The URL can be used to link to this page

Home My Public Portal About10531 FREER ST_Building__ 76A638A`CE4e03=-63 .'APPLICATION FOR BUILDING. PERMIT , COUNTY OF LOS ANGELES BUILDING ,DEPARTMENT OF COUNTY ENGINEER AD°REss BUILDING AND SAFETY DIVISION - LOCALITY f-Al►, 1 ' _ JOHN A. LAMBIE. COUNTY•ENG_INEER NEAREST ^ WILLIAM A.JENSEN, SUPT OF BUILDING - CROSS ST ,/� t: TDISTRICT NO GROUP, TYPE' PROCESSED� FOR APPLICANT"TO FILL IN coNsr. L o �- BUILDING STI AL CLAS FICATION SEWER MAPADDRESS '� PGSS NO DWELL'. UNITSLOT NO BLOCKRFICATE: NOT REQUIRED RECEIVED r TRACT / I d— -]' - MAP HIGHWAY STATE MAJOR SECOND, OCA _NO OF SLOGS. NO (CIRCLE) - SIZE OF.LOT NOW-ON;LOT USE Z•NE —SPECIAL 11 USE.OF _ "CONDITIONS _ V EXISTING LDG /' ,{• I 'lSirp OWNER I `C NE U 11 U B ILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS FRROL T ' E25 F_ / ARCHITECT OR - TEL ENGINEER • NO - SIDE •- P L a ADDRESSn i O A .r 'TE / �. CONTRALTO J NO 0� �P ADDRESS DESCRIPTION OF WORK, d� ►+.pv�, 0. w A h NEW ADD ALTER REPAIR.'. DEMOLISH a A r SQ FTN O'OF '`• .NO .OF / N I GT•' 4 i re� n1a�:'70`G --- SIZE t-33 a ST•ORI S.-� -',FAMILIES/'I .�� y� ,1, USE OF , J "&A-iA wit�'s'�" f�.AAS a�- •- STRUCTURE SIGNATURE �E�yb'" A y+!�"✓"�.I�.n"r1J VYIG� APPLICAN - VALUATION $ coo A. pPROV'AL3 DATE I (NSPECTO%S,SI GWAT RE PC ,O - r.PMT FRAME LOCATION FEE $• . FEE jFEE 5,29AS FORMS, MATERIALS 9 FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I4 HAVE,READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE IS-CORRECT AND AGREE TO COMPLY FURNACE LOCATION.- WITH ALL 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- TION•OF THE LAB&M,PE E OF THE STATE OF CALIFORN RELAT. p ING TO WORKMENSA I NINSURA NCE LATH. EXTSIGNATURE OFHOUSE NUMBER COR- PERMITTEE r RECT AND POSTED ?_ ADDRESS - FINAL • ''? - JOHN F.,LEWIS, PRINCIPAL ST am URAL ENGINEER PLAN CHECK VALIDATIONGqlK mo CASH = PERMIT VALIDATION O' CASH 1 'SE' 19 .2'3 D 2 850A 5..7.0 0 ilt,o 3 4 2 91' DFc 12 : 1 °0 . APPLICATION FOR BUILDING PERMIT . COUNTY OF LOS ANGELES. BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION I FOR APPLICANT TO FILL IN BUILDING ADDRESS �v I hereby affirm that] have a certificate of consent to self insure, BLD jJCyAQpfjEss or a certificate of Workers'Compensation Insurance, or a certified copy thereof(Sec.3800,Lab C)- I C Y"Q J C C ZIP (� v LOCALITY, Policy No Company SIZE OF LOT• NO OF BLDGS NOW ON LOT ❑ Certified;copy Is,hereby furnished - ( NEAREST CROSS ST ElCertlfied,copy Is filed with the county building Inspection TRACT BLOCK LOT NO department. USE ZONE MAP IN Date- Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE'OF EXEMPTION FROM WORKERS' j�j[VNE � 'M.'"aPe T Cit TEL q z- 3 3o YES NO COMPENSATION INSURANCE �fj �y WITHIN j000 Fr.of scHlooL� (This section need not be,completed If the permit Is for one hundred ADDRESS It f dollars ($100) or less) 1 Q S I e• ' ��'�' DISTRICT GROUP TYPE CONS FIRE ZONE PROCESSED BY C 1 e 0 ZIP I certify that in the performance of the work for which this permit v►q �� Is Issued, I shall not employ any person In any manner so as,to Compensation Laws. ARCHITECT OR ENGINES TEL NO become subject to the Workers`Com p STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO DWELL UNITS NOTICE TO APPLICANT If, after making this, Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR TEL NO SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwithB Gtl7 FRONT comply with such provisions or this permit shall be deemed revoked ADDRESS LIC NO P L LICENSED CONTRACTORS DECLARATION SIDE CITY LIC CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 - SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ FT SIZE NO OF STORIES NO OF FAMILIES 1 Professions Code,and my license is in full force and effect. NEW ❑ BKS PG Poo. Number LIC.(IdSS DESCRIPTION OF WORK qpp ❑ VALUATION CL Contractor Date Q , LC Cedes Sr �� Yr3�f ALTER El $ 3��- 0 El REPAIR ElO I am exempt under Sec `/ BAPC for this reason At eri l•✓ Va." c-p)'< PJ �✓�V/4 DEMOL ❑ DMA P/C# w Date USE OF EXISTING BLDG URM ❑- ( �- . Signature APPLICANT(PRINT) TEL NO LDMA Perm# ANT Z L9/I,'as owner of the property, or my employees with wages as Z iil•l•i ea their sole compensation, will do the work and-the structure is ADDRESS , ,3�,0� ~ t 3 � I not.intended or offered for sale (Section 7044, Business and � FINAL DATE% Q PFOfeSSlOr1S Code) - WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL El 1, as owner Of the property, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J I ITEMS AMOUNTS SPECIFIE94N THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY' .. .-J licensed contractors to construct the project (Section 7044, YES❑ NO Eff TOTAL 1. 1.7 o 90 Business and Professions Code) • WILL THE INTENDED-USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING "- CHB Li OCCUPANT REQUIRE A RMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH �1. I` `•HES•i: 117.90 CONSTRUCTION LENDING AGENCY• COAST AIR QUALITY NAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR pS ✓hlx�= �Ii\ -_ q_j(/�)�, hI /_� (� GUIDELINES IJJ V\ �J �•' CHANGE •130 1 hereby affirm that there is a construction lending agency for Yes❑ No N the performance of the work for which this permit Is Issued(Sec IHAVE READ AZARDOUSMATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 3097,CIV C) • CHECKLI UN ERSTAND MY REQUIREMENTS_UNDER THE LOS ANGELES COUNTY CODE, r {�f ) p-, N TITLE HAP R 220 SECTIONS T UGH 220 140 CONCERNING HAZARDOUS F IOOCI�13 IJI, J/i5/7i� Lender's,Name MAT PORTING AND iO OBTAI IN RMIT FROM THE SC n� CL Lender's Address ///j(< x 937 I SIM 9'51 OWNER AGENT V - - 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 PC FEE PERMIT FEE �� •� N with allpea7y ordinances and State laws relating to building m cons ctio , and hereby•auth z representatives of this County -- ISSUANCE FEE to pon the above roperty for inspecti n purposes n ��S INVESTIGATION FEE TOTAL FEE / ` O m S19-, of Appl—I.,Agent SEE REVERSE FOR EXPLANATORY LANGUAGE