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HomeMy Public PortalAbout5237 HALLOWELL AVE_Building__ 78A938A.rCE#803-7.46 A P P L.I C A T•I O N FOR BUILDING: PERMIT 1 BUILDING AND SAFETY DIVISION BUILDING , Department of County Engineer ADDRESS p County of Los Angeles - LOCALITY y �i JOHN A.-LAMBIE, COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN; SUPT OF BUILDING CROSS ST. L.�''�'►�"' . DISTRICT NO. - G OUPTYPE SEWER MAP. FOR. APPLICANT TO FILL IN I L I /<B K PG DNGCONST. uL ADD EISS ,S"a�f3 7 X. 1.14/b Lu 4 LAt ,�'ft��� STATISTICAL CLASSIFICATION I - LOT NO. i •CLASS. NO.�DWELL'. UNITS BLOCK - _ MAP STATE TRACT' J 7 NUMBER r HWY -YES USE ZONE SPECIAL rNO. OF BLDGS. } CONDITIONS SIZE OF LOT.5� A 13,Z NOW-ON LOT USE OF tt L� - - EXISTING BLDG. ��'y D,c AS - BUILDING YARD HWY STREET NAME EXIST. /'� _ SETBACK WIDTH. OWNER (� ©/T C` /V C C Po//,q �� FRONT MAIL � t / j� P. L. / .. ADDRESS..?+,, ,7 ,7 (!A110LV,&_1 0` SIDE TEL. Pi L. - - - C ITY - j�L� "'G T I ' NO. /• S-�id• • ' INSPECTION RECORD ARCHITECT OR TEL. - ENGINEER r .,/NO. - ADDRESS TEL. FY CONTRACTOR NO. ADDRESS' DESCRIPTION OF WORK NEW ADD t1jALTER REPAIR - DEMOLISH SQ. FT. NO. OF NO. OF SIZE - STORIES FAMILIES 0 USE OF STRUCTURej APPROVALS SIGNATURE OF " APPLICANT DATE INSPECTOR'S SIGNATURE ADDRESS - FOUNDATION: LOCATION FORMS, MATERIALS ' $ FRAME: FIRE STOPS. FEE BRACING. BOLTS- 40-17 ✓`WNF�. VALUATION FURNACE: LOCATION. �- -� FEE GAS VENT, DUCTS I HEREBY ACKNOWLEDGE THAT I 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 TING BUILDING' NSTR CTION. SIGNATURE OF - r HOUSE NUMBER COR- r "PERMITTEE / RECT AND POSTED ADDRESS - FINAL JOHN'A.LAMBIE, COUNTY ENGINEER, CLYDE N. DIRLAM, PRINCIPAL STR , RAL ENGINEER PLAN CHECZ VALIDATION CK. M:O. CASH PERMIT VALIDATION CK. m,o. CASH- - �, I. .1 J f`4.4Y2 4 1. 1 .0 0 In - DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT A/-r COUNTY OF LOS ANGELES BUILDING - WM.--J. UILiNG - WM. J. FOX, CHIEF ENGINEER z FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK.NO. PERMIT NO: BUILDEI NG ADDSS iCAe py E A d � �Z �c 7= /y LOCALITY /� G, Tye RECEIVED BY DATE OF APPL. DATE ISSUED CROSS BT. BUILDING 2' HER �C` d ADDRESS ;J MAIL3 / LOCALITY ADDRESS R.�IQ D d.YLa NEAREST TE CITY -fi.90/�JL� NO. � CROSS BT. FIRE NO.OF TYPE GROUP_ ARCHITECTOR TEL. ZONE PLANB� ENGINEER NO. BLDG. ORD.NO: ADDRESS SETBACK LINE APPROVED TEL- 'CONTRACTOR NO. BY - DATE UBE APPROVED ADDRESS /%��vec ZONE_ BY DATE LEGAL CORRECTIONS DESCRIPTION LOT NO. BLOCK TRACT 7 Q,3 X �3f� I NO.OF BLDOS. S1ZE OF LOT NOW ON LOT � USE OF I NO.OFI NO.OF Q EXISTING BLDG. FAMiuEe RCOMB _ DESCRIPTION OF WORK NEW ALTERATION ADDITION O REPAIR MOVING DEMOLISH p 3Q.FT. NO.OF Z 912E 4SS ROOMS STORIESWALD L-COVERING �2TUL1 ,C7 I COVERINDCMPOfif/M/ r BUILDING W ledx/a)"'yeA moi' (J-y/Or��rE"IlN�,2 .fie Tia r�f . it t 1 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 �y�,.,r /v-T J AND STATE LAWS REGULATING BUILDING CONSTRUCTION. , FRAME: FIRE STOPS, SIGNATURE OF BRACING,BOLTS �F��tvu'vr/iL�i J 1 PERMITTE LATH,INT.: AUTHORIZED AUT. LATH,EXT.: DBS-3 SCIM SETS 1-48 $.