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Home My Public Portal About5144 ARDEN DR_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT -j COUNTY OF LOS ANGELES ® ' ® � �® WM. J. FOX, CHIEF ENG ®INEER iii FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLL/AN CK.NO/.. / uPERMIT NO. BUILDING 1 ADDRESS LOCALITY ��i�lloL/� Gam/ - RECEIVED BY DATE OF APPL. DATE ISSUED NEAREST �� Na'5 $-a — v CROB9 9T. BUILDING 7/ OWNER ,EIC E f7ig 72P, Cc J ADDRESS j� MAIL ��oo LOCALITY / ✓ ADDRESS NEAREST c$�� TEL CROSS ST.';' CITY J/fO,E/✓fig No. SY?!l/ 2,,l !' FIRE NO.OF rz TYPE _ GROUP ARCHITECT OR / TEL. ZONE PLANS Z_ ENGINEER NO. / / Y ADDRESS BETBACK LINE .. APPROVED CONTRACTOR �/�� ( NO. BY DATE USE �f APPROVED ADDRESS �/a -- ZONE /Y� By DATE LEGAL �� CORRECTIONS DESCRIPTION LOT NO. / Y I BLOCK / TRACT /.�744 �/ � NO.OF SLOGS. L SIZE OF LOT -6.&x Z..34 I NOW ON LOT USE OF I NO.OF NO.OF �Dt L .r- EXISTING BLDG. D , FAMILIEBO I ROOM13� I r�e �l —,/p/ � DESSCRIPTION OF WORK j v _ /j �L L a c Kr !�!r SJr •�C-, NEW ✓ ALTERATION ADDITION �U -'(•5 r/ �/�� / /j��G"' J L�%',,(r✓•= O A REPAIR /� �oP MOVING DEMOLISH S ZET �Jd a , ROOMS STORIES D WALL ROOF /� ' COVERING ST?�C C D I COVERING�oM)po.ri rie►J USE OF NEW 1 BUILDING Z I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION �INBPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES • FORME MATERIALS _ AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE SIGNATURE OF BRACING,BOLTS PERMITTEE � LATH,INT.: AUTHORIZED AOT LATH,EXT.: !�' Y DBS-3 SOM SETS 1-48 $ 7 �t�7i P.C.8 75' PLASTER.INT. 7��/ FEE �� PLASTER,EXT. VALUATION �D FEE ' FINAL „µµ� TE FL CITY .. 70AGOBA CE#8092/00 APPLICATION FOR BUILDING PERMIT 1 COUNTY OF LOS ANGELES BU'Ess fN. /�. 7. DEPARTMENT OF COUNTY ENGINEER : BUILDING AND SAFETY DIVISION LOCALITY ; JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SUPIT OF BUILDING CROSS ST- _./'�,, �lJ�• DIICT,NO. I ' OUP I TYPE P SSED BY FOR APPLICANT TO FILL IN j CONS 'e I ADDRESS / • STATISTICAL CLASSIFICATION S ER MAP K* pp_CLASS.NO.• 'DWELL.UNITS I . L. LOT NO. L-� _ BLOCK MAPSTATE YES NUMBER _^ _ HWY. TRACT USE ZONE . SPECIAL NO.OF SLOGS. CONDITIONS SIZE OF LOT I NOW ON LOT USE OF - ' EXISTING BLDG. BUILDING EXIST. YARD HWY STREET NAME OWNER ' TEL. SETBACK WIDTH i NO. FRONT y� - /�� P.L. ADDRESS /I/. SIDE _ ARCHITECT OR _ - - TEL. P•I-• ENGINEER NO. ..�/INSPEC,"TION RECORD R } ADDESS _•� �^+, .t 14 CONTRACTOF4 �,� _� / .L' >. - - 104 A6DRESS//l7' f�7G. OS'�/�} ��. �/�6�: C) DESCRIPTION OF WORK oG O NEW ADD ALTER REPAIR DEMOLISH. SO.FT. <, . NO.OF NO:OF aW SUSE OF IZE �T STORIES FAMILIES - - _ _ (nSTRUCTURES --, �/54)VO ® *y'/72 �1 SIGNATURE APPLIC:4 �✓ - - . . VALUATION APPROVALS - DATE 1 SP CTOR'S SIGNATURE WWPMT. _ FOUNDATION: LOCATION. FEE $ �--'� wT� ”` FEE $ FORMS, MATERIALS c� 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRE STOPS; . PLICATION AND STATE THAT THE ABOVE IS CORRECT AND BRACING, BOLTS - AGREE TO COMPLY.WITH ALL COUNTY ORDINANCES AND FURNACE: LOCATION, - STATE LAWS REGULATING BUILDING- CONSTRUCTION. GAS VENT,DUCTS I CERTIFY THAT IN DOING THE WORK AUTHORIZED I LATH, INT. WILL NOT EMPLOY ANY PERSON I=�ATI F THE WORKMEPENS TION LAWA. LATH,EXT. SIGN URE OF HOUSE NUMBER COR- PERM TTE RECT AND POSTED - ADDRESS FINAL CLYDE N. DIRLAM, PRrNCIPAL ST' RAL ENGINEER PLAN CHECK VALIDATION . ax. .O. CASH PERMIT VALIDATIO CK.