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HomeMy Public PortalAbout6102 HART AVE_Building__ '76 A 636 CE 980.3.4/72 7. APPLICATION FOR BUILDING PERMIT � '-..COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF-COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING /^/O ^ �/( MAKE CHECKS PAYABLE TO: ADDRESS 46 x �/ HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY _ FOR APPLICANT TO FILL IN NEAREST Print or type only) CROSS ST. BUILD �/ j n/� DISTRICT NO. GROUP TYPE ROCESSED BY ADDRESS .WjID� Al �j�/`//C,/ /wz c© CONST /� STATISTICAL C�}}''LA,,SSIFICATION SEWER MAP LOT NO. C ��j BLOCK CLASS NO.�DWELL,UNITS BK PG TRACT .~i/© USE ZONE MAP l / NOF BLDGS. NO. D3 SIZE OF LOT !� / 5: NOO.W ON LOT �l SPECIAL USE EXISTING NG BLDG. /7'U/'f'� T' 00 CONDITIONS OWNER. . AIVA(11/FG /�U/'JJC/ NOL S;j`�>>9 . - BLDG.SETBACK FROM - ir s f q FRONT PROP.LINE OF /1/T / y� (STREET) ADDRESS G/�,e: A`• lolor-% • TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL -CITY TLrO�/�.C' ���/ y - HIGHWAY WIDTH FROM C.L. ARCHITECT OR ©bfilv�C.�L TE NOL C _ J c } O1 = c., ENGINEER pp �1 31DE PROP.L NE O OM LOG.SE TBAC K FR ADDRESS S 4 QC`�J A L�(STREET) CDU r//�� TEL. TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL C CONTRACTOR 90 WA1Z-,G, NO. HIGHWAY WIDTH FROM C.L. ADDRESS - NO Q5:9 �yd + /`J/ V W LIC. CITY CLASS CORNER CUTOFF YES ❑ NO Z CONSTRUCTION LENDER NAME AND BRANCH 1po/z %`2Fpew' L 'S'4z SEE R VERSE IDE OR Sff CIA APP VALS ADDRESS le'.:oIAI= ffpA1;:wy ,7 L/ / SQ. FT. NO. OF / N(5. OF NEW ❑ SIZE 41-1 STORIES / FAMILIES I USE OFA ADD 2 STRUCTURE //Oi�11 `^' ,( � I LTER ❑ - _' l/.: G4`/_ OA `AIR❑ /1 SIGNATURE OF APPLICANT DEMOL ❑ e VALUATION S 6/1"6,90 APPROVALS - DATE- -'INSPECTOR'S SI-GNATU RE P,C. PMT. FOUNDATION: LOCATION FEE $ FEE $ ZJ FORMS, MATERIALS FRAME: FIRE STOPS, r� I HEREBY ACKNOWLEDGE THAT/I HAVE READ THIS APPLICATION BRACING, BOLTS - /7J i AND STATE THAT THE ABOVE IS 'CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STR UC TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED - HEREBY I WILL NOT EMPLOY ZANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF ALIFORNIA IN RELATING TO LATH, INT. ':%�!/ P�✓,f' WORKMEN'S COMPENS TION INSURA E. ^ �� F , LATH, EXT. SIGNATURE OF ;V�I/v PERMITTEE HOUSE NUMBER COR- ADDRESS fol�� /y' / 'e RECT AND POSTED -y� / FINAL PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDAT % CK. f M.o cASH TR 3 Z D 4v.7 5 PPLOCA T®N FOR µ BUILDING FOR APPLICANT"TO FILL IN ADDRESS ��Z l v! BUILDING LOCALITY ADDRESS N EA REST p. CITY. c ZIP' .�/'75�® CROSS ST: SIZE OF LOT �j� '�(/��'! NO.OF LOTBLDGT.. NOW ON LOMAP BOOK "PAGE PARCEL : pDISTRICT GROUP -TYPE- FIRE TOCESSEDBY TRACT / BLOCK:'y SLOT NO.,, ' .• -CONS E ��'�!