Loading...
HomeMy Public PortalAbout4834 HELEO AVE_Building__ DEPARTMENT OF BUILDING AND SAFETY. ,, APPLICATION FOR 'PERMIT L , COUNTY OF LOS ANGELES WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN .FOR OFFICE USE ONLY DISTRICT NO. PLAN CK.NO, PERMIT NO. BUILDING ADDRESS /.G/ /. / IG' [�� -7.3 / 97 �/ G�: J Y P �J �1\ LOCALITY r-_- ."j1�.��iySs�d,�r, fRECEIVED BY. _ DATE OFAPPL. DATE,ISSUED CRDSSS T. 10 u p Z V. A. / c' BUILDING / V OWNER ADDRESS ( / �C �• !��V MAIL LOCALITY ADDRESS NEAREST TEL. CROSS ST. CITY NO. FIRE NO.OF TYPE GROUP RcHl —ENTECGINEER OR E . S� '71r ZONE PLANS 1 Jam' (/ r��`L o ^ y� {`¢ a SETBACK LINE \ i ADDRESS ii O _. O gS - V APPROVED TEL. BY DATE CONTRACTOR �� � - NO. A USE `� APPROVED ADDRESS ZONE P�' BY DATE LEGAL / CORRECTIONS DESCRIPTIOsN� LOT NO. BLOCK TRACT NO.OF��f y2 r SIZE OF LOT V�'Y Y� -I NOW ON LOTS USE OF NO.OF NO.OF EXISTING BLDG. FAMTL ROOMS DESCRIPTION OF WORK NEW ALTERATION ADDITION O A REPAIR MOVING DEMOLISH Ll SQ.FT. / �/ NO.OF / - Z SIZE / �'7" ROOMS 1,4 STORIES WALL ""�� ��gg_�"" ROOF COVERING �' yl -.r.^�"' I�CyOVERING ljls �ii� USE OF NEW 2r& er - BUILDING- •1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECT13R DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS G rj S AND STATE LAWS REGULATING BUILDING CONSTRUCTION. r—' &a,., t FRAME: FIRE STOPS, .G( /^ y SIGNATURE OF OWNER qr7 BRACING,BOLTS � %:+��� � 3o"�S /� LATH.INT.: � ) 1 AUTHORIZED AG LATH,LATH,EXT.: DSS-3 25M SETS 4-47 $ �70 0- P C.$ qq �,l3 PLASTER,INT. FEE A PLASTER,EXT. VALUATION -- [7 - FEE ) �' FI NAL 1 ( �'' i 76A633A CE.#60310*-... APPLICATION1TIO'' F®' BLJt-L bi NG...Y, E!RmY iT ,'•� ,.'.. 6OWfY QF:LOS=RNGELES; .: Bulr D1Nc DEPATMENT OF.COUNTY ENGINEER a°oREss BUILDING .ANDSAFETY :DIVISION•', LOCALFTI ' JOHN A.,LAMBIE, COUNTY ENGINEER, NEAREST CAS SATT;D..GRIFFIN, SUP'T,OF BUILDINGCROSS ST: - DISTRICT NO. GROU �-YpE - -PROCESSED BY `. FR FOR APPLICANT TO 'FILL IN'' c :- :. 'cDNs ING "STATISTICAL C IFICATION SE AP _ ESS " CLASS:NO. WELLUNITS�j �� �O. T .'BLOCKgMAP.. i HWYE YES.r.NOg v� NUMBER: � 'L�` 6�'3 j/� U EZONECONDITIONS F LOT�/�•/�' / ,_ . NO. O'N' LOGS -NOW ON LOT A. F,ING.BLDG..'-(y�4.1�a•rte }I"' BUILDING EXISTSETBACK YARD 'HWYSTREET NAME yylDTli:MAILR FRONTr ESS ,, _ ?'' - .(/��' 811 ETEL.._ NO ._ - _INSPECTION RECORD:•�ITECT R _ TEL..EER - NO TEL F. ,`. r ,.CONTRA CTO �e .c''NO.� 6. * .. ::., 'ADDRESS`.. ," - -• _ DESCRIPTION OF:WORI{ NEW. ' ADD .ALTER' REPAIR :'DEMOLISH . _ .SQ.FT. Cyf - -:.NO;OF NO.'OF- r h SIZE,T . �gy+-•' STORIES' 'FAMILIES _ .- USE,OF °f - - STRUCTURE. , e o'tiL .SIGNATURE APPLICANT �G1�y APPROVALS DATE INSPECTOR'S SIGNATURE ADDRESS © FOUNDAT.ION:'LOCATION U FORMS,MATERIALS / f� O . VALUATION$ - �� --- FRAME.FIRE STOPS.- v BRACING,BOLTS P.C. - PMT. ^. l DU - "% FURNACE:LOCATION. .. , FEE $ [PMT. 'GAS-VENT,DUCTS ' Q` I HEREBY.ACKNOWLEDGE THAT-I HAVE READ-THIS AP- LATH.INT. � PLICATION AND:STATE.THAT THE ABOVE IS,'CORRECT AND AGREE TO_COMPLYWITH ALL COUNTY,ORDINANCES AND STATE LAWS REGULATING. BUILDING_ 'CONSTRUCTION. . LATH,EXT. ` SIGNATURE OF;= HOUSE`NUMBER,COR= PERM ITT RECT AND POSTED 4DDRES& FINAL ; CLYDE N: OIRLAM, PRINCIPAL"ST URAL ENGINEER PLAN CHECK VALIDATION �K. M.O.; CASH PERMIT.VALIDATION A . 