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Home My Public Portal About6127 GOLDEN WEST AVE_Building__ 78A638A.DBS-3 8•55 -APPLICATION FOR BUIL®I . ERMIT 1- DIVISI6N OF BUILDING AND SAFETY BUILDING{ ADDRESS ^,�P/ Deportment of County Engineer, - _ County of Los Angeles LOCALITY � C WM.J. FOX, COUNTY ENGINEER NEAREST A A _ CASSATT D. GRIFFIN, SUPlD'i7 T OF BUILDING CROSS ST. /T6'E! DISTRICT NO. GROUP TYPE SEWER MAP FOR APPLICANT TO FILL C IN I _ONST. I ®K PG yBU'LDING ,�` qSTATE - ADDRESS6'j`2/f/, D/�Q +�e�/sy/ ✓ NUMBER -/�.0�� HWY " .YES, NO . LOT NO. Q, 6?'F6'26.§Z 1 n/ X BLOCK/I U9E ZONE- SPECIAL' CONDITIONS TRACT eO- NO. OF BLOGS. , SIZE OF LOT-rO X .Z_S'Y I NOW ON LOT EXIST. SETBACK BUILDING YARD HWY STREET NAMEWIDTH ` USE OF FRONT �rq EXISTING BLDG. S ;P:L. lB' lei✓ OWNER • --,A +SIDE �//' P. L.MAIL ' ADDRESS/� 7*- („rDaka�-ly� T O TRACT DWELL. - 1.UNIT - - - S INDUSTRIAL _ TEL 1 DWELL. - I'UNIT CITY -eI'Ll/O/� NO*T7&/ - 6 PUBLIC-BLDG. _ ARCHITECT OR .,O _ TEL. - 2 DUPLEX f UNIT ,7- ADDN.. ALT.. ETC. ENGINEER D j(//YGri- - NO. _ 3 APT.• UNITS r .. 8' MISCEL. - - • ADDRESS 4 COMMERCIAL - CONTRACTOR I!/4Y.4-aP , 'TELNO' INSPECTION RECORD ADDRESS -DESCRIPTION OF WORK �f �S5" � r �✓ccS NEW ADD ALTER REPAIR DEMOLISH 77 �ip JCS IJ' SC!. FT. '/ NO. OF ) NO. OF SIZE try STORIES' / FAMILIES .��„fT• ��.�r�f 1 6�/� i .I✓�,� U E OF STRUC URE. ��'f0 j O --e J&fk SAV/D S W.1$/ A2>/�/�E�J'/DE T 7`-,—_,*D/A4- • Ge �' AJ'/�'.E-/ ,E/2 Gam' _ SIGNATURE APPLICANT - - APPROVALS �fp%lf,E' 771 L 6QC/0/V r1yA + ADDRESS ��yyyyc - - - DATE 'INSPECTOR'SStGNATURE - Y. P.C. $ FFORMS. MATERIALS ION FEE • FRAME:.FIRE STOPS,' VALUATION - $/ . BRACING. BOLTS FEE FURNACE: LOCATION, - + 1 HEREBY ACKNOWLEDGE THAT I"HAVE READ THIS" GAS VENT.DUCTS ` APPLICATION AND STATE THAT THE ABOVE IS-CORRECT_ _ AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. ' AND STATE LAWBGU NG BUIL NG CONBTRUC-• TION. � - LATH, EXT. - - - SIGNATURE OF - r _HOUSE NUMBER COR- ' ' PERMITTEE RECT AND POSTED' ADDRESS - FINAL WM.J. FOX, COUNTY ENGINEER VALIDATION C. N. DIRLAM.CHIEF BLDG. INSPECTOR - AC006 3 AUG 17 1 6.0 0 to DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES BUILDING 1- J. FOX, CHIEF ENGINEER •NO. OF BLDG. ORD.NO. DISTRICT NO. PLAN CK. NO. PERMIT NO. (� PLANS SETBACK LINE APPROVED FIRE �- , ZONE BY _ DATE RECEIV-99 BY DATE ZfOF APPL. DATE IS UED ZONEUSE BY DATE,DATE �!/ � �� /� • APPLICANT FILL IN HEAVILY OU'T'LINED PO TI ONLFY a: BUILDING O a: NAME ADDRESS W Z ADDRESS LOCALITY 1. 6 S Z NEAREST Uu W CITY CROSS ST. Q STATE TEL. LICENSE NO. a, NAME 04 A V W MAIL p NAME 3 ADDRESS - V O TEL. Q ADDRESS CITY NO. Z CITY 1 HEREBY ACKNOWLEDGE THAT l HAVE READ THIS, O APPLICATION AND STATE THAT THE ABOVE IS CORRECT U STATE TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LICENSE NO. NO. AND STATE LAWS REGULATING BUILDING CONSTRUCTION. Z LOT NO. SIZE OF LOT COGiI Zc�� SIGNATURE OF 2 O WNER O J NO. OF BLDGS. _ /' Q a BLOCK NOW OBJ LOT -Y AUTHORIZED AGT.!!L t l7 I "I W �i TRACT a& (;f, �/� CORRECTIONS O USE OF BLDGS. - NOW ON LOT Xr✓- J✓ .N/ .lAr..