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HomeMy Public PortalAbout10014 GREEN ST_Building__ 78A898A CE#809.10-S6 APPLICATION FOR BUILDING PERMIT 1 BUILDING AND SAFETY DIVISION BUILDING Department of County Engineer ADDRESS County of Los Angeles LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN, SUPT OF BUILDING CROSS ST. -L DISTRICT NO. GROUP I TYPE SEWER MAP` FOR APPLICANT TO FILL IN S BK PG CONST. BUILDING I ADDRESS ©0/ STATISTICAL CLASSIFICATION 9,52),d?,- .1 1197"01 �� . � Ole CLASS. NO DWELL. UNITS OT . • BLOCK MAP STATE NUMBER HWY YES d I USE ZONE SPECIAL � ( NO.OF BLDGS. CONDITIONS SIZE OF LOT J(�J NOW ON LOT USE OF EXISTING BLDG. BUILDING EXIST. s SETBACK YARD HWY .$T_, ET NAME WIDTH OWNER FRONT MAIL p P. L. ADDRESS .S p "5�/` 14.sd SIDE / +rTEL. P. L. CITY /irn n/� f �1 No. INSPECTION RECORD ARCHITECT 6R TEL, ENGINEER NO. ADDRESS � TEL CONTRACTOR NO. •-��iQ" ADDRESS DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH SQ. FT. I` NO. OF NO. OF SIZE ! STORIES FAMILIES US R CTU APPROVALS SIGNATUREOF APPLICANT IJDATE INSPECTOR'S SIGNATURE f CC ADDRESS, FOUNDATION: LOCATION - ' w' FORMS. MATERIALS $ VSJz P. C. S FRAME: FIRE STOPS. FEE BRACING. BOLTS /// FEE $ FURNACE: LOCATION, VALUATIQN / GAS VENT. DUCTS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH. INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH. EXT. STATE LAWS REG NG BU�ING STRUCTION. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE AT RECT AND POSTED ADDRESS O �• FINAL JOHN A.LAMBIE, COUNTY ENGINE R, CLYDE N. DIRLAM. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION M.O. ASH `_ 0955U AUG 5 1 8.50 0 �1 . 76A638A CE#1303-10.56 APPLICATION FOR BUILDING PERM-IT 1 BUILDING AND SAFETY DIVISION BUILDING _ ADDRESS Department of County Engineer County of Los Angeles LOCALITY .� JOHN A. LAMBIE, COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST DISTRINO. GROUPTYPE SEWER MAP FOR APPLICANT TO FILL IN I BK PG CONST. '—�— BUILDING - I ADDRESS STATISTICAL CLASSIFICATION 40 I CLASS. NO. DWELL. UNITS LC>•! / LOCK MAPSTATE / NUMBER x,ry ��� HWY YES NO T � / UUSEZE SPECIAL O. OF BLDGS ' CONDITIONS SIZE OF LO NOW ONLOT �,.�D USE OF 7 �40 uV EXISTING BLDG. BUILDING YARD HWY ST EET NAME EXIST. • SETBACK WIDTH OWNER '/ ® - Q /CFRONT , P. L. Lo MAIL ;7$Q SIDE ADDRESS .S .�D C/'� / C P. L. CITY �/�D F> >�. NO INSPECTION RECORD ARCHITECT OR TEL, ENGINEER NO. ADDRESS TEL r CONTRACTOR NO. / J ADDRESS ­6� J� ZLe DESCRIPTION OF ORS NEW ADD �/ALTER REPAIR i/ DEMOLISH SQ. FT. NO. OF NO. OF SIZE STORIES Z FAMILIES U OF STRURE S -rr. /7 � + APPROVALS SIGNATURE OF APPLICANT , DATE INSPECTOR'S SIGNATURE ADDRESS ��© .iL�'I s FOUNDATION: LOCATION if FORMS, MATERIALS G - $ p C. S FRAME: FIRE STOPS. /�-�''�� FEE BRACING. BOLTS ' VALUATI�/o FURNACE:GASVENT, DUCTS LOCATION. FEE fj00, I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH. INT. f/v PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH. EXT. STATE LAWS REGUL �BUI ING CONS CTION. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED •�j s / �'(may ADDRESSJ-6 FINAL Jfiy->,.. -''„• JOHN A. LAMBIE, COUNTY ENGI EER. CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENGIqgtRR PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION M.O. AS_- ) ' ACO09561-- Aug 5 1 13.50 0 WORKERS' COMPENSATION DECLARATION I hereby affirm that L have d certtRcate of core t to self Insure, or a ce#tlficate of Wor{cdrs' Comperuatlon Insurance, APPLICATION. FOR BUILDING .PERMIT or a cerHfled copy thereof (Sec. 3800, Lab. C) COUNTY OF LOS ANGLES BUILDING AND WETY Policy No. Company BUILDING' `L Certified copy is hereby fumisher}. FOR APPLICANT TO FILL IN ADDS ❑ CwItfied copy is filedw' Ith the county bullding Inspec- BUILDING- _ . .-Non department. - AWRM Date ApplicantCTTY ZIP LpG41fn NO. OF NEAREST CERT1FiCATE OF EXEMPTION FROM WO�CERS' LOT sX I NOW ON LOT Cir �ST COMPENSATION INSURANfF (This section need not be com owrlER Irted If the'perm it Is for one TRACT BL A55GASSES"MALOT NO. P BOCK PAGE PARCEL No. hundred dolla)z..($100).cr lea. �- USE ZONE ' 6MAP 1=certify Nxrt In the performgoce of the yrork for which this perrAlt Is Issued, I shall not.employ arly per oq In any manner ADDRESS SPECIAL bN5 so as to be4ome subject to the Workers CompertWron taws. Q CITY ZIP C7 Date Applicant ARCHITECT Oft TR- DISTRICTGROUPrFIRE PROCE54®BY 0 rFOTICF TO APPLICANT: If, after making thrs Certificate of ENGINEER NO. Exemption, you should betome .wbject to the.Workers' a Compen*itlon proVIslons of the.Labor Code, you mforth - 4e-.-3 for - ADDRESS /C ii with comply with wch_provisions or ,this permit shall be TEL STATISTICAL CLAS&P1CATION AFT. .deemed.revoked. CONTRACTOR NO. JCOt�. Z UCEPiSFp CONTRACTORS DECLARATION CLASS UG CLASS Na. UNITS I hereby affirm that I am Ilcensed under provt}Ions of Chapter 9 ADS NO. I NEW .(commencing with Section 1000y.of Dlvlslon 3 of the Business UG - SEWER MAP andPrgfesslorp Code,and my Ilcense is In full force and effect. CITY CLAS BJC VAUDATION SQ. Fr NO. OF JW. OF CHECK' Ucerlse Number UG C`ku>{ SIZE STORIES FAMJUES ONE VALUATION Contractor Date DESCRIPTION OF WORK NEW ❑ ; ❑I am exempt under Sec. ADD El •-J , ALTER ❑ B.13P.G. for tflls reosag REPAIR ❑ ; Date: USE OF EXJSTING BLDG. DEMOL El Slgnature APPLICANT tTEL FINAL W ONER-BUILDER DECLARATION. DATE I hereby affirm that I am exempt from the Contlactors.Llceno Law for the following reaion (Section 7031.5, BuWn*=,dnd ADDRESS RNAL t Profealons Code): -17 I, as owner of the property, or my employees with A�DID�RI r •L" 'T woges as their sole compensation,will do the work.gng LOCAUTY , 33072-2.41 the structure is not