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HomeMy Public PortalAbout4805 HALLOWELL AVE_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES I L WM.,J. FOX, CHIEF- ENGINEER FOR APPLICANT TO'FILL IN FOR OFFICE -USE ONLY DISTRICT NO. PLANCK. NO. PERMIT NO.BUILDING FAUDID7RRECEIVED'BY DATE OF ADPL. DATEISSU' D RESTSS ST. [ADDRESS �..C3�t .�. f�. LOCALITY 88 D � /� ./(�j�r J_ .NEAREST I �`_ TEL ROSS ST. Ge/x,,,./C Lda dl� NO. FIRE NO. OF TYPE� qq GROUP, � TECTOR' - TEL. 'ZONE - PLANS V EER NO. BLDG. ORD. NO. SETBACK LINE 1 /✓ Y SS APPROVED - - BY .;, -1 DATE ACTO �I -O, USE �� APPROVED",BY- i DATE t� ' ZONE r' HOUSE NUMBERING EGALRIPTION T NO. BLO•�CK MAP NUMBER �?—� � L7 FIELD CHECK BY TRACT '1 NO. ASSIGNED BY�'-*'/ DATI=491 4-10 NO. OF BLDGS. CORRECTIONS . SIZE OF LOT / I NOW ON LOT 0- USH OF I NO. OF - 7-,-7 eR.-_a R`' V2—: .w- Jk EXISTING BLDG. FAMILIES C3 _j'gv:o DESCRIPTION OF WORK 43 to NEW - I elALTERATION I I ADDITION _ �,E REPAIR '9�'I. I DEMOLITION, I I I - ---` - �-- _� SQ. FT. NO. OF SIZE �, ROOMS STORIES Z EXT. WALL • - ROOF �D r COVERING Ld�'�� I COVERING << USE OF STRUCTURE � r ,APPROVALS INSPECTOR'S S•GNATURE DATE 1 HEREBY ACKNOWLEDGE THAT 1 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'CONSTRUCT N. _/e�vv,J •- ���qqq / FURNACE: LOCATION, ,Sl-•r/r.! �f SIGNATURE OF /J A - '/�J GAS VENT, DUCTS PERMITTEE _" e`L. ,�yW�l�°�\ f �A�A _ �/�fl�k�� alt" LATH. INT. XD DREGS. LATH, EXT. AUTHORIZED AGT. PLASTER, INT. 76A8f 8A• DBD1f "lo-so � FFEE $ 9 1_ - '- �0 7d FEE PLASTER, EXT. �- VALUATION $ ✓�.e.Q> FINAL 4 . ................. 76A638A CE#8038.61 APPLICATION ' FOF,Z--: BUILDING. PERMIT COUNTY'OF :LOS ANGELES BUILDING ADDRESS DEPARTMENT.OF COUNTY ENGINEER BUILDING AND SAFETY 'DMSION ' LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST- WILLIAM A.'JENSEN Si)P'T OF BUILDING CROSS ST. '•' DISTRICTO: G OUP TYPE P ESSED By?,', FOR APPLICANT TO FILL IN ' CONST:I:d 1, BUILDING J ,r'�ry�p-- j STATISTICAL CLASS (CATION S WER MAP ADDRESS . .hL''LvG - L.�• 11 BK. �.a.. ,. CLASS.NO. _ DWELL.UNITS ' LOT NO. BLOCK - ATER ERTIFICATE ,NOT REQUIRED RECEIVED i TRACT MAP • HIGHWAY �t OF BLDGS. ( NO (CIRCLE) STATE MAJO SECONDr LOCAL SIZE-OF LOTY�f3 -5NOW ON LOT I USE ZONE SPECIAL USE OF �- _s J �. CONDITIONS EXISTING BLDG.