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Home My Public Portal About5927-29 IVAR AVE_Building__ '7 164,638A CEA803 3-68 APPLICATION FOR BUILDING PERMIT COT TY OF LOS, ANGELES BUILDING DEPARTIVIENT OF COUNTY ENGINEER AooREss 9- 7 Xlje BUILDING AND SAFETY DIVISION JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY �e �:•(. COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST CROSS ST. FOR APPLICANT TO FILL IN DISTRICT NO GROUP I TYPE PROCESSED BY YP Y) C.U I T CONST er/"m O e- (Print or-t e onl Jc� [�/ AP BUILDING ^' 7- 44Z �/E, STATISTICAL ,DWIELL,IUONITS. - SEBKR•M ADDRESS PG y LOT NO. BLOCK USEZONE MAP n NO. TRACT - //,., 'SPECIAL • - . NO.OF SLOGS. (— CONDITIONS SIZE OF.-LOT A910 /.:re s, NOW ON LOT USE OF EXISTING BLDG. _ BLDG.SETBACK FROM ' FRNT P .LE TEL. �+ TYPOS OF EROPINGI IN OTBACK/HIGHWAY } YARD , _1$TRTOTAL ) OWNER . EG 1•I,1Y/. NO. A d HIGHWAY WIDTH FROM C.L. ADDRESS tomcat ;� } CITY BLDG.SETBACK FROM - - ARCHITECT OR TEL, SIDE PROP.LINE OF (STREET) ENGINEER LP NO. TYPE OF-EXISTING SETBACK- -HIGHWAY• } YARD - - -TOTAL ADDRESS 5A-r--ys-Aj HIGHWAY WIDTH FROM C.L. TEL. .. } _ )- CONTRACTO NO. p_ LIC. ADDRESS NO. CORNER CUTOFF YES ❑ NO V clTv SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK U a z NEW ADD ALTER REPAIR DEMOLISH SQ. NO. OF. NO. OF FT,SIZE 2 S TORIES FAMILIES USE OF STRUCTURE r SIGNATURE OF APPLICANT VALUATION $ ZOQO. APPROVALS DATE INSPECTORS SIGNATURE P.C. PMT. 5 FOUNDATION: LOCATION FEE $ FEE $ /, FORMS, MATERIALS 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, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA. ' TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. LATH, INT. ING TO WORKMEN'S COMPENSATION INSURANCE. / LATH, EXT. SIGNATURE HOUSE NUMBER COR- PERMITTEE = RECT AND POSTED ADDRESS FINAL FINAL JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION ` CK. M.O. CASH _ PERMIT VALIDATION K. M.O. CASH �i(',Y 3 0 :0 3 14 1 D 172 5 . APIPUMMON FOR R o M LSO NG [PER M �l COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN e I G AD Ess "" �� y BUI DD ESS,� / ^ <� —y /' I hereby affirm that I have a certificate of consent to self insure, �r�/ or a certificate of Workers'Compensation Insurance,or a certified ° Z copy thereof e .3800,Lab.C.) c r 7 LOCALITY POlic NO. r/' Com spany—Z/y �� SIZE OF LOT NO.OF BLDGS.NO ON OT rtified copy is hereby furnished. NEAREST CROSS ST ❑ Certified copy is filed wit ounty bIldin inspection TRACT BLOCK LOT NO. USE ZONE MAP NO. deamlment.' j7 ASSESSOR MAP BOOK PAGE PARCEL D (�Applican SPECIAL CONDITIONS CERTIFICATE OF EXEMPTI OAA WORKERS' ERYES NO COMPENSATION INSURANCE &r1211R111 L WITHIN 1000 FT.OF SCHOOL? ADDRES (This section need not be completed if the permit is for one hundred DISTRICT GROUPgC0111ST'IrIEZONE PROCESSED BY dollars($100)or less.) CI I certify that in the performance of the work for which this permit `7 is issued, I shall not employ any person in any manner so as to ARCHI EC OR ENGINEER TEL.NO. become subject to the Workers'Coriipensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO._r_ �DWELL UNITS NOTICE TO APPLICANT: If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' C NT CTOR T,L• SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. ADDPE$SLIC.NO. r FFRONT tf- r SIDE LICENSED CONTRACTORS DECLARATION LIC.cLAs� PL U CD I hereby affirm that I am licensed under provisions of Chapter 9 C��- SEWER MAP (commencing with Section,7000)of Division 3 of the Business and S Z NO. STORES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW El BK PG D + C NO OR � uV�� /t� ADD ❑ VALUATION O-0 License Number l �Lic.Class - / p v" - y Contractor ate, S - p ALTER Elz ®� � ®�' REPAIR ❑ 1 am exempt under Sec. ,�yy►► I BARC.for IN / I,r® DEIVIOL 11LDMA P/C It 4!4g OF EXIS INGG. Date: 11e1,1,61?14/Yr ERM. ❑ Signature APPLICANT(PRINT) TEL.NO. LDMA Perm# ❑ 1, as owner of e O . or my employees with wages as s 61':l•!a a their sole comp ns on,will do the work and the structure is ADDRESS F ;r not intended or Bred for sale (Section 7044, Business and ' FINAL DATE a3Ci ��. ,?�l Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL -' .,.✓_�2��'�j J 1 ITEMS ❑ 1, as owner of theproperty, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN Y g THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL4.{1 --a licensed contractors to construct the project.