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HomeMy Public PortalAbout4835 HELEO AVE_Building__ DEPARTMENT OF BUILDING AND. SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES RL D 0 9q G WM. J. FOX, CHIEF ENGINEER FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN _DISTRICT NO. PLAN CK. NO. PERMIT NO. BUILDING ADDRESS LOCALITY S _O ' RECEIVED BY DATE OFAPPL. DATE ISSUED NEAREST d� lb _ }/ Y/_qj CROSS 9T. .{C .� BUILDING / gym` sj <j �• �fl .A OWNER JJ .s/2./ �:_. DDRESS . MAILLOCALITY ADDRESS ,�A �..fiJ� •... �/j NEAREST PITYTEGL.Gti_/ NOL CROSS ST. (�'"u.�'Y' ��2 FIRE NO.OF TYPE'S/' GROUP ARCHITECT OR TEL. ZONE PLANS -•'�' .--' .,,y ENGINEER l I .ero i9 // NO. I J y c✓!/ y BLDG. ! ORD.NO. ADDRESS SETBACK LINE APPROVED TEL. CONTRACTOR rti!Tl'/`�'' NO. - SY DATE USE ` (j APPROVED ADDRESS ZONE }• lj BY DATE LEGAL - CORRECTIONS DESCRIPTION I .LOT NO. BLOCK p c A TRAf CT ✓ ra All 11'7 S. !<�/�J! l � i� J 7 /•� f/rt�• NO.OF BLDGS. ,1 . SIZE OF LOT �".�_ ..,.[ I NOW ON LOT- / USE OF v;.t^ ��'•`^p.-�',� ND.OF ,,p1 N0.'0 F ,c EXISTING BLDG.FY�nE_. I FAMILIES J- I ROOMS DESCRIPTION OF WORK t NEW. ALTERATION ADDITION O A REPAIR MOVING DEMOLISH - O Sq.FT. 44©O NO.OF / / Z SIZE ..� 7>< _/J ROOMS / STORIES / D WALL ..II� I ROOF +6 r COVERING `y'(1 ,•.(-t-r"1• COVERING USE OF NGEW BUILDIN I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. v FRAME: FIRE STOPS. SIGNATURE OF BRACING,BOLTS I OWNER LATH,INT.: 9 o' AUTHORIZED AOT. " j rl LATH,EXT.:' ''' �'f• DBS-3 25M SETS 1-47 $ P.C.6 .PLASTER.INT. FEE. PLASTER.EXT. - VALUATION i.� FEE S_ .,`_�„_ FINAL IF I. DBS-3 2SM SETS 6-46 DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES I"I Who. J. FOX, CHIEF ENGINEER DING FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK. NO. PERMIT NO. BUILDING /) ADDRESS v U LOCALITYdlr RECEIVED DATE OyF AP,P/L�. DATE ISSUED NEAREST d / A =y �P CROSS ST. . .VR+.4/,l< �A A,^.L J' � � -- 0� BUILDING OWNER 4 //�� ;-�/ y / ADDRESS MAIL �J -,/ Gji A i✓ �j N JJLOCALITY ADDRESS NEAREST CROSS ST. CITY i f NO. FIRE NO.OF TYPE I GROU� ARCHITECT OR TEL. ZONE- "I PLANS ENGINEER !' NO. BLDG. J ORD. NO. ADDRESS SETBACK LINE • APPROVED y` y •� �7 TEL R' h 4 r' CONTRACTOR �"• tel� j,; ,�/ NO. BY DATE USEAPPROVED ADDR�ES �/6.di`n � ) .�,+ -�'l'��f,.>/•'i%� lr 'Y//A + ZONE BY DATE LEGAL i CORRECTIONS " DESCRIPTION I LOT NO. I, BLOCK TRACT rs�r 3 A_0Z 0NO. OF lJ ✓ S/ uFT `; f yy � P''�i✓v�T i SIZE OF LOT aj P✓ Jt !(�/n I NOW ON pLOTB USE OF I N I EXISTING BLDG. FAMILIES S ROOM$- DESCRIPTION OF WORK NEW ALTERATION ADDITION O A REPAIR MOVING DEMOLISH G :0. FT. NO.OF a SIZE J 6*ROOMS, STORIESWALLROr ©Q COVERING p�7f'A �"y, !� I COOVERINGA y USE OF NEW BUILDING APPROVALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION, PECT DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, BRACING, BOLTS SIGNATURE OF ��f ✓�/ ?"/ //fes, j ��G�l S 3 OWNER !� � LATH, INT.: AUTHORIZED AOT,� ��� �� //��� ��� �� 7 vw / - � _ LATH, EXT.: i $ PLASTER, INT. FEE PLASTER, EXT. ai VALUATION "V o ® FEE FINAL 76A638A DBS-k 3-55 APPLICATION FOR BUILDINGPERMIT 1 DIVISION OF BUILDING AND SAFETY 'BUILDING 3 -A/ Deportment of County Engineer ADDRESS County of Lots Angeles LOCALITY J. FOX. CONTYNEAREST CASSMATT D. GGRI F NU SUP•TENGINEER OF BUILDING CROSS 6T. 0Z. DISTRICT NO. GROUP TYPE _12-1 SEWER MAP PG FOR APPLICANT TO FILL IN �- I CONST. A k3K BUILDINGc MAP` STATE ADDRESS ..�✓ Of�4 G NUMBER I HWY YES' 0 . LOT NO. BLOCK USE ZONE SPECIAL 1 CONDITIONS TRACT 3 4 '/ ry'`,,�/I {/ v NO.OF BLDGS. BUILDING EXIST. SIZE OF LOT U `'�/� ��s� J NOW ON LOT SETBACK YARD HWY STREET NAME WIDTH USEOFEXISTING BLDG. L xw7. 'tY FRONT �/ 'w0 tJ P. L. OWNER SIDE P. L. MAIL ADDRESS Gr O TRACT DWELL. t UNIT - 5 INDUSTRIAL TEL. 1 DWELL. 1 UNIT CITY NO. 6 PUBLIC BLDG. ARCHITECT OR TEL. 2 DUPLEX I UNIT 7 �ADDN..ALT., ETC. ENGINEER NO. 3 APT.. UNITS - 8 MISCEL. ADDRESS /,+ "yC�� 4 COMMERCIAL CONTRACTO�R/moi— , / c- NO�lf',I e�/��Z1�' INSPECTION RECORD ADDRESS 'Y�/��lsl/ l/& DESCRIPTION OF WORK NEW ALTER_ REPAIR DEMOLISH o� SO. FT. % O. OF �` NO. OF SIZE STORIES FAMILIES USE OF STRIEPTUIE _s sle •SIGNATURE OF t Off' APPLICANT APPROVALS er ADDRESS S DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION I-� CJ G P.C. $ FORMS, MATERIALS (%/./ FEE FRAME: FIRE STOPS, VALUA ION $/L �.'