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Home My Public Portal About5621 GRACEWOOD AVE_Building__ •� • APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) BUILDING q COUNTY OF LOS ANGELES ADDRESS i�.k14 , GRACEMMVDEPARTMENT OF COUNTY ENGINEER CITY AvecAblAs ZIP BUILDING AND SAFETY DIVISION NO.OF BLDGS. BUILDING / SIZE OF LOT. � NOW ON LOT ADDRESS �k.2 r _ PrW TRACT BLOCK LOT NO O LOCALITY Ave, TEL. NEAREST OWNER A NO. CROSS ST. ASSESSOR ADDRESS M. GF%AtCj=*Mt> MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE PR ESSED BY CITY D p, ZIP Q CONS y� ZONE ARCHITECT OR TEL. �'�S / �/ % { ENGINEER NO. STATISTICAL CLASSIFICATION S WER MAP ADDRESS CLASS NO.�DWELL.UNITS BK PG CONTRACTOR TN •. 107 E ZONE MAP NO LIC. , NO. NO. � � SPECIAL • LIC. CONDITIONS CITY CLASS �� ROAD DEPARTMENT APPROVAL REQUIRED YES NO � CONSTRUCTION LENDER NAME AND BRANCH Q BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET) ADDRESS CITY HIGHWAY } YARD 'TOTAL SETBACK FROM TYPE OF EXISTING SIZE SQ. F �� STORIES FAMILINO. OF NO. LIES ONE CHECK FRONT PROP. LINE HIGHWAY WIDTH Z ' DES-CRIPTION OF WORK A D NEW ❑ U ADD BLDG.SETBACK FROM F-K%M0 2• fift— SIDE PROP.LINE OF (STREET) O D _� LTER _ TOTAL SETBACK FROM TYPE OF EXISTING Y4 myH } YARD REPAIR IGHWAY C- SIDE PROP. LINE HIGHWAY WIDTH w EXISOT NG BLDG.g` Lf Rj,%MOL ❑ } Z APPLICANT TEL CORNER CUTOFF YES ❑ NO (PRINT) NO. BY (SIGNATURE) IN OPEN SPACE YES NO ^� 7� IN COASTAL PERMIT ZONE YES [] NO ❑ VALUATION$ ,26—D I , I HEREBY 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 CON- STRUCTION. I CERTIFY THAT IN DO THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY ON IN VIO A OF THE LABOR CODE OF TH STATE OF -C IF NIA RELA NG TO WORKMEN'S COMPEN 10 NSU A E. SIGNATURE OF PERMITTEE ADDRESS TE FINAL BY CITY w \ NO. � DATE — HAKE CHECKS R-IYAf3LE TO: FEE $ FEE HARVEY T. BRANDT, COUNTY ENGINEER PLAN'CHECK VALIDATION CK. M O. CASH PERMIT VALI TION CK. M.O. CASH z , 76A638A CE#803 5/74 8 7 5nmnv 18 D 6 9.0 -'�x T,y APPLICATION FOR PERMIT T • DEPARTMENT OF BUILDING AND SA 11l COUNTY OF LOS ANGELES aI L D I N G W M. J. FOX. CHIEF ENGINEER v,", FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK.NO. PERMIT NO. BUILDING - ADDRESS LOCALITY - RECEIVED BY DATE OF APPL. DATE ISSUED NEAREST -- CROSS ST. _ BUILDING OWNER ADDRESS -" MAIL LOCALITY ADDRESS NEAREST TEL. CROSS ST. CITY NO. FIRE NO.OF TYPE GROUP ARCHITECT OR TEL. ZONE PLANS ENGINEER NO. BLDG. ORD.NO. ADDRESS _ SETBACK LINE APPROVED + TEL. BY DATE CONTRACTOR NO. USE APPROVED ADDRESS ZONE BY DATE LEGAL / CORRECTIONS DESCRIPTION LOT NO. I BLOCK TRACT NO.OF BLDGS. SIZE OF LOT I NOW ON LOT - USE OF I NO.OFI NO.OF EXISTING BLDG. FAMILIES ROOMS DESCRIPTION OF WORK NEW ALTERATION ADDITION O A REPAIR MOVING DEMOLISH L7 Sq.FT. NO. IF Z SIZE �' ROOMS STORIES 1 _ D WALL ROOF f' COVERING I COVERING USE OF NEW BUILDING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS _. AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE OF / BRACING,BOLTS PERMITTEE LATH, INT. AUTHORIZED AGT LATH, EXT. 7GA63BA 9-48 DBS-3 same SETS $ P.C.