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Home My Public Portal About6436 LIVIA AVE_Building__ I 76A638A CE#803 8-63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELESBUILDING (�f /j DEPARTMENT OF COUNTY ENGINEER ADDRESS �Y /V', BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A JENSEN, SUPT OF BUILDING CROSS ST DISTRICT NO I GROUP YPEROCESSED Y FOR APPLICANT TO FILL IN �,6 coNsr BUILDING / ��_ STATISTICAL CLASSIFICATION S ER MAP ADDRESS Fj �, \U/' K PG CLASS NO DWELL UNITS 99 LOT NO BLOCK WATER NOT REQUIRED ® RECEIVED ❑ CERTIFICATE TRACT Sb MAP 115 , HIGHWAY STATE MAJOR SECOND, LOCAL NO OF BLDGS NO V (CIRCLE) SIZE OF LOT NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS EXISTING BLDG TE 77 OWNER — �J. BUILD NG EXIST SETBACK YARD HWY REET NAME WIDTH ADDRESS 3 FRONT ARCHITECT bR TEL P L ENGINEER NO SIDE a ADD ESS T (! l�/ �.Ad '41-IF, t'�r",Q' 0 N O ✓ r Rory=J V ADDRESS 6 f �/ DESCRIPTION OF WORK 'ZU '�' Ljj Lu NEW ADD ALTER REPAIR DEMOLISH H SQ FT NO OF NO OF SIZE STORIES FAMILIES USE OF STRUCTURE p- SIGNATURE OF APPLICANT VALUATION $ APPROVALS DATE INSPECTOR 5 SIGNATURE FOUNDATION LOCATION FEE $ FEE $ FORMS, MATERIALS FRAME FIRE STOPS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS p AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION (VITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS p 1 aiyy BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK r- AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH INT TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN 5 COMPENSATION INSURANCE LATH EXT SIGNATURE OF HOUSE NUMBER COR- PERMITTEE &46r2 RECT AND POSTED ADDRESS FINAL JOHN F LEWIS PRINCIPALS C RAL ENGINEER PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATIO cK MO CASH Lr1tr 5 _ 3 8 NOV 4 1 D 1 1 .50- .v 76A638A CE#803 9-68 �»� �� APPLICA'T'ION FOR BUILDING PERMC COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DMSION LOCALITY' ��jyj 1G' CI JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS, SUP T OF BUILDING CROSS ST FOR APPLICANT TO FILL IN DIST ICT NO. GRO TYPE P p B (Print or type only) 0 CONST T�7 BUILDING //// STATISTICAL CLASSIFICATION S WER MAP ' ADDRESS h+I ✓�/9 CLASS NO.��DWELL UNITS BK PG C LOT NO. BLOCK USE ZONE MAP NO 10-3 TRACT SPECIA L NO.OF BLDGS. CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. l:-es I er1 ,, BLDG SETBACK FROM 1 C /'Y` NO --D,/ FRONT PROP LI NE OF -(STREET) OWNER CCAM�77'''• TYPE OF EXISTING SETBACK HIGHWAY } YARD - TOTAL ADDRESS S r HIGHWAY WIDTH FROM C L ?em I - CITY ��7 BLDG.SETBACK F ARCHITECT OR TEL. SIDE PROP.LINE OF (STREET) ENGINEER NO. TYPE OF 1EXISTING SETBACK WAY } YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. CL CL CONTRACTOR Q C TE NOL 6 '7 ? C: ADDRESS3d6 i A NA T NO iZ�/ 3 CORNER CUTOFF YES ❑ NO ❑ C LIC CITY C fI d I A CLASS C'3 SEE REVERSE SIDE FOR SPECIAL APPROVALS 4 CONSTRUCTION LENDER a NAME AND BRANCH e -rOo w T,/h Q3� ADDRESS _r Ab FT NO OF NO. OF NEW G[ A re / A SIZE STORIES FAMILIES OF ADD /n USE / So o , STRUCTURE J ALTER ❑ ��' e �A ❑ SIGNATURE OF REPAIR APPLICANT DEMOL ❑ VALUATION $ 3 APPROVALS DATE INSPECTOR'S SIGNATURE P.0 PMT / FOUNDATION: LOCATION E FE $ FEE$ FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE- LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS• STRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT LABOR CODE OF E STA OF 'CALIFORNIA IN RELATING TO WORKMEN'S COMP ATION SUR E • LATH, EXT SIGNATURE OF HOUSE NUMBER COR- PER M OR-PERMRECT AND POSTED / ADDRESS-1-494 1r9 •V is iA FINAL ,S y7 j� JOHN F LEWIS PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDATION M O CASH tst' 9 o c� s Vu,1 9 1 D 1725- a WORKERS' COMPENSATION DECLARATION Ins.er boraa