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HomeMy Public PortalAbout5019 FARAGO AVE_Building__ I 7BA888A CF#803 11 5-1 APPLICATION FOR BUILDING PERMIT 1 COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DMSION LOCALITY JOHN A LAMBIE COUNTY ENGINEER NEAREST CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST DISTRICT NO GROUTYPE SEWER MAP FOR APPLICANT TO FILL IN �` = coNsr-� K f G BUILDING STATISTICAL g�SSIFICATI N ADDRESS � ___(S[L Y ' / CLASS NO DWELL U TS LOT NO _T BLOCK MAP GZ a, STATE NJMBER ��>r/ HWY YES NO TRACT f4 -7 USE ZO SPECIAL NO OF BLDGS CONDITIONS SIZE OF LOT NOW ON LOT Od USE OF D EXISTING BLDG UILDING EXIST S TBACK YARD HWY STREET NAME WIDTH OWNER 1� FRONT t MAIL P L ;ARCHITECTOR DDRESS 0 Ay 6t SIDE TY (7 r TEL P L TEL ./ TI-INSPECTION RECORD ENGINEER NO119,010, . ADDRESS TEL CONTRACTOR NO ADDRESS h DESCRIPTION OF WORK NEW ADD ALTERDEMOLISH SQ FT NO EPAIR NO OF SIZE STORIES FAMILIES USE OF STRUCTURE - SIGNATURE OF c APPROVALS APPLICANT ADDRESS,63/f `0.Ydo CL vC FOUNDATION LOCATION DATE INSPECTOR S SIGNATURE _ )FORMS MATERIALS ,y /-3 sol $ FIRE O`/,er B a FEE ; F BRACING BOLTS STOPSRAME i4 J9 VALUATION f V FURNACE LOCATION FEE — GAS VENT DUCTS IH EREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LATH INT PLICAION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGU1,ATING BUILD G CONSTRUCTION LATH EXT SIGNATURE OF HOUSE NUMBER COR PERMITTE RECT AND POSTED ADDRES FINAL - JOHN A LAMBIE COUNTY ENGINEER CLYDE N DIRLAM PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK bio CASH PERMIT VALIDATION CK M o CASH 1 t 94OR FEB 13 1 A 200 M rly e� 7SA838A CE#8035 5i APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING O DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DMSION LOCALITY 45'•, ci JOHN A LAMBIE COUNTY ENGINEER NEAREST W� WILLIAM A JENSEN SUP T OF BUILDING CROSS ST l� FOR APPLICANT TO FILL IN DISTRICT NO GR P TYPE PRO ES E BY Q S l CONST BUILDING cOI STATISTICAL CLASSIFICATION - ER MAP ADDRESS SSK PG CLASS NO!:!--DWELL UNITS I Z LOT NO BLOCK WATER NOT REQUIRED RECEIVED Y CERTIFICATE TRACT i MAP '� �J �CGRC AY EI STATE MAJOR SECOND LOCA HW NO OF SLOGS/ NO �-O SIZE OF LOT /V-O NOW O • N LOT US= ZONE SPECIAL _^ USE OF / CONDITIONS �O'� EXISTING BLDG TEL A OWNER I NO BUILDING YARD HWY STREET NAME EXIST SETBACK WIDTH ADDRESS FRONT ♦1 _� ,(I Yl a� ARCHITECT OR TEL P L �►C/ v� fC- ENGINEER (IY SIDE O P L V ADDRESS- - --=. /1 TEL _ INSPECTION RECORD CONTRACTOR —�/ NO Chi IKoa/� 3 � �� e � 10 j U ADDRESS e.✓ 'nom-// y( ZW p�f W D CRIPTION OF WORK �1,�'�� � }.,r'',�`+� e � � �.