The URL can be used to link to this page

Home My Public Portal About10130 LANDSEER ST_Building__ TEMPLE ' IT'Y 7•AaeBA CIE 4803- APPLICATION FOR BUILDING, PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENTENGINEER OF COUNTY ENGINF DDRESS 3 D BUILDING AND SAFETY'DMSION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST, WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. DISTRICT N GR UP TYPE P O S BY Cl FOR APPLICANT TO FILL IN `j', 0�'' CONST. BUILDING STATISTICAL CLAS IFICATION SEWER MAP ADDRESS 3- 0S • V • BK PG CLASS.NO.-j2-DWELL:UNITS � ' LOT NO. . /A' 5 BLOCK ,WATER NOT REQUIRED ❑ RECEIVEDEl TRACT �pJ 2 Z CERTIFICATE , �r pMAP HIGHWAY STATE MAJOR SECON }LOCAL NO.OFSIZE OF LOT I.Z O I NOW ON LOTS USE ZONE SPECIAL LE) USE OF CONDITIONS EXISTING BLDG. TEL. OWNER' lam/'. ¢ NO. B ILDING - EXIST. ! �+ nn SETBACK YARD HWY •STREET NAME WIDTH ADDRESS b . �4S LZS - !-,.• ,b• FRONT / ARCHITECT OR TEL. P L. ENGINEER NO. SIDE } ADDRESS ' P.L. / TEL, INSPECTION RECORD O , NO CONTRACTOR J�PP elle . � V ` p� �T- AV' / �n>✓ ./��.k%,�P si. ci.SLxi t0 ADDRESS(.,3L -� �S /4(A G/ de• S.G' - - DESCRIPTION OF WORK S�� ' d �- - 771,Ievj4l;ll a NEW S D ALTER REPAIR. DEMOLISH /. /j '- / �.,y�J// Z SQ.FT. `� NO.OF NO.OF .�1� +� �y _ IZE .7 STORIES FAMILIES USE OF ST U UR { ° a awl t SIGNATURE OF IV APPLICANT VALUATION$ / APPROVALS DATE INSPECTOR'S SIGNATURE FEE- $ J FOUNDATION: LOCATIFORMS.MATER ALSON ;�,. ,./ j /_e FRAME: FIRE STOPS, 11 1! e• l S(• I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE-IS C0RRECT,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 C IFO IA RELAT ING TO WORKMEN;S COMP ATION INSU N d LATH,EXT.SIGNATURE PERMITTEE OF 1 HOUSE NUMBER COR- RECT AND POSTED ADDRESS ^, ^'� liH�� f FINAL �I P r/�� V CLYDE N. DIRLAM, PRINCIPAL STR CT RAL ENGINEER PLAN CHECK VALIDATION c M.o. cases PFJLM VALIDATION cK M.O. CASH LAC,0i f3 :�- SEP '?7 2 3 D 2 1'.0 0 ��:�03, 7 4 7 GDT 10 1 D 4 5.0 0 / APPLICATION.TOR COUNTY OF LOS ANGELES T,_ DEPARTMENT OF.COUNTY ENGINEER BUILDING PERMIT BUILDING AND SAFETY DIVISION BUILDING FOR APPLICANT TO FILL IN ADDRESS j p/ D �r �•� BUILDING 'ADDRESS/D/ v LOCALITY ' D NEAREST B CITY IP O O CROSS ST. �( 0, OF BLDGS. ASSESSOR SIZE OF LOT OW ON LOT MAP BOOK PAGE' A PARCEL DISTRICT JGROUP,rPE FIRE J.P CE DBY ' TRACTOtCO.S ' ' ' B OCK LOTNONST.��; ZpW{ y� TEL � STATISTIIC//AL CLASSIFICATION a 'OW NE NO. cCJJ too _ SEWEQR MC Ap ADDRESS D CLASS NO. DWELL,UNITS '� BK/�1PG MAP. CITY ZIP oo �/ NO. ARCHITECT TEL. PECIAL ENGINEER NO. - `j�,'1 •CONDITIONS' ' ADDRESS l ROAD DEPARTMENT'APPROVAL REQUIRED YES❑ NO ❑ CONTRACTOR TEL. BLDG.SETBACK FROM ' - N FRONT PROP.LINE OF •(STREET) LIC. ADDRESS NO. HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF ISTING CITYLIC. FRONT PROP, LINE HIG WIDTH . CLASS _ CONSTRUCTION LENDER + G� NAME AND BRANCH - BLDG.SETBACK FROM p ADDRESS CITY SI DE PROP. LI NE OF (STREET) _G> SQ. FT ? NO. OF ry NO. OF CHECK HIGHWAY + YARD = TOTAL SET CK FROM TYPE OF EXISTING d-' SIZE 3 STORIES a,L. FAMILIES ONE - SIDE Pf CIP. ANE HIGHWAY WIDTH DESCRIPTION OF WORK NEW + _ _ ADD CORNER CUTOFF ES ❑ NO ❑ Z .q ALTER ❑ JEPAIR❑ IN OPEN SPACE YES ❑ NO ❑ USE OF IN COASTAL PERMIT ONE YES ❑ NO ❑ EXISTING, BLDG. - DEMOL APPLICAN 1 TEL ' (PRINT) 1 NO. BY (SIGNATU I HEREBY ACKNOW EDG MAT HAVE WEAAff THIS APPLICATION' AND STATE'THAT THE AB E 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 EMPLOY ANY PERSON IN VIOLATION OF THE - LABOR CODE OF THE STATE OF .CALIFORNIA IN RELATING TO - WORKMEN'S COMPENSATION INSURANCE. - - SIGNATURE FINAL BY" PERMITTEE DATE Of ADDRESS TE L.en_ P.C.Fee$ �. „� Permit Fee CITY N0. ' Issuance Fee ' VALUATION$ /.ate o 0 o •- -• - Total Fee 'PLAN CHECK VALIDATION CKM CASH v PERMIT VALIDATION CK MO CASH r .76A63BA-CE*8038 12/75 v APPLICATION .FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby,affirm that I have a certificate of consent,to self Insure, BUILDING ADDRESSoZi2 K) lbl or a certificate'of Workers' Compensation Insurance,or a certified ZIP copy thereof(Sec.3800,Lab C.) �' : LOCALITY Policy NoCompany , SIZE OF L T - NO.OF BLDGS NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST IF ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO USE ZONE MAP NO department Date Applicant ASSESSOR MAP BOOK PAGE PARCEL / SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' Ow .� TEL NO YES NO COMPENSATION INSURANCE, IM WITHIN i000 FT of scHOOL9 769 (This section need not be completed If the permit Is for one hundred ADDRESS e•' � DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY dollars ($100) or less CIT ZIP I certify that In the performance formance of the work for which this permit /��dd is Issued, I shall not employ any.person_in any manner so as to ARCHITECT R ENGINES TEL NO become subject to the WorkerssAI��C��Om f S tion Laws/ v STATISTICAL CLA IF CATION APT CONDO_ Date�W_� Applicant IVL) (/ii7�afv�^� ADDRESS CLASS NO, DWELL UNITS NOTICE TO APPLICANT.- If, after making this Certificate of, REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become Subject to the Workers'— CQNTRACR TEL O �j SET BACK, YARD HWY PROP LINE WIDTH Compensation provisions of the Labor 'Code, you must forthwith O 0 FRONT comply with such provisions or this permit shall be deemed,revoked. ADDR S 1 LI o�^ P IL LICENSED CONTRACTORS DECLARATION `� ��cS PILE CITY � LIC CLASS- ,, P L I hereby affirm that I am licensed underprovlsions of Chapter 9 &IwiQ SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO FT SIZE NO o TORIES NO O FAMILIES Professions Code,and my license is In full force and effect, NEW ❑ BK PG a License Number Lic CIBSs DE PTION OF WORK ADD ❑ VALUATION 00 Q U Contractor• Date ALTER ❑ % Law6 s`64nl ❑ I am exempt under Sec ,4 ` REPAIR 110 B&PC.for this reason DEMOL ❑ LDMA P/C# W Date USE OF EXISTING BLDG' - - URM ❑ Signature' APPLICANT,(PRINT) TEL NO LDMA Perm# - Z ❑ I:`as owner of the property, or myemployeeswith wages as ACCT.B their sole compensation, will do the work and the structure is ADDRESS F FINAL DATE not Intended or offered for sale (Section 7044, Business and sIj j 11!a:f Professions Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL- UT ATERIAL --- ❑ I, as owner of the property, am exclusive) 'contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE. FINAL_B ' ,� ITE -J, p P y. Y g AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE licensed contractors I to construct the project-(Section 7044, yes El No 1:1f i TTL 117 ® 90 Business'and Professions Code) _ -- WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING 117.901 i yy{/ OCCUPANT,REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH / CHECK e9I_! CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKUST FOR r _ _ GUIDELINES - - 1 '7 , CHANGE A .0101 3 it t I hereby affirm that.there Is a•construction lending agency-for YES❑ No❑ 6 l CHANGE' V a the performance of the work for which this'permlt IS ISSUBd(SBC I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING .3097;CIV C) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, _ N '••TITLE 2,CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS ' 3 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD - GOOC—I,�f ftJ 1 - f 95= EL Lender's Address I3t.�1/ 1 AN 7:_.2. O OWNER OR AGENT o I certify that I have read this application and state under penalty 0 of perjury that the above Information IS correct I agree to comply PC FEE PERMIT FEE - with all county ordinances and-State laws relating to•budding construction, and hereby authorize representatives of this County ISSUANCE FEE OD to er upor�th boveto nperty for inspection urposes. �- ' �LO �► 3 INVESTIGATION FEE TOTAL FEE syewu<e ofof Aopcam�� owe SEE,REVERSE FOR EXPLANATORY LANGUAGE L'WO' RS'`COMPENSATION DECLARATION .. -� �. - _ . 'moi•'� -* .- �<:,p. .« �.., - - ••Y< �'' •�..t - - i- -ji_hei�yoQi9Gvm,that-1 have o certificate of consent°,fo self :i4 p • Insu�`_or b eertpic,ate of Workers' Compensq)ibn'Insurance,: _ __ _ - ■ �`� �- __ _APPLICATION F�O_ :R�s�UILDI�NG: �VII�' � or a certified co y'thereof• Sec. 3800; Lab: C' - - i' COUNTY OF LOS'ANGELES BUILDING•AND SAFETY +' Polis„No .~ • - % .. Company, . _._ .. _ _ ❑'o,Ceitifie&'copy,'is.hereby:furmshe& F,OR,APPLICANT TO FILL IN BUILDING y,�`' l ADDRESS JCS 'Certified'copy`.is'filed'with'the county building inspec- BUILDING' ////�� .tion departrii6Hit` i`” n" ' - ADDRESS lC1� ^ Jf� 'Dcite`� Applicant CIT,Y- ��i'_/Y? L� vr�� ZIP �� LOCALITY' d'�,G• CERTIFICATE OF-EXEMPTION'.FROM•WORKERS'fv'-V" _ ._�. ._ ._. . - .NO OF-BLDGS•--rj� - NEAREST. `. - r�'',COMPENSATION`'INSURANCE' ;'«a 3 ,h',r' SIZE OF LOT - :T"" NOW ON LOT /�' CROSS ST 1, (This section'heed'not`be-completed'.if',the permit is for.,ohe -- - i-`---._ _ _.. _ _ ASSESSOR" -.11 hundred dollars,($100)or less.,). TRACT BLOCK LOT.NO "S glk ` MAP BOOK'° I,` PAGE PARCEL, �TEL' 1 �aQ� USE ONE MAP" _ t �' ::'�7,,•' - r-'? ', OWNER" /tJ . 1'• NO'7� ( _ (`certify-thbt in the performance•of tFie wo�k'foi.which'-this.- `� NO Slt``'- "��„ '� . i SPECIAL• - - d permit,is issued, I`sh611 not erriploy any person in.any manner Off/0_ __ C s 's to become'subject'to the°Workers'Co'rr'p ri-atiori aws:- ADDRESS 13 0_ __ c� CONDITIONS s;n•-' `.«;t <, O ,' rL a- by.