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Home My Public Portal About4900 KAUFFMAN AVE_Building__ {{�� AP II��/IIIA I'II Q/�, jam(\�5I'p IIII1 If}��[ ]��' I��yq INI-��1pp pQp\� 78AB98A CE}809.9-60 AY L' 1lmLVLI� II L®N�, tl VLL9 tl..+'VLL®tlE V tl IfsY 11V11� LL COUNTY OF LOS ANGELES BUILDING ADDRESS O d /ei�U� R/� ' DEPARTMENT OF COUNTY ENGINEER 7 BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST ,,,, Q �i WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. DISTRICT!�O. GROUP, -HYPE _ PRO ED BY FOR APPLICANT TO FILL IN �, ) Q GROUP] CONST BUILDING t O]p viQ _ ) STATISTICAL CLASSIFICATION I SEWER MAP ADDRESS BK PG CLASS. NO. Iff DWELL. UNITS LOT NO. `r' BLOCK MAP STATE YE N 7`, NUMBE '9 HWY. TRACT SJ� � USE ZONE SPECIAL NO OF SIZE OF LOT J� 6` /(27 KNOW ON LOTS J / CONDITIONS USE OF EXISTING BLDG. //WLIi�G �'!.y!'L�' - BUILDING EXIST. TEL. /�� SETBACK YARD HWY STREET NAME WIDTH OWNER +fid, .yG�g�.�'rNO. A �� FRONT ADDRESS �4®D L�i44ydo p,4N SIDE ARCHITECT OR TEL. P.L. ENGINEER NO. j ! - 'INSPLECTION/RECORD ,. // >, p 4 ADDRESS ? �(3� ',.�.II *`�. ✓r G+fAr:J �`,�^4F O Q� TEL. (h. �G- .=v" �,'i,�-r)(. C'/lsJ f ...�°".,�� CONTRACTOR` ��AI�F_�Co NO i� .i J U ADDRESS O DESCRIPTION OF WORK w n. NEW ADD x ALTER REPAIR DEMOLISH h SQ.FT. �// NO.OF NO.OF SIZE �7'�'00 STORIES /.USE OF FAMILIES —STRUCTURE - SIGNATURE OF APPLICANT VALUATION$ APPROVALS• ''DATE a INSP CTOR'S SIGNATURE FEE $ - FEE '$ �` FOUNDATION: LOCATION FORMS,MATERIALS a>,� M _ - FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS. �N '4` 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 THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I SHALL NOT LATH, INT. -.._.- f 7� y �✓ ' EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBU ECT - _ _ TO THE WORKMEN'S COMPENSATION LAWS OF CALIFORNIA. LATH,EXT. SIGNATURE OF�/I ! HOUSE NUMBER COR- PERMITTE ' ' c J RECT AND POSTED ADDRESS FINAL 'x�(r'* CLYDE N. DIRLAM, PRINCIPAL STR RAL ENGINEER 'PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH ��j DMPPARTb= 9F..:C9DNTY BUIEtSAFETY MM MD TSION OF LDIRTG ARID SAF COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER APPLICATIONCASSATT D. GRIFFIN, SUPT OF BUILDING, .. , FOR APPLICANT TO FILL IN DISTRICT OFFICE USE ONLY DISTRICT NO. PLAN CK.OR Rec.No. PERMIT NO. BUILDING / /Y2 �o a ADDRESS e>6 LOCALITY .�� .0�F J T RECEI, ED BY DATE OF APPL. DATE ISSUED NEAREST R. G>S ✓ CROSS ST --ADDBUILD[RESS G ®� �� OWNER MAIL // �� m ADDRESS ADDRESS .�!p _ f , �y,,,� LOCALITY �m '_ ' NEAREST �/=?= / TEL. CROSS ST. ,+ CITY ..LCGGi✓ E0. �73�� . ARCHITECT OR TEL. FIRE NO. OF TYPE GROUP ENGINEER NO. ZONE PLANS ADDRESS BLDG. �� / ORD. NO. SETBACK LINE TEL. USE CONTRACTOR NO, ZONE/";IBYPROVED DATE `�� ADDRESS - •� HOUS/ErNUMBERING LEGAL MAP NUMBER a-en NO. ASSIGNED BY DEBCRIPTION >LOOT NO.- B CK � �y-h`�•� 3,�. CORRECTIONSTRACT ]"-' v- - ' O X l� I NOW.ON LOTNO. OF S,� D V / SIZE OF LOT �( ` USE OF . NO. OF EXISTING BLDG. rl.�s `b ��i FAMILIeB - DESCRIPTION OF WORK i �,g o — o. � REP IR' I-I DEMOLITION I-I ADDITION I- ® ST4GG+0D Z r SO: FT. NO:OF• /' SIZE .1-3d ROOMS STORIES EXT. WALL ROOF COVERING STt/C e o I COVERINGS'-, PS I USEO RUCTU V161-0 7 v yeJ APPROVALS _ INSPE OR'S SIGNATURE DATE FOUNDATION: LOCATION ��o� FORMS, MATERIALS 7 I HEREBY ACKNOWLEDGE THAT -1 HAVE READ THIS AP- FRAME: FIRE STOPS, PLICATION AND STATE THAT THE INFORMATION GIVEN,IS BRACING, BOLTS CORA REE TO COMPLY WITH ALL COUNTY.