The URL can be used to link to this page

Home My Public Portal About8915 HERMOSA DR_Building__ Op3s 11.96r.55, APPLICATION FOR BUILDING PERMIT �� g BUILD ING DIVISION OF BUILDING AND SAFETY ADDRESS > Ti 11 I/ J li L Dep Count I of County EagiAngeles eer COIIIIty Of L08 AIIQ@).@B LOCALITY OHN A. LAMBIE. COUNTY ENGINEER NEARESTtt A/,^ 1� ��'jj IJ 1 /�CP ASSATT D.GRIFFIN. SUPT OF BUILDING CROSS ST. R0 Sr--hlF, R D FOR APPLICANT TO FILL IN DISTRICT�O. G{ROUP TYPE SEWMAP SK P I'r bwA ny1- ,.1 /��CONST. O ADDRESS - .U£�/"ASA AYE. NUM EMAPR G;z T SH WY TATE YES NO .LOT NO. // d BLOCK USE ZONE SPECIAL CONDITIONS TRACTNO.OF pT/�dy �7 O {� 7.? -12, I NOW ON LOTS +L/ BUILDING EXIST. SIZE F LO YARD HWY STREET NAME �^ SETBACK WIDTH USE OF ,D�Fy`/�/C'TJ d EXISTING BLDG. FRONT �_ - 'Q'� . I,,, p e l P.L. OWNER ! yy • OS Bl),P V SIDE P. L. MAIL / .y A/ A { r� �-C/� h A A, C ADDR�E+SS) //�S�/�", {�44GW/IN/CO /1 YG O TRACT DWELL. IUNIT / ,l,t / r� / TEL ;r.6 6 INDUSTRIAL CITY i 1 DWELL. I UNIT 6 PUBLIC BLDG. ARCHITECT OR TEL. 2 DUPLEX 2 UNITS ENGINEER NO. 7 ADDN.,ALT.. ETC. 3 APT. __UNITS 8 MISCEL. ADDRESS 4 COMMERCIAL TEL. CONTRACTOR TNO.EL INSPECTION RECORD ADDRESS DESCRIPTION OF WORK NEW ADOV ALTER REPAIR DEMOLISH SO. FT. I.W NO. OF NO. OF SIZE STORIES �y FAMILIES { r, USE OVgWR l'= A _ 1(' SIGNATURE OF 1 ✓� K APPLICANTA I-�� J APPROVALS ADDRES,_5`/y 5/A 1-2,9 SS A N t {Jy.0 DATE INSPECTOR'S SIGNATURE FO UNDATION: LOCATION P. C. S FORMS.MATERIALS 0 FEE FRAME: FIRE STOPS. VALUATION / Sy/� (!(J BRACING, BOLTS FEE FURNACE: LOCATION, I 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 EGULATING BUILDING CONSTRUC- TION' /]� LATH. EXT. SIGNATURE OF //f" �-{�� J HOUSE NUMBER COR- ^ PERMITTEE ,C...� `j RECT AND POSTED ADDRESS FIT/N1A1.TL JOHN A.LAMBIE,COUNTY ENGINEER VALIDAT OA CLYDE N. DIRLAM, CHIEF BLDG. INSPECTOR CK MO GASH LR1�D 5 07 5 FEB 13 1 4 .0 0 In 76A89BA CE#803. 10-56 APPLICATION FOR BUILDING PER//MITn/ c 1 BUILDING AND SAFETY DIVISION BUILDING //� E TTE !\M O Department of County Engineer ADDRESS e/T(-J I County of Loa Angeles LOCALITY / �� l JOHN A. LAMBIE, COUNTY ENGINEER NEARESTOSn CASSATT D. GRIFFIN. SUPT OF BUILDING CROSS ST. C� DISTRICT NO. I GROUP .HPE SEWER MAP FOR APPLICANT TO FILL IN II BK Pc I CONS BUILDING '� SK ADDRESS ,r�J- y t }- / //� STATISTICAL LASSIFICATION LOT NO Y/GS/ �AL-/--' U��T/�BLOCK CLASS. 1 O. DWELL. UNITS MAP \�,p / . _ STATE YES NUMBER �l 6 �F HWY TRACT S%/ /{/Y //,� USEZONE SPECIANOL SIZE OF LOU (/ /� D I NOW ON DF LOTS-^� /•��'� CONDITIONS USE OF /� II EXISTING BLDGl)/Y GEEING BUILDING EXIST. OWNER �I/'y D.J�O/I�/V G SETBACK YARD HWY STREET NAME WIDTH FRONT \ �� / ADDRESSSIDE L /�V J r� V►�Xr CITY7/��j/� n /� ) //y-`A n /.5/// /0,4� Ci / T No 'J.06L�e6G P L AINSPECTION.RECORD ARCHITECT OR TEL, ENGINEER NO. ADDRESS CONTRACTOR ��F NO. ADDRESS /.' DESCRIPTION OF WORK NEW I 00 AT REPAIR DEMOLISH SO. FT. NO. OF NO. OF SIZE' D X STORIES FAMILIES USE OF STRUCTUR APPROVALS - SIGNATURE OF APPLICANT�y` //�� ('+SIA/� DATE INSPECTORS SIGNATURE ADDRESS S75�N.A r5CNI R0 FOUNDATION: LOCATION FORMS, MATERIALS S � p, C, S FRAME: FIRE STOPS. FEE BRACING. BOLTS $ q eo FURNACE: LOCATION, VALUATION GAS VENT, DUCTS FEE 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH. INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY W/ITFFLLALL COUNTY ORDINANCES AND STATE LAWS REGLjGf+ Na BUCONSTRUCTION. LATH. EXT. - SIGNATURE �j��+��yTJHOUSE NUMBER