(Section 7044, YES El NO ❑ s i�'[tL °-°° `� Business and Professions Code.) � WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING f;HE;[s OCCUPANT REQUIREA PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THESOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. CHANGE a... I hereby affirm that there is a construction lending agency for, YES 1-1NO 1:1the performance of the work for which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD 3097,Civ.C.). - PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES m. COUNTY CODE,TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING - t iijii -l;;ilil j, .Ilii' 7b Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAoMb. AMII'- ALender's Address OWNER OR AGENT o° I certify that I have read this application and state that the above RC.FEE PERMIT FEE Ginfis correct.' I agree to comply with allcounty n State law lating to building construction,andoe repres ntat es of this County to enter upon ISSUANCE FEEntioned pro for inspect' urposes. INVESTIGATION FEE TOTAL FEE/j�t 0a++ CG�� SEE REVERSE FOR EXPLANATORY LANGUAGE, . app�OC� �.�'��[�]• BOO G� o M�L�DO[�C� pC��I�il��' i1 COUNTY OF LOS ANGELES . BUILDING ARID SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADOR s 1 hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS or a certificate of Workers'Compensation Insurance,or a certified5 9 2 7 N. I va r Ave. copy thereof(Sec.3800,Lab.C.) CITY IZIP LOCALITY PolicyfJo.WCP12456 Company Citation Iris I Temple C i t 91780 / NO.OFBLDGS.NOW ONLOT ❑ Certified copy is hereby furnished. ' Co. NEAREST CROSS ST. ,ftCertified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. 5904 11 4 USE ZONE E.ASSESSOR MAP BOOK PAGE PARCEL y/J'� / ' ODate 5—1 5—QQplicant 5386 011 0 1 1 057 l[ / L CONDITIONS �7Q },, g}y $4Q I G C SINNER TEL.NO. C` CERTIFICATE OF AAT W RICE I . Robert Feltham 287-4153 YES No COMPENSATION INSURANCE WITHIN loco FT OF SCHOOL? . ' ADDRESS (This section need'not be completed if the permit is for one hundred 5927 N. Ivar Ave. DISTRICT GROUP TYPE CONST,' FIRE ZONE PROCESSED BY dollars($100)or less.) CITY ZIP V I certify that in the performance of the work for which this permit Tem l e l t91780J, J is issued, I shall not employ any person in any manner so as to ARCHITECTO ENGINEER TEL.NO. become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS ,CLASS NO.1? t'—DWELL UNITS NOTICE TO APPLICANT. If, after making this.Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you. should become subject to the Workers' CONTRACTOR TEL.NO. SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith W.G. JOHNSON .ROOFING C0 . 241-1832 FRONT comply with such provisions or this permit shall be deemedrevoked. ADDRESS LIC.NO. PL 3510 Fletcher Dr. 157140 SIDE } LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS P L a Los Angeles . C.' I hereby affirm that I am licensed under provisions'of Chapter 9 SEWER AP (commencing with Section 7000)of Division 3 of the Business and SQ.FT SIZE NO.OF STORES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW ❑ BK PG . t DESCRIPTION OF WORK License Number 1 571 40 Lic.Class' C39 Rer00f 10 ADD ❑ VALUE N D D- ContractorWG JTnHNSnN Date 5-15-90 ALTER Z_ ❑ I am exempt under Se ING CO: gtEPAIR B.&PC,for this reason— DEMOIL 1-3LDMA P/C# ate:. US OF EXISTING BLDG. (JRM ❑ jj Signature APPLICANT(PRINT) TEL.NO. i LDMA Perm# . El I, as owner it'•pr �mplo h s 90• W.G. JOHNSON ROOFING O. O ��.�.�o� ............ . . their sole compensation, will do the work and t structure is ADDRESS 0s DATE _+;h not intended or offered for sale (Section 7044, Business and FINAL < �' Professions Code.) : WILL THEAPPLICANT OR FUTURE BUILDING OCCUPANT HANDLER HAZARDOUS MATERIAL �. .,, j OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN. _ ❑'1, as owner of the.property, am exclusively contracting With THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL �j — licensed contractors to construct the project.(Section 7044, -- TOTAL AL 93 - YES❑ NO Business and Professions Code.) . _ , �. {�a h' WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING �.}�It,K 3.�'•= �- OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTIONOR MODIFICATION FROMTHESOUTH _ CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST :HAN _ ., -- .I0 FOR GUIDELINES. T 1 I hereby affirm that there is a construction lending agency for YES❑ NCf'L3 (' the performance Of the Work for which this permit IS ISSUed(SBC. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD 0000-000 } ?fit C 'E-1 J+�I 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES I i00 I-0 ,!e I 1 - :If 1'J/ i• m. COUNTY CODE,TITLE 2,CHAPT R2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING 'o Lender's Name HAZAR MAT R LS R G D FO T I P MTF SCAQMD. """" `7� 1 I 4 a L+. Lender's Address owReR ERT o I certify that I have read this application and state that the above information is correct. I agree to comply with all county P.C.FEE `' PERMIT FEE ordinances and State laws relating to building construction,and 40L-11. 63 ¢. hereby authorize representatives of this County to enter up ISSUANCE FEE ^ the v me ion pr p y ins ction purposes. fl"`"t INVESTIGATION FEE TOTAL FEE 61p,vwm of Ayplmm a Au.m 13 e SEE REVERSE FOR EXPLANATORY LANGUAGE