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Home My Public Portal About5346 LOMA AVE_Building__ - I DEPARIMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT :COUNTY OF LOS ANGELESAUL A I L I " • � WM. J. FOX. CHIEF ENGINEER 1953B U FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING � � v!�'�O � �• DISTRICT NO. PLANCK. N%.'ti PERMIT NO. ADDRESS7oJo J ' RECEIVED Y D%A�T�,+�FPPL. NEARESTLGGD�A�TLOCALITY ,✓ - 7 ISSUED� � //6CROSS ST. BUILDING ADDRESS OWNER J / / MAILLOCALITY -7C� f/ ADDRESS 3 3 & L: C— 10 7-4 - NEAREST CITYCROSSI.1y TEL.NO. /��(�gy�� ST. NO. OFD/�(f TYP GROU ARCHITECT OR TEL. ZONE PLANS _ ENGINEER NO. BLDG. ��-/ /t 4 " SETBACK LINE ADDRESS APPROVED - ' TEL. BY DATE CONTRA CTORO, � NO. SN 'L��3 ,USE �/�{ APPROVED Y /,�-� (1�a AZ4 uttv�;. ZONE /V BY DATE i ADDRESS G.. ry� HOU/SSE NUMBERING • LEGAL �D I / DESCRIPTION LOT NO. 3 / I BLOCK MAP NUMBER FIELD CHECK/BAY TRACT NO. ASSIGNED BY• &w DATE //"! �.� Q NO. OF BLDGS. C RECTIONS -�., �• SIZE OF LOT Q Q I NOW ON LOT A USE OF NO. OF EXISTING BLDG. I FAMILIES �'' DESCRIPTION OF WORK _ NEW I ALTERATION'I I ADDITION REPAIR ( I DEMOLITION - SQ. F'T. NO. OF SIZE p� 1 ROOT MS STORIES COVEXT RING t1CCCv'1,S/D/�I%POVOERINGC p A-8- USE �r �^ r /�E�eo�if/,Q il.d[S •O�Lr4.t/T d D.� OF STRUCTURE APPROVALS INSPECTOR'S SIGNATURE DATE 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FOUNDATION: LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS CORRECT. 1 AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS, HEREON AND WITH ALL COUNTY ORDINANCE$ A D STATE BRACING, BOLT S ��,Gy„�Gr_ LAWS REGULATING BUILDING CONSTRU TIO S FURNACE LOCATION, URE �-� SIGNATOF GAS VENT, DUCTS _ PEi'iMITTE I I LATH, INT. ADDl\hR6S8 / /� ` LATH, EXT. AUTHORIZED AGT. .. PLASTER, INT. 76A6i8A• D863 10-80 .� P C. $ Q FEE / r PLASTER, EXT. VALUATION $ FEE �- FINAL I , 76A898A CE#809-8-87 APPLICATION FOR BUILDING PERMIT; COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS lU BUILDING AND SAFETY DMSION LOCALITY JOHN A.LAMBIE,COUNTY ENGINEER NEAREST FAu ASSATT D GRIFFIN,SUPT OF BUILDING CROSS ST DISTRICT GRO P ° TYPE SEWER MAP FOR APPLICANT TO FILL IN -�1L B P CONST Q/� STATISTICAL CJ,.E�.SSIFICATION BLOCK .✓( K CLASS N DWELL UNITS MAP STATE YE NO NUMBER HWY U ZONE SPECIAL NO OF BLDGS_. CONDITIONS T nl JlA1/f eNOW ON LOUSE OF T ` LDG A/fsv� l/"1 BUILDING YARD HWY STREET NAME EXIST. OWNER fJ .v�� "aI V.dC_lP�P SETBACK WIDTH MAILI^ � ) P L C ADDRESS , 7a/l .Jg A-��+nv/./dL/� SIDE CITY DA/ltih v! .X�+(/1 NO �� P L INSPECTION RECORD ARCH I ECT OR II TEL ENGINEER NO ADDRESS TELl_$re . , N }ylt _ CONTRACTOR NO ADDRESS DESCRIPTION OF WORK NEW '___ADD ALTER REPAIR DEMOLISH y' SQ ZE FT. NO OF / NO OF / SISTORIES FAMILIES4 USE OF STRUCTURE �� A 4 SIGNATURE OF APPROVALS r APPLICANT �_ A� ' -�J•�� /( �I `/ DATE INSPECTOR'S SIGNATURE 41 ADDRESS FOUNDATION LOCATION / FORMS.MATERIALS (� nLi2m=f C ; FRAME FIRESTOPS,E BRACING.BOLTSVALUATION . ) QFURNACE LOCATIONE GC. - GAS VENT.DUCTS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- PL P- LATH,INT PLICATION AND STATE THAT THE ABOVE,IS CORRECT AND AGREE TO COMPLY ITH ALL COUNTY,ORDJNANCES AND STATE LAWS R G�LATING BUILDING' C6NSTR� LATH,EXT. �+ SIGNATURE O ,/( iiiJJj�/// HOUSE NUMBER COR- FERMITTE �� ,9 RECT AND POSTED ADDRESS ��A��'�/, FINAL �I JOHN A. LAMBIE,COUNTY ENGINEER, V // CLYDE.N DIRLAM, P INCI AL STRUCTUFiAL NGINEER PLAN CHECK VALIDATION CK. bf O. H PERMIT VALIDATION •_ CK M.O. CASH ,IC0 4 4 3 9' M 2 0 1 2.0 0 2 ®� . . aPPUC AMCH FOR BWL0W3 PERMN � COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS BUILDING