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HomeMy Public PortalAbout6036 IVAR AVE_Building__ 76A638ACEx$8036-62APPLICATION FOq BUILDING ll ER COUNTY OF LOS ANGELES BUILDING ` �r DEPARTMENT OF COUNTY ENGINEER ADDRESS _ BUILDING AND SAFETY DIVISION , LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST..,. i •� DISTRICT NO. .G OUP TYPE ESSED BY FOR ,APPLICANT TO FILL IN= coNsr.' BUILDING e STATISTICAL CLASSIFICATION WER MAP ADDRESS t -- �.. K CLASS. NO. DWELL. UNITS LOT NO. I �17 , BLOCK WATER - CERTIFICATE: NOT REQUIRED RECEIVED TRACT ('j MAP -���/j� HIGHWAY STATE MAJOR SECON LOCAL e NO.OF BLDGS. A NO. •�C/' (CIRCLE) SIZE OF LOT - © �j( 'S NOW ON LOT USE ZONE _ SPECIAL USE CONDITIONS" EXISTING BLDG. R.S S ... - TEL. OWNER ` NO. - BUILDINGEXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS,' �� ,�� AA MNIQ ?I\ FRONT ARCHITECT OR TEL. P• L.. ENGINEER NO. "SIDE 1' P. L. a ADDRESS _ O TEL. - U CONTRACTOR NO. - N ADDRESS O DESCRIPTION OF WORK W CL NEW ADDALTER REPAIR DEMOLISH - h Z SQ. FT. NO. OF /, NO. OF ` . .SIZE STORIES -1 FAMILIES "�. USE OF RUCTURE \y�� �Q SIGNATURE OF VALUATION $ CCC APPROVALS, DATE 'INSPECTOR'S SIGNATURE FOUNDATION: LOCATION P.C. PMT: ` : FEEFEE RMS, MATERIALS /J $ r� $ •� FORMS, FIRE STOPS. r// �/ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS A (d 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. 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 CALIFORNI A•RELAT. ING TO WORKMEN'S /Cp ION INSURAN E. LATH,EXT. . _ SIGNATURE OF ` HOUSE NUMBER COR- - PERMITTEE RECT AND POSTED_ - •ADDRESS' FINAL / �_jf ` JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH -'PERMIT VALIDATIONCK. M.O. CASH " 9" FEB 2 5 i H 6.0 0, LI'O N I-6 z /per I�I}�r, QCAT ll 1!1 }1}�. ppm( 1p� , p/��► �}F��1}��(,p�/[��� 76A638A CE�$H03 !1G ���V ® FOR �/��II����V� PFRMIT COUNTY OF LOS ANGELES BUILDIN / DEPARTMENT OF COUNTY ENGINEER ADDRES G _ \ BUILDING AND SAFETY DIVISION LOCALITY r JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. /�.�r� DISTRICT 0. GROUP TYPE PROC ED BY FOR APPLICANT TO FILL IN ��� CONST. BUILDING 'STATISTICAL CL 1FICATION SEWER MAP ADDRESS \\' ~r C K� P 'CLASS._NC DWELL. UNITS LOT NO. BLOCKWATER CERTIFICATE: NOTREQUIRED F7 RECEIVED ❑ TRACT z) u`-`- MAP / HIGHWAY NO _ NO. s+ 00 (CIRCLE) STATE MAJOR SECON LOCA .OF BLDGS. SIZE OF LOT t, >- i NOW ON LOT USE ZONE SPECIAL USE OF r") \ CONDITIONS ' EXISTING BLDG. TEL _ OWNER �; \ Q �',I NO. '1' BUILDING EXIST. \ `\ SETBACK YARD HWY STREET NAME WIDTH. ADDRESS \ ��� Q\' ) ��1�\ 1 FRONT �9 ARCHITECT OR TEL. P. L. /? Z7(/ / ENGINEER NO. SIDE P. L. d ADDRESS _ Q TEL 0 CONTRACTOR •Q 4' NO. ADDRESS '�\ j •7 \\ r\A�`""�. r - A t- DESCRIPTION OF WORK u W EL NEWW In ADD ALTER REPAIR DEMOLISH In SQ. FT. L�� �, NO.OF j NO. OF SIZE 1 T_; ST RIES \ FAMILIES USE OF STRUCTURE \ "-4.e - SIGNATURE OF APPLICANT f VALUATION APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION X FEE S FEE $ s FORMS, MATERIALS SYQ 63 ,d am FRAME: FIRE STOPS, I HEREgY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS (Q' 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. I CERTIFY THAT IN DOING THE WORK ' AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. LATHINT. TION OF THE LABOR CODE OF THE 5 ATE OF CALIFORNIA RELAT. , - A ING TO WORKMEN'S•COMPEN ATION IN URANCE. h G -/ 4 /� ^ LATH. EXT. SIGNATURE � u HOUSE NUMBER COR- ' PERMITTEE t-•"� RECT AND POSTED qq ll ADDRESS rINAL � 2-Q 0 !