HomeMy Public PortalAbout4940 GOLDEN WEST AVE_Building__��' ��- . - ��" - A P - L I C A T I O N F O R B U I L P I N ( ' P E R M I T
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DEPARThIM OF COUNTY ERGO=
DIVMON OF BUILDING AND SAFETY BUILDING
COUNTY OF LOS ilPGMEB
V6gL -" J. FOX Couxrr ffmammR APPLICATION
CASSSATT D. WUP?nN, SUr'T Of NUIL3l MG
FOR APPLICANT FU IN FOR OFFICE USE ONLY
DISTRICT NO. PI Am Cx.on Rsa.No. Pl"IT NO.
eu1LDIMa
AD
RECEIVED NY DATE OF APPL- DATE ISSUED
NKA U92T
CAQW 8T. fU1LDINa
OWN IDR /A-) ADDREM
MAIL LOCALITY��
ADDREM M.T
TEL CROSS
ARCHITECT OR TEL CITY NO. FIRE NO. OF TYPE QRP;
EttaIK H I&" L ZONE PLANS d
BLDG. Ai
7ZLZS
N
SET
CONTRACTOR L.
SY TE
C I lPe 5; HO NUY INa t
L4.
� L ✓ KAP Nu a . ASSIWCM MY,Ex I's
D ESCR I O
R COBHEClIONS
TRACT 0 s Tp
No. of.L.,...
•ru of LOT S ON M 3 -->
Utt OF MO. OF
3� csr
DESCRUyf= OF WOB= cf.
REPAIR DEMOLITION _
SQ. FT. NO. OF NJ ILN
SIZE ROOMS STORIM
EXT. WALLROOF
COVERING Coymmics
USE OF STRUCTURE
/U`
APPH
INNPECTO •IaNATURE DAIX
FOUNDATIONS LOCATION
FORMS, MATERIALS
I HEREBY AC3CMCWL.MQE THAT 1 HAVE READ Tula AP- FRAHsi FIRM NTorS,
PLICATION AND STATE THAT THE 1PUORIIATION GIVEN 10 BRACING BOLTS
CORRECT. FU RNACE LOCATION,
1 AW" TO COiQR.Y WITH ALL ORDINANCES GAN VENT DUCTS
AND STATE L.A111fS REQLMTINa iU0 D1 UCTION.
SIGNATURE OF LATH, LNT.
rwmrrrm
LATH. m[r.
ADDRESS
r1ASTtFt, LNT.
AUTHORLZED Ata'T.
PLASTER, KXT.
�j P. C. S gi HOUSE NUMBER COR-
�aIpp
FEE
RECT AND rOSTm
VALUATION FEE S CJ F04AL
76Ai&SA DIS& ♦Si ,
„._ r'bEPARTMENT OF B=ING AND SAFETY APPLICATION FOR PERNn
COUNTY OF LOS ANGELES BUILDING WM. J. FOX, CHI” xNGINmxR
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PLAN CIC. NO. PERMIT NO.
ADS IK" D16&WS S G'�i �/3 IZ
LOCALITY RCEIVKD BY, DAT[OF APPL DATE ISSUED
NEAREST (_
CROlS Q B d BUILDING
ADDRX08 Q, !7
OWN[R ,
MAIL �� LOCALITY -e f
ADDRESS !V NgAR gB7' .
.�. , CR08S ITT.
CITY HOFIRE N OF TYPE /• GROUP J`
ARCHITECT OR. TI<L ZONE rl-.✓••NB ��/ rf•
ENGINEER NO. BLDG, ORD. NO.
SETBACK LINE
ADDRESS APPROVEDTILJ ..
BY DATE
CONTRACTS USE APPROVED
ZONIK BY DATE
ADDRESS r HOUSE NUMBERING
L[GAL
DESCRIPTION I-OT NO. BLOCK MAP NUMBS �R1�D CH[CK BY
TRACT NO. ASSIGNED By—
Ora
Y
• NO. OF BLD GH. CORRECTIONS
SIZE OF LOT NOW ON LOT
U8E OF NO. OF
IXI*TING BLD0. 0 (f/ FAM LL"
�B6i►r �o
DESCRUMON OF OHL
NEW ALTIRATION I ADDITION
0
REPAIR DEMOLITION - - - -
Sq. FT. NO. OF Q
SIZE ROOM➢ STORMS 4
EXT. WALL ROOF 1
COVERING COVKRING&
USE OF STRU RK
I
APPROV
INSPECT 'S SIGNATURE DAT=
I HKREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FOUNDATIONt LOCATION t
PLICATION AND STATZ THAT THE INFORMATION GIVEN 18 - FORMS, MATERIALS
CORRICT.
