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Home My Public Portal About5000 KAUFFMAN AVE_Building__ 76A638A CE.#803 3-69 EMPL •.CIT APPLICATION-FOR BUILDING PE.R..MIT COUNTY OF LOS ANGELES. BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION I• ` JOHN,A. LAMBIE, COUNTY ENGINEER LOCALITY. COLEMAN W. JENKINS, SUP'T OF BUILDING NEAREST CROSS STC FOR APPLICANT TO FILL IN IS'TRI T NN0./{�� G U TYPE 0 PRO, _ ,(P,RINT-OR».T V•PE ONLY) ' `' !/ ' -:- •, a BUILDING _ STATIST-ICAL CLAS FICATIDN -r •SEWER.MAP ADDRESS 5000 - CLASS NO.'- DWELL.UNITS— BK" PG LOT NO. • BLOCK USE ZONE MAP•' - •- NO. ` TRACT SPEC:At NO: OF SLOGS. r' CONDITIONS SIZE OF LOT ^•- -•- 'NOW-ON LOT USE OF EXISTING BLDG.1.- rbbidimce BLDG. SETBACK FRONT- - TEL. TYPE OFONT PREO%PSTINGE SETBACK HIGHWAY '.YARD (STTRO AL), OWNER D$niA1' Bg,,-'dcW N0. ADDRESS 50000 Kauffman WAY WIDTH FROM C.L. - CITY Git ARCHITECT OR - - TEL. - BLDG.SETBACK"FRO -` STREET) ENGINEER - N0: SIDE PROP. LINE OF - _ TYPE OF EXISTING 'SETBACK' H IG -+ YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. � - TEL- � CONTRACTOR Rigid, Mfg:..--Company NO. .263.5181 i L - +. - - } ADDRESS P.-0. BOX 6782 NO. 159496 . LICCORNER CUTOFF YES ❑ NO: ❑ C CITY I'og• 22 G ASS .C-;39 SEE REVERSE SIDE FOR.SPECIAL APPROVALS CONSTRUCTION LENDER - - • F NAME AND BRANCH LL- ADDRESS _ LL SQ. FT.. NO. OF..._.- NO. OF.,.,, .. ❑ V SIZE .STORIES FAMILIES NEW. - STRUOCTURE R'eroof.' _ ADD - ._ _. .... - - .._._. ALTER REPAIR ® r SIGNATURE OFDE10L ❑ - A'PPLICANT f VALUATION $ '680000 APPROVALS ,. .DATE INSPECTOR'S SIGNATURE •P.C. PMT. FOUNDATION: LOCATION - FEE $ _ - FEE $ 12,00. FORMS.; MATERIALS' I HEREBY ACKNOWLEDGE THAT I-HAVE READ THIS APPLICATION FRAME: FIRE STOPS., - , BRACING BOLTS-.' AND STATE THAT.THE'ABOVE IS CORRECT .AND AGREE TO COMPLY FURNACE: LOCATION,? WITHALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC- -GAS VENT DUCTS TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE LATH, INT. . OF THE STATE OF CALIFORN}(�,Ih j2F Af#G go AOORKMEN'S COM- PENSATION INSURANCE. jjjj,,]],, ],(j 1` lj mp - • c� /gJJ]%Q ATH, EXT. SIGNATURE OF ` 11C•CC..av V HOUSE NUMBER'CORRECT PERMITTEE l AND POSTED �' 0 00CLS Ave ljo . ADDRESS FINAL JOHN. F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. - CASH - PERMIT VALIDATION' cK. M.O. CASH ' rfi 2 2-a 1 a 12.0 i DEPARTMENT OF BUILDING AND, SAFETY APPLICATION FOR PERMIT COURTTY''OF:LOS ANGELESWM.""J: 'FOX, CHIEF ENGINEER IL • I FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY,', , : PLANCK. NO. _ PERMIT NO BUILDIDISTRICT NO: : _ ADDRESS .ADDRESS '♦ I t - RECEIVED BY.: DATE OF,APPL. DATE ISSUED. LOCALITY NEAREST S. / • � � � sem : CROSS:ST..,C�.� 'il?+,i'l,,r��r y..`. �� BUILDING ' / - 'ADDRESS , Q O -A ti - 4 A.! - OWNER MAIL'. ^�.,. . A� //y/,�.,/,�. - LOCALITY _ /"9'� V't ADDRESS S -• /. ems../"TjL° _�i.-.?y✓- ,�,�`;.. - or NEAREST , �j .. ,.• �TEL�, ( _ �- CROSS ST.. f�i/�'/l ./-G OF- CITY. 1NO. /'j ®- FIRE NO.'OF• :I TYPE 4,4 I GROUP ARCHITECT,OR - '.TEL. ''ZONE ImPLANS /^ ENGINEER NO. BLDG. QRD. NO. _ - SETBACK LINE •<. O f„ _ ADDRESSa APPROVED - •' TEL. BY. .. DATE .. CONTRACTOR •' NO. USE APPROVED ' - 70NE-4, BY DATE ADDRESS' - : .HOUSE NUMBERING LEGAL, _ , DESCRIPTION ' LOT NO. [BLOCK NUMBER FIELD CHECK BY" TRACT .