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Home My Public Portal About8811-13 LAS TUNAS DR_Building__ 76AB98A DB?-3 3.53 I) APPLICATION FOR BUILDING PERMIT 1 DIVISION OF BUILDING AND SAFETY BUILDING -13 £ ADDRESS +�+ Department of County Engines: ! —TI1'A iL ,rp County of Los Angeles LOCALITY - WM.J. FOX. COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST. � DISTRICTNO. GROUP SEWER ^MAP FOR APPLICANT TO FILL IN CONST. J- (TYPE � I B C_ I' BUILDING �` MAP STATE YES -1, ADDRESS / 9 NUMBER Y /HWY .L� LOT NO.GJ-/J ✓ r� ^• �� OC �� USE ZONE ZONE SPECIAL CONDITIONS TRACT W f'- r3� C -3 SIZE OF LOTS �- O /- �O� NO. OF SLOGS. BUILDING EX19T• NOW ON LOT SETBACK YARD HWV STREET NAME WIDTH UBEOF pp� FRONT EXISTING BLDG. n '�'1 �i P.R L. N DE OWNER^f' ��//T,c`` N(1 f'� �Itt//)J��ly�,��e-,��T-r� p� L. MAIL ADDRESS%)Z 'b' �t_o_ �C�'-"" O TRACT DWELL. 1 UNIT B INDUSTRIAL ! _ _ TEL.��J L 1 DWELL. 1 UNIT CITY TEL � 6 PUBLIC BLDG. ARCHITECT OR TEL. 2 DUPLEX1 UNIT 7 ADON.. ALT.. ETC. ENGINEER NO• 3 APT. _UNITS TA M19CEL.s/v/rQ,eOd/y ADDRESS 4 COMMERCIAL TE CONTRACTOR �� ,� NOL. INSPECTION RECORD ADDRESS / �- `^�^� -�✓- -'-"' DESCRIPTION OF WORE ' NEW` ADD ALTER {r,,ALTER REPAIR DEMOLISH so FT FT./G"'�V/ �l • STORIES I F MIILIES SIZ US-E pNF�S,,TR_UCrL�E \ SIGNATURE APPLICANT APPROVALS ADDRESS I � � DATE INSPECTOR'S SIGNATURE IJ5FOUNDATION: LOCATION S ^` P. C. Ii FORMS. MATERIALS 3 (J FEE FRAME: FIRE STOPS, VALUATION S BRACING, BOLTS FEE FURNACE: LOCATION. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT. DUCTS APPLICATION AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. AND STATE LAWS REGULATING BUILDING CONSTRUC- ` TION. LATH, EXT.HOUSE NUMBER COR- SIGNATURE OF �(�r.-tyi� PERMITTEE RECT AND POSTED _ ADDRESS � FINAL WM.J. FOX,COUNTY ENGINEER VALIDATION C. N. DIRLAM, CHIEF BLDG. INSPECTOR t�o� 93 '1:. 14 1 200 G 76A638 OBS.312.54 4 APPLICATION FOR BUILDING PERMIT 1 DIVISION OF BUILDING AND SAFETY BUILDING l Department of County Engineer I ADDRESS County of Los Angeles LOCALITY WM. J. FOX, COUNTY ENGINEER NEAREST -CASSATT 0. GRIFFIN, SUPT OF BWLOING CROSS ST. y ' f DISTRICT NO. GROUP SEWER MAP FOR APPLICANT TO FILL IN TYPE BK PG BUILDING t % CONST. ADDRESS G, MAP STATE yCg I NUMBER 20046HWY LOT NO. L'E BLOCK USEZONE SPECIAL CONDITIONS TRACT /z (y ,3 nnn �•/ � •- SIZE OF LOT. Syg�tII NOW OF ON LOTY BLOCS BUILDING YARD HWSTREET NAME EXIST. ' USE OF �r- SETBACK WIDTH EXISTING BLDG. FRONTT . L � `S ''RFrT OWNER kb I - le' 0-Q_ SIOE MAIL �7 (1^r� P. L. ADDRESSl S / /' D t i - /J TEL. T �j �(`'J 1 DWELL. I UNIT 5 INDUSTRIAL CITY `�-yr/Rt2 �- NO.�'/ H'/tl/ 2 DUPLEX—UNIT 6 PUBLIC BLDG. ARCHITECT OR TEL. ENGINEER NO. 3 APT. UNITS ADON., ALT., ETC. ADDRESS Q COMMERCIAL 8 MISCEL.— CONTRACTOR pj� .CONTRACTOR � TNO.EL. INSPECTION RECORD ADDRESST L' - 7taCIf_ DESCRIPTION OF WORK `Y NEW ADD ALTER I REPAIR DEMOLISH 50. FT. NO. OF NO. OF SIZE STORIES FAMILIES OF STRU TIIIZE s t h� s'��— SIGNATURE OF ' .f k-4 s, (IuG A. .4 APPLICANT L APPROVALS ADDRESS DATE INSPECTOR'S SIGNATURE P. C. S FOUNDATION FORMS, MATERIALS LOCATION �c f �� FEE FRAME: FIRE STOPS. VALUATION S ��..