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Home My Public Portal About5739 ENCINITA AVE_Building__ )6A698A DB6-9 t254 ' '. APPLICATION FORBIJILDIIVG PERMIT �. bIWSION'OF-BUILDING AND SAFETY BUILDING ADDRESS CountJ 7 Dep y of County Engineer County of Los Angeles EN .iocnuTY M W . J. FOX, COUNTY ENGINEER NEAREST CASSATT O. GRIFFIN, 6uR•T or BUILDIrvG CROSS ST. DISTRICT NO. ROUP SEWER MAP FOR APPLICANT TO FTIL IN T PE SK P BUILDING � 2� A/D � t NGIA//TAi$ P I ICONS.. ✓ 4+� ADDRESS J;V MAP . STATE /� TT NUMBER � DO (O .HWY ®_ LOT.NO. 119 BLOCK USEZONE SPECIAL 1, CONDITIONS .� - TRACT U�IN4� •W /&VV. n / f4 jLC> NO. OF BLDG S. SIZE OF LOT I NOW ON LOT BUILDING yARD HWY STREET NAME - EXIST. USE OF ^ 3,,' / /� SETBACK WIDTH EXISTING BLDG. /,J VVC- k �fAI(t+ FRONT �D� P. L. OWNER �Tn�13IF61,5 � SIDE MAIL �� .� P. L. ESS ADDR ' .TEL. DWELL, i UNIT 5 'INDUSTRIAL- CITY , NDUSTRIALCITY , C NO. 2 DUPLEX—UNIT 6 PUBLIC BLDG. ARCHITECT OR TEL. - ENGINEER NO. 3 APT. UNITS 7 ADDN..ALT..-ETC. ADDRESS q COMMERCIAL 8 MISCEL. CONTRACTOR • L. /' ` INSPECTION RECORD - ADDRESS �3/7 moo. Wf�fiNV T gLr Sc G• DESCIRIPTIONI OF WORK 29 pp NEW ADD ALTER . REPAIR DEMOLISH SO, FT. -NO.SOF NO. OF SIZE SST'O/R RIES FAMILIES SIGNATURE OF APPLICANT APPROVALS ADDRESS DATE INSQECTT��ORRp'S SIGNATURE $ P. C. 3 FOUNDATION FORMSMATERIALSION 44155' IL�.,Il.u.-tl--�_ wwTT !TO FEE FRAME: FIRE STOPS. �I ff7;_ZJ ! E BRACING. BOLTS VALUATION OL -- FEE a FURNACE: LOCATION. GAS VENT, DUCTS F I HEREBY ACKNOWLEDGE THAT I HAVE READ THISAPPICATION AND STATE THAT THE ABOVE IS CORRECT ANDL LAGREE TO COMPLY WITH ALL CONTY ORDINANCES LATH, INT. I I I5• S `Y.1.YOt.th�u�-+ AND STATE LAWS REG TING BU DING C NSTRUG TION. 4 LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTE RECT AND POSTED . ADDRESS FINAL I11 Iss F1J/r Xlt4✓-`-�� WM. J: FOX. CGUNr ENGINBPi VALIDATIONS BY I A- 2YO 5:�2` 14AR29- . 1 1 0.0'DEPUTY.0 = DEPUTY "" //�� . BY BY / ® DEPUTY- DEPUTY . 'WORKERS' COMPENSATION DECLARATION I hereby affirm that'[ have a certificate of consent to self ` QppUCAMN FOR BUOLD.ONG PIE ° M07 g insure or a certificate of Workers' Compensation Insurance or a certified copyihereof.(Sec 3800, Lab G.) / - COUNTY OF LOS ANGELES BUILDING AND SAFETY •' "Policy 1,o rCompany - •-❑TqI Certified co is herebyfurnished. - FOR APPLICANT TO FILL IN' ADDRESS C.] Certified.copy isfiled,with the county building inspec BUILDING._, 'A' tion department. ADDRESS CITY / P/r.%:.' y�x/ 1 ZIP �,/ta wr .. Date .Applicant - - NO. OF BLDGS. LOCALITY 'CERTIFICATE,OF EXEMPTION FROM WORKERS' SIZE OF LOT. NOW ON LOT ' NEAREST' - - _ _ ._ CROSS 57. COMPENSATION INSURANCE" - ASSESSOR (This seoio&eed notbe-completed if the permit is for one `,,.�: TRACT BLOCK LOT NO. MAP BOOK PAGEPARCEL .. hundred dollars ($100)or.less ) .,r ... TEL. . / / r•�.� - - _ : OWNER �' / NO. = l." /'/f USE ZONE MAP ( " �.• c71. �"7 v'I'cerfify thob in the performance of the'work for which this •`S SPOECIAL permit is Issued, I shall not employ onyperson in any manner s ADDRESS' s �r •'/+• V' CONDITIONS so as to become subject to the Workers'Compensation.Lows rt - - �.• - ,- O CITY.�1 Ya. A �i T`t Cr/�`� ZIP h •Date Applicant• n;, �r ARCHITECT OR TEL: _ J - DISTRICT G OUP TYPE „i•• FIRE \1 PROCESSED BV NOTICE TO APPLICANT: If;'after making this Certificate of ENGINEER NO.- - l/ 7' CONST. ZONE '�•' Exemption you should become subject to the Workers -- //�)y ,// - V T //y'/ > Compensation`provisions of the Labor Coda, you'must forth '. ADDRESS - rV�} /�� y t r with 'comply with such provisions,or this. permit shall be G x 4,YC C' It. .