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Home My Public Portal About9828 LEMON AVE_Building__ DEPARTMENT, OI-BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OFLOS ANGELES ® � WM, J. FOX, CHIEF ENGINEER 'FOR APPLICANT TO FILL IN FOR OFFICE'USE ONLY BUILDING DISTRI511NO.• PLAN CK. NO. PER7G IVI�IT NO. X/ ADDRESS 6�J / RECEIVED BY DATE OF APPL. DATE ISSUED LOCALITY' ^ NEAREST CROSS 8T. BUILDINGl/7 / / - ADDRESS LT (,off' OWNER MAIL I LOCALITY ADDRESS hP U � NEAREST �� TEL. CIIOSS ST. CITY •�PY P.�I A NO. FIRE - OF TY SZ7I G,8f P ARCHITECT OR I TEL. ZONE PLANS ENGINEER NO. BLDG. SETBACK LINE /'V ADDRESS �+ 'Aq ,I1 APPROVED - - CONTRACTOR O W rd 4 d/�O H/ NO.TEL O u �CJ (!V BY DATE USE APPROVED ZONEBY DATE ADDRESS 'Jot S b 5 'Pose ea HOUSE NUMBERING- i LEGALFIELD CHECK BY DESCRIPTION LOT NO BLOCK MAP NUMBER ,,��3 TRACT 5 r /V ` •NO. ASSIGNED BY.�DATF NO. OF BLDGS. CORRECTIONS SIZE OF LOT 3 NOW ON LOT USE OF NO. OF _ EXISTING BLDG,• , FAMILIES DESCRIPTION OF W-0 45z NEW 'I I ALTERATION ADDITION I - O REPAIR I I DEMOLITION I I I 0 SQ FT. , NO. OF SIZE ROOMS STORIES Z EXT. WALL ,,QROOF 1' COVERING �/ C COVERING USE OF STRUCTURE 1/ A v /?7 1 r ' .• ° APPROVALS INSPECTO 'S SIGNATURE DATE 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FOUNDATION- LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS - CORRECT. I AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS, I� HEREON AND WET ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS LAWS REGULA+rING BL&ULDIN CONSTR ION. l FURNACE. LOCATION 12,i/ SIGNATURE OF GAS VENT, DUCTS PER MITT E LATH, INT. ADDRE68 J 18� LATH, EXT. `i. AUTHORIZED AGT. " PLASTER, INT. 76A638A DB611 10-60 $ P. C ' r l� �� FEE PLASTER, EXT. VALUATION J D $ FEE �.� FINAL I I v _ 4 ]6A636A CE�r8032-63 APPLICATION,-FOR' BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A JENSEN, SUP T OF BUILDING CROSS ST �� c�-'C e_, %f DISTRICT NO GROUP TYPE CESSED BY FOR- APPLICANT TO FILL IN `S e, CONST PR�� `� FFXISTINGEILDG T.G. STATISTICAL CLASSIFICATION SEWER MAP 9828_ E. Lemon T C• CLASS NO DWELL UNITS �� v�: - BLOCK r/ WATER NOT REQUIRED RECEIVED ❑ �Q CERTIFICATE MAP , L} ��"'""W NO x C?47�S HIGHWAY STATE MAJOR SECOND, OCA NO OF,BLDGS T NOW ON LOT• USE ZONE SPECIAL , CONDITIONS Residence OWNERHarry Graven TEL NO BUILDING YARD HWY' STREET NAME EXIST pp TT SETBACK WIDTH �r ADDRESS 5VG lY • San Marino San Ga FRONT ARCHITECT OR TEL P L ENGINEER NO SIDE '„ P L C. ADDRESS O CONTRACTOR �7 V 1 r i n Roof C wo`'AT7050 0 {V A ADDRESS 60 :S ISan Gabriel Blvd. 0 DESCRIPTION OF WORKSan Gab. ` w NEW ADD ALTER REPAIR ) DEMOLISH SQ FT NO OF NO OF {• •- SIZE STORIES FAMILIES I USE OF STRUCTURE t, ; Re-rpof flat roof of house:" SIGNATURE OF APPLICANT VALUATION 238.00 - ,"• APPROVALS DAT INSPECTOR'S SI NATURE . P C, ._ PMT FOUNDATION LOCATION < FEE $ 'FEE $6,00 FORMS MATERIALS'- ' FRAME FIRE STOPS, _ 1 HEREBYACKNOWLEDGE THAT I HAVE READITHISAPPLICATION BRACING BOLTS. . - AND STATE THAT"THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION ` WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING •GAS VENT DUCTS BUILDING CONSTRUCTIO •I CERTIFY THAT IN"DOING THE WORK t AUTHORIZED HERE Y I ILL NOT EMP ANY. PERSON IN,VIOLA- LATH INT ` TION OF THE LAB DC OFLTHE A OF j{Ip LIFORNIA RELAT- INGTO WORKMEN S SAT ON A C�/Jf' LATH EXT SIGNATURE OF HOUSE NUMBER COR- ' PERMITTEE RECT AND POSTED ADDRESS 0 S• San, Gabr e B1V FINAL - 2 , 'an Gabriel JOHN F.LEWIS. PR NCI AL ST URAL'`ENGINEER. PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDATIONUK M O CASH 1, •WORKERS' COMPENSATION DECLARATION >�suihereby,affirm that I have certificate consent to Self' A P P L I CAT I Q FOR BUILDING P E.RM I T ,,1'__ e;'a certificate of Workers' Compensation ation Insurance, � t , or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS.ANGELES.