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HomeMy Public PortalAbout5674 LOMA AVE_Building__ 76AH96A CE#009.1-61'•I •APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS �'1 _ BUILDING AND SAFETY DMSION LOCALITY t 1 JOHN A. LAMBIE, COUNTY ENGINEER NEAREST / WILLIAM A. JENSEN SUPT OF BUILDING CROSS DISTRICT NO. GROUP TYPE P ESSED BY FOR APPLICANT TO FILL IN CONST.�G BUILDING / yo n STATISTICAL CLASSIFICATION SEWER MAP ADDRESS �b Tia.' C�[�'� CLASS.NO.. DWELL.UNITS �— I K .CP LOT NO. BLOCK WATER ' NOT REQUIRED RECEIVED ©� CERTIFICATE: ',�;p;�'•= •TRACT - MAP HIGHWAY STATE MAJOR".SECOND LOCAL NO.OF BLDGS. _ NO.�' cCIRCLEI SIZE OF LOT 5'y O/ X1Jl?,.f 1 NOW ON LOT US,E ZONE /GOND SPECIAL USE OF 9 ONS •:; EXISTING BLDG. — Q. TEL./J ry OWNER, f.�'� JU, NO.1S� � 7 BUILDING EXIST. YARD HWY STREET NAME / ST34CK WIDTH ADDRESS /y //o. (// [Q , ' / y 'FRONT. -ENGARCINEER IT EC R t // ,JJ(� NO tr.S3/ SIDE -/ ADDRESSz y�� L(./,/ P.L.+ (/lu�lc�Mtt�ltTE� INSPECTION RECORD l � CONTRACTOR.•�Lt3'ttPi�'. [ NO. ��� V ADDRESS �r., n l7�lA/f I/K / r�f. j DESCRIPTION OF WORK > Gr 0, . 0 NEW ADD ALTER REPAIR DEMOLISH S ZE T' -• •D STORIES FA IES .. - ✓/ ..�G/:<+iJ� tJ�� �J:�c y Y. z I USE OF / i t -7 A1,110/>Y/�.. STRUCTURE' �• /` � - .,.- SIGNATURE OF / �� ft / ��� s—�✓11..i 'rY' r ~ APPLICANT /G eyfCL' ( .�✓ /� Ll•G�G' // �` /� �; '`�' VALUATION$ , DO IE "l"� 'vJl /.�yr ,•_x,22... '� '7 FOUNDATION: PATE / fr SECTOR;S.SIGNATURE FEE $ ® RATl%l���AJ . FORMS, MATEERIALSS y+ FRAME: FIRE-STOPS, 2 / r 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS -/ tR,� AND STATE THAT THE ABOVE IS CORRECT AND AGREE-TO COMPLY FURNACE:LOCATION, f '` WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK, .-.- JIJ AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- TION 'OF THE LABOR CODE F THE STATE OF CALIFORNIA RELAT- ULATH, INT: •[ // /`/,A�'/// /LY - ING TO WORKMEN'S C PE SATION INSU CE. �/%/4/ + LATH,EXT. PERMITTEE SIGNATUREO �'�,%-�•- HOUSE R RECT AND POSTED ( 1 ! ! '/�",,✓u� ADDRESS - B �' FINAL I'�G�V'r a 7 t vaZIA1.,6 CLYDE N. DIRLAM, PRINCIPAL S7cK. RAL ENGINEER AS PLAN CHECK VALIDATION CK. M.O. CH PERMIT VALIDATIONM.O. CASH Lk,o 4 I L OCT 26 1 .0 2 4 i DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES WK J. FOX, CHIEF ENGINEER FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN DISTRICT NO. PLAN CK. NO. PERMIT NO: BUILDING ' `� r-7 / ADDRESS T /t/ C�{��-��H`)�t�-�^o,.� �_� / &g � �yh I RECEIVED BY DATE OF APPL. DATE ISSUED LOCALITY :��° ". NEAREST. CROSS ST. 1-�- .! o BUILDING OWNER ADDRESS � � ,Ooyr O 4Y1 MAIL LOCALITi ' �" 3 NEAREST ADDRESS aJ®� � �� �„�,,��- TEL'y; V / CROSS ST. CITY �� ( .NO; /��r ZFIRE NO. OF ONE I PLANS 7`I TYPE I GROUP% ARCHITECT OR TEL. ENGINEER NO. BLDG. ORD. O? �g SETBACK LINE y' ADDRESS ! 