�.•�.i r' it��.//'urates` DESCRIPTION OF WOIKK USE OF BUILDING } O O ` z a r NEW TYPE GROUP NO. OF NO. OF ALTERATION ROOMS FAMILIES ADDITION SIZE �r REPAIR - _ STORIES MOVING WALL COVERING DEMOLISH I ROOF• COVERING C/ ` P.C $ FINAL"APPROVAL FEE Q® $ cO I _IN7SPECTOR' VALUATION FEE V DATE a' '?,NAME DD•.^, :i-4:,asnl s�Ts ! APPLICATION FOR PERMITDEPARTMENT'OF BUILDING AND SAFETY COUNTY OFLOS ANGELES A 11 WM. J. FOX, CHIEF ENGINEER BUIL' NQ,'OF _BLDG. _ ORD.NO. DISTRICT NO. PLAN CK. NO. PERMIT NO. PLANS SETBACK LINE �� FIRE APPROVED _ ZbNE BY ( DATE R EIVED B DATE OF APDL. DATE)IS1S'U& ZONE APPROVED E1 ,2-14-4q 2-1 L -4' ZONE I BY DATE APPLICANT FILL IN HEAVILY OUTLINEtD�PPORTIO��NJJJ////ONLY C BUILDING , ( do A p NAME ADDRESS V �" ADDRESS LOCALITY U Z_ _ F' O NEAREST V W CITY CROSS ST. E C Q STATE TEL. LICENSE NO. NO. I NAME MAIL E NAME 3 R ADDESS � A � 2 t• TEL < ADDRESS d tel( CITY NO. F r Z CITY I HEREBY ACKNOWLEDGE THAT 1 HAVE READjTHIS O APPLICATION AND STATE THAT THE ABOVE IS CORRECT U STATE TEL'. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LICENSE NO. NO. - AND STATE LAWS R LATING BUILDING CONSTRUCTION. 7 L T NO. - 817E OF LOT 100 2y .°SIGNATURE OF WNER Q I.- NO. OF BLOCS. �Y`AUTHORIZED ACT. t 13 _ BLOCK NOW O,ILOT C yr +•v y IF J TRACTS tel/ �,pa^ „� .�C�ORRECTIONS D USE OF BLDG NOW ON LOT 8. T1-' 'a. DESCRIPTION OF WORK U USE OF BUILDING A.yd71Ya r A PT -- U7non may be ri ,,._,. ti'iolafiotf I( Wrr Pr��t,, 6 0 Cctuti4ne -- �`"`u o_uer-s'`to ar (/ X� �i� ' Z 'rw lE� ^iGI n t •-- ,� x cxufLtof m dIs - 'v NEW TYPE 1 G��Pif.• •(•mNO.OF N d� ALTERATION ROOMS •� 1 FAAt10 IES /j��r ADDITION` f SIZE � . ----` /� REPAIR STORIES r ti MOVING WALL COVERING » i.►• ys a yMr DEMOLISH rROQF COV ING Is .�Q P.C.s FINAL APPROVAL s S N' IN£PECTOR'3 VALUATION F66 �'�' DATE I NAME 7eA:SeA 1388-9 APPLICATION ®Ft -BUIL DING PERMIT A It-9e - DIVISION OF BUILDING AND,SAFETY BUDIL°'NG ' ADRESS Dep ortment-of County Engiaeer County Of Los Angeles - LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST • CASBATT D.GRIFFIN, SUP'T'OF BUILDING CROSS ST. An - -t . DISTRICT NO. ROUP. SEWER MAP FOR 'APPLICANT-TO FILL IN TYPECON � „BK, PG- � '-�• ' _/� BUILDING ADDRESS' 4oA/ {iYt�S/ p�G(/ Y MAP STATE YES NO NUMBER- HWY ' USE ZONE ^SPECIAL LOT NO. �' BLOCK CONDITIONS 'TRACT NO.OF.BL'DGS. BUIL--DING EXIST. SIZE OF LOTS0'X`, _S NOW ON•LOT ,� YARD HWY STREET NAME USE OF - - - SETBACK •'WIDTH EXISTING BLDG.6j'0ejje FRONT -P. L OWNER - SIDE • - , /� P:L. - ADDRESS(�/ k-� � A-e- O TRACT DWELL.' I UNIT 5 'INDUSTRIAL �� C/e NO '-p/�$ 1 DWELL. �7� 1 UNIT CITY `xf 6 PUBLIC BLDG.'