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Home My Public Portal About5923 KAUFFMAN AVE_Building__ 76A638A CE#803 3-66 APPLICATION FOR BUILDING PERMIT /7 COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DMSION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER ,NEAREST / �/ 1 COLEMAN W J.ENKINS.SUP'T OF BUILDING CROSS ST. - DISTRICT NO. GRO TYPE PROCESSED BY FOR APPLICANT TO FILL IN CONST, BUILDING STATISTICA ASSI FICATION SEWER MAP, ADDRESS G ` V CLASS NO. _ DWELL UNITS BK - - -PG - LOT NO. ZS f BLOCK iUSE ZONE MAPN457 O. / TRACT �jsd SPECIAL - - NO. OF BLDOS. CONDITION SIZE OF LOT - NOW ON LOT - - USE OF BLDG. SETBACK FROM TEL •FRONT PROP. LINE,OF- (STREET) OWNE ooC.= 2=g NO TYPE OF EXISTINGESETBACK HIGHWAY + - YARD` = TOTAL ADDRESS o.0 HIGHW Y . CITY = ARCHITECT OR TE - BLDG. SETBACK FROM• ,- _ - ENGINEER NO. .- SIDE PROP. LINE OF (STREET) TYPE OP EXISTING' SETBACK- HIGHWAY + YARD - TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. I- TEL. - - .•�� + - _ -- - CONTRACTOR. " " NOLIC •" ADDRESS NO CORNER CUTOFF YES Ej NO 1:1 d d CIT cls SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK . W d NEW ADD ALTER REPAIR DEMOLISH � - �' t/7 SO.FT. - NO OF NO. OF Z SIZE STORIES FAMILIES USE OF STRUCTUR r S GNATURE OF APPLICANT T - - VALUATION$ ; /'� I ,00 _ c APPROVALS DATE INSPECTOR'S SIGNATURE r' P.C.. PMTzz-oc, FOUNDATION, LOCATION FEE$. FEE$ FORMS, MATERIALS FRAME, FIRE STOPS, // �,pf / I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT -•'�•��-•'--,-.! :�. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO'COMPLY. FURNACE: LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING .GAS VENT. DUCTS ' 13UILDING CONSTRUCTION I CERTIFY THAT IN DOING THE'WORK 1 AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. - ' TION OF THE LABOR C OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S C NSATION INSURANCE. LATH.'EXT. SIGNATURE OF - 'HOUSE NUMBER COR- • PERMITTEE{ RE AND POSTED ADDRESS v FI-NAL ER PLAN CHECK VALIDATION CK. M O.- CAPERM�iil FFH _ JOHN PLVALIDA ION F. LEWIS, PR'INCIPALTRCK. RM O ENGC SH, 5 5 ,8,3-o NOV 1 1 D 4.Q Ocl.'a I ' E DEPARTMENT OF COUNTY ENGINEER DMSION' OF BUILDING AND SAFETY ' COUNTY OF LOS ANGELES BUILDING WILLIAM J: FOX.'COUNTY ENGINEER APPLICATION CASSATT D. GRIFFIN, SUPT OF BUILDING FOR APPLICANT TO FILL IN FOR-OFFICE USE ONLY BUILDING- pp�� ,q A / DISTRICT NO. PUN CK.OR REC.No, PERMIT NO. ADDRESS /i of ISI .� V.I='YIY LOCALITY �jit, ,/ �}P}�, ti �,/�', RECEIyED BY DATE OF APPL. DATE ISSUED NEAREST NEARI ROSS c, OWNER .�.- Z�°^ jy1 ADDRESS MAIL ,r .� LOCALITY 7y ADDRESS fi `� 'Z / r 4 �Q ,A �C � -J� NEAREST- CITY ,♦'� _ i`/ L/ TEL. CROSS ST. ARCHITECT,OR TEL.. FIRE NO: OF TYP GROLLP ENGINEER �� O, �� ZONE PLANS ADDRESS BLDG. - ORD. NO. SETBACK LINE • TEL. USE APPROVED CONTRACTOR - N ZONE BY - PATE r-- HOUSE NUMBERING ADDRESS X2 BLOCK LEGAL MAP NUMBER "'O v NO. ASSIGNED BY DESCRIPTION LOT NO . X2 _ _ _ CORRECTIONS TRACT .