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Home My Public Portal About5104 BALDWIN AVE_Building__ 76A638A CE#8038-64 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS 51d, N. Baldwin BUILDING AND SAFETY DIVISION LOCALITY Tn1a C' JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS,SUP T OF BUILDING CROSS ST. DISTRICT NO. TY E P SSED BY FOR APPLICANT TO FILL IN - �� CONST.! . GROUP te,f BUILDING STATISTICAL CLASSIFICATION SE ER MAP ADDRESSCLASS NO.�LDWELL UNITS . BK f PG / s LOT NO. p� .r.' LOCK A USE ZONE NO, J .� TRACT lOSZ 1 J I SPECIAL NO. OF BLDGS. /` CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. HOUSE sC Gargae BLDG. SETBACK FROM TEL. FRONT PROP. LINE OF (STREET) OWNER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL ADDRESS N. NI GN WAY WIDT,Hy FROM C.L. CITY TAMPIP City BLDG. SETBACK FROM ARCHITECT-OR TEL. ENGINEER NO. 3377AI9 SIDE PROP. LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS 16300 A Arrow H1 hwa Iwin a HIGHWAY WIDTH FROM C.L. d TEL. + = O CONTRACTOR NO U ADDRESS 13351 E. CTBrVe NO CORNER CUTOFF YES NO _ O CITY CLAS SEE REVERSE SIDE FOR SPECIAL APPROVALS u W J DESCRIPTION OF WORK CL NEW ( ADD ALTER REPAIR DEMOLISH SQ.FT. NO. OF NO. OF SIZE STORIES FAMILIES USE OF b STRUCTURE Sw PoolJAL/►!✓ Pee,4 3 A `� ' 7 ez.; t SIGNATURE OF APPLICANT Z12 �= VALUATION$ 2 000O � APPROVALS DATE INSPECTOR SSIGNATURE P.C. � PMT. �Ly FOUNDATION, LOCATION - FEE S �_ FEE$ ._.._.- FORMS, MATERIALS /x 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 COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS 9UILDI NG CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LABOR CODE OF THE STATE OF CALIFOR IA RELAT- ING TO WORKMEN'S COMP AT INSUR N LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE may/ RECT AND POSTED ADDRESS F I N A L JOHN F. LEWIS, PRINCIPAL S URAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION S7 M.O CASH 0049'u f-WR2923 D 7.50 u,��; 0 0 5 0 „R29 1 D 1 5.GI�� d APPLICATION, EOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING A DRESS/V _ BUILDING ADDRESS' �, ��„ l �j�-/ I hereby affirm that I have a certificate of consent to self insure, J`J v N or a certificate of Workers' Compensation Insurance,or a certified Copy thereof(Sec.3800, Lab.C.) CITY r��A ( ) ZIP ( LOCALITY Policy No. Company SIZE OF L_OT! ` NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. I NEAREST CROSS STor ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. 1 USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL - SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER ,3 E NO. �j COMPENSATION INSURANCE 4�ritL*k" - op b� 91_ b 1� WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS -�0 q WS-31i3tsf,6 W� DISTRICT GROUP TY ONST. FIRE ZONEPRO ESSED BY dollars ($100)or less.) I certify that in the performance of the work for which this permit CITYL� e- ZIP 0 b ZO� is issued, I shall not employ any person in any manner so as to N I J J become Subject to the Workers' Compensation Laws. ARCHITECT OR ENGINEER TEL NO. STATISTICAL CI�SS�FICATION 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 t0 the Workers CONTRACTORLX�O. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith d)pig rA L V.- (?ty� q oQll FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS `,�''( �j ��7 'n,, ' LIC.NO. P L 70 Y`1 &STkS �_0 I/�v SIDE LICENSED CONTRACTORS DECLARATION CITY pfVA C� �3 LIC.CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 EWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW BK PG (' License Number Lic.Class DESCRIPTION OF WORK ADD ❑ VALUATION L) a pop- p� U � Contractor Date P"D D f� a,n, ALTER ❑ $ ' S0�' cc ❑ I am exempt under Sec. �� pHou S�I�"1�� REPAIR ❑ $ Q B.&P.C.for this reason DEMOL ❑ W LDMA P/C# Date: USE OF EXISTING BLDG. URM ❑ IL SignatureAPPLICANT(PRINT) TEL NO. LOMA Perm# Z I, as owner of the property, or my employees with wages as Z °"' their sole compensation, will do the work and the structure is ADDRESS 0 ACCI `° not intended or offered for sale (Section 7044, Business and FINAL DATE Q =�;I _ lz� __ Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUSMATERIAL ❑ I, as owner of the property, am exclusively contracting With OR A AAMOUNTSTURE SPEC SPECIFIED ONITHE HAZARDOUS MATERIALS INFORMATIONGUIDE?G A HAZARDOUS MATERIAL EQUAL TO OR ER THAN THE FINAL BY licensed contractors to construct the project (Section 7044, Business and Professions Code.) ves 1:1 No❑ ;I l ; f105 WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH =_t''• s,n- ;i yl °�•i? CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ NO❑ a the performance of the work for which this permit is issued(Sec. p� I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, _ TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS - ?lo ri'F , Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. I� .;I:-� Ir fa I o Lender's Address - O OWNER OR AGENT ` ^�•' € FIS 1«-1„i, o I certify that I have read this application and state under penalty P.C.FEE PERMIT FEE of perjury that the above information is correct.I agree to comply with all county ordinances and State laws relating to building co construction, and hereby authorize representatives of this County ISSUANCE FEE 10 to enter upon the r y above-mentioned property for inspection%u R INVESTIGATION FEE TOTAL FEE/m i4 4natum of Aaicm�o,A Dae D /\ SEE REVERSE FOR EXPLANATORY LANGUAGE