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Home My Public Portal About5005 DOREEN AVE_Building__ J A']6A638k CE .803 4/72 I APPLICATION FORSUILDING PERMIT �] r `COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING MAKE CHECKS PAYABLE 70: ADDRESS HARVEY T. BRANDY, COUNTY ENGINEER LOCALITY - FOR APPLICANT TO FILL IN NEAREST Print or 1 onl CROSS ST..-. - IA DISTR NO. GRO TYPE PRO SSE BY. BUILDING VO CONST \ ADDRESS STATISTICAL LASS(FICATION SEWERM P rf LOT NO. ), I 0-f-' BLOCK C LA SS'NO. DWELL,UNITS BKL PG3 TRACTqo E ZONE MAP NO.OF BLDGS. �� NO. SIZE OF LOT NOW ON LOT SPECIAL SE UI CONDITIONS EXISTING BLDG. 7` - TEL. /7` 1. OWNER — (/ NO. ..•V BLDG.SETBACK FROM ADDRESS Ce u FRONT PROP,LINE OF (STREET) TYPE OF EXISTING SETBACK„- HIGHWAY 4 HARD = TOTAL CITY HIGHWAY WIDTH FROM C.L. T � ARCHITECT OR TEL. Q i C,.2V = OWN ENGINEER NO. - BLDG.S BACK FROM ISTREET) ADDRESS SIDE PROP.LINE OF ' _ TEL. TYPE OF EXISTING1 SETBACK I HIGHWAY } YARD = TOTAL O CONTRACTOR NO. HIGHWAY1 WIDTH FROM C.L. O LIC. /� _ ADDRESS NO. ✓ + LIQ a CITY CLASS CORNER CUTOFF YES ❑ NO ❑ h Z_ CONSTRUCTION LENDER NAME AND BRANCH SEE REVERSE SIDE FOR SP IAL APPROVALS ADDRESS SQ. FT. NO. OF NO. OF NEW ❑ - SIZE STORIES FAMILIES USE OF ��,,7„ ADD ' STRUCTURE /-00 ALTER ❑ SIGNATURE OF REPAIR❑ APPLICANT OEMOL ❑ ' VALUATIO DO/ APPROVALS Of TE IHSP/ TOR's GN Tone J FOUNDATION: LOCATION N / F E S _ FEE '/c) FORMS, MATERIALS FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT I HAVEREADTHIS APPLICATION BRACING- BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT', DUCTS STRUC TION. I CERTIFY THAT IN DOING THE WORK AUTH AIZED p HEREBY I WILL NOT EMPLOY ANY PERSON IN V104ATIO OF THE, LATH, INT. 16 l 1 1774, LABOR CODE OF THE STATE OF CALIFORNIA IN R ATING TO WORKMEN'S COMPE NSA N 1 HCE. LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- ` PERMITTEE RECT AND POS i u 27. ADDRESS FINAL W.' , PLAN CHECK VALIDATION CK. M.D. 'DASH _ PE 1LIDATION DK. ' 410. CASH LtaCo C o y 973 APR 1 Z 1000 D 2 8.50- Q WORKERS'COMPENSATION DECLARATION I hereby affirm that I have a'certificate ofconsent to self /j4 OPPO (j(�� /p�� I�I��I�� gyp} j��y �r�rylp��,.j� �rE}�I�y�ffjL�gj�� Il insure, or a certificate of Workers' Compensation Insurance,. ^(/"1111 Il � `�j/ryl�B®Il V U -®Uhl' �� D�U V�'/ �L50011011�� or a certified copy thereof (Sec. 3800, Lob.•C.). COUNTY OF LOS ANGELES BUILDING AND SAFETY 'Policy No. I Compo - - Certified copy is hereby furnished.. - _ FOR APPLICANT TO-FILL IN - _ _ BUDDING • -�—D ADDRESS WPal* 12 ' Certified copy is filed with the county building irispec- BUILDING tion department ADDRESS' 0,- - - _ _ .LOCALITY 1 '� - - NEAREST Dat •/-f:✓1��Appi<anl CITY' _ ZIP CROSS ST. CERTIFICATE OF EXEMPTI M WORKERS' NO. OF BLLOT - ASSESSOR - COMPENSATION INSURANCE - - SIZE OF LOT NOW ON LOT j MAP BOOK PAGE PARCEL .(This section need not becompleted if the permit is for one USE ONE MAP hundred diillars,($100)or leis.) TRACT BL K � LOT NO. - At I certify thotPin.the performance of the work for which thisOWNER (�(,y10. - CONDITIONS S permit is issued,' shall not employ any person in any manner. - bISTRIC GROUP TYPE •. FIRE PROCESSED,BY O ADDRESS' /-• ,1<•i CONST. ZONE V so as to become subject to'the Workers'Compensation Laws. J fl(AJ R 3 � . . . , s Date - Applicant •- CITY IF STATISTICAL CLASSI�N APT., CON _. U NOTICE TO,APPUCANT: If, after making this'Certificote of ARCHITECT OR TEL - _ 'Exemption, you should become subject to the Workers' ENGINEER NO. CLASS IN DWELL. UNITS_ W Compensation provisions of the Labor Code, you must forth- ADDRESS - - - SEWER MAP - Z with comply with such" provisions or.this permit shallbe deemed revoked TEL' VALIDATION CONTRACTOR : N a LICENSED CONTRACTORS DECLARATION UC. ` I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO.;?Z0_0 ' VALUATION (commencing with Section 7000)of Division 3 of the Business andr LIC Professions Code;and my license is in,full force and effect. CITY ,V CLASS '$. D . SQ.