The URL can be used to link to this page

Home My Public Portal About5319 GLICKMAN AVE_Building__ 76A638A CE#8038-64 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDI s 1 C��i l i�LiLlr /G' DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER •NEAREST J COLEMAN W. JENKINS,SUP'T.OF BUILDING CROSS ST. DISTRICT NO. IGROUP CONST. PROCESSED FOR APPLICANT TO FILL. IN ,+ BUILDING STATISTICAL LASSI FICA TION SEWER MAP ADDRESS .. � "�� CLASS NO. DWELL UNITS B P LOT NO. �-- BLOCK USE ZONE NMAOP �G� G Ls' TRACT `�9;, L-j �,� SPECIAL NO. OF SLOGS. [ CONDITIONS SIZE OF LOT �® 1 NOW ON LOT_ USE OF EXISTING BLDG. f/W �a�y „BLDG. SETBACK FROM f FRONT PROP. LINE OF �ajy��`� �1+ � (STREET) OWNE - T��`� � ,�IAf � ��/ TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS!i,� /y /e y- HIGHWAY WIDTH FROM C.L. CITY am?L-e �// i� C� - c'e.^✓ ARCHITECT O• TEL BLDG. SETBACCKK PROM M - ENGINEER SIDE PROP. LINE OF - (STREET) TYPE OF EXISTING SETBACK HIGHWAY -I- YARD - TOTAL ADDRES F-Ai XE�szr. HIGHWAY WIDTH FROM C.L. d TEf-. + = O CONTRACTOR NO U LIC CORNER CUTOFF YES E].'' NO O ADDRESS NO CITY CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS V W" DESCRIPTION OF WORK h Z NEW ADD ALTp REPAIR DEMOLISH ^ SQ,FT.= NO. OF NO. OF J 7" SIZE STORIES FAMILIES' USE OF STRUCTURE Ad c 7 N �J/(/ SIGNATUF i APPLICAN >e - VALUA $ ~, , APPROVALS DATE INSPECTOR'SSIGNATURE P.C. PMT. FOUNDATION, LOCATION FEE$ -- FEE$ 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 9UILDING CONSTRUCTION. 1 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 STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.U. CASH 1L'I SEP 20 2 14.504 I APPLICATION FOR Il BUILDING PERMIT FOR APPLICANT TO FILL IN ADIDRESS 6.�3/� BUILDING �^ ADDRESS S^ J / L AA ) LOCALITY NEAREST + CITY Cl ZIP CROSS ST. �..� { NO.OF BLDGS. +f ASSESSOR SIZE OF LOT (°� 1 NOW ON LOT ` MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE [allolE ESS�D Y TRACT 7 BLOCK LOT NO CONST. _ E OWNER NO. G STATISTICAL CLASSIFICATION SEWER P ADDRESS 1� k C—k tit Av CLASS NO. 2-1 DWELL.UNITS BK PG CITY ZIP USEZ NE MAP ARCHITECT OR No �/ 0 ENGINEER NO. r SPECIAL CONDITIONS ADD ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONTRACTOR . TEL. /i_ NO. /,5j G BLDG.SETBACK FROM A q FRONT PROP.LINE OF (STREET) ADDRESS ^Z S. AT-/"*v 7-IL NO. i�2(� _ TOTAL SETBACK FROM TYPE OF EXISTING L HIGH AY + YARD - FRONT PROP.LINE HIGHWAY WIDTH LIC. CITY CLASS e _ CONSTRUCTION LENDER ` , + a NAME AND BRANCH O BLDG.SETS U ADDRESS CITY SIDE PROP.LINE OF (STREET) 0 SQ.FT. NO.OF NO.OF CHECK HIGHWAY + YARD = TOTAL SETBACK FRO TYPE OF EXISTING q^ j SIDE PROP.LINE GHWAY WIDTH w SIZE JJ(� STORIES / FAMILIES ONE N ❑ + = Z DESCRIPTION OF WORK NEW Lin i- ADD CORNER CUTOFF YES ❑ NO E]ALTER ❑ IN OPEN SPACE YES ❑ NO ❑ CC ` REPAIR ❑ EXISTTIINGUSE BLDG,JtA AA_ Pto c L 4 DEMOL ❑ N COASTAL PERMIT ZONE YES ❑ NO ❑ APPLICANT (PRINT) I ER � 6� O. r- BY(SIGNATURE) I HEREBY ACKNOWLEDG THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY IWILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- PENSATION INSURANCE. y�[f SIGNATURE F FINAL BY PERMITTEE DATE ADDRESS G 7 NO. TEL. _6 CITY !M,- C> P.C. Fee$ Permit Fee Issuance Fee VALUATION$ (/ U Total Fee PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 1 8 9 - 6 9.0 0 dW OS Y6A69 E b�B'B'/7E- -- C-�3- - Yl Y6 WORKERS' COMPENSATION DECLARATION j I