���..rj P.C 0 p\�- PLASTER,INT. / ZO"0� FEE P.LABTER,EXT. VALUATION G' L —� FEE FINAL l APPLICATION FOR BUILDING PERMIT COUNTY'OF LOS ANGELES BUILDING AND SAFETY WORKER'S'COMPENSATION DECLARATION FOR APPLICANT TO ILL IN BUILDING ADDRESS T BUILDING ADDRES I (� I hereby affirm that I have.a.certificate of consent,to self Insure, or a certificate of Workers' Compensation Ins an a cer d _ copy thereof (Sec 0 Lab.C) CITY ZIP<71-716 6 LOCALITY _ Policy No _ ` •Company SIZE OF LOT NO OF BLDGS NOW ON LOT ❑ Certified copy is hereby furnished NEAREST CROSS ST I' Z Certified copy Is'filed with the county budding Ins echon TRACT BLOCK LOT NO ` departent ."' USE ZONE MAP NO _ l Date Applicant l• ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORK S'• OWNER TEL NO U �[�/ ,, COMPENSATION INSURANCE Ae / `— WITHIN 1000 FT OF SCHOOLS YES No (This section ne .not be completed if the permit is for one hundred ADDRESS S DISTRICT GROUP TY CONST FIRE ZONE PROCESSED BY dollars ($100)or 1) ' CITY ZIP •- I certify that in the 211 efformance of the work for'which this permd is issued, I Shall not employ any person in any manner SO as t0 ARCHITECT OR ENGINEER - TEL NO �J ' become-subject to th Workers'Compensation Laws.' STATISTICAL CLAS IFICATION - APT CONDO Date App tVnt - ADDRESS - - - CLASS NO � DWELL UNITS ' NOTICE TO APPLICANT If, after making -this- Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you, should become subject to-' the Workers' CON R CTO N TEL NO. - - SET BACK YARD HWY PROP LINE WIDTH - Compensation provisions of the Labor Code, you must forthwith [ l! Le 172 FRONT comply with such provisions or this permit-shall be deemed revokedA_DD U �op L LICENSED CONTRACTORS DECLARATION .0 SIDE CITY - LIC.CLAS 'P L I hereby,affirm that I am licensed underprovisions of Chapter 9 — SEWER MAP (commencing with Section 7000)of Division 3 of,the BusineSs,ar1d SQ FT SIZE NO OF STORIES .NO OF FAMILIES Professions Code,a y,Ii -se Is In full force ars ff�t. NEW T BK PG License N �Y Lic Class DESCRIPTION OF WORK ADD E] - VALUATION Contractoum Date - ALTER ❑ cc. ❑ 1 am exempt under Sec. REPAIR ❑ 0 B&PC.for this reason DEMOL ❑ LDS P/C# W Date USE OF EXISTING BLDG URM ❑ a Signature, APPLICA T PRI ) LDMA Perm# Z 1 8 ❑ I, as owner of the prop or'my employees with wages'as - Z i�t.t} i o� their sole compensa , wd1 do the work and the structure is ADDRESS O not intended or ered for sale (Section•7044, Business and FINAL DATE Professions Cc e.) WILL THE APPLICANT OR FUTU E BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL J !