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Home My Public Portal About8802 HERMOSA DR_Building__ CE 0803 REV.1 I/78 r APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDING O /s� C (, ADDRESS O L� C BUILDING ADDRESS Q D P- ,G CT 1 LOCALITY y CITY /j 1t(� If ZIP Gi CROSS Si. yQ�iILCLV SIZE OF LOT c 6 , NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE PR CES�E9 BY TRACT BLOCK LOT NO. �/ '�. CONST. _ ZONE -/- // TEL. [ Q" 1Y/ J OWNER - 1L[ NO -D 3J (�`- STATISTICAL CLASSIFIC�ATION SEW ER MAP ADDRESS tY d"CJ�-� / CTAI2s (Y r . CLASSNO.�� ' DWELL.UNITS '/ BK/O PG CITY &-14 L IP ARCHITEQOR TEL 1 VALUATION ENGINEER NO. � < 1i ADDRESS 6-'6D e - O L A r ,(, BLDG,SETBACK FROM TEL (('' FRONT PROP.LINE OF ---r -I-CLJ ISTREETI - CONTRACTOR NO,26-4-220 HIGHWAY + YARD TOTALSET BACKFROM iYPEOF EXISTING . LIC. - FRONT PROP.UNE HIGHWAY WIDTH ADDRESS 1K0. Q + .Z O = -20 �.e, CITY CLASS CONSTRUCTI ENDER BLDG.SETBACK FROM NAME AND BRANCH SIDE PROP.LINE OF - ISTREETI HIGHWAY + YARD _ TOTAISETBACK FROM TYPE OF EXISTING ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH U SO.FT. NO.OF NO.OF CHECK + = u SIZE STORIES FAMILIES, ONE USE ZONE MAPq / 0 Q Q DESCRIPTION OF WORK. [D r L \ /7- NEW ❑ NO. sa< Sp �J SPECIAL _/51F71.2 , •^('� �f ADD ❑ CONDITIONNST //I i' S LCC yF ALTER ❑ DATE EXISTING BLDG. FINAL BY Z REPAIR V USE DEMOL _ APPLICANT TEL C IPRINTI NO. Q ° 30967A BY ISIGNATUREI a Y # a o e e o 1 HEREBY A ACKNOWLEDGE THAT HAVE READ M L APPLICATION AND STATE V THAT THE ABOVE TI CG BUIL AND AGREE i0 COMPLY WITH All ORDINANCES W AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT INMING THE 2 2 o - 61,00 WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF V THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WOR MEN'SCOM- PENSATION INSURANCE.- � g o 0 0 3 1•CI SIGNATURE OF u 0626-80 PERMITTEE ADDRESS Z / c CITY ✓ NO�s —8 �r7 Q L F ° P.C- Fee S Permit Fee o2 > Issuance Fee W / 6 Total Fee v / APPLC,LN FOR R CATI I COUNTY OF LOS ANGELES BUILDING PERMIT D ARTMENTOFCOUNTYENGINEER ' BUILDING AND FET V ISION '- FOR APPLICANT TO FILL IN BUILDING ADORES. u LDEIN. LOCALITY ODw 94 A / NEAREST CITY rf- yp CROSS 6T. 1 1- ,OF DLOG.. ASSESSOR CrA SIZE OF LOT NOON LOT MAP BOOK PAGE PAF L HltTal 4a0YP RH ESLD B TRACT ^ OCK LOT NO. Na� - IwEeEPIT YILOING STATISTICAL CLAS! ATION eHWHa MA D CLASS NO. DWELL.UNITS Lo 7 LEE TONE MAIL /\ P IHCIAL D TIONS 'CITYHam'" _ a0A.HEPAwTM ENT AIIaOVAL BE I... IS. NO V MOVING THI�� CONTRACTOR NC. FRONT IROS LIINLROF" (.T...T) `7 NNIFNAT ♦ YARD PAL BHTHACK FROM TYPE OP L1tI9T... V FRONT IRO I.LINE MI4XW AY WIOTN W6 DDRes9 O N e C FEL. 1 BH CONTRACTOR312 DRH58 BLDO.RSETOA<K FROM TIDE P.LINED 4 ISTREET) CONSTRUCTION LENDER M J NAME AND A.... ` .....AT « YARDlAl ter...L F 'Ill.. ....T...LINHO 14 WIDTH S SID ROP,. v G v v USHSO e i TOFF YE!❑ ND❑ PRD.DIseD Y.E of VILOIN4 s,.�(bkr.+,y� I B � N OPEN I.C.\ • El O SP.RN060 F t4IHH N CO.