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HomeMy Public PortalAbout9830 FLAHERTY ST_Building__ 76A638A CE#803 8-64 APPLICATION FOR BUILDIING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION L O C A L I T e JOHN A. LAMBIE', COUNTY ENGINEER NEAREST COLEMAN W. JENKINS.SUP'T.OF BUILDING CROSS ST. J DISTRICT NO.. GROUP TYPE. PROCESSE BY FOR APPLICANT TO FILL IN p CONST 4 BUILDING STATISTICAL ASSIFICATION SEWER MAP / 36 r ADDRESS T � TIT CLASS NO. DWELL UNITS BK B PG LOT NO. // BLOCK USE VZON MAP TRACT -'T(!' li7 N O. L CJ rS�ECIA NO. OF SLOGS. NDITIONS SIZE OF LOT NOW ON LOT USE OF E ISTING BIQG, Q l BLDG. SETBACK FROM ♦ `t� NOL FRONT PROP. LINE OF �•� `�� (STREET) OWNER TYPE OF EXISTING SETBACK HIGHWAY + YARD — TOTAL Al ADDRESS r- a S HIGHWAY WIDTH 'F.OM C.L. CITY '��' + ARCHITECT OR TEL. BLDG. SETBACK FROM ENGINEER NO. SIDE PROP. LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. CL CONTRACTOR d1I� �•y' V ' NOL - 303 + ADDRESS p a- NO CORNER CUTOFF YES NO E _ O CITY w� LIC SEE REVERSE SIDE FOR SPECIAL APPROVALS W DESCRIPTION OF WORK n Z_ NEW ADD ALTER REPAI DEMOLISH SQ.FT. NO. OF NO. OF SIZE STORIES FAMILIES USE STRUCTURE SIGNA URE OF APPLICANT VALUATION$lo') APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. .�� FOUNDATION, LOCATIONFOR LS FEE�� FEE$ � 712 AME, FIRE STOPS,FRAME, FIRE STOPS,. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT ,%./6 `"iv"`✓''� AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION 0 _ ---- WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS 13UILDING CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. :� 3-afp� c% •3'e`<.'.f/'^•fx-`f TION OF THE LABOR CODE OF THE STA E O CAL ORNIA RELAT- _ ING TO WORKMEN'S C17MPE SATION INSU N E. LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE --CT AND POSTED ADDRESS - F I N A L ' JOHN F. LEWIS. PRINCIPAL STRUCTURAL EPIN--r&ER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. 76A638A C.03 8-64 .APPLICATION FOR BUILDING PERMI�r rl 7 a COUNTY OF LOS ANGELES BUILDING j DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE'. COUNTY ENGINEER NEAREST COLEMAN W. JENKINS,SUP'T.OF BUILDING CROSS ST. DISTRICT.NO. G UP TYPE. - PR'QgC�SSED BY FOR APPLICANT TO FILL IN �`- CONsr (/ -tow BUILDING STATISTICAL CLASSIFICATION SE ER MAP ADDRESS CLASS NO. DWELL UNITS. BK PG LOT NOTemple City BLOCK USE ZONE MAP .� q TRACT SP" SPECIAL ' N0. OF BLDOS.NO. SIZE OF LOT NOW ON LOT USE OF G BLDG. SETBACK FROM OWNER rTEL. AT 6-2018 FRONT PROP. LINE OF (STREET) y, TYPE OF EXISTING SETBACK HIGHWAY +' YARD = TOTAL ADDRESS 9830 Flaherty HIGHWAY WII'DT 'F M C.L. P7 + CITY ARCHITECT R TEL. SLOG. SETBACK FROM ENGINEER N — 910E PROP. LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESSHIGHWAY WIDTH FROM C.L. d TEL + _ O CONTRACTOR _ - NO U ADDRESS LIC roLo_ CORNER CUTOFF YES NO 0 CITY LIC SEE REVERSE SIDE FOR SPECIAL APPROVALS w DESCRIPTION'OF WORK /, n NEW ADD ALTER REPAIR DEMOLISH SQ.FT. NO. OF NO. OF SIZE STORIES FAMILIES USE OF STRUCTURE Install ay Night L)uopac unit. SIGNATURE OF APPLICANT VALUATION$ 1366.00 APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION, LOCATION FEE$ FEE$ 11 . 50 FORMS_MATERIALS__- FRAME, FIRE STOPS, ,! I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION n �� WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS A 9UILDING CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK Q .. ,. F 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 I URANCE. LATH. EXT. SIGNATURE OFj HOUSE NUMBER COR- PERMITTEE0 - RECT.AND POSTED. w ADDRESS E 1-ap, L44s, San Gabriell F1 NAL JOHN F. LEWIS. PRINCIPALSTR URAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK M.O. CASH 035 2 n) AR 7 1 D 11 .50- CV ,. WORKERS' COMPENSATION DECLARATION I kere5 affirm that I have a certificate of consent to self y APPLICATION FOR BUILDING PERMIT' 'nsur�,or a certifkate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Polity No. Company ❑ Certified copy is hereby furnished. BUILDING, FOR APPLICANT TO FILL IN ADDRESS > Q ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS ) CITY L ZIP �� LOCALITY Date Applicant ff NO. OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT(©C- 3 , % NOW ON LOT CROSS ST. COMPENSATION INSURANCE ASSESSOR pp CL (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK O,j PAGE PARCET hundred dollars ($100)or less.) TEL. OWNER ` NO. USE ZONE MAP certify.that in the performance of the work for which this NO. permit is issued, I shall not employ any person in any manner ADDRESS o 1 SPECIAL a CONDITIONS so as to become subject to.the Workers' Compensation Laws. Q CITY ZIP V Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY NOTICE TO APPLICANT: If,.after making this Certificate of ENGINEER NO. CONST. ZONE Exemption, you should become subject to the Workers' w Compensation provisions of the Labor Code, you must•forth- ADDRESS a with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. CONTRACTOR NO. Z 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 