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HomeMy Public PortalAbout5347 ENCINITA AVE_Building__ 4 1 � 76A638A CE #803 3-69 P-/ APPLICATION FOR BUILDIN PERMI r - .COU14T:Y OF LOS ANGELES BUILDING ✓� DEPARTMENT OR COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST CROSS ST. FOR APPLICANT TO FILL IN DISTRICT N . / GRO TYPE CON P 0 Es E (PRINT OR TYPE ONLY) 1 Cly BUILDING f/ — STATISTICAL CLA (CATION SEWER MAP ADDRESS S 3 7 I /V I � CLASS N0. DWELL.UNITS BK PG, LOT NO. BLOCK USE ZONE MAP N0. TRACT � SPECIAL N0. OF BLDGS. / CONDITIONS SIZE OF LOT NOW ON LOT USE OF 1�, G EXISTING BLDG. // BLDG. SETBACK FROM '41OWNER Q - `j ,j; NOL lj (� FRONT PROP. LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL ADDRESS o �� S �. s•t; HIGHWAY WIDTH FROM C.L. CITY /I/ L / /1 + ARCHITECT OR TEL. SIDE PROP. LI FROM (STREET) ENGINEER NO. TYPE OF EXISTING SETBACK AY + YARD = TOTAL ADDRESS f '' y� HIGHWAY WDTH FROM C.L. CONTRACTOR V W /✓ NO. + } LIC. CORNER CUTOFF YES ❑ NO E] a ADDRESS NO. LIC. CITY CLASS VE REVERSE SIDE O P,EC APPROVALSIx CONSTRUCTION LENDER F NAME AND BRANCH 6 L ADDRESS 'TBv vSQ. FT. N0. OF N0. OF ZSIZE STORIES FAMILIES NEW kARPLICANT OF S� , A, n ,•� ADD ❑ CTURE ! VV 414 ALTER ❑ C PAIR ��� � ATURE F / DEMOL - ❑ATION $ ® APPROVALS DATE , INSPECTOR'S' SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE $ FEE $ c � FORMS, ORMS MATERIALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME: FIRE STOPS, BRACING BOLTS .+ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC- GAS VENT DUCTS TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE LATH, INT. OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- PENSATION INSURAN E. SIGNATURE OF o -a�/�v LATH, EXT. PERMITTEE HOUSE NUMBER CORRECT AND POSTED ADDRESS!®Q S, IT FINAL JOHN F. LEWIS, PRINCIPAL STRUCTURAL GINE PLAN CHECK VALIDATION CK. M.O. CASH - PERMIT VALIDATION CK. M..CCASH WORKERS'COMPENSATION DECLARATION hereby affirm that I have certificate insure, or a certificate of Workers' Compensation of con In t to st,r6nce,self -APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING _ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS i�3 ,:�t ` /CS Aertified copy is filed with the county building inspec- BUILDING �/r� > tion department. ADDRESS LOCALITY s/ NEAREST ` Date Applic ✓ � CITY Lr ZIP Zf'22 CROSS ST. -uc rf-- CERTIFICATE OF EXEMPTION FRO ORK S' O. OF BLDGS. ASSESSOR COMPENSATION INSU ANCE SIZE OF LOT �� NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP os G hundred dollars ($100)or less.) TRACT BLOCK LOT NO. Ir NPECO. IAL L6 ��/� N�du�J�3� R S } I certifythat in the performance of the work for which this OWNER C CONDITIONS PR ESSED�BY 0 permit is issued, I shall not employ an person in an manner N / _ DISTRICT GROUP YPE FIRE p p y y p y ADDRESS �L�2'S /��Gi4t/�/C _ CONST. ZONE so as to become subject to the Workers'Compensation Laws. �,a T3 E CITY ZIP /OOH STATISTICAL CLASSIFICATION V APT. CONDO. 0 Date Applicant ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CLASS NO. f DWELL. UNITSLU Exemption, you should become subject to the Workers' CL Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or.this permit shall be deemed revoked. CONTRACT4:9;._-,_,0r �t/lG���/ �6���%6 BK. �{'G,J VALIDATION LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS y������i9/y�E NCt?G �� VALUATION (commencing with Section 7000 of Division 3 of the Business and LIC. y lf�Q� Professions Code, and my license is in full force and effect. CITY � CLASS (� $ / _ SO. FT. NO. OF NO. OF / CHECK License Number Lic.Class SIZE STORIES FAMILIES / ONE $ f4000023 Contractor Date DESCRIPTION OF WORK NEW - � ADD El 2 ° 3.305 I am exempt under Sec. ALTER FINAL / r .ti J 0 5 B.