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Home My Public Portal About6455 GOLDEN WEST AVE_Building__ 76A638ACE#8038-64 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS l BUILDING AND SAFETY DIVISION LOCALITY / JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS ST. DISTRICT O. GROUP TYPE P ESSED BY FOR APPLICANT TO FILL IN ` y CONST. BUILDING STATISTICAL CLASSIFICATION 9qER MAP ADDRESS CLASS NO. _DWELL UNITS BK PG LOT NO. .-/� ` BLOCK/ USE ZONE MAP - NO.. 0 37 TRACT �/ ��1� SPECIAL` NO. OF BLDGS.NO. SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. SETBACK FROM EL. FRONT PROP. LINE OF (STREET) OWNER —' 4 O. TYPE OF EXISTING SETBACK HIGHWAY YARD — TOTAL ADDRESS S•" All!2�- 'oc�1/ HIGHWAY WIDTH FROM C.L. C _ + - CITY BLDG. SETBACK FROM ARCHITECT OR TE . SIDE PROP. LINE OF (STREET) ENGINEER / NO. TYPE F EXISTING SETBACK HIGHWAY + YARD = TOTAL O ADDRESS HIGHWAY WIDTH FROM C.L. CL TEL. + = O CONTRACTOR NO LIC CORNER CUTOFF YES NOEl Cid ADDRESS NO O H CITY LIQ SEE REVERSE SIDE FOR SPECIAL APPROVALS w DESCRIPTION OF WORK N Z NEW ADD ALTER REPAIR DEMOLISH SQ.FT. NO. OFNO. OF SIZE STORIE FAMILIES USE OF �� STRUCTUR 7 ' SIGNATU E OF APPLICANT VALUATION$ / -- •i � APPROVALS DATE INSPECTOR'S SIGNATURE P.C PMT. FOUNDATION, LOCATION FEE$ FEE$ fj FORMS, MATERIALS FRAME, FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE: LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS 9UILDING 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- ING TO WORKMEN'S COMPENSATION INSURANCE. LATH. EXT. SIGNATURE O HOUSE NUMBER COR- PE42MITTEE RECT AND POSTED ADDRESS F I N A L JOHN F. LEWIS. PRINCIPAL STRUCTRAL ENGINEER PLAN CHECK VALID ON CK. CASH _ PERMIT VALIDATION CK. ) M.O CASH 76A6'9A;f,00 8-6A PPLICATION FOR BUIL ING PERMI ' COU TY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST / COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS ST. D15IRICTO. G P TYPE PR SS BY FOR APPLICANT TO FILL IN -N—, � CONST. BUILDING STATISTICAL C ASSIFICATION SEWER MAP ADDRESS CLASS NO. DWELL UNITS BK� PG LOT NO. BLOCK USE ZONE MAP NO. TRACT SPECIAL NO. OF SLOGS. CONDITIONS SIZE OF LOT NOW ON LOT USE O EX,ST,NG B BLDG. SETBACK FROM TEL FRONT PROP. LINE OF (STREET) OWNER O. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDR ES HIGHWAY WIDTH FROM C.L. CIT r + ARCHITECT OR TE BLDG. SETBACK FROM ENGINEER NO. SIDE PROP. LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL } ADDRESS HIGHWAY WIDTH FROM C.L. CL TEL + = O CONTRACTOR O . U LIC ADDRESS NO CORNER CUTOFF YES NO O f__ CITY CLA S SEE REVERSE SIDE FOR SPECIAL APPROVALS W DESCRIPTION OF WORK n Z NEW ADD ALTER REPAIR DEMOLISH SQ.FT. NO. OF NO. 01' SIZE STORIES FAMILI FS USE OF STRUCTURE SIGNATURE OF APPLICANT VALUATION.cc p 4:-2 APPROVALS DATE INSPECTOR'SSIGNATURE P.C. PMT. FOUNDATION, LOCATION FEE$ FEE$ �� / C`/-�> 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 r WITH ALL COUNTY ORDINANCES ANDSTATE LAWS REGULATING GAS VENT. DUCTS 9UILOING 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 THESTATE OF CALIFORNIA RELAT- ING TO WORKMEN'S COMPENSATION INSURANCE. LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS.! F I N A L �- JOHN F. LEWIS. PRINCIPAL ST R RAL ENGINEER PLAN CHECK VALIDATION CK. M O CASH PERMIT VALIDATION cK. M.O CASH 2 3:ti FAY 19 1 D 6.0 0cv 76A638A C.