$ PLASTER,INT. FEE $ PLASTER,EXT. VALUATION "' FEE 4.� FINAL T I DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT i COUNTY OF LOS ANGELES L D I N G WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK. NO. PERMIT NO. BUILDING - ADDRESS �- LOCALITYZ57 RECEIVED BY DATE OF APPL. DATE ISSUED NEAREST CROSS ST.. /,1 BUILDING tt ADDRESS OWNER !: , 7/' i MAIL _ - LOCALITY ADDRESS NEAREST TEL. CROSS ST. CITY ;�. NO. FIRE NO. OF TYRE v GROUP ARCHITECT OR TEL. ZONE I PLANS I ENGINEER NO. BLDG. ORD. NO. SETBACK LINE ADDRESS - APPROVED TEL. BY DATE CONTRACTOR NO. USE APPROVED ZONE - BY DATE ADDRESS HOUSE NUMBERING LEGAL II` DESCRIPTION I LOT NO. I BLOCK MAP NUMBER _FIELD CHECK BY ( TRACT NO. ASSIGNED BY DATE NO. OF SLOGS. CORRECTIONS SIZE OF LOT NOW ON LOT USE OF I NO. OF EXISTING BLDG. FAMILIES DESCRIPTION OF WORK � NEW I ALTERATION I I ADDITION I O REPAIR I DEMOLITION I I I _A Q. FT. NO. OF SIZE ROOMS STORIES Z D EXT. WALL ROOF 1' COVERING COVERING USEOFSTRU¢TURE. APPROV� INSPECT R'S SIGNATURE DATE I HERESY ACKNOWLEDGE THAT I HAVE READ THIS AP- FOUNDATION: LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS CORRECT. 1 AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS, HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS LAWS REGULATING BUILDING CONSTRUCTION. FURNACE: LOCATION, SIGNATURE OF & -- '� GAS VENT, DUCTS PKRMITTE ^ LATH, INT. ADDRESS - 'e r: LATH, EXT. J74AS25A, UTHORIZED AGT. PLASTER, INT. DBS9 10-50 $ r "'�..� P. C. Ili FEE PLASTER, EXT. s ALUATION FEE ""` FINAL I 25M SETS 4-4 �r k ARTMENT OF BL AND SAFETY TION r-u ZRMIT tWLq NTY OF I ANGELES`� WM. J. FOX, ar11EF ENGINEER LP %w _ FOR. APPLICANT TO F LL IN FOR OFFICE USE ONLY BUILDINGDISTRICT NO. PLAN CK. NO. PERMIT NO. ' ADDRESS �- Gracem od AVe• --- - - LOCALITY Arcadia Callf• RECEIVED BY � DATE OF APPL. DATE ISSUED NEAREST CROSS ST. Live Oak Barnett BUILDING OWNER 1h. " B :L. arnet tai - ADDRESS MAIL { t I -ADDRESS z 111> CTraC e wo o d Ave. LOCALITY -- ----- -.