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HomeMy Public PortalAbout4918 KAUFFMAN AVE_Building__ DEP MENT-'OF BUILDING AND SAF &I Y � q S Pf LICATION FOR PERMIT � 1" COUNTY OF LOS ANGELES 1 l��lJgbJ�I r WM. J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY fr DISTRICT /PLAN CK.NO. PERMIT NO. BUILDING ADDRESS 9?l3OMA ted 3 Z/Z,© LOCALITY RECEIVE BY DATE OOF�APPL. DATE ISSUED NEAREST CROBBST re ,�+ BUILDING OWNER ADDRESS MAIL i .(�_.. . REBS % LOCALITY AD NEAREST TEL. CROSS 8T. /��ri / �i✓����' CITY NO. FIRE NO.OF ARCHITECTOR TEL. ZONE PLANS TYPE GROUP ENGINEER NO. OLDS. ORDS.NO. ADDRESS SETBACK LINE APPROVED r TEL. ' ' BY DATE CONTRACTOR �_•� USE APPROVED ADDRESS V�GCJ' ZONE BY DATE LEGAL' (® CORRECTIONS DESCRIPTION LOT NO. BLOCK TRACT - NO.OF LDGS. SIZE OF LOT $ I NOW ONBL.le!ft .g USE OF INO.OF NO.OF EXISTING BLDG...e2gej FAMILIES O ROOMS DESCRIPTION OF WORK NEW ALTERATION ADDITION O A v REPAIR MOVING DEMOLISH L7 SO.FT. NO.OF Z SIZE ROOMS STORIES D r WALL ROOF COVERING I COVERING USE OF NEW ���jjj - - BUILDING P t i I•HEREBY ACKNOWLEDGE THAT I .HAVE READ THIS - APPROVALS .APPLICATION AND STATE THAT THE ABOVE IS.CORRECT - INSPECTOR DATE FOUNDATION: LOCATION ���' ♦�� AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE OF BRACING,BOLTS PERMITT LATH, INT. AUTHORIZ GT LATH, EXT. 76A639A-3 7-49 $ P.C.$ PLASTER, INT. FEE PLASTER,EXT. VALUATION FEE �.o"" FINAL �l��G, —/2 --P-0 DEPARTME14T OF BUILDING AICD .SAFETAPPLICATION FOR PERMIT �.f COUNTY OF LOS ANGELES YM� a WM. J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IW FOR OFFICE.USE ONLY BUILDING DISTRICT. PLAN CK.NO. r/- PERMIT NO. ADDRESS AC�"vI � yG�!c�_G' G.t�P. _ , ,Y+� , �l Q zo LOCALITY ( A - RECEIV/6 BY /yDC�ATE OF APPL. 111 �(DATE ISSUED NEAREST / / �,�,�°"Yo V'—/4 � ® CROSS ST. •� y i BUILD OWNER ADDRESS ;i MAIL ^I --• LOCALITY ADDRES r L NEAREST TEL. . - CROSS ST. CITY NO. '•t FIRE NO.OF TYPE GROUP ARCHITECTOR TEL. ZONE PLANS Z- -ENGINEER NO. _ BLDG, lj�� -/�ORD.NO. ADDRESS - ` SETBACK LINE 0 c- 95,95,4- C y APPROVED f / TEL. -� CONTRACTOR.,,:?�C}s� ' BY DATE USE APPROVED ADDRESS �l� .�6LtVi ,'� .,- ZONE df� BY DATE LEGAL I - �' CORRECTIONS DESCRIPTION LOOT NO. BLOCK TRACTNO.OF SIZE OF LOT ,I( �(pp I NOW ON LOOS._ 2 r - USE OF NO.OF NO.OAF h�,�,,- . EXISTING BLDG. I FAMILIE4� ROOMS - - - - - DESCRIPTION OF WORK NEW ALTERATION I ADDITION - - - DEMOLISH O REPAIR MOVING A L7 SQ.FT. p ,�J NO.OF - SIZEROOMS STORIES -/ Z _ D WALL ROOF ^may` } />� r COVERING �j ) - I COVERING USE OF NEW BUILDING , I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS'�CORRECT FOUNDATIONI: LOCATION INSPECTOR - DATE ' AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES _ FORMS,MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. 1(,�� FRAME: FIRE STOPS, SIGNATURE /L va BRACING,BOLTSPERMITTE _F' _^�„j� � LATH, INT.��/Jn.. ✓ice AUTHORIZED AGT FLAT:H:, :EXT. '76A638A s-aa PLASTER,INT. DBS-3 5DM SETS $ P,C,$ e �9 FEE u PLASTER,EXT. VALUATIONFEE . FINAL 3 A D%VISION OF BUILW-AND SAFETY Department of County Engineer County of Los Angeles WM. J. FOX, COUNTY ENGINEER APPLICATION , � . , —y� FOR APPLICANT TO FILL IAV ADDRESSap�o0 L BUILDI ' ADDRESS l D y �..C�.�"Y�YtA.C7µ.