Loading...
HomeMy Public PortalAbout9450 DAINES DR_Building__ SION DEPARTMENT UI COUNTY ENG B F � DMSIORT OF BUILDING ARID SAFETY p; COUNTY OF LOS ANGELES �+ WILLIA� J. FOX. COUNTY ENGINEER Uitl 16 1953 APPLICATION `CdSSAT D. GRIFFIN, SUPT OF BUILDING 7. FOR APPLICANT TO FELL IN FOR OFFICE USE ONLY /�� S DISTRI NO. PLAN CK.OR REc.Ido. PERMIT NO. BUILDING I/�1� p �g7 4 / �-�`�- g ADDRESS . Y5- �� ,I e / LOCALITY / /� �'-j��� �l� R/E�/C�yE/IyED BY DATE LOCALITY `A/PPPL. ATE^�IS/S�UECD CRO88 8T. . 14 , �' BUILDIN6 OWNER /MAIL �t^''�A•A.d- 7 i-, • 9 C.�iS a ADDRESS ADDRESS �(/ 15, 40AIAlll s �j j . �y LOCALITY \ ✓ L/ e�9� h/, C� /�.TE /'Y"� �.P�r NEAREST . �;v OAR eaLl CITE!.% CROSS ST. �Q�Y/ I" ARCHITECT OR TEL FIRE NO. OFTV, ENGINEER s� NO. ZONE I PLANS / L ADDRESS /LG GIS SETBACK LINE ` T L. USE APPROVED CONTRACTORO. ZONE+ I .� BY DATE HOUSE NUMBERING ADDRESS LEGAL ° MAP NUMBER 4;�-47 49'9�f NO. ASSIGNED BY DESCRIPTION I LOT NO. BLOCK CORRECTIORTS TRACT 7D g 'I NO. OF BLDGS. " SIZE OF LOT ,1 NOW ON LOT Q USE OF NO. OF q / �/p�l EXISTING BLDG. FAMILIES DESCRIPTION OF WORK ,_ ` o — NEW ALTERATION ADDITION REPAIR -I DEMOLITION -I I J Z _ y SQ. FT. NO. OF 4 �• - -S`-7 ZZ ®ed.�i' T P&A.d SIZE ROOMS STORIES ZEXT. WALL ROOF _ COVERING !�' dC�'/C%Ge I COVERING 9aWj'll: USE OF STR URE tet��f/�/"i��� I"'r�G Z�! ``�4J" 1 � ►.L rr!6'.'.. 4 APPROV S INSPECTOR'S SIGNATURE DAT FOUNDATION: LOCATION - r ✓ FORMS, MATERIALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRE STOPS, 'G PLICATION AND STATE THAT THE INFORMATION GIVEN. IS BRACING, BOLTS . p CORRECT. FURNACE: LOCATION. I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES GAS VENT, DUCTS S AND STATE LAWS REGULATING BUILDING CONSTRUCTION. ^ LATH. INT. (` SIGNATURE OF PERMITTEE LATH. EXT. ADDRESS 9-�/. "V D PLASTER, INT, 4 AUTHORIZED AGT. - PLASTER, EXT. P. C. $ (�, HOUSE NUMBER COR- FEE. / •s�<.. -�� .af__. 6f .'z- S S' RECT AND POSTED VALUATION FEE $ �,00 FINAL 76ABBBA DBS 3 G-GR ' ' DBS-3 25M SETS 8-45 t DEPARTlEI T OF BUILDING AND SAFETY APPLICATION FOR PERMIT, COUNTY OF LOS ANGELES 41 WM. J. FOX, CHIEF ENGINEER' FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK. NO. PERMIT NO. BUILDING ADDRESS s+ OL.v_¢.�/JvGr1_ r��� ('./ �� ��✓ �� d ! �-+w � /S , LOCALITY 1 JJ�p - *.sy�'rr�J/��ri�, _ RECEIVED, BY DATE /O/F APPsL. DATE ISSUED NEAREST ��r /- ` v `+� I Z— CROSS ST. I /�. `y,�� / e/ t.C�t�/'� BUILDING e' ( OWNER 'ADDRESS gv MAIL LOCALITY ! ( ADDRESS NEARESTEo / � TEL. CROSS ST. SL ! !��^ p /y V CITY NO. FIRE I NO.OF / I PLANS TYPES �I GROUP ARCHITECT OR �y TEL. " ZONE I iJ".�- ENGINEER ,r/ NO. BLDG. ORD. NO. ADDRESS I SETBACK LINE , APPROVED CONTRACTOR �ALf//�-' �'.iy "y�-'k/ ' BY r DATE USE APPROV ADDRESS _/ �C "7 1� 4...1 �p> ZONEf'ggi � B'Y IL ' DATE ' LEGAL _I ' Gi A ,.rrr' ! �1 CORR S _ DESCRIPTION�Y��p LOT NO. I BLOCK 'l.00- 1 (� `�1y9. y .•.•TRACT ,R� �A �bd ��7I�,f ... / a�1.A* /, NO.'OF SLOGS. ,SIZE OF LOT,P6y � C) i NOW ON LOT USE OFF I NO. OF EXISTING BLDG. FA I.0 ROOMS DESCRIPTION OF WORK NEW ALTERATION ADDITION - - O A_ REPAIR � MOVING DEMOLISH O' Sc). FT. NO.OF Z SIZE ,/ ROOMS STORIES / r- WALL ,®�P' - ROOF COVERING f� - I COVERING USE OF NEW BUILDING ,p - xp4"f) G I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION, INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE OFBRACING, BOLTS ' a OWNER //� LATH, INT.: AUTHORIZED AGTLATH, EXT.: • - . - � /� ( P. C. S/ -.PLASTER, INT. ( / FEE I PLASTER, EXT. VALUATION (?L5 FINAL iT /�/ FEE 1. _ WORKERS' COMPENSATION-DECLARATION �. �} . - Cl I hereby affirm that I have a certificate of consent to self "- A �n F O p D - nn �( 4 insure, or a certificate of Workers'Compenstion Insurance, or /�_�� [/11 IJ�J (J`t� IJ (Jl/u (J a certified copy thereof (Sec. 3800, Lab. C..) COUNTY OF LOS.ANGELES BUILDING AND SAFETY . Policy No.' Company, Certified copy is hereby furnished. BUILDING FOR APPLICANT'TO FILL IN ADDRESS aCertified copy is filed with-the county building inspec- BUILDING .