µ� BRACING. BOLTS FEE / ^— FURNACE: LOCATION, GAS VENT, DUCTS I HEREBY ACKNOWLEDGE THAT I HAVE READ T - ATION AND STATE THAT THE ABOVE IS CORRECT ANDNDAGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT. AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. LATH, EXT. SIGNATURE O HOUSE NUMBER COR- ^ PERMITTEE RECT AN.POSTED ADDRESS ' ' I10012 t I FINAL \O 11S`5� ��.(• N--� WM. J. FOX. COUNTY ENGINEER VALIDATION - By _ACO7 2 5a�i1R AUG29 1 4.00 DEPUTY ��/�• + -- DEPUTY BY By ® DEPUTY DEPUTY y �.. TI ....... APP IT COUNTY OF LOS ANGELES d1i:olNc +,;' DEPARTMENT OF COUNTY ENGINEER }IDREss BUILDING AND SAFETY DIVISION ocnu y JOHN A. LAMBIE, COUNTY ENGINEER ARES WILLIAM A. JENSEN SUPT OF BUILDING OSS SUlnn 5 Ci GROUP TYpE I ROC ED BY FOR APPLICANT TO FILL IN yii; s;/ CONST. BUILDING e J T `Tn� �/� STA 1 GCA SWICATION SIR MAP ADDRESS t•T(O� /JJ O/`Q1,�'p /fin V}� /IKJI_�>- 'I �} I BK LOT NO� �[4)9,(J/ X71, /�0��/@�C ;'i NUM 'IN' 4�cLDW ELL. "NITS STATE YES JO� // HWY. TRACT �� y �� '{ Q (�a 6� USE- SgECIAL SIZE OF LOT 6 / X -5 "I 7 8 NOW ON LOTS CONDITIONS USE OF EXISTING BLDG. O'GI(�L�tX. BUILg1pCCv A iWY STREET NAME EXIST. n EL. SET K WIDTH OWNER O. FRONT P. L. ADDRESS ��3 ..if�H?.L / SIDE ARCHITECT OR TEL P. L. ENGINEER NO. INSPECTION RECORD Y ADDRESS d TEL. /S/ CONTRACTOR GV y(Xy� Cw NO. l.1 �� C ADDRESS is O DESCRIPTION OF WORE u W d N NEW ADD ALTER REPAIR DEMOLISH Z . FT. (Jl NO.OF NO.OF _ SIZE l .IL STORIES FAMILIES USE OF STRUCTURE /- SIGNATURE OF APPLICANT VALUATION 5 Q �'V I A APPROVALS b/DATE!�' INSPECTGR'S:SIGNATURE FE -$' FEE $ FOUNDATION: LOCATION FORMS. MATERIALS FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE 10 COMPLY FURNACE: LOCATION. WITH ALL.COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED 1 SHALL NOT LATH, INT. EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKMEN'5 COMPENSATION LAWS OF CALIFORNIA. LATH,EXT. SIGNATUREOFa� \ Q � HOUSE NUMBER COR- / PERMITTE `` L! RECT AND POSTED ADDRESS V FINAL - / /Co/ /�WU'"✓�'-/ CLYDE N. DIRLAM. PRINCIPAL STR RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PEBNIIT VALIDATION v GK. N.G. GASH LACO 4 8 8 2 1,23 PIAY 17 1 D 6.00- v .ovldz_� APPLICATION FOR BUILDING PERMIT FOR ,APPLICANT TO FILL IN (Print or IYOP OnIV) BUILDINGg� �3 �qs COUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF COUNTY ENGINEER CITY'77F4,7 E' CAr X ZIP BUILDING AND SAFETY DIVISION NO.OF SLOGS. BUILDING .}� SIZE OFLOT r/ 9l NOW ON LOT I /l- ADDRESS e;N T, TRACT 7��+✓ BLOCK LOT NO, tlJ � LOCA LI TY__7NEARE ST OWNER /4 NOLg41"54 CR CO OSS STSSOR I. ADDRESS ,z. L.4 SFiCEn/A O'emt MAPEBOOK PAGE PAR L A 9i79i DISTRICT GROUP TYPE FIRE PRO SSED By CITY WEST CO✓1Al-4 ZIP CONST. ZONE ARCHITECT OR TEL. ENGINEER NO. STATISTICAL C��LJJA��SSIFICA TION SEWER MAP ADDRESS ..tt CLASS NO._f�DW ELL,UNITS BKS G CONTRACTOR' /V (y�/} G7 NOOL/- . _f USE ZONE MAP _/- NO. ADDRESS �� Z4 SERENA AP.NO.G C,/ -�? SPECIAL _ d LIC. CONDITIONS CITY WCsT CO✓1^1/I CLASS ROAD DEPARTMENT APP RO AL REQUIRED YES❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLOC.SETBACK FROM FRONT PROP.LINE OF (STREET( d ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING O HIGHWAY } YARD SO. FT �/ NO. OF NO. OF CHECK FRO ROP. LINE HIGHWAY WIDTH U SIZE /. STORIES / FAMILIES Q ONE O } DESCRIPTION OF WORK n `, I NEW U ENCYOS/A16 PO.0 CX'JADD ❑ BIDE PROP.LIN LDG.SETBACK F F (STREET) Z ALTER, HIGHWAY YARD o T TRACK FROM TYPE OF EXISTING USE OF REPAIR❑ SIDE PROP. LINE HIGHWAY WIDTH EXISTING BLD`{G..