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HomeMy Public PortalAbout5352 BUTTONS AVE_Building__ APPLICATION FOR BUILDING PERMIT FOR AR;P'LII.ANT TO FILL IN (Pllm Gf type GD Iv) ' .BUILDING 5352 u-7---ORIS COUNTY OF LOS ANGELES' , AooRESs DEPARTMENT OF,COUNTY ENGINEER CITU N BUILDING AND SAFETY DIVISION �/fA -ZIP _ NO.OF BLOCS. BUILDING ..�,��� SIZE OF LOT X - NOW ON LOT 1 ADDRESS t TRAC Z BLOCK I LOT NO. LOCALITY '1 OWNER /.dE S/� NO 'Q CROSS ST. { ' A55ESSOR f ADDRESSSSS Z 'To// MAP BOOK PAGE PARCEL - CITY / {� ZIP DISTRICT GROUP TYPE FIRE OCESSED BY 9/7�0 , O �. CONST:i, ZONE '. ARCHITEC OR TEL. !V/ ENGINEER NO. STATISTICAL CLASSIFICATIONSEWER MAP ADDRESS CLASS NO OWELL,UNITS 'BK G CONTRACTOR NaL 'U ZONE MAP - LI ' NO. Q C. ADDRESS NO. SPECIAL 0 LIC, CONDITIONS CITY CLASS ROAD DEPARTMENT APPR REQUIRED YES❑ NO ❑ CONSTRUCTION' ENDER NAME AND BRANCH BLDG:SETBACK FROM FRONT PROP.LINE OF `•(STREET( ADDRESS CITY HIGHWAY } YARD - TOTAL SETBACK FROMI TYPE OF EWSTING SSo.IZE FL/J IJ'T I NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH SIZE dO TORIES FAMILIES ONE DESCRIPTION OF WORK NEW BLDG.SETBACK FROM V U DD SIDE PROP. LINEOF (STREET) CC ALTER ❑ TOTAL SETBACK FROM TYPE OFY WIDEXISTING 0 ❑ HIGHWAY } • YARD = Y U REPAIR - SIDE PROP. LINE IHI WATH d USE OF } _ - © N EMOL Cl EXISTING"BLDG. - APPLICANi ,��� TEL } CORNER CUTOFF YES ❑' NO ❑ (PRINT) ��6�p/� BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑ - IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALVA T ION, I HEREBY ACRNLEDGE THAT I HAVE READ THIS APPLICATION /r• F���^ '- '"^-'� �O ��„" �o y AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH 'ALL ORDINANCES AND LAWS REGULATING BUILDING CON- /���JG'/�• �� /Vb����ly r1 // y(�Y(t J STRUC TION. 1 CERTIFY THAT IN DOING THE WORM AUTHORIZED _ HEREBY WILLNDT EMPLOY ANY PERSON IN VIOLATION Of THE LABOR CODE 0F ,THE STATE OF CALIFORNIA IN RELATING TO --/ =75�/✓Ff/JS GO/` C0L✓E/4//YG WORKMEN'S COM PE ON INSURANCE. SIGNATURE OF /1 PER- ADDRESS / . . TEL. - FINAL BY CITY NO. DATE ,11:1 FF CHECKS PAYABLE '10: FEE' FEE _ HARV.E V.T. BRA NDT, COUNTY ENGINEER PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. MD. CASH' " 255-AUL 7.:. 1 D - 35.25 ® e 7SA630A CE#005 5/74 - V I 7GA636A CE;19D36-62APPLICATION FOR BUILDING PERMIT , ,, ' COUNTY OF LOS ANGELES ' BUILDING A 1 DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY iJ7 JOHN A. LAMBIE, COUNTY ENGINEER NEAREST f WILLIAM A. JENSEN. SUPT OF BUILDING CROSS ST. DISTRI T NO. I GROUP TYPE PFSEED BY FOR APPLICANT TO FILL IN � coNs . Y ( J BUILDING STATISTICAL ClA�S5�IFICATION - S WER MAP A DDR E55 CLASS. NO.-CLASSIFICATION UNITS `�� BK/ G LOT NO. BLOCK WATER CERTIFICATE: NOT REQUIRED RECEIVED TRACT f� MAP q�/� HlcHwnr STATE MAJOR SECOND. OCA�/� NO. OF BLDGS. MAP ICIRCLEI {, SIZE OF LOT Q C NOW ON LOT USE ZONE SPECIAL USE OF ..�-T ! CONDITIONS EXISTING BLDG. c, f TEL. OWNE NO. BUILDING YARD HWY STRE T N ME EXIST. SETBACK WIDTH ADDRESS !/ FRONT OR/ TEL. P. L. L•4 ���� +L/ ENGINEER NO SIDE P. E ADDRESS / A / O TEL U CONTRACTOR T' NO. (/, / - ADDRESS C DESCRIPTION OF WORK 0 W NEW D ALTER REPAIR DEMOLISH O_ N SO. FT. NO. OF Z ST SIZE STORIES FAMILIES — USEOF STRUCTURE �/f -; GAY f 2 2 SIGNATURE OF APPLICANT -` 7 VALUATION $ � APPROVALS DATE INSPECTOR'S SIGNATURE PC PmT.FEE $ FEE $ d- FOUNDATION: LOCATION FORMS. MATERIALS FRAME: FIRE STOPS. / I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS / AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS / BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK I / AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. l ING TO WORKMEN'S COMPENSATION INSURANCE. I LATH. EXT. SIGNATURE OFHOUSE NUMBER COR 1 ' ' \ PERMITTEE RECT AND POSTED /� ADDRESS f. ?21 511/1'M n,vT FINAL 6NfL�,- A,/Gh� V���J /*�.,yyiy:�✓�..�' JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGI R PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.D. CASH LhIL0 9 22 5 1 .jim;i g 1 D 6.00- 76A633 8•e=.6APPLICA►TION FOR BUILDING PERMIT DIVISION OF BIDDING AND SAFETY, BURRING ADDRESS Lti N , DepDTtment of County Engineer q y� County of Los Angeles LOCALITY C.�" WM.J. FOX, COUNTY ENGINEER NEAREST 0d�-C� jr I .. C_ASSATT D. GRIFFIN, SUP•TOF BUILDING - CROSS ST. DISTRICT O. GROUP TYPE SE BKPG CONST. FOR APPLICANT TO FILL IN V L I ✓ BUILDING,1^3s—g T1� NUMAPMBER �V HWY fig® TATE ADDRE59 dd_/_�¢ /LOT NO. /` BLOCK _ U9E,Z NE SPECIAL(J CONDITIONS TRACT ppy i/ p 4 I NO. OF BLDGS., BUILDING EXIST. SIZE OF LOT T 7 NOW ON LOT SETBACK YARD HWY 9 NAME WIDTH USEFRONT •' zr EXISTING N NG BLDG. P L. N OW NEIj 9/iPi.A,. Q SIDE MAIL �< ^ ADDRESS e� OL. I O TRACT DWELL. 1 UNIT 5 INDUSTRIAL TEL. 1 DWELL. 1 UNIT CITY Zt(T- NO. 6 PUBLIC BLDG. 2 DUPLEX 1 UNIT ARCHITECT OR� • /2 TEL. 7 ADON., ALT., ETC. ENGINEER ///niBiawA �+'��d1101 3 APT. _UNITS ' B M19CEL. ADDRESS 4 COMMERCIAL TEL. INSPECTION RECORD CONTRACTOR /Yw'[ TEL. ADDRESS DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH 9 SIZE � NO, ONO. OF yR� BTFAMILIESRIEF 9 9T V / SIGNATURE OF APPLICANT �J( APPROVALS ry ADDRESS ,O Z stiff I DATE INSPECTOR'S SIGNATURE _ FOUNDATION: LOCATION FORMS. MATERIALS , FRAME: FGRE STOPS. �f k� VALUATION (JY - 'S O� BRACING, OCBOLTS �F tlL.t._I' FURNACE: LOCATION. - 1 HEREBY ACKNOWLEDGE THAT i HAVE READ THIS GAS VENT, DUCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECT ! AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. t 3 ,2V TMM�A�.///A����'''�SSYYD��---••"--���� AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. LATH. EXT. W SIGNATURE O HOUSE NUMBER COR- PERMITTE���ttlttivvv REST AND PORTED I ADDRESS FINALL4�_ WM.J. FOX.COUNT'ENGINEER VALIDATION C. N.DIRLAM,CHIEF BLDG. INSPECTOR j{G3798 MAR .6 16 1 9.0 0 3799v tN 6 1 3 8.0 0 In i ' r WORKERS COMPENSATION%DECLARATION -- - _� T _ --7 ,_ a . .ra I' hereby affirm that have a rs' C¢ote of consent to self /n� PPn OC n hI O®Nn FO i� OLDI n� MIAMI'1'insure, or a affirm certificatetI of Workers Compensation Insurance, _ _ (F=LT LL_ _(/� u u� u� Il�lu�u u ora certified copy thereof`(Sec'3800,'La COUNTY OF LOS ANGELES BUILDING AND SAFET'Y'.., Policy No BUILDING 4 — s�'I Certlfied,copy is hereby furnished:n , ,�� -t. '. " FOR APPLICANT TO FILL IN ' • I ADDRESS . I U N tified ropy is,1 led with the cou ty'buifcling inspec- - BUILDING /�'7 - 1 U711 tion department y + ,= ".t,"'+% ADDRESS J J� Z- J - ^�� -• C,li+�c , Date .._ / .._ �(/r /L_ ZIP LOCALITY _ V' CER IFIL E OF EXEMPTION-FROMORKERS' ?`'•' '-- -"* ` - - `-N OF BLDGS. - NEAREST- _-- --4-�•- .-..