�- tion department. ADDRESS �5 LOCALITY iC/Lz NEAREST Date Applicant CITY AiZ ZIP CROSS ST. 'CERTIFICATE OF EXEMPTION.FROM WORKERS' �p �n i NO. OF BLDGS. ASSESSOR COMPENSATION-INSURANCE SIZE OF LOT O 7 NOW ON•LOT MAP BOOK I GE PARCEL (This section need not be completed,if the permit is for one a USE ZONEVGROU0 qq ' .hLndred dollars ($100)or less.) TRACT BLOCK LOT NO. - olQ o TEL.. , O 2 I certify that in.the performance.of the work for which this OWNER NO. p -4S, ermit,is issued, shall not em to an erson in an manner DISTRICE FIRE PRO ESSED BY P py yP yDDRES � JNST. ZONE' sa as to become subject to the Workers'Compensation Laws. ' / Im Date / Applicant CITY ZIP STATISTICAL CLASSIFICATION APT. CONDO. - L.7 NOTICE TO,APPLICANT: If, after m frig this ARCHITECT OR TEL.Certificate of ENGINEER - •NO. - �/ � Exemption, you• should become. subject to the Workers' CLASS NO. DWELL. UNITS Compensation rovisions of the Labor Code, you must forth-P Y ADDRESS J SEWER MAP � with comply with such provisions or this' permit shall b.e /� Z TEL. 7 VALIDATION deemed revoked. : , , CONTRACTOR NO. BK PG/ LICENSED,CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS No VALUATI N (commencing with Section 7000)of Division 3'of the Business and LIC: Professions Code, and my license is in full force and effect. CITY CLASS $ �QdO SQ: FT;XS_/} NO. OF NO. OF CHECK License Number Lic.Class 6 SIZE STORIES FAMILIES. ONE • - . . NEW El $ Contractor - Date DESCRIPTION OF WORK I am exempt from the licensing requirements asl am a t� _ ADD �� FINAL licensed architect ora registered professional engineer ALTER ❑ J— 7 v/ acting in my professional capacity. (Section 7051, REPAIR ❑ DATE / cS®"o \ Business and Professions Code). USE OF _ FINAL n EXISTING BLDG. DEMOL ❑ By ( �� ���p✓ Lic.or Reg. No. - Date APPLICANT TEL. Cf - OWNER-BUILDER DECLARATION (PRINT) NO. I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, .Business and ADDRESS Professions Code): PRESENT z 4 2 7, 2 A BUILDING I, as owner of the property, or my employees with ADDRESS # o o"o o.o . wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY. 2 °J.� .7 8 O O 7044, Business and Professions Code). MOVING TEL. . I, as owner of theproperty, am exclusive) contractingCONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). 03..0 2-8'1_ REQUIRED TOTAL SETBACK FROM EXIST, CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT .-�d the performance of the work for which this permit is'issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name - P.C. Fee$ Permit Fee ' Lender's Address w 1 certify that I have read this application and state that the Issuance Fee ' above information is correct. I agree.to comply with all County Investigotion Fee 1. ordinances and State laws relating to building construction, Total Fee and hereby authorize representatives of this County to enter Qupon the above-mention d property for inspection purposes. o � a_ 'a— SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of Applicant or Agent. Dote - - ©s WORKERS'COMPENSATION DECLARATION is S/ to I hereby affirm that I have certificate of.consent to self LI �.