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Home My Public Portal About4846 KAUFFMAN AVE_Building__ DEPARTMENT OF COUNTY ENGWEER DIVISION OF BUILDING ARID SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER APPLICATION CASSATT D. GRIFFIN, SUP'T OF BUILDING FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING G �J DISTRICT NO. PLAN CK.OR REC..No. PERMIT NO., ADDRESS �ir` Qi S �/X 7��/ � LOCALITY '� �' • a RECE ED Y DAE OF AP DATE ISSUED w NEAREST - 7 2Z CROSS ST. - / OWNER CA ^j''� MAIL �•— �Y LOCALITY /� ADDRESS S7 - ✓V� • j� /y , TEL. f c� /y NEAREST (1�1 �� CITY (.��x-� .-✓"Y. NO.h'T/"�Z�-b / y CROSS ST. i..� O� ARCHITECT OR TEL. FIRE NO. OF' TYPE GROUP ENGINEER NO. ZONE PLANS 2_ I a 9L.� ADDRESS SETBACK LINE TEL ,� q USE APPROVED !� CONTRACTOR T / i NO. I��•-2s t! USE HY DATE ADDRESS.h D / C HOUSE NUMBERING LEGALI / / I MAP NUMBER NO. ASSIGNED BY ° DESCRIPTION^ � LLO�T,NO. (o �9BLOCK CORRECTIONS TRACT. ILi�^'�- S-3 44A. -.B 5� I NO. OF SLOGS. N SIZE OF LOT OW ON LOT _ USE OF I NO. OF n ffS„ EXISTING BLDG. FAMILIES DESCRIPTION OF WORK � a � 2� O NEW ° ALTERATION ADDITION - A O `\. REPAIR. I DEMOLITION .I I ' � ' "'-'-�" D \ SO. FT. ) NO. OF SIZE ROOMS STORIES EXT. WALL �J ROOF COVERING/�" E, I COVERING .,. USE OF i(3�ai+�'�P•w� / / /, � ,.......� a CDU a APPROVAJ:S r INSPECTQJVS SIGNATURE DATE FOUNDATION: LOCATION -- MS, �9 FORMS, MATERIALS ,.+!''�" I HEREBY ACKNOWLEDGE THAT'1 HAVE READ THIS AP-' FRAME: FIRESTOPS, �gg PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING. BOLTS COR AGREE TO COMPLY WITH ALL COUNTY ORDINANCES J FURNACE: LOCATION. {//J AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT,'DUCTS /rYl r ^ SIGNATURE OF ,/ LATH. INT. �? PERMITTEEQ -� cQ��y-, LATH. EXT, > � ADDRESS S :� b C •, PLASTER, INT, r'? AUTHORIZED AGT. ° $ � H USE NUM ER COR- ' •-'� . FEE RECT AND POSTED AATION FEE $2� FINAL 76A68" coo S' 8-88 • _ COUNTY OF LOS ANGELES BUILDING AND SAFETY iq/ � WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BLIILD ESS BUILDING ADDRESS 1 hereby affirm that I have a certificate of consent to self insure, 46P �--AUEFMAiJ AkrG or a certificate of Workers'Compensation Insurance,.or a certified CITY ZIP copy thereof(Sec.3800,Lab.C.) Policy No. Company ec ( L15- G C LOCALITY SIZE OF LOT /_ NO.OF BLDGS.NOW ON LOT ❑ Certified.copy is hereby furnished. & I NEAREST.CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. ASSESSOR MAP BOOK PAGE PARCEL v� Date Applicant SPECIAL CONDITIONS OWNER TEL.NO. CERTIFICATE OF EXEMPTION FROM WORKERS' W —t-4 t— ($—ZS"13 -7 WITHIN 1000 FT.OF SCHOOL? YES NO COMPENSATION INSURANCE ADDRESS (This section need not be completed if the permit is for one hundred C,p M r-- /4"S 4 d317 VE DISTRICT GROUP TYPE CONST.' FIRE ZONE PROCESSED BY dollars($100)or less.) CITY ZIP / 1 certify that in the performance of the work for which this'permit h/ is Issued, I shall not employ any.person in any manner so as to ARCHITECT OR ENGINEER TEL.NO. «c79f become subject to the Workers'Compensation Laws. S Ar C.S pG It A — � � STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS .-�• CLASS NO.�DWELL UNITS NOTICE TO APPLICANT., If, after making this Certificate of ( -L �N S `• W CO VI NA CAM REQUIRED TOTAL SETBACK FROM EXIST Exemption, ) CONTRACTOR TEL.NO. you Should become subject ,t0 the Workers' � SETBACK YARD HWY PROP LINE WIDTH Compensation provisions'of the,Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemedrevoked. ADDRESSLIC.NO. PL LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS PIL C I hereby affirm that I am licensed under provisions of Chapter 9 SEWER P Professions,Code,and my license is in full force and effect: (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF TORES NO.O FAMILIES ° NEW ❑ BK PG D C) License Number LIC.Class - DESCRIPTION OF WORK ADD VALUATION yVj Contractor Date ALTER ❑ _C4 �hsLiM�L.GIt-tkA REPAIR .11❑ I am exempt under Sec. $' B.BP.C.for this reason �l.t �( f �GDEMOL ❑ USE OF EXISTING BLDG. LDMA P/C# Date: S �' URM. ❑ Signature APPLICANT(PRINT). TEL.NO. LDMA Perm# j 0l, as owner of the property, or my employees with wages as p ADDRESS �'�'�•' " their sole compensation, will do the work and the structure is .,,;,)_r` amu•. not intended or offered for sale (Section 7044, Business and (7 (fZAU ( ,e CI FINAL DATE PTOfeS310rIS Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL' OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN ,t�,x• ❑ 1, as owner of the property; am exclusively contracting with THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY S'kJ 1 AL q m L-' licensed Contractors to construct the project.