HomeMy Public PortalAbout10941 FREER ST_Building__ 7&A@36. CKjObS WX7 APPLICATION. FOR BC)ILDING PERMIT �..
CV NT' OV LOS ANtrt.i.M 9UIL.DINO ,
DEPARTMENT OF COUNTY ENGUMM ADDRR"
BUILDING AND SAFETY DIYLSION LOCALITY
JOHN A.L,.AMBIE,COUNTY IENGINESR N.E REST ,l �
CAR&ATT n GRIFFIN Curr of HuiLmmcs RO
DISTRI NO. G OUr .�,� SEYVER V"
FOR APPLICANT �O FILL IN Bx ,
N
QUDRESH ILDING ATISTICAL CLSBSUPICATION -
�
LOT NO. BLOCK CLASS.NO UNI
'MAP SI ATE YSE
NUMBED htWY
TRACT U%670AE U%67HF Cl
NO.OR BLDGS. - CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF VL- Q�d
BUILDING
SETBACK YARD Y HW8TREI{rNAJoM IST.
►.CSr � �j� _ WIDTH:
OWNER FRONT
ADDRE18 ��/'` 4� �PJ�I f ► QIDE
CITY No -
ARCHTHL IPNSPECTION RECORD
ITECT QR
ENGIN$ER NO. ,
ADORE"
T'E L
CONTRACTOR C NO .
'DhSCBEMON OF WORK
NEW ADD RETAI DEMOL1814 _ -
,SQ.PIT. H -O NO.OR
SIZE STORIES FAMILIES'
USE Olt STRUCTURE
SIGNATURE OF _I' APPROVALS
APPLI
+� 1lIDPE IV53IOl1A7URE
ADDRESH /2 ��L fOUNDATION; LOCK ION " ..
FORMS MATERIALS
P.C. FRAME: FIRE STOPS.
BRACING,BOLTS
-VALUATIONS URNACE: LOCATION.
GAe VENT____DUCTS
D HTREOY ACKNOWLEDGE THAT i HAVE READ THIS AP- L;kTH INT.
PLICATION AND STATE THAT THE ASO V7'}S CORRECT AND
AGREE TO COMPLY WITH ALL.COUNTY I C¢�$g AND
STATE LAWS RE6U NO ILDI G RUC I'I LATH,EXT. -
SIGNATURE OF HOUSE NUMB$R COR
-
PFLiRMI ��•• GT AND POSTED?
ADDR -� Wil. l7NAL
JOHN A.LAMBIE.COUNTY ENGINEER. CLYDE;N.DIR M PRINCIPAL StRu RAL E.NGIN8X!
PLAN CE=VAILDAX= ar- hLo. CASH PEBWr VALMATIO39 mo C.Alw
TE ALE CITY
r -
79AG38A cr.#80}1-61 APPLICATION FOR BUILDING PERMIT
Y
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DMSION LOCALITY v L c
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST.
DIS ICT pw� GROUP ITYPE SSED BY
FOR APPLICANT TO FILL IN d �S CONST.`�
ADD BUILDISS T r��E� STATISTICAL CLASSIFICATION KR/MAP
CLASS.NO. , DWELL.UNITS `T
LOT NO. BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE: /�
TRACT NO.OF BLDGS. No
-� � (iCGRCLE)HWAY STATE MAJOR SECOND, LOCAL J
SIZE OF LOT �J P I NOW ON LOT USE ZONE SPECIAL
USE OF �: CONDITIONS
EXISTING BLDG. - `
TEL.
OWNER r - f NO.^ - BUILDING EXIST.
SETBACK YARD HWY STREET NAME WIDTH
ADDRESSfye_(_ FRONT
ARCHITECT OR TEL. P. L.
ENGINEER NO. SIDE
P.L.
ADDRESS INSPECTION RECO
O
TEL.
CONTRACTOR NO. U
ADDRESS Q
DESCRIPTION OF WORK
W
CL
NEW ADD v ALTER REPAIR DEMOLISH Z
SQ.FT. r//..�� NO.OF NO.OF A
$IZE J V STORIES FAMILIES / o
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATION$ / 7
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. ) FOUNDATION: LOCATION -
FEE $ '7 FEE $ FORMS,MATERIALS
FRAME: FIRE STOPS, s ;,
IHEREBY 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 rj
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 CO PENSATION INSURANCE. QN-' l r
LATH,EXT.
