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HomeMy Public PortalAbout10321 FREER ST_Building__ 76A69CA OBS-3 9-55 ' APPLICATION FOR BUILDING PERMIT �. DIVISION OF BUILDING AND SAFETY BUILDING y� j Deportment of County Engineer ADDRESS /(.' County of Los Angeles LOCALITY (� WM.J. FOX. COUNTY-ENGINEER NEAREST CASSATT D. GRIFFIN,SUPT OF BUILDING CROSS ST. DISTRICT NO. GROUP J TYPE .I SEWER MAP FOR APPLICANT TO FILL IN I CONSBK PG PG ./� y� /� /.- T. /t —SC STATE ADDS �� �^ _ r?1/A. _�.I,�("GB OCK�f/.Ci\t, N MA ER L� CI HWY ' - YES- O LOT NO. LL) SCI l O� LSI /110 15; ?I L l' USE ZONE SPECIAL CONDITIONS TRACT IQcl I NO.OFBLDG3. BUILDING EXIST. SIZE OF LOT I NOW ON LOT SETBACK YARD HWY STREET NAME WIDTH USE OF FRONT _EXISTING BLDG. P. L. OWNER p Qj,� p_6 SIDE ' MAIL / O ,TRACT DWELL. 1 UNIT ADDRE^SS Q_ .. n c' 5 INDUSTRIAL CITY �S/��w_ e lA�T�1 X NO.GL. �� 7 DWELL'. 1 UNIT 6 PUBLIC BLDG. ARCHITECT ORTEL. 2 DUPLEX I UN ®i1AiZ/1��� 7 DDN.,ALT.. ETC. ENGINEER NO. _ 3 APT. UNI 8 M-ISCEL. ADDRESS 4 COMMERCIAL TEL. INSPECTION RECORD CONTRACTOR NO. l R y�_ ,�p� - ��,!/ ADDRESS w\ --- 77�J "d f II Aon' �v e2'A'�`e�'!. DESCRIPTION OF WORE � �/ or,41 ! NEW ADD ALTS - REPAIR DEMOLISH r SQ. FT. '--NO. OF NO. OF _ SIZE STORIES FAMILIES USE OF ST UCTURE u SIGNATURE OF / ��w APPLICANT �qq!/1 �I �!o^y D / APPROVALS ADDRESS Q' / ;y(J �g/ji'ti.KY s�}./�,! DATE INSPECTORS SIGNATURE FOUNDATION: LOCATION P. C. $ FORMS, MATERIALS . 5 5° FEE FRAME: FIRE STOPS. VALUATION $ �Q� BRACING, BOLTS FEE FURNACE: LOCATION. 1 HEREBY ACKNOWLEDGE THAT 1 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��/ -T/,.f �jS �, HOUSE NUMBER COR- PERMITTEE v I v �• �{ RECT AND POSTED ADDRESS �+ ��" -'�✓ FINAL WM.J. FOX, COUNTY ENGINEER VALIDATION C. N. DIRLAM, CHIEF BLDG. INSPECTOR - _ 05300- m 5. 1 2.00 N 76A63BA DBS-3-12-54-- APPLICATION- BS-3.12.54` APPLICATION- FOR BUILDING •PERIII_IT ].. DIVISION OF BUILDING AND SAFETY ]BUILDINGCi b 'Department of County Engineer 9 County of Las Angeles LOCALITY ILY,� WM. J. FOX, COUNTY ENGINEER . NEAREST I �CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST. DISTRICT NO. GROUP SEWER MAP FOR APPLICANT TO FILL IN v/r TYPE -{ BK /- BUILDING :r, `h.., - `rsMAP CONST. L / 4 1 ADDRESS U `•/ ] NUMBER �' r, HWY Y lD LOT NO. `T � �JJf,I BLOCK USE,.�O{IE COSPECIAL NDITION _ TRACT I l9 1 S - `�. C 1 NO: OF BLDGS. C41D 11 SIZE OF LOT So a I NOW LOT BUILDING YARD ,HWY. STREET NAME EXIST. USE OF SETBACK WIDTH EXISTING BLDG. FRONT r4• .�fl _ - P. L. i � �-•��C�l`� OWNER D V SIDE MAIL - P. L. ADDRESS Q CITY , NO. I I-•DWELL. 1 UNIT •/ 5 INDUSTRIAL ARCHITECT OR •- TEL. 2 DUPLEX_UNIT 6 PUBLIC BLDG. a ENGINEER NO. 3 APT. UNITS 7 'ADDN.,ALT., ETC. b ADDRESS - 4 COMMERCIAL 8 MISCEL. T - EL a CONTRACTOR T'. 7�.3 INSPECTION RECORD _ a 9 /00 ADDRESS DESCRIPTION OF WORD' NEW PADD ALTER REPAIR DEMOLISH ' SO: FT, a 't O. OF NO. OF �D�►'1 �I.p'lf L,' V !