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Home My Public Portal About6258 HART AVE_Building__ 76A 638A CE#803 3-68 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES y BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS" — cel- BUILDING AND SAFETY DIVISION LOCALITY �� G/f JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST CROSS ST. LD Iv FOR APPLICANT TO FILL IN DISTRICT NO. NST•PE PROCESSED,BY \GRO TYCO (Print ort pe only) y BUILDING .STATISTICAL CLASSIRICATION SEWE .MAP ADDRESS CLASS NO.�DWE L•UNI;TS. BKeE PGa6' LOT NO. 2 3 BLOCK USE ZONEMA NOP OU3 TRACT s PECL 'tel COEDIT ONS ' NO.OF BLDGS. SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. BLDG.SETBACK FROM TEL. 63 FRONT PROP:LI NE OF (STREET). OWNER O• -TYPE OF EXISTING SETBACK 'HIGHWAY' + ' YARD = TOTAL ADDRESS _ HIGHWAY WIDTH FROM C.L. CITY 115, C c Q i ,5_O + = Z 0 ARCHITECT OR EL. BLDG.SETBACK FROM (BYRE ) SIDE PROP.LINE OF .ENGINEER O' TYPE OF"EXISTING SETBACK HIGHWAY + YA RD _ AL ADDRESS HIGHWAY WIDTH FROM C.L. CONTRACTOR OWIYIe�^ NO + o LIC. ADDRESS NO. CORNER CUTOFF YES E] NO ❑: v - CITY CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK L" NEW ADD ALTER REPAIR' DEMOLISH SQ. FT. NO. OFNO. OF '��•! ( (. SIZE •STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF APPLICANT VALUATION $ :3,5-a 00 APPROVALS DATE INSPEc R'S SIGNATURE P.C. PMT. FOUNDATION:.LOCATION r FEE $ FEE $ /000 FORMS, MATERIALS / FRAME: FIRE STOPS, . IT 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 AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- LATH, INT. _ ING TO WORKMEN'S COMPENSATION INSURANCE. - LATH, EXT. SIGNATUREOF HOUSE NUMBER COR- PERMITTEE' RECT AND POSTED ADDRESS FINAL f JOHN F. LEWIS. PRINCIPAL STRU RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH LAS.6 2 4 3.1 SEP 4 ,: D 9.101 0 w APPLICATION FOR BUILDING PERMIT FOItAPPLICANT TO FILL.IN (Print or type only) BUILOINc, y- `/ y'` Ile-17- '-ADDRESSCOUNTY OF LOS ANGELES Z�7 - /(� �/ � DEPARTMENT OF COUNTY ENGINEER CITY 1 �Ay ZIP BUILDING AND SAFETY DIVISION 06.OF BLDGS. BUILDING / aj� SIZE OF LOT N ON LOT - ADDRESS lg7Op_ TRACT LOT NO. LOCALITY . � S NEAREST OWNER _f Q O. -- CROSS ST. - ASSESSOR MAP BOOK col, PAGE PARCEL CITY TQ%YZ� E G� ` `,_ DISTRICT GROUP TYP CONE FIREZES2SEd117� ST ZONE Z I P ARCHITECT OR - TEL. ENGINEER NO. _ STATISTICAL CL��A��'SS��IFICATION ER MAP ADDRESS dl , ,! CLASS NO. L_. _DWELL,UNITS BK P CON TRA CTO �j' /!� NOL�� 77#6 USE ZONE MAP LIC. f/` NO. . ADDRESS - - NO. .� /-�7 - �/ SPECIAL _ LIC. �y CONDITIONS CITY CLASS�O - - ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ - CONSTRUCTION LENDER NAME AND BRANCH BLDG.SETBACK FROM - FRONT PROP.LINE OF (STREET) }.. ADDRESS -CITY - - - HIGHWAY } YARD -_ TOTAL SETBACK FROM TYPE OF EXISTING U SO. FT. NO. OF N0-0 F CHECK FRONT PROP. LINE HIGHWAY WIDTH SIZE STORIES IFAMILIES. ONE XO DESCRIPTION OF WORK NEW. ❑ C3 ADD- BLDG,SETBACK FROM LLI (STREET) N SIDE PROP. LINEOF Z ALTER ❑ HIGHWAY + YARD = TOTAL SETBACK FROM ..TYPE OF EXISTING RLPAIR❑ SIDE PROP. LINE .HIGHWAY WIDTH USE OF .L + DEMO EXISTING BLDG. ❑ APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑ . (PRINT) - NO. BY (SIGNATURE) IN OPEN.SPACE .YES ❑ NO ❑„ Q� IN COASTAL ZONE. .