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Home My Public Portal About9526 BLACKLEY ST_Building__ ,76A°98AD98:9 PPLICATION FOR BUILDING PERMIT DIVLSION•OF BUILDING.AND-SAFETY BUILDING Deportment of County Engineer ADDRESS */ p County'of Los Angeles LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST F O J�SJLV CASSATT D.GRIFFIN, SUPT OF BUILDING CROSS ST. /•- fes' ` FOR APPLICANT TO FILL IN DIsrR �No. GROUP TYPE, SEWER MAP BK PG - CONS BUILDING LI�CkL ?j O STATE ADDRESS HAT YES NUMBER NO LOT NO. �Q BLOCK USE ZONE SPECIAL " CONDITIONS . TRACT' I. S v I — ' NO. OF'BLDGS. ') EXIST. BUILDING - - SIZE OF LOT I NOW ON LOT �• ARD HWY STREET NAME SETBACK YWIDTH , USE OF EXISTING BLDG. FRONT - P.L. OWNER -VeC«. r - SIDE P.L. AC A DDRESS O TRACT DWELL. I UNIT ? 5 INDUSTRIAL ' CITY NOL I DWELL. I UNIT•TE . -fr ' , 8 PUBLIC BLDG. ARCHITECT OR - _ TEL. 2 DUPLEX 2 UNITS - ' 7 ADDN..-ALT.. ETC. ENGINEER- NO. 3 APT. UNITS f 8 MISCEL.• ADDRESS - 4 COMMERCIAL TEL. INSPECTION RECORD CONTRACTOR, t NO. { ADDRESS '7 13..t. DESCRIPTION OF WORK - NEW ADD ALTER 00 REPAIR DEMOLISH 0 ' SQ. FT. NO. OF NO OF - SIZE STORIES FAMILIES OF ST UCTURE iff Y .• to w NATURE O- APPLICANT �� APPROVALS < ADDRES _ DATE INSPECTOR'S SIGNATURE _ FOUNDATION LO ' p - S P.C. S FORMS, MATERIALS 11 �fa, 40 LA.,.. � FEE FRAMIE• FIRE STOPS.- VALUATION TOPS.VALUATION - - S /y BRACING, BOLTS • FEE f Cl FURNACE LOCATION. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT. DUCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECTAND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT. -AND STATE LAWS REGULATING BUILDING CONSTRUC- O U TION. /��J LATH, EXT. SIGNATURE OF k• '"� ~- " HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL` JOHN A. LAMBIE. COUNTY ENGINEER VALJJATION CLYDE N. DIRLAM, CHIEF BLDG: INSPECTOR CK MO CASH LAC1 8' 9'E`� OCT.31 1 i &.0"0 RTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES 1 ® ' WM. J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY q� _ DISTRICT NO. , PLAN CK.NO. PERMIT NO. BUILDING '1 . j _ �(�, ADDRESS '2 , i LOCALITY RECEIV}/ED11Y DATE OF APPL. DATE ISSUED NEAREST q CROSS ST. _ BUILDING I ^� OWNER ADDRESSMAIL ADDRESS �.�(/r LOCALITY NEAREST TEL. Gjy CROSS HT. CITY NO. �{ I' FIRE NO.OF � V T 'PE j7j_GROUP / ARCHITECT OR TEL. ZONE PLANS ENGINEER NO BLDG. /� r Q r' ADDRESS SETBACK LINE { /J� , APPROVED s TEL. BY DATE CONTRACTOR NO. USEAPPROVED ADDRESS ZONE/ / BY, DATE LEGAL �u CORRECTIONS DESCRIPTION �!LOT NO. BLOCK TRACT /� J lJ✓ /� �'/°r �dC//.,r. ��5�' i NO.OF BLDGS. , I SIZE DF LOT NOW ON LOT USE OF I NO.OF I NO.OF a EXISTING BLDG. FAMI LIES ROOMS - - --" - DESCRIPTION OF WORK NEW V< ALTERATION ADDITION ' ._ _.. .. 0 REPAIR MOVING DEMOLISH 0 SW.FT. ��0 40 NO.OF t• F_:. Z SIZE ROOMS STORIES D WALL ROOF .....�7 ::.