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Home My Public Portal About10923 DAINES DR_Building__ 7BA698A OBS-3 2-59 FOR BUILDING PERMIT, -• "� � DIVISION OF BUILDING AND SAFETY BUILDING Pr Department of County Engineer County of Los Angeles LOCALITY WM.J. FOX. COUNTY ENGINEER NEAREST .CASSATT D. GRIFFIN, SUP'TOF BUILDING CROSS ST. ...q... DISTRICT NO. GROI TYPE -� SEWER MAP � . FOR APPLICANT TO FILL IN `'. .700 T�(> BK PO CONS BUILDING �} fr a y� MAP STATE YE; O ADDRESS lc `q-J /� ,7 / , NUMBER HWY LOT NO. a4 BLOCK US Z HE SPECIAL CONDITIONS CIAL TRACT NO. OF BLDGS. I J I BUILDING EXIST. SIZE OF LOT � NOW ON LOT SETBACK YARD HWY STREET NAME* WIDTH USEFRONT EXISTING BLDG. '7� > p L. 2�J OWN _ SIDE P.L. .MAILi O TRACT DWELL. 1 UNIT ADDRES 15 �� 5 INDUSTRIAL _ TEIr DWELL.O I UNIT CITY •4= C NO: B PUBLIC BLDG. 2 DUPLEX I UNIT ARCHITECT O �I 7 ADON..ALT.. ETC. _ ENGINEER NO. 3 APT. _yL-UNITS $ MISCEL. - ADDRESS 4 COMMERCIAL TEL• CONTRACTOR TNO.EL INSPECTION RECORD - ADDRE DESCRIPTION OF WORK NEW ADDI ALTER REPAIR DEMOLISH _ "j' T - STORIES FAM�F 8ES `. SIGNATURE OF ( �/ • ppp ROVALS APPLICANT ADORE 9S DATE INSPECTORS SIGNATURE FOUNDATION: LOCATION Z S Ami P. C. S -�P FORMS. MATERIALS �✓ FEE FRAME' FIRE STOPS. VALUATION Is BRACING. BOLTS -I • FEE l "� FURNACE: LOCATION. I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GA9 VENT' DUCTS APPLICATION AND STATE THAT THE ABOVE 18 C R _ AND AGREE TO COM ITH ALL COUNTY R S' LATH. INT. AND STATE LA REG BUILD NST TION. LATH. EXT. SIGNATOR - C� HOUSE NUMBER COR- PERMIT EE RECT AND POSTED Q ADDRESS FINAL IR'-I.3 sIn /�94-T• WM.J. FOX,COUNTY ENGINEER VALIDATIONQ N. DIRLAM. CHIEF BLDG. INSPECTOR I ( p0602w kP25 1 4.00 D. DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMT COUNTY OF LOS ANGELES U I L®I N G .WM. J. FOX, CHIEF ENGINEER l� 'FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY ° BUILDING /�^I T /'] I /� DISTRICT NO. PLANCK.QNO. /^,yPERMII�T/NCO. ADDRESS /09-23. �F•fJy(�// SCS 1�RI /� 3S 4 / J ` 3 /J LOCALITY 7E/rMrq�•p`�/� /`�,I/I/?y RECEIVED BY [/DATpE'OF APPL. DATE ISSUED CROS39T. 1{ LL�l7lVy 7TYG ! a�-3 BUILDING pq c ` ADDRESS /�O OWN MAIL `.�C'+, a R ` I LOCALITY7- rr7ele. r/{N ADDRESS ./J.J OL 1) NEAREST CITY TEM � CITY NO. CROSS ST. FIRE NO. OF I TYPE / _ I GROUP ARCHITECT OR TEL ZONE r._. PLANS 1/ ENGINEERNO. BLDG. ORD. NO. . SETBACK LINE ADDRESS APPROVED {-� c^_ t1TEL BY CONTRACTOR AmjwG'j-, I /' NO. FO. B6 y/ USE DATE UDE APPROVED bb r/ Kok ZONE�� BY DATE ADDRESS 10301/ E 1ggw,6A AZ'rl !l'TD 6 I�Iok A- HOUSE NUMBERING DESCRIPTION I LOT NO. 2.0 I BLOCK MAP NUMBER A - O FIELD CHECK BY TRACT 1 Do '99 NO. ASSIGNED SY a DATE No. of BLDcs. CORRECTIONS SIZE OF LOT �j� NOW ON LOT USEOF INO. OFe EXISTING BLDG. 7{•,,,p . O' C, 3 5-/C If kHERZDESCRIPTION OF WORN ONA I ' ALTERATION ADDITION I DEMOLITION - A - �b�p NO. OF / ! ^ - . 61 QQ��/ {'! ROOMS STORIES Z ALL ROOF O /.�' r ING ST�ccO I COVERING ` O�„I��.STRUCTU RH lFIAfGNi�✓ INSPECA1.6y``/lJlLREINSPECTOR' .81GNATIIRE—DATE��REBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- . FOUNDATION: LOCATIONION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALSREE TO COMPLY WITH THE CORRECTIONS LISTED ; FRAME: FIRE STOPS. N AND WITH ALL COUNTY ORDINANCES AND STATE ' BRACING, BOLTS REGULATING 'BUILDING CONSTRUCTION. FURNACE: LOCATION, SIGNATURE OF • - An �\Up�`� GAS VENT, DUCTS ,J✓ �/ PERMIT --pTEE/ , a2i-w ' F4 � ADDRESS F/1 �,//J•S� �'j/ w LAT INT. �/7&-w VZ '� 1 LATH, EXT. AUTHORIZED AGT. 1. , �y PLASTER, INT. OBAOi BA• OB)l 10-BO P. C. ® oy OU FEE PLASTER, EXT. t/7 VALUATION FEE $%/ FINAL I " WORKERS' COMPENSATION DECLARATION I hereby affirm that I haver certificate of consent to self /OY 1117.11 �LL /E]\M V 11-®UU BU R M U('a P IS UUII V 17 insure, or a certificate of Workers' Compensation Insurance,� /rL111 Il LS V//"�l 11 , or a certified copy thereof (Sea 3800, Lab C:) ^COUNTY OF'LOS ANGELES' - "BUILDING AND SAFETY Policy No. Company BUILDING ❑ Certified copy i's hereby furnished. . _ FOR APPLICANT TO FILL IN. ADDRESS - 4 Certified copy is filed with the building in pec- BUILDING O ; C tion deparlrymenL - ADDRESS J - Date -�Z.Appica 1 - CITY- ZIP LOCALITY' ` CERTIFICATE OF EXEMPTION F OM WORKERS' NO. OF BLDGS. NEAREST - - - SIZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCE _ _ __.