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HomeMy Public PortalAbout10868 FREER ST_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMTI' COUNTY OF LOS ANGELES BUILDING® I WM. J. FOX, CHIEF MNGINEER T ' FOE APPLICANT TO FILL IN FOR. OFFICE USE ONLY BUILDINd, DISTRICT O. PLAN C.K. NO. PK MIT N . ADDRX=. LOCALITY IV®CY DAT[OF APPL DATK ISSUED NEARZZT Q CROQG BT. CUILDING c ay . ADDRKt1 0 OWN MAIL MAIL i D" � LOCALITY ADDR[ft NMARMOT TICL_ CROSS ST. CITY Awl NO. FIRS NO. OFQ ARCHITECT O Tal- ZONK PLANS ITYO� 1 ,77 ENGINKKR NO. CL,DQ, SKTBACK LINK ADDRIBB. APPROVED - TIEL- CY DATK CONTRACTOR NO. USEAPPROVD - ZON6 E ISE DATE ADDREQS HOUOK NUMCERINQ r wrs►,L DKSCRIPTION LOT NO. I CLOCK MAP NYMCKR_ I trIILD CHUCK CY TRACT NO. ABSIQNKD CY A TE NO. OF BLDQS.•' CORRONS GIZE OF LOT LECTI NOW ON OT USK OF NO. OF MuETINQ 13LD4. FAMILUM DWCREMON WORE _ NEW ALTiRATION ADDITION REPAIR DEMOLITION I - 6= ROOMS QTORIK@ 1 EXT. WALL ROOF M�r COVIU RINQ T COVRING USE OF STRU pp APPROVALS INSPECTOR'O SIGNATURE DATX 1 HMtIDY ACKNOWL.EDQK THAT 1 HAVU RK:AD THIS AP- FOUNDATIONi LOCATION PLICATION AND QTATK THAT THE INFORMATION QIVKN IS FORMS, MATURIALE CORRECT. . I AQRKK TO COMPLY WITH T}iK CORRECTIONS LISTUD F MR: FIRIZ BOLTS , HKREON AND WITH ALL COUNTY ORDINANCKS AND STATE LAWS RKQULATINQ BUILDING UCTION. FURNACEi LOCATION, [75A"SA, NATURK OF GAB VKNT, DUCTS PERP I TT .Jr I1.TH, INT. LATH, EXT. ca f's THORI731 AOT. 24 - PLASTI R, INT. DO" to-sO ; FF C. f PLASTER, KXT. LUATION d t �� FINAL DEPARTMENT OF BUILDING AND SAFETY APPLIgATION FOR PERMIT COUNTY OF LOS ANGELES ® ' ..1 VWM. J. FOX, CHIEF [MUIN[ER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY 13UILMIM13 J DIBTRPLAN. OK.NO. P[RM T MO. ADDRESS „( IOT •'� .. "8dn z LDOALITY FL 1\1 V il RYOFIV[D DATE O AFP L DATIQU[D ROS SIT. ` 6�,,w ((�' n OWN[R1% 7 ` `,�' ! +► ► ADDR[eM MAILy� }}�� �m ADDR[r b/�(� {o L00,1tITY N[AREMT D �1 n,L J 0 f ^� Ij5 ORDMRT. -- FIR[ N0.OF pROU r ARCH'—IIT OR TEL ZON[ FLAMM EN"MEER N0. A 7yj F y ■LDC. _0 ORD.NO. DR If- ■ETCADK LIN[ APPROVED TEL MY DATi CONTRACTOR Mo. UB[ APPRU` ED -. D 16 O ... ZON[A MY DAT[ L[ML CORRECTIONS D[iORIPTION I LOT NO. ■LOOK +•�� TRAITNO.Or RLDGM ■IZ[OF LOT NOW ON LOT D UNE OF NO.OF NO.OF f "IsTime DESCRIPTION OF WORK HEW ALTERATION ADDITION O REPAIR MOVING D[MOLIMH 0 i SFT. 680 RCOM■ MTmi" WALL WOOF r OCAFE RIM0 Q /V A J/ OV[RINO , NUILDIMM 1 H[RDY ADKNOWL[DO[ THAT I HAV[ READ THE■ APPROVALS APPLICATION AND STATL THAT THE ANOV[ 10 CORRE'OT FOUNDATION: LOCATION INBP[CT'OR DATE AND ADRI[ TO COMPLY WITH ALL COUNTY ORDIMAMDEN FORME,MATKRIAL15 . . AND QTATiC LAWN R[OULATINO ■UILDIND OOMSTRUDTIOH. FRAM[? FIRKMTOPSy ■IONATuRx OF ■RAOIN MOLT'S - ` QWH[R LATH,IMT.I ` AUTHORIZED ADT L �• 1l�L+Yr LATH,[XT.J oa-a uM itre s-� e P..II.• d`Q rLAWMK,INT. F[[ rL.AlTT'[R,"T. VALUATION p III FEE - TEMPLE CITY lick 76A636ACE 803 2-63APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE• COUNTY ENGINEER NEAREST , WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. J DISTRICT NO. G OUP TYPEESSED BY FOR APPLICANT TO FILL IN coNsr. - BUILDING STATISTICAL CLASSIFICATION WER MAP ADDRESS Sz -- BK G CLASS. NO. DWELL. UNITS �' LOT NO. BLOCK WATER NOT REQUIRED RECEIVED ❑ CERTIFICATE: TRACT �T G J MAP HIGHWAY STATE MAJOR SECOND, CAL NO.OF BLOGS. t`l0. (CIRCLE) SIZE OF LOT NOW ON LOT Z USE ZONE