The URL can be used to link to this page

Home My Public Portal About8826 HERMOSA DR_Building__ 16A.38A CE#8035-., APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS OC BUILDING AND SAFETY DMSION LOCALITY L GS JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENBE.. Bul ToP BUILDING CROSS ST. O I5TRIGyNO. I C�rP TYPE P SED BYI FOR APPLICANT TO FILL IN S e" CONST. BUILDING G 7 G_ STATISTICAL CLASSIFICATION SE R MAP O C_Q..0 J PO ADDRESS CLASS.NO. DWELL. UNITS LOT NO. O OCK WATER NOT REQUIRED ❑ RECEIVED I CERTIFICATE: TRACT 3117-13 MAP HIGHWAY JCISTATE MAJOR SECOND. OCA NO.OFSIZE OF LOT ✓ (.L I NOW ON LOTS SO ZONE ,SPECIALLE) USE OF CONDITIONS 'EXIST INC TEL OWNER N Z BUILDING YARD HWY TREET NAME EXIST.. SETBACK WIDTH ADDRESS FRONT q - n ARCHITECT OR - TEL, - P. L. ENGINEER NO. SIDE O P.L. ADDRESS A TEL �A [}� INSPECTION RECORD ax CONTRACTO NO V'k �YLn✓/i(LrC. '4A.0 11. "- /:CSV. � O ADDRESS S -!� / / U DESC9ptON OF W AK (� /9 / 2 C 7A A AY ✓A J^ — NE ADD ALTER REPAIR DEMOLISH / r r _ ,� �M , FT. NO.RI NO.OF �+ r - IZE Z 7 STORIES FAMILIES V USE OF STRUCTURE ..LC Al__ SIGNATURE OF APPLICANT ." VALUATION APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION FEE v 77T.$ / FORMS.MATERIALS -G 2 n/Jv FRAME: FIRE STOPS, HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION BRACING, BOLTS ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, .5_U"_ YL WITH ALU COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPL ANY PERSON IN VIOLA- LATH, INT. IS/IA A 1/ A TION OF THE LAB CODE OFT ST OF IFORNIA gELAT- ING TO WORKMEN'S C N N LATH,EXT. (�l SIGNATURE OF HOUSE NUMBER COR- A, PERMITTE '� RECTANDPOSTED O l�/iY�I A' ADDRESS FINAL I V V CLYDE N. DIRLAM. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALID ATION -� M.O. CASH PERMIT VALIDATION CIL/; N.C. CASH 9 6 1 FEB 52 3 A 2 1 .0 0 ; ' l �8521 % FEB -151 A 42 .00, h r V APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ' BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN, BUILDING D ResS (� I hereby affirm that 1 have a certificate of consent to self insure, BUI I G ADDRS�S _ O O or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) CITY ` ZIP �� (i LOCALITY Policy No. Company SIZE OF LOT NO.OF SLOGS NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the,county building inspection TRACT BLOCK LOT NO. MAP NO department. USE ZONE ' Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS e D / CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER L COMPENSATION INSURANCE �It W a� WITHIN 1000 FT OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars IS 700)or less.) CITY ZIP I certify that h the performance of the work for which this permit is issued, 1 shall not employ any person at any manner so as t0 ARCHITECT OR ENGINEER TEL NO. become subject 10 the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date_ Applicant ADDRESS CLASS NO. —�z DWELL UNITS NOTICE TO APDL/CANT: If, alter making this Certificate ofREQUIRED TOTAL SETBACK FROM E%1ST Exemption, you should become Subject to the Workers CONTRACTOR TEL NO SET BACK YARD HWv PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. RE } LICENSED CONTRACTORS DECLARATION SIDE 0 CITY LIC.CLASS P L O 1 hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)Of Division 3 of the Business and SO.FT.SIZE NO.OF STORIES NO.OF FAMILIES O.S Professions Code,and my license is in full farce and effect. NEW ❑ BK PG O License Number Lic.Class 12ESCRIPTION OF WORK ADD ❑ VALUATION / , 0 Contractor Date '� I �N / w ALTER ❑ $ a M4-'r L- A-XQ (N "v z ❑ I am exempt under Sec , r REPAIR � $ BAP.C.for this reason L W III til5q/4/40#111101. ❑ LOMA P/C 0 Date: $E OF x15TING BLDG. URM ❑ ��/rSignature APPLICANT I T) TEL NO. LOMA Perm I XpQ 1, as owner of the property, or my employees with wages as Z their sole compensation, will do the work and the Structure is ADDRESS F rot intended or offered for Bale (Section 7044, Business and FINAL DATE Q Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ 1, as Owner of the property, am exclusively contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? PINA Y Business contractors to construct the project (Section 7044, Buand Professions Code.) WILL 13NOD 3303 142.29 11 WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT ON FUTURE ES BUILDING 1 ITEf1S COASTAIR REQUIRE A PERMITMANAGEMENT FOR ISIMI LOTION D) EE KHWTTNFROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST NR QunuTv MANAGEMENT psTRx;T IscaoMot SEE PERWTTIND CHECKLIST FOR GNDELINEs I hereby affirm that there is a construction lending agency for YES❑ ND El TOTAL 142 0 the performance Of the work for