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Home My Public Portal About5812 KAUFFMAN AVE_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION.FOR PERMIT COUNTY OF LOS ANGELES ,� ®' VNM. J. FOX, CHIEF ENGINEER - FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK. NO. PERMIT NO. BUILDING ADDRESS Ire ,' RECEIVEDwBY'. DATE /O/F APPL. DATE ISSUED LOCALITY •JQ 4 NEAREST ��u V /—• `�� — CROSS ST, ;�� iA'if ,14 v�j/ elo A=A BUILDINGti, ' ADDRESS OWNER L _14loolo1 I C to ✓O " MAIL I LOCALITY ADDRESS 3 1 IK 'G• i.! f/✓HG'''1 NEAREST CROSS ST. • 'TEL. CITY W,( �• NO. ,••J!�,' Z L7 FIRE NO. OFA I TYPE GROUP ter. ARCHITECT OR I TEL. ' ZONE PLANS ENGINEER NO. BLDG. , SETBOdACK LINE ADDRESS •• APPROVEDTEL. , BY DATE CONTRACTOR jSiC' .P p',-o' NO. USE APPROVED' ZONEy/� BY I, DATE ADDRESS HOUSE NUMBERING LEGAL DESCRIPTION LOT.NO. BLOCK MAP NUMBER �Q i—FIELD CHECK BY TRACT ' gj NO. ASSIGNED BY ATF NO. OF BLDGS. —- CORRECTIONS•- SIZE OF LOT S �( U I NOW ON LOT �_f USE OF NO. OF EXISTING BLDG, f G�L:.b C° -r/ , S�O I FAMILIES - DESCRIPT109 OF WORE NEW I I ALTERATION I I ADDITION 'I - Al . REPAIR I I DEMOLITION Sq, FT. --��// NO. OF •� •• S&E �� L/ROOMS ]� / STORIES/ D EXT. WALL ROOF ,/' r COVERING Sr(%GC o I COVERING (f -1 o O y USE �-��TR -0 RE El C--..f Q1-AP w* . // AC'A 1 APPROVALS ' ` INSPECTO,R'S SIGNATURE DATE 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FOUNDATION: LOCATION �,/2 CA PLITION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS J CORRECT. 1. AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS,, HEREON AND'WITH,,ALL COUNTY ORDINANCES AND STATE BRACING,'BOLTS LAWS REGULATING'BUILDIN CONSTR•CTION. FURNACE: LOCATION,• ' SIGNATURE OF /��, A i GAS VENT, DUCTS • PERMITTE ! /. LATH" INT.• ADDRESS / LATH, EXT. AUTHORIZE_D AGT. PLASTER, INT. 70A030A• D1983 10-80, P. C. $ , ®.• oD FEE PLASTER, EXT. VALUATION DOQ\ FEE $ FINAL /� w ,A O" - A - I,FDWRTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES S� 1- 1, WM. J. FOX, CHIEF. ENGINEER t APPLICATION.-.� ..-.,�• .-• __R • FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT-NO."-.r PLANCK. OR Rec'.ND_'• PERMIT'NO. BUILDING �'"�j /� f ` "et,: ADDRESS V C�/� !Il' / (AV7�f/'+'�r�C'7�GR.- i°. :G.Y,�,v+.e•'�' �.v� +► �. Q . . �.y-- // �,--'/ - »1g: `-'}`•`,; RECEIVED BY i `DATE OFJ 1A PL. DATE ISSU D LOCALITY NEAREST r� CROSS ST. / �i•J 71w eq �Y �x 4+ BUIL_DING" / �q00or ADDRESS' OWNER JCfCl� J`/�C1 �1 Jam/ J �n f '^.S �(/✓ ��V LOCALITYMAIL ADDRESS..r V' C� Ln�61 �' 1 NEAREST? n D , CROSSSY,,. CITY /-�d/�l/J/s" T�/ NOL(A/ FIRE I NO. OFTYPE ORO =ARCHI'TE-VT'OR„ TEO:LA t ZONE t PLANS _7P P; J ENGINEER e, 4;e-1 •�/4�QrJ N - V BLDG. / I . SETBACK,LINE NO 'ate r �- ADDRESS '• USE 1P APPROVEDTE CONTRACTOR ` h NO.4 '"' ZONE,` �- BY HOUSE NUMBERING DATE ADDREBS_�8�2 """mo i/'��'A'i'/ i ' L/ MAP NUMBER }NO. ASSIGNED BY LEGAL DESCRIPTION I LOT NO. BLOCK ^_ ' CORRECTIONS ' TRACT SIZE OF LOT�O X �b I NO. ON LOT OF BL - - NDW USE OF NO. OF EXISTINBLD O.:7��. �S P r �f7 FAM ILfE9 I ' DESCRIPTION OF WORK NEWSALTERATION ADDITION D REPAIR DEMOLITION - r Sq.FT. NO.OF n SIZE ROOMS STORIES '- - - EXT.WALL I ROOF - COVERING COVERING USE OF STRUCTURE en wn /�f k7 we J .INSPECTION FOR -� APPROVALS ' OCCUPAN_CYAS INSPECTORISSIGNATURE DATE FOUNDATION: LOCATION ' 'FORMS, MATERIALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- PLICATION PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRE STOPS, �_ CORRECT. - BRACING, BOLTS I ASREE TO COMPLY WITH ALL COUNTY ORDIN4ESFURNACE: LOCATION, AND STATE LAWS REGULATING'BUILDING CONSTRUGAS VENT, DUCTS SIGNATURE OF)�J- " ��, L'E�(rJ� LATH,•INT. . PERMITTEE LATH, EXT.ADDRESSER, INAUTHORIZED AGT. PLASTER, EXT. FEEHOUSE NUMBER COR-RECT AND POSTED VALUATIONFINAL FEE' 76A636A DBS 3 7-51 ! DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT 1 COUNTY OF LOS ANGELES ®® � ® I L ® I 'KEG . WM. J. FOX, CHIEF ENGINEER V d FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY i DISTRICT NO. PLAN CK.NO. PERMIT NO. j BUILDING 15 2 �l O• �Q V f'T �►'� 4✓1�ZJL�, - q -!' ADDRESS LOCALITY Te �1�P' (!otl RECEIVED DATE OFAPPL. DATE ISSUED NEAREST �I ' rI T / — Y• CROSS ST. �JoA L-.l,;_ BUILDING �) «� �,(., q „s e� ADDRESS OWNER �� / MAIL 1 _ LOCALITY r ADDRESS 5' .�G�� vn.,Gvr Gvti • ' NEAREST ��t CITY T / 91#1 CROSS ST. �✓�'^•�� I FIRE NO.DF TYPE 1 / GROUP•�"/'� ARCHITECT OR TEL ZONE �-•� PLANS '�'IM/��' _"V/ ENGINEER NO. _ BLDG. � � ORD.NO.- ADDRESS SETBACK LINE APPROVED TEL CONTRACTOR � Grp � BY DATE� NO. " USEAPPROVED ADDRESS ZONE BY DATE LEGALi �� _...,, CORRECTIONS DESCRIPTION LOT NO. BLOCK- TRACT C� �,qo I " 5,�NO.OF SIZE OF LOT 1 G XI I NOW ON LOTS USE CI INpOOOMF NwILIERAEXISTP_ DESCRIPTION-OF _ WORK r NEW - ALTERATION ADDITION REPAIR MOVING 'DEMOLISH Sq.FT. 11 G NO.or 1 Z SIZE l 1{ "]i0 ROOMB l STORIES D WALL �'+ COVERING �.7 TUGGp ( COVERING ('/-Gln D, j USE OF NEW �'1`Sl BUILDING rl u a O 1 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS' APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT• FOUNDATION: LOCATION INSPECTOR DATE. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES' FORMS,MATERIALS " ` _. �Q AND STATE LA REGULA ING BUILDING CONSTRUCTION. J FRAME: FIRE STOPS, SIGNATURE OF BRACING,BOLTS 19 �6 PERMITTEI LATH, INT.: AUTHORIZE GT LATH, EXT.: DSS-3 SOM SETS 1-48 $ P C.III PLASTER,INT. / FEE PLASTER,EXT * . r C �nl VALUATION FEE + V V FI NAL \ 10,0 '� WORKERS' COMPENSATION DECLARATION ' I hereby affirm that-I'have a certificate of consent to self insure, or a certificate of Workers' Compensation Insurance, t APPLICATION, FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab:C.) COUNTY'OF LOS ANGELES BUILDING AND SAFETY Policy'No.• Company` 1 ' BUILDING . ❑. Certified copy is hereby furnished. -FOR-APPLICANT—TO FILL`IN ADDRESS -- ❑f' '.,Certified copy,is.filed with the county building inspec- BUILDING ��'J �^i / tion department:" ; ADDRESS, / ��7�' Date yApplicarit CITY -ZIP- �U LOCALITY N . OF BLDGS. NEAREST . '4`CERTIFICATE OF EXENIPTION�FROM WORKERS' SIZE OF LOT'�v ,,r NOW ON LOT CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not be'completed,ifohe permit is for one TRACT 'i 7• BLOCK T LOT NO' MAP BOOK, PAGE PARCEL hbndred_doIIafs ($100)or less:) ,„ " TEL- NO ` / OWNER . /�/. NO (fib USE ZONED' MAP NO: I certify that in the performance-of the work for which this ' ermit',is-issued,I shall not,employ an ersor in an manner ADDRESS'• - �: -/ SPECIAL O P P Y. Y.P Y.