The URL can be used to link to this page

Home My Public Portal About9179 FORTSON DR_Building__ 76AG38A CE#803 8 63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING n DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. jLt ,„ ��y DISTRICT NO. GROUP TYPE PROCESSED BY FOR APPLICANT TO FILL IN �-p� CONST. 'v A-, BUILDING - +�/� �`��„/ �� STATISTICAL CLASSIFICATION SEWER MAP ADDRESS ?/ `� J �V CLASS NO DWELL UNITS Alb LOT NO. V BLOCK WATER CERTIFICATE: .NOT REQUIRED ® RECEIVED ❑ J TRACT / NOP-2pO� HIGHWAY NO OF BLDGS C RCLE) STATE MAJOR SECOND. OCAL �-^ SIZE OF LOT J �S� 1� NOW ON LOT USE ZONE SPECIAL USSONCONDITIONS 'SEOF kl'etj?_/ OWNER , /eQI /oL_L_4 R.� NO ((/ �/ BUILDING EXIST `� �-p ]� SETBACK YARD HWY STREET NAME WIDTH ADDRESS ql ( ixr5e y//�� Ve♦ FRONT _ O ENGINEER ARCHITECT OR , r 4.`G`f NO SIDE �Y-77- P L ADDRESSTEL7xr 0 /`� m/lIp - I A O CONTRACTOR `�L-! 1`- / NO /1 1 CG' iot yy�� (fid 77 ADDRESS OO& I— `(n.AIAl-,0 Ix DESCRIPTION OF WORKer NEW ADD ALTER REPAIR DEMOLISH �, T, a'r+ Q FT NO OF NO OF C.fih4 C�'l C.�i' SIZE STORIES FAMILIESv- USE OF �j. ��+!'-�.✓�2s" k STRUCTURE l/ I . 5 ( '/ • �G.�� Alb PIA-3-1 C I ( SIGNATURE OF APPLICANT VALUATION $ ` jLy'p APPROVALS DATE INSPECTOR'S SIGNATUREPC 71F � FOUNDATION- LOCATIONP J•' /4" FEE $ �� FEE $ I.S FORMS. MATERIALS 'J� �'�° �t%�.✓�� 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. } f WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS ` BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK I AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. F• TION OF THE LABOR CODE OF THE STATE OF CAL FORNIA RELAT- INGTO WORKMEN'Sa�;W SU NCE LATH EXT SIGNATURE OF HOUSE NUMBER COR- ++ PERMITTEE j' RECT AND POSTED i! ADDRESS v� FINAL ' . JOHN F. LEWIS. PRINCIPAL STR RAL ENGINEER PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK MCI CASH LINO 3 1 2 9 1.0 AUG 2 5 2 3 D 3,3 5. 5 1L� 3 -1- 3 0,-o AUG 2 5 1 D 1 5.0 0 v DIVISION OF BUILDING AND SAFETY Department of County Engineer LP N FU- ' County of Los Angeles BUIL WM. J. FOX, COUNTY ENGINEER APPLICATION FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING - _ DIBTRIC�O. PLAN Cr-oR Rrm.No: PERMIT NO. �7 P ADDRESS 111 -79 E • F_6�1 �� R • 13 /V ox/ e: -9 -3 ,7.P J� PAF Cl /'RECEIVED BY DATE Of ADPL. DATE`ISSUED LOCALITY TEMTy NEAREST ` RDSB ST. C.i N BUILDING + /�n OWNER �..1�D A �' A 2Rt ADDRESS L=-., -V=0nTS0kJ D MAILAr$e LOCALITY 1 I , ADDRE58 /� /C /� R CROSS OSSST ST. _ C 714, CITY •-r� P L' Np, A ( �IJNs i RE� NO.OF TYPE ,.}. ORQUP�, - ZQNE •` I PLANE I `L ENGINEERT OR /y w Aj�n NO q }^ .�L�•- /��Rp�,p� V IC BETTE CK LINE G0 ADDRESS nn USE'. APPROVED ' W t;/4' TSL SONE BV DATE f0 CONTRAOTOR NO. /HOUSE NUMBERING 1-� ADDRESS MAP NUMBER_ 2Dr.