Loading...
HomeMy Public PortalAbout5125 ARDEN DR_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES BUILDING WM.J. FOX, CHIEF ENGINEER NO. OF "ol1{&BLDG. ORD.NO. DISTRICT / PLAN _570 CK. NO. PERMIT NO. PLANS SETBACK LINE - FIRE �. APPROVED l.%' d ZONE BY _ DATE RECEIVED BY DATE OF APPL. DATEASSUED USE APPROVED �� ZON BY DATE L 'll 5 APPLICANT FILL INj HEAVILY OUTLINED PORTION ONLY B U I L D I NG -'R• Ir AM- O NAME`.. ADDRESS ' W Z ADDRESS / LOCALITY •C„�h / "/ (//(/ ``: i = O NEAREST U W CITY CROSS ST. STATE Q LICENSE NO NO. NAME -`''j It W MAILr Ul ) O NAME 3 ADDREJS`S�/ /j 1® Q ADDRESS O CITY L •L I�I(d�/! � NO. C F Z CITY I HEREBY ACKNOWLEDGE THAT 1 HAVE READ. THIS O APPLICATION AND STATE THAT THE ABOVE IS CORRECT U STATE TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LICENSE NO. /) NO. AND STATE LAWS REGULATING BUILDING CONSTRUCTION. Z LOT NO. SIZE OF LOTPd//j SIGNATURE OF O OWNER NO. OF BLDGS. 1 Q D. BLOCK NOW ON LOT AUTHORIZED.AGT.ul �� �( �'✓ - `% � l7 mW • i .J w TRACT/V/ 8 CORRECTIONS D USE OF BLDGS. NOW ON LOT DESCRIPTION OF WORKUSE OF BUILD NG z D r NEW TYPE � GROUP ' NO. OF NO. OF ALTERATION ROOMS/'. , FAM'LIES ADDITION SIZE REPAIR STORIES MOVING WALL COVERING. DEMOLISH I ROOF COVERING $ �A P. FINAL-APPROVAL pa ®� FEE /// LXAME FEE DATE VALUATI `m*amt sx irs x9.44 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY \UNTY OF LOS ANGELES WM.J. FOX, CHIEF.ENGINEER v ILDIN ,; (Jp NO. OF BLDG. - ORD.NO. DISTRIQT NO. �N CK. NO. PERMIT NO. PLANS SETBACK LIN ® %, (/J' G FIRE APPROVED ^r ZONE ' BY DATE CEI EAADn BY ATE OF�APPL. DATE ISSUED USE / APPROVED �' t [,� I �/1 i,� ZONE i BY DATE ' t °T ^T' APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY It I BUILDING O a, NAME ADDRESSI- III FW- Z ADDRESS LOCALITY = Z NEAREST - L U W CITY CROSS ST. STATE TEL. r, �� N LICENSE NO. Ir NAME W MAIL C Ix p NAME 3 ADDRESS / /��� �/•j`�av�✓�A�� 11�E �D U O G 4 MOO NOL TE Q ADDRESS CITY . F i Z CITY �� 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS O APPLICATION AND STATE THAT THE ABOVE IS CORRECT U STATE TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LICENSE NO. NO. AND STATE LAWS REGULATING BUILDING CONSTRUCTION. ZO LOT NO. PV t\pp 1 :2' SIZE OF LOT / 0)(/70 SIGNATURE OF f` BLOCK NOW ON LOT / /9 NO. OF BLDGS. �` ,��' � �!' . J F M10M6 AUTHORIZED AGT. Q d J 0TRACT tN —17 - GORRECTION8 ! W D USE OF BLDGS. NOW ON LOT DESC??RI/PTION /OF iWORKUSE OF BUILDING J11T tf �y/T t7 �, -�W '/`"�''`b 14A iThis construct War Productuf ion Boar:l o:clers. You I r r O ion to consult with your local War c iUrdefiicie be!ore commenc- ing the work a a �{ r- NEW TYPE GROUP - 4.! NO. OF NO. OF ALTERATION ROOMS FAMILIES ADDITION SIZE '� 2 REPAIR 5TORIES6.� OO `0 B MOVING WALL COVERINGS - ,,� ®0 / c rq/ DEMOLISH ROOF COVERING `/-�O H P6 .� lee FEE $ o tl FINAL APPROVAL INSPECTOR'8°'�'� } VALUATIONy FEE ®� DATE �vO I NAME �1O' e ©S 76A638A -�- 'GE N803 IRE-.6/78) W`014 APPLICA 10 FOR BUI NG PERMIT COUNTY OF LOS ANGELES BUILDING AND )SAFETY FOR APPLICANT TO FILL IN ADIDRESS BUILDING / ADDRESS !1/ LOCALITY NEAREST CITY /j G. r ZIP / a CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT GROUP I TYPE / - FIRE ESSED BY TRACT BLOCK LOT NQ /j—� COyb, ff .TEL. n/• � OWNER P (J""C NO ; -7(iC• J STATISTICALCLASSIFI TION EWER MAP ADDRESS Ag hU> - CLASS NO. DWELL.UNITS BK CITY ZIP ARCHITECT OR - TEL- ENGINEER ` ENGINEER T •,! NO.A 7 VALUATION V ADDRESS _ BLDG.SETBACK FROM r L. FRONT PROP.LINE OF (STREET) CONTRACTOR NO. TOTAL SETBACK FROM TYPE OF EXISTING LIC. HIGHWAY .