•9TAL PERMIT 2.X8 Y..O NO APP'ICANT {J TEL. RIM BY ( RC) ( / aeBY A eDOH THAT I N AND STATE THAT THE ABOVE IS CORRECT A 4 RHE TO LCOMPLY LATIN0BVIL°INE ITRV ORB CIHRTIPYS THAT rvW..IN. THE WORK AViXORICSHD HEREBY L O EMPLOY R VI ^ LABOR OLARTIONO I CODEOF THEE STATOF CALIFORNIA I, HATIN4T TO R 7c FINAL \\\ II\ 61GNATURE OFMPHNs E. PERMITEE DATE (n� qI L F• , -I 't� ADDRESS ' 1 LInvestigation fee 'Qa Permit Fee (�O TLL. CITY NO. Issuance Fee 7 / VALUATION `F-il 0 P O ti Total Fee Y ° PLAN CHECK-VALIDATION CK. M.D. CASH PERMIT VALIDATION• CK. M.o. °AtH CoC3 L� D O \ 'I o o Cn r 1�o of i I CH aAsv-ce n/!-•/T9�� fj� Tl CE g803(REV.11/]8) _ APPLICATION .FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FI L.IN BUILDING ADDRESS BUILDING ADDRESS .Bo' �'7 LOCALITY - / /1 NEAREST / CITY: �L Lel ZIP CROSS ST. O.OF BLOCS. �/I SESSOR _ - SIZE OF LOT ^''yy I OW ON LOT D/L' CAP BOOKr'7 PAGE PARCEL Z �l BLOCK LOT NO, O1R��' GROUP CONST /TYPE TIRE E PROCES D By J TRACT I ! A y[ '1M/ l/ OWNER T•L� a1AGro zfl} ATISTICAL CLASS]FICA TION -" ER MAP ADDRESS pGs ♦ �24A0 CLASS NO. DWELL.UNITS BK PGCITY- s't( rG C' IPARCHITECT OR TELLUATION �j � /YENGINEER -NO. - " ` OCAADDRESS DG.SETBACK FROMT TELONT PROP.LINE OF +�^�L'�T`� ISTREETCONTRACTOR (per{ S O. TOTALSETBACKFROM TYPE OF EXISTING f ^tLIC. GHWAY + VARD = FRONT PROPLINE HIGHWAY WIDTH ADDRESS 4 3 ri aT NOZ ZO]^� LIC. - + zD o z l-0 CITY /A CLASS CONSTRUCTION LENDER DG.SETBACK FROM NAME AND BRANCHDE PROP.LINE OF ISTREGHWAY + VARD = -TOTALS ETBACK FROM TYPE OF EXISTINADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH Q SOIT"j'.J]L NO.OFNO.OF + -- ' _SIZE f STORIES' FAMILIES SE ZONE MAPDESCRIPTION OF WORK NNO' Ou c /I A -r CIFEE O DITIONS M ALTER ❑ FINAL BY ! , Z REPAIR- ❑ DATE �( "� Z 'sr�✓ USE OF DEMOL ❑ G EXISTING BLDG. x"'«97 .y,✓ I't, 9. . a - Z APPLICANT TEL WRINTI Sti1,2 dawn o2E3 8' (� _ CR BY I .. O HEREBY ACKNOWLEDGE THAT VE READ THIS APPLICATION AND STATE /2 7 THPi THE ABOVE IS CORRECT AND.AGREE TO_COMPLY WITH ALL ORDINANCES _ W _ AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE = D WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF // /� A `�� I V ` THELABOR CODEOF THE STATE CALIFORNIA IN RELATINGTO WORKMEN'S COM. I V.q_ �i PJ Z PENSATION INSURANCE.' - 5 C1,23-0" SIGNATURE OF (o ,R(� ! F'� 1,7 r. PERMITTEE _ __ __ _ ADDRESS Z / TEL _ _- - C ,�•o „ C ? C c v CITY -/ NO. P.C. Fee$ c? �: Permit Fee > Issuance Fee n W 6 Total Fee APPLICATIf),N FOR BUILDING PERMIT COUNTY OF LOSi4NGf7LES BUILDING AND SAFETY � l'/bRKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN eulQDoss BUILDING ADDRESS I hereby affirm that have a certificate Of consent to self insure, $$02- Hermosa Dr. (1 lot)or y thereof ( of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.CJ CITY ZIP LOCALI 1330196 State Comp. Temple Cit 91775 Policy NO. Company SIZE OF LOT NO.OF BLOGS.NOW ON LOT �❑RRI Certifiedcopy is hereby furnished. NEARESTCROSS Ih! Certified copy IS filed With the county Iltll IOSpaction TRACT BLOCK LOT NO. department. USEZONE MAP NO. Date 4 10 79 SA licant ASSESSOR MAP BOOK PAGE PARCEL PP SPECIAL CONDITIONS CERTIFICATE OF EXIM FROM WORKERS' OWNER TEL.No. COMPENSATION INSURANCE Frank Mah 310/922-3403 WITHIN 1000 FT OF SCHOOL? YES NO ADDRESS (This section need not be completed if the permit is for one hundred 1925 pent S t. DISTRICT - GROUP CONST.' FIRE ZONE PROCESSED BY dollars(f100)or less.) CITY ZIP I