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Home My Public Portal About10802 GRAND AVE_Building__ ;6ASE6A-IW- APPLICATION FOR BUILDING PERMIT ], DIVISION OF BUILDING AND SAFETY ADD ESS ,(� ". Department of County Engineer County of Los Angeles LOCALITY �,- JOHN A. LAMBIE, COUNTY ENGINEER CASSATT D.GRIFFIN, SUPT OF BUILDING NEAREST c- CROSS ST. DISTRICT NGROUP TYPE SEWER MAP O. FOR APPLICANT TO FILL IN ✓ - I _ BK PG BUILDINGT. It^' _ CONS ADDRESS NUMBER 1 HWY MAP STATE YES O LOT NO.� BLOCK USE Z NE SPECIAL � !� CONDITIONS TRACT x.302 A— NO. OF u „y,} NOW ON LOT EXIST. BLDGS. '4 SIZE OF LOT ?"` t SETBACK YARD HWY A STREET N ME USE OF WIDTH EXISTING BLDG. FRONT P. L. f� OWNER 1,:;:.: �„air;l FIDE MAIL �7 $V .Y'—ii0`'�-Ti�<�l` / ADDRESS O TRACT DWELL. I UNIT TEL 5 INDUSTRIAL CITY NO.'/ 1 DWELL. I UNIT 6 PUBLIC BLDG. ARCHITECT OR TEL. 2 DUPLEX 2 UNITS 7 p�DDN.,ALT., ETC. ENGINEER NO. 3 APT. UNITS ADDRESS UI 4 COMMERCIAL t3 MISCEL. II CONTRACTOR '-+ .. :..;' '- NO �;-. ";�:`' � - INSPECTION RECORD _ADDRESS.::._ �' .J.'= !.. �...:? -� P d.°t--Ia A, Ir .e,. DESCRIPTION OF WORK ,,, NEW ADD ALTER• REPAIR DEMOLISH SO. FT. NO. OF NO. OF " SIZE "' STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF APPLICANT APPROVALS ADDRESS DATE INSPECTOR'S SIGNATURE $ FOUNDATION: LOCATION FEE $ Z �/ FORMS,MATERIALS FRAME: FIRE STOPS, VALUATION $-f u C BRACING, BOLTS FEE -y"-/ - FURNACE: LOCATION, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT, DUCTS J „J APPLICATION ANQ STATE THAT THE ABOVE IS CORRECT AND AGREE T01/1CMPLY WITH ALL COUNTY ORDINANCES LATH, INT. AND STATE LAMS, REGgLATING BUILDING CONSTRUC- TION. LATH, EXT. t v1< SIGNATU I HOUSE NUMBER COR- TTRECTPERMIOF AND POSTED i ADDRESS FINAL �� .�y�E. %'2'E� JOHN A.LAMBIE,COUNTY ENGINEER V��111IDATION CLYDE N. DIRLAM. CHIEF BLDG. INSPECTOR O CASH ' 10191,50A NOV 1 1. 6 12 .00Aa 2357`,' mov15 24.00 +� WORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of caImur to self APPLICATION FOR BUILDING P E RMI T Insure, or a certificate of Workers'Compenstlon Iruurance, or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Polry n Certified copy It hereby furnished. BUILDING FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy It filed with the county building Inspec- Bl 1LDING Tion department. ADDRESS Q V O 0 LOCALITY NEAREST Date Applicant CITY ZIP CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKEf�S' • OF BLDG& ASSESSOR COMPENSATION INSURANCE S14E OF LOT ON LOT MAP BOOK PAGE PARCEL (This section need not be corn leted If the permit Is for oneUSE ZOtE �O Z BLo« Lor No. No. hundred dollars ($100) or less. TR4CT TEL SPECIAL CL OWNER / NO. CONDMONS 0 I certify that In the performanc work for which this O permit Is Issued, I}hall not em oy any, rso ny manner O Z� DISTRICT GROUP TYPE FIRE PROCESSED BY V to.as to ome blest t }h 'Work tion Laws. �R D /� `' 1� 1CONSTIz:1 ZOtE Dai e Appl l t ARCH TECT OR STATISTICAL CLASSIFICATION APT. JODNDO. G NOT] TO ICANT: If, er aking this Ce ate of W Exemption, you should co sublect to th or V4GINffR NO. CLASS NO. DWEIJ_ UNITS N Compensation provisions a Labor Code, you ust forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be deemed revoked. (� NO. O BK PG, VALJDATION LICENSED COf4TRACTORS DECLARATION uC. _ I hereby afflrm that I am licensed under provisions of Chapter 9-- ADDRESS Nco �� VALUATION (commencing with Sectlon 7000)of Division 3 of the Business and LIC Dv O� Professlorts Code, and my license Is In full force a e{{J, C - (LASS __ $ / 54. FT. NO. OF NO. OF CHECX License Number Llc.Cla Sig 2 1 STORIES FAMILIES ONE NEW ❑ S I�"L L/�s> � p� / DescRIPTION of WORK - Contractor e am exempt from the llcensing require nts as(dm a A ON ADD licensed architect or a registered professional engineer J t ALTER FINAL acting In my profeulonal capacity (Section 7051, �/ �R ❑ DATE �D�� Buslnefs and Professions Code). USE OF FINAL EXISTING BLDG. ❑ Er Llc.or Reg. No. Date APPLI TEL OWNER-BUILDER DECLARATION PRINT IV I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section.7031.5, Business and ADDRESS Professions Code): ❑ I, at owner of the property, y employees BUILDING pr p rty, or m em to ees with ADDRESS wages as their sole compensation,will do the work and the structure Is not Intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL I, as owner of the property, am exclusively contracting CONTRACTOR NO. -2.53,S9 A with licensed contractors To construct the project (Sec- ADDRESS # 0 0 0 a o Han 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY �� YARD HWY Tor PROP Frau WIDTH I hereby affirm that there Is a construction lending agency for FRONT 2'0'o fj Q (] the performance of the work for which this permit Is Issued P.1. o 0 0'8 a 0 O•S (Sec. 3097, Civ. C.)., SIDE P.L. Lender's Name 512,1 T 8.1 $ Lender's Address P.C. Fee S Permit F" - I certify that I have read this application and state that the Issuance Fe* above Information Is correct. I agree to comply with all County nvestlpation Fee g� ordinances and State laws relating to building construction, v Total Fee reby autho xe representatives of this County t enter upo v entic nad property for inspection p es. SEE RFVUSE FOR EXPLANATC?RY LAMGHIAGE Slgnaturo o Ap t or Agent Date C