�,.3 - NO. ASSIGNED BY DATE NO. OF BLDGS. CORRECTIONS-. -- SIZE OF LOT , IG K NOW ON LOT ^ USE OF NO. EXISTING BLDG.-. I FAMI LIES DESCRIPTION OF WORE NEW I.'.�I ALTER I -..I ATION ADDITION ,. REPAIR DEMOLITION - -- - - - - --A SQ. FT. r .NO. OF SIZE ROOMS - STORIES - -Z EXT. WALLROOF - r COVERING I COVERING' USE OF`STRUCTURE AD APPROVALS - - INSPECTO 'S'SIGNATURE DATE I HEREBY ACKNOWLEDGE THAT t HAVE' READ THIS AP- FOUNDATION: LOCATION - PLICATION AND STATE THAT.THE INFORMATION GIVEN IS FORMS, MATERIALS 'Fr"Xl•'/L.+^�a2-Li? L,T Z'- CORRECT.. 'f 1 AGREE TO COMPLY WITH THE 'CORRECTIONS LISTED FRAME: FIRE STOPS, - HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS LAWS REGULATINGBUILDING CONSTRUCTION. - - .FURNACE: LOCATION, fr-- SIGNATURE OF s.. GAS VENT, DUCTS_ PERMITTEE - �s LATH, INT. ADDRESS e.d ':7 ..7A ,< �«L.'�aw. ,f•+ v_-,. t_ .. /��r^'' I - t- - LATH, EXT. AUTHORIZED AGT: - - - PLASTER, INT. - - - 7eAe3sA:•DBs$ .10-50*./s M/M/ _ P. C. $ _ . .. /1, �//V B FEE PLASTER, EXT. VALUATION - V FEE $ �f FINAL i DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES � � L�1, WM._ J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY /i DISTRICT NO. PLAN CK. NO. '/PERMIT NO. BUILDING ADDRESS �.®� s /f .+rr< ®� ' y�sG O._ ,✓/ ...*> C,•. • RECEIVED BY' DATE OF APPL. DATE ISSUED LOCALITY NEAREST CROSS ST. BUILDING ADDRESS .S�10 -00 /V ,AA .A /V ✓F - OWNERd MAIL' - •r. LOCALITY- ADDRESS OCALIT. /T7-LS/{ �i •�iy ADDRESS 9r. �H �®�/.•/'i�c!y,�a.. v/iti`:+-.�' NEAREST E= AA 1"1' TEL / CROSS 3T. ipLL,/` k CITYL''�rx�1-n�7'A �. NO. >ZS�izG FIRE NO-OF TYPE '( / GROUP ARCHITECT OR �. .TEL. ZONE r- I PLANS - ENGINEER NO, BLDG. O F/00 _ �,TU ORD. NO. SETBACK LINE / !"� 9�e ADDRESS APPROVED- _ TEL: BY DATE CONTRACTOR NO. - USE /J APPROVED - ZONE BY "DATE ADDRESS - HOUSE NUMBERING , , LEGAL - ..a0�6 DESCRIPTION LOT NO. - BLOCK MAP NUMBER �'' MELD CHECK BY TRACT !u �._ _ NO. .ASSIGNED BY �� DATE NO. OF.BLDGS. q CORRECTIONS , SIZE.OF LOT L I NOW ON LOT�,9"'YI • /� USE OF NO. OF �� A` G /I iQ Al x el"4/L/ EXISTING BLDG, I FAM ILIE9 _ ,DESCRIPTION OF WORE � � NEW I I ALTERATION I. I ADDITION ,'4A 9' REPAIR I ( DEMOLITION SQ. FT. ju NO. OF / /✓i+. �y '/G .�GP�n+._f/w.e G) SIZE j�d" ROOMS STORIES �/ Z D EXT. WALL ROOF - r COVERING „�G,i(�.r,�+ I COVERING /g USE OF STR CTUREJ �J ` cz APPROVALS - - INSPECTOR'S SIGNATURE DATE 1 HEREBY ACKNOWLEDGE THAT 1 HAVE.READ'.THIS AP- FOUNDATION: LOCATION / PLICATION.AND,STATE THAT THE INFORMATION -GIVEN IS FORMS, MATERIALS �A,,,,�,G � .s� CORRECT. . �. _. J I AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME:'FIRE STOPS,' HEREON AND WITH ALL COUNTY ORDINANCES AND STATE- BRACING, BOLTS y LAWS REGULATING BUILDING CONSTRUCTION. [")' t_ FURNACE: LOCATION, SIGNATURE OF /Q�j // �I�T� GAS VENT, DUCTS PERMITTE�wyy°0°"'�l�l 19N` LATH, INT. / _•J ADDRESS s LATH, EXT. GYN" i 1 L7GA688A- THORIZED AGT. DBGs 'i046 $ P. C. $ PLASTER, INT.FEE PLASTER, EXT. LUATION FEE $I� FINAL R i OF f r WORKERS'COMPENSATION DECLARATION insure,oraafirm-tha certi,ficatte of WorkersrtComtpe�sat on ensurancelf :- -� �� r�O•�z .. ;Og b U�.