Loading...
HomeMy Public PortalAbout10835 DAINES DR_Building__ DEPARTMENT OF COUN77ENGWn• ROD U�J r` I',1VISION OF BUILDING AND SAFETY � L0 0 D V rp�I�ni •.r COUNTY_OF LOS ANGELES ti .WILLIAM J. FOX. COUNTY ENGINEER APPLICATION kl CASBATT O. GRIFFIN, SUPT oP BulLnlxo FOR APPLICANT TO FILL IN FOR OFFICE USE.ONLY DISTRICT NO, PLAN CK,OR REC,NC, PERMIT NO. ADDBUILDING .A�L.�/)/hh�/ �60�7 �9 76� LOCALITY. ice �//Ji /JJV/Ai//I RECEIVE Y P DATE OF APll DATEISSUED NEAREST CROSS ST, T '9i�-O BUILDING S s� ADDRESS L. / .,OWNER MAIL LOCALITY K U/ ADDRESS /im/rf. NEAREST - / TEL. CROSS 8T C-"LG SND CITY. /JA /.�..�,�A-✓J�J/n/ . NO OF PFS I Gjj.Q TE ENGIARCIN EERAA//�^,�'.� Y1F%Ay-/N�O� `yBLDG. O1 PL. LANS I ry/ // - UP ADDRESS 1�977a)? �.7q�.u../ ✓/f-2 cf'� BL SETBACK LINE Q _Y'� I_F NpO TUSE CONTRACTOF04_9iA.t7A /,OS.�(/��J NO. 6 �/n ,517 ONE BYPROVED ATE � O ADDRESS 7 CJ S CN.-t� �//6 L HOUSE NUMBERIMU LEGAL _/D MAP NUMBER �4 NO. ASSIGNED BY DESCRIPTION T..NO. A CORK CTIONS TRACT .t)l' l'i ��y3:./�GY r.�J ..T//LsQ /O�s/ � Z 3•/Op SIZE OF LOT 7/- d S/ -71 I NOW ON LOT A-s USE OF I NO. OP O Z O I EXISTING BLDG: FAMILIHS DESCRIPTION OF WORE z ♦i LB c. cDr uuaaa SCoe 6I.R9- D� NEW /DEMOL•ITION ADDITION IAES^IC)FcJ uN 0- II�N TT REPAIR 11 NI y r S ZE T ROOMB sToRms EXT. WALL ROOF COVERING S -�5/= USE OF STRUCTURE APPROV4LLS 00 INSPECT '3 SIGNATURE DATE FOUNDATION: LOCATION / FORMS, MATERIALS !-a_�....� I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME: FIRE STOPS. _// �✓ PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS CORRECT. I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION. L. AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAB VENT, DUCTS -4 SIGNATURE OFV__ _ S✓ Gam'- �.r, LATH, INT. PERMITTEES / ADDRE58 //S _//J Q (`_. y.'i ((�'fl.JZ ,J .\, LATH. E%T. PLASTER. INT. it - L IZED AGT. ' PLASTER, EXT. O/ NOU9ENUMBER COR. RECT AND POSTED ION ,FEE ���+ FINAL yyl �JIL%/7 DBE 8 O-OII APRUCAMONfOR 1 �f - @P • COUNTY OF-LOS'-ANGELES' • BUILDING AND SAFETY', WORKER'S COMPENSATION DECLARATION: FOR APPLICANT TO FILL IN - BUILDING -I ' - BUILDING AD Es �`. , hereby affirm thaPl have a certificate of consent`to*sell insure,• or a certificate of WorkersCompensation Insurance;-or a certified' O - - ••� ' t copy thereof'( 3800,Lab.C) • CITY i_C ZIP �y/1�� _ LOCALITY / Policy NO. —9T� •Company� � .• SIZE OF LOT NO.OF BUDGE.NOW ON LOT ` 016erbbed copy Is hereby furmshetl Ji- I/ - NEAREST�SS T ❑ Certified copy Is filed with the cou y build) TRACT. BLOCK - LOT NO. ` ... depljment _ -. ' NE _'— ._ + - ASSESSOR MAP BOOK-' PAGE PARCELUSEZO •MAP NODatey q. 9s Applicant ." Q ., ., SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' owNER - Tec No. _ _ COMPENSATION INSURANCE [i k4 :J2 e WITHIN;1000 FT OF.SCHOOLS YES No f (This section need not be completed if the permit is for onehundred ADDRESS O / ��� DISTRICT GROUP TY ECONST FIRE ZONE ROCESSEO BY dollars 1$100),or less.) � , ' CITY - ZIP� "- I certify that in thee-performance of the work-for which this permit - S. /{A� 2 if{ is issued,1 shall not employ any person in any manner so.as