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HomeMy Public PortalAbout9159 LA ROSA DR_Building__ 76A638A APPLICATION FOR BUILDING PERMIT , .� �q COUNTY:OF LOS ANGELES BUILDING DEP'ARTMENT 1 QF COUNTY ENGINEER ADDRESS"" - - L a- _. BUILDING'AND-SAFETY DIVISION. - . LOCA D I T r = :!!` . JOHN,A. LAMBIE. COUNTY.,ENGINEER ,' NEAREST,,-, G • COLEMAN W..JENKINSl$UP'T OF BUILDING, CROSS ST','. DISTRICT NO:-:: ;GROUP TXPE �� P OCESSED BY- -FOR APPLICANT TO FILL IN'.' 6 ,p CONST...-Ir— G BUILDING STATISTICAL'CL'ASSIFICATION •SEWER MA - ADORE SS. .'•* ' �.Z CLASS'NO."•�_DW ELL UNITS BK •PG�`Z� 'LOT NO - BLOCK USE ZONE, MAP , TRACT ,'SPECIAL' , •NO. OF BLDGS: _ •CONDITIONS - SIZE OF LOT. NOW.ON LOT USE OF'EXISTIN BLDG, BLDG..SETBACK FROM NE OF TFRONT'PROP. LI - EL ���/ -' l/l! ' 'OWN O.a/o 3� _ (BTREET)�' TYPE OF • E%ISTINO' SETBACK � HIOHW YARD,, — TOTAL ADDRESS - HIGHWAY FROM CIL. -- - , CITY � .- � .�- - ,• ..+. :i�. BLDG. SETBACK FROM -A'RCHITECT OR. •• TEL.' ' ENGINEER NO. SIDE.PROP. LINE'OF ¢ (STREET)- ' , _ _ - - TYPE Of -EXISTING SETBACK HIGHWAY---"-+ YARD = •TOTAL _ ',ADDRESS' - - HIGHWAY WIDTH FROM C L ' TEL. _ •CONTRACTOR'-• NO - ' •.}a. LIC' _ ADDRESS' 'NO CORNER CUTOFF YES NO . -C - CITY Y L I c - SEE'R]EVE-RSE-SIDE FOR SPECIAL APPROVALS' - - . . e DESCRIPTION-'OF WORK t n ADD', ALTER REPAIR DEMOLISH - a SQ.FT.__ -NO OF NO..�O,F .. - •Z SIZE STORIES '• -`FAMILIES ` -USE OF STRUCTI1, SIGNATURE OF _ -APPLICANT y VALUATION$ ,d Q•.QQ ,-" -" APPROVALS' DATE INSPECTOR'S SIGNATURE °P.0 PMT,.. FOUNDATION, LOCATION - FEE$ _ - FEE$ ,�' FORMS, MATERIALS FRAME, FIRE STOPS,- t. 'I HEREBY ACKNOWLEDGE THAT I HAVE READ'THIS APPLICATION BRACING=BOLTS STOPS,- `A THAT THE-ABOVE ,IS CORRECT AND AGREE TO,COMPLr ,FURNACE,:.LOCATION '_ WITH ALL'COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS 13UILDING CONSTRUCTION '1 CERTIFY. THAT. IN DOING THE WORK , _ AUTHORIZED'HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH INT'.:.'-' ' ,TION-AF-THE LABOR CODC OF THE STATE OF CALIFORNIA',RELAT- - - INC TO WORKMEN:SCrfMPENSATION INSURANCE - LATHc• EX-T. _ SIGNATURE OF• HOUSE'NUMBER COR-- .' PERMITTEE" ' RECT AND'POSTED- a:A'DDRES — I N A L •�' - JOHN'F. LEWIS. PRINCIPAL STR A'L.ENGINEER PLAN;'CHECH VALIDATION CK. e M D. CABHPERMIT VALIDATION + M.O CASH -76AV686A CE#803 9-674 - _ APPLICATION FOR BUILDING PERMIT ., COUIjTY OF LOS ANGELES BUILDING DEPAR'TMENT''bF. COUNTY ENGINEER ADDRESS �I 1 S Y o BUILDING AND SAFETY DIVISION` LOCALITY � t JOHN A. LA'MBIE, COUNTY ENGINEER COLEMAN W. •JENKINS, SUP T OF BUILDING NEAREST CROSS ST. . NG7 PEXISTING OR APPLICANT TO FILL IN DISTRICT NO. GROUP CTYPE ONS, ' P CESSED BY L. (Print ort Pe only) . - STATISTICAL CLASSIFICATION SEWER M 4<1 DS CLASS NO: DWELL,U_NITS •� BLOCK USE ZONE MAPC