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Home My Public Portal About10637 BOGUE ST_Building__ . I 78A89BA DBB.H APPLICATION. FOR BUILDING PERMIT , i 1-55 DIVISION OF BUILDING. AND.SAFETY BUILDING ADDRESS Department of County Erigineer County of Los Angeles LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN, SUPT OF BUILDING DISTRICT NO. GROUP SEWER SEWER MAP FOR APPLICANT TO FILL IN ^ ,� TYPE � BK PG i CONST.- BUILDING y� �- MAP STATE ADDRESS �!/ NUMBER YES' O' HWY LOT NO. - BLOCK US Z NE SPECIAL - • CONDITIONS TRACT ja►�� y� I NO. OF SLOGS.�_ BUILDING EXIST. , SIZE OF LOT yfllY� V NOW ON LOT YARD HWY STREET NAME USE OF SETBACK WIDTH EXISTING•BLDG. FRONT Z OWNER. �C®•/a,��Q, SIDE . P. L.- MAIL ADDRESS O -TRACT DWELL.' 1 UNIT 5 INDUSTRIAL TEL: DWEL'LO 1 UNIT CITY. ;NO. 6 PUBLIC BLDG. ARCHITECT OR TEL. 2 DUPLEX 2 UNITS 7 ADDN.,ALT., ETC. ENGINEER --� NO. 3 APT. UNITS 8 'MISCEL. _ ADDRESS 4 COMMERCIAL . TEL' 01a INSPECTION RECORD CONTRACTOR NO. 73ee 7 ADDRESS DESCRIPTION OF WORK NEW ADD _ ALTER REPAIR DEMOLISH SO. FT. i Gl�3/� NO. OF NO. OF SIZE Y STORIES FAMILIES - - USE OF STRUCTURE / SIGNATURE OF ' APPLICANT APPROVALS ADDRESS DATE INSPECTORS SIGNATURE FOUNDATION: LOCATION y `1G.• i� $ P. C. $ /Z1D -FORMS,MATERIALS 6 FEE J FRAME: FIRE STOPS, 11w-9 w-9 VALUATION - - $ BRACING, BOLTS FEE FURNACE: VENT, CATION, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS UCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECT ✓ ,/�(p , _ • AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT. `'7 J/" v'li'°�% AND, STATE LA REGULATING BUILDING CO`STRUC- LATH. EXT. L aqa fiW`� TION. SIGNATURE C C7 HOUSE NUMBER COR- 7 PERMITTEE RECT AND POSTED ADDRESS FINAL JOHN A. LAMBIE. COUNTY ENGINEER VALIDATION CLYDE N. DIRLAM. CHIEF BLDG. INSPECTOR' CK MO CASH + a 1 4',°8'.5;- '!CT 19 .1 .6 1:5__Q.0 A-* APPLICATION FOR BUILDING PERMIT I. • COUNTY OF-LOS ANGELES BUILDING AND,SAFETY, .BUILDING ADDRESS WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING DpRpSS I hereby affirm that I have a certificate of consent to self Insure, 3 or a certificate of Workers"Compensation Insurance,or a certified CITY copy thereof(Sec'3800, Lab C) � LOCALITY _ Policy No Company SIZE OF-LOT 01B NOW ON LOT• - ❑ Certified copy is hereby furnished 3 NEAREST CROSS ST ❑ Certified copy,fs'filed with the county,building inspection TRACT BLOCK LOT No department _ USE ZONE MAP NO Date Applicant '' ASSESSOR MAP,BOO PAGE -PARCEL SPECIAL,CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER,.D TE 0 / YES COMPENSATION INSURANCE _ — ` NO- COMPENSATION WITHIN 1000 FT OF SCHOOLS (This section need not be completed if the permit Is for one hundred ADDRESS O� 'DISTRICT GROUP TYPE CONST FIRE'ZONE `PROCESSED BY dollars ($100)or less.) CITY - -� ZIP• - ,- - - I certify that in the performance of the work for.which this permit is Issued, I shall not employ any person In any manner so as to. ARCHITECT O�,INI . - - - - TEL No become subject to the Workers'Compensation Laws .