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HomeMy Public PortalAbout5453 BALDWIN AVE_Building__ I DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES D I WM. J. FOX, CHIEF ENGINEER NG FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING DISTRICT NO. PLAN CK. NO PERMIT NO. ADDRESS LOCALITY // J RECEIVED BY DATE OF PPL. DATE ISSUED /` �.�,�rr' i/�- d� �-a C' `'°^ rl NEAREST t''r CROSS ST, ® ���� BUILDING A / �c,�//t^'�• Y7/, / ADDRESS Ste/ 3 /l// //�c/��•f//,YJ -- OWNER MAIL � r /C a / LOCALITY C ADDRESS / r �'`� NEAREST CROSS ST. CITY �G/h �j 9��/�� ND /" �'•l�C/ ZFIRE NO. OF ONE I PLANS I TYPE I GROUP, 3, ARCHITECT OR TEL. ENGINEER NO. BLDG. 0005' FjD NO. SETBACK LINE , �/�,�] ADDRESS A APPROVED , �I. CI'/f/ NEL. L USE r DATE 10 CONTRACTOR ,[, ,/ /��/� NO. / / ,J � USE AA APPR�O�G�ED�' ,� y r ZONE By BY �/�/''t1-'�'!C i?! DATE/ ADDRESS HOUSE NUMBERING LEGAL `y©®p DESCRIPTION -LOT NO. -FLOCK MAP NUMBER FIELD CHECK BY TRACT NO. ASSIGNED BY DATE iaf G v NO. OF BLDGS. CORR/EJCnTIONS SIZE OF LOT 5SX L/ INOW ONLOT P �GI✓/'}G� ri S 2219 l/a / USE OF I NO. OF �/ _ EXISTING BLDG, — _l �t,t'-F(LIES "^I' IQ DESCRIPTION OF WORK NEW b—I ALTERATION I I ADDITION O REPAIR I I DEMOLITION I I ;u SQ. FT. NO. OF Q D SIZE 11,'j ROOMS � STORIES EXT. WALLf' ROOF Y COVERING AA '�� t„ Q COVERING USE OF STRUCTURE r - =17 , .� APPROVALS' INSPECTOR'S SIGNATURE DATE 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FOUNDATION: LOCATION �^ PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS CORRECT. 1 AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS, HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS �/ ��_ 'A LAWS REGULATING BUILDING CONSTRUCTION. �f FURNACE: LOCATION, SIGNATURE OF f �1 /�'/ ���j' f GAS VENT, DUCTS / '"•�� 111[g�� iii ,l' % �- PERMITTEE < l ' r 7 a r LATH, INT. ADDRESS-2 r" i f 4.'�' I'1 r,�_JA/�-' P Q� LATH, EXT. AUTHORIZED AGT.� ' �� !� �e-1 -�C��.��N7` c�• j T �/�� PLASTER, INT. / 7eweaaA• Deaa V aQly� yVV P. C, $ K / F �� ! © a"+ �-2---0 FEE � PLASTER, EXT. VALUATION (�'y $ `a G L7 'aY FEE �O � FINAL �� ;r' •- L APPLICATION FORBUILDING PERMIT i1 _ COUNTY OF LOS ANGELES BUILDING AND SAFETY a WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that l have a certificate of consent to self insure, BUILDING ADDRESS -�J � dp4,�fJvO or a certificate of Workers'Compensation Insurance,or a certified 4 ` copy thereof(Sec.3800,Lab.C.) CITY-/���''" yr ZIP ,J% Policy No. Company LOCALI �� SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK,y- PAGE PARCEL J ``/i ti j f SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL.NO. ADDRES COMPENSATION INSURANCE S WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred y _ 4 C�%C �d ris` + DISTRICT GROUP TYPE C ST.' FIRE ZONE SIED Y dollars($100)or less.) S 49 CITY ZIP j C3 certify that in the performance of the work for which this.permit `A' �- ii' "�/ " is issued, I shall not employ any person in any manner so as to ARCHITECT ORE INEER TEL.NO. W 1 become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CIONDO 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 to the Workers' CONTRACTOR TEL.NO.L�ra�'I�.��l �r � � ,��! "` SETBACK YARD HWY PROP LINE WIDTH Compensation provisions'of the Labor Code, you must forthwith L��' "'" �� �7 FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO.��++ / j IPV i-J , %f CCI �J, _> C./ '/ .�/ PL I LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS PL I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP ca (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORES NO.OF FAMILIES cz Professions Code,and my license is in full force and effect. NEW ❑ BK PG License Number Lic.Class DESCRIPT ON,OF WOR ADD ❑ b+ VAL ON �✓/� Contractor Date ALTER ti z ❑ I am exempt under Sec. _ �'����� � `- REPAIR ❑ — BARC.for this reason DEMOL ❑ LDMA P/C# Date: USE OF EXISTING BLDG. LIRM ❑ Signature APPLICANT(PRINT) TEL.NO. LDMA Perm# ❑ I, as owner of the property, or my employees with wages as their sole compensation,will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and '�`+� r•,. /�� '/ FINAL D )#yQ rofessions Code.) d/ 6%-11` 151.55' ( WILLTHEAPPLICANT OR FUTURES LDING OCCUPANT HANDLE AHAZARDOUS MATERIAL J I, as owner of theproperty, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN - 9 L Y g THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY NS licensed contractors to construct the project.