-- \\q JOHN F. LEWIS, PRINCIPAL STURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH .a. 76A638A Cpt,-,r?�-:6' 2 APPLI, CATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY. DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST " WILLIAM A. JENSEN, SOP'T OF BUILDING 'CROSS ST. DISTRICT-IN XICAT-ION TYPE RO BY ' FOR APPLICANT TO. FILL IN CONST: BUILDING STATISTICAL CL, SE ER MAP _ ADDRESS .,� - �-- - - P CLASS. NO. t_DWELL. UNITS LOT NO. t BLOCK WATER CERTIFICATE: NOT REQUIRED RECEbVED' TRACT MAP ///� 'HIGHWAY NO:OF-BLDGS. NO. d V ICIRCLE) STATE MAJOR SEC D LOCAL SIZE OF LOT � NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS - EXISTING BLDG. S♦ 2\.-,C_.�" - \,.y� TEL. _ y ' 'OWNER ,\ \ \ NO. '.I rt�•a�- BUILDING • EXIST. -" SETM BACK YARD HWY STREET NAE WIDTH ADDRESS �, 7 ZFRONT -. ARCHITECT OR - TEL. P. L. Z•� �� ENGINEER `'}''`. NO. -�,y� SIDE ' P. L. ADDRESS pCL TEL. '/ d ,A_7"Ct. 7-t� F /ri�'f". .�r3--6�r4'.u4--fid/.. 0 CONTRACTOR ',:V� -NO. 'S\,\ ' � _ sr / /^ /' ADDRESS - . . �.—! '_(i. 0. 1�i-L.e. C�Lf I./1./�,. (lr.hC..' a �.+ DESCRIPTION "OF WORK � � '�`� -' 0 NEW ADD ALTER REPAIR DEMOLISHd. SQ. FT. - NO. OF NO. OF / v� -6,- �C"s�° ,-Q4v��c All? s 4d�'I•lPJIt:'�`�Z SIZE STORIES t _ FAMILIES USE OF . ' :r� J� vt(I 8... V tl vlf� i�J A. i /3YC�CC STRUCTURE GZ.S+_ Cti• r r h.v c\'•.\ \ t��,,.. /� ,j� - C1 NT v(9'-?✓ cafe/ /cJ. G z r ~ f i SIGNATURE OF • - APPLICANT VALUATION \ APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. / FOUNDATION: LOCATION FEE $ FEE $ ( +.. • FORMS, MATERIALS �. �p c1 s �C.Rw ''-'y,.. ' 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. I 'CERTIFY THAT'IN DOING THE WORK - AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- -I -LATH, INT. ' TION OF THE LABOR CODE OF THE,STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S COMI-_ENSATION INSU ANCE. I,. LATH, EXT. SIGNATURE•OF. \ 0 1 HOUSE NUMBER COR- PERM ITTEE OR-PERMITTEE .. RECT AND POSTED ADDRESS ) �.�� 7-7 II FINAL `' - ' ? JOHN F. LEWIS: PRINCIPAL STRUCTURAL EN NE R PLAN CHECK-VALIDATION CK. M o. . CASH PERMIT VALIDATION CK. M.O. CASH Li • I WORKERS'�COMPENSAT,ION DECLARATION 4' R' insurcgboraa certif caste of War e s' Compensation Insurance, �.CNT O LI�I have a,certific'cite of consent to selft F uU O URONG p C QN or a certified copy:thereof.(Sec. 3800, Lab. C.) COUNTY OF LOS'ANGELES BIfILDIRIG AND SAFETY' Policy No. Company BUILDING ❑ Certified copy is hereby furnished. e FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING Tion-department. ADDRESS 1 ��ii r - CITY` .f YL `e.l�` ZIP C1�75�' LOCALITY Date Applicant NO.OF BLDGS. - • NEAREST CERTIFICATE OF EXEMPTION,FROM WORKERS'-' SIZE OF LOT . NOW ON LOT CROSS ST. COMPENSATION INSURANCEASSESSOR (This section need not be completed if the permit is: one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars($100)or less.)';- :'. TE p USE ZONE OP OWNER. 