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HomeMy Public PortalAbout5511 HALLOWELL AVE_Building__ 7hA� A CE#803 9-68 APPLICATION FOR BUILDING PERMI COUNTY OF LOS ANGELES BUILDING/ DEPARTMENT OF COUNTY ENGINEER ADDRESss��' BUILDING AND SAFETY DIVISION LOCALITY' - JOHN A. LAMB]E, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRICT NO. GROUP TYPE PROCESSED BY J CONST�� (Print or type only) �(�� _/ BUILDING STATISTICAL CLASSIFICATION SEWER MAP ADDRESS -CLASS NO. le BK PG ' LOT NO BLOCK U�S,E'�ONE NO. Q TRACT ` ��' SPECIAL ONS NO.OF BLDGS. SIZE OF LOT __Llo NOW ON LOT USE OF EXISTING BLDG. BLDG.SETBACK FROM TEL. FRONT PROP.LINE OF-71��-//d -(STREET) 'OWNER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL HIGHWAY WIDTH FROM C.L. ADDRESS � CITY LZ_ & O BLDG.SETBACK FROM ARCHITEC OR TEL. SIDE PROP.LINE OF (STREET) ENGINEER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS" HIGHWAY WIDTH FROM C.L. t ? TEL. + = CL CONTRACTOR NO. C LIC. ADDRESS NO. CORNER CUTOFF YES LlNO C LIC. CITY CLASS SEE REVERSE SIDFOR SPECIAL APPROV S LL CONSTRUCTION LENDER u NAME AND BRANCH5�� F ADDRESSQ. SQ. FT. 17 NO. OF NO. OF NEW ❑ SIZE STORIES FAMILIES USE O ADD M111214r STRUCTURE 7 LTER ❑ X•`Z ❑ �./,� SIGNATURE OF REPAIR APPLICANT DEMOL ❑ VALUATION $ �l OOO APPROVALS DATE INSPECTOR' IGNATURE 7C, PMT.FEE S. /+�' FOUNDATION: LOCATION FEE S �o�� J FORMS, MATERIALS FRAME: FISTOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION I BRACIRE NG BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY I FURNACE- LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTI ON. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S CO PE NSATION INCE/^ 4 LATH, EXT. d� SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED log ADDRESS FINAL I Y JOHN PLAN CHECK VALIDATION cK M O CASH _ . PERMIT,,VALIDATION STRUCTURAL TUREN M O CASH R 6.3 4 NO AUG 2 8 1 D 2 .2..5 OP V U ' L ® I BUILDING L; ADDRESS ��J l -967.1 .a- APPLICATION LOCALITY ,! DIVISION OF BUILDING AND SAFETY c"Rasa a. � v Department of County Engineer DISTRICT NO. RECEIPT NO. PERMIT NO. County of,Los Angeles J -76--/S-4— 4) S-0 WM. J. FOX, COUNTY ENGINEER GROUP DATE RECEIVED DATE ISSUED CASSATT,D. GRIFFIN, BUP•T aF BUILDIND- ' -a 3- !? ' 10i FOR APPLIyCANT TO FILL IN TYPE CONST. RECEIVED B f ISSUED�B Y OWNER v_ _ MAP lI�� Q STATE YE N ' MAIL /� �7 NUMBER /XdU 7 HWY ADDRESB �( CITY " ,5 UBEEEZONE ••SPECIAL . Tom/ CONDITIONS Al ARCHITECT OR L5 OD ' ENGINEER ,/ NO. , BUILDING YARD HWY STREET NAME EXIST. SETBACK WIDTH ADDRESS 9 FRONT TEL. P.L. CONTRACTOR NIL SIDE P.L ADDRESS BUILDING � DATE CORRECTIONS INSPECTOR ADDRESS �j /�7I '1,1�f LOT NO. Al 6 ,6 'v" d 3 / BLOCK TRACT '47_,(Psi.1TJ ,`W , 1 /1 ®© I NO.OF BLDGIL SIZE OF LOT i7 NOW ON LOT USE OF EXISTING BLDG. DESCRIPTION OF WORK A 0 NEWDD ALTER REPAIR DEMOLISH Z BO.FT. G5cd.7cNO. OF NO.OF ID. SIZE �Z ACW� ST OR168 FAMILIES - UBEOF_BTRUCTURE G "Z NO.OF EMPLOYEES 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IB APPROVALS INSPECTOR'S SIGNATURE DATE CORRECT. ITADREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCAION AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS �� l !/ ,a£ FRAME: FIREOLTS SIGNATURE OF BRACING,BOLTS PERMITTEE _ �� _- •� ���� FURNACE: LOCATION, OAS VENT,DUCTS ADDRESS LATH, INT. AUTHORIZED .AGT. LATH, EXT. IS t P. C.g �tJ HOUSE NUMBER COR- RECT AND POSTED / VALUATION FEE FINAL ids +J6 b 7GA63BA DBS 3 4-S4 r yC% '76A 63,3-A 'CE#803 9-68 a ' APPLICATION FOR BUILDIN__ PERM COUNTY, OF LOS ANGELES BUILDING - -/ o a�.iBLL DEPARTMENT OF COUNTY ENGINEER ADDRESS ,, BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE; COUNTY ENGINEER NEAREST COLEMAN W. JENKINS', SUPT OF BUILDING CROSS ST. S �� 'FOR APPLICANT TO FILL IN DISTRICT NO: GROUP TYPE' PR CE SED BY (Print,or type only) pes 4:11CONST L BUILDING STATISTICAL CLASSIFICATION- SEWER MAP' ADDRESS CLASS NO,c0- DWELL.UNITS� BK N, PG LOT NO. D BLOCK USE ZONEROND.TIONS AP fes_/- O. 2 0 o 9-- _ TRACT,' - PECIAL NO.OF SLOGS. 72ov - - SIZE-OF LOT + NOW ON LOT ' USE OR EXISTING DG. BLDG.SETBACK FROM TEL. FRONT PROP.LINE OF G �✓ LL (STREET)' OWNER NO, TYPE.OF EXISTING SETBACK HIGHWAY + YARD = TOTAL j- HIGHWAY WIDTH FROM C.L. ' ADDRESS C ��+ Loca 6d + ZC CITY = Z O BLDG.SETBACKFROM ' ARCHITECT OR TEL. SIDE PROP.LINEOF (STREET) ENGINEER - NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C,L. C CONTRACTOR TEL. +NO. L ADDRESS LIC.; CORNER CUTOFF.- _ YES ❑ NO �� NO: C clTv class SEE REVERSE �SIDE FOR SPECIAL APPROVALS CONSTRUCTION LENDER a NAME AND BRANCHy 1�ZZ -2- 1CF ADDRESS, SQ. FT. ._ NO. OF NO. OF NEW ❑ i. 1 SIZE `1� STORIES FAMILIES ❑ •��Y - USE OF I ADD STRUCTURE ALTER REPAIR❑ SIGNATURE OF f APPLICANT . DEMOL ❑ VALUATION $• OQ APPROVALS , - DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION:,LOCATION FEE $ 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, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-, GAS VENT, DUCTS STRUCTION. .1 CERTIFY THAT' IN DOING THE WORK AUTHORIZED LL - _ HEREBY I .WIOT EMPLOY ANY PERSON IN VIOLATION OF THE 'LATH, INT, LABOR- CODE ,THE STATE OF •CALIFORNI R TING TO ,WORKMEN'S COM SATION INS URAN , LATH, EXT, .H� SIGNATURE OF HOUSE NUMBER COR- _ PERMITTEE _ - RECT AND POSTED _ J .4 ADDRESS FINAL JOHN F LEWIS PRI CIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDA'T'ION C M O, CASH _ PERMIT VALIDATION CK. M 0. CASH WORKERS' COMPENSATION DECLARATION hereby affirm that f have certificate of consent to self APPLICATIONf®R lJ I L D 1 IV,C. PERMIT , insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec' 3800; lab..C.) , COUNTY OF LOIS ANGELES, BUILDING A_ ND SAFETY. Policy No. Company • - 1.Certifiad cBUILDING opy is hereby furnished: FOR APPLICANT TO FILL-IN ADDRESS t/ ICGL—,/4 Certified copy is filed with.the county building inspec- BUILDING" tion department' ADDRESS �S �✓C=z,.