HomeMy Public PortalAbout8621 HALDEMAN ST_Building__ - I
79Aa3e1tcfi#003,s BD APPLICATION FOR BUILDING PE MIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS _
BunDING AND SAFETY DMSION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST 99
WILLIAM A. JENSEN SUPT OF BUILDING CROSS
DISTRICT O. GROU TypE SSED BY
FOR APPLICANT TO IN CONST.
BUILDING
STATISTICAL CLASSIFICATION I S WER MAP
BK PG
ADDRESS
CLASS NO :� DWELL UNITS
LOT NO BLOCK -MAP AT YES "NO '
NUMBER
_7 HWY
TRACT o ozZONE SPECIAL �j �J
SIZE OF LOT �J I NOW ON LOTS CONDITIONS // r /• -
USE OF (F
EXISTING/)BLDG /J ,/ BUILDING YARD HWY T NAME WIDTH
EXIST
SETBACK T .
OWNER /K 0�14Ae-4 � �u•r'f&L L
FRONT
P L R
ADDRESS SIDE
ARCHITECT OR TEL P L
ENGINEER NOINSPECTION RECORD
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ADDRESS - / �- / '
CONTRACT c ERi �I GrJ O l '�t /dt L� % � OV
ADDRESS /LS—/(j ` ?/1I B el - Q
DESCRIPTION OF WORK v
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CL
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y
NEWADD ALTER REPAIR DEMOLISH N
Z
SO FT. /o) NO OF NO OF
SIZE. STORIES FAMILIES
USE OF
(eL
STR CTURE
SIGNATURE ice,
APPLICANT ,
VALUATION$ 3 ��'•"� I - ,
n 'q APPROVALS DATE INSP CTOR S SIGNATURE
PMT
FEE $ U /(J d FOUNDATION LOCATION-
FEE $ 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, �J� I
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS /
BUILDING CONSTRUCTION I CERTIFY THAT IN THE PERFORMANCE -
OF THE WORK FOR-WHICH THIS PERMIT IS ISSUED I SHALL NOT LATH, INT
EMPLOY ANY PERSON IN ANY MANNER 50 A TO BECOME SUBUECT /y t _
TO THE WORKMEN S COMPENSA ON LA F CALIFORNIA LATH,EXT
SIGNATURE O. HOUSE NUMBER COR- ,
PERMITTEE- RECT AND POSTED /
ADDRESS FINAL
CLYDE N DIRLAM, PRINCIPAL ST CT RAL ENGINEER
PLAN CHECK VALIDATION cK M.D. CASH PERMIT VALIDATION CK. M O. CASH
tKo1 6' 7 8 MAN 2'7 2 3, 1; - 22.5Q A
` p' j..Uo 2 0 5 2 FEB 3 1 A. 4 5
APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO.FILL IN, (Pr nt or type only
BUILDING "8621 _B. Raldeman St. - COUNTY OF,LOS ANGELES
ADDRESS DEPARTMENT OF COUNTY ENGINEER
CITY San-Gabriel- ZIP -- BUILDING AND SAFETY DIVISION
_-�_ _ _ NO.OF BLDGS BUILDING_ -
SIZE OF LOT- NOW ON LOT ADDRESS
TRA SL-CK LOT NO 4f LOC ALIT
TEL NEARES - _
OWNER Eelen Godfrey - - NO -- - CROSS ST,
ASSESSOR
ADDRESS 8621_$. -Raldeman MAPBOOK � �J PAGE �5 PARCEL
-_ DISTRICT_ GROUP TYPE FIRE SSED BY
CITY San Gabriel ZIP CONST ZONE
ARCHITECT OR _ TEL
ENGINEER NO
"_STATISTICAL CLASSIFICATION SEWER N4AP
ADD RESS �- - `CLASS NO.� _DWELL UNITS BK PG
AA
CONTRACTOR Rigid NOL - ZONE NOPLIC _
ADDRESS - 337_ S. Woods -Ane. NO 159496 ;7-
/ SPECIAL•
LIC CONDITIONS
CITY- Los An eles CLASS - C-39. ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑
CONSTRUCTION-LENDER
NAME AND BRANCH BLDG SETBACK FROM y
FRONT PR -LINEOF _ (STREET)
ADDRESS CITY - _ �
HIGHWAY } YARD -_ TOTAL SETBACK FROM TYPE OF' EXISTING V
SQ FT NO:OF NO- OF CHECK' - FRONT PROP LINE HIGHWAY WIDTH
SIZE STORIES FAMILIES ONE - CD
DESC RI PT-ION OF WORK - - - NEW ® a
ADD ❑ BLDG.SETBACK FROM -c N
Re-roof -with composition - SIDEPROP LINEOF STREET) Z
ALTER ❑ HIGHWAY } YARD = T-OTAL SETBACK FROM YPE OF EXISTING
• REPAIR❑
SIDE PROP. LINE H HWAY WIDTH
USE OF _ DEMOL El }_- - - - -
-EXISTING BLDG; - -- '
APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑
(PRINT) _ _ _ NO.
BY (SIGNATURE) - - IN-OPEN SPACE - - YES ❑- NO ,❑,
IN COASTAL ZONE YES ❑ NO ❑
VALUATION$ 865.00- - CATEGORICAL EXEMPTION YES[:] NO ❑
I HEREBY ACKNOWLEDGE,THATI HAVE READ THIS APPLICATION ENVIRONMENTAL _
AND-STATE THAT-THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED - (DATE) -
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION I CERTIFY THAT, IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE)
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STATE OF CALIFORNIA AI NRELATI NG TO -
WORKMEN'S CO MPC Nitidt♦aS{I�,p y.GE C d�1
SIGNATURE OF bllSt FF1111��b
PERMITTEE __ _
ADDRESS 337-'S. Roods-AkeiLiie.` bW12 '
- -• - FINAL - BY
EL. -
CITY NO.
TDATEC PMT.
/
t11hE C.HL C,1`S PI}A13LL- 10' F'E $' FEE $ 10.00
HARVEY T,- BRANDT, COUNTY ENGINEER
PLAN CHECK-VALIDATION _CK M o CASH - PERMIT VALIDATION CK M O CASH
5 2=6r,lAid =30 l.'A. - 10-0 0,•93
76A638A CE#803 12/72