I AGRIM TO COMPLY WITH TMK CORRECTIONS L1BTm FRAM[i FIREBTOPS, i ,�. , /Y�
H�EON AND WICOUNTY ORDINANCES AND A7 BRACING, BOLTS -A-
LAWS REGU LATI;Y-i 7 NG U ON. I FURNACE. LOCATION, ___
SIGNATURE OF GAD VENT, DUCTS
PEFZ,M 1
LATH, INT.
ADDRESS we
LATH, EXT.
AUTHORIZED ABT.
PLASTER, INT.
76AGSnA'• DA" lo-no P. c. S !�
,y FEEL PLUTER. ECT.
VALUATION FINAL 'I� 1
WMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES BUILD 1 N G
WM. J..Fl3X, *HtEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING //��
DISTRICT NO. PLAN CK.NO. - PERMIT NO.
ADDRESS / l .0%, ,r � •i
LOCALITY RECEIV'ED�BY DATE FAPP�LJ. DATE1881.190
NEAREST
CROSS ST. -
BUILDING
OWNER
ADDRESS i d IS
�J
MAIL LOCALITY
ADDRESS
�! NEAREST
CITY O QNO. 'J'"1.. .T-- - CROBB ST. f '
_ FIRE NO.OF TYPE GROU
ARCHITECT OR TEL ZONE PLANS P
ENGINEER NO. BLDG.
SETBACK LINEf6ORD.NO.
ADDRESS — �-^
APPROVED -
TEL By DATE
CONTRACTOR 'Y\,�yNO.
USEf, APPROVED
ADDRESS
ZONE M- BY DATE
LEGALDESCRIPTION LOT NO. / BLOCK 20 1 6 COR,R/ECTIONS
/ NO.OF BLDG . -z /
SIZE OF LOT [ u NOW ON LOTB ,
USE OF NO.OF NO.OF
EXISTING BLDG. I FAMILIKS
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
O
REPAIR MOVING DEMOLISH L7
SCJ.FT. h NO.OF Z
SIZE / V ROOMS STORIES r
WALL ROOP d,L. •a:"
COVERING I COVERING
USE OF NEW
BUILDING
O
00
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE 19 CORRECT FOUNDATION: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. N 5
FRAME: FIRE STOPS,
SIGNATURE OF BRACING,BOLTS
PERMITTEE LATH,INT.:
AUTHORIZED AOT - LATH,EXT.:
TA ki
DBS-3 SOM SETS 1-48 IS �8 dl`.r P.C.+ PLASTER,INT.
9 PEE —r PLASTER,EXT.
VALUATION
FEE .2Z FINAL
i, WORgRS' OOMPENSAfiION DECLARATION' .
hereby affirm that I haveb tetfflcate of to self ►PPLIC�A�IOI� FOR' BUILDING.-PERMIT
Insu or p cerftflcate of Workeli Compensation Insurance, s
or d ertlfled copy thbmof (Sec 3800, Lab..C) - .COUNTY OF LOS ANGELIS '' WLDING AND f11Ff Y .
,.� r
Policy No. Company's
• BUILDING_
❑ Certified cQpy.ls hereby fumisheii. r FOR APPL1CANF,TO FILL IN ADDRESS
❑. Certified copy is filed with ttte.coilntybojMing Ir*iec- BUILDING r
tion departrierat. ADDf 55
=
Dotes AppllcdhTNO. ZJ P L��y
OF BLDG&
CERTIFICATE OF EKEMPT10N fiROM WORKERS SITE OF LOT NOWON 1OI'_ _- - !
CROSS ST.
