HomeMy Public PortalAbout6400 BARELA AVE_Building__r
PMFARTNMNT OF BUILDING AND SAFETY I APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES BUILDING� 1 � ® '
wm. J. FOX. OHIEF ENOINEER
lllll�
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
oUILDING � � � �� DI�"fRIOT NO. PLAN OK.NO. PERMIT N0.
ADD /../ W759 I J
LOCALITY al1 IVSD INY DATE OF APrL DATE ISUED
N EAR— � ` V
L //DA/`U BUILDING
OWN[R H. ADDRESS
MAIL 9 L
MAIL ODALITYADDR
''�•
NEAREQT
J T D G C R Old ST. 0 Is VT
FIR[ NO.OFTYP OR
O
AROHITET OR TEL ZONE PLAN!•
ENGINEER NO•
pLDp, ORD.NO.
DD BETSACK LING
^ 7J�r. APPROVED
CONTRACTOR �• ` J•'{J/ 17 BY DATE
`1 DO[ AP D
�I �! J N[ _' CY DATI
P
LIGAL ^llo0 CORRE ONS
DECORIPTION LOT NO. BLDOK
TRACT
NO.OF ELDG7. ( le k!
■IZE OF LOT NOW ON LOT J
U9E OF NO.OF NO.OF ,. ..
I
DESCRIPTION OF WORK lt7
N trW
ALTERATION ADDITION ai• O
A
REPAIR MOVING D[MOLISH `T co
MQ.FT. NO.OF
■IZH ROOM■ STORIES X11 >
OOvrRINO CDV[RING
UBE OF NEW
-0UILDINO Y' m
✓ tV�t' r. sic,T
Lj::"r ay
I HEREBY ADKNOWLEDOE THAT I HAVE READ THIS APPROVALS
APPLIDATION AND STAT[ THAT THE AMOVE IS CORRECT FOUNDATIONS LOCATION INOPE13TOR DAT[
AND AOR[[ TD DOMPLY WITH ALL OOUNTY CRDINANO® FDRMS, MATERIAL!
AMC) STATS LAW/ REGULATING ■UILDINO OCN UOTI ON.
W'MAPL
_ FRAMES FIR[STOPS,
■IGNATURI OF — SRACINO MOLTS
PERMITTE r LATH, INT.
AUTHORIZED AOT
Zz LATH, IXT.
7&A&=A-a 7-H �� F V V P.D.* r- 1 r- PL/1!•T[R. INT.
a VA,qq--..�•- F[E T PLAJR[R.SCG �.
VALUATION ` VV *L� FINAL ' r
FE[
�IORKERS'COAAAE TION'DEt1:ARATION
Irm-}ha1+I hays r% ce'Comte.r% consent to self A �� ��� I�� � -PERMIT .
assure.-or�'ceOlflcate of Workers Compensation Insurpnce, C 7
cr a c%rtlfied copy thereof (Sec. 3WO Lab. C-)` - -- - - I
. 1 , , ; . - - .COUNTY OF LOS ANGELES BUILDING I►ND SAFETY.
,
Polic�No.,, r- , • Company .. , - _-.._. ...--4.
Certlfiedc6pyAmhe furnlahed..o,,, .:', , :-.. EKJILDNNG -�
re,y FOR'APPLICANT TO ILL IN ADDS (p QO �/� • s4-✓� i i
`CertfflAd'cb`?y is lied Hvlth the county bul q Inipec- - 13111LDItJGv - - - V9
•')lort-�re�artme�4f:`•, ;'. ADDRESS .
Date_ .�ry / Applictrlr T: CITY LP l �� I LOCALMY
CERN HCATE OF EXEMPTION F RCSAA lzojis SIZE Of LOT (� SBI BGs.
