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Home My Public Portal About10727 LA ROSA DR_Building__ 76A538A CE C8031 I_SJ APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING44 Val-A DEPARTMENT OF COUNTY ENGINEER nooREss BUILDING AND SAFETY DIVISION LOCALITY T._ . G , JOHN A. LAMBIE,COUNTY ENGINEER NEAREST ' ' M CASSATT D.GRIFFIN, SUPT OF BUILDING CROSS ST. CV 'DISTRICT NO. GROUP TYPE SEWER AP FOR APPLICANT TO FILL IN ^1� T3 BK �(I G �y_ CONST.�1� V BUILDING / STATISTICAL CLASSIFICATION ADDRESS ,0 .9 A{/ZOSA —ill CLASS. NO. DWELL. UNITS LOT NO. BLOCK MAP STATE YES I O NUMBER �.. Q% q j HWY. TRACT US ZONE SPECIAL NO.OF SLDGS. CONDITIONS SIZE OF LOT 51 X IO/ NOW ON LOT / USE OF //// // EXISTINGBLbDG. oM -Hq /IC 19k• BUILDING EXIST. T (� YARD HWY STREET NAME OWNER -Te AA/ V. SETBACK WIDTH 'f Re VP • C FRONT MAIL P.L: Y Y-•A .ADDRESS X07 ' `7 1A k06, SIDE TEL. (TZ P.L. CITY c C I f ND. INSPECTION RECORD ARCHITECTOR TEL ENGINEER NO. /� / [ ADDRESS 24 CONTRACTOR �j NOO. ADDRESS OWA;eP- 13K1 e./\•• DESCRIPTION OF WORN NEW ADD ALTER REPAIR DEMOLISH ' SO. FT. NO.OF NO.OF SIZE klc=:I. STORIES FAMILIES USE OF STRUCTURE - , 411 f .r . / '/11O Zoo Ad SIGNATURE OF APPROVALS APPLICANT l DATE INSPECTOR'S SIGNATURE ADDRESS FOUNDATION: LOCATION FORMS,MATERIALS: MATERIALS FRAME: BOLTS FIR . S� 'Y'•`� FEE BRACING.BOLTS (� VALUATION 7" -- S /L il'O FURNACE: LOCATION. FEE T GAS VENT.DUCTS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH,INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPL ITB ALL COUNTY ORDIN CES.AND 1 STATE LAWS GU TIN 8 C N. LATH, EXT SIGNATURE OF HOUSE NUMBER COR- PERMITTE RECTANDPOSTED ADORE PCI ✓ FINAL / 7" S842jz �—�.i CLYDE N.DIRLAM, PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH X663'9 1 5 m AUb.15 1'A 4.0'0 �, � a--• DEPARTMENT OF COUNTY ENGINEER DMSION OF BUILDING.AND SAFETY BUILDING COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER APPLICATION '- CASSATT D. GRIFFIN, SUPT OF BUILOINO ' FOR APPLICANT TO FILL IN FOR OFFICE.USE,ONLY. /1`� DISTRICT NO. PLAN CK.OR Roc.NO. PERMIT NO: BUILDING ADDRESS /V / 7 1,O Q ` •^I — ' � I / /T q� . 11 LOCALITY / `%'/ RECEIVED BY DATE OF APDL. DATE ISSUED ,� J NEAREST CO86 B7 BUILDING OWNER 21 /1/ ADDRESS /d L MAIL- bLOCALITY ADDRESS 60 be,, TEL.'47 CROSS 6T. CITY S Ga6P%� I qsy1i,}. ARCHITECTOR TEL. FIRE I NO. OF - TYPE , I GROUP 3 . ENGINEER NO. ZONE PLANS �� ADDRESS BLDG. L D I I O DN O. 14V- ,yT �/ SETBACK LINE it CONTRACTORI^/ . V- M`NU NO. T 9 TNl ZONE BYUSE PROVED DATE ADDRESS I_/ 7'A fo Saa e6 I HOUSE NUMBERING ' LEGAL MAPNUMSER ` ' S /. NO. ASSIGNED BY DESCRIPTION I LOT NO. #7 I BLOCK