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Home My Public Portal About6426 ENCINITA AVE_Building__ I 1 DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES fl ® � �B WM. J. FOX, CHIEF ENGINEER B LLQ II FOR APPLICANT TO ,FILL IN FOR OFFICE USE ONLY BUILDING 1 DISTRICT T NO. PLAN CK. O.— b PERMIT NSA. ADDRESS 7 r` JA�!/3(7_ R EI VED BY DATE OF APPL. DATE ISSUED LOCALITY NEAREST / (, (� AA]] _ r'r( _ CROSS ST, L O Af AJ V' N ti /A)1' BUILDING ADDRESS OWNERA- IJ C- MAIL LOCALITY _ ADDRESS �.Z �E� NEARESTTEL. ' / B_�, T + CROSS ST. [+ CITY {� �� ' NO. / AO's ZFIRE ONE I PLAN F� A RCHITECT OR TEL. / ENGINEER `( -• }�$ NO. }v r BLDG. - RIjD�IQ `, I BE LINE }h TGL M. ADDRESS G A /I ,�� APPROVED TEL BY DATE ' CONTRACTOR • V(J-Q NO. /• USE /I / BAVPROVEW ZONE /"}� DATE - O ADDRESS HOUSE NUMBERING LEGAL ILOT.'NO!"' ( BLOCK MAP NUMBER J IELD CHECK BY ` DESCRIPTION TRACT r A/,lT- NO. ASSIGNED B__--Y BATF No. OF BLDGB.I,1 ..11 CORRECTIONS SIZE OF LOT G� �i I NOW ON LOT ,1/G M ' USEOF NO. OF EXISTING BLDG. FAMILIEsNent q gf, - - DESCRIPTION OF WORK -� z l�'Gl N. 7"/� A16 7 NEW x ALTERATION ADDITION I - D r: _OG A/o tJG - Tu U) D REPAIR I I DEMOLITION SO. FT. NO. OF C0 dT r1S.E�IIIJCY SIZE .. - ROOMS STORIES -J36 RrCAHr +SMIFlIL D e EXT. WALL f5TQ Qr d ROOF ( 1 f COVERING K COVERINGw/IITCI�Q }/n r�/11.E CIa7TbM �F 'F3A rt/ 0 USE OF STRUCTU 7"R/I�o LFrAJ2D 1; AA 141 ill i li "W. .. A-Fu OJ)A d!2 f'R y2-4 10- h>J?AS - l1D1 }rfTkFM AIAJ IS 'APPROVALS K INSPECTOR'S SIGNATUR E DATE 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FOUNDATION: LOCATION 1�d /// • PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS Y' CORRECT. I AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS,ft HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS f'> LAWS REGULATING�ILgING CN6TR FURNACE: LOCATION. � SIGNATURE OF /Y'�]dL/_/J(g`/,p GAS VENT, DUCTS f� PERMITTE�/E � / ADDRESS -f (D- /�YC�( Z�Y6�yI "__"�_�'^..� LATH. INT. t9' LATH. EXT. J �/ i.Y` l 7 IU AUTHORIZED AGT. PLASTER, INT, I• 7GA638A• D889 10-80 P. C. $ �� FEE () PLASTER, EXT. V VALUATION 51 FEE � � FINAL A.- 76A638ACER8033-69 APPLICATION FOR BUILDING . COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER AODR ESS41, 2 BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, BURT OF BUILDING NEAREST CROSS*ST. DISTRICT O. ,GROUP TYPE PROCESSED BY FOR APPLICANT TO FILL IN CONST. Print ort De only) - �s �- BUILDING n STATISTICAL CLASSIFICATION CLEASSIFICATION - SEWER.MAP ADDRESS 6426 Encinitas Temple e Ci CLASS NOI�DWELL.UNITS__—_L SK PG LOT NO. BLOCK USE ZONE MAP NO7 TRACTJ� J 7 A �j / SPECIAL NO.OF SLOGS, CONDITIONS SIZE OF LOT NOW ON LOT , USE OF EXISTING BLDG. Re B.Y BLDG.SETBACK FROMTE , OWNERRay G. Fortner NO./iV6-3125 FRONTPROP.LINEOF -(STREET). TYPE OF EXISTING SETBACK HIGHWAY } YARD - TOTAL ADDRESS 9519 E . Las Tunas„ HIGHWAY WIDTH FROM C.L. CITYTemple City, Calif. * _ ARCHITECT OR TEL. SIDE PROP, L NEOFFM (STREET) ENGINEER NO. TYPE OF EXISTING SETBACKHIGHWAY + YARD = TOTAL ADDRESS Merle HIGHWAY WIDTH FROM C.L. CONTRAC Q R (e o�' 286-3125 + > D_ ADDRESS 13 N •Dais .. NO. CORNER CUTOFF YES ❑ NO ❑ U LIC. 13370s CITYPasadena .Calif. CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS U DESCRIPTION OF WORK d h z NEW ADD ALTER REPAIR DEMOLISH SQ. FT. NO. OF OF SIZE STORIES FAMILIES USE OF STRUCTURE DEMOLITION SIGNATURE OF APPLICANT VALUATION 0 O S' APPROVALS DATE INs vEc roR•s SIGNATURE P.C. PMT. 'FOUNDATION: LOCATION FEE S FEE $ FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. I CENT(FY THAT IN DOING THE WORK _ AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- LATH, INL INC TO WORK MEN'S< PE NSATION INSUR NCE. LATH, EXT. SIGNATURE O , HOUSE NUMBER COR- PERMITTEE- n AA, RECT AND POSTED / ADDRESS C FINAL JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.G. DASH _ PERMIT VALIDATION CK. M D. GRSH IQjr9757;-.