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Home My Public Portal About10703 LA ROSA DR_Building__ DEPARTMENT UI COUNTY ENGINEER BUILDING� � �®' DIVISION OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER APPLICATION CASSATT D. GRIFFIN, SUF'T OF BUILDING FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY ADDREISSG /� 7a A DISTRICT NO. PUN CK.OR Rec.NO. PERMIT NO. 5 6 �3� 3 -y /7-'f`�S-�-s LOCALITY CRECEIVEp BY DATE OF APPLr� �-D`dT EISSSUED NEAREST tyO/_V " .Z CR088ST ✓e, . BUILDING /♦r/SGA ADDRESS / 0 7 OWNER I / `.'MAIL (' V I / ' � ADDRESS ' //��/ //JJ�JQ Qh b�'��/ LOCALITY W�AA CITY SAIL �.'lA IID%/ TE � !. NEAREST /. CROSS ST. ARCHITECTOR TEL. FIRE NO. OF TYPE- GROUPS ENGINEER NO. ZONE I PLANSI J BLDG. G !.7 / O D:LNO. ADDRESS A� j �J� /Il SETBAUSE1CK'L1INE TI;A CONTRALTO �/Y I NO. • �q (07 ZONE/T -! BYPROV ED ADDRESS ot 77 A Sa Son GQ6i. HOUSE NUMBERING LEGALMAP NUMBER ` V / , NO. ASSIGNED BY DESCRIPTION I L T NO. 3 BLOCK CORRECTIONS TRACT 17967 V 7 SIZE OF LAT ffI D Ig/10101 NOW ON LOTS USE OFN L� EXISTING BLDG'. N Lies - DESCRIPTION OF WORK D - NEW DEMOLITION ADDITION Z REPAIR > r 80. FT. NO. OF93 !J SIZE ROOMS STOOR�IESO G COVEEXT. RING 5ro&eoALLl COVERING Comh USE OF STRUCTURE A� at Car APPROVALS INSPECTOR'S SIGNATURE DATE FOUNDATION: LOCATION FORMS, MATERIALS 1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME: FIRESTOPS, R PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS ��7' �✓ CORRECT. FURNACE: LOCATION, 1AGREE TO COMPLY WITH ALL COUNTY ORDINANCES GAB VENT, DUCTS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. SIGNATURE OF +yy • C- �• ' (/ • / 1 LATH. INT. PERMTEE {/ I. A ✓P�� sy ADDRESS n /7f / J� S4n. A/Jr/�/ LATH. EXT. PLASTER. INT. AUTHORIZED AGT. PLASTER. EXT. A $ / FEE C. S (O S ' HOUSE NUMBER COR- Q 0 ' RECT AND POSTED A [VALUATION FEE S �p C' FINAL 5 7GA888A D889 8.51 -,.96A639A.CeB03.R ,TAPPLICATION FOR BUILDING PERMIT •�AbUN'PY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADORE 1070J I- A eorA BUILDING AND SAFETY DIVISION LOCALITY JOHN.A. LAhl COUNTY ENGINEER. COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST CROSS ST. Q FOR APPLICANT TO FILL IN DISTRKICT NO. GROU TYPE PRo SSED By (Print or type only) ( CONST j BUILDING STATISTICAL SSIFICATION SEWER MAP ADDRESStA 2f C JI CLASS NO.—K—DWELL.UNITS= BK PG LOT NO. BLOCK USE ZONE MAP NO, TRACT SPECIAL- NO' PECIALNO.OF SLOGS. .. CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. EV IrliFA, ev BLDG.SETBACK FROM Xy EL. FRONT PROP.LINE OF —(STREET) OWNER NO. TYPE OF EX I STING SETBACK HIGHWAY } YARD = TOTAL ADDRESS Q �,^ L E J HIGHWAY WIDTH FROM C.L. } _ CITY BLDG.S ETBACK FROM ARCHITECT OR TELI1 SIDE PROP. LINEOF (STREET) ENGINEER NO. TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. TEL. t = CONTRACTOR NO. LIC. ADDRESS LNO,IC CORNER CUTOFF YES El NO U LIC. CITY CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK _ NEW ADD ALTER REPAIR DEMOLISH - SO. FT. ''nn NO. OF NO. OF i 4_1 f-� P SIZE y STORIES FAMILIES D USE OF STRUCTURE Gf� SIGNATURE OF APPLICANT VALUATION S �J (y'� APPROVALS' DATE IHe OR PMT.FEE S FEE S /I /EJ V FOUNDATION: MATERIALS ION FRAME: FIRE STOPS, !/ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, 4 WITH ALL COUNTY ORDINANCES ANO 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- / 1, TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAL LATH, INT. (G V INC TO WORKMEN'$COMP $ATION 5 RANC LATH, EXT. SIGNATURE OF OUSE NUMBER COR- PERMITTEE- RE'TA ND POSTED Aooftess d L tlJ ` FINAL JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION K. M.D. CASH _ PERMIT VALIDATION M.O. CASH LACO4 8 5 3-� MAY 28 1 0 2 2.50- -- y ��WORKERS' COMPENSATION DECLARATION APPLICATION FOR BUILDING PERMIT I heretFjjnfirm that I have a certificate of consent to self insure, or a certificate of Workers'Compenstion Insurance,or a certified copy thereof (Sec. 3800, Lob. C.) '\ COUNTY OF LOS A S G AND SAFETY Policy No,—Com pany • Certified co is hereby furnished. BUILDING copy v FOR APPLICANT TO FILLIN ADDRESS D Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS 03 LA ApS P, LOCALITY Date Applicant CITY M fi - ZIP Q CROSS NEARESTT. x CERTIFICATE OF EXEMPTION FROM WORKERS'- NO. OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL - (This section need not be completed if the permit is for one - USE ZONE MAP i hundred dollars ($100)or less.) TRACT I BLOCK I LOT NO. NO, TEL. // SPECIAL r d I certify that in the performance of the work for which this OWNER p L_ NO, 7. CONDITIONS O DISTRICT GROUP TYPE FIRE PROCE ED BY permit is issued, shall not employ any person in any manner V ADDRESS L� /tK CON so as to become subject to the Workers'Compensation Lows. OCT �J� ad Dote Applicant CITY ' ZIP STATISTICAL C FI ATION APT. CONDO. ARCHITECT.OR - TEL. �9� NOTICE TO APPLICANT: If, after making this Certificate of - 7(/ 1Li Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS_ 6 N Compensation provisions of the Labor Code, you must forth- ADDRESS _ SEWER MAP Z with comply with such provisions or this permit shall be deemed revoked. U� TEL BK. PG, VALIDATION CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION . 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 LIC. l Professions Code, and my license is in full force and effect. CITY CLASS - S _ - SO. FT. NO. OF NO.OF CHECK License Number Lia,Class SIZE Z.�� STORIES FAMILIES ONE Contractor Date DESCRIPTION OF WORK C-X` jjj N NEW ❑ ` I am exempt from the licensing requirements as am a W Jou_ i j g.A ADD ❑ licensed architect or a registered professional engineer , - p�� ALTER [_] FINAL acting in my professional capacity (Section 7051, /V.JJ REPAIR ❑ DATE U4 . Business and Professions Code). USE OF EXISTING BLDG. FINAL By DEMOL ❑ �ti4L1 c Lic, or Reg.No. Dote APPLICANT TEL. , OWNER-BUILDER DECLARATION (PRINT) - NO. I hereby affirm that I am exempt from the Contractor's License Low for the following reason (Section 7031.5, Business and ADDRESS - fession5 Code): PRESENT11 — , BUILDING I, as owner of the property, or my employees with ADDRESS .. wagesos their sole compensation,will clothe work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. I, as owner of the property, am exclusively contracting CONTRACTOR NO. z` 1 7 JC.5 A with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). - - # e • • e a I REQUIRED TOTAL SETBACK FROM EXIST. m he$ there is a LENDING AGENCY SEi BACK YARD HWY PROP. UNE WIDTH - I hereby affirm Ihat there is a construction lending agency for 'FRONT- 2 • - 14300 the performance of the work for which this permit is issued P.I. 4 3.Q 0 0 (Sec5 . 3097, Civ. C.). SIDE- -- _ - • o o RL Lender's Nome - 0 a 15-80 P.C. Fee$ Permit Fe Lender's Address w I certify that I have read this application and state that the Issuance Fee aabove information is correct. I agree to comply with all County Invesrgaiion Fee. -.. - _ $ ordinances and State laws relating to building construction, Totol Fee and hereby authorize representolives of this County to enter a upon the above-mentioned pro rty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of A plicam �� ®s or Agent Dote ` '