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HomeMy Public PortalAbout9115 DUFFY ST_Building__ I _ DEPARTMENT, OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES wES6 U I L®8 N G WM. J. FOX, CHIEF ENGINEER u v FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT PLgN CKI/Nq.� PERMIT f�,0./� BUILDING K oO. )K.1� 3 ADORES3 LOCALITY • RE EIVED BY DATE OF APPL. ❑ T�,ISSUED NEAREST Su CROS89T. ' ADDLoNG RESS �r / S- OWNURMAIL ADDRESS JG_j {1�.(,.A . NEAREST Y �C TEL. Xn� CROSS ST. ` _J /Z CITY (2 � NO 6IY' +� ZIRE NO. OF ONE I PLANS ` ry GR ARCHITECT OR TEL. ENGINEER NO, SETBACK LINE I��/ ADDRES! APPROVED CONTRACTOR p(. c. ��E /�1 l' BY ,/ DATE 1 -1 ZONE -/ BYPROVED DATE ADDRESS Lr ,f`6 f. 'T G �����•���•1H�OUSE NUMBERING LEGAL ' DESCRIPTION I LOT NO. BLOCK MAP NUMBER���/�, _FIELD CHECK BY TRACT NO. ASSIGNED BYJ//�/Y1�1/�� _AAT c' NO. OF BLDGS. CORRECTIONS �/ SIZE OF LOT `.I ^ I NOW ON LOT /77. USEOF I NO. OF EXISTING BLDG. FAMI LINO DESCRIPTION OF WORE F GF7rl�f n.rc a SPvvvF1J i/ NEW I I ALTERATION I I ADDITION REPAIR I DEMOLITION I I I T SD. FT. NO. OF ` �l'�ron G,y.✓ ✓c....•T /'A�/../ �D SIZE D/ ROOMS E STORIES [/'� /n Aye lJY 130SE / r EXT. WALL ROOF !: �•'n� /` C 1 / COVERING COVERING n ^fid/Z �-ZDOP i /i+i Sl/- TOMu0SiLG- USE OF STRUCTURE Al � ^ APPROVALS ^� uC0 `Z G INSPECTOR'S SIGNATURE DATE 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FOUNDATION: LOCATION CA PLITION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS ��/p.,� y-...�. .-S 1^•/j j CORRECT. I AGREETO COMPLY WITH THE CORRECTIONS LISTED 1 FRAME: FIRE STOPS, HEREON AND WITH ALL COUNTY ORDINANCES AND STATE � -BRACING-BOLTS LAWS REGULATING BUILDING CO 3 STRUCTION. FURNACE: LOCATION, �ff SIGNATUREOFGAS VENT, DUCTS PERMITTEEd [-' /u' ` LATH. INT. ' ADDRESS % OJ `. C_• ".�� ' "`.� .N,�/�^ / i ,.�!%" .3 1/ LATH, EXT. � AUTHORIZED AGT. M PLASTER, INT. 76A666A- DONS 10-60 {A . _999 pj 5 � FEE �I PLASTER, EXT. A �N VALUATION /�� ' FEE SJP� FINAL •�. _ /Q'r `J Z'� 1 WORKERS' COM?ENSATION DECLARATION I hereby affirm that have a certificate of consent to =elf U P P U CQT p O N FOR C° O L D O N G P C�RNT insure, or a certificate of Workers'Co mpe not c Insurance, or <` a certified copy thereof (Sec. 3800, Lab. C) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. - Company BUILDING 0 Certified copy is hereby furnished, FOR APPLICANT TO FILL IN ADDRESS ❑ ' Certified copy is filed with the county building inspec- BUILDING L tion,departybent. 1 /,�,TA ADDRESSfJ / LOCALITY Applicant r" I til F�^�l NEAREST Date CITY / ZIP CROSS ST. CERTIFI ATE OF EXEMPTION FROM W RKERS' NO.OF BLOCS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT / MAP BOOK PAGnE PARCEL (This section need not be completed if the permit is'for one 0- 6 3y3 USE Z E MAP OrJ hundred dollars ($100)or less.) i TRACT BLOCK LOELN SPPEECIAL _d I'cerlify that in the performance of the work for which this OwNERl7�l7 f erg NOW CONDITIONS _ O permit is ued, I shall not mp y any person in any anner �], l� STRICT GROUP TYPE FIRE PR ESSED BY ' V so as to oma subject orkers'Compens n L. ADDRESS /��/.r//k/ /�K r' CONST.) ZO 0x r) CITY /v/i/ /C (_i ZIP 76 ✓f/ ��G�J // ✓ Q, kDdi€ �-- icant ' STATISTICAL CLASS ATION PT. CONDO. V NOTICE TO APPLICANT: If, after' making this Certificate of ARCHITECT O pp TEL /'//�' Z / W Exemption, you should become subject to the Workers' ENGINEER 19Q ,('// NO. CLASS.NO. DWELL. UNITS_ N Compensation provisions of the Labor Code, you must forth- ADDRESS 4'1 SEWER z with comply with such provisions or this permit shall be '�j deemed revoked., - CONTRACTO BK. PGIC.cyGJ VALIDATION LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS .��� NO. VAL TON (commencing with Section 7000)of Division 3 of the Business and LIC Professions Code, and my license is in full force and effect. CITY -� f CLASS S SQ. FT NO, OF, NO. OF CHECK. ' License Number Lic.Class SIZ STORIES FAMILIES ONE NEW $ Contractor Date DESC IPTION OF WO_liRK , ' S Qr / I am exempt from the licensing requirements as I am a /!C7/) ADD _ licensed architect or a registered professional engineer ALTER FINAL acting in my professional capacity (Section 7051, 0 /j�/dd a DATE ��•'C$ _,� Business and Professions Code). USE OF �•L� / REPAIR- e s e e EXISTING BLDG. U/// � GL/�O/'1 DEMOL"� BY Al /'' P .# 2 3 Lic.or Reg. No. Date APPLICANT _ TEL. 2 e - 6000 OWNER-BUILDER DECLARATION (PRINT) NO. © /y0 I hereby affirm that I am exempt from the Contractor's License ADDRESS _ �' 6 7V e e e ,6 O 0 0 Law for the following reason (Section 7031.5, Business and Professions Code): PRESENT❑ G // N� . .0 9,25-81 \O �/ I, as owner of the property, or my employees with ADDRESS BUILDIN jW wages as(heir sole compensation,will do the work and - �/f the structure is not intended or offered for sale(Section LOCALITY e, - t 7044, Business and Professions Code). - MOVING TEL. R' I, as owner of the property, am exclusively contracting CONTRACTOR. NO­ with with licensed contractors to construct the project (Sec- ADDRESS K` •a} J tion 701 Business and Professions Code). • 'e e s q ..J REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. UNE WIDTH 2 e (� 2�,5 O ),hereby affirm that there is a construction lending agency for FRONT -the performance of the work for which this permit is issued P.I. e e 4 2& v �' (Sec. 3097, Civ. C.). SIDE PA '' Lender's Name S ( 0 9,25-81 P.C. Fee$ . OW 7 f �n Permit Fee r lr J O Lender's Address / 1 certify that I have read this application and state that the / U Issuance Fee above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, m and reby authorize represe atives of this Co ty to enter Total Fee / J� mupo t gab�owe-m ant iio p any for inspe<ti purposes. (� SEE REVERSE FOR EXPLANATORY LANGUAGE ^ Signature o Applicant or Agent Dote OO s