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HomeMy Public PortalAbout10646 BOGUE ST_Building__ r ADBe•H !1.55 APPLICATION FOR 'BUILDING -PERMIT 1,1.55 DIVISION OF BUILDING AND SAFETY ADDRESS NG 00�4�,Oytl Department of County Engineer County of Los Angeles LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN, SUPT OF BUILDING CROSS ST. !� FOR APPLICANT TO FILL IN DISTRICT No. GROUP TYPE SEWER MAP BK, PG CONST. BUILDING �q ADDRESS tp• � C..� NUM ER;--? Sj{yAyy YES LOT NO. US BLOCK Y ZONE SPECIAL / CONDITIONS TRACT I _ , SIZE OF LOT ��-X.//Q7 11 NO. OF BLDGS.•� BUILDING - EXIST. R NOW ON LOT USE OF YARD HWY STREET NAME SETBACK- WIDTH ' EXISTINGBLDG. . ^ - FP. LT f _ „� , OWNER/�'✓•ri�.C.c.l. �.LNY /tSL.,G�C_. SIDE .26 �-j —� ��Qp fir' P. L. ADDRESS��ij�O _ 011ier /-+(.*•�1G, Kd�/ O TRACT DWELL. I UNIT J 5 INDUSTRIAL CITY, " NO OIL •-300 I DWELL. Q 1 UNIT 6, PUBLIC BLDG. ARCHITECT OR TEL. 2 DUPLEX 2 UNITS, 7 ADDN.,ALT., ETC. ENGINEER NO. 3 APT. Z UNITS 8 MISCEL. ADDRESS 4 COMMERCIAL CONTRACTOR L� ..,,,0Q , Nro&.7•- 36 0 INSPECTION RECORD ADDRESS&10 _j,tFL, /A,4-U4m1y DESCRIPTION OF WORK NEW ADD ALTER . REPAIR DEMOLISH SQ. FT. NO. OF NO OF SIZE � 1 " STORIES / FAMILIES ` USE OF STRUCTURE , SIGNATURE O ' APPLICANT APPROVALS ADDRESS qb dcz. DATE INSPECTORS SIGNATURE FOUNDATION: LOCATION P. C. $ �r[ FORMS, MATERIALS / v FEE FRAME: FIRE STOPS, ® VALUATION, l S © _ BRACING, BOLTS V � VliT.rv1 I FEE �- FURNACE: LOCATION, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT, DUCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECT A AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT. AND STATE LAW�^y REGULATING BUILDING CONSTRUC- - TION. F'(/`J1� LATH: 1 EXT. SIGNATURE O HOUSE NUMBER COR- � PERMITTEE RECT AND POSTED S ADDRESS ' FINAL `l7 ,r JOHN A.LAMBIE. COUNTY ENGINEER VALIDATION CLYDE N. DIRLAM, CHIEF BLDG. INSPECTOR CK MO CASH - ,r� A 4. 8',1- OCT 1.9".1 •6 s.,ta _ , 1' G-,:-OCT 23 1 30.0--o 4 -'76A638A.-� -i' D3 5-65 APPLICATION- FOR: BU I•LDI NG, F / IT ,� . COUNTY OF LOS ANGELES BUILDING - DEPARTMENT OF COUNTY%ENGINEER BUILDING AND SAFETY DIVISION_- . LOCALITY JOHN A. LAMSIE.,COUNTY ENGINEER'. NEAREST �,(O COLEMAN W JENKINS,SUP'T of BUILDING CROSS ST DISTRICT-•NO :GROUP- -T YPE� PRO ,SSED BY FOR APPLICANT ,TO'FILL.IN coNsr`' �< BUILDING r�/'. s v: /+ ST'AT'ISTICAL' C IFI 'TION SEWER'MAP ADDRESS CG' (a �V� CLgSS•N0'-_DWELL x �� UNITS ,BI-_' PG—� LOT NO - BLOCK, •r. USE ZONE MAP ` 'NO. .TRACT - f � SPECIAL,-- �'- 'CONDI TIO _ NO. OF BLDGS. - _ -�• - - SIZE OF LOT � �( - -NOW ON LOT ( _ USE OF / EX IST,NG'BLDG. za BLDG.