&P.C. for this reason REPAIR DATE _�;_ Date: USE GING BLDG. DEMOL FINvt� 07 0 3—F 4 Signature APPLI � OWNER-BUILDER DECLARATION dui N6 . 6� 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): PRE FENT 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. Ll I, as owner of the property, am exclusively contracting CONTRACTOR NO. G .6 A with licensed contractors to construct the project (Sec- ADDRESS ° a u a o 'tion 7044, Business and Professions Code). J ,�1 CONSTRUCTION LENDING AGENCY REQUIRED TOTAL SETBACK FROM EXIST. c YARD HWY ° � . CJ SET BACK PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the.work for which this permit.is issued P.L. 7 ,° f ' :1 (Sec. 3097,.Civ. C.). SIDE.. .; P.L... o '� 07--E4 Lender's.Name Lender's Address P.C. Fee$ . �.. �> Permit 'Fee oe I certify that I have read this application and state that the Issuance Fee above information is correct. I agree to comply with,all County Investigation Fee g ordinances and State laws relating to building construction, Total Fee ! d and hereby authorize representatives of this County to enter upon the above-mentioned propert #or insp ction purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Si re of plican r nt Date ®s WORKERS COMPENSATION DECLARATION • insure, or afl�ertif carte of Worke s' Compensation Insuran of APPLICATION FOR BUILDING PERMIT or Q,certifjed,copy thereof (Sec. 3800, L COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy Company BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS Certified copy 3 filed with �co n b ing inspec- BUILDINGtionpar nt. ADDRESS �`�Z6�( Cl"� LOCALITY // NEAREST Date; pplicant CITY /:.en ZIP CROSS ST. ERTI CATE OF EXEMPTION FROM WOR RS' O. OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the'permit is for one U Z NE MAP hundred dollars ($100)or less.) TRACT BLOCK LOT NO. NO. I TEL. SPECIAL y. I certify that in the performance of.the work for which this OWNER NO. CONDITIONS permit is issued, I shall not employ an09 y rson in any manner L— // DISTRICT GROUP TYPE FIRE PR O00?C SED BY O so as to become subject to the Wor s'Compensation Laws. ADDRESS J T ` G��� r�A/ CONST�./// ZO E CITY 01 - / v - Dote Ap cant ��� Cbz ZIP STATISTICAL CLASS I TION APT. JCON ARCHITECT OR TEL. G°7 NOTICE TO APPLICA If, after moking this Certificate of ENGINEER �f(�� Exemption, you s� ould become subject to the Workers'' NO. /d �� CLASS NO. DWELL. UNITS � Compensation pfovisions of the Labor Code, you must forth- SS/ , �Ga�c�•L, SEWER MAP ADDRE with comply with such provisions or this permit shall be ` Z deemed revoked. /1_ BK PG, VALIDATION CONTRACTOR � ��',iF"NO. LICENSED CONTRACTORS DECLARATION /) j LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS `7" �V (.� NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. SIO Q r-- Professions Code, and my-Li ense is in fill force and effect.` CITY < CLASS $ �C ► SQ. FT. SNO.TO IE FA OF CHECK fl License Numbe G� ((���(J Lic.Class—rte/ SIZE STORIES �FA�MIrLIES ONE Contractor _ Date I- /- DESCRIPTION OF WORK/ `/��,t�. A D Q $ —92367A I am exempt under Sec. ���L✓ L� `" '�Lc' ALTER E] FINAL # 0 0 0 0 2 3 B.