`COMPENSANON-IN$U T/ J
LOT
fthCi's,tdlorv'n,eed riot•bi rorn letddlf•fhe'airmlf T�fdr:one T - ._ .^ - _ ASSESSOR t. f
"• fwndrod dol ars ;1b0 dr, r. .' l TRACT LOT NO. MAP BObK PAGE, PARCH
I i ) JTEL
Ir rift' that"in fh `�prfarmar baa the'wock fof Wb' this NO: "�► LtsE z
s mit Is.hsiied, l s}iall nol employ`6�y n In ahy�rnann.r _ L,(�_._ _
. ��O ADDRESS(o 00- _ �.. _._� �I O01 DmOtJS
sFi as to be8or le iuBlect to thi Workert Coni a,
- _ _ � . C� ZIP_
Dae ' Appllcan4
NOTICE' APPLfCrANT: k,'_cA.4 strl6king thls tffccte of
ARCH OR i TEL
DtsTRler GROUP•.TYPE_..._. _. FRE _ _ BY }0.
�xerhpt on yo+r'should 'be�otne subject to,the Workers COr6T z G
Compinsatlo�-ptovlsions•of-the-tabor+gode�you-muit forth- . ADDR _ } - � - - :I S. - - -
.i Ith cofndly with.such.*ovlslons of .thlw-permlt shall be - STATISTICAL(3tiSSIhiGATION APT.
deemedAevoksid. ;�ti. , �• ;� - {y►q 11 t .l
UCENSED CONTRACTOR$DECLARATION. ti - L CLASS NO. �DMI.L.UNITS -
I hereby affirm that I am II under proylafon of.Chopw 9 �1 ^I<L `Z �!
SEWER MAP
1
((�mrnrngncln9 with Sedf4o; Pf.?Ms#on Sof the�LWnon and -- - - -- _Air_ --. ---
Pro ewloris.�bde, grid my llcerne is IK full forcd and V L yCLASS -. -� - VALDADON
�' 1LIr:�, I TS oRVES FAAAI ES Ot•E j. t f
Llcbtup IJ§mh3er VAl1JAl}dN11._ _�-
Cpntractor z" kp►1'R['s-"F rr:.ISP. DE t1PTION OF WbRIC... - . - - DD $ .5s,
7� 4,2,2,A%.-1_
I am exempt under Sec ALTER.
'F
B.BP.G for this reason_ _ REPAIR- - - -- r Q q, 1 (�
_ USE OF
E)OST'ING NI G. 1`- 1- -t- -.
FMAL
5lpngfur• owNER$uILDER DECLARATION__ . I YJiE G& S' N►cf1 Z NO
o. 5 t0 _fl, --
I hereby affirm that I am-exeMpt from-the Conftactors-Ucense - - `f
Law for the following'-reasdn(SActl6n 7031.5, Business and ADDS. t �dk T tJ I
'Ptofessrons Code).'. .., . ._..+t r:. _ ._. -. _. PRESENT
NG
I, as.owner of thl Prop"- , or my employees with _- �� --- _ - -.- _.. _-• `. _ _ '. }-'�--`
. wageias thtelr sole compensation,will do the work andf.'1 _ n'T
the struct'o Is not intended.o,r offergd for sale(Sedlpn LOCALITY
7W#, Buslneas and Professloru£ode).- - - - MOVING -- - - - '-
CQqTRACTOR 1,40,
1,ps owner of the property, am excluslvely contractingr
- with-lleensed-eontroetore'tcrconstruet the prolec�'(Sec_ _
tion 70" &nJness and Profession Code AbDRE�� �� � _ _ 9 -6
CONSTRL1CT10N L$1DING AGENCY _-_ SET YARD HW1 PROP. CK. WIDTH' �T Q i`8
1 hereby affirm thtat there In a construction lending agency for - n
the perfortrtance of the work for which this 'permit -
(Sec.'3D97, Ov. C }- I� ..
8. Lenders Name P.L -- - - -- ' ;• -_ .,
�. LDMA Ref_
Lenders Address p�FeedISO Permit Fee-' +
n
A certify thvf f.-have read thls.applicatbn_arid.state that the - .'- -- -- - /(I J (1
hwrarwrFee�- , LDMAPfC.I
above Informs-Mon Is correct. I agree to comply w*all County Irv�at4Qtrtlon FM ^7
.p -arid. lay-rgfating to bullding.,SfoPlttrQctlpn, ._ . - _.�.. .__._ total F«: - !i. / LDMA .--i ,i
.. and hereby author repr"entatives of this County to'enter
u n the abov for Inspection
sail IMVMM Poe COIANAT09Y L.hl10UAOi
Slq Applfoarrtor t — - - - -- - - -