HomeMy Public PortalAbout9678 LIVE OAK AVE_Building__ 76AG36A DF. 3-bb
APPLICATION FOR. BUILDING PERMIT
DIVISION OF BUILDING AND SAFETY nno Els"st<y ,+��
Department of County Engineer
County of Los Angeles LOCALITY 7_5 c
WM.J. FOX, COUNTY ENGINEER NEAREST /%f�1
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST..
DISTRICT O.- GROUP SEWER MAP
TYPE -
FOR APPLICANT TO FILL IN I ,�I B' �o
coNsr
Ir-
BUILDING
-
BUILDING �/ - qSTATE
ADDRESS (f3 'Q /�. NUMBER. tsC.E�a HWY YES NO
LOT NO. c�'�s/� �/ BLOCK USE ZONE SPECIAL -
CONDITIONS ' y
NO. OF BLDG
SIZE OF LOT (� I NOW ON LOTS BUILDING YARD, HWY STREET NAME. . EXIST.
SETBACK WIDTH
USE OF _
EXISTING BLDG. FRONT
P.L.
OWNER - SIDE -
P.L.
MAIL (�
ADDRESS / - O 'TRACT-DWELL. f UNIT -
5 INDUSTRIAL:
TEL. X-76_91&. WELL. f UNIT 8 PUBLIC BLDG. -
CITY NO."
ARCHITECT OR TEL.
2 ,DUPLEX f UNIT 7 pDON.,ALT., ETC.
ENGINEER NO. 3 APT. UNITS
8 MISCEL.
ADDRESS 4 COMMERCIAL
CONTRACTOR TNo' INSPE2C�TION RECORD
ADDRESS �1�• _ 2Z+t�G '"1---f�� Iil c"\ k-C m Nt,� lu, -
DESCRIPTION OF-WORK
Q? SAau.p
NEW ADD' ALTER REPAIR DEMOLISH
SQ. FT. - NO. OF NO.OF
SIZE jp C STORIES FAMILIES A /
USE OFSTRUCTURE
.
rz-
SIGNATURE OF
APPLICANT APPROVALS
ADDRESS ODATE INSPECTfSR'S SIGNATURE
FOUNDATIOW LOCATION
$ �AG9 P.G. S /� FORMS, MATERIALS
GGii FEE �/ FRAME: FIRE STOPS..
VALUATIONBRACING, BOLTS
FURNACE: LOCATION,
I HEREBY-ACKNOWLEDGE THAT 1 HAVE ..READ THIS GAS VENT, DUCTS l -
APPLICATION AND STATE HAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY Y1,T,
ALL COUNTY ORDINANCES LATH. INT. �yG
AND .STATE LAWS RE LATING BUILDING CONSTRUC-
TION. .. f LATH.'EXT.
"SIGNATURE-OF HOUSE NUMBER-.COR- --
PERMITTEE RECT AND POSTED
C 11
ADDRESS FINAL 10
WM.J. FOX,COUNTY ENGINEER VALIDATION C. N. DIRLAM, CHIEF BLDG. INSPECTOR
1 C0 6 5 9-7—Lf) Juga 1 1 6 1 1 .0 0 A � to _
f. 6 6 13 O J���v 6 1 2'2.0 0
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76A6 38A CE M80310-58 AY PL IC�TI®■ ®�• ���LLu�®.Y■ 4V� ��■ \.....
COUNTY OF LOS ANGELES Bu1LDING '
DEPARTMENT-. OF COUNTY ENGINEER gDDREss .
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A.LAMBIE,COUNTY ENGINEER NEAREST. -
.CASSATT D.GRIFFIN,.Sup•.T OF.BUILDING CROSS ST. f
.S
DIST:; O. 7GROUP TYPE ESSED BY _
FOR APPLICANT TO FILL IN 1. cotsr
BUILDINGS
WER MAP STATISTICAL CLASSIFICATION_ --
ADDRESS 6t (1 /� . .I v -'(n, JIZ .• ..
y _ w- CLASS. NO:- WELL:UNITS'
LOT BLOCK MPTP' = STATE
/7_"e, NUMBER HWY. YES
TRAC .
l'�fls>Lt� e0 — USEZONE —SPECIAL
�� �
Q l -A: S ,
SIZE OF LOT Ld / /1, / I NOW ON LOT ` � CONDITIONS -
USE OF "
EXISTING'BLOG.. - - BUILDING .EXIST..