� ✓rte i fav�� 'Z NEW ADD ALTER REPAIR DEMOLISH SQ FT NO OF NO OF IZE STORIES FAMI ES USE OF 9 F 9 STRUCTUR Moil. I SIGNATURE APPLICANT v r VALUATION$ APPROVALS a DATk INSPECTOR S SIGANT RE PMTJ FOUNDATION LOCATION , 2 FEE $ r .7 FEE $ / ♦ P`� FORMS MATERIALS O its 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 ONRTIFY THAT IN DOING THE WORK AUTHORIZED Y I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT TION OF TN CoLA R CODE O ��A OF CALIFORNIA RELAT INC TOW N B CO PE ATI N E LATH EXT SIGNA71 RE NUMBER COR PER -bQRECT AND POSTED ADDRESS FINAL CLYDE N DIRLAM PRINCIPAL STR URAL ENG NEER PLAN CHECK VALIDATION cK too CASH PERM VALIDATION No CASH 9 8 4,O t2 SEP 6 23 D/ 3.7 5 le 9 S 4 1 G SEP 6 1 D 1500- Q I 41 I DMSION OF BUILDUM AND SAFETY l I Department of County Engmeer NG County of Los Angeles WM J FOX COUNTY ENGINEER APPLICATION FOR APPLICANT TO FILL IN ADDREBUILDISSNG ► v BUILDING SO �� �✓Q /. LOCALITY e� ADDRESS V �7 G(/�C_ G NEAREST LOCALITY —re,M A L f CROSS ST NEAREST I DISTRICT NO PLAN CK OR Rea No PERMIT NO OWNER a„ (f' /� / ! ` 'RECEIVED BY DATE OF APPL DATE SSU D MAIL ADDRESS S—� /� A. �'�Gyfl/17 J� y y USE ZONE NO OF .,TYPPE_ GROUP FIRE ZONE e- m L � C 1 1 V NO rm, r6 � , _ A- 1 �� I ' I CITY ARCHITECT OR TEL �,yy�.�..� ZONING I DATED ENGINEER NO r.J43 APPROVED BY 8-1.eJ ADDRESS ` BUILDING P� ORD/No SETBACK LINE �` J ( t i ,um t TEL APPROVED-p—bTZ DATE CONTRACTOR NO BY HOUSE NUMBERING �y RESS ADD LEGAL ' G I BLOCK MAP NUMBER" P� / NO ASSIGNED BY DESCRIPTION LOT NO A DATE CiORRMTIONS I INSPECTOR Q TRACT f % / / , NO OF SIZE OF LOT 7,S ' a- os- i NOW ON LOTS !//S L 11 RICUSE OF NO OFI EXISTING BLDG G C AMILIEB ` I // OSS/�/C I O DESCRIPTION OF WORK Z NEW ALTERATION ADDITIONI r REPAIR DEMOLITION I�� J�R/ � /7lil � '•�y� SQ FT 5�'� b NO OF ss SIZE ROOMS SR OFTORIES ING ��/ EXT WALL I COVERING L/O�I'1 1 �I d j.��j reqArz 7 COVERPF I USE OF //STRUCTURE �4b c`Z.1�6)f 6-4c, oy o! F APPROVALS Opp \ ( y INSPECTOR S SIGNATURE DATE -0 \` \h Q FOUNDATION LOCATION dl � v/0- FORMS MATERIALS /✓ r Z✓r/ l 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP FRAME FIRE STOPS PLICATION AND STATE THAT THE INFORMATION GIVEN IS CORRECT BRACING BOLTS P1eC/ iAGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE LOCATION i AND STATE LAfW�'SS REGULATING BUILDING CONSTRUCTION GAS VENT DUCTS SIGNATURE PERMI TTEF F` t 'J f ` LATH INT . A, ADDRESS /i t ^1F Q , C. o // LATH EXT ell PLASTER INT AUTHORIZED AGT pg�� PLcp ASTER EXT IV Jr FEE ffi HOUSE NUMBER COR RECT AND PO VALUATION FEE FINALAA Wpp 76A688A D88 3 8 53 F Ilse A�,B;e APPLICATION FOR BUILDING PERMIT -� DMSION OF BUMDING AND SAFETY 111.1 LDING ADDRESS 3�/tq �Gls Q d a Deptatment of County Engineer County of Los Angeles LOCALITY e T JOHN A LAMBIE COUNTY ENGINEER NEAREST CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST A-'h y6L V FOR APPLICANT TO FML IN DISTRICT NO GROUP TYPE SEWBK MAP PG CONST r -/ _I BUILDING MAP �„ C STATE ADDRESS y �+ NUMBER �7 / HWY YES LOT NO BLOCK USE ZONE