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Home My Public Portal About10709 DAINES DR_Building__ VS 7646jSA CE08031RIII APPLICATION FOR, BUILDING PERMIT _ COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN Ej BUILDING f'O 70 ADDRESS / BUILDING '- Al DRESS i)aL LOCALITY NEAREST CITY7rkmolZIP '(,1 CROSS ST. 3:5-1 OT11�6 NO.OF BLDGS. ASSESSOR SIZEOFLOT _ 'NOW ON LOT MAPBOOK, PAGE PARCEL DISTRICT GROUP TYPE FIRE SEED BY TRACT ) BLOCK LOT NO. CONST. ZON OWNE O. 11•(' o STATISTICAL CLASSIIFTIC/ATI MAY � ADDRESS_� (,�C �YI C.S CLASS NO. DWELL.UNITS BK PG CITY f1 ZIP''n V//,, . .� ARCHITECT OR IIF TEL. Fy VALUATION qj ENGINEER --�-�. NO. (JC ADDRESS BLDG.SETBACK FROM TEL FRONT PROP.LINE OF ISTREETI CONTRACTOR S C 4 NO, TOTAL SETBACKF ROM .TYPEOF EXISTING LIC.,,, HIGHWAY + YARD . _ FRONT PROP.LI NE HIGHWAY WIDTH ADDRESS NO. LIC. + _ CITY CLASS BLDG,SETBACK FROM CONSTRUCTION LENDER SIDE PROP.LINE OF (STREET) NAME AND BRANCH - HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING ADDRESS CITY _ SIDE PROP,LINE HIGHWAY WIDTH O 50.FT. SNT OF NO.OF CHECK + - - V SIZE STORIES FAMIU ES ONE J9 0 DESCRIPTION OF WORK 'ri c- C "f NEW ❑ P.C. Fee$ Permil Fee ADD ❑ Issuance Fee N ALTER Y REPAIR ❑ 'Total Fee USE OFI DEMOL EJEXISTING BLDG. e- n/ n./` f.' ZO APPLICANT TEL- - IPRINTI D BY ISIGNATURE i // Y THEREBY ACKNOWLEDGE iAHAVE RECO APPLICATION AND STATE THAT THE ABOVE IS CORRECT ANDND AGREE TO COMPLY WITH ALL ORDINANCES x AND LAWS REGULATING BUILDING CONSTRUCTION. CERTIFY THAT IN DOING THE V WORK AUTHORIZED HEREBY WILL NOT EMPLOY ANY PERSON IN WORKMEN SCOW. " IH E LABOR CODE OF iHESTATE Of CALIFORNIA IN RELATING TO WORKMEN'S COM Z _ PENSATI ON INNCE._ ' 51 SIGNTU PERMTTEEE F /�.'t ,A 1��/C./'� �(J _ •YJ r' ADDRESS - ` Z =5:3.31 IA \ . �•/I TEL e�e}e y'e 1 CITY UNE }} -- NOP '2 Com) U ��_ Q� °'°3Q,Q SPECIAL H 'e'e'e 3400 CONDITIONS FINAL Q �� BY . 2L s DATE _ COUNTYOF'LOS ANGELES BUILDING AND SAFETY .. WORKER'S COMPENSATION DECLARATION FOR APPLICANTTO FILL IN BUILDING ADDRESS I hereby affirm that Ihave,a certificate o; consent to self insure, BUILDING ADDRESS on a certificate of Workers Compensation Insurance`or.a certified O Ael r• ,. _ 'i copy thereof.(Sec.3800,Lab✓C.), cliY _ J- - ZIP D8•T ooGYJ70/. rfo to /�'✓ia�I .tom' T LOCALI / Policy Ne Company _ SIZE LOT - NO.OF BLDGS.NOW ON LOT - ❑,/Certified copy is hereby'fumished. - - NEAREST CROSS T' - lo (certified copy is filed with the county building inspection' t TRACT BLOCK LOT NO T department - USE ZONE MAP NO. II ASSESSOR MAP HOOK - - PAGE- -- PARCEL - _ • Date Applicant Ter'%Yefe/r ACIdMf d — �- SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' owNER ret No. _ • /`� !