COR- PERMITTEEE .. �I /i, RECT AND POSTED ADDRESS SAN FINAL I :� JOHN A. LAMBIE. COUNTY ENGINEER, CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.G.CASR PERMUT VALIDATION CK. M.G. CASH LACo 3,3-47,&:; ;GCT 15 1 4.0 0 " g �. ) WORKERS' COMPENSATION DECLARATION I'1heL96y a#i,m,that I have a'cer1i1ea:e of -nsent tg self APPLICATION FOR -BUILDING PERMIT i te,"or19:it tlfi cote of.Workers'Compensolion Insurance, (� certifiee-copy thereof (Sec. 3800, Lob. C.) / STATFr COUNTY OF LOS ANGELES BUILDING AND SAFETY n ./ Policy No.lOB5$1� Company �U NI� lul l� �Cerufled copy is hereby furnished. FOR APPLICANT TO FILL IN BUaowG Qq 1 5 eADDRESS � "`,A.OS,(f,_ ZJ Certified copy is filed With the county building inspec- BUIIDING ) C OJA -t$ion department. /�' //��/// ADDRESS / y- L Date 2-ZZ- 0 Applicant L/��A6 /Ur!'iLY/ CITY G 7 ZIP - LOCALITY TeI.,AAe CL-.. CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT 2 CROSS ST. $ (This sectionmeed not be completed if the permit is for one ASSESSOR hundred dollars (SIDE) or less.) TRACT BLOCK I LOT NO, MAP BOOK PAGE PARCEL TELO USE ZONE MAP I certify that in the performance of the work for which this OWNER _12 FH.I \L NO. ! 09 NO, permit is issued, I shall not employ any person in any manner —�- SPECIAL so as to become subject to the Workers'Compensation Laws, ADDRESS A — CONDITIONS CITY ZIP Date Applicant ARCHITECT DR TEL NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO - DISTRICT GROUP TYPE FIRE PROCESSED BY Exemption, you should become subject to the Workers' ,50� K_� CONS ZONE Compensation provisions of the Labor Code, you must forth- ADDRESS � 3 With comply with such provisions or this permit shall be JIESTATISTICAL CLASSIFICATION APT. CO deemed revoked. CONTRACTOR L.m Igo'IM . (c2 S LICENSED CONTRACTORS DECLARATIONLIC CIASS 2- NO. 1 DWELL. UNITS_ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS/ 6 -1!(7yx: NO. b (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP }}��'� Professions Code, and my license is in full force and effect. CITY A CLASS BK.V1 FG /C/3 VALIDATION y: (/ 50. FT.((,,p NO.OF NO.OF CHECK D. License Number-J/569/23 Lic.Class G SIZE 7/Z STORIES IN ' ONE Q (/� /� Z-Z3 8 / VALUATION 8 /Contractor � ,(' �Y Date DESCRIPTION OF WORK L'� 2. RMDD ❑ 1 am exempt*under Sec. I W Ch( L !O , ALTER B.BP.C. for this reason ] 00REPAIR $ j LLIN Date: USE OF DEMOI ts-="`` U) EXISTING BLDG. rj Fr D• Signature APPLICANT � I TEL FINAL PRINT) -[O NO. ooS7 s/ OWNER-BUILDER DECLARATION ^ DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESSL OD O��'• FINAL 'a e.': ytI i -Lr '=a = Professions Code): - PRESENT By / I/ sl.T, �--- �' ❑ t ' -_'-.-t)(I I, as owner of the property, or my employees with BUILDINGADDRESS wages as their sole compensation, will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ❑ 1, as owner of the property, am exclusively contracting CONTRACTOR NO. ' with licensed contractors to construct the project (Sec- Of(rSI_-•1E1i_i // '2t/:$}' ADDRESS -`'c� . tion 7044, Business and Professions Code). _ REQUIRED TOTAL SETBACK F •':'T t "�` 1 t?1:�%'p CONSTRUCTION LENDING AGENCY SET BACK YARD HWV PROP. uNE 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.I. (Sec. 3097, Civ. C.). SIDE Bl. Lender's Name 30 �i DMA Ref. If m Lender's Address D.C. Fee E Permit Fee o 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 - ordinances and State laws relating to building construction, Total Fee co LDMA