The URL can be used to link to this page

Home My Public Portal About9813 LA ROSA DR_Building__ a IS..38A C.#8.3S-GIAPPLICATION FOR BUILDING PERMIT COUNTY OF LOS. ANGELES BUILDING DEPARTMENT OF COUNTY ENGII4EER ADDRESS BUILDING AND SAFETY DMSION LOCALITY ,JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. DIST�lCT NO. G UP _TYPE SSED BY FOR APPLICANT TO FILL IN ;r i S� CONST. LAZ�L BUILDING STATISTICAL CLASSIFICATION SONER MAP ADDRESS K /}P CLASS.NO.-AI DELL.UNITS 7 LOT NO. BLOCK WATER NOT REQUIRED RECEIVED CERTIFICATE: TRACE' % Y / MAPSTATE MAJOR SECOND HIGI 7 ! NO.OF BLDGS. NO. (CIRCLE) , LOCAL SIZE OF LOT J b NOW ON LOT USE ZONE r SPECIAL USE OF - / CONDITIONS �EX IST G BLDG. UILDING YARD HWY EE NAME EXIST. SETBACK WIDTH ADDRES 7el . FRONT ARCHITECT OR TEL. P. L. / ENGINEER - ' NO. SIDE O ADDRESS T �J INSPECTION RECORD Af TO CONTRAC ' -SY I tiI9/f'. ( /1,fi(1JF �YV_/S?f.•� /At�•�! 0A' __, et` V r DESCRIPTION OF WORK n•/ nd� 3.a.M_� 1i.` Z ADD ALTER REPAIR DEMOLISH )� SIZ FT. NO.OF OF I- IZE .tet v STFFRIES FA S.• MILIESUSE OF STRUCTURE k/ .!/C' ��C�r /�Q F•(XA � /1kI`•. - r r• /✓ / �/�/J[/ :1.:rJ�Jn .FJ-�f1ilN-f/1/*L!A- �- .G.i/LO: �-r��l�AA✓/+l 'K✓d- SIGNATURE OF APPLICANT VALUATION$ � .c II�� APPROVALS 6Vr ) DATE INSPECTOR'S SIGNATURE P.C. r7 '71 C PMT. C/Q FOUNDATION: LOCATION �J f , '�.•�'� /P, ' FEE $ G Z FEE $ J FORMS.MATERIALS PY•f^//.L/- �'i✓✓. 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 IGAS VENT DUCTS BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING'THE WO AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN V A- LATH, INT. ,I L n /{ ✓// TION OF THE LABOR CODE OF,THE STATE OF CALIFORNI TNG TO WORKMEN'S ENSAT�NSURANCE. LATH,EXT. 1 SIGNATURE OF :I HOUSE NUMBER COR- PERMITTEE - RECT AND POSTED I . oI ADDRE FINAL CLYDE N. DIRLAMS,PIiINCIPAL STRUc URAL ENGINEER PLAN CHECK VALIDATION (Z-), M.O. CASH PERM VALIDATION c( M.D. CASH Lj�tn 7 3 '3 9.". JAN 2 32 3 D 2 2.rj Q ! m Q ��.�7 7 5 0 FEB 2 1 D . 4 5.0 0 WO?KERS'COMPENSATION DECLARATION �L .1 heileby,a cer that haW r certificate of tion Int to self APPLICATION FOR BUILDING PERMIT LI IS ir•:}.ire;or a certificate of Workers' Compensation Insurance, � ' °or a certified copy thereof (Sec. 3800, Lab. C.) //UU��''�� _ .COUNTY OF LOS ANGELES � � BUILDING AND SAFETY Policy NoNo vAmpony 01GhNeT!r BUILDING r ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS- G Zq ds"Q ❑ Certified copy is filed with th < unty building ' spec- BUILDING E- - tion depart menL ADDRESS E. .LOCALITY r Ift NEAR Date. Applican CITY�_ ZIP CROSS ST.. CERTIFICATE OF EXEMPTION FROM WORKERSNO.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 - TRACT BLOCK. LOT NO NO. - hundred dollars ($100)or less.) / � I �� TEL: SPECIAL I certify that in the performance of the work for which this OWNER _ N CONDITIONS d permit iS•issued, I shall not employ any person in any manner C - - - DISTRICT G UP TYPE FIRE PRO SSED BY .O ADORESSS�PTYY r-- j 2 CONST. ZQg1E a so as to became subject to the Workers'Compensation Laws. Jo n ��J ,C7 r a Date Applicnt. CITY ZIP\ - - STATISTICAL CLASSIFICATION APT. NDO. U - NOTICE TO APPLICANT: If, after