� LOCALITY ✓� �" I NEAREST' LOCALITY 121111 1 .el— CROSS ST. - - DISTRICT NO. PLAN CK. OR Re0. No. PERMIT NO: NEAREST CROSS ST. OWNER . (tet. _ RECEIVEED BY DATE OF APPL. ?DA�TEE I"SSIJE`D[,, MAIL ADDRESS ! USE Z09E NO..OF TYPE 'GROUP FIRE ZONE "La— y � TEL. �} , U PLANS - CITY pLl�di{oDs : l��M � NO. � ARCHITECT OR TEL. ZONING DATED ENGINEER NO. APPROVED By- Yi n BUILDING ORD.NO. ADDRESS SETBACK LINE: ' n r /STEL. �Q.. /� �1 APPROVED - ' DATE, CONTRACTOR /l�l.l.{�if �I�vyVJTN0. wl G!1 3 / By, HOUSE NUMBERING ADDRESS LEGAL MAP NUMBER - NO. ASSIGNED BY DESCRIPTION LOT NO. I BLOCK. - - DATE CORRECTIONS I INSPECTOR c TRACT NO. OF BLDGS. _ SIZE OF LOT I NOW ON LOT 0, USE OF - - I .NO. OF I. _ - /9 !l �.. EXISTING BLDG. FAMILIES /�1�iC19 p a DESCRIPTION OF WORK .z NEW ALTERATION ADDITION ��� n F . REPAIR I I DEMOLITION I 41 As SQ. FT. �NO. OF T SIZE ROOMS STORIES. EXT. WALL - - ROOF I �� COVERING . I COVERING USE OF STRUCTURE `7Oki) ( 1fu APPROVALS INSPECTOR'S SIGNATURE DATE K FOUNDATION: LOCATION " _ FORMS, MATERIALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRE STOPS, PLICATION AND STATE THAT THE INFORMATION GIVEN IS CORRECT. BRACING, BOLTS I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE:LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS ' SIGNATURE OF � ,Q,-�. LATH, INT. PERMITTEE ADDRESS. /,�.,����pp1T..�L ..(�• ! p LATH:- EXT. AUTHORIZED AGT. 1 u !l3 N^ PLASTER, INT. PLASTER, EXT.- OQ FEE HOUSE NUMBER COR- y, RECT AND POSTED - VALUATION FEE p2 �O•, _ FINAL 76A638A DB89. 2-99.> - / ,..•,..• - - _ . . app�OC�Q�DO I FOR G �OL�©OHO PIERM� COUNTIY.On.i�bS ANGELES Ile BUILDING ARID SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDwG ADDRESS BUILDING ADDRESS p i` 491 S ka,,Vma VL Av-e. I hereby affirm that I have a certificate of consent to self insure, 4-t 19 ka uffma t� Ave. (� /� p 9 or a certificate of Workers'Compensatio Insurance,or a Certi' CITY ZIP —�'" Te I� e I�� `a l �+0 copy thereof(Sec.3800,Lab.C.) LOCALITY I I �►v� (� Cit � IZ�O -Temple Cit Policy No. - _�-6 ompany Sa SIZE OF LOT 1 I NO.OF BLDGS.NOW ON LOT NEAREST CROSS ST. ❑ Certified copy is hereby Wished. 54 x f b p �-T'�" TRACT. BLOCK p LOT NO. La. � 4 S0. x Lo vo e Y A 2 u s0. Certified copy is ' d with the county <ilding,inspection I LSO 8 O z l 1 8 USE ZONE FAP IN department. ✓O� 1 Date 1 �"�' Applicant ASSESSOR MAP BOOK (� PAGE O 1�j: PARCEL 0 1 n � _ -I. PECIAL CONDITIONS CE IFICATE OF EXEMP ION FROM WORKERS' OWNER e _I l a�ITIEL.NO NO o `� YES No COAAPENSATION INSURANCE le vi -Tai zth ixIA J 18- 0 S-6 3 O 6 WITHIN 1000 FT.OF SCHOOL? ADDRESS (This section need not be completed if the permit is for one hundred Sa 144 e DISTRICT -GROUP TYPE CONST' FIRE ZONE PROCESSED BY dollars($100)or less.) CITY zIP I certify that in the performance of the work for which this permit j D 3 ✓ 3 is issued,.I shall not employ any person in any manner so as to ARCHITECT OR ENGINEERTEL.NO. become subject to the Workers'Compensation Laws. STATISTICAL ICL�AjSSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. d / DWELL UNITS' - NOTICE TO'APPLICANT: If,.after making this Certificate of REQUIRED TOTAL SEr99CKFR6M EXIST ` Exemption,:'you-should be68,IT1e subject to the Workers' CONTRACTOR J� - �] EL. O.rp SETBACK YARD