` BUILDING AND SAFETY Policy No Company BUILDING Certified copy is hereby furnished FOR AP,POC NT:TO FILL• IN. 'ADDRESS' ` a Cerftfied.copy is filed with the county building inspec- BUILDING tion part nt ADDRESS _ LOCALITY Date rte(/ Applicant { - ZIP C._� CROSS ST CERTI CATE•OF EXEMPTION FROM WORKERS' 01�O OF BL GS ASSESS R COMPENSATION INSURANCE SI E _L.LOT NOW ON LOT MAP BOOK :' PAGE PARCEL (This,section need not be completed if the permit is for one USE Z NE ESPECIAL 3 ; hundred dollars ($100),or,Iess ) TACT BLOC N , K TEL �I certify Ithat in the performance of the work for which this OWNE /��S N DITIONS d permit is,issued, ADDR SS I shall not employ any person in manner / t DISTRICT GROUP TYPE FIRE PROC D BY O so as to ec me su /tr�the.Work ompen t n Laws CONST ZONE V �J(, CIT ZIP- '� 1 �tlJ 0 k-3 ;3 O Date Hppl Ica STATISTICAL CLASSIFICATION APT C DO V NOTICE O AP ICANT If, of r m ing this Certificate of ARCHITEC OR TEL ENGINEER NO CLASS NO _DWELL UNITS 1d1 Exemp on, .y should become subject to the Workers', d Comp nsatio provisions of the Labor Code, you must forth- ADDRESS SEWER MAP H with comply with such provisions or this permit-shall be Z deemed revoked` TEL BK PG VALIDATION , CONTRACTOR _ NO , LICENSED CONTRACTORS DECLARATION ' LIC -1 hereby affirm that]am licensed under"provisions of Chapter 9- ADDRESS 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 ISTORIES FAMILIES ONE Contractor Date DESCRIPTION OF WORK NEW ADD I am exempt under Sec ALTER FINAL 17 B&P C for this reason - DATE / - REPAIR USE OF .FINAL Date EXISTING BLDG DEMOL p By _92560A Signature APPLICANT TEL q g r OWNER-BUILDER DECLARATION.. PRINT' N # o e • s o f 4:'I,hereby affirm that l am exempt from the Contractor's License �i.7 t! � - Law for,the-following reason (Section 7031 5,'Business and ADDRESSIP Tv 4 ,-,e • 7 a O 0 Professions Code)' 4. "' PRESENT 8 0 0 c=i' BUILDING' y • o •. j, as owner,-of the property, or my employees,with ADDRESS " 7 wages as their sole compensation;will do the work and O 7,2 9-8 5 the structure is not mtersded or offered for'sole(Section LOCALITY t, 7044, Business and Professions Code) - MOVING TEL I, as owner of the property, am exclusively contracting CONTRACTOR NO with'licensed contractors to construct the project (Sec- �R f - ADDRESS iwn,7044, Business and'Professions,Code) } REQUIRED TOTAL SETBACK FROM, EXIST T CONSTRUCTION LENDING AGENCY YARD HwY ' SET BACK PROP LIN �WIDTH - yI hereby'affirm that there is a construction lending.agency for FRONT. - • 's ,the'performance of the work for which this permit is issued P L (Sec •3097, Civ C,) r SIDE „ Q -P L Lender's Name r. • - - I P C Fee$ ° - Permit Fee, N + - \•� �""• - ' - Lender's Address �- - �• `• .� I certify that I have'read this application'and state that the Issuance Fee " above information is correct I agree to comply with all County Investigation Fee $' ordinances and State jaws relating<to building construction, Total Fee O d and hereby authorize'representatives of this County to enter upon abov - quatforied property for'inspectio urpos � _ - ,' 7 SEE REVERSE FOR EXPLANATORY LANGUAGE Sign6tAe of Applicant or Agent D '