� / 61- 7,;, ~�� - ,,' SIZE OF LOT I 7-� I NO ON LNO OF OTS p �' UBE OF NO. OF EXISTING BLDG. FAMILIE DESCRIPTION OF WORN �/(30N r�,?1 /,✓/LL 6' /6� E'�/E`Ll f o - NEW, ,I} ALTERATION ADDITION REPAIRDEMOLITION I SiAlX /�� D r SO. FT. NO. OF SIZE ROOMS STORIES U U EXT. WALL ROOF COVERING I COVERING- //�}� USE OF STRUCTURE 1.7 ,S IPL 6•-t ELr--O ' APPROVALS INSPECTOR'S SIGNATURE DATE FOUNDATION: LOCATION • - ' ' FORMS, MATERIALS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRE STOPS, PLICATION AND, STATE THAT THE IN GIVEN IS BRACING, BOLTS CORRECT.I AGREE TO-COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION. AND STATE LAWS REGULATING BUILDING C6 ONSTRUCTION GAS VENT, DUCTS SIGNATURE OF - N. LATH, INT, r ' PERMITTE ��eee!!!�..fip1 Ln ul'1 Iat_ . a l LATH. EXT. - ADDRESS' t�I�-/✓ ' • - PLASTER, INT. AUTHORIZED AGT.-- �� r� y� PLASTER, EXT. FFE HOUSE NUMBER COR-E RECT AND POSTED VALUATION AA , E 8 � FINAL 7,whtvhAff tl Sv d .. 76Ae36w 0083 e-aa � , 76ABSBA DBS-3 A OiP L I C AT I O N FOR BUILDING P E R • l - - ` - tI-BB DING DIVISION OF BUILDING AND SAFETY A"ULDDRESSar CLvG Department of-County 'Engineer �. County of Los Angeles LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER - NEAREST CASSATT D.GRIFFIN, SUP'T OF BUILDING CROSS ST. FOR,APPLICANT- TO FILL IN DISTRICT No. GROUP EWER .MAP TYPE BK PG'• CONST.+ 0 BUILDING J_ '/ , (�y:t�, NUMAP MBER ®� ,STATE ,YES NO .ADDRESS - �l�C.Lty. LOT NO. I It Aff" BLOCK USE ZONE SPECIAL - _ - CONDITIONS TRACT �^ � .� 1. 5 I NO. OF BLDGS. q • SIZE OF LOT t7 _(! NOW ON LOT O-► BUILDING EXIST. SETBACK- YARD HWY STREET NAME WIDTH -USE OF - � ' EXISTING BLDG. - FRONT ' OWNER �Lt/�(iL� -•SPIDE L. ADDRESS /� "ma"""r" " r^N�^� LES/-C, O TRACT DW E L.' 1 UNIT 5 INDUSTRIAL CITY fliyyl�Q�Ge. (moi NO. T/°Z//So 1 DWELL: 1 UNIT 6 PUBLiC'BLDG.-. ARCHITECT R TEL. 2 DUPLEX 2 UNITS •"' ENGINEER NO. - 7 ADDN..ALT.. ETC. 3• APT. UNITS - S MISCEL. - ADDRESS - 4 COMMERCIAL -TEL INSPECTION RECORD CONTRACTOR NO. ,ADDRESS DESCRIPTION OF WORK. NEW (ADD ALTER REPAIR DEMOLISH d ' //�p� Y . r rt //,j 7—c� '' SQ. FT. NO. OF NO.OF SIZE 0141STORIES -FAMILIES USE OF 6TROCTURE SIGNATUROF 'n .' E APPLICANT "-"APPROVALS�DrSrllIS R3, • F,41ef^ ADDRESS DATE INSPECTOR'S SIGNATURE C. S FOUNDATION: MATERIALS FEEION ��✓� /J/.�,�,•,/,.�/ /Q - FRAME: FIRE STOPS. VALUATION S BRACING. BOLTS FEE - - FURNACE: LOCATION, 1 •HEREBY ACKNOWLEDGE .THAT A HAVE READ THIS GAS VENT. DUCTS 3-2,t-50 APPLICATION AND STATE THAT'THjg'ABOVE IS CORRECT - -, V1r11�L�Y AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. V� Y AND STATE LAWS' REGULATING, BUILDING CONSTRUC- TION. LATH. EXT. SIGNATURE OF - HOUSE NUMBER COR- PERM EE OR-PERMITTEE ,RECT AND POSTED ADDRESS FINAL JOHN A. LAMBIE.COUNTY ENGINEER VALIDATION CLYDE N. DIRLAM. CHIEF'BLDG.,INSPECTOR CK MO CASH - i� i o 4 3 5 5 JAN 1 1 8.0.0 . �' WORKERS'COMPENSATION DECLARATION hereby affirm that I have a certificate of consent, to self APPLICATION R BU I L D I N G� PERMIT insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800,'Lab. C.) _ J ` 5' 5r2 , y �jO�l1� COUNTY OF-LOS ANGELES BUILDING AND SAFETY Policy No. Certified copy is hereby furnished.