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HomeMy Public PortalAbout4906 HELEO AVE_Building__ I� ES 'kRTMENT4&' COUOF TY OF LOS AND. SAFETY APPLICATI01�i FOR PERMIT] WM. J. FOX. CHIEF ENGINEER FEB `�� a �/ ,. ..,. - ..... _. m-.. FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. - PLAN CK.NO. PERMIT NO. { BUILDING 7� Jt. / 3 3 ADDRESS (J'G+ ///,O°" 4-4 I y�� / �•.I LOCALITY' 4 L E ® r o L c , �RE)p�C)EIVED BY -DATE OFAPPL.. LDATE IS SUED r . NEAREST CROSS ST. BUILDING ADDRESSOWNERMAIL � LOCALIT �� . DRESS qFWa&'Lll4 I n N•EAREBT, /9 CITY GC LYfM,.GA 4 -NO. �_Q CROSS ST L. (�LTJ �_. e��' ;� V—" ,c FIRE ,/ NO.OF O1 TYPE - GROUP-r / PLANS L �j,l ARCHITECT OR TEL. V ZONE ENGINEER NO. g BLDG. ! - ( - - ._l,_._. \ ORD.NO. ADDRESS _ SETSACK,LINE r APPROVED ('� //�� JJ// TEL BY DATE CONTRACTOR �. li. _I �•• NO. USE v APPROVED ' s ADDRESS ZONEoo.``. BY: DATE eLEGAL DESCRIPTION LOT NO. .� BLOCK ; �'E,/ I CORRECTIONS 6 . �q x TRACTNo.OF BLOB pp, SIZE OF LOT 0 � I NOW ON LOTS I d A ,R _ . USE OF NO.OF - NO.OF EXISTING BLDG. FAMILIES ROOMS �~ - DESCRIPTION OF WORK NEW' ALTERATION ADDITION _ ..-_.. .. .... _ . ....... ...__�.. ._ . . .. _ . . . . A REPAIR MOVING DEMOLISH L7 54.FT. NO.OF Z SIZE ROOMS STORIES ' - y WALL' ® ROOF .:a"i .3:.':"�;. r COVERING ( �!1 ? I COVERING styl�`l,�fs6,t-=Ec USE OF NEW BUILDING 1 HEREBY ACKNOWLEDGE THAT I' HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS- FRAME: FIRE STOPS, .� SIGNATURE OFn` -�,(" BRACING,BOLTS PERMITTEE - LATH, INT. AUTHORIZED AST LATH, EXT. �G 76AS313A 9-48. DBS-3 SOM SETS $ " P.C. ,. PLASTER,INT. OaOXh FEE I PLASTER,EXT. �J � VALUATIO14 .�7 + FEE .� Z" FINAL (/�: I DEPARTMENT OF BUILDING AND SAFETY AP PLICATION D I PERMIT COUNTY OF LOS ANGELES WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLANCK. NO. PERMIT NO. BUILDING ADDRESS LOCALITY RECEIVED BY DATE OF APPL. DATE ISSUED NEAREST CROSS ST. BUILDING ADDRESS OWNER MAIL LOCALITY ADDRESS NEAREST TEL. CROSS ST. CITY NO. FIRE NO. OFI TYPE I GROUP ARCHITECT OR TEL. ZONE PLANS ENGINEER NO. BLDG. ORD. NO. SETBACK LINE ADDRESS APPROVED TEL. BY DATE CONTRACTOR NO. USE APPROVED ZONE BY DATE ADDRESS HOUSE NUMBERING LEGAL DESCRIPTION I LOT NO. - BLOCK MAP NUMBER -FIELD CHECK BY TRACT NO. ASSIGNED BY-- DATE NO. OF BLDGS. CORRECTIONS SIZE OF LOT NOW ON LOT USE OF I NO. OF _ EXISTING BLDG, FAMILIES DESCRIPTION OF WORK NEW I I ALTERATION I I ADDITION O REPAIR I DEMOLITION SQ. FT. NO. OF O SIZE ROOMS STORIES - Z EXT. WALL ROOF r COVERING I COVERING USE OF STRUCTURE APPROVALS INSPECTOR'S SIGNATURE DATE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FOUNDATION: LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS CORRECT. I AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS, HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS LAWS REGULATING BUILDING CONSTRUCTION. FURNACE: LOCATION, SIGNATURE OF GAS VENT, DUCTS PERMITTEE i - LATH, INT. ADDRESS LATH, EXT. AUTHORIZED AGT. PLASTER, INT. 76ASSSA• 0893 10-80 P. C. $ `r� FEE PLASTER, EXT. VALUATION $ FEE FINAL I ORKERS'COMPENSATION.DECLARATION 1 hereby affirm that I have,a certificate.of.consel(!