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Home My Public Portal About4928 KAUFFMAN AVE_Building__ APPLICATION 1�}�.. fps g/��, PERMIT }�.qr,E R til 0 T . 76A 638A CE#803 8-63 /-1��V��®! V FOR®� ��Y�®��VI 11. COUNTY OF LOS ANGELES ADDRESS 4% j3� DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY /-�/l�1 E C— 1 Q JOHN A. LAMBIE,.COUN.TY ENGINEER NEAREST J 4 WILLIAM A. JENSEN, SUP•T'OF BUILDING :CROSS ST. 11 ' DISTRICT-NO. GROUP TYPE" 2R.00ESS ED BY FOR APPLICANTTO FILL IN �� CONST. ✓ ort -��' ADDRESS �i� j�/ K ,i1/� �Awy(L,/q� STATISTICAL C�A�SSI FICATION SEWER MAP ADDRESS ��(( ��) '\/Tl.� �'qi,'/Y `_�J1/�i _ .• ' . :.pK 77 PG .CLASS. NO. DWELL. UNITS— LOT LOT NO. !o BLOCK WATER G /yam CERTIFICATE: NOT REQUIRED �' RECEIVED ❑ TRACT {✓�V MAP HIGHWAY i f NO. OF BLDGS. NO. zU 1,6 (CIRCLE) STATE MAJOR SECOND. LOCAL SIZE OF LOTl� 7Q NOW ON.LOT USE ZONE SPECIAL - USE OFC �cM.�n CONDITIONS ' EXISTING L.G.B �? TEL. ' OWNER kJQ�-� NO. T)DI BUILDING - EXIST. AODRES ' (`�. ��p �E-,`/f/jj-A SFPROINTK ZQ�YARD HW STREET NA NR' `^"nT� —ENGINEER OR�J J .: I C/ ' `QYO NO :SIDE l.Ll`' ADDRESS . 9/;d/ CONTRACTORCAL P F P00-5, NEL. ADDRESS4086-6- DESCRIPTION 8 6DESCRIPTION OF WORKv Lu N W ADD ALTER REPAIR. DEMOLISH SO. FT. 'NO. OF NO. OF SIZE STORIES. FAMILIES s USE OF STRUCTURE. S i� 'o/_ - J�SIGNATURE OF APPLICANT VALUATION $ L' 'APPROVALS - JDATE INSPECTORS SI GNA�T,U RE P.C. 7 7S PMT. �-* �-GlQ FOUNDATION: LOCATION 7//? FEE $ 3 FEE $ �'7 �� FORMS, MATERIALS, FRAME: 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. WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS'VENT. DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY'1 WILL NOT EMPLOY ANY PERSONA-VLA- LATH. INT. TION OF THE LABOR CODE OF THE STATE OF CALIFOAT- INGTO WORKMEN'S CO PENSATIONINS 'RANG .-.LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- PERM ITTEERECT OR PERMITTEERECT AND POSTED ADDRESS FINAL g"2c>-6 4 JOHN F. LEWIS.-PRINCIPAL STRUC URALENGINEER PLAN CHECK VALIDATION CK. M O CASH PERMIT VALIDATION M.O. GASH_ -- O S'.2 9� JUL 6 1 0 1 5.0 0'- N per,per. }� �a p� ' * . �p /� jI� A7 �,e 79A999A CE 809.9-60 APPLICATION LIGATION F®n1` ��L�®®�V l �Q\j00u p COUNTY bF LOS ANGELES BUILDING j ADDRESS I. DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCA 1 JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM.A. JENSEN SUPT OF BUILDING CROSS'S ° DISTRICT IV P TYPE P CESSED BY FOR APPLICANT TO FILL IN t D U �I .. �I CONST: LQJ. 5 LDING /J p 'J ,�/ STATISTICAL.CLASSIFICATION SEWER MAP ' a ADDRESS 71�o?'O �S A4'f'y�/r1A�11 'BK CLASS NO.—&- DWE"LL:UNITS, ® I. (• LOT NO. V. BLOCK MAP NUMBER D - H ATE YES—HWY. ES NO TRACT "IL.�4.-� O USE ZONE NO.OF BLDGS. CONDI - ' . ONDITIONS ' SIZE OF LOT. „f�a, x /710- I NOW ON LOT USE OF - .4- / .. .. EXISTING BLDG. BUILDING EXIST. YARD HWY STREETN:4ME. TEL. SETBACK WIDTH OWNER ( 1�a 7-4 71/- NO./r FRONT P. ADDRESS ARCHITECT SID I - ARCHITECT OR - TEL. P.Cr '•• - ENGINEER - NO. INSPECTION RECORD ADDRESS CLTEL' • UO CONTRACTOR lJ -�1,� 1 NO. .. f, �, �/ f ✓.r -z " l ADDRESS" - - - I O DESCRIPTION OF WORK Lu H . NEW AD ALTER REPAIR. DEMOLISH Z SQ. FT. NO.OF .. NO.OF SIZE STORIES FAMILIES Uie USE OF , '. . STRUCTURE - �. - AAdf, � SIGNATURE OF APPLICAN VALUATION$ I - �:.