1 Gf CC es' N .BIg $Tl��l I certify that in the performance'of the work'for'which this SPECIAL permit is issued, I shall not empfoy.any person in any manner ADDRESS t e w i'd CONDITIONS CL so as to become subject to the;Workers' Compensation Laws. e�., _ O CITY JC(Y) > ICC" ZIP C j U Date Applicant ARCHITECT OR TEL, DISTRICT' GROUP TYPE FIRE PROCESSED BY 0 NOTICE TO.APPLICANT: If, after making-this Certificate of ENGINEER NO. CONST. ZO E O Exemption, you should becorrte..subject to the-,Workers' Compensation-provisions of.the Labor Code, you must forth- ADDRESS " �� v N .with comply with.such provisions or this•permit shall be TEL. STATISTICAL CLASSIFICATION ART. CONDO. Z deemed revoked. CONTRACTOR Re� t fCfler NO.,- — LICENSED CONTRACTORS DECLAN.RATIOLIC. CLASS NO._,4:11 DWELL. UNITS I.hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP .(commencing.;vith'Section 7000)of'Division 3 of the Business LIC. and Professions Code;and my license is in full force and effect. CITY CLASS BK. PG. VALIDATION SQ..FT: NO. OF NO.,OF CHECK License'Number Lic. Class SIZE STORIES FAMILIES ONE VALUATION Contractor Date tL,c7. S ( � DESCRIPTION OF WORK cao� NEW -7c) I ADD ❑ D ❑I am exempt Seca' U S "'IOYI h t` e ❑ ALTER B.&P.C. for'this,reason $ "L `REPAIR ❑ Date:' USE OF ❑ EXISTING BLDG. DEMOL APPLICANT TEL. APP Signature" --- � (PRINT) '- FINAL , NO. . OWNER-BUILDER.DECLARATION DATE I hereby affirm that I am exempt from the Contractors License Law for the.following redson (Section 7031.5, Business and q ADDRESS IN W ssions,Code): "' PRESENT ; -By FINAL BUILDING I; as owner.of the' property; or my employees with "' a•gDDRESS 'T" wages a -their sole compensation,will'do the work and '' L' the structure is not intended or offered for sale(Section' LOCALITY. /�''I"(/rte art .15 ( nlv9�. 7044, Business and Professions Code:) °MOVING TEL. t(/� ITEMS ❑ 1, as owner of the property;am exclusively contracting CONTRACTORNO. with-licensed contractors to construct the'project.(Sec- ADDRESS T3'1NL ' 4°®6 ' tion 7044, Business and Professions Code:) �{ u -, REQUIRED' YARD HWY TOTAL SETBACK FROM EXIST: CHECK 7 063 CONSTRUCTION LENDING AGENCY. SET BACK PROP.;LINE WIDTH " I hereby affirm that there is a construction lending agency for ,FRONT HANG ,[II the performance of the work for whichthis'permit is,issued P.L. (Sec: 3097, Civ. C.). _ SIDE. P:L.' Lender's Name. 0011-10-0...001 , 9/.10/92 o �• D O LDMA Ref # 6 1 q P.G. Fee$•. Permit Fee o/ O O 42AM `ireLf' 3 Lender's Address `r o I certify,:that I have read this application and state that the Issuance Fee 7c LDMA P/C# above information is correct.)agree to comply with all County Investigation Fee _ 0 ordinances and State laws relating to building construction, Total Fee O. LDMA Perm. # a and hereby authorize representatives of this County to enter up the above=m �►gentionned property for inspection-purposes. v� Y., Q� e Q g SEE.REVERSE FOR EXPLANATORY.LANGUAGE Signature of Appliic'aarFt�or-Agent bate