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HomeMy Public PortalAbout10939 DANBURY ST_Building__ ]6A639A CEO603,0.69 APPLICATION FOR BUILDING PERMIT :Y COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY t .JOHN A. LAMBIE, COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN, SUPT OF BOILDI.G CROSS ST. DISTRICT NO. GROUP TYPE e P dSSED BY PADRE OR APPLICANT TO L IN I CONST. DING STATISTICAL CLASSI KATION SE ER MAP . ESS BK - PG CLASS.NO.MAP ��DyW�ELL.UNITS O.'_ OCK MA NUMBER 8Z o J O HWYSTAT. YES NO T ,^ 2 _ USEZONE SPECIAL P yp NO.OF.BLDGS• CONDITIONS OF LOT QO% 5U YId IXR/ NOW ON LOTFTING BLDG. BUILDINGYARD HWY STRE NAME EXIST.SETBACK WIDTHER t L.i /f /" l'O FRONT P.L.RESS h SIDE TEL G P.L. NoINSPECTION RECORD ITECT ORNEER ESS l/RACTOR -C OW TEL ADDRESS DESCRIPTION OF WORK );A—T` ' aADDRESS10,?p?do;Vf- ADD ALTER REPAIR DEMOLISH ' NO.OF NO.OF STORIES FAMILIES RE EOF NT APPROVALS' DATE INSPECTOR'S SIGNATURE Q f- OUN DATION: LOCATION FORMS.MATERIALS -II_LVI-�",'�"�-N$ ©fji (J +T'BRACING, AME: FIRE STOPS.-,; .... .,... ..: ,� BOLTS -C O r FUR NAC E: LOCATION. F E $ ��I FEE S I GAS VENT,DUCTS _ 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH.INTI PLICATION AND STATE THAT THE ABOVE iS CORRECT AND p _ AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND - VI ! y7+------- STATE LAWS REGU TING BUILDING CONST UCT ON. LATH,EXT. - SIGNATURE.OF HOUSE NUMBER COR- PERMITTE RECT AND POSTED y� / ADDRESS Q INAL 1 v '''''',,,,,,yyyyyy,,,,,,''''''"""""" CLYDE N. DIRLAM, PRINCIPAL ST�RAL ENGINEER PERMIT ,.. PLAN CHECK VALIDATION �K. M.o. SASH PERT VALIDATION CK. M.O. CA9H 1(o 7 2 9. 1 R-IR 42 3, A 2 1.0 0,A h - L&7.58'82 MAR 11 11A 4 2.0 0 M WORKERS' COMPENSATION DECLARATION 0 -MT I R/ —33/—J/ �FI����'(/�� �p}�r,,�/�tpL�q�L1� hereby affirm that haver certificate of consent to self /U PPUC /O\M V. B OR I UM DM V V PISU�1L1L7 T insure, or a certificate of Workers' Compensation Insurance, (ro LS "`VVV--- (r L1 R ed c%y tftereof (Sec.38W L C.), Oc Z.7,�' ,%r COUNTY-OF LOS ANGELES. - BUILDING.AND SAFETY . `Ao icy No.IZ Company���) � • ❑ Certified co is hereby furnished. FOR APPLICANT TO FILL IN ' - BUILDING PY Y ADDRESS. •O! BUILDING y Certified copy is filed with the county building inspec- - ADDRESS �- 'H q S 7 ' tion department. / Date r c1 'V` Applicant CITU' /CZIP - LOCALITY NO. OFNEAREST LOT CERTIFICATE OF EXEMPTION FRO ORKERS' SIZE OF LOT NOW ON LOT CROSS ST. N COMPENSATION INSURA E o _ (This section need not be completed if the permit is for one TRACT BLOCK LOT'NO.'. ASSESSOR hundred-dollars ($100) or less.) TEL MAP BOO S PAGE O 2 V PARCEL'02' OWNER Q r•QC eN NO. - USE'ZONE MAP, L7..— �7 I certify that in the performance of the work for which this /^� NO. permit is issued, I shall not employ any person in any manner ADDRESS j�-g O ` k)—J SPECIAL OLS 0— d. so as to become subject to the Workers' Compensation Laws, CONDITIONS O CITY ZIP - U Date Applicant - - ARCHITECT OR TEL. K NOTICE TO APPLICANT: If, after makingthis Certificate of ENGINEER NO. .DISTRICT .GROUP TYPE FIRE ESSED BY CONST. ZONE O Exemption, you should becomesubject to the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions a, this permit shall be /_ TfIGy G•�77 STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTOR OV f C_ N0.116 I,Jp r� LICENSED CONTRACTORS DECLARATION LIC S� CLASS NO. �-'� 'DWELL. UNITS_ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS S7� �+ N'S3 7 (commencing with Section 7000)of Division 3 of the Business T LIC. r� SEWER MAP and Professions Code,and my license is in full force and effect. CIN._(/'(,GN 4�� CLASSG TJ BK VALIDATION 3�p � C3 SQ. NO. OF NO. OF CHECK License Number ! Lic. Class / SIZE STORIES FAMILIES ONE //1� VALUATION ' Contmcto4 /— G� Date DESCRIPTION OF WORKre f/-fab I—1 �,/ NEW ❑ S /AT ION ❑1 am exempt under Sec. ✓ti �C/v^— '�(� C�4s� /7 ADD ❑ fe D ALTER B.BP.C. for this reason " / !�--TC yd �,7 ❑ $ - - USE OF t _ \\ [ REPAIR Date: DEMO. ❑ EXISTING BLDG. 1 �__ Signature - APPLICANT TEL. OWNER-BUILDER DECLARATION (PRINT) �� `-z -`_ NO. FINAL I hereby affirm that I am exempt from the Contractor's License _ DATE , law for tke EoflowinADDRESS g reason (Section 7031.5, Business and FINAL ns-C Professloode) - PRESENT - B r AA((CTa ❑ I,1as owner of the property, or m employees with BUILDING T r nl 4 P P Y. YADDRESS wages as their sole compensation,will do the work and - - - //(( `_ ^07 ,7 Il IF efstructure Is not Intended or offered for sale(Section LOCALITY D ,p{ lr�yV "' '�`' r Mr 1cr ._IJ 7044, Business and Professions Code.) MOVING TEL. 1 ITEMS ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project(Sec- - TOTAL j,27� 00tion 7044, Business and Professions Code.) ADDRESS. LLQ REQUIRED TOTAL SETBACK FROM EXIST. CHECK 127.00 CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT CHANGE ,1}Q the performance of the work for which this permit is issued P7. - - (Sec. 3097, Civ. C.). 'SIDE ' P.L. 0000-0001 . 11 4!90 Lender's Name. O LDMA Ref. # 3 Lender's Address P.C. Fee$ Permit Fee /13,610 v U Q(} 3 1 AM11.34 c, I certify that I have read this application and state that the Issuance fee / 3'U 0 LDMA P/C q 8 above information is correct. I agree to comply with all County Investigation Fee - ordinances and State laws re toting to build' construction, Total.Fee Z 7, U(] LDMA Perm. # and here thorize representatives ounty to enter upon th ove- e ` roper nspec/tion puurpoosses ` ( /x d - - SEE REVERSE FOR EXPLANATORY LANGUAGE Signature -pplimn or Agent Date -