� �._ ., 1' COVERING I COVERING —BUILDING NGOF W iILrL�s6 �/ bf 1 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATIONI: LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS - S /�•-y AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, n_ SIGNATURE OF BRACING,BOLTS .ep P 9 PERMITTEE � LATH, INT. /( AUTHORIZED AGT LATH, EXT. Y - 76A639A 9-48 PLASTER, INT* DSS-3 SOM SETS $ P.C.>$ ' FEE PLAHTER,EXT. ,-LV VALUATION FEE /Gi FINAL DIVISION OF BUILDING AND'SAFETYr Department of Conn En eer �j f County of Los Angeles Z�' WM. J. FOX, COUNTY ENGINEER APPLICATION FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY Q /, DISTRI NO. PLAN CK. OR REc.No. PERMIT /NO. BUIL3 DIN' LDNG FDDRIIS / .YV RE EIVED SY DATE OF APPL. DATE IBBUED Y ®� T. - BUILDING ADDRE88 �A'(O �r (r OWNER 'T MAIL - .LOCALITY ADDRESS - NEARESTt�� / � TCL CRO88 OFT. CITY NO. O FIRE NO.OF I q-Y G ARCHITECT OR TEL Y: ZONE .i+'� PLANS - ENGINEER NO. SLOG. 1�, / /� //�� QRD.rN�13 `r BETBACK LINE d'G , / / RD ADDRESS USE APPROVED TEL; ZONE i BY DATE CONTRACTOR -NO. HOUSE NUMBERING ADDRESS - "MAP NUMBER �/� NO. ASSIGNED BY DESCRIPTION LOT NO. � -CORRECTIONS TRACT OrrI• N OF SLOGS. SIZE OF LOT NOW ON LOT USE OF - - I Fa1B r d� /✓�/G.� EXISTING BLDG. �" ✓ �� , 7 ,� •19� 4 DESCRIPTION-OF WORK " NEW ALTERATION /ADDITION Z D REPAIR . DEMOLITION r SQ.FT. NO.OF SIZE •�, ROOMS STORIES EXT.WALL I ROOF - COVERING !S COVERING _ USE OF S VCT RE �. INSPECTION FOR - APPROVALS OCCUPANCYAS _ INSPECTOR'S'SIGNATURE DATE FOUNDATION: LOCATION FORMS, MATERIALB / I ND HEREBY ACKNOWLEDGE THAT I HAVE REAL) THIS AP- 1, PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRESTOPS, vV CORRECT. BRACING, BOLTS 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ACE: LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FURNACE:VENT, DUCTS ! I SIGNATURE OF�/a.�J�.�- d LATH, INT. r �� PERMITTER a� .._ • �� D LATH, EXT. ' n ADORES ff PLASTER, INT. AUTHORIZED AOT. PLASTER• EXT. rr/ FEE HOUSE NUMBER COR- (! QJ RECTANDPOSTED FEE 14/ VALUATION �O Jar ® ®® I' FINAL i 76A63BA, DBS 3 1-52 1 76A638A DSS-3 12.64 , + r 'APPLICATION F®R-' EU-IL®ING PERMIT ], DIVISION OF BUILDING AND SAFETY BUD'IL DING Department of County Engineer Aa.J r7�s County of Los Angeles LOCALITY WM. J. FOX, COUNTY ENGINEER CASSATT D. GRIFFIN, SUPT OF BUILDING. rt NEAREST CROSS ST. (/e_V- DISTRICT.NO. GROUP TYPE MAP FOR APPLICANT TO FILL•IN I -c;- ISEWER BK PGBUILDING - ADDRESS �' MAP �.g STATE yES NO ly NUMBER V� HWY LOT NO 40 BLOCK USE ZONE SPECIAL CONDITIONS TRACT - NO' OF BLOGS. - SIZEcOF LOT I NOW ON LOT BUILDING EXIST / USE OF SETBACK YARD HWY .STREET NAME WIDTH EXISTING B DG FRONT m P L OWNER SIDE - MAIL- P L ADDRESS TEL 1- DWELL. 1 UNIT 5 INDUSTRIAL CITY /� NO L - 2- DUPLEX_UNIT 6 PUBLIC BLDG ARCHITECT ORf TEL. - ENGINEER NO. 3 'APT UNITS 7 ADDN ,ALT, ETC ADDRESS' 4 COMMERCIAL MISCEL TEL. CONTRACTOR NO - - INSPECTION RECORD ADDRESS Q G,GJ3_ I ,�.Y=r +�.,� T I 4'c�•C.. DESCRIPTION OF WORK NEW ADD ALTER REPAIR _ DEMOLISH FT. NO OF - NO OF '^ y SIZE STORIES � � FAMILIES ' US OF RUCTURE - SIGNATURE OF APPLICANT `i'� , APPROVALS :rm ADDRESS DATE INSPECTOR'S SIGNATURE _ FOUNDATION LOCATION _ P. S FORMS, MATERIALS FEES ® FRAME FIRESTOPS, (� BRACING, BOLTS - `r"i '.