SPECIAL USE OF CONDITIONS EXISTING BLDG. � LE'7" E OWNER NBUILDING EXIST. SETBACK YARD HWY S REET NAME WIDTH ADDRESS `' FRONT ARCHITECT OR TEL.' P. L. ENGINEER NO. SIDE P. L. CL ADDRESS O CONTRACTOR NO. E ADDRESS Z f.C. DESCRIPTION OF WORK r' a NEVVW ADD ALTER REPAIR DEMOLISH SQ. F . Y NO. OF NO. OF - - SIZE Z STORIES FAMILIES USE STRUCC TURE SIGNATURE OF OF _ APPLICANT VALUATION SD© ,511, APPROVALS 17ATINSPECTOR'S SIG T, E 'C) FOUNDATION: LOCATION �y FEE $ �7 FEE S FORMS. MATERIALS 6 L FRAME: FIRE STOPS, ti► �, ���� 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS 3 Y � " AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS '�,M�� -.............d..r 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 CODE OF THE STATE OF CALIFORNIA RELAT. ING TO WORKMEN'S COMPENSATION INSURANCE. LATH. EXT. SIGNATURE OF HOUSE NUMBER COR. PERMITTEE RECT AND POSTED _ ADDRESS FINAL JOHN F. LEWIS. PRINCIPAL STRU URAL NGIJEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CA WORKERS'COMPENSATION DECLARATION insure,oroafcertif cafirm tharte of Workers' Comtpensat on eInsuran ent to lf APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING t tion department. ADDRESS ; Date Applicant CITY '. ZIP t LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' " NO. OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT I CROSS ST. (This section need not be completed if the permit is for one ASSESSOR 4 hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL OWNER NOUSE ZONE MAP V . I certify that in the performance of the work for which this NO. permit is issued, I shall not employ any person in any manner SPECIAL W so as to become subject to the Workers'Compensation Laws. ADDRESS CONDITIONS t/ t � Date `�,�;'. Applicant CITY ZIP } NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY Exemption, you should become subject to the Workers' ENGINEER NO. CONST. ZONE Compensation provisions of the Labor Code, you must forth- ADDRESS 0 with comply with such provisions or this permit shall be . TEL. STATISTICAL CLASSIFICATION APT. CONDO. deemed revoked. CONTRACTOR NO. I W 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 and LIC SEWER MAP 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 STORIES FAMILIES ONE VA�LI TION DESCRIPTION OF WORK NEW ❑ J Contractor Date ADD ❑ $ am exempt under Sec. ALTER ❑ s B.&P.C. for this reason REPAIR ❑ $ Y . Date: USE OF EXISTING BLDG. ) DEMOL ❑ + « z a " Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION PRINT NO. DATE l ) I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL 4 d Professions Code): By ,, BUILDING �nrl' ' t ❑ 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. �f 1, as owner of the property, am exclusively contracting CONTRACTOR NO. », with licensed contractors to construct the project (Sec- 4_0 w 9 " r tion 7044, Business and Professions Code). ADDRESS REQUIRED TOTAL SETBACKOM 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. tf f . (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name $ I.' ar P.C. Fee$ - Permit fee LDb1A Ref. # Lender's Address r ' 0 1 certify that I have read this application and state that the Issuance Fee a LDMA P/C# 5 above information is correct. I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee" LDMA Perm. # and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date � -- - 7 �- � ARRS'COMPENSATION DECLARATION hereby affirm that I have a ceftlflcate of con"nPlo — APPLICATION FOR BUILDING PERMIT nsure, ora certificate of Workers'Compenstlon Insurance,,or or i certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY tollcy No. Company BUILDING Certified copy Is hereby furnished. FOR APPLICANT TO FILL IN ADDS Certified copy Is filed with the county building Inipec- BUILD{NC tion department. fU F. C.