/ COMPENSATION INSURANCE rl`i:rel •/`�3-O/ 7 WITHIN 1000 FT OF SCHOOL? ' YES NO - This setion'need not be com leted if the ermit is for one hundred ADDRESS ( cP P DISTRICT- GROUP TYPF,CONST. FIRE ZONE PROCESSED BY dollars($100)'or less.) - - �/I/�K/moi CITY ZIP p I certify that h the performance of the work for which this permit. - O _ 2 ' is issued, shall not employ any perm at any manner sous to J beCOme'SUbjeCi t0 The Workers'Compensation Laws. - - ARCHITECT OR ENGINEER. TEL NO. P � STATISTICALGLASSIF DATION APT CONDO ' Date Applicant, ADDRESS - - _ CLASS NO: DWELL UNITS 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 BACK YARD .HWY PROP LINE WIDTH Compensation provisions of the Labor Code,.you must forthwithf FRONT comply with such provisions or this,permit shall be deemed revoked., A REPS LIC NO. P L LICENSED CONTRACTORS DECLARATION 1sd` a Irwcl• . Gf"PB.Pl� SIDE GITV - LIG CLASP PL I hereby affirm that I am licensed underprovisions of Chapter 9 100.4SEWER MAP (commencing with Section 7000)of Dlvision,3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES' Professions Code,and in license Is In full force and effect. 8 . � NEW El BK - PG License Number.lr -�gZr UQ Class G-P7 - DESCRIPTION OF WORK ADD R VALUATION//,� �O D Q Contractor 1m2 'Ns�r.L Leaf: Date f'70'9b nor •f r t ALTER ❑ $' / / �0• 0 / F 11I am exempt under Sea REPAIR ❑ Q B.&P.C. for this reason DEMOL ❑ LOMA PIC Date: - USE OF EXISTING BLDG. URM ❑ - Signature _ APPLICANT(PRINT) TEL NO. LDMA Perm k _ - ? S Cl I, as owner'of the property, or my employees with wages as f �w�* G��/'?•Z O their.sole compensation, willdo the work and the structure is ADD ESS _ not intended or offered for sale (Section 7044, Business and ,r.• O✓�A' I BN N FINAL DATE f' / •a 1 _ I-' ProfE5SI0n5 Code.) WILL THE APPLICANT OR FUTllRE BUILDING OCCUPANT HANDLE A HAZARDOUS'MATERIAL �} `_Z•-' 9V OR A MIXTURE.CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE I J i S - ❑ I, as owner of the property, am exclusively contracting withFINAL BY > _ '�-. AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE4 licensed contractors to construct the project (Section 7044, YES❑' NO l� - 1.{ �L -` 3---'- Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH - •-'�"-�'L "- CONSTRUCTION LENDING AGENCY -COAST AIR DUALITY MANAGEMENTDISTRICr ISCAOMD)SEE PERMITTING CHECKLIST FOR-, - - Gu1DeuNEs.' _. - ' i'I-11'ZG I hereby affirm that there is a construction lending agency for YES El NO - - the performance of the work for which this permit is issued(Sec. ' rnHAVE READ THE HAZARDOUS MATERIALS INFORMATON GUIDE AND THE SCACMD PERMITTING 30W,Civ.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, (•-('i'�•'r ,,..) =j iS�,C TITLE z,CHAPTER 220 SECTIONS z 20 IDD THROUGH 2.20.140 CONCERNING HAZARDOUS EI I ,1_r I {}i • _ Lender's Name MATERIALS REPoanry AN D>O OBTAim A P IT FRoM THE scnomo. o Lender's Address: - 'C 11111r� 1 I{ moi, G) MNER OR AGENT - . o I certify that I have read this application and state under penalty RC.FEE PERMIPFEE of perjury that the above information is correct.I agree to comply with all county ordinances and State laws relating to building < construction, and hereby authorize representatives of this County ISSUANCE FEE C (o s to enter upon th/epbove e/ntionedOperty for inspection purposes. - - - .