to of cane of Workers'tComtpe�saT on Insuranceto f A Ll' LI ��C U�O_[�] FOR., o M 0�D I N C� p E R vG�]i �U or a certified copy thereof (Sec 3800, lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company /i! _ ❑ Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS CO' Gl ✓�/� l/� ❑, Certified'copysis filed with the county building inspec- BUILDING'6+722& {�, 1vbn T1 G^ dd,,,��cs ' tion department ADDRESS CITY . U � � C�ZIP d V' Date Applicant p NO OF BLDGS NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT q3 X LOCALITY l�o NOW ON LOT" ' CROSS ST .1 COMPENSATION INSURANCE- ASSESSOR �^p (This section need'riot be cdmpleted if the permit•is for one TRACT �ZSO4 BLOCK LOT NO IT T 1171:- MAP BOOK ✓7 p' PAGE PARCEL hundred dollars ($100) or less ) TEL r( ' - e - OWNER [(�(N T �/�U" ' NO, -O USE ZONE' _ MAP NO- 1, O-1,certify that in the performance of'the work for w1iich this SPECIAL 'permit is issued, I shall not employ any person in any manner ADDRESS - CONDITIONS O so as to become subject to the,Workers' Compensahon'Laws U CITY;- ZIP ` Date Applicant ) - ARCHITECT OR TEL PP .DISTRICT GROUP TYPE FIRE PROCESSED BY NOTICE TO APPLICANT ,If, after making this Certificate of ENGINEER NO CONST . ZONE ,Exem tion, you, should become sub ect to the Workers' f/ -compensation provisions of,the Labor.Code, you must forth- ADDRESS v; Du- with with comply with such provisions, or•,this permit shall be TEL STATISTICAL CLASSIFICATION APT CONDO Z .deemed revoked CONTRACTOR NO — LICENSED CONTRACTORS DECLARATION LIC CLASS NO DWELL UNITS I hereby affirm that I am licerised'under provisions of Chapter 9 ADDRESS NO SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC CITY CLASS ' and Professions Code,.and my license is in full force and effect BK PG VALIDATION SQ FTNO OF NO OF CHECK License Number Lic Class "" SIZE STORIES SIN FAMILIES U�� ONE VALUATION / ' Contractor "Date ' DESCRIPTION OF WORK NEW $ odlic 6Q ❑1 am exempt under"Sec 7/A/ (,- S (7710,A/ ADD 7 to •p�A✓ •� GlitllN -� - ALTER E] B&P C for This reason 'rUSE,OF G p REPAIR El ` Date EXISTING BLDG 51A/ ✓G r�I !1'K(O �• EMOL ❑ (ICANT Signature APPTEL PRINT) �GN//A/ T GH(v NO a _Q FINAL - OWNER-BUILDER DECLARATION DATE I hereby affirm that I am exe-mpt from the Contractor's LicenseA-S Law foknj::::� r the followin reason Section 7031 5, Business and ADDRESS y/r�r °l"�' FINAL r'i it Professions Code) PRESENT _ 'By' - BUILDING ❑' I, as owner of the property, o� my employees with ADDRESS wages as their sole compensation;will do the work and - i'i 0.11'_ ff the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code ) MOVING _ TEL _. , , D_ TOTAL 2,7 .90 CONTRACTOR NO T Y ` I, as owner of the property, am exclusively contracting �_-. -'-}-� with licensed contractors to construct the project (Sec- l..c lX •. r" 7 J ADDRESS _ tion 7044, Business and Professions Code )', u -1 e1j �„ ) y.1'',;�p• �{ o�lf! REQUIRED TOTAL SETBACK FROM' EXIST G - 4IY3� CONSTRUCTION LENDING AGENCY SET BACK YARD -HWY PROP LINE WIDTH r _ I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this-permit is issued P L (Sec 3097, Civ C ) SIDE I_il.Sl i�-l�I)!Jy 1J;27/ P L Lender's Name p~ G 'tom i - .4I P C Fee$ Permit Fee 3 I , C LDMA Ref # Lender's Address N ''ll o I certify that I have read this application and state that the Issuance Fee 12) �v LDMA P/C# above information is correct I agree to comply with all County• Investigation Fee cif ordinances and State laws relating to building construction, Total Fee 3,7. I O TDMA Perm # < and hereby authorize representatives of this County to enter upon the 6cibve-m on property for inspection puiposes. SEE REVERSE FOR EXPLANATORY LANGUAGEf Applicant or Agent Date