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HomeMy Public PortalAbout6427 LIVIA AVE_Building__ D85-3 2SM SETS 10.46 DEPARTMENT. OF BUILDING AND SAFETY APPLICATION FOR PERMIT WUNTY OF LOS ANGELES WM. J. FOX, CHIEF ENGINEER 6 FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY // /� �Ay DISTRICT NO. /PL/AN9CK. NO. PERMIT NO..''/ BUILDING � 1 J�1 / ,ft%/T !1 V� 6 6 / �� s­'s 8 0 ?/— LOCALITY (p �V/ � F^-' Y LOCALITY�rj�JPL�' C� 7Y RECEIVED BY DATE gOFAPPL. DA�T,EEISSU'EED NEAREST CROSS ST. ^IY,049 r� / n BUILDING -OWNER /iGY / {/ / l�el� /nom _ADDRESS 761 Al. nL IiIIA A14 MAIL ADDRESS �7 y1s ,�Q. =���yr�I�.X� ✓✓�. LOCALITY p, /� pCROSS ST. - 00 L E CITY i"! NU`/Ti �•�Q�I - FIRE NO.OF TYPE r GROUP ARCHITECT OR S�Z�✓� NEO. ZONE PLANS ENGINEER ::r- BLDG. 1- /V / ORD. NO. ADDRESS SETBACK LINE (� APPROVED TEL. CONTRACTOR NO. BY DATE USE APPROVED ADDRESS ZONE/q/ BY DATE LEGAL DESCRIPTION I LOTNO. 3 BLOCK CORRECTIONS TRACT /I-J D SIZE OF LOT 7r9 IBX SQL I NOW ON LOTNO.DFS (>Me USE OF D O NO. F y... NO.OF EXISTING BLDG. FAMILIES I ROOMS DESCRIPTION OF WORK NEW ix I ALTERATION ADDITION O REPAIR MOVING DEMOALISH L7 SQ. FT. a NO. OF Z SIZE /�/ ROOMS STORIES _ - y WALLS, ;r ROOF - �� r COVERING ��O I COVERING USE OF NEW /� -BUILDING e � v `T 77z/ L I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION SPECT R DATE AND AGREE TO COMPLY WITINH AL OUNTY ORDINANCES FORMS, MATERIALS 3- 17 U4'1 AND STATE LAWS REGLATUILDING CONSTRUCTI0 JJ FRAME: FIRE STOPS, SIGNATURE OF BRACING,BOLTS OWNER 1 LATH, INT.: AUTHORIZED AGT. LATH,EXT.: ���]]] PLASTER. INT. � FEE PLASTER, EXT. ✓$ 9 VALUATION FEE /�106-* FINAL �� Q813-3 2HM BETE 10-46 r DEPARTMENT OF BUILDING AND SAFETY M, APPLICATION FOR PERMIT L7OU TN Y OF LOS ANGELES n 1 WM. J. FOX, CHIEF ENGINEERLOU U`� FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING / I �', , eA _ DISTR ^NO. PLAN CK. NO. PERMITNO. ADDRESS /(J I1// V d LOCALITY P�FZ �I 7y BUILDING RECFIVFD BY � �D�A/AT E ODATE ISSYUED NEARE CROSS8T. � OD� 7 I OWNER ADDRESS r MAIL ADDRE98/�' _(r ,(�/� 'l U0 � LOCALITY NEAREST L CROSS ST. CITY 44. NO _ 'FIRE NO.OF STYPE 1 / GROUP ARCHITECT OR I CEO ZONE- —"I PLANS— ENGINEER LANS \/ V _ ENGINEER f. \\\ BLDG. / D.NO. ADDRE89 SETBACK LINE SCS APPROVED / TEL. CONTRACTOR N��l NO. BY DATE UBE APPROVED ADDRESS ZON J BY DATE LEGAL • CORRECTIONS DESCRIPTION I LOT NO. � BLOCK TRACT Ivy _ • _7 X' X NO.OF BLD09. SIZE OF LOT //,^✓,, – NOW ON LOTUSEOF / —EXISTING BLDG. /1 I FA�I�EB I NO OF ROOMSeC� DES RIPTION OF WORK NEW ALTERATION ADDITION ' ` O A REPAIR MOVING DEMOLISH Q SQ.FT. NO. OF SIZE yy'o ROOMS STOjRjZS D WALL /r ROOF r COVERING' v COVERING USE OF NEW BUILDING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS y AND STATE LAWS REGULATI BUILDING CONSTRU TthN. SIGNATURE OF FRAME: FIRE BRACING, BOLTS Y OWNER /�� LATH.INT.: AUTHORIZED AOT. LATH,EXT.: �P.C.I$ PLASTER. INT. /m FEE 111 PLASTER, EXT. VALUATION / D 'tr FEE FINAL t f WORKERS'COMPENSATION,DECLARATION I hereby affirm that-I have a certificate of consent to self n D O ADFLONG DOinsure, or a certificate of-Workers'Compe tion Insurance, or O G' L�G�iv a tifi�d�jo t re (Sec 3800, ) COUNTY OF LOS AN ELES BUILDING AND SAFETY Py No`s Compan t BUILDING Certified co is hereby furnished ADDRESS ©' copy v /t�' '/ �/ FOR APPLICANT TO FILL IN ❑ Certified copy is filed with the county,buildmg inspec-, BUILDING tion department, ADDRESS L V f LOCALITY � , � Le �� NEAREST Date 2 -I —� I App'hcant 4At �-� a'�te� CITY ,%J JV