HomeMy Public PortalAbout5014 KAUFFMAN AVE_Building__ FOR �;PPLICAN o PLIFILL ICATIOf�lN (Print or type onFOR BUILDING. PE MIT
UILDING 9-/� pp CO Y OF LOSGELES
ADtSRESS (1/'2 _ � �A� DEPARTMENT OF CO TY ENGINEER
BUILDING AND SAFETY DIVISION
CITY '�-�'�9 �10 .j/I ZIP -
x NO.OF BLDGS. BUILDING l
SIZE OF LOT - - NOW ON LOT / ADDRESSQ 5 jam) 1sr/t
TRACT 3Z' BLOCK LOT NO. / / LOCALITY
TEL. NEAREST
OWNER NO. CROSS ST.
ASSESSOR - -
ADDRESS C�/J /�.. CJ .7//(.� MAP BOOK PAGE PARCEL
f � DISTRICT GROUP TYPE FIREPROC ED BY
ZIP CON
CITY S ZONE
ARCHITECT OR TEL.`
ENGINEER NO.
_ STATISTICAL CLASSIFICATION. EWER MAP
'ADDRESS 9 ��,��,aa CLASS NO�_DWELL,'UNITS:��4 BK G
.CONTRACT /W�D�► 1?f ��� NOL y J'[(/1�Rj{ U ZONE MAP e/
ADDRESS � P L�� NO c1 1J7/� SPECIAL -
NO. �� CONDITIONS
CITYLIC
!7,, 1 CLASS
ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑
CONSTRUCTION LENDER�� j / S
' NAME AND BRANCH `� -Q p"' B DG.SETBACK FROM
n A ONT PROP.LINE OF '(STREET) '
a
AY } YARD
ADDRESS CITY /� - TOTAL SETBACK FROM TYPE OF EXISTING ON H GHWCJ
' SQ. FT. NO. OF NO. OF CHECK _ FRONT PROP. LINE HIGHWAY WIDTH
SIZE STORIES - FAMILIES ONE
❑ } _ O
DES'CRI PTION OF WORK e,ego&/� y?(,�l',�L NEW U
BLDG.SETBACKFROM STREET) tail
zq'la— c/D yPP/Jij.S ADD ❑ ,SIDE PROP. LINE OF z
` /Q(Ue§__ /VUiL.+`e.l. ALTER TOTAL SETBACK FRO YPE OF EXISTING
HIGHWAY } YARD
//� REPAIR❑ � SIDE PROP. LINE HI WAY WIDTH
USE OT }
NG BLDG. ��'�(�/�t _, DEMOL
EXISTING
APPLICANT
�4/ A b�fJ/PJ TEL
-- _CORNER CUTOFF Y „N
.ES ❑, - O
(PRINT) ❑
BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑
IN COASTAL ZONE YES ❑` NO ❑
VALUATION CATEGORICAL EXEMPTION YES❑ NO ❑
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL
AND STATE THAT THE ABOVE IS CORRECT AND'.AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE).
W ITH .ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN. DOING THE WO AUTHORIZED ` IMPACT REPO PROCESSED (DATE)
HEREBY I WILL NOT EMPLOY ANY PE SON IN VI ATION OF T E _ -
LABOR CODE OF THE STATE OF L.IOIOR IAA N R IN
WORKMEN'S COMP _TIO SU CE. r �'
SIGNATURE F �CA
PERMITTE �
ADDRESS / CgCGt//,�GJ'Li
FINAL BY
TE
CITY NO. rECl $
PMT.
1_ � OO
d.F .IE fhS P:�)'A(�L�' 7'O: FEE � r
HARVEY T. BRANDT. COUNTY ENGINEER
PLAN -CHECK VALIDATION CK. M.O. CASH a PERMIT V IDATION CK. M.O. CASH
76 A638A CE#803 12/72. .1 ' 6 9-13. 0 1 � 9.0 O
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76A638A CE*803 e_63 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY `
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST w /
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROUP TYPE CESSED BY
FOR APPLICANT TO FILL IN CONST.
BUILD'NG ` STATISTICAL CLASSIFICATION EWER AP'
ADDRESS SG `�, ` U \ M BK L G
CLASS. NO. DWELL. UNITS (fJ
LOT NO. BLOCK WATER
'CERTIFICATE: NOT REQUIRED I RECEIVED ❑
TRACT NOP, ({CGRC LE) STATE MAJOR SECOND, —AL I
NO. OF BLDGS.
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF n CONDITIONS
EXISTING BLDG. Gb C,b''
1 TEL.
OWNER y ^\oy(, NOAT' 472-6 BUIL ING EXIST.