��,�-, _ APPROVALS DATE INSPECTOR'S SIGNATURE P _ ! PMT. :C. FOUNDATION: LOCATION FEE $A I. I FEE $ r FORMS, MATERIALS. I -FRAME: FIRE.STOPS, / ••.I HEREBY ACKNOWLEDGE THAT I HAVE.READ THIS APPLICATION BRACING, BOLTS /. } J%'fin( ^� j�.,r..1 1-1/, 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. EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBU ECT TO THE WORKMEN'S COMPEN ATION LAWS OF CALIFORNIA. ' AAs— LATH„EXT. / SIGNATURE.OF HOUSE NUMBER COR- PERMITTEE_ --PERMITTE ”- � RECT AND POSTED tL ADDRESS i!�/�_42 '' FINAL CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL EpWrREEft PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 76A63A CE.lt803 10�.56 A I qA T I O N R SU I LD .N G/ ;-P�E R-MI r .. BUILDING AND SAFETY DIVISIONBUILDING 4 " Department of County Engineer ADDRESS " County of Los Angeles LOCALITY. 'JOHN A. LAMBIE, COUNTY ENGINEER NEAREST CASSAT,T D.GRIFFIN, SUPT OF BUILDING CROSS ST. DISTRiGTN _ GROUPI I YPE SEWER'- MAP FOR APPLICANT TO FILL IN., T '�/ B _ CONST.S�` ' BUILDING. - ADDRESS "' �/ N 4r G. j�f7 /•Cl STATISTICAL C SSIFICAT16N. LOT'NO. ® ' BLOCK CLASS. NO. DWELL."UNITS` I` MAP NUMBER:-P-01TATE4 SHWY YES O .,TRACT /'J O..O - USE ZONE SPECIAL - i NO, OF BLOGS.- DITIONS - SIZE'OF-LOT =� /'!G (! :I.NOW-ON LOT EXISTING BLDG. k /X, ?(�-/ " .j_'' " ',/• ;•"�� B I- _ EXIST. YARD' HWY STREET-NAME I `- SETBACK � -. WIDTH OWNER Ll �cif FRONT nO/ " P. L. oC MAIL - -50 .AD DRESS - /C. _ SIDE _ CITY ARCHITECT ORTEL. INSPECTION RECORD . ,. `' � ENGINEER - NO. ADDRESS TEL . CONTRACTOR /y'Y.� / NO. ADDRESS C� ..�,i.�T .' �� - •:1 / T,cp DESCRIPTION OF WORK NEW .ADD ALTER REPAIR- DEMOLISH - - SQ. FT. - NO.OF NO.OF SIZE G-` -STORIES. FAMILIES USE OF STRUGT Y E APPROVALS- .. SIGNATURE OF �- APPLICAN- - DATE INSPECTOR-S,SI'GNAT URE v ADDRESS - - FOUNDATION: LOCATION _ _ FORMS.'MATERIALS _ _ - P.1c. 3 FRAME: FIRE STOPS. ii FEE BRACING. BOLTS `�1 .:) ' VALUATION n / $ FURNACE: LOCATION,- - ., GAS VENT. DUCTS /- f 1 HEREBY ACKNOWLEDGE THAT i HAVE READ THIS AP- LATH. INT: PLICATION AND STATE THAT THE ABOVE IS CORRECT AND _ - AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH, EXT. STATE' LAWS'RECD LA 1'NG BUILQlVG CONSTRUCTION. _ SIGNATURE OF _ i" - HOUSE NUMBER COR- PERM ITTE" OR-PERMITTEE �� '' v ^ RECT AND POSTED ADDRESS FINAL JOHN A.LAM' IE, COUNTY ENGINEER, .,CLYDE N. DIRLA_ P INCI AL•STRUCTURAL f N PLAN. CHECK VALIDATION CK. M.O. CASH PERMIT-VALIDATION -.cK. m:0. cash _- A3.5-:9 4.U- -GCT-2 WORKERS'COMPENSATION DECLARATION " - hereby 'af � • � .. �� n .actif6toWrkrsCminlsura �� m � �DM�--insureore -&F1 � (ON -F0 or a certified copy thereof�(Sec. 3800, Lab. C.) e , moo- il� 106-1 COUNTY OF LOS ANGELES. BUILDING AND SAFETY PDolicyNo. .Company• l-raiz. . . Certified copy is herebyfurnished. FOR APPLICANT-JO FILLIN BUILDING ADDRESS Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS: LOCALITY J NEAREST .11 Dote1` I ' 7�� Applicant.Attii_'f—A