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HomeMy Public PortalAbout10826 ARROWOOD ST_Building__ f 76A638A CE#80310-56 APPLICATION I'OR BUILDING PERMIT. 1 COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER. NEAREST ' CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST. - DISTRICT O. GROUP TYPE- P �• SSED BY FOR APPLICANT TO FILL IN -,` coNST I " .ElUILDING /�(3�` /')- STATISTICAL CLASSIFICATION I Si BK R MAPP� ADDRESS / O to (��JItJ-c,C_S �c CLASS.NO. DWELL.UNITS LOT NO. 29 BLOCK MAP / 1'3WYE YES t� NUMBER " s TRACT 14©2O - - .USE ZONE SPECIAL ��^! ^� ty .ANO OF BLDGS., L/��. CON ECIIO LJ SIZE OF LOT 10504 IT S f 1r2V tNOW ON LOT 2 USE CY 1 DWelliTw 1 Gar ,a BUILDING � EXIST. EXISTITI NG BLDG. �.7 - YARD. HWY STREET NAME SETBACK' .,WIDTH OWNER Bynner-A & Elizabeth Marti _,FRONT � - MAIL P. ADDRESS - - - SIDE :TEL. P.L. CITY No. INSPECTION RECORD ARCHITECT OR - TEL. ENGINEER NO. ADDRESS _ CONTRACTOR Circle Bee .Cons&At6047 ADDRESS 1123 S6 San Gabriel Blvd DESCRIPTION OF WORK NEW X¢�ADD ALTER REPAIR DEMOLISH —SIZE TS81-12X24 GSR ES FAMILIESUSE OF 1 STRUCTURE Divelling SIGNATURE APPLICANT _ � n APPROVALS DATE INSPECTOR'S SIGNATURE ADDRESS FOUNDATION:LOCATION FORMS,MATERIALS VALUATIO $ FRAME:FIRE STOPS, - L r BRACING,BOLTS I`L $ O d (PMT. S �I FURNACE:LOCATION. FEE GAS VENT,DUCTS J �� ' Ir- I HEREBY ACKNOWLEDGE THAT I HAVE.READ THIS AP- 1 �. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND LATH.INT. ,.;' .�1r,�+• ,y,; AGREE TO PLY WITH ALL COUNTY ORDINANCES ANDv 11 STATE L S REGULATING BUILDING CONSTRUCTION. LATH,EXT. SIGNATU E" HOUSE NUMBER COR- PP p m I TTP ORPERMITTE RECT AND POSTED �( ADDRESaZ I FINAL CLYDE N.'DIRLAM. PRINCIPAL STEK). ZURAL ENGINEER PLA CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION M.O. CASH ®F iy��� ` WORKERS' COMPENSATION DECLARATION insureboraa certif carte of Wo ke s' Comcertificate pensat on Insuranceent to'self :�O Q, o D d.D ]C - p `,or a,certified�copy ythereof`(Sec. 3600, b.G.) COUNTY OF LOS ANGELES BUILDING AND,SAFETY Policy No.���/�� Company � C El /� BUILDING \ Certified'copy is hereby furnished, .. FOR APPLICANT'TO FILL IN ' 'ADDRESS Certified copy is filed with the-count in nspec- BUILDING tion department. AVMZESS 2( / a Date /Applicant - CITY' lJ� ZIP LOCALITY NO. OF BLDGS. NEAREST. CERTIFICATE OF EXEMPTION-FROM WORKE ' SIZE OF LOT: . NOW-ON LOT CROSS ST.. COMPENSATION INSURANCE'' ASSESSOR (This'section need'not be completed if the permit is for one TRACT BLOCK LOT NO. ASSE 00K �C� PAGE (ARCEL� hundred dollars ($100) or•less.)' "> (�Jr TEL. MAO OWNER (eiw NO: USE ZONE. MAP 'I certify that;in the performance of the work for which this - NOSPECIAL >_. permit is issued; I shall not employ any person in.any^manner - ADDRESS.:/ L✓OO �'/ CONDITIONS �7 /• 141 7 CL so as to become subject to the Workers'Compensation Laws. O CITY ( ZIP Date Applicant. ARCHITECT ORT TEL. NOTICE TO APPLICANT:- If, after makin this Certificate of, �"^ DISTRICT G OUP TYPE FIRE PROCESSED BY g'. ENGINEER NO:. CONST. ZONE F Exemption_you become subject; to