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Home My Public Portal About4910 GOLDEN WEST AVE_Building__ APPLICATION. FOR BUILDING PERMIT _ Z DrMON OF BUELDING AND SAFETY Q . 76 AMORESS Dopmimeat. of o>nat7 EaQtn�ac Co+2t7 of 2 'AnQ�l�s LOCALITY WM.J. FOX. rOOLINTY ElIaINtQi NEAREST CASBATT D.aR1FFIN,'SlU#'t OF BUILDIN4,- CR08Ji BT. FOR APPLICANT-TO. FILL IN DIcrRI No. aRour- TYPE H OK MAP BUILD LNG _ CONST ADDRE96 a y+ MAP b r STATE .yu . NO NUMBER HWY LOT NO. BLOCK USS ZONE SPECIAL CONDITIONS TRACT - _ A- ' NO. OF BLDGS, - 1----_' 61ZE•OF.LOT .J J V' NOW ON LOT BUILDING YARD HWY STREET NAME EXIST. USE OF 6ETBACK - WIDTH EXISTING BLDG. FRONT P. L {! W OWNEgo BIDE 3 MAIL '. ADDRESS .` TEL "r &10' I DWELL 1 UNIT a INDUSTRIAL .CITY V NO. 2 DUPLEX-, UNIT� 6 PUBLIC BLDG ARCHITECT OR - TEL, - ENGINEER NO_ 3, APT-UNITS 71 ADDN.,ALT., ADDRESS' 4' COMMERCIAL B MINCE - CONTRACTOR NO. UTSP=6N M=Bb ADDRESS - DFSCHIP'IION OF.WORK NEW ADD TER REPAIR DEMOLISH - 130. FT. NO. OF NO. OF SIZE STORIES FAMILIES _ USE OFVTRUCTURE F ^ r SIGNATURE OF APPL I CAM APPROVALS LZ DATE IN,SPECTOR•$ SIGNATURE FOUNDAT pN:LOCATION r.C. S eORM. UTERI10 ER FRAME: FIRS STOPS,BRACING BOLTS S 04 FgE FURNACE: LOCATION. GAS VENT DUCTS _1 HEREBY ACKNO EDGE THAT I A EAD THIS AND T ICATION AND COMPEL WITHAHALL COUNTY ORDIINANCrHE ABOVE 16 QORKIK S$ LATH INT.-AND STATIE LAWS REOULAI G BUILDING RUG TION. LATH Q(T. . SIGNATURE OF HOUSE NUMBER COIF. PE MITT6S RECT AND POS® AD D RE FINAL VV�L J. Fox. coumT K"Qwz= . VALIDATION *Y b�UTY 1.0 0-'. ev BY. D EP UTY� C mp.UTy APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) =SS COUNTY OF LOS ANGELES k"i.� .�: - DEPARTMENT OF COUNTY ENGINEER CITY/ ZIP �'�7 � � BUILDING AND SAFETY DIVISION 11l�.�3 K i� � NO.OF B BUILDING SIZE OF LOTo NOW ON LOT ADDRES TRACT-1- �7� BLOCK LOT NO_ LOGALIT TEL �+-� �/ NEAREST OWNER usNOCROSS ASSESSOR ADDRESS Q Coaj b MAP BOOK PAGE PARCEL f! e _ g +� DISTRICT GROUP TYPE FIRE SED BY CITY Ciw� K '�+i ZI t � :j CONST. Zp " ARCHITECT OR TEL.ENGINEER NO. NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NO�_DWELL.UNITS EBK�PG CONTRACTOR NOL'USE ZONE MAP NO. ADDRESS NO f,. SPECIAL CITY LIC. 72a u CONDITIONS CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ CONSTRUC ON LENDER NAME AND BRANCH BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET) ADDRESS CITY _ TOTAL SETBACK FROM TYPE OF EXISTING NIG WAV } YARD HIGHWAY WIDTH SQ. FT. . NO. OF NO. OF CHECK FRONT PROP. LINE SIZE 7j.S STORIES FAMILIES 'ONE n } = 6r DESCRIPTION OF WORK NEW 1- U ADD )Z BLDG.S BACKFROM Ce c SIDE PROP. OF (STREET) ALTER ❑ HIGHWAY } YARD - T K FROM TYPE OF EXISTING U REPAIR❑ SIDE PROP. LI HIGHWAY WIDTH LU USE OF } ,,..�� = N EXISTING BLDG. �✓<�C� DEMOL [:] Z AP PRIN PLICA -J_ _ Np > x� CORNER CUTOFF YES ❑ NO ❑ BY (SIGN IN OPEN SPACE YES ❑ NO ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S CO PE ATIO N SIGNATURE O PERMITTE TEL FINAL BY CITY )tZ-- �� N0. DATE S1AKE CHECKS PAYABLE TO: P.C. PMT., FEE FEE HARVEY T. BRANDT, COUNTY ENGINEER PLAN'CHECK VALIDATION CK. M.O. CASH _ HERMIT VALIDATION CK. M.O. CASH' 76A638A CE#803 574 - PARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT r COUNTY OF LOS ANGELES S U ' L ® ' N G WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING DISTRICT NO. PLAN CK.NO. PERMIT NO. C� �j �� .