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HomeMy Public PortalAbout6262 IVAR AVE_Building__ y 809 10-68 APPLICATION FOIA BUELDI:NC�_,.PER1�fi.11".. :.. 76A69BA CE N COUNTY OF LOS ANGELES` BUILDING- DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A.LAMBIE;_COUNTY ENGINEER NEAREST _ ..CASSATT,D.GRIFFIN,SUPT OF BUILDING - CROSS ST. - DISTRIC-LNLO. GR TYPE r PR CESSED BY FOR'APPLICANT TO-.FILL IN ' �j I coNsr ' I BUILDING .. :I,`"$EWER MAP - ADDRESS STATISTICAL CLASSIFICATION BK PG LOTNO.\%-{�a ._ BLOCK CLASS.NO: DWE : UNITS- . MAP •rSTATE _ YES NO - NUMBER -� .HWY... TRACT - USE ZONE SPECIAL- NO; PECIAL NO:OF BLDGS. „��77 CONDITIONS - SIZE OF LOT I NOW ON LOT ` v//[[\��,�lr_ USE OF EXISTING BLDG.. BUILDING. olEXIST., ” - YARD HWY % STREET NAME SETBACK N .WIDTH_ OWNER / - FRONT,. MAIL: (© P.L. ADDRESS SIDE Tg P:L., . CITY 2. INSPECTION,;RECORD, ,:r • NO. ARCHITECT O - - TEL. ENGINEER NO.: •7"�ri. 0 �/!d�- � u.-�.: chi ry:�'"Y`F�� f� ADDRESS ��qqrr�� C0 NT RA CTO RW' 6S)%01 L//�� j .NO `ADDRESS' " - DESCR TI N OI=:W O S. .NEW .ADD .ALTER REPAIR. DEMOLISH SQ_FT. NO.OF �NO.OF SIZE - .STORIES - FAMIt1ESUSE OF STRUCTURE •. .. - - _. - SIGNATURE O l � - 'APPROVALS APPLICANT - _ DATE',t INSPECTOR'S SIGNATURE. ADDRESS FOUNDATION; LOCATION -. - - FORMS;MATERIALS $ P.C. $ - FRAME: FIRE STOPS..` - FEE BRACING.BOLTS''- VALUATION _FURNACE: LOCATION, - FEEGAS VENT. DUCTS. I HEREBY ACKNOWLEDGE THAT'-1 HAVE READ THIS AP- LATH,INT. - PLICATION AND STATE THAT THE ABOVE IS CORRECT AND - AGREE TO COMPLY WI - L CO ORDINANCES AND -STATE, LAWS REGU I ING CONSTRUCTION_ LATH, EXT. SIGNATURE-OF -" _ HOUSE NUMBER COR- ;•'� _ _ PERMIT EF - - RECTANDPOSTED ' ADDRESS / FINAL - CLYDE N.'DIRLAMA-RINCIPAL.STRRAL-ENGINEER. PLAN CHECK VALIDATION CK. M.O. CASH PERMIT-VALIDATION cK. m.O. cA..,`_' ,j WORKERS'COMPENSATION DECLARATION f'c I ?neteby affirm that 6 have ocertificate of consent'to selfG3Gv� ' u i Dp p O . insure, or a certificate of Workers' Compensation Insurance, . p p d C���� '�� ] O d®Dl C� or a certified copy thereof (Sec. 3800, Lab. C.) • COUNTY-OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ' a Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING Certified copy is filed with the county building inspec- BUILDING ADDRESS tion department. ADDRESS2 ax— 1�! Date Applicant CITY ZIP I 1 F LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' l+7 7 f_ < 10 NO.OF.BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT / NOW ON LOT CROSS ST. (This section need not be completed if the permit is for.one ASSESSOR hundred dollars ($100)or less.) - TRACT BLOCK LOT NO. MAR BOOK PAGE, PARCEL yy 1 TEL. USE' ONE MAP OWNER QYhL&j 'IVC'SOY NO.• I certify that'in the performance of the work for which this NO. permit is issued, I shall not employ any person in ony,manner ft''•� -� - SPECIAL, i so as to become subject'to the Workers' ,.ompensation Laws. ADDRE"SS� LJZ�Z 1 ar7• Q (' CONDITIONS 0 Date //" Applicant, CITY 1 ZIP `v-Uo NOTICE TO APPLICANT:.If,'after making this Certificate of ENGINARCHIECT.OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O Exemption, you should become subject to .the :Workers' ENGINEER NO. CONST. / ZONE