----------_- - . CITY Arcadia, Calif. NOL. I '..)ne CEASENEARES T. FIRE NO.OF I TYPE it GROUP ARCHITECT ORTEL. ZONE I PLANS ENGINEER \'� NO. BLDG. ORD. NO. ADDRESS SETBACK LINE TEL. APPROVED - CONTRACTOR NO, BY DATE USE APPROVED ADDRESS ZONE BY DATE `EGA` D CRP I ION I LOT NO, CORRECTIONS I BLOCK ` 'b. a c v'Sin 1 s c 1Qn _t TRACT , k,G'L At a �'"' A z Y1T r NO. DF BLDGS. SIZE OF---OT 60 x -130 NOW ON LOT none USE OF I NO.OF I NO. OF EXISTING BLDG. FAMILIES ROOMS - ,, C• DESCRIPTION OF WORK VV ALT N _EW _ 11 ERATION ADDITION _ A REPAIR MOVING DEMOLISH p SQ. FT. 4 74 NO.OF l ZD SIZE ROOMS STORIES WALL ,�tOOF c t�T'1 y)X31 1,-) 1 ----- r COVERING rlasterbeak:DVERING srJ.ln- es USE OF NEW 1 tTTie BUILDING APPROVAL I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION, INS CTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, `A SIGNATURE OF BRACING, BOLTS OWNER LATH, INT.: AUTHORIZED AOT-'`' LATH, EXT.: $ P. C. $ PLASTER, INT. Q FEE PLASTER, EXT. VALUATION FEE FINAL DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES B U 1 L ® ' N G WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK.NO. PERMIT NO. BUILDING ADDRESS LOCALITY �!• f RECEIVED BY DATE OF APPL. DATE ISSUED NEAREST ._} CROSS ST. BUILDING OWNER xEL ADDRESS S'LOCALITY - MAIL ADDRESS - V � . — NEAREST TE CROSS ST. CITY NO. e> FIRE NO.OF TYPE GROUP ARCHITECT OR - TEL. ZONE PLANS ENGINEER NO. BLDG. ORD.NO. ADDRESS SETBACK LINE 1(.� APPROVED TEL. BY DATE CONTRACTOR NO. USE APPROVED ADDRESS ZONE BY DATE -=D8f66° TI LOT NO. .`AL ALOCK d" CORRECTIONS ,. --- — TRACT" ,,�� I NO.OF'BtDG6. _SIZE OF LOT NOW ON LOT USE OF NO.OFNO.OF EXISTING BLDG. I FAMILIES I ROOMS DESCRIPTION OF WORK NEW ALTERATION ADDITION O A REPAIR MOVING DEMOLISH L7 SQ.FT. NO.OF Z SIZE ROOMS STORIES D WALL ROOF t' COVERING I COVERING USE OF NEW BUILDING j L 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS AND STATE LAWS G TING 1 BUILDING CONSTRUCTION. - FRAME: FIRE STOPS, SIGNATURE OF BRACING,BOLTS PERMITTEE LATH, INT.: AUTHORIZED AOT LATH,EXT.: DBS-3 50M SETS 1-4e $ P.C., PLASTER,INT. FEE �. PLASTER,EXT. �i 81 VALUATION FEE /l J, FINAL .Y XwoR 'GZkMrtNSA�ION bECrl.�R,60' -N r. .�G . I-"re of rm tthat I have q�°certffi o� co sent to self - 4 l�,l�I N� -PERMIT insu,e or a-tertffi4ate of W'orl rs' Cctmpe lors liuurdnce, = APP�LICATI NTOR 8. a'r'd recti led tdpj%YRq" f S�3800;RLdb:•C`..)' r''' -- - _ _ _r -- - - - y, COUNTY OF LOS ANGELES BUILDING Mb-SAFETY Rbl o mwrlY Cert)fted•wpi, is herby fumished:. FOR APPLICANT TO FILL iN ADS 1*Ifled'co0y'ls fired"'ihe county bullding Ihipec- BUILbi tion•dep*artmtint.' :-w ADDRESS J bL G! A -6I -W CPID Date'•• �:_ .,.ARplicantt CITY L ` ZJP 0 LE .�LfTY Ct7TIFICATE df Q TIO fROM'WORKER' c NO.-OF BLDGS. 'COM JINSATION I SURAN�1., SIZE OF LOT SO C..� NOW ON LOT ST. ` '(Thls'lectlon need,not bw'- om leted If the permit,Is for'pne - . . _ -'_ _.-- hur>dre¢�dollgrs($100)or Ieja ) c.;- i TRACT stoat LOT NO. MAp ARCEL T - OSE ��edify'that In'thp performance.of the watrk,f6.r whlch this. OWNER - - e�rrh�f b IasSied'Ish4lt'noYe.mploy qny p..