certify that in the performance of the work for which this permit Los Angeles 90026 IS issued, I Shall not employ any person in any manner s0 as to ARCHITECT OR ENGINEER TEL.NO. become subject to the Workeri Compensation Laws. N/A STATISTICAL CLASSIFICATION A" CONDO Date Applicant ADDRESSCLASS NO. DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM IDUST Exemption, you should become subject to the Workers' CONTRACTOR TEL.NO. SETBACK YARD HIM PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith i!nited Roofil: Co. .. Inc. 21 22 -4081 FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. P L 1321 Dal' St. 137650 SIDE LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS a PL p I hereby affirm that I am licensed under provisions of Chapter 9 Los An¢2les r CA 900'1 C'-39 SEWER MAP U (commencing with Section 7000)of Division 3 of the Business and SO.FT.SINO.OF STORES I NO.OF FAMILIES 0= Professions Code,and my license is in full force and effect. ( 2 1 SFD NEIN SK PG CD 137650 C-39 DESCRIPTION OF WORK ADD ❑ VALUATION , W License Number Uc.class Remove e)d St7.T1 roofing. Tl":3` 1L O_ Contractor United Roofin,gate 1OJ31/96 ALTER ❑ $ .365.00 z dimeasional fiberglass shi1 .URM •REPAIR IR $ ❑ I am exempt under Sec. B.BP.C.for this reason Date: ❑ LDMA P/C N USE OF EXISTING BLDG. 11Date: Signature APPLICANT(PRINT) TEL NO. LDMA Paan k El 1, as owner of the property, or my employees with wages as United Roof ng Co. Inc. 213 223-4081 - O their sole compensation,will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and 1821 Daly St. , LA CA 90031 FINAL OATS Q rL;d Professions Code.) WILLTHEAPPLICA ORFUTUREOUILDINGOGCUPANTHANDLEAHAZARDOUSMATERIAL �z ? OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN ❑ 1, as owner of the property, am exclusively contracting With THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY - 'h licensed contractors to Construct the project.(Section 7044, Business and Professions Code.) TEs❑ NO WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT FUTURE BUILDING OCCUPANT REQUIREA PERMITFOR CONSTRUCTION ORCAIO FROM THESOUTH CONSTRUCTION LENDING AGENCY GOABT AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)O)SEESEE PERMITTING CHECKLIST , a ihl,ll'[ _j'IF( FORGUIDELINES. I hereby affirm that there is a construction lending agency for vEs❑ NO❑ the performance of the work forwhich this permit is issued(Sac. HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMO _ 3097.CIV.C.). - i p PERMITTING UNOERSTANO MT REpUIREMENR UNDER THE LOS ANGELES rt! I /'j m_ LOUNtt CODETITLE2, PTEfl 2. AND FOR OBTAINING PERMITOUGH 2a.OMTHE CONCERNING 3 Lenders Name H RDOI ERIA EPOR1 ANCIONS AININGAPERMIT MOM THESCAQMD. Lenders Address :'1:!i. 1 h`: ':.LL• ii O aRuw I certify that I have read this application and state that the above $Zinformation i3 oOfIeCL I agree t0 comply With all county P.C.FEE PERMIT FEE �J 33G ordinances and State laws relating to building construction,and hereby authorize m sentatives of this County to enter upon ISSUANCE FEE the above-m dorop y for inspection purposes. 4/10/95 INVESTIGATION FEE TOTAL FEE Nypbmc+Con o.a C/ SEE REVERSE FOR EXPLANATORY LANGUAGE