The URL can be used to link to this page

Home My Public Portal About10910 DAINES DR_Building__ TEMPLE CB°l Y ,unu CE 4e4]1-, APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ADDRESS BUILDING Aq/Ngf ,i DEPARTMENT OF COUNTY ENGINEER 0 9/ D E BUILDING AND SAFETY DIVISION` LOCALITY - C If JOHN A. LAMBIE, COUNTY ENGINEER NEAREST ` WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. DISTRICT NO. GROUP TYPE PRO Y FOR APPLICANT TO FILL IN . 08 T CONS BUILDING STATISTICAL CLASSIFICATION SEWERMAP ADDRESS /O9'If/ Ctiyi, STBK PG ( CLASS.NQ.� LL DWE . UNITS /-' �/O LOT NO.GU /60 .2,O p BLOCK WATER NOT REQUIRED RECEIVED ( CERTIFICATE'. / TRACT U"2 MAP 'T HIGHWAY, J� v ((yy / NO.OF BLDGS. NO. f. O S'o ICIRELEI STATE MAJOR SECOND. LOCAL S IZE�OF L07 k X 7O I NOW ON LOT / USE ZONE SPECIAL EXISTING BLDG. � yi/ .e. CONDITIONS EL OWNERYARD HWY STREET NAME EXIS (' BUILDING T. ADDRESS / /9 9LO ,f72.i.ASKS $T SETBACK WIDTH ARCHITECTOR .i. FRONT ENGINEER �' Z� ��Nes 6p �✓ SIDE P. L. ADDRESS TEL. I INSPECTION,RECORD p Q CONTRACTOR NO. ILIF z�_q 1-.4 ADDRESS DESCRIPTION OF WORK / v i+� O w a NEW AD ALTEREPAI DEMOLISH SQ. FL6 NO.OF OF Z SIZE B.V4 STORIES FAMILIES USE OF . / P PA SIGNATURE A PLICAN (IIiL L✓V✓7 VALUATION$ APPROVALS DATE INSPECTOR'S SIGNATURE P.C. . FOUNDATION: LOCATION AMT FEE $ ' FEE $ FORMS, MATERIALS (/ �J I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION F BRACING, BOLTS 5 J /J'h'J AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. A ----------- WITH ALL COUNTY OROINANC ES 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- DEATH, INT: MV/I,AYrjY 161#1C12- TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT _ ING TO WORKMEN'S COMPENSATION INSURANCE. SIGNATURE OF LATH,EXT. _ PERMITTE mar L,�" ,,{�J,�� H OUSENUMBERCOR —� �--�y�yr�' _ �Z ERECT AND POSTED ADDREss�_0 FINAL CLYDE N. DIRLAM', PRINCIPAL STRUCTURAL EN R CI I4 CHECK VALIDATION GM.O. DASH PERMIT VALIDATION GK. m.o. GABN x.5559 OCT 16 1 0 6.00- ( . . 76AG38A CE.9 803 1-62APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS / L BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. DISTRICT NO, GROUTYPE P SED BY FOR APPLICANT TO FILL IN t P CONST. BUILDINGI'` STATISTICAL CLASSIFICATION S ER MAP ADDRESS Q D N/' U lY CLASS. NO. DWELL. UNITS-_----I PG.' LOT NO. BLOCK WATER CERTIFICATE: NOT REQUIRED RECEIVED TRACT MAPHIGHWAY NO. OF BLDGS. NO . ICIRCLEI STATE MAJOR SECOND. CAL SIZE OF LOT NOW ON LOT USE ZONE -SPECIAL USE OF CONDITIONS EXISTING-BLDG. ,E, p� OWNER H /7 M �+ /'Y NO.�// ��, O A� BUILD NG EXIST. SETBACK EYARD HWY TRET NAME p WIDTH ADDRESS jO / /O `, J A /yF S FRONT i ARCHITECT OREL. P, L. ENGINEER NO, ` SIDE P. L. 6 ADDRESS - - O CONTRACTOR NOL �tu ADDRESS / DESCRIPTION OF WORK _ � `" 1W is NEW ADD ALTER REPAIR DEMOLISH •' - I Z SQ. FT. NO. OF / NO. OF SIZE STORIES / FAMILIES USE OF STRUCTURE ,E P LAC E SIGNATURE OF APPLICANT VALUATION $ �� J D APPROVALS DATE1 INSPECTOR{$SIGNATURE � FOUNDATION: LOCATION �y �--�� --•F�J.I FEE S !'�—� FEE $ �-^ FORMS, MATERIALS 7/ti� :JA1°�N�ll FRAME : FI RE STOP4, // HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. / Z WITH ALL COUNTY ORDINANCES AND STATE 'LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION, 1 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 WORK M EN'5 CCMMP'ENSATION BURANCE. LATH. EXT. SIGNATURE OF ,OXY n.� HOUSE NUMBER COR- PERMITTEE /J / � p- /+ /7 RECT AND POSTED ADDRESS 7 1O /_ D/4 I lVt J !/ R FINAL JOHN F. LEWIS, PRIJJCIPAL STRUCTURAL EN R PLAN CHECK VALIDATION OK, M.D. CASH _ PERMIT VALIDATION CK. M.O. CASH if'�La4 1 8 0SEP11 1 D 6.00- Q /� �774i(2Gfi�� COUNTY OF LOS ANGELES .A BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION O O FOR APPLICANT TO FILL IN BUILDING DDRESS S , I hereby affirm that 6have Ia certificate of consent to self insure,. BUILDING ADDRESS IN- or a certificate of Workers' Compensation Insurance, or a certified Fes . Tx DA- copy thereof(Sec.3800,.Lab.C.) �_CITU ZIP ''thi � t Policy No. 