V Compensation provisions of the Labor Code, you must,forth- Ji v� Q'�• v �'J W with comply with. such provisions or this permit shall be ADDRESS - r, a deemed revoked. ! TEL. STATISTICAL CLASSIFICATION APT. ONM U) CONTRACTOR F NO. z LICENSED CONTRACTORS DECLARATION / LIC; CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP Professions Code,,and my license is in full force and effect. CITY CLASS / Qf " SQ. FT. i NO.OF NO. OF � CHECK BK./ PG. / Gtr VALIDATION. License Number Lic.Class SIZE �'. STORIES f FAMILIES ONE -VALUATION Contractor Contractor Date DESCRIPTION OF WORK NEW ' a ADD O $, I am exempt under Sec. ALTER B.BP.C. for this reason ` REPAIR $ Date: USE OF EXISTING BLDG. DEMOL Signature APPLICANT TEL. FINAL. OWNER-BUILDER DECLARATION (PRINT) NO. DATE-= — �:8 7 b 5.A• I hereby affirm that I am exempt from the Contractor's License Law for the following reason,(Section 7031.5, Business and ADDRESS FI # 0 0 0 0 0;1 Professions Code): PRESENTT BUILDING 1 a o 6 0.'5 0 I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and e o o 60,506 the structure is not intended or offered for sale(Secionion LOCALITY /�/i 7044, Business and Professions Code). MOVING TEL. D v ®�j 0 1,'1 3.'`8 8 DI,_as owner of the property, am exclusively contract CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS' tion 7044,Business and Professions Code). v OM CONSTRUCTION LENDING AGENCY SETT BACK YARD -HWY TOTAPROP.SETBALCNEFR WIDTH INST hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this'Permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L Lender's Name LDMA Ref. # m P.C. Fee$ Permit Fee Lender's Address J / 1 certify that.I have read this application and state that the Issuance Fee / t S ✓ �LZ.P/C# D above information is correct. I agree to comply with all County Investigation Fee 1 9. ordinances and State laws relating to building construction, Total Fee 4 1 LDMA Perm. # $ and ereby autho ' e representatives of this County to enter up the above- a do d property for inspection purposes. ,l m SEE REVERSE FOR EXPLANATORY LANGUAGE -rn� oZ f 7�. Signature of Applicant or Agent Date ��r?�pSe.Jr�LKfi I • 3` 1 . I I '� J✓ , W:fi,,ml f(unve­r) OMPENSATION DECLARATIONat M nn insure, ora certificate of Worke sriCompen Compificate of ensation eInsura Int to nsurance, hot I U V �Ll V 11 o'rea certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. _Company - Certified copy is hereby furnished: FOR APPLICANT TO FILL IN BUILDING ADDRESS EJ Certified copy is filed with'the county building inspec- BUILDING tion department. ADDRESS 6 z6 / V J�( �l�//z— 71 Date - Applicant CITY 2T`✓j24 (/� '7-Y ZIP I , LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BiDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT 76 X /00 NOW ON LOT ® CROSS ST. (This section.need not be completed if.the permit is for one 5 Cj ASSESSOR hundred dollars ($100)or less.) - TRACT BLOCK LOT NO. J Q MAP BOOK PAGE PARCEL " TEL. USE NE � MAP - OWNER rJr c �csoKN0. '? 