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HomeMy Public PortalAbout10667 FREER ST_Building__ � • TEMPLE, C9TV . ..•' . 76A038IC11#8082/60 APPLICATION FOR BUILDING PERMIT Z COUNTY OF LOS ANGELES BUILDING /� ADDRESS l/(J DEPARTMENT OF COUNTY•ENGINEER BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST: ' DISTR T NO�p GRO P �TYPE .PR - FOR APPLICANT TO FILL IN D I I-coNsr. '� / L_ r STATISTICAL CLASSIFICATION SEWER MAP BUILDING —ADDRESS. 06-4 I U BK P j7 ,( CLASS.NO. / DWELL.UNITS LOT NO. I Z f A Az c e 4 A� BLOCK A MAP STATE ,YES NUMBER � O - HWY. TRACT USEZONE SPECIAL /9,�.� SIZE OF LOT 6�j I NO.OF.BLDGS. CONDITIONS ,(�//"� t.!/.��, NOW ON LOT USE OF 1 pp p - EXISTING BLDG. •� � G?T I� ' BUILDING - EXIST. YARD HWY STREET NAME, /�L TEL.Cy SETBACK WIDTH OWNER(-• G n rl-�k� � SD.t,r.�NO.fc-r"e v G7.? FRONT_ - �y 7 q p�7 P.L. ADDRESS 70• /1�YM©�✓O Yr/4S� -SIDE _ ARCHITECTOR TEL. P.L. ' ENGINEER No. INSPECTION RECORD ADDRESS CONTRACTOR/#r--v,,, '/`"' za w/ NO. /Sy� O ADDRESS/J d tJ 4= U� /SIG C'�C�h� L"� fi S. r' DESCRIPTION OF WORK NEW. HADD- ALTER REPAIR DEMOLISH V SQ.FT. / NO.OF NO.OF. RWi SIZE C� a� STORIES FAMILIES - ,o USE OF STRUCTURE�-7 � �' X 2.6\ CA f� /�7 � ��s�k� /�l�T /�L' Grf•✓� Car�r `- yam, � b SIGNATURE OF X�v////_'T 4E] ------ APPLICANT VALUATION � APPROVALS DATE INSPEC,TOR'S SIGNATURE P C sy - � �'�/ FEE FOUNDATION: LOCATION FEE $ FORMS,MATERIALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRE STOPS, L� PLICATION AND STATE THAT THE ABOVE IS CORRECT AND BRACING, BOLTS /,.� . FURNACE: LOCATION AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND , I �+ STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT;DUCTS AA 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED 1 LATH, INT. WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE WORKMEN'S COMPENSATION LAWWS� OF CALIFORNIA. LATH,.EXT. Q 7,J SIGNATURE OF ��_�� HRECT AND POSTED R ♦ - ,/ v PERMITTEE L�/ �G /@,+� ADDRESS FINAL f/ems /for It- CLYDE N. DIRLAM, PRINCIPAL ST 'CT RAL ENGINEER PLAN CHECS VALIDATION. cK. M.O. CASH PERMIT VALIDATION (,:K. M.O. CASH OF i D1 i 1 lC 76A638A CE#803 B-63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ' - BUILDING 1676C,7 DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITYT�/� !� (� 7y JOHN A. LAMBIE, COUNTY ENGINEER NEAREST ,cam WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST DISTRICT NO. GROUP ,TYPE P OCE�SED BY FDRESS R APPLICANT TO FILL IN S" 8 CONST G�� STATISTICAL CLASSIFICATION SEWER MAPG� GCLASS NO DWELLUNITS K PGC TS BLOCK WATER CERTIFICATE. I NOT REQUIRED I 'I rl— RECEIVED ❑ HWAY TRACT - NOP '20 HI(CIRCLE)LE) STATE MAJOR SECOND, CA NO OF BLDGS % SIZE OF LOT 78 NOW ON LOT• USE ZONE SPECIAL USE OFCONDITIONS EXISTING BLDG ♦ tom'-A1C 15 14-1 , T E ffl /��J OWNE NO. T/ BUILDINGEXIST < / SETBACK YARD HWY STREET NAME WIDTH ` ADDRESS 7b M 57 &• FRONT ARCHITECT OR -_;_1 TEL P L. 2- 0 e_� ENGINEER _ NO. SIDE _ P L ADDRESS - d CONTRACTOR ... TEL ONO ADDRESS / {• �/'� �/LGGF� �� DESCRIPTION OF WORK ^Y ' '' ``!�,J �'� ^o -dam. NEW ADDALTER REPAIR DEMOLISH �" H SQ. FT. // NO. OF NO OF SIZE SGL t STORIES FAMILIES USE1IJ� STRUCTURE47- SIGNATURE OF APPLICANT VALUATION $ APPROVALS DATE INSPECT R'S IGNATURE P.0 PMT FOUNDATION. LOCATION FEE FEE $ C) O FORMS. MATERIALS $ 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 _ 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- LATH, INT ' TION OF THE.LABOR ODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN' MPEN SATI RANCE LATH. EXT. '1lex.,SIGNATURE OF �^� HOUSE NUMBER COR- - PERMITTEE vvv���... RECT AND POSTED ADDRESS `' � 5 FINAL PLAN CHECK VALIDATION CK. MD cnsH JOHN F. LEWIS. PRINCIPAL STRUCTURAL E N•fi R PERMIT VALIDATION CK M O CASH Lkc; c : a a SEP 2 6 -1 a 9.0 0- c WORKVS',COMPENSATION DECLARATIONAli ' kms,abo�raafceofcrateofWokes' Compensatonve d certificate of Sensurannt to e, = APPLICATION FOR BUILDING PERMIT ,or a certified copy thereof (Sec. 3800, Lob.