• G� / OWNE ^ DGZ•�G�� NE • / BUILDING YARD HWY -STREET NAME 4' EXIST. SETBACKWIDTH FRONT ARCHITECT OR _ TEL. - P L. ENGINEER NO. _ SIDE. P. L. O ADDRESS • •' - INSPECTION RECORD U _TEL,, CONTRACTOR`�_i_ 4ll�Z,&0U NO ���L� 7 . ADDRESS ,- ,ft'aC, L�f/J�'7' - f r . V DESCRIPTION OF WORK � '� •' re 'ADD• ALTER REPAIR :DEMOLISH f R SQ.'FT.' -NO.OF NO 'OF IZE t STORIES 'FAMILIES 'c U OF SE STRUCTURE 'SIGNATURE F - C�fit l� !J: n v APPLICA VALUATION$ 't' ) '. .. _ - /�i//�� APPROVALS DATE INSPECTO y R& FEE $ r FEE $ �v� FOUNDATION: LOCATION ./ �•� j .FORMS,MATERIALS FRAME: FIRE STOPS,- '1-HEREBY ACKNOWLEDGE THAT[-HAVE READ THIS APPLICATION BR.ACING BOLTS, AND STATE THAT-THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, ' "WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED\HEREB -I WILL NOT EMPLOY ANY PERSON IN VIOLA,- LATH, INT. _ TION OF THE LA R C DE OF THE STATE OF CALIFORNIA R_ELAT. •_ ' ING'TO WORK N'S C PENSATION INSURANCE l�[.,�J,{ -LATH,EXT. SIGNATOR OF- -C_ HOUSE NUMBER COR- P,ERMITTE -° RECT AND POSTED'.05, ' ADDRESS 1 FINAL CLYDE N.'DIRLAM, PRINCIPAL STR RAL ENGINEER'F,',•. PLAN CHECK VALIDATION P.ERB& VALIDATION cK 'm.O. SASH j: ;,0:0 3.8:8��.�:JDtd•1 $�4�4� D--• ..UC)� ..� . - _ . . " U.C.71- ---JM-1,8 -,-AL D 6-.O,O— l� `• 76A638A CE$�8031-62 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING �? DEPARTMENT OF COUNTY ENGINEER ADDRESS V BUILDING AND SAFETY' DIVISION LOCALITY 17L V JOHN A. LAMBIE, COUNTY ENGINEER .' NEAREST • WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST DIWICT NO. - TYPE PRO SSE - FOR APPLICANT TO FILL IN '\� CONST. BUILDING Q STATISTICAL CLASSIFICATION -SEWE MAP ADDRESS L o ua v2 j4zg5.a' ^� CLASS NO DWELL. UNITS �— K fG` LOT-NO BLOCK WATER NOT REQUIRED RECEIVED CERTIFICATE: TRACT NO. ID 0 HIGHWAY STATE. MAJOR SECOND, LOCAL N0.OF BLDGS. SIZE OF LOT NOW ON LOT _7 USE ZONE SPECIAL USE ' CONDITIONS ' EXISTING BLDG /}'}- " OWNER /AQ6 TEL S NO. BUILDING YARD HWY STREET NAME EXIST ' SETBACK WIDTH ADDRESS _FRONT ARCHITECT OR TEL. P. L ENGINEER NO. SIDE } P L d ADDRESS - Q .I� .�C TEL CONTRACTOR �` Q O��- SF G ADDRESS 4U LC)`I✓ 00 4.9 Z, 0 DESCRIPTION OF WORK W CL NEW ADD ALTER REPAIR DEMOLISH - _Z FT. 'r,:..J,I0 OF NO OF - - SIZE ��o STORIES. FAMILIES USE OF y�p STRUCTUREel SIGNATURE OF ' APPLICANT• VALUATION $ ' �- - APPROVALS DATE INSPECTOR'S SIGNATURE PC PMT FOUNDATION LOCATION F E FEE $ op"� FORMS, MATERIALS FRAME FIRE STOPS, I HEREBY ACKNOWLEDGE THAT-1 HAVE READ THIS APPLICATION BRACING, BOLTS g`ED Pv' AND,STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY, FURNACE- LOCATION.• WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS` ! ,r BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK. , l AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. ING TO WORKMEN.S COMP ATION INSURANCE LATH, EXT SIGNATURE OF � ��„ /;•y/ HOUSE NUMBER COR- PERMITTEE GL.. RECT AND POSTED FINAL- ADDRESS Lr�+vQ2 �z LZc:-i► '�-�-� FINAL- ^ /'K �" (r JOHN F. LEWIS, PR NCIP;4L STRUCTURAL EN LAN CHECK VALIDATION CK MO CASH _ PERMIT VALIDATION CK. CASH LAGO 4. 