�',�;n,.^-Y TEL. J. STATISTICAL CLASSIFICATION APT. CONDO. deemed revoked - CONTRACTOR NO. b w W " 'LICENSED CONTRACTORS DECLARATION.' ' -fi " � ' /: -' rr'Y':i. r yt NO_ t1r <v f ': CLASS NO. - DWELL. UNITS_ O "1 hereb affirm,that I am,licensed under. rovisions`of.Cho ter 9 ADDRESS a •. Y P P LIC r SEWER MAP �• .. - w (commencing with Section 7000)of Division 3 of the Business �, l•;� G : 5' j and Professions Code;.and;my license is in'full force.and effect ✓,r CIN "�'/^' !/ 6,'_ C�irr / CLASS gK � PG + - VALIDATION SO FT. NO. OF NO, OF CHECK. License Number y� Lia. Class f Y rl SIZE4 - - STORIES FAMILIES ONE - - >. VALUATION DESCRIPTION OF WORK. Y •i'li! NEW. ❑ .a . ;Contractor - Dole.-' s' $ n - - ADD ❑ D ❑I am exempt under Sec. ^7""A v"`=%F•!� ii/.0 tom% ALTER ❑ s B.BP.C. for this reason C •.� .�r':"':/ REPAIR, - $ - Date .�. -f7 USE OF: �.'`J„. + w • . EXISTING BLDG /`r•” DEMOL,❑ r . Signature- S'J..• il...�s!/�i/ APPLICANT yE v�:r. TEL. _ fl"uat NO. FINAL OWNERBUILDERDECLARATION DATE f° I hereby affirm that I am exempt from.the Contractor's License ,,.�,,, 'r Law for the following reason.(Se'ction'7031.5, Business and ADDRESS -. '��4 ''✓�r, �+` ''-� - FINAL # _ / Professions Code): . . /.,;.`_ PRESENT - BY p L• .. `- BUILDING - - ,,I Hr•47 .4 ❑ I as.ov✓ner of tFe property, or my employees with ADDRESS - wages as their sole compensation,will do the work and 7 the structure is not intended or offered for sale(Section LOCALITY _ - 7044, Business and Professions Code.) MOVING ,• 'TEL. ❑ II as owner of the property, am exclusively contracting CONTRACTOR NO. - with licensed contractors to construct the project (Sec ADDRESS " 14 tion 7044; Business.ond Professions Code.) •• - _ REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY" SETBACK YARD 'HWV 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. (Sec: 3097„Civ. C:),:, SIDE - - . --Lender's'Nome - - s / C '8 ' vLDMA Ref. p �• Ji 2 i'!I� iu P.C. Fee.S Permit Fee C•;::'i Lender's Address ' I certify that I have read'this-application and state that the Issuance Fee '1 `.1 T -..i ff LDMA P/C It above informotion is correct<I agree to comply with all County Investigation Fee - b�' - 'ordinances and State laws relating to building construction, Taint Fee—w✓ / �1 `f' ID Perm.'# < "and hereby,authorize representatives of this County to enter � upon the above-mentioned propre/rty�for,inspection purposes. ' o u,-`t v, r?�„�/,? - pc✓!!. /7 'Z 4 f t SEE REVERSE FOR EXPLANATORY LANGUAGE. - - Signature of,Applicant or Agent Date .r - . WORKERS' COMPENSATION DECLARATION r�f�p �/,aa /� p p Ips I� Fri p p p F�.n/� p r� n hereby affirm that I. haver certificate of consent Insurance, 7& IJ IJ II ��(` /pk��O IryII 1 FO R I„(II II�.11 D� LI hII U e, FE R r�Y 1t. T � insure, er a certificate of Workers' Compensation Insurance, //'ll ll, Il LS `V-!r"U ll ll V Il Uhl Uv ,LS U V�!J IS 0�11/C/Il or a certified copy thereof Sec 3800, Lab. C.) / - `COUNTY OF LOS ANGELES: ..._ .. BUILDING.AND SAFETY policy oy1911 Cr�pany�9Je7y AyU .. ` ❑ Certified co is hereby furnished.•. 