`SETBACK FROM - ' �/r L�L� " y TEL - FRONT.PROP.'LINE OF CCL (STREET) OWNER @ J' NO ' TYPE OF E%]STING- SETBACK HIGHWAY + YARD'r = TOTAL , ADDRESS - 'HIGHWAY WIDTH 'FROM'C.L ' CITY fl el-Alt '- - A/7 ARCHITECT OR TEL --- BLDG SETBACK FROM - - - ENGINEER, - NO _ SIDE PROP. LINE OF - (STREET) , _ TYPE OF 'E%ISTING SETBACK HIGHWAY + :YARD - .:TOTAL ADDRESS HIGHWAY WIDTH FROM C-L ' T /v - EL ,.. + -... _ cy CONT-R ACTOR. NO - "O O ADDRESS 0O oxL,U/ 4} X-M 5`7`1CORNER'CUTO,FF YES NO El V CITY p `T /L' C LASS ,SEE REVERSE SIDE f OR•'S.PECIAL APPROVALS O DESCRIPTION OF WORKuj u NEW kADD ALTER - REPAIR -DEMOLISH ' S Q.FT N O. O F _N O O F 1 _ "`�h C.e+C.'Q`•7-`� Y^" Z SIZE STORIES _•FAMILIES USE OF STRUCTURE SIGNATURE F .rc it - _ � - • ..APP LIC ANT VALUATION$ - �-J� APPROVALS DATE, .'INSP'EC_70R'S SIGNATURE P.0 s PMT ,� F�OUNDA''TION,'LOCATION /�`� .As ¢. FEE$ , FEE$�I,l� i FORMS, MATERIALS - (� _ - r 'FR AME,'FIRE STOPS, I HEREBY .ACKNOWLEDGE THAT I HAVE,READ THIS APPLICATION f BRACING BOLTS-'. _-AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COM`' 'FIURNACE: LOCATIONWITH­ALL COUNTY ORDINANCES AND STATE LAWS REGULATING- GA$ VENT DUCTS' ' 9U ILDING_C TION 1 CERTIFY'THAT IN"DOING'THE"WORK AUTHOR] HEREBY I ILL NOT.EMPLOY ANY PERS IN VIOLA- LATH. INT TION O THE LABORCOD OF THE STAT OF CALIF NIA RELAT ING T WORKMEN 5 COMPE SATION I U NCE LATH`EXT - • �3o-�Cp .. - - - SIGN URE'OF _ +HOUSE NUMBER COR-- 'FERMI E �)' ry ' RECT AND POSTED.- Ji ADDRESS © L "-�Jr" NAL. JOHN--FLEWIS. PRINCIPALS 6TURAL ENGINEER PLAN CHECK VALIDATION cK M-O CASFI _ PERMIT'VALIDATION ' cK M o CASH ,9 '5 2-3'0 ._FEB 9 2 3' Q -. .1.2.7 5 a _. Lr o:.9 5.,2'4,0' FEB,. 91 D - _2 5: r. �, WORKERS' COMPENSATION DECLARATION r I hereby-affirm that I have a' certificate of consent to, self, rrsure, or a certificate of Workers Compensation Insurance, APPLICATION FOR BUIL DINGPERMIT or-a cer�i�ied copy thereof (Sec.- 3800,.Lab.'.C.) COUNTY OF LOS ANGELES (BUILDING AND`SAFETY Policy No, . VCo'rripany ' 105Kkd' BUILDING r ❑ Certified copy is'hereby furnished... FOR APPLICANT TO FILL IN, ADDRESS. LD .90 Certified copy is filed with the county building inspec- BUILDING / ` - "op -tion department:, ADDRESS 1ObtfQ E ST. (E' CMK [ CITY' CE '-G C ZIP LOCALITY Date; ' Applicant' i. NO. OF BLDGS NEAREST CERTIFICATE'OF'EXEMPTION,FRO ORKERS'' SIZE OF,LOT O X65 NOW ON LOT CROSS ST `COMPENSATION INSURA CE• C ASSESSOR :- L (This section need not.be completed if•the permit;-is for-one' TRACT =BLOCK. LOT NO' MAP BOOK S v PAGE (OIO''"PARCELOO •hundred dollars ($100) or less.)" • - ',=k _ TEL ��p OWNER AR.. h1�J LL NOS-loLB - USE.ZONE MAP NO 4 I certify-that in the performance of the work'for which.this / SPECIAL a } permit is issued, I shall not employ anyperson in.any manner, ADDRESS.-• �D�`f6 - - O(JkE CONDITIONS so as to become subject to the Workers'Compensation.Laws: - 0 CITY-- u C ZIP K- Date'- Applicant' ARCHITECT OR .