-ORDINANCES FURNACE: LOCATION, j r`� „f�-- $ AND STATE LAWS R GULATING UILDING CONS IO GAS PENT, DUCTS SIGNATURE OF,- _ LATH. INT. PERMITTE / ATH. EXT. �P / ADDRESS • PLASTER, INT, AUTHORIZED AGT. PLASTER, EXT. C1 �' FEE / HOUSE NUMBER COR- RECT AND POSTED n VALUATION Cr FEE S FINAL 76ASS" Dass 9-88 1 ]� • .. :. ga.. " WORKERS; COMPENSATION DECLARATION C I hereby affirm..that have a certificate'of consent to self Q Q insure, or a certificate'of Workers' Compensotion'Insurance, . LI O, O '�L�s''a�, r_ .;�', EELIVLl LJ or`a certified'copy thereof (Sed. 3800, Lab :C.) COUNTY OF. LOS ANGELES BUILDING AND SAFETY !: ` Pdl icy No Company „ FOR APPLICANT FILL IN BUILDING C . .Certified copy js hereby furnished. ADDRESS' . J�' Llr /G.dn� Certified copy is filed with the county building'inspec:.' G i` AV" " ADDRESS D�. i4tq�YvyLAd . .tion department. CITY 2Jtwt�ko �'. L ZIP LOCALITY - Dote -Applicant, :. :_ NO..OF BLDGS.-. CERTIFICATCOF.EXEMPTION FROM WORKERS SIZE OF LOT NOW ON t07 NEAREST CROSS ST. . COMPENSATION INSURANCE ASSESSOR :.(This''section need not be completed•if:the permit is for one TRACT BLOCK, LOT NO. MAP BOOK PAGE PARCEL- t certify that in the erfr less / hundred dollars ($100) o ) (9 TEL. Y/ ON/NER' -}— (� 7��- NO: a�S7S��1 y. p ormance 5 P of the,work for which this "' SPENCIAL a permif,is issued,I shall noYemploy any person fn anymanner - ADDRESS Q. {f =d/l/�� AvJL'�'` 'l so as to become subject to the-Workers'Compensation Laws. - O Q( p CITY �iW�� C :"ZIP I�70 CODITIONS Date Applicant '• ARCHITECT OR TEL. `. ENGINEER NO. DISTRICT .'GROUP` TYPE FIRE PROCESSED-BY P Y making-this Certrficate,of ZONE � NOTICE`TO APPLICANT: Jf after, bject= to the Workers �///; V Compensation provisions-of the Labor Code, you must forth- ADDRESS V ��, C J ;. ONS •°, LU with comply wiih•,sud, provisions„or,;ihis permit-shall be `' TEL. STATISTICAL CLASSIFICATION..T� ,.APT. CONDO CONTRACTOR `� - NO. ,'.-,. I Z deemed revoked.', .- .., _. � —. LICENSED.CONTRACTORS:DECLARATION' LIC. CLASS NO. DWELL.,UNITS )'hereby affirm that l am licensed underprovisio'nsof ChopterA ADDRESS NO. _ (con rnencing.with Section 7000)of Division 3 of the Business LIC. SEWER MAP' and Professions Code,and my license is in full force:and effect. CITY. CLASS BK PG VALIDATION SQ.'FT. N0. OF NO. OF CHECK ' License;Number Lic. Class STORIES FAMILIES "'ONE SIZE- ..:- a (, f f Contractor Date DESCRIPTION OF WORK NEW VALUATION ❑1 am exempt under Sec ei COQ , wQ S ADD D, o ALTER ElB.&P.C. for this reason �e�/ .. V El Date: USE,OF REPAIR EXISTING BLDG. DEMO L.❑ Signature '. APPLICANT `/, �i TEL.. FINAL' a OWNER-BUILDER DECLARATION :"` (PRINT) c:/,-1 .1 �G t'� 'tom NO. ��7 I " I hereby affirm`that 1 am exempt from;the Contractor's License DATE ] d f� Law-for"the'following reason.(Section '7031.5,:,Business and .- ADDRESS /T'� 1/�-+/ s FINAL -Professions Code) .. PRESENT gy t m �77 BUILDING LJ I,'ps owner of the'property,.or m employees with • -'' YADDRESS _. •_c wages as their-sole compensation,will do the work and the structure isnot°intended or„offered forsale'(Section LOCALITY 7044; Business•and Professions Code.) MOVING TEL — _it,.-� CONTRACTOR NO.- ❑ I,.as,owner;of the property,,am'exclusivelycontracting. with licensed contractors to construct.the project,(Sec- ADDRESS. tion 7044, Business and Professions Code.):. :: r. ;REQUIRED -TOTAL,SETBACK FROM- EXIST: CONSTRUCTION•LENDING AGENCY SET,.BACK YARD HWY 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.: �' ; ._ a (Sec. 3097, Civ:C.)•'. SIDE' Lender's Name. Q m OO Q LDMA Ref. # • .. - - P.C..Fee$ Permit Fee (f O - 3 Lender's Address' o I certify that I_'hdve read this application'and state that the Issuance Fee oc� � LDMA P/C# M1 above information is correct. I agree to comply with al Cougty Investigation fee ` 8 ordin ces and State laws relating to building construction, Total Fee ;{O :' LDMA Perm. # _ ^ a and re tlio z repre ntatives.of this County.to enter upon h ov - tione _ o ert or Inspection ur nes. ` a ^ /r 9 SEE REVERSE FOR EXPLANATORY LANGUAGE_ _ Siq°a e of-Applicant or Agent Date