- . - NO:OF NO OF HECK '.. License Nu (� - Lic,Class SIZE STORIES it FAMILIES ONE Co ntrOctor Date d DESCRIPTION OF WORK - X- - NEW - _ -lla\T ADD .. I am'exempt under Sec. - - ' - ALTER 'FINAL •_ ,. - B.BP.C.'for this reasonUaFREPAIR Q DAT LIZ. Date: %ISTING BLDG. �— . ..- DEMOI- 0 _.FIN _. RY 30988A Signature - APPLICANT TEL. - - 'q` OWNER-BUILDER DECLARATION ' ' PRINT ' NO. __ 'D #•°'� ° °, ° 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 I ° ° 4 9,8 8 ' - 1 '�• I, as BUILDING owner of the property,-or my employees with ADDRESS - - - "" �'°; S� wages as their sole compensation,will do the work and - - ° 4.9;a,8 v - the structure is not intended or offered for sale(Section LOCALITY - ,- 1'I-,Q 3'�'�8 4 'I 7044, Business and Professions Code). MOVING TEL... - , I, as owner of the property, am exclusively contracting CONTRACTOR NO. {. with licensed contractors to construct the project (Sec- ADDRESS 'tion 7044, Business and Professions Code). REQUIREDTOTAL SETBACK FROM EXIST:, ` CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH• D - - 1 hereby.affirm that there is a construction lending agency for ..FRONT - - - - - the Performance of the Work for which this permit is issued 'P.0 -s (Sec. 3097,.Civ. C.). - SIDE Lender's Name QQ $ - - - Lender's Address P.C. Fee$ Permil Fee . - I certify that I have read this application and state that the - Issuance Fee DI Q above information is correct. Logree to comply with all County Investigation Fee _ p' �jr _ •' ordinances and State laws relating to building construction, Total Fee a and hereby authorize representatives of this,County to enter - bpatLt a above-m ntianed pr p Yor inspection purposes. - - •-• - —^ - - - �/ - SEE REVERSE FOR EXPLANATORY LANGUAGE ' fpplicant or Agent Os l APPLICATION FOR REWCATION •BUILDING PERMIT DMSION OF BUILDING AND SAFETY BUILDING �f n DePartLent of County Engineer ADDRESS �// "7� L County of Los Angeles )6AB99 JOHN A. L.AMBIE,COUNTY ENGINEER LOCALITY +DBsa9-11-55 CASSATT D. GRIFFIN. SUPT OF BUILDING NEAREST ' CROSS ST. + I FOR APPLICANT TO 'FILL IN DISTRICTNO. GROUPTYPE SEWER MAP {{ � Ty BK BUCONST. BUILDING Ao - ADDRES2�EJ� P MAP q STATE LOCALITY -p4L,�bJS NUMBER �yL'�D HWY. YES NO PRESENT /q� USE ZONE SPECIAL �j �:y� BUILDI G G �� . / ,�M �j ` - / CONDITION (/ i[ (J ADDRESS- LOCALITY ` �T LOCALITY J�N 1.0� �. BUILDING EXIST. //��'�TT�-�^^ /l SETBACK -YARD HWY STREET NAME WIDTH OWNER LJ('} ro W(^, , IV A/�2• FRONT (a/) ,yee 7 4- AD RMAILESS 303,3 /`fY{�/Ci1��"D% P I OC'�� L✓�V CITY � TELNO. � / c^PIDE V SURETY DATE D EC'D P G/1 MOVING TEL T/ / Z BOND$3�g0 - �FILED�-�o� Y 01 .4l CONTRACTOR 02Q/YA NO. OO CASH DATE RECD DEPOSITS FILED BY ADDRESS BUILDING TEL. CONTRACTOR NO. -y ATE NSPECTORIS SIGNATURE ADDRESS FOUNDATIONV LOCATIO FORMS.MATERIALS PRESENT - USE OF s%41UC�k ' LLL to %� BUILDING FRAME: FIRESTOPS. - BRACING,BOLTS PROPOSED USE OFr`+ FURNACE: LOCATION - BUILDING ' -GAS VENTS.DUCTS ' LF:TH. INT.SO.FT' NO. OF ' SIZE ROOMS STORIES / WALL ROOF HOUSE COVERING COVERING' D OUSEMBERCOR- LEGALf. RI-Cr AND POSTED DESCRIPTION PC,:,I NO74&v. I BLOCK C ` - ✓/� rr�� FINAL 7 TRACT i 1.2 940 DISTRICT GINEER SIZE OF LOT S'S�/Igy I NO.OF BLDGS. WORK COMPLETED NOW ON LOT SURETY BOND USE OF NO.OF RELEASED EXISTING BLDG. FAMILIES THEREBY ST TH THE INF ION WVEN 15, �I HEREBY ACKNOWLE E.THAT I`H VE READ THIS CORRECT. 1, APPLICATION AND STATE THAT-THE ABOVE IS CORRECT SIGNATURE 'WAND AGREE TO CO PLY WITH ALL COLIN RDINANCES APPLICAN AND STATE LA EGULATING BUIL -CONSTRUC- y TION. ADDRESS SIGNATURE OF pERM ITTEE14 VALUATION S P. C. S f' ' FEE C. ADDRES FEES JOHN A. LAMBIE.COUNTY ENGINEER VALWAT�IOIQI CLYDE N. DIRLAM.CHIEF BLDG. INSPECTOR CK MO <A H 5 z 5 A 15.00 v C�F 6'7 6 a FEB 18 6 A... 1, 5.0 0 r