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Home My Public Portal About5475 HILTON AVE_Building__ ]eAGSeA CEX05'0'3 T.Se APPLICATION FOR BUILDING PERMIT Z BUILDING AND SAFETY DMSION BUILDING r Department of County Engineer ADDRESS .J County of Los Angeles LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST. OI STRICT O. GROUP TYPE SE��W@EEK MAPPG FOR APPLICANT TO FILL IN Z I CONST. I C. O BUILDING yes y;�T,l, �ry�= ESS QJ, STATISTICAL CLASSIFICATION ADDR 'LOT NO. (J BLOCK CLASS. NO1Dg-/' DWELL. UNITS / MAP 1STATE NUYES O TRACT i NUMBER eJL9 DOHWY USE ONE SPECIAL C NO. OF BLD GS. D ONDITIONS SIZE OF LOT 6 Q 1- NOW ON LOT /V D USEOF EXISTING BLDG. BUILDINKG YARD WIDISTH HWY STREET NAME EXT. _N 4F.• L SETBAC OWNER `I'M�S I KJ / CSS FRONT Al L ADDRESS �7 �1 �7 )/n/t%�/h/y 14)417''''/ G, ) SIDE CITU TCM DK / _/� V ND Y P L ARCHITECT R TEL, INSPECTION RECORD ENGINEER NO. a•�� 1 1�1 �LAIIG [� \Td.d ADDRESS �4JI 11r h] �� w TEL. �.�e l.�.��• CONTRACTOR 197.CAV� w / NO. ADDRESS DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH 5 NO. OF NO.OF EST IES _ FAMILIES U 5 UCT_ URF/ h APPROVALS SIGNATURE APPLICANT DATE INSPE OR'5 SIGNATURE ADDRESS FOUNDATION: LOCATION FORMS, MATERIALS $ P, C, S FRAME: FIRE STOPS. FEE BRACING. BOLTS VALUATION _ FURNACE: LOCATION. FEE !/jr0jrP GAS VENT. DUCTS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH. INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPkY WITH ALL COUNTY ORDINANCES AND LATH. E%T. STATE LAWS GULATIN�, BWILpipfG mONCTION. SIGNATURE OF Ir/'r[// Tyj(r / ' HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL :? r9 JOHN A. LAMBIE. COUNTY ENGINEER, CLYDE N. DIRLAM. PRINCIPAL STRUCTURAL ENGIU&ER PLAN-CNECK VALIDATION CK. M.O. ens PERMIT VALIDATION CK. M.O. ASH 72 G D 07 1 9 3`f, APR 15 1 6 11IgC1p 1-G2C?&�LV, APR 16 1 1 O,Q Q n SB-p 76AG38A OBS-3 a-aa V APPLICATION FOR BUILDING PERMIT DIVISION OF BUILDING AND SAFETY BUILDING Department of County Engineer ADDRESS L County of Lob Angeles LoenuTr WM.J. FOX, COUNTY ENGINEER NEAREST 1 CASSATT D. GRIFFIN, SUP'TOF BUILDING CROSS ST. DISTRICT NO. GROUP TYPE -(�-�J�SEWER MAP FOR)�APPPLICANT TO FILL IN ^(Z/�I coNsr.� i9fBUILDPG ADDRESS '^NG -IT ! I NUMBER ER 7 6'e X STATE HWY YES �10� LOT NO. BLOCK USE Z NE SPECIAL // )� CONDITIONS TRACT 'f j ✓l - �{ NO. OF SLOGS. ,_- BUILDING EXIST. - SIZEOFLOT .I�`/ � - I NOW ON LOT SETBACK YARD HWY STREET AME WIDTH U5" _� FRONT h EXISTING BLDG. P L l —/1L- OWNER SIDE P. L. MAIL ADDRESS .t 2t,^ O TRACT DWELL. 1 UNIT 5 INDUSTRIAL TEL -ONV 1. DWELL. 1 UNIT CITY NO. - 6 PUBLIC BLDG. - 2 DUPLIX 1 UNIT ARCHITECT OR TEL 7 ADDN.,ALT.. ETC. ENGINEER NO. „rDn'1 3 APT. �_UNITS 6 MISCEL. ADDRESS 4 COMMERCIAL y INSPECTION RECORD FOND{ ADDRESS DESCRIPTION.OF WOR II In Rc�ncm'T� .0 ovcC„ �_.f?. NEW ADZ / `D ALTER • REPAIR DEMOLISH SIZE T I J YV NO. OF STORIES / NOMOFE USE OF 6TRUCTUT - �za SIGNATURE OF APPLICANT APPROVALS ADDRESS DATE INSRECTOR'S SIGNATURE FOUNDATION: LOCATION FORMS. MATERIALS CO.,,I FRAME: FIRE STOPS. VALUATION BRACING, BOLTS 111'10 SV Y PQY ��I FEE B� ,-� FURNACE: LOCATION. 1 HEREBY ACKNOWLEDGE THAT i HAVE READ THIS GAS VENT,DUCTS APPLICATION AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. Y� AND STATE LAWS REGULATING/ BUILDING CONSTRUC- w TION.ATURE OF ////[[//AA///////////JJ//,,JJ LATH. EXT. 61GPERMTTEE4a. L HOUSE RECT AND P08TEDR �Q. S-i J ADDRESS FINAL 1' U WM.J.FOX.COUNTY ENGINEER VALIDATION G N. DIRLAM.CHIEF BLDG. INSPECTOR tilD T 1 A 8 ZR,. OCT 9 1 6- 1 5.0 0 e . 