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Home My Public Portal About4942 ENCINITA AVE_Miscellaneous__ 76M444-CE#8752_60 MISCELLANEOUS APPLICATION 1 COUNTY OF LOS ANGELES OCCUPANCY-SAFETY-JTRAILERS DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DMSION ADDRESS ` 7 JOHN A LAMBIE. COUNTY ENGINEER WILLIAM A JENSEN SUPT OF BUILDING �C� �! LOCALITY FOR APPLICANT TO FILL IN NEAREST OWNER CROSS ST MAIL DISTRICT NO GROUP TYPE PROCESSED BY ADDRESS6�F /ice / CONST CITYMAPSTATE TEL /�NO wL�`- NUMBER S014 HWY YES NO CONTRACTOR NO USEZONE SPECIAL CONDITIONS ADDRESS LEGAL DESCRIPTION I LOT NO BLOCK BUIlfDING EXIST SETBACK YARD HWY STREET NAME WIDTH TRACT �Q NO OF BLDGS NOW ON LOT FRONT USE OF P L SIZE OF LOT EXISTING BLDG SIDE PL APPLICATION FOR INSPECTION RECORD OCCUPANCY L/ INSPECTION SAFETY PERMIT �� TRAILER USE LIMITED TIME USE Ae I ,� � ��QT 47, 0 G 0 O DATE y DATE �v FROM lY- - � .i 7 TO l W USE OF STRUCTURES OR DEVICES ul i F3 F G. INSPECTION FOR OCCUPANCY AS 3 A4 F6 - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS DATE INSPECTOR S SIGNATURE APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WJTH ALL COUNTY ORDINANCES OCCUPANCY APPROVAL AND STATE LAWS TIN B LDING CONSTRUC- GROUP OCC LOAD TION SIGNATURE OF TRAILER USE PERMITTE SAFETY PERMIT ADDRESS TEMPORARY /^ STRUCTURE APPROVED (� TEMPORARY STRUCTURE REMOVED ) FEE �L� FINAL APPROVAL g-�1-2(�7 ATION CLYDE N DIR CK MO CASH PRINCIPAL STRUCTURAL ENGINEER LAL07 7 9 6Q; MAR28 2 2 0 1 5.00' 70M444-CE#B7$2-60 MISCELLANEOU APPLICATION 4 COUNTY OF LOS ANGELES OCCUPANCY-SAFETY-TRAILERS DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION DOREISS Z :C"'�eic JOHN A. LAMBIE. COUNTY ENGINEER WILLIAM A. JENSEN. SUPT.OF BUILDING OCALITY FOR APPLICANT TO FILL IN EAREST l�_ OWNER ROSS ST. MAIL IS.TRICT NO. I GROUP TYPE PROCESSED BY hADDRESS TEL. C �. ONST. CITY NO. � ��% MAP STATE UMBER C.,G-` HWY YES NO TEL. CONTRACTOR NO. SE ZONE SPECIAL CONDITIONS f �I ADDRESS � ,Z/ "- �{/;_ in/� Tr . LEGAL DESCRIPTION I LOT NO. I BLOCK ILDING YARD HWY STREET NAME EXIST. TBACK WIDTH NO.OF BLDGS. TRACT !.' -} NOW ON LOT PONT USE OF SIZE OF LOT EXISTING BLDG. SIDE P.L. APPLICATION FOR INSPECTION RECORD OCCUPANCY INSPECTION - SAFETY PERMIT TRAILER USE LIMITED TIME USE a O u DATE _ DATE I I a FROM: TO: USE OF STRUCTURES OR DEVICES �+ 0 � W INSPECTION FOR OCCUPANCY AS ;.a[_k: i�L/t I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS DATE INSPECTOR'S SIGNATURE APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES OCCUPANCY APPROVAL AND STATE LAWS REGULATING BVILDING CONSTRUC- GROUP OCC. LOAD TION. i SIGNATURE OF 1/_/ ,.,;, J TRAILER USE PERMITTEE �,� %y '_L: ,:�✓.• `� SAFETY PERMIT ADDRESS %�- _f �` ;•f /��-��`� TEMPORARY STRUCTURE APPROVED TEMPORARY mm ON STRUCTURE REMOVED FEES 777-e- FINAL APPROVAL VALIDATION CLYDE N. DIRLAM, CK MO CASH PRINCIPAL STRUCTURAL ENGINEER Or ,y WORKERS'COMPENSATION DECLARATION CE 875(2-80) MISCELLANEOUS APPLICATION I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION /insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN BUILDING ,J _ ADDRESS Certified copy is hereby furnished. UILDING /� 1/ vCi j�f�l-�- j/ , LOCALITY ADDRESS ? _7 Certified copy is filed with the county building inspection Lo LITY ��`�� `tee G C NEAREST department. CROSS ST. Date Applicant EAREST ,( y' /� 'y's n DISTRICT NO GROUP PE PROCES� BY . CROSS ST. L`� �.L��//p �.G vL- S /'' �^'t �7( _) ONST. CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK pggp n dl� rylGHwgY NO. ✓-(! (CIRCLE) STATE MAJOR SECOND CAL Q, (This section need not be completed if the work involved NO. OF BLDGs. p TRACT NOW.ON LOT USE ZONE SPECIAL CONDITIONS U by the permit is for one hundred dollars ($100) or less.) USE OF cc . SIZE OF LOT EXISTING BLDG. I certify that in the performance of the work for which this O permit is issued, I shall not employ.any person in any manner MeWNERe(�I�7 �Lp JafJ� ® � so as to become subject to the Workers' Compensation Laws. IL r _� OCCUPANCY GROUP /�_� W /� +v a ADD ESS 7,j 3S �Ci�yJ G'�G Cl) Date Applicant OCCUPANT LOAD z TEL. NOTICE TO APPLICANT: If, after making this Certificate of CIT �O ll�" ry s Exemption, you should become subject to the Workers' APP"LICAT'rOUtOR EXIT HARDWARE: Compensation provisions of the Labor Code, you must forth- with comply with such provisions or this permit shall be TRAILER USE❑ GEOLOGY INSPECTION El No Spec. Knowl. ❑ deemed revoked. .a LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION Panic Devices ❑ I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT Q (LIST ITEMS BELOW) NO. of EXITS 9 (commencing with Section 7000) of Division 3 of the Busi- ness and Professions Code, and my license is in