•Q �.w. �- VALUATION ' FEE rew� FURNACE LOCATION,, , GAS VENT, DUCTS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE-THAT THE ABOVE IS CORRECT - - AND AGREE TO COMPLY•WITH ALL COUNTY ORDINANCES' LATH;INT. k ` AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. - LATH, EXT. 14 �1 . w • SIGNATURE OF HOUSE NUMBER COR- _ PERMITTEE RECT AND POSTED ADDRESS—? FINAL - WM. J. FOX. COUNTY- ENGINEER "VALIDATION.. • ` - BY e - - �- . .�.tW�,-.OI,9' f •''f'EB - 1 •8.0.0 •� DEPUTY DEPUTY BY. BY ® _ • DEPUTY DEPUTY . WORKERS'COMPENSATION DECLARATION -' ' �'-' _ f affirm r - +t- • +• consent selfAPPLICATION F OR .• U- ,I d DI NG PERMIT Inera certificate Worke ' Compensatn Insurance, :, or'a`certif4dcopy thereof (Sbc 3800; Lab C ) • . . - -• COUNTY OF LOS ANGELES BUILDING*AND SAFETY Policy No UM5Z79 CompanyE12aver iris.'Cb. ' - - - - - - ' c•I.-`� -- , D�' Certified copy is hereby furnished - �'• FOR APPLICANT TO FILL IN BUILDING / ' ADDRESS b Certif ed'copy'is,filed'with tl e-co unty^ uilcl g inspec- ^- BUILDING f t tion depm arTerit +13• ADDRESS 9526 Blackie .. .r - - - IY Date''' '6-1'H-85- Applcont CITY Tem le Cit ZIP 91780 LOCALITY _. CERTIFICATE OF EXEMPTION OF&' 'ORKERS' - - - •-'NO-OF BLDGS NEAREST - - "COMPENSATION-INSURANCE! •'' s SIZE OF LOT NOW ON LOTCROSS ST_ ; /!sem (This'section need not be completed if the permit'is for•one - — - -- ASSESSOR } .•• hundred dollars ($100)or less ) h,,,,., t.- TRACT• V BLOCK" LOT•NO MAP BOOK PAGE PARCEL TEL I cerhfy,thatim the performance ofrtFie.work for-which this OWNER Robert Hayton' NO.287=4283 U ZONE OP i permlt'is issued,,I-shall not employ any person in any manner __- ADDRE559526 Blackie - -- - - � SPECIAL-' - - CONDITIONS so as to become sublect,to the Workers'Compensation Laws Q •%,,. r.".�t r. ..'vi t•- ' _. CITY -TeITI le Cit ZIP-.91-7HO _.. - - r , y, u ` Date " ,Applicann ARCHITECT OR, TELIM _ NOTICE'TO APPLICANT' If; 'after`mak�^ng this Certificate of DISTRICTS. GROUP TYPE _ FIRE. ]�,PRO�'ESSED BY ,- O ,,. ENGINEER. NONE _ NO _ CONST y % ZONE • Ezemption;`'you should become subject to.T-the Workers' 'Compensation'provisions of the'Labor''Code,;�ou-must forth-' ADDRESS :with comply'•twith.such provisions or this permit,shall be deemed revoked ;{: TEL STATISTICAL CLASSIFI ATION APT CON 1/l j' - CONTRACTOR Ur11ted Roof in CO.NQ 223-4081 LICENSED CONTRACTORS DECLARATION }`. - LIC CLASS,NO DWELL UNITS I hereby affirm,that I am hcensec'under Prov„isions of Chapter 9 ADDRESS 1821 Dal Street NO 137650 SEWER MAP' (commencing with Section 7000)of Division 3'of the Business and - _ LIC •- - Professioris Code, and r-ry.hcense is -fuWforce and`effect CITY LOS An eles, 90031 CLASS_C-39 BK��,' - - VALIDATION ; r - _ SQ FT _ NO 'OF_ NO_OF CHECK o '4/-/137&f0- C-39 SIZE STORIES FAMILIES ONE j • License Numlaei -Lc Class ” j •' VALUATION ti °tr " " DESCRIPTION OF WORIreroofin --with-'3=