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Home My Public Portal About5221 FARAGO AVE_Building__ APPLICATION FO R � COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING PERMIT BUILDING AND SAFETY DIVISION BUILDING FOR APPLICANT TO FILL IN ADDRESS BUILDING ADDRESS 2z O LOCALITY CITY Cj� IP ZNEAREST CROSS ST f -e L- NO OF BLDGS ASSESSOR SIZE OF LOTS `S i - NOW ON LOT MAP BOOK PAGE PARCEL tiie 3 DISTRICT GROUP TYPE FIRE P CE ED BY TRACT 1IL1 7 BLOCK LOT NO �"� 0 (9 T CO; Z iE � TEL •L OWNER y /NCO ,1c STATISTICAL CLASSIFICATION SEWER MAP ADDRESS 1 F 6&C, VG CLASS NO � • DWELL UNITS G BK/Z/G CITY e m IPi cl ZIP I1W USE ZONE NOP SOS" /� !l ARCHITECT OR TEL ,V SPECIAL ENGINEER NO CONDITIONS ADDRESS 142, I/ ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONTRACTOR it HEEo.L .-7 BLDG SETBACK FROM LIC FRONT PROP LINE OF (STREET) ADDRESS NO HIGHWAY t YARD TOTAL SETBACK FROM TYPE OF EXISTING CITY LIC FRONT PROP LINE HIGHWAY WIDTH CLASS � CONSTRUCTION LENDER } - NAME AND BRANCHCA rl�y� � 5 a r n�- +wBLDG SETBACK FROM ADDRESS( r v*- ITY SIDEPROP LINEOF (STREET) SQ FT NO OF NO OF CHECK HIGHWAY } YARD - TOTAL SETBACK FROM TYPE OF EXISTING I= SIZE 'y� STORIES FAMILIES ONE SIDE PROP LINE HIGHWAY WIDTH t DESCRIPTION OF WORK 4 NEW ❑ CC� ADD CORNER CUTOFF YES ❑ NO ❑ Z LTER [:] IN OPEN SPACE YES ❑ NO ❑ REPAIR❑ USE OF EXISTING BLDG � CEMOL IN COASTAL PERMIT ZONE YES ❑ NO ❑ ❑ APPLICANT TEL 'f (PRINT) C W NO 4 BY (SIGNATURE) PF LHERELL EREBY ACKNOWLEDGE THAT I_HA VE READ THIS APPLICATION �D ATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ALL ORDINANCES AND LAWS REGULATING BUILDING CON ION I CERTIFY THAT IN DOING THE WORK AUTHORIZED ` Y I WILL HOT EMPLOY ANY PERSON IN VIOLATION OF THE CODE OF THE STATE OF CALIFORNIA IN RELATING TOEN SCOMPENSATION INSURANCE TURE OF y FINAL iti / BY TTEE - DATE SS NOLPC Fee$ Com' 7U`t Permit Fee5 Issuance Fee ATION$ 1111 6� Total Fee PLAN CHECK VALIDATIO CK O CASH PERMIT VALIDATION cK M o CASH 098�P4AR 1123 D 65.70b"6 4 6 1 APR 1 $.3 a 4 6 P.9APR 1 '-1 � 1 5 63 5 A5- 78A898A CE0803B 12/75 A ROAD DEPT PERMIT 7OFWAY FOR ANY MATERIAL 570 2A -7 DONE IN THE ROAD RIG 7"638A CIE#8032/60 APPLICATION FOR BUILDING PERMIT 1 COUNTY OF LOS ANGELES BUILDING 7 DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DMSION LOCAL( 4 JOHN A LAMBIE COUNTY ENGINEER NEAREST WILLIAM A JENSEN SUP T OF BUILDING CROSS ST DISTRI2 NO I GRP P TY E r PR ESSED BY FOR,APPLICANT TO FILL IN �'Q CONST BUILDING ,p STATISTICAL CLA (CATION EWER MAP ADDRESS / W+�� SK PG! / A CLASS NO DWELL UNITS LOT NO LOCK MAP STATE / NUMBER�D�i� HWY YES TRACT ! USE ZONE SPECIAL cm- NO OF BLDGS CONDITIONS SIZE OF LOT ✓ I NOW ON LOT ti USE OF EXISTING BLDG BUILDING EXIST - EL.B�h� ETBACK YARD HWY STREET NAME WI TH OWNER O//''fir --// FRONT _QO Q P L a� ADDRESS Yl SIDE ARCHITECT OR v TEL /P L .- ENGINEER NOI INSPECTION RECORD ADDRESS TEL ��6J1 7"i� -A- 9l CONTRACTOR NO 1 ADDRESS Y 1 L/ ~ ICU DESCRIPTION OF WORK �� -�� 4" '��' O NEW X ADD ALTER REPAIR DEMOLISH f So FT NO OF NO OF J l36, l.✓1./�./i le s�/!JB b d�' /a �h G. SIZE STORIES FAMILIES / USE OF V U NNy STRUCTURE A-11� BOGNATURI F IVd/7, L APPLICANT VALUATION$ APPROVALS DATE INSPECTOR S SIGNATURE ''�:30/� FOUNDATION LOCATION )/ FEE $ FEE $��V FORMS MATERIALS ! z7',,/P G/ 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP y FRAME FG BOLTS �y �_ /A BRACING BOLTS ---, �/ C n PLICATION AND STATE THAT THE ABOVE IS CORRECT AND} FURNACE LOCATION AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT DUCTS $ °� STATE LAWS REGULATING BUILDING CONSTRUCTION I ) > 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED I ' LATH INTI 2<. (Q.0 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE i WORKMEN