HomeMy Public PortalAbout10534 FREER ST_Building__ i
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
k COUNTY OF LOS ANGELES
WM. J. FOX, CHIEF ENGINEER m 9 L- o"I G'
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
•BUILDING / 71 C � DISTRICT O. PLA_ N_CKoNOO. PERMIT NO.
'ADDRESS V J,13 ,re,
LOCALITY �a p !�I RE�-EIV,EdD BY 'DATE OF APPL. DATE ISSUED
NEAREST 4,• 0 S ,Z
CROS99T. ��d�11 I
BUILDINGI j
OWNER
� �G •` ADDRESS / �C� 44 ff
MAIL �a. �{� ;;c lI LOCALITY �G� �L f—= e' 1-rY.
ADDRES8 7�J 4� V NEAREST w/
TEL. CROSS ST. Q i' A,5
CITY K-� 'NO. , ` "�/ 7l FIRE NO. OFawl TYPE -+I GROUP:.t—
ARCHITECT OR�(I - TEL. ZONE -PLANS
ENGINEER (/ NO. BLDG. ORPNO.
SETBACK LINE
ADDRESS APPROVED - - -•
TEL. BY DATE
CONTRACTOR '��A� NO. USE APPROVED
- •- - ZONE �f BY DATE
ADDRESS HOUSE NUMBERING
LEGAL U 2r OI _FIELD CHECK BY
DESCRIPTION I LOT NO. 7 I BLOCK MAP NUMBER
TRACT / o�C� NO. ASSIGNED BY DATE
NO.'OF BLDGS. CORRECTIONS
SIZE OF LOT'•, /(J Q Cf S� NOW ON LOT /
' USE OFU'�y I NO. OF
EXISTING BLDG, FAMILIES _
DESCRIPTION OF WORK �'��
�PdM?a's PO4Af 4//TflCil"11414 y 2.7c?O Ot'
NEW I I ALTERATION I I ADDITION
GdN'�EKS/O�DG t3�Oh'DO/✓�� �?D�dam.
REPAIR I I DEMOLITION I I I A
SQ. FT.ISSff V L I'OtV NO. OF
SIZE T�Z7'p/�RROOMS STORIES •t• ? ��Xnn,I1' >`�'
EXT. WALL ROOF `r
COVERING,4; jI COVERING .' - ,3;J
USEZ STRUCTURfi '•
A, ",.6 /(fw � �CIiL �. amu- �!6-4 t+!c'
CSL Y1-1)^I_
APPR
l .M "1�J/1.L�SG.J� �'�"r.�l4e ✓ � ')`"•NS_PECOT,ORI'S SIGNA_TORE _'DATE
1 HEREBY/ACKNOWLEDGE THAT I HAVE READ THIS AP-' FOUNDATION: LOCATION
PLICATION AND STATE THAT THE INFORMATION GIVEN ISFORMS, MATERIALS
CORRECT. -
1 AGREE 'TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE'STOPS,
HEREON AND WITH ALL COUNTY.,ORDtNANCES AND STATE BRACING, BOLTS
LAWS REGULAT,I/-GBull-DING CONSTRRUCCtIOON. - ' FURNACE: LOCATION,
SIGNATURE OF "n�' U4-)
/I it f1 GAS VENT, DUCTS
PERMITTEE„ 11 ►'V�/`V'J " ° '• „
ADDRESS-- / V• �I L� /�',JV_l� J��,r LATH, INT. '-
LATH, EXT:
AUTHORIZED AGT. _
PLASTER, INT. �, `t•�i_
7aAG38A• cess,' io-so $ . C. # - -
t�r /y r
rjF EE 7,3� PLASTER, EXT.
VALUATION (JX(JJ( EE $ r
/ �� FINAL
I '
., 1
76A638%PCE08038-64 APPLICATION FOR BUILDIN PERMIT
COUNTY OF LOS ANGELES BUILDING 3
DEPARTMENT OF COUNTY ENGINEER 4 D D R E S
BUILDING AND SAFETY DIVISION L O C A L I T
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W JENKINS,SUP'T OF BUILDING CROSS ST. ,
DIST CT NO GROUPTYPE E Y
FOR APPLICANT TO FILL INp CONST. i2 A
BUILDING' a _ STATISTICAL C SSIFICATION SEWER YAP
ADDRESS bS3 '2Ql�.� CLASS NO. DWELL UNITS BK PG,'
LOT NO BLOCK USE ZONE -MAP
NO.
