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Home My Public Portal About9852 LEMON AVE_Building__ 76weseA CE#00310-OB APPLICATION FOR. BUILDING• ,PERM•I1'{�.--,r;•. � 1; COUNTY-'OF LOS ANGELES . BUILDING ..n; ADDRESS. - DEPARTNENT-OF-COUNTY ENGINEER- ' , - BUILDING AND-SAFETY. DIVISION ' LOCALITY Ms]Z1OHN-Ari.LAMME. COUNTY ENGINEER CNEAREST ROSS ST CASSATT D,GRIFFIN, SUP .T OF,BUILDING -� CISTRIPT NO. - GROUP-'1.7F- AOR. ROUP-• :+SFE P R APPLICANT,TO FILL INquiz coN STATISTICALCrgSIFICATION 'r'I SEWBER"_MAPF, ADDRESS «_ -v (CLASS.NO DWELL UNITS LOT NO - ~/• ' a Z LOCK NUMAP HAT YES TRACT rZ- f, '.GD USEZONE VrY SPECIAL x, NO OF.,BLDGS CONDITIONS SIZE OF LOT r ' `I',NOW ON'LOT USE OF EXISTING BLDG. BUILDING :YARD 'HWY . -STREET•NAME EXIST. s+ SETBACK WIDTH.; OWNER ` FRONT '�y `• /-�•I MAIL P.L. 61Lz�1)_ ADDRESS SIDE i r TEL CITY TEL INSPECTION RECORD - ARCHI ECT OR ENGINEER ADDRESS" `l r�TEL- 1 ( /�� F H_ CONTRACTOR NO ! _,.-•' ADDRESS J ,r/• D•y/ 1'l 4- �A il DESCRIPTION OF WORK NE ADD ALTER.' REPAIR -DEMOLISH �ry p y� / FT. 13 NO OF NO OF / �, 1'�iC If�� / I/ `7 SIZE STORIES FAMILIES, USE OF STRUCTURE G n 4 11 SIGNATURE OF - APPLICANT APPROVALS DATE INSPECTOR'S INSPECTOR'S SIGNATURE ADDRESS y FFLOCATION- MATERIALS 2 - VALUATION 5 - - - FRAME- FIRE-STOPS. - r - �/�► , BRACING,BOLTS PC FURNACE:LOCATION. FEE $ FEE �� ' GAS VENT,DUCTS- 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- , t , 'PLICATION.AND STATE THAT THE ABOVE IS CORRECT AND LATH INT: - AGREE TO COMPLY.WITH ALL COUNTY ORDINANCES AND STATE LAWS RE ATIN BUILDING 'CONSTRU ION. LATH,EXT -SIGNATURE, HOUSE NUMBER COR- r/ PERMITTEE RECTAND•POSTED - .• ADDRESS FINAL .-CLYDE N DIRLAM. PRINCIPAL ST CT AL ENGINEER -PLAN CHECK VALIDATION C,' M o •--CASH PERMIT VALIDATION CK.' M O CASH + - ' IIJL II _ Jt.;0�92 4 6 ' 1U� 1 A 51,00 APPLICATION FOR BUILDING PERMIT FOR AP9LICANT TO FILL IN . (Print or type only) COUNTY OF LOS ANGELES _ BUILDING ADDRESS DEPARTMENT OF COUNTY ENGINEER CITY ZIP 9 A BUILDING AND SAFETY DIVISION NO OF BLDGS BUILDING SIZE OF LOT NOW ON LOT , ADDRESS 'T_ BLOCK LOT L LOCALITY NEAREST OWN S N L Q CROSS ST ASSESSOR ADDRESS %cRrAMAP BOOK PAGE PARCEL / DISTRICT GROUP TYPE FIRE PRO SSED BY -CITY �} ZIP 0(, NST ZONA ARCHITECT OR TEL ENGINEER NO STATISTICAL CLA751FIC TION SEWER MA ADDRESS TEL CLASS NO DWELL UNITS BK PG CONTRACTOR NO LjSk ZONE OP LIC ) SPECIAL ADDRESS NO cif!a LIC CONDITIONS ' CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG SETBACK FROM FRONT PROP LINE OF (STREET) ADDRESS CITY TOTAL SETBACK FROM -TYPE OF EXISTING SQ FT NO OF NO OF CHECj HIGHWAY t YARD_ = FRONT PROP LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE r DESCRIPTION OF WORK e %W6�� NEW + O ADD BLDG SETBACK FROM fy 7 _ SIDE PROP LINE OF )STREET) O t� ALTER TOTAL SETBACK FROM TYPE OF EXISTINHIGHWAY + YARD = SIDE PROP LINE HIGHWAY WIDTH REPAIR Z USE OF __ _ EXISTING BLDG DEMOL ❑ + APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑ (PRINT) NO IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE) -_ IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION$ (i IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE - WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM - - PENSATION INSU /� SIGNATU OF //� PERMITTE k ADDRESS �AlIZ FINA'f �., CI N TEL D/Y DATE BY MAKE CHECKS PAYABLE TO FEE FEEPC $ PMT HARVEY T.BRANDT,COUNTY ENGINEER 1- 5-PLAN CHECK VALIDATION CK MO CASH PERMIT VALIDATION cK M o CASH 9=8 13 1' ® 1.J.Q Q Alf. ®s 76A638A CE 0803 3 75 