f SPE +✓ ` O. ` - -� �� SP CIAL ONDIT ONS NO.OF BLDGS: LOT" NOW ON LOT a�V - - - BLDG: BLDG.SETBACK FROM TEL. FRONTPROP.LINEOF (STREET) NO' TYPE OF EXISTING SETBACK HIGHWAY } YARD TOTAL HIGHWAY WIDTH FROM C.L.1 - , - , + _ ••CITY, - T G•. BLDG.SETBACK FROM ARCHITECT OR TEL. SIDE PROP.LINE OF (STREET) ENGINEER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD'- _ TOTAL , ADDRESS �I �/r L HIGHWAY WIDTH FROM C.L. TEL + _ a C 0 N T R A C T 0 - - _ O ADDRESS/0/2 T• NO -19.7-2.2 CORNER CUTOFF YES ❑ NO ❑ CD CITYQ, CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF"WORK N z NEW ADD ALTER REPAIR DEMOLISH ' SQ. FT. NO. OF NO.'OF SIZE STORIES - FAMILIES - - USE OF, STRUCTURE " SIGNATURE"OF APPLICANT Ly VALUATION ' APPROVALS DATE INSPECTOR'S SIGNATURE P.C. • '1 - PMT, / d FOUNDATION: LOCATION FEE $ :1,'1� FEE'$ 6 4�`�• FORMS, MATERIALS - FRAME•: FIRE STOPS,• - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS'APPLICATION 'BRACING BOLTS : 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. .TION OF THE LABOR CODE OF-'THE,STATE OF CALIFORNIA RELAT-- LATH, INT. ING TO WORKMEN S COMPENSATION INSURANCE - LATH, EXT. ' SIGNATURE O� '� ' 'HOUSE NUMBER COR- PERMITTEE - - RECT AND POSTED ADDRESS -'G� " _ FINAL JOHN F LEWIS PR NCIPAL STURAL ENGINEER PLAN CHECK VALIDATION CK M 0 CASH _ PERMIT VALIDATION CK MO. CASH 3 2.:2 5.N , 4 0 .5. 5-;,; ' 4AY28• 1 -D 6 450� kof 76A439 2od� •=L I'L'D�hN COUNTY OF LOS ANGELES e ULP I N DEPARTMENT OF COUNTY ENGINEER ADDRESS % .G'c a' BUILDING AND SAFETY'DMSION L O C A'L I T Y. Cti(Z JOHN A. LAMBIE. COUNTY ENGINEER NEAREST COLEMAN W. JENKINSSUP'T OF BUILDING CROSS ST DISTRICT NO. GROUP TYPEa 'PROC SSED.BY ' FOR APPLICANT' TO' FILL IN �' p�j h Z CONST: BUILDING - STATISTICAL CLASSIFICATION •S WER MAP', ADDRESS ` t A CLASS NO. L2 DWELL UNITS,------, BK ig PG Z' 2 LOT NO. - - / CK USE ZONE MAP �7 - l,' h �,J NO. Z-d�• / TRACT .2 �; /r/ "�� SPECIAL �) NO. OF BLDG9 CON 1 I N SIZE OF LOT NOW ON LOT USE OF BLDG. SETBACK FROM _ TEL 'FRONT PROP. LINE OF (STREET) OWNER NO TYPE OF EXISTING SETBACK HIGHWAY YARD TOTAL ADDRESS HII/G/HW Y FROM C L. + _ CITY BLDG. SETBACK FROM _ ARCHITECT OR- TEL. r 910E PROP. LINE OF (STREET)- E C NO. /� 3 — TYPE OF E%ISTINO SETBACK HIGHWAY i- YARD — TOTAL HIGHWAY WIDTH FROM"C L. ADDRESS / L(/i [J/1r - TEL.. .�• _ CONTRA CTO O'L c - .g - NO CORNER CUTOFF • YES NO E] C ADDRESS - -LIC 'a - -'. -'t.- , s-Y, ti .{.ti C: TY SEE REVERSE'SIDE FOR''SPECIAL�APPROV`ALS:, DESCRIPTION OF WORK - J a NEW ADD ALTER REPAIR DEMOLISH -� .'yet z SQ,FT. NO OF NO. OF +4 SIZE aim STORIES FAM'l IFS '• °- _�- 1 USE OF STRUCTURE SIGNATURE OF -••� _ - .i `I•' APPLICANT VALUATION$ /---�_ .• %< '•^ �, I �QZI� .00_ APPROVALS DATE,.. -^-'INArTOR'SSIO' TUBE FOUNDATION, LOC'AT10_N .