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Home My Public Portal About5528 BALDWIN AVE_Building__ -7e p 45; 76AG38A CE#803 a-83 A I AT . PPL C. ION_ FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY � -� JOHN A. LAMBIE, COUNTY ENGINEER NEARESTQ v WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST. DISTRICT NO. GROUP TYPE P OCESS�,D BY FOR APPLICANT TO FILL IN S, T CONST.. ��iL. _ _ _ BUILDING , STATISTICAL CLASSIFICATION SEWER MAP ADDRESS �s � CLASS. NO._�DWELL.UNITS -RBK?J PG/j �p .L� Y LOT NO. CJ BLOCK WATER NOT REQUIRED RECEIVED ❑ CERTIFICATE: TRACT /c7 MAP D HIGHWAY NO. STATE AJ SECOND,LOCAL NO.OF BL D (CIRCLE) SIZE OF LOT J J 1� I NOW ON LOT USE ZONE SPECIAL USE OF T CONDITIONS EXISTING BLDG. TEL. i• OWNER NO. BUILDING YARDHWY STREET NAME EXIST. SETBACK WIDTH ADDRESS �o? ' ARCHITECT OR TEL. FP�L.T ENGINEER NO. SI.DE P. L. ADDRESS ' TEL. U, CONTRACTOR NO. ADDRESS /O DESCRIPTION OF WORK I o 64— Al W NEW ADD V ALTER REPAIR DEMOLISHN SQ.FT. �•- NO.OF NO.OF / ✓� f;, ,d9L c A'frlf- / s SIZE .0-7 O STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF- APPLICANT F APPLICANT VALUATION,$ , 7�'� '` �d'r APPROVALS DATE INSPECTOR'S SI NATURE FOUNDATION: LOCATIO F E $ FEE $ FORMS, MATERIALS ��'� •L_ FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS /J 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- i-• LATH. INT. Ir TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- �--- x/'wn' 'r ING TO WORKMEN'S COMPENSATION INSURANCE. % �' LATH.EXT. �.(, 30'-� AAZ SIGNATURE OF - HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL JOHN F. LEWIS. P NCIP(AL ST URAL`ENGINE R PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH LhL;o-0 7 7 1 JUL 2 1 D •.1. 1.50- 9 WORKERS' COMPENSATION DECLARATION , insure,hereby certificatffirm that e of Workers' Compensation eInsuran e1 have a certificate of consnt.to lf APPLICATION. FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) . ., COUNTY OF LOS ANGELES BUILDING AND-SAFETY Policy No. Company .�T�� AZIAV BUILDING p El copy is hereby furnished. � ' FOR APRLICANT TO FILL IN - ADDRESS ,--i��ertified copy is filed with the county building inspec- BUILDING tion departgment. /�.' D,, ADDRESS�,r Date 'D�/g-7fAPPIicanT .//��•C6°�l CITY / G �C/ ZIP %/,�v LOCALITY NO. OF BLDGS. NEAREST CERTIFICATE,OF.EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCEASSESSOR (This section-need not.be completed-if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100),or:less.) �L'iI��VFi �//'� �[�!G -? USE ZONE .:MAP OWNER " ' NO. I certify that in the performance;of the,work for which thispip ,) SPECIAL .permit is issued, I shall not employ any person in any manner ADDRESS �� , �yrL� //r CONDITIONS d so as to become subject to The Workers'Compensation Laws. /7 Q / CITY ��L� G/ ZIP �/ M V Date Applicant ARCHITECT OR TEL. PP DISTRICT GROUP TY FIRE PROCESSED BY NOTICE TO APPLICANT: If; after making this Certificate of ENGINEER NO. _ ST. Z NE 2 -0 Exemption, you should become subject to the Workers' �� w'" Compensation provisions of ihe.Labor Code, you must-forth- ADDRESS o_ with comply with-such provisions or this permit,shall be TEL. �Ge Q STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. CONTRACTOR /LFA NO. rip f�/®�� Z_ LICENSED,CONTRACTORS DECLARATIONLIC. CLASS NO. 42/ DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS e6/,Zj� ZJ/ NO. �� SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. ;t� and Professions Code,and my license is in full force and effect. CITY i�l�.�f�� /�� / CLASS *I c'// BK PG VALIDATION.' `�� - SIZ FT. STC OF FA OF CHECK ` License Number Lic: Class �� SIZE STORIES FAMILIES ONE VALUATION Contractor Date DESCRIPTION OF WORK T� ��Aem- ew^O ❑ $ /,� -�^" ., .. /TDP fi E.. T ll�i' DD '❑ Sv , ❑I am exempt under Sec. XA1We4r �,� A TER ❑ BAP.C. for this reason �� F�ICI�C Qd AIR ❑ $ Date: EXISTINOF G BLDG. 220DEMOL ❑ Signature APPLICANT i.�j�� TEL. ` FINAL (PRINT)f /iir'7 /��+ NO. OWNER-BUILDER DECLARATION DATE I hereby affirm that-I am exempt from the Contractor's License ADDRESS `> �%1 �' �v �v�/ Law for The following reason (Section 7031.5,'Business'arid FINAL Professions Code): 1P.C. RESENT $Y UILDING ❑ I, as owner of:the property, or my-employees.with DDRESS �(f(�,/ -, �- wages as their sole compensation,will do the work and K� '�"' "_Q(� ,:350 s�{�°3 { the structure is not intended or offered for sale(Section OCALITY 7044, Business and Professions Code.) OVING . TEL. , j)ENS 7-11 V ONTRACTOR NO. _ 102 _ ❑ I, as owner of the property, am exclusively contracting •� with licensed contractors to construct the project(Sec- {)til' -°�'m DDRESS, tion.7044, Business and Professions Code.) i i;�; ;�y�3d REQUIRED TOTAL SETBACK.FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH - _ I hereby affirm that there is a construction lending agency for FRONT '_ ° I the performance of the work for which this permit is issued P.L.' (Sec. 3097, Civ. C..). SIDE Lender's Name, U J . r'13 r u " ---- o U i:{1{1 !.