. ARCHITECT OR TEL., -2; DUPLEX 2 UIJITS ENGINEER pa✓/�Gi� NO. 7 ,ADDN`;ALT., ETC. 3• APT.,, UNITS ' '8 MISCEL. _ , - ADDRESS - 4` COMMERCIALTEL - CONTRACTOR t��.iotiey� NO ' INSPECTION RECORD, - • ' ADDRESS DESCRIPTION OF WORE ! NEW', ;ADD - -ALTER REPAIR •DEMOLISH SO. FT. Op NO. OF_ NO OF SIZE ✓p•� STORIES FAMILIES U OF S UCTURE y*%�' SIGNATURE�OF �§ APPLICANT APPROVALS ADDRESS �-,� . - •' - . ' -DATE INSPECTOR'S SIGNATURE • FOU NDATION•LOCATION I ' ' P. C. $,• - -'FORMS.MATERIALS V O •'FEE FIR ME* FIRE STOP$. _ VALUATION BRACING. BOLTS a FEE ,'� FURNACE LOCATION. n I HEREBY ACKNOWLEDGE THAT '1 HAVE,READ THIS 'GAS VENT, DUCTS APPLICATION AND"STATE'THAT THE ABOVE IS CORRECTAND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT:. - • _ ' AND .STATE' LAWS REGULATING BUILDING CONSTRUC- TION.' ONSTRUC-TION. - - _ LATH. EXT. SIGNATURE OF HOUSE NUMBER COR= PERMITT RECT AND POSTED ADDRESS FINAL _ ;Z� .! %• - JOHN AA.LAMBIE. COUNTY ENGINEER VALIDATI CLYDE N.•DIRLAM, CHIEF BLDG. INSPECTOR CK MO /ASH• 1• ` ' , , � •; 4 2 ? JUL WORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of'consent to self , A P PL I CATION - FOR -BUILDING'-PERMIT. , i,' e, or a certificate of-Workers'-Compensation,Insurance,, - F ' or certified copy thereof (Sec 3800, Lab�C`) " COUNTY,OF-LOS ANGELES-. BUILDING"AND.SAFET.Y Policy No °�_21Z2 0. Company El"El" BUILDING 'Certified copy iso hereby,fu�nistied. FOR APPLICANT`TO'FILL IN'' ADDRESS /�� Aj, 'L�' Certified copy is filed with the county building mspec BUILDING ADDRESS Za' e L ti Gu ieST : • '+ ': tion department—, _ - T- �,I •, t c.cC CIN LiL '��. ZIP 1 1�� . LOCALITY Date_ ` 4 'Applicant NO .OF BLDGS NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF.LOT'"` ,NOW'OWLOT COMPENSATION INSURANCE" ' r CROSS ST ip - _� - r.. ,;' - ASSESSOR, " _ ' (This section need•not,be completed if'the permit is one TRACT • BLOCK LOT NO" MAP BOOK, PAGE. PARCEL ' ''hundred dollars ($100)-6r fess•)''' ' - = TEL J. NO � 3 Q.Z.�j USE ZONE,' NAP I certify;that in tlie'performance of a work for which this ermrt'is issued, I shall not em I ,an 'm an manner ADDRESS, 1� -�, SPECIAL:,- person h s '- P p y y- CONDITIONS 4 �+ so,as;to,become sublect'to t Workers'Compensation Laws11 , O ' . , . CITY ZIP - t V1-11 . Date • ' Applicant `M 1 t- � ARCHITECT.OR TEL �^ ` d DISTRICT GROUP_ TYPE __ FIRE PROCESSED BY- ""0" NOTICE, TO AP.LICANT',lf; after making this Certificate of ENGINEER NO - _ , CONST„ ZONE U `Exemption,//yyou should become'sublect-•to the ,Workers' U Com 5tion-provisions of the Labor Code, you must.•forth- .- `ADDRESS _ ��O 12" - a •withamply,,with:such-provisions,'or •this permit shall be TEL,,-4 1 3' STATISTICAL CLASSIFICATION APT CONDO N /� Z' deemed revoked - CONTRACTOR- Ivli; 2 FF NOZIp 'e. LICENSED CONTRACTORS DECLARATION ;,,, t, I LIC- CLASS NO DWELL' UNITS I hereby affirm that I am'li'censed under provisions of Chapter 9', ADDRESS 1 Gj'K, �I c NO 31-163 4 � SEWER MAP (commencing with:Section.7000)of Division 3,of the,Business ' LIC and Professions Code,and-my'license is in full