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Home My Public Portal About6222 KAUFFMAN AVE_Building__ �Bo3(REV.a(�BI, '• .` - -, _ r 'l%XPPLICAT'ION FOR BUILDING PERMIT -.COUNTY OF LOS ANGELES BUILDING AND SAFETY BUILDING ,FOR APPLICANT TO FILL IN', - 'ADDRESS CO BUILDING ' ADDRESS /i N. LOCALITY --�� NEAREST-. - CITY ( '49 /�l ZIP CROSSST SSO SIZE OF LOT ��/b NOW ON LOT �Q MAP BOOK PAGE PARCEL -TRACT M 8 C°- �3 9LOCK LOT NOH ��J DISTRICT' GROUP JCON�T/ FIRE- PRO SED:BY OWNER NO� •1i�7 r d -4i 3 V .•, „ _ I M STATISTICAL CLASSIFICATION SEWER MAP ADDRESS (/a!Ak /7 CLASS NO DWELL' UNITS'•, / BK�_5G CITY Gw Irr_tf4 rtl ZIP- ARCHITECT OR /vu,TNO � VALUATION $ �� v ENGINEER C .JY� b(J(� ADDRESS O qkt,4xL, BLDG SETBACK FROM q-- E -7 C�- FRONT PROP LINE OF ISTREETI CONTRACTOR /a .NO /"�� /6&y . TOTAL SETBACK FROM TYPE OF EXISTING tt ff-- ll LIC•pp HIGHWAY + -YARD FRONT PROP LINE HIGHWAY .WIDTH ADDRESST rvOU'�� f'7 /. LIC CITY e CLASS'- CONSTRUCTION LENDER BLDG SETBACK FROM NAME AND BRANCH SIDE-PROP LINE OF (STREET) �� TOTAL SETBACK FROM TYPE OF EXISTING HIGHWAY + 'YARD = SIDE PROP LINE IHIGHWAYI WIDTH ADDRESS CITY _0 SO FT NO OF IN OF CHECK + _ ? u SIZE STORIES FAMILIES ONE DESCRIPTION OF WORK t ^ NEW•• ❑ P.0 Fee$ 0-0 Permit'Fee CJS- 5� ❑�A ADD r- ❑ _ Z� Issu_ance'Fee / V Al G ,. ALTER, REPAIR ❑ Totol Fee �, r' ✓'• USE OF EXISTING BLDG 5� DEMOL El 4 v-7 o. Z APPLICA A.,I� / TEL - � a P �4Z3 1 p PRINT (.KX` 1 NO -c�J6�6 . ,�7. Q z ft BY ISIGNA `�-a o.-? � Y • . 2,- 4920 . I HEREBYKNOWLEDGE AT HAVE READ THIS APPLICATION AND''STATE , THAT THE AB/11"LATING E IS'CORRECT AND AGREE TO COMPLY WITH ALL-ORDINANCES W AND LAWS R BUILDING CONSTRUCTION I'CERTIFY THAT IN DOING THE /~_- x .-o'o• 4.4 9,.Z 0 WORK AUTHORIZED REBY I'WILL NOT EMPLOY ANY PERSON IN VIOLATION OF /`� r7{�. • ' THE LABOR CODE O E STATE OF CALIFORNI N RELATING TO WORKMEN S COM- �Gr!1�-• Z O IL`� )\7'/ 7 PENSATION INSUR E �j SIGNATU a� _ 4 -' 2 A, PERMITTEE lQ O - ADDRESS / # 0 1 CITY I NO 4 `2.`-2 Q 8,5 0 - USE ZONE MAP Q ° 6'2 4 8.5 O v ' NO �•O�'3 SPECIAL , r 0SO.7-79 CONDITIONS. •-, - FINAL BY J d _ DATE i DMSION OF BURRING AND SAFETY !r� Depostrnent of County Engineer ILi + Count! of Los Angeles c' WM. J. FO , COUNTY ENGINEER APPLICATION FOR APPLI Aar a O FILL IN ADDRESS Z a LOCA CITY L'ITY " ADDRESS C � (' c /^ NEAR EBT LOCALITY -S 6'�L.�j. `Q CL&' CR088 8T. J'7C�yLO/7 NEAREST e-4DISTRICT NO. P N CK. oRRREC:-No. /PERMIT No.,- CROS®ST. O �[ /V I6(al RECEIVED BY DATE OF APPL. -'DAT ISSUED OWNER AMAIL DDRESS C?--75j l.CtV'.� �o�-� �/"• / .3D�,3.� �'�' . USE Z0r4 E NO. OF TYPE //G�RdOUP/ FIAE ZONE CITY fff �!T TE T7 �.I PLANS .. I , ' li+' N ARCHITECT OR " TEL. ZONING _ DATIM ENGINEER NO. �OGU APPROVED BY BUILDING ADDRESS B SETBACK LINE: 2D •, '. �� '/ J CONTRACTOR NC' N APPROVED DATE.' BYs HOUSE NUMBERING . LEGAL MAP NUMBER �w� NO. ASSIGNED SY - DESCRIPTION L T BLOCK cIrl_ DATE_ CORRE TIONS INSPECTOR TRACT NO. OF BLDGB. SIZE OF LOT NOW ON LOT USE OF - NO:OF EXISTING BLDG. FAMILIES p DESCRIPTION OF WORE '' NEW ALTERATION ADDITION REPAIR DEMOLITION SQ. FT. NO. OF. SIZE �+ ROOMS STORIES - •- C�OVERING�) CC I COVERT Oeye7"<- USE OF STRUCTURE APPROVALS ' INSPECTOR'S SIGNATURE DATE FOUNDATION: LOCATION FORMS, MATERIALS Q �} I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS'AP- FRAME: FIRE STOPS, .� f PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRAE: FIR STOP. (�•7 CORRECT. - 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, r/ - AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS, SIGNATURE OF LATH, INT., /�n A c l PERMITTEE ` . �r LA�DHR7ES -' LATH, EXT. PLASTER, INT. IZED AGT. �7 PLASTER, .EXT. AHOUSE NUMBER COR-FEE RECT AND POSTED ION aC9O �� FEE �zO—� FINAL 76AS36A DBS 3 E-58 -1 - `rORKERS'•COMPENSATION DECLARATION hereby affirm that I haver certificate of consent t' self -AP'PLIC'ATION .FOR' BUILDING "P;E RM I T insure, or a certificate of Workers'.Compensation Insurance, i, or a certified copy'thereof (Sec. 3800, Lab: C. r COUNTY BUILDING AND SAFETY - ' Policy No. ,, •.Compdriy •• - - - ... . . ❑ Certified co is hereby furn shed. FOR APPLICANT TO FILL= IN ButlDirvG PY Y ADDRESS Gam, yj(�tw ❑ Certified'copy is filed with`the county building inspec- BUILDING ,q _ tion department. ADDRESS _ `h CITY, , ZIP 7 16NO 11� I' LOCALITY Date 'Applicant CERTIFICATE'OF EXEMPTION FROM WORKERS SIZE OF LOT• NOW ON LOTGS NEAREST CROSS ST _ COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT. " - BLOCK LOT NO ^ MAP BOOK' PAGE 17 PARCEL hundred dollars-($100)''or,less.) L USE. MAP OWNER . MA , NO !_certify that in the performance of the work for which this SPECIAL permit,is•issued, P.sholl-not employ any person in any manner ADDRESS CONDITIONS so as•.to become subject to th'e,Workers' Compensation•Laws. �7• 0 v, CINZIP ( _ Date Applicant - 'ARCHITECT OR TEL O ENGINEER NO :. •.. DISTRICT- GROUP- TYPE FIRE PROCESSED'BY NOTICE-TO APPLICANT: If;.'after-making-this Certificate-of - CONST. ZONE ; ' U Exemption, you, should -become subject to the, Workers' 0� ;3: w Compensation'provisions of e,Labor Code, you musttforth- - 9DDRE55 _ J ;� with'comply with such-provisions or..this permit„shall be' TELSTATISTICAL CLA SIFICATION NDO. Zdeemed:revoked. CONTRACTOR NO. 'LICENSED CONTRACTORS DECLARATION LIC CLASS NO DWELL. UNITS LJ.,APT.JCO s ; I hereby affirm that I am licensed under provisions bf Chapter 9 ADDRESS NO-- i. LIC SEWER MAP (commencing with Section 7000):of,Division 3 of the Business CITY- CLASS + ,and Professions Code,and,my license,is in full force and effect. BK PG' - VALIDATION SQ. FT. ' NO. OF NO OF CHECK License Number Lic.•Class SIZE STORIES FAMILIES ONE - DESCRIPTION OF WORK NEW ❑ s• �• ADO Coritractor Ddte - G - - ,ADD ❑ El am_exempt under-Sec. �(� G, ► SALTER .❑ _ B.&P.C. for this reasony ” F2 REPAIR;[] ; Date: USE.OF- EXISTING BLDG DEMOL ❑ Signature - r APPLICANT TEL. ; ) FINAL ( . OWNER-BUILDER DECLARATION PRINT NO.4 DATE I hereby affirm that I am exempt from the Contractor's License:-• - ` Law f r-'the fbIlowing.reason (Section 7031.5, Business and ADDRESS FINAL' Prof Bions.-Code). :,; PRESENT _ gY ACGTae' I, BU LDING as.'owner of the property, or my employees with ADDRESS -�'� s 92.25 wages as their sole compensation,will do the work and '' 3303 i, M' w the structure is not intended or offered for sale'(Section LOCALITY 1 ITEMS 7044;Business and Professions-Code.) MOVING TEL- - CONTRACTOR NO - ❑ I, as owner of the property, am exclusively contracting TOTAL 92 ®.,25' with licensed cdntractors.to construct the project (Sec- tt tion 7044, Business and Professions Code.) . ' [ADDRE - CHECK ' ' -92.25ED TOTAL SETBACK FROM -EXISTCONSTRUCTION LENDINGAGENCY., K YARD HWY PROP LINE WIDTH• -CHANGEI hereby affirm that there isa construction lending agency for the performance of the work for which this permit is issued(Sec. 3097; Civ C.). . - 0000"00G1 - 6/11/96Lender's'NameLDMA Ref # ,5� ? 1 AM 9ecc $ Perm t FeeLender's Address j certify'-that I have read this application;.and state that the Issuance Fee � LDMA P/Cabove information is correct. I agree'to,comply with all County ion fee 77 ordinances and State laws relating°to building construction, Total Fee O(• a LDMA Perm:# a nd hereby authorize representatives of this County to enter • u on the above-mentionedpro erty for inspection purposes'. t o SEE REVERSE FOR EXPLANATORY LANGUAGE S ature of Applicant or Agent Date