•, ADDRESS //t;l _.. LOCALITY RECEIVED BY DATE OF APPL. DATE ISSUED NEAREST - QL e ' CROSS ST. BUILDING OWNER . „„ ADDRESS MAIL �� / �!� ` „� LOCALITY ADDRESS !w. rY /r .r, r. NEAREST TEL. -�*. CROSS ST. CITY / NO. FIRE NO.OF TYP _ GFjQUP ARCHITECT OR TEL. ZONE PLANS % 'rv` / ,ENGINEER ti % NO.. lll��lll �! _ BLDG. ORD.NO. ADDRESS SETBACK LINE — APPROVED TEL. BY DATE CONTRACTOR NO. USE �/( APPROVED ADDRESS _ ZONE ,i - 1 BY DATE LEGAL DESCRIPTION �L/OT NO. • I BLOCK �'- _ CORRECTIONS TRACT y /"7 f NO.OF SLOGS. SIZE OF LOT NOW ON LOT USE OF NO.OFNO.OF EXISTING BLDG. I FAMILIES I ROOMS DESCRIPTION OF WORK NEW 'r ALTERATION ADDITION A REPAIR �/ / MOVING DEMOLISH S Z � _ET A.), f '4_ ROOMS STORIES s D WALL ya ,+� `- ROOF �.�r • n -- r COVERING COVERING _T USE OF NEW BUILDING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ TH19 APPROVALS__ APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION •r- NSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS I f- AND STATE LAWS GULATING BU GING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE OF BRACING,BOLTS w PERMITTEE • — LATH,INT.: AUTHORIZED AGT - LATH,EXT.: Des-3 sore SETS 7-17 $ P.C. O PLASTER,INT. �6EXT. VALUATION �� - - FEE I ` DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES U ' L D I G 1 WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING DISTRICT NO. PLAN CK.'NO. PERMIT NO. ADDRESS l//' � (/ �(mss-- ..ate"_' 1 '-2 C LOCALITY RECEIVED BY /DATE OF APPL. DATE ISSUED NEAREST UJ,�G, CROSS ST,. D i BUILDING -y- OWNER ADDRESS MAIL ... LOCALITY C a ' ADDRESS (/Y/ NEAREST .'/ CITY '�TEL ' 7CFIRE NO. OF ROSS ST.' I PLANS I TYPE-�- I GROUP ZONE ARCHITECT OR TEL. ENGINEER NO. BLDG. NO. SETBACK LINE ADDRESS APPROVED ! (.., TEL. BY DATE CONTRACTOR (,./N �-i NO. USE APPROVED ZONE /BY DATE ADDRESS HOUSE NUMBERING LEGAL ,LD CHECK BY DESCRIPTION I LO;NO. I BLOCK MAP NUMBER FI TRACT /3 � -NO-.--ASSIGNED BY ❑ATE NO. OF BLDGS. CORRECTIONS SIZE OF LOT40 f ' "' NOW ON LOT USE OF NO. OF _ EXISTING BLDG. I FAMI L., DESCRIPTION OF WORK NEW I I ALTERATION I I ADDITION I r ZAr LST/ /,ten. ;.iC'ixll O REPAIR I I DEMOLITION FT. NO. OF SQ.ME ROOMS STORIES - D EXT. WALL ROOF • ° r COVERING r G f/ I COVERING, USE OFSTRLMTURE APPROVALS INSPECTOR'S SIGNATURE DATE 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FOUNDATION: LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS CORRECT. I AGREETO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS, HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS LAWS REGULATING 3J' LDING COPSTRUCTION. 1 FURNACE: LOCATION, SIGNATURE OFf4A GAS VENT DUCTS PERMITTE LATH, INT. ADDRESS DD / - LATH, EXT. AUTHORIZED AGT. PLASTER, INT. ( f• 7GAcaaA• ossa to-so $ / P. C. $ �. y t FEE PLASTER, EXT. VALUATION ' FEE ffiS'� FINAL f I j ' 'N31ZI(ERS' COMPMMT1ad-DECLA2ATION - hereby Oirm that r hd*I a t�TCom of consent .r self APPLICATION FOR BUILDING P E RM I T Inkire, orb cert7ficat• of�Fbrkers Comperisatlon Insurance, orLtcetttfled copy thereof (Sec. 380D. Lab. G.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified copy Is hereby furnished.. FOR APPLICANT TO FILL INEl �� ADD KESS Certified copy•ls filed M. the county bulldlno lnspec A BUILDING! 