797 I•certify that in the performance of the work' for which this NO. permit is issued, (shall not employ any person in any monne SPECIAL so as to become subject to the Wor rs' omp nsation Laws. ADDRESS ��� K/O'�C/�siil� CONDITIONS 0 CITY nt it 01 et ZIP !'UO C7 V Date r" Applicant 0' ARCHITECT OR TEL. NOTICE TO APPLICANT: If,.after making ENGINEER NO this Certificate of DISTRICT GROUP TYPE FIRE P ESSED BY 0 . U Exemption, you should become subject to the Workers' NE ONST. Z10 Compensation provisions of the Labor Code, you must forth- ADDRESS SIA" 9-1.7 L+1 with comply with such provisions or this permit shall be 0} deemed revoked. TEL. STATISTICAL CLASSIFI TION APT. CONDO. to CONTRACTOR O (CIG T- NO. 7 LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS' I hereby affirm that,l am-licensed under provisions of Chapter 9 ADDRESS 51fM E OS '�t3 CSV 11!5 NO. ii I - (commencing with Section 7000)of Division 3 of the Business and LIC. SEWETPG- P Professions Code, and my license is in full force and'effect. CITY CLASS BK X. VALIDAT16N SQ. FT.) pp No. OF / NO. OF [ CHECK U License Number Lic.Class' SIZE / 773. STORIES ( FAMILIES (. ONE' :VAffi DESG PTION OF WORK S/Af GCC- ( [;s, NEW Contractor Date ADD I am exe11 mpt under Sec, ^I e?-C 1 yhlze L! ALTER " D a , B.BP.C. for this reason • Z� REPAIR $ - Date: USE OF EXISTING BLDG. DEMOL Q Signotureg APPLICANT TEL: FINAL OWNER-BUILDER DECLARATION PRINT N1'�Z(C r^-4-5•U%f NO. ;/ 7 I7 DATE L 2 9,0 9,:9 A' I hereby affirm that I am exempt from the Contractor's License Law for the,following'reason (Section 7031.5, Business and, ADDRESS o xiimv/W izC69b! FIWAL.,✓� ( '4 } # o.o 0 o to ProfessionrCode): PRESENT BYNG I, as owner of the property, or my employees with' ADDR SS �'ZC z _V tT i n J 0 6 2.1.57, wages as their sole compensation,will do the work and I + x the structure-is not intended or offered for sale(Section LOCALITY 71 1 3 °,° 6 2'1 5 7 c� 7044 Business and Professions Code). TEL. VING M - "' '. . o = � •. 0303-88'. I, CONTRACTOR NO. as owner of the'property, am exclusively contractingth licensed contractors to construct the project (Sec- CONSTRUCTION ADDRESS tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY REQUIRED ' YARD HWY TOTAL SETBACK SET BACK PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of,the work for which'this permit is issued P.L. (Sec..3097, Civ. C.). SIDE P.L. Lender's Name ny / LDMA•Ref. # m P.C. Fee$ Permit Fee o 3 Lender's Addrt3ss 0 7 4 it 7 5 1 certify that I have read this application and state that the Issuance Fee LDMA P/C# g above information is correct. I agree to comply with all County Investigation Fee ordinances and State.laws relating to building construction, g a a 7 4 1,7 5 c=� 4 9 9 Total Fee LDMA Perm. # N and hereby authorize representati es of this County to enter ° 8 8� <m upon the above-mentione op r y for inspection purposes. �• -a .i `. 0 (c. cl — SEE REVERSE FOR EXPLANATORY LANGUAGE t SivActure of APPITc7fit or gent Date -o WOkKERS'COMPENSATION DECLARATION M • •1�herey_. to iNureboradfcerti4:atte of Workers' Compensat on of'coent Insuran elf or d'certified'copy thereof (Sec. 3800, Lob: C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING �. Certified copy is hereby furnished. ,v' -FOR APPLICANT TO FILL IN ADDRESS 6..ZG�/'9`- Certified copy is filed.with'thecounty building inspec. BUILDING / tion