Perm. # and hereby authorize representatives of this County to enter upon the above-mentioned Property for inspection purposes. at SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent D yPIKERS' COMPENSATION DECLARATION here, aircertfica have dce':Comp of 'coneent to self APPLICATION FOR BUILDING PERMIT insure, or c,cert ificate of•Workers;Com pensatian Insurance, or,e;certified copy thereoT (Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY • ^ Policy No, Company BUILDING 'hull ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county building inspec- BUILDING Pq tion department.. ADDRESS 1"r +U v[ R r Dale Applicant CITV ZIP LOCALITY 42 CERTIFICATE OF EXEMPTION FROM WORKERS' �/'��/7� NO. OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT [ vr'ZJ NOW ON LOT CROSS ST. I /+ (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL ///TEL. L/, USE NE MAP _^ / s- 1 certify that in the performance of the work for which this OWNER Ji �� V f�'Q. /'6J .�� NO. t .0 CJJ permit is issued, I shall not employ any person in any manner I,� /� SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS fq/L,1/ 9• A /'T �)2 -� CONDITIONS Date 1 •� Applicant ��,r•�V�`V V,4'" � CITY m /� L�. ZIP / NOTICE O A LICANT: If, after making this Certificate of ARCHITECT OR TEL, DISTRICT GROUP TYPE FIRE PROCESSED BY ENGINEER NO. �1f.. CONST./ ZONE Exemption, you should become subject to the Workers' N/JI V/ N Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. C DO, deemed revoked. CONTRACTOR W NO. LICENSED CONTRACTORS DECLARATION I.C. CLASS NO. ZI DWELL. UNITS__ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (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 BK FG I It VALIDATION a, SQ.-FT: NO, OF NO. OF CHECK +J License Number Lic.Class SIZE STORIES FAMILIES I ONE V NEW VALUATION Contractor Date DESCRIPTION OF WORK 11 D 9 p�s D $ Vo I am exempt under Sec. Adtj Ii 4&J P-m� ATR ❑ W' BAP.C. for this reason WlAbicketjdi r , OU Sr REPAIR ❑ $ N Date: USE OF EXISTING BLDG. 5• r • L/• DEMOL ❑ z Signature APPLICANT TEL FINAL OWNER-BUILDER DECLARATION PRINT NO. DATE v I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL Professions Code): PRESENT RT I, as owner of the property, or my employees with BUILDINGADDRESS wages as their sole compensation, will do the work and , the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. j 1, as owner of the ptoperfy, am exclusively contracting CONTRACTOR NO. 1 with licensed contractors to construct the project (Sec- A. tion 7044, Business and Professions Code). ADDRESS Hs..PICT.s REQUIRED TOTAL SETBACK "'/ +_Ce01,' CONSTRUCTION LENDING AGENCY SETBACK YARD HWY PROP. LINE WIDTH G":IUI I hereby affirm that there is a construction lending agency for FRONT L ITEMS EMS the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C). SIDE P.L. TOM 315 m (30 Lender's Nome _ LDMRef. CHECK 315.1111). Lender's Address Permit Fee 4 CHAIN,aE _ .00 3 certify that I have read this application and state that the Issuance Fee UPilo LDMA P/C R _ above informationis correct. I agree to comply with all County Investigalion Fee f -1��-L-i� (n-..11 l ly7rtC�= ordinances and State laws relating to building construction, Total Fee LDMA Perm. M61 L. and Yereby authorize representatives of this County to enter ric+ i Fjrl Ra(.t upo the above-m ntioned property for inspection urposgs. G} Is'�.��' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant gent Dat