ADDRESS aQ _ I hereby affirm that I have a certificate of consent to self Insure, �- or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sac 7��ab C) CITY ZIP q C 7 8o LOCALITY Policy No b 'V �� Compan ��"-'� SIZE OF NO OF BLDGS NOW ON LOT ZrCertrfled copy Is hereby furnished NEAREST CROSS ST /J n El rtm Copy Is filed with the =PouI peal TRACT BLOCK LOT NOdepartment USEZONE MAPNO Date a7 /v` plicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FRO WORKERS' OWNER TEL NO y YES NO COMPENSATION INSURANCE ADDRESS F ( �7� WITHIN 1000 FT.OF SCHOOL? (This section need not be completed If the permit Is for one hundred DISTRICT GROUP TYPE CONST' FIRE ZONE PROCESSED BY dollars($100)or less.) CITY ZIP I certify that In the performance of the work for which this permit T, ' J-a is issued, 1 shall not employ any person In any manner so as to ARCHITECT OR ENGINEER TEL NO become subject to the Workers'Compensation Laws STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO 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' CONTRACTgr TEL NO SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith WU� J4 ^� FRONT comply with such provisions or this permit shall be deemed revoked ADDRESS LIC NO F-7 / d P L // C4 SIDE � LICENSED CONTRACTORS DECLARATION CITY LIC CLASS p L c I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP c� , (commencing with Section 7000)of Division 3 of the Business and FT SIZE NO OF STORES NO OF FAMILIES Q= Professions Code,and my license Is In full force and effect NEW ❑ SK PG CD D v License Number—" 9 oil C-— � DESCRIPTION OF WORK Llc Class - ADD ❑ VALUATI oi.li W Gti Contractor ate �- ALTER ❑ $ Z ❑ I am exempt under Sac REPAIR $ j'IzLj B&P C for this reason DEMOL ❑ LDMA PIC p Date USE OF EXISTING BLDG URM ❑ 3, I �;s��t i r• filer Signature AP LICANT(PRINT) / TEL NO LDMA Parlrl q ❑ 1, as owner of theproperty, 4 �/. F H S 2-2-88 z f ITEMS or my employees with wages as O a their sole compensation,will do the work and the structure Is ADDRESS F T-, ,. _,1 not Intended or offered for sale (Section 7044, Business and I) Z FINAL DATE I I j t AL 70 38 WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE AHAZARDOUS MATERIAL /O 2$� 9 S.•CIE1-K Professions Code) .�3Ie ❑ 1, as owner of theproperty, am exclusive) contractor with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN Y g licensed contractors to construct the project (Section 7044, THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL a CHANGE HAa 1`II 1 _ Business and Professions Code) YES El No Eli VG WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH t ft yy_ •! .t CONSTRUCTION LENDING AGENCY FCOASTU DEL QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST 0 ��}�I-0 1;i 1 In l I'i I hereby affirm that there Is a construction lending agency for YES 13NO El the performance of the work for which this permit Is Issued(Sec 1 HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD 3097,CIV C) PERMITTING CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE,TITLE Z CHAPTER 2 20 SECTIONS 2 201 OD THROUGH 2 20140 CONCERNING Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD Lenders Address OWNER OR AGENT 0 1 certify that I have read this application and state that the above PC FEE PERMIT FEE Information Is correct I agree to comply with all county ordinances and State laws relating to building construction,and hereby aut orize representatives oft s County to enter upon ISSUANCE FEE the ebov aRtlort9tf pro m purposes p m D-J Z- !d INVESTIGATION FEE TOTAL FEE �+ 4 a Ag « ra o.r SEE REVERSE FOR EXPLANATORY LAN &AGE.