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Home My Public Portal About4856 HELEO AVE_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES 1`966 I L ® I G WM. J. FOX. CHIEF ENGINEER AUG U l' FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY UILDING / ' DISTRICT NO. PLAN CK.NO. - PERMIT NO. ADDRESS �Od li' o/ �/ 4F_ L F6 \� LOCALITY . RECEIVED BY DATE pOr APPL. DATE ISSUE�aD NEAREST } BUILDING OWNER ;�� i del .�1 t� ,o�"'� ADDRESS MAIL C� CJ ADDRESS c/aN LOCALITY / ,, NEAREST / g TEL. /'l CROSS ST. 6s� CITY f7's 4 � a."16, 4 4� �0 NO. �,. I Sb4 FIR Ea.or ARCHITECT OR V ! TEL. ZON PLANE TYPO Y GROUP ENGINEER o\ (p �/" NO. BLDG. s ¢�- 3 ? OR4.NO ADDRESS SETBACK LINE J J"f APPROVED CONTRACTOR ��/ { l� �t1�`�y No. BY p ATE ADDRESB E = 'f C..c/v�.f4 `� �� ZONE 'P // BYUSEAPPROVED DATE LEGAL � / ® CORRECTIONS DESCRIPTION LOT NO. { BLOCK TRACT -z- 47 NO.OF SLOGS. SIZE OF LOT�,( "2_97_,!5NOW ON LOT USE OF .._ NO.OF NO.OF EXISTING BLDG. FAMIL S'" �/� �"9�(� G� � G'i A xv DESCRIPTION OF WORK NEW ALTERATION ADDITION All/ .V'hl.-I`I O REPAIR MOVING DEMOLISH � a.• ./�� / O_ Sq. . / /' NO.OF FT / Z SIZE 6 / 402 ROOMS STORIES / Q t 4' -p- A-Qr[- r WALL r COVERING c.5��/✓ I COVERING ',(, CbIJ � BU E OFGE'"' > 55 G ly— ��,,ncao ,sass ats. /z r,v 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS, APPLICATION AND STATE THAT THE ABOVE IS CORRECTSECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION FORMS.MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE BTOPB, SIGNATURE OF/� � r-L J BRACING.BOLTS PERMITTEE J( it , LATH. INT. A�FgG• � +�. AUTHORIZED AGT LATH, EXT. 7,6A63BA-3 2-50 $ /43; P. e-� P.C.6 J ?O PLASTER.INT. FEE 2_l i J PLASTER.EXT. VALUATION FEE FINAL =DEPARTMENT OF BUILDING AND SAFETY PPLICATION FOR PERMIT COUNTY OF LOS ANGELES' f WM. J. FOX. CHIEF ENGINEER _ v s FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY > DISTRICT NO. PLAN CK.NO PERMIT NO. BUILDING ADDRESS ®�`�^' s— LOCALITY „ ��i�11 �5 RECEIVED BY DATE OF ADPL. DATE ISSUED gg�� NEAREST CROSS ST. f,-4;.1 ( � / �y OWNER - ' ram<��lM .l=i .l", M../1.�--'=-.� ADDRESS /NG ® f / ADDRESS ,d_ r MAIL LOCALITY NEAREST TEL. qq CROSS ST. CITY Ejl d l .9 NO. R� A ARCHITECT OR q�7 FIRE NO. TYPE TYPE ,/ GROUP ENGINEER pq AJt /."� NO. ZONE PLANS Y BLDG. / ORD.NO. ADDRESS SETBACK LINE 2-1�,-) / / f p�Q� APPROVED CONTRACTOR IV 1, �...dfII-NO� BY - DATE USEAPPROVED ADDRESS 1 d' -- ,,,. -_ ,�,,. �_._ I ZONE BY LEGAL 4 �® J CORRECTIONS DATE DESCRIIPTION`� LOT NO. BLOCK TRACT { v - SIZE OF pG� NO.OF BLDGS. LOT I NOW ON LOT USE OF NO.OF NO.OF EXISTING BLDG. DESCRIPTION OF WORK NEW C ALTERATION ADDITION O A REPAIR MOVING DEMOLISH p Sq.FT. NO.OF Z SIZE _,t5 ROOMS 1` STORIES > WALL ROOF COVERING USE OF NEW BUILDING Al - -A df /*PIP&i I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IB CORRECT FOUNDATION: LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE OFBRACING,BOLTS PERM !/•� v� LATH, INT. AUTHORIZED AMT. _. LATH, EXT. 7GA63BA-3 2-S13 $ ` PLASTER,INT. FEE PLASTER.EXT. �^ VALUATION FEE "o FINAL APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES _ iUPLDING AND SAFETY WORKER'S COMPENSATION DECLARATIONFOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUIL w�Cz/ADDDjREESS or a certificate of Workers' Compensation Insurance,or a certified `a 5"62 , copy thereof c 3809 ab.C. CITY SLG ZIP J.Z "'-- LOCALITY Policy No. Company SIZE OF LOT NO.OF BLDGS.NOW ON LOT �' --•�-�L--C El Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. dep rt e r //7 USE ZONE MAP NO. Date- I`-'�' Applicant F'-u -% vi ASSESSOR MAP BOOK D��O PAGE On.