(Section 7044, YES❑ NO❑ Business and Professions Code.) �•%y` ; i:); �S I WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROMTHESOUTH - .t va: al.l� CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST '•..H(•iNL- FOR GUIDELINES. - I hereby affirm that there is a construction lending agency for YES ElNO El the performance Of the work for which this permit IS Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD - �' {`� E: 1—i t!if 4 i 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES '" L7?��li• - •�•'-• --• ' m. COUNTY CODE,TITLE 2.CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING ;�' r � Lender's Name .HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. •;;, '} 4 i i 1')a±rj ICLLender's Address OWNER ORAGENT o' 1 certify that I have read this application and state that the above T F R FEE PERMIT EE P.C. - $ information is correct. I agree to comply with all county N ordinances and State laws relating to building construction,and a. hereby authorize representatives of this County to enter upon ISSUANCE FEE thq abov mentioned proppyty for inspection purposes. Q INVESTIGATION FEE TOTAL FEE Sip,xture M Appic m ApartoV Dab • SEE REVERSE FOR EXPLANATORY LANGUAGE . QpG° UC/AU H FOR BDOLDHD PERMN' COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION' FOR APPLICANT TO FILL IN BUILDING ADDRESS BUILDING ADRESS CCGtL Ave 'I hereby affirm that I have a certificate of consent to self insure, ' or a certificate of Workers'Compensation Insurance,or a certified man Ave copy thereof(Sec.3800,Lab.C.) CI �j i gatJ Z'h4— ct I-� LOCALITY / Policy NO. Company SIZE OF T NO.OF BLDGS.NOW ON LOT Te 4, e ElCertified copy is hereby furnished. : d �/j NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. ' USE ZONE MAP NO. Date Applicant ASSESSOR AP BOO 2 PAGE PARCEL S _O 1 — E7 7+ /A I SPECIAL CONDITIONS OWN R TEL.NO. ,` YES NO CERTIFICATE OF EXEMPTION FROM WORKERS'. COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL? ADDRESS i (This section need not'be completed if the permit is for one hundred. q�O I)t?i DISTRICT GROUP TYPE CONST,' FIRE ZONE PROCESSED BY dollars($100)or less.) CIN ZIP ®Q / certify that in the performance of the.work for which this permit d Y is issued, I shall not employ any person in any manner so as'to AR HITECT ORE GINEER TEL.NO. become subject to the Workers'Compensation Laws. _ s0" _ I As ,�; ��2 STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT: If, after makingthis'Certificate of �" �AVI K0. REQUIRED TOTAL SETBACK FROM EXIST C ACTOR TEL.NO. Exemption, you ShOUId become Subject t0 the Workers' SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith e� FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS ` �� LIC.No:. PL LICENSED CONTRACTORS DECLARATION CITYLIC.CLASS PIIL g I hereby affirm that I am licensed under provisions of Chapter 9 SEWER P (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STZRESNO.OF FAMILIES Professions Code,and my license is in full force and effect. "[b.v NEW ❑ BK PG O. License Number Lic.Class DESCRIPTION OF WORK. ADD ❑ VALUATION D Ivu c i' D Contractor Date ,L v ALTER/Lo Gitte N•21;>i �7 y�C�` L� 0A S4 REPAIR .❑ ❑ I am exempt under Sec. B.BP.C.for this reason Aoi,-5e e,I-ca�& Ale i.0 DEMOL ❑ LDMA P/C# Date: USE OF EXISTING BLDG.MAV C�- s+Act f PI"� Iri' RM. ❑ � Signature AP LICANT(PRINT TEL. 0. LDMA Perm# �I, as owner of the property, or my employees with wages as C s ,their sole compensation,will do the work and the structure is ADDRESS . . n.1 _. not intended or offered for sale (Section 7044, Business and CGS AMS G �"d FINAL DATE � a�+M! Professions Code.) 3 ��-J/ a T-r ; WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZAR SMATERIAL J .i.jt, ❑ I, 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? FINAL BY licensed contractors to construct the project.(Section 7044, VES❑ NO❑ 1 i a I F I L280 J Business and Professions Code.) �•• _ WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING t..-I!r S:f''. - OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST a� FOR GUIDELINES. CHANCE I hereby affirm that there is a construction lending agency for YES❑ No❑ the performance Of the work for which this permit is Issued(Sec. 1 HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD _ 'I- 3097,CIV.C.J. PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES + COUNTY CODE,TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING L'4 Ei is Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. p q bl EI43s~ t-M!1,,CL `# t Lender's Address OWNER OR AGMT o° I certify that I have read this application and state that the above information IS Correct. I agree to comply with all county PA.FEE PERMIT FEE �� ordinances and State laws relating to building construction,and a. hereby authorize representatives of this County to enter upon ISSUANCE FEE /� the ab ve a Toned prop y for inspection purposes. 0 �' INVESTIGATION FEE TOTAL FEE �� GJfj sgnewre w MWr m o.Awm - oaro SEE REVERSE FOR EXPLANATORY LANGUAGE,