� - NO. ABBIGNED BY L%� LEGAL CORRECTIONS DESCRIPTIDNI LOT NO. I BLOCK TRACT M 1Q C, /� Sooii ��p 1-� 3) '39 SV X 1 q O `� I NO. OV LDOS. SIZE OF LOT V /d� i NOW ON,LOT �� USEOFLome /. / 7- ate EX STING BLDG. LME �" (�'ARR(r� FAMILLIEB ' ; H . DESCRIPTION OF WORK ,1p��`f. iI'ld7 !o ° A f✓f_fJ��2 7'!x/3-i✓�'''6 '' �� o NEW ALTERATION ADDITION ./ o,- � v �/ _ s > . REPAIR DEMOLITION f/j� /{/ HIZE , {' 'Tc� c sRrOIrO'MS ' STORIES e _ CROVIF OVERINGJ�yjIVC* iVL.QEI�VI OOVERING C - USE OF91TRUCTURE INSPECTION FOR APPROVALS OCCUPANCYAS INSPECTOR'S SIGNATURE DATE FOUNDATION: LOCATION FQRMBti MATERIALS [� 1 HEREBY ACKNOWLEDGE THAT 1HAVE READ THIS AP-. FRAME: FIRE STOPS, PLICATION AND STATE THAT THE INFORMATION GIVEN IS CORRECT. BRACING, BOLTS 1 ABREE TO COMPLY WITH ALI,LIOUlf TY ORDINANCEH, FURNACE: LOCATION, AND STATE LAWSlv �211 B CONSTRUCTION. GAS VENT,DUCTS SIGNATURE OF > LATH, INT. PERMITTEE /y� ADDRESS I r 1 1 �. F0 R TSO Al DP,_a LATH, EXT. PLASTER, INT. AUTHORIZED AOT. PLASTER, BCT. 460 FEE �v � HOUSE NUMBER COR- RECTANDPOSTED , OU VALUATION FEE FINAL -7..- J'� 76A63BA DBS 3 I-52 DE I i -,.__ntTILDING AND SAFETY APPLICATION FOR PERMIT GQUNTY-OF-LOS ANGELES WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY �� rl iJ /• - DISTRICT NO. PLAN CK.N 3,0/NO. BLIILDINp /S i i'"/h�/�Ty{Lyif-� �/fw�y, ,r� ADDRESS LOCALITY DATE OFAPPL.' DATEISSUED NEAREST � ��ICROSS ST.' ` EC1q BUILDING- / / - OWNER �MAILp�/v(j-Pi[/ ADDRESS. ADDRESS V �/ / LOCALITY CXa u NEAREST IC.,d� (� TEL S 7 ®.y c� CITY,- NO: CROSS ST. FIRE NO.OF Y`� A ' -�—' I� S � —TYPE r/ I GROUP) � ARCHITECT OR TEL. ZONE PLAN �{ ENGINEER .NO. _ - BLDG +'��OG'��/ OOR.D.ANO. ADDRESS SETBACK LINE TEL APPROVED A- CONTRACTOR (G�I,�/LL/ �' NO.*S � }v� / BY DATE USE ADDRESS `+ y4fJ Azta",, ` ZON� APPROVED DATE LEGAL j CORRECTIONS DESCRIPTION LOT NO.G N l I BLOCK TRACT v� SIZE OF LOTrJ /S ) r- Q I NO.OF BL - NOW ON LOT USE OF NO.DF NO.OF - EXISTING BLDG. I FAMILIES I ROOMS DESCRIPTION OF WORK NEW ALTERATION ADDITION ' ' - O REPAIR MOVING DEMOLISH S4•FT. NO.OF (� Z SIZE ROOMS J STORIES / - Z WALL ROOF r COVERING I COVERING - r/ . USE OF NEW V BUILDING y� .,. X70 � � OF I' HEREBY ACKNOWLEDGE THAT I HAVE READ THIS` APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION`. INSPECTOR DATE - AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES: FORMS, MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: SIGNATURE OF BRACINGG,,BOLTS OWNER LATH,INT.: AUTHORIZED AG LATH,EXT.: DBS-3 25M SETS 7• $ / O= P C III PLASTER. INT. IO y0 O O FEE- •�1 ��r �400 O $/ PLASTER,-EXT. VALUATION FEE / �� FINAL WOR r i(Sec.. ON DECLARATION I herebyaffirm I'there ertificat@'of''ctins�rit to self inure, r a certs' Compensation Insurance, APPLICATION FOR-- BUILDING P E R•M I T or �!certified co , 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company i BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS I ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS . D - �� Ce ;DateApplicant CITY ,� l ZIP LOCALITY 1. NO. OF BLD, S. NEAREST CERTIFICATE OF EXEMPTION,FROM WORKERS'-- SIZE OF'LOT,�S' X /Z® NOW ON LOT CROSS ST (f COMPENSATION INSURANCE" �. ASSESSOR (This section need not be completed if The permit is for one TRACT BLOCK LOT•NO MAP BOOK PAGE PARCEL hundred dollars ($100) or less.) TEL. OWNER$ NO — O USE ZONE NO Is I certify that in the performance of%the work for which this permit is issued, I shall riot employ any person in any manner ADDRESS /) SPECIAL a iz /- CONDITIONS so as to become subject to the.Workers'Compe ation. ws. O 00 r / CITY'�t C ZIP U •Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE 'PROCESSED BY O NOTICE f0 APPLI ANT: If, after m g.this Certificat of ENGINEER NO CONST. ZONE ' Exemption, you --should become s lett to the War ers' .