5..1'-© SEP 19 1 .D 4.0.0- I 411111/7-1 76A638A CE#803 1-62APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ' BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS !Z2 BUILDING AND SAFETY DIVISION LOCALITY ` JOHN A.`LAMBIE, COUNTY ENGINEER NEAREST _ 'WILLIAM A. JENSEN, SUP'T'OF BUILDING CROSS ST L DISTRICT NO GROUP TYPE _ P ESSED,BY FOR'APPLICANT TO FILL IN CONST,. BUILDINGSTATISTICAL CLASSIFICATION S ER MAP , ADDRESS - j)°JCA' I , BLOCK WATER CLASS NO DWELL UNITS LOT NO 7 � SL) l CERTIFICATE NOT REQUIRED- RECEIVED TRACT Q MAPca ,n HIGHWAY STATE-MAJO ECOMD, LOCAL- NO OF BLOGS.'' NO ('!�/ (CIRCLE) SIZE OF LOT NOW ON LOT USE,ZONE SPECIAL ' USE OF - CONDITIONS EXISTING BLDG, - TE Ir. o -OWNER. CA RQ r,iaBUILDING STREET NAME I EXIST. YARD HW'y SETBACK WIDTH ADDRESS., FRONT _ 1 - ARCHITECT OR TEL. P L ENGINEER NO. SIDE - P L d ADDRESS - - ' - O TEL V CONTRACTOR/ PQ O�'1Ce .NO ,�tp ��yj ,fi� ADDRESS ` �O� Cllr ,� - �� '` 7,<I //�i.+lt".d"l.'. .t•:�dP'D ✓�OF DESCRIPTION OF WORK y NEW X ADD ALTER REPAIR DEMOLISH J z SQ. FT.. NO OF NO OF. SIZE /,STORIES FAMILIES USE OF U _ � /f -s9���• STRUCTURE _5te..YlIyd-- SIGNATURE OF -' APPLICANT VALUATION $ - �f �I 1 /� APPROVALS DATE INSPECTOR'S SI CyNA�U�RE F UNDATION LOCATION _ ,PC PMT FEE $ FEE $ ♦e� FORMS, MATERIALS FRAME: FIRE STOPS. ' /��i� I HE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS ! fL AND STATE THAT THE ABOVE- IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS, REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT W07-AA, , TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT; - ING TO WORKMEN'S COMP ATION INSU CE. 'LATH. EXT. SIGNATUREOF - - HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS T. FINAL 94 JOHN jJOHN F. LEWIS, PRINCIPAL STRU URAL-ENGINEER ' PLAN CHECK VALIDATION CK M'O CASH = PERMIT VALIDATION cK M 0 CASH -,ve , k3 lb� 76ASSBA CF#10 -.�q -APPLICATION FrR BUILDING PER, Ml cl F'L6s.-ANGELEs- LDIN6 6U� N 'E" Ob -Ty"0 'AID -5 D C61YNTY F24 EPARTMENT OF GMUR 1-6(tALiTy JOHN A.-LAMB[E,'CO'UNTy ENGINEER' CASSATT D.,'GRIFFIN,,,SUP't"OF'13UiLlilNG -BUILDMG AND, SAFETY DIMSION', �T IC UP,,' (�RrrEr By_ TYPE IN- qONST., Vok AppmCANT-TO FML ITATISTICAT M SLsWER,MAP U,LD"� - <"� - - , - �K A 0 L UNITS 7-2 CL SS. N .��E'L. % LOT NO. 13LOCK MAP 8TATE NUMBER HWY IjE ZONE' �`,�S' U. P661 A'L -TRA'C NO.'OF'BLDGS­ 'ell 7 ONDITIONS S I ZE OF LOT NOW'ON LOT.7' . USE'OF EXISTING�.BLDG.