OOMPENSATION INSURANCE ASSESSOR,
N
((ThThIs section need not completed+f iiia permit h for.one TRACT. BLOOC - LOT 140. :Z MAP p.s pgR{g
hundr`bchdollar: .I or`Iess
4 cerflf)C4hatAn)h¢ pecformanoe of•the work for.wvbICh this
permit,Is-Issued, I shall mot bmplay,bn pe on In:any panp'er , ADDRESS *
so as to become subje�to the Workers'CompenKplon•"Lews. � COFbffK3F}S'
. - .. . -ZIP
y -ZIP . . - � r '.; - ���}}} •
Date ApplIca ntAffil T� QROUP --- BY
NOTICE•TO AP I IC,4t�f; If,-bftor snaking thea Carttficote of �1GI NO.. �T ZO E
Exemption, yau.sbbuld bwcom•, sublect to .the Woiiu"'
.'Compensatlbn provisions of the 4obo[ Code, you must fdrth>- AbbRESS
with comply-wlfh lsurh provislons or tbls pe' It shall be TEL STATIST1CAL MA S1Fl PION APT. CgtDO.
_deemed reyAed . CONTRACTOR Nd.. Z
LJCB�.SF� CCMITRA�tCK25.DECIARAT�Ofa: LIG CLAM.1
UNrtS
I hbr66off I'M fhaf I amJlcemed under provisions of ChQpter# _._. ADDRESSEWER MAP.
(commencing with$&diol]7000)9f0.ylflon 3 of IF4 Bwlheu - UG
and Profesl.o.ru Code,and rAy.IJc:ns..ls In full"force and effed. , ' � CLASS BIC PG. 'VALIDATION'
FT NO. OF NO. QFCHOX
JJc�nse Number _TCIc clogs SLZE STGRIES FAAOULIES OPE
r - r_ __ - _ _ �• VAW ATFON
ConTractor DES6UPT1CNJ bF WO NEMC El ; 2r-p.
I am exempt under
Sec., • �� AIS ,
_ _ . _. A1TEIt. 4
B.$P_C, �i thls reason - REPAIR ;
4; '
bkA�OL
Signature APPVCMff _ NO. WNAL r'
OWN9t$UIlDER DECLARATION DATE
I hereby afflr�n that I am exempt from the Contractors License
1zW for thb-folio-4Aag,recsori (SW16n 7031;5, ffuilnea.hnd. �S RNAL•
Profesilons Code)., BBUUS� - By - - -
❑ I, as owner of thie, propirty,-or my"emploY�wffh ADb tnr4T.i
wages.as their sale compensation,will do the work and
he structure li_r)ot-Intended or offered for sale(Section LOCALffY _ ".•�w_- i'
' Claw and Rfofpsslohf Code.) MCIVING _ �`.�,. - �.' 1 LT i
lYJ I, as owrler'ofthe , am exclusively con(rgcflhg OR NO. ti '�yi �1
with Ilgen*o contract b cortitrud the proled jSq�- . - _ _ _-, - -. :ter. uTAL 1313,914
-lion 704t,:,Buslnes and Profusions Code.} ' FROM �r
ADDRESS
OC>JJSTRUCT(Z7tl LENDING AGEIJCY
YARiJ FI1M1TOTALr
I hereby affirm that there I+a construction lending agency.for 1ROrl7
.the performancq'of rhe wot'k for which tb114-permli.Is fsiVed -
(SOc- 3Q97, 0 G} SIDE J 1
tender's Name -06*-Q�1 1 J2 1/9'
LDMA W.i
7164 ' '� � 9:�•
Lenders Addrets
I certify thgt l have regd.�his a*I atlgp bad st'to that The f :- - hnjaou LDMA P/C l
above Information Is correct. I ogre&to comply wits}allCounty Inwui�aHdn FM . ._ �j . '
wdlndnces and Stgtq laws relating to building construction, Total FM • "/ LF)JMA Perm •/
and hereby autharlie.representativeY-of this County to enter •--
upon bove-mentioned property "nspectior'pur xxmL
'A WIQV�{✓�IrOR Ea4AP4AT0[Y LAr,auAw
x
Signature of.fAppl t or t' Doug r
WORKERS'.COMPIENSATION DECLARATION r
! hereby affcor that I have r certificate ns tion Int to self APPL1CAT1QN—FOR,-'B ILDING- PERMIT
Insurer or a certificate of Workers' Compensation Insurance,• -or a cdrtlfled-copy therbo{ (Sec 3800, Lab. C.) COUNTY OF LOS ANGELES Y BUILDING AND SAFETY
POIky�40. Company r Y
Certified,copy,is hereby fumlahed. zgx
FOR APPLICANT TO FILL IN A LD1
Cpelfied copy Is ffled with the countybullding Inspec- 9utSS F �•-
tion department. ��d C�
Dated _ y Applicant CM LP
CE4ZTIFICATE OF IDCWPTION FROM WORKERS' Sla OF LOT 1,,7 D NOW ON LOT T
CROSS ST..