ZIP 'f CROSS ST CERTIFICATE OF EXEMPTION'FROM W KERS' NO OF BLDGS ASSESSOR COMPENSATION INSURANCE a SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one "E� P hundred dollars ($100)or less ) TRACT BLOCK LOT NOpTEL I cert fy'that m theperformance of the work for which thisCIAL OWNER /. Y,6/� � l r/� NOa /7 e15aR NDITIONS '0 permit is issued, I sholl,not employ any person in any manner ! '/ n , / ! / DIT I GROUP TYPE FIRE BY u so as to become sublect'to the Workers'Compensation Laws ADDRESS >(C-7 - / - N/ �i/G �{���} n CON ` W CITY TG rI�LG� �ilT 7 ZIP 17�� Date Applicant STATISTICAL CLA IC TION APT CONDO - NOTICE TO APPLICANT If, after making this Certificate of - - ARCHITECT OR TEL - 'W Exemption, you should become subject to the Workers' ENGINEER NO CLASS NO DWELL UNITS d Compensation provisions of the Labor Code, you must forth- N with comply with such'provisions.or this permit shall be ADDRESS SEWER deemed revoked . /S u rL L.�s TEL 7 CONTRACTOR, $C! - DIS NOn yS '�O� BK PG, VALIDATION LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS /0 IC GES7_ Ip1) VALUATION (commencing with Section 7000)of Division 3 of the Business and Professions Code, and my license is in full fo5ce and effect CITY L�tL��l! .�L'' e-4e-41,hI/-' CLLICASS Q'_ I $ O0O a o0 n uy SQ ,FT NO OF NO OF CHECK License Number a %.S T Lic Class SIZE STORIES FAMILIES ONE ContractorAJ1 1/1s 9411 lS_S Date a— f --/ DESCRIPTION OF WORK NEW, I am exempt from the licensing requirements as I am a —j((3 '� �v 1 VAN�� �� ' ADD ❑ licensed architect or a registered professional engineer ,, ALTER ❑ FINAL acting in my professional capacity (Section 7051, �•.'�' / /(J(,y / pUSG ❑ DATE ,�REPAIR Business and Professions Code) _ USE OF EXISTING BLDG DEMOL ❑ ' FINAL Lic or Reg No Date APPLICANT TEL OWNER'BUILDER DECLARATION - (PRINT) NO' I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031 5, -Business and ADDRESS Professions Code) PRESENT I ❑ BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation;will do the work-and /1. the structure is not intended o-r offered for sale(Section LOCALITY �zµ 1 3 O A 7044, Business and Professions Code) MOVING TEL , j, as owner of the property, am'exclusively contracting CONTRACTORNO # o 0 0 0,0 1 ' with licensed contractors to construct the project (Sec- ADDRESS s tion 7044, Business and Professions Coda) 2-0 0 34,0 O REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE' WIDTH I hereby affirm that there is a construction lending agency for- FRONT �� 0 0 0. 34,0 O H the performance of the work for which this permit is issued P L (seg 3097, Civ C ) SIDE 02 1 9-8 1 PL Lender's Name Lender's Address PC Fee$ PermitFee w I certify that I have read this application and state that the Issuance Fee aabove information is correct I agree to comply with all County Investigation Fee _ ordinances and State jaws relating to building construction, Total Fee and hereby authorize representatives of this County to enter cupon the above-mentioned property for inspection purposes r SEE REVERSE FOR EXPLANATORY LANGUAGE ^ SignaturWof Applicant or Agent Date 0 - es APPUCATIONFOR BULONG PERNT COUNTY OF LOS ANGELESLDING.AN .. BUI D SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN ~� r BUILDING YESS 1 hereby affirm that I have a certificate of consent to self Insure, Bu DII G AZDDRESS ` ( lC!!