YARD HWY TREET N 'ME
SE'iBACK SWIDTH
ADDRESS FRONT I A
ARCHITECT OR TEL. P. L. �•
ENGINEER NO. SIDE
P. L,•.
ADDRESS
TEL. I.` I�IMA' .i//blI•— �/' 1A"4/ "'r� Q
CONTRACTOR yy e4L, U NO. ttt-Q, 71 1
ADDRESS Z.�I LTJAS�'�c71 v� -
o '
DESCRIPTION OF WORK 13
j2 -q.6t' a
NEW ADD ALTER REPAIR DEMOLISH H
SQ. FT. NO. OF NO-OF z
SIZE STORIES FAMILIES n
USE O
STRUCTURE 3 ' 2 Ira.
s-- z
SIGNATURE OF -
APPLICANT I ZU-
VALUATION $ 32
9' APPROVALS l7 PATE INSPECTOR'S SIGN6TURE
O' FOUNDATION: LOCATION'/,,
FEE $ FEE $ FORMS, MATERIALSyl'T
FRAME: FIRE STOPS. O- � M1-
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS 1 �1 _/_
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 1
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON I VIOLA- LATH. INT. ✓'!�
TION OF THE LABOR CODE OF THE STATE OF CAL IFOR % RELAT- ,
ING TO WORKMEN'S COM ENS ON SUR NCE.
LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND.POSTED
ADDRESS FINAL �Uh
JOHN F. LEWIS: PRINCIPAL ST RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK. . M.o: CASH
Uto 4 9 0 1-0 OCT 1 5 1 D 1 8.5.0
APPLICATION FOR BUILDING PERMIT '
FOR APPLICANT TO FILL IN (Print or type only)
BUILDING *. - COUNTY OF LOS ANGELES '
ADDRESS 6 J DEPARTMENT OF COUNTY ENGINEER -
CITY IP j BUILDING AND SAF TY DIVISION
NO. F BLDGS. BUILDING
0.0 `rQ/
SIZE OF LOT to NOW ON LOT ADDRESS
TRACT BLOCK LOT NO, LOCALITY
TEL NEAREST
OWNER _ NO. OC CROSS ST.
-. ASSESSOR
ADDRESS MAP BOOK PAGE RCEL
DISTRICT GROUP TYPE. FIRE PROC SPED BY
CITY ZIP
1 V CON T. ZON
ARCH ECT OA TEL:
ENGINEER NO.
STATISTICAL CLASSIFICATION EWER AP
ADDRESS _ CLASS NO�_OWELL•UNITS C B � PG
TEL. U ZONE MAP -
CONTRACTOR
NO
-
LIC. NO.
ADDRESS NO. _ I SPECIAL '
LIC. ( CONDITIONS
CITY -yvv CLASS - -
CONSTRUCTION LENDER FADDEPARTMENT APPROVA REQUIRED YES❑' NO❑
NAME AND BRANCH, BLDG.SETBACK FROM °a
FRONT PROP.LINE OF f (STREET) C
ADDRESS CITY.
HIGHWAY } - YARD = TOTAL BACK FROM TYPE OF EXISTING oz
.SQ. FT. NO.-OF NO. OF CHECK _ FRONTPROP. LINE HIGHWAY WIDTH C
SIZE STORIES FAMILIES -ONE -
LL
DESCRIPTION OF WORK NEW }
ADD ❑ BLDG,SETBACK FROM (STREET) z
SIDE PROP..LINE OF
-�- n �c ALTER ❑ HIGHWAY } YARD - TOTAL SETBACK FROM TYPE OF EXISTING
- HIGHWAY WIDTH
REPAIR❑ SIDE PROP. LINE
USE OF DEMOL ❑ }
EXISTING BLDG.
APPLICANT k TEL CORNER CUTOFF YES ❑ NO ❑
(PRINT) GJV0 N0. 472
BY (SIGNATURE) N OPEN SPACE YES ❑ NO ❑
IN COASTAL ZONE YES ❑ NO ❑
VALUATONY Q0�(/ 4' - •� " CATEGORICAL EXEMPTION YES❑ NO ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL
AND STATE THAT THE ABOVE-.ISCORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE)
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE)
HEREBY TWILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE -
LABOR CODE OF THE STAT OF CALIFORNIA.IN RELATING TO
WORKMEN'S CO MPE NSAT N UR C .
SIGNATURE OF
PERMITTEE
ADDRESS O d
FINAL BY -
TEL. ATE —/�i / Y
CITY NO.
ABLE TO: FEE FEE
HARVEY T. SRANDT. COUNTY ENGINEER
AfA Kh I ECKS PA Y
.PLAN CHECK VALIDATION CK. M.O. CASH o PERMIT VALIDATION. CK. M.o. CnsH
9- 43NJUL 10 1 D A 1 2.0 0 t-
76A638A CE#803 7/73 /t