S COMPENSATION LAWS OF CALIFORNIA LATH EXT' k SIGNATURE OF ' HOUSE NUMBER COR PERMITTEE RECT AND POSTED s , ADDRESS `FINAL ty CLYDEIN DIRLAM PRINCIPAL ST CT -AL ENGINEER PLAN CHECK VALIDA ONcK m o CASH ,r'^ E PERMIT VALIDATION CK MO CASH ` FAF03 9 1 1 JUL ;)- �O 1 1t D u�0 (_/ a ' > r WORKERS COMPENSATION DECLARATION insure reby�rdffirm certificate that I have a certificate of consent to Self APPLICATION FOR BUILDING PERMIT ^^ r insure or a certificate of Workers Compensation Insurance or certified copy thereof (Sec 3800 lab C ) t SY -L COUNTY OF LOS ANGELES t BUILDING AND SAFETY `� 1 Policy No Company -- - " - BUILDING F c Certified copy is hereby furnished FOR APPLICANT TO FILL IN ^ADDRESSS� afle-1 4 ❑ t Certified copy is filed with the county building inspec BUILDING tion department i l 1 ADDRESS �� ll/7/`"' - F v 3 ., 4t t t - �- - - f Date kS„ ' �t Applicant t CITY vZIP V LOCALITY t �- CERTIFICATE OF EXEMPTION FROM WORKERS S / - NO BLDGS NEAREST M --t COMPENSATION INSURANCE t i 1 SIZE OF LOT NOW ON LOT CROSS ST (This section need not be completed if the permit is for one ASSESSOR TRACT V BLOCK LOT NO hundred dollars ($100)or,less ), r MAP BOOK PAGE PARCELa _ T L �[[ { USE ZONE MAP 1 certify that in�'theiperformonce of the work for which;This OWNER O [T n NO } permit is issued �I shall not employ any person in an iy manner _ gDDRESS �--� K r' SPECIAL t^ so as to become sublect to the Workers Compensation Laws 7//�� I\ CONDITIONS 0 Dar71e Applicant ° CITY _ ZIP ^ r NOTICE TO APPLICANT If after making This Certificate of ARCHITECT OR TEL DISTRICT GROUP TYPE �_ FIRE PRO SSED BY O Exemption \you should become t sublect to the r Workers ENGINEER NO �/� CONST, ZONE t Compensation provisions of the Labor Code you must forth ADDRESS 5`v 0 r3 V/ _ ?✓� W with comply with such provisions or this+permit shall be - - - - - y deemed revoked�r TEL STATISTICAL CLASSIFICATION r APT + CON CONTRACTOR NO LICENSED CONTRACTORS DECLARATION, , , - r LIC CLASS NO L�DWELT 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 _ t SEWER MAP i s Professions Code and my license is in full force and effect CITY CLASS BK ) VALIDATION ` r SQ FT NO OF NO OF CHECK License Number 1 Lic Class f ° SIZE 12,15 STORIES FAMILIES ONE �} r 43 , t z ❑ VALUATION > > � t '` s r DESCRIPTION OF WORK NEW ^ i Contractor Date ADD $ (5 6 ❑ I am exempt under Sec r " ' Uajf ALTER ❑ B 8P C for this reason REPAIR ❑ $ Dafe USE OF 2(� Q A ` x t ' EXISTING BLDG DEMOL ❑ _ 0 0-0 Signature APPLICANT T L FINAL ' 0 0 ADDRESS OWNER BUILDER DECLARATION PRINT_ _ +DATE f w - - - I hereby affirm that I am exempt from the Contractor s License R r � VESS FINAL � r< V b I o 04 Q 50 Low for the following reason (Section 7031 5 Business and s - — �c Professions Code)"' V J T - PRESENTBUILD NG T BY _ • o a 4 0 5 0 U ri ❑ I as owner of the property or my employees with ADDRESS d _ «� S a1 _ r, -; t i wages as their sole compensation will do the work and 221 -,84- the 2184- the structure is not intended or offered for sale(Section LOCALITY t 7044 Business and Professions Code) _ MOVING _ - TEL- I as owner of the property am exclusively contracting CONTRACTOR - NO with licensed contractors to construct the project (Sec J I -- tion 7044 Business and Professions Code) ADDRESS r i REQUIRED TOTAL SETBACK CONSTRUCTION LENDING AGENCY _ SET BACK YARD HWY 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 `i a _ PL- " > Lender s Name $ LDMA Ref # � - P C iFee$ Permit Fee -Lender s Address > ;+ r n, , I certif ^that I have read this a lication and state that the _ _Y PP - Issuance Fee - LDMA P/C4#-a above information is correct I agree to comply with all County Investigation Fee r g ordinances and State laws