HomeMy Public PortalAbout9154, 9154 1/2, 9158 LAS TUNAS DR_Building__ DEPARTMENT OF BUILDINQ AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES ? B U I L ®'�
WM. J. FOX, CHIEF ENGINEER --
FOR APPLICANT Tp FILL IN FOR OFFICE USE ONLYBUILDING j
5� DISTRICT NO. PLAN CK.NO. PERMIT NO.
ADDRESS T/ ( (i.( (/'•`tea. � � .� �.. _� C�
LOCALITY RECEIV DATE OF APPL. DATE ISSUED
NEAREST - 1sew /;� 7 —
CROBS ST. 4l!1'��"�•�a.
BUILDING
/Z-
OWNER ADDRESS i/•- ,..o9'rI t..t°I
MAIL /A/ r /r „ ,�j LOCALITY
ADDRESS
lj V NEAREST
CITY ��.
�"� NO.
DROSS ST.
a ,
FIRE NO.OF / TYPE.: GROUP
ARCHITECT OR- TEL. ZONE PLANE �--
ENGINEER NO. BLDG. ORD.N
ADDRESS . SETBACK LINE r
±/({�. _ aPPROVED
CONTRACTOR .NO ( � BY DATE
USE APPROVED
DDRE98 /v ~ G► / ZONE BY DATE
LEGALryry CORRECTIONS
DESCRIPTION LOT NO. I BLOCK ir``�� G
TRACT
NO.OF BLDGS.
_SIZE OF LOT I NOW ON LOT
USE i I NO.OF
EXISTINGBLDG. FAMILIES ROOMS
DESCRIPTION OF WORK
NEW. ALTERATION ADDITION
REPAIR MOVING DEMOLISH �� /� 6
SQ.FT. NO. �w Z
SIZE ROOMS STORIES
WALL ROOF
COVERING I COVERING
USE NEW
BUILDING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS .
AND STATE LAWS RE LATINO BUILDING CONSTRUCTION,
FRAME: FIRE ,
SIGNATURE OF BRACING,BOLTS
PERMITTEE LATH,INT.:
AUTHORIZED AOT LATH,EXT.:
DBS-3 SDM SETS 7-47 $ P.C.III - PLASTER,INT.
FEE ! PLASTER,,EXT.
VALUATION FEE '�,� FINAL
WORKERS' COMPENSATION DECLARATIOW4;- 1
hereby affirm that 1 havecertificate of consent to Self --- APPLICATION
•; P L I C AT I O N FOR BUILDING P E RM I T
insure, or a certificate of Workers' Compensation Insurance, �►P
or a certified copy thereof•(Sec. 3800, Lob. C.)
COUNTY OF LOS.ANGELES . BUILDING AND SAFETY
Policy No. Company BUILDING
Certified copy is hereby furnished.
QFOR APPL CANT TO FILL IN ADDRESS
0 Certified copy is filed with the county building inspec- BUILDING �.
tion department. ADDRESS LOCALITY
NEAREST
Date Applicant CITY ZIP CROSS ST.
CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF LDGS. ASSESSOR c
COMPENSATION INSURANCE SIZE'
IZE OF LOT NOW O LOT MAP BOOK _ PAGE PARCEL
(This section need not be completed if the permit is for one 11
USE ZONE MAP
46
hundred dollars ($100)or less.) TRACT BLOCK - NO.
SPECIAL
I certify th t in the performance of the work for which this OWNER N G!" CONDITIONS 0
permit is' sued, I hall not employ an person in an manner DISTRICT GROUP TYPE FIREa:�
O
P p Y Y p y ADDRESS � �, � CONST. ZONEV
22
s as to a t.to the Workers'Compensation Laws.
CITY Iia• ZIP O
Date Applicant ARCHITECT OR EL. STATI TIC L C SSIFICATION APT._ ]CONDO. U
TOA ICA T: .If, after•making this Certificate ofXNOTIC ENGINEER NO. CLASS NO. 1 DWELL. UNITS
Exemption, you should become subject to the Workers' a
Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP
with comply with such provisions or this permit shall be TEL. Z
deemed revoked. CONTRACTOR NO. BK. PG, VALIDATION
LICENSED CONTRACTORS DECLARATION LIC.
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALLI
(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 ,
SQ. FT. - NO.OF NO.OF CHECK
License Number Lic.Class SIZE STORIES FAMILIES ONE
_ .NEW
Contractor Date DES IPTION OF WORK
ADD -�
aI am exempt under Sec. FINAL \
9-� -�
I B.BP.C. for this reason -ISATE •
I USE OF FINAL- n
Date. EXISTING BLDG. -� DEMOL. By a--fid
Signature APPLICANT T
OWNER-BUILDER DECLARATION PRINT -'
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and ADDRESS "
Professions Code): PRESENT 3 7 7+9 A
BUILDING
❑ I, as owner of the property, or my employees with ADDRESS # o a o a 0
wages as their sole compensation,will do the work and
the structure is not intended or offered.for sale(Section OCALITY
0 o Q
7044, Business and Professions Code). MOVING TEL. 2 2.85
aCONTRACTOR NO.
I, as owner of the property, am exclusive) contracting
with licensed contractors o construct the project (SeU 'G�
tion 7044, Business and Professions Code). ADDRESS
REQUIREDTOTAL SETBACK FROM. EXIST.
CONSTRUCTION LENDING AGENCY SETBACK YARD HWY PROP. LINE WIDTH d
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'
m
Q Lender's Name
P.C. Fee$ Permit Fee 100,_15)
Lender's Address
I certify that I have read this;application and state that the
Issuance Fee
above information is correct. ]'agree to comply with,all County Investigation Fee
g ordinances and State laws relating to building co truction, Total Fee
u and hereby authorize re pr sentatives of this Cou toe&
upon \ abRve-mentioned roperty mins ecti purp es.
a
o SEE REVERSE FOR EXPLANATORY LANGUAGE
n
Signature of Applicant or Agent' ®s