full force and PARKING effect. SPACES REO'D PROVIDED License Number Lic.Class LIMITED .TIME USE Contractor Date DATE DATE FROM: TO: ❑ I am exempt from the licensing requirements as I am a, licensed architect or a registered professional engineer SIZE OF NO. OF INSPECTOR'S acting in my professional capacity (Section 7051, Bus- EXISTING BLDG. STORIES s "NATURE meSS and PI'OfeSslOt1S Code). rO.O USE OF BUILDING r - FINAL APPROVAL //11 Cie.or Reg.No. Date /97 f:jf �• V b e ;9-� HOME OWNER-BUILDER DECLARATION XISTING BUILDINGS ND USE _ A r]2 n , I hereby affirm that, I am exempt from the Contractor's : a : N License Law for the following reason (Section 7031.5, Busi- ness and Professions Code): SPSP PA PROKINVIDED PROVIDED 1, as owner of the property, will do the work and the structure is not intended or offered for sale (Section 7044, Business and Professions Code). OPOSEO USE OF BUILDING '7 CONSTRUCTION LENDING AGENCY �G�/ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec. 3097,Civ.C.). Lender's Name PROPOSED MAX. OCC. Lender's Address PERMIT FEE I certify that I have read this application and state that the above information is correct. I agree to comply with all County ISSUANCE FEE ordinances and State laws relating to building construction, TOTAL FEE and here authorize representatives of this County to enter upon bove-m Ion pr pe ty for inspecti n purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE I Sig ature of P mittee 6ate WORKERS'COMPENSATION DECLARATION CE 875(2-80) MISCELLANEOUS APPLICATION hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION Insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Seca 3800, Lab.C.) Policy No. Company FOR APPLICANT TO FI I UILDING (�//�I DRESS 2 ❑ Certified copy Is hereby furnished. BUILDING y LOCALITY ~ ADDRESS - �^ Certified copy is filed with the county'building inspection c NEAREST department. ocwLITY CROSS ST. _ Date Applicant ry REST p )' DISTRICT/1]�N? GROUP TYOPNE Q PRO SED BY ROSS ST. • zvS SIV yJ 6/!� CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK MAP (CIRCLE) HIGHWAY STATE MAJOR SECO D LOCAL (This section need not be completed if the work involved NO. OF BLD S. - NO. (CIRCLE) tl l P TRACT - NOW ON LOT USE ZONE SPECIAL CONDITIONS O by the permit is for one hundred dollars ($100) or less.) USE OF �[A10- 1\ SIZE OF LOT EXISTING BLDG. Y Q I cektify that in the performance of the work for which this �^ permit is issued, I shall not employ any person in any manner J I&WNER so as to become subject to the Workers' Compensation Laws. OCCUPANCY GROUP UJ U 0 D DRESS ((,. U) Date Applicant yr Z NOTICE TO APPLICANT: If, after making this Certificate of ITv �/LLy , NOL Zo J' Z� OCCUPANT LOAD z Exemption, you should become subject to the Workers' APPLICATION FOR EXIT HARDWARE: Compensation provisions of the Labor Code, you must forth- with comply with such provisions or this permit shall be TRAILER USE GEOLOGY INSPECTION C1 No Spec. Knowl. ❑ deemed revoked. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION Panic Devices ❑ I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT ❑ (LIST ITEMS BELOW) NO. OF EXITS 9 (commencing with Section 7000) of Division 3 of the Busi- ness and Professions Code, and my license is in full force and PARKING effect, REQ'Q E:= PROVIDED SPACES License Number Lic. Class LIMITED TIME USE Contractor Date DATE DATE FROM: TO: I am exempt from the licensing requirements as I am a; INSPECTOR'S licensed architect or a registered professional engineer SIZE OF NO. OF acting In my professional capacity (Section 7051, Bus- EXISTING BLDG. STORIES SI NATURE iness and Professions Code). E ` /� FINAL APPROVAL SENT USE OF BUILDING �/I��L__ ` `�.�. Lic.or Reg.No. Date HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS 9211.3A ON LOT AND USE I hereby affirm that, I am exempt from the Contractor's :#.• • 0 • 8.8 License Law for the following reason (Section 7031.5, Busi- nNo. PARKING •,0 0 0 0 e • 2 ess and Professions Code .SPACES PROVIDED ❑ I, as owner of the property, will do the work and they structure is not intended or offered for sale (Section 0 5 2 8. 8 5 7044, Business and Professions Code). P ED USE OF BUILDING CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097,Civ.C.). Lender's Name PROPOSED MAX. OCC. Lender's Address PERMIT FEE I certify that I have read this application and state that the above information is correct.I agree to comply with all County ISSUANCE FEE ordinances and State I ws relating to building constructdon, TOTAL FEE and hereby authorize presentatives of this County to enter upon the ove- ne property for inspectiopu poses. SEE REVERSE FOR EXPLANATORY LANGUAGE nature of Permittee Dat