Intended or offered.for sale(Section 7044, Butlnea and Professlons Code.) MOVING TR. 1 FTEKS I, as ovinor of.tfie prop",am exclusively contracting CONTRACTOR NO. with Ilconsed contractors to.con{truct the project (Sec- ADDRESS f0TFL 202 4 .1 .. tion 7044, BuAlnes and Professions Code.) CHE(I ILK CONSTRUCTION LENDING AGENCY 1?41YARD HWY TOTAL.O.Ag E FROM 2 -1 hereby affirm that there Is q constrictlonaending ogency for PRONT .l the performance of the work fpr which this permit is,Issued P.L. (Sec 3097, Civ. C.) SIDE.. P.L Lenders Name Q:C F« Perm l t Fie ��/• G !-DAM Ref. r t 1 Lenders Address iLTO AM 9:27 o I certify that I have rood this application and state that the 6Kance Fes s LDMA P/C f above Information Is correct. I ggrep to comply with aU County IM1vWlgatior, Fee ordinances and State laws rolatirng.to building"construction, Tonal Fee v vLDNW Perm n eroby authorize representatives of this County to enter. pore a above-rnentlo ed property In$140106n u 9 iQ ; ice ZU 1iHIIIIIIIIISi POR EMAKATORY LANGUAGI - Signature of Appllcant or t -APPLICATION FOR BUILDINGPERMIT COUNTY OF LOS ANGELES ILDING:AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL INADDRESS I hereby af}Irrn that I hive a certificate of consent to self InSLZO, BLE-DING ADDRESS L9�/ or a certlflcate of Ykrkem' compenwtion Insurance,or a cermled zfP copy thereof(sec 00 C.) Polley carr �� • �.../, TE4AP�. c'-rte( ct1-Tg G / sag of NO,OF OF BLDGS.NOW ON LOT '1 ❑ Certffled copy b hereby fumbhed �'7 Y Cp?Ia ,;G) <ZIF NEAREST CR09K ST. ❑ Gwtf oopy Is filed wfLh the county bulldtng Inepecion TAT BLOCK LOT Na LR4E E MAP N0. ,-bete -2- A, � � X58 MAP BOOK PAGE TEL o S 8PEC7AL CONDITIONS ,C .O- o / CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE RVU HUYt M $1 -V05W MN 1000 Fr.OF sca-loOIJ YES NO ADDRESS dol section need not be corYlpietAd If the permit b for one hundred I�1, &fr. �\ C�—r W-RICT aRX P TYPE CCt B FTSE ZONE PROCESSED BY dol We($100) or lase.) _ W via.'+�+ Q7r� I certfty that In the.performance c( the work for which this permft 7EIAV L� Q,I zP _ Is Issuedmanner ewes I shall.not employ arty person In arty mannewes bo • ARCFOIECi OR ElJl31NEEA TEL NO. Q� become sub)eot to the Nbrkers'Cortlerr psatlbn Lowe- S"RTk9T1CAL APT CONDO Date_ VOl ant ADDRESS CLASS NO.�DVVEIL 1ryTTS NOT)Cf TO APPLKANT,• If, after makhg this Certificate of FEOUFED TLTPJ_SETBACK FROM E)18T Exemption, you should become sub)eot to the Workers' CONTRACTOR W—W— g1 NO. SET BACK )AFD HWY PROP'LI E WDTH Campeneetion provbb+ie of the Labor Code, you must fortfnv►th STN c `( LOM- I T corr>pfy with such provbbns.or this permit eha11 be dpP LeemoO reyo+ed. ADDRESS LIC Na, FRONT 216 # 22I l22 SUE LICENSED CONTRACTORS DECLARATIONcrn,,,1,,_fi yvq;leX, UQ�Sa PSR MAP c I hereby.afilrm that I am lcertsed wxerpro b s of Chapter