#8038-64. APPLICATION FOR BUILDING PERMIT -- � COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER A D D R E SS .i�'1V—.'% u; BUILDING AND SAFETY DIVISION LOCALITY �� JOHN A. LAMBIE. COUNTY ENGINEER NEAREST COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS ST. DISTRICT NO. GROUP TYPE CESSED BY/ FDRE OR APPLICANT TO FILL IN "'�� ' CONST. e' . STATISTICAL CLASSIFICATION WER MAP CC� BKS PG / '—S CLASS NO.yDWELL UNITS ` -.r �C ' �G'( BLOCK 1_ U ONE MAP NO. < C `7:�7`• 222 SPECIAL -` CONDITIONS N0. OF SLOGS. LOT NOW ON LOT BLDG. SETBACK FROMllFRONT PROP. LINE OF � (STREET) � T W TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL �T `r � ae /'.'//' HIGHWAY WIDTH FROM C.L. T + �= !_� ! i l r CITY ARCHITECT OR T BLDG. SETBACK FROM _ ENGINEER O. / SIDE PROP. LINE OF 'y ) }t (STREET) TYPE OFEXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS - HIGHWAY WIDTH FROM C.L. TIffL. ' f + _ ! O CONTRACTOR NO � L V LIC CORNER CUTOFF YES NO O ADDRESS NO CITY LLCASS SEE REVERSE SIDE FOR SPECIAL APPROVALS (~d DESCRIPTION OF WORK N NEW t D ALTER REPAIR DEMOLISH Z SQ,FT. -- NO. OF NO. OF SIZE STORIES FAMILIES _ USE OF STRUCTURE dip SIGNATURE OF APPLICANT - VALUATION$ (� APPROVALS ATE INSPECTOR'S SIGNATURE P.C. PMT. {' C' 6 FOUNDATION, LOCATION - �-� ,.� .A 'F FEE$ FEE$ �� FORMS, MATERIALS - FRAME, FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS ! 4 9UILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK r AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. C TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. ING TO WORKMEN'S COMPENSATION INSURANCE. LATH. EXT. 4 SIGNATUR�HOUSE NUMBER COR- AND COR- PEStMITTEE AND POSTED ADDRESS F I NAL - ,f JOHN F. LEWIS, PRINCIPAL STR RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. ' M.O CASH 0, 76ABsaA CA 11503(RHV.15/715) APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN B�LDINc ADDRESS ADDRESS° ° r. "e� LOCALITY / NEAREST GTY ZIP / r 0CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT / MAP BOOK RAGE PARCEL DISMCT GROUP TYPEFIRE PROCESSED BY TRACT BLOCK LOT NO. 7 !, ( C0145T. ZONE TEL YY ONER ,V IV s — C WNO. /"`'37� `r i p STATISTICAL CLASSIRCATION "SEWER MAP ADDRESS S I G—"�� G� CLASS NO. �DWELL UNITS--] 4t BK PG CrFY �C/�!� d1 7iP ARO-IITECT OR TEL- VALUATION $ ENf �73()GI N EER NO. ADDRESS BL F M TEL FRONT PROP.LINE OF (STREET) CONTRACTOR NO. TOTAL SETBACK FROM TYPE OF EXISTING LIC HIGHWAY + YARD FRONT PROP LINE HIGHWAY .WIDTH ADDRESS NO. UC_ + CTTY CLASS BLDG.SETBACK FROM CONSTRUCTIQfJ LENDER SIDE PROP.LINE OF (STREET) NAME AND B NCH HIGHWAY + ARD TOTAL SETBACK FROM TYPE Of EXISTING ADDRESS GTI &DE PROP.UNE HIGHWAY WIDTH SQ.FT. NO.OFF CHECK + V SIZE STORIES /FAMILIES ONE, DFSCRIPT}ON OF WORK 7` NEW P.0 Fee$ Permit Fee L. � ADD Issuance Fee AL TER REPAIR ` Total Fre C a LIS E OF EXISTINGBLDGVC-JAJ' O�� /U /EP(�r/ DEMOL(/ Z BY ISIGNATU 7'(1 9.8A I HEREBY AC)a4OWLEDGE -HAVE READ THIS APPUCATKNI AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WRTH ALL ORDINANCES 9 # 0 0.0 0 0 1 ANO LAWS REGULATING BUILDING CCttSTRUCTION.I CERTIFY THAT IN DOING THE WORK AUTHORI�HEREBY I WILL NOT EMPLOY ANY PERSON IN V1O ATKNI OF h THE LABOR CODE OF THE STATE OF CAJFORNLA IN RELATING TO WORKMEN-S cow 2'- 0 34,0 0 PENSATKNII N7 o.a o3AO05 SIGNATURE O PERMITTEE 1031 -79 ADDRESS } C E^-" L S CITY /T/G C gpl, 4 TEL. LISE ZONE MAP } �] CONIT NO. L//>L 7 � SPECIAL