HomeMy Public PortalAbout5839 A,B,C GOLDEN WEST AVE_Building__ J -
APPLICATION F BUILDING PERMIT
FOR APPLICANT TO FILL IN (Print or type only)
BUILDING �7— COUNTY OF LOS ANGELES
ADDRESS (fL jLf ill f S/ DEPARTMENT'OF COUNTY ENGINEER
G -
ary /YJ `� i ZIP BUILDINND SAFETY DIVISION
NO OF ' BUILDING
SIZE OF L//OT`` NOW ONN LOT LOT ADDRESS !y
TRACT BLOCK LOT NO LOCANEAREST
LITY
OWNER ��C/V �� /NO CROSS STASSESSOR
ADDRESS g -3 lo'D Gam{ /j� W c S't MAP BOOK' PAGE PARCIL
TRICT GROUP TYPE FIRE PR SED BY -
-CITY`�J�J� ,zz- ZIP Q� CONST , ZpNE�
ARCHITECT OR TEL Y `3
ENGINEER NO STATISTICAL CLASSIFICATION LA SEWER MAP}
ADDRESS / 1 CLASS NO DWELL UNITS �BK
CONTRACTOR Do//�(a,0 /��Lj� USE ZONE rcpoprC
MAPADDRESS( ,rA_67ZI)VNO-3aO / /`C / IALLC
DITIONS
CIT � CLASS
CONSTRUCTION LENDER• ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
NAME AND BRANCH BLDG SETBACK FROM
FRONT PROP LINE OF (STREET)
ADDRESS CITY TOTAL SETBACK FROM TYPE OF (STING
SQ FT j / NO OF - OF CHECK HIGHWAY + YARD = FRONT PROP LINE HIGHWA 'WIDTH
SIZE U�+' FA STORIES FAMILIES ONE }
DESCRIPTION OF WORK NEW ❑ + O
ADD ❑ BLDG SIDE ROPBLINEOFF (STREET) O
Q� ACK FROM
"IF !/ ALTER ❑ HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
REPAIR! SIDEPROP LINE HIGHWAY WIDTH N
-USE OF- + _ Z
EXISTING BLDG ;''� DEMO L ❑
APPLICPGLF!^ TEL CORNER CUTOFF YES NO ❑
(PRINT) ✓�/� NO gQ�
IN OPEN SPACE S ❑ NO ❑
BY(SIGNATU I r/ IN COASTAL PERMIT ZONE,-"' YES ❑ NO ❑
VALUATION
IHEREBY ACKNOWLEDGE 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 I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF _
THE LABOR CODE OF THE STATE OF CALIFO IN RELATING TO WORKMEN S COM Al I
-PENSATION INS NCE v
SIGN F - / ' � f7'T�7� •��C�/" � Q�/'��`//J -�
PERMITTEE
ADDRE "
' FINAL BY
CITY TEL NO DATE 5 -- -77
PC Jr
MAKE°CHECKS PAYABLE TO FEE $ FEET
HARVEY T.BRANDT,COUNTY ENGINEER /V +
PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION K M o ASH
15 4 14 :L
®i 76A638A CE#803 3 75 3�/
t E t - - y`'j••(.'^to q 4r' �,- •C, ,
Y''76A638ACE+#8031-62oAPPL.ICATION ^F'OR; BC11L'Dil'N,G PERM,1'T
1.