�C ) - . - COUNTY OF LOS ANGELES _ BUILDING AND `SAFETY �olicy No. Company Certified copy is hereby furnished FOR APPLICANT TO FILL IN DDR SS /v A / ADDRESS 606� C17/l— ❑ Certified copy is filed with the county 9 inspec- BUILDING ! tion department. f?ec- ADDRESS Ird 667 cGtR bT ern A Date Applicant CITY. Tp M PXX. r—/Ty" ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' , NO .OF BLDGS D NEAREST COMPENSATION-INSURANCE SIZE OF LOT 71 X 7$ 'NOW ON LOT `"w CROSS ST. (This section need not be completed'if the permit is fair one d�• / ASSESSOR hundred hundred dollars ($100)or.Iess ) - TRACT Z D BLOCK L NO MAP BOOK PAGE PARCEL OWNER MAKRAM M/h'HAjL. No 8�b !/4 USE ZONE MAP. I certify that'+n the performance of the work-for wh+ this NO permit is issued, I shall not employ any'pfr many a er ��' SPECIAL 8+ so as to become subject to the Workers' ensatio L s. ADDRESS' CONDITIONS 0 CITY ZIP. V Date 1—�' Applicant' 1261 " NOTI TOT• 'If, after making this Certificate of ARCHITECT OR W'N�R TEL. DISTRICT GROUP TYPE FIRE O ESSED BY O ENGINEER O P NO. CONST ZONE I�• Exemption, you should become -subject to the Workers' _ Q Compensation provisions of;the Labor Code, you must forth- ADDRESS �` ✓ , W with comply with such provisions-or this-permit shall be" Ll: deemed revoked - TEL STATISTICAL CLASSIFICATION APT CONDO. Cl) CONTRACTOR Gil�1S� NO. Z LICENSED CONTRACTORS.DECLARATION LIC CLASS NO. DWELL. UNITS I hereby affirm that I am Icensed under provisions of Chapter 9 ADDRESS NO (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP Professions Code, and my license is to full force and effect. CITYCLASS /J VALIDATION SQ FT /i NO OF . l NO OF �,../� CHECK BK License Number Lic Class SIZE 5 �f STORIES 611+Q� FAMILIES ONE ❑ VALUATION Contractor Date DESCRIPTION OF WORK NEW ADD $ { I am exempt under-Sec. ❑ , ALTER EC, for this reason REPAIR ❑ s Date: USE OF DEMOL EXISTING BLDG ❑ Signature APPLICANT / TEL /i,�(�696 FINAL PRINT v lI hr OWNER-BUILDER DECLARATION /n NO DATE ��ssCCJJ I,hereby affirm that I am exempt•from the Contractor's License to66'� ��,� Q 5 ADDRESS Law for the following,reason'(Section 7031.5, Business and FINAL Pr 'fessions Code): PRESENT- d �� T BY BUILDING' riq I, as owner of the property, or my employees with ADDRESS 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 ro ert CONTRACTOR NO .�.•, - - p p y, am exclusively contracting - •`--�` • with licensed contractors to construct the project.(Sec- tion.7044 Sec-tion•7044, Business and Professions Code). ADDRESS 7 3 3 8,A REQUIRED TOTAL SETBACK FROM - 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 ;I s° 2 6 5,5 0 (Sec. 3097, Civ C.) " SIDE _ PL. 265,50 Lender's Name ; - 4 - t✓o, 'LDMA Ref. # (�. O 626,t87 m Lender's Address P.C. Fee$ Permit Fee �✓ 1 - I•certify ihat-j have read.,this application and state that the Issuance Fee `g U kLDNA P%C#, `�•y" , above information is'correct. I ogree.to comply with all County Investigation Fee o ordinances and State jaws Felating to building construction, Total Fee LDMA Perm. # "' t " and�heieby"authorize represent es of this County to enter m "upon the ab e-mentioned ro ty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicanror,Agent Date - •i