DATE INSPECTOR SSIGNATURE
P C PMTFORMS FOUNDATION MATERIALS
ON
FEE$ FEE$
FRAME FIRE STOPS /
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
9UILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN SO ENSATION INSU NCE LATH EXT
SIGNATURE OF HOUSE NUMBER COR
PERMITTEE RECT AND POSTED
n
ADDRESS i2el4 FINAL
/ JOHN F LEWIS PRINCIPAL STRUCTURAL EN R
PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDATION CK M C CASH
5674Z8 WV 4 1 D 6.001-411
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- �T1rON OF BUILDING y AND eS A2r�ETY 8 1 ®,' __�,��"
f� I �Departtnent of Conn En
County of Los Angeles
WM J FOX, COUNTY ENGINEER APPLICATION
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
A/ D _
DISTRICT NO. �P�LAN CK OR REO NSD+ PERMIT N+O
BUILDINGADDRESS SI 3 0/-• �iis°A.�6� J� !`+ ��3✓/— /� 7�V
RECEIVED BY DATE OF APPL DATE ISSUED
LOCALITY yam„ ti s
NEAREST
CROBBBTBig:= ' BUILDING S/3 �V0 N� a A
ADDRESS (/Q / wI/�/ L.,,-
OWNER
MAIL LOCALITY .0 C
ADDRESS NEAREST /
TEL CROBB ST
CITY NO FIRE FNOP TYPE GROUP
ARCHITE TEL ZONE NS
ENGINEE ` NO BLDG ORD NO
SETBACK LINE /y�+y
ADORES e USE APPROVED
TEL ONE,(-/ BY DATE
CONTRA O NO a HOUSE NUMBERING
ADD 8 e'7 V 63� p MAP NUMBER-2 0 1 10 NO ASSIGNED BY
LEGAL CORRECTIONS
DEBCRIPTION I LOT NO BLOCK
TRACT
NO. OF LDGS. CO
Z� a� eo ?inl[JO✓S �/��SGlE,�,�/fcly�
SIZE of LOT Q I NOW ON LOT
USEOF NO OF r
EXISTING BLDG �.�}' .(r0f7b1`,L1 O
DESCRIPTION OF WORK v
a 17o.+.1 of 76W 02 S�on//9A�g.l0�
NEW I ALTERATION I I ADDITION
REPAIR DEMOLITION J
BFT No or
ZE ROOMS STORIES/ E9
EXT WALL ROOF
COVERING COVERING f�.a.eb-_4-�4:;- AE JO ,S V—
USE OF STRUCTURE
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INSPECTION FOR APPROVALS
OCCUPANCYAS INSPECTOR'BSIGNATURE DATE
FOUNDATION LOCATION
FORMS, MATERIALSL, -�
i HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN IB FRAMEt FIRE STOPS, /
CORRECT BRACING, BOLTS
1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING BUILDING CONBTRU FURNACE LOCATION
TION GAS VENT DUCTS
SIGNATURE O / - , LATH, INT
PERM ITTE
ADDREB Uzo x e"" LATH EXT
PLASTER, INT
AUTHORIi[D AOT
PI Al3TER, EXT
HOUSE NUMBER COR-
`.�G� RECT AND POSTED
VALUATION f/ F[[ S`�/ e O FINAL
7SA632A DBS 3 1 52