� N`,', Y, OR A MIXTURE CONTAINI HAZARDOUS MATERIAL EQUAL TO,OR GREATER THAN THE _ ❑ I, as owner of the property, am exclusively contracting Wltll AMOUNTS SPECIFIED E HAZARDOUS MATERIALS INFORMATION GUIDE'S FINAL BY j 0 y 9 t—t licensed contractors to construct the project (Section 7044, ;f I i¢,� Business and Professions Code) VES❑ NO WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING - - r+' ^5 4 _ _ OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEME DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR t• 6! — t GUIDEUNES - _ +_liAl-IbE r cl I_ I hereby affirm that there is a construction lending agency for VES❑ N N the performance of the work for which this permit'ls Issued(Sec W I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING ' 3097,CIV C) CHECKLI UNDERSTAND MV REQUIRE NTS UNDER THE LOS ANGELES COUNTY CODE, I ( _I:I_ _ • nil` 1 t'f._tEY:I • TIT CHAP 220 SECTIONS 2 10 THROUGH 220140 CONCERNING HAZARDOUS - '1'= + �•.— '-, Lender's Name ERIALS REP G FOR O AINING A PERMIT FROM THE SCAOMD IL Lender's Address - �; t_073 ONNER OR AG o I certify�th have read this application and state under penalty'of perjurhat the above information is correct I agree t0 comply PC FEE - PERMIT FEE. with all county ordinances and State laws relating to budding ' v ; construction, and hereby authorize representatives of thiyto4pdy ISSUANCE FEE to tp etupon th ave-mentioned property for inspects ur (p (0 Y INVESTIGATION FEE TOTAL FEE m ^ Sgy­aApp�­ If f . SEE REVERSE FOR EXPLANATORY LA&LIAGE Vk)RKERS'.COMPENSATION,DECLARATION '.' a ' ' I(hereby;affir{n that' I -have a•certificate of 'consent'to self ensu e, or a certificate of.•.Workers' Compensation Insurance,, APRLICATI:OI `� .O;R.• �UILD'IN€�: PERMIT or,a certified copy thereof (Sec: 3800, Lab. > COUNTY`OF LOS 4ANGC. LES' BUILDING'`AND SAFETY ' Polic_y'No'' Company_'. , Certified copy is hereby furnished. FOR APFLICANT'TO FILO IN A�RES�SG Ce ed co is filed with the-coun `Tbuild`in ms ec- BUILDING 'copy tY 9 P ADDRESS tion department.' . . : ` CITY' j ZIP LOCALITY d;Date' -'Applicant: ;.NO. OF,BLDGS._ NEAREST r.. - - . CERTIFICATE OF:EXEMPTION+FROM WORKERS',,"','. SIZE,OE,LOT'.S-3' 3" NOW ON LOT CROSS ST. %• COMPENSATION INSURANCE ' .0 .�,; - ,• - ASSESSOR .. .'(This section need not b6�cor poeted if-the;perrfiit'is'for one TRACT' T t ' - BLOCK + LOT.NO MAP BOOK PAGE PARCEL' .hundred'dollars,($160) or,less.,) _ n• .'•r. �}- TEL.' OWNER','.: C!�/. O NO USE ZONE MAP (-certify that'm'the performance'of',The work,for which=this ^ -•NO permit is issued, (shall not em to an person in an manner = ADDRESS �iQ' ti,--- _ SPECIAL - �` T..P P Y• Y P y-- Ki CONDITIONS so as t'o_-become s_ublect to,the,Workers�•Compensation.La'ws. O CITY v- .. ZIP. U 7,4 ;.Date' Applicant. ARCHITECT OR TEL ` / DISTRICT'; GROUP TYPE FIRE 'PROCESSED BY, 'Q -i NOTICE'TO APPLICANT:,If, after making`.this Certificate of •-- ENGINEER Qy s NO S�Srs~����F! CONST. ZONE Exemp'tion,'you. should; bec6ime,,;sublect to;'the:Workers' Lul