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Home My Public Portal About9132 LAS TUNAS DR_Building__ f 76A638ACE48031-62 APPLICATION FOR BUILDING PERM T COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS L,a-5 BUILDING AND SAFETY DIVISION LOCALITY C ' JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. D�lC N ROUP TYPE D B - FOR APPLICANT TO FILL IN ,� Q CONST. BUILDING [) n STATISTICAL CLA SI (CATION S ER MAP ADDRESS \ 0. V V,0. L. BK GO . CLASS. NO. DWELUNITS -- LOT NO. BLOCK WATER NOT REQUIRED RECEIVED ❑ CERTIFICATE: TRACT b .MAP HIGHWAY STAT MAJOR ECOND, LOCAL NO. OF BLDGS. .NO. (CIRCLE) SIZE OF LOT NOW ON LOT USE ZON-E SPECIAL USE OF - CONDITIONS EXISTING BLDG. ' TEL. OWNER O ►� NO. BUILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS zz0 FRONT ARCHITECT OR - TEL. P. L ENGINEER, NO. SIDE P. L. ADDRESS - d O TEL. u CONTRACTOR ( NO. 2 ADDRESS z,. B\h 0 DESCRIPTION OF WORK W CL Vf NEW ADD ALTER REPAIR DEMOLISH Q. FT. NO. OF NO. OF SIZE STORIES FAMILIES USE ` /-� t r ' STRUCTURE \ l., 1� t A -SIGNATURE OF jJ APPLICANTS tr( VALUATION $ APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION FEE $ FEE $ FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY .FURNACE: LOCATION, , WITH ALL COUNTY ORDINANCES AND STATE LAWS ULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOI T WORK .AUTHORIZED HEREBY I WILL,NOT EMPLOY ANY PE ON I A-VIO LATH, INT. TION OF THE LABOR CODE F TH STATE OF CA FOR REI/AT- ING TO WORKMEN'S CO 5 T INSURAN LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECTAND.POSTED ADDRESS '-FINAL JOHN F. LEWIS. PRINCIPALST R. RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION /C M.O. CASH Lt 05 1. 3 8w OGT 4 1 D 6.00-' APPLICATION FOR BUILDING PERMIT Gc� COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDIN�ADQRESS r BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, — or a certificate of Workers' Compensation Insurance,or a certified 41 GI Y 1 .ZIP`` copy thereof(Sec.3800,Lab.C.) LOCALITY Policy No. Company ,.-'s —e SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. - ❑ Certified copy is filed with the CTRACT BLOCK LOT NO. �bwlding spection ,f department. USE ZONE MAP NO. Date A ant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. _ COMPENSATION INSURANCE I l} !� f WITHIN 1000 FT OF SCHOOL? Yes No f � (This section need not be completed if the permit is for one hundred ADDRESS dollars($100)or less.) \ ' � t t tJ7 DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY � T` � fJ j CITY ZIP I certify that in the performance of the work for which this permit is issued, I thall not employ any person in any manner so as to. _ J ,l ' !�f/!e r �- become subject to the Workers'COmenSatiOn aw . �� ARCHITECT OR ENV-- WET STATISTICAL CLASSIFICATIONAPT CONDO Date " i ti"+ Applicant ADDRESS �f, 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' CONTRACTOR TEL NO. _ SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith L- Ar. / ..,, � - FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS �_ LIC.NO. PL :` LICENSED CONTRACTORS DECLARATION CITY�'.- LIC.CLAS PL I hereby affirm that I am licensed underprovisions of Chapter 9 I' ` ' P "` SEWER MAP >- (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES d NEW ❑ BK Professions Code,and my license i in full force and effect. / PG , Q License Number !i 11 1 Lic.Class ( `- � DESCPIPTION OF WORK �QD ❑ VALUATION { Contractor ate ;.t ? t a- - I} 4 , r tiALTE R ❑ $ ,t[. t J z !. #I� . i f.� J UL El "I"-+ REPAIR El I'am exempt under Sec. $ � 8.&P.C.for this reason DEMOL Da USE OF EXISTING BLDG. URM 13 cc P/C it Q Signature t1 APPLICANT TEL NO. - LDMA Perm ❑ 1, as owner of ..Y property, or my employees with wages as ADDRESS t O 'f"i W their sole co pensation, will do the work and the structure is not intended or offered for sale (Section 7044, Business and FINAL DATE Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL J .i OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE licensed contractors to construct the project (Section 70444, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 1 El 1, as ownerof the property, am exclusively contracting 4 ;tz , ves El No Business and Professions Code.) . WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH - CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDEUNES I hereby affirm that there is a construe' 'fending agency for YES 1:1 NO the performance of the Work for w Is permit Is Issued(Sec. [HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING t t � L N 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 _�11...;. �/..L.�itO d S Lender's Name MATERIALS REPOR,T/7 AND FOR p�jTAINING PERMIT FROM THE D: o Lender's A s t fes-,— rX OWNER OR AGENT o I certify that I have read this application and state under penalty o PERMIT FEE of perjury that the above information is correct.I agree to comply P.C.FEE �^ j* jj with all county ordinances and State laws relating to building l h s.� JLJ constructi n, and hereby authorize representatives of this County ISSUANCE FEE Qto enter ypon the abo men ned property.for inspection purposes. ,1� �� Z I} INVESTIGATION FEE TOTAL FEE"' J Sgnl—of A;1PIN aA�.a Agentf. ��- DeM ../ �•! a SEE REVERSE FOR EXPLANATORY LANGUAGE