�/....�'��G � — DEMOL ❑ }APIPL CANTNT) qN//"I�/�y �I10 �z-'k CORNER CUTOFF YES NOBY (SIGNATURE) IN OPEN SPACE YES NOQ Q'o"K 'V IN COASTAL ZONE YES ❑ NOVALUATIONY /ZaAw� CATEGORICAL EXEMPTION YESNOI HEREBY ACKNOWLEDGE THAT I HAVE READ APPLICATION ENVIRONMENTALPNO STATE THAT iXE ABOVE IS CORRECT ANDEE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THEK AUTHORIZED IMPACT REPORT PROCEED A (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON INATION OF THELABOR CODE OF THE STATE OF CALIFORNIRELATING TO AWORKMEN'S COMPENSAT INSURANCE. ) I1 SIGNATURE OF PERMITTEE n ADDRESS QF l"? FINAL BY CITY h/49sr 66"11V-4 331-i3o6 DATE _3P.C, PMT.t1.A KE CIiE CFS P:1).16EE FEE $ FEE $HARVEY T. BRANDT. COUNTYGINEER AA I PLAN CHECK VALIDATION CK. M,CI. CASH _ PERMIT VALIDATION M.o. cpsH 3 7 3 273 OCT 31 1 D 1 5.O O s 1 76A63BA CEUB03 12/72 / WORKERS'COMPENSATION DECLARATION r.. p .. Ill cer that I have certificate of consent self inAPPLICATION FOR BUILDING PERMIT sure or a certificate of Workers' Compensation Insurance, ' or 6 certified copy thereof (Sec. 3800, Lab. C.) - '"- - COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company - a Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING r7F// Lo ❑ O C Certified copy is filed with the county building inspec- BUILDING ADDRESS tion department. ADDRESS BB// Date& Applicant CITY ZIP /7 LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' - - - O.OF BLDGS. - NEAREST_ COMPENSATION INSURANCE, SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for'one TRACT BLOCK lOT NO. ASSESSOR. - hundred dollars ($100)or less.) p MAP BOOR 5 PAGE PARCEL A o a TEL /SOS/ USE ZONE MAP L certify that in the performance of the work for which this OwNEIteQ40/%p /� NO. �� - "Z�� r permit is issued, I shall not employ any person in any manner ADDRESS p �/ /�/�✓� F /� ✓ -- - �- SPECIAL -- -- -- - 6 so as to'bemme subject to the Workers'Compe tion Laws. CONDITIONS O `l�Z9le'T6 �re��J.e clTy NIUif/TE�zECL p. . ZIP 5;0116"S/0 09 Date Ap is a'n . ARCHITECT OR TEL O NOTICE'TO APPLICANT: If, after making This Certificate of ENGINEERCA.SA.PF'.7 NO3.S�-/O _ DISTRICT GROUP' TYPE . _ FIRE PRO SSED BY IV- Exemption, you should become subject to the Workers' "] ,1O CONSTI ZONE Compensation provisions of the Labor Code, you must forth- ADDRESS ZBZZ /FFG%� /e1� /ri/ vzW with-comply with such. provisions or this permit shall be deemed revoked. - - STATISTICAL CLASSIFICATION- - - - - TEL - - � - APT. CONDO. Z y CONTRACTOR NO. _ LICENSED CONTRACTORS DECLARATION - - - - LIC,- - - - CLASS NO. 27i DWELL. UNITS hereby affirm that I,am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and _ -_ LIC __ _- SEWER MAP Professions Code, and my license is in full force and effect. CITY CLASS BK - '-' VALIDATION - SO. FT. NO.OF NO.OF _ CHECK License Number Lic.Class SIZE 7 STORIES FAMILIES ONE , VALUATION Contractor Date DESCRIPTION OF WORK - - - NEW-- 0 , ADD $ VOG '�. DO , I am exempt under Sec. QiGE+ -- ❑ - ALTER 25522A . B.BP.C. for this reason REPAIR- ❑ - $ - Date: - USE OF DEMO! ❑ tt e e e o '2 3 t EXISTING BLDG. Signature - - - APPLICANT TEL - FIN e * 89,25 OWNER-BUILDER DECLARATION PRINr No. DAT `7� I hereby affirm that am exempt from the Contractor's License !� o e e 8 9-2 5 5 Law for the following reason (Section 7031.5, Business and ADDRESS FIN ssicns Code):" PRESENT BY 0 q29-86 BUILDING '.�p¢�+�,p{�e I, as owner of the property, or my employees with ADDRESS �l wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). - MOVING- - TEL "— • - - V1 I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensedcontractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). • ;?6087A - CONSTRUCTION LENDING AGENCY_ "- - REQUIRED YARD - HWY TOTAL SETBPROP.ACK FROM EXIST WIDTH I hereby affirm That there is a construction lending agency for FRONT - # a e s e e the performance of the work for which this permit is issued - P.I, - - - - - - -- -" - (Sec. 3097, Civ. C.): SIDE l - 1 1 5 5 0 .... - P.I. m Lender's Name C^ LDMA•Ref. p Lender's Address - - P.C. Fee S - 2 5 Permit Fee- -/(JJ r - - ' - e e M 5 5 060 I certify that I have read.this application and state that the Issuance Fee M LDMA P/C N-.. ( 209— 8 6 a above information is correct. I agree to comply with all County Investigation Fee g ordinances and State laws relating to building construction, _. - .. - Total Fea —O LDMA Perm. N - and hereby authorize representatives of this County to enter , Qe above- terry for inspe/ct�ionpp/ur/pos/es. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent - - - Date - -'- - - - - - -- - - - - -- - - - - - - - WORKERS' COMPENSATION DECLARATION hereby affirm that I have o certificate of consent to self II BUIL6 PERMIT insure, or o certificate of Workers'Compenstion Insurance, or APPLICATION�O a certified copy thereof (Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company - Certified ropy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS. Certified copy is filed with the county building inspec- BUILDING Qa 1� tion deportment. ADDRESS 8$11-I 4 E,LAI 10IIAC •U�-• LOCALITY' 2 iQLP/r NEAREST Date Applicant CITY 0 ZIP CROSS SL CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT (0 8 A.Qd NOW ON LOT V AIt MAP BOOK PAGE PARGEI (This section need not be completed if the permit is for one 1 �" USE ZONE MAP QD hundred dollars ($100)or less.) TRACT .�L Z l BLOCK TCi LOT NO. v� //�y NO. Y TEL. l.i � SPECIAL d I certify that in the performance of the work for which this OWNER AIAO NO.'1'dl_a1RV0 '� CONDITIONS O permit is issued, shall not employ an DISTRICT GROUP TYPE FIRE OC SED BY P P Y y person-in any manner V ADDRESS I'I O I A?p r A-1 :AIA CONST. Z so as to become subject to the Workers'Compensation Laws. �� J ary I+l.Onrre9eLlo CA ZIP CiD6Y0— Date Applicant STATISTICAL CLASSON APT. CONDO. V ARCHITECT OR TEL. NOTICE n, APPLICANT If, cafter ome subject this Certificate of ENGINEER NO. Lu CLASS NO. - DWELL. UNITS_ 1 Exemption, you should become subject to the Workers' 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. TEL' BK, p VALIDATION CONTRACTOR 0 W A E0.