HomeMy Public PortalAbout10618 LIVE OAK AVE_Building__ -
ENVISION OF BUMDING AND SAFETY "
Depax on! of County Engineer
County of Los Angeles I
� -WM. J. FO COUNTY ENGINEER _ APPLICATION
FOR APPLICANT TO FILL IN
BUILDING
BUILDING �j�j� rte'/
ADDRESS !/�V /� -�((jGG'/r, f/ - LOCALITY
/ �"p _ - NEAREST
LOCALITY /I///('fi�•f_ GC/ _ - CROSS ST.
NEAREST, _ DISTRICT-No. PUN CK.OR Rcc. No,
PERMIT NO.
CROSS,ST -
OWNER �J,OrT Y1l�.�71,�' _ RECEI+V ED BY DATE OF APPL. - DA E / D
MAIL �7 C,�""'1 .-►... � �1�'E�.'L'+'L.,v3� • .!/J
ADDRESS -'
ONE JTL�NS
OFTYPEGROUP IRE ZONE
CITY _ � I.�l�-==�•I'.-
t
ARCHITECT OR TEL. /1 ZONING
ENGINEER - n�� NO. • APPROVED By
S s.•T,�ys/�r�- - �• BUILDING
ADDRES
SETBACK LINE:
v - TEL. ' APPROVED - DATE _
CONTRACTOR A��� -�. NO. By. t
• _ ` HOtWk NUMBERING '
ADDRESS OL�"?�Ir:'� x�
LEGALMAP NUMBER - NO.-ASSIGNED
DESCRIPTION LOT NO. I BLOCK
DATEI CORRECTIONS I INSPECTOR
TRACT
SIZE OF LOT �,/) �� I NO. OF BL'DGS.
NOW ON LOT
USE OF - NO. OF
EXISTING BLDG • FAMILIES p
DESCRIPTION OF WORE
DEMOLITION z
NEW { ALTERATION ADDITION �• _ r
y 1
REPAIR
SQ. FT. - v /� -NO. OF
SIZE / /� ROOMS STORIES '
QCT..WALLv-* ROOF _
COVERING COVERING
USE OF STRU
APPROV
INSPECTOR' SIGNATURE, DATE '
_FOUNDATION: LOCATION
FORMS, MATERIALS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRE STOPS,
PLICATION AND STATE THAT THE INFORMATION GIVEN IS
CORRECT. BRACING, BOLTS
' I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE- LOCATION,
AND STATE LAWS'REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS
SIGNATUR .OF/ \1 �`�J � A .r LATH, INT.
PERM 1 E/ �1/.V .X-�.✓✓`�v -
� l
ADDRESS
LATH, EXT.
PLASTER, INT.
AUTHORIZED AGT.
O PLASTER; -
��� P. C.$
FEE HOUSE NUMBER COR-
T'I RECT AND POSTED
VALUATION FEE FINAL ,7'
_ d "
:$$'aMON OF BLUING AND SAFETS 24M ,,
f=` Department of County Engineer A `
Coun}y of Loaf Angeles y _
WM. J. FOX,. COUNTY ENGINEER 'APPLICATION
BUILDING
FOR APPLICANT TO FILL IN ADDREBUILDING
sB
ADDRESS 14Q(�p (Jr •'1/�jil '..•7',(✓�II///'1 'f LOCALITY •�CGy/ ],�/D—` //
LOCALITY (/;¢ J I ��'/, j( i 4 Y CROSS ST.
CNEAREST
ROSS ST. I�JL'Vl�i�7_� DISTRICT NO. `- PLAN CK. OR Rea"No. - PERMIT NO:
OWNER //J�^ ,• �, ]���j/'7� _
RECEI ' DATZE.7O�F A t7PP`Lv..,- "ODADAT�ISISULSD
ez
MAIL
ADDRESS)m /� �
J�/� t-]/V✓ �i � �.�} -USE ZONE'NO. OF • PE GROUP FIRE-ZONE ,
PLANS
'CITY (=/t/� �/� �✓ /*-I NO.
_ 2
ARCHITECT ORS ZONING-
f :�QQQ
ENGINEER
APPROVED BY-
' BUILDING
ADDRESS �O ,� O�R„4•No .
SETBACK-LINE:
TEL APPROVED
CONTRACTOR NO. BY, ,/�/ •C� - ��g„
HOUSE NUMBERING
ADDRESS - •` ^OD �
LEGAL MAP NUMBER / NO: ASSIGNED BY l
DESCRIPTION LOT�NO 32 BLOCK - I 1CORRECTIONS I -INSPECTORp
_// DATE + ''
TRACT �-�r� �� 5-2 4?D
NO. OF SLDGS.
SIZE OF LOT r A , )orf�� I NOW ON LOT I • `�-��USEOF FA
q A, 0,, OF
EXISTING BLDG. ., C���- I FAMILIES
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
REPAIR `I DEMOLITION
SQ. FT. NO. OF
SIZE - I -
�j 1� /� a
f ROOMS ,STORIES
COVERING_WALL_`-,/_.-j_1 /,
N�yi/. � � I ROOF �'/� � J, -
COVERING //L7.7Ci'
USE OF STRUCTURE ;
FIS-
,g;zc-::20 a L� G"'.��. .=-oe,-r s APPROVAfS •� ,
��� INSPECTORA;SIGNATURE
DATE.'