SIGNATURE OF HOUSE NUMBER COR- 'L 7- --
PERMITTEE/,� P? "G RECT AND POSTED
ADDRES$/o!7g lzAa, FINAL
CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL EN R
PLAN CHECK VALIDATION cv- M.O. CASH PERMIT VALIDATION cK. M.O. CASH
W4ERS'jCC IAPEN5ATION DECLARATION
- ., l iuUre , that I have cert Come of ro�.nt ro >�� APPLICATION FOR ,BUILDING , PERMIT
Insuro, or a certHlcote of Worker' Compensation Insura7iu, ,
or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Pollcy.No.: : Company
CertHled cbpy Is hereby furnhhed. r' FOR APPLICANT.TO FILL IN App� '
E] Cert Hied copy Is filed with the county building Irap*c- auiLbitib (l
tion deportment. ADDRESS
Date App It co nt crry ZIP LOCALh 1
CbnFKA1E OF F MWnQN FROM WORIgRS'. NO.OF NEAREST
OQMPENSATK W I NSU RANCE SIZE OF LOT NOW ON ST TA
(Thh on Geed not be corn leted If the parrinit Ys for-one �.
hurm� dollaq(1;1-00}o{ lest - TRACTBLOdc tC7f AAAF BOb1C - PAGE ' PAkC,a
OWNER r o. 1/�/ usa OnF
F rectify that In.tfine,performance of the korrkipr wl5ich this. ►p,
permit is rssued;I II not employ any hl nner , S
so as to' me b�ect to the WR
�.� PDcft tl
NO O A�pl ret a ng th s Cai itficate of AFK}iRECT bR NCO. ISRGFRUP. TYPE BY
EX*m on, 'you should :-sublect to the Workors' QQNEER
cdmperswtlbn provlllbrls Labor Code,'you must forth y J
with. co{npfy wttfm,}uch provl.slons or thl4.permFt shall be _
deemed ked.. u T STATtShCAL
TION AFT. fn
COWMAC:TOR Z.
LICENSED CONTRJ4CTORS DECLNZATKSN,., , LK: .. CLASS Nb. bwai. UNITS
J hereby affirm that am I"need under provbloos of ChapW 9 ADDRESS No.
(commendrl with SoOlon.7000)of Dtvisior,3 of the Busher and. MAP
Ptofeulorn Code, and my Ilceose is 1n fulr force and effect, CITY '' CLASS � �
OR
SQ.'FT DF CVO: C�iEO(
LlcenwNumber, Llc. ea S✓YF - CSf�
Contractor ,pate " DUCO PTIONOF 41 ,6",6w
;µUA7110� DD O
-ADC)
I am exempt-under Sec.
ALTER
B.&P.C. for-this roason --- — rL - REPAIR . _
_ Da». ENDO DEMO(
C)F
Slgnaturs
OWNER$UILDER DECLARATION I
.1 hereby affirm that I am exempt from-the Contractoep Llto tw
.Law for the following feasor*CSectloh 7031.5, Busher and-
Pro
nd _
ProfewIons Cod$)i
BUILDING i
I, as owner of the proppeerrtyry,� or my employees with ADDRESS
wos es as thelrsgle tomponshtlon,will do the alo'q. 8 b�mO A
the structure Is not Intended or offered for �Ile70+1 , Bwlner grid Proferloha Codo) MOVINGTEL 1, as owner of the property, am excluslvblytraACTOR with Il-:41bontractors t4-contftvd the pct (Sec
tion 7044,-Builnea'and Fraf000nsCode). r !�ADDIRM ° 1''9{1,7 5
CONWRUCnON LENDING AGENCY
YARD
I hereby affirm that then Is a construction leading Ctpenry for FRONT
the performance of the work-for which this permit IsiasC"ed P o5•Iit.a`7
{Sw-,3097, CIv.C.}. SIDE Q
P.L.
Lenders Name
LDMA Ref.!'
$ Lenders 4ddres} P_C. Fee= Permk Fee
I certify that 1 have reod'thls application and state that the lauxxwe Fee 9.s—o LDAM P/C* ti
g above Information Is coned. I agree to comply with all County Invesripdtlon r-"
ordlrancp and State krws reWng to building construe4on, Total -75 Perm. / 1
and hereby authorize representatives of this County to enter �.
upon the loned for,lnspectbn
o
SO WMM KW EU"MTORY MMWA04
of ApplkQ+t or Agent
;r-A WORKERS'COMPENSATioN bEC1.ARATION „ -
byaffirm fi a, I'have k&n' om of ron..nt to self APPL-ICATION., FOR ,B IJILDINC" PE•IZMITInauro, or a ceritflcate of Worker' Comperiwtlon Irnurgnce, _or a'certified copy thereof (Sec. 3800, b. C) - -
COUNTY OF LOS ANGELES, BUILDING,AND-SAPM r l
PolIcy,No_ Company. • ' twRDRdO - -
• Certtfled copy,is hereby fuml}hed, . .. FOR APPLI NT-TO FILL IN -
�SS
Certtfted'co6ent filed v/Ith'fhe 2ouaty tiiilldlrig inspec- BUI tJG O 7 -
7 ,
floe_dipartrrient. ADDRESS jj
Date Applicant' ar' CITY 4 t Z,P' L^ ,Z LOGALMY -
"" CE3MFIC`?1TE OF Bffi TION fROMWC)RIORS' _ t _ .OF BLDGS.- NEAREST....._ -
+-+ COMPENSAT-EON I NSU RAf SUI OF LOT NOW ON L T ST.