hereby affirm that I have certificate. of consent to self APPLICATION FOR BUILDING. PERMIT insure, or a certificate of Workers' kers' Compensation Insurance, or a certified copy thereof (Sec. 3800,:Lab. C.) COUNTY OF LOS ANGELESBUILDING AND SAFETY Policy No. Company El Certified copy is hereby furnishedBUILDING / . FOR APPLICANT TO FILL IN ADDRESS S f L E] Certified copy is filed with the county building inspec- BUILDING, tion department. ADDRESS l AyP /��f `� CITY ZIP ( /J R LOCALITY Date Applicant _ NO. OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS'. SIZE OF LOT (J t� • NOW ON LOT !® CROSS ST. 041 VE COMPENSATION INSURANCE ASSESSOR �d�� (This-section need not be'completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK oC PAGE PARCEL' hundred.dollars.($100) or less.) TEL. OWNE I NO. dJ°r' J ,� USE ZONE MAP NO. F certifyrthat in.th"e performance of The work for which this Al /' / � "p ]SPECIAL � is'issued, I shaILnot,employ,any erson in any',rganner ADDRESS,53/- Al C_ L-.(�t-1f4A CONDITIONSYe�mit o as to become subject to the Woy�k Co 3MM/ / '_ O _.�Qd f 7 U CITY 77— / ZIP Date SL Applicant ARCHITECT OR' TEL. O', NOTICE TO APPLICANT: If, after making-this Certificate of ENGINEER NO. DISTRICT. GROUP TYPE FIRE PROCESSED BY CONST. Z NE r Exemption, you should become subject to the. Workers' tV Compensation provisions of the Labor Code; you must,forth- ADDRESS Y p� with comply with such provisions or this permit shall.be TEL. STATISTICAL CLASSIFICATIONAPT. 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. SEWER MAP co' cmmen i ( .ng with Section 7000)of Division 3 of the BusinesLIC.s , and Professions Code and m license is in full force and effect. CITY CLASS e ec. VALIDATION Y BK. PG. SQ. FT. NO. OF NO. OF -CHECK License Number Lic. Class SIZE 120 STORIES FAMILIES ONE VALUATION Contractor Date DESCRIPTION OF WORK �l� NEW ❑ $ "Y G ADD Lv LLS 0 ❑I am exempt under Sec. � G _S/6 P.. ► �-` ALTER ❑ B.&P.C. for this reason T /Q f�QJ ✓L � USE OF REPAIR ❑ Date: EXISTING BLDG. DEMOL ❑ Signature APPLICANT TEL- FINAL _ OWNER-BUILDER DECLARATION (PRINT). NO DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL —Professions Code). PRESENT BY �� i•-• a ❑ I, 'as owner of theproperty, or m em to employees with BUILDING W0.-I a a Y P Y ADDRESS _ r wages as their sole compensation;will do the work and LOCALITY 3307, 59.25 the structure is not intended or offered for sale`(Section _ -7044, Business and Professions-Code.) MOVING TEL: , NEMS I,,as owner.of the property,-am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project.(Sec- TOTAL ' 59-25 , tion 7044, Business and Professions Code.). . ADDRESS c �� REQUIRED YARD HWY TOTAL SETBACK FROM. EXIST. CHEC t ;�7�4 CONSTRUCTION LENDING AGENCY SET.BACK PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT f,,;l-[�jNG .00 the performance of the work for which this permit is-issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. . Lender's Name yIU —� I� i m /1 ( ✓ LDMA Ref. N 5166 t Ail 9:56 � P.C._Fee$ Permit Fee 3 Lender's Address l� 0 1 certify that I have read this application and state that the Issuance Fee / ® V LDMA P/C# Poo.8 above information is correct. I agree to comply with all-Count Investigation_ Fee R ordinances and State laws relating to building construction, 1 Total Fee J /.� J LDMA Perm."