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HomeMy Public PortalAbout9918 LAS TUNAS DR_Building__ BUILDING BUILDING ADDRESS APPLICATION LOCALITYNEAREST DIVISION OF BUILDING AND SAFETY CROSS ST. Department of County Engineer DISTRICT NO. RECEIPT NO. PERMIT NO. County of Los Angeles Is-- 6/.i .04 WM. J. FOX, COUNTY ENGINEER GROUP DATE RECEIVED DATE ISSUED CASSATT D. GRIFFIN, SUPT OF BUILDING qy FOR APPLICANT TO FILL IN TYPE CONST. RECEIVED BY �y ISSUED BY /�1-9 +� I'o'. /i1 OWNER 4,,MXQ oL..L.Ra `-` �a y4 6- tJO tt I . . .r-Tr-- �" MAP STATE MAIL �— NUMBER ® HWY ADDRESS Q USE ZONE SPECIAL q TEL. CONDITIONS ' CITY �►�C.�At.�1. NO. C ARCHITECT OR TEL. ENGINEER NO. BUILDING YARD HWY STREET NAME EXIST. SETBACK WIDTH ADDRESS FRONT —[� - (�7 ? 'r r� CONTRACTOR ,� ,,2!jMr.j)fy- ELD6,1.041 .- q SIDE `l /" i ..) �s.,eaR��,a�J iT� AI.F .1 P. L. ADDRESS DATE CORRECTIONS INSPECTOR BUILDING ADDRESS p - 6 f LOT NO. BLOCK TRACT to NO.OF SLOGS. BIZE OF LOT &10 L I NOW ON LOT USE OF EXISTING BLDG. %/ D4V DESCRIPTIO OF W K A_ L7 NEW ADD ALTER REPAIR DEMOLISH Z SD.FT. NO. OF NO.OF r SIZE STORIES FAMILIES USE OF STRUCTURE Ila x s FxV r tY _t4 I nt ate' ' NO.OF EMPLOYEES 1 HEREBY ACKNOWLEDGE THAT i HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN 18 APPROVALS INSPECTOR'S SIGNATURE DATE CORRECT. . 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS FRAME: FIRE STOPS, SIGNATURE OF BRACING,BOLTS - PERMITTEFURNACE: LOCATION, GAS VENT,DUCTS ADDRESS LATH, INT. AUTHORIZED AGT. LATH, EXT. $ P. C.S HOUSE NUMBER COR- _ - FEE RECT AND POSTED VALUATION _ FEE IIIc- "' FINAL 76A636A D95 3. 12-53 DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES BUILDING . . WM. J. FOX, CHIEF ENGINEER NO. OF BLDG. ORD. NO. DISTRICT sNO. PLAN CK. NO. PERMIT NO. PLANS SETBACK LINE FIRE APPROVED do= J ZONE eBY DATE RECEIVRQ�BY DATE OF APPL. ,DATE ISSUED ZONEUSE '�77 PROVED DATE BY APPLICANT FILL IN HEAVILY OU'T'LINED PORTION ONLY BUILDING p K NAME ADDRESS W 2 ADDRESS LOCALITY F = Z - NEAREST K W CITY CROSS ST. Q STATE TEL. LICENSE NO. NO. W NAME �k Z MAIL NAME ,Y,c� ,'',isfl" Q ADDRESS , _ ADDRESS A .r" CITY(,. -TO. QCITY �`� 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS U APPLICATION AND STATE THAT THE ABOVE IS CORRECT STATE TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LICENSE N NO. AND STATE LAWS REGULATING BUILDING CONSTRUCTION. SIGNATURE OF `'- LOT. NO. Gd SIZE OF LOT _O _ OWNER / Q _ NO. OF BLDGS. AUTHORIZED AG Ur BLOCK NOW ON LOT N /// CORRECTIONS W TRACT D USE OF BLDGS. NOW ON LOT ,r DESCRIPTION OF WORK USE 3 �iTl7 —BUILDING J Q Z O NEW t� TYPE GROUP NO. OF NO. OF�"- ALTERATION ROOMS — FAMILIES ADDITION SIZE �V I REPAIR STORIES tl MOVING WALL COVERING �e-_t-) _ tl DEMOLISH ROOF COVERING s P. C. FINAL APPROVAL FEE f� 4/ $ 600 { INSPECTOR'S VALUATION FEE `� DATE I 1 NAME_ r r WORKERS' COMPENSATION DECLARATION hereby that lhave a certificate oiis cself acetificateof Workers'Compenston Insurance, APPLICATION FOR BUILDING PERMIT a certified copy thereof.(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO fILL IN AOD Ess ❑ Certified copy is filed with the county building inspec- BUILDING �L tion department. ADDRESSMIS LAS I,,JLOCALITY NEAREST Date Applicant CITY , ZIP 17490 CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' I 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 ($100) or less.) TRACT" BLOCK LOT NO. 0 NO. ---5-0,07 � g TEL..+ C—? SPECIAL O - �� I certify that in the performance of the work for which this OWNERLON IELUM NO.FJ "G CONDITIONS o"t0. Z "`� permit is issued, shall not employ any person in any manner DISTRICT GROUP TYPE FIRE P ESSED BY ADDRESS C-L D y, v CONST. ZONE so as to become subject to the Wo r rs'Compensation Laws. .5- DU i� j % Date Applic ITY L_ o ZIP STATISTICAL CLASSIFICATION APT. CONDO. NOTICE TO PPLICANT: If, after making this Certificate of ARCHITECT OR TEL _ ,� Ly Exemption, you should become subject to the Workers' ENGINEER Q PLS" �� CLASS NO. DWELL. UNITS 0. Compensation provisions of the Labor Code, you must forth- ADDRESS (_ , SEWER MAP Z with comply with such provisions or this permit shall be �r� deemed revoked. TEL. , BK PG d/ VALIDATION CONTRACTOR NO. LICENSED CONTRACTORS DECLARATIONwLIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS r'v NO. VALUATION (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 Contractor Date DESCRIPTION OF WORK CAe 'C— LI IN4E NEW $ - ❑ \ ADD I am exempt from the licensing requirements as I am a oI PJ licensed architect or a registered professional engineer ALTER FINAL acting in my professional capacity, (Section 7051, Pi-AD I PIG. C_B,WALL REPAIR DATE Business and Professions Code). USE-OF EXISTING BLDG. ® � DEMOL� By XLic. or Reg.No.f-" 19 7_T1 Date APPLICANT TEL OWNER-BUILDER DECLARATION (PRINT) (� j NO. I hereby affirm.that I am exempt from the Contractor's License � 8®� Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): PRESENT ❑ 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 sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. z 4 313 2 A with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). 0 0 0 0 0 1 REQUIREDTOTAL SETBACK FROM EXIST, CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH Ihereby affirm that there is a construction lending agency for FRONT 2.- - 38.,5 0 the performance of the work for which this permit is issued P.L. a a ❑.3 8'S 0 c=� (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name 0 3,0'97 8 1 Lender's Address' P.C. Fee$ Permit Fee / w 1 certify that I have read this application and state that the Issuance Fee J b above information is correct."I agree to comply with all County Investigation Fee Y,C 0 ordinances and State laws relating to building construction, 3V wO Total Fee and hereby authorize representatives of this County to enter aupon t above-mens' ned property for inspection purposes. a ©s SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or gent DaMe _ -