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Home My Public Portal About9067 HERMOSA DR_Building__ 76A538A CE#803 8-84 APPLICATION FOR BIJ LDI NG PERMIT , COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DMSION LOCALITY JOHN A. LAMBIE-. COUNTY ENGINEER NEAREST COLEMAN W. JENKINS,SUP T,OF BUILDING CROSS ST. DISTR T NO. ROU TYPE O ESSED BY FOR APPLICANT TO FILL IN coNsr. BUILDING 1TI STATISTICAL C ASSIFICATION 5 ER MAP ADDRESS 9067 Hermosa, T. C . CLASS NO. DWELL UNITS �'� BK /SPG LOT NO. BLOCK USE ZONE MAP L NO. TRACT C �� SPECIAL X0. OF BLDG9. ��..•JJJ CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXIST, NG T T BLDG. 9ETBACK FROM OWNER 11 • U • Eubanks Ho.LAT7-4267 FRONT PROP. LINE OFAX4 (STREET) TYPE OF I EXISTING SETBACK HIGHWAY } YARD = TOTAL ADDRESS 9067 Hermosa HI W Y I WIDTH FROM C.L. CITY Temple Cit } BLDG. SETBACK FROM ARCHITECT OR TEL. 91DE PROP. LINE OF (STREET) ENGINEER NO. TYPE 01 E%19TIN0 9ETBACK HIGHWAY } YARD = TOTAL ADDRESS jt HIGHWAY WIDTH FROM C.L. d CONTRgi in Roof Co. NOL 2.-87-0507 } = O ADDRESS 600 So. San GaUiel 16065 CORNER CUTOFF YES Ej NO ❑ Q c, YSan Gabriel C'I C39 'SEE REVERSE SIDE FOR SPECIAL APPROVALS u W DESCRIPTION OF WORK w Z NEW ADD ALTER REPAIR DEMOLISH SO.FT. NO. NO. OF SIZESTORIES FAMILIES 5,R CTUREReroof house, garage, & C r i n compo. skiing e SIG NA TUR OF APPLICANT n VALUATIONS Y OO 000 / APPROVALS DATE IX9P EC TOR'3910 NATURE T. FOUNDATION, LOCATION PEES FEES FORMS,.MATERIALS._ FRAME, FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS 9UILOI NG CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH. INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. ING TO WORKMEN'5 OMMP,�CN'SA•TI'O,N� IINSURANCE. LATH. EXT. SIGNATURE OF � 1 HOUSE NUMBER COR PERMITTEE RECT AND POSTED ADDRESS rpR Yl rci Ma Q n e ' FINAL JOHN F. LEWIS. PRINCIPAL ST TbIiAL ENGINEER PLAN CHECK VALIDATION CK. M.D. CASH PERMIT VALIDATION( CK. M.D. DASH 3 0 AUG2 5 1 D 6.00 _' DEPARTMENT OF COUNTY ENGIUM DIVISION OF BUILDING AND SAFETY BUILDING . — COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER - "" W' r CASSATT D. GRIFFIN, SUPT OF SUIU0INa APPLICATION' I_ FADDRESS R APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. ! :PLAN CK.OR_REC.NO. /,PERMIT NO.` OG S {FI y t \ RECEIVED BY DATE OF APDL. IDATEISBUED NEAREST S-0 WAY eBUILDINGLill .� . U b ADDRESS a + / MAIL LOCALITY I I /A le ADDRESS -/ C1 •8 t!• Vt U ) > TEL. NEARESTI Y e+ I Q/IA.I_L'II v CITY - NO CROSS ST. � ARCHITECT OR TEL. FIRE NO. OF TYPE _ GROUP' = ENGINEER �j 'A a ti No. ZONE - I PLANS 11 ADDRESS D N ^' �1 V� 0 `' W lO Vld', BLDG. I { - n p �• SETBA Ki1NE ` d J Y CONTRACTOR 0'�A*\1 � uQ NEL Q,1V S �V ZONE - f USE APPROVED. DATg f - ADDRESS 3 ��1 1=• t-J �OLI�•. �p I HOUSE NUMBERING LEGAL �l MAP NUMBER �� I NO. ASSIGNED BY DESCRIPTION LOT NO. ..i 'BLOCK ,... CORRECTIONS' TRACT / 1 (� NO. OF BLDGS. 812E OF'LOT SaX -�j b I NOW ON LOT USEOF1 NO. OF - - - - ---- — - -- EXISTING BLDG. OSL 'O IJtp I F.w111EE DESCRIPTION OF WORK Al ^ D — NEW " ALTERATION ADDITION //♦�T�lM X22 A o / 6)_ REPAIR 1-1 DEMOLITION W" " r SO. FT. NO. OF / F' SIZE 7 a �S ROOM9 ' STORIES EXT. WALL �11 ROOF pp 7 /✓ /! COVERING YUCl0 I COVERING SIN lY1 _ USE OF STRUCTURE r - r Al All) AIV PZtfcrr Nai[SAtz��+oJe F TfIH!✓6 /jPHk7-APPROVALS—l�6R7iC�944Y/ _ INSPECTOWS SIGNATURE DATE FOUNDATION: LOCATION ,e /1 FORMS, MATERIALS /' �'-L `7 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRE STOPS, PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS jjff COR AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION. / J - AND STATE LAWSREGULATINGBUILDING CONSTRUCTION. GAS VENT, DUCTS l/ SIGNATUREOF _ WMW tl\A LATH, INT. ( -� i�( PERMITTEE 111 Vt��s_ lV^ VVI rvL ADDRESS. ''3-S\'1 r--_ .