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HomeMy Public PortalAbout5936 IVAR AVE_Building__ 76A638A CE#803 10.56 APPLICATION FOR BUILDING PERMIT . 1 BUILDING AND SAFETY DIVISION BUILDING Department of County Engineer ADDRES§�=_> 1 County of Los Angeles LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER _ NEAREST CASSATT D.GRIFFIN, SUPT OF BUILDING CROSS ST FOR APPLICANT TO FILL IN DISTRIC GR I TYPE Y I SEWER MAP" y� BK G _ CONST. BUILDING`�921, ,.� / �� I ADDRESS r�(_ STATISTICAL SSIFICATION 162 LOT/Nr � Q1 f BLOCK CLASS. NO. DWELL. UNITS MAPSTATE YES O NUMBER Q - HWY TRACT -�� USE ZONE .SPECIAL �+ NO. OF BLDGS. CONDITIONS i �A 'y� .. SIZE OF LOT ® /� $ I NOW ON LOT /� - USE OF _ EXISTING'BLDG. '�� BUILDING YARD HWY STREET NAME EXIST, SETBACK WIDTH OWNER FRONT _ A t MAIL P. L. ADDRES 4, SIDE - - TEL. P. L. CIT TEL, INSPECTION RECORD . ARC TECT O - TE ENGINEER NO. ADDRESS , i TEL, jrr CONTRACTOR N4�1� IF - ADDRESS s DESCRIPTION OF WORK - NEW ADD 4 ALTER REPAIR DEMOLISH - - - - - SQ. FT. NO. OF NO. OF - - _ SIZE - -STORIES FAMILIES./— A AMILIES.US oF,TrR C URE j APPROVALS SIGNATU- OF / _ APPLICANT DATE INSPECTORS SIGNATURE ADDRESS .� FOUNDATION: LOCATION ,o- VVV......rrr FORMS, MATERIALS r� a %/9/Y •,��� - P. C. $ �J`� FRAME: FIRE STOPS. / FEE BRACING, BOLTS VALUATION > $ FURNACE: LOCATION, q�Z FEE GAS VENT. DUCTS I HEREBY ACKNOWLEDGE THAT I HAVE READIS AP- LATH,-INT. PLICATION AND STATE T T THE BOVE S COR CT AND AGREE TO COMPLY IT L NT DIN ES AND LATH. EXT. (7— STATE LAWS R A LD C RUCTION. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE ! RECT AND POSTED g� ADDRESS FINAL - �-�- JOHN A. LAMBIE, COUNTY ENGINEER, CLYDE N.DIRLAM, PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION m.o. CASH PERMIT VALIDATION cK, m.o. CASH :x,15 -6'-2'S:; AUG 2 3 1 6 1 0.51'0 A v l 5 6 3-s AW 2 3 1 2 1-;00 M 76A688A C6#8086-88 APPLICATION FOR BUILDING PERMAT 1 COUNTY OF LOS ANGELES BUILDING A°DREss 'DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION LOCALITY r JOHN A.LAMBIE.COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. DISTRIC NO. GROUP TYPE P SSED BY FOR APPLICANT TO FILL IN 7'° I CONST.] I BUILDING a I SEWER MAP ADDRESS - 6 ' �� STATISTICAL CLASSIFICATION BK PG LOT NO. %U 11Q_ CLASS.IVO. � DWELL. UNITS BLOCK MAPSTATE NUMBER HWY. YES N TRACT 7 /� Ay USE ZONE SPECIAL / (`� NO.OF BLDGS. CONDITIONS SIZE OF LOT, a Xj�;S I NOW ON LOToT USE OF EXISTING BLDG. BUILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH OWNER FRONT MAIL //�� P.L. ADDRESS ` 0(o SIDE TEL. P.L. CITY v NO. INSPECTION RECORD ARCHfTECT 0 TEL. ENGINEER NO. ADDRESS TEL CONTRACTO NO. ADDRES DESCRIPTION OF WORK NEW ADD ALTER EPAI_ DEMOLISH SO.FT.. NO.OF NO.OF SIZE STORIES FAMILIES USE OF STRUCTURE APE ,f SIGNA'T'URE OF APPROVALS APPLICANT ' � DATE INSPECTOR'S SIGNATURE ADDRESS IT FOUNDATION: LOCATION FORMS.MATERIALS J P.C. S ,�,^.� FRAME: FIRE STOPS, i FEE BRACING, BOLTS VALUATION $ ,cq LS' FURNACE: LOCATION. L✓ FEE p(i GAS VENT.DUCTS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- PL P- LATH, INT. PLICATION AND STATE THAT THE ABOVE IS CORR T AND AGREE TO COMPLY WITH ALL COU TY ORDINA ES AND STATE LAWS REG T 1 CON UCTION. LATH. EXT. SIGNATURE OF �, HOUSE NUMBER COR- PERMI TErw RECT AND POSTED ADDRESS ` FINAL CLYDE N.DIRLAM, PRINCIPAL STR URAL ENGINEEf3 PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH ,1 9 5 7°; JAN 20 1 A 2.0.0 M ` OF