//l1�i1/rG J7S z?�f✓u 4'/Y-9� INVESTIGATION FEE - TOTAL FEE / ire—or AupTem o,nWm ome (O SEE REVERSE FOR EXPLANATORY LANGUAGE - WORKERS' COMPENSATION DECLARATION 'ji •-�I I hereby affirm that i have a certificate of consent to self f1 //[�� O D �/[� //p�� rry,�� FOR �1p�p�(/�� PER �/A❑� ILIS insure;'or a certificate of Workers' Compensation Insurance, - APPd�ICQcr. ®0N 11 OR MID�U V.G 0 .ISU�1YG T - -6r a certified copy thereof(Sec 3800, Lab. C COUNTY OF LOS ANGELES BUILDING AND SAFETY .. Pal cy NoQt ti.3 1 15 - Company S 1 ATt h IP•Po')) BUILDING ®.. Certified copy is hereby furnished.. FOR AP TO FILL IN ADUREss D Vz f 011 3 5 i've t ❑'. Certified copy is filed with.the-county building nspec- BUDDING - 'tion department.- '; ADDRESS k< �'] L s 1"s - '"" - P lj LOCALITY Q .x NEAREST _ " Date Applicant _ CITY Y• C ZIP x CROSS ST. - �'I�E YI' '. CERTIFICATE OF EXEMPTION FROM.WORKERS' - - N .OF BLDGS. ASSESSOR - "' ,COMPENSATION INSURANCE - SIZE'.OF LOT ..NOW ON LOT -. al MAP.BOOK. PAGE PARCEL (This section need not be completed if the permit is for one cc ! } USE ZONE. MAP.' hundred dollar's.($100)or esst) y TRACT BLOCK LOT NO. J .)' NO ..... V . TEL- I SPECIAL' } I certify that in the performance of-the work for which this OWNER J.� ey- NO. - .•fi CONDITIONS \ 6 permit Is issued,'I.shall not employ any person.in any manner DISTRIC7, .GROUP TYPE - FIRE PROCESSED BY - O so as to become subject to the Workers'.Compensation Laws. ADDRESS "] l L .� q CONST. ZONE U ZIP .. SU. 'J Y -3 Q .Date - - Appliconf - CITY �Yh , q STATISTICAL CLASSIFICATION CONDO. V NOTICE TO APPLICANT: If, after'making this Certificate of ARCHITECT OR TEL - Exemption,. ,you should become 'subject to the Workers" ENGINEER ' CLASS NO. DWELL UNITS - a Compensation provisions of the Labor Code, you must.forth- _t J _ ' - with comply.with such provisions or,this permit shallbe kDDRfss SEWER / ,�.•, ' Z deemed re0oked. TEL' r� V' (C� VALIDATION CONTRACTOR + -tKIV[Ls O. _ LICENSED CONTRACTORS DECLARATION UC. ' �I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS/0 S ,<. NO. .�yy 7 7 VALUATION - - (commencing with Section 7000)of Division 3 of the Business and LIC . - Professions Code, and my license is in full force and effect. CITY CL455 - , SO. FT' NO.OF NO. OF CHECK • D - • ,License Numberli yy 7 7 Lic.Class SIZE STORIES FAMILIES ONE . . _ Contractor - Date - DESCRIPTION OF WORK ;}.` 6P NEW ❑ $ �� -f c �•8 8 a 8 A r ❑'1 am exempt under Sec ADD - . . 4 s - �' 'Y'00 ALTER ❑ FINAL , - • °,° °� - B.BP,C. for this reason REPAIR ❑ • DATE o 2'[�3 31.S O USE OF Date: - EXISTING BLDG. Y-% e - DEMOL-❑ BINAL r l4 - - °,. 3• 5 p r Signature APPLICANT _ 3 ' . PRINT �. _2 QL_ _. 