TRACT b SPECIAL
NO. OF BLDGS. —� CONDITIONS
SIZE OF LOT Uo l5a NOW-ON LOT ,
USE OF
EXISTING BLDG. BLDG. SETBACK FROM
TEL FRONT PROP. LINE OF (STREET)
OWNER ]] l 3�b TYPE OF EXISTING SETBACK HIGHWAY + YARD = ,TOTAL
ADDRESS H HWAY WIDTH 'f OM C.L.
CITY v I
BLDG. SETBACK FROM /
ARCHITECT OR F L. SIDE PROP. LINE OF r (STREET)
ENGINEER O
TYPE OF EXISTING SETBACK, HIGHWAY + YARD = TOTAL
ADDRESS - - HIGHWAY WIDTH FROM C L a
TEL ••� + �O = O
CONTRACTOR NO V
LIC CORNER CUTOFF YES NO d'
ADDRESS NO _ O
CITY C ass SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK, CL
GUTTER DRIVEWAY APPROACH, Z
EW ADD ALTER REPAIR DEMOLISH AND PARKWAY TREE REQUIRED
SQ"FT. NO. OF NO OF
SIZE GO STORIES FAMILIES
USE OF er sidewalk and .driveway approach i
STRUCTURE
s+illations should be taken out at the•L. A. Co. Road Dept., Ata en
Ica, O
SIGNATURE OF a lengthy dole . suryey & Design work*takes time and is not starts •
APPLICANT until Permit has boon'issued. Appy for parkway Tree perml a .
Gl�
Hall
VALUATION$ / APPROVALS DATE INSPECTOR'S SIGNATURE
UNDATON, LOC
P.C. PMT. S FO FORMSI MATERIALSON /5� '• �•
FEE FEE$ lI��QJP „r
FRAME, FIRE STOPS,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT'AND AGREE TO COMPLY FURNACE: LOCATION _
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS ���
9UILDING CONSTRUCTION I 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 URANCE LATH. EXT.
SIGNATUREOF� �f�� -HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
-ADORES S/ '- F I NAL •C.��,�-S�,(,�� '� „6r7��
JOHN F. LEWIS, PRINCIPALST � TURAL ENGINEER
PLAN CHECK VALIDATION CK M.O CASH' _ PERMIT VALIDATION CK. M.O CASH
iJtGo1 9 8 2u Mayiz5 10 1 1.50- t
WORKERS' COMPENSATION DECLARATION
• d F insure;'
ter that I haver certificate of consent to self A P P L I CAT I O N .F O R � B U I•L®I N G. PERMIT ,
insure; os a certificate df WorkerS'•Compensation Insurance, ,
or a certified copy•thereof (Sec 3800, Lob C.)
