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Home My Public Portal About8720 BURGHARDT RD_Building__ 76A638A CE48038-60 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS �J BUILDING AND SAFETY DIVISION LOCALITY l JOHN A. LAMBIE. COUNTY ENGINEER NEAREST COLEMAN W. JENKINS¢UP'T OF BUILDING CROSS ST. ./ DISTRICT NO. GROUPTVPE PR SED BY FOR APPLICANT TO FILL IN CONST. BUILDINGO��O E, /PG/rAR.ol STA STICAL CLASSIFICATION SEWOR MAP ADDRESS a CLASS NO. DWELL UNITS BK PG LOT NO.,aNqjM /3 BLOCK USE ZONE MAP /F TRACT AC19,4a SPECIAL N0. aF BLDa3 CONDITIONS 512E OF LOT NOW ON LOT USE OFl 5 G G BLOB. SETBACK FROM T dT TEL. _T/O� FRONT PROP. LINE OF (STREET) OWNE O J ,/ NO. �J - TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL ADDRESS g eIA;lq HIGHWAY WIDTHR gm C.L. CITY tLIA BLOB. SETBACK FROM + ARCHITECT O TEL. / SIDE PROP. LINE OF (STREET) ENGINEER NO. - _ TYPE OFEXISTING SETBACK NIGNWAY + YARD = TOTAL ADDR E55 Ap SLE �j HIGHWAY WI OTN FROM C.L. Ch- CONTRACTORE7 (J U �r/!d/NO �q- + - O ADDRESS B NO 16 i97-6 CORNER CUTOFF YES NO 0 LIC clTr CIL A SEE REVERSE SIDE FOR SPECIAL APPROVALS V U.1 DESCRIPTION OF WORK CL Z_ NE ADD ALTER REPAIR DEMOLISH .FT. NO. OF NO. OF S12E � T 6 STORIES / FAMILIES USE OF 1 STRUCTURE L SIGNATURE OF APPLICANT VALUATION$ / B�JQ APPROVALS ATE ./ INSPEC 6R'SSIONATURE P.C. FEES FOUNDATION,FORMSMATERIALS FEE$/ (O n FRAME, FIRE STOPS, HERE By THAT THEL GE 35 HAVE AND THIS APPLICATION BRACING BOLT ANDWITH STATE THAT THE ABOVE IE CORRECT TE AGREE E LATING FURNACE: LOCATION U WITR NG COUNTY TI O. I CER AND STATE LAWS REGULATING GAS VENT. DUCTS AUTHORIZED CONSTRUCTION. CERTIFY THAT IN DOING THE WORK RUTHOF THE HEREBY 1 WILL NOT EMPLOY ANY PERSON IN RELAT- ING LATH. INT. , `( TION OF TRE LABOR COPE OF THE STATE OF CALIFORNIA RELwT- _ ING TO WORKMEN'S COMPENG#TION INSURANCE. aV• YF -� ^ �] LATH. EXT. SIGNATURE OF /�(/"v^J' J_T HOUSE NUMBER GOR- PERMITTEE � RECL AND POSTED ADDRESS Z FINAL JOHN F. LEWIS. PRINCIPAL ST T RAL ENGINEER PLAN CHECK VALIDATION cn. M.o. CASH JOHN VALIDATION CASH Lnf p 4 0 �7'�' JUL 2— 2 3 R. 2 6.7 5 A .r1'„0 1 7 i 6'- AU6 18 1 N 5 3.5 0 WORKERS' COMPENSATION DECLARATION hereby affirm that I havea certificate of consent to self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lob C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No.IDy7F� ompony BUILDING 0 Certified copy is hereby furnished. �� FOR APPLICANT TO FILL IN ADDRESS 2,0 Certified copy is filed with the unty building insp BUILDING 7�tion department, ADDRESS Date / 24 plicant % CITY ZIP LOCALITY NO. OF BLDGS. NEARESST O CERTIFICATE OF EXEMPTI N FROM WORKE S' SIZE OF LOT NOW ON LOT CROSS T. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACE BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) TEL' USE ZONE MAP OWNER O NO. I certify that in the performance of the work for which this NO. r />.t— �,�/ SPECIAL Y permit is issued, I shall not employ any person in any manner ADDRESS GSC/ �`-'✓ CONDITIONS a so as to become subject to the Workers' Compensation Laws. O CITY r ZIP U Date Applicant ARCHITECT OR TEL, Cc NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO DISTRICT GROUP TYPE FIRE PROCESSED BY y ,j CONST, f/ Z NE H Exemption, yoshould become subject to the Workers' �DO -✓ ✓ U Compensation provisions of the Labor Code, you must forth- ADDRESS w N with comply with such provisions or this permit shall be TEL / / STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTOR _ NO.6W/64( y E q LICENSED CONTRACTORS DECLARATION ,p LIC. ^ CUSS NO.nlDWE I UNITS_ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS C� NO. z_ (commencing with Section 7000)of Division 3 of the Business � ) e- �s LIC. SEWER MAP and Professions Code,and my license is in full force and effect. CIN (/ ,M�i CLASS r�Tjp BK. PG_ VALIDATION SO. FT. NO. OF NO. OF CHECK License Number Xz7.f Lic. Class SIZE STORIES FAMILIES ONE � Z y� VALUATION � Contractor /(/ /Y'qP �p pate � DESCRIPTION OF WORK NEW ❑ f ( ,(%qy�/n ► i ❑1 am exempt under Sec. ��. ADD % El nr:- a ALTER ❑ R`:4' .a B.BP.C. for this reason $ ._ USED REPAIR ❑ ate EXISTING BLDG. DEMOL ❑ Signature APPLICANT TEL FINAL WNER-BUILDER DECLARATION (PRINT) NO. DATE r ILIIyL -1-�.:w = '�3, I hereby affirm that I am exempt from the Contractor's License _ Law for the following reason (Section 7031.5, Business and ADDRESS FINAL(— Professions INAL(— Professions Code): PRESENT B , BUILDING y ❑ I, as owner of the property, or my employees with ADDRESS I f ,i'.li/ wages as their sole compensation,will do the work and LOCALITY the structure is not intended or offered for sale(Section I' 7044, Business and Professions Code.) MOVING TEL. _I.L(J_t tl(1PI1 _'rry %O"� �- El 1, as owner of the property, am exclusivelyCONTRACTOR NO.contracting with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code,) ADDRESS CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH REQUIRED TOTAL SETBACK FROM EXIST, hereby affirm that there is o construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.I. Lender's Name ? p LDMA Ref. N Permit Fee Lender's Address ,cam o I certify that I have read this application and state that the Issuance Fee 0125/ J LDMA P/C It 8 above information is correct. I agree to comply with all County Investigation Fee /� ordinances and State lows relati o building construction, Total Fee / e LDMA Perm. # a and her authorize repre ati of this County to enter upont e a ove- q on rop y for inspection purposes. o d 4e / Z� SEE REVERSE FOR EXPLANATORY LANGUAGE ignatore of i plicont or Agent Dote