- YES ❑ NC) ❑ VALUATIONP o7`J �/' CATEGORICAL EXEMPTION YES❑ N-O ❑ I HEREBY ACKNOWLEDGE THAT IHAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE 15 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 NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM INS/URAN SIGNATURE OF ./ PERMITTEE / - ADDRESS 7��` �<//1//�. ,�G!/✓ pyo FINAL TE CITYS�'pI/ /% / NOG �7"Ve DATE GS BY - MAKE CIIECKS FA YA13I_E -(0: FEE $ FEE HARVEY T. BRANDT, COUNTY ENGINEER 15�� PLAN CHECK VALIDATION CK. M.O. CASH' o PERMIT IDATION DK - M.O. -CASH r s 7 9 973, JUN 21 i Q 9.OOA 76A638A CE#803 12/72 - "r C__ L -- U'r-- 1 Q'!1 YL C--, r 1 APPLE CAif 0® IIS FOR BWLMNG PERfi�►1 T IF&APF?I'CANT TO FILL IN (Print or type only) , BUILDING COUNTY OF LOS ANGELES ADDRESS T DEPARTMENT OF COUNTY ENGINEER urY -y1.L 'j, ZIP71r(—) 6UILDING.AND SAFETY D1 •ISION NO:OF BLDGS. BUILDING SIZE OF LOT Q NOW ON LOT ADDRESS TRACT �� C), BLOCK LOT N04-3 7 LOCALITY iL TEL. NEAREST OWNER �1 (y�j �► Z� NO` CROSS ST. Lr'� �1 ASSESSOR ADDRESS �5 [��"r MAP BOOK PAGE PA CEL f CITY j ZIP f DISTRICT GROUP TY E FIRE t FON ffP /�E BY ARCHITECT OR TEL. V ENGINEER NO. STATISTICAL CLASSIFICATION AEWER MAP ADDRESS TEL. CLASS NO. DWELL.UNITS'- ::::jBK PG CONTRACTOR NO. USE ZONE MAP LIC. �a ADDRESS SPE NO. SPECIAL LIC. CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ N CONST R I NDER NAME ANCH BLDG.SETBACK FROM FRONT PROP.LINE OF - (STREET) ADDRESS CITY, TOTAL SETBACK FROM TYPE OF EXISTING SQ.FT. NO.OF NO.OF ( CHECK - FRONT PROP,LINE HIGHWAY WIDTH SIZE �� `HIGHWAY + YARD STORIES FAMILIES ! ONE } DERIPTION OF WORK SCNEW. ❑ O edretats ADD BLDG.SETBACK FROM 0� ` SIDE PROP.LINE OF . (STREET) O ? ALTER lZY TOT ETBACK FROM TYPE OF -EXISTING w HIGHWAY + YARD = IDE PROP.LINE HIGHWAY WIDTH USE OF REPAIR .❑ Z EXISTING BLDG. e DEMOL ❑ + APPLICANT ` ` TEL CORNER CUTOFF YES ❑ NO ❑' IPRIN 1 + NO ` IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE), • IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION $ I HEREBY.ACKNOWL DGE THAT I HAVE READ*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 I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM. 7 L1Ae PENSATION INSURANCE. ss SIGNATURE O PERMITTEE - ADDRESS ' F / TEL. r FINAL BY CITY - NO. P.0 PM 5-. DATE /�7 MAKE CHECKS YABLE TO: FEE $ . F ET HARVEY T.BRANDT,COUNTY ENGINEER PLAN.CHECI(VALIDATION cK. M.O. CASH o PERMIT VALIDATIONc .. M.O. -CASH 23 5 es 76A63BACE#803 3.75' 't APPLICATION FOR BUILDING PERMIT FOR'APPLICANT TO FILL IN Print or type only) BULLOING ' _ COUNTY OF LOS ANGELES " ADDRESS /� U ' DEPARTMENT .OF COUNTY ENGINEER CITY j_ 'P V l ZIP. - BUILDING AND .SAFETY-DIVISION - _ I NO.OFBLDGS. BUILDING - SIZE OF LOT NOW ON LOT ^^ - ADDRESS TRACT BLOCK LOT NO, O. LOCALITY A TEL G NEAREST _ • OWNERNOON I . C gyp, CROSS ST. 160 ..=- ASSESSOR ADDRESS.. 6 ro MAP BOOK - PAGE PARCEL L DISTRICT - GROUP TYPE - FIRE PROCESSED BY ' CITY rL. .Ci+ ZIP ,y� _ CONST,- Z -E . ARCHITECT O TEL ENGINEER NO° *C1i STATISTICAL CLASSIFICATION' SEWER MAP ADDRESS �� W 0 CLASS NO. _OWELL,UNITS BK PGTE - CONTRACTOR NO X31 USE ZONE NOP f( LIC.. . ADDRESS � -- NO, , LtlY . CON DI TI ONS � = SPEC AL CITY - LIC. .. - _ CL�� ij�, CLASS C�� ROAD RTDEPAMENT APPROVAL REQU1-RED YES❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG,SETBACK FROM - -- - - FRONT PROP.LINE OF (STREET) } ADDRESS - CITY - HIGHWAY } YARDTOTAL SETBACK FROM TYPE.OF EXISTING .