making this Certificate'of ARCHITECT OR TEL. _ - W 'Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS_ d ' 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.. - r TEL 9K, PG, VALIDATION - - CONTRACTORS PIO. LICENSED CONTRACTORS DECLARATION � - UC. I hereby affirm that I am licensed under provisions of-Chapter 9 ADDRESS N VALUATION - (commencing with Section 7000)of Division 3 of the Business and LIC. .y C Professions Code, and my license is in full force and effect. CITY CLASS $ 6- , (�p•'')�� - SQ: FT.' . NO. OF '" NO. OF CHECK _ License Number AS ?.(d c:Class B� SIZE STORIES FAMILIES . ONE ��f1 ' t � DESCRIPTION.OF WORK N NEW ❑ $ Contractor�•Z'rD W68H Date ❑ 1 am exempt under Sec. Q$ YL ADD C7 �q 2 9 4 5 A ALTER ❑ FINAL /7 , - B.BP.C. for this reason REPAIR D E /G # • "• • • 2 3 USE OF Date: EXISTING BLDG. DEMOL FI/ Signature APPLICANT TEL. 1.-19286 '- OWNER-BUILDER DECLARATION PRINT NO. e e 1-928 6 6 hereby affirm that 1 exempt from the Contractor's License , - Law for the followingg r reason (Section 7031.5, Business and ADDRESS - ' Professions Code): RE ENT BUILDING �' (� 1 8—' 85 ❑ - - . t O I; as owner of the property, or my employees with ADDRESS � wages as their sole compensation,will do the work and - t .l 1K the structure is not intended or offered for sale(Section LOCALITY 7 ••,y 7 t., •. _ r.\ 1, .-, - 7044, Business and Professions Code). MOVING TEL ry V F tF`s, 1 ❑ ICONTRACTOR - NO. , as owner of the property, am exclusively contracting _ with licensed contractors to construct the project (Sec- ADDRESS s 'tion 7044, Business and Professions Code). - - REQUIREDTOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY. SET BACK YARD HWnsY PROP. LINE WIDTH ► ,� I hereby affirm that there is a construction lending agency for .FRONT - the performance ofivthe work for which this permit is issued P.L. - y r• l eR'�pp 333•i $= ` (Sec. 3097, C . C.). SIDE 'P.I. ti , Lender's Name [ - ° ••ti' C - P.C. Fee$ Permit Fee L O V - - Lender's Address H certify that I have read this application ond.state that the , - Issuance Fee ¢ above 'nformation is correct. I agree to comply with.all County Investigation Fee s • - g ordi a es and State laws relatin to building construction, N Total Fee ' u an h by authorize represe t i es of this County to enter 1 ' up a above-menti e y for Inspection put oses. - - - - -•- `•,• •' - - , SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of Applicant or AgeN Dafe '®s APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS BUILMM 1 hereby affirm that 1 have a certificate of consent to self insure, O Q �r or a certificate o Workers'Compensation Insurance,or a certified CITY-T- CgpyfhefPff _ La J �_ C- , LOC P/61/myl lJ CompanyU� SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified Copy Is hereby furnish e NEAREST CROSS ST. Crtl}letl copy is filed with t uny building inspection TRACT BLOCK LOT NO. �d�/p me LDISTRI ONE MAP NO. Date ASCE OR MA�B K PAGE PARCEL Applicant S SPECIAL CONDITIONS CERTIFICATE OF EXEMP N FROM WORKERS' OWNERAkd�� TEL_Np_'� �� N 1000 FT.OF SCHOOL? YES NO COMPENSATION INSURANCE ADDRESS 63S (This