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Home My Public Portal About9841 HOWLAND DR_Building__ Al PLICATION FOR BUILDING P�ER,I I� At` FOR APPLIC'AN it to FILEAN (Prim O, I,Pe ..IV) I 'l / Bu1LD,NG pp�� (9 //� ++ + , n T COUN OF LOS ANGELES ADDRESS, J 8-1' 1 L"��-Fy�✓ �R DEPARTMENT OF COUNTY ENGINEER CITY Tc-MOpt C1Z -ZIP 1 -7 0 BUILDING AND SAFETY DIVISION NO.OF SIZE OFILOT e)O x 1671 NOW ON LOTS ADDRESS J /� L; lo vrl4/FSP I>2 TRA CT Sp_75-� BLOCK LOT NO. Z$ LOCALITY CL% OWNER E I4=_WtFTT AAS7J-rad NO. 4_7606 NEAREST VASSESSOR ADDRESS 9S4 i 140is Li;n•7_X, MAP BOOK PAGE PARCEL [[hh DISTRICT GROUP TYPE FIRE FIR ESSED BY CITYT�F/[PL� CfY ZIP 10)1 O� CONST. ZO S, ARCHITECT OR TEL. _JG l/iwJ ENGINEER NO. STATISTICAL CLASSIFICATIONSEWER MAP ADDRESS CLASS NO.-2i-DWELL.UNITS LCBK PG% TEL. USELZOAP- /R//CONTRACTOR O !/ l0IC. /sOADDRESS NO, p/ PECIALLIC. I— ONDITIONS CITY CLASS ROA DE EPARTMENT APPROVAL REOU�RD YES❑ NO❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG.SETBACK FROM I FRONTPROP.LINEOF 1 (STREET) Y ADDRESS CITY _ TOTAL SETBACK FROM TYPEOF EXISTING O SQ. FT NO. OF NO. OF CHECK HIGHWAY } YARD - HIGHWAY WIOTH U SIZE S STORIES FAMILIES I ONE FRONT PROP. LINE LC + O DESCRIPTION OF WORK NEW ❑ U ADO SLOG.SETBACKFROM a RGLG � O �CO B qeT M t7 13 . eIJ_ SIDEPROP. LINE OF (STREET) Z •� �• J ALTER ❑ HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING L •Vf NINA. 'RM• BRcAK REPAIR SIDE PROP. LINE HIGHWAY WIDTH USO s A icTA _ EXISTING BLDG. !ZE S I7j�,'�+GE DEMOL p + APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑ (PRNT) evt-gc-yY/1/FLJYON)NO.2-9&-7(i0 IN OPEN SPACE YES ❑ NO ❑ '� BY (SIGNATURE) Q IN COASTAL IONS YES ❑ NO Y ❑ - VALUATION DOO CATEGORICAL EXEMPTION YES❑ NO ❑ HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT AND.AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (OATE) WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (GATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIDLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION INSURANCE. .G 9 /l�S/rf. /�✓Fn TO CFt/�✓E/J �R SIGNATURE OF �L®r .Q~SG/.""/� //✓sf.�C+/L>/✓S. /1 J�%A. PERMITTEE ♦ ADDRESS I LJ(,.{�.aJD G'7�7y �_/JLL Tl7 GO/� fATAMr I.I✓_S PFT ' FINAL TEL. DATE L�/J G✓/��(/�� cITvT�M-Ot..G-f GtYY No, ZP 6-76ry JL1FE CfIECI:S COU fiLf, EN FEE $ / FEE �`-T HARVEY T. BRANDY, COUNTY ENGINEER PLAN CHECK VALIDATION CK. M.O. 'CASH PERMIT VALIDATIO CASH - 1 1 6rNOV J!o- 1 U 4 8.7 Jr 76A638A CEA803 12/72 _ /T� V P , WORKERS"COMPENSATION DECLARATION ereby affirm That have a certificate of consent to self APPLICATION FOR BUILDING PERMIT 4. are, or a certificate of Workers'Compenstion Insurance,or certified copy thereof j$ec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY - licyNo. Company BUILDING � Certified copy is hereby furnished Fc�cgfox> OR APPLICANT TO FILL-IN ADDRESS Certified copy is filed with the county building inspec- G A� n� t9n dep2ir3nenl. S �8� �E✓<•-LT{/�� Q. LOCALITY / I� NEAREST ) to Applicant �., L' 21P C' 7 O CROSS Si. CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR �- COMPENSATION INSURANCE LOT OX I (p NOW ON LOT 2 MAP BOOK PAGE < PARCEL his section need not be completed if the permit is for one11.4"16WK U/WONE mdred dollars ($100)or less.) 7 5$ BLOCK LOT NO. 2-6 �r'�_�1�yy TEL. ,,11 SPECIAL - .