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No Company BUILDING
❑ Certified copy is hereby furnished FOR APPLICANT TO FILL IN3
ADDRESS-
!1
Certified copy is filed with'the county building mspec- BUILDING
tion deportment- ADDRESS 10 I53 /r���l�"
Date- Applicant' CITY �40" `'c? " -•t'r-( ZIP !, I LOCALITY r -
CERTIFICATE OF EXEMPTION FROM WORKERS' 2 NO OF-BLDGS ' NEAREST
COMPENSATION INSURANCE SIZE OF LOT 7/ ,C, CL NOW ON LOT CROSS ST
(This section need not be completed if the'permit'is for one ASSESSOR
hundred dollars ($100)or less ) TRACT BLOCK LOT NO MAP BOOK PAGE Y- PARCEL
V C"'W 0� TEL USEINE NE" MAP-. �y
I certify that in the performance of the work for which this OWNER Cl do 1T/� NO LI NO' 1,'3 -
permit is issued, I shall not employ any person in any manner SPECIAL A T g
so as to become su lett to,the Wo ;Com nsat�on La ADDRESS l GI[�LfTO K••• CONDITIONS ACCT•8 _
CITY wi-r "4e ZIP ( 176-4 n . 3307.- ,DO.3 r
` Date ApplicantMIA
NOTICE TO PTPLIANT- If, after making this Certi ate o ARCHITECT OR i TEL �jf DISTRICT GROUP TYPE "'• FIRE PROCESSED,BY
Exemption, you ould become subject to the orkers' ENGINEER t NO. —gyp CONS ` ZONE a
Compensation.Provisions of the Labor Code, you must forth- ADDRESS 2uJ pry 4S J`L/ "►' CTAT
with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION ' DO
deemed revoked. CONTRACTOR �l� NO. r � �`i�5
LICENSED CONTRACTORS DECLARATION LIC CLASS NO DWELL-UNITS+' -;2 TG
I:hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO _..._ n
(commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP 1024.58
Professions Code, and my license is in full force and effect. CITY CLASS ; BK PG
CDATION iV2�F
SQ. FT NO OF NO OF CHECK'
License Number Lic Class SIZE q •
�� / STORIES FAMILIES, ` ' ONE CHA,7tIG�-C
VALUATION,
G1NEW •�
Contractor Date DESCRIPTION OF WORK 1►1 C,L3❑ .T (�t� nn .. ;• O
,pp� ADD 0000-ClO1 sig I am exempt under Sec f C. 7 � Z - {i
ALTER s 1. 4866 1 RMiii ...
8.8P C. for this reason rn-- 3 REPAIR ❑ 130" O(\f\ N
USE OF v v
Date: EXISTING BLDG qI DEMOL
Signature APPLICANT TEL FINAL
OWNER-BUILDER DECLARATION (PRINT) NO DATE .
I hereby-affirrti that I am exempt from the Contractor's LicenseQ � >
Low for the following reason (Section 7031 5, Business and ADDRESS CIK.J 3>~ ' KG FINAL
Professions Code):• PRESENT By
BUILDING /p �'! •" 7 /J' .'
I, as owner of the property, or my,employees with ADDRESS (/
wages as their sole compensation,will do the work and
the structure isnot or or offered for sale(Section. LOCALITY
7044, Business and Professions Code). MOVING TEL- i
CONTRACTOR NO-
I,'as owner of the property, am exclusively contracting ,�, ,� �. � •`� .
NC-
With licensed'contractors to construct the project (Sec- ADDRESS
tion 7044, Business and Prof essions.Code).
REQUIRED TOTAL SETBACK F t'
CONSTRUCTION LENDING AGENCY SET BACK - YARD HWY PROP. LINE WIDTH �_.•- t • '�t>>
.I hereby affirm that there is a construction lending agency for FRONT ��•� \• �' 1
the performance of-the work.for which this peimtt is issued P L
(Sec. 3097, Civ C.).' SIDE — t �. ' . •�' t\
P.L
Lender's Nome _ _^'' S' i✓ ti•:1 ...1
LDMA Ref. p
t0 - C Fee$ Permit Fee �{
Lender's Address P J :=� )`+7 �t• +M
o I certify that I,have read this application and state that the
Is Fee /a 0 LDMA P/C# !"I
P above information is correct. I agree,to comply with all County Invests orlon Fe
o ordinances and State laws relating to building construction, g "?