SPECIAL CONDITIONS TRACT -` NO OF y SIZE OF LOT I NOW ON S LOT / BUILDING EXIST SETBACK YARD HWY STREET NAME WIDTH USE OF EXISTING BLDG FRONT Fp �7 ! P L OWNER ` ItiC r IC S0.Gt � Q� / SIDE MAIL ADDRESS O 9 Fcv, GI V OTEL + O TRACT DWELL 1 UNIT 5 INDUSTRIAL /e CITY h„gl e C ITL/ NO I DWELL 1 UNIT 6 PUBLIC BLDG ARCHITECT OR TEL 2 DUPLEX 2 UNITS 7 ADDN ALT ETC ENGINEER NO 3 APT UNITS 8 MISCEL ADDRESS 4 COMMERCIAL TEL INSPECTION RECORD CONTRACTOR NO ADDRESS r• f ,,����DESCRIPTION OF WORK NEW cops LTER EPAI DEMOLISH 9� d SQ FT J�u(! NO OF NO OF WrZICA SIZE 7 STORIES FAMILIES ® A/ USE OF STRUCTURE G.. IA/& C SIGNATURE OF APPLICANT APPROVALS ADDRESS 5'0 / DATE INSPECTOR S SIGNATURE FOUNDATION LOCATION $ /D © �a� FEE S FORMS MATERIALS �� FRAME FIRE STOPS VALUATION S f BRACING BOLTS FEE `0 FURNACE LOCATION I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT DUCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH INT AND STATE LAWS REGULATING BUILDING CONSTRUC TION LATH EXT SIGNATURE OF HOUSE NUMBER COR PERMITTEE vaz X96 RECT AND POSTED ADDRESS FINAL JOHN A LAMBIE COUNTY ENGINEER VALIDATION CLYDE N DIRLAM CHIEF BLDG INSPECTOR CK MO CASH L AP,0 1 4 2 7- JUL 20 1 600 m DIVISION OF BUILDING AND SAFETY Department of County Engmeer County of Los Angeles BUILOHNG! WM J FOX COUNTY ENGINEER APPLICATION FOR APPLICANT TO FILL IN ' FOR OFFICE USE ONLY DISTRICT NO PLANCK OR R[o No PERMIT NO BUILDINGZ ADDRESS 6 [ n /� �� CEIV D BY OFAPPL DA E ISSUED LOCALITY (V („� NEAREST o + ' S ROBE ST �w.�J� ' BUILDING 1 ADORERS OWNER V-Z„ZIJL� MAIL \ LOCALITY ADDRESS __-(j NEAREST Q U140153BT CITY _ Q t FIRENO OF I TYPE GROUP �� _ . r�l���• ARCHITECT OR TEL. PLANS J ZONE ENGINEER N SETBACK LINE 1 .i �S/fOIZD rN0 ADDRESS DON ] T APPROVED TEL ZONE �.�-r� BY DATE CONTRACTOR NO HOUSE NUMBERING s ADDRESS MAP NUMBER 2-0" r NO ASSIGNED BY LCGAL CORRECTIONS DESCRIPTION LOT NO 14 BLOCK — TRACT 9 � SIZE OF LOT Z�I NNO OF OW K L 08 rf �p A41' 04.0 USE OF NO OF �anQ 17 EXISTING BLDG 1\ FANlLI[B DESCRIPTION OF WORK NEW ALTERATION ADDITION I _ D r REPAIR DEMOLITION 7 / �—� Sa FT NO OF BIZE ROOMS STORIES EAT WALLI OOf R COVERING COVERING USE OF STRUCTURE r � INSPECTION FOR APPROVALS OCCUPANCY AS INSPECTOR S SIGNATURE DATE FOUNDATION LOCATION FORMS, MATERIALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME FIRE STOPS PLICATION AND STATE THAT THE INFORMATION GIVEN IS CORRECT BRACING BOLTS a 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE LOCATION AND STATE LAWS REGULATING BUILDING CONSTRUCTION OAS VENT DUCTS SIGNATURE OF LATH INT PERMITTEE 0 LATH EXT ADDRESS �1 PLA13TEP INT AUTHORIZED AST l/ PLASTER EXT FEE ;/ 1 1HR RECT AND POSTED VALUATION FEE It 0�- )FINAL IBB 11011111176A638A DBS 3 1 S2 Y r y COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9712220048 PHONE (818) 285 0488 EXT LEGAL ID NO OF CONST BUILDINGADDRESS TR 11497 LT 13 BL 001 SQ FT STORIES TYPE 5019 FARAGO AV STRUCTURE 0 VN TEMP CA 917803526 ASSESSORIO BER NEAREST CROSS STREET 8574 008 036 THOMAS PAGE 597 GRID 04 LOCALITY TEMPLE CITY TENANT EXIST G USE RESIDR 2 ISSUED ON PROCESSEDX ON EXIST OCC GRP 12/22/97 UT 12/22/98 OWNER TEL NO BLDGS NOW ON LOT VALUATION FINAL DATE FINAL BY CODE SANWA BANK (626) 564 4112 2 4 100 587 COLORADO AVE I Z PASADENA CA AI C ION OF WORK TEAR OFF AND RECOVER WITH 20 Y OMP SHINGLE GAF FEE DESCRIPTION QUANTITY UOM AMOUNT APPLICANTEL NO SEXTON ROOFING (626) 963 6882 AA BLDG PERMIT ISSUANCE 27 75 AC STRONG MOTION-RESID _ =-4100 00 VAL 0 50 SPECIAL CONDITIONS D2 PERMIT W/O--EN HC -4100 00 VAL 133 05 �iZ CTCi A�FEESzk 161 30 CONTRACTOR TEL NO �G�(/'� APPROVALS DATE INSPECTOR S! NATUR SEXTON ROOFING (626) 963 6882 / 718 E ALOSTA LIC NO LOCATION AND SETBACKS GLENDORA CA 91740 601896/C39 SOILS ENGINEER APPROVAL ARCHITECTN N � �{ / \�, FOUNDATION/TRENCH FORW LIC NO � lJ �(� � '"�lll 111 SLAB/UNDERSLABANDER FLOOR I RAISED FLOOR ING UN L00 INSULATIONSR MABK GE FIRE P�14AP N ` 147H277 3 1,01FLOOR 11---- -- - - — -- --- -- -- -_J�� S H IWir— ASS 0OF FAMILIES DWELLING UNITS ON NO 21SHEARF- rl RRdffSCHOOL WITHIN HAZARDOUS ,j H I N IL AIR QUALITY 1000 FEET MATERIALS NO NO NO FRA INSPECTION REQUIRED R SET BACK YARD HWY PROP LINE WIDTH —"'VL FRONT PL ` u� INSULAnON/WEATHER STRIP SIDE PL TNT M LATH/DRYWALL EXTERIOR LATH RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T BAR CEILINGS LOT DRAINAGE REPORT ID DPR261 ROUTE TO BS0508 1 S' WORKERS .COMPENSATION DECLARATION I hereby affirm that h f 'I have a certificdte'6f consent,to'self P E RA I T-4 insure; ora ; APPLICATION F®R �UMVI tt arra ified'copy there of'.(Sec. Lab. c) COUNTY-OF LOSANGELES BUILDING AND,SAFETY �I.' Policy No ) Company J 5 Certified co is'hereb furnished: BUILDING ..t ' 2( i❑ !. i .. PY Y, FOR APPLICANT TOfILL IN ADDRESS ✓ ' ('Certified copy is filed with'the county building inspec BUILDING f . 1y tion•department; " . ADDRESS Date r, A licani. ? CITY (, l��f. t rZIP r � r> ' PP t r w LOCALITY k K a 3 t a j CERTIFICATE.OF;EXEMPTION-FROM WORKERS• , Kr ,,,, .. NO.(OF BLDGS.i NEAREST,. 1 .•' ;COMIP.ENSATION.INSURANCE.. SIZE'OF LOT "aCf�f I c,. NOW ON LOT s�� ' , I =• ,:„, C;, #- (Thissecti:onneed not be completed if.'the permit is for`one `'• - ASS SSOR c , rpt - ,,. •. TRACT , BLOCK• LOT NO • hundred'dollars ($100)pr less.)':•..' •.. ' ' . ,- BOOK" PAGE ` PARCEL'- d MAP Y Y i. t , t { OWNER tt :•:� i:r � { , >i f rr'`I TEL; i t t,'. { r USE'ZONE MAP: '. 0.. ,.. t .. 9.. rJ- NO. I certify that in the performance.of the;work for whicH"this f'j NO:"'. U •`permit islissued,,l shall not employ any person in any manner' t, ?. �i.. SPECIAL z: LiL'';'. ' ADDRESS -.:i:.:� ��. /.4, Y r.