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Home My Public Portal About9145 HERMOSA DR_Building__ 7GA638A CE#.03 11.57 APPLICATION FOR BUILDING PERMIT �. COUNTY OF LOS ANGELES BUILDI NG zz5 ' Z DEPARTMENT OF COUNTY ENGINEER t BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE,COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. NO. GROUP TYPE EWER MAP FOR APPLICANT TO FILL IN DISTRICTP CONST. BUILDING ADDRESS / � STATISTICAL CLASSIFICATION �j CLASS.NO. DW ELL.UNITS LOT NO. J BLOCK MAP q STATE O // NUMBER .�.ri�r✓ HWY. YES O TRACT 7 USEZ NE ,'SPECIAL NO.OF BLDGS. CONDITIONS SIZE OF LOT I NOW ON LOT USE OF ea-0 EXISTING BLDG. BUILDING YARD HWY TREET NAME EXIST. SETBACK oe WIDTH OWNER FRONT Q/1 MAIL P.L. ADDRESS I+ .SIDE TEL. P.L. CITY INSPECTION RECORD ARCH ITECT O TEL. L. ENGINEER NO. ADDRESS iJ�/q TEL. A" F47X{'bl CONTRACTOR NO. ADDRESS DESCRIPTION OF WORN P 'S P lTrf�EAD 1� NEW ADD AREPAIR DEMOLISH . SO. FT. LT NO.OF NO.OF -&In .S7APV/FD SIZE STORIES FAMIL ES USE OF STRUCTUR MFiA/ /K.F-fl/f ;VkA 1,Y l,h oil/h-rvr%I'se JAS, SIGNATURE OF N APPROVALS aD ve) - &,(q , APPLICANT ��•.JJ / DATE INSPECTOR'S SIGNATURE ADDRESS FOUNDATION: CATION MATERIALS FORMS.MATERIALS P.C. S FRAME: FIRE STOPS. FEE BRACING. BOLTS VALUATION S / FURNACE: LOCATION.. FEE / '✓ GAS VENT,DUCTS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH, INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND ' STATE LAWS R^^__EGULATING� UILDING CO S CTIO LATH,EXT. SIGNATURE OHOUSE NUMBER COR- PERMITTE RECT AND POSTED ADDRESS FINAL CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL EN ER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.D. cns f&,2.3.8 .p,s;. JLN3 Q L -A 1 O'O ®:. TEMPLE COTY 76..... APPLICATION FOR BUILDING PERMIT COUNTY OF LOSANGELES BUILDING / DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AING ASAFETY DIVISION LOCALITY A .JOHN A. LAMSIE, COUNTY ENGINEER NEAREST WILLIAM.A. JENSEN SUPT OF BUILDING CROSS ST. DISTRICT NO. GROU I TYPE SSED FOR APPLICANT TO FILL IN ) coNsr C�Y✓�/ BUILDING STATISTICAL CLASSIFICATION SEWER MAP [.�Y ADDRESS CLASS. NO.—EDWELL.UNITS LOT NO. BLOCK WATER NOT REQUIRED RECEIVED �� I CERTIFICATE: TRACT MAP y-�,(/� HIGHWAY STATE MAJOR SECOND.C07&AL NO.OF SLOGS. NO.•��[/[J / (CIRCLE) SIZE OF LOT_ NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS EXISTING BLDG. F . OWNER TELO. BUILDING YARD HWY STREET NAME EXIST. I SETBACK _WIDTH ADDRESS ,�.Q An t/� AR FRONT - ARCHITECT'OR '�� I�,�i TEL. P. L. ENGINEER NO. SIDE P.L. ADDRESS D. TEL, INSPECTION RECORD O CONTRACTOR NO. V ADDRESS BE O DESCRIPTION OF WORK W d NEW ADD ALTER REPAIR DEMOLISH H SQ. FT. NO.OF NO.OF z IZE STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF APPLICANT VALUATION$ 51,0 _ APPROVALS DATE INSPECTOR'S SIGNATURE p C. PMTQ FOUNDATION: LOCATION FEE FEE'$ FORMS.MATERIALS FRAME: FIRE STOPS, IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS - AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING 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 COMPENSATION INBU BANC LE ' SIGNATURE. F HOUSE NUMBER COR- PERMITTEE RECT AND POSTED //JJ ��yy --//��$-y� � �� ADDRESS FINAL l �( —(O i V'A//,iG�^"� CLYDE N. DIRLAM, PRINCIPAL STR RAL ENGINEER PLAN CHECK VALIDATION cK. M.o. EARN PERMIT VALIDATION cK M.O. CASH LID 3301 My 31 1D 11 .50 76A638A CE 0803 1/7I � N �/ APPLICATION FOR UILDING PERMIT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION B(LD)G DRESS COLEMAN W. JENKINS, ,SUPT DFBUILDING LOCALITY FOR APPLICANT FILL IN NEAREST � Print ort a onl CROSS ST. BUILDING - - _,_GCT.NO. Gp�OUP T�PE P SSED BY ADDRESS / �G _ _ Q CPST. LOT NO. 3 BLOCK CLASS CCL//O(!SSIFICATION. j SEWER/I.�AP /} CLASS NO.�S DWELL,UNITS Z•, BK t_.._PTJ TRACT USE ZONE MAP fj �� N O.OF SLOGS, SIZE OF LOT NOW ON LOT _ SPECIAL USE OF CONDITIONS EXISTING BLDG. -' OWNER EL NO. LDG.SETBACK FROM ADDRESS �/ E MOST -DIC F ROP.LINE OF --(STREET) p TYPE 0 TING SETBACK HIGHWAY } YARD = TOTAL CITY •�/C QT HIGHWAY WI FROM C.L. ARCH ENGINEER O Q4Q /Z �' NOL6 V.i 6-/ - + - BLDG.SETBACK11 FROM ADDRESS ffQ L SIDE PROP.LINE OF (STREET) T LO /♦ p TYPE OF E%ISTING SETBACK HIGHWgV } D I = TOTAL O CONTRACTOR 8 /GJ HIGHWAY WIDTH FROM C.L. CD ADDRESS LIC)71 C 91 NO ` Q/ } _ O CITY C)(� A/ G CLASS CIS CORNER CUTOFF - YES_❑_ _ NO_❑ w CONSTRUCTION LENDER NAME AND BRANCH SEE REVERSE SIDE FOR SPECI# APPROVALS ADDRESS Q Sq. FT / NO. OF NO. OF (NEW _ SIZE STORIES FAMILIES USE OFF ffADD' STRUCTUREF ALTER ❑ REPAIR[:] - _ - SIGNATUROF APP LICA VI& MOL $ :( ❑ VALUATIO �J Zar eO APPROVALS DATE INSPECTOR•B (CNA TU RE P.C. PMT. FOUNDATION: LOCATION FEE S FEE $ �. FORMS, MATERIALS y. FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY 'FURNACE: LOCATION, WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON-, GAS VENT.'DUCTS' STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF SHE LATH, INT. LABOR CODE OF THE STATE OF CALIFORNIA IN RELATI TO WORKMEN'S COMPhN^S(��I 1IW${Iq ��/ (Ty✓/ " `LATH, EXT. ' SIGNATURE ,KI p CaC/ F HOUSE NUMBER COR RECT AND POSTED ADORES FINAL JOHN F. LEWIS. PRINCIP STRU RAL ENGINEER PLAN CHECK, VALIDATION cK. M.D. CASH _ PERMIT VALIDAT N CK. M.D. DASH iidp � 116" OCT) 5 2' D ' 8.55- a 7.v Ocr 1 D 2 0- Q uil,o 5 8.5 APPLICATION FOR BUILDING PERMIT . COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN - SUILGI BUILDING ADDRESS ADOREss f V I hereby affirm that I have a certificate of consent to Self insure, or a certificate of WorkersCompensation Insurance,or a certified copy thereof(Sec.3800,Lab.�C.)O l�.i/ CITTC ��K �.�� ZIP�I��Q LOCALITY Policy NoNWC 27S/3� Company SIZE rP /C ` �• SIZE OF LOT NO.OF BLDGS.NOW ON LOP ❑ Certified copy is hereby furnished. NEAREST CROSS 5T ❑ Certified Copy is filed with thi bul'Iding iF�pegtlon TRACT BLOCK LOT NO. deepparttm�enQt.{/ /( // USE ZONE MAP NO. Dates-9'9,r Applicant (YU'A''.1/C ASSESSOR MAP BOOK - PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEM TON FROM WORKERS' OWNER yy 1Y--�� - TEL NO.