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Home My Public Portal About5130 BALDWIN AVE_Building__ APPLICATION FOR BUILDING PERMIT F05\APPLICANT TO FILL IN (Print or type only) 6' /�� BUI LCnNG COUNTY OF LOS ANGELES A!DD Ess DEPARTMENT OF COUNTY ENGINEER I ' -3 SAFETY BUILDING AND SAFETY D ISION - CITY ZIP n NO OF BLDGS , BUILDING ^ SIZE OF LO NOW ON LOT ADDRESS s —tw—D _ I TRACT B O LOT NO LOCALITY TE NEAREST _ y OWN NO CROSS ST ASSESSOR ADDR SS _ MAP BOOK PAGE PARCEL DISTRICTGROUP TYPE FIRE PROCES BY CITY ZIP //� �' CON ZONE ARCHITECT OR TEL � ENGINEER NO _ STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NO DWELL UNITS B PG1 CONTRACTO SE ZONE MAP /j NO :240 0 ADDRESS NO yS ZSPECIAL LIC ✓ CONDITIONS CIT C LASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CO RUCTION LENDER NAME AND BRANCH BLDG SETBACK FROM F T PROP LI NE OF (STREET) a ADDRESS CITY HIGHWA t YARD TOTAL SETBACK FROM TYPE OF EXISTING CC_'. SQ-FT NO OF NO OF CHECK FRONT PROP LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE t C DESRIPTIC OF WORK NEW ❑ G~.', ADD ❑ BLDG SETBACK FROM 'd SIDE PROP LINEOF (STREET) V: ALTER ❑ Z HIGHWAY t YARD = TOTAL SETBACK FROM E OF EXISTING REPAIR[:] USE PROP LINE HIG Y WIDTH USE OF t = EXISTING BLD DEMOL ❑ APPLICANT TE CORNER CUTOFF YES ❑ NO ❑ (PRINT) NO IN OPEN SPACE YES ❑ NO BY (SIGNATURE) ❑ IN COASTAL ZONE YES ❑ NO ❑ VALUATION D� CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON STRUCTION I CERTIFY_ THAT IN DOING THE WORK AUTHORIZED IMPACT REPO T ROCES SED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF TH LABOR CODE OF TATE OF LIFOR NIA IN RELATING T i <� WORKMEN S COM NSATI N INSURA SIGNATURE O • t PERMITTEE ADDRESS FINAL BY EL CITY NO DATE PC 111hF ( 1/1 ( KS 131) 1131L 10 FEE � FEE HARVEY T BRANDY COUNTY ENGINEER PLAN CHECK VALIDATION — cK M o TCASH _ - PERMIT VALIDATION 2 M 0 CASH r I �'r 396,3 JUL 24 s D 3525® 76A638A CE#803 12/72 76A638A CFn803 5 65 APPLICATION FOR BUILDI G PERM'li7--' COUNTY OF LOS ANGELES BUILDING /y DEPARTMENT OF COUNTY ENGINEER ADDRESS C/ BUILDING AND SAFETY DIVISION LOC A L I T Y JOHN A LAMBIE COUNTY ENGINEER NEAREST _ COLEMAN W JENKINS SUP T OF BUILDING CROSS STESE / - DISTRICT NOR U TYPE FOR APPLICANT TO FILL IN sj� CONST FADoR G / Y STATISTICAL ICATION SEWER MAP v CLASS NO DIWELL UNITS RK��G� BLOCK I USE ZONE MAP fj `^ NO �J SPECIAL r NO OF BLDGS CONDITIONS LOT Q^1 NOW ON LOT } BLDG SETBACK FROM TEL FRONT PROP LINE OF — (STREET) NO TYPE OF EXISTING (SETBACK- HIGHWAY + YARD — TOTAL HIGHWAY WIDTH FROM C L CITYµ ARCHITECT Of TEL BLDG SETBACK FROM - ENGINEER NO SIDE PROP LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C L TEL + _ CONTRACTOR NO O LIC ADDRESS NO CORNER CUTOFF YES NOLC V CITY CILASS SEE REVERSE SIDE FOR SPECIAL APPROVALS O DESCRIPTION OF WORK - I ti a NEW ADD 2 ALTER REPAIR s DEMOLISH SO FT NO OF NO OF SIZE STORIES FAMILIFS USE OF STRUCTURE (,(: SIGNATURE OF APPLICANT VALUATION G G APPROVALS DATE INSPECTOR SSIGNATURE P C PMTFORMS FOUNDATION MATERIALS ON FEE$ FEE$ 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 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS 9UILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELAT ING TO WORKMEN SO ENSATION INSU NCE LATH EXT SIGNATURE OF HOUSE NUMBER COR PERMITTEE RECT AND POSTED n ADDRESS i2el4 FINAL / JOHN F LEWIS PRINCIPAL STRUCTURAL EN R PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDATION CK M C CASH 5674Z8 WV 4 1 D 6.001-411 i e �' i ��IV `� F \f nom, - �T1rON OF BUILDING y AND eS A2r�ETY 8 1 ®,' __�,��" f� I �Departtnent of Conn En County of Los Angeles WM J FOX, COUNTY ENGINEER APPLICATION FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY A/ D _ DISTRICT NO. �P�LAN CK OR REO NSD+ PERMIT N+O BUILDINGADDRESS SI 3 0/-• �iis°A.�6� J� !`+ ��3✓/— /� 7�V RECEIVED BY DATE OF APPL DATE ISSUED LOCALITY yam„ ti s NEAREST CROBBBTBig:= ' BUILDING S/3 �V0 N� a A ADDRESS (/Q / wI/�/ L.,,- OWNER MAIL LOCALITY .0 C ADDRESS NEAREST / TEL CROBB ST CITY NO FIRE FNOP TYPE GROUP ARCHITE TEL ZONE NS ENGINEE ` NO BLDG ORD NO SETBACK LINE /y�+y ADORES e USE APPROVED TEL ONE,(-/ BY DATE CONTRA O NO a HOUSE NUMBERING ADD 8 e'7 V 63� p MAP NUMBER-2 0 1 10 NO ASSIGNED BY LEGAL CORRECTIONS DEBCRIPTION I LOT NO BLOCK TRACT NO. OF LDGS. CO Z� a� eo ?inl[JO✓S �/��SGlE,�,�/fcly� SIZE of LOT Q I NOW ON LOT USEOF NO OF r EXISTING BLDG �.�}' .(r0f7b1`,L1 O DESCRIPTION OF WORK v a 17o.+.1 of 76W 02 S�on//9A�g.l0� NEW I ALTERATION I I ADDITION REPAIR DEMOLITION J BFT No or ZE ROOMS STORIES/ E9 EXT WALL ROOF COVERING COVERING f�.a.eb-_4-�4:;- AE JO ,S V— USE OF STRUCTURE 7` INSPECTION FOR APPROVALS OCCUPANCYAS INSPECTOR'BSIGNATURE DATE FOUNDATION LOCATION FORMS, MATERIALSL, -� i HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IB FRAMEt FIRE STOPS, / CORRECT BRACING, BOLTS 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING BUILDING CONBTRU FURNACE LOCATION TION GAS VENT DUCTS SIGNATURE O / - , LATH, INT PERM ITTE ADDREB Uzo x e"" LATH EXT PLASTER, INT AUTHORIi[D AOT PI Al3TER, EXT HOUSE NUMBER COR- `.�G� RECT AND POSTED VALUATION f/ F[[ S`�/ e O FINAL 7SA632A DBS 3 1 52