{a7 ! `�. J,• r. w so as to become subject to the Workers Compensation.Caws: (. CONDITIONS ,f �r r, Date °''' :APPlican( J /T !J ,1F '(sem ,- CITY I t }r,;,f J�L:r ZIP r +..NOTICE<TO APPLICANT:,,If.-after'mdking-.this Certificate of. ., .�~ ARCHITECT OR TEL• DISTRICT 'GROUP' TYPE FIRE PROCESSED BY :r ' 1 ENGINEER . NO: . Q Exemption- you, should becor�i'e-subject to:-the Workers' t CONST : ZONE ; .� % Compensation provisions of theaobor.�Code:you.must forth r t` r O .• ADDRESS with'comply with such' provisions' or this permit'shall_•be .:TEL.- STATISTICAL APT. CO deemed revoked t `W t CONTRACTOR } ' NO. r . -' LICENSED:CONTRACTORS DECLARATION. 'LIC. CLASS YJO.'' - DWELL. UNITS- W. y.e t ' I hereby affirm that,I;am'Iicensed urider'provisians of Chapter 9 'ADDRESS NO., ^ :'(commencing with�Section'7000)of Divisi6n°3 of the Business and SEWER MAP t r' Professions Code and-my aicense is jn full force,ond'effect.,' CITY CLASS t r' ON BK.'. PG a, a. SO. F.T NO..OF a NO: OF CHECK :License Number Lic.,,Class SIZE. STORIES- FAMILIES 1. ONE !' �. r. VALUATION VALIDATI `. , 1 DESCRIPTION OF WORK ,!i <) ;? NEW Contractor Date , ! r , �:. - ADD ' I am exempt under See I r FALTER 0 �• ®, - 1 B.BP C for this reason , . - - A 2, .• EXISTING BLDG., r.r O ' USE � f REPAIR EXIS �'r t DEMOL °Signature: _ :. TEL. FINAL „f OWNER-BUILDER DECLARATION _ AP IPC PL ANT RINT NO. DATE 'I hereby affirm that I am'exernpUfrom the Contractor sLicense I ;Law for the followin,g.reason:(Sectton_,7031 5; BusmessAand FINAI y i ADDRESS ^ t Prof�ssions.Code) PRESENT. By_ I '- ,r I, as'owner of ahe 1property,.or my employees with ADDRESS 11 e a !. 'swdges as their sole compensation;will do'the work and t ;.� the structure is notintended-or 8fferedfor sale'(Section LOCALITY S, jll pl a �;. 7044, Business and Professions Code) ` MOVINCr '-TEL•, 5. Io o lot, w'+y•y'C I; as owner'of the property, am exclusively contracfin g CONTRACTOR. NO. with:licensed contractors to•consir,uct.the project (Sec on 70.44; Busiriess and Profession's'Code). ADDRESS 3 ! 1 `. f. RE REQUIRED TOTAL SETBACK CONSTRUCTION LENDING AGENCY ', SETBACK YARD HWY pROP.:.LINE WIDTH:: t I hereby affirm that there'is a coFROM nstruction lending agency for FRONT t .:.the'pe fbrm6nce of the work for which this permit is•issued _P.L. . F I (Sec.:3097 Civ'. C ) s' r SIDE' •Lender's A. Name o LDMA Ref. tY m PtC'Fee S` t Permit Fee ,;. • Lendels'.Address ,.� "a I certify that'I have'read.this application and state thdt`the / f� f ` o Y PP_., ' " Issuance Fee LDMA P/C - o. above iriformotion.is correct:'I agree to comply with aII County Investigation Fee 0 ordiriances dnd State--laws relating'to,building construction r.. , Total Fee. / 4 o.. ` - _ .:r.:� f t s LDMA Perm. N.. -. r and authorize'representatives of,this Countyto enter .. upon the above-mentioned property for inspection purposes r , SEE REVERSE FORIEXPLANATORY LANGUAGE / Signature of Applicant or Agent Date.