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN B L J('rAdbRESS I hereby affirm that I have a certificate of consent to self Insure, BUILDI DRESS ) or-a certificate of Workers' Compensation Insurance,or ertified copy thereof Sec 3800 b C CITY ZIP �iO Q LOCALITY Policy NO mpany^�`� SIZE OF LOT NO OF BLDGS NOW ON LOT f ❑ Certified copy Is hereby furnished NEAREST CROSS ST ❑ Certified copy Is filed with the county budding Inspection TRACT BLOCK - -LOT NO de par me USE ZONE MAP NO Date A licant ASSESSOR MAP BOOK PAGE PARCEL PP SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER-/�//� QQ TEL NO' COMPENSATION INSURANCE • G n WITHIN 1000 FT OF SCHOOLS YES No (This section need not be completed If the permit Is for one hundred ADDRES r I DISTRICT GROUP TYP CONST FIRE ZONE PROCESSED BY � dollars ($100) or less) CITY 'ZIP I certify that In the performance of the work for which this permit Is Issued, [,shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TE U O become subject to'the Workers'Compensation Laws 7 STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS 7 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' C T ACTOR T 9a5 SET-BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revokedA KESS p O P_L - LICENSED CONTRACTORS DECLARATION SIDE Y -LIf,�C PL I hereby affirm that I am licensed underprovlsions Of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ FT SIZE NO OF STORIES NO OF FAMILIES - a Professions Code,a h f d rr� e Is m full force arm - NEW C3 BK PG loop. ' License Nu r IC CIasS c D CRIPTION OF WOR .ADD ❑ VALUATION aQ Q Contracto Date 10 kooeci� ara ALTER ❑ ❑ I am exempt under Sec 'S REPAIR ❑ B&PC for this reason g M DEMOL ❑ LDMA P/C'* W Date USE OF EXISTING BLDG URM ❑ a g ' 125°cC (n Signature APPLICANT(PRINT) _ TEL NO LDMA Perm# JJVJ _ Z ❑ I, as-owner of the property, or my employees with wages as Valer�fin t z I their sole compensation, will do-the work and the structure Is ADDRESS O TOTAL 25®55 not intended or offered for sale (Section 7044, Business and FINAL DATE Q ' Professions Code) WILL THE VgpPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL 2 _ J CHECK - 125.55 ` -OR A MIXTf1RE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑ I, as owner of the property, am exclusively contracting with AMOUNTS SPECIRD ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY '5 licensed contractors to construct the project (Section 7044, VES 1:1 No CHANGE 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 SOUTHR ' CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKUST FOR 0000-0001 9l11l95 GUIDELINES _ , '1 hereby affirm that there is a construction lending agency for YES❑ No �+ • a the performance of the work for'whlch this permit is issued(Sec IALS - ITTING 2232 1 AM1�•45 ° 3097,CIV C MANE READ I UNDERSTANHE D MMATERIREME TS UNDER ANGELHE ES COUNTY MD MCODE N ) , CHECKLIST I UNDERSTAND MV REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS Lender's Name MATERIALS RR O NG glyD fO�b GZRMIITFROM THE SCAQMD o Lender's'Address �pN��✓.� /d/JYI� f.�R OWNEHOR AGENT ^� O 0 1 certify that I have read this application and state under penalty O of perjury that the above Information IS correct I agree to comply PC FEE PERMIT FEE �{ - 01 with all county ordinances and State laws relating to budding , construction, and hereby authorize representatives Of this County ISSUANCE FEEOD to enter upon the ab n Heil property for mspech n purposes / a `! INVESTIGATION FEE - TOTAL FEE um a Anile«Aq t o41 SEE REVERSE FOR EXPLANATORY LANGUAGE