'Company SIZE OF LOT O.OF BLOCS.NOW ON LOT s- 0 Certified copy is hereby furnished. NEAREST-CROSS ST. ElCertified copy is filed with the county building inspection TRACT BLOCK LOT NO. TAMr ' department .. ESE ZONE MAP NO. Date Applicant ASSESSOR - PAG PARCEL � 7 Q/ SPECIAL CONDITIONS - • CERTIFICATE OF EXEMPTION FROM WORKERS' . OWNERnn 7 TEL NO.// YEStCOND0 COMPENSATION INSURANCE V M6 UI'E 2 b. WITHIN 1000 FT OF SCHOOL? (This Section need not be completed if the permit is for one hundred ADD 5S nr W �-V� DISTRICT GROUP TYPE CONST. FIRE ZONBY dollars($100) or less.) �(�`m'1 Q /7 1� CIO�S I�r (SP4 'Tj — ZIP I certify that in the performance of The work for which this permit � yt� 1 '/ ✓tel is issued, I shall,not employ any person in any manner so as to become.subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO. STATISTICAL C__L��ASSI,,FICATION Date Applicant ADDRESS CLASS NO. � DWELL UNITS NOTICE TO APPLICANT, If, after making this Certifi0ate OfREOUIREp TOTAL SETBACExemption, you should become. Subject t0 the Workers' CONTRALTO TEL NO. SETBACKyggp HWY PROP LI Compensation provisions of the.Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS - - LIC.NO. PL LICENSED CONTRACTORS DECLARATION - GIDE CITY LIC.CLASS PL I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO FT.SIZE NO,OF STORIES NO.OF FAMILIES Professions Code,-and my license is in full force and effect Q 1 I I NEW ❑ BK PG } DESCRIPTION OF WORK VALUATION D d License Number - Lic.Class _ ADD O Contractor Date ALTER ❑ $ 1 D ❑ I am exempt under Sec. /Ny� �MX� REPAIR El $ Q BARC. for this reason Y �GQ�L� DEMOL ❑ W .COMA P/C x Date: USE OF EXISTING BLDG.. URM ❑ C _ CL Ignature APPLICANT(PPoNTI TEL LOMA Perm# `' {_�' Z J$ r a tb I, as owner of the property, or my employeeswithwages as Z -� �y�..?� p their sole compensation, will do the work and the structure is ADDRESS _ rnl�ji! not intended or Offered for sale (Section 7044, Business and S �}' FINAL DATE/ S Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL �' C �•I�. ❑ , J OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J (J I, as owner of the property, am exclusively contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL B,'J:.. licensed contractors to construct the project (Section 7044, Business and Professions Code.) - YES El No❑ V •, e • WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING 2.e 71 OCCUPANT REQUIRE A.PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCYCOAST AIR QUALITY MANAGEMENT DISTRICT ISCACMpI SEE PERMITTING CHECKLIST FOR ID -. ` _ 'GUELINES � \�� 1 � •, I I I't;1 h_ I hereby affirm that there is a construction lending agency for YES El NO 1:1 w the performance of the work for which this permit is issued(Sec. TOTAL AL 472 m � r' p1 - HAVE READ I HE UNDERSTAND MY REQUALS IREMENTS TS ATION UNDER TH GUIDE AND THE ANGELES COPERMITODE. Leede CIV. m CHECKLIST. UNDERSTAND TI REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE _ TITLE I LSREPCHAPTER TNG SECTIONS OBTAINING 0 THROUGH 2ROM T CONCERNING HAZARDOUS 3 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. o Lender's Address - _ CHANutJUL,! o - av+Nea oA ACErvT - _ . o I certify.that I have read this application and state under.penalty Q' of perjury that the above information is correct.I agree to Comply P.C.FEE- PERMIT FEE r2 n o with all county ordinances and State laws relating to building J COOStruCtiOq and hereby authorize represenfatiJBe of this County - ��ZISSUANCE FEE / it (/O to enter u on the ab ve-mentioned property for inspecti n p rposes. 'J`",O iNCI a INVESTIGATION FEE TOTAL FEE r/ SEE REVERSE FOR EXPLANATORY LANGUAGE -