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Home My Public Portal About6472 LIVIA AVE_Building__ 76A638A CF *803 4/70 LIC TION FOR KIL DiNi(rPERMIT . COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING ✓ JOHN A. LAMB]E, COUNTY ENGINEER ; ADDRESS COLEMAN W. JENKINS. SUPT OF BUILDING LOCALITY l� FOR APPLICANT TO FILL IN NEAREST Print or tvoe onl CROSS ST. BUILDING DISTR NO. GROUP TYPE_ PRO SSF.Q BY ADDRESS I CONST STATISTICAL CLASSIFICATION SEWER AP LOT NO. BLOCK .� CLASS NO. Al DWELL,UNITS �� BK PG TRACT U E ZO E MAP NO.OF BLDGS. J> j NO. 0 673 SIZE OF LOT NOW ON LOT #- SPECIAL USE OF ONDITIONS EXISTING BLDG. TEL./2 OWNER �' NO. BLDG.SETBACK FROM ADDRESS CJ' e> LF3 FRONT PROP.LI NE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY C_+ HIGHWAY WIDTH FROM C.L. 07 ARCHITECT OR TEL. yjet32r� t Z ENGINEER G NO. BLDG.SETBACK FROM ADDRESS SIDE PROP.LINEOF 1014 (STREET) TEL. TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL CONTRACTOR NO. HjGHWAY WIDTH FROM C.L. ADDRESS Np t _ (,� p Lool LIC. V CITY CLASS - CORNER CUTOFF YES ❑ NO ❑ C1: CONSTRUCTION LENDER " NAME AND BRANCH Y�G'a't� SEE REVERSE SIDE, FOR SPECIAL APPROVALS LLJ ADDRESS s��' •« N j Z SQ. FT, NO. OF NO. OF NEW ❑ SIZED STORIES FAMILIES _ USE OF / ADD «— STRUCTURE /p - r� ALTER ...��r. a6`"` REPAIRFTL SIGNATU E OF f i APPLICANT 4 EMOL ❑ VALUATION $ APPROVALS DATE INS PE TOR•5 SIGNATURE P.C. PMT. OG FOUNDATION: LOCATION FEE $ 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 STRUC TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED .- Av HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF TME LABOR CODE OF THE STATE OF •CALIFORNIA IN RELATING TO LATH, INT. - ,t 'I/ WORKMEN'S COMP= N INSURANCE. ':�J' LATH, EXT. SIGNATURE OF �� /`�' HOUSE NUMBER COR- PERMITTEE 1 r /�_. 2 6lyyy4� RECT AND POSTED 1 /OV ADDRESS (r2�e /(� �-• �► i^A r ® 1 .�— FINAL JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH. n� 7 8 APR 23 0 33.00— . J APPLICATION FOR BUILDING PERMIT FOR _ ICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES rDD r DEPARTMENT OF COUNTY ENGINEER e zIP BUILDING AND SAFETY DIVISION NO.OF BLDGS. BUILDINGT p 1C � NOW ON LOT ADDRESS.aS(�4 BLOCK LOT NO, I LOCALITY TEL. - NEAREST OWNER k e NO.a 1 1� CROSS ST. ASSESSOR ADDRESS �(O MAP BOOK PAGE PARCEL DISTRICT GROUP . TYPE FIRE PROC ED BY -CITYTery� Ca-,i ZIP ql-t M� cc.�� `� CONST ZONE ARCHITECT OR TEL. v' Cl ✓ v ENGINEERNO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS TEL. CLASS NO. DWELL.UNITS N BK B�PG CONTRACTOR NO. USE.ZONE MAP LIC. Ql NO. C� ADDRESS NO. SPECIAL LIC. /�+n CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG.SETBACK FROM FRONT PROP,LINE OF —O--�� (STREET) ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ.FT. NO.OF NO.OF CHECK HIGHWAY + YARD FRONT PROP.LINE HIGHWAY WIDTH SIZE STORIES ` FAMILIES ( ONE } DESCRIPTION OF WORK NEW + O ADD ❑ BLDG.SETBACK FROM ac p ur SIDE PROP.LINE OF (STREET) O ALTER cc] TOTAL SETBACK FROM TYPE OF EXISTING w HIGHWAY + YARD = SIDE PROP.LINE HIGHWAY WIDTH N USE OF REPAIR ❑ EXISTING BLDG. + OU e, 4-cS`Q DEMOL ❑ APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑ (PRINT) J NO.- IZ IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE) IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION G 'L? I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE �•� �•��-� _ei1^?'L ��` #� THAT THE ABOVE ISCORRECT 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(NSU CE. .. SIGNATURE O PERMITTEE ADDRES FINAL BY �. TEL. DATE lZ/Z'77 CITY NO. dd MAKE CHE S PAYABLE TO: FEE '� FEET s HARVEY T.BRANDT,COUNTY ENGINEER PLAN CHECK VALIDATION cK. M.o. CASH PERMIT VALIDATION cK. M.O. CASH 78, 11'r';;A.PR2 1:7. .5 A ; es 76A638A CE#803 3-75 f