1 TEL L\ OWNER-BUILDER DECLARATION nD•� NO.i/N �� G/ 1 0 7 83 l.hereby affirm that'I am exempt from the Contractor's License — Low for the following reoson'(Section,7031.5, Business and -.Professions Code): s PRESENT BUILDING as- I� as-owner of the property, or my employees with ADDRESS wages as.their sole compensation,will do'the workand - - ;,f7r/Q Sx �/ the structure is not intended or offered for sole(Section LOCALITY ' - Y� / 7044;,Business,ondProfessions Code). MOVING ` TEL - - z.8 8&-7 A, I, as owner of the property, am'exclusively contracting CONTRACTORS NO. /2 with licensed contractors to construct the project (Sec- gDDRES5 ' ... � ' � ' tion7044, Business and Professions Code):• - , - ,2 ° .� '6 7, 66 . REQUIRED, TOTAL SETBACK FROM EXIST. r CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH - - F ,1 - '- I Hereby affirm that there is a construction lending agency for - FRONT - r ®•- - _ 1 6 7..6 6'cxi', the performance of the work far which this permit isissuedP.L. -. ' (Sec 3097, Civ.'C.). / SIDE' 0 '1'.07-.8•� Lender's,Name / LI��L— P.L. - - Lender's Address - P.G. Fee$ tJ ` Permit Fee - .r & I certify that I have'read this.application lication and state that the Q ' . Y PP Issuance tae above information is correct. I agree to comply with:all County Investiga ioT ae -ordinances and State laws relating to building construction, (p Total Fee �j G' .and hereby authorize representatives of this:County to enter upon the above-mention d proper fo�rji nspection purposes. /' SEE REVERSE FOR EXPLANATORY LANGUAGE - Sign re of Applicant or.Agent ®s Data a WORKERS' COMPENSATION DECLARATION - I hereby offirm'that I have a cerifficate ofconsent to self //p�� 0 �(/,a �pylp� gyp} �F�r IL �Ip�Ip�p/��.r PERMIT. r�f�p}�F7�7�r�g��7� insure, or a certificate of Workers Compensation Insurance, - !/'V PPLIC M011 V-' r OR BU�'�®'�.O G 0" ER O IT - -or o certified copy thereof (Sec 3600; Lab C. - .,. " COUNTY OF LOS ANGELES BUILDING-AND"SAF V •' Policy No "" -' Company BUILDING ❑ Certified copy is hereby furnished.. 1' ' ... FOR APPLICANT T.O FILL IN. ADDRESS r❑ Certified copy is filed with th'e county building inspec-' BUILD ING + - tion department. , ` ADDRESS Q •Date Applicant" CITY` i / - ZIP ; LOCALITY NO. OF BLDGS. NEAREST - - .CERTIFICATE OF EXEMPTION FROM WORKERS' •. _ SIZE OF LOTI6 - -NOW ONLOT ��' CROSS ST. ' COMPENSATION.INSURANCE r { •._ ASSESSOR . (This section need'not be completed cif the permit is for one" - TRACT' BLOCK `+ - LOT NO. MAP BOOKPAGE�2 PARCEL O{O QQ hundred dollars ($100).or'less ) •• - TEL _ z. NO OWNER L ;f�, /� USE ZONE >. MAP „tt certify that in ther,performance of the work forwhich'this - - permit is issued, Ishall not employ any..person in any:monner - ADDRESS G V _ - SPECIAL a CONDITIONS so as to become subject to the Workers' Compensation Laws. _- , , - - - O I CITY � / ZIP' V Date Applicant - - ARCHITECT OR -r- TEL `v„ry - DISTRICT GROUP