` M.O. CASH WORKERS'COMPENSATION DECLARATION �] APPLICATION - ILIA I hereby affirm that I have a certificate of consent io-self`' insure, or a certificate of Workers' Compensation Insurance; AP P L I CATION FOR BUILDING PERMIT or`a certified copy thereof (Sec. 3800, L b C. COSY-OF LOS ANGELES BUILDING AND SAFETY Policy N6. Company Ce ified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS LOCALITY �— NEAREST `!?E.Date ApplicantO� CITY 7 ZIP21ANC CROSS ST. ER IFICATE OF EXEMPTION FROM WORKERS' ANO. OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT S NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP hundred dollars ($100)or less.) ' TRACT BLOCK LOT NO. NO. � TEL SPECIAL A I certify that in the performance of the work for which this OWNER ` c NO. '; CONDITIONS IL permit is issued, I shall not employ any person in any mannerDISTRICT .GROUP TYPE FIRE PROCESSED BY O so as to become subject to the Workers'Compensation Laws. ADDRESS �/) CONST. LZO U Date Applicant CITY' 2 / ZIP 6SlO STATISTICAL CLASSIFI ATION AP . co NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR. TEL. ENGINEER NO. CLASS NO. WELL. UNITSLU Exemption, you should become subject to the Workers' DEi Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER VAP with comply with such provisions or This permit shall be11-1TEL. y VALIDATION deemed revoked. CONTRACTOR E �C. NO. � BK. PG, LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I,am licensed under provisions of Chapter 9 ADDR177 ESS !Q 7 NO. 3 ALUATION (commencing with Section 7000)of Division 3 of the Business and �- / LIC. f Professions Code, and my license is in full force and effect. CITY /� C' / CLASS n` SQ. FT. NO.OF / NO. OF / -CHECK License Number Lic.Class /�' / SIZE STORIES ! FAMILIES t ONE Contractor - Date �y DESCRIPTION OF WORK NEW � $ ADD: I am exempt under Sec. ALTER, FINAL -p 7 B.&P.C. for this reason REPAIR DATE. /`f�UJ USE OF DEMOL FINAL, Date: EXISTING BLDG. ' FAK n By Signature APPLICANTTEL. OWNER-BUILDER DECLARATION PRINT NO. �$� I hereby affirm that I am exempt from the Contractor's License �� t Law for the following reason (Section 7031.5, Business and ADDRESS ,o /5 (/ c Professions Code): P 6 R=I / i ;96965A BUILDING I, as owner of the property, or my employees with ADDRESS #'o 0 0 0 0 wages as their sole compensation,will'do the work and the structure is not intended or offered for sale(Section rADDRESS TY 2 0 2 8 O O 7044, Business and Professions Code). G TEL. ACTOR NO. 280,006 I, as owner of the property, am exclusively contracting .o 0 with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). ) 919-82 IRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY ACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE m P.L. o Lender's Name P.C. Fee$ Permit Fee S Lender's Address t I certify that I have read this application and state that the Issuance Fee above information is correct. I agree to comply with.all County Investigation Fee $ ordinances and State laws relating to building construction, Total Fee u and hereby authorize representatives of this County to enter upon 1 bove-mentio dprop rt�pection purposes. ' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of App icant or Ag t Date ®3