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HomeMy Public PortalAbout10631 FAIRHALL ST_Building__ DEPARTMENT OF jC01 M ENGME6R - DMSIONOF OU Mnq SAND SAFETY I ` ' - GELES B WILLIAM J FOX, COUNTY ENGINEER APPLICATION CASSATT D GRIFFIN, SUPT OF BUILDING FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING , DISTRICT NO "PLANCK OR REc No PERMIT NO' ADDRESS 1/ + S 7(/Cri7/- /) ✓z k 2 LOCALITY e RECEIVED BY ( DATE OF APPL DATEISSUED NEAREST H ae er c.3 CROSS ST �j - , ABUILD DD EISSG I Q OWNER /- 4, A h4 1 MAILADDRESS � J LOCALITY t NEAREST TELCROSS ST CITY V Y'" O FIRE - NO OF TYPE GROUP,', ARCHITECT OR TEL ZONE E I PLANS II ENGINEER NO ADDRESS BLDG r O r /� �," '-'O ` O 01 SETBACK LINE . �, TEL USE APPROVED r CONTRACTOR O ZONE BY 1 ATE Q/ ADDRESS V a- ,, iAt +I r t HOUSE yN�UMBERING LEGAL �1 MAP NUMBER °i1,0y NVO ASSIGNED BY---L— DESCRIPTION Y i DESCRIPTION T NO f� BL K _ , j CORRECTIONS TRACT SS X NO OF BLDGS SIZE OF LOT IDD NOW ON LOT !L USE OF NO OF EXISTING BLDG Amlhm { - DESCREMON OF WORK -F'" 0ALTER NW rION - - REP IR DEMOLITION I-I ADDITION I D r SQ FT NO OF SIZE (1077 ROOMS STORIES COVER,'G J UCC D I COOOF VERING COV c f . USE OF STRUCTURE APPROVAtL INSPECTOR'S SIGNATURE DATE ` FOUNDATION LOCATION FORMS, MATERIALS` ..6.4►.�' •+ ��i^�/�� I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME FIRE STOPS �/�/ PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS ` �J.do..�v ti.v/ ?m ✓� CORRECT FURNACE LOCATION 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES GAS VENT, DUCTS w AND STATE LAWS REGULATING BUILDING CONSTRUCTION SIGNATURE OF / ��' LATH, INT ✓ PERM ITTE / /� LATH EXT ADDRESS /Z / + / PLASTER, INT AUTHORIZED AGT • � 'r�� � a i PLASTER, EXT 111_"A $ © 01 C $ `S_O HOUSE NUMBER COR- �v ��0�- FEE RECT AND POSTED 17 VALUATION FEE E2 Z ab FINAL v ' 7GA888A 088 8 8-82 \ Y 1 ' w, P� 7EA9A CE#908,059 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING " DEPARTMENT OF COUNTY ENGINEER ADDRESS , a BUILDING AND SAFETY DIVISION LOCALITY 10 tL4 JOHN A LAMBIE,COUNTY ENGINEER NEAREST CASSATT D GRIFFIN,SUP T OF BUILDING CROSS ST v DISTRIC O GRO TYPE ' PR FOR APPLICANT TO FILL IN CONsr I ' , BUILDING ,{ - Jam"` ��1 i /�� ADDRESS /p (" / I L STATISTICAL jJ./LSSIFICATION SEWER MAP LOT NO CLASS NO 4y/G DWELL UNITS-1 BK�/1 �/ BLOCK ,MAP STATE YES - ' NUMBER ' HWY OZE 'TRACT /k�� USE ZONE r� SPECIAL SIZE OF LOT_;j o X 1-30 I NO OF BLDGS �y �( CONDITIONS NOW ON LOT C/ /l�I_- USE OF t EXISTING BLDG BUILDING - EXIST �/f Q C T- p YARD HWY STREET NAME OWNER 1 Q/MAIL ,�Sp FJ 1 M`•A(�O/�/1 r�6 a SETBACK p WIDTH ADDRESS /U�J! � /.�+lT�/>t LV FRONT T AA ii �z 6 / SIDE Lfj p EAL MA � CITY TE 'V "a��� P L INSPECTION RECORD `6J CJ ARCHITECT OR TEL ENGINEER NO - ADDRESS CONTRACTOR B �� �� TEL NO ADDRESS _ DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH SQ FT NO OF NO OF ' SIZE joa STORIES FAMILIES USE OF STRUCTURE ePA771a 0O� V r OIL- SIGNATURE O �ALWV APPROVALS . APPLICANT/ 9 ` Q � �p - ADDRESS�Vf'7J/ F_ ?50--j,YyL(I.JC-( T.GtDATE INSPECTOR S SIGNATURE FOUNDATION LOCATION FORMS MATERIALS - $ c P C $ FRAME FIRE STOPS �T (Q FEE BRACING BOLTS y'd / VALUATION �� (1 $ �"Q FURNACE LOCATION ' FEE r_ GAS VENT DUCTS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- PL P- LATH INT PLICATION AND STATE THAT THE ABOVE IS CORRECT AND I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND - STATE LAWS REGULA)PJNG UILDING' CO STRUCTION LATH EXT / HOUSE NUMBER COR SIGNATURE Ogg ^�h / s PERMIT T�A1 �'/7 �� l' > RECTANDPOSTED F ' ADDRESS FINAL CLYDE N DIRLAM PRINCIPAL STRUCTURAL ENatmega PLAN CHECK VALIDATION CK m O CASH t PERMIT VALIDATION " CK .M O CASH Y r i�AL o 9, 0 3 1 JUL7 K' 1 'A 5 Q 0 ° ' APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL I BUILDJN&r6E$S� , ^ /� e + f I hereby affirm that I have a certificate of consent to self Insure, B�ILD1pLG/PDD �� A `� r / L lJ(� ��.CJ r '` /�l (� 4�- or a certificate of Workers' Compensation Insurance, or a certified ` l��/(f�n/ A L(�� qA copy thereof(Sec 3800,Lab C) r CI ZIP r / � J� � � LOCALITY Policy No ell l Company `a`� J�' STZE OF LOT NO.OF BLDGS NOW ON LOT ❑ Certified copy IS hereby furnished NEAREST CROSS ST L E)kertified copy is filed with the unt building inspect?A TRACT BLOCK LOT NO delpa�rlt nt USE ZONE MAP NO Date V.l. Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEM ION FROM WORKERS' OWNER TEEN `�r COMPENSATION INSURANCE 0 ` / Z�O� WITHIN 1000 FT.OF SCHOOLS YES NO (This section need not be completed if the permit is for one hundred ADDRES ^ y� E-1 DISTRICT GROUP TYPP CONST FIRE ZONE PROCESSED BY dollars($100)or less) ' - I certify that the performance of the work for which this permit � - '6 is Issued, I shall CITY ZIP all not employ any person in any manner so as to Of UG become subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO P STATISTICAL CLA SIFJCATION I 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 t0 the Workers' TRACTOR TEL NO SET BACK YARD HWY PROP LINE WIDTH j- Compensation provisions of the Labor Code, you must forthwith -V^ ��'P FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS C P L LICENSED CONTRACTORS DECLARATIONSIDE SIDE CI LI^C-CILP L I hereby affirm that I am licensed underprovlsions of Chapter,9 Y J /�/"7 H7 5 CSEWER MAP � (commencing with Section 7000)of Division 3 of the Business and SQ FT SIZE NO OF STORIES NO OF FAMILIES Professions Code, r� ir��j9-y full force and effect l t;� NEW ❑ BK PG a License N r CLIC CIeSS DESCRIPTION-OF WOR ADD ❑ VALUATION , Q Contractor Date 'L t --�— �; �� r r/V� $ 2 a JOE () CO oSI �o�I �C Ott M ALTER ❑ J t' S A4 S w °C ❑ lam empt under Sec Q REPAIR $ F- B&PC for this reason CLASS / I �-i4fWOLA5 yY+ tC DEMOL ❑ 1 V LDMA P/C# (�,J Date USE OF EXISTING BLDG URM ❑ Signature BPfIMAANcT1(P{3((JT) �91C� � f� LDMA Perm# _t'_ �='�•a�•'=Z ❑ I, as owner of the property, or my employees with wages as Q�J i O their sole compensation, will do the work and the structure ISIVD not Intended or offered for sale (Section 7044, Business and I. Egg N �N FINAL DA Q 1-j = -_7 _ X5-0 Professions Code.) '[ p _f F?!_ a WILL THE.APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL .. OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑ I, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIE N THE HAZARDOUS MATERIALS INFORMATION GUIDES FINS BY ''''•-" licensed contractors to construct the project (Section 7044, Business and Professions Code) YES ❑ No WILL THE INTENDE USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING , OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDELINES •- ::-. r.r3r•... .(: I hereby affirm that there is a construction lending agency for YES❑ NO '-}'-''-1=f- lam: C4 the performance of the work for which this permit is issued(Sec 0) 3097, CIV C. [HAVE READ TH AZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING -�. •+-'•== N ) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, Lender's Name MTL RiACHAPT ORT2 20 ING SSECTIONS 2 20 10 A RRORUGH 2 20 40 E SCAQMD G HAZARDOUS 3 o Lender's Address oe _ o I certify that I have read this application and state under penalty q of perjury that the above Information is correct I agree to comply PCLFrzE PERMIT FEE o /// with all county ordinances nd State laws relating to building ro constru n, and hereby orize re esentatives of this Count ISSUANCE FEE ter on th ve- tion erty for inspection rpos (p. a r 7a O'v INVESTIGATION FEE TOTAL FEE /..2 7. LLQ or pu�am rg„ oa�a lJ / -7 SEE REVERSE FOR EXPLANATORY LANGUAGE