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Home My Public Portal About5423 ENCINITA AVE_Building__ t - 76A638A CE 1303162 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS r BUILDING AND SAFETY DIVISION LOCALITY JOHN A LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A JENSEN, SUP T OF BUILDING CROSS ST DISTRICT NGROUP CTYPE ONST P OCE D BY FOR APPLICANT TO FILL IN BUILDINGI i STATISTICAL CLASSIFICATION SEWER MAP ADDRESS / BK G CLASS NO DWELL UNITS LOT NOa Off APF WATER y CERTIFICATE NOT REQUIRED ® RECEIVED ❑ TRACT J MAP HIGHWAY NO OF BLDGS NO Q� (CIRCLE) STATE MAJOR SECOND OCAL SIZE OF LOT 7 `V \ NOW ON LOT 00/0- USE ZONE SPECIAL -p�� USE OF CONDITION SP' EXISTING BLDGTEL OWNER/ A-� Y�( � NO BUILDING I EXIST YARD HWY STREET NAME SETBACK WIDTH ADDRESS S/ /C..�yC:/�"C '��S '� 4 . f RONT ( I ARCHITECT OR AEL 'P L ENGINEER NO 1 1SIE)E / r —P L ADDRESS - ! � �� qty ,��r 9116 E Le �t _ ' f/' 2, /y' /aF, 3r''t+6�'�"C_ ,.;��J -0 CONTRACTOR j('9_i /�/1lfi/j4/Yr,F OC�'% iJ'T/ � c V ADDRESS /.r. (�•,%�� Jiir � � ii iL, DESCRIPTION OF WORK " ' ! / t �''�' W NEW-L' 'ADD v \ ALTER REPAIR DEMOLISH SQ FT ,,y .� NO OF NO OF s /' SIZE vee'-�r STORIES / FAMILIES, USE OF STRUCTURE SIGNATURE OF&_ r n i"'� r , , �� /! `�1 - APPLICA VALUATION$ O �(�. I ��' Q rz APPROVALS DATjE INSPECTOR S SIGNATIy RE PC 9 J _ PMT J (FOUNDATIONLOCATION /yl 67 FEE $o`/ _ FEE $ FORMS MATERIALS `� L\FRAME FIRE STOPS � 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ' BRACING BOLTS AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY ;FURNACE LOCATION WITH ALL'COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I'WILL NOT EMPLOY ANY PERSON IN VIOLA 6TH INT ` �� • / -f14;�+ _ TION OF THE LABOR CODC OF THE'STATE OF CALIFORNIA RELAT ING TO WORKMEN S COMPENSATION INSURANCE UATH EXT SIGNATURE O�JHOUSE R PRMITTEE RCT AND POSTEDAu1�1�t Il ADDRESS ' FINAL JOHN F LEWIS PRINCIPAL STIR URAL ENGINEER PLAN CHECK VALIDATION 0 mo CASH _ I PERMIT VALIDATION CK M D CASH LiCo6 8 4 9NOV 13 2 3 D 2 1 .5Ui v L Lo 7 6 1 ,2 ;N3v 2 9 1 D 4 6.5 0 [S 76A638A C`A031REV 6/76 ` - •- ' I ty�l _ - s '� 'S / 't h. , • . l r• `1 a_ ' `*P ,t - APP,,LICATION FOR BU ILD'ING PE`'RM IT COUNTY?OF LOS ANGELES Y BUILDING,AND SAFETY w' , FORAPPLICANT'TO FILL IN ADIDRESS A '� BUILDINGe ADDRESS Ala�.NI�Q' LOCALITY 6 I= I ? NEAREST CITY, ,G jqL F ZIP' CROSS ST �+ / NO OF BLDGS f' ASSESSOR _ t, SIZE OF LOT r�O X / NOW ON LOT i/V lV MAP BOOK" PAGE ` PARCEL �M DISTRICT GROUP' TYPE ' ' FIRE ]",IIPROCESSEDBY-,-, TRACY" BLOCK i LOT NO CONST ZONE+ t Ile'TEL` OWNER LlNO x - - STATISTICAL CLASSIFICATION �;:' <' SEWER MAP,zu _ VC— }+ p J� ; ADDRESS CLASS NO i 1 DWELL UNITSti ' f BK �G t�' `CITY-� `Ft✓r ZIP r~ �' ARCHITECTOR - TEL VALUATION ENGINEER, t NO I ADDRESS (' A US 0V BLDG SETBACK FROM 1 ° t TEL' FRONT PROP LINE OF •' f� `- '^ "(STREET) CONTRACTOR `NO HIGHWAY + YARD _ TOTAL SETBACK FROM 'TYPE OF EXISTING ` FRONT PROP LINE HIGHWAY ,WIDTH ADDRESS,' 0V1,S /NO . <y,� i LIC �}C� Jam(✓ 4 x + } 7`" _ ffir3 4:a w CITY CLASS^ BLDG SETBACK FROM CONSTRUCTION LENDE f ;' PROP ,• i" ' NAME AND BRANCH t A SIDE 'LINE OF (STREET) _� ' HIGHWAY -+ 'YARD = TOTAL SETBACK FROM 4TYPE OF" EXISTING V ADDRESS, CITY - SIDE PROP LINE. HIGHWAY WIDTH. SQ FT NO OF NO`OF CHECK v + = J SIZE STORIES FAMILIES ONE, LL y, DESCRIPTION OF WORK NEW P C Fee$`, } r� Permit Fee ` µ ADD ❑ �- r ? r tom' ❑ i Issuance Fee, �', O I '+ ALTER' • : �I - r r REPAIR ,❑ y Total Feet USE OF EXISTING BLDG - DEMOL ;L , a 1z O APPLICANT TEL J _ (PRINT) NO RN l �'7� +r'"+ BY(SIGNATUREI, r I HEREBY'ACKNOWLEDGE THAT I HAVE READ THIS,APPLICATION AND STATE +..q L, �,'� ',wt �� (,. d •]L 4'��t�'tt` S.'_ ' THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY,WITH ALL ORDINANCES ,'"� `r+ r� r I I ! r.