the' Workers' ` iU Compensation provisions of the_Labor Code; you must•forth- ADDRESS with-comply with such provisions•or this permit;shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTOR G k_ Vfal0. '(�)�� Z LICENSED CONTRACTORS.DECLARATION LIC CLASS NO. DWELL. UNITS ADD 7 NO. I hereby affirm that I am licensed under provisions of.Ch"apter 9 - SEWER MAP m (commencing with Section,.7000)-of Division 3'of the Business LIC. and'Professions Cok,and m license is in-full force and effect CITY• O CLASS Y VALIDATION ' �=—o G SO. FT.. NO. OF, NO. OF' q r CHECK BK: PG. License Number ' Lic. Class_. SIZE 8St 'STORIES FAMILIES 1 ONE Contractor lC Date - ` VA UATION DESCRIPTION OF WORK NEW ❑ �^O� / ADD E] S �/ I am exempt under Sec. ALTER ❑ B.&P.C. for this reason _ REPAIR: $ Dater USE-OF . EXISTING BLDG. DEMOL ' Signature y APPLICANT TEL. FINAL _ OWNER-BUILDER DECLARATION (PRINT). NO. I hereby affirm that I am exempt from the Contractor's License DATE Law for the following.reason (Section-7031.5, Business and ADDRESS FINAL t Professions Code) PRESENT BY BUILDING (' , a t ❑- I, as,owner of the property, or•.my employees with•' ADDRESS wages as their sole compensation,will do the work and - t the structure isnot intended or offered for sale(Section LOCALITY - 1_,!J 7044, Business and Professions Code.) ;l,' MOVING:+ -•- TEL. 3 n CONTRACTOR NO. " ❑ I; as owner of.the property, am exclusively.contFacting with licensed contractors to construct the project (See - .-• ,. �;.._a a sj ADDRESS tion 7044, 'Business and.. Professions Code p=,: SS CONSTRUCTION LENDING AGENCY x.` REQUIRED TOTAL SETBACK FROM �} fi BACK YARD HW SET Y PROP. LINE WIDTH I hereby affirm that there.is a construction lendingeogency for FRONT, :i IAC"Iz the performance of the work for which this permit is issued. ' PA­ (Sec. 3097, Civ. C.'). SIDE P.L. - Lender's Name .. il_ !t_'_ ':F \ LDMA Ref. # PC: Fee$ Permit Fee _ Lender's Address - 1 certify that I have-read this application and state that the` Issuance Fee LDMA P/C'# ; above information is correct. I agree to comply with.all County Investigation.Fee ' 8 ordinances.and State laws relating to building construction, , Total Fee' p a LDMA Perm. # ` d and hereb e r resentatives of this County to.enter '. upo a ove-merit ned-property for inspection p pose k, „ � . SEE REVERSE_FOR EXPLANATORY LANGUAGE,,N-,,.* Signature'of App i a or Agent Dat WORKERS' COMPENSATION DECLARATION I Hereby affirm that I have-a'certificate of consent-to self D O D no M p p unsure, or a certificate of Workers' Compensation Insurance, �'� CA �.ON FOR U R D�LI V G [P IE RM T or a cer►ified copy thereof (Sec. 3800 b. C.) - / COUNTY OF LOS ANGELES' BUILDING AND SAFETY 01 - Poli" No. D �O� Company BUILDING L✓I ' Certified copy.is hereby furnished: FOR APPLICANT TO FILL IN ADDRESS (� 2ro JoCc ❑• Certified copy is.filed with the county building spec- BUILDING a ; tion department.' ADDRESS j~y „ . s� :. CITY" ZIP LOCALITY bate V'Applicant °� NO. OF.BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKE SIZE.OF LOT NOW-ON