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Home My Public Portal About9833 DAINES DR_Building__ p p p /� 7eSssaewo® APPLICATION FOR BUIL DING PERMIT f DIVISION OF BUILDING AND SAFETY B U 1 Department of County Engineer -ADDRESS )� County Of Los Angeles LOCALITY - JOHN A. LAMBIE. COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST FOR APPLICANT TO FILL IN DISTR C'1�La TYPE SEWER MAP BK PG GG�� /� H CONST. ADDREISS� ,�3 E 'Pyq y�� NUMBER 2Q Q STATE YES NO LOT NO. 3/ BLOCK USE ZONE SPECIAL ^^ CONDITIONS TRACT � � �y � NO.OF BLDGS. SIZE OF LOT G X l 1-O NOW ON LOT - BUILDINGEXIST. BLDG. - SETBACK FRONT YARD HWY STREET NAME WIDTH USE OF - EXISTING n ,,r1 J n P L OWNER -J-J -"rA P,e QG(�MIv J 1� SIDE ' MAI L ADDRESS /9'3 3 d/ I N P" O TRACT DWEL I UNIT _ l�n 1 !, 5 INDUSTRIAL .CITY I C/'7 N �I+� NO.)? J3 DWELL. 1 UNIT 6 PUBLIC BLDG. ARCHITECT OR f TEL. 2 DUPLEX 2 UNITS ENGINEER NO. 7 ADDN..ALT., ETC. 3 APT. UNITS - 8 MISCEL. ADDRESS 44 COMMERCIAL ' T CONTRACTORELNO.. INSPECTION RECORD . ADDRESS DESCRIPTION OF WORK NEW ADD (ALTER REPAIR DEMOLISH SQ. FT. OF NO OF SIZE STORIES FAMILIES USE OF STRUCTURE SIGNATURE O APPLICANNT, APPROVALS ' ADDRESS DATE INSPECTOR'S SIGNATURE $ FOUNDATION LOCATION P. C. $ FORMS.MATERIALS I FEE FRAME FIRE STOPS, P nn VALUATION BRACING. BOLTS FEE FURNACE: LOCATION. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT. DUCTS �- APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. ' AND STATE LAWS UZGVMNNG BUILDING CONSTRUC- TION. LATH. EXT. �- SIGNATURE O HOUSE NUMBER COR- P ERMITT OR-PERMITT RECT AND POSTED ADDRESS FINAL JOHN A.LAMBIE, COUNTY ENGINEER VALIDATIM CLYDE N. DIRLAM. CHIEF BLDG. INSPECTOR CK MO ( CAS - ! 2 23�4 NOV 9 1 4.G 4 � i5A698A CE j8b311_57 APPLICATION FOR BUILDING PERMIT 1.• COUNTY OF LOS ANGELES BUILDING ? Ap DEPARTMENT OF COUNTY ENGINEER . ADDRESS 7 _ BUILDING AND SAFETY DMSION LOCALITY JOHN A.LAMBIE,COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. _ DISTRICT NO. GROUP TYPE SEWER MAP - FOR APPLICANT TO FILL IN BK PG- CONST BUILDING STATISTICAL C SSI FI CATION ADDRESS '� �/ E' _ LOT NO C11� BLOCK CLASS NO�DWELL UNITS MAP STATE YES TRACT I397C NUMBER HWY. + USE ZONE SPECIAL - - NO OF BLDGS I CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG BUILDINGEXIST. YARD HWY STREET NAME -T. L I��A-s� SETBACK WIDTH OWNER FRONT MAIL z $ r�- c A P L ADDRESS ✓./ c �` /`c SIDE ' CITY i fJLr Gi Tr NO 16 d 33 P L ARCHITECT OR TEL INSPECTION RECORD ENGINEER 0 oeNO. 5- ADDRESS u < CONTRACTOR TEL ADDRESS DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH SQ.FT. - 1l� NO OF NO OF SIZE /i�6 STORIES FAMILIES USE OF STRUCTURES Q SIGNATURE OF - - . APPROVALS APPLICANT me • DATE- INSPECTOR'S SIGNATURE ADDRESS FOUNDATION: LOCATION FORMS,MATERIALS ' P C $ _ FRAME FIRE STOPS, FEE BRACING,BOLTS VALUATION $ L1 FURNACE LOCATION, , FEE _r GAS VENT,DUCTS I HEREBY'ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH,INT. '. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH-,k_LL COUNTY ORDINANCES AND , STATE LAWS RE 4 BUILDING CONSTRUCTION LATH,EXT. SIGNATURE OF, HOUSE NUMBER COR- "P RECT AND POSTED y� ` ADDRESS S FINAL CJ CLYDE N. DIRLAM, PFIINCIAL STRUCTURAL EN yR PLAN CHECK VALIDATION CK. M.O.' CASH PERMIT VALIDATION CK. , M O CABH [ 0 7.1.01" MAY 9 1 A 2.0 � � ®. APPLICATION FORBUILDING-PERMIT Y p COUNTY OF LOS ANGELES BUILDING'AND SAFETY • n . . WORKER'S COMPENSATION DECLARATION- FOR APPLICANT TO FILL IN @UILDIN DS { I'hereby affirm that I have a certificate of,consent to self Insure, BUILD G'AD RFSS �S J7 or a certificate of Workers' Compensation Insurance,or a certified Copy,thereof,(SBC 3800,Lab CCIcM �' ^�� CA 17/'7 ZIP �O LOCALITY