TYPE -FIRE PROC" ED BY 0: ' NOTICE TO APPLICANT: If, after making this Certificate of FQ QR-•- /. LQ ' - -NO. Ei. J 7..5 (/ CONST. ZONE 0 Exemption, you should become..subject to the-Workers' - - �:- - O.T- P" _ ,y s ' w Compensation provisions of,the Labor Code you must.forth- ADDRESS q L/A/ ./� f/ ✓-- .a with comply with such.provisions or this permit shall be _ :TEL' STATISTICAL CLASSIFICATIONAP . C(ADO N deemedrevoked CONTRACTOR NQ !/J� � � z LICENSED CONTRACTORS-DECLARATION .�. LIC. CLASS NO.�DWELL. UNITS ' - ADDRESS NO. I hereby affirm that am It of Division of Chapter 9 ,SEWER MAP ' (commencing with Section'7000)of Division 3 of the Business LIC. - and Professions Code,and rry license is in full force and effect: CITY _ CLASS BK PG VALIDATION - SO:FT.', NO. OF NO. OF CHECK- c License Number Li c.'Cass SIZE �U STORIES FAMILIES ' . ONE • l - -- 'VALUATION Contractor Date DESCRIPTION OF WORK NEW $ _0� 'El am exempt under Sec:' / ADD LTER El ' l= B.BP.C. for this reason - - - - S�`<<t.t a� \ L' •i '' t"t ^ Ks,,` r - REPAIR ❑ -� A \ �` :. kSY �,,- A . . Date: _ USE OF.,., is , t ... EXISTING BLDG �// .'� DEMOL ❑ - ` !•, . .: Si nature x APPLICANT_ _ TEL g .. UC T) r '% D NO. _sem FINAL t OWNER-BUILDER DECLARATION - DATE I hereby off irm that I am exempt from the Contractor s License - gDDREsS E(-n .lAwz'� T7t/ Law for the following. (Section•7031.5,-Business and <�-- FINAL w' f "Professions Code):: .` ' L:. - PRESENT - - By- - - ' BUILDING • - iS I (' g , I, as owner df'the property,' or,my employees with ADDRESS • wages as their sole compensation,.will do the work and ` " - "' - - - u the structure is not intended or offered for sale(Sectiom LOCALITY 1 7044; wBusiness and Professions'Code:) - - MOVING-, - TEL - - --• - - in:� r - L-J - as oner of the property, om exclusively contracting CONTRACTOR NO. ` t.i ITE I+� with licensed contractors,to°construct the project-(Sec- tion 7044, Business and Professions Code.) 1 't `i ' ../ .�1 s _ ,.REOUI RED- TOTAL SETBACK FROM - EXIST.• S ' . - CONSTRUCTION LENDING'AGENCY SETBACK "YARD HWY PROP. NE WIDTH + 1, �t�rL` JJ90 •I hereby.affirm that there is a construction lending agency for " PRL - ° r c' { ':HANGE the performance of the work for which this permit is-issued '" - Z( `w ! - (Sec 300,_Civ:'C.). - • "SIDE c ' v s {y Lender's Nam e t f rJri - - .., fl 1 €�-I11Ll-oo - i{� 1 .L• CDMA Ref 'i .. P.C. Fee.$ Permit Fee / ./ ""1 QiG'J 1 , :111 `.y`f ,Lender's Address - vwv 'I certify that L have read this application'and state that the Issuance Fee �/ LDMA P/C p' D 8 above information is correct. I agree tocomply with all County' Investigation Fee;' _ R ordinances and State laws ielating to building.construction, Total Fee CDMA Perm. R < ar by authorize represe fives of this Count to enter o t a ove-men fon - o erty for.inspec ion es: SEEREVERSE FOR EXPLANATORY LANGUAGE ure of" pplicant or Agent Date