� LOG111TY — NEAREST • Applicant CTTY L — ZJP I Q CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE of LOT 1 4 �ONO . - O �L MAP 5ESSORcR PAGE PA,t� COMPENSATION INSURANCE Is section need not be completed If the'permit Is for one 1 U ONE undred dollars ($100)or less.) T�cr � �� LOT NO,.. I'-2—p NO. m S >_ certify that In the performance of the work for whic Is OWNER �12 � h1 NO. 44 —Ol1. }' CONDITIONS Q rmlt Is Issued, I shall not employan person In an nner 0 GROUP TYPE FIRE BY U o as4CaET a msubject to theWorkers��Fw_[A y ° � v ££ S T' /� C—7p Jr� O CITY lr Cf(T r ZIP I ! O C}ate —Alicant A RCH T STATISTICAL 0-ASSIFICAPON AFT. DO. W JOTIIf, afteOR TEL r mak* thl Ce Iflcate of xemptlon, you should become sub ct t the Workers' ENGINEER �' C1AS5 NO. DWELL UNfTS N :ompenwtlon provisions,of the Labor Code, you must forth- �� gyy� Z vith comply with such of or this permit shall be teemed revoked. CONTRACTOR t 0 BK PG, VALDATION LICENSED CONTRACTORS DECLARATION UC. hefeby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION commencing with Sectlon 7000)of Division 3 of the Business and LIC. 'rofessions Code, and my license Is In full force and effect. CITY CLASS $ SQ. Ff. ? tVO.OF ` NO. OF Cl IEOC Icense Number Llc.Class SIZE J STORIES�t'I v FAMILIES ONE $ :ant ractor Data DESCRIPTION OF WORK O _ NEW �c�©0 I am exempt from the licensing requirements as I am aADD licensed archlt&d or a registered professional engineer t ALTER FINAL / acting In my professional capacity (Section 7051, REPAIR EJ DATE Buslneu and Professions Code). USE OF DEQ ❑ FINAL EXISTING BLDG. `L C Ii BY Ic.or Reg. No. Date APP+_K1,NfTEL OWNER-BUILDER DECLARATION (PRINT) NT NO hereby affirm that I am exempt from the Contractors License ' law for the following reason (Section 7031.5, Business and 6D I DRESS ofessions Code): -0 9 D 2 ° °0001 1 I, as owner of the property, or my employees with ADDRESS � wages as their sole compensation,will do the work and c ° 1 6 Q the structure Is riot Intended or offered for sale(Section LOCAUtTY o 0 1 6 (l 0 0 7044, Business and Profeulons Code). MOVING Ta. , I, as owner of the property, am exclusively contracting CONTRACTOR NO. ozr2'—.a.z with llcensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY SEEQU I YARD ice,BACY TOTALESETBACK FttOM hereby affirm that there Is a construction lending agency for FRONT e performance of the work for which this permit Is issued P 3097, Civ. C.). SIDE P.L. ender's Name r P.C_Fee S Permit Fee ender's Address certify that I have read this application and state that the Issuance Fee ,�Q bove Information Is correct. I agree to comply with all County nvedtgation Fee oil rdinances and State laws elating to building construction, `(p 6 Total Fee nd here4y authorize re sentatives of this County to enter pan the bove-ment property for Inspectlon purposes. SEE RIVEM FOR EXPLANATORY LANGUAGE SI ant or Agent .Dote my- L1--