-cD o.b\ Al. .. -J�. LATH. EXT. C.l✓I^f PLASTER, INT AUTHORIZED AGT O PLASTER, EXT. - �� o o P. C. B FEE - HOUSENUMBERCOR- 6S-0 RECT AND POSTED 1(r�/y{� VALUATION - S/O O G 1 /,1 1i1 • 1 FEE ��, FINAL P / (.¢- W ' WORKERS'.COMPENSATION DECLARATION e by affirm that I have a certificate of consent to self APPLICATION FOR BUI-LDING -PERMIT : in ur ,'oMIce f'cate ker Comp1 nsation ( ' tone¢¢,ooLl) Ia 38 '}.gly�E;I �� COUNTY`OF LOS ANGELES � ` 'BUILDING AND SAFETY �S • P 1. BUILDING Certified.copy is hereby fur fished. F.OR'APPLICA T TO FILL IN ADDRESS >_❑ Certified copy is filed wit e ty buil g insp c-.�" BUDDING - - tion department I / - - - ' CITY' ZIP LOCALITY �! . Date - Ap 'can - _ _ NO. OF BLDGS.., - NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE Of LOT NOW ON LOT CROSS ST. • COMPENSATION INSURANCE ' - ASSESSOR (This section need not be completed if the permit is for one. TRACT - - BLOCK LOT NO _ MAP.BOOK PAGE PARCEL hundred dollars ($100)or less.) - _• T . _� - OWNER_. USE ZONE MAP - - I certify that in the performance of.the work for which this - NO. SPECIAL - - - - >_permit is issued', I shall not employ any person in any manner ADDRESS CONDITIONS d so as to become subject to the Workers' Compensation Laws. - CITY.. _ ZIP' .. - U f: Q Date Applicant ARCHITECT OR - TEL DISTRICT -' GROUP TY PRI - FIRE I PROCESSED BY Q NOTICE TO APPLICANT:-If; after making this Certificate of ENGINEER - NC.' C T ZONE t- Exemption,•you..should become. subject to the;Workers: -;�� ' • - a Compensation provisions of the,Labor Code; you must forth-., ADDRESS with comply with .such provisions or, this permit shall be v) deemed revoked. - . _ - CONTRAC 1DR ) N STATISTICAL CIAS�SJIFI/CATION' APT. CONDO. Z LICENSED CONTRACTORS DECLARATION - LIC. CLASS NO.�DWELL. UNITS_ - I herebyaffirm that)am licensed under provisionsof Ch'apter9 ADDEE NO' SEWER MAP (commencm w'th ction 7000 f Division 3.of the Busm s �- - -- LIC. and Professions o e, y �se Is in full fore n CITY CLASS Q BK _ VALIDATION / SQ. FT. NO: OF NO. OF CHECK 'License Number $i c.'Class SIZE STOR FAMILIES ONE ` VALUATIO Contractor' Date DESCRIPTIONOF WOR NEW ❑ _ � Ju-+ - ❑ $ ► Elam exempt underSec. ADD ec ( ALTER .❑ - - - - B.BP.C. for this reason REPAIR El f Date: USE OF _ _ EXISTING BLDG. DEMOL ❑ Signature APPLICANT-_ - - TEL. - - - FINAL - - OWNER-BUILDER DECLARATION (PRINT) NO. I hereby affirm that I am exempi from the Contractor's License - - - ' Law for the following reason (Section 7031.5, Business and ADDRESS FINAL:'- Professions Code): PRESENT B - - i BUILDING - T tit t i e ❑ I, as owner of the proper or m employees.with - ' P P Y• YADDRESS _. - -" .. . .. s wages ct!r heir sole compensation,will f o the work"and ' ' '- J�u f-- - the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code.)- - - - MOVING - TEL. .❑ - - -4c I, as owner of the property, am exclusively contracting CONTRACTOR NO. - - TOTAL with licensed contractors to construct the project (Sec- gDDRESS tion 7044, Business and Professions Code.) REQUIRED - TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY . - SETBACK YARD HWV PROP. LINE WIDTH. - '-` CHANGE' ,EIII I hereby affirm that there is a construction lending agency for � 'FRONT. the performance.oF the work for which this permit is issued ' BC (Sec. 3097, Civ. C.). - SIDE -- Lender's Name / _/� Pi C. Fee$ Permit Fee Zb: l: -CDMA Ref k AM •?FIL ._ Lender's Address Certify at have ie read this application and state that the Issuance Fe L,`,7' LDMA P/C 4 ~ IS above form nis correct. bogree to comply with all County Investigation Fee - _ _. - - -.• - ordine es'an State lS lacing to building onstru ion; Taal'Fee LDMA Perm. # - a and eb thorize setves of ihi o my to e ter upoetiproy�erfy foCibsp SEE REVERSE FOR EXPLANATORY_LANGUAGE Signature of Applicant or Agent