HomeMy Public PortalAbout9823 KEY WEST ST_Building__ ' 76A638A CE 8803 2-63 APPLICATION FOR P U I L D -P -
COUNTY- OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY'ENGINEER ADDRESS 9823 Key West
BUILDING AND SAFETY DIVISION LOCALITY TemU1 itv
rJOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A JENSEN, SUP T OF BUILDING CROSS ST
DISTRICT NO GR 6 LIMP TYPE 'P C SSED BY
FOR'APPLICANT TO FILL IN ��l CONST
BUILDING - STATISTICAL,CLASSIFICATION S4NER MAP
k __BK G
ADDRESS CLASS NO DWELL UNITS '�
LOT NO - BLOCK WATER `
CERTIFICATE NOT REQUIRED RECEIVED
TRACTMAP
-3.16y— -NO OFBLDGS NO l (iCI CVLE) STATE MAJOR SECON CAL
SIZE OF LOT NOW ON LOT USE ZONE' SPECIAL ,
USE OF - - CONDITIONS
EXISTING BLDG
TLL,,,,
OWNER C NEO[86-5011— BUILDING EXIST
SETBACK YARD HWY STREET NAME,,i/I WIDTH
ADDRESS,_ same 'FRONT -
ARCHITECT OR - TEL - - P LID � - -
ENGINEER NO _ I SE _ a
P L - O
ADDRESS - -
- TEL
CONT.RACTOf�a,C1f1C InstallerS NO 2-1234 O
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ADDRESS 1OP20 1��, (� Y�•' V
DESCRIPTION OF WORK W Lu
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{
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NEW DD ALTER REPAIR< DEMOLISH ,
SO FT, NO OF, NO OF ' ", � '
SIZE - STORIES FAMILIES
USE OF
STRUCTURE I - `
I
70M,,BTU V111,
SIGNATURE OF I:, _
,APPLICANT - I„
VAL'UATION,S 273,00
e APPROVAL'S _ DATE INSPECTOR S SIGNATURE
P'CPMT FOUNDATION' L A
•y FEE,S ��• FEE S 6 nnFORMS, MAT
FRAME' FIRE-ST S
.�
DI HEREBY ACKNOWLEDGE THAT I HAVE`READ THIS APPLICATION 'BRACING BOLVAS
AND STATE THAT THE•ABOVE IS CORRECT AND AGREE TO COMPLY• FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND 'STATE LAWS REGULATING GAS VENT 'DUCTS
BUILDING'CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN•VIOLA- ' LATH;INT' ` •'
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT -
ING TO WORKMEN S COMPENSATION INSURANCE • t LATH' EXT ' -
/(
51GNATU RE O��. J /� �� HOUSE NUMBER COR
PERMITTEE " RECT AND POSTED '
ADDRESS FINAL
JOHN, LEWIS P.RINCIPAL'ST CT RAL ENGINEER
- PLAN• CHECK VALIDATION •CK ; M o CASH.' _ PERMIT,VALIDATION CK MO CASH
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76A638ACE'#8o3,. APPLICATION FOR BUILDING PE •I
COUNTY OF LOS ANGELES BAOIL°!ss
.DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY'ENG'I'NEER NEAREST / R
WILLIAM A.-JENSEN, SUPT OF BUILDING CROSS ST. (/
DISTRIC NO G, P TYPE P BY
DISTRIC�NFOR APPLICANT TO-FILL IN ��'", coNsr.
BUILDING-gg
JSTAT ISTfCAL_CLA 16ATION SEWER MAP
ADDRESS .`, ..'CA 'MBK ,P�
LASS. No.-. DWELL.UNITS
LOT NO: — BLOCK.' WATER 11CERTIFICATE:' NOT REQUIRED RECEIVED
TRACT al_'�l
NO. / (C RCLE) STATE MAJOR SECOND OCAL
NO.OF BLOGS.
SIZE OF LOTNOW ON LOT USE ZONE SPECIAL
USE OF - CONDITIONS
EXISTING BLDG.
TEL. J J
OWNER. NO.' , BUILDING ` EXIST.
SETBACK YARD HWY STREET NAME WIDTH
ADDRESS `},_ C i{ ) ' FRONT •�j� _ ^/,�'�-
ARCHITECT OR -TEL'. P. L. r�Z�
ENGINEER NO. SIDE
.. P. I r O.
ADDRESS' �------ •77 - - O
CONTRACTOR - 'CA,"i- tL;;.uy�P NO �//•J
ADDRESS - O
DESCRI TION OF ORK oUw.