• NO. - - LICENSED CONTRACTORS DECLARATION LIC. 1 hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. ygLUATIONIL .� (commencing with Section 7000)of Division 3 of the Business and LIC. - Professions Code, and my license is in full force and effect. CITY CLASS 1:%1/" _ SIZ FT. NO.OSTORIES NO. OF CHECK ONE License Number Lic.Class SIZE STORIES OA/E FAMILIES — ONE Contractor Date DESCRIPTION OF WORK NEW o $ I am exempt from the licensing requirements as I am a Fr7tlia,� �. gJFROMEXIST, DD `licensed architect or a registered professional engineer ALTERFINAL acting in my professional capacity (Section 7051, ® DATEBusiness and Professions Code). USE OF REPAIR EXISTING BLDG. LtlrK O�Frta%• DEMOL ❑ '. FBINALLic.or Reg. No. Dote APPLICANT _ yOWNER-BUILDER DECLARATION (PRINTI GM • C�AZ1YE $-BSf/I hereby offirm that I am exempt from the Contractor's LicenseLow for the fallowing reason (Section 7031.5, Business and ADDRESS /701, x� www wA st 6•/0Professions Code): PRESENTBUILDINGI, as owner of the property, or my employees with ADDRESSwages as their sole compensation,willdotheworkand the structure is not intended or offered for sale(Section LOCALITY7044, Business and Professions Code). MOVING I, os owner of the property, am exclusively contracting' CONTRACTOR 4 86.7 Awith licensed contractors to construct the project (Sec- ADDRESS e e e etion 7044, Business and Professions Code). REQUIRED TOTAL SETEXIST,CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROWIDTH 2 e e 22.0 0 hereby affirm shot there is a construction lending agency for FRONT the performance of the work for which this permit is issuedI P.L. e o 0 2 2,Q C u (Sec 3097, Civ. C). SIDEPL. 421-81 Lender's Name Lender's AddressC $ Permit FeeI certify that I have read this application and state that the Issuance Feabove information is correct I agree to comply with all Countyordinances and State lows relating to building construction, — _and hereby,otithorize representatives of thi ounty to enter Total Fee upon the•above-mentioned prope ty far peel on purposes. a /7& '^ /1 SEE REVERSE FOR EXPLANATORY LANGUAGE _ // Signomre of Applicant r Agent Date Os WORKERS'COMPENSATION DECLARATION hereby �a certificate I-haver certificateoftion lnsutq self - APPLICATION FOR BUILDING_ PERMIT__ insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lob.{.