• STATISTICAL CLASSIFICATIONAP7 - CONDO Date •Applicant - ADDRESS� - -- CLASS NO 4 DWELL UNITS r Y 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 SET BACKYARD HWY - "PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked ADDRESS LIC NO PL LICENSED,CONTRACTORS DECLARATIONSIDE CITY LIC CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO FT SIZE NO OF,STORIES NO OF FAMILIES Professions Code,and my license Is in'full force and effect ,Z t NEW ElBK PG a DESCEJIPTIO WORK - ADD $I VALUATION G�i7 Q License Number Llc Class' $ Contractor Date ALTER ❑ ❑ I am exempt under Sec REPAIR ❑ B&PC for this reason DEMOL ❑ CDMA P/C#' - W Date USE OF EXISTING BLDG �- ( URM ❑ '"�; - • i•..d f SignatureAPPLICANT(PRINT)._ - TEL NO LDMA Perm Z ❑ I, as owner of the property, or my employees-with wages as Z __ their sole compensation, will do the work and the•structure Is ADDRESS O not intended or offered-for sale (Section 7044, Business and FINAL DATE 0 r Professions Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J' ❑ 1, as Owner Of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES licensed contractors to construct the project (Section 7044, FINAL BY VES❑ NO❑ Business and Professions Code) `?t; WILL THE INTENDED USE OF THE BUIDLING BY THE,APPLICANT OR FUTURE BUILDING _ OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH T.r,`j�,f CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR ; ri _ .GUIDELINES ,r' _ - I hereby affirm that there is a construction lending agency forvEs❑ No❑ - �," i' , .I)T;'I ' f -�� a N the performance of the work for which thisermit is Issued(Sec ° r f _ p I HAVE REAMTHE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING' • i�•.N��.,, a.j•_-°Q>f.eF 3097,Civ C) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, __ N TITLE 2,CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING'AND FOR OBTAINING A PERMIT FROM THE SCAQMD e:I tr[]hEi j ht'. o Lender's Address _ OWNER OR AGENT O o I certify that I have read this application and state under penalty s of perjury that the above Information is correct I agree to comply PC.FEE - - - t�r� PERMIT FEEt li N with all county ordinances and State laws 'relating to building FF �v^^ m construction, and hereby authorize representatives of this County ISSUANCE FEE / �/D CJ i ; 1 AN to enter upon the above-mentioned property for Inspection purposes INVESTIGATION FEE TOTAL FEE 3• - ^ �S�enamre of Apent SEE REVERSE FOR EXPLANATORY LANGUAGE WrmthtC OMPENSATION DECLARATIONIh"ereby oI have a pert ficate.:af.consent ,a.self APPLICATION .1=O R B U I L D I t!I G PERMIT P Insut_!or a certificate of•Workers' Compensation Insurance, ' PERMIT ' - or a c�rtified'copy thereof'(Sec: 3800, Lab C.) - - -- >,_• _ - COUNTY OF LOS ANGELES BUILDINGAND SAFETY Policy No. - Company. Q PY y FOR APPLICANT TO FILL IN BUILDING j 7 '` Certified co :s hereby furnished ADDRESS Certified'copy-is filed with the-county building inspec- BUILDING tion•dep'artment. ADDRESS DateApplicant CITY 16tH 1• I-� 1 / ZIP �� O'V CERTIFICATE OF EXEMPTION FROM WORKERS — - NO-OF BLDGS NEAREST. COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS,ST (This section•need-not be completed�if the permit is,for>one - �- -- ASSESSOR ^ hundred dollars ($100)or-less.).. _ I TRACT BLOCK LOT NO MAP BOOK PAGE PARCEL TEL uL I �j' ) USE ONE MAP / fy - II not em to do erson,n an OWNER RAU '-GC7AA'1- rU N NO T7 c'�' NO r - so aslt I beocom,:'l sh ericit a nce any work for w�iich this � . permit is issued, I sha p y y p y'manner• 2 �G U r SPECIAL,- - -- d c� le-c7f to'the W:Q,Compensation'Laws. ADDRESS I O �7 -77./Z"" CONDITIONS u -�„'j -,1 •�•/'?'