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HomeMy Public PortalAbout5619 HALLOWELL AVE_Building__ 76A636A D65.3 12.54 APPLICATION FOR- BUILDING ®RBUIL®ING PERMIT .. 1. rr DIVISION OF BUILDING AND ,SAFETY BUILDING Department of County Engineer ADDRESS County of Los Angeles LOCALITY WM.J. FOX, COUNTY ENGINEER NEAREST CASSATT-D. GRIFFIN, SUPT OF BUILDING CROSS ST'. DISTRI T NO. GROUP TYPE SEWER MAP FOR. APPLICANT TO FILL IN I BKj PG BUILDING ADDRESS J�116 �� / CONST. / Jif / / MAP STATE NQ ,,,, %O' Dr ���/ p NUMBER HWY LOT NO a r '-lJT� $ USE ZONE S ECTAL n� CONDITIONS TRACT i' W I/ /Y/�^ + T2_ " �' Q� `/ NO OF BLDGS. HWY STREET NAME SIZE OF LOT (S C.� R I NOW ON LOT BUILDING ygRD' -EXIST: _ SETBACK /` WIDTH USE OF �} �U c'!6 tI'f l �� . EXISTING BLDG. ./ �+</. J / yt!!� - FRONT / OWNER Y�yl ft F+_ 1// fl�� SIDE MAILp /' Po/ P. L. ADDRESS 'N,<5'eC TEL. �^ 1 DWELL. 1 UNIT 5 INDUSTRIAL ,�f N CITY � �r7 1�." O..D�q - 2 DUPLEX_UNIT 6 PUBLIC.BLDG. ARCHITECT OR TEL. _ ENGINEER /''�y�/�*� �'P" NO. 3 APT. UNITS - ^7 "ADDN.,ALT., ETC. ADDRESS Q�>fr � , �� r'/�Y p� "'o `/ Q COMMERCIAL B MISCEL. _ TEL. CONTRACTOR NO. INSPECTION RECORD ADDRESS - lll��, 6 0 rr C h--L DESCRIPTION OF WORK y ,f NEW ADD ALTER J' REPAIR DEMOLISH_ / . SO. FT. � � SIZE NO. OF NO. OF L STORIES FAMILIES USE OF STRUCTURELL `e �V b`L`I � t SIGNATURE OF '� /y, 1/ �) APPLICANT APPROVALS ADDRESS 6,. � .A" tf'--??'� - DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION $ P. C. S FORMS, MATERIALS FEE FRAME:FIRE STOPS, ,VALUATION V $ (�(1 BRACING, BOLTS P� �J,I.Pi-4A•°► FEE FURNACE: LOCATION, GAS VENT, DUCTS /7 ! J 4s3�>;%i •'' ` I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THEABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT. it xt AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. TION. 1 LATH, EXT. SIGNATURE OF �•?. �' � ., t' c-Q HOUSE NUMBER COR- _ PERMITTEE RECT AND POSTED S _ ADDRESS FINAL WM: J. FOX. COUNTY ENGINEER VALIDATION - -BY Co 3 7 4► MAY 16 1 .0 0 DEPUTY DEPUTY By. BY ® DEPUTY _ _ DEPUTY APPLICATION FOR ,BUILDING PERMIT `9r�OR APPLICANT TO FILL IN (lo,into, type only) BUILDING. COUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF COUNTY ENGINEER clr'Y ` zIp /QQ BUILDING AND SAFETY DIVISION `` NO.OF BLDGS. BUILDING SIZE•.O,F LOT NOW ON LOT ADDRESS �46 C TRACT _ BLOCK LOT NO. LOCALITY T L. NEAREST OWNER � CROSS ST. ASSESSOR ADDRESS �j MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE P ESSED BY CITY zip BOO �� < CONS T.,GZONE ARCHITECT OR - TEL ���y :!5,0 Irnf� - ENGINEER NO. �laa STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NO. _DWELL.UNITS BK/ JPG CONTRACTOR TEL.NO USE ZONE MAP _ LIC. / NO. ADDRESS NO. k` / SPECIAL LIC. CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES� NO CONSTRUCTION LENDER NAME AND BRANCH UOA BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET) d ADDRESS CITY HIGHWAY } YARD TOTAL SETBACK FROM TYPE OF EXISTING O SO. FT. NO. OF NO.'OF CHECK FRONT PROP. LINE HIGHWAY WIDTH U SIZE STORIES FAMILIES ONE CD DES'C RI PTI ON OF WORK NEW - U BLDG,SETBACK FIR Q_ ADDSIDE PROP. LINE OF (STREET) cro ❑ (f, ALTER ITOIIALSETBACK FRO HIGHWAY } YARD M TYPE OF EXISTING = HIGHWAY WIDTH REPAIR❑ SID ROP. LINE USE OF t = EXISTING BLDG.. DEMOL ❑ APPLICANT TEL CORNER CUTOFF YES 13O NT) (PRINO. (SIGNATURE) IN OPEN SPACE YES E] NO BY (R NT) Q IN COASTAL ZONE YES [:] NO ❑ VALUATION s I�(/� CATEGORICAL EXEMPTION YES NO ❑ I HEREBY ACKNOWLEDGE THAT I 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 OT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE 0 'THE STATE OF CALIFORNIA IN RELATING TOper, 4 Ile WORKMEN'S CO MBE TION INSURANCE////a ���j l 171f l / t SIGNATURE OFj PERMITTEE ADDRESS J d I U, FINAL Y TE L. CITY NO. DATE 1A 999 6 P Mcedd