which this permit is issued(Sec. I HAVE READTHE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING CHECK 1Q 217 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY GDOE, (Tn TITLE 2 CHAPTER 2.20 SECTIONS 2.20 100 THROUGH 220 CONCERNING HAZARDOUS CHANGE u lil' Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. CHANGE Lenders AddressIC 3.1 wmeR eP wE r 1 certify that I have read this application and state under penalty OOOO-0001 2/ 9/96p of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE m with all county ordinances and State laws relating to building 4784 1 Ati11:57. m construction, and hereby authorize representatives of this County ISSUANCE FEE to enter upon the al? mention_ed ropertY for inspection pu�rpos s. A (� INVESTIGATION FEE TOTAL FEEy A SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY l� WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADrDD.J,RESS I I hereby affirmthat I have a certificate of consent t0 self insure. BUILDING A{DD`,ORjJ(¢" 2[� P4�'2 + +i or a certificateof.Workers'Compensation Insurance, or a certified AA k9 ^ "' copy thereof(nc.3800,Lab.C.) CITU ZP?/7 0 A? LOCALITY Policy No. Company -SIZE OF LOT I NO OF SLOGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST- / / ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. / department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL (/J M � SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNEER.r� TEL COMPENSATION INSURANCE ' f� 1�E `✓OA c�� WITHIN 1000 FT.OF SCHOOL? YES NO This section need not be completed if the permit is for one hundred ADDRESS �� e✓� / v / DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY dollars ($100)or less.) CITY ZIP I certify that in the performance of the work for which this permit , is issued, I Shall not employ any person in an manner s0 as to ARCHITECT OR ENGINEER TEL NO. J' 0 ✓ r..'�'�•'( ,,. become subject t0 the WorkersCompensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO._-:2� DWELL UNITS NOTICE TO APPLICANT: If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR TEL NO. SET BACK YARD HWV PROP LINE WIDTH Compensation provisions Of the Labor Code. you must forthwith FRONT 11 comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.N0, P L O SIDE U LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS PL W I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP J (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORIES NO.OF FAMILIES LL Professions Code,and my license is in full force and effect. I NEW ❑ BK PG , K License Number Lic.Class DESCRIPTION OF WORK ADD ❑ VALUATION y, (/ i Contractor Date :WddL X�lY l nl 6rs1-- ALTER ❑ $ �•}. l ;n, 00 A,47127/f L. A m) 1'V�-'J/a L C/ REPAIR Y3' a ❑ I am exempt under Sec. / �/ $ 2 B&PC. for this reason i / �7 YU Lip �J i kf Ll/ _J.'PEMOL ❑ LDMA P/C A ~ Date: �U'SS OF) IGTING BLDG. URM ❑ 7 n� Signature gPPLICANT`( INTj TEL NO, LDMA Perm x 1, as owner of the property, or my employees with wages as Z O their sole compensation, will d0 the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and FINAL DATE o Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL J ❑ 1, as Owner of the property, am exclusively contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044, ,y Business and Professions Code.) YES El No❑ Lid' i 4'6} qn WILL THE INTENDED USE OF THE BUIDLINBY THE APPLICANT OR FBUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROMROM THE SOUTH } ITEMS CONSTRUCTION LENDING AGENCY coast AIR QUALITY MANAGEMENT DISTRICT Iscgomol SEE PERMITTING CHECKLIST FOR GUIDELINES w J .;Pin hereby affirm that there is a construction lending agency for YES 1:1 NO❑ T(ET �' -� m - the performance of the work for which this permit is issued(Sec. 4p�/ ++i 7 ^((�� IHWE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMDPERMIT71NG �.��_4'.A 14-2.2'J 3097,CIV.C,) CHECKLIST.I UNDERSTAND MV REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TITLE 2 CHAPTER 220 o, 2 20 100 THROUGH 220 140 CNCERNIN Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMO.G HAZARDOUS C$OTIF .01) Lender's Address 5:!Fll 1,r w+»eR OR weNr , I certify that I have read this application and state under penalty ::yy�1'1pp�� n}{{TT11 '11 s� p Of perjury that the above information is correct. I agree to comply PC.FEE PERMIT FEE / �� lNJ1,)V`IIt�+Jl a ��CroS AD with all county ordinances and State laws relating to building 4754 j p;T i�.W4 M construction, and hereby authorize representatives of this County ISSUANCE FEE to enter upon the above-mentioned property for inspection purposes. INVESTIGATION FEE TOTAL FEE + SEE REVERSE FOR EXPLANATORY LANGUAGE