&P.C. for this reason (it �S G REPAIR 7 K, DATE Date: USE OIF BLDG. DEMOL'0 FINA 10 - 29.02 EXISi nature APPLICANT TEL. BY = g PRINT / �� NO. s`s ° ° - 29,02 OWNER-BUILDER DECLARATION f � `` 1 hereby affirm that I am exempt from the Contractor's License ADDRESS Law for the following reason (Section 7031.5, Business and , 0 Q 71 —8 5n Professions Code): PRESENT BUILDING Q'C 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 kADDRE Y 7044, Business and Professions Code). TEL. ;22368A ❑ CTOR NO. C I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec- s � # 0 0 0 0 0 1 'tion 7044, Business and Professions Code). L. .�/ ED TOTAL SETBACK FROM EXIST. L/1C i CONSTRUCTION LENDING AGENCY' SETBACK YARD HWY PROP. LINE WIDTH �� - ( ° o59.25 I hereby affirm that there is a construction lending'agency for T a._�_ the performance of the work for which this permit is issued ' - ° ° ° 5 9.2 5 5 (Sec. 3097, Civ. C.). FO P.L. OQ71 —85 v Lender's Name ,) Lender's Address $ Permit Fee I certify that I have read this application and state that the �/i v�C Issuance Fee Q above inform is carr I. I agree to comply with,all County Investigation Fee $ ordinance nd tat f 's relating to building construction, Total Fee 1.2 u and her y a epresentatives of this County to enter upon a ve- o ed property for inspection purpose a SEE REVERSE FOR EXPLANATORY LANGUAGE n ®s - Sign Applican or Agent Date WORKERS'COMPENSATION DECLARATION N nt to sf insureborafcertifcarteofWorkes' ComtpensatoneInsurane, APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING Certified copy is hereby furnished: FOR APPLICANT TO FILL IN ADDRESS S Z' ❑ Certified copy is filed with the county building inspec- BUILDINGy tion department. ADDRESS Sv LOCALITY ' NEAREST Date Applicant CITY ZIP CROSS ST. CERTIFICATE OF EXEMPTION'FROM WORKERS' NO. OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP D hundred dollars ($100)or less.) TRACT BLOCK T NO. NO. ` l * TEL. rtpr SPECIAL �4X4j,4 ' I certify that in the performance of the work for which this OWNER NO. i`' CONDITIONS Sf J: •/G ®- permit is issued, I shall not employ any person in any manner ( DISTRICT GROUP TYPE FIRE PROC D BY so as to become subject to the Worke s'Compensation Laws. ADDRESS CONS/T./ ZONE Date a Applicant C CITY ZIP ARCHITECT OR TELSTATISTICAL CLASSIFICATION e APT. CONDO. V NOTICE TO APPLI ANT: If, after making this rtificate of v . JLU ENGINEER NO. CLASS NO. �� DWELL. UNITS Exemption, you should become subject to a Workers' CL Compensation provisions of the.Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be deemed revoked. TEL' BK. PG,S VALIDATION CONTRACTO NO. LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. — 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 CLAS $ , SQ. FT. NO.OF NO. OF CHECK License Numbea42 ,3 Lic.Class&2/ SIZE STORIES FAMILIES ONE ^� ❑ $ Contracto Date /_���U DESCRIPTION OF WORK EW ADD ❑ I am exempt under Sec. p ALTER ❑ FINAL B.BP.C. for this reason DATE © (� REPAIR Date: USE OF DEMOL FINAL EXISTING BLDG. By Signature APPLICANT TEL. OWNER-BUILDER DECLARATION PRINT D NO. I hereby affirm that I am exempt from the Contractor's Licenser( Law for the following reason (Section 7031.5, Business and ADDRESS 3022 Professions Code): PRESENT ❑ BUILDING j ffT o.0 0 0'o. I, as owner of the property, or my employees with ADDRESS wa es as their sole compensation,will do the work and .. the structure is not intended or offered for sale(Section LOCALITY 2.