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Home My Public Portal About5955 KAUFFMAN AVE_Building__ DMSION OF''BUILDING •AND SAFETY - DBpartmeat.of County Engineer BU - NO R Coy of Los Angeles Wtvl. J. •FOX COUNTY ENGINEER i' ,APPLICATION BUILDING'' FOR 'APPLICANT TO-FILL,'IN ADDRESS9<l',f� /1 �►W{ lrle�l ~ BUILDING' LOCAL17Y:ti`�i' ..5 -., -ADDRESS ��is- /r114�/�J C�/7 .. '. _ - • •a /J� /^ °„ - - NEARESTa '. LOCALITY•`_/CH'/-,0le-'C- l'J"l.� CROSS ST. NEARF_8T - / - QISTRICT'NO., PLAN.CK..oR Rbc:-No: y PERMIT'N0., CROSS BT. ^'�B Q/:��Yt� •.•. - v .- - -L'�� / OWNER ' 4/G />` yad T�• _ RECEIVED BY, DATE OF`APPL'. 'DATE ISSUED, MAID ADDRESSSS' USE ZON -O.-OF ' T •TYPE '•'GROUP Flf_tE ZONE - // LANB� CITY�irr A/C' TEL ARCHITECT OR 'TEL. �� ZONING- DATED APPROVED BY- BUILDING,''. ; ENGINEER -_ - - ,NO'. ^- , - ^ ADDRESS - _ - ` BUILDING,-'.' 7�"•I i ' ORD:No. - - SETBACK LINE:,' �� / 'l�`+-�•. _ TEL''. _ 'APrRovEDa r DATE F _ 'CONTRACTOR NO.- • _ - - - - - HOUSE'-NUMBERING • ADDRESS• LEGAL a •` -MAP NUMBER"-�"D'0 I NO. ASSIGNED BY -• DESCRIPTION LOT NO, BLOCK ' - _' ' ,'. _ •' '- f -',- DATE, I YP CORRECTIONS - INSPECTOR TRACT �_ / '-NO. OF BLDG8.• - '^ __ .. .,.�_ _ SIZE OF LOT ��X• / 7�j I NOW ON LOT '-��• - - - SUSE"OFNO. OR EXISTING BLDC3. *:Q'L fe_ ° FAMILIES 9 J r- • DESCRIPTION OF'.WORK, -. : - z NEW - ALTERATION -ADDITION :,� - - _ ;•'�' - REPAIR • DEMOLITION SQ. FT. 'NO. OF..; SIZE 'ROOMS- STORIES - .EXT. WALL - ROOF• � '�✓ - - `, COVERING I'COVERING('Asgfr?pSf a I. USE OF STRUCTURE':, f 1604e Oupy 'D 7e.,j"j 17 t :APPROVALS. INSPECTOR'S SIGNATURE"' ',DATE FOUNDATION: LOCATION FORMS,.,MATERIALS I HEREBY ACKNOWLEDGE THAT-1 HAVE READ THIS AP- ,'FRAME: FIRE STOPS, PLICATION AND STATE THAT'THE INFORMATION GIVEN-18_ - CORRECT.. - BRACING,.-BOLTS, "y• _ - - 1 AGREE TO COMPLY WITH ALL-COUNTY•ORDINANCES.' ACE: L - ' AND STATE LAWS REGULATINGFURN - OCATION,' , BUILDING CONSTRUCTION.' 't GAB,VENT, DUCTS ' b•4y -_ _ SIGNATURE-� Y9�"/'/i _�+>r_/ a { UTH',' INTO PERMITTE� r, , - _ _ ADDRESS � . fl_�X•KT�`. L�Y� �P, :-- .'LATH, EXT. '.. - - - �• _ PLASTER, INT, ^- AUTHORIZED AGT. �® ,P. C.$ •PLASTER, •EXT. —�� FEE HOUSE'NU,MBER COR- , RECT AND.POSTED .VALUATION'. - 'FEE �-.� ��. FINAL'- 76A698A D88 9.E-DS DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES j 1 WM. J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING DISTRICT NO. "'PLAN'CK.NO. ""' PERMIT NO. ADDRE88 ,� O ICA O®1� — —__��,� �� ZU LOCALITY ft et '� RECEIVED BY DATE OF ADPL. TDATE ISSUED CREA OBSBT [3 -7IL BUILDING OWNER r �� ADDRESS! MAIL k15-14(0ADORERS a LOCALITY I F �J, A NEAREST �B O D pq_ CITY 'C r f TEL"� CROS B BT. NO. FIRE �' NO.OF TYPE GROUP ARCHITECT OR ��[) - TEL. ZONE' �► PLANS } ENGINEER (./' 'NO. - BLDG. I ..r�d� n ORD NO. ADDREHS BETBACKILINE III 1 .7M* /' _w APPROVED RACTOR dO��y � ND, -- BY . 