___ �; ASSESSOR- -'hung section need n0) or comp"leie`d if'the permit i3'f6r one'""` TRACT- BLOCK LOT NO. MAP BOOK ..PAGE z PARCEL hundred dollars ($100) or less.) - � {- ,,�I TEL '�) OWNER-. -�J O/cJ7Y E NO'�/ /.�CJ', USE ZONE MAP - I certify that in the performance of the work for which this ' ,) _ - NOl permit is issued, I shall not em to an y 36:c ' JC ? ` d SPECIAL � - Y p employ Workers' Com in an manner ADDRESS 3V G i � LV ' CONDITIONS n, so as to become subject to the Workers'Compensation Laws: - _ - , - _ O CIT /T/1/ /2- 19'10/✓/ C/q zip' a a y Date - - Applicc m -* ARCHITECT OR !TEL Of NOTICE TO APPLICANT: If, after making this,Certificate.of - ENGINEER -3,6 NO ;_20,2 'DISTRICT GROUP TYPE FIRE PROCESSED BY O CONST. ZONE t- Exemption, you should become.subject to the Workers' nG _� ,V. ( � w Compensation provisions of the Labor Code, you must forth- ADDRESS LL/�O ✓ ��= - - a p N forth- with-comply with such provisions or this permit shall be r TEL. -T6// STA TISTICALCLASSIFICATION APT, CONDO. Z •deemed revoked'. - CONTRACTOR 4 NO 7 LICENSED CONTRACTORS DECLARATION - LIC. yo p CLASS NO. 12/ DWEII UNITS - I hereby offirm that l am licensed under provisions of Chapter 9 ADDRESS N. �f-Y��. NO. ,>p 336 LIC. SEWER MAP (commencing with Section 7000)of Division 3 of the Business 1 Q .' and Professions Code,and my license is in full force and effect. CITY j'Y) CLASS BK_ VALIDATION ,'/!9�3 4 SO. FT. SNO.TO OF NO. OF CHECK - License Number L CJ Lic Class - SIZE STORIES FAMILIES.< ONE' ,''��TT__ -VALUATION - Contractor/YWWId7Y[ /OXIF'•- Dote- 3� SL DESCRIPTION OF WORK ��0 l'09 NEW o l �� a ) '�: - t' ADD ,❑. 9 D. ,7,I; ❑I am exempt under Sec.- - V EZ Z 46�S ALTER ❑ j f tr V'(:_ B.BP.C. for.th is' ason - - - - - u�7i�• Tj�'1�'' �U l-l`! •REPAIR ' S _ _ ,moi , Date: - USE OF. //�'� L,' - ❑ - jl PIAL DE =Fm EXISTING BLDG. LA/Q�XSh�a l' Sig tu APPLICANT /t TEL. FINAL t - R-BUILDER DECLARATION (PRINT] +�/ir/ NO D�� DATE tC CHriNLa T"-` I hereby affirm.thot I am exempt fromthe Contractor's License - - - '`A T r Law for,the following reason (Section 7031.5, Business and ADDRES W4legz- /� �T/�t' FINAL]//�, Professions Code) - ... - • PRESLN7 - - - - B / ❑ I, as owner of theproperty, or m em d employees. with BUILDING `T y' '11 °+= • Y P Y ADDRESS 'wages as their sale compensation,will do the work and D ❑ the structure isnot intended or offered for sale(Section LOCALITY 7044,.Business and Professions Code.)' - MOVING - , TEL.- - - I, as owner of the property, am exclusively contracting CONTRACTOR D. with licensed contractors to construct the project ADDRIES 5 ' tion 7044, Business and Professions Code.) - CONSTRUCTION LENDING AGENCY REQUIRED YARD HWY TOTAL SETBACK FROM EXIST-- _ SET BACK PROP. LINE WIDTH hereby affirm that there is a construction lending agency for FRONT _ _ - the'performance'of the work for-which this permit-is issued P.I. - - -(Sec. 3097, Civ. C.). - SIDE.' Lender's Name Lender's Address m j� O O LDMA R.I. N ' ` P.C. Fee$ Permit Fee d � � - - o I certify-that I'have read this application and state that the - Issuance Fee LDMA P/C N 8 - above information is correct. I agree to comply with all County Investigation Fee' R ordinan State laws relating to building construction, - Total Fee LDMA Perm. N ' a an ereby'au rile representatives of this,County to enter 0 on the -mention roperty for inspe� pur� /p - , - "- '- - - '/// _ .. SEE REVERSE FOR EXPLANATORY LANGUAGE - 5' o A plicam or Agent Date - '