+1 1 AND LAWS REGULATING BUILDING CONSTRUCTION CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF t THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM ` Z ,r 1 PENSATION INSURANCE _ ' SIGNATURE OF PERMITTEE „.A —ail ADDRESS TEL 'CITY NO ` USE ZONE, MAP " NO f tr'R r L 'f > , SPECIAL f y* CONDITIONS FINAL BY, _ • 4 �$ i "L DATE A APPLICATION FOR BUILDING PERMIT �] COUNTY OF LOS ANGELES . ' BUILDING AND'SAFETY WORKERS COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING AESS 7'I hereby affirm that,I have a certificate of;consent to self Insure, e>UIN ADDR SS or a certificate of Workers Compensation Insurance,or a certified >' copy thereof(Sec 3800,Lab C) CIT zIP � � LOCALIT Policy No " Company SIZE OF LOT + NO Y OF BLD SNOW ON LOT ElCertified copy Is hereby furnished NEAREST CROSS ST J r TRACT BLOCK ` LOT NO ; ❑ Certified copy is filed with the county building inspection - , department - - USE ZONE MAP NO ^ Date Applicant >< ASSESSOR MAP BOOK + PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM`WORKERS' Ta�/ TEL NOWITHIN 1000 FT OF SCHOOLSYES No COMPENSATION INSURANCE(This section need not be completed If the permit Is for one hundred t DISTRICT �GROUP TYPE CON FI ONE PROCESSED BY dollars ($100) or less) CITY IP , I certify that In the performance of the work for which this permit ZIP Is Issued, I shall not employ any,person in any manner so as to O J > ARCHITECT O NGINEER TEL NO become subject to the Workers Compensation Laws S ATISTICAL CLS IFICATION APT CONDO Date Applicant -ADDRESS . CLASS NO DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST` Exemption, you should become subject to the Workers CONTRACTOR TEL NO ` SET BACK YARD 'HWY _ PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith LC<✓ FRONT comply with such provisions or this permit shall be deemed revoked ADDRESS LIC NO P L r LICENSED CONTRACTORS DECLARATION SIDE - CITY CLIC CLASS P L I hereby affirm that I am licensed underprovislons of Chapter 9 "j I SEWER MAP _ (commencing with Section 7000)`of Division 3 of the Business and SQ FT SIZE NO OF STORIES NO OF FAMILIES _ Professions Code,and my license is in full force and effect NEW 1:1 BK PG DESCRIPTION OF WORK ADD ❑ VALUATION License Number Lic Class - 0_ Contractor Date �-` � ALTER 110ccElI am exempt under Sec j REPAIR [1 B&PC for this reason 4 DEMOL ❑ LDMA P/C# W Date ' USE OF EXI NG BLDG URM ❑ d { (A Signature APPLICANT(PRINT) TEL NO LDMA Perm# .I as owner of the property, or my employees with wages Be Zs ' their sole compensation will do the work and the structure is ADDRESS- O J> CCTo� P not-Intended or offered for sale (Section 7044 Business and FINAL DATE ' Q Professions Code) WILL THE,APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A MIXTURE,, ,gtNTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J ElI 'aS owner of the property, am exclusively contracting with AMOUNTS SPEL�I�D ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY, 7 ' 1,ITEMS + licensed contractors to construct the project,(Section 7044 YES ElNO❑' Business and Professions Code) TOTAL 1112 m 30 a WILL THE INTENDED USE OF THE BUIDLING BY THE,APPLICANT OR FUTURE BUILDING 7 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH NECK 102.30('�� ' CONSTRUCTION LENDING AGENCY ` COAST AIR QUAJTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKUST FOR CS 3 �fElfY y 1S3Lo J�I GUIDELINES - I hereby affirm that,,there is a construction lending agency for YES El No 1:1 /p i7E ' •t 1� w the performance of the work for which this permit Is issued(Sec �6 t � I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097, CIV C) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE,LOS ANGELES COUNTY CODE a TITLE 2'CHAPTER 2 20 SECTIONS'2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD1��1 -�! o Lender's Address OWNER OR ACENrS jill+r ,j{� 'ii o '- O I certify that I have read this application and state under penalty LL OPC FEE PERMIT FEE , of perjury that the above Information Is correct agree to comply with all county ordinances and State laws relating to building o a construction, and hereby authorize representatives of this County ISSUANCE FEE 00 100 Hier upon the ab mentioned operty for inspectio pur#os GG' ' a fp INVESTIGATION FEE TOTAL FEE Mooren,o Age SEE REVERSE FOR EXPLANATORY LANGUAGE