g� COUNTY 'OF LOS, ANGELES
BUILDING
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LocAL1TY
JOHN+A:LE
AMBIE, COUNTY. NGINEER ` NEAREST
ILLIAM'A'JENSEN, SUP_'T OF BUILDING CROSS�ST �,<•, �;I,..;'I tls„ /j Le�l"''
DISTRICT NO' GROUP'• TYPE 'PROCESSED BY-
.FOR APPLICANT TO FMIL IN ,%'n f CONST',
r
BUILDING a a-,' �•`'•�" STA STICA CLASS FICATIONI ' ,SEWER WAP t "
'
ADDRESS, Ef ,G.'•/�r f �i:,•` s j . T.-; - 1 :...BK IPG
�CLASSl NO 2 DWELL UNITS A'
1' -LOT N•O Zi ,', BLOCK 'WATER -
}� CERTIFICATE NOT REQUIRED' 'RECEIVED
TRACT, .• �, ,;. }f •rt.• MAP `� ,•HIGHwnr ' STATE MAJOR SECOND, OCA•
NO OF BLDGS NO' "-i., }/ ,(CIRCLE)
` SIZE OF LOT. ' ;,- ^, (w'�is -NOW ON LOT •+f ,USE ZONE 'S ECTAL "% ,n,_l•
.USE OF - 9° '' CONDITIONS <
! EXISTING BLDG) '�r, -
t �a TEL p ,r' �' ' —� ,�. •. `..
:f O NER,• 'I'• /clt'.t aft • NO Ptfi✓[y A54L -BUILDING - EXIST '
'n. tt �,9 r, ` ! -SETBACK YARD HWY:, ,{ STREET-NAME eWIDTH
� (ADDRESS 4:.' "H/ .!^+x`,C;lf•.r'!!''Gk'a.5 r• :; FRONT •py A 'art'- •I�'�;"', J/iI ,r•' - 0.
j, ,yARCH ITECT OR „TEL P I- j1._''(:r%:fff fes' - �,F d
ENGINEER: - - - - NO - - SIAE°A'' - 4' O
•• ADDRESS- _ - ,;, N �•j, /� •7,f,� o
TEL .F /� f I.�/1!•[y1YW t.0't rL `l1/V^'G" J_CONTRACTOR /SYF•�:rSf 1, r`Y,'� ib�' NO tI� �✓,r:;`.� /} - �'
-ADDRESS•44c4"P..F '•P�e<:tA,Gre G.ai�'wti•/54;o '1:7.
DESCRIPTION OF WORK,
Wy Oy O
ANEW ADD + ALTER •REPAIR DEMOLISH
' SQ FT ' - NO OF - NO OF" - '`u-C� - �D•�c�'� 'jtJ l- 1J .•V-
•�.' SIZE STORIES , FAMILIES
-'USE OF e i ,,��••�}
STR U_CTU RE- >-„{. `J�i:4P” I'S =1>c F Iff'/S!'•
'= SIGNATURE:OF / •' - ' MA1n.' /tr'�'�-�t+CY..0 ��j' 'y,'
- APPLICANT �� �P/"lry.�- ) _ R`S>•g'•'e, mow" - - - •� _ 'LJ. y
VALUATION $'./ •�V CJ f ` •. J - • { , '
'APPROVALS -DATE-l' INSPECTOR S SIGNATURE
PC C = ,,J� PT .�"j'ti,•' FOUNDATION LOCATION.
'f "FEE-$-"' / FEE ;, 1- .''+ FORMS, MATERIALS - -
_ _ FRAME FIRE STOPS, - -
y I HEREBY ACKNO LEDGE THAT 1 HAVE READ THIS•APPLICATION BRACING BOLTS nn•�:O'w ;' `
AND STATE THAT'THE ABOVE-IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION / / /• vYry v/ t ` ,
" WITH' ALL COUNTY ORDINANCES AND STATE LAWS .REGULATING GAS VENT, DUCTS
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-
INGTO WORKMEN,S,e MPENSATION INSURANCE
.• 'CATH_EXT .' au /���✓: �,',
SIGNATURE'OF HOUSE NUMBER COR-,
-,PERMITTEE k_ - ;S)RECT AND,POSTED 9 / ♦ ,.�}
` AD_DRESS_,., i ", .1, f"w- t .t',..6J..c, '„d'«y ,P7'J .» , r
FINAL 7-�/- r' `
^ -JOHN F LEWIS PRINCIPAL STRUCTURAL_ENGINEER
PLAN CHECK VALIDATION CKM O CASH , ,i PERMIT-VALIDATION cK'F 'M o <"CASH ,
" �• t. y " t.V I 4A ,p ,`M;. ,'�y"'.'y57 WY•L ,. 1 iI'S•+''".�s/ i 4i .. '