'I ? DATE- CONT - USE APPROVED - ( _ •/ ADDRESS ZONE BY. DATE i LEGAL CORRECTIONS DESCRIPTION LOT NO. BLOCK 2^el4 TRACT _ 60,526 y. NO.OF BLDGS. - S 12 IS { SIZE OF LOT e� p /� NOW ON LOT EXISUSE TING BLDG.Aes I G!J k FAM NO.OF NO.OF FAMILIES ROOMS (7 UJ DESCRIPTION OF WORK - NEW ALTERATION I ADDITION lie REPAIR MOVING DEMOLISH O_ SO FT. NO.OFZ SIZE t ROOMS STORIES WALL ROOF yy��qq _ _ _ _ - COVERINO /� I COVERING 1 USE OF NEW �D n -- BUILDING Ta L,EA A,1—7'0 /?o G F Aj?Of=A TAQ L S 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS - APPROVALS APPLICATION AND STATE THAT THE ABOVE IB CORRECT, FOUNDATION: LOCATION INSPECTOR DATE _ AND AGREE TO COMPLY'WITH ALL COUNTY ORDINANCES FORMS, MATERIALS AND STATE LAWS REGULATING BUILDI G CONSTRU ION. - ' // FRAME: FIRE STOPS_, SIGNATURE OF• BRACING,BOLTS ERMITTE LATH, INT. AU IZED AGT LATH, EXT. 7J&A-3 7-49P.C. PLASTER, INT. / �� EE PLASTER,EXT. / ^ VALUATION -- l$ ��a�• FEE L,$ FINAL ' .7•TEMPLS CITE 7B.e3'8ACE,#8092160 APPLICATION' FOR BUILDING- PERMIT - 1 "'COUNTY'OF LOS'ANGELES ' BU•ILDiNG DEPARTMENT :OF' COUNTY ENGINEER -AD'D'RESS . BUILDING'AND SAFETY DIVISION LoCALi' JOHN A..LAM BIE;.,COUIVTY-ENGIN•EER'. NEAREST WILLIAM A. JENSEN 9UP'T•OF BUILDING CROSS ST. - DISTRICT NO. GR UP CONST. PR CESSED BY` ' FOR APPLICANT'TO,FILLIN" TYPE' cr BUILDING _ STATISTICACCLASSIFICATION SEWER MAP ADDRESS 'BK- , _PG, ,CLASS NO.Nir4DWELL. UNITS • • LOT NO:: a" =BLOCK STATNUMBER 'HWY." .YES_ NO• TRACT,, `. USE Z_ON_E SPECIA _ ` I,NO..OF BLDGS. r �j -CONDITIONS• tt SIZE OF LOT., J NOW ON LOT USE OF r• ,_ EXISTING BLDG. e BUILDING, :-EXIS J T SETBACK ' YARD HWY STREET NAME-»b WIDTH. . OWNER t° L6 FRONT P.L. 4 t ADDRESS .SIDE ARCHITECT OR, - TEL.- P.L. ENGINEER .NO' INSPECTION RECORD ADDRESS. r - w• _ - - - , TEL': -,. L .t - - � - - _CONTRACTOR NO: O ADDRESS, U ,.DESCRIPTION. OF WORK i = O , - E, , NEW' . ADD ALTER REPAIR DEMOLISH :+ W SQ.FT NO.OF , .:NO OF, ,- SIZE _ STORIES • .FAMILIES . . USE OF STRUCTURE la SIGNATURE'OF - _ - APPLICANT VALUATION$ -APPROVALS DATE INSPECTOR'S SIGNATURE _ PJQ. PMT. �' FOUNDATION: LOCATION F.EE `$ - • FEE $ •^ - - .FORMS, MATERIALS ' 1 HEREBY•ACKNOVNLEDGE THAT.-I HAVE READ THIS,AP- FRAACIN , BSTOPS, BRACING, BOLTS - PLICATION AND STATE THAT THE'ABOVE IS CORRECT AND :FURNACE: LOCATION, .AGREE T6 COMPLY WITH ALL.COUNTY ORDINANCES-AND GAS VENT DUCTS STATE. LAWS -REGUL•ATI'NG" BUILDING',CONSTRUCTION. 1' CERTIFY,THAT IN:-DOING THE ,WORK",AUTHORIZED -1 -,LATH,-INT: WILL NOT:EMPLOY ANY,PERSON .IN-VIOLATION OF THE -WORKMEN'S COMPENSATION-LAWS OF' CALIFORNIA: LATH,EXT. - t " ;� - HOUSE NUMBER COR- - SIGNATURE PERMITTE RECT AND POSTED ADDRESS" � ? FINAL" '1.6-t6a CLYDE N.'DIRLAM, PRINCIPAL STRUCTURAL'E R- PLAN-CHECK VALIDATION CK, • M.O.