HWY- PROP1.ly€_ WIDTH , Compensation provisions of the:Labor.Code:you must forthwith V�Mall a I l Co V u a N 00,1-9 FRONT comply'with such.provisions'or this permit shall be deemed revoked. ADDRESS � LIC.No. P IL .' a oaf V e Blvd •, f3+(,2 Y3 o SIDE - "�•s:LICENSED CONTRACTORS DECLARATION CITY �f LIC.CLASS g PL Yp `1 here. affirm.that I an licensed under provisions of Chapter 9 I SEWER MAP SQ.FT.SIZ NO.OF STORESNO.OF FAMILIES _.; (commencing with.Section 7000)of Divi ' 1-13 of the Business and r O NEW ❑ BK PG ' i o Professions Code,and my licerise is i II force and effect. I V•.: ,;:- _ Q DESCRIPTION OF WORK ADD VALUATION License Number` g Lic.Class V Contractor x,1'1• ' Date a" i1i ALTER ❑ $ z ❑ 'I am exempt under.Sec. �_T V Q (' REPAIR ❑ $ ���% DD BARC.for this reason DEMOL ❑ _ `Y` ' `� �- ?h USE OF EXISTING BLDG. LDMA PIC# C Date: URM. ❑ Signature APPLICANT(PRINT) V •- TEL.NO. LDMA Perm# •• a - A I-➢ L L Co S . I ►:I 1. - -00 z , ❑ I, as owner of the property, or my employees with wages as 'Y O their sole compensation,will do the work and the structure is ADDRESS it ' + F ' not intended or offered for sale Section 7044, Business,.and b L ISL✓ w ^NU f} $ FINAL DA 7,� Plofesslons Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL Ad I, as owner of theproperty, am exclusive) 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 B licensed contractors to construct the project.(Section 7044, YES❑ NO❑ Business and Professions Code.) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING 1 '4•• '` i - - T J _ I OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH '-` •. CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST dl- FOR GUIDELINES. I hereby affirm that there is a construction lending agency for YES El NO El the performance of the work for which this permit is issued(Sec. •. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES ado. COUNTY CODE,TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING o Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. a Lender's Address -n - Y -: i 7`: •�• OOWNER OR AGENT o 1 certify that I have read this application and state that the above : information is correct. I agree to comply with all County P.C.FEE PERMIT FEE ordinances and State laws relating to building construction,and r ' / �IFj a. hereby authorize representatives of this County to enter upon eG � ISSUANCE FEE 76 the above-mentioned property for inspection purposes. 0-0 a //jj 4i INVESTIGATION FEE TOTAL FEE Xn re of Applkant a Agent Date SEE REVERSE FOR EXPLANATORY LANGUAGE WORKERS COMPENSATION DECLARATION + 1 hereby affirm that I have a certificate of consent to self �(' ll M M LI UVIJC/►J :insure o0 certificate of Workers' Compensation Insurance, O LI V or a cerTifiUk thereof (Sec. 3800,'Lab. C.)-':' fj(��/ ` ,rCOUNTY•OF LOS ANGELES ; 3 BUILDING ARCD SAFETY Policy NatN�l&(ompany�JA .TLw[J Certified copy is hereby furnished. FOR APPLICANT TO FILL IN �' BUILDING= '•` i" ADDRESS Certified copy'is-filed withyhenty'building`inspec BUILDING tion department. ADDRESS, Date : Applicant' C CITY , ZIP y LOCALITY:;•.