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HomeMy Public PortalAbout5027 ARDEN DR_Building__ APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (P,Int o, type only) BUILDING ADDRESS /G'. - BUILDING .�—> ADDRESS r` CITY / '� j') 'V ZIP .s+j��,.._ NO.OF BLDGS. LOCALITY p(,, SIZE OF LOT '�yic3 NOW ON LOT NEAREST CROSS ST. s ASSESSOR J TRACT � / BLOCK LOT NO / MAP BOOK PAGE PARCEL TEL. DISTRICT G TYPE FIRE / R ESSED BY OWNER ' NO. 7S ZONE( '\ ADDRESS STATISTICAL CLASSIFICATION SEWER CITY _ ZIP n CLASS NC _DWELL,UNISS '_ L BKG ARCHITECT O I. TEL ENGINEERUSE ZONE MAP ( /C NO. ADDRESS 2 C% .. t SPECIAL TEL. c CONDITIONS CONTRACTOR NO ROADEPARTMENT APPROVAL REQUIRED YES NO LIC. ADDRESS NO. -1 0- FROM CITY LIC. FRON PROP.LINEOF (STREET) C LASS HIGHWA + YARD TOTAL SET ACK FROM TYPE OF EXISTING CONSTRUCTION LENDER O NAME AND BRANCH T P P. LINE HIGHWAY WIDTH ADDRESS CITY SQ, FT.31i,'/ NO OF NO. OF CHECK BLDG.SETBACKFROM SIZE J // t STORIES FAMILIES ONE SIDE PROP.LINEOF (S ET) V CC NEW ❑ HIGHWAY + YARD _ TOTAL SETBACK FROM TYPE OF ISTING _C) DESCRIPTION OF WORK - �-V ❑ SIDE PROP. LINE HIGHWAY ,DTH U ADD W + = a ALTER ❑ Z t31 REPAIR❑ CORNER CUTOFF YES ❑ NO ❑ USE OF DEMOL 01EXISTING BLDG p IN OPEN SPACE YES ❑ NO El, , A PPLIC T L _p �� IN COASTAL ZONE YES NO (PRINT) y? CATEGORICAL EXEMPTION YES NO ❑ BY (SIGNA TU ) ENVIRONMENTAL Q IMPACT EXEMPTION DECLARATION SIGNED (DATE) VALUATION$ �p �® IMPACT REPORT PROCESSED (DATE) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIJEE ION AND STATE THAT THE ABOVE IS CORRECT AND AGRLY WITH ALL ORDINANCES AND LAWS REGULATING ON- STRUCTION. I CERTIFY THAT IN DOING THE WOED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOHE LABOR CODE OF THE STATE OF CALIFORNIA INTO WORKMEN'S CO TION INSURANCE.SIGNATURE F FINAL , --I PERMITTEE DATEiAADDRESS P.C. $ PMT.$FEE 'D FEEDTEL CITY NO. PLAN CHECK VALIDATION CK, M.O. CASH PERMIT VALIDATIO CK. 0. CASH 4, o APR 1 1 U 1 5.0 U 76A638B CE#803A 5/73 APPLICATION FOR BUILDING-PERMIT F4R APPLICANT TO FILL IN (Print or type only) EUI LD DEPARTMENT ADTY OF LOS ANGELES DRESSNT OF COUNTY ENGINEER RESS�Q � r' e 011— CITY vle d11 ZIP / f�Q BUILDING AND SAFETY DIVISION 7//� O�� p NOW ON LOTF B S ADDRESS . BUILDING SIZE O F LOT TRACT BLOCK LOT NO. LOCALITY —7—CC- yO�asf CryY TE L. 14 NEAREST OWNER �"f �^/Q NO. CROSS.ST. ® .9ep ASSESSOR ADDRESS MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE PROC SSED BY CITY ZIP / (/ CONST. ZONE �_ ��/ ARCHITECT R TEL. Sem ! �wDGY.Es."'�c� ENGINEER - NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS / TEL ,CLASS NO. P—�_DWELL,UNITS SK PG . CONTRACTOR e /' �+ a NO. �`d 022 USE ZONE MAP LIC /� NO. c'7 <p ADDRESS �' NO �✓ /4/ SPECIAL ' LIC. CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES� NO CONSTRUCTION NDER y NAME AND BRANCH BLDG.SETBACK FROM a ` � (STREET) C ` L; FRONT PROP.LINE OF ADDRESS CITY HIGHWAY } YARD TOTAL S BACK FROM TYPE OF EXISTING SQ, FT. NO. OF NO..OF CHECK FRO PROP. LINE HIGHWAY WIDTH c SIZE STORIES FAMILIES ONE } = 4 d DESCRIPTION OF WORK NEW v; BLDG_.SETBACKF OM Z ADD SIDE PROP. LINE F (STREET) ❑ ALTER ❑ HIGHWAY } YARD TOTAL TBACK