// or a certificate of Workers' Compensation.Insurance, or a certified "F copy thereof (Sec 3800b YY1A• ZIP POIICy'NO � �COmpany '"Jp LVV`PLE LOCALITY SIZE OF LOT NO OF BLDGS NOW ON LOT ❑ Certified CROSS ST copy Is hereby furnished _ _ Certified copy is filed with the county building Inspection TRACT' p BLOCK LOT NO department Q pQ O� USE ZONE MAP NO Dates]-G�� Applicant ASSESSOR f�A Bf10� PAGE PARCEL S, SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER I TEL N COMPENSATION INSURANCE t S44goo P�•���_ -ZZ3�B WITHIN 1000 FT OF SCHOOLS YES No , This section neenot e com d permit Is for one hundred ADDRESS ( d bleteif the P P Z �l V DISTRICT - GROUP TYPE CONST FIRE ZONE PROCESSED BY dollars ($100) o�'less) CITY ZIP I certify that In the performance,of the work for which this permit L G+ Q Is Issued, I shall not employ any person In any manner so as to ARCHITECT OR ENGINEER TEL NO Q become Subject to the Workers'Compensation Laws STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO 4 DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' - C NT ACTOR _ TEL yO 2 ,9 SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith e_OIU$I. 211�3�1� 7U� FRONT comply with such provisions or this permit shall be deemed revoked ADDRE SY� �[rf LIC O P L LICENSED CONTRACTORS DECLARATION I �7 I IV � A. Lf�q SIDE CITY ,y� YS LIC CLAS P L - I hereby affirm that I am licensed underprovislons of Chapter 9 I►► SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO FT SIZE NO OF STORIES NO OF FAMILIES Professions Code,and my Icen e Is In full force effect NEW ❑ BK PG } ' -,,�j�{jI'g '� DESCRIPTION OF WORK ADD ❑ VALUATION d License Number LK; Class� Q Contractor�.��!1. Date Z'�3' C��L ALTER ❑ $ I pob C1 ❑ I am exempt under Sec REPAIR ❑ $ Q B&PC for this reason DEMOL ❑ LDMA P/C Date USE OF EXISTING BLDG PRM- ❑ 0- Signature (CANT(PRIN TEL NO LDMA Perm# �' Z ❑ I, as owner of the property, or,my employees with wages as 0 9 ME 14 10 3-9W z 1 8 their sole compensation, will do the work and the structure is A R SS _ L_ FINAL DATE ~ •L_;I e l I not Intended or offered for sale (Section 7044, Business and 1707 U rL1 Q /-F - Professions Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS-MATERIAL / ^ � I '(i CMG, I OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE, TTEMG i ❑ 1, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY 7 licensed contractors to construct the project (Section 7044, 0 YES No TOTAL 260 0 Business and Professions Code) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING qtri tt 1 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH _ t_H K —d ,e I, CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES IG- qJ ILI I hereby affirm that there Is a construction lending agency for YES❑ "N4y— N the performance of the work for which this permit Is issued(Sec _ 3097, CIV C (HAVE READ THE HAZARDOU MATERIA IN FORMATIONGUIDEANDTHESCAQMDPERMITTING N ) - CHECKLIST I UNDERST R EMENTS UNDER THE LOS ANGELES COUNTY CODE, Trr 2,CHAPTE S 10 0 100 THROUGH 2 20 140 CONCERNING HAZARDOUS I �I{(;_(—�(�I�1 Lender's Name MA S R D F TAINT A PERMIT FROM THE SCAOMD ` o Lender's Address ``' " i ] 1 Art •",°CI'. 0 o I certify that I have read this application and state under penalty 0 of perjury that the above Information IS correct I agree to comply PC FEE' PERMIT FEE 7a with all county ordinances and State laws relating to building construction, ancJA11Jreby uthorize representatives of this County ISSUANCE FEEco 0 to er upo o entio ed property for Inspection purposes a `D C INVESTIGATION FEE- TOTAL FEE n a IK o« 6- D.. ' SEE REVERSE FOR EXPLANATORY LANGUAGE