• ''., n. G TY' ZIP- 9_��Date Applicant NOTICE'TO APPLICANT 'If; after mak,rig this CeF1lflcdle of ARCHITECT OR TEL _O DISTRICT _GROUP� TYPE i,. __ FIRE PROCESSED BY. ENGINEER �NO. CONST., ZONE LU Exemption; you should 'become subject 'to,the Workers' '" /J ; Compensation provisions of the Labor Code, you must forth- ADDRESS ��-v - - - -- -- d with.comply with such provisions or this,permit shall be -• -- - -• - r -' TEL < _ STATISTICAL CLASSIFICATION w APT �ONDO #A deemed,revoked. CONTRACTOR NO LICENSED CONTRACTORS DECLARATION.. - - --- - - -LIC - - CLASS NO' DWELL UNITS I hereby affirm that,I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of•Drvision 3 of the Business and „ _ __ -__ ; _ _..-_ _ _LIC. SEWER MAP Profession's Code; and my license is in full force an effect CITY CLASS BK "' VALIDATION SQ FT NO.OF _ NO OF,_-•_ I. CHECK L'cense,Number Lic.Class SIZE � STORIES FAMILIES ONE r, .. ALUA ION T DES IPTION-OF-WORK " ' - - N V, - Cdntractor Date NEW Q ADD $ O t Pilo.I am exempt under Sec. -k1{ ALTER B.BP.C. for this reason -' e V' Crt Q�l`1 J� REPAIREXISTING OF ' Date: -' _ DEMOL ' u EXISTING BLDG 6 3 59 A APPLICANT TEL. ` Si nature - - t_ . /� �--- e / FINAL ; g (PRINT) -AL)L CO Mr /�•�1�NO L1��Od S DATE 0 0 0 0 0; OWNER-BUILDER DECLARATION _ _ 1,hereby affirm that I am-exempt from-the Contractor's,License - /y�� dG VIZ �� k m,° (G �,5 Law for the following'reason!(Section 7031 5, Business and ADDRESS /«o �� FINAL' o Tip yr Professions Code): PRESENT - -'8y _ I �6 BUILDING 10�1�7 r`30 - 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 % -7044,-'Business and Professions Code): -- ' MOVING """' ' ' --TEL - ( ' CONTRACTOR NO ❑ I;as owner of the property, am'exclusively contracting with'licensed-contractors-to.construct-the-project (Sec- 1' tion 7044, Business and Professions Code)., ADDRESS - LREQUIRED.. -TOTAL SETBACK FROM.... - CONSTRUCTION LENDING•AGENCY ` SET BACK YARD HWY PROP LINE WIDTH' hereby affirm that there is a construction lending agency for FRONT the performance of-the work for-which this permit-is-issued -P L7-- (Sec --(Sec 3097, Civ. C.). SIDE Lender's Name r P C- Fee$ Permrt Fee - - - - - Y �D LDMA Ref.:# Lender's Address (� certify that I have-read.th,s appl,cation.and•state that the _...-...- = Issuance Fee PDA P/C#- ----- -- - -•• - a above information is correct: I agree to comply with all County Investigation Fee S ordinances and State laws'relating to_building construction, _. ,. Total Fee r LDMA Perm-#- 2 - U - and hereby authorize representatives of this County to enter upon above-mentioned property fo inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE v Signature- or Agent --.. . - • Date '-.- - - . . •-. _ ...-•-- - _ _ - -�_- - _ 7 i