^ CERTIFICATE OF EXEMPTIO OM WORKERS'-- - 3n'x'� NO. OF BLDGS:- - NEAREST.,._... COMPENSATION I URANCE'• SIZE OF LOT NOW ON LOT Z CROSS ST. (This'section need not.be compll ed if the permit is for,one J��� - ASSESSOR' ' hundred dollars ($100)or less..) TRACT BLOCK LOT NO. i MAP'BOOK` PAGE, PARCEL TE I certify that in the perfo+ L _ USE ZONE MAP rmance of The work for which this OWNER / NO NO permit is issued,'l shall not employ any person in any manner` _ _ SPECIAL - - ` so as to become'sublect to the Workers'Compens6tion'Laws. ADDRESS ice:"+" CONDITIONS y t u Date - AP Iicant _ - CITY. ZIP __. ._ ., NOTICE TO APPLICANT:.If, 'after*making this Certificate of ARCHITECT OR / TEL. _DISTRICT, _G OUP TYPE FIRE PR CESSED BY •O Exemption, you should become subject' to 'ihe Workers'. ENGINEER �a+.. ' U`�t, NO. CONST. . ZONE Com ensation' rovisions of'the'LaboFCode;you*must forth- P P Y ADDRESS ` - - - �` V with'comply with'.such provisidns or this, permit shall be :- - ---- - TEL ) STATISTICAL'CLAS JC TION. APT. ONDO. deemed,revoked CONTRACTOR NO. — LICENSED CONTRACTORS DECLARATION - - LIC:-•- ----. - - CLASS NO. DWELL.-UNITS I hereby LICENSED that I am licensed under provisions of Chapter 9 ADDRESS ` NO. - SEWER AP (commencing;with Sectio 7000)of Division 3 of the Business.and _ ___ v„ . _... .__.._ _._.. LIG - 'VALIDATION Professions Code, and my 4license is in full force and effect. CITY CLASS BK :PG LID'ATION SQ_FT. NO. OF ___ NO, OF, . CHECK n. Licens?e . Lic.Classy '✓' SIZE STORIES�� FAMILIES ONE a :. VALUATIONDESCRIPTION'OF:WORK.. �' - NEW 0ContraDate El $❑ ADD Ier S TER B. eason - REPAIR�a $ '_ az U OF -. Date: _ � DEMOL Q EXISTING BLDG: . . .:_ f .- _- --- ;?'6 9 3.5 A' .- 'Signature' _. . 'FINAL i APPLICANT. - TEL OWNER-BUILDER DECLARATION ,. PRINT) NO. bDAT ° _ y # o^o e o I•hereby offirm,that I•arri exempt.from the Contractor's License Law for.:the following reason:(Section 7031.5, Business and ADDRESS INA Pr6fLssions•Code): s _ _ ,. PRESENT L ` 1.� ° 33i£00 BUILDING O I, as owner of the property, or my employees with ADDRESS _ _� -11_, t o o�0 3'.7j;o o�s wages as them sole compensation,will do the work and . - the structure is not intended or offered for sale(Section LOCALITY a. Business and'-Professions-Code). MOVING TEL r D' - - j [� 2 9; FTI, as owner of the property, am exclusively contracting CONTRACTOR NO. 1 ! with licensed contractors to construct the'project (Sec- ADDRESS + tion 7044, Business and Professions Code). REQUIRED.- SETBACK FROM, X T. _. -CONSTRUCTION TENDING 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: _ �: (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name i 0 �� • - - P:C.-Fee.$. . . ..� ,PermitFee-­ der .. I .-LDMA Ref # I Lender's Address jj�']] D ' x (:certify that I.have_read.this,application and state than"the _ _ Issuance Fee r J (/' -LDMAP/C#i - t" _;. above information is correct. I agree to comply,with all County Investigation Fee - g ordinances and State laws relating to building construction, i and.hereby authorize representatives of this County to enter Total Fee t LDMA Perm. q ' u n a ave-mentioned property for inspection p rpos /�- 7i SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Ap ant or Agent D - __ w.