(Section 7044, YES❑ NO❑ _._.. Business and Professions Code.) TOTAL j j AL 1=- ..IL a �'�5 WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING _ {{ OCCUPANT REOUIREA PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CHECK .E.5 Lu'75 CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. _ i.x• �,;^ "I� I hereby affirm that there is a construction lending agency for YES❑ NO❑ the performance Of the Work for Which this permit IS issued(.Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD - .3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES _ _ _ m. COUNTY CODE,TITLE 2,CHAPTER 2.20 SECTIONS 2.20.1 DO THROUGH 2.20.140 CONCERNING - I„I�.L I[_.I-I 1 It to Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. 3aO "'4 ;' IL Lenders Address ';7 0 1 AM �0 OWNFA OR AGQJT o' I certify that I have read this application and state that the above g information is correct. I agree to comply with all county P.C.FEE PERMIT FEE/36, CIN ordinances and State laws relating to building construction,and <. hereby At;1,a representatives of this o my to enter upon ISSUANCE FEE 901 the of To/ned property for ins purpose /�� ---/� � INVESTIGATION FEE TOTAL FEE �v � O 5 A pllmtor Agent Date SEE REVERSE FOR EXPLANATORY LANGUAGE, APPLICATION FOR BUILDING PERMIT � COUNTY OF LGA ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN NNEAREST SS BUIL ING ADDRESS I hereby affirm that I have a certificate of consent to self insure,or a certificate of Workers'Compensation Insurance,or a Certified Al` ( �} �� copy thereof(Sec.3800,Lab.C.) CITY zIP Policy No. Company SIZE OF LOT p NO.OF BLDGS.NOW ON LOT R❑ Certified copy is hereby furnished. O ,( r -. ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. 1 Date Applicant ASSESSOR MAP BOOK PAGE j Q PARCEL JCaJ SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER 'T TEL.NO. YES NO ADDRESS COMPENSATION INSURANCE I.ryl �co�C Lei (e/v 2-xs- 6� WITHIN 1000 FT.OF SCHOOL? / (This section need not be completed if the permit is for one hundred �- S'-3• A/- �<<�c�/G1 f.y� f�v� DISTRICT GROUP TYPE CONST.' FIRE ZONE PROD SSED BY dollars($hat or less.) CITY d 1 zip _ a � ,�I certify that in the performance of the work for which this permit �--� /� Li 7' '�• is issued, I shall not employ any person in any manner so as to ARCHITECT O ENGINEER TEL.NO. become subject t0 the Workers'Compensation Laws. STATISTICAL CLASSIFICATION I APT CONDO Date Applicant ADDRESS CLASS NO.€�R DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate of REQUIRED I TOTAL SETBACK FROM EXIST CONTRACTOR TEL.NO. Exemption, you should become subject to the Workers' y.� / SETBACK YARD HWY PROP LINE WIDTH Compensation provisions'of the Labor Code, you must forthwith Faw2f' CO�rIS�yf.(G/ /�-rr C 3 33 /tPd'/ FRONT ADDRESS LIC.NO. comply with such provisions or this permit shall be deemed revoked. PL Z2-6 A -410 6�1111 LICENSED CONTRACTORS DECLARATION CITY L LIC.CLASS FIDE o I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP C.3 (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORES NO.OF FAMILIES Professions Code,and my license is in full force and effect. s / ,Z NEW El BK PG O License Number Lic.Class DESCRIPTION OF WORK ADD � $ U ` Contractor Date ALTER ❑ Z ' El am exempt under Sec. P REPAIR ❑ B.&P.C.for this reason s fiafila�n n f Li�J /Ewyl, DEMOL ❑ LDMA P/C q Date: USE OF EXISTING BLDG. URM ❑ Signature APPLICANT(PRINT) TEL.NO. LDMA Perm N ❑ I, as owner of the property, or my employees with wages as ()/v /� Sf �/� (2/3 22'10v` l z A $ their sole compensation,will do the work and the structure is ADDRESS W7-0. ' ,[� C -?�/ not intended or offered for sale (Section 7044, Business and 7 0. 4J - " G j'I. 3 _ �! FINAL DZa ;,, Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL J T"S'!ej"• ' OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN 1 T @ i@ 1, as owner of the property, am exclusively contracting With THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY Q licensed contractors to construct the project.