� EXIST- ' SETBACK! AR�D-,=Y �',,'�STREET.NAME ER 41rs. Carl R" ­ss`�n 'FROI;N;T:: OWN inu L 'ADDRESS-i' MAIL . .10-2,33 SiD t Te4n-p I NO.: -ARCHITECT OR TEL. INP�PECT ON,R CORD- ENGINEER NO. ADDRESS R CF -3 CONTRACT6 I-'fjCT'&j, 5i64 j7stelar 4�7_ t, 1 JI— _J, 'DE9C'tpTlQN_,OFVORK­ ,�EW ':k"ADD' ­-ALtER,_ REPAIR NO. SQ NO. OF SjjjFT.:� j6� ` �OF 4' FAMILIES STORIES 2 USE'OF - STRUCTURE 4�4*E&fi�--��Tii ouse df f i&e Sr)-a--c' ie./i SIGMkTlj��E'O�'.._ AV :;;pl -APPROVALS DATE INSPECTOR:S SI AMURE FOUNDATION: LOCATION,T/,�/ ADD FORMS, MATERIALS'. FRAME:-FIRE STOPS, ,VALUATION 0 BRACING, BOLTS, 'FURNACE: LOCATION,- 0-C.- GAS VENT,,DUCTS FEE� $ JEE­ $'Z� I*HEREBY ACKNOWLEDGE'THAT I HAVE�READ THIS'AP- PLiCATION AND STATE THAT THE ABOVE IS CORRECT AND - LATH;'ANT, V? 4 A - Y-WITH ALL COUNTY ORDINANCES AND GREE 0 ZMPRI LATH, EXTt STATE -)LAWS- EGUI_AaNG BUICIDING, CON§X-5ftTION'. HOUSE ANNUIMBER-COR, SIGN A'r,U RE OF RECT. POSTED FERMI rTEE7 -F I'N AL, -1, _T' -ENGINEER Rl��c,!F��STVTc -w CLYDt N ,-bilRLAM, P AIL ,MX?. CA5H -ALIDA CK.J"�'o. PLAN,CHECK:VAl­MAT'l0' N. OEkk-T V TION c� H, j: u 7 5,8'�g `3 'D. LA j 5 5' D;4 _17 76, 638A A _ ; C�#803(?:,:11/7 O ,8) r.r£ APPLICATIO.iV/ . ORW.BU1 1 ;P'E:RIVI'1`I" COUNTY OF.LOS ANGELES _ 3• .. -BUILDING AND,SAFETY. _ :. ;�._ •. _ FOR,APPLICANT TO.FILL IN .._ BUDDING _ L ADDRESS BUILDING y`^ ADDRESS ��. )_ f � �-� YY__ moi- LOCALITY,,.,, "-� NEAREST p�, CITY C ZIP CROSS ST' NO OF BLDGS•'' ASSESSOR. t_ SIZE OF LOT NOW ON LOT _ MAP BOOK', - PAGE•- PARCEL •t_ DISTRICT"' GROUP^ TYPE r AFIRE ;ED BY ` TRACT i� BLOCK, t LOT NO /�/�// jc. CON m' ; OWNER ` �^� ��µf7 3J� IVIO �O " STATISTICAL-CLA 'C N T SEWER M _ v• ADDRESS CLASS NO, DWELL.UNITSK r CITY. .-.._, .. - "F ZIP"", ARCHITECT OR TEL VALUATION ENGINEER ADDRESS BLDG SETBACK FROM r f TEL FRONT PROP•LINE OF t `(STREET) CONTRACTOR �� V'L'yE:� O ''/�'�r _ TO_TALSETBACKFROM. TYPE OF EXISTING F• LIC HIGHWAY + YARD FRONT PROP LINE HIGHWAY WIDTH "' ?• ADDRESS C� C� NO , � pC' CITY VL/� E 1��-C... M CLASS CONSTRUCTION LENDER - BLDG SETBACK FRO NAME AND BRANCH _ SIDE PROP LINE' ETI _ HIGHWAY t YARD' - TOTAL SETBACK F M TYPE OF EXISTING 9L - ADDRESS r CITY« T ;SIDE PROP LI HIGHWAY tWI TH,; SO FT NO OF NO OF CHECK '+ V, SIZE STORIES ' as FAMILIES• -OW— USE ZONE MAP _A 0 •DESCRIPTION OF WORK a _ _`cL`- NEW •+� - NO SPECIAL R' ADD CONDITIONS} y ��_ �• IL ALTER O FINAL //.J I BY z REPAIR -� DATE USE OF DEMOL EXISTING.BLDG •..C= t_ l2 'APPLI RANT ' �� TEL' lP INTI t) �- NO BY(SIGNATURE( �..-! '9' M 1... ' �. ~ I HEREBY.ACKNOWLEDGE THAI V._READ THIS=APPLICATION AND•STATE �. "�' : be ... ' THAT THE ABOVE IS CORRECT—AND AGREE_TQ_60MPtY'WITH ALL-ORDINANCES •''"' _ _LL '' . AND LAWS REGULATIN ING-CONSTO CCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED ITEREBY I WILL NOT EMPLOY ANY PERSOWIN VIOLATION OF HE LABOR CODE OF THE STATE OF CALIFO4NIA�, LATING TO WORKMEN SCOM` „, ,i ZPENSABON'INSURANCE g o p o0 0SIGNATUREOF =-, ' 2•,0 0'��w t PERMITTEE ADDRESS Z o tl{o .o p';0 a TEC_.,': ., .