a (mTr wdbg w(th Section 7000)of Dl ed n 3 of.me Buatneae and eQ FT.SIZE Na OF STORES 40.OF FAMLES Protes3lor>s Code,and Ilcenee-18 In full force and '7A-15 NEW BK F'0 1 ITEM.; License Ninnber �- Lie-cias$ oEsa�TaN of vOFnc ADD ❑ vtiuAmoN ► TOTAL 1�r L7.1� p Contractor StN&LE l Or Date ALTER 1:1 $ CI-E(K 1�57.72 U ❑ 1 am exempt under sec. fv REPAIR ❑ �� RAPL.for ttile reason DEMOL ❑ LD►eA P/C Date: USE OF EX7STINO BLM i /2f3 ��• _ URM Q iiir_�rf 3i�fltufe (PFirIF) _ TEL N0. LDMA Perm 0 * 1 ❑ I, as owner of tine property or my a rpioyeee with wages ea gU � —(D � Z � . their ace compensation, whl'do the work aDd the ahijchure Is ADDRESS Cts O not intended or o(fered for sale (Seckc 7044, Busheas and �' C� «�(I--��J Fa7rlLL D1uE 1 Professions Code.) YOLL TI-E APPLIGWT OR FUnIf BULDM OCCU.PWT Fi i1L MZ Fooue UK VL ❑ I, ee owner of the property, em eXakAfvely contrectir,g with ori A I�rrur�carPiax�A wzAaoolre uAaeati�m�i k�veh T i n e 3 � ��.T..i Ibeneed contractors to construct the pro)ect (Section 7044, 'LeurrYa srt off TrE wzA�olra uAlertie WoaavgN GLIDE? BY Alk BLetnesa and Pm(osslo s Cod).) YES El NO - .1 YOLL THE WDEED USE OF T-E aI LMO BY TFE APPL."KT OR FUIUM dlD!!0 CONSTRUCTION LENDING AbENCY .MTY A" 4WEL NTT 4 1Ct"e a-�a�a.leT� ITEMS t hereby affirm mat there Is a COraftuction Ienaing agency for yEs❑ No❑ TOTAL 2233.61 N the perforrnance c(the work for which mb permit Is Ismer(Sec- µ4EFV1B m I FWE FEAR TFE�6 WOMM"GLIDE AND THE 3G�D PEFMTTNO `-f1L 1.-r4 2233.61 3087,Civ.C.) a-ECltLlsr. LHDEA TFE 105 AMOELE9 GOLNTv cooE, TM-EONCERNHOFAZAMCUS Leader's Name 66KrEFILALP Fl�f p AND Fa� ?L F�fb0.1J 7HE Lenders Addrea3 o 000m a'Arun I certify that 1 Ova read this appllcatJ n and state under penalty $z� of per]ury that the above fnformerion Is correct I agree to oon#y P.C.FEE ,,, 4 'l;-- PEST FESgy7 OOIXJ� 1W1 ;x/26/9` �G with all county ordinancee and State Vewn relating to bLr5dng / 7` �' q o c ' and hereby e property FitaNee f of �GHTp1,�rp— , eq-6 SSUANCE FEE ��s•�� 1027 1 AM10:31 m WTW / MESTIC3410N FEE T01AL FEE .V—r d A�a ADW I SEE REVERSE FOR EXPLA ATGRY LANGUAGE -APPLICATION FOR BUILD PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN FO,-, p�//! I he-retry affirm that I have a certifloate of consent to sett in re, AL1DREss or a cerCfh�e of Mckers' Compensation Insurance,cr a cerfffledcopy thereof(Sec 3800,Lab.C.) G�n ,)f. l� ��17p0Polky No., � o — �' 7Ajr LL ! G Y SIZE NO.CF BLDG&NOW ON LOT ❑ Certlfled copy Is hereby fumfehAd 6. 