H
NEW ADD. ALTER REPAIR DEMOLISH
SQ. FT. • NO. OF NO. OF
SIZE STORIES FAMILIES
USE OF'
STRUCTURE
TCL
SIGNATURE OF
APPLICANT
VALUATION.$ i..0 •'�"
/�',�/J APPROVALS DATE •INSPECTOR'S SIGNATURE ,
FEE $- - FEElmf'.$• (/ (/ FO FORMS, MATER:AL'SON
FRAME: FIRE STOPS,
_ I HEREBY A _
CKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS !I
AND STATE THAT THE ABOVE'IS CORRECT AND AGREE TO COMPLY FURNACE:-LOCATION.
WITH ALL COUNTY ORDINANCES AND STATE, LAWS REGULATING GAS VENT..DUCTS
,.'BUILDING CONSTRUCTION. I CERTIFY THA ;IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT.EMPLOY ANY _
TION OF THE 'LABOR E THE STAT "'CALIFORNIA R L 'LATH. INT.
ING TO WORKMEN'S^ P N ASI OII.NSU F;,Lq}��
I CSV /" LATH, EXT. y
SIGNATURE OF ! „ '� / �L!/�' HOUSE NUMBER COR- �" 1
P,E,RMJTTEE W��s-'� !!!___ RECT•AND POSTED
FINAL
' - JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENG` ER
PLAN CHECK VALIDATION CK.- M.O. CASH _ ",'PERMIT VALIDATION CK. M.G. CASH
APPLICATION FOR BUILDING PERMIT
FOR&PPLICANT TO FILL IN (Print or type only)
BUILL,'!NG COUNTY OF LOS ANGELES
ADDRESS �i DEPARTMENT OF COUNTY. ENGINEER
CITY �;,> ,� j .Z I P - BUILDING ANDS TY DIVISION
BUILDING
22 s
SIZE OF LOT � ' � NOWOON LOTS / ADDRESS )
TRACT! /� BLOCK LOT NO. ,� LOCALITY
TEL. NEAREST
OWNER �� NO. CROSS ST..
r ASSESSOR'
ADDRESS ,C'�/ MAP BOOK PAGE Af2CEL
DISTRICT 1GROURITYPE FIR PRO SED BY
CITY Otsj %� `� ` ZIP CONST. ZO
ARCHITECT OR TEL. �i®(
ENGINEER NO. '
STATISTICAL CLASSIFICATION VJER MAP
ADDRESS CLASS NO DWELL.UNITS BK
CONTRACTO�Rj Tl NEL �lJ�s U ZONE M0.
LIC
ADDRESS p� �r fr NO•,,St�•� ''�T J' SPECIAL.
CITY ef�,C...' �✓�-� LIC. CONDITIONS
CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑
CONSTRUCTION LENDER
NAME AND BRANCH BLDG.SETBACK FROM
FRONT PROP.LINE OF (STREET)
ADDRESS CITY HIGHWAY + YARD 'TOTAL SETBACK FROM TYPE OF 1EXISTING
SQ. FT p NO. OF NO. OF CHECK - FRONT PROP. LINE HIGHWAY WIDTH
SIZE 2c'>,9 STORIES FAMILIES ONE
_ Y
+
DESCRIPTION OF WORK NEW ❑ .E O
U
ADD
BLDG.SETBACK FROM
D10 le t em k ❑ SIDE PROP. LINE OF (STREET) O�
LTER HIGHWAY + YARD = TOTAL SETBACK FROM TYPE A EXISTING C~j
REPAIR❑ SIDE PROP. LINE HIGHWAY WIDTH LU
_ t/)
USE
EXISOT NG BLDG. /��L�jC/�'C DEMOL ❑ + Z
APPLICANT TEL .1A CORNER CUTOFF YES ❑ NO ❑
(PRINT)
BY (SIGNATURE)
IN OPEN SPACE YES ❑ NO ❑
�.