� v DO (� n insure; or a certificate of Workers'Compensati�:nK!'surc;ice�. or a certified copy thereof (Sec. 3800, Lab. C.)• ° < COUNTY OFLOS AWCELES - � �BUILDING �►idD SAIFETV Policy No.493382 Company STATE. COMP. 1N FUND - , /' ® Certified copy is hereby furnished. FOR APPLICANT TO FILL.IN BUILDINGADDRESS T. Certified,copy.is filed with the county building inspec-' o BUILDING ' tion department. ADDRESS. ' LOCALITY NEAREST Date2r2 �� Applicant CITY ZIP . CROSS ST. •" CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR COMPENSATION INSURANCESIZE OF-LOT NOW ON LOT MAP BOOK I PAG PARCEL (This section need not be completed if the permit is,for one USE ZONE MAP hundred dollars'($100)or less.) TRACT BLOCK, LOT NO. NO. TEL. - SPECIAL I certify that.in the performance of the work for which this OWNER NO. �/ CONDITIONS 11 permit is issued, I shall not employ an person in an manner * DISTRICT GROUP TYPE LFIRE PROCESSED BY O so as to become subject to the WorkersCompensat on Laws. ADDRESS O DAM,S DRIVE, � CONST O E tJ CITY TEMPLE CITY ZIP1 Q 8O Date Applicant STATISTICAL, ASSIFI ATION T. CONDO. NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. Exemption, you should. become subject to the Workers'' ENGINEER NO. CLASS NO. DWELL!UNITS L . Compensation provisions,of the Labor Code, you must forth- ADDRESS SEWER.MAP with comply with. such provisions or.this permit shall be TEL. Z deemed revoked. BK.' PG, T VALIDATION CONTRACTOR OZZIE BELZER NO-285 8 LICENSED CONTRACTORS DECLARATION ' LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS .01.2 FIESTA AVE.• NO. 135598 VALUATION- av (commencing with Section 7000)of Division.3 of the Business and LIC. $ Professions Code, and my license is in full force and effect CITY CLASS .> rV D SQ. FT. NO. OF NO. OF CHECK License Number 135598 Lic.Class B� SIZE STORIES FAMILIES ONE NEW $ DESCRIPTION OF WORK Contractor• Date 2-21-4T_ �•I am exempt under Sec. ADD • ALTER O FINAL - B.&P.C. for this reasonQ DATE iVT REPAIR USE OF FINAL Date: EXISTING-BLDG. DEMOL .❑ By �L k Signature APPLICANT TEL. OWNER-BUILDER DECLARATION PRINT NO. 2,95 3R86 1 hereby affirm that I am exempt from the Contractor's License �� ) Law for the'following reason (Section 7031.5, Business and ADDRESS - Professions Code): PRESENT ❑ BUILDING _ I,. as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and I ' the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ' = I, as owner of the property,'am exclusively contractinCONTRACTOR NONE• NO. j` 0'0 1,9 A with licensed contractors to construct the project (Sec- ADDRESS 'tion 7044, Business and Professions Code). # 0 0 0 0,0 tFRONT UIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY .BACK YARD HWY PROP. LINE WIDTH hereby affirm that there is a construction lending agency for D 2.0 2.7 3.7'5 the performance of-the work'for which this permit,is issued .(Sec. 3097, Civ. C.). E - 'o`o 2'7 3.757 NONE . . o Lender's.Name 0 22.37 8 3 P.C. Fee$ Permit Fee - Lender's Address I certify that I have read this application and state.thot'the Issuance Fee �. a above information,is correct. I agree to comply with.all County. Investigation Fee g ordinances and State laws relating to building construction, Total Fee u and hereby authorize representatives of this County to enter upon the above-mentioned pro erty for inspection purposes. aa SEE REVERSE FOR EXPLANATORY LANGUAGE ig Applicantr Agent Date - - •®f -