�D u V E�Lt • or a certified copy the (Sec, 3800; Lab C-)' OUNTY OF LOS ARIGELES,t. C BUILDING AND SAFETY Policy No. Company BUILDING ❑ 'Certified,copy.is'here6 furnished. :. ,FOR APPLICANT. To,FILL, I y. ADDRESS QoO Certified copy:is filed with the'county building'inspec - ET BUILDING: tion department. Date' Applicant- CITY �� ZIP LOCALITY } NO. OF.BLD S NEAREST, CERTIFICATE"OF EXEMPTION FROM WORKERS SIZE OF LOT NOW ON LOT CROSS S7, COMPENSATION INSURANCE r " ASSESSOR (This section n'eed'not be completed if.the permit'is',for one TRACTOT NO. MAP BOOK PAGE PARCEL F hundred dollars ($100).or less ).` TEL. w OWNER - NO. xv, USE ZONE MAP '. I-certifythat insthe performance'of the work for which''{his ISPECIAL permit is issued, I shall:not employ any person in.any.manner. ADDRESS ® CONDITIONS_ d so,as to become.subject,to the Workers.Compensation;Laws. O '. f CITY".. ! x Date& Applicant/ ARCHITECT.OR, P EL s Z I v ENGINEER',. NO 1.DISTRICT .GROUP TYPE FIRE yP CESSED BY NOTICE.TO'APPLICANT:' If,. after making_this-Cer ificate of ! CON ZONE' �' Exemption, you ,should'become•subject to the'. Workers' . /C�.ff/� w Compensation provisions,of.the Labor Code;you must•forth- ADDRESS '. C� G� r ' �" a with,comply.,vvith'such- provision's,or this permit,shall'be TEL: STATISTICAL CLASSIFICATION APT: CONDO deemed revoked. CONTRACTOR '' NO. Q �d _ Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO�_D'WELL UNITS I hereby affirm that I am licensed underprovisions:of Chapter9 ADDRESS 6 NO. QD• (commencing.with Section 7000)'of'Division 3.of the Business LIC• CITY CLASS' C SEW MAP.` and Professions_Code,and my license_is in full force and effect. gK ER PG. VALIDATION t -License Number 8o Lic.;Class RIDES AMILIES 'ONE' SQ:-FT NO. SIZE STORIES VALUATION Contractor fA ozY Date Z ' DESCRIPTION OF WORK NEV , . _ AD ❑' r$ •/'T`!� �►�'^-: I am exempt under:Sec. r 8 .. _ ALTER `: ..B.&P C. for,3his reason — a. SE OF ` REPAIR' Date: Z,r S EXISTING BLDG DEMOL ❑• Signature APPLICANT• TEL. FINAL p WNER- UILDER.DECLAR ON (PRINT)`.V' NO: ! W . I hereby affirm that 1 am exempYfrom the Contractors License DATE. �J P Law for'ihe.following reason:(Seetion 7031:5, Business and ADDRESS ' FINAL+ Professions Code): PRESENT : Ay.-r ACCT. ' BUILDING ❑ I, as owner of the property; or'-my will with ADDRESS 3303. ge a air Hyl wages as their sole compensation,wit do-the work and L 'the structure is not intended or.offered for sale(Section LOCALITY i ITEMS' 7044, Business and Professions'Code),_ MOVING M TEL. D.... CONTRACTOR,. ' NO. ' ❑ 1; as owner of the property,.am exclusively contracting TT L •with licensed'contractors to construct-the project-(Sec- ADDRESS : > ;+ tion 7044,_Business and:Professions Code.) CHECK 1 °yo4 REQUIRED TOTAL•SETBACK•FROM EXIST. CONSTRUCTION LENDING AGENCY,` SET BACK YARD HW PROP. LINE WIDTH. CHANGE I herebyaffirm;that there is a'construction lending agency for - FRONT the.'performance of,the work for which this permit is issued P.C.' (Sec: 3097, Civ. c.). SIDE 0000-0001: 6l12;� Lender906 's Name. ff ! LDMA Ref. # 1 0, 1 M 't=4,8 P C. Fee$ Permit Fee �� 3 Lender's'Address I certify that I have read this application'and'state that the Issuance Fee CDMA P/C# above information is correct.,I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total:Fee % LDMA Perm. #' a and hereby authorize;representatives of this Countyto enter aupon the above-mentioned'property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE' Signat of Applican rAgent Date a