+ YARD. = FRONT PROP.LINE JHIGHWAYI WIDTH ADDRESS NO. LIC. + ` CITY CLASS BLDG.SETBACK FROM CONSTRUCTION LENDER SIDE PROP.LINE OF (STREET) NAME AND BRANCH HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING 9>6 ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH C SO.FT. d NO.OF NO.OF CHECK + = V SIZE STORIES FAMILIES ONE (7� DESCRIPTION OF WORK -w NEW e 1 P.C. Fee$ADD Permit Fee QIssuance Fee REPAIR Z ALTER ❑ Totol Fee USE OF DEMOL ElEXISTING BLDG. 2 APPLICANTr / TEL / \ (PRINT) r �,�I(i ,) Q C BY(SIGNATURE( U a I HEREBY ACKNOWLEDGE TOT I HAVE READ THIS APPLICATION AND STATE Y THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES V AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE Z WORK AUTHORIZED HEREBY WILL NOT EMPLOY ANY PERSON IN VIOLATION OF 27:62 2 A THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- Z , PENSATION INSURANCE. _ � �#'O O O O O 1 SIGNATURE OF (f�/✓ PERMITTEE ���JJJ 2 0''o f7 9 0.0 ADDRESSi5 1 r''"� Z 'o'01079.0050 TEL. CITY . r C NO. G ' O b'_7 9 USE Z�JNE MAP j� Q NO. � SPECIAL r CONDITIONS LU DATEL / ��� BY — WORKERS'COMPENSATION DECLARATION � � �r' ✓_ � i I hereby affirm that I-havecertificate of consent to self APPLICATION FOR BUILDING PERMIT Il 5nsure, o'a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY BUIL Policy No. Company I Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRDENSSG 1o? / Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS LOCALITY r NEAREST Date Applicant CITY Ile_ ZIP CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if.th"e permit is for one• USE ZONE MAP (::.:p �/� hundred dollars ($100)or less;) TRACT BLOCK LOT NO. NO. SPECIAL I certify that in the performance of the work for which this OWNER rte ' / I CONDITIONS permit is issued, I shall not employ any person in any manner DISTRICT .GROUPTYCONT. ZONE t, PESFIRE PROC ED BY,, O so as to become subject to-the Workers'Compensation Lows. {i, ADDRESS J I3 Date -2 Applicant ✓/� P � e, 4CA CITY ZIP STATISTICAL CLASSIFICATION APT. CONDO. NOTICE fO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. ENGINEER NO. CLASS NO. UNITS W Exemption, you should ' . .become subject. to the WorkersIL Compensation provisions of the Labor Code, you must forth- y ADDRESS SEWER MAP- �/ with comply with such provisions or this' permit shall be deemed revoked. TEL.NO. BK VALIDATION CONTRACTOR n P! LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VAL ATION o� (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY CLASS $ , SO. FT G NO. OF NO. OF ,( CHECK License Number Lic.Class SIZE p STORIES FAMILIES / ONE �// DESCRIPTION OF WORK NEW ❑ $ / o 01_� Contractor Date , ADD ❑ 465.4A am exempt under Sec. r�e,e ALTER 11FINAL• f' o 0 0 0Z J DATE B.&P.C. for this reason I REPAIR ❑ 2 03 57.00 ' Date: 10 1 USE OF DEMOL EXISTING BLDG. E] BIN o o J 7, Signature APPLICANT / TEL. OWNER-BUILDER DECLARATION PRINT ,fj � ''� � NO' 22-83 I hereby affirm that I am exempt from the Contractor's License Law for the'following reason (Section 7031.5, Business and ADDRESS Professions Code): PRESENT /1 BUILDING ,C/ \ I, as owner of the property, or my employees with ADDRESS to wages as.their sole compensation,will do the work and .. i�. the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. c I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). ADDRESS REQUIRED TOTAL SETBACK FROM EXIST. n _ CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH ► I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. Q Lender's Name ro , P.C. Fee$ , , �a Permit Fee - C\ Lender's Address I certify that l have read this application and state-that the Issuance Fee f.0.� S CD O a above information is correct.I:agree to comply with.all County Inve3tigat,on F, e O`. ,.• .J ordinances a.nd State laws relating to:building':construction, a ' Total.Fee o .; u and hereby.authorize represeniatives'of this County to enter n Jl y upon the above,me toned ro erty f ins pection'.purposes. %H 3 SEE REVERSE FOR'EXPLANATORY LANGUAGE ,� Sign re of Applicant or Agent - - Date _ ®s ,