- CASH' 1 PElMT VALIDATION. CK. WORKERS'COMPENSATION DECLARATION t - 850'566'ZA - 'k' A r - y -•. _ _, I;hereby affirm that_I hove.a,certificate,of�corisent,to self ~• A P P L I C AT I_O N I.O R B U I L D I N'G -PERMIT nsure, or a certificate of Workers' Compensation Insurance, i or c 6ertified copy'theYeof (Sec 3800;41'66`.`C )S -COUNTY OF LOS,ANGELES BUILDINGAND SAFETY r P.oI cy; a - -225 ��/r4','pa;,y Fremont Indemnity.- _ = - - 0 ' pY' y' F • FOR APPLICANT.TO`FILL IN BUDDING C', , Certified co is hereb furnished:,+a: ..� ./ J , s ADDRESS' Certified'cdpysis filed with the cou'rity,b'uilding mspec- BUILDING'r L `tion-de pa'rtmerit• ^s'' i y ADDRESS 5955. Kauffman ) Temp1'e�'C'Yt�y'- D6te-J ]:/.4•]/85 ,iAppl�16nt.i-Virgin Roof,Co. CITY ZIP LOCAUrY CERTIFICATE OF EXEMPTIONeFROW WORKERS' — -NO-OF BLDGS. - --'-'r NEAREST, COMPENSATION INSURANCE: »•-'';ice' c} SIZE OF LOT NOW ON LOT CROSS, ,ST Jkhis section.,need,not!betcompleted-if rthe,perm it:is for•one - - -- -- - ASSESSOR, hundred dollars($100),o i less.+); TRACT BLOCK LOT NO MAP BOOK I , ,a:.,; GE PARCEL r TEL USE ZONE 'MAP r i - I;cert4 that nin the performa ice of the'`work for"•which'this' OWNER`, "P3u1 Pro _. NO NO. SPECIAL r> - ^r d pe�mitis',issued,"I shall'notemploy any person'in any mariner 5343. W. - ]4 ]S•t=•St-. - CONDITIONS) 1 t O so'as`to become`'subject.'to the W6'rker$''Compens6iion'Laws ADDRESS - a -',.-.,.` ,� .;: t V•' .-•q, .' • - •- ,b '_ .CITY .Hawthorne `90250 ZIP_•.. _ - _. - -••'- --.F_ _ � �' _ i • "• Date' ' = Applicant :.~ 's - - yr ,r.`', O NOTICE'TO rAPPLICANT: If; after makingthis4Certificbte of ARCHITECT OR ' TEL.- DISTRICT „GROUP, TYPE_ _ FIRE_ - PROCESSED BY,. ENGINEER- NO. Exemption y6u;.should'`become'subject.to.the 'Workers' ' CONST '' /' ONE W Compensation provisions of the Labar Code, yowmust forth= ADDRESS with-comply.witK_such- provisions or this,-permit shall•'be -.._ y deemed.revoked; - , , :: '•,: . TEL ' STATISTICAL CLAS555��{ICATION i APT CO DO z r'•- CONTRACTORVirgin Roof Co. No: 287-0507' f _ LICENSED CONTRACTORS;DECLARATION --P,O. Box--J LIC -160650- { CLASS-No �DWELL;,UNITS I hereby affirm that I,am"licensed"under•provisions of Ch'apter9 ADDRESS NO commengn with Section 000 of Division 3 of the Business and SEWER MAP, *-. Pco 9 ) - LIC:• . P.rofes'sions Code;and my-'license`is'ir full'f6rce'and"effect.''' San' Ga'bri`el C39E. _ _ CITY CLASS 1' VALIDATION 160650' So. FT NO OF NO OF _ CHECK BK �' License Number "` `Lic'Class' 'C39 SIZE STORIES FAMILIES ONE -. -. •,A., s VALUATION r 'V1+r in� Roof;'Co. L' 1'1V•]' 85 DESCRIPTION OF WORK 'Re-roof•- ara e._ "EW-'--❑ $ ';400.00 Contractor g Date ❑ " ADD _ ❑ I our exempt under Sec. �- with -Class A- f-ibe-r- lass shin 'l ALYER ❑ ! ' µ -� ` 5 squares. ' i B.