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company C .ed copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING " � �/-� ADDRESS ( / /T L,� /�J Certified copy is filed with the county building inspec- - BUILDING j tion department. ADDRESS G L -79�DateApplicant CITY W ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' -'- ' - NO:OF BLDGS. - -- - - NEAREST COMPENSATION INSURANCE SIZE OF LOT NOWON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR TRACT BLOCK LOT NO. MAP OOK•' PAGE. PARCEL .hundred dollars($100)or less.) TEL -s / , /1 Fr• '7iZ L�p USE ZONE NOP I certify that in the performance of the work far vihich this OWNER' r r NO. /�•L .SPECIAL J - - d permit is issued,.)shall not employ any person in any manner _ - ADDRESS• - - '- L, CONDITIONS so'os to become'subject to the Workers'Compensation Laws. - O V • 1 _ CITY _ ZIP. Date` Applicant ARCHITECT OR TEL., NOTICE TO APPLICANT: If, after making'this Certificate of ENGINEER NO DISTRICT _ GROUP TYPE I FIRE PRO ES ED BY Exemption, you should become subject'to the% Workers' - �� - CONST ZONE y W Compensation provisions of the Labor Code, you must forth- ADDRESS With comply with-such provisions or this permit shall be" ,TEL,- STATISTICAL CLASSIFICATION APT. CO DO. N deemed revoked. CONTRACTOR YYL A200A O 011 Z LICENSED CONTRACTORS DECLARATION %••- - - - - - —Oc CLASS N6. L—DWELL'. UNIT5 hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS z4 Ll $ d NO. 3r .. (commencing with Section 7000)of Division 3 of the Business and _. _ _. .- LIC. A 7 SEWER MAP '-' Professions'Code;and my license is in full'force and effect. CITY ,[j- /2•�6L CLASS e, 3 BK. - VALIDATION �77 o - •� _ _ SO. FT_. NO.OF - NO.OF _ CHECK_ Y i License Number"JJzs333 Lic.Class CJ SIZE - STORIES FAMILIES -ONE VALUATION 1 _ - c / (,✓p �� /'XI.�.T DESCRIPTION OF'WORK' /Q rte}- NEW ❑ Contt'acto ris I�DOfI✓G ' Date__!!�� "--LL y-� ❑ $ (J(/ Ot'G200Gf✓L OOL✓A� / D- ADD am exempt under Sec. - - ❑ ' , l� / / [ALTER B.BP.C. for this r /��.`J• •~ __ O 5_-I y�o Lc3 d�NATi4/,( y-i bE6o REPAIR ❑ $ - - - - / G C ✓ "r USE OF DEMOL ❑ . . _ EXISTING BLDG. C'dnn�L�Jr� �� APPLICAN // TEL. �l FINAL UWIVLR-BUILDER DECLARATION PRINT) ryOYz'� NO. ...DATEZ.z f -- - -- 1 hereby affirm that I am exempt from-the Contractor's License ADDRESS S 7- STV W'ft5 fJ�Q S{tAJ 64-bp FI I Low for the following reason (Section 7031.5, Business and - _ Professions Code): - - PR SENT ❑ .. BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and , the structure is not intended or offered for sole(Section LOCALITY - 7044, Business and Professions Code). ' ' MOVING - - -" TELT 63 65 A I, as owner of the property, am exclusively contracting CONTRACTOR NO. s! With licensed contractors to constructtheproject (Sec- ADDRESS # ° ° ° ° °'1 tion 7044, Business and Professions Code). CONSTRUCTION'LENDING-AGENCY- - CK SETQUIREDBACKYARD HWY TOTAPPOP.ALNEF WIDTH' - I ° ° 59.25 I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued -- P.L. - - - - - ° ° °5 9.2 5 UL (Sec. 3097, Ci, C.). SIDE P.I. _ u 1.20`87 Lender's Name - LDMA Ref. q ' \ - - Lender's Address •' 'I certify.that I have read this application and state that.the - - ----- -... Issuance Fee -- - - �O- LDMA P/C R - a above information is correct. I agree to comply with all County Investigation Fee S. ordinance to laws relating to building construction, Total Fee - - -- - and e u ize representatives of this County to enter r ZS - {DMA Perm. q n t enfione property for inspection