1 APPROVED 1 TEL. BY DATE CONTRACTOR _ � ,}f�� -- NO. ` USE APPROVED •- ZONE y BY DATE ADDRESS HOUSE NUMBERING LEGAL DESCRIPTION I LOT NO. I BLOCK MAP NUMBER-7---6 O 1�7 FIELD CHECK BY TRACT fJ NO. ASSIGNED BY �3 C ATE NO. OF BLDGS. CORRECTIONS SIZE OF LOT / / I NOW ON LOT -1� USE OF �� NO. OF `/U EXISTING BLDG. I FAMILIES DESCRIPTION OF WORK l _ NEW I I ALTERATION I I ADDITION 0 •. REPAIR I .I DEMOLITION SQ. FT. NO. OF SIZE Jr / ROOMSc STORIES Z D EXT. WALL ' - I ROOF 1' ' COVERING 1>°'�-i COVERING USE OF STRUCTURE V APPROVALS' INSPECTOR'S SIGNATURE DATE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FOUNDATION: LOCATION �n PLICATION AND STATE THAT THE INFORMATION GIVEN IS i FORMS, MATERIALS CORRECT. { I AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS, HEREON AND WITH.ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS LAWS REGULATING BUILDING CONSTRUCTION. FURNACE: LOCATION, SIGNATURE OF L. GAS VENT, DUCTS l v Lj r� PERMITTEE �+ LATH, INT. ADDRESS ' LATH, EXT. . AUTHORIZED AGT. s - /v .�-J 4- PLASTER, INT. - 7eA3saA• D69a 10-80 $ / P. C' $ © d'�J FEE ,� PLASTER, EXT. �7 Oji VALUATION ! ®F 0-%:) FEE $-,7 �✓ FINAL ' IVI C&- C/ 2 77 ° 76A 638A CE#603 5-65 A PP O ICATI N FOR BUILDING PERMIT � V COUNTY OF LOS ANGELES . BUILDING 6 DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY Te le Cit JOHN A. LAMBIE. COUNTY ENGINEER NEAREST d COLEMAN W. JENKINS,SUP'T.OF BUILDING CROSS ST. OX,"7,e � DISTRICT NO. G UP TYPE PRO�C SS ED•-BY FOR APPLICANT TO FILL IN :;e)9 CONST.y� BUILDING STATISTICAL "_ A71FICA TION.. SEWEg�IAP ADDRESS 6 N. LOmB AvenueCLASS NO. W ELL UNITS . B PG LOT NO. 8 .- BLOCK - USE ZONE MAP NO. TRACT 16305 SPECIAL ' FNO. OF BLDGS. CONDITIONS SIZE OF LOT - NOW ON LOT USE OF •- - - EXISTING BLDG. M rn Pnol BLDG. SETBACK FROM TEL. - FRONTP ROP. LINE OF �j(/ ✓ "� .(STREET) OWNER R. PidMOnSton NO. TYPE OF EXISTING I SETBACK HIGHWAY + YARD _ TOTAL ADDRESS 6 HIGHWAY . WIDTH. FROM C. L; _ I CITY Temple City �G1 - .--- . + ZU = d BLDG. SETBACK FROM - ARCHITEC OR TEL. SIDE PROP. LINE OF (STREET) ENGINEER ,pAdams E No. SP -2210 TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS 5A871 E. Firestone t�Blvd. HIGHWAY WIDTH FROM C.L. CONTRACTpORAnthon Pools NO SP 3-2210 + 0 ADDR ES55871 E. Firestone LI 0190179-05 CORNER CUTOFF YES ❑ NO 1:1 O CITY South Gate c Ass SEE REVERS ROVALS 0 AND PAP. )TREE RE DESCRIPTION OF WORK � �� Q W .�F � H NEW ADD ALTER REPAIR DEMOLISH $ Z SQ.FT. NO. OF NO. OF' ' U{er ',vs drive Way approa6 irk- SIZE 01 '- STORIES FAMILIES tallations s�ould. a {alcen out e+ 'th^ L. A. Co. R11-< ep, FItadol USE OF -- °ted'I order to avoid STRUCTURE- Ice. Or v . °c:"-," ``....`� .~ :n V dela . Survey'4 .Dasigl: O!L"Ict.., time and is not started SIGNATURE F �j lntil Permit has bcen i3SUGd. &PPI;77 13:1-11a n N VALUATIO $ 3350.00 �i p PMTA PROVALS DATE INSPECTOR'S S GNATUR P C. 13 e88 • FOUNDATION, LOCATION FEE FEE$ 27.75 . 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 COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS 91_1ILDING CONSTRUCTION. I CERTIFY THAT.:IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY AN191RSON IN VIOLA- LATH. INT. TION OF THE LABOR CODE OF THE TA O LIFORNIA RELAT. < _ ING TO WORKME C MPENSATIO , R CE LATH. EXT. SIGNATOR OIMBER COR- PE:RMITT RECT A-R'B-POSTED ADDRESS FI N A 1 JOHN-F. LEWIS. P INCIPAL STR L URAENGINEER PLAN CHECK VALIDATION4 cK. M . CASH _ PERMIT. VALIDATION CK. M.0 CASH 9 6 S E`o JUL18 2 3D 1 3.:8.8 A a Lko 9 8%'0-1 Q jUL 2 5 _ 1 D '2 7:7 5- WORKERS'"t'4OMPFNSATiON