=Avb sel P�O M D RO M -insure, or a certificate of Workers',Compenstion Insurance, or CAV 10 N A FOR � a certified copy thereof (Sec. 3800, lab. C.) I COUNTY OF•LOS.ANGEL S � � BUILDING AND SAFETY Policy No. Company �. Certified copy is hereby furnished: FOR-APPLICANT TO FILL IN `BUILDING 11 if L L � S fi Certified copy is filed with the county building inspec- D BUILDING /� r .� tion department. ADDRESS /7ClG(� /� r�/ / LOCALITY ( r ("� ,7 C Date Applicant CITY �°�YGE �� ZIP �3 p NEAREST /l 7/J CROSS ST. c, , CERTIFICATE OF EXEMPTION FROM WORKERS' . Y NO.OF BLDGS. 7 ASSESSOR " COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT G— MAP BOOK PAGE PARCEL (This section need not be completed if the permit is'for one USE ZOO MAP hundred dollars ($100)or less.).. TRACT BLOCK LOT NO: i` NO. / TE o SPECIAL., I"certify that in the performance.of-the worVfor which this OWNER , of //fG�l�, NOa� 5�9�'y : CONDITIONS- 3N -• -- A D TRICT GROUP TYPE FIRE PROCESS BY u permit is issued, I shall not employ any person in any manner ADDRESS r/ G/rGi Sf` CONST. Z N so as to become subject`to the Workers'Compensation Laws. n � T i IM CITY /��C' ZIP � fe Date Applicant - STATISTICAL CLA IC TION PT. ,CONDO. NOTICE TO APPLICANT: If, after makingthis Certificate of ARCHbTECT OR TEL. �, ENGINEER• NO. CLASS NO.`S ' DWELL. UNITS Ae Exemption you•should become subject to the Workers' y Compensation-provisions•of the Labor Code, you must forth- ADDRESS SE ER z with comply with such provisions or this permit shalt be TEL. deemed revoked., • CONTRACTOR � i«Ic12 NO. P 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 LIG Professions Code, and my license is in full force and effect: CITY CLASS . ' $ .47�-/ _ SQ. FT. NO. OF NO.-OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE - - .. NEW. - E:] Contractor Date DESCRIPTION OF WORK ' O P 9 9 JMv Lr Oen 0.. ADD am exempt.from the licensing requirements as I am a licensed architect or a registered professional engineer ALTER FINAL• acting in my. professional,.capacity (Section 7051; REPAIR .EJ DATE Business and Professions Code). USE OF DEMOL- FINAL - EXISTING BLDG.- d BY Lic:"or Reg.No. Date APPLICANT TEL_ OWNER_BUR ILDEDECLARATION^ (PRINT) - �` NO.£TAJ`�/Z I hereby affirm that I am exempt from the Contractor's License ,r•�� Law for the following reason (Section 7031,.5, Business and ADDRESS Profffessions,Code) PRESENT BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the•work and the structure.is not intended or offered for sale(Sectiori "LOCALITY ;7044, Business and Professions Code). MOVING TEL. ` •I, as owner of the property, am exclusively contracting ' ' CONTRACTOR NO. with licensed contractors to construct the project(Sec- ADDRESS 4 3 9 A tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST. q CONSTRUCTION LENDING AGENCY s' SET BACK YARD HWY PROP. LINE .WIDTH. 0'a o o'o I I hereby affirm that there is a construction lending agency#or FRONT the performance of the work for-which'this permit is issued P.L. l_ Z o 2`0 Q Q. (Sec. 3097, Civ. C•). SIDE P.L. 2.05,0.0 Lender's Name - 41 P.C. Fee$ .