^•. - ---- -- + ` t {•" ^+°''COMPENSATION INSURANCE t, . . SIZE OF LOT TW ON.LOT CROSS ST. .. '(T iislseclion need`not be.completed if'dhe permit'is`for one - " --- - --- "= - - -- - - ------ ASSESSOR ' hundred dollars ($100)or.less.), , TRAC7 .. BLOCK LOT NO MAP BOOK - PAGE: PARCEL i TEL I;certi4y that in`the+performance of the'workdfor which this OWNER - --V'L LN-14-;J-'- NO. U -� z U 7zONE ;.Y permit a issued_'I shall not employ any person In any,manner /Sq'E• 1 ,./� SPECIAL•+. - - - ""-- 1y d so as to became subject to the Workers'Compensation Laws. ADDRESS 'S 4-"�^' [r CONDITIONS 1 t V T.. t,. M 1- Ca i. .. -• ,f . . ,. . _ _ .' _ .ZIP. . - ..__ - .r _t _ _ _ i C APphcant t ARCHITECT OR TEL. 1 -- O NOTICE TO APPLICANT If'ofter making- this Certificate of DISTRICT _ GROUP TYPE FIRE PRO ESSED BY f.. ENGINEER NO. U Exem tion ou' should become subject to the 'Workers' _ CONST t , ZON `t 6ompensation•provlvons of the Labor Code you musGforth ADDRESS - SO "". - -/ - - -- -- with comply with,'such provisions or, this%permit shall beZ. -- STATISTICAL CLASSIFICATION APT CO deemed revoked +^ + {_ +-„A CONTRACTOR (J/ NO. l�Z LICENSED CONTRACTORS DECLARATION,,R ---- ) "LIC. 6/ O / _- N CL455 O -L! �DWEiL UNITS ry T I hereby offirm that Porn licensed under provisions of Chapter 9 ADDRESS Q W- C �// �- NO. ` (commencing with Section 7000)of Division 3 of the Business and - - _ �. -"-_..,LIC c SEWER MAP - ProfessionsCode, and my license is m-full farce'and effect. . CITY L" U�JI NS CLASS ( i - ' - - = 1 - VALIDATION- 9 SQ. FT. NO. OF _ NO OF CHECK; + BK: PG LKense,Number Uc.Clas, 3S SIZE - STORIES '” FAMILIES ' ONE + - O - VALUATION_ " - % %y� ��/' '+ ✓ 'YTote �' - DESCRIPTION Of WORK - �.1� 0� - - - - ^ NEW :❑^ Contractor ❑ $ /-� % - - -- to. .Ci .S - - �I�r%� r�tiL .ADD �.I am exempt under Sec - ALT- - r - ER B 8P C. for this reason _ - � •. REPAIR °-- - - -' USE 9 T - 'Date ' -' OF DEMOL EXISTING. Q ` x •-- , 8 - - - APPLICANT TEL. FINAL h - e • e 7. _^�.. 3 OWNER-BUILDER DECLARATION PRINT) NO. ) .� O A.A$•L], $.rU ,,Lherebyaffirm that, exempt from.the Contractor's License - ' `- - - - - - -, DATE --- G C v u Law for the following'reason (Section 7031.5, Business and ADDRESS I FINAL _p -Professions'Code): - _ _ _ _. .. _ - PRE ENT - - - - BV. . BUILDING ' ` I, as owner of the property, or my employees with • ADDRESS - .- -. _ . .. - wages as their solecompensation,will do the work and � - ` the structure is not intended or offered for sale(Section LOCALITY 7044;Business and Professions Code). _ -"'-- - `- - MOVING - - -" - TEL - - -• -- L' - - - -' - ' ❑ CONTRACTOR - - NO: - # .I o .I, as owner the property, am exclusively contracting + , -'with-licensed-contractors to construct the project (Sec- -- -' - ADDRESS tion 7044, Business and Professions Code). REQUIRED -YA ' HWY' TOTAL SETBACK FROM. _ . . _ ---_ . . _v_• - "CONSTRUCTION LENDING AGENCY RD - SET.BACK PROP. LINE I WIDTH I ` I construction lending affirm that there is colending agency for 'the performance of the work for-which this•perm itis issued (Sec 3097 Civ. C.). ry ,. -f .Lender's Name ' , LDMA Ref. N -f - .._ P.C. Fee.$ - __. Permit Fee •_ ___ i-•-. _ 1 Lender's Address „- - D .I certify I have-read this,application.and.state that the IssuonceFee- Q. LDMA P/C W- -- - �m above information is correct. I agree to comply with all County Investigation Fee - - _ f- f m _ordinances.and Stale laws relating_-to building construction, Teal Fee MA Perm M-- - �� and hereby authorize representatives of this County to enter - - LD m u e ab -menYoned pro erty for inspection purposes. 1 SEE REVERSE FOR EXPLANATORY LANGUAGE -Sig t re•of Applicant or Agent- 7 Dat