`� IN COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION, �- 074O
I HEREBY ACKNOWLEDGE THAT I HAVE READ,THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION, I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EM PL K ANY PERSON IN VIOLATIONr THE
LABOR CODE OF THE ATE OF CALIFORNIA IN REL"AT G To
WORKMEN'S COMPENSP. 0N;INSURAyCE. -
SIGNATURE OF
PERMITTEE yc
ADDRESS �f / FINAL CITY b °r • NOLd' �F1 DATE I?j /� BY /
(HPMTi
AKE CHECKS PAYABLE 70: F E'+ •/ FEE
HARVEY T. BRANDT, COUNTY ENGINEER
] P C.PLAN*CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK. M. CASH
1.. n8 (T 17 1 0 4 2.0 0
76A638A CE#803 5/74
-CT#boa f,Cj 6/78)
'APPLICATI FORBVIL.DING PERMIT -
COUNTY OF LOS ANGELES 'BUILDING AND SAFETY
FOR'APPLICANT TO,FILL IN BUILDING
,ADDRESS
BUILDING',�'i
ADDRESS S`I LOCALITY
NEAREST
z
CITY / `.�s�'/�� / ` ZIP Y CROSSST
NO OF BLDGS. ASSESSOR
SIZE OF L6TL:�61- ►����(✓4- NOW ON LOTMAP BOOK PAGE PARCEL
r �-
DISTRICT GROUP _ TYPE FIRE ESSED BY'
TRACT �j1 BLOCK LOT NO, �' ^;-//-II /may) CONST ZONE 1
TEL -
OWNER /r`��A •_'L/.��_r .NO
STATISTICALCLASSIFICA ION - SEWER MA
ADDRESS �o�J ��'I ° �=�✓ -
// CLASS NO DWELL UNITS -�-BK�L PG ,
CITY IV✓ G•%�� ZIP
ARCHITECT OR •TEL VALUATION
ENGINEER NO _//4
J p D'o
ADDRESS ° BLDG SETBACK FROM
/ FRONT PROP LINE OF '-= STREETI-
CONTRACTORG [� /!d/���! !VO TOTAL SETBACK FROM TYPE OF EXISTING
jLIC HIGHWAY + YARD = FRONT PROP LINE HIGHWAY WIDTH
ADDRESSS � ;/J�' NO r,�✓' Y 7'
• LICA r-'1
CITY �i-�l/j/�i <J' CLASS
CONSTRUCTION LENDER l BLDG SETBACK FROM ,
NAME AND BRANCH tiF' SIDE PROP.LINE OF :(STREET)
HIGHWAY + YARD _ TOTAL SETBACK FROM TYPE OF EXISTING
ADDRESS CITY SIDE PROP LINE HIGHWAY WIDTH C
SIZE �'�
STORNO IES -. FAF INOMOI ES ONECHECK_ + — 0
o 3S
DESCRIPTION OF WORKµ� NEW P C ,Fee$ Permt Fee,
All ADD ❑ p '
❑ Issuance Fee
ALTER
USE REPAIR ❑ Total Fee /
EXISTOING'BLDG ��IaCJL��'r, DEMOL ❑ Z
APPLICANT TEL '
IPRINyI
i G
I
J
BY(SIGNATURE) -r / > „
I HEREBY ACKNOWLEDGE THAT J 'TFH,HAVE READ, APPLICATION AND STATE' -' ' uw -
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALCORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE _ .,�,: 4.5 9.5 A
WORK AUTHORIZED HEREBY-[WY'ILL.NOT EMPLOY ANPERSON IN VIOLATION OF - - - V
THE LABOR CODE OF THE STATE OF'CADFORNIA IN RELATING TO WORKMEN S COM• Z
PENSATION INSURANCE O-O 1
SIGNATURE OF` ( i�,,f� �f�• �,�. d 21-14200
.
PERMITTEE L
ADDRESS t �•�, 5' .f`/' z _ ;O.o1.4 2`'0'0 6 , '
TEL NO v �� `>f 0 0 5,n r i,
CITY i l�f✓ ,)3 J 33 Q 9— 9
ZONE MAP
N
O ;SPECIAL
.. -
0� CONDITIONS^ y wr A ~
FINAL GBY spy' `..y+ rla
DATE !� - 96YC.��?r1/ ''' _• ._ , .. — - ...