� ,�LO CITY NO Q Q P P C Fee$ Permit Feel (.� r Issiance•Fee / l ' Total Fee l•v �.. ... � .. .;. ,. �. ' _ 'BUILDI76A638A APPLICATION FOR ITM ~ COUNTY OF LOS ANGELES BUILDING -- // DEPARTMENT OF COUNTY ENGINEER ADORE ss �/ .l -BUILDING AND SAFETY DIVISION . LOCALIr'Y� JOHN A. LAMBIE. COUNTY ENGINEER _ NEAREST L COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS DISTRICT-NO ',GROUP2 .T^YPE - P OC,ES D•B.Y. FOR APPLICANT TO FILL IN - 62 �� c ,NST. - -BUILDING" h L� jj STATISTICAL CLASSIFICATION' _ SEWER-MAP. , -ADDRESS $ V - •/' CLASS NO. DW E L L,U NI TS� BK :P CI/; " LOT NO. ,- BLOCK USE ZONEMAP NO. v" ' TRACT �n -�� SPECIAL' _.. NO. OF SLOGS. CONDITIONS SIZE OF LOT NOW ON LOT USE OF - - _ EXISTING BLDG. SETBACK FRO M_ - /{/7 1•� TEL p-� FRONT PROP-LINE OF (STREET) OWNER V - F NO. r " .7 TYPE OF EXISTING SETBACK HIGHWAY _ • YARD = ;NOTAL HIGHWAY DTH ' ADDRESS O _ . CITY 7emple 0, BLDG. SETBACK FROM _-- ARCHITECT O TEL. SIDE PROP. LINE OF -' (STREET) ENGINEER *" -NO. ' TYPE OF EXISTING SETBACK`- 'HIGHWAY + VYARD - TOTAL ADDRESS /f HIGHWAY WIDTH FROM C.L a CONTRACTOR 6 NOL• � -�• UO' / �I + - �_ OV L'IC 1A' O- CORNER CUTOFF YES NO O ADDRESS NO. JV LI CITY kgs I CLc�Asi St " SEE REVERSE SIDE FOR SPECIAL APPROVALS v Lu DESCRIPTION OF WORK 0- -2 -2 o zT' QlJt— "' z_ NEW • ADD -, ALTER ciiiiAIR DEMOLISH �.N j:. �. �dLY' V Tq P'e S AD Le SQ.FT. - NO. OF NO. OF SIZE STORIES ��y. FAMILIES _ ( eA 1�, USE OF a-. 6b 4 4'S6eKA . A C,60 I l, P G J 7` STRUCTURE SIGNA. URE OF' �I�W'�tL APPLY CANT VALUATION APPROVALS DATE INSPECTOA'SSIGNATURE PMT: ,lam'-� 'FOUNDATION, LOCATION , F F E E$ FORMS, MAT-ERIALS-_- i - ,FRAME,•FIRE!STOPS, I HEREBY ACKNOWLEDGE THAT 1 HAVE-READ THIS APPLICATION- BRACING BOLT •AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS - •9UILDI NG CONSTRUCTION I CERTIFY-THAT IN DOING THE WORK AUTHORIZED HEREBY I WIL NOT EMPLOY ANY PERSON IN VIOLA. LATH INT ' TION OF THE LABOR COD OF THE STATE OF CALIFORNIA RELAT• ING TO WORKMEN'S COM TION I UR - LATH EXT. SIGNATURE O - ,HOUSE NUMBER COR- - I• PERMITTEE RECT AND POSTED 1 ADDRESS Fl NAL PLAN CHECK VALIDATION CK. M o. cnsH _ JOHN F. LEWIS: PRINCIPAL-STRUCTURAL E R PERMTT -VALIDATION, CK M�. C/ASH 1 b 6.7 ,CRY 2 0 1' D L..C10- e TEMPLE CITY 76AG30A CQ#803- 1-61 APPLICATION FOR -BUILDING PERMIT " COUNTY ,OF LOS ANGELESBUI ElsN S. 4 8oS N o' DEPARTMENT OF COUNTY ENGINEER , BUILDING AND SAFETY DMSION LOCALITY e / e, JOHN A. LAMBIE, COUNTY ENGINEER X NEAREST J WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST: I( OG6' ZErT.j DISTRICT NO. I GROUP TYPE PRO Y FOR APPLICANT TO FILL IN j-,O y r CONST. FADDRESS G ./ STATISTICAL CLASSIFICATION SEWER MAP SO s/y, a pc•., l le J) BK �( PG o CLASS'.NO.