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Home My Public Portal About9219 FLAHERTY ST_Building__ � 3 47t V 1 I 76A638A CE#803 8 63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS' ANGELES BUILDING 9:Z r 1::7L11yIX;e 5� DEPARTMENT OF COUNTY ENGINEER ADDRESS , BUILDING AND SAFETY DIVISION LOCALITY JOHN A LAMBIE COUNTY ENGINEER NEAREST i WILLIAM A JENSEN SUP T OF BUILDING CROSS ST DISTRICT NO GROUP TYPE ESSED BY FOR APPLICANT TO FILL IN 5, (-d $, coNsr pp n ADDREISS q� ( � ISL I�fC�2T �� STATISTICAL CLASSIFICATION S BWFER MAP CLASS NO DWELL UNITS -=] & L T BLOCK WATER ❑ NOT REQUIRED RECEIVEDCERTIFICATE TRACT AN" t+ l� 4-"Q �•1�'7MAP le HIGHWAY NO OF BLDGS NO fcIRCLE) STATE MAJOR SECOND C Ly SIZE OF LOT NOW ON LOT UU�E SPECIAL USE OF p CONDITIONS EXISTING BLDG �/y�� (_/�� qA OWNER UJ�I�S��Q"� 1��y�"�y,��J N(O/a�D7 �D, B� ILDING I EXIST *ADDRESS 1 Y a7�ZA Ir S� SETBACK YARD HWY STREET NAME WIDTH FRONT ARCHITECT OR ` TEL P L ENGINEER l/V R �1 NO Ar(ol-00 SIDE ADDRESS /� ` TEL T � >' d� 0- CONTRACTOR fPC"L !> NO /` /; CJS �' � /Q� , fir'/� U ADDRESS 8 6 0(o L? LA3 �f AM-5 5 6" (C •�{/ �7�f7� (/4 � ��LIY�_. ?0° DESCRIPTION OF WORK �' C ,d�'�1t�► "� �'` '�� > f E ADQD ALTER REPAIR DEMOLISH lP Ug f�,44 X � ^� �"'a!d z NO OF NO OF U ZE T lj STORIES FAMILIES v J��+ A� /�'�!+ A� USE OF 1, � �n STRUCTURE 'V? Sbvi" SIGNATURE OF APPLICANT YYY111 t VALUATION S ol APPROVAL$ DATjE INSPECTOR SSIGNATU RE PC PMT FOUNDATION LOCATION FEE S FEE $ �� FORMS MATERIALS I 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 WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT TION OF THE LABOR COD OF THE STATE OF CALIFORNIA RELAT ING TO WORKMEN S COMPENSATION INSURAN LHOUSE XT SIGNATURE OF � NUMBER COR PERMITTEE � !��7 AND POSTEDADDRESS 0 `�" PLAN CHECK VALIDATION cK Mo CASH JOHN F LEWIS PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION 0 m PERMIT VALIDATION c�K mo CASH I LAAO S 5 U 1 0 APR 3 C ? 3 3 D 5 75 L+�o 8 3 0 2� APR 3 0 D L 5 �, 0 a � / 76A638A CE#603 3 68 �P� APPLACATIO FOR EUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPAUMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DMSION LOCALITY f JOHN A LAMBIE COUNTY ENGINEER COLEMAN W JENKINS, SUP T OF BUILDING NEAREST CROSS ST DISTRICT NO GROUP TYPE IL P �CESSED BY FOR APPLICANT TO FILL IN CONST Print ort e only) r� d BUILDING STATISTICAL C SSIFICATION SEWER MAP, ADDRESS / ! 14 C S T CLASS NO DWELL UNITS BK& PG LOT NO BLOCK USE ZONE NOP �d U TRACT - SPECIAL NO OF BLDGS +� CONDITIONS SIZE OF LOT NOW ON LOT ` In USE OF / EXISTING BLDG L? BLDG SETBACK FROM OWNER / _4 NOL 2.g7_1,6/Z FRONT PROP LINE OF -(STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL ADDRESS L HIGHWAY WIDTH FROM C L ��11 + CITY LE /T BLDG SETBACK FROM �U ARCHITECT OR TEL SIDEPROP LINEOF (STREET) ENGINEER NO _ TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL ADDRESS HIGHWAY WIDTH FROM C L TEL + _ CONTRACTOR NO O LIC CORNER CUTOFF YES ❑ NO ❑ C.3 ADDRESS NO CITY CD CL SS SEE REVERSE S DE F R SPECIAL APPROVALS DESCRIPTION OF WORK Lr4wJ dAAA46=e=e9z NEW (op LTER REPAIR DEMOLISH s v r SQ FT NO OF NO OF SIZE STORIES FAMILIES ` / USE OF aAA11,094_4 UM STRUCTURE k � SIGNATURE OF APPLICANT VALUATION $ APPROVALS y i ,DA E INSPE TOR S�SIGN TU:E P C PMT FOUNDATION LOCATION , FEE$ FEE $ FORMS MATERIALS x FRAME FIRE STOPS �y,� ti I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS II-1 AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE'�OCATION WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS /ll It�'IOP GiK7 BUILDING CONSTRUCTION 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT ING TO WORKMEN S COMPENSATION INSURANCE LATH EXT SIGNATURE OF // ` HOUSE NUMBER COR PERMITTEE RECT AND POSTED ADDRESS fz14//cg £G// FINAL PLAN CHECK VALIDATION CK Mo cnsH _ JOHN F LEWIS PRINCIPAL STR RAL ENGINEER PERMIT VALIDATION CK MO CASH LAW 6 c 8 2"o SEP 5 i D 3 825- APPLIG-AT[ON FOR BUILDING PERMIT COUNTY OF LOS ANGEA BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING DRESS I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS or a certificate of Workers'Compensation Insurance, or a certified copy thereof(Sec.3800,Lab.C.) CITY ;� v ZIP LOCALITY Policy No. Company SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. USE ZONE MAP NO. department. Date 3-3 Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER �� ! k1l TEL NO. COMPENSATION INSURANCE J �'T WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS rJJ�D DISTRICT GROUP Y NST. FIRE ZONE PROCESSED BY dollars($100)or less.) CITY /,� � ZIP I certify that in the performance of the work for which this permit �Lj f-1 '�-Lo is issued, I shall not employ any person in any manner S Ito CHITECT OR ENGINEER TEL NO. become subject to the Workers'/Compp/nnsation Law cs-� GrLJAR STATISTICAL CL�ASSS/1FICATION APT CONDO Date Applicant �cD�'/sSJ ADDRESS CLASS NO..� DWELL UNITS NOTICE TO APPLIC4NT." If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you Should become Subject t0 the Workers' CONTRACTOR t J L TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation'provisions of the Labor Code, you must forthwith l0 FRONT comply with such provisions or this permit shall be deemed revoked. ADD2-7 RE FTQ � LIC.NOS / P L i / SIDE LICENSED CONTRACTORS DECLARATION CITY . LIC.CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 G SEWER MAP >- (commencing With Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STO S NO.OF FAMILIES a NEW ❑ BK PG Professions Code,and my license is in full force and effect. v License Number��2��iC.Class 3 DESCRIPTION OF WORK C , ADD ❑ $LUATION r� 0 L��' �' ALTER ❑. Contractor �} Date W ❑ I am exempt under Seo��U �� p� REPAIR ❑ p $ B.8P.C.forithis reason S l�l DEMOL ❑ I L b1A P C# �" Date:_ 30" USE OF EXISTING BLDG. URM . Signature( �-�� f APPLICANT(PRINT t TEL NO. LGMA Per,#. y ❑.I,,as owner of the property, or my employees with wages as P6 Z their sole compensation, will d0 the work and the structure is ADDRESS 7 Y O not intended or offered for sale (Section 7044, Business and ,J r�� FINAL DATE Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL �' ! , 'r-• " OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN'THE J I, as owner of the property, am exclusively contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL 13Y 7 —jr licensed contractors to construct the project (Section 7044, ves❑ No❑ Business and Professions Code.) WILL THE INTENDED 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(SCAOMD)SEE PERMITTING CHECKLIST FOR LI GUIDENES. �vGG p S I hereby affirm that there is a construction lending agency for YES El NO❑ '`"t= 4=t N the performance Of the work for which this permit IS issued(.Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097,Civ.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TITLE 2.CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS 3 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. _if : -':I{_(i-I - •';E .r° if o Lender's Address =1= i; O OWNER OR AGENT �'I-2 0 s AI 3:LS o I certify that I have read this application and state under penalty O of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE N with all county ordinances and State laws relating to building construction, and"hereby authorize representatives of this County ISSUANCE FEE 00 co to enter upon the above-mentioned property for inspection purposes. �.-3/q�� INVESTIGATION FEE TOTAL FEE m Signature o Applicant o.Agent C Date ��"�� SEE REVERSE FOR EXPLANATORY LANGUAGE