CORRECTIONS TRACT ,/ •7 �-4, NO. OF SLOG . SIZE OF LOT JI / U/ OQ.I NOW ON LOTS �7 q USEOF �^ I NO. OF --- -- - I -� EXISTING BLDG. FAMILIES DESCRIPTION OF WORK O - REAALTERATION ADDITION IR DEMOLITION D 60. FT. NO. OF SIZE ['�.3 ROOMS STORIES /�/� COV EWALLROOF NO LJ / I COVERING VOIYI.V USE OF STRUCTURE APPROVALS INSPECTOR'S SIGNATURE DATE FOUNDATION: LOCATION f{ FORMS, MATERIALS A / I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRE STOPS. PLICATION AND STATE THAT THE INFORMATION GIVEN I6 BRACING, BOLTS CORRECT. ON. 1 AGREE TO COMPLY WMH ALL COUNTY ORDINANCES GAB VENT,FURNACE: LOCATION. DUCT AND STATE LAWS REGULATING BUILDING CONSTRUCTION. _ SIGNATURE OF/ L � / LATH, INT. �r 3 PERMITfEF-- LATH. EXT. ADDRESS - /J� A PLASTER, INT. AUTHORIZED ACT. ,/, � PLASTER, EXT. S �'7 7 Q'.p P, C. S ( 00 p FEE �J HOUSE NUMBER COR- A D RECT AND POSTED VALUATION FEESt 10 � FINAL 76AS38A D088 0.03 L _ (YJ t . ® WORKERS'COMPENSATION DECLARATION a.`. . J "'.a i'• - _ �+.. „ -- 'I-;herab affirm that I have�a certificate of consent tot self `^ insure or a ce7tificote of Workers' Compensation Insurance, - - APPLICATI.ON__�FOR :�BU.IL'DI-N.G. PERMIT ' . or certified copy thereof (Sec 3800, Lab C.) - COUNTY OF LOS ANGELES BUILDING-AND SAFETY Policy No., Company ._/0 ..-. �-'-r Certified.mpy is,herebyfurnished. FOR APPLICANT TO FILL IN ADDRESS {07.2 / L4 OSH -� Certified copy is(ilea'with the county buildi'n'g inspec- BUIL �^s - tion department. - ADDRESSDING '� A d C Date' Applicant.: CITY /L- C<'f ZIP / 7D 0 LOCALITY - ' CERTIFICATE OF EXEMPTION FROM WORKERS' - --" - " - -- - NO. OF BLDGS. - ---. NEAREST - ' COMPENSATION INSURANCE 't SIZE OF LOT NOW ON LOT CROSS ST. (This'section need not be completed if the,permitlis for one - p. •-•� - - — -- - ASSESSOR - -� "'•'r�° .hundred dollars ($100)or.less.) . TRACT ' O( / BLOCK LOT NO. /� MAP BOOK' "'` PAGE PARCEL -I certify that in the performance o4 the work for which,this OWNER' R J -•�r NO.(' - E' Y h C,- USE MAP No. permit is issued, I shall not employ any person in any manner /1 OS' VW- _ - SPECIAL -- - -- - - - - 6 'ADDRESS' CONDITIONS S?as to bec me subjecf'to'the Workers' ompensation Lows. O a' ��//Ci - ^U //(yam//�'�- CITY. . . . C. r l,lT" _ ZIP I"j Y- Date 4 icon , _ _ 0 NOTICE TO APPLICANT If, afte' akin this erIificate of ARCHITECT OR TEL j O .DISTRICT _ GROUP TYPE _ FIR6 _. CE SED BY ' V ENGINEER NO. r/ CONST¢ ZONEP Exemption,•you 'should become sub' cyto the 'Workers " " � �•'� (�/( p Compensotion'provisions ofLthe Lobo i Code, you must forth ADDRESS __ G. withcomplywith,such provisions or this permit shall be _. -- ---- - - - -- - V tD �� N deemed revoked. - _ p �Jc• TEL Z• STATISTICAL CLASSIFI TION APT-. CONDO. Z '� CONTRACTOR W) '� �' NO. 4!s''753� (_ \ LICENSED CONTRACTORS DECLARATION. . , tr ) CLA55 NO 2 DWELL: UNITS_ the affirm that l am licensed under provisions of Chapter 9 ADDRESS ��JJ((�+� 1/wl !JOU L C. ..J7 .