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Home My Public Portal About4904 ENCINITA AVE_Building__ BUILDINu BUILDING'" /YD_ ADDR6BB i ��• APPLICATION LOCALITY 2fe a. NEAREST DIVISION OF BUILDING: AND SAFETY CROBS',. Department of County Engineer DISTRICT NO. RECEIPT NO.f PERMIT NO. County of Los Angeles ` 15— 8l-511* 74396 WM. J. FOX, COUNTY ENGINEER GROUP DATE RECEIVED ^DATE ISSUED CASSATT D GRIFFIN, SUPIT OF BUILDING /� l J �� / / — ? - � rdm FOR APPLICANT TO FILL IN TYPE CONST. E�IVED 4/ BY L '- UED-BY j OWNER ` _ MAIL , t�D ��/ NUMBER ,� d MAP sHE YE NO ADDRESH ��•j /y!L .A r�� USE ZONE SPECIAL TEL , CONDITIONS CITY NO ARCHITECT OR TEL/ LfVd ENGINEER NO BUILDING YARD IIWY STREET NAME EXIST. SETBACK WIDTH ADDRESS /+ { FRONT �^ CONTRA CTOR(41� NO ✓�I �+g_ SIDE E - P L ADDRESS DATE CORRECTIONS INSPECTOR ADDRESS® LOT NO 040 TRACT NO OF SLOGS -1 Me I"'0.AA" lzk11�y� 91ZE OF LOT I NOW ON LOT C/V USE OF FXIliTING BLDG DESCRIPTION OF WORK n\.j vm-lk J' -1 ° NEW ADD ALTER REPAIR DEMOLISH _ Z SO FT. Q NO. OF J NO OF D BIZE �./ STORIES / FAMILIES r USE OF STRUCTURE NO OF 1 EMPLOYEES 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP-' PLICATION AND STATE THAT THE INFORMATION GIVEN IS, APPROVALS INSPE TOR'S SIGNATURE DATE CORRECT I IAGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION LOCATION AND STATE LAWS REGULATING BUILDING CONSTRUCTION FORMS,MATERIALS r J FRAME FIRE STOPS, (p� SIGNATURE OF // BRACING, BOLTS PERMITTEEFURNACE LOCATION, GAS VENT, DUCTS ADDRESS ^o. LATH, INT. AUTHORIZED AOT LATH, EXT 'A -Y $ P C ®�j HOUSE NUMBER COR- FEF �I RECT AND POSTED VALUATION FINAL SCC 76A638A DBS 3 0 5-54 76A638A CE#803 9-68 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS v �L BUILDING AND SAFETY DIVISION LOCALITY JOHN A 'LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS, SUP T OF BUILDING CROSS STC" FOR APPLICANT TO FILL IN DISTRICT NO GRQUPI CONST P o E e (Print ort pe only) [� BUILDING STATISTICAL C S IFICATION S ER MAPS ADDRESS 0 En CLASS NO DWELL UNITS —11---IG LOT NO BLOCK USE ZONE MAPNO _lz 0 b TRACT SPECIAL NO OF BLDGS CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG BLDG SETBACK FROM TEL p FRONT PROP LINE OF (STREET) OWNER NO 2S _6 TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C L 11-1 t = CITY BLDG CK FROM ARCHITECT OR TEL SIDE PROP L (STREET) ENGINEER NO TYPE OF EXISTING SETBA IGHWAY } YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C L TEL CONTRACTOR NO C LIC ADDRESS 529 E. Valley v CORNER CUTOFF YES ❑ NO C CITY CASs V,_3 SEE REVERSE SIDE FOR SPECIAL APPROVALS 4 CONSTRUCTION LENDER NAME AND BRANCH Z ADDRESS SQ FT NO OF NO OF NEW ❑ SIZE STORIES FAMILIES USE OF ADD ❑ STRUCTURERe—roof ALTER ❑ Wlti Qt O OII1 O REPAI SIGNATURE OF - APPLICANT, DEMOL ❑ VALUATION S 353 • APPROVALS DATE INSPECTOR'S SIGNATURE P C PMT `7V FOUNDATION LOCATION FEE $ FEE S FORMS, MATERIALS FRAME FIRE STOPS, I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLIL TION 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 STRUCTIONI CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERS N VIOLATION OF THE LATH, INT LABOR CODE OF T TATE CA FO IA I RE ATING TO WORKMEN'S COMP A ION I U NC LATH, EXT SIGNATUR O HOUSE NUMBER COR- PERMITTE RECT AND POSTED +ADDRESS 529 E• Valls Rlvd., S• G. FINAL JOHN F LEWIS PRI CIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK mo CASH LA('y1 4 5 3� AUG15 1 D 9.0o ? WORKERS' COMPENSATION DECLARATION