relating to buildingconstruction d and hereby authorize representatives of this County to enterToral FeeLDMA Perm # �# 9 Amon the ab o mentioned property fro inspection purposes r i SEE REVERSE FOR EXPLANATORY LANGUAGE -- S45rure of Applicant or gent - - --- Date C _ 40 W10, ORKERS COMPENSATION DECLARATION40 wl herebyaffirm that I have a certificate of consent to self r insure or a certificate of Workers Compensation Insurance APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec 3800 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnishedFOR APPLICANT TO FILL IN BUILDING _ ADDRESS Certified copy is filed with the county building inspec BUILDING tion department ADDRESS I I LOCALITY (� {, NEAREST Date Applicant CITY '� ZIP —T 7CJ0 CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS .5r NO OF BLDGS , ASSESSOR 1 COMPENSATION INSURANCE SIZE OF LOT J SQr t 1NOW ON LOT r a r { MAP BOOK t PAGE PARCEL (This section need not be completed if the permit is for one ' USE ZONE MAP hundred dollars ($100)or less ) TRACT BLOCK LOT NO Nljs O ,p f�, TEL ��J r� 7 SPECIAL Y I certify that in the performance of the work for which this OWNER r t(f�tr T�� NO WAKE 7 CONDITIONS permit is issued I shall not employ any person in any manner I 1 + t t ' ,�J.�_��))'� DISTRICT GROUP TYPE FIRE PR SSED BY 0 so as to become subject to the Workers Compensation Laws Y N h ADDRESSof b — .o-(� / 1 {/ r,CT 3 CONST ZONE ell Date Applicant CITY � �1 ZIP �` k�+ STATISUTICCXJAL CLASS) KATION APT 1CONJ O NOTICE TO APPLICANT If after making this Certificate of ARCHITECT OR 1 'ti �� } TEL '+ U ENGINEER NO CLASS NO DWELL UNITS W Exemption you should become subject to the Workers � Compensation provisions of the Labor Code you must forth ADDRESS 1 SEWER MAP with comply with such provisions or this permit shall beZ deemed revoked CONTRACTOR; ` \ , k ti, ` `TEL + _ BK PG Z/ VALIDATION LICENSED CONTRACTORS DECLARATION UC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO VON (commencing with Section 7000)of Division 3 of the Business and > LIG ,s,,,�� Professions Code and my license is in full force and effect CITY `CLASS t $17 L!/0-� 0 0O , SQ FT NO OF NO OF \ CHECK License Number Lic Class SIZE I STORIES FAMILIES ' ONE Contractor Date DESCRIPTION{OF WORKr + ( NEW JE $ 1 79A I am exempt under Sec �t � t fi0 �' tvIADD # 0 0 o e o 1 ALTER FINAL B 8P C for this reason ~. 7 R REPAIR DATE o e4988 Date USE OF 3DEMOL FFINAL 0 004988FtEXISTING BLDG Signature APPLICANT {� cgW /''TEL �/ �� Y OWNER BUILDER DECLARATION PRINT IL1 jL `iid �,y�T4 1206-84 1 hereby affirm that I am exempt from the Contractor s License ADDRESS O r �' '"`�0 Law for the following reason (Section 7031 5 Business and - Professions Code) BUILDING I as owner of the property or my employees with ADDRESS wages as their sole compensation will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044 Business and Professions Code) MOVING TEL fT7u( CONTRACTOR NO \ I as owner of the property am exclusively contracting 1 with licensed contractors to construct the project (Sec ADDRESS tion 7044 Business and Professions Code) REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LIN WIDTH 0 1 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 ) SIDEFO y PL * ' o Lender s Name ' Lender s Address P C Fee E Permit Fee 1 a I certify that I have read this application and state that the a Issuance Fee l s0 above information is correct I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction Total Fee / d and hereby authorize representatives of this County to enter upon the above mentioned property for inspection purposes _ _ 4 SEE REVERSE FOR EXPLANATORY LANGUAGE / i 14 ✓� Signature of Applicantant or gent' Date