HomeMy Public PortalAbout9751 CRAIGLEE ST_Building__ � 0'
I76A638A CE#803 5-65 APPLICATION FOR. BUILDING PERMIT LJ'
COUNTY OF-'LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER' ADDRESS
BUILDING'AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,SUP'T OF.BUILDING CROSS ST.
- DIST,�CT NO. GR TYPE - PROCE SED BY '
FOR APPLICANT TO FILL IN J�� CONST.
BUILDING ` -/may p_" I STATISTICAL C�LASSIFICATI ON SEWER MAP
ADDRESS .� \,�r�--A, 6�-`-"„ :-CLASS NO.�DWELL'U•NITS "' K PG-�j
LOT NO. �/�- BLOCK - USE ZONE. MAP
NO.
TRACT_ irr�- L�i{/L.? G(I e �.� SPECIAC`'V _ - •, ..
NO. OF BLDGS. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF y -
EXISTING BLDG. C '"'t �+ BLDG. SETBACK FROM f
TEL.•S(�y - FRONT PROP. LINE OF �YZL��RE ET).
n OWNER ' •lA�����/� �q iN/O` r�aCC- }'� zTYPE OF EXISTING ,SETBACK HIGHWAY + -YARD = TOTAL -
ADDRESS r i'6`I �1,,.A- `�T•.��� HIGHWAY WIDTH - 'FROM C.L.: .. -
CITY / -- ` -BLDG. SETBACK.FROM
A-R'CFT`E'G.T IRPpj_ �ke TEL. - �.SID .PROP. LINE OF - (STREET)
ENGINEER ?'� Z _ NO. & - -
TYPE OF EXISTING SET B
HIGHWAYWIDTH FROM C:L.
ACK" NIGHW AY - YARD - TOTAL '
"
.-ADDRESS 7 .�, ,. V v°`�0"
A.� TEL.' { I + = d
CONTRACTOR �.. �l`` NO - L..8-y/
ADDRESS � rfi �LC /' 7e� CORNER CUTOFF YES NO � '," OV
LIC .
CITY f. j4 CLASS SEE REVERSE SIDE FOR SPECIAL"APPROVALS O
DESCRIPTION OF WORK v
W
v
0-
NEW
NEW - ADD �1"ALTER REPAIR -•DEMOLISH - N
Z
SQ.FT._ / NO. OF NO. OF
SIE STORIES - F
ZAMI LI ES:
USE OF ,/1" -�^ /1 A )r+
USE
�-t I -
�3 C-12 C3
SIGNATURE OF
'A.PPLICANT -
VALUATION$
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. _PMT. 6a FOUNDATION, LOCATION
FEE$ FEE$ 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
9U ILDI NG CONSTRUCTION. I.. CERTIFY THAT..'IN DOING THE WORK
AUTHORIZED HEREBY�I WILL NOT EMPLOY ANY.PERSON IN VIOLA' LATH. INT. -
TION OF THE LABOR-CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMP SATION INSURANCE.
L'•ATH. EXT.
SIGNATURE OF _ HOUSE NUMBER COR- "
PERMITTEE `••J// y �• RECT AND POSTED n //��s
ADDRESS �Jy� V'€--� ON� FI NAL No A�E4
JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENG
°PLAN CHECK VALIDATION. CK. M.O. CASH PERMIT VALIDATION. CK.' M.Q CASH
L nCi 2;7 9 5-3 juNI 14 1 D 8.0 Q'"
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qq?��I . . , `-•: . , }8.�� ` qg.�� ge a{ //18I/�// (�►� p��`.��pry
78A89BACC T.809.9-60 APPLICATION 6 ®9 i ��18..�®H \i�l' Y,� I' ! ..
COUNTY OF LOS ANGELES BUILDING - r
DEPARTMENT OF COUNTY ENGINEER ADDRE Z ."
BUILDING AND SAFETY DIVISION LOCALITY
JOHN-A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENS_EN-SUP'TOF BUILDING CROSS ST.
DISTRICT NO. GROUP BY
cSD
FORAPPLICANT NST.