Polley No. Company` ;SIZEE-O�FLOT- /lam NO OF BLD_GS,NOW ON LOT ❑ Certified copy Is hereby furnished NEAREST CROSS ST 0 Certified copy Is filed with the County building Inspection TRACT BLOCK LOT NO ` department _ USE-ZONE MAP NO ' ASSESSOR MAP BOOK PAGE PARCEL Date Applicant ' • SPECIAL CONDITIONS 'v� CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER /' TEL NO N ' VES NO COMPENSATION INSURANCE' �+ S �IVLY S,/ YQ I 'WITHIN 1000 FT OF SCHOOL? (This section need not be completed If the permit Is for one-hundred ADDRESS- (This %�� /�, �;�,�/� 33 Dq I/V ES D . DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY dollars,($100)or less) �• CITY ,�- - �` n/V ZIP I certify that in the performance of the work for which this permit- !�L E Lq1/7100 is,Issued, I shall not employ any person In any manner so as to ems'KJ 3 become subject t0 the Workers'Compensation Laws ARCHITECT OR ENGINEEIJR- TEL'NO - , STATISTICAL CLASSIFICATION' APT CONDO- _ Date Applicarit ADDRESS - CLASS NO � DWELL UNITS' NOTICE TO APPLICANT If, after making this Certificate of .REQUIRED- TOTAL SETBACK FROM EXIST, Exemption, ' you should- become 'subject t0 the Workers' CONTRACTORO�� .r�� TEL NO SET BACK, PROP LINE WIDTH' - Compensation provisions of the Labor Code, you must forthwith YARD HWv, FRONT • comply with such provisions or this permit shall:be deemed revoked ADDRESS LIC NO P L _ r LICENSED CONTRACTORS DECLARATION SIDE 0 CITY LIC CLASS P L ,C.1 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 O -Professions Code,and my license is In full force and effect NEW ❑ BK •, PG , - License Number LK: Class DESCRIPTION OF WORK. �' r dd ADD ❑ VALUATION _ �� W Contractor Date ALTER k. $ �.SOO' EL O 1 am exempt under Sec DD �� w REPAIR ❑, z B&PC for this reason DEMOL ❑ $ ` LDMA P/C# �',: •• - Date USE OF EXISTING BLDG URM - ❑ , Ignature APPLICANT(PRINT) TEL NO LDMA Perm 1 I, as owner of the property, or my employees with wages.as Z l CC i e v their sole compensation, will do the work and the structure Is ADDRESS O p _ F IFJS e. rx)t'intended or offered for sale330.3 (Section 7044, Business and � l - FINAL DATE - Q QO PTOfeSSIOr1S Code) _ WILL THE APPUCANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL I ITEMS , ❑ I, as OWDe( Of the y, y g OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? Q c licensed'Contractors to construct the project (Section 7044, FINAL ,. '^ Business and Professions Code) YES❑ NO❑ • I }- [}(� WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING - -.CHECK - .LIJL•v 0 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH '_� CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR _ t a 1�1 GUIDELINES - 4, CHANGE I hereby affirm that there Is a construction lending agency for YES❑ ' NO❑ the per of the work for which this permit Is Issued(Sec - tke pe GIV C I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING �1 • CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS,ANGELES COUNTY.CODE, _ _ i!E)�-0001 � �I�_i f�r N L, -• I TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS p+ Lender's Name - MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD �8 3 q' '%M i'f a 11t �i Lender's-Address 1 r t3.1 1 Q - OMER OR AGENT - 3 1 certify that I have read this application and state under penalty p 'of perjury that the above information Is correct I agree to comply PC FEE PERMIT FEE ( with all county ordinances and State laws relating to building m construction, and hereby authorize representatives of this County ISSUANCE FEE aD to ter upo the ove-me ipned property for inspection purposes •✓ INVESTIGATION FEE' TOTAL FEE 4y� ,pnon,re a-PDY «Apo„ Dere SEE REVERSE FOR EXPLANATORY LANGUAGE