✓ t UL r/ NO. 77 SG Y_ SEWER MAP (commencingwith Section 7000)of Division 3 of the Business and _. ._�_.}') _. .. ._ uC: _ r ) Professions.Code, and my license is in full force and effect. CITY ��1xJ (f CLASS G-� I ;,:9K, ' �. {' - VALIDATION - p ,. Q __ SO, FT. _ NO. OF _ NO. OF _ CHECK I s License Number RIO Lic.Class' `� SIZE S2 STORIES I FAMILIES ONE 1- t - p VALUATION Date Y - O •- - DESCRIPTION OF' WORK -_ Y ADD Contractor $ ❑ 1 am exempt under Sec. T yt}, ' �• - ALTER ❑ _i B.BP.C. for this reason SC�pEEIu REPAIR- ❑ '$' ONO- '-' •-"" . USE Date: . E%STOING BLD J!�- t.:.) DEMOL ❑ 1 .. s - - APPLICANT TEL •1_ Signature - . - - PRINT -/}Z2. A7YS NO. 1L2'7 ?S -FINAL ✓ ' OWNER-BUILDER DECLARATION - .+. _ -DATE .._ ., __ ..:_.... ,-. . . ._ .. .1 hereby affirm that am exempt from theContractor:s License. _ - Low for the following reason (Section 7031 5, Business and ADDRESS FIN 1 ',b 8_5.2.A 'Professions'Code): - "' " " - ' ' PRESENT / q -B- - ❑ BUILDING C �' /�'OPt- t # •.e •.� I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and - 136.25,' T the structure is not intended ar offered for sale(Section LOCALITY. .' 7044, Business and Professions'Code). - -' MOVING'`: - '" _ " TEL. .E 1, as owner of the property, am exclusively contracting CONTRACTOR _ NO. -1 1 34.255 ', y _ with licensed contractors to construct theproject (Sec- ' - � ,~`� (J„� 4 8 7 tion 7044, Business and Professions Code). ADDRESSK - t i 1 s , ~ \ , CONSTRUCTION LENDING-AGENCY- .< SETOBACKD YARD' NWy TOTAL ETBACK F M EXI WIDTH ` ,"` -+,' b:_ hereby affirm that there is o construction tending agency for FRONT ,the performance of the work for which this permit is-issued - - PtL`^v ` -- - - - -- - - -- - •- • ` - - -- - - - - - (Sec. 3097, Civ. C.). SIDE PA.- Lender's Lender's Address _ me LDMA Ref. N L ndrtefy ha P C Fee E __ _ Permit Fee J 0 1 � t - - - - _ 1 have.read this application and state that the —. Issuance Fee--- (/b-T V4PLDFN&AP/ENQ above information is correct. agreero comply with all County estigation Fee,ordinances and State laws relating to_building construction, � TotalFee ' LDMA'Perm. N --- f - and hereby authorize representatives of this County to enter ^� m upon rhZove-m,&aJtQnecI properly for inspeFtionnlirposes. - a ((' SEE REVERSE FOR EXPLANATORY LANGUAGE -- '-t - 'ignat ur fAp m for Agent - _ ate..