'FOR APPLICANT TO FILL IN BUILDING 5 �j copy- y ADDRESS c3 Certifiedcopy is filed with the county-building inspec- A tion department. ADDRESS Date Applicant CI LC G� NO. OF BLDG9/7 LOCALITY ' CERTIFICATE OF-EXEMPTION FROM WORKERS' " SIZE OF LOT NOWONLOT ' - NEAREST •_ -CROSS 5 - T. "COMPENSATION INSURANCE - ASSESSOR (This sectionneed not be completed if the permit is for one TRACT ' '" � BLOCK `- LOT NO, -"- MAP BOOK - , PAGE PARCEL hundred dollars ($100) or less )' ', . , - TEL a,. :OWNER %; [� ��' NO. Cs•0 USEON MAP' I certify that in the,performance.of.the work for which,this - J _ j��]j)� NO. permit is issued, I shall not employ any person in any manner ADDRESS 70.5 �MA- I� Vjy - 1'�~ ISPECIAL CONDITIONS a so as(to become subject to the Workers'Compensation Laws. - - 0 CITY=T.� PL GLS• ZIP 17 O Date-Applicant ARCHITECT OR - TEL: K NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER - NO. DI TRICT ' G OUP CONST. FIRE E PROCESSED BY - O Exemption, you should became_,subject to the Workers' w el Compensation provisions of the Labor Code, you must forth- ADDRESS. 5/Og'F_ � ,with comply with such provisions or this permit shall be fir. . alp TEL STATISTICAL CLASSIFICATION AP CONDO_ rn deemed revoked. CONTRACTOR • I.ONST NO. Z86AS - - - -- Z. LICENSED CONTRACTORS DECLARATION 6J// -V. 4;we- itel A 414110 CLASS.NO. DWELL. UNITS— . I hereby affirm that 1 am licensed under provisions of Chapter 9 ADDRESS NO.'J"L7 y� / LIC. or �..G s SEWER MAP (comm Professions with Section 7000)of:Division 3 04 the Business / Pl.� �i! L and Professions.Code,and my license is in full force and effect. _ CITY CLASS BK. �. � .VALIDATION ' SQ. FT. 'NO. OF O. OF CHECK License Number y' `/9$ Tic. Closs ` Icr SIZE STORIES FAMILIES ONE - 'E.�' ,j7��P16Qfr. . . _ VALUATION - - Contracto77 - Date /G/ Z DESCRIPTION OF WORK NEW ❑ $ ADD ❑ JC% D ❑,I am exempt under Sec. _ 550 `� - ALTER F❑ B.BP.C.'for this reason REPAIR,1�p $ ' _ - _ Date: USE OF 'L EXISTING BLDG. I �✓G DEMOP'❑ Signature -� �' APPLICANT L' TEL FINAL OWNE IIDER DECLARATION (PRINT)�• �/✓� " � NO 2S6"'� 7 O/ . DATE ....... -.: I hereby affirm that I am exempt from the Contractor's License - �. '� -/ G y _ 7 Law for the following reason (Section 7031.5, Business and ADDRESS % / N • FIN Professions Code): - PRESENT - By (f ❑ I, as owner of the ro ert or m em Io ees with BUILDING' ACC.T.T - P P Y, Y P Y ADDRESS _ - wages as their sole compensation,will do the work and LOCALITY D ddl�� 33.00 the structure is not intended or offered for sale(Section _ 7044, Business and Professions Code.). MOVING .. . -TEL. .. - ' , - 1�-1TEI ITEMS El1, as owner of the property, am exclusively contracting CONTRACTOR NQ - ff�'l1ff�l'Y with licensed contractors to construct the project (Sec- - ADDRESS. - - TOTAL . -. J' J m LV' tion 7044, Business and Professions Code.) - - p 7, REQUIRED TOTAL SETBACK EXIST. -. ._ LHE4Y. 315x00 YARD HWV "' •' - ,. CONSTRUCT H hereby affirm that here)iiss a conssttruccttio Glend ng agency for FRONT ACK PROP. LINE WIDTH " - Cunt`_E .00 the performance of the work for which this permit is issued P.L. NI'I''N - (Sec. 3097, Civ. C.). SIDE '^+ P.L. Lender's Name .—•• ..0000-6001 10/?4/89 $ -_ . .v> v. ,. .CDMA Ref. N - _ L P C. Fee$ Permit Fee r 6359 1 AM "r:0? Lender's Address - a I certify that I have read.this application and state that the - Issuance fee .5 LDMA P/C'N D 8 above information is correct. I agree to comply with all County Investigation Fee R ordinances and State laws relating to building construction, Total Fee A .LDMA Perm. R . a and hereby authorize representative of this County to enter 1. _ _ - upon the above-mentione'>d per :inspection purposes. - - - - -' a /lam•/ _ SEE REVERSE FOR EXPLANATORY LANGUAGE nature of Applicant or Agent Date' - -