� . COMPENSATION INSURANCE, _ ASSESSOR
`(This Wloh need not be c�oOmpleted if the permit Is for one - TRACT BLOCK LOT NO. MAP �( PAGE PARCEL
1 hUnd4c! dollprs (;100)or lets ) TEL
USE ZONE MAP
1 _I cgrtlfy that In the Performance of +,e work for which this
Permit Ii Issued, I shall not employ any person In any manner ADDRESS �ONS
so as to become subjed to the Workers'Compensation'Laws r U
atY zIR d
Date App l l ca n t ARCHITECT
NOTICE TO A�PPILI FT: If, after_making this Certificate of ENGINEER TEL i DISTRICT GROUP TYPE FIRE. PROCESSED gY
Exemption, y.qu should become 'cad bleto the, Wor)ceh' _�.
oONST. Zbm
Compensation provlslons'of the,I-abbr Code, you must forth- �0� )/
.with comply with such of
or this .permit shall be TEL STATISTICAL CLASSIFICATK)N APT. CONDo..
deemed revoko. OONTRACTOR NO. _
IdCEfJ$EO CQNTRACTO£S bECLARATION UC CLASS NO. ��, DWELL UNITS
I hereby afflrm that I am licensed under pravltlons of Chapter 9 ADDRESS NO.
(commencing with Section,7000 of Dlvl uC SEWER MAP
( 9 ) a�Qn•3 of the Business � '- 045,5
and Profess lb ns Code,.and my IIcenso n' full force andvffect. pG Q. VAllDATIQN
1 SQ. FT. NO. OF NO. OF CHECK
f License Number LI4 .Class_ 54g STORIES STORIES FAMILIES ONE
VALUATFON
�*Dgtb DESCR1PT10N OF WORK NEW ❑ r�a�.
Con dor _
❑ :��
❑I am exempt.underc—Se .fid � � d-- ADD •
ALTER..E r
B.BP.C. for this rbason REPAIR ;
Fie. USE OF
DCISIT NG BLDG. DEMOL LJ
Signature- APPLICANTFIRIFINAL
OWNER-BUI(D.ER.DECLARA-1`10N DATE t -'T
I hereby affirm that I am exempt from the Contractors License
Law for the foliowing reaspn (Sectlon 7031.5, Busineu and ADOR FINAL 1'
Professlons Code): _ r ��+'T i
❑ I, as owner of.th o cr m em I with BUILDING - ACCT.
e'Pr perry, Y P � Rt35 t- w...t:
wages as their sole compensoilon,will do the work and t` %_ C.
the structure Is not Intended oroffered for tale(Sedloh LOCALITY 1 "
7 I, as owner of the prop", am exclusively cortirgctln9
7044; Buslneu and Profealoru Code.) r MOVING , q
lFr. 1 ITEMS.
CONTRACTOR l� � ��-.:?-;1"- �_ `•'�Y .• �y'�/-- a'
with licensed contractors to construct the prblgct Seo- _ _ . 4 AL . -2 19-:38
tlon 70.44, I3uslneu and Profesaions.Code.) ADDRESS5' •�>f' yJ
G`�y� _ �i�■
f CONSTRUCTION LENDING AGENCY RET YARD HWY AL '.FRO�q
REQU 6D 1
1 hgreby affirm that there Is a construction lendlnpp agency for FRONT .00
the performance•of the work for which this percnit is Issued P.L. + - _ {
(Sec 3097, Civ. C-). SIDf1 e
.,� P.L J ;. p 4
Lendees Name LMPLJr'IFJV� 7� ❑�
.ts�� LDMA Ref.. . ...t" "! �y �y p
P.0 Fes Paan It Fee ! 5 SO -1 A 1 G:5
Lenders Address
.1 certify that I have read this applicatlon and state that the Issuartice Fes •5( - P/Cli
above Information Is.correct. I agree to corn pply-with all County ln~rgcrHon Fee
` ordlntnces and State laws relatinq to bulfdlnq construction, Total Fee LDMs Perm.
and hereby authorize representatives of this Qounty to enter
upon bov ment ned ol:)"f Inspection purposes.
f +�r sm■h mu FOR buiANATOt[Y.LANGuAGG
1 Sl9natvrs of Appl or nt Date