(lilb'sectlorrheed not be cam leted If the permlrJs for one - - - - �.- _-
' ARCEL
hun,dfgd.dollar;($100)or letFs w,.. TRACT T NO. MAP BOOK PAGE P
USE /�
OW S2 E N0. (/� h.1 J'-}
I tlfy chat In.r�e Per'for4rTarice of,ihq.wor for whlc�,thIs _
If fi isstldd, s+fa�l not elnpfdy any. n In any manner, _ SPECtiD41
. _.. . Pbt�°• A> - cS MONS I
to I eCotne sUb16;t to tfib Work" 'ComPgflvatlon L"m f j
'
DaAppllcant �T/ ARCH ITECT -
NOTI TO.APPLICANT:-af, aftel thli Certtficafe of ,NO DI$TRICi GROUP. TYPE iCONST_ _ r f3RV _ r BY_. . .,
�C1cem nsaZONE
ronoh pro old become Cc>djecf i y o' W forth-
ADDRESS
616 R 3
tom nsatfoh vlslorn of'the Labpr Code,• u moat forth
with.compiy•wttkn,su&r provlslorts or7.this,permit shall be - -- TEi- - . - ,
deemed,rpvo4cpd_ STATISTICAL CL SSI TION ;. AFT. - r
,, i. 1,.:,, ''•• CONTRACTOR �` NO. �1.._
___
LICENSED tONT1fACTORS D3 C1ARATlOf`L CLASS NO. DVYELI_?UNrrS
I hereby dffltrn that am Ikgnsed under prpvislpns of Chapt+r 9 ADDRESS NO.
(comme�xJng w)th f(°n 7000)of Dlvtifon or a Buslnesi and - _ _ -._ -__ _. -LC - :_ --• __ -- SEWER MAP 11
Profesilorn,�oderand my Iice rise Is'frijuIHolxe an$•e�fect CITY CLASS VAl3aAT70N -
o •l, .;,'. CH
Bk .. PG. "r
5Q FT, NO. NO Cf
L��errie`N'u`mbei ' L.c_Class - SITE — S'iC ftI F LB. .. ._ �
•_ �. V TION .
Contractor ;•�s c - DESCRIPTION OF'WORIC - - NEMr - ;
V Y'
I arTr exempt under Sec _ •tt' .
- kms•. . C.-T �� 1 �. _ #0.0 0,°_°_1_
B.&P. for'thIs reason' _ �. REPAIR - -' - -
-
USE OF r DEMOL
EXISTING'BLDG. -. .. .
_ /� G
51Qr1ahjFe - - I�NAL P a o 4 X.0..6 '
owNER-BUILD(:R DEaARATION' _-, -. _ T _ _ BATT a __
L affirm that.)-am from.the-Conh doesLcansq - ' - - /�
hereby Pt ADDRESS -- - r ,`) �ya•� 8.'t.
Law for the follo,#yi4rbcrsbn_(Sectlon 7031.5, Business and ~
PtofwLorts Ctsdli�'._ .,_ - BUILDING ,
WWI
I, as owner of the propirty,.or my emplpyees with ADDRESS
wagei as tfitlr sole comperuaflon,wlll do the w&'k and.
the structure•Is not Iptepded or offgred for sale(Section''' TEL
Bvalner'and frofeaslon�Codej _- - W0Y1 _-. — -
I,as owner of the property, am exclublvely'coptractln¢ CONTRACTOR NO.
w" Ilcerabd-contractors-to construct-the Project (Sec- - ADDRESS
tlpn 7b44, "mess and Professions Code). f
'CONSTRUCTION LENDING AGENCY' -TOBy,,pf YARD IfwY' PROP. UNE WTDTi1 - -,-- -
TOTAL SETBACK M^
I hereby Arm that them Is a construction lending agency for. FRONT i
�-the,performance af.the work for which this permit•Is-Inued - P L - —• - - - - _
(Sec 3097, tiv. G� SIDE
P.L.
' Lenders Name -' O .* f f.
Lenders AddresA P-C Fee= . . . - Perms Fee _ Ref
2^ _ sF
I_cgdtfy.lhat.l have read this Jippllcatlon.and:state that_the lssuanceFee a -LD&%kP/C-#.
above Ipforrrxrtbn h correct..)agree to comply wNh'all County Invest) -. �_-_ __ _ -
ordlnancys ar State_ - relatlr�g fP byllctin �qyp -gLlgn. T Tow) /r tflAkA Penn. f
and herdby outho esentatives of thts•County to enter
upon.thal v ed property for Inspec•tion'purpoees..
f✓■MVVM=PM M04ANATORY lANGUA04
I m
�, IlmMpr•Apent- -- ---. Dab ._-�_.._ _ _ •- -. _ --. -- - - _ _ '_ __ .-- -- _ .. _ ._. .. _ r