� ' CONDITIONS so as to become subject,to,the,Workers'Compensation Laws. / _ U CIN ZIP:, 0 Date Applicant^- ARCHITECT OR TEL DISTRICT JGROUP TYPE FIRE P OCESSED BY ' 0 NOTICE TO APPLICANT: 'If,' after making,this Certificate of '• ENGINEER NO CONST Z E O Exemption, you ,should become.subject to the Workers' w Compensation provisions of The Labor Code; you-must forth- ADDRESS V S 0- with comply.with ,such, provisions,or, this'permit shall-be TEL. STATISTICAL CLASSIFICATION APT. CONDO. N deemed-revoked. CONTRACTOR NO Z LICENSED,CONTRACTORS}DECLARATION - LIC CLASS NO " DWELL. UNITS' I hereby affirm thaf,I'd'm licensed under provisions of Chapter 9 ADDRESS NO ` (commencing with'Seclion7000)of Drvision•3 of the Business LIC SEWER MAP •' z. '. and Professions Code„and my license is in full force;and effect. CITY CLASS BK• PG�/ VALIDATION SQ-'FT NO. OF NO. OF CHECK License Number Class SIZE' STORIES FAMILIES ONE 'VALUATION 6 C5 Contractor Date' DESCRIPTION OF ..WORK —/PDdF Nom- ❑ $ E]I am .. f ADD El exempt.under Sec. ALTER' ElB.BP.C. for this reason ~REPAIR $ Date: USE OF r. EXISTING BLDG DEMO[ ❑ Signature^ APP(ICAN j ®/� �`.% NO FINAL PRINT OWNER-BUILDER DECLARATION :; - y DATE t I hereby affirm that I am exempt from the Contractor's License S Law for the following'reasori:(Section 7031.5,.BusnessADDRESS ”and FINAL` Professions Code): PRESENT ByIVi f LPL I, as owner 'of theproperty,mo}'m BUILDINGS ; y employees with ADDRESS / �{L ,:i;i o 3 - • :wages as their sole-compensation,will do the work andC - f�17 the structure is not intended or-offered for sale'(Section LOCALITY i 7044, Business-and Professions.Code.)' MOVING �.•.- •TEL.. _ - . CONTRACTOR' NO. i T El _ I, as owner,of the property, am exclusively-contracting X i L ,-with licensed contractors to construct,the project (Sec= ADDRESS. 44 tion 70 , Business and Profess_ a i Professions Code.) I EHL 3 m 6,_:r REQUIREDTOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY_ SET BACK YARD- HWY PROP LINE WIDTH l.!E .:• i., .�. I hereby affirm that there is a construction lending agency for FRONT, f? the performance of the work for which This'permit is issued P C :�iffif�C z ILI (Sec.-3097, Civ. C.). SIDE PL ti; •K' Lender's'Name MDMA Ref,#_ '.t if ? ii—I�,iiJ� -.: . P.C.:Fee$ Permrt Fee 4040, Lender's Address �; j (°� �;• � I certify that I have read this a lication and state that the IssuanceFee LONA P/C# ' : i S?. above information'is correct. Lagrree to-comply with all County Investigation Fee ordinances and.State laws relating:To building construction, Total Fee / (O LDMA Perm # a and hereby authorize representatives of this County to enter upo above-m nt' ne props ty f r 'nspection'purposes. ' SEE REVERSE FOR EXPLANATORY LANGUAGE Date Signature of Applicant or Agent '