$P.C,for this reason REPAIR.,❑ USE OF , Date: EXISTING BLDG d,we 11 in DEMOL ❑ APPLICANT Virgin Tri Roof Co. TEL'. FINAL s ' OWNER-BUILDER DECLARATION PRINT g NO 287-OSO DATE I.hereby.affirm•thdt,I am exempt from.the Contractor's License _ p•O, Box J San Gabriel 1 `9 ]7 78 Law for the follow irig reason (Section•7031.5, Business and •ADDRESS FIN `Professi'oris Code): _ PRESENT ' BUILDING _ • ` I as owner of the property, or my employees with ADDRESS_ �'- �7 `wages as their's61e compensation;will do tFe work and - the structure is not intended or offered for sale(Section LOCALITY •--7044,-Business and-Professions Code)—: -'" �' MOVING � '3'41 8A I, as owner of the property, am exclusively contracting CONTRACTOR NO #o,e'o o .o .•` ' -F ' 'with-licensed:coritractors to-construct'the•prolect'(Sec •tion 7044, Business and.Professions Code). ADDRESS y s t f I'• e Za 5Q I CONSTRUCTION LENDING AGENCY"" "� - _, REQUIRED _ - YARD HWY- TOTAL SETBACK.FR j _r 2'a 5-0 U y SET BACK PROP LINE WIDTH- o'm o 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. - --• -• - � - � ,-- �: - ; (Sec. 3097, Civ. C.).' SIDE I"1: 0'b—8:5 eh Lender's Name rtigation - -- $ 18.0LDMA Ref # Permit Fee---Lender's Address-1 certify that I_have�46d_.this.appliction and state-that.the Issuance Fee• - •- ]0•50--••- LDMA P/C-#,-- a above information is correct. I agree to complywith all County .ordinances and State laws relating to,building construction, ;28.•.50 _ t) and h reby authorize representatives of this County to enter - Total-Fee LDMA Perm"# �. - a upo he above-mentioned ropers for inspection purposes.. - - ,. y •� //- SEE REVERSE FOR EXPLANATORY LANGUAGE' . - —• aiure of-Applicarit-or-Agent- - Date - APPLICATION FOR BUILDING PERMIT . COUNTY-,OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDING A KESS WORKER'S COMPENSATION DECLARATION r C - J I hereby affirm that I 11 have a certificate of consent to self insureBUILDING ADDRESS,. , , FUM or a certificate*of Workers' Compensation Insuran e,or,a certified CITY �J ZIP ° copy thereof (Sec 3800,; b C)' ,// �fD� C. 1 LOCALITY Policy No�J 7 Company SIZE OF LOT , NO OF BLDGS NOW ON LOT 11lGertified'copy Is hereby-furnished. - �%'�4 _NEAREST CROSS ST ' ❑ - ' - Certified copy Is filed with t ng insp -TRACT BLOCK LOT NOection USE ZONE MAP NO • department _• . ,Date /�—/ Applicant / .. ASSESSOR MAP BOOK PAGE - PARCEL t - _ - .- 'SPECIAL CONDITIONS- CERTIFICATE OF EXE N FROM WORKERS'.* OWNER n (� ^�� TEL NO //�'1/ /I---1�1f'`' WITHIN 1000 FT OF SCHOOL? YES NO COMPENSAT INSURANCE � , (This section need not be completed the permit is for one hundred ADDRESS If ✓,/ _ dollars ($100) or less) I� o L DISTRICT GROUP TY E CONST FIRE ZONE PROCESSED BY CITY ZIP I certrfy that in the performance of the work for which this permit IS Issued, I shall not employ any person In any manner,so as t0 ARCHITECT OR ENGINEER - �` 'TEL NO' ' become Subject-to the Workers'Compensation Laws STATISTICAL CLASSIFICATION APT CONDO ' Date Applicant ADDRESS CLASS NO >n"� DWELL UNITS - f NOTICE TO APPLICANT If, after making this Certificate. Of• REQUIRED TOTAL SETBACK FROM EXIST Exemption; you should become subject to the Workers' CONTRACTEL (��,,4\ SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code,-.you must,forthwith TOR dft,eE LT— I(R5I FRONT comply with such provisions or this permit shall be deemed"revoked { ADDRESS_ UC NO - � PL �' S SIDE LICENSED CONTRACTORS DECLARATION CITY 1� n LIC.CLASS P L I hereby affirm that I am licensed underprovisidns.of Chapter 9 �J 1 SEWER MAP (commencing with Section 7000)of D14ision 3-of the Business and 'SQ FT SIZE NO OF STORIES NO OF FAMILIES Professions Code,and my licen els in full force and effect NEW 'BK' PG , a License N ber LIc Class- �— DESCRIPTION OF WORK ADD ❑ VALUATION O Contractor Date 11— —�� ALTER ❑ $- � " cc ❑ I am exempt under Sec. REPAIR ❑. $ 0 B&PC for this reason d DEMOL ❑ LDMA P/C# W i USE OF EXIS KING BLDG _ URM ❑ Signature APPLICANT(PRINT) TEL NO LDMA Perm# 1 •Z ❑ I, as 'owner oft rty, or my employees with wages as their.sole comp ion, will do the work and the structure is ADDRESS ACCT. JL FINAL DATE 3M not Intended o ffered for sale (Section 7044, Business and� _ G 1.�°j5 • PfOfeSS10OS Code) WILL THE APPLICANT OR FUTURE.BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL '2q •1 ITEMS A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑ I, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY licensed contractors to construct the project (Section 7044, YES❑ NO❑ TOTAL 125. 55, Business and Professions Code) - WILL THE INTENDED USE OF ,THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING (��(`�` _ OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CHECK 1 CONSTRUC.`TION,LENDINU` AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR ' GUIDELINES CHANGE . ' °00 I hereby affirm that there Is a construction lending agency for YES❑ ' NO❑ a the performance of the work for which this permit Is Issued(Sec I HAVE READ THE HAZARDOUSMATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING ° 3097,CIV C) CHECKUST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, I v / w TITLE 2,CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS '0000—OQLi 1!7p 5 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD o Lender's Address 3094 • 1 ASI 9°0$ O OWNER OR AGENT o I certify that I have read this application and state under penalty Of perjury that the above Information IS correct I agree t0 Comply - P•C FEE - PERMIT FEE with all county ,ordinances and State laws relating to building construction, and y uthorZe representatives of this County ISSUANCE FEE a to u e abo j e ti ed property for Inspection purpos s� �,� T , _ - ( INVESTIGATION FEE TOTAL FEE !� SEE REVERSE FOR EXPLANATORY LANGUAGE