WORKERS' COMPENSATION DECLARATION hereby affirm that I havecertificate of consent to ff AP P L1_CAT I O N � F O R 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 Polio Company ���- -�J Certified co is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ' copy Y ADDRESS ❑ Certified copy is filed with the county bui{din inspec- BUILDING Z 51774 tion department. (y//1 ADDRESS Date ' pplicant _ v CITY 1 �` j, LOCALITY C S ~ CERTIFICATE OF EXEMPTION FRO ORKERS' NO. OF BLDGS. NEAREST SIZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURA CE 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.) OWNER 11NO —�f�o� USE ZONE MAP NO. I certify that in the performance of the work for which this c� y� SPECIAL a permit is issued, I shall not employ any person in any manner ADDR .% / /s,r�' CONDITIONS so as to become.subject to the Workers' Compensation Laws. y O CITY 77 (f( ZIP 7 U Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY Ly NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST. NE 0 Exemption, you should become subject to the Workers' �tf/ (/ U Compensation provisions of the Labor Code, you.must forth- ADDRESS O v a with comply with such provisions or this permit shall be �i TEL �© STATISTICAL CLASSIFICATION APT. CONDO. u') deemed revoked. CONTRACTOR Z LICENSED CONTRACTORS DECLARATION 'LIC. CLASS NO. DWELL. UNITS — I hereby affirm that I arri licensed under provisions of Chapter 9 ADDRESS Cr NO.k,231 7 �7 ' (commencing with Section 7000).of.Division 3 of the'Business Q LIC. SEWER MAP /L ) ' and Professions Code,and.my license is in full force and effect. CITY CLASS G 3'9 BK. PG. VALIDATION /, / SQ. FT NO. OF NO. OF CHECK 4dr License Number 3/ 7 Lic. Classe 3.n SIZE STORIES FAMILIES ONE VALUATION, rz ���! DESCRIPTION OF WORK OB[S NEW ❑ Contractor _30 — �, Date $ ADD ❑ " ❑1 am exempt under Sec. s ► ALTER ❑ B.&P.C. for this reason '1p B DC —�C{� $ Dote: _ USE OF', V EXISTING BLDG. DEMOL ❑ Signature APPLICANT TEL. FINAL OWNER- R DECLARATION (PRINT,). NO. ' g' DATE ,44 I hereby affirm that I ag exempt from the Contractor's License _ Law for the following reason (Section 7031.5, Business and ADDRESS FINAL Professions Code): PRESENT BY ❑ I, as owner of the property, or my employees with ADDRESS _•`::I a wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY ' _r,, .-a._'_s 7044, Business and Professions Code.) MOVING TEL. _ fir. CONTRACTOR NO. _ x: i 1.= El 1, as owner of the property, am exclusively contracting _ with licensed contractors to construct the project (Sec- ADDRESS ji_'" i _xn�_"� _ _ 0. tion 7044, Business and Professions Code.). ., REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. `C ¢El—K : CONSTRUCTION LENDING AGENCY SET.BACK PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONTi;'"� _ the performance of the'work for which this permit is issued P:L. r`' �Pi`= (Sec. 3097, Civ. C.). SIDE Pr.L. Lender's Name LDMA Ref. # _ P.C. Fee$ Permit Fee , % Lender's Address r_ 1 AN.1 0 1 certify that I have read this application and state that the Issuance Fee �` 0 ? LDMA P/C# 0 above information is correct. I agree to comply with all County Investigation Fee 8 ordinances and State laws relating'to building construction, Total Fee / �• e!" LDMA Perm. # a and hereby authorize representatives of this County to enter. upon t i Bove-men ned prop for inspection'purpoosses. SEE REVERSE FOR EXPLANATORY LANGUAGE Sign f Applicant or Agent Date