DECLARATION hereby affirm that I have a certificate of consent to self APPLICATION FOR BUILDING PERMIT I ''insure, or a certificate of Workers'Compenstion Insurance, or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company F] Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS ` •+-A� �-�/ ❑ Certified copy is filed with the county building inspec- BUILDING �/ tion department. ADDRESS r / ,� LOCALITY r-- _ / - NEAREST . Date Applicant CITY e ZIP Jv CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not or less.) TRACT BLOCK LOT NO.be completed if the permit is for one / o USE ZONE MAP hundred dollars ($100) MN r EL •�- �'"( SPECIAL � I certify that in the performance of the work for which this OWNER � ,� /r,/I O. e T CONDITIONS permit is issued, shall not employ son in any manner DISTRICT( GROUP TYPE FIRE PROC SED BY so as to co e subject to the orker ' nsation ADDRESS �'J CONST Z E #+ )(cit Appli CITY ZIP STATISTICAL CLASSIFICATION APT. CONDO. l� NOTICE TO ARCHITECT OR TEL. EmAPPLICANT: If, after making this Certificate of ENGINEER NO. CLASS NO. DWELL. UNITS Exemption, you should become subject to the Workers' g Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP, o with comply with such provisions or this permit shall be _ 1 7 VALIDATION deemed revoked. CONTRACTOR �-.�rP�Csf/.l//YfJO. -��µ. �-``�/-%'� BK. PG, L - LICENSED CONTRACTORS DECLARATION LIC, I herebyaffirm that I am licensed under provisions of Chapter 9 ADDRESS 7 P P ?r NO. � � / �' VALUATION � (commencing with Section 7000)of Division 3 of the Business and LIC. J.�ft /Q Professions Code, and my license is in full force and effect. CITY !Fi CLASSA , / .J SQ. FT. NO. OF P NO. OF CHECK License N er L Li .Class_ _L� SIZE STORIES �— FAMILIES ONE Contrac d DESCRIPTION OF WORK � �✓ NEW ❑ $ ❑ _ ADD I am exempt from the licensing requirements as am a "' - licensed architect or a registered professional engineer ALTER FINAL ^�7 acting in my professional capacity (Section 7051, ` ❑ DATE G REPAIR Business and Professions Code). USE OF FINAL EXISTING BLDG. E" ❑ By DEMOL Lic.or Reg. No. _Date APPLICANT - _—TEL OWNER-BUILDER DECLARATION (PRINT) ccetl I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS 3i Professions Code): PRESENT BUILDING pD y I, as owner of the property, or my employees with ADDRESS 0 wages as their sole compensation,will do the work and r� G� the structure is not intended or offered for sale (Section LOCALITY O�9,O n 7044, Business and Professions Code). MOVING TEL. (r z I, as owner of the property, am exclusive) contracting CONTRACTOR NO. # 1 P P Y, Y 9 0 0 0 0 0 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). 2 x 1 3 3.0 0 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 a o a 1 3 3,0 0 5 the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE 0$,0.7-81 Lender's Name n in P.C. Fee$ oY$ ® Permit Fee Lender's Address 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 0 ordinances and State laws relating to building construction, Total Fee y authorize representatives of this County to enter aupon above- property t ection p pose . m. J aSEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Dote - ©s 1 4 I 7 • WORKERS'COMPENSATION DECLARATION � LLLIII ''insure bor afclertificatethatlof Workershave a 'Colmpensstrtifcate fonalnsurranoce, ost�r APPLICATION F BUILDING PERMIT a certified copy thereof (Sec. 3800, lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company LDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BU ADDRESS Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS r O LOCALITY —7 r NEARE Date Applicant CITY e/ ZIP (90 CROSSSST. CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT - MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP hundred dollars ($100)or less.) TRACT 30S__ BLOCK LOT NO. C6 / NO. ->a �w EL. r ( SPECIAL I certify that in the performance of the work for which this OWNER O. 297 CONDITIONS O permit is issued, I shall not employ any person in any manner / �^ DISTRICT GROUP TYPE FIRE PR ESSED,BY k) so as to be am e ubject to the Worke pensati n ws. ADDRESS ,4 No C - j/ i('3 CONST., ZONE Date / Applicd % ^ CITY E l� ZIP 0 STATISTICAL CLASSIFICATION`V/ PT. CONDO. la NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. L9 ENGINEER NO. CLASS NO. �, DWELL. UNITS Exemption, you should become subject to the Workers' eft Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be TEL. L deemed revoked, &"BK. PG, VALIDATION CONTRACTOR NO. f LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed u der provisions of Chapter 9 ADDRESS �1 NO. 1, VALUATION (commencingwith Section 7000 Division 3 of the Business and v��f pp //�� Professions Code, and my Ii nse is in full force and effect. CITY /f C ASS1 A7— $ YOO SQ. FT. NO. OF NO. OF CHECK License Number Z/ Lic.Class SIZE STORIES /FAMILIES ONE Contract Date DESCRIPTION OF WORK iC1Vl/�1� NEW ❑ U ❑ _ ADD I am e empt from the licensing requirements as I am a46f ?3 yad licensed architect or a registered professional engineer ALTER FINAL acting in my professional capacity (Section 7051, ❑ DATE " ' REPAIR Business and Professions Code). USE OF �LiMDEMOL ❑ FINAL EXISTING BLDG. v By Lic. or Reg. No. _Date APPLICANTT L. OWNER-BUILDER DECLARATION (PRINT) �. J O. 2,19 I hereby affirm that I am exempt from the Contractor's License � Law for the following reason (Section 7031.5, Business and ADDRESS �/ v Professions Code): PRESENT BUILDING ❑ I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and z 4 9 Z 3 A the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. # 0 0 0 0 0 1 I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS 2.0 1 87. 00 tion 7044, Business and Professions Code). 1 8 7.Q Q c=�. REQUIRED TOTAL SETBACK FROM EXIST. 0.0 CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued fInvestigation L. �v 6 -20 � c,L•+ v r— (Sec. 3097, Civ. C.). DE Lender's Name Lender's Address Fee$ Permit Fee w I certify that I have read this application and state that the Issuance Fee above information is correct. I agree to comply with all County Fee 0 ordinances and State laws relating to building construction, Total Fee and In re y tho�ize representatives of this County to enter < u h o e entioned for inspectio u�ps. a OILi SEE REVERSE FOR EXPLANATORY LANGUAGE J - Signature of Applicant or Agent Date ©s