L IN
BUILDING _ _ STATISTICAL CLASSIFICATION ZBK
VER MAP
BUILDING
PG
ADDRECLASS. NO. DWELL-UNITS _
LOT NO.. BLOCK MAP. STATE YES NO� '
NUMBER �(/ - HWY.
- TRACT -USE ZONE - .SPECIAL
SIZE OF LOT �(! (,`?�I'NOW ON LOTS• �. CONDITIONS '
USE OF
EXISTING BLDG. / BUILD.INGEXIST.
TEL `/�' SETBACK YARD FiWY �I R T NAME WIDTH
OWNER NO. YYJ' FRONT
P.L.
ADDRESS �� %22t'� SIDE .
ARCHITECT ORT EL. P.L.
ENGINEER NO INSPECTION RECORD
ADDRESS - CL
a_
.. TEL. O.
CONTRACTOR : o. /S/1[`y� / NO. V
.P ADDRESS � A - O� �DEui—
SCRIPTION OF WORK AL NEW ADD ALTER REPAIR DEMOLISH �p ��•�,r N
SQ.FT. NO.OF NO:OF - ' .� f/71 '../! P� /',�'!"'��„'3i•,!''J. Z..
a SIZE Z STORIES F MI( ES f/r/�'/, -
USE OF J A.�/LG� .� GSI. •_�� .
STRUCTURE 4F �.
901GNATURE F `� "•••��• ��
APPLICANT 14 ,.�
-VALUATION$ ,�I .. �! dd L _
APPROVALS DATE INSPECT, R'S'SIGNATURE
P& MT c PMT. FOUNDATION: LOCATION'
FEE $ `�++ I FEE $ ":.�/ '4 FORMS. MATERIALS <
FRAME: FIRE STOPS,
I HEREBYJAC KNOW LEDGE THAT.I HAVE READ THIS APPLICATION BRACING,.BO LTS b/ -
AND STATE,'THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE: LOCATION;
WITH ALL .COUNTY ORDINANCES AND STATE 'LAWS REGULATING 'GAS VENT DUCTS Z '
BUILDING CONSTRUCTION. I CERTIFY THAT IN THE PERFORMANCE . - -
OF THE ;WORK FOR WHICH THIS PERMIT IS ISSUED I SHALL NOT'
LATH,
EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBUECT .INT'. �•� /.!/7A .�_�'
TO THE WORKMEN'S COMPENSATION LAWS OF. CALIFORNIA. v
- LATH,�EXT. / J J
SIGNATURE D HRECT AND POSTED COR-
PERMITTEE _ -
ADDRESS - FINAL
CLYDE N. DIRLAM, PRINCIPAL ST URAL ENGINEER
PLAN CHECK VALIDATION cK. M.O. CASH PEPMT VALIDATIONUK. M:o: CASH' '
UL 17
Au"� 1 2 9 , ��3 7 � � o �-.G 0,
WORKERS COMPENSATION DECLARATION
1 hereby affirm thatty have,a certificate of consent.to self Qa O D Q,+. D p_. D . D O
insure', or a;certificate of Workers' Compensation)nsur`ance, la p p d D QU�O H. F O Q. Q UJp d Q�
or a certified copy thereof (Sec.'3800°Lab: C
a - -
COUNTY OF LOS ANGELES BUILDING ARCD SAFETY'
Policy No ;Company � z.. �✓/
- _
Certifiedwcopy:is.hereby.furnished:. ,. FOR.APPLICANT TO FILL IN`, ., ` BUILDINGDY ^' 7S� n �i•J
Cerhfied;copy is filed with the county building inspec BUiLb NG' #
y
�' d.
on department., ^r.• - ADDRESS �J `�� -
Date l Z.3+��4pphcdnlCITY ZIP OCALITY '
r
` - O.OF BLDGS_:-,:. ,-_ NEAREST> ..
C RTIFICATE OF.EXEMPTION FROM WORKERS
'COMPENSATION INSURANCE
SIZE.OF LOT NOW'ON LOT CROSS ST.