30.00 n 1a4a� W117 1 _ APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING.AND S FETY WORKER'S COMPENSATION DECLARATION Fo APPLICANT TCV FILL IN, BUILDING ADDRESS re y affirm that I have a certificate consent t0 self e, BUILDING ADDRESS' 1 'T or rtific to Of Worke F pen on//II nnS e, or a ertifie(J 1. 4 �( Ot l p (;Xi . IT zip / (fir \(rr/ CJX LOCALITY P IC C SIZE OF LO NO,OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnishe pppppp NEAREST CROSS BT ❑ Certified copy is filed with the my ilding inspec TRACT BLOCK LOT NO. department. II USE ZONE MAP NO. Date ApplicaN ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS - CERTIFICATE OF EXEMPTION FROM WORKERS' OWNERIW COMPENSATION INSURANCE WITHIN tooD FT of scrfooL? YES NO (This section need not be completed if the permit is for one hundred ADORESs dollars ($100)or less.) DISTRICT GROUP I TV CONST. FIRE ZONE PROCESSED BY ' I certify that Subjein ct ZIP the performance of the work for which this permit ,f is issued, shall not employ any person aany manner so as to �/ fr G�L,LGLGi become bj¢ct 10 the Workers'(`iOmpep$atlOn 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' CONT T SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. ADtS� LI P L Vff LICENSED CONTRACTORS DECLARATIONSIDE CITY LIC. S P L . S I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP Y (Commencing wit on 7 of Division 3 Of th Busine nd OUSE SIZE NO.OF STORIES NO.OF FAMILIES Professions Co Is in full force of L NEW ❑ BK PG License Nu Lia Class P �MAADD ❑ VALUAT{pNA r, ®� Of Contractor ate ALTER ❑ $ L1/ W a �/-�` REPAIR ❑ ❑ am exempt under Sec. Q $ Z BBP.C. for this reasonAax �7"J DEMOL ❑ LDMA P/C# _ Date: EXISTING BLDG. URM ❑ Signature APPLICANT(PRINT) TEL NO. LDMA Perm# f ❑ Las owner of the property, or my employees with wages as Z their Sole compensation, will do the work and the structure is ADDRESS O not intended Of offered for sale (Section 7044, Business and FINAL DATE Q __ - +� Professions Code.) WILL THE APPLICANT OR FUTURE HAZARDOUS MATERIAL HANDLE A HAZARDOUS THAN THE C ORA MIXTURE CONTAINING ONI THE HAZARDOUS MATERIAL INFORMATION TO OR GREATER THAN THE `v `� 'J { -" j RIAL ❑ 1, as ed co Of the property, am exclusively contracting 44, -e.:- AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIpE4 FINAL BY licensed and Proles t0 Code.) the project (Section 7044, Business and Professions Code.) WILL ❑ NO❑ 1_'�HI '7 T WILL THE INTENDED USE OF THE BUIDLINGCONSTRUCTION BY THE APPLICANT OR FUTURE BUILDING . _ COAST REQUIRE A PERMIT FOR CONSTRUCTION DI MODIFICATION FROM THE SOUTH pp 21-22.Lj ± CONSTRUCTION LENDING AGENCY GUIOE AIRNE QUALITY MANAGEMENT DISTRICT IBCAOMOI SEE PERMITTING CHECKIIST FOR CHECK GES13NES hereby affirm that there is o construction permit agency for S_('jf{p SUh VES❑ NO❑ HE— the performance of the work for which this permit is issued(Sec. 0 IHAVEEC READ I UNDERSTANDHE MY SMENTS UNDERATION THE OS ANGELETHE S COUNTY CTING ODE, 3097.CIV.D.) _CHECKLIST 2,CH UNDERSTAND TI REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. 3 W TITLE 2.CHAPTER 220 SECTIONS 2.20n00 THROUGH 2.20.1 40 CONCERNING HAZARDOUS 5" ± P-1 Hit: i Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. L{`!,�,_�1 .. _. .T o LendersA cess en OF Em /.,� ? 4 Hi�iilj�_•'f o a o certify t I& I ha ad this appli and state Unger penalty O of peri./ that th a eye infor n is rrect.I age to comply P.C.FEE PERMIT FEE / with a county or nances nd;Slate ws relati to ildin m Cons tion, a reby a hOr' res ntative this Un ISSUANCE FEE �y ato cupon t - e on roper for' e f 5. ro j INVESTIGATION FEE TOTAL FEE , roq SEE REVERSE FOR EXPLANATORY LANGUAGE