{�{ 1 / L LDMA Ref. #.. f ;v�{ Fee$" Permit Fee (O J - 3�5��°i 3 Lender's Address - - • - I certify that I have read this application and state that the Issuance Fee LDMA P/C# , o Y PP 8 above information is correct. I agree to comply with all County nvestigation.Fee n ordinances and State laws relating to building construction, Total Fee e� P 30, LDMA Perm. # a and heaut rizerepresentatives of this County to enter u e abov entio ed property for inspection purpos a • J SEE REVERSE FOR EXPLANATORY LANGUAGE. Signature of Applicant or Agent Date _ - WORKERS' COMPENSATION DECLARATION 1 hereby affirm that I have a certificate of consent to selfA P P L I CAT I OIN 4`01? BUILDING PERMIT insure, or a certificate-of Workers'Compenstion Insurance,or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING (y ADDRESS Certified copy is filed with the county building inspec- BUILDING -5-2 � � tion department. ADDRESS > / v✓/ v1, LOCALITY NEAREST Date Applicant CITY ;tZ z /9.x/7 Cl7-Y ZIP CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR 61/ COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one l USE ZONE MAP 'S�/�C hundred dollars ($100)or less.) TRACT / S BLOCK LOT NO. NO. C V f r �L y [� / ( SPECIAL certify that in the performance of the work for which this OWNER L'lf L/�LSTL�7 NO. T ,3 Ys CONDITIONS O permit is issued, I shall not employ any erson in any manner /� 7„ DISTRICT GROUP TYPE FIRE PRO ESSED BY ADDRESS 14 Re 2 a CONST ZONE so as tq become subject to the Wo2�� ' Laws. 11,r3 / f Date 2y ApplicantCITY ZIP STATISTICAL CLASSIFICATION G� APT. CONDO. U 1 ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this Certificate of _ Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS P Y I ae9 Compensation provisions of the Labor Code, you must-forth- ADDRESS SEWER MAp� with comply with such provisions or this permit shall be _ .J a + _ TEL. VALIDATION deemed revoked. NO CONTRACTOR _[;/Y �'/1' js`C,. . LICENSED CONTRACTORS DECLARATION / �j LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESSI/ 2 b1'/ ( a�'/t�/%� 1 W1VNO._3A' 31'/ Z VALUATION (commencing with Section 7000)of Division 3 of the Business and �j f) LIC. Professions Code, and my license is in full force and effect. _CITY /� �/L� G lj` CLASS $ -2-® SQ. FT. NO. OF NO. OF CHECK License Number f Z Lic.Class/ j SIZE STORIES FAMILIES+ ONE i� 7 0 �`� l� / ��2/� NEW $ Contractor i?� Date a-L DESCRIPTION OF WORK 1I am exempt from the licensing requirements as I am a / ADD 0 F-] licensed architect or a registered professional engineer ALTER FINAL DATE' acting in my professional capacity (Section 7051, rrk n C Business and Professions Code). USE OF• g REPAIR J9 EXISTING BLDG. 12 ;r DEMOL FINAL v p Lic.or Reg. No. Date APPLICANT J. �r TEL. OWNER-BUILDER DECLARATION (PRINT)%�,/J�/9/}Z/Y iTSS'd C NO. I hereby affirm that I am exempt from the Contractor's License ADDRESS //d Z If' < �7Q Law for the following reason (Section 7031.5, Business and Professions Code): PRESENT ElBU I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY - P 1 2 R 2 A 7044, Business and Professions Code). MOVING TEL. CONTRACTOR NO. I, as owner of the property, am exclusively contracting # 0 0 0 0 0 1 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). 2 ° - 43.00 REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm tharthere is a construction lending agency for FRONT �� U ° ° ° 4 3,0 0�z the performance of the work for which this permit is issued P.L. � 0 (Sec. 3097, Civ. C.). SIDE 0 9, 22-8-1 P.L. Lender's Name m P.C. Fee$ Permit Fee _ Lender's Address w I certify that I have read this application and state that the Issuance Fee above information is correct. I agree to comply with all County Investigation Fee ` 0 ordinances and State laws relating to building construction, Total Fee � and hereby authorize representatives of this County to enter < upon the, bove-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ^ ignatur of Applicant or Agent Date es