�, Permit Fee O < ? - _ , � `�'X1.0-8J Lender's Address _ f I certify that l have read this application and state that the - _ y issuance Fee above information is.correct. I agree.!a comply with all County Investigation Fee or nances and State laws relating to building construction, in er rize representatives of this Countyto enter Total t a ve- e ione� property for inspection p'u'rposes. U- �lSEE REVERSE FOR EXPLANATORY LANGUAGE^ , Signature of Applicant or Agent Dote ©s, WORKERS'COMPENSATION DECLARATION l i APPLICATION FOR BUILDING PERMIT I h,?reby off"rrm that I have a certificate of consent to self • •;nss;re, s,r a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C:) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No.' Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS 906 � Q � Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS 144?�6 �p �(r LOCALITY Date Applicant CIT &L t. ZIP12/7fc) NEAREST ROSS ST. A CZS -f� CERTIFICATE OF EXEMPTION FROM WORKERS' J NO. OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT �© n .��L NOW ON LOT � MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAPO hundred dollars ($100)or less.) TRACT BLOCK I LOT NO. NO. �–+ TEL. C i ( SPECIAL �- I certify that in the performance of the work for which this OWNER V �� NO. Z - [CONDITIONS IL permit is issued, I shall not employ y pe on i any manner / !GiO! G DISTRICT GROUP TYPE FIRE PR ESSED BY 0 so as to become subject to the War rs' s ti n Law . ADDRESS`l // v p CONST ZONE 1 Sok ^� 3 99 CITY '/ ZIP /?e Dat.'Applica STATISTICAL CLASSIFICATION PT. CONDO. b NOTICE TO APPLttCANT: If, ter making this ertificate of ARCHITECT OR TEL. G U Exemption, you should b o e subject to the Workers' ENGINEER NO. O S� CLASS NO. A/* UNITS Compensation provisions of a Labor Code, you must forth- ADDRESS 9 SEWER MAP with comply with such provisions or this permit shall be TEL. f c� deemed revoked. CONTRACTOR NO. BK. PG / o / VALIDATION LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS j�}Y►/ NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. a Professions Code, and my license is in full force and effect. CITY CLASS $ / , SQ. FT NO.OF NO. OF CHECK License Number Lic.Class SIZE Sao STORIES FAMILIES ONE 1I DESCRIPTION OF WORK NEW $ Contractor Date ADD El I am exempt under Sec. OI, LQR> ALTER FINAL -1-7 l B.BP.C. for This reason REPAIR DATE - J, Date: USE OF DEMOL FIN EXISTING BLDG. BY Signature APPLICANT TEL. OWNER-BUILDER DECLARATION PRINT NO. I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 703,1.5, Business and ADDRESS ► r 7 rT Prof ssions Code): PRESENT BUILDING o I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section FADDRESS Y 7044, Business and Professions Code). G TEL. ^ r. r I, as owner of the property, am exclusively contracting CTOR NO. r p with licensed contractors to construct the project (Sec- 'tion 7044, Business and Professions Code). t' RED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY CK YARD HWY PROP. LINE WIDTH , I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C. SIDE io P.L. Lender's Name Lender's Address P.C. Fee$ Permit Fee [2 Ts I certify that I have read this application and state that the Issuance Fee above information is correct. I agree to comply with.all County Investigation Fee g a dino ce and St to laws relating to building construction, Total Fee S.• S6 v and h re y out pres tatives oft County to enter uPon e bov ntio r pe y for i pection purposes. a �7 L– SEE REVERSE FOR EXPLANATORY LANGUAGE , Signature of Applicant or Agent Date —� ®s