FROM TYPE OF EXISTING = REPAIR❑ 5 PROP. LINE HIGHWAY WIDTH USE OF DEMOL ❑ } EXISTING BLDG. AP PPRINT' a6p�-f �� d NpL�7�O� CORNER CUTOF YES ❑ NO ❑ BY (SIGNATURE) IN OPEN SPACE YES ❑ NO E] Q IN COASTAL ZONE YES NO ❑ VALUATION$V ,6 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 REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO 7—/®�/,��.O�t�Qe ��_e/l -1,<M WORKMEN'S CO SATION INSURANCE. ./ 7 /t9 f Ct- �-, �C SIGN.ATUR a � PERMITTE ADDRESSFINAL TEL. ! DATE �j T / B Y� CITY NO. MAKE CIIF_CKS AYABLL TU: FEE ✓ FEE HARVEY T. BRAN DT. OUNTY ENGINEER 2S s_ PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION . M o. CASH & 6 O r"2-.IUL 5D 1 28.50e''6 76A638A CE#803 7/73 j 78A636A CE#8035-6I APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ADD ESS DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST / WILLIAM A. JENSEN SUPT OP BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRIGTIN ROUP .�1 Pgoe SSED BY�L II�slS ..L CONST. �f BUILDING STATISTICAL CLASSIFICATION SEWER MAP ADDRESS L BK CLASS. NO.�DWELL. UNITS— fa� � 5 , LOT NO. :2 7 BLOCK WATER NOT REQUIRED RECEIVED p CERTIFICATE: TRACT �.,J_j.,�/ MAP �y � /� HIGHWAY NO.OF BLDGS. NO�! �/ (CIRCLE) STATE MAJOR COND, OCAL SIZE OF LOT /�-��X $'/J� IND ON LOT USE ZONE SPECIAL USE TOCONDITIONS EX SINGBLDG. 1 jTEL. " OWNERJA.✓ (GS. 1%-'71A "; Olt NO.(:,IL'1.I7S BUILDING EXIST. 1 _ SETBACK YARD HWY STREET NAME WIDTH ADDRESS J���[7 is rc�r-a Dr- ct-ry�.l�-C>� FRONT - I ARCHITECT OR — TEL. P. L. ENGINEER NO. SIDE P. L. O ADDRESS _ - INSPECTION RECORD u TEL. w CONTRACTOR NO. O E— .-k6DRESS U W DESCRIPTION OF WORK N i, Z NEW ADD ALTER REPAIR DEMOLISH50. 11 �IZET ,� S � STORIES NO'1 FAMOF ILIES i USE OF STRUCTURE r, SIGNATOR '/� APPLICANT VALUATIO'IJL'� APPROVALS DATE INSPECTOR'S SIGNATURE P. '" -^� �i FOUNDATION: LOCATION I _ FEE ""� FEE $S Z FORMS,•MATERIALS 5 FRAME: FIRE STOP:;, IHEREBY 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 BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK >- AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH, INT. I ` TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S COMPENSATION INSURANCE. LATH, EXT. SIGNATURE-410, ` HOUSE NUMBER COR- PERMITTE -`' RECT AND POSTED FINAL CLYDE N. DIRLAM, PRINCIPAL ST RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERM VALIDATION cK- 'm.o. CASH ;­ "' APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or tvoe only) BUi LCING �—'7 / - COUNTY OF LOS ANGELES ADDRESS . .-' / l' -•` L:r '� I. DEPARTMENT OF COUNTY ENGINEER clrY 1 �: ! t ). C 72 zip r f ffi BUILDING AND SAFETY DIVISION N6,OF BLDGS. BUILOING .- / - -'y IZE OF LOT NOW ON LOT ADDRESS TRACT 7 � BLOCK LOT NOLOCALITY ' C� _ L�/-{�1 �J �� � OWNER I ! h�(r t NO•! l /�I 'NEAREST'�.7 CROSS ST. 1 ,� .... L f�•�` �7 ASSESSOR ADDRESS •3 l/» If' A� t't„j _�,/ MAP BOOK PAGE PARCEL DISTRICT IGROUP TYPE FIRE PROCESSED BY CITY �""' ZIP CONST. ZONE ARCHITECT OR TEL. ENGINEER NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS _ !i CLASS NO. ,_DWELL,UN ITS BK PG CONTRACTOR NOLO / ,'� ,1< USE ZONEFMAP eLIC.+'ADDRES5F � CIAL LIC. ./"! E 1 DITIONS CITY-5r h f !"�., CLASSC w `.