department. ADDRESS,��t`2.W G/oot - LOCALITY v NEAREST Date -Applicant CITY �i ZIP CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS'. NO. OF BiDGS. ASSESSOR f COMPENSATION INSURANCE SIZE OF, NOW ON LOT. MAP BOOK HGE PARCEL (This section need not be'completed rf the permit is for one -- USE ON MAP hundred dollars ($1.00)or less.) TRACT BLOCK LOT NO NO. TELy '. SPECIAL. I certify that.in the performance of;{h'e work for which this OWNER- IPA'f i Q �i*I N O CONDITIONS`` d permit-is issued, l shall not employ any person in any manner �� DIS RI GROUP. TYPE FIRE PROCE ED BY O so as To subject to ihe,Workers'.Compensation,Laws, ADDRESS .Z. "�-f� '� CONST. ZONEad V Date Applicant/1 �Le�^�' LA CITY ZIP ' STATIST ICALCLASSIFICATION APT. CO O. u NOTICE JO,APPLICANT:. If, after' making this Certificate of ARCHITECT O 7EL. Exemption,. you should become .subject to the, Workers' ENGINEER NO:' CLASS NO. DWELL._UNITS C Compensation provisions of"the Labor Code you'must forth- ADDRESS - SEWER MAP' with:comply-with such provisions or this permit shall'be' TEL. Z deemed revoked. CONTRACTOR �_? NO. ^ BK, PG; VALIDATION- CONTRACTOR CONTRACTORS DECLARATION` LIC. I hereby affirm that I am licensed under provisions of Chapter9' ADDRESS NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. '1 Professions Code,•and.rhy license.is'in full_,force and effect. CITY CLASS , •. ,-. ., . ': SQ.:ET. , NO.'OF NO'OF - .CHECK ._ ... License Number` Lic:Class SIZE STORIES FAMILIES ` ONE DESCRIPTION OF WORK Contractor 'Date NEW O $ �_ ADD - lam DD Iam exempt underSec• ALTER FINAL 4 2'814 A B.&P C for this reason REPAIR I o 0 0 DATE Dgte: USE OF � FINAL , # ° EXISTING BLDG: DEMOL ry, ( 0 Signature' APPLICANT y TEL. BY / I .°.° 2 El 5 0 . . OWNER-BUILDER DECLARATION (PRINT) NO:. I hereby affirm that I am exempt from the Contractors License 9'_e 0 2 a 5 0 Law for the following reason-(Section 7031.5, Business and ADDRESS _ D Professions Code): PRESENT BUILDING 0909 85 •. . 1; as owner of the property, or-my.employees with ADDRESS wages as their sole compensation,will do the work and the structure isnot intended or offered for sale(Section L[CALITY i M4.4_Business and Professions Code). .MOVING TEL El as.owner.of'the'property,am exclusively contracting CONTRACTOR NO. with`licensed•.contractors to construct the project (Sec ADDRESS 'tion'7044, Business and Code)._ REQUIREDTOTAL SETBACK FROM. EXIST. CONSTRUCTION LENDING'AGENCYSET BACK YARD HWY PROP. LINE WIDTH hereby affirm that there"is a construction lending'dge' for" FRONT D � `—'' #�N the performance of the work for'wh'ich'this permit is issued P:L.. iSec. 3097, Civ. C.)._ SIDE., _ Q Lender's Name ' - P:C. Fee$ .Permit fee L ,• - - __., Lender's Address - - I certif that I have read this,q application and state that the y PP Issuance Fee above information is correct. I agree to comply with,all County Investigation Fee g ordinances and State laws,relating to building construction, Total Fee - 24 u '.and hereby authorize representatives of this County to enter SO m .upon thea ve-ment'oned roperty for inspection purposes: - aEF „. v-' ^ SEE REVERS OR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date