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Home My Public Portal About5033 BALDWIN AVE_Building__ If 76A638A CE803 6 62 APPLICATION FOR BUILDING PERMIT a COUNTY OF LOS ANGELES BUILDING t DEPARTMENT OF COUNTY ENGINEER ADDRESS el BUILDING AND SAFETY DIVISION ' LOCALITY JOHN A LAMBIE COUNTY ENGINEER NEAREST WILLIAM A JENSEN SUP T OF BUILDING CROSS ST _ DISTRICT NO G OUP TYPE ESSED BY FOR APPLICANT TO FILL IN coNsr BUILDING STATISTICAL STATISTICAL CLASSIFICATION W ER MAP ADDRESS CLASS NO DWELL UNITS--/— �- LOT NO a BLOCK WATER CERTIFICATE NOT REQUIRED R EIVED TRACT MAP / HIGHWAY NO OF BLDGS NOG (CIRCLE) STATE AJO ECOND LOCAL SIZE OF LOT .� NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS EXISTING BLDG 141 r ) Np OWNER OO— ja(/ NOTEL vU BUILDING EXIST I �( SETBACK YARD HWY STREET NAME WIDTH I ADDRESS Q ✓h /'� FRONT //yy ARCHITECT OR TEL P L ZCl ENGINEER' NO SIDE I � r P L d ADDRESS O TEL CONTRACTOR 01,W � NO 17h ADDRESS O DESCRIPTION OF WORK P17 -0 dr a NEW ADD ALTER REPAIR DEMOLISH --��ssgg �/yyhto T N O O F N O O F • ? SIZE STORIES FAMILIES ✓ USE OF y S k, y Itor?,. L= STRUCTURE # r d r,7 4t IYt•o a4 L SIGNATURE O & rd�NRw.'aY APPLICANT VALUATIO APPROVALS?l } DATE INSPECTOR S SIGNA 1 PC PMT !, FOUNDATION LOCATION _ rj 2 IST w FEE $ FEE � � 1.,� FORMS MATERIALS FRAME FIRE STOPS / I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS L 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 ,. TION OF THE LABOR C OF THE STATE OF CALIFORNIA RELAT LATH INT ING TO WORKMEN O ENSATION INSURAN E LATH EXT Y W SIGNATURE O OUSE NUMBER COR �} PERMITTEE RECT AND POSTED v ADDRESS FINAL F 1I LEWIS PR, NCIPAL PLAN CHECK VALIDATION cK M O CASH _ JOHN PERMIT VALIDATION T cK RM o EN CASH ER Lr LCJ�' J J C�,�,. '�111� 5 D 3 3 / 5 2 9 8"-3 1 ItiR ` 6 7 50- I 76A638A CE 14803 4/70 �.{� APPLICATION FO BUILDING PEMIT ' COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK t PAGE PARCEL BUILDING AND SAFETY DNISION BUILDING ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST Print or tvoe onl CROSS ST. DISTRICT NO. GROUP TYPEP ESSED BY BUILDING �J / CONST..-gJ ADDRES 10, STATISTICAL CLASSIFICATION SEWER MAP TRACT LOT TI N� � BLOCK CLASS NO.-Z/—DWELL,UNITS BKi5 Pe'4 USE ZONE MAP NO.OF BLOGS. NO. SIZE OF LOT -7 NOW ON LOT A_ ) SPECIAL USE OF /t / CONDITIONS EXISTING BLDG. EC.L . TEL OWNER NO. �! BLDG.SETBACK FROM ADDRESS S FRONT PROP.LINEOF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY E� HIGHWAY WIDTH FROM C.L. ARCHITECT R TEL + _ ENGINEER L NO, J�C> BLDG.SETBACKFROM ADDRESS � SIDE PROP.LINE OF (STREET) TEL. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CONTRACTO /d .tin., NO. �� 3 HIGHWAY WIDTH FROM C.L. >_ ADDRESS,zWS o.';7-3 2- + = O LIC. V CITY CLASS CORNER CUTOFF YES ❑ NO CC CONSTRUCTION LENDER NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS w CL. ADDRESS NZ SQ. FT. NO. OF NO. OF NEW ❑ SIZE STORIES FAMILIES USE OF / p ADD STRUCTURE/,/ �C1 ALTER ❑ PL . REPAIR❑ SIGNATURE APPLICANT w�T P�PEMOL ❑ VALUATION $ V66V v APPROVALS DATE INCTOR's IGNA TU RE FEE $ � FEE Q D FOUNDATION: MATERIIALSON (O 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, WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUC TION. I CERTIFY THAT IN DOING TH WORK AUTHORIZED HEREBY 1 WILL NOT P 0 ANY PERSON N IOLATION OF THE LATH, INT. LABOR CODE OF T OF •CALIF R IN LATING TO 0 A 0 1 SURANCE. LATH, EXT. Sl NATURE O HOUSE NUMBER COR- PERMITTEEA RECT AND POSTED ADDRESS Pe) FINAL JOHN F. LEWIS. PRI 'CIPALSTRU TURAL ENGINEER PLAN CHECK VALIDATION cK. M.O. CASH _ PERMIT VALIDATIO CK. M.O. CASH ( n('r9272,� MAR1921 D 5.40- 9 2 7 3 .40- CQ9273 HAR19 1 D 9.0 a • WORKERS' COMPENSATION DECLARATION hereby affirm,that I have certificate of consent To self APPLICATION FOR B U VIL D I N G PERMIT insure;.or a certificate of Workers' Compensation Insurance, a or a certified copy thereof (Sec. 3800, L b. C ) _f COUNTY OF LOS ANGELES s BUILDING AND SAFETY P�olicyy�N ,� Company ST � -1y IF `CJ. Certified co is hereby furnished. FOR APPLIC NT TO FILL IN BUILDING PY Y ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING r � 1 tion department. 