(Section 7044, L '—R 6 Business and Professions Code.) Yes❑ No❑ TOTAL i'@_ "=+9— WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING ' OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION ORMODIFICATION FROMTHESOUTH '•-�@�E}-�': -a'/�c-'-` CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST le-I FOR GUIDELINES. j.: '•3%. i R - I hereby affirm that there is a construction lending agency for YES 1:1NO Elthe performance Of the Work for which this permit IS ISSUBd(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES S' COUNTY CODE,TITLE CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING 0000-1-500i ?l 1'?'i` •`^I Lenders Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. n Lenders Address -11- R„ C') R i i 15"s L I� OWNM OR AG o' 1 certify that I have read this application and state that the above information is correct. I agree to comply with all county P.C.FEE PERMIT FEE ordinances and State laws relating to building construction,and ° a_ hereby author' a representatives of this County to enter upon ISSUANCE FEE /J3 T I � the abo e�i1e finned property for purposes , insp i �l INVESTIGATION FEE TOTAL FEE a� Sig.W plirent or Age,R a SEE REVERSE FOR EXPLANATORY LANGUAGE, APPLICATION FOR BUILDING PERMIT �l COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING A D S [BUILDING I hereby affirm that I Clave a certificate of consent to self insure, 5 6 /�l „A �/�v por a certificate of Workers'Compensation Insurance,or a certifiedcopy thereof(Sec.3800,Lab.C.) ITY ZIP PolicyNo. Company /� �•� LOCALITY P y SIZE OF LOT NO.OF BLDGS.NOW ON LOT dlJ ❑ Certified copy is hereby furnished. NEAREST CROSS 67. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. ASSESSOR MAP BOOK PAGE PARCEL Date Applicant S•–� .0/e v /�z SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL.NO. �G;pSS- YES NO ADDRESS COMPENSATION INSURANCE � WITHIN 1000 FT OF SCHOOL? / __�� (This section need not be completed if the permit is for one hundred � �3 f3 c��({L.U;',w 1Nn/� e DISTRICT G OUP TYPE CONST.' FIRE ZONE E ED Y dollars($hat or less.) I certify that in the performance of the work for which this permit CITY .� � �� .ZIP 7/��� `� � •��/ is issued, I shall not employ any person in any manner so as to ARCHITECT R ENGINEER TEL.NO. become subject to the Workers'Compensation Laws. STATISTICAL C SIFICATION PT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS SD NOTICE TO APPLICANT.' If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become Subject to the Workers' CONTRACTOR 1 TEL.NO. SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith Owl �� � �/ �� ��/3, _ —/�/ FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS I LIC.NO. P L - -/;-V Til._ / c o p! $ ,� 6-/7 LICENSED CONTRACTORS DECLARATION CITY L d LIC.CLASS SIDE o I hereby affirm that I am licensed under provisions of Chapter 9 �l SEWER MAP V (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORES NO.OF FAMILIES Professions Code,and my license is in full force and effect. I NEW BK PG ® CD License Number Lic.Class DESCRIPTION OF WORK ADD VALUATION Lvu c� 0 v Contractor Date ALTER ❑ f fG El am exempt under Sec. 74 c-,� c-' REPAIR El B.BP.C.for this reason W 7DEMOL ❑ LDMA P/C#-0 Date: USE OF EXISTING BLDG. URM ❑ Signature APPLICANT PRINT) TEL.NO. t� LDMA Perm# 4 El 1, as owner of the property, or my employees with wages as J1J15 s��f� �� -/�O Zp ;r•3— s their sole compensation,will do the work and the structure is ADDRESS I F i, ti-j a , /J� TE /1 not intended or offered for sale (Section 7044, Business and Y/ C.e) /® - FINAL IVI ® ;7 Professions Code,) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL g I, as owner of theproperty, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN B y !TEMS Y g THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL licensed contractors to construct the project.(Section 7044, > r - .,_' �� ��,,,� � : 3 tom• Business and Professions Code.) ves❑ No❑ ;CIT I � WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING f• ' OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH :.LI•R a1L CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST _ _ FOR GUIDELINES. CHANGE I.Jj..i I hereby affirm that there is a construction lending agency for YES 1-1NO1:1 the performance of the work for which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES { m, - COUNTY CODE,TITLE 2,CHAPTER 2.20 SECTIONS 220.100 THROUGH 2.20.140 CONCERNING iIlli; r rc Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. _ aLender's Address ow+E+0Rn0wT o' I certify that I have read this application and state that the above information is correct. I agree to comply with all county RC.FEE PERMIT FEE �j ordinances and State laws relating to building construction,and �' r a. hereby authorize representatives of thisounty to enter upon ISSUANCE FEE the ab m tinned property for' ion purpose . ✓ Q INVESTIGATION FEE TOTAL FEE ,, 0 7 3 i (o r s're�arare vn,xnror�om Dare SEE REVERSE FOR EXPLANATORY LANGUAGE,