• FOR APPLICANT TO F L IN BUILDING L, _ ADDRESS ✓ � / �� ❑ Certified copy is filed with-the county building inspec- BUILDING -7 tion department. ADDRESS oC Date �! � App CITY ZIP l TOLOCALITY CERTIFICATE OF EXEMPTI FROM WORKERS' NO. OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT / So NOW ON LOT CROSS ST._ (This'section need not be completed if the permit.is for one ��---// IO�S ASSESSOR. hundred dollars ($100)or less.) TRACT J t� / BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL. USE ZONE FN OWNER NO. - � v I certify that in the performance of the work for which thisCL permit is issued, I shall not employ any person in anymanner ALso as to become subject to the Workers'Compensation Laws. ADDRESS ITIONS rZ V CITY ZIP_��_./O. `� 79i a N� Date Applicant ARCHITECT OR U TEL. DISTRICT GROUP TYPE FIRE ESSED.BY O NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST. ZONE Exemption, you should become subject to the Workers' Compensation provisions of,the Labor Code, you must forth- ADDRESS a/ -.`7c d �'� CL CL with comply with such provisions .or this permit shall be TEL STATISTICAL CLASSIFICATION APT. CONDO. deemed revoked. CONTRACTO NO. —Ge5`35— 9 LICENSED CONTRACTORS DECLARATION LIC CLASS NO. �J DWELL. UNITS Z I hereby affirm that 1 am licensed under provisions of Chapter 9 ADDRES ,> /V- �c c- NO-23 Z 3 / (commencing with Section 7000)of Division 3 of the Business and LIC-- SEWER MAP Professions Code, and my license is in full force and'effect. CITY 9�73�CLASS C-�� BKPG./�i9 VALIDATION 07-12'(?—Z/— SQ. FT. NO.-OF -- NO. OF CHECK License Numbe ic.Class SIZE STORIES FAMILIES ONE � 0 VALUATION DESCRIP N OF WORK NEW $ Contra a ` El ADD ❑ 1.0 m 1 der Sec. ALTER ❑ , B.BP.C. for this reason REPAIR ❑ $ Date: USE OF DEMOL EXISTING BLDG. Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) NO. DATE ell I hereby affirm that I am exempt from the Contractor's License Low for the following reason (Section 7031.5, Business and ADDRESS F Professions Code): PRESENT ❑ BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY ' 7044, Business and Professions Code). MOVING' -TEL:- F_] ' ],'as owner of the property, am exclusively contracting CONTRACTOR NO. �5 3 7,7 A ` with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). ADDRESS # 0 0 0 0 o REQUIRED TOTAL SETBACK FRO S .. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH ° -.6(150 ' 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. o 0 - 60 5 0.5 { (Sec. 3097, Civ. C.). SIDE o _ -P.L. lender's Name •0 0,9 5 8 6- Lender's Ref. # P.C. Fee$ Permit Fee ' - Lender's Address I certify that I have read this application and state that the Issuance Fee 0 ' ��Z) -LDMA P/G# a above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee C��` ` LDMA Pern`# ' u and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. a .— fj SEE REVERSE FOR EXPLANATORY LANGUAGE ature of Ap icgnt or Agent Date Oo