- U . S . FT ' � 'N:O. OF � �NO. OF � CHECK FRONT-PROP. LINE HIGHWAY WIDTH SIZE rC1 STORIES FAMILIES. ONE - DESCRIPTION OF WORK NEW W ❑ BLDG.SETBAC OM ADD - - - - SIDEPROP. LINEO (STREET) ALTER ❑ OTAL SETBACK.FROM TYPE OF .EXISTING. ...�CU H-IGHWAY } YARD =REPAIRE PROP. LINE HIGHWAY WIDTH ❑ _ D _ USE OF _ +IF ,_ EXISTING BLDG_ DEMOL ❑ - ' APPLICANT TEL CORNERCUTOFF YES NO ❑ _ (PRLNT) N0. ' 't IN OPEN SPA CE• - - Y.ES ❑_ NO ❑- - .BY (SIGNA_TURE) - - IN COASTAL ZONE YES E] N 1:1.VALUATION $ . �a� � `- - CATEGORICAL EXEMPTION' YES❑ -NO ❑ 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE 15 CORRECT AND-AGREE TO-COMPLY- IMPACT EXEMPTION DECLARATION SIGNED- WITH IGNED (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 NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE M THE STATE R CALIFORNIA IN RELATING. TO {j��.,1��'�� it)ctj c'Al� ®ea -ry �.w , A� ^ WORKMEN'S COMPE � ATION INSURANCE. +J 1 ) J�Ji SIGNATURE OF r �s,v .d'l 'l. kL.„�.,,/ P-ERMITTEE _ .A ..ADDRESS _ A k 121 —cl TE y -FINAL. : Ulu BY CITY ( NO. d�' (p`3 DATE - 11;1hE CHLC<;S PAYABLL- LO. P.C. $ ` ,PMT.$ FEE FEE HARVEY T. BRANDT, COUNTY ENGINEER Ayr -� PLAN CHECK VALI TION cK. M.O. CASH e _ PERMIT VAI ATION CK. M.O. CASH 9:'-`6-5V'MAk: 7_22[�� Y - -6.6"MAR. ? 1 D 3.5:2 5. `F 76A638A CE#803 12/72 LL ' "76. .638..A:,F#803 d'%72 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS .ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING MAKE CHECKS PAYABLE TO: ADDRESS HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY C/- FOR APPLICANT TO FILL IN NEAREST Print ort a only) CROSS ST. DISTRICT NO. GROUP TYPE PROCESSED BY BUILDING !T ADDRESS 55' .� E ' coNST.Cj' f STATISTICAL CLASSIFICATION SEWER MAP LOT NO. BLOCK CLASS NO. DWELL.UNITS BKF P TRACT Q - ONE MAP • �f NO.OF SLOGS. NO. O SIZE OF LOTopfd 3 NOW ON LOT �'— 1 SPECIAL 11 USE OF - 1 CONDITIONS- �EtXISTING BLDG. - - TEL. - '."c�•, OWNER NO. BLDG.SETBACK FROM ADDRESS FRONT PROP.LINE OF' (STREET) q� /a p� TYPE OF EXISTING .SETBACK HIGHWAY + YARD = TOTAL CITY T�/Vpj e/♦ Y IGHWAY WIDTH FROM C.L. ARCHITECT OR TEL. + _ ENGINEER NO. _ LDG.SETBACKFROM.,' 0 ADDRESSSiQf-PROP.LINE OF (STREET) TEL. .y TYPE OF.EXISTING SETBACK HIG YARD TOTAL �. CONTRACTOR.D. �:, NO. oC - HIGHWAY -WIDTH FROM C.L. O ADDRESS £ Np ,��'� _ + W IC. CITY G ,� .E CLLASS "� CORNER CUTOFF YES ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS ADDRESS SQ. FT. NO. OF. NO. OF NEW ❑ ��( - SIZE :O STORIES FAMILIES ' USE OF ADD 3 STRUCTURE ` ALTER ❑ /G7 C.( 01. REPAIR❑ 'l SIGNATURE O h ) APPLICANT DEMOL ❑ . VALUATION $ 67 09, UD APPRO ALS DATE INS cTOR'S S GN TURF P.EC. PMT. FOUNDATION: LOCATION ,/L y 7 .FE $ FEE $ dC/ - FORMS, MATERIALS �+J '_ MEL,FG 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, WITHALL ORDINANCES AND 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. i LABOR CODE OF THE STATE OF 'CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION INSURANCE. LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE GRECT AND POSTED ADDRESS FINAL PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT V DATION c,,. .0. CASH �- V u WORKERS' COMPENSATION.DECLARATION I. h affirm that I have., certificate of consent to self L/�LI LI �Q� O O O M dD0 1 pE.R Gud n ure r a certificate of'Workers' Co ensu`o Insura e; or a- fi a C. 38 C ..COUNTY OF LOS ANGELES BUILDING AND SAFETY Poli y pan 4—) ' y V - BUILDING ❑ Certified co hereby f rniahed: -F R PLICA T T ILL N ADDRESSl�e�� BUILDING ❑ Certified copy isofiled , th ounty b ild1 inspec- ADbR tion departmen Date ACITY' ZIPi LOCALITY NO. OF BLDGS:;' NEAREST CERTIFICATE.OF EXEMPTION FROM WORKERS'.` SIZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCE A SESSOR (This section need not be completed if The permit is for one TRACT,. BOCK LOT P BOOK PAGE PARCEL hundred dollars ($100)or.less.) TE - OWNER USE ZONE MAP Ilcertify that in the performance.of the work for.-which this SPE per is issued, I shall not ernploy'any person in any manner ADDRESS SPECIAL d . CONDITIONS sops to become subject,to the Workers'Compensation Laws. O CITY ZIP. Date Applicant.' ARCHITECT OR ` TEL. NOTICE TO APPLICANT; If,, lifter makin this Certificate of ENGINEER - NO. DISTRICT "GROUP TYPE' FIRE PROCESSED BY 9' CON ZONE O Exemption, you should become subject to the Workers' Compensation,provisions of'the Labor Code,'you must forth- ADDRESS �/ - ✓ a_ with .comply with .such provisions -or this,permit shall be ' TEL' STATISTICAL•CLASSIFICATION APL CONDO.... N deemed revoked. CONTRACTO �` NO Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. � � DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 _ : _ ADD E NO. LIC. SEWER MAP . .(commencing i e '0 7 )'of Division.3 of��ta s' s _ ��t i CITY CLASS and Professi s d icense is in:full,foct.. '' gK pG VALIDATION y�//lJ�, SQ. FT. NO. OF NO. OF - CHECK . - License N Lic. Clds SIZE STORIES FAMILIES ONE / VALUATION Q� Contrac 4 Date DESCRIPT NEW DD ❑ $ ❑I am exempt under Sec. D ALTER ❑ B.BP.C. for this reason- 4_3REPAIR ❑ $ Date:. USE OF.:. / C DEMOL ❑ EXISTING BLDG. ( ✓ Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) NO. r� I hereby affirm that I am exempt from the Contractor's License • K _ DATE' J- Law for:the following reason:(Section 7031.5,Business'and ADDRESS FINAL ' Professions Code): PRESENT By-." `'r'' •s BUILDING Y {1+_+ s m ❑ I, as owner of the property, or my.employees with ADDRESS _ .. - - :, 4 wages as their sole compensation,will do the work and = { the structure is not intended or offered for sale Section LOCALITYTTErE 7044,Business and Professions Code.) MOVING ,. TEL. Y CONTRACTOR NO. 5 ❑ I, as owner of,the property, am exclusively contracting . ., - i 4 3 L yam, p_3 with licensed contractors.to construct the project.(Sec- ADDRESS tion 7044, Business and Professions Code.)- CHEC}� l� o �a REQUIRED TOTAL SETBACK FROM- ' EXIST. CONSTRUCTION LENDING AGENCY SET BACK.' YARD HWY PROP..LINE WIDTH hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this'pbrmit is.issued P.L. (Sec. 3097, Civ. C.). SIDE P:L.. !If{j{t! Lender's Name. $ LDMA Ref: # c�l `4N; 2 i � P.C. Fee$ Permit Fee !�'� 3• Lender's ddress o I certif that ave read plication and state that the Issuance Fee 6' / LDMA P/C# D 0 8, abov i for at n is c e t. Fag a to comply wit all County Investigation Fee �Ceee'+++ ordi ces n Stat law felatin to building onstru on, Total Fee /� V LDMA Perm. # a anFN reb horiz rep ntati es of th' my t it r u n he ov t on p e y for in s ` SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent ate_