-:- 6 0,5 0 7044, Business and Professions Code). MOVING TEL. b 0 5 0� ❑ CONTRACTOR NO. o 0 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). ADDRESS o.72.7-84 REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HwY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.I. (Sec. 3097, Civ. C.). SIDE w P.L. Q Lender's Name P.C. Fee$ Permit Fee S� Lender's Address I certify that I have read this application and state that the Issuance Fee above information is correct. I agree to comply with,all County Investigation Fee $ ordinances and State laws relating to building construction, d J-0 u and hereby authorize representatives of this County to enter Total Fee upon t above entio property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signatur of Applicant or Agen Date ®f WORKERS'COMPENSATION DECLAP.ATION insure, oroafcertif cafirm tharte of Workers'1CompensationsInsurance, APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company _ p 11Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN ADDRESS FTKCortified copy is filed with the county building inspec- BUILDING E� A tion department. ADDRESS LOCALITY G Date Applic-pf/ c - _:�r� CITY / ?LG" c ZIP CROSS ST. CERTIFICATE OF EXEMPTION FRO ORK S' ­41 O. OF BLDGS. ASSESSOR COMPENSATION INSU NCE SIZE OF LOT ��� NOW ON LOT _ MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP U hundred dollars ($100)or less.) TRACT BLOCK LOT NO. ' Q te- NO. TELT / d SPECIAL I certify that in the performance of the work for which this OWNER 'f�fl L�N� NC,G-�(u 7 5 CONDITIONS permit is issued, 1 shall not employ any person in any manner _ DISTRICT GROUP TYPE FIRE PR ESSED-BY so as to become subject to the Workers'Compensation Laws. ADDRESS �/Z5 �/y%C CONST./ ZONE CITY / ZIP �li'/!6 Si U a� (/ 3 Date Applicant — STATISTICAL CLASSIFICATION APT. CONDO. NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. ��1y ' Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO.- DWELL. UNITS Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be _ V deemed revoked. CONTRACTaC G iG�1fl/� 6 ��� BK. /4G,.r7 VALIDATION LICENSED CONTRACTORS DECLARATION -/ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS ��//,��.���c� Nt�6 VALUATION (commencing with Section 7000)of Division 3 of the Business end LIC p Professions Code, and my license is in full force and effect. CITY ./ �� CLASS p _ $ SQ. FT. ) NO. OF NO. OF CHECK License Number Lic.Class _ SIZE GL STORIES G_- FAMILIES ONE Contractor Date DESCRIPTION OF WORK NEW E� ADD I( I am exempt under Sec. _ 1YL /-�/l�l ? ALTER FINAL • . , i (' .ti B.BP.C. for this reason _ REPAIR DATE Dote: USE Of FINAL EXISTING B DG. DFMOL LI By APP4 Signature ._ OWNER-BUILDER DECLARATION - NOG 6 "-e I hereby affirm that I am exempt from the Contractor's License i Low for the following reason (Section 7031.5, Business and ADDRESS J Professions Code): QBUILDING 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 kRE Y 7044, Business and Professions,Code). G TEL. I, as owner of the property, am exclusively contracting ACTOR NO. with licensed contractors to construct the project (S�c- S • 1 tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY IRED TOTAL SETBACK FROM EXIST. YARD HYVY CK PROP. LILJ WIDTr; ► I hereby affirm that there is a construction lending agency for T the performance of the work for which this permit is issued P.L. _ - r (Sec. 3097, Civ. C.). m Lender's Namee S ..7.7 Permit FeeLender's Address �rI certify that I have read this application and state that the Issuance Fee G� 'C {, ) above information is correct. 1 agree to comply with all County ation Fee ordinances and State laws relating to building construction, f and hereby authorize representatives of this County to enior Total Fee upon th bove-mentioned proper or tnsp ction purposes.` -t ! i SEE REVERSE FOR EXPLANATORY LANGUAGE Si re of plicae Date