LOT CROSS ST. COMPENSATION'INSORANCE ASSESSOR (This`section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOKqSN PAGE PARCEL hundred dollars ($100) or less.) TEL. �+ �y OWNER NO. USE ZONE MAP �/� .14 a F / I certify that in-the performance of the work for which this NO.:• �/ F permit is issued, I shah not employ any person in any manner ADDRESS �' SPECIAL CONDITIONS so.as.to'become subject to the Workers' Compensation Laws. 0 CITY li( ZIP U Date Applicant ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this,,Certificate of ENGINEER ��' '�' DISTRICT �GROUP TYPE FIRE '; PROCESSED.BY NO: CONST. ' ZON6 O Exemption, you:should become,subject.to the Workers' ` / tU Compensation provisions of the Labor Code you,must forth- ADDRESS �- O D 3. Y I with comply with such provisions .or this permit shall be, TEL. STATISTICAL CLASSIFICATION APL CONDO N deemed revoked. CONTRACTOR ... NO. - — k�5 � o� / Z LICENSED CONTRACTORS DECLARATION LIC -CLASS NO.�DWELL. UNITS _ 'I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS ( NO._ (commencing with Section 7000)of Division 3 of.the Buiiness LIC. SEWER MAP - -. and Professions Co aB .nd my license is in full force nd effect. CITY ,p (Q CLASS '\ BK. PG. VALIDATION (R{32 ( SQ: FT. NO. OF NO. OF CHECK License NUmhef Lic. Class �+- ` SIZE FS STORIES FAMILIES ONE (� - VALUATION Contractor ' Date 1 DESCRIP oWbF WORK NEW ❑ Cd i. j. ADD ❑ $ �� ❑I am exempt under Sec. „ALTER BAP.C. for this reason $ USE OF REPAIR Date: EXISTING BLDG. . S t DEMOL Signature- i . FINAL APPLICANTC TEL. .. 'OWNER-BUILDER DECLARATION' (PRINT) J' ( NO. q / DATE ���✓G/i. I hereby affirm that I am exempt from the Contractors Licensef�Cl- Law for the following reason(Section 7031.5, Business and ADDRESS FINAL Professions Code): PRESENT . - BYCIS (y'..•:I as ❑ I, as owner of the ro ert or,m employees with BUILDING P P Y YADDRESS' wages as their-sole.compensation;will do the work'and the structure is not intended or offered for sale'(Sectiori LOCALITY 7044, Business and Professions Code.) MOVING ' TEL ITE -' CONTRACTOR NO. —t I, as.owner of the property, am exclusively contracting i i_i l�1- _E 40 with licensed'contractors to construct,the project (Sec- ADDRESS s tion 7044, Business and;Professions.Code.).. 4 t: �_;; { REQUIRED -TOTAL SETBACK FROM 'EXIST. CONSTRUCTION LENDING AGENCY. SET-BACK YARD HWY PROP. LINE I hereby affirm that there is a construction lending agency for FRONT the.performance of the work,for which this permit,is,issued RE :. (Sec. 3097, Civ. C.-): SIDE P:L..' Lender's'Name _•. m � CDMA Ref. # - . ' .� `• ;. P C. Fee$ Permit Fee - 3 Lender's Address , �'a o I certify that I have read this application and-state that the Issuance Fee 13 LDMA P/C# above information is-correct. I agree to comply with all County Investigation,Fee 0 ordinances and State laws relatin fo buildin construction; Total Fee nn �t 9' 9 � P� CDMA Perm.:# and hereby au!,aorize�r�esentativ�esof is -t a ter upon thevpection urp ses. 2l SEE REVERSE FOR EXPLANATORY LANGUAGE , nat e o App ca or Agent' Date