` TEL. DISTRICL, GROUP TYPE. FIRE PROCESSED BY- NOTICE TO APPLICANT: If, ,after;tmakinthis,.Certificate of ENGINEER NO 9 CONST ZONE. O Exemption, you -should become'-subject ,to the`Workers' O� - 3 ; ✓ 3 Lu- CL Compensation-provisions of,ihe Labor Code;you musYforth_ ADDRESS :.with comply'with such provisions or'this.permit•'shall be' TEL G'7 STATISTICAL CASSIFICATION APT, CONDO to deemed revoked.. ` CONTRACTOR Ra�+eaor NO. Z :LICENSED,CONTRACTORS DECLARATION,_ ^ LIC (� CLASS NO 7 DWELL UNITS - I hereby affirm that I am licensed u'nd'er provisions of,Chapter 9 ADDRESS 2 C..r C•NO SEWER MAP (commencing wrth,Section-7000),of Division 3 of the-Business CITY .COV IA[ C C ASS t and Professions Code,'a my license is in'full force and effect. BK. PG VALIDATION SQ FT." NO. O NO 'OF CHECK License Number `}� 3� Lic Class d'� SIZE STORIES FAMILIES ONE Ano-) VALUATION Contractor j Date' _ 1fcl DESCRIPTION OF WORK /�- I�++YrI NEW ❑ '$ Z CUD - ��: l ooCC W� RODS I f�tl1710 ADD I.am 'exempt u der Sec. ALTER ❑, ► B,BP.C. for this reason REPAIR ❑ $ - Date: USE.OF ��. " EXISTING BLDG' L�- 4 , " DEMOL ❑ Signature APPLICANT TEL FINA OWNER-BUILDER DECLARATION (PRINT)' / MOjJ NO �b�a.�S 2.n DA :I hereby affirm that I am exempt°from The Gon4ractor's License A, L`aw for the-following reason (Section 7031.5, Business and ADDRESS d�' �.! rsiC, KJ� FINA Professions Code): PRESENT _ By. - BUILDING .•❑ I, as owner of the property;or my employees with ADDRESS -wages as their sole compensation,will do the work and `' al ) ;; •- f' - " .'a •.; - _ ,_ ,_- the structure'is not mtended.or offered for sale(Section LOCALITY �T r 7044, Business and Professions Code.) MOVING TEL. ❑- I, as.owner,of tK ro ert am"exclusive) contracting CONTRACTOR NO i P P Y. Y 9 w,�3 a 'r' with licensed;contractorsao construct.the protect (Sec- � ADDRESS - ' ' Tion 7044, Business and.Professions Code. - _ REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION'LENDING'AGENCY SET BACK YARD HWY PROP LINE WIDTH - -I JET= "thereby affirm that there-is'a construction lending agency for , FRONT ', ::,Hf•� �:t16-performance of.the work'fo_r wHich,this'permit is;issued P L' `- (Sec. 3097, Civ. C ). , SIDE Lender's'Name _ ''ti s£ _tt_EiE' _,;_'°=•k`.i 3 i - LDMA Ref. # .c Lender's Address P C Fee$' Permit Fee - IN • I.cer{rfy that,I have read This'application and state that the r Issuance Fee )DMA 8 above information is correct. I agree to comply with all County Investigation Fee o ,ordinances and State laws relating to building construction, - Total Fee 7 r'� LDMA Perm #• - - <' and hereby authorize representatives of this County to enter- 'up on.th nter'upon.the a rfienVno property'for inspection purposes. SEE REVERSE FOR EXPLANATORY•LANGUAGE _ tSignature ofApp cant or Agent - Date _ I _