Loading...
HomeMy Public PortalAbout5654 LOMA AVE_Building__ bEPARTNf NT=CW, BUILDING.AND SAFETY APPLICATION.FOR PERMIT COUNTY OF�'LOS ANGELES WM: J. FOX. 'CHIEF ENGINEER BU_ I LDIN -.;FOR-APPLICAM TO FILL IN FOR OFFICE. USE ONLYBUILDING SL DIST RIC NO. PLAN/CK. NO.`. PERMIT,NO. ADDRESS ,� • ICJ LOCALITY ,,p -RE C.,E'I/V'ED BY DATE OF APPLL... ' .DATEISSUED - NEAREST CROSS ST. ' BUILDING / �//` ADDRESS �17. �` / �I. �� OWNER MAIL // _ 6i LOCALITY T' �•l.. / ADDRESS NEAREST - TEL CROSS ST 'df ARCHITECT OR. ...TEL.- � � ` FIRE y I PLANS "�/'I NO. OF �' I.�eP-7 ZONE ENGINEER NO. D _ '- p b SETBACK LINE 7°0 l 7 ADDRESS - APPROVED. . EL. - - - ,BY c.. DATE CONTRACTOR. ,. �"?.t.L.K.G./�..i -. NO. USE - APPROVED'- ZONE �� BY DATE ADDRESS HOUSE NUMBERING - LEGAL ' DESCRIPTION I LOT NO. . I BLOCK MAPNUMBER FIELD CHECK,BY' TRACT _ / .� ! 3 .NO. ASSIGNED BY A�DATE NO. OF BLDGS. CORRECTIONS -- SIZE OF LOT S �.X NOW ON LOT (/� USHOF .I.NO. OF EXISTING BLDG:, FAMILIES C. Z �- ' DESCRIPTION OF WORK NEW + ALTERATION + .+ ADDITION o .. ,REPAIR L I DEMOLITION SQ. FT. / NO. OF / SIZE �( d - ROOMS !O Y STORIES EXT. WALL ROOF COVERING COVERING USE•OF STRUCTURE .. - ®L• 6 �AC�� .'_. .. -�? 17 r cl If - APPROVALS • _ INSPECTORS SIGNATURE , DATE _ I HEREBY. ACKNOWLEDGE THAT I HAVE READ THIS AP- - FOUNDATION: LOCATION PLICATION AND STATE THAT THE• INFORMATION GIVEN IS FORMS, MATERIALS. ,uj ��„r�, •y.�y',fLE+• - CORRECT. - .. 1 AGREE TO .COMPLY WITH THE- CORRECTIONS_ LISTED FRAME: FIRE STOPS, e° ` HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS 131, LAWS REGULATING-BUILDING .CONSTRUCTION. FURNACE:-LOCATION, /�GV Vr J r SIGNATUREOF.. GAS:VENT, DUCTS ./ PERMITTEE .. .+ r7-.�.J - �.✓� ADDRESS ! D..S-_1p G.. - •� C LATH, INT. LATH, EXT: �1,,r+,,,� •�5, �K�' AUTHORIZED AGT. PLASTER, INT. - - 7ewe88A D8li8. .f0-50 - O a P. C. $ p g FEE /, 7 PLASTER,EXT,'' - - VALUATlON $ GyQ _ 'Y FEE'' _.G.__-- FINAL fly �'LS ,Si WORKERS'COMPENSATION DECLARATION ® e insure, orairm afcertif matte of Woes'.Compensation eInsurancI have a certificate of connt to e, A P P LI CAT I®� ®� �' ®� PERMIT or a certified copy thereof_(Sec.3800, Lab. C.)' COUNTY OF LOS'ANGELES BUILDING AND-SAFETY Policy No.164614n Company State Fund ❑ Certified copy is hereby.furnished.,. v FOR APPLICANT TO FILL IN BUILDING ADDRESS © Certified copy is filed with the county buifding inspec-- BUILDING" tion deportment. ' ADDRESS 5654 No. Loma Date' . 11-1-88 ApPliconi -Rand'ol Roofing-L' CITY Terri 1e City ZIP Ca. LOCALITY CERTIFICATE OF EXEMPTION FROM'WORKERS' NO. OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section.need not be"completed if.the permit is for oneASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LOT NO: MAP BOOK PAGE PARCEL' -•, TEL. USE Zr(E MAP . I certify that in the'per'formance of the work for which',this OWNER N0.286-7556 NO.' ADDRESS permit is issued, I