4.9i0 OJOL`UEr.1 WP-STAVP_ : tign department. p,� pp Dane. Applicant CrrY TEMP6& CI?Y ZIP CA •91'MC> LOCAllTY No.OF T CERTIFICATE OF E(E PT1CNJ FROM WORKERS'' s¢�'OF LOT '6/-S X ASO NOW ON LOT CROSS T COMPENSATION INSURANCE ASSESSOR (This section need not be comleted if the permit Is for one TRACT BLOCK LOT NO.' asp BOOK PAGE pq hundred dollars (;100) or less: OWNER r 1 CH A E L A. YU RCEL TEL C8187�86-3� USE MAP I certify that In the performance of the work for which this Q -211 AL permlt Is Issued, I shall not employ any.perwnln any manner• ADDRESS 4-910 Esour, &4 WEST A.V2 . (�K ''1 ` CONSPECD so as to become subject to the Workers'Compensation Laws. r COfDffIONS O Darte-1 �4 j�`1 MICAML_ A • -fU AR 7ECT O°PL£ CfTY �p CA .41Tb4 :od El NOT Applicant ENGINEER TD DI GROUP TYPE RE BY O NOTICE TO Aou. If, after Making this Certificate of {lo. J, aMST. 4 Exemption, you. should become object to the WorkersV Compensation provisions.of the labor Code, you must forth- . ADDRESS with comply with such provisions or ,this permit shall be TEL TFON APT. deemed revoked. CONTRACTOR NO. — UCENSED CONTRACTORS DECLARATION uc CLASS No.. UNITS I hereby afflrm that I am licensed under provisions of Chapter 9 ADDRESS (commencing with Section 7DW)of Division 3 of the Business LIG d Professions Code,and my license Is In full force and-efiect. Crry CLASS Br- fr� PG7 9� VALIDATFON SQ. FT. NO. OF NO. OF CHECK License Number Llc CIas4—T SIg 1//� STORIES 2 FAMILIES ONE _ VALUATION Contractor j3ate IPnoN of woRK AVD- FAMILY NEWrZ❑ ;AM v0 ❑I am exempt under Sec. MASTAk SEVROOM, A, '1 ER— EP RN4111 ALT ► ALTER B.BP.C. for this reason RM,A,43) R40r- REPAIR❑ $ Date: USE OE. EXISTING BLDG, DEMOL ❑ Signature APPUCANr. TEL FINAL OWNER�BUILDER DK-LAMT16N I DATE I hereby affirm that I am exempt from the Contractors License Law for the following reason (Section 7031.5,.Business and ADDRESS FINAL � �3 _ Professions Code): By BUILDING ❑ I as owner of the property, or my.employees with qppRESS wages as their sole compensation,will do the work and �, (may I7 the structure Is not Intended or offered for sale(Section [Inyiielgaflon rrY , ;` . . 7044,Business and Professions Code.) G TD- ® I, as owner of the property, am exclusively coptracting ACTOR NO. ", _ - 1 ITEM 409 -28 3 with llcersed contractors to construct the project (Sec- SS -TOTAL tion 7044,.Business and Professions Co0e.) EXibi- CONSTRUCTION LENDING AGENCY MIS YARQ HWY DECK . 4W.28 I hereby affirm that them Is a construction lending agency for NT CHANE _ •00 the performance of the work for which this permit Is r{aued (sec 3097, civ, C,). P.L. 4 f •0000-MIO yyy �y i2 Lenderf Name q -� "i' 000D-MIO1 171/MG�F/� Lender's Address M 1• Pertnit Fee . yh ,r} 1 Ff 111 7 I certify that I have repd this application and state that the lmxmce Fee P/C i , above Information Is correct. l agree to comply with all County Fee ' ordinances and State laws relating to building constructlon, Total FM LDMA Penn. and hereby authorize representatives of.this County to enter upon the abovo-mmentioned pro for Inspection pu x{s!{j/]( ^ Ln Cn 7f�i(+"7 tE RaVusa POR ZM ANATanw+GUUAGGovwv+� a ►-` Slgrwt�Afp,11td5�.ncr!!AVant Date r