�DWELL. UNITS ! f+ -4YB BLOCK WATER ,NOT REQUIRED RECEIVED CERTIFICATE El - MAP HIGHWAY STATE MAJOR SECOND, LOCAL- NO.OF BLDGS'. NO •iZ I 0 (CIRCLE) T J dk/ O NOW ON LOT USEZONE SPECICONDITIONS ,lLDG., `e-S/�.?.r�,tlQ, a•� / o l o Pte+—Jge 4-re. ✓� "!e a� �,- OWNER a^- - TEL. a'f - Mass M 7`w.i •.. it F a S O. 3 S BUILDING ST. •�� r SETBACK YARD- HWY STREET_NA WIDTH' ADDRESS /'� _ FRONT / ARCHITECT OR TEL. P L ENGINEER NO. SIDE P.L. I ADDRESS CL TEL. ./ //It Z INSPECTLQF RECORD. p CONTRACTOR- - NO. u'k ,sfeta. , V ADDRESS DESCRIPTION OF WORK �� '— A� - � "��� O W d NEW DD ALTER REPAIR DEMOLISH rn Z SQ. FT. NO. I FA OF — IZE D © STORIES FAMILIES USE OF STRUCTURE All SIGNATURE OF APPLICANT VALUATION$ - APPROVALS DATEI INSPECTOR:SSIGNAATURE ' FEE $ FEE $PMT. Q' FOUNDATION: LOCATION j� ~�Vs ��f �'-" 'FORMS, MATERIALS //q/. ,y FRAME: FIRE STOPS, ��77 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE.IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES ANy S REGULATING GAS VENT DUCTS / \• J,":.\•. , BUILDING CONSTRUCTION I CERTIFNG THE WORK. I - AUTHORIZED HEREBY I WILL NOT EMSON IN VIOLA- TION OF THE L BOR CODE OF'THE,SFORNIA RELAT- LATH, INT. / /.,• " ING TO WORKM N'S COMPENSATION LATH,EXT, SIGNAT HOUSE NUMBERCOR \ / PERMIT a/ RECT AND POSTED ADDRESS FINAL: gkfh CLYDEN. DIRLAM, PRINCIPAL STRU RAL ENGINEER PLAN CHECK VALIDATION cI. M.O. CASH PERM VALIDATION , K.' M.O. . CASH `,' - 5 7 9 "I IVY 14 APPLICATIOMFOR BUILDING PERMIT •�.r„ COUNTY OF LOS ANGELES BUILDING AND SAFETY ' WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I have a certificate'sif consent to self Insure, BUILDING D RES or a certificate of Workers' Compensation Insurance,or a certified Copy thereof (Sec 3800,Lab.C) CIT E �� ZIP LOCALITY Policy No. Company SIZE OF LOT NO OF BLDGS NOW ON LOT ❑ Certified copy Is hereby furnished: NEAREST CROSS ST ' ❑ Certified copy Is filed with the county building Inspection TRACT BLOCK LOT NO department - USE ZONE -MAP NO Date Applicant ASSESSOR MAP BOOK PAGE PARCEL T —6 SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNE EL O COMPENSATION INSURANCE �� �/"T/�/ 13 +7 7 -5/ WITHIN 1000 FT OF SCHOOL? YES NO (This section need not be completed if the permit Is for one hu red ADDRES /� !