N ®' Total Fee 49 4. f� LDMA Pefm. a
.and hereby authorize representatives of this County to enter a
m u o t e ab v -mentioned pert for inspection purposes. ir � '
n �2 .7:. .1 -.•1
m Q 1(fir SEE REVERSE FOR EXPLANATORY LANGUAGE
• Signature-of Ap ant or Agent Dote :-•t e•••+• , �� i:r1 5,+'d rh -
L:
- r WORKERS' COMPENSATION DECLARATION `
I hereby affirm that I have'a certificate of consent to self
insure, or a certificate of Workers' Compensation Insurance, : A P P L LCAT,I O N _ F.O R B U I L D I N-G PERMIT_
or a certified copy thereof (Sec. 3800,,Lab. C.) COUNTY OF LOS-ANGELES- BUILDING AND,SAFETY
Policy No. Company
BUILDING
❑ Certified copy is hereby furnished. ., FOR APPLICANT TO.FILL,'IN ADDRESS
❑ Certified copyisfiled with the county building inspec- BUILDING /r^, S �• -- _,_. . �•
Tion department. ADDRESS I5/ �,
Date Applicant CITY 5ilyl --- 'Z ZIP, LOCALITY ✓
NO. OF BLDGS NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE-OF LOT NOW ON LOT, CROSS ST
COMPENSATION INSURANCEASSESSOR
(This section-need not be completed if The permit is f& one TRACT BLOCK' - LOT NO.- MAP BOOK PAGE PARCEL
hundred dollars'($100) or'less.) L
t OWNER /l,� O.00I USE ZONE NOP •�. ._ Z 7�
'I certify that in'the performance of the work for-which this SPECIAL
permit is issued, I shall not employ-any person in any manner ADDRESS f�U�� - Jl� CONDITIONS .
so as to.become subject to the'W k rii C�o�rp/p/ansatio s. O
/uZ ��G/!s �� CIN ZIP
Date Applicant �1}J ARCHITECT OR TEL DISTRICT GROUP TYPE FIRE PRO SSED BY
NOTICE-TO APPL ANT: If,. aft in t i if a e o � ENGINEER NO � O
Exemption,. you should become .subject to the,Workers'/UTAI Sa8 CONST ZONE U
Compensation provisions of the Labor Code, you must forth-�. ,) ADDRESS 3 r'i'
with comply with such provisions-or this, permit shall be(�M TEL- STATISTICAL CLASSIFICATION PT. 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 Z7 VALIDATION
SQ FT ' NO OF• f NO OF- CHECK'"
License Number S" �-Lic. Class SIZE STORIES / FAMILIES ONE
VALUATION
Contractor Date '
DESCRIPTION OF WORK NEW ❑ $
❑I am exempt under Sec. 5 ADD 1-1 ► 1
B.BP.C. for this reason EPAIR ;
Gt j�J
USE F w ❑ 0
Date: EXISTING BLDG. Sr 'DEMOLJx
Signature APPLICANT TEL FINA
OWNER-BUILDER DECLARATION (PRINT) NO: DATE ��fJJ.—Z f�
_
I hereby affirm that I am exempt-from the Contractor's License
Low for The following reason (Section 7031.5, Business and 'ADDRESS /V FINA
-Professions Code):, PRESENT B
El BUILDING �. REEA S (' ''.3
I, as owner of the property, or my'employees with ADDRESS rt`'('! "
-wages as their sole compensdtion,•will do the work,and
the structure is not intended or offered for sale(Section LOCALITY J ,;.:!! lv jehti,
7044, Business and Professions Code.) MOVING. TEL _ .,_ -
j, as owner of the property, am exclusively contracting CONTRACTOR f NO 3t i
` with licensed contractors to construct the project,(Sec- - ADDRESS - TOTAL m3
tion 7044, Business and Professions Code.)
REQUIRED YARD HWY TOTALSETBACK.FROM. EXIST.. !_:€••€ECK - - '8-.63
CONSTRUCTION LENDING AGENCY SETBACK 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.
Lender's Name
LDMA Ref #
` P.0 Fee$ Permit Fee
Lender's Address Pol
certify that I have read this application and state that the Issuance Fee/(!1_-< LDMA P/C# -'' ,-;• ,� 1 ,
above information is correct. I agree to comply with all County Investigation Fee" _ ' A-Pe,
r,\ �_ �' + r` a - •�
'g ordinances and State jaws relating to building construction, Total Fee (S/ r :[DMA Perm q '
a and hereby authorize representatives of this County to.enter
aupo the bo entione property for inspection purposes.
�. O3rZ r :SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of plicant or Agent- D04e
lr Y A7TAIY JIl Mr-l- .11M,A]]A) /'1�ist;1