fe) P.C. Tei 11,1 K CNEC<;S P:1 Y,1I3L1� 'I O: FEE � HARVEY T. BRANDT, COUNTY ENGINEER PIJ LAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH 4 '9 9,6%JAN 29 1 1 5.0:0 A'38 76A638A CE14803 12/72 76A638A CE 4803 ""APPLICATION FOR BUILDING PERMIT` COUNTY OF LOS ANGELES, ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION 'BUILDING JOHN A. LAMBI E, COUNTY ENGINEER ADDRESS. COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY . , FOR APPLICANT TO FILL IN NEAREST. CROSS ST. Print ort a onl s;=' ,3' � E.:� '. ;✓ BUILDING DISTRICT�[JO, R P TYPE ) PROCESSED BY t / .r t CONST. r" ADDRESS ~ "✓Z+ -r rf ..A",.t ,f" ".- ...-! ""` ) ..l - .,•, tr STATISTICAL CLASSIFICATION SEWER MAP LOT NO. 4q �AY� J BLOCK CLASS NO.. -DWELL,UNITS BK G TRACT f j_ e�'� r r�`J USE ZONE MAP ws }} _ NO.OF BLDGS. . *✓ J SIZE OF LOT NOW ON LOT p{ j SPECIAL USE OF Alf ) i CONDITIONS EXISTING BLDG. " • r ^ TEL OWNER -_ s '{� i .'„ NO s r}>•;fl `" BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET) ADDRESS t`". .r y ,F3: ' 4../'.^ •.i Y,. '�,.:.:.�' EXISTINGTYPE OF SETBACK CITY J` A + j HI HW YW DTHTOTAL ROM C. HIGHWAY + YARD = ARCHITECT OR TEL. + _ ENGINEER ,,NO, BLOG.SETBACK M ADDRESS SIDE PROP.LINE OF (STREET) / TYPE OF EXISTING SETBACK HIGH W YARD = TOTAL ...�,A^..r� p TEL. HIGHWAY WIDTH FROM C.L. CONTRACTOR NO. O LIC. V ADDRESS NO, + _ w J LIC. � CITY CLASS CORNER CUTOFF YES ❑ NO. ❑ CONSTRUCTION LENDER' NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS O ADDRESS D_ SQ. FT. NO, OF NO. OF NEN, El ' _ W SIZE STORIES FAMILIES .�"' H'-' USE OF ..-7" ADD ❑ r t�I .,,, .. a .( y?� ? r .•7<Fn ✓ff -( STRUCTURE r,!•1 r°t r (- k� ,f f # y ALTER i REPAIR❑ � f � }..r �.. SIGNATURE OF E -APPLICANT - DEMOL ❑ "" - VALUATION $ 1` tJ APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION FEE $ FEE $ f /$ 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. LAWS REGULATING BUILDING CON- GAS VENT, DUCTS - STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED _ HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S CO'-APENSATION INSURANCE. r „J _r, t Ypr LATH, EXT. SIGNATURE OF PERMITTEE r" ^" HOUSE NUMBER COR- RECTA 0 OR- RECTAND POSTED ADDRESS FINAL JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. ^ M.O. CASH d 0 ©5 IJBA6380 CV#8031RC'V.6/78) . APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDING. ADDRESS BUILDING ADDRESS ` LOCALITY T41 4, L NEAREST / CITY ZIP B CROSS ST. l e � /� NO.OF BLDGS. ASSESSOR SIZE OF LOT p(, 049.NOW ON LOT MAP BOOKPAGE PARCEL DISTRICT GROUP TYPE FIRE PROCESSED BY TRACT BLOCK LOT NO. CONST. ZONE OWNER STATISTICAL CLASSIFICATION. SEWER MAP ADDRESS CLASS NO.. 1/ DWELL.UNITS BK 2 PG CITY ZIP S 6 ARCHITECT 07 TEL. VALUATION $ �Q ENGINEER NO. J ADDRESS / BLDG.SETBACK FROM TEL FRONT PROP.LINE OF (STREET) CONTRACTOR NO. HIGHWAY + YARD __ TOTAL SETBACK FROM TYPE OF EXISTING LIC. FRONT PROP.LINE HIGHWAY WIDTH ADDRESS NO. LIC. + CITY CLASS CONSTRUCTION LENDER BLDG.SETBACK FROM NAME AND BRANCH SIDE PROP.LINE OF (STREET) HIGHWAY + YARD .= TOTAL SETBACK FROM TYPE OF EXISTING ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH 0 SQ.FT. NO.OF NO.OF CHECK SIZE STORIES FAMILIES ONE DESCRIPTION OF WORK N ❑ P.C. Fee$ Permit Fee -34,0(3 a Issuance Fee 7,0 U pb ALTER REPAIR ❑ Total Fee 3 U o USE OF DEMOL EXISTING BLDG. ❑ Z APPLICANT TEL O PRINT) NO. Q D BY(SIGNATURE) Q IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Y THAT THE ABOVE ISCORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES W AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE _ WORK AUTHORIZED HEREBY IW ILL NOT EMPLOY ANY PERSON IN VIOLATION OF V THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM Z PENSATION INSURANCE. - A 1'01A 0 A 0 SIGNATURE O PERMITTEE 74 ADDRESS 0 43.00 Z TEL. 0 .0.0 - 4 3 