r APPLICATION FOR BUILDING PERMIT COUNTY OF LOS-ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION BUILZ ADDRESS FOR APPLICANT TO FILL IN BUILDING ADDRESS &—I —72 V I hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers' Compensation Insurance,or a certified ZZ ' v' �' copy thereof (Sec.3800,Lab.C.) j CIT ZIP �7 No. Id�d � �/ 'JA LOCALITY Policy Company SIZE OF LOT NO.OF BLDGS.NOW ON LOT Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. departme t. 1� USE ZONE MAP NO. Date Applicant v /� ASSESSOR MAP BOOK PAGE PARCEL WE ,q/) � SPECIAL CONDITIONS WE43TIFICATE OF EXEMPTION FROM WORKERS' OWNER � TEL NO. YES No COMPENSATION INSURANCE lei� WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESS �' _ DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars($100) or less.) vc• - I certify that in the performance of.the work for which this permit CITY 1, ZIP /75 9 ob Y21-5 V is issued, I shall not employ any person in any manner so as to - WIL gRCHITECT OR ENGINEER TEL NO. Pr f_11 become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT C ND Date Applicant ADDRESS CLASS NO. 2-1 DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRA CTf6At� O 6' TEL NO. '�J/ SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith UU Vti FRONT comply with such provisions or this permit shall be deemed revoked. ADDRES LIC.NO. PL LICENSED CONTRACTORS DECLARATION ��-3� SIDE CIT / IC.CLAS PL I hereby affirm that I am licensed underprovisions of Chapter 9 4 a«•1W11W� SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZENO.OF STORI NO.OF FAMILIES Professions Code,a d my license is in full force a d effect. -- NEW ❑ BK PG , License Numb 74`3 j� Lic.Class DESCRIPTION OF WORK rr ADD ❑ VALUATION a Contractor �� Date �ioAul � S: �`n K ALTER ❑ $ / O O r'ooF', ElI am exempt under Sec. REPAIR 11� h� $ B.&P.C.for this reason /o 7 a( DEMOL ❑ LOMA P/C# W Date: USE OF EXISTINGJ3LDG.1 URM ❑ i f1 .St%� j C/) Signature APPLICAN (PRINT) TEL NO. LDMA Perm# z X99�/ 4... ❑ 1, as owner of the property, or my employees with wages as c di w 1"17'al� !/� Z t-i •1_i r y their sole compensation, will do the work and the structure is ADDRESS not intended or Offered for sale (Section 7044, Business and 7i r �, (� _ 70r✓ FINAL DATE a =t_• _: a t_ Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS ATERIAL - - 1 i i EM� OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑ 1, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY -•. = a r licensed contractors to construct the project (Section 7044, 3 3 3 !Business and and Professions Code.) YES❑ NO❑ y • WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING ' i•R5 •' OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH j•? ' `� CONSTRUCTION LENDING AGENCY COAST AIR QUADTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKUST FOR GUIDELINES. `..•;'Pt-33 ir3C a I'+_ I hereby affirm that there is a construction lending agency for YES❑ NO❑ N 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.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, s I-y N 3..15!{f51-5.3S:y .s TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.740 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. o Lender's Address f) 0 OWNER OR AGENT o I certify that I have read this application and state under penalty of perjury that the above information is correct. I agree to comply P.C.FEE PERMIT FEE with all county ordinances and State laws relating to building constru�' ,, and hereby authorize representatives of this County ISSUANCE FEE 00" to enteabove/mentioned property for inspectio purpose . Cp + 1q"Q � � V �A � INVESTIGATION FEE TOTAL FEE /'— /l`� sg ore Aper nl.,Agent Fat, I J —!J SEE REVERSE FOR EXPLANATORY LANGUAGE