��r ori 'any monndr so os Jo blGomeaub}ecf?o ttiz>f Workeri''Cofnpe'nsa}lori Laws. CONDI1sON5 Date 'n Ap)illtaht ..y: ,. :..,. . CITY.- - - - LP NOTKI•TO 7f; ofte+' makk4i his ' tfidite of ARCH NNOO. DISTRICT GRo4rP TYPE ZCX1� LiY-.- . Exemption yb�u' should bdcome silbTe�t' to the Workers' —- r�^- T ' Z Gompensatlon,proJlalorn ofMheLaEZor'Code; you,mu> l ADDRESS (�1 .S(/fl. _ _ ✓ - t with c4rnp[,A•with suph pkovlsloryr or th p&rmq l - - - ' r o. L( IZ sraTlsna cAt pssaFtu>al oN. Apr. ee ; dms .revoked:, a• iu.-' CONTRACTOR !-`\L 1 (_ LICENSED CONT6. 'TORS DECLARATIODJ, .' ' -- -- 11 y�- ' , tiC. - QASS NO. DWL3L u rrs- ; 7 hsw6y'affirm ihdt I am Ilcensgd finder proyfelor�of Chapter 9NO. - { ( ng with Sectlon'70p0)of Dlvfsidn 3.6f tfie Business and � � I pS - LiC SEWER MAP Y :.Profen Codp'dod'my licgrrse'bin.full'fd�ce and effect. CITY CCASS - - - VALDATION T I c., t _ . . ..�... _. BK. PG. SQ NO.OF_ _ NO.qF - _ CHECK i •_.•r'` i LlcenieN4m S Llc C) - SIZE 5705 I] bE fracto 'I :d:', (�;i _..,.. t. DBkmFr10NbF wORtc -,ls+ _ - EW cg:; Q� , 1 aryl gxempf undef Sec ll��K ALTER - B.3P.C. for this reason Y(x_L - eo REPaR -$ - -- U OF j J -- - - °: AACM EXISTING BLDG. Signature - -___. .,_..._:. APPUCANt fMINT)wI tJO. RHAL } OWNER-BU I LDEl2 DECLARATI ON - _ DATE._ - -,!hereby affirm-twit-I.am exempt from the_:oatrbctors License { (�[' f+ Q 5 A Law for the follow ndi ret&on jSectlbn 703}•.5,' Business and - ' -Profbasibns Code _ _..�. _� .-=- __. .. BUrLDrNG D I,,cs owner of tho-•Property, or m employees with ADDRESS y wages as}heli sole compensation wllfdo'thi work and the structure Is not Intended oraffered'forsale(Section LOCALITY ti-. o_o.2(� -704A, Business and Profis»slonrCode -`- -' - _ h10VING TEl -. n1, as owner of the property, qm exclusively contracting �' j tiylTfi licensed contractors to construct the-project (Sec- - Q.2 0 7 8,6 tion 7044, Butilnew and•Profeesions CpdejTOTAL SETBACK-FROM ADDRESS CONSTRI}CT10N LENDING AGEIJCY. g YARD -HWY PROP:LINE WIDTH I hetebbyy.gffirm ftt.there Ina construction lending agency for FRONT the perfounance-of'•the work for which-this permit Is Issued - P.L. (Set. 3097,'CIv. C.�. SIDE k - Lenders Name - .. 4, P.C. Fes$ - f a..it Fes LDMA W. Lender;s Addrees I certify.that.I have.read_this application.end-state that.the Issuance Fee- /D r�O-= LDMA P/C above Information is correct. I agree to comply with all County In Fee " ..grdinar)ces and Mate {aws relating to b Ilcling construction, Total fee S-. LDINA Perm. and ereby ou+or1w representatives of fhls•County to enter Upon a abov ntl property for litspectlon purposes. ' W REVtiRf✓1 FOS DQL.AIIATORY LAPOGUAGE � i _ •mr _ of-Appikanror-Ay.nt - oar. - - - - - - -