} � � �- V ROAD DEPARTMENT APPROVAL REQUIRED YES NO El CONSTRUCTION LENDER O NAME AND BRANCH BLDG.SETBACK FROM C_,) FRONT PROP.LINE OF ISTREETI J ADDRESS CITY HIGHWAY } YARD TOTAL SETBACK FROM TYPE OF EXISTING LL- SQ. iSQ. FT NO. OF NO. OF CHECK - FRONT PROP. LINE HIGHWAY WIDTH >_SIZE �% STORIES FAMILIES ONE ce } M /" � DESCRIPTION OF WORK NEW CQ ».7r C.- CD A ADD ❑ BLDG.SETBACK FROM L SIDE PROP. LINE OF (STREET) W ALTER ❑ HIGHWAY } YARD TOTAL SETBACK FROM TYPE OF EXISTING ~ = REPAIR❑ SIDE PROP. LINE HIGHWAY WIDTH USE OF DEMOL ❑ ~` EXISTING BLDG. APPLICANT _ TEL CORNER C�7T'®.E,F. YES NO (PRINT) NO. BY (SIGNATURE) IN OPEN SPACE YES NO IN COASTAL ZONE YES NO QQ VALUATION sP �i-'j(../ I^��—^"' 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 TE) WIT HALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COEN A TION INSURANCE. % SIGNATURE OF PERMITTEE. - ADDRESS 4. j TEL "'•.,,7,'. _ FINAL BY CITY '`J `•-,) -'{,�J NOL. i 1 '7 - >, DATE MAKE CIIECKS PAYABLE TO: F E 4' FEE HARVEY T. BRANDT. COUNTY ENGINEER I / PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDATION CK M O CASH a ?w• 76A638A CEit803 7/73 76A638A SCE b803 2-63 APPL'ICAT CO N FOR:B U(LD(N G PE RM(T. . COUNTY OF LOS ANGELES BUILDING 4✓ DEPARTMENT OF COUNTY ENGINEER ADDRESS,. BUILDING AND SAFETY DIVISION LO' CA' LITY JOHN A. LAMBIE, COUNTY.ENGINEER NEAREST _ ' WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. DISTRICT NO GROUP TYPE- P OC S O D BY FOR APPLICANT TO FILL IN coNsr. ' . BUILDING STATISTICAL GLA IFICATION SEWER MAP ADDRESS O Z' �QN ✓� / - CLASS. NO. DWELL. UNITS ' LOT NO. BLOCK' WATER. + - ❑ CERTIFICATE': NOT REQUIREDRECEIVED ' TRACT •�, - - MAP - HIGHWAY STATE MAJOR ECOND.' NO.OF BLDGS. NO. �© (CIRCLE) SIZE OF LOT - .NOW ON LOT. USE.ZONE SPECIAL USE OF _ CONDITIONS EXISTING BLDG.' - �. ('�— ' TELA . - `OWNER �.. / 'Q. NO BUILDING .EXIST. SETBACK YARD ' :HWY STREET NAME .WIDTH ADDRESS FRONT ARCHITECT,OR TEL. P.L. ENGINEER NO. SIDE - ADDRESS + 'CONTRACTOR. TEL. 4A., O Cp ADDRESS O .DESCRIPTION OF WORK W NEW AD ALTER REPAIR. DEMOLISH Z SQ. FT. • NO. OF - NO. OF" SIZE ,STORIES FAMILIES USE.OFs,y �y _6 tel. ��( 1 .l -Qo ST UCTU REQ- �6yLfsl/ Avii— SIGNATURE OF, APPLICANT V.ALUATION.$.' APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION ' FEE $ FEE FO RMS,-MATERIALS - FRAME: FIRE STOPS. E 1 HEREBY ACKNOWLEDGTHAT 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. - BUILDING 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'S COMPENSATION INSURANCE. � LATH, EXT: _ SIGNATURE OF i® HOUSE NUMBER COR- -�+�•/ 'PERMITTEE -' RECT AND POSTED •ADDRESS- I FINAL- JOHN F. LEWIS. PRINCIPAL'Sr URAL ENGINEER' PLAN CHECK 'VALIDATION. CK. M.O.. CASH _ PERMIT VALIDATION CK. M.G. CASH 017' AFIEg - �� APPLICATION FOR BUILDING PERMIT ,e• 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 self insure, BUILDING ADDRESS r �1� or a certificate of Workers Compensation Insurance,or a certified �Q I copy thereof(Sec.3800,Lab.C.) CITY ZIP 7 LOCALITY Policy NO. Company SIZE Of LOT NO.OF BLDGS.NOW ON LOT ❑_Certified copy is hereby furnished. NEAREST CROSS ST ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. USE ZONE MAP NO. department. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE ADDRESS SS r�` rr VTEL 7 WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRE DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars ($100)or less.) 2— t°.v, n I certify that in the performance of the work for which this permit CITY ZIP is issued, I Shall not employ any person in any manner so as t0 q CHITECT OR ENGINE5R TEL NO. _ become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT.' If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' j CONTRACTOR TEL NO, SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith L1 /ice FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO: P IL } LICENSED CONTRACTORS DECLARATION' CITY LIC.CLASS 11 PILE O I hereby affirm that I am licensed underprovisions of Chapter 9U (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZENO.OF STORIES NO.OF FAMILIES. SEWER MAP _ � Professions Code,and my license is in full force and effect. NEW ElBK PG O F WORK - VALUATION , U DESCRIPTIO O License Number Lic.Class \ ADD ❑ LIJ Contractor Date �j f ALTER El $ ❑ 1 am exempt under Sec. L�1 V1 REPAIR t'.QVZ BAP.C.for this reason 1 e. � DEMOL I❑' LDMA PIC# Date: - USE OF EXISTING BLDG. URM �' ❑ Signature APPLICANT(PRINT) TEL NO. LDMA Perm# x 5. ❑ 1, as owner of the property,.or my employees with wages as Z AOC T z Za• their sole compensation, will do the work and the structure is ADDRESS O330331;i i=G not intended or offered for sale (Section 7044, Business and FINAL DATE F' "`3 _`- Professions Code.) t VL .WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑ 1, as owner of the property, am exclusively contracting with AMOUNTS S licensed contractors to construct the project (Section 7044, __ TA.L 1PECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY I I e s Sir" YES o NO El ,• y Business and Professions Code.). + CHECK �yL I i�v "'� WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING L•t dE�.K i•..i'�n V_s OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH ' .CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR -,HANGE GUIDELINES. I hereby affirm that there is a construction lending agency for ves❑ No❑ the performance of the work for which this permit is issued(Sec. 3097,Civ.C. HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING F) ( I 1 jp I' i ;'i 6 CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER,THE LOS ANGELES COUNTY CODE, 1J-..T U 1 'TI.1 I/' TITLE 2.CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS � I n Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. Erir j 'I ti;-4 ,_.j... m Lender's Address cc OWNER OR AGENT 3 1 certify that I have read this application and state under penalty CL of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE ro with all county ordinances and State laws relating to building M construction, and hereby authorize representatives of this County ISSUANCE FEE v� O d ��to r u on the bove; er�N ed prop-rt�y ffoorriinspecti purp es. j ,// / �JI/!ZO INVESTIGATION FEE TOTAL FEE N X lig-ture of App .l w Ag 11 Date „ i SEE REVERSE FOR EXPLANATORY LANGUAGE