- MAY 5 A- D 6.00~ v WORKERS' COMPENSATION DECLARATION r �l ��E __ f herebyaffirm that I have a certificate of consent to self "- O O '/( `((^�( )))�I��P��u�p�� I��}+ I'^�` M`/l��T �r�rj RD ''❑q///IT1 insure, or a certificate of Workers' Compensation Insurance, O P��C AD W U V u 0 R•• v U��D�a �+ v u E t+�t+V u�7 '-or a certified copy thereof (Sec. 3800,tab. C:) COUNTY OF LOS ANGELES '' BUILDING AND SAFETY Policy No. Company •'- ' // ,'`` ElCertified copy BUILDING /is hereby furnished. _ FPR APPLICANT TO FILL : - ADDRESS !�7a� ❑ Certified copy is filed with the county building inspect BUILDING t. //' - , „tion department. ADDRESS '} #'lVv1 J✓f // Date Applicant CITY (/ ZIP LOCALITY V GG pp 1 NO. OF BLDG5. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS'� SIZE'OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCE ' ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. - MAP BOOK PAGE PARCEL hundred dollars ($100) or less.) , 1 TEL r OWNER - /V Q NO. - USE ZONE MAP certify that in the performance of the work for which this NOS SPECIAL - d permit is issued, I shall not employ any person in any mon r ADDRESS f N CONDITIONS so as to become subject to the Workers'C an ation _ 0 CITY zip. Data 'Applicant ` t ARCHITECT O / /� TEL. ' _O 11 NOTICE TO APPLICANT: If, after making this Certif ate of ENGINEER f/ v GO DISTRICT GROUP CONS FIONE �CESSED BY Exemption, you should become subject to the Workers' qq �Q� _2 w Compensation provisions of the Labor Code, you must forth- ADDRESS Q .DC ✓ a -with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. deemed revoked. CONTRACTO NO. . - z LICENSED CONTRACTORS DECLARATION - G.wf I a. - UC. CLASS NO. a/ - DWELL. UNITS_ I hereby affirm that I am licensed under provisions of Chopter9 ADDRESS lily NO' SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. and Professions Code,and my license is in full force and effect. CITY CLASS BK PG VALIDATION' SQ. FT. NO. OF NO. OF CHECK .. License Number -Lic. Class SIZE 77 STORIES FAMILIES ONE VALUATION Contractor Date DESCRIPTION OF WORK .O NEW ❑ $ IV NI' $ ADD El ❑ 7. D I am exempt under Sec. ALTER ❑ + B.BP.C. for this reason r'r'^ N ,^r REPAIR ❑ s r USE OF Date: .\�' EXISTING BLD t - DEMOL ❑ Signature APPLICANT / 1 TEL. FINAL OWNER-BUILDER DECLARATION V` (PRINT) NO. ,/• �/ DATE herebyaffirm that e W t from the Contractor's License /,� ' Law for the followingg r reasonson(Section 7031. 5,'Busineds'and ADDRESS �'" I FINAL - 2'3 Pr'fessions Code): PRESENT - By i ACCT.a• ❑ I, as owner of the property, or my employees with BUILDING / „- pi^ 303 101.010 wages as their sole compensation,will do the work and LOCAL" - a.✓^s'r 1 the structure is not intended or offered for sale(Section D , 1 7044, Business and Professions Code) - MOVING . . TEL. a�.`L CONTRACTOR NO. ❑ I, as owner of the property, am excl Le y contracting `T1 ACCT.: with licensed contractors to construct the project (Sec- ii"`N1J1J1 ADDRESS tion 7044, Business.and Professions Code.) 133133 852.92 \\v' -REQUIRED. TOTAL SETBACK FROM -EXIST.- E: Sa 1 u, CONSTRUCTION LENDING AGENCY .SET BACK YARD HwY PROP. LINE WIDTH --�� 2 ITEMS I hereby affirm that there is a construction lending agency for FRONT- ,11 the performance of the work for which this permit is issued P.L. i `�% ks {i TOTAL - 953 . 92 (Sec. 3097, Civ. C.). SIDE T' {1�..t„ P.L..... ,rCHECK 953.92 Lender's Name , LV 90 a S 6 Z LDMA Ref. It CHANGE .00 P.C. Fee E Q -� Permit Fee Lender's Address _ I certify that 1 have read this application and state that the - Issuance Fee' -/ P/C q• o above information is correct. I agree to comply with all County' Investigation Fee O o� ' G a �I 0000-0001 . 6/24/96 Rordinances and State.laws relating to building construction, ictal Fee / LDMA Perm. N ]DED 1 PM 544 m and here authorize represehtatives of this County to enter upon ih- b ntio�ned fFop�rty for inspectio9 rpo S. f/O- Ul SEE REVERSE FOR EXPLANATORY LANGUAGE Signet a of Applica or Agent - "_ _ _ ,