# a and a auth rize represe ativ of this County to enter u n bov e n op i pec n urposes SEE REVERSE FOR EXPLANATORY LANGUAGE . * Signature of Ppl t or Agent Date Vv&RKERS'ICOMPENSATION DECLARATION hereby Jself acmtifateof Worke ' Compensata certificate of ion InsurnceAPPLICATION F®R BUILDING P E RM I Toa or a certified copy thereof (Sec. 3800, Lab. C. �� COUNTY OF LOS ANGELES BUILDING AND SAFETY PolicyN6J9 Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS 9 L�( -� Certified copy is.filed'with the county buildin linspec- BUILDING J tion depor menf: sl ADDRESS`. — Date. W Applica 1 �G CITY ZIP /9� LOCALITY ERTIF CATEOF EXEMPTION:. OMI V,ImitSis R ' NO.OF BLDGS: NEAREST. COMPENSATION INSURANCSIZE OF LOT NOW ON LOT CROSS S7. (This section need not be completed if the for one ASSESSOR hundred dollars ($100)or less.) TRACT BLACK _ LOT NO. MAP BOOK PAGE. PARCEL TEL. �5 � USE ZONE MAP / �) I certify'thai in the performance of the work for which this OWNER / �G NO. ci NO, l ✓ 9 permit is issued, I shall not employ any person in any manner ADDRESS 6/ /� / —1 SPECIAL 0 so as to become subject to the Workers'Compensation Laws. "` UU CONDITIONS Date . Applicant CITY 2 ZIP W. NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR / EL• DISTRICT GROUP TYPE FIRE PROCESSED BY ENGINEER CONST. ZO E U Exemption, you should become subject to the Workers' W Compensation provisions of the Labor Code, you must forth- .ADDRESS v��3�✓ /// ��/� J`v(� r� V - - `� - with comply.with such provisions or this,permit shall be _ deemed revoked. CONTRACTOR STATISTICAL CLASSIFICATION APT. CO O. ' - Z LICENSED CONTRACTORS DECLARATION , LIC. y ` CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS/,5I�ZCJ NO. (commencing with Section 7000)of Division 3 of the Business and _ LIC ,a SEWER MAP Professions Code, and my license,is in full force and effect. CITY � %� CLASS(� BK. PG. VALIDATION a y , v/ SQ. FT_. NO.OF NO.OF CHECK License Numberf �1)tA ; Lic.Class (!� SIZE STORIES FAMILIES ONE VALUATION Contractor r [ Date.1::3./S7/0DESCRIPTION OF WORK ; �� EW ❑ $ ADD / (✓' � 1 628A I am exempt under Sec. �� 00111. ALTERf o • • • 2 3 B.$P.C. for this reason REPAIR ❑ $ • • 37,50 Date: EXISTING BLDG. DEMO' ❑ USE OF � U- - '® ® • 3'7,50 Signature APPLICANT .r TEL. . FINAL,. '7 g OWNER-BUILDER DECLARATION (PRINT) Npj c:S— — DATL3 -�� 0 3.0 5.-85 I hereby affirm that I am exempt from the Contractor's License Law for the following-reason (Section 7031.5, Business and ADDRESS FINAL Professions Code): PRESENT B ' 1 629 A BUILDING 0 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. ® ® a 4 O 5 0� I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS 0 3,0 5—8 5 tion 7044, Business and Professions Code). REQUIRED . TOTAL SETBACK FROM EXIST. 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. - (Sec. 3097, Civ. C.). SIDE P.L. _ Lender's Name �j LDMA Ref. # — P.C. Fee$ Permit Fee Lender's Address poll w I certify that I have read this application.and state that.the �. �® - Issuance Fee E LDMA P/C#- above information is correct. I agree to comply with all County Investigation Fee I ordinances and State law relating to building construction, Total Fee � )6 LDMA Perm. # u a ere authoriz rep4esentatives of this County to enter pan the a .ove-me- ion d property for inspection urpos �. �iC' SEE REVERSE FOR EXPLANATORY LANGUAGE Signa/ a of A hcant or Agent Date