LIC. SEWER MAP 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 1 STORIES FAMILIES ONE ❑ VALUATION DESCRIPTION OF WORK NEW Contractor Date $ / S-�,, O ADD ❑ ► ❑I am exempt under Sec. ❑ ALTER BAP.C. for this reason REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMOL ❑ Signature APPLICANT TEL. / FINAL OWNER-BUILDER DECLARATION (PRINT) E7 NO 6 [( - p DATE (�v G I hereby affirm that I'am exempt from the Contractor's License ADDRESS �7J�17^ S Law for the following.reason (Section 7031.5, Business and FINAL Poil, rofelsions Code): PRESENT By . I, as owner of the ro ert or m employees with BUILDING property,Y• YADDRESS wages as their sole compensation,will do the work and { t s the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code.) MOVING TEL. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. `=' r i'_t=,• with licensed contractors to construct the project (Sec- [AD7DRESS tion'7044, Business and Professions Code.) s�-! •_ } TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY YARD HWY PROP. LINE WIDTH I herebyaffirm that there is a construction lending agency for t_. Et•i; Ec 9 9 Y - the performance of the work for-which this permit is issued (Sec. 3097, Civ. C.). CHANGE Lender's Name. LDMA Ref. # Permit Fee / s`:# It I-'`,f; i Lender's Address O` 6 s:.i_1.'a o I certify that I have read this application and state that the Issuance Fee LDMA P/C# , 76501 Z y above information is correct. I agree to comply with all County Rordinances and State laws relating to building construction, Total Fee ' LDMA Perm. # a and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ffSignatu-ref Ap icant or Agent -�- Date t WORKERS' COMPENSATION DECLARATION APPLICATION FOR BUILDING PERMIT 1,446 affirm tit I have a certificate of consent to self irisu,e, orad certificate of Workers' Compensation Insurance, or a Cevrtified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Pplicy No. Company BUILDING ❑ Certified copy.is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS /jJ✓ / ❑ Certified copy is filed with the county building inspec- BUILDING ADDRESS C /.�4H tion department. /�` Qom, Date Applicant CITY —6-A LE GIT ZIP `7/ O[J LOCALITY GGy NO. OF BLDGS. LP NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE.OF LOT- / ! / NOW ON LOT" L CROSS ST. GHI`I COMPENSATION INSURANCE ASSESSOR p [/� (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCELS' / hundred dollars ($100) or less.) ' TEL. OWNER I� 4WNO.0[8¢¢Z D USE ZONE MAP I certify that in the performance of the work for which this NO. permit is issued, I shall not employ any person in any manner ADDRESS # 57` SPECIAL a- CONDITIONS so as to become subject to the Workers'Compensation Laws. O CITY zz ZIP ( U Date Applicant ARCHITECT OR TEL. W NOTICE"TO APPLICANT: If, after makingthis Certificate of ENGINEER NO. DISTRICT GROUP TYPE FIRE PROCESSED BY CONST. ZONE � Exemption, you should become subject to the Workers' �O� w Compensation provisions of the Labor Code, you must forth- ADDRESS V Q, with comply with such provisions or this permit shall be T _,y, STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked., CONTRACTOR , ( c,�" Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. Q121 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 LIC. SEWER MAP and Professions Code,and my license is in full force and effect. CITY CLASS BK PG yy VALIDATION SQ. FT NO. OF NO. OF CHECK License Number Lic. Class SIZE STORIES FAMILIES ONE VALUATION `'`= Contractor Date DESCRIPTION OF WORK NEW ❑ -t«w - ADD ❑I am exempt under Sec. A-W W��e�= ALTER ❑• / B.&P.C. for this reason O TOT.-AL 397 - 05 REPAIR ❑ 7a Date: USE OF �- EXISTINGBLDG. DEMOL ❑ i„. MU-1. _f'"•';',a.`.' Signature APPLICANT TEL FINAL OWNER-BUILDER DECLARATION (PRINT) Yd& N . ` ( E? `r /� DATE I hereby affirm that I am exempt from the Contractor's License ADDRESS j(7 / G/T G' 7/ gd Law for the following reason (Section 7031.5, Business and FINAL ProfQssions Code): y i4 ,rl%v-'. I ' 6'- PRESENT B - = BUILDING 1, as owner of the property, or my employees with ADDRESS �,!'�`i ijaji_,t._1;i 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. I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code.) .REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SETBACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for LInvestigation the performance of the work for which this'permit is issued (Sec. 3097, Civ. C.). - j^ { i3 f 1 (Ti Lender's Name q 1 n� PermitFeeItDMA Ref. #tl,Lender's Address1 certify that I have read this application and state that the / / Issuance Fee LDMA P/C N above information is correct. I agree to comply with all County ee 6 ordinances and State laws relating to building construction, Totol F % LDMA Perm. # a and hereby authorize representatives.of this County to enter upon the above-mentioned propertX for inspection purposes. SEE REVERSE FOR EXPLIkk" TQRY LANCIfA sfi G..s -d Signotbfe of Ap icant Agent Date F-` ~"` V-