•2:_P". ,: -a 1 _ CITY .. _ fix GlV1 .._ _�1 •ZIP_t_ t v i Date Applic& csr ARCHITECT OR TELI. ^O NOTICE-TO APPLICANT'•If,- after -makin �this',Certificate of- DISTRICT ,, GROUP. TYPE, FIRE; - ._.P13JJCESSED_BY - Ir g - i ENGINEER NO• CONST, ZO Exemption;''you--should, become'-subject`4orthe,Workers' tel^ Q) #Compensation provisions of;tFe;CaboE,Code;,`you must forth, LU ADDRESS -�� >'• - -- d with comply,..with such, provisions <oilvhis ,permit; shall be,,- with _ . - -;•.-...- - •----- N deemed reJoked. c ;; TEL" STATISTICAL CLASSIFICATION APT C DO Si-`>.��' '!'�� CONTRACTOR NO ' _. �p 4 -. -• ..__ J LICENSED-CONTRACTORS,DECLARATION.,r..' ,A - ;ro- -: : uC`�- < .' CLASS NO DWELL. UNITS_ r I hereby'affirm.that I am'licensed under provisions of Chapter 9 - ADDRESS NO i commencm withrSection 7000 ofDivision 3 of the Business and 'SEWEI;MAP rofessionsCode;"and my.`license is.in full'force dnd'effect. CITY - ° CLASS BK -^ VALIDATION .t `r'• .,. SQ-4-4t CHECK PG. _ t .'.b . - [• i••..r.' ro ja~ SIjE STORIES, FAMILIES - ONE .Iti lice,nse.Numbe� -'Lic.Class Y « •o-', u :•r =-' VALUATION :°4`" 7' DESCRIPTION OF WORK"• •NEW ❑ '_ C t�+{ Contractor' Date ; I am exempt under Sec ADD T,I n ,ALTER B.BP.C. for this reason �1n REPAIR_USE Q s• - r """ "" Date - r' EXISTING BLDG, DEMO, ❑ - - - - Signature `k3.• �._. s'. -•, APPLICANT; -'- = - TEL FINAL } F OWNER-BUILDER DECLARATION PRINT NO t DATE 7 -- - --• --' - I hereb'-affirm that-I am exempt from.the Contractor•'s.License �. Law for-the folloHiing.,rebson (Sgctioh 7031.5, Business and ADDRESS--''- e DDRESS'' Prof ssions Cod e)i _ w _ -- RESENT a ,i :c . . - uy BUILDING �, - '• •5 1 47(9 rpt `r I,.as owner of .the ro ert or;m -em to ees with' ADDRESS # e- �. - =`1' ' P-•p,,,_Y, y P Y wages as the msole compensation will_do the work arida - y=' i , thesiructure is not intended or offered for sale'(Section LOCALITY i'i "! �' }. (,'e `5,'5 Q'• ' 7044, Business and Professions�Code):' �' - 'MOVING''' "5'`»' TEL �t. '- ,' w { -$m o'1 1 5 0 ❑ ^f CONTRACTOR- �' T.NO = - _ i': ~ I,'as owner of`the'property, am exclusively contracting t'. 'With licensed`contractors')o-construct the prolec,r(Sec=. - ?�`�O(j ==8 .. 6:. . . tion'7044,'Business arid Professions Code). ADDRESS ,; REQUIRED ._ TOTAL'SETBACK.F._ CONSTRUCTION LENDING AGENCY ---_:;_. SET BACK YARD' ''-HWY pROP ,LINE, I hereby affirm,tlibt there is a'const uction lending agency-for", •T FRONT- the performance-of-the7,wo}k-for which this permit-is issued' P L = « •- - '� - - _ " ` (Sec:3097, Civ. C. „° SIDE- t, Lender's Name LDMA'Ref # t � . $ *:' P:C,-Fee S __._ :a`'�,..._ Permrt-Fee--- r' •,1.1 -- - i•r _ _ r _%.. -Lender s Address- a r 1-'certify,.that.l have,read.this.application ond,'state;that the _ _ , issuance=Fee- -• V-•t/ CDMA P%G 4f'` a abov"e•information is correct. I agree to comply with all County investigation Fee - ordm_antes a'nd State 16w_s relatin torr--- - _ ,, __„ __. _ _ _ -- • , s_ ., --Total Fee• --- 1= .. '%:. ' :LDMA-Pe?m #�. _>-i. .. --v, - u and hereby authorize~ ntatives of this County'to'enter t - ;upon tiie above- for inspection,purposes. t SEE REV ERSE`FOR EXPLANATORY-LANGUAGE Signature of Applicant or•Agent-. .--- - Date-'- '„'� _.,.r_ _ .. - _ _ •_ ._. - _.—__ _ -_ .. _ .,- ., I-- ._ �.