`" :+ 4 WORKERS COMPENSATION DECLARATION to ensu rr' oraafcert f carte of Worke srtCompensat on ficate of coent Insuran elf APPLICATION FOR BUILDING PERMIT or a certified opy thereof (Sec 3800 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY [J Policy No Company Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS .:fa Certified copy is filed with the county building inspec BUILDING CO T // ✓ tion department ADDRESS J rwciQ rl Y^ ,A Date Applicant CITY P ZIP V LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERSI / - NO OF BLDGS NEAREST COMPENSATION INSURANCE SIZE OF LOT / X J NOW ON LOT CROSS ST (This section need not be completed of the permit is for one //�� //�� ASSESSOR hundred dollars ($100)or less ) TRACT 11'T BLOCK /7 LOT NO MAP BOOK PAGE I PARCEL I certify that in the performance of the work for which this OWNER T I(`0 N !P NO ��, 10 UV ` E NO P � — Z� permit is issued I shall not employ any person in any manner r SPECIAL so as to become subject to the Workers Compensation Laws ADDRESS / oy /1 CONDITIONS Date — Applicant CITY 1. ZIP 0 NOTICE TO APPLICANT If after making t is Certificate of ARCHITECT OR TEL DISTRICT GROUP TYPE FIRE OC SED BY Exemption you should become subject to the Workers ENGINEER NO CONST�� ZONE Compensation`provisions of the Labor Code you must forth ADDRESS with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT I CONDO deemed revoked CONTRACTOR NO LICENSED CONTRACTORS DECLARATION LIC CLASS NO �' DWELL UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP Professions Code and my license is in full force and effect CITY t CLASS BK PG VALIDATION �. SQ — VNCf OF NO OF CHECK O. License Number Lc Class SIZE! STORIES FAMILIES ONE VALUATION V Contractor 1 Date DESCRIPTION OF WORK ' S NEW a: ADD s ' OGd 0 I am exempt under Sec 21 13 ALTER 1 IJ.1 B 8P C for this reason REPAIR ❑ $ 1 Z USE OF1! Date EXISTING BLDG r 9J MOL q� APPLICANT TEL `T C r F Signature FINAL _ OWNER BUILDER DECLARATION PRINT NO DATE "307 171 rr 1 hereby affirm that I am exempt from the Contractor s License Law for the following reason (Section 7031 5 Business and ADDRESS FINA j �I EMM Professions Code) BYgU y }-. .�( BUILDING 1IITAL 171 . 75 li I as owner of the property or my employees with ADDRESS r wages as their sole,compensation will do the work and -Asti 17- 1-9 the structure is not ntended or offered for sale(Section LOCALITY 7044 Business and Professions Code) MOVING TEL t HANGE co I as owner of the property am exclusively contracting CONTRACTOR NO with licensed contractors to construct the project (Sec tion 7044 Business and Professions Code) ADDRESS