# _ y CVC--7jE"T'1' '$L�].', K76W7EIa NO.2 Qdr - V, CONDITIO $ / 0 ertify that in the performance of the work for which this O rmit is issued, I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE PROC SED BY U S I CWC. IJ f� ^, . CONST. Z/1 E 1 as to become subject to the Workers Compensation Laws. `hJ LX/ �f OC �' - ' O to Applicant _ �LE G ZIP I7� 0 STATISTICAL CLASSIFICATION - APT. CONDO. VCT OR TEL.OTICE TO APPLICANT: If, after making this Certificate of j` , �emption, you •should become subject to the Workers' R NO. CLASS NO. 2-1 UNITS / H ompensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP I t Z ith comply with such provisions or this permit shall be k - r eemed revoked. CONTRACTOR NTEL' BK. PG, 6 � VALIDATION O. LICENSED CONTRACTORS DECLARATION - UC. hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION ommencing with Section 7000)of Division 3 of the Business and LIC / ii11 rofessions Code, and my license is in full force and effect. CITY CLASS $ SO. FT NO. OF NO. OF CHECK cense Number Lic.Class SIZE STORIES FAMILIES ONE $ ontractor Dote DESCRIPTION OF WORK IJ'D Z�j X 2 I NEW ❑ ] I am exempt from the licensing requirements as I am a Q O N O O / s ADD licensed architect or o registered professional engineer ALTER ❑ FINAL acting in my professional capacity (Section 7051, 117TY15.0 M- -M (SA"24 .III REPAIR ❑ OAT Business and Professions Code). USE OF FI L ' EXISTING BLDG. DEMOI ❑ id or Reg.No. Date APPLICANT TEL. OWNER-BUILDER DECLARATION (PRI NT) NO. hereby affirm that I am exempt from the Contractor's License ' aw for the following reason (Section 7031.5, Business and ADDRESS - 'rofessions Code): PRE ENT - aBUILDING AI 1, as owner of the property, or my employees with* ADDRESS wages as their sole compensation, will do the work and LOCALITY the structure is not intended or offered for sole(Section 1 7044, Business and Professions Code). MOVING TEL. \ ] I, as owner of the property, am exclusively contracting CONTRACTOR NO. ` with licensed contractors to construct the project (Sec- ADDRESS - tion 7044, Business and Professions Code). - - CONSTRUCTION LENDING AGENCY REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. SET BACK PROP. LINE WIDTH �9 1 4 9.2 A hereby affirm that there is a construction lending agency for FRONT - he performance of the work for which this permit is issued P.L. - # o o 'o o e 1 . Sec. 3097, Civ. C.). - SIDE - - - P.L. 2 ^ ^ 79, 00 encI Name ender's Address n P.C. Fee S Permit Fee Z e e e 7 9. O O U certify that I have read this application and state that the Issuance Fee / O'8.0 -1780 have information is correct. I agree to comply with all County Investigation Fee - rdinonces and State laws relating to building construction, Total Fee nd hereby authorize representatives of this County to enter pan the above-mentioned property for inspection purposes. Ti i+✓� '�_3 f' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicani or.Agent Dote I ®s WORKERS' COMPENSATION DECLARATION - hereby affirm that I have r certificate of consent to self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C.) . . COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified co is hereby furnished. FOR APPLICANT TO FILL IN BUILDING (` PY Y ADDRESS ❑ Certified copy is filed with the county building inspec- BUDDING L - tion department. ADDRESS I HOE.J[-An)17 'A2 Date Applicant CITY LL GL ZIP / .7 60 LOCALITY NOOF BUDGS. CERTIFICATE OF EXEMPTION FROM WORKERS' - SIZE OF LOT NOW ON LOT' 'Z NEAREST COMPENSATION INSURANCE CROSS ST. AG NES — CJLt L/C-7 ASSESSOR (This section need not 6e completed if the permit is for one TRACT z.s BLOCK LOT NO. MAP BOOK PAGE I PARCEL hundred dollars ($100) or less.) TE OWNER E V'7L is-7 4 -T'O.J N f (, USE ZONE I certify that in the performance of the work for which this - NO. AL permit is issued, I shall not employ any person in any manner ADDRESS G.-J �•✓�1 �L— — CONDITIONS d so as to become subject to the Workers'Compensation Laws. rte0.` 0 CITY�— L= ZIP - 7SU Date ��9 Applicant t - 23�-- >>•--- ARCHITECT OR TEL. Of NOTICE TO APPLICANT: If, after makingthis,Certificate of ENGINEER dw-�'T_^�. NO. DISTRICT GROUP TYPE FIRE PROCESSED BY CONST. ZONE Exemption, you should become subject to the Workers' T`��(�7( P Compensation provisions of the Labor Code, you must forth. ADDRESS � a with comply with such provisions or this permit shall be TEL. STATISTICAL ClAS51FICATION APT. CONDO. to deemed revoked. CONTRACTOR NO. z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO."'i"' DWELL. UNITS — I hereby affirm That lam licensed under provisions Chapter 9 (commencing with Section 7000)of Division 3 of the ADDRESS NO. e Business LIC SEWER MAP and Professions Code,and my license is in full force and effect. CITY CLASS BK PG. VALIDATION SO. FT. SNT OF NO. OF CHECK License Number Lic. Class SIZE STORIES FAMILIES ONE VALUATION 11Contractor Date DESCRIPTION OF WORK R45— S/-/!A/C L� NEW /, pO ZooF or- oL,SE oxvc ADD 1:1 $ 7 1'9- ► ❑I am exempt under Sec. ALTER ❑ B.BP.C. for this reason REPAIR ❑ $ ' Date: USE OF EXISTING BLDG. DEMOL ❑ Signature APPLICANT ,� �EL FINAL �y OWNER-BUILDER DECLARATION (PRINT) eVJ_--2,t-7`r Cl7J JTAg EO. 2 6-7L0 D�� I hereby affirm that I am exempt from the Contractor's License - Law for the following reason (Section'7031.5, Business and ADDRESS FIN Professions Code): PRESENT B _ - ❑ I, as owner of the property, or m employees with BUILDING P P Y� YADDRESS wages as their sole compensation,will dotheworkond t 4y�c. the structure is not intended or offered for sole(Section LOCAUTY poll .- IpI 7044, Business and Professions Code.) MOVING TEL. • .- -_ C tlJ I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS ' f t 9 - 88 tion 7044,.Business and Professions Code.) _ REQUIRED TOTAL SETBACK FROM EXIST. F='- G CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH t4°�`• 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 P.L. Lender's Name, ig LDMA Ref. # P.G. Fee$ Permit Fee Lender's Addresses _ AIN .5';irFV 1b o I certify that I have read this application and state that the - Issuance Fee LDMA P/C# \ above information is correct. I agree to comply with all County Investigation Fee r s ' ordinances and State laws relating to building construction, Total Fee O LDMA Perm.p and hereby authorize representatives of this County to enter _ _ upon the above-mentioned property for inspection Purposes. �G .. 5 �a-rte..., SEE REVERSE FOR EXPLANATORY LANGUAGE ri Signature of Applicant or Agent