_ . ._ ASSESSOR
(This section'need not be completed^•if-the permit is for one - - - i.
hundred dollars($100)or less.,) TRACT' BLOCK. LOT NO MAP'BOOKr * PAGE PARCEL
OWNER �: O- N L." USE NE MAP i
Z•
I cerfify that'in the performance of the work for which,this NO. < y'
,;
permit is issued,'I'shall.not employ an person in an manner _ SPECIAL
so as+To become'subject To the Worke sPCompensot ori`Ldws.-. ADDRESS �'1-'��" CONDITIONS _ V
r. CITY . ZIP ®.'<'
Date Applicant•.
i - ARCHITECT OR,' TEL _ t DISTRICT, ,GROUP TYPE FIRE_ PR C SED:B/ 0
NOTICE TO'APPLICANT; If, after making this Certificate of ENGINEER NO:'
EXernption \you, 5hould•"become subject to the'Workers' - - - _
CONST ZONE
Compensation•proyisions of the Labor Code,,you;must forth- ADDRESS - - V
with-comply. with such-,provisions or,this permiyt shall- be - - - -
3
deemed revoked ,• : CONTRACTOR U NL, _ }M
t, �
STATISTICAL CLASSIFICATION APT. '.0 DO f
LICENSED CONTRACTORS DECLARATION,.. ,•, ;s- _ •- ,' LIC.
CLASS.NO. DWELL. UNITS
(hereby.affirm thaf I am licensed under provisions of Chapter ADDRESS , l.i/ U�!C ✓�„_ NO:;'. w J� t
(commencing with Section 7000)of Division 3 of the Business and _ ; .LIC, E
c SEWER MAP:. , 1.
Professions Code,'and my license is m,ful6;force'aruli.effec't. CITY UCS' M / CLASS. - ""` .'VALIDATION
<, ,
BK PG
(!/c / SQ,FT NO OF NO:OF CHECK_ 1
License•Nu er Lic.Class" ' SIZE STORIES FAMILIES ONE. +
VALUATION J
7 .: DESCRIPTION'OF WORK' ' P:.��U NEW
Contmc y ADD � ( `
•Date $
I am exempt under Sec l�"(:�-t") C2 rr F� D A
ALTER
B.&P.C.•for this 'reason REPAIR.~: Y
�3.255A
az USE`OF i
,f
Date 5• EXISTING BLDG.- ;DEMOL ❑ # o
lt; _. ,.: TEL... FINAL
SrgnaTure APPLICANT '
PRINT) NO _ z _�
OWNER-BUILDER DECLARATION _ DATE: [f o v.,7-8 O O - :,--
,",I hereby affirm that I am exempt;from•the Contractorfs License w
Law for the following reason'(Section 7031.5; Business and ADDRESS FI x.
w.
":Professions Code): . PRESENT"
7aoo�.,
' I, as owner of the Property, or pmy. employees with Y, BUILDING
DDR SS
F i'p23 :•85
._-. _
wages astheir sole compensation,will"do the work'and
the,structure is not intended or offered for.sale(Section LOCALITY '
.k
7044,'"Business and Professions'Code):' MOVING
with"Iicen owner of theconproperty, am exclusively contracting CONTRACTOR NO
property,Y, _
to-construct-the project'(Sec _
tion 7044, Business and Professions Code). ADDRESS.c w r
REQUIRED TOTAL.SETBACK FROM XIST._.
YARD �HWY
" CONSTRUCTION'LENDING'AGENCY " SET BACK- PROP. LINE. , WIDTH _
I hereby affirm that there is a construction:lending agency for, ' FRONT Y
the-performance of the work-for which this permit?is issued - P:L: - +
(Sec.3097, Civ. C.). SIDE
Lenders Name _
Fee.-
P.C. _ _
LDMA Ref. # * t
_ (O
--•- Fee$ Permit
Lender's Address
(,certify.that. I have read this.,application.and state_that the Issuance Fee G CDMA P/C#
a above information.is correct. I agree to comply with all County Investigation Fee
� .
o' ordinances and State laws,•relatin to building construction,
9- 9 _ __ _ - total Fee (J `' CDMA Perm. # w r }
'u and hereby a horize representatives of chis County to enter
he ab en ioned pr perty for inspection purposes.
• r! L�li jn:Z�G LO \
EE SREVERSEy 1 FOR EXPLANATORY LANGUAGE
J
-•Signature.of-Applicant or Agent - 'Dat - - -_ .-- _ _ - _ __-• ._ _._ 'QQ i
i