shall not employ any person in any manner 5654 No. Lorna SPECIAL _so as to become subject to the Workers'Compensation Lows. CONDITIONS .C U y Date 12-15-,8 pplicant, Randol Roofing ... CITY ZIP NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL.ENGINEER NO DISTRICT OUP TYPE FIRE PROCESSED BY O Exemption, you should become subject to. the Workers' O CONST. ZONE U Compensation provisions of the Labor Code, you must forth- ADDRESS �u T 3 f LU with comply with such provisions or this permit shall be _ TE STATISTICAL STATISTICAL CLASSIFICATION APT. CONDO. aJ deemed revoked: CONTRACTORRandol Roofin N4d.88-4040' LICENSED CONTRACTORS DECLARATION s LIC, CLASS NO. DWELL.•UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 529 E. Valley Blvd NO 451937 (commencing with Section 7000)of Division 3,of the Business and LIC SEWER MAP Professions'Code, and m license is'in full force and effect. CITY S•.G. 91776 CLASS C-39 Y BK. PG. VALIDATION l C-39. SQ: FT. NO OF NO. OF CHECK License Number 4'51937 Lic.Class ' SIZE STORIES FAMILIES ONE a 'Re-roof house an NEW ❑ VALUATION Contractor Randal Roofing Date 1-31-90 DESCRIPTION OF WORK $ 2914.00 I am exempt under Sec. garage with GAF Timberline. ADD ❑ fiberglas roofing. Class ALTER' '❑ At�C ag 8.8P.C. for this reason Roof REPAIR ,® = •S -F� c nl: Date: USE OF SFD 330 .. .f7.2� EXISTING BLDG. . DEMOL ❑ it Ty :t APPLICANT TEL 1 ITE Signature ---•-.FINAL IS PRINT Randol Roofing No288-4040 /� �� m �� OWNER-BUILDER DECLARATION r DATE [/ SII s '�a _ p I hereby affirm that I am exempt from the Contractor's License ADDRESS 529. E. Valley Blvd. §.G. 91776 Fl t cp Law for the following reason (Section 7031.5, Business andtiVit: _s .25 Professions Code):' PRESENTBY L� f' ❑ BUILDING CHANGE l,.-os-owner of the property, or my employees with ADDRESS — wages as their sole compensation,will do the work and •- ---' the structure is not intended or offered for sale Section LOCALITY i 7044, Business and Professions Code). MOVING TEL. _� -0'7IIS / � 9 I, as owner of theproperty, am exclusive) contracting rADDRE R NO., y< , AM c with"licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). REQU - REQUIRED ROM CONSTRUCTION LENDING AGENCY RED YARD HWY TOTAPROP.SETBLIINECK F WIDTH I hereby affirm that there is a construction lending agency for . the performance of-the-work for-which this permit is issued •(Sec..3097, Civ. C.). Lender's Name m Permit Fee LDMA Ref. N lender's Address48.75I certif that I have read this a lication.and state that th10.50Y PP Issuance Fee LDMA P/C q above information is correct. I agree to comply with all Countyn Fee 0 ordinances and State laws relating to building construction, To ee 59.'25 LDMA Perm: N ' R and her by authorize r resentati"ves of this County to enter m upo ov en ' ed pro er for inspection p pas S. A. / /Jdp� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Dae .