force and effect CITY 1� Q-00 Z 3, CLASSBK � VALIDATION G SQ'FT NO OF NO OF,-' ` CHECK ' License NurnbeP 5'y V•3 Y Lie Class `G- 3 GI" 1. SIZE STORIES FAMILIES ONE ns r - C7 - u VALUATION Contractor l3 V L VIt Iii' � K.I q Date 1 1 `�� DESCRIPTION'OF WORK 4= — NEW, ❑ ; `C SG eo �. ..ADD �❑ Z d pop. 1. I am exempt under Sec.' & P /�►✓� O. _ ALTER ❑ B-&P.0-for this reason ° D SIJ �� [REPAIRXs' Date USE OF _ EXISTING BLDG DEMOL ❑ :Signature -_ APPLICANT Q TEL OWNER-BUILDER'DEC LARATION = (PRINT) t I hl l?✓l;I,c�.r NO "� FINAL--7 DATE L/ I hereby affirm that I am exempt from the Contractor's License Law for the following.reasonr(SecTton 7031 5, Business and ADDRESS Professions Code) PRESENT- _ C - BUILDING- , ACCT'._4 ' ❑ I, as owner of-the property, or,my'errSployees with ADDRESS a - wages as their.sole-compensation,will do the work and = 1 00 the structure is not intended or'offered for sale(Section LOCALITY r :` aauI • 7044'•Businesi'and,Professions Code,): 4• MOVING b.. TEL •. ,.Tµ _ . 1 JTM CONTRACTOR- NO r M ' ❑ I, as owneiF-of the propefty,am exclusively contracting ,r TAS •' _ * with licensed contractors to con-struct•the-prolect,(Sec- ADDRESS " ..• TOTAL ��3"UO Y _ =Tion 7044, Business and Professions Code.) I� v 4 t�, "•. y :REQUIRED, TOTAL SETBACK-FROM- EXIST-- ». MICK 153.00 ` CONSTRUCTION LENDING AGENCY � SET-BACK' YARD HWY PROP LINE WIDTH � � - ,i - ^ I hereby affirm that there is a construction lending agency-for FRONT , the performance•of the-work for which this perm_ it is issued P L; (Sec 3097, Civ C ). - SIDE r�. P L- - m f1f 1f'�( (�y�1 i Lender's'Name �� LDMA.Ref „N rr GOVUI-0001 '711J1/w�i t P C Fee Per 4423 1 FF 912:02 _ Lender's Address $' mrt Fee - " I certify that I have read 'this application and state that the, '' Issudnce Fee O LDMA P%C#•' •` - above information is correct:'I agree to'comply with all County Investigahon'Fee ('� i yV . �� \ .� s, rz, . ordinances and State'laws'relating'to building construction, Total Fee-"' J v O ^LDMA Perm''#' a and Hereby authorizere sentatives of this County to enter upon,,The/above= nti f ro/pJrty for'inspection purposes ' y' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature,of Applicant or Agent Date a s^- ivr WORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to Self. APPLICATION, FOR BUILDING, P E RM I T insure, or a certificate of Workers'Compenstion Insurance, or ' ,,,insure a certified copy thereof (Sec 3800, Labs C') COUNTY OF LOS ANGELES BUILDING AND-SAFETY Policy No Company \ ❑• Certified copy is hereby furnished _. -FOR APPLICANT TO,FILL IN ADDRESS ❑ Certified copy-is filed with the county building inspec- BUILDING Temple, Cit Y tion department ADDRESS 6127 N. Golden West - LOCALITY NEAREST Date Applicant CITY ZIP CROSS ST Garibaldi CERTIFICATE OF EXEMPTION FROM WORKERS' NO OF BLDGS ASSESSOR ' COMPENSATION INSURANCE SIZE OF LOT. : NOW ON LOT MAP BOOK PAGE r PARCEL (This