{r A SIZE Q �.. STORIES / FAMILIES 7�..ftf,r USE OF STRUCT • l All D�o` SIGNATURE OF' _ `H APPLICANT ary C /TiLh•1APPROVALS ADDRESS DATE INSPECTOR'S SIGNATURE P. C. S FOUNDATION, MATERIALS P FEE / FRAME: FIRE STOPS. VALUATION GI -S `, r 00 - BRACING,'BOLTS `- h .,✓�- FEE FURNACE: LOCATION, yT -.7/r - O,I, GAS VENT, O I HEREBY ACKNOWLEDGE THAT- I HAVE READ THIS DUCTS APPLICATION AND 'STATE THAT THE ABOVE IS CORRECT ��7 AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT. AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. ., LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- RECT AND POSTED PERMITTEE - +ADDRESS FINAL 5d ��,„. ,,,,,�� NJ WM..J. 'FOX: COUNTY ENGINEER VALIDATION �✓, /�,/� BY .,:i�P 4 6 ?..=8•:U": "JUN•14 ..1: 6 1,1 .0 0 AY 6-7 9'S`.�U,14,* 2 2:.0 0 Jr. DEPUTY - -- _� DEPUTY BY BY - - _ _ DEPUTY - - DEPUTY APPLICATI N .ffPOR BUILDING RM IT FOR'APPLICANT TO FILL IN _(Print or type only) COUNTY OF LOS ANGELES Bu': ING DEPARTMENT OF COUNTY ENGINEER ADDRESS �r �'? CITY (ls, "�` -,ZIP BUILDING AND SAFETY DIVISION N OF BLDGS BUILDING SIZE OF LOT,� , N WON LOT ADDRESS TRACT 19' BLOCK LOT NOS LOCALITY _ p TEL- NEAREST A 1 OWNER SIJ NO / CROSS ST c V ASSESSOR ADDRESS' MAP BOOK PAGE A PA CITY ZIP DISTRICT GROUP TYPE,CON � FIRE RREP SSEDIBY ARCHITECT OR TEL �,©� . r�/ C 1 ENGINEER NO STATISTICAL CLASSIFICATION SEWER MAP ADDRESS T CLASS NO DWELL UNITS �BK 0,VPG CONTRACT L_E: N USE ZONE MAP �7 LI _ _ NO G✓� ADD RES * N 5 SPECIAL LIC/ CONDITIONS CITY C-0(/ I A/ CLASS CONSTRUCTION LENDER ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ NAME AND BRANCH A BLDG SETBACK FROM FRONT PROP LINE OF (STREET) ADDRESS CITY __ TOTAL SETBACK FROM TYPE OF EXISTING HIGHWAY + YARD SQ NO OF NO OF ' CHECK FRONT PROP LINE HIGHWAY WIDTH SIZE STORQ FAMILIES ONE } DESCRIPTION OF WORK ����'1nTi i NEW ❑ + - p 1 1V .BLDG SETBACK FROM � `m( ADD E SIDE PROP LINE OF (STREET) O ALTER ElTOTAL SETBACK FROM TYPE OF EXISTING ,l USE OF � REPAIR 1:1 HIGHWAY + YARD = SIDE PROP LINE HIGHWAY WIDTH Z EXISTING BLDG )�CIV DEMOL ❑ + ' APPLICANT TEL' CORNER CUTOFF YES ❑ NO ❑ (PRINT) J (j NO 4 IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE( 2 IN COASTAL PERMIT ZONE YES ❑e ) NO ❑ VALUATION —R'/A T7"F �tC. F d 'te�9A i 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STAT _ THAT E THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF Ay THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM PENSATION INSURANCE• N � SIGNATURE OF J17w PERMITTEE ADDRESS IINAO CITY��-��J-i�.tit� NO 3.•3 O 33 DATE L -y ^� gY MAKE CHECKS PAYABLE TO: FPC EE $ FET $ (�G HARVEY T.BRANDT.COUNTY ENGINEER ,y PLAN CHECK VALIDATION' CK. M.O. CASH PERMIT VALIDATION cK M.O. /CASH ; �."3.7CIPR 25 :1 U- 9 1.0 0 ®S 76A638A CE#803 3-75 - ' WORKERS' COMPENSATION DECLARATION insure, or afcertif carte of Workers' Compensat on5ve, a certificate of nt to self Insurance, AP P L I C/��T MON FOR BUILDING PERMIT 'or a certified copy thereof (Sec: 3800; lab. C.) COUNTY OF ANGELES BUILDING AND SAFETY -Policy No. Company ' ❑ BUILDING Certified copy is hereby,furnished. FOR'A'PPLICANT TO FILL IN ADDRESS/�.3a� ❑ Certified copy is filed with the county building inspec- BUILDING• /�A A.3 tion department. FA ADDRESS- K. 