SETBACK
_ YARD' HWY. '4REET NAME
. WIDTH
OWNER
°`v ° �.Q .S�I�'�� T _
.� 'FRON
MA REBS. ' �'�� ®�/� �� ,SIDE �- a
' ADDRESS �
TEL. P,.L. ..
CITY NO.
ARCHITECTOR TEL. INSPECTION RECORD
ENGINEER. - NO. ' - ••
ADDRESS
. . TEL.
r;
CONTRACTOR- NO.
.ADDRESS
DESCRIPTION OF WORE
NEW ADD ALTER REPAIR DEMOLISH
SQ S ZET. O N OOF NO.OF
�7 RIES FAMILIES y
USE OF STRUCTURE
SIGNATURE OF - APPROVALS. - -
APPLICANT
'DATE "INSPECTOR.'S,SIGNATURE
ADDRESS 77 FOUNDATION: LOCATION IyjA� _
-� - FORMS;MATERIALS U/AfY -
- P.C. $ 'FRAME: FIRE STOPS.
'---�� FEE - : BRACING,.BOLTS -
VALUATION $ FURNACE:r LOCATION;'
FEE l GAS VENT,DUCTS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP-� LATH.INT: "-
.PL CATION AND STATE THAT THE ABOVE IS CORRECT AND -
AGREE TO COMPLYWI &COUNTY ORDINANCES ANDLATH,EXT.
STATE LAWS REGU IL ING ON UCTION.
' 'SIGNATURE OFHOUSE,NUMBER COR-
PERMITTE f -FiECT AND POSTED
ADDRESS - L�INAL ��. It
...CLYDE N. DIRLAM,"PRINCIPAL STRUCTURAL-E
PLAN CHECS VALIDATION CK. hl.o. CASH PEBMIT.VALIDATION cK. M.O. CASH
�� 6 1 7 .9 P'IkY 5 1 .t1 1) .00
s
01
WORKERS'COMPENSATIONjDECLARATION
M
I hereby affirm that I have,a,certificate of consent to,self D O Al
D D D D nn
nsure, or a certificate of Workers' Compensation'Insurance, - Q p p d 0 C�QT d ] Oo Q• Q d D D GAJ Ccs p C QG O _
V6 certified copy theieof (Sec.;3800, Lab- C )';
Pottcy,rvo .1039547-, .•'cormPony.State Compensation
COUNTY OF LOS'ANGELES BUILDING i4ND SAFETY
.f .
❑ Pv v Insurance Fund FOR�APPLICANT TO FILL 1IN. Cy/ `r te
BU' - '
Certified.co ,is hereb'-furnished
g I -..ed`copy is filed W, The ounty b ding ins c ILD'ING. _
,BUILDING
ADDRESS
- ^ :ADDRESS 9678 .Liveoak
�' tion department, t
Date Applicant CITY -- - - - -
6 28-89 y Temple Clty ZIP .91780 LOCALITY •_� j '
CERTIFICATE OF EXEMPTION F M WO RS ":" -`'NO. OF•BLDGSr -•-- s, NEAREST.:., -
`COMPENSATION:OI' RANC SIZE OF LOT NOW ON LOT CROSS;ST. A, t
(This section,ne'ed not be completed if=the.permit is for:one - - - - - - ASSESSOR
hundred or, or les's.;) TRACT BLOCK LjO�T NO. MAP:BOQK ^- PAGE{ PARCEL
r 'OWNER "cyrit xla Eichorst... - '28'7-14'65 US ONE MAP
1 certify' that m the performance of the work for"which this .OW' O i>.
z
L�
permit is issued,tl shall not employ any person in any manner _- ADDRESS 96.78..:L1V20a1t _ _-. .. ._. ' f SPECIAL, -
"" CONDITIONS
so as to'becorne subject to the Workers .Compensation Laws. - ®'
s,�.
cliY._. .Temple` it.y
Date APPlicant _
ARCHITECT�{�R TEL.
NOTICE'TO APPLICANT` If after' moking'this Certificate of ENGINEER""n.e NO, DI$ UP-t CONST �'
TRICT. -GROUP! P, FIRE PROCESSED BY
Exemption `.you should 'become sublect to ether'Workers } J ZONE U
\1// t 3
Compensation•provisions-•of,4he°Labor'•Code, you:mustforth- ADDRESS _ = _ _ _ _ LU
with,comply. with"such;:provisions;or,this permit shrill be' - - -
_ J;
deemed,reyoked.,- .. • ,. r. ' United ROOfiri CO PT.