� _ - _ , . __ _'Q D1 i APIFUC MON FOR.: BUL©NG (PERMff � COdkTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS BUILDI G ADDRESS 1 hereby affirm that I have a certificate of.consent to self insure, 9� or a certificate of Workers'Compensation Insurance,or a certified CI ZIP copy thereof(Sec.3800,Lab.C.) ��'z� 10 74po LOCALITY Policy No. Company SIZE OF LOT oF NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. _ NEAREST CROSS Sr. • OCK LOT No. ❑ Certified copy is filed with the county building inspection TRACT BL USE ZONE MAP NO. department. ' ASSESSOR MAP BOO PAGE PARCEL Date Applicant gr �/ �� �_/ SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER r TEL.NO. YES NO COMPENSATION INSURANCE9506, WITHIN 1000 FT OF SCHOOL? ADDRESS (This section need not be completed if the permit is for one hundred p X DISTRICT GROUP TYPE CONST.' FIRE ZONE PROCESSED BY dollars($100)or less.) CITYZIP certify that in the performance of the work for which this permit f O I �� �2�2 � is issued, I shall not employ any person in any manner so as to ARCHITECT ENGINEER TEL.NO. �!, become subject to the Workers'Compensation Laws. _ STATISTICA,L,��C��L))ASSI�SIFIGATION APT CONDO Date Applicant ADDRESS CLASS NO. D LL UNITS NOTICE TO APPLICANT. If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR TEL.NO. 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 deemed revoked. ADDRESS LIC.NO. P IL LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS SIDE a I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT SIZE NO.OF STORES NO.OF FAMILIES C 77 Professions Code,and my license is in full force and effect. NEW ❑ BK PG v DESCRIPTION OF WORKVALUATION D W License Number Lic.Class ADDI Try ❑ CO) Contractor Date ALTER ❑ $ Z ❑ I am exempt under Sec. REPAIR ❑ $ B.BP.C.for this reason DEMOL LDMA P/C# USE OF EXISTING BLDG. Date: URM. ❑ Signature APPLICANT(PRINT) TEL.NO. LDMA Perm k ❑ I, as owner of the property, or my employees with wages as .Q their sole compensation,will do the work and the structure is ADDRESS FINAL DATE _ ,_ w;i•+, not intended or offered for sale (Section 7044, Business and yA G Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL .,4 _S_ JZ_ j f�l, as owner of theproperty, am exclusive) 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, YES❑ NO❑ Business and Professions Code.) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING ^" —'+'`•^ OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH / e 'i i:-- »-- a �••^•- �a .t_� CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST i-:..;• 1_ FOR GUIDELINES. 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. 3097,CIV.C.. I HAVE READ THE.HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES 9. COUNTY CODE,TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING is Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. Lender's Address CL ER OR AGENT '' t.','- J :• W o' 1 certify that I have read this application and state that the above i. _ 1-;' $Q information is correct. I agree to Comply with all county P.C.FEE PERMIT FEE / ��� ' Xzi ordinances and State laws relating to building construction,and ¢�. hereby authorize representatives of this County to enter upon ISSUANCE FEE SJ 6 the above-mentioned property for.inspection purposes. INVESTIGATION FEE TOTAL FEE Innrm A(pM 0me/� �� SEE REVERSE FOR EXPLANATORY LANGUAGE