$� - Y COMPENSATION INSURANCE 'LZ'�✓ �S— 643 WITHIN 1000 FT.OF SCHOOL? YES No This section need not be completed if the permit is for one hundred ADDRESS )4� —,�` _Sb, �n ( P P / DISTRICT GROUP TYPE CONST. i FIRE ZONE PROCESSED BY dollars($100)or less.) I certify that in the performance of the Work for which this permit CITY f r�PI—r— ITT ZIP^`y/r,OO is issued, I shall not employ any person in any manner so as to F.+ r V U 'become subject to the Workers'Compensation Laws. ARCHITECT OR-ENGINEER TEL NO. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT.. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject t0 the Workers' CONTRACTOR ..T y TEL N J SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith ST•bi SALrS eo5(o716 FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESSC NO P L 5 LICENSED CONTRACTORS DECLARATION _ 7,,E`�41pPN1 R 6971 SIDE i1 CITY T�� o�`J��A LIC.CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 rt fr'M SEWER MAP ' (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE N0,OF STORIES NO.OF FAMILIES NEW ❑ BK PG Professions Code/.and }-mmyy li�cyense is in full force and effect. dL License Number i2?7y F'� Lic.Class DESCRIPTION OF WORK 1� - ADD ❑ VALUATION O �', 1KL LOT �P COntract.T,AJ/.A/LLEODate -r-9-95— C M FLbT ALTER ❑ $ �Ob U ❑ I am exempt under Sec. S�+C-UI= RcoF f 20 rn Q0�'y /4P REPAIR ❑ $ O BSP.C. for this reason S!-A✓�l�bE ON RSLr 72 n--wr " DEMOL ❑ 'V LDMA P/C♦ W Date: USE OF EXISTING BLDG. - URM ❑ Signature APPLICANT(PRINT) TEL NO, LDMA Perm Z ❑ I, as owner of the property, or my employees with wages as Z their sole compensation, will do the work ADDRESS antl the structure is O Ic not intended Or Offered for sale (Section 7044, Business and _ FINAL DATE h •p\� Q JdOJ 90v 1 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ��v— 1'.I _J ITEMS El I, as owner Of the property, am exclusively contracting withOR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 7 Ti IT.11 90 = 7 licensed contractors to construct the project (Section 7044, YES❑ No❑ 1'i ga �� Business and Professions Code.) I WILL THE INTENDED USE OF THE BUIDLJNG BY THE APPLICANT OR FUTURE BUILDING CHECK OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SOAOMD)SEE PERMITTING CHECKUST FOR CHANGE GUIDELINES 'CHANGE 1 hereby affirm that there is a construction lending agency for YES El NO El the performance Of the work for which this permit is issued(Sec. (HAVE READ THE HAZARooU5M4ERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING !�;T(T C t C 3097,CIV.C.) OHECKUST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. 71�no 770 i •UI / ! TITLE 2,CHAPTER 2.20 SECTIONS 2,20 1 00 THROUGH 220.140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. 0352 o - 0.J 2 1 Pi 4:57 e57 Lender's Address CI w,meP of neem o I certify that I have read this application and state under penalty of perjury that the above information is Correct I agree to Comply P.C.FEE PERMIT FEE $ with all county ortlinances and Stale laws relating to building m construction, and hereby authorize representatives of this County ISSUANCE FEE m entg o t abov mentioned property for inspection purposes. _ < / INVESTIGATION FEE TOTAL FEE O' SEE REVERSE FOR EXPLANATORY LANGUAGE