_ �' BRACING,BOLTS VALUk-ON FEE' "T—��+ FURNACE: LOCATION, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT,DUCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT. AND STATE LAWS REGULATING BUILDING CONSTRUC- (� ,p TION. LATH. EXT. SIGNATURE O .lam �/j�( L/�( HOUSE NUMBER RECT AND POSTED TE " 1 ADDRESS ` ��y'� FINAL I�I'�C� ��f AA- ate WM.J. FOX,COUNTY ENGINEER VALIDATION C. N. DIRLAM,CHIEF BLDG. INSPECTOR 45oc MAR 27 1 4.00 In WORKERS' COMPENSATION DECLARATION i hereby affirm that I have a certificate of consent to Self APPLICATION FOR l�I L D I N G PERMIT insure, or a certificate of Workers'Compenstion Insurance, or a certified copy thereof (Sec. 3800, Lab. C. 1 ' COUNTY OF LOS ANGELE BUILDING AND SAFETY Policy No. Company BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with t,/h/eJr/c/o/10nt�inec- BUILDINGTion department. L�10ADDRESS F✓L� (r LOCALITY` Date ' — / ApplicantCITY 4f1 ZIP NEAREST d CROSS S � CERTIFICATE OF EXEMPTION FROM WORKERS' / NO. OF BLDGS.' ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAG PARCEL (This section need not be completed if the permit is for one USE NE i MAP 0 hundred dollars ($100) or less.) TRACT BLOCK LOT NO. I(��' // 872 TEL. ECTAL I certify that in the performance of the work for which is E M&OWNER NO CONDITIONS permit is issued, I shall not employ any pe son in any n r � �✓ f� /y /� / DIS ICT GROUP TYPE FIRE PROLE ED BY so as'1 become subject to the Wor ompens io s. ADDRESS 8.�7 lT ��V/� fi 4��j ^ CONST. ZONE t IM CITY CA. ZIP Dat W Applicant STATISTICALACLASIFICATION APT. CONDO.ARCHITECT OR ff TEL. ("NOTICE TO APPLICANT: If, after making this C rtificate of ENGINEER (AJ NO.� �✓ CLASS NO _DWELL. UNITS Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESSi4m SEWER. AP with comply with such provisions or this permit shall be ``�y / TEL. deemed revoked. CONTRACTOR QWAI� NO. VALIDATION LICENSED"CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION' (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY CLASS SQ. FT A NO. OF J NO. OF CHECK License Number. Lic.Class SIZE/ STORIES / FAMILIES ONE /��//�, NEW ❑ $ p/ ®d� Contractor Date- DESCRIPTION OF WORK / 2 ADD �0�163A ❑ I am exempt from the licensing requirements as I am a • licensed architect or a registered professional engineer ALTER ❑ DATEFINA '� a # o'0 0 0 2 3 acting' in my professional capacity (Section 7051, REPAIR Business and Professions Code). USE OF ❑ FINAL -2 0 o'j 7.6 0 EXISTING BLDG. DEMOL ❑ By Lic.or Reg.No. Date APPLICANT TEL. �_ io•o o'rJ 7,6 0 H OWNER-BUILDER DECLARATION (PRINT) NO. ^� 1 hereby affirm that I am exempt from the Contractor's License /L Cr✓J a 0 Law for the following reason (Section 7031.5, Business and ADDRESS s Professions Code): PRESENT ❑ BUILDING I, as owner of the property, or my employees.with ADDRESS / wages as their sole compensation,will do the work and CP� the structure is not intended or offered for sole(Section LOCALITY i 7044, Business and Professions Code). kADDR TEL. I, as owner of theproperty, am exclusive) contracting CTOR NO. . Y 9 with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). ED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY YARD HWY CK PROP. L1�tE WIDTH 5 Thereby affirm that there is a construction lending agency for T 0,1 6 A the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). # o o'o a a 1 Lender's Name 2 a 1 9 b 0 0Lender's Address $ �. Permir Fee/ oo a o: 9 6 0 0wI certify that I have read this application and state that the ssuance Fee i above information is correct. I agree to comply with all County ti n Fee( 6 Q 06 1 1 T 8 1 0 ordinances and State,laws relating to building construction, Total Fee and hereby authorize repres ntatives of this County to enter a upon'th above-mentione roperty for ' spection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ^ Signature of Tpplif.nt or Agent Date ©s