to� - V' D� /1. J �/ become subject to the Workers Compensation taws. ARCHITECT OR ENGINEER TEL'NO. - STATISTICALCLA IFI ATION APT CONDO Date ' - Applicant - ADDRESS - - CLASS NO' DWELL UNITS NOTICE TO APPLICANT. If, after,' making this Certificate of, ' - REQUIRED TOTAL.SETBACK FROM EXIST s Exemption;' you should 'become subject to the Workers CONTRACTOR TEL NO. SET BACK YARD -HWV PROP LINE WIDTH Compensation provisions Of'the Labor Code, you must forthwith d P91 FRONT .comply with such provisions or this permit Shall be deemed revoked. Ag, 5 +v -LIC.NO: ^ FRO LICENSED CONTRACTORS DECLARATION / ` L Z sloE. EL CITY LIC j7LAS`1_ -_ P L I hereby-,affirm that I am licensed underprovisions of Chapter 9 (� (commencing•with Section 7000)of Division 3.Of the Business and SO.FT SIZE NO.OF STORIES NO.OF FgMILIES SEWER MAP , ,z e' a. Professions Code,and my Ilcense Is In fulLforCe and effect - -NEW ❑ BK PG License No e ` L,c,Class (�� C�� DE IPTION OF WO ADD((DD - ❑ ypLUAT10N �( � D W ConNdA4 tractor Date.^s �9_ 1/ - ALTER ❑ $ © OF •:N ❑ 1 am exempt under Sec. - _ :REPAIR ❑ $ _ B.&P.C..for this reason I - DEMOL ❑ CDMA P/C Date: _ USE OF EXIS INC BLDG URM ❑ Signature' _ - APPLI (%y(V]J ) TEL NP, CDMA Perm ❑ I. as ownerofthe property, or my employees with wages as !N✓/. /L their sole compensation, will do.the w6rk.,and the structure is r'1 - rr• i .trot'intended or offered for'Shce.(Section 7044, Business and _ FINAL DATE. - -Q SJV3= "' ylju,90 Professions Code.) 'MLL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL. ✓ ".R O - , ❑ I, as Owner Of thB OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE i-IIFhi Property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE?,- FINAL BY licensed contractors to construct the..project'(Section,7044, _ T_IlpL 108 a.-90 YES NO 1:1 Business and P fesaiDna cQtle.) CHECK 108.90 WILL.THE INTENDED USE MI THE COOLING BY THE MODI CAT OR FROM THE SOUTH. OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION DI EE PERMITTING FROM THE SOUTH - 'CONSTRUCTION LENDING AGENCY 'GUIDE AIR ouqurv.MArvgcEMErvr oisTRla Iscgom0l SEE PERMirnrvc cHwrcusT FOR - • GE cumauNEs. '.CHHh�il� _.00. . I hereby affirm that there is a construction,lending'agency for- Yss❑ NO❑ - -- - - ` -the performance of the work,for Which this permit is issued(Sec. IHAVE READ THE MAZARWUSMATERIALSINFORMATIONgTHE SCAOM ERMITTING _ ` 3OB7,Civ.C.) CHECKLIST OERSTANO MV RE REMENTS UNDECTO ANGELES LINTY COpE, �}�}(�rT { C O(('�TITLE 2 q R 220 SECTION O.IQ TROUGCONGER G Hg2AR000S "`�++-'iJr��IJ 1: rf JLendef s Name MATERI 1' ND T RIE SC ID -Lender's AddressA,�1/(./✓ - . .632j ��. �51 =,1+5 IS - o��+eA or+Acexr 1 certify that I'have read this application and state under penalty Q_ P.C.FEE PERMIT FEE / j� ' o of perjury that the above information'Is:correct.('agree to comply, - (Q m with allcounty ordinances-and State la relating to building - M constructs and here authorize r - tatives of this County - - - ISSUANCE FEE V�� • - - _ to a n the abo m do G for inspection Durposes. INVESTIGATION FEE - ,TOTAL FEE SEE REVERSE FOR EXPLANATORY LANGUAGE