` OWNER Y��I�I�L No �5 5782 ` J STATISTICAL CLASSIFICATION V SEWER MAP ADDRESSHCLASS.NO. IDWELL. ... UNITS BK •.PG CITY F��/ �,L ' .0 /' +` ZIP.•. 7 C�. USE - MAP Ze0 ARCHITECT-OR n TEL. K:- NO.SPECIAL �' ENGINEER Z�� CONDITIONS ADDRESS"" C" ',a ROAD.DEPARTMENT APPROVAL REQUIRED YES ❑ •NO TEL.' CONTRACTOR �E�/l/e" NO. BLDG,SETBACK FROM. LIC." FRONT PROP.LINE OF "(STREET) " ADDRESS NO" HIGHWAY + YARD', TOTAL SETBACK FROM TYPE OF EXISTING LIC FRONT PROP.LINE HIGHWAY -WIDTH CITY. . . -- "CLASS CONSTRUCTION LENDER NAME AND BRANCH BLDG.SETBACK FROM O 0 ADDRESS _ CITY SIDE PROP.LINE OF (STREET) � SQ:FT. n�j NO.OF NO.OF. % , CHECK HIGHWAY + R = O L SETBACK FROM TYPE OF EXISTING SIZE `f STORIES FAMILIES ONE SIDE PROP.LINE HIGHWAY WIDTH N DESCRIPTION OF WORK ComAL• v �� �� NEW ❑ + = Z . .CORNER CUTOFF ESp,4,7, / , W EI g . O �L✓ � x' ❑ ALTER !-k k ers 31 � IN OPEN SPACE YET ❑ NO ❑ EP IR '❑ USE OE' DEM N COASTAL PERMIT ZONE YES Q. NO ❑ EXISTING BLDG. APPLICANT TEL (PRINT) A13'I 40 7�/ it//ELU'l1'1 SEYNo.Z83-5782 `�� 2rvs �� a!C .� BY,(SIGNATURE) •'7 HEREBY ACKNOWLEDGETHAT I HAVE R AD THIS.APPLICATION AND,STATE • "' - ' "` �- - ` THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES - AND LAWS REGULATING BUILDING CONSTRUCTION.-;I CERTIFY THAT IN.DOING THE WORK'AUTHORIZED HEREBY'1,WILL NOT EMPLOY ANY•PERSON IN VIOLATION OF - - THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN:S COM- - - PENSATION INSURANCE. - SIGNATURE OF FINALS 5: .BY , PERMITTEE "� DATE ADDRESS 169 DATE ADDRESS CITY 41-Ty,• TEL. �57 2 P.C.Fee$ Permit fee I G S Issuance-Fee- VALUATION ssuance Fee'VALUATION A /� CIO.- . 16-00 � OV Total Fee . PLAN CHECK tlALOA ION CK. M.O. CASH - PERMI1`tl/YLOA ION K. M.O. CASH 2 ?B=OLT . . 1 1.`7 5 ,&� - ©S. 76A63819 CE X80319 6/76 —' "• --. - _ _ _. - WORKERS' COMPENSATION DECLARATION insurebor afirm ce of carte of Worke s'-Compensat oa certificate n eInsurancef /n1 PIPLICA o certified cop'ythereof (Sec.3800, Lab. C:) (d COUNTY OF LOS ANGELES •- BUILDING AND SAFETY fsDTicyNdCompanylBUILDING d - aCertified copy is hereby furnished: FOR APPLICANT TO FILL IN ADDRESS ``_v lQ�. • — �' ¢`1��T _ I�J'_ Certified copyr is filed with the count building'inspec- BUILDING fi¢n.deparTmenT. ADDRESS LOCALI7X ..: -. ,. .. NEAREST n Date Applicant CIT C:..�(. ZIP l� V CROSS.ST. !7� ��►+�. CERTIFICATE OF EXEMPTI N FROM;WORKERS' NO. OF BLDGS ASSESSOR t COMPENSATION INSURANCE SIZE_OF LOT IZ 'r!1t Cps' NOW ON LOT MAP BOOK PAGE PARCEL (Th's'section need not be completed rf the permit s for one ' MAP Cis t ., hundred dollars ($100),or less.): /' ZONE NO., s TRACT J /'.v ,BLOCK LOT NO. �r TE OWNER ups' NL,.,. 5� /� USE 6�certify thatjn'•.the performance of the work for which this "" PE CONDITIONS. '' k tis permit,is'is5ued, I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE PR CESSED BY so as,to become subject to the,Workers'Compensation Laws. ADDRESSe='Y 7 7 p*�` f/ CONST ZONE �J .�' Date Applicant", CITY ZIP STATICAL CLA IFICATION APT. ,,CONDO." ` ® . ,NOTICE TO APPLICANT: .If, after"'making�this;Certificate of; ARCHITECT.OR TEL. r Exemption, you should' become.subject to the Workers' ENGINEER NO. CLASS NO . DWELL. UNITSIL Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER.MAP -'' with, ply with-such provisions.or this permit shall be �n - deemed revoked. -• TEL CONTRACTOR ;P7• -tQ /c.. NO S^ f- BK. PG; VALIDATION . LICENSED CONTRACTORS DECLARATION LIC.`' I hereby,affirm that l am licensed under provisions bf Chapter 9 ADDRESS (�� N 7?� VALUATION (commencing with Section.7000)of'Division 3 of the Business and LIC: Professions Code; and my license.is m full force and,effect, CITY Ci CLASS ` $ SQ.,. U NO. OF NO.OF CHECK. . �7 -- I . License Numb Lic.ClassSIZE STORIES FAMILIES' ONE D Contract ate ` •� r�+ DESCRIPTION OF WORK /w- d NEW ❑ 'ADD am exempt under Sec FINAL 8,8P.C.for"this reason REPAIR Q — DATE Date: USE OF ..ls�� DEMOL ❑ 4.5l—'-s_— 'JG 6 FINAL a Signature EXISTING BLDG. APPLICANT .}}TEL. By # °`02,3 OWNER-BUILDER DECLARATION s; PRINT 6 �AkJO: hereby affirm that I am exempt"from-the Contractor s License ! �� 2 °.p 5 7''J ra Law for,the.following reason(Section-1031.5,.Business and ADDRESS. ° J�7,3 8� Professions Code):, PRESENT - :- BUILDING ' I, as owner of the property, or my employees with. ADDRESS 0 9,2 wages as their sole com" '' ion,,will do'the,.work and. the structure is not.':intended or offered forsale,(Section LOCALITY. 7044, Business•and Professions Code) MOVING* TEL: o r, I,.as owner;of ihe-property, am exclusivelycontracting s. ', CONTRACTOR NO. J G 1 A with licensed contractors to construct the proleet(Sec tion 7044, Business and Professions Code). ADDRESS # a 0 0 o io 1 - REQUIRED TOTAL SETBACK FROM EXIST. - CONSTRUCTION LENDING AGENCY SET BACK YARD HWY. PROP. LINE,. WIDTH 2.9 -.7 a Q Q 1.hereby affirm that there is a constructiondending agencyfor FRONT D t' the performance of the work for which'th'is permit is issued, P.L. o,o ®" r (Sec. 3097, Civ.'`C ). - SIDE O 9.21 -83 Lender's Name' Lender's Address P.C:Fee$. Permit Fee I certify that l have read this'applicationand state'that the Issuance Fee` �� -above information,is correct.I;agree to comply with.all County InvestigaT on Fee y , g ordinances -an .State;lows relating to building construction Total Fee.: u and hereby thoriie'representatives of this County to enter upo the ablve,-mentioned property for inspection purposes. ' _ SEE R1.EVER SE'FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent. Date ®s