A►PPLICATI01ITOR BUIL®INGPERMIT
COUNTY OF'4OS'ANGE1 E'S BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION w FOR APPLICANT TO FILL IN BUILDIN P7
I hereby affirm that I have,a certificate of•consent to self Insure, BUILDING'ADDRES -
or a certificate of Workers' Compensation Insurance, or a ceri fled
copy thereof(Sec 3800; ) _ CITY / ZIP
p n T LOCALITY
POIICy NO Company V SIZE OF LO NO OF,_BLDGS NOW ON LOT,
❑ Certified copy'IS hereby furnished -'o -� •NEAREST CROSS ST
❑ Certdied'cO TRACT BLOCK LOT NO
py Is fded'with'the Qounty bwlding Inspection PSE ZONE MAP NO h I
' depart 'e/n/1�.7r ` A P{��/A/`O '
Date I �/ APPllcant ( �ALt G/.-I�s�S /I/O ASSESSOR MAP BOOK - :y:
'PAGE,' - - -PARCEL
-T— ^' .SPECIAL'CONDITIONS
_ CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER T L.NO r
COMPENSATION INSURANCE i� WITHIN 1000 FT OF SCHOOLS YES No
(This section need not be completed If the permit is forone,hundred- ADDRESS
dollars ($100)or less) - - s� DISTRICT'' GROUP TY ONST FIRE ZONE P CESSED BY
t, CITY ZIP - • G ,x
I certify that'In the performance of thev'work for,which this permit
eqIs Issued, I shall not employ any•,person in any manner.so as to p J
become Subject to,the Workers"Compensation Laws ' ARCHITECT O NGINEER TEL NO STATISTICAL CLA IFICATION APT CONDO
Date Applicant ADDRESS - - ,CLASS NO DWELL UNITS
- - - NOTICE-ZT0-APPLICANT-If,�'-after-making• this`Certificate-`Of - �y- •` -- '- - - � REQUIRED - TOTAL SETBACK FROM EXIST
Exemption, you should' become subject to the Workers' CONT COR SET BACK
YARD ,HWY PROP LINE WIDTH
Compensation -provisions ot',the Labor,Code, you must forthwith FRONT
comply.with such provisions or this permit shall be,deemed revoked` ADD erdv O �Q PL
LICENSED CONTRACTORS DECLARATION - �( SIDE
CIT oo r - •I� A - P L
I hereby affirm that I am licensed underprovisions of Chapter ,9 v G SEWER MAP
(commencing with Section 7000)of Division 3'of the Business and a SQ F r SIZE NO OF STORIES NO OF FAMILIES
Professions Code,and m 'he e i in full force an e - ! NEW ❑ BK, PG
DESCRIP ION F WORK - VALUATION
License Number LI ,Class02 ADD ❑ aQ O
Contractor ale T P ALTER ❑Ask $ i
❑ I am exempt under Sec` 's `� REPAIR
B&PC for this reason" DEMOL ❑ III
Date USE OF,EXISTING BLDG URM T
V
- •' . - - ❑ LDMA P/C# w- F i HT 5 L7 5
Slghature ' - d 1 id�i
APPLICANT(PRI) TEL NO _ LDMA Perm#
❑ I, as Owner'of the propert CHECK 175465
y„•or my employees with wages as � Z ,
their sole compensation, will do the work and the structure is ADDRESS F tt�w �� J
not intended or offered for. sale (Section 7044, Business and FINAL DAT Q 4f1t1 .00
Professions Code) L M
WILL THE APPPCANT OR FUTURE BUILDING OCCUPANT HANDLE A,HAZARDOUS-MATERIAL ('')('�('�(��ry(�(y Q 6/95 Qi-`
❑ I, as owner of the 'property, y g OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J 0000—0001 7, 6�/'�
p p y,•am exclusive) contracting with
licensed'contractors to construct the project (Section 7044, AMOUNTS SPECIFI N THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY
Business and Professions Code) WILL
❑• No 17 1 App
WILL THE INTENDED USE OF THE BUIDUNG,BY THE APPLICANT OR FUTURE BUILDING - _ - +• 1 +,�^ Ct111141ti.'
a OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH `
CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY'MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKUST FOR
GUIDELINES -
P I hereby,,affirm.that there Is a construction lending agency for 'YES❑ •NO IQ
N the performance of-the work for which this permit Is Issued(Sec
rn , - I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING
a 3097, CIV C) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE
( I TITLE 2 CHAPTER 2 20 SECTIONS 2-20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS
4 3 L'ender's Name MATE LS REPORTING D FOR TAINING A PERMIT FROM THE SCAQMD
1 c Lender's Address A 14 ka Ig -
p
0 1 certify that I have read this application and state under`penalty
O ` P C FEE - PERMIT FEE 13.5 a
of perjury that the above information is correct I agree to comply J
o with all county ordinances and State laws relating to building-
jm construction,-and hereby authorize representatives of thls'County ISSUANCE FEE
ato en r upon the ab ve- tl ned�roperty for inspection purposes �O
INVESTIGATION FEE - TOTAL FEE -
� • Sgnetu o��A9ent � Det ! (p ^ .•
SEE REVERSE FOR EXPLANATORY LANGUAGE