L pri:"Yh L& - CITY ZIP CROSS ST.' -CERTIFICATE OF EXEMPTION FROM WORKERS' NO:OF BLDGS. ASSESSOR COMPENSATION.INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK - PAGE` PARCEL (This section need,not be.completed.if-the permit is for one USE ZONE. MAP hundred dollars ($100)or less')' TRACT': BLOCK 10T NO NO.. TEL. SPECIAL. ('certify that in,ihe performance of the work,for-which this OWNER A NO'` c.O , / CONDITIONS IL permit is issued, I shall not employ any person in any manner DISTRICT,.' GROUP TYPE FIRE PRESSED BY O so as to become subject to the.Workers'Compensation Laws. ADDRESS CONST.' ZO E ,v9. ' �. Date `5� Applicant. � ' '�� CITY e ' ZIP STATISTICAL CLASSIFICATION APT.- CONDO. NOTICE TO APPLICANT: If,, after making this`Certificate of ARCHITECT6R',- TEL. r CL Exemption, you.should-become subject to the 'Workers'' ENGINEER NO. CLASS NO DWELL. UNITS Compensation provisions of the Labor Code, you'must forth- ADDRESSSEWER MAP H with comply with such provisions or this permit shall be deemed revoked. CONTRACTOR � Q L.. i C7�10. r BK PG, VALIDATION LICENSED CONTRACTORS DECLARATION ' LIC, 1 hereby affirm'that I am licensed,under provisions of Chapter 9 ADDRESS - NO. I S60S6 LVALUATION (commencing with Section 7000)of Division 3 of.the Business and LIC. Professions Code, and my license is in,full.force.and effect. CITY C g-u�;�• CLASS. C" O D SQ. FT. NO. OF NO OF CHECK License Number 111$G45L� 'Lic:.Class g 1' SIZE STORIES FAMILIES ONE Contractor��[Xiflf cL 1. Cas[v�r/ Date j-- 'rh-Y DESCRIPTION OF WORK :• 1, NEW Q ADD El am exempt under'Sec. i' ALTER FINAL B.&P.C.for this reason y REPAIR DATE r' USE OF FINAL • t}` Date: EXISTING BLDG. DEMOL By e Signature APPLICANT ,TEL. OWNER-BUILDER DECLARATION PRINT ti NO. t-10z i0 I hereby affirm that I am exempt from the Contractor's License D 2-2 4:8 A Law for the following [eason (Section 7031,5, Business and ADDRESS Vra1 . Professions.Code):' PRESENT #ie c'c o"o BUILDING I; as owne? of.the property, 'or•my employees with ADDRESS ; wages cis their sole compensation,will do the work and i o o /( Q 5 .�. the structure isnot.intended or offered.for'sale(Section LOCALITY . .7044, Business and Professions Code)." MOVING TEL. 0 0 0.4 0, 5 0 Cm ❑ CONTRACTOR NO. 1, as owner of the.property, am exclusively contracting' r With licensed contractors to construct the project (Sec- ADDRESS 0i5,2,5-�8 3 'tion 7044, Business and Professions Code). • I REQUIREDTOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY. SET BACK YARD HWY PROP. LINE WIDTH 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 FD P.L. v Lender's Name - $ Lender's Address P.C. Fee$ PermiYFee I certify that I have read this application and state that the Issuance Fee c T K above information is correct. I agree to comply with,all County Investigation Fee g ordinances and State laws.relating to building construction, Total Fee c u and hereby authorize representatives of this County to enter upon the above-mentioned property.for inspection purposes. < SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or.Agent Date ®s