4 ADDRESS W3 CITY.` ( P-. - (ie ZIP LOCALITY Date f Applicar� O. OF BLDGS. CERTI ICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT NEAREST CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if The permit is for one TRACT BLOCK I LOT NO. MAP BOOK I PAGE I PARCEL hundred dollars ($100)or less.) e TEL. � OWNER NCS Gj� USE ZONE MAP I certify that in the performance of the work for which this y NO. SPECIAL >_ permit is issued, I shall not employ any person in any manner ADDRESS �vJVA KJ CoCONDITIONS a- so as to.become subject to the Workers' Compensation Laws. _ O CIN �^ ) ZIP U Date Applicant ARCHITECT OR TEL. a ENGINEER NO. DISTRICT GROUP TYPE FIRE PROCESSED BY NOTICE TO APPLICANT: If, after,making this Certificate' of ' CONST. ZONE F- Exemption, you should become .subject to the Workers' / U Compensation provisions of the Labor Code, you must forth- ADDRESS of -3 v a with comply with such provisions or this permit shall be TEL. Q� STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. CONTRACTOR NO. D Z LICENSED CONTRACTORS DECLARATION LIC. i�11I�/c CLASS NO.�DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter9 ADDRESS � J NOS 7V/V ` LIC. SEWER MAP � (commencing with Section 7000)of Division 3 of The Business CITY �� Z �'} CLASS and Professions Code,and m license is in full fort and effect. BK PG. VALIDATION SQ. FT. NO. OF NO. OF CHECK License Number YJ(��ii`�' / Lic. Class_ SIZE I STORIES FAMILIES ONE ❑ VALUATION Contractor ✓� Dat1 .e �� 7' DESCRIPTION OF WORK NEW a ®G� ❑ 2 ADD El I am exempt under Seca ALTER ,❑ , B.BP.C. for this reason "'� � � REPAIR $ D USE OF EXISTING BLDG. DEMOL t Signotu� APPLICAN TEL. �t/L W ER- DEC ION (PRINT) D �? lJY�L' NO. 7 !J FINAL (� /� "e- /fir DATE I hereby affirm that I am exempt from the Contractor's Licenseq RESS c= O-�P� GD 1�v 4,Law for the following reason (Section 7031.5, Business andFINA Professions Code): PRESENT ❑ I, as owner of theproperty, or m em Io employees with BUILDING - s Y P Y ADDRESS i �1= wages as their sole compensation,will do the work and t ( LOCALITY / ��- i� the structure is not intended or offered for sale Section ; ! €=i_, 7044, Business and Professions Code.) MOVING TEL. CONTRACTOR NO. ' 22 El 1, as owner of the property, am exclusively contracting i,( -4_ ,�-�.��f-4 rr'` with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code.) REQUIRED TOTAL SETBACK FROM EXIST. f z 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 wor for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE Lender's Name. - - -, z 9 qy� - -`=°r- LDMA Ref. # ?`..s t•_ all `is =::' I P.C. Fee$ Permit Fee Lender's Address ^7 a I certify that I have read this appli tion and state that the Issuance Fee LDMA P/C# above information is correct. I agr o comply with all County Investigation Fee 8 ordinances and ST a laws r I i to building construction, Total Fe�D /v LDMA Perm. # a and hereby ut a repr s Lives of this County to enter upon th a io operty for ' pecc ion pure es. . 711� SEE REVERSE FOR EXPLANATORY LANGUAGE g p' nt or Agent to y