2 NEAREST CROSS ST. ❑ Certified copy Is filed with the county budfng I TRACT BLOCK LOT NO. tmeaL UM DONAP E MNO. Date4e Ax&ant 51 AS.SE`ssOR SPECIAL CONUTXDNS CERTIFICATE OF EXEMPTION FROM WORKERS' clWNER COMPIENSAT10N INSURANCE W4414M VATHN 1000 FT.OF SCHOOL? YES NO (fhb section deed not be corrQleted If the parTnit b for one hundred DISTFOCT GROUP TYPE CONST. FIRE DONE PROCESSED BY dollars($100)or leas.) A 7 I certify that In the perforrnence d the work for whish this perrNt /y p Is lamed, I shall not ernp{oy any person In arty manner eo as to ARC:HMBr OR Z�RTEL N�a becorne Subject to the VAx*.ars'Compeneat W Law& SPOTSTr-&L Ct.k93FG41pN APT CONDO Date Applloant ADDRESS CLASS NO. '/_Z DWELL UNITS NOTICE TO APPLr NT H, after' makhg this Certffloete of REOLARED TOTAL SETRAC,K FROM EXIST E empQlOn, you al-ruid becorna subject to the Vlbr'kara' TEL 110, SET BACK )AFD HWY PROP LINE WIDTH Compersaflon provisions of the Labor Code, you moat torthwfth 2w 944 I2 ooy with Such provtabne or thls permit shall oked.all be deemed rovADDRESS FRON7 mpf PL LICENSED CONTRACTORS DECLARATIONJWWL&.�r 'ygQ 2 Z SIDE 1 hereby affl7m that I am lYcensed underprwtabrm of Chapter 8 • LIC PSEWER MAP (commenchip with Section 7000)of Dlvblon 3 of the&;Mrxm and sa Ff. NO OF STORES NO OF s NEW Q BK PG , Proteaelone Code,and my Ilcenae IS In full face and effect License Number�_ LIo Cfese J!CAF[]ON OF ADD ❑ � «+ContractorDateMY DF'RtC ALTER ❑ $❑ I am e)mrnpt under Sec. REPAIR ❑ $RAP.C.for thla reason DEMOLLDMA Pic �Date: OF EXLSTWG Rd - URM ❑ 1 a APPtlCAfff(PFMfr) = TEL ^ LDMA Perm t y El _ 1, as owner of the property, or my ea ployeeei with wageC as u Vf fhelr Sole compensation, will do the work and thetru eoture Ea SS 0 not Intended or offered for sale (Section 7044, aAnees and FINAL DIVE 30.OD Pro(eeslons Code_) wa.L TFE FUTURE OR F7mlBul_orxr CCCLF T FLANUZ A HZAr�«ta•&CSIA ❑ 1, as owner of the property, am excfuatvefy contracttnp with OR A MncnsE COWMA ro A RAZARoous MATERv Eou►i To OR oPre4m Tt"n-E tk�nsed contracforo to conStrtrct the project (Section 7044, ,,Mourn&ePECFED 014 TFE FVZAFDOUS LUUERALs Guice? FINAL BY and Professions Code.) YES 1-1 HO wu T-E PrrEroEO USE OF TI-E BUOLrro BY TlE APRJGWr OR FUTURE BLx_DM TOTAL_ 184 . 9.5 _ OCCLF&W A PB:MU FCR CONSTRUCT"OFl 7"A TFE 80UTH CONSTRUCTION LENDIgG AGENCY =8(. T 4t8T�T CSC.-OW PCR CHEC, _ 134.95 r''m «. ry to u c I hereby affirm that there b a corTeducibn lending agency for YES❑ �� � � ,. ��f ��tinx the performance of the vvorlc for�tT ttrFs permit to issued(Sec. AVVV//f/-�A'f 0.0 w rfAn n E AZAr�oL�e um�xvE rFO 5.UNDEN Dine AND THE 3087,CN.C. T}E Lenders Nemo sECl7M{B HTHPK lel Lenders Address ��JN7 1Z�Z 000 -0001 fa l?6I 95 O OR AG19a V_ 1 certify that I have reed this app6catfon and state under penalty 1[] ° 1 AM 10:6? RQ of pedury that the above information la correct I agree to comply P.0 FEE PEFiIRT FEF with all county ordinances and State laws relating b building corbthrdion, and authortze represertatfves of this County ISSUANCE FEE - to enter property for Inspection . P m l�� P;WSTKWION FEE TOTAL FEE SEE REVERSE FOR EXPLANATORY LANGUAGE