r •--��-- �'^ �'- �p CJ Compensation provisions,of the Labor Code,-'you must;forth-. • ADDRESS Z r�„fly._ /�/'L�9_ rg o -� , �j � with comply, wrth'sucFi ,provisions or,this permit+•shall'be TEL• STATISTICAL CLASSIFICATION APT. CONDO.'' Z` deemed revok -ed. ^ _ CONTRACTOR NO•„ ., — - r LICENSED•CONT,RACTORS.DECIARATION; +'' ”` LIC' '� CLASS.NO. - 4 DWELL:UNITS :± I by hereaffirm that I'am'licensed under provisions of.Chapter9 ADDRESS NO. _ '• `(commenang with Sectiori 7000)of Div,ision 3 of the Business LIC ' SEWER MAP, and'Profe'ssions Code,and my license is in-full force aiid'e_ffect: CITY CLASS BK �• . VALIDATION' ' SQ FT.//.o NO. OF / NO OF' / CHECK License'Number - '•L'ic. Class, SIZE /fid• STORIES I FAMILIES / ONE is .. _, .. 'VALUATION s i DESCRIPTION OF ORK NEW. ❑ r Contractor Date ; 4� t :ADD ❑I'.am exempt under Sec. r /� ► _ B.BP.C.,for,this reason SALTER ❑ i REPAIR ❑ $ Date, USE OF EXISTING.BLDG /q DEMOL ❑ APPLICANT _•Signature L FINAL.Lj / OWNER-BUILDER DECLARATION• .. - (PRINT), NO DATE', % (!� I hereby affirm that I am exempt from the Contractor's License r Law for,the'following.'reason'(Sectwn"7031'.5,'"Business and ADDRESS 3 --Professions Code):. ' r PRESENT- By /V<�CG[� ' ,fir! ,s �y BUILDING. tila•T n s LTJ I,'as owner of the'property,.or'my ,employees with . ADDRESS: V �[�vE(�' wage's ds their sole^compensation-,wiII do'the work and �'""' '' ��` ^• '. 3303 } } the structure is not mterided or'offered for sale(Section LOCALITY - v. . MOVING; TEL,, ► t y r J _ 7044, Business and Professions'Code.') r �" ❑r I, as owner of the: ro ert am:exclusivel coniractm CONTRACTOR P P .Y, Y- 9 _ __ _ - �- _si.'' ;,t•: AGC�T,n s • _ virth licensed contraefors to construct.the;project-(Sec- ADDRESS jt y �' -+- ec tion 7044, Business'and Professions Code. i - -- 1 v ' °'-1'� REQUIRED'- NOTAL SETBACK"FROM' EXIST*," ti,-•j�`r'" •` I E YARD '"HWY' S CONSTRUCTION LENDING'AGENCY'' '' SET BACK PROP LINE,, WIDTH' i� �,S l ?�•STE�{S' - I hereby affirrri-ihat there is a construction lending agency for FRONT 1 �'1 the performance of the�work for which this permit is issued P.L. -' ' - TI TAL - •� m. (Sec.'3097,'Civ. C )n` `:. /... SIDE �HECK ' �EJCYL ' L ., .. P L..• Lender's.Name �f+ 11 / y� - r �.�`t:x ktv� �i * r tib. �1 a �y J Z L7 �� �j. ee Permit, / �V LDMA Ret # \.. `- r 4i NGE �V • Lender's-Address s T � o I certify'•tFiat I have.read this apphcation'and5state Thai the '} Issuance:Fee ;1 LDMA P/C# , 4-' above information.incorrect. I agree to comply with all County Investigation Fee / `` Q00Q-0001`, 7/iu/96 8 ordinances-and State laws-relating-'.to building construction„ Total Fee /• J LDMA Perm. # 7ees-1 �r� �e(�`7 Q. and'Kereby outhonze,represertatives of this County to enter J + upon the above-mentioned property for inspection purposes. �° �• �G r-IP. _ .SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent •Date - _ ,