hereby affirm at I have a certificate of consent to self Y APPLICATION FOR BUIL®I N G- PERMIT ' insure, or a certificate of Workers'Compenstion Insurance, or a certified co y thereof (Sec 3800, La C ) � -COUNTY,OF LOS ANGELES BUILDING AND SAFETY Policy 1.Nc 7LCompany r1:3e BUILDING Certified copy is hereby furnished ' - FOR APPLICANT TO FILL IN ADDRESS z Certified copy is filed with the`county building mspec- BUILDING /� // tion departm �ent r ADDRESS / / LOCALITY l–P �[ NEAREST Date — Applicant CITY ZIP CROSS ST I CERTIFICATE OF'EXEMPTION FROM ORKE N OF BL ASSESSOR COMPENSATION INSURANCE SIZE OF-LOT _ NOW ON LOOTT MAP BOOK PAGE PARCEL (This section'need not be completed if the permit is,for one USE`/z�ONE MAP hundred dollars ($100),or less ) TRACT ,BLOCK LOT NO /I/I�1 SPOECIAL OWNER TP Y!'!/ I�L� NO / CONDITIONS Q I certify that'in-the performance of the work for which this - permit is issued, I shall not employ any person in any manner 4I A DISTRICT GROUP TYPE FIRE CESSED BY V ADDRESS / [ CONST ZONE so as to become subject to the Workers'Compensation Laws v CITY ZIP V, Dare Applicant STATISTICAL CLASSIFICATION APT CONDO ARCHITECT OR - TEL NOTICE TO APPLICANT If, after making'this Certificate of W Exemption, you should become subject to the Workers' ENGINEER NO CLASS NO DWELL UNITS iZ Compensation provisions of the Labor Code-, you must forth-- ADDRESS v SEWER MAP _ Z with comply with such provisions or this permit shall be /��,��.�T QJ ![� deemed revoked CONTRACTO C �GJ'7 NO / 7 T BK PG �fj(� VALIDATION LICENSED CONTRACTORS DECLARATION , LIC �j �/ I herel y,affirm that I am licensed under provisions of Chapter 9 _ ADDRESS SPI NO kd7 ! VALUATION (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 $ d� 0 D n ^� SI F ST OF FA OF CHECK License Numbe (�'/ Lic Class SIZE STORIES FAMILIES ONE ` i DESCRIPTION OF WORK NEW � $ Contractor Date _ e am exempt from t e licensing requirements as I am a ADD licensed architect ora registered professional engineer ALTER Q FINAL/— INAL Z acting in my professional capacity (Section 7051, REPAIR DATE ✓! Business and Professions Code) USE OF, FIN EXISTING BLDG DDE�MOc�L[� By Lic or Reg No Date APPLICANT S N L 7 lJ�f7 7 7 ! ' 'OWNER-BUILDER DECLARATION - PRINT 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) - PRESENTEl _ BUILDING I, as owner of the property,,or my employees with ADDRESS wages as their sole compensation,will do the work and , 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 contracting CONTRACTOR NO with licensed contractors to construct the project (Sec- ADDRESS �5 8 4.7 A tion 7044, Business and Professions Code) , REQUIRED TOTAL SETBACK FROM dWXID'STTH # o s • o 0 CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE tt 1 I hereby affirm that there is a construction lending agency for FRONT e 1 5 3.O O the performance of the work for which this permit is issued P L , (Sec 3097, Civ C ) SIDE o 1 5�3.0 0,6 Lender's Name - 01. 13-86 m Lender s Address PC Fee$ Permit Fee> I certify that I have read this application acid state that the Issuance Fee above information is correct agree to comply with all County Investigation Fee �J ordinances and State laws relating to building construction, Total Fee ° vzo) , •' 2 and hereby outhonz represent"ti s of this County to enter U up e above-me t ned prop ty for inspection purposes r / SEE REVERSE FOR EXPLANATORY LANGUAGE `Signature of Os r Apca plint A nt Dote