0 0 CITY NO. Q /, I 0 31 —78 USE ZONE NOP �y a e�' SPECIAL CONDITIONS _ ec DFINAATELAUS " BY - u �'t 0• �� 1 HG 4,n� WORKERS' COMPENSATION DECLARATION hereby irm that I have a certificate of' consent to, finsureor acertifcate of Workers' Compensation sur �oAPPLICATION FOR` ,BUILDING_ PERMIT 1 or a certified copy thereof (Sec. 3800, Lab. C.') COUNTY OF LOS ANGELES BUILDING,AND SAFETY Policy.No. Company ElCertified copy is hereby furnished. f.OR APPLICANT TO FILL IN BUILDING {_-� ADDRESS E7Certified copy i.filed with the county building inspec- BUILDING f` `i � _ / . tion department. ADDRESS Date Applicant CITY ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' ,'btb OF BLDGS: � / NEAREST COMPENSATION INSURANCE SIZE OF LOT d X �(�,'(/N0 ON LOT (This section need not be completed if the permit is for one ASSESSOR ,hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE• PARCEL OWNER% �y�` USE ONE MAP � �{ I certify that in the performance of the work for which this + NO. permit is issued,'I shall n employ any person in any manner //,� SPECIAL + ADDRESS' r/�Q A - I CONDITIONS CL so as-to become subject to kers C,ompe afiws, - V �� CITY l��/ �.. - ZIP . 119Date Appli ARCHITECT OR TEL. NO CE -TO APPLICANT: If, after making this'Certificate of DISTRICT-_ .GROUP. TYPE FIRE: PROC SED BY ENGINEER NO. ^ CONST. ZONE 0 Exemption, you should become subject to the Workers' !� 4J Compensation provisions of the Labor Code;-you must forth- ADDRESS �� ✓ _ IlL with comply with such. provisions ,or this permit shall be- - • tiJ TEL. STATISTICAL CLASSIFICATION APT. DO. deemed revoked. CONTRACTOR• LICENSED CONTRACTORS DECLARNO.ATION - - •- -- - - CLASS NO. LJ DWELL. UNITS LIC.- I hereby affirm that lam licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and LIC. SEWER MAP Professions Code, and my license is in full force a`nd effect. CITY CLASS BK PG VALIDATION SQ. FT. NO. OF NO. OF CHECK License Number Lic.Class SIZE STORIES ' - FAMILIES ONE ❑ - VALU �I,ON Contractor Date DESCRIPTION OF-WORK �'•' NEW E�// /7�. ADD ❑ / (/ (/ r, ❑ I am exempt under Sec: - - ALTER ❑ , .• B.&P.C. for this reason REPAIR. .❑ $ ' Date: USE OF EXISTING BLDG. 4i1(F_X� DEMOL ❑ Signature APPLICANT TEL FINAL -7 2$9 OWNER-BUILDER DECLARATION (PRINT) NO. DATE- Z (i• I.hereby affirm that.l am exempt from the Contractor's License # ©. 0 0 0 0 Law for the following reason'(Section 7031.5, Business and ADDRESS FIN 'Professi Code): PRESENT BUILDING I, as owner of the property, or m1.10 8 y employees with ADDRESS 8 Q Wages as their sole compensation,will do the work and o 0 1 11 22 IL the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING ?EL. _ I, as owner of the property, am exclusively contracting CONTRACTOR- NO. 9 8 5 ❑ . with licensed contractors to construct the project (Sec- ' - ""- - -' `--' - "' --- '' - -` -� - • ADDRESS tion 7044, Business and Professions Code). REQUIREDTOTAL SETBACK FROM I T. CONSTRUCTION LENDING AGENCY SET BACK -YARD HWY- PROP. LINE WIDTH ~ I hereby affirm that there is a construction lending agency for FRONT the performance of the work-for which this permit is issued P.Lc - - - - (Sec. 3097, Civ. C.). SIDE P.L. _. _.. - ..... .Lender's Name oma{ LDMA Ref. #- m P.C. Fee$ Permit Fee t ./(J lender's Address I certify that I have read this application and state that the _ Issuance Fee /0 1 SO - LDMA P/C# '- ¢ above information is correct. I agree to comply with all County Investigation Fee~ _ 0 ordinances and State laws relatingto building construction, 9 dotal Fee- LDMA Perm. # u and hereby authorize representatives of this County to enter u& above-meptioned pfypert for inspection purposes. Z SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date - - - - - - -•-- ---• - - - - - - -- - •- - �°