REQUIRED TOTAL SETBAC CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT OZ44 1 P1'110 Gig. the performance of the work for which this permit is issued P L (Sec 3097 Civ C ) SIDE PL Lender s Name c LDMA Ref M m P C Fee$ IL Pe m t Fee Lender s Address J' I certify that I have read this application and state that the Issuance Fee li LDMA P/C N o above information is correct I agree to comply with all County In est gat on Fee 0 ordinances and State laws relating to building construction Total Fee LDMA Perm-# > H and hereby authorize representatives of this County to enter m upon the above mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE S atu of Appl canto Agent Date r r 76A638A CE 603 6-62 ®PPI CpTI®N FOR BUILDING PESMIT IJ.. - COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER AooREss15 BUILDING AND SAFETY DIVISION LOCALITYc' JOHN A. LAMBIE. COUNTY ENGINEER NEAREST ' %`- " WILLIAM A. JENSEN,'SuP'T OF BUILDING CROSS ST. `I DIST TNT- :GROU PR ES �D BY, I FOR APPLICANT TO FILL IN f -� CONST.TYPE / BUILDING ; STATISTICAL CLASSIFICATION SEWER'MAP ADDRESS. C1 _ CLASS. NO.�DWELL. UNITS : c+✓ LOT NO. BLOCK WATER NOT REQUIRED RECEIVED ❑ CERTIFICATE: TRACT MAP !-� HIGHWAY NO. • �J (CIRCLE) STATE MAJOR SECON , LOCAL NO.OFBLDGS. -���� - SIZE OF LOT NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS EXISTING BLDG. ��f1�y f TEL. 77 !>r� BUIL!/G OWNER ^ NO. 7 YARD HWY STREET NAME 'EXIST, SETBACK WIDTH ' ADDRESS tit f FRONT- ARCHITECT OR ol TEL. ENGINEERNO. 'SIDE P. ,�.i+7. r 1. ADDRESS �J t 1\ z r .�0!fJl •'Le��.. i� .;,, ,A2•2 +4 TEL. _ _' -u•+' ,. _ CONTRACTOR NO. V. 16 'ADDRESS Gf,t��r � �9��. ,V�i+�,fr'S:•G.r�.>F .lA:Itinf. DESCRIPTION OF WORK` "�" . NEW ADD ALTER REPAIR DEMOLISH {{ k�,�,• ,p ,g SQ. FT. NO. OF NO. OF ;�w>, o" tS 1 8`FS.r SIZE STORIES FAMILIES + - f 1 r g . USE OF j .�•'t"i°)b.. 4�':•5.�31 .> ✓".�" t a 'O,r<'v's }�ii'sk.'. STRUCTURE — .GL' i - 'u''rl. s.;' - •`i�.,il!..;���� j � ask,- SIGNATURE OF APPLICANT v VALUATION Sr rr APPROVALS ��,r`�;;iDATE INSPECTOR'SSIGNATURE r•; P C FOUNDATION: LOCATION P. PMT - . / FEE FORMS, MATERIALS FRAME: FIRE STOPS, I EREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING,.BOLTS 'r'f p•" AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. WITH ALL COUNTY ORDINANCES. AND STATE LAWS REGULATING GAS VENT;DUCTS �r"" y-yy BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK _ AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- ) ` LATH. INT. t TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S(;PMPF34SATION INSURAIN LATH, EXT. SIGNATURE OF // HOUSE NUMBER COR- PERMITTEE �G RECT AND POSTED ADDRESS r'L� FINAL , ��/� s�'�� JOHN F'- LEWIS, PRINCIPAL STI - DURAL ENGI•.EER- ` PLAN CHECK VALIDATION CK. M.O. CASH cK H PERMIT VALIDATION M.O. ,CAS , o 7 1 n 8.00— .