^ FEE$ ©a .S PMT. _ 7 FORMS, MATERIA'L'S %f�'�iJ k' FEE FRAME;FIRESTOPS,+ ;`�•I(f - I HEREBY'ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, ; BRACING 601_7.S�' 'I AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:`L'OC'AT-ION ' \ •:?� �" WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IG AS VENT. DUCTS 9UILD ING N COSTRUCTION I CERTIFY THAT IN DOING THE WORK - AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. LAjTH. INT. - TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- _ ING TO WORKMEN'S COMPENSATION'INSURANCE LATH. EXT. SIGNATURE •/syn�f f � PERMITTEE �i��%%7LG/I.OI HOUSE NUMBER R- REC AND POSTED ADDRESS,/C� Ldmlfe� F I N A L JOHN F. LEWIS. PRINCI A ST AL ENGINEER ,,PLAN CHECK VALIDATION cK: M.D. ' cAsH _ �; PERNIIT VALIDATION CASH 2 2 3 -Q 9 3.75 ..� ��'r. �"3 a_2:8'��- lrr�k�28 ` 1 D,:2 5:5; 4 APPLICATION FOR BULLDINGRERMIT '. j. COUNTY OF LOS ANGELES - BUILDING AND SAFETY'- WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO-FILL IN-, BUIL G ADDRESS , BUILDING ADD ESS _ - •• - •� C�R-�- I hereby affirm that I have a•certificate of,consent to self Insure Or h or a certificate of Workers' Compensation, nsurance,or a certified',- copy thereof (Sec 3800, Lab C) CIT-Y-- /�•I y ZIP LOCALITY Policy No-- Company �" /Y �/ y SIZE OF LOT• NO.OF BLDGS NOW ON LOT /' ElCertified copy'Is-hereby furnished. NEAREST CROSS ST -❑ ,Certified copy Is filed with the'county building Inspection TRACT - BLOCK. _ LOTNO " • - department • - - ,, ' ' - USE ZONE y• MAP NO - Date - Applicant. - ' ASSESSOR MAP BOOK•. ' PAGE PARCEL i'• _ - - SPECIAL CONDITIONS 1NER CERTIFICATE OF EXEMPTION FROM WORKE " RS' OWTEL NO/�j y 1 `y s COMPENSATION INSURANCE `� / ///� BAt4IJ si• V - S3�$ WITHIN 1000 FT OF;SCHOOL? YES NO (This section need not be*com le'ted If the permit Is for one hundred ADDRESS P P dollars ($100)or less) Q, O DISTRICT GROUP' TYPE CONST' FIRE ZONE ''PROCESSED-BY , .-- "' •`, - - - ' , ' , -. • CITY '-ZIP- ,I certify that in,the performance of the work for which this permit �'' d Is Issued,,I shall not employ"any pers In an manner so as t0 ' ARCHITECT-OR ENGINEER• = TEL NO become subject-to the Workers'Come anon Law STATISTICAL CLASSIFICATION APT CONDO �' DatezA:-s 71 Applicant, C� - ADDRESS - - - CLASS NO DWELL UNITS NOTICE TO APPLICANT If, after'making this Certlf ate, of A/J1 ?' REQUIRED - TOTAL SETBACK FROM •' EXIST, Exemption; you should become subject to the Workers" CONTRACTOR TEL NO SET BACK - -YARD ,-HWY PROP LINE WIDTH Compensation provisions Of the Labor•Code, you must forthwith +0 N P_lz� FRONT r comply with such provisions•or this permit shall be deemed revoked . ADDRESS .