CONDTIlONS DATE //I� �J�J BY DATE / / r WARS,COMPENSATLON DECLARATION I hereby affirm ttwt 1 havb,a.certificate.of consdnt to self Insure, pr a certificate,of Workers'Com'penstlon Iruurance, or AP h��CAtI O N B U I -PERMIT , a certified po thereof (Sec. Gab. C.) COUNTY OF LOS AN EL' G AND SAFETY Poi7lcy N y ny=rW4VS_Certified copy Is hereby furnished; ' it —r�/ FOR APPLICANT'TO FILL IN DI� Cprtlfied copy Is filed wlth the county bulyd Ing.Inspec- NJ1LDIW, tion department ADDRESS LOCAL ITY _ } NEAREST Date Applicant ITY ZIP ST, CERTIFICATE OF EXEMPTION FROM WORKERS' . bF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAPBOOK PAGE PARC13 (TitIj section need not be completed if-the permit Is for one /! hundred dollars ($100)or,len.) TRACT BLOCK LOT NO, NO. v SPECLAL •a 1,certlf� that In'the,performance of the work for which this �' CONDITIONS O permit Is.lpked,'I shall not empf py.any person In any manner Y(STRICT GROUP TYPE FIRE &Y U s6 as,to become'su,blect'to the Workbrs'Compeniatlon Laws. ADDRESS '"��` �l CONST. ? ��0 . Date Applicant = ARCHITECT OR r ZIP . STATt5TIGy,CLASSlF T10N CONDO. NOTICE Td APPLICANT: If, offer making this Certificate'of ItEER w Exdtnptlorr, you should becomd subject to the Workers' �' CLA$S NO. 4W44 UNITS N Compenlatlon provisions of the Labor Code, you must forfih- ADDRESS — S4wE Z with comply,with sack provisions or this..permit 'shall be deemed revoked: CONTRACTOR . t�jo PG VALIDATION e LICENSED CONTkACTORS D�QAR.00N LIC. I hwggby'affirm that I am licensed urider provisions of Chapter 9 VALUATION (aommen.p9 ^ Sec4on 7000 of D1.Von 3 of the"(nen gnd L}C Professions.&09, and my Ilcerue Is in full.force end effect. AAV aAS, _ Sp. FT. NO. NO. OF CHECK -11cense.Number itic.Clau SIZE STORIES F6MIJES Ot.ENEW COntraor Dote DESCRIPTICMJ OF WORK I am exempt from'the licensing requirements as i arn.a /� ADD Ilcensed'archlteddr a rs+glsfered profmilonpl engineer - ALTER FINAL �j acfing In my 'pro4esslonal• copacIty (Section 7031, REPAIR E] DATE / `„Y► Buslnew. and Profeaslonz Code). USE OE FX NG am., �RNAL/ Llc:of Req.No, ` pat. APPUGANT 1�L ER-BUILDER DECLARATION PRINT t i0. I heteby,affIrm th I om exempt frorh the Contractor)LIcense 1 Law forre th• following-mason (Section 7031.5, Buslner" and ADDRESS G Prafewlons Code): /y ` LID I; as.owner of the, property, or my employees with $ADDRRESg ��✓� woges as their sole co tion,will do the work and the structure It not Intehded'or offered for sale(Section LOCALTY 7044, Buslneis and ptdfesslons Code). . MO.VI NO TEL: I,as owner of the property, am pxduslvely contracting CK2 w with Ilcensed contractorq to-construct the project (Sec- ADQRM . tlorr70+44, Buslneis and Profetslons Code).AGENCY TOTAL SETBACK FROM CONSTRUCTION LENDING AGENC . SET YARD HWY PROP. CK DThI8 6.2 A 1'ftereby offlrra thdt there is a construction lerldfing bgshcy for FRONT # o 01 0 o b the performonpb of the work for Which this per I;Inued P.L. , P.L. P I° ,5 O Leriders Name 1 $ Lender's Address P.C. Fee i Permit Fee c ertify".that I have read this applltatJon and state .0 4.2 that the h uance Fee aboye Infotmgtlon Is cgrcect. i agree to pomply with all County In~lRation F« ordingntes dnd State laws relating to' building construction, and here whoriz �17.rTI'��.o nty to enter Total Ise upon o- n p ses. $U Irt:veese role EXPLAr4ATan LANGUAai nature of Applicant or Agent - - l� WORKERS` COMPENSATION DECLARATION i0 herj,.o affirm that I have a certificate of consent to self APPLICATION FOR, BUILDING P E RM I T Iruuro,,or a certificate of Workers' CompertsaTlon Insurance, � - or a certified co f' Sec 3800, La . C.) 4'� No-WaMmpany � � V COUNTY OF LOS ANGOM BUILDING AND SAFETY BUILDING CertWed copy if hereby fumished. �i�`!-.'%,3 .. -FOR APPLICANT TO FILL IN ADDRESS Certified copy Is filed with the county building Inspec- BUILDING c� tion d rim t. c e f,DORESS JJ vs ✓�� t ` ` rL »w• Dcte'�D ilcant (((// j 2 U NO. OF BLDGS� NEAREST CERTIFICATE OF EXEMPTION FR2OM WORKERS'. SIZE OF LOT NOW ON L07 CROSS 5T. COMPENSATION INSURANCE CROASSESSORT. (This sectl need not be 4ompleted'If the permit Is for one TRACT- BLOCK LOT NO. MAP BOOK F PAGE PARCEL' hundred dol ($1,00)or leas ) r TEL OWNER J Ci NO.- cArtlfy.thgt Int performaneq.of the wor(c-for which this / permit Issypd,7 (,not employ anypeisort In any manner ADD�SS 6. �� p /N"'! /�_ so-a;to become aub� to tl�j Workers Compehsatlon LaWL COt�U1C Q ' CITY G� `� - - U Date Appll ht. { TEL NOTICE TO APPLIQ4NT: If, er.making this Gertlficate of ENGINEER NO. 29.`1 fl P FIZZ PROCESS® BY Q Exemption, You. shoulr{ beco a subject to.the 1A(orkeri Compensation provlslons.of the bor-Code,.you must forth- ADDRSS 7 c� GrO vylTh comely with.such provlsi¢ or this permit' shall be L TEL -TAV ATISTICAL CLASSIFKi4TIpN APT. OONDO. deemed revoked.,. CONTRACTOW NO.72 7- LICR4SEb CONTRACORSbKLARAtON . - �� J�_, o LK-NO. S-S g �S CLASS NO. � �___DWELL_UNITS I hereby affirm that I am 1lcerued under provisions of Chapter 9 _ Y�� ! NOSEWER � (commencing with Sectio[ 7000)of Division 3 of the Business sad Profeaslorn Code,and my IlcQnse tf In full force and effect. CITY - CLASS / � VALDATION y�/ SQ..FT. NO. or- NO. OF CHECK License Number IIcL.CClgss ) SIZE STOR16 . FAMILIES ONE V ConhnctoTy�' DESCRIPnON)JOF WORK �o ,Y� SEN/ ❑ : I'am exam rtdbr Sec Q ✓L G f t� o C�tIr. ADD ❑ S ATTER ElB&P-C for this a '^ ` REPAIR ❑ ; (STING BLDG. iJ 'l XMCJ ❑ Signature APPLICANT TEL OWNER-13 ER DTCLARATION NO: FINAL . DATE I hereby affirm that I am ex pf from the Contractors License . Law for the follovring reaso (Section 703.1.5, BjWneos and ADDRt$5 FINAL M Professions Code): ❑ I, as owner of the pr or my employees with BUILDING wages as their sole com Eatlon,wll I do the work and .. ADS — — The structure Is not Intend or offered for sale Sectlon , ( LOCALITY r 7044,$uslness and Profen ns Code,) QPNTRAC7rC)R NO. - MOVING TB I A •�l< I, as owner of the property, m exclusively r;bntracting �•; r with Ilcensed conitdciors to natruct the project (Sec- ADbwoss. ��.os tion 7044, Business and Pro Ions Code.) REQ L)I kLLK YARD HWY ' CONSTRUCTION LENDIN AGENCYTOTAL I hereby affima that therm li a con Ion lending agency for FRONli the performs�tc�e of the work for wh ch this,permit IS Issued.. P.L (Sec 3097, Cfb. C. SIDE, Lender's-Name - LDMA W. f t-&V 1..I q Ler�ees Address P.C_ Fua f Permk Fse I certlfy that I have read Ir application and state that the issuance Fee �A P/C above Informatlon Is co to comply with all County Ir vestlgatlon Foe ordinances and State laws Ing fo, bul ding coostructlon,. Total Fee LDMA Perm. and hereby authorize tatives of this County to enter upon the op"for in;pecf(lon pu ` e o nt or Agent Date