section need not be completed if the permit is for one USE ZONE, MAP TRACT BLOCK NO 3 LOT NO C) hundred dollars,($100)or less )' p TEL Z• SPECIAL I certify that in'the performance of'the work for which this OWNERMr.,' & Mrs. A.'anl�n N0285-3024 CONDITIONS O DISTRICT GROUPTYPE FIRE PRO SSED BY V permit is issued, I shall not employ any person in any manner Same' a above CONST ZONE so as to become subject to the W kers'Compensation Laws` ADDRESS' 'a 3 O -+Date Z Applicant CITY ZIP STATISTICAL CLASSIFICATION APT CONDO W NOTICE TO APPLICANT If, after-'aking\this Cer icate of ARCHITECT OR TEL. CL Exemption, you should become subject 'to the Workers' ENGINEER n Ja' NO CLASS NO �DWELL UNITS Vf Compensation provisions of the Labor Code, you must forth- ADDRESS TEL SEWER MAP Z with comply with such provisions or this permit shall be • deemed-revoked' CONTRACTOR- NO BK LPG, VALIDATION - . LICENSED CONTRACTORS DECLARATION LIC I hereby affirm that I am licensed under provisionsrof Chapter 9 _ ADDRESS -NO - VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC " Professions Code, and my license is in full force and'effect CITY CLASS - $ SQ FT NO OF NO OF CHECK LicenseNumbe`r Lic Class SIZE 427 STORIES FAMILIES ONE G n eo Cont_racfor Date DESCRIPTION OF WORK enc to sure of NEW El patio. - ADD 0 I ce exempt from the licensregistered profremen l as I am a ALTER ❑ FINAL licensed architect or a registered professional engineer � DATE acting in. my, professional capacity (Section 7051, REPAIR ❑ Business and Professions Code) _ USE OF_ EXISTING BLDG DEMOL ❑ BYAL Lic or Reg No Date APPLICANT TEL OWNER-BUILDER DECLARATION (PRIN O' - I hereby affirm that I am exempt from the Contractor's License; � Same a'S above Law for the following reason (Section 7031 5, Business and ADDRESS Professions Code) PRESENT ❑ BUILDING j, as owner of We 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 t 7044, Business and Professions Code) MOVING TEL �2 1 ,4 6 A ® j, as owner of the property, am exclusively contracting CONTRACTOR NO with licensed contractors to construct the project (Sec- dM j 0 e o 0 0 1 tion 7044,-Bust ness and Professions Code) ADDRESS REQUIRED TOTAL SETBACK FRO2 0 1' 0'6,0 0 CONSTRUCTION LENDING AGENCY- SET BACK YARD HWY PROP LINE I hereby affirm that there is a construction lending agency for FRONT 0�0 1 0,6 0 0.c= the performance of the'work for which'this permit is issued P L (Sec 3097,-Civ C ) SIDE - t 2,0'2,- 1 PL , Lender's Name n/a Lender's Address P C Fee$ Permit Fee I certify that I have read this application and state that the Issuance Fee c above information is correct I agree to comply with all County Investigation Fee • .•r /ordinances and State laws relating to building construction, Total Fee nd hereby authorize representatives of this County to enter a on the above-mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE - Signature f App cant or Agent Date i O