purposes, yy ^ / O- 7 SEE REVERSE FOR EXPLANATORY LANGUAGE , ignoture of Applicant or Agent- 'WORKERS'COMPENSATION DECLARATION �F hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT DISI insure, or o certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified co is hereby furnished. BUILDING y 7� t ❑ copy Y FOR APPLICANT TO FILL IN ADDRESS O Z /w��5 ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS G /,3 �(�;T 55 a7u95 LOCALITY Date Applicant CITY z L (,, I 1 Zip '7a NEAREST CEARE ST. 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 hundred dollars ($I00)or less.) TRACT I BLOCK LOT NO. �/., NO. c iEL. C'/ SPECIAL I certify that in the performance of the work for which this OWNER NO� '—G= 3 CONDITIONS d permit is issued, I shall not employ any person in any manner [, ,t DISTRICT .GROUP TYPE FIRE PR ESSED BY O so as to become subject to the Workers'Compensation Laws. ADDRESSy a/I A" CONST. ZONE U �F'']� r�Z r;l-per' ®s�! 0 CITY 644 6 C;/7- Zip S - ✓ J 0 Date 91 Q; Applicant, r� �� STATISTICAL CLASSIFICATION APT. CONDO. 0 ARCHITECT OR TE NOTICE i0 APPLICANT: If, after making this Certificate of ENGINEER O. U Exemption, you should become subject to the Workers' CLASS NO. Zai DWELL. UNITS_ Wa Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP N with comply with such provisions or this permit shall be Z deemed revoked. TEL. BK. PG, VALIDATION ' CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION UC. . I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and LIC VALUATION (� Professions Code, and my license is in full force and effect. CITY t CLASS $ 0 ;02771 A SQ. FT. NO.OF NO. OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE # e e e e e 1 NEW {yT S Contractor Dote DESCRIPTION OF WORK N ® ( e e `Z a S Q ❑ I am exempt under Sec. L ADDR ❑ FINAL e e e 2 a rj Q 0 B.BP.C. for this reason EA AE-P REPAIR ❑ DATE Q a22-85 Date: USE OF FINAL DEMOL EXISTING BLDG. ❑ By Signature APPLICANT TELA Qr AV OWNER-BUILDER DECLARATION PRIN7 No. O-7 Ihereby affirm that I am exempt from the Contractor's License Low for the following reason (Section 7031.5, Business and 'ADDRESS b E Professions Code): PRESENT ❑ \hv I, as owner of the property, or my employees with BUILDINGADDRESS wages as their sole compensation,will f o the work and �Dhe structure is not intended ar offered for sale(Section LOCALITY vls4, Business and Professions Code). MOVING TEL. (� ownerofthe property, amexclusively contractingCONTRACTOR NO.th licensed contractors to construct the project (Sec- ADDRESS \ tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.I. Lender's Name Lender's Address P.C. Fee E ! Permit Fee I certify that I hove read this application and vara that the Issuance Fee ro so a above information is correct. I agree to comply with all County Investigation Fee 3-6 ordinances and State laws relating to building construction, Total Fee G and hereby authorize representatives of this County to enter Upon the above-mentioned property for inspection`purposes. -e7 SEE REVERSE FOR EXPLANATORY LANGUAGE Y e Signature of App icon or Agent Date ®s