-• - - ,LIC NO P t_' • ' LICENSED CONTRACTORS DECLARATION CITY•• LIC CLASS P L SIDE , I hereby affirm,thaf I am licensed underprovisions of Chapfer 9 SEWER MAP (commencing with Section 7000)Of Division 3 Of the Business and' SQ FT SIZE- NO OF STORIES NO OF FAMILIES • Professions Code,and my,llcense Is In full force and effect &a NEW ❑ BK PG a SCRIPT'I�O'N COF/WORK VALUATION LUATIONLicense Number Llc Class , - _ _ Q Contractor Date U ALTER ❑ C nt L( S REPAIR 0 E] ❑•I am exempt under Sec G $ U B&PC for this reason 7 DEMOL LDMA P/C Date USE OF EXISTING BLDG v LL.G - URM El _ ., - ;�f•_i, a 8 -^• _ Cn Signature 'APPLICANT(PRINT),. TEL NO, LDMA Permit j, ElI:as'owner of the property, or my employees with wades:as' Z i -' their sole compensation, will do the,work•and,the-structure Is ADDRESS 0 1 �'f Si', FINAL DATE s not Intended or offered for sale (Section 7044, Business and � '• .� �- '- •Q 1, rofessions Code) N TOTAL AL �-8 1 °° 6-5 x WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT,HANDLE A HAZARDOUS MATERIAL y , OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR,GREATER THAN'THE., { as owner of the property, am exclusively Contracting.With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE FINAL BY �. y'N ` 3 L a a L censed contractors,to construct the project (Section 7044, yes El ❑ _ t�HANt3 Business and Professions-Code.) a' isl WILL.THE INTENDED USE OF THE BUIDLING BY THE APPUCANT OR,FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR-MODIFICATION FROM THE SOUTH - • •'CONSTRUCTION LENDING AGENCY 'COAST AIR QUALITY MANAGEMENT DISTRICT'(SCAQMD)SEE PERMITTING CHECKUST'FOR - - - - GUIDEUNES' I hereby,affirm.that there Is a construction lending agency for Yes❑ NO❑ -• f'�jl f-�EI="� =-• t a ' the performance of the•work for which-this permit Is Issued(Sec ,. p� HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING J 1L _ '�''�•� a+%};,� 3097,Civ.C) CHECKLIST I UNDERSTAND MY'REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TITLE 2,CHAPTER 2 20 SECTIONS,2 20'100 THROUGH 2 20 140 CONCERNING HAZARDOUS Lender's Name MATERIAL'S',REPORTING AND FOR OBTAINING,A PERMIT FROM THE SCAQMD a - - 4 ` ' •. )•�;;"?'3 i!i_t 1. .;,.�• )Gid -a - - R CD Lender's Address 0.: - - - ., MN ER oRS,G�Ni•�a: d '1YtS10 fk\'yR 4:•i,"t`?"3"G(1•[;::ICs,l..l b - �' ,. � - o I certify that I have read this application and state under penalty _- ,o - PC FEE Fk }: 5ir�,ettt:,• N:PERMITFEESa'r,H,t.�i%`�. - - - - - - - of perjury that the above Information Is correct,I agree to-comply ` a with all county ordlnan and State laws relating to building N'. construction, and here ut'-¢e repres n atives of this County t` ',_=ISSUANCE•FEE' w ; to enter upon the above- en ne ct+eR purposes. '' ` * .,,;�f, `•� '`. �.;_;•� �'TO INVESTIGATION FEE TOTAL'FEE P // `` - r- -• - ' �• s�m,a oI pnd�,o,teem ome !> ,/,. !�✓ - . SEE REVERSE FOR EXPLANATORY LANGUAGE