;r•ti STATISTICAL CLASSIFICATION
� • • CONTRACTOR g �,�3-223-408TH +. _
LICENSED CONTRACTORS DECLARATION , -- -• -- - - . -•�.-- -. STCLASS NO: l DWELL UNITS
—
I
A CONDO g
LIC._.._ , -
y under provisions,of Chapter 9 ADDRESS 1821 Daly St., NO: 137650
(here affirm that I am dicens)df.Division 3 of tr a Business and ,,-- _ !
commencin with Section 7000 o, EW P
.,. _. L.
Professions Code, and m license' in full"force and effect. CITY LOS .Angeles CLASS C-39 - -'
S ER MA
Y T
SO, FT. . NO.OF ^:- NO._OF CHECK DA 10
BK. PG.
13` '50 7' C-39 SIZE STORIES FAMILIES`• ONE ^t nVA
11 IN:
license Num r Gc:.Class r, r „ VALUATION i
' .,. DESCRIPTION Ot."WORK 'R2IilOVe' eXlSt'lri NEW :_ }. .; _
Conlracto ate 6 28'.8'9 f 5703-.'00
roof. -Install 19 s s. 3-tab _
ADD
I am ex pt unde ea.
__ : q
•. >, Insta '1 3 sqS — — LTE
- A R
B.&P.C. for this reason Ply built—& S _
P
RE AIR-
_ Date: USE OF C� $SS 'B. Smok detectors :r 'DEMOL ❑ # i
EXISTING BLDG. ' re uireed. . ._, -..
Signature APP PR NT)United ROOF ing CO. T `3-223-4081 FINAL
OWNER-BUILDER DECLARATION _ _ _ DATE.- --
t hereby affirm•that,]-am exempt from.the.Contractor's License -' y
Law fdr the faljowing:reason'(Section 7031 5 Business and ADDRESS 1821 Daly' St." 'Los Angeles, .9003 FIwA''
...
'Profe"ssi'ons Code): _ PRESENT
e
I, as owner of the property, or my employees with ADDRESS _
wages as their'sole cam ensotion',will do the work and _ _} _ �`�
a
A:. ✓.
the structure isnot:intended r.offered for sale(Section LOCALITY g ;t x ,jl� t ►o•!tl
7044:Business:'and ProfessionsCode). 'MOVING ."' "'TEL. -
CONTRACTOR NO. ( '
J> as owner of the property, am exclusively contractinga�r ,
with'licensed contractors to construct the ro'ect Sec- ' ' "- - - ITEM
r rr T/;��...T t Et 1�
)P I ADDRESS v. "Illli7L t m �
.tion 7044, Business and Professions Code ' •' �(ryry
REQUIRED.. „ HWY TOTAL SETBACK fROM_ _ EXIS .: _ �. {a�__. vESocV
CONSTRUCTION'LENDING AGENCY: ` SET BACK YARD PROP. LINE WIDTH'
I hereb affirm that there is a construction lending a enc for AA , !
Y 9 9 Y FRONT �rt1
-the performance of-the•work-for which-this permit-is issued - F:L. • ..... :_ __, .. . .. .. v _ _ _ __
-Sec 8097; Civ.•C.). - SIDE _ - •
P.L. �}�y `�
Lender's Name 13000'j�Vs31 b/10,/89
o _ s LDMA Ref # r .. ^a
m .c.. _. - -_-._. -S- - -_._.... -•-- P.C. Fee$ . ..__. Permit Fee--7 OO
xlxx, 6. 1 Fhi
Lender's Address
.I_certify.that_1 have.read this.application and state..that.the _. .: _: -- :.+. Issuance Fee--•=-10 50. LDMA-U& D
above information is correct. I agree to comply with all County. Investigation Fee
a\
0 ordinances'and State laws relati to buildin construction,
m ., -_ - _.- - ... .- _g.. _ _ _._: __.. _ _ _ .. _ -Totol Fee.:- �LDMA'Perm-;#••,_'
86..-50 -
and hereby autho' represe' trues of this County to enter •
m =upon th "above entionecJ roperty for inspection purposes. t 6
6-28-89 SEE.REVERSE FOR EXPLANATORY LANGUAGE"• t
Sjgnature of/j plicontor