2 `®F . COUNTY OF:LOS ANGELES BUILDING AND SAF TY WORKOR'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRES I hereby affirm that I have a certificate'of consent to self,insure, BUILD IIyGD s or a certificate of-Workers' Compensation Insurance,or. a certified copy thereof eC.38 ab. C. CT j ZIP n Ye p .thy (/ / / O Policy N - _ �J SIZE OF.LOT N . F BLDGS.NOW ON L T ' LJ NEA ST CROSS Certified copy.is hereby furnished. � ❑ Certified copy is filed wit the county building inspeo 10" TRACT BLOCK LOT NO, depa tm_ent. USE ZONE - -MAP NO. Date7DeApplicant ASSESSOR MAP BOOK PAGE PARCEL - _ SPECIAL CONDITIONS CERTIFICATE OF EXEM ION ROM WORK :; OWNER Th , �T L COMPENSAT.IO 'INSURANCEMMUM(FWITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred A i N DISTRICT GROUP TYP CONST. FIRE ZONE PROCESSED BY dollars ($100)or less.) 3 � I certify that in the performance of the work for which this permit ZIP �/ is issued, I shall not employ any person in any manner.so as to become subject to the Workers'Compensation Laws. ARCHITECTFOR ENGINEERTEL NU._ STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. 4"1 DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONT OR.� ,�� T 1 /—Z / SET BACK YARD HWY PROP LINE WIDTH ^.,Compensation provisions of the Labor Code; you must-forthwith J 7 FRONT comply with such provisions or this permit shall be deemed revoked. qpI IV XO_ P L LICENSED,CONTRACTORS DECLARATION PILE -CIT .. S'.. P L VC I hereby affirm that 1 am licensed underprovisions of Chapter 9 a S SEWER MAP '(commencing with:Section 70 00)of Division•3 of the Busine'ss'and SO T.SIZE NO.OF STORIES 'NO:OF FAMILIES d Professions Code,and rpy 'tens 's for�(9/end NEW ❑ BK .PG V License Nu e CIasS� DESC W - ADD ❑ ,VALUATION Contractor ALTER ❑ 0 0 ElI am exempt under Sec. / REPAIR ❑ U . BAP C.for this reason Date. DEMOL ❑ LDMA.P/C# LU d USE O X G URM ❑ z Signatu APP CANT ) � / N �1 �A.Perm#. ❑'l, as owner the p erty, or my emp,oy es wy ges as AVL Z {L a a their so mpens ion, will do the work e cture is ADDRESS pp O not inten d or offered for sale (Section 704 Business and 0� FINAL DATE Q _ Professi Code.) I7� s I EM WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE,A HAZARDOUS MATERIAL - VV -` J OR A MIXTURE CONTAINING A HAZARDOUS�MATERIAL EQUAL'TO OR GREATER THAN THE ,T pp''��'� ❑"1, as owner'of the property, am exclusively contracting with AMOUNTS SPECIFIED ON.THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY T fTHL m O@ SJ` licensed contractors to construct the project (Section 7044, YEs❑ NO❑ '' Business and.Professions Code.) i7N WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR MARK GUIDELINES. I hereby affirm that there is a construction lending.agency for YES❑ No❑ a the performance of the work for which this permit is issued(Sec. p� IHAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING ??:}-�'��'+i j 1• 3097,Civ.-C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, i E!_?'-�S I_'�1#. i .0>.•i"E'+ TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20140 CONCERNING HAZARDOUS - Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. —F s+ j i a 3 - IL Lender's Address yh O _ OWNER OR AGENT --- o I certify that I have read this application and state under penalty o of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE - -' w all county ordinances and State laws relating to building �7 m struction,and hereb rize representatives of this County ISSUANCE FEE �' O OV perty for ins r a INVESTIGATION FEE TOTAL FEEa 1 ) � g e,e o1 � ei o�Agent Dale. { ��/ // SEE REVERSE FOR EXPLANATORY LANGUAGE