� PARCELa�9 �..-' SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER e 4 TEL NO. / YES NO COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESS _ C�� DISTRICT GROUP TYPE CONST. FIRE ZONE' PROCESSED BY dollars ($100) or less.) "�`� �3�i CITY ZIP I certify that in the performance of the work for which this permit Y is issued, I shall not employ any person in any manner so as to ARCHITECT R ENGINEER Lc-- - TEL NO. {}_ y D �1��G� become.subject t0 the Workers'Compensation Laws. C 9-7 ,(7�� 'S" � STATISTICAL CLASSIFICATION APT CONDO . Date - Applicant ADDRESS `.� i ,1 ' ' �C f'1 Q CLASS NO. DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate of v�t�1✓ ��V �'�"`/ REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' IDDAESS ON RACTOR ,, -�T.�ELL;NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions ,of the Labor Code; you must forthwith E /✓ ' /�/ /i fLfJ F�r: FRONT comply with such provisions or this permit shall be deemed revoked. i 'LIC.NO. / P L- LICENSED CONTRACTORS DECLARATION � '� SIDE CITY J /" LIC.CLASS !c P L I hereby affirm that I am licensed underprovisions of Chapter 9 �/ '� �� Eil� SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.,SIZE NO,O)STORIES NO.OF,FAMILIES Professions Code,and my license is in full force an effect. e NEW 1:1 BK PG 1 p DESCRIPTION OF WORK 'LGLy �'-� �- VALUATION , " P/A Lic. Class ADD ❑ Q License Num er i �--�-�� Contractor s �' Date �'l `j=�� CLAe� — $�ry� S ALTER ❑ $ �'s �' V 7v Sl�'t� rip[;?seip L REPAIR ❑ $ O ❑ I-am exempt under Sec. B.&P.C. for this reason • DEMOL ❑ LDMA P/C# V lLI Date: USE OF EXISTING BLDG. URM ❑ 23 a 1 a s*i<,c UD Signature APPLICANT(PRINT) TEL NO. LDMA Perm# ACV.IL Z ❑ I, as owner of the property, or my employees with wages as Z c,1 their sole compensation, will do the work and the structure is ADDRESS O .303 •�0°' not intended or offered for sale (Section 7044, Business and FINAL DATE Q Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Q AC •�• El I, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 7 �•1T a licensed contractors to construct the project (Section 7044, =+^r -+ 611.94[y YES❑ NO-❑ 3360 11 e 94 Business and Professions Code.) 1 ITEMS 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 �r�� J t r` TOTAL } GUIDELINES. - 9t.�i,{ k G O D,y, `'e tOFAL 6452 a 44 I hereby affirm that there is a construction lending agency for YES NO❑ "_/VI, p�il/fJl� t a the performance of the work for which this permit is issued(Sec. INFORMATIONIHAVE READ THE HAZARDOUS MATERIALS 662.44 O 3097,CIV.C.) CHECKLIST..I UNDERSTAND MY REQUIREMENTS GUIDE TRMI D RTHE OS ANGELES '/J -^ B►� �TTING ��s�� ` 6 � GFIANG TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS / E { Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. CH o Lender's Address OWNER OR AGENT o ^�I certify that I have read this application and state under penalty 0000-0001 11/29/95 o P.C.FEE PERMIT FEE of perjur -hat the above information is correct.I agree to comply �t7 o i rt N with all c unI or and State laws relating to building v. / ,��f}77 1 PM1*-3O - m constr n, and hereby authorize representatives of this County ISSUANCE FEE I e poi the above-m onad property for inspection purpos d r' INVESTIGATION FEE TOTAL FEE Siq 1 re plica.or Agent Da e SEE REVERSE FOR EXPLANATORY LANGUAGE