'Q-� Date Applicant CITY ZIP q17(� V' LOCALITY N . OF BLDGS - NEAREST,• CERTIFICATE OF EXEMPTION FROM WORKERS', SIZE OF LOT NOW ON LOT CROSS ST 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 O _ USE ZONE MAP . y I certify that in the performance of,"the work for which this r, NO. y _ SPECIAL permit is issued, I shall not employ any person in any-manner ADDRESS �/�2QJ1'. CONDITIONS so as to become subject to the Workers;Compensation Laws. O 7 0 CITY- 1 ZIP Date�2Applicant ARCHITECT OR, TEL. DISTRICT �GIOUP TYPE FIRE PROCESSED BY O Cie NOTICE- O A PLICANT: If, after aking this Certificate of ENGINEER - - "NO.' CONST ZONE' 0 Exemption, you should becom subject to the Workers' p a .Compensation provisions of the Labor Code, you must-forth- ADDRESS ��4 3 V :/ N with comply with such-provisions, or.this permit shall be �/' TEL. STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTOR O W� NO 1D - — LICENSE15 CONTRACTORS DECLARATION ADDRESS j1�' '�_'� - LIC' CLASS NO. DWELL UNITS 44 — ADDRESS hereby affirm that I am'licensed under,provisions of Chapter 9 ' ' NO SEWER MAP .(commencing with Section 7000)of Division.3•,of-the Business - 1�" 4 0 1 LIC. and Professions Code,and my(cense is in full force and effect. CITY 01� CR C _/ CLASS BK PG VALIDATION ,`J SQ FT. NO OF NO. OF CHECK ',License NumberL ����y/LLic. Clbss SIZ STORIES �ri� FAMILIES ONE VALUATION ',Contractor d..1A AlViii '•-'•�r'Date' DESCRIPTION OF WORK wv� NEW, ❑ ADD ❑ `� El am exempt under Sec. ALTER ❑ B.BP.C. for,this reason• 0k REPAIR Date:' USE O EXISTING BLDG DEMOL ❑ Signature APP(PRINT) Np FINAL O NER-BUILDER DECLARATION' DATE •5 _�o % Z I hereby affirm t at I am exempt from the Contractor's License Law-for the fo owing'reason"(Section 7031.5, Business and ADDRESS FINAL Professions Code): PRESENT By BUILDING ❑ I, as:owner of the'property, or'my employees with ADDRESS t=:`'' 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. `'❑ CONTRACTOR NO ;,,IV 1, as owner of the property, am,exclusively contracting _,_,;'..• with licensed contractors to construct the prolect.(Sec- tion 7044, Business and Professions ADDRESS Code.) , ', _ REQUIRED TOTAL SETBACK FROM EXIST. ;:=�. 1.' 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' ) P.L - a ;-1 Lender's'Name t Ivs.: - _'•+_i f rt1P. m LDMA Ref. #' , p P.C. Fee$ Permit Fee a »° Lender's Address _. i,i.,sir • . a 1 certify that I have read this application and state that the Issuance Fee - 7 LDMA P/C# o above information is correct. I agree to-comply with all County Investigation Fee / 8 ordinances and State laws-relating•to building construction, Total Fee .:2 �. (v �' LDMA Perm # a and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. _ :10 r SEE REVERSE FOR EXPLANATORY LANGUAGE, Signature of Applicant or'Agent- Date -