- /� U Compensation provisions of the Labor Code, you.must forth- ADDRESS ✓,D�' — 0- with with comply,with such provisions or this permit shall be EL STATISTICAL CLASSIFICATION_ APT. CONDO.-- N Z deemed revoked.•• CONTRACTOR NO. • • LICENSED,•,CONTRACTORS DECLARATION LIC CLASS NO��DWELL UNITS hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO._ i SEWER P (commencing with Section 7000)of.Division 3 of the Business LIC and Professions Code,and my license is in full force and effect. CITY CLASS I PG VALIDATION SQ FT S NO. OF NO. OF CHECK License Number Lic. Class SIZESTORIES IFAMILIES ONE VALUATION Contractor Date DESCRIPTION OF WORK NEW ��❑jjj,,, t ❑ ADD I am exempt.under Sec:' S popALTER El B.&P.C. for this reason209 REPAIR ❑ s Date: USE,OF } EXISTING BLDG. DEMOL ❑ Signature_ APPLICANT TEL FINALS. , OWNER-BUILDER DECLARATION (PRINT) NO. DATE � l` �� et D I hereby affirm that I"am exempt from the Contractor's License Law for the following reason,(Section 7031.5, Business and ADDRESS FMAC i PP jfessions Code): PRESENT ByDING r'�w✓ LL j, as owner of the property; or my employees with ADDRESS ACCTA I i wages•as their sole compensation,will do'the work and 3307 103.011 the structure is not intended or offered for'sale(Section LOCALITY •7044, Business and Profess ions'Code.) MOVING TEL. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO ,} 1-ITEi 1J with licensed contractors to construct-the project (Sec- ADDRESS - -_ \ TOTAL 15.`.-`p m! 0, i �,w Tion 7044,'Business and Professions Code:).' L� REQUIRED YARD HWY . TOTAL SETBACK FROM EXIST t' CHECK' 1`3.00 CONSTRUCTION LENDING AGENCY SET-BACK PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT' 00 ) the performance of the work for which this permit is issued P. L. (Sec. 3097, Civ. C.). SIDE Lenders Name P L 0000-0001 b/ 8/89 $ LDMA Ref # P.C. Fee$. Permit Fee , 38�b 1 ,AM 9:32 Lender's Address I certify that I have read this application and state that the Issuance Fee �4 LDMA P/C# 8 above information is correct.]agree to comply with all County Investigation FeeI�� /.� O R ordinances and State jaws relating to building construction, Total Fee • V LDMA Perm # a and hereby authorize representatives of this-County to enter up a bove-' entione property for inspection purposes. ' . = I �,; , SEE REVERSE FOR EXPLANATORY.LANGUAGE,, , nature of Applicant or g t Date WORKERS' COMPENSATION DECLARATION affirm that I have a rtee'f'insure WF OR� B U I L D I N G., PERMIT .APPLICATI' ?N or a certified copy thereof (Sec•3800, Lab..C.) COUNTY OF LOS ANGELES :,f BUILDING AND SAFETY Policy No. Company BUILDING El- Certifiedcopy is hereby furnished. _ FOR'APPLICANT TO FILL IN ADDRESS 9/7 ,,:❑,- Certified copy is filed with the county building inBUILDINGspec- � ADDRESS tion department. Date Applicant ' CITY _ ZIP�_, 7�✓ LOCALITY NO OF BLDGS., _, _ NEAREST •- CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST COMPENSATION INSURANCEASSESSORV. (This section need not be completed if the permit is for one TRACT` BLOCK LOf NO MAP'BOOK, '`tj c�d'� PAGE O��o PARCEL hundred dollars ($100) or'less.) ) TEL. r USE ZONE-' MAP i OWNER ,'1/ NO — NO. � I certify that in the performance of the work for which this y✓l SPECIAL • } permit is issued, I shall not employ any person in any manner ADDRESS CONDITIONS so as-to become,subject to'the Workers'Compensation Laws. _. OV CITY — ZIP U Date Applicant ARC T TEL. DISTRICT • 'GROUP TYPE FIRE PROCESSED BY NOTICE TO APPLICANT:, If,'.after. making this Certificate of' ENGINEER NO. CONSTZ NE Exemption, .you should become subject to, the' Workers' U Compensation provisions of the Labor Code, you must forth- ADDRESS O 3 ✓ with comply with such provisions.or' this•permit shall be / •TEL. STATISTICAL CLASSIFICATION APT, . CONDO. ,Z deemed revoked. CONTRACTOR ly w�LP�f� :• NO .�j — LICENSED,CONTRACTORS DECLARATION LIC. CLASS NO DWELL. UNITS I hereby affirm that I am licensed under provisions,of Chapter 9 ADDRESS NO. SEWER MAP (commencing with Section 7000)of Division 3 of the,Business LIC t , 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 I STORIES FAMILIES ONE • VALUATION Contractor Dat - DESCRIPTION OF WORK NEW EJ _ .. _ :' - ADD ❑ � ❑I am exempt under Sec. C .B r -a ALTER ❑ h f C BP B. . .. or this reason _ • t REPAIR ; Dote: USE OF,, EXISTING BLDG DEMOL ❑ Signat - Wim APPLICANT f - TEL. _ FINAL g (PRINT) NO. OWN -BUILDER CL RATI' DATE g I hereby affirm Th ` am exempt from the o actor's License' " Law for'the following reason (Section'70 1.5,:Business and ADDRESS FINAL' Professions Code): PRESENT B_y ❑ I, as owner of the.property, or my employees with ADDRESS y y ACCTo14 wages as their sole corripensation,will do the work and `'}�' the structure-is not intended or offered for-sale(Section LOCALITY u'64■13 7044,•Business and Professions Code.) MOVING TEL. " ❑ I, as owner of ihe, ro eri. CONTRACTOR NO. I ITEMS,..*,-,,. p p y,.am,exclusrvely,contracting - �r�y + , .. "With licensed contractors to construct the project-(Sec- ADDRESS r� .-' - 'TOTAL.' f�"*.: 13 tion•7044, Business and-Professions Code.) _ �v REQUIRED YARD HWY TOTAL SETBACK FROM'' EXIST_ o.r CHECK.` 64■�3 CONSTRUCTION LENDING AGENCY SET BACK PROP LINE WIDTH, - - I hereby,affirm that there is a construction lending.ogency for FRONT the performance of,the work for which this permit is issued P.L- 'm°"° L[1>t711VC •00 (Sec. 3097, Civ. C.). SIDE . o Lender's'Name tI7 i VtJVi1T_WJV1' 11/30/9? m LDMA Ref. #.`•: F: r_` _. P C Fee$ Permit Fee - 6734, 1. AM'Q■26 Lender's Address �■ 7 a j certify that.l have read this application.and state that the Issuance Fee LDMA P/C'# ' ^ o above information is•correct.'I,agree to comply with all-County Investigation Fee / f 8 ordinances and State.laws relating to building construction, 11Total Fee LDMA Perm. # a and hereby authorize•representatives of,this County to enter • upon the= ve-mentioned property-for mspechon purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Sig re of Applicant or Age Date �� `