- 1; i Lam. Date Applicant CITY ZIP LOCALITY CERTIFICATE OF.EXEMPTION FROM WORKERS' O OF BLDGS'. NEAREST COMPENSATION INSURANCE SIZE OF LOT "' NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one 22 ASSESSOR hundred dollars ($100)or less.) TRACT '.s BLOCK"' LOT NO- .J MAP BOOK PAGE PARCEL TEL USE ZONE MAP' 1 certify that in the performance of the work-for which this OWNER-/Y�/✓/ i ! NO NO permit is issued, I shall not employ any person-in any manner ��• — -SPECIAL S ADDRESS Tom- GGO L-�/�GL CONDITIONS so as to become subject to the-Work r ' ompe, tion Laws. U, CITY ZIP Date Applicant ARCHITECT OR 7EL. NOTIC TO APPLICANT: If,.;after making'this Certificate of DISTRICT GROUP TYPE FIRE SSED BY 0 ENGINEER NO CONST ZONE Exemption, you should become subject to the Workers - U Compensation provisions of.the Labor,Code, you must forth= ADDRESS �. ' Cy I k with 'comply with such pro4isions or this permit shall-be TEL, !b-, STATISTICAL CLASSIFICATION APT C6UNDO. N deemed revoked. CONTRACTOR C� NO. J726— Z LICENSED CONTRACTORS DECLARATION LIC / CLASS NO. DWELL.,UNITS I hereby affirm that I am•licensed under provisions of Chapter 9 ADDRESS S NO 6 77 l (commencing with Section 7000)of Division 3 of the Business andnn,' LIC /� SEWER P °Profes'sions Code,'arid my license­is in full force and effect. CITY/l't'Q" b /�y'< CLASS /J BK S• VALIDATION SQ FT. NO O NO'OF CHECK' License Number 7 Lic Class SIZE STORIES FAMILIES ONE -VALUATION r6� ,1m�7!T •Zf� DESCRIPTION OF WORK. NEW ContractoDate: ❑ $ ADD ❑ O I am exempt under Sec. . ,4 •' ALTER B.&P.C..for this reason REPAIR ❑ _ Date- USE OF EXISTING BLDG DE OL ❑ Signature APPLICANT / TEL l g OWNER-BUILDER DECLARATION- NO ^�� DATE L � ) I hereby affirm that I,am exempt from the Contractor's License Law for the following-,reason (Section 7031.5, Business-and ADDRESS L L . FIN Professions Code): RE N - BY,;, w� BUILDING 1, as owner of the property, or my employees with . ADDRESS 9 8 S 4 A wages as their sole compensation,will-do the work and ' the structure is not intended or offered for sale(Section [AD LITY - ; 7044, Business and Professions Code).' ING TEL • o o.0 0 1 1 s owner' f TRACTOR NO °'� �.1 a o e a the property, am exclusively contracting, , z with licensed-contractors to construct the project (Sec- RESS /� i� 1 °•� Q 6'1:3� tion 7044, Business and Professions Code) , , QUIRED TOTAL SETBA K, '/` } 1 CONSTRUCTION LENDING AGENCY BACK YARD HWY - PROP. LINE WIDTH IL J 0 C\ •O'i 8 8 I hereby affirm that there is a construct ion,lending agency for ONT. VVV--- the performance"of the work foc',which this-permit is issued', L (Sec.-3097, Civ. C.). E Lender's Name - LDMA Ref, # Lender's Address Fee 3- - Permit Fee . I certify that I have read this application and state,that the Issuance Fee V� LDMA P/C if o above information is correct. I agree to comply with all County tigation Fee 9 ordinances and,Stote laws relating to building construction, L TotaLFee LDMA Perm. q R and he y outhorize.-representatives of,this County to enter upo e�above-mentlonecl property for inspect'on purposes. .. ' SEE REVERSE'FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent,