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Home My Public Portal About10602 KEY WEST ST_Building__ 76A689A gAPPLICATION FOR EU'ILDING PERMIT �. �15WISION OF BUILDING AND SAFETY BUD Ess UILO�. �. L Department of County Engineer 1 - County of Los Angeles LOCALITY 4� X1 WM.J. FOX, COUNTY ENGINEER NEAREST CASSATT D GRIFFIN, SUPT OF BUILDING CROSS ST. -�I FOR APPLICANT TO FILL IN DISTRICT NO. GRo�uP (TYPE Is EWER MAP �- B PG t.= �{- `� CONST. STATE ADDRESS Q ~ ` \ NUMBER ER f'� a �G HWY `moi (Eo:� LOT NO. �_)kCe� yy BLOCK USE ZONE SPECIAL �� CONDITIONS TRACT .1/�7 �y i / OL)v - J oo A I� NOW ON LOTS ,L, BUILDING YARD HWY STREET NAME EXIST. SIZE OF LOT SETBACK WIDTH USE OF FRONT EXISTING BLDG. U Se. �V QL1I�C+l ._ << P. L. OWNER S SIDE MAIL ADDRESS j�/��A ``P,.:.t O TRACT DWELL. I UNIT 5 INDUSTRIAL • TEL 1 DWELL. I UNIT CITYa%M!Ak Cc `v NO. 6 PUBLIC BLDG. ARCHITECT OR TEL. 2 DUPLEX I UNIT `.ADDN , ALT. ETC. ENGINEER I NO. 3 APT. UNITS11 8 MISCEL. ADDRESS 4 COMMERCIAL CONTRACTOR V w NO' INSPECTION RECORD ADDRESS DESCRIPTION OF WORK NEW ADD ALTS REPAIR DEMOLISH SQ FT. 1„fes NO. OF I NO. OF SIZE Y/��,JJ STORIES ] FAMILIES USE O STRUCTURE - q nh � SIGNATURE OF APPLICANT('' APPROVALS ADDRESS V �Z DATE INSPECTORS SIGNATURE FOUNDATION' LOCATION 7_ $ P. C. $ FORMS. MATERIALS /J C / 7 ! , FEE FRAME* FIRE STOPS. VALUATION ✓ $ 2 BRACING. BOLTS FEE v FURNACE' LOCATION. I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS- GAS VENT, DUCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT. AND STATE LAWS REGULATIN BUILDING CONSTRUC- TION. U /y LATH.EXT. SIGNATURE OF Ill {.. HOUSE NUMBER COR- PERMITTEE� RECT AND POSTED ADDRESS' FINAL WM.J. FOX,COUNTY ENGINEER VALIDATION C. N. DIRLAM. CHIEF BLDG. INSPECTOR 111,0 fi 3 i i in AUG 3 �, APPLICATION FOR BUILDING, PERMIT' ,. - hLICANT TO FILL IN' (P,,nr,oi +YPe 6n10' " •BUILDING _ _ COUNTY OF LOS- ANGELES r ' ADDRESS O/o0"� ,C�eL - DEPARTMENT OF COUNTY,ENGINEER 'CITY T 6,1//-9`- BUILDING AND, SAFETY DIVISION NO OF BLDGS BUILDING ISIZEOFLOT )t 0 NOW ON LO ADDRESS TRACT 2— V BLOCK; L 10C<'-' •' LOCALITY ,'•.�' TELr�[/ p NEAREST OWNER , , ,rLT�/L NO q72-/�7 / CROSS ST / ASSESSOR ADDRESS 0?,6 2_ MAP BOOK PAGE• PARCEL` ' DISTRICT GROUP TYPE ' FIRE P ESSED BY'' CITY ZIP CONSTI? ARCHITECT OR TEL Q �" ENGINEER _ G O 3 3772 'STATISTICAL CLASSIFICATION ' e i J SEWER MAP s' ADDRESS 0 Q �Q,�y�dQ/"� C� CLASS NOOL�—DWELL UNITS �� BK3 'CONTRACTOR ' NOL33 Z/TE US ZONE MAO �� ) i ,� i ADDRESS g'O,, Ski= LO �� SPECIAL r LIC CONDITIONS r` = CITY ��' U�N l9'. ` CLASS ^ - "s ROAD DEPARTMENT APP RONAL,R EQUIRED YES ❑ -, NO ❑ ' CONSTRUCTION LENDER NAME AND BRANCH BLDG SETBACK FROM - "FRONTPROP L'INEOF '(STREET), `ADDRESS CTI' HIGHWAY e} YARD _ NOTA SETBACK FROM TYPE OF EXISTING ' SQ' FT, „NO OF NO OF 0 CHECK FRONT-PROP LINE HIGHWAY WIDTH SIZE D STORIES FAMILIES `/ ONE t DESCRIPTION OF WORK2��Te6�Cr;Ma `f B� EW. ❑ BLDG SETBACK FROM - t, U ADD SIDEPROP LINEOF p LTER ❑ HIGHWAY YARD = TOTAL SETB K ,ROM TYPE OF EXISTING ~ '} V REPAIR❑ SIDE-PROP LINE HIGHWAY WIDTH a USE EXISOT NG BLDG (GQ,Q/j•��,Qj EMOL TEL ❑ + / v r ` �� Z AP,PLIC'Ay yy�� CORNEIf, CUTOFF YES �,, NO''❑ - (PRINT) •� n IN OPEN SPACE +' - _ YES ❑ Ng ❑ BY (SIGNATURE) IN COASTAL PERMIT ZONE YES ❑ NO ❑ i VALUATION, �0 ,D• '' :n ,�. z . .•r ,_ •i I HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION AND STATE THAT-THE ABOVE IS CORRECT AND AGREE.TO COMPLY,WITH ALL ALL ORDINANCES AND LAWS REGULATING BUILDING CON- - x1 STRUC?ION ,I CERTIFY THAT IN DOIN6,THE WORK AUTHORIZED ; HEREBY I WILL NOT EMPLOY ANY-PERSON IN VIOLATION OF THE LABOR CODE OF THE TATE OF CALIFORNIA IN-RELATING' TO 'WORKMEN'S COMPEN TI N INSURANCE SIGNATURE OF PERMITTEE ADDRESS FINAL , ,� 17 ./p9 - ^ •'^ ,i TE LJ 2 N O '7 1� DATE BYE C I TY MAKE CHECKS PA}At3LE TO , P c t- •'PMTS FEE'$ ''FEE HARVEY T. BRANDT, COUNTY ENGINEER a ^•PLAN CHECK VALIDATION CK M O CASH,' PERMIT VALIDATION_ :cK' b '.M CASH 91 8`25 0 ' 78A838A'CE*803 5/74 - -• I }: WORKERS'COMPENSATION DECLARATION insureboraa certif catte of Workers' Compensation eInsuran elf APPLICATION FOR - �U L D I N G P E RNI I T ora certified copy thereof (Sec 3800, Lab C ) -1 - I . COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No CompanyBUILDING ' Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS •�dG, Certified copy is filed with the county building inspec- BUILDING =/�l= 001 tion department - ADDRESS m� j/ \,�� j.r:� LOCALITY - //'' 'NEAREST' Date- Applicant CITY L �j ZIP CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS' Iv NO OF BLDGS ASSESSOR ' SIZE OF LOT k7 L t7 NOW ON LOT MAP BOOK COMPENSATION INSURANCE PAGE PARCEL (This d' section neenot be completed if.the permit is for one , USE ZONE MAP TRACT L QBLOCK LOT �r mT�. NO hundred dollars ($100)or less ) SPECIAL; '} TEL' y I certify that iIL n performance of,the work for whch.ihis ' OWNER]/).4. /jlJ//� �/ M1 NO &I: ' CONDITIONS 0 �-�� DISTRICT '. GROUP TYPE FIRE + PR ESSED BY O permit'is issued, I shall not employ any person in any manner ADDRESS ��r _�' f�T ` CONST ZO E ` so as to become subject to the Work Compensation ws , _ CITY / ��L�{/ a ZIP, �f M Date Applc ARCHITECT OR' TEL ST TISTICAL LASSI ICATIO APT , CONDO . NOTICE iT0 APPLICANT If,' r making this Certificate of \ V CLASS NO DWELL UNITS l� \ s W Exemption, you should ome subject to the Workers' ENGINEER NO 'Compensation provisions of the Labor Code, you must forth- _ _ ADDRESS SEWER MAP \,, H y with comply, with such provisions or this permit shall be EL deemed revoked CONTRACTOR/�� / NO BK PG, VALIDATION LICENSED CONTRACTORS DECLARATION LIC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO VALUATION = (commencing with Section 7000)of Division 3 of the Business and t'`• i LIC s O� Professions Code, and my license is in full'force and effect CITY '' CLASS _ $ - g7 SQ FT NO OF NO OF 'CHECK Acense Number Lic Class SIZE STORIES FAMILIES ONE 4 $ y 'Contractor ' Date DESCRIPTION OF WORK NEW a LADD ❑ I am exempt under Sec- / ALTER ❑ DATE (� �� B 8P C for this reason X11 y REPAIR ❑ i�fifi ❑ FINAL EXISTDate USE OF F BLDG DEMOL FI , Signature ` APPLICANT TEL By OWNER-BUILDER DECLARATION PRINT NO I hereby affirm that I a'm exempt from the Contractor's License .Law for the following reason (Section 7031 5,-Business and ADDRESSo'oA0 Professions Code) P < < •_,, BUILDING 0 0 817.3 I, as owner of the property, or,my employees with ADDRESS . t^ wages as their sole compensation,will do the work'and o 8 70 0 _ , 't FLOCALITY ie structure is not intended or offered foF-sale(Section r t`, 13 8 ,;7044, Business and Professions Code) : MOVING '` TEL 1,.d 0 7—'g 3 I, as,owner,of The property, am exclusively•contractmg CONTRACTOR NO j with licensed contractors to construct the,project (Sec- ADDRESS • ' tion37044, Business and Professions Code) REQUIRED TOTAL SETBACK FROM EXIST r ` CONSTRUCTION LEND]NG:AGENCY YARD HWY n' SET BACK PROP LINE WIDTH P, f•, t S t r herebyaffirm that there is a.construction lending agency for t �'- > 9 9 Y FRONT- 1, the performance of tke work`for which this permit is issued P L •' ®r z - (Sec-3097, C4,10,) SIDE m j PL 5 , o Lender's Name .s Lender's Address P C Fee$ Permit F I + Y I certify that-I have read this application and state that the Issuonce'Fee above information'is correct I agree�to comply with all County Investigation Fee ' g ordinanc- and State laws relating to'building construction, Total Fee i t. iy and hereby authorize representatives of this County'to enter ,Upon !4e above-mentioned property for inspection purposes z ` ' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Apphcant or Agent r Date ✓ r ®s