FOUNDATION:
FORMS, MATERIALS �^ 'g/�_ •�.
1 HEREBY ACKNOWLEDGE THAT I-HAVE READ THIS AP FRAME: FIRE STOPS, 7r/
PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING„BOLTS
CORRECT.
1AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION,
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. ./GAS VENT, DUCTS -
SIGNATURE,OF!� '✓r!�' �, LATH, INT.
PERMIT-f EE I�
//�� f / o Y ��•] /fes) r`� �'-•' LATH, EXT.-
ADDRESS/,/
r / PLASTER, INT. q
_ AUTHORIZED AGT. /�-��'�"+_ /'a
-� .-+L...�• �Oa� d U PLASTER, EXT.
PC
FEE. BE NUMBER COR-
/
RECT AND POSTED
C9 $
- VALUATION FEE Z 0 FINAL
76AS38A DBS 3 E-SS -y �•V -
w COUNTY OF'LOS ANGELES' BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS
I hereby affirm that'I have a certificate of consent to self Insure, BUILgif D R S•
or a certificate of Workers' Compensation Insurance, or a certified �(/
copy thereof(Sec 3800,,Lab C) CITY 619 k
ZIP - `O��y i
LOCALITY
Policy,No Company SIZE rIE LOT NO OF tL PS NOW ON LOT
El Certified copy,is hereby furnished - ` - ✓h NEAREST CROSS ST,
❑ Certified copy is filed with the county budding Inspection TRACT - BLOCK LOT NO -
•department USE ZONE MAP NO J _
• Date Applicant ASSESSOR MAP BOOK -• PAGE PARCEL -
SPECIAL CONDITIONS
^ CERTIFICATE OF EXEMPTION FROM WORKERS' � 1 'r
. COMPENSATION INSURANCE QWN v; `f J TE / WITHIN 1000 FT OF SCHOOL'?, YES NO
(This section need not be completed If theermit Is for one hundred ADDRE S a
P a L J J 1e_,D DISTRICT GROUP TY CONST FIRE ZONE PROCESSED BY
dollars ($100) or less) � / V -
r._ CITY ZIP
1 certify that In the performance of the work for which this permit / /
is issued, I shall not employ any person In any manner so as to ARCHITECT OR ENGINEER TEL NO D�+
become subject to the Workers'Compensation'Laws - STATISTICAL CLASSIFICATION V APT CONDO
Date Applicant, ADDRESS CLASS NO a DWELL UNITS
NOTICE TO APPLICANT If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST r
Exemption, you should become. subject to the •Workers' CONTRACTO TEL-NO SET BACK YARD HWY PROP LINE WIDTH
Compensation;provisions of•the Labor Code,.,you'must forthwith FRONT
comply with such prov)sionS or this permit shall be deemed revoked ADDRESS LIC NO P L
LICENSED CONTRACTORS DECLARATION SIDE
CITY - LIC CLASS P L
Ihereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP
(commencing with Section 7000)•of-Division 3 of the Business and SQ FT SI N OF STORIES O OF FA LIES - '
Professions Code,and my license Is in full force and effect W- BK PG
o d
License Number Llc Class DESC PTION OF WQRKK % _ ADD - , ❑- •VALVA N - O
e;ph.•��//11 .
Contractor Date ALTER ❑
El am exempt under Sec REPAIR El
B&PC for this reason DEMOL ❑ U
LDMA P/C#
Date _ USE OF-EXISTING BLDG - URM ❑ a
t co
Signature - APPLICANT(PRINT) _ _ _ TEL NO LDMA Perm# _ ;• g Z
Z ACP
iia�r
1, as owner of the property, or my employees with wages as
Ration,heir will do the work and the structure is ADDRESS _ • - ,�;! _": .Li x a a_I
not Intended.or offered for sale (Section 7044, Business and FINAL DATE q Q ^
Professions Code) „WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL • I l �( vl M s TENS ,
OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE [
❑ I, as owner of the property, am exclusively contracting WI}h AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE'S FINAL BY 0 � � e_ ��
licensed contractors to construct the project (Section'7.044, �I( 12.1 `•-k-- ,
YES❑ NO❑
, Business and Professions Code) CHECK •, ', •I�f
WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING - - '.} .E21 _I
OCCUPANT-REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH h _
CONSTRUCTION LENDING AGENCY +COAST AIR OUAUTY MANAGEMENT DISTRICT ISCAQMD)SEE PERMITTING CHECKLIST FOR r_ �Y
GUIDEUNES
I hereby affirm that there is a construction lending agency for YES❑ NO❑
the performance of the work for which this permit Is Issued(Sec
I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING
3097, Civ C
N ) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, ]_ij 00—OCE' s 10,1�f�+Li.
TITLE 2 CHAPTER 220 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS f
01
Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD
o Lender's Address ?ic M a i
O - G ER GR AGENT
oI certify that I have read this application and state under penalty
O of perjury that the adn
ation Is correct I agree to Comply PC FEE PERMIT FEE
N with all county ordid State laws relating to building
m co coon, and he rep sentatives of this County - - - - ISSUANCE FEE0 t r upon the rop rty for Inspection purposes '7
a
INVESTIGATION FEE TOTAL FEE
uea Appb�m Dale
SEE REVERSE FOR EXPLANATORY LANGUAGE