/ dollars($100)or less.) ' 6� j�d DISTRICT GROUP TYPE CONST' FIRE ZONE PROCESSED BY I certify that In the performance of t w k for w ' h th permit CITY ZIP Is Issued, IP.h n0 employ any h o n r O a- n t0 ARCHITECT OR ENGINEER "TEL NO become e o, a Workers' m STATISTICAL CLASSIFICATION APT CONDO Date / Applicant ADDRESS CLASS NO. DWELL'UNITS NOTIC T APPLICANT . If, t r I this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should b t t0 the Workers' CON T _ TEL O / ///J SET BACK YARD HWY PROP LINE WIDTH Compensation provisions Of h abor ode, you must forthwith 627e� ✓ ° �" '+� FRONT comply with such provisions or this permit shall be deemed revoked AD �f !�/,I�, '/, LIC 0��� P L LICENSED CONTRACTORS DECLARATION'' '/ L4,67 ,q` 4 �� t�Q SIDE CITY nQ C CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 � �0/&6 SEWER MAP >- (commencing with Section 7000)of Division 3 of the Business and SQ FT.SIZE NO OF STORIES NO OF FAMILIES n' Professions Code,an my hen is in full force and ect NEW C1 BK A/ PG v License Numb Llc Class DESCRIPTION OF WORK ADD ❑ VALUATION �L Contractor Date - - ALTER El $ CU,90. 00 U CL - w C � L ❑ I am exempt under Sec REPAIR $ z BBPC.for this reason DEMOL ❑ LDMA P/C# Date USE'OF EXISTING BLDG /1,•� URM ❑ Signature APPLICAN �}I EL �7f/ / LDMA Perm# ❑ ,as owner of the property, or my employees with wages as /L � /� !�?!—�fi IZO their sole compensation, will do the work and the structure is ADDRESS �yJ not'Intended or offered for sale (Section 7044, Business and �/Y'�K�/� ,(� /t/tel. ��WJ FINAL DATE Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ,: ✓ !, I ?'II,- OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL,TO OR GREATER THAN THE ❑ I; as owner.of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY u licensed contractors to construct the project (Section 7044, VES El NO Elf! ;AL.: 1 2.$ = 35 I -Business -- and Professions Code) a •n 4k • - WILL THE INTENDED USE OF THE BUIBY THE APPLICANT OR FUTURE BUILDING CHECK OCCUPANT REQUIRE A PERMIT FOR CONNSTRSTR UCTION OR MODIFICATION FROM THE SOUTH ^ W CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR F u k IS i GUIDELINES CHANGE hereby affirm that there Is a construction lending agency for YES❑ No Ela the performance of the work for which this permit is issued(Sec I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, yy ! TITLE 2,CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS fit- (.�r- =• Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD Lender's-Address 4163 1 PH 12Of a 1 0 OMER OR AGENT o I certrfy that read this application and state under penalty 0 of perlur at a above Inf rmation Is correct.I agree to comply P•C FEE PERMIT FEE N with IOU ordinanc and S to laws relating to building m co ructi nd r hor a epresentativei�% ISSUANCE FEE t enter ntio roperty for Insp �� .INVESTIGATION FEE TOTAL FEE ' � $P,>I 1 ApplRanl�A 1 Del ' 1 SEE REVERSE FOR EXPLANATORY LANGUAGE