WtiOn need not be completed if the permit is for one hundred y¢?6 L e I Cllers($hat)In tIe3p CITYI certify that In the pertormance of the work for which this permit 11�•.t is issued, I shall.not employ any person In any manner s0 as t0 ARCHITECT OR ENGINEER TEL NO. become subject l0 the Workers'Compensation Laws.. STATISTICAL CLASSIFICATION APT CONDO Date & Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT: If, after making this Certificate of RECUIRED TOTAL SETBACK FROM EXIST Exemption, you Should become subject to the Workers' CO TRACJOR G �6 jN$.s,;-74 SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith LP FRONT comply with such provisions or this permit shall be deemed revoked. ADDRRW, a�� C.N �� PL LICENSED CONTRACTORS DECLARATION arY ��Tu C LIC.LASSG a siDE a R PL U I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP (commencing with Section 7000).Gf Division 3 of the Business and S SIZE NO.OF ST9RES NO.OF MILIES O Professions Code `tl licenS)is in full force and a ct ® ( 7k NEW BK PG License Num LIC.CI835 ` DESCRIPTION OF W K ADD ❑ VALUATION W 0o ry 2c 2& 806c>— Contractor L Date 7 'Z ALTER El $ z If 7——9V '3 ! / REPAIR ❑ ❑ I am exempt under Sec. B.&P.C.for this reason DEMOL ❑ LDMA P/CM Date: USE OF EXISTING BLDG._ URM ❑ Signature APPLI NT(PRINT p TEL.NO. LDMA Perm p ❑ I, as owner of the property, or my employees with wages as p A:•r- their sole compensation, will do the work and the structure is ADDRESS, F n�•�_i e`: not intended or offered for sale (Section 7044, Business and FINAL D QQ �! Professions Code) WILL THE APRIWNTOR FUTURE BUILDING GCCUPANTHANDLE AHAZARDOUS MATERIAL ❑ I,-es owner of theproperty, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN / I ; S ;�t��; . Y g THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FI SV licensetl'contmctors to construct'the project.(Section 7044, YES NO - r - - TIOT 33 ��qa g� Business and Professions Code.) i y WILL THE INTENDED USE MI THE CONSBUILDING BY THE APPLICANT IO FUTURE BUILDING 1 NEC!' OCCUPANT DUALITY MANAGEMENT DISTRUCTIOAQMD)SEE PE IONFROM THECOLITH Nd'. 1�+'uvii CONSTRUCTION LENDING AGENCY COACT AIR DUALITY MANAGEMENT DISTRICT(SWOMDi SEE PERMITTING CHECKLIST FOR GUIDELINES �) IL�ItI`TP / • Iy;�A10� .Lill I hereby affiim that there is a construction landing agency for YES El NO❑ � � - _ the performance of the WOrk for Which this permit is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD m 3097,Civ.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE,TITLE Z,CHAPTER2.MSECTIONS22.1m TNROUGH2ffiIWCONCERNING [I 1 � '' 3 Lenders Name 0-[l[li'l l (/i(/7'!I HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THESCAOMD. �4 Lenders Address o-AHwon.GRR - JllV o- I certify that I have read this application and state that the above information Is correct. I agree Q Comply With all county P.C.FEE PERMIT FEE In ordinances and State laws ratan o building construction,and « hereby authorise represent of this County to enter upon ISSUANCE FEE the above-mentioned prop y r inspection rposes�� 3100 _ y INVESTIGATION FEE - TOTAL FEE 9yJIunMIMHanIUAT1 �N , a 2 ' SEE REVERSE FOR EXPLANATORY LAN UAGE