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HomeMy Public PortalAbout6034 LOMA AVE_Building__ ,76A638A.C'E:,#BD3 I216APPLICATION FOR BUILDING PERMIT .fl 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 FOR APPLICANT TO FILL IN NEAREST Print or tvDe only) .CROSS ST. DISTRICT NO. GROU TYPE P S D BUILDING J o �e'. 1- CONS ADDRESS Q V AS (� STATISTI AL CLASSIFICATION SEWER MAP LOT NO. BLOCK CLASS No_lv_DWELL.UNITS 'BK PG 7 TRACT P USE ONE MAP SIZE OF LOT r ,�J NOW ^^ON LOTS ,' ^I SPECIAL USE OF EXISTING BLDG. (1, O�Oweli ai�i CONDITIONS OWNER NO. 33C4 BLDG.SETBACK FROM ADDRESS �4"-� FRONT PROP.LINE OF (STREET) ,3 TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY HIGHWAY WIDTH FROM C.L. ARCHI EC OR TEL. - / d-� + ENGINEER N BLDG.SETBACK FROM ADDRESS SIDE PROP.LINE OF (STREET) TEL. TYPE OF EXISTING SETBACKHIGH + YARD = TOTAL CONTRACTOR NO. HIGHWAY WIDTH FROM C.L. LIC. + - or ADDRESS NO. - LIC. U CITY CLASS ORNER Cl ITCIFF YES E] NO.2� NAMETAND BRANCHNOER SEE REVERSE SIDE FOR SPECIAL APPROVALS o LLJ ADDRESS N SQ. FT. NO. OF NO. OF NEW ❑ Z SIZE STORIES FAMILIES USE OF ADD STRUCTURE ALTER REPAIR❑ S1Gt,ATIJRE OF APPLICANT OEMOL ❑ VALUATION $ �� APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE $ FEES FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS ANO 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 THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPE TI N INS URA NC LATH, EXT, j j SIGNATURE OF /LJ HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGI EER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT,VALIDATION C,. Ar --6,6 :0 �:�,- SEP 3 1 D 3.4.5 0~ a DEPARTMENT OF BUILDING. AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES e L Eo I WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY g' �y,,� DISTRICT NO. PLAN CK. NO. PERMIT NO. BUILDING ADDRESS {�' f✓.. '� N r �/� All-L _6�_ ,/REECCEIVED BY DATE OFAPPAL. DATE ISSSSUEED� LOCALITY NEAREST - V 6� arm .55-76' f�'1,9—,c57 /! —/ ./ -` 1 e - - � � r )� CROSS ST. BUILDINGADDRESS �O Q �/ ' OWNER LOCALITY MAIL ADDRESS 64 '' CROSS ST. � J73 A-7 r� J1 � ,'�� TEL. ' CITY o4e - �AjJ NO. FIRE NO. OF TYPE GROUP ARCHITECT Oft TEL. ZONE I PLANS I I f v ENGINEER l NO. BLDG. ; ORD. NO. SETBACK LINE - ADDRESS _ APPROVED TEL.. BY DATE CONTRACTOR ,may'/ J� NO. USE APPROVED ' ZONE Q BY DATE ' ADDRESS HOUSE ;NUMBERING LEGAL DESCRIPTION I LOT NO. 3 !LI BLOCK - MAP NUMBER S-• —FIELD CHECK BY TRACT NO.NO. ASSIGNED'SY � DATE � �+ NO. OF BLOGS. _ CORRECTIONS - SIZE OF LOTEU , {,� I NOW ON LOT USE OF j -7y� N O. O F ,--EXISTING BLDG. L, J �"' V l_[FA [FAIa DESCRIPTION OF WORg D r y-R-�_Mi AIC— NEW. /V1C NEWT I ALTERATION I I ADDITION I _(�)r•-J / "- ' REPAIRI I DEMOLITION ,(� ,�* SQ. FT: NO. OF ._1 PP44 P Dd fp ' ,n SIZE ROOMS STORIES ,® ) , ,/ y t�/// / )0 – D EXT. WALL 'A_, "I ROOF _ j jJ [Ji x O IN LG+ ►/ n r COVERING _v'v'i�V� COVERING USE OF STRUCTURE /y APPROVA INSPECTOR'S ECCTOR'S SIGNATURE DATE I HEREBY/jACKNOWLEDGETTHAT 1 HAVE READ THIS AP- FOUNDATION: LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN IS 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 COfNS)TRUCTION. SIGNATURE OF Y"'1 � FURNACE: LOCATION, !!' A ,fl ,GAS VENT, DUCTS. PERMITTTE'r LATH, INT.!B fc� �' / /7/. *JS""°.ie.G+�'.�> f/'i..<P4A'►aS�" - O lJ aADDRESS - _ LATH, EXT: AUTHORIZED AGT. X(CT<P/rr- ' _ PLASTER, INT. - 76A638A• DBS3 ',10-50:• $ P. C. $ FEE PLASTER, EXT.. B ' J YL VALUATION � `JS-� a '$ ""'7 4. FEE. t a;- - FINAL f�P�- " � '3 -0 d z Job No. Permit NRO District No....................... BUILDING SET BACK LINE Date -Issued)f49M..... .................... I agree to locate this building not less than...:........:.....:...feet A� . ...................... Job Address ............. 0 ......... from the......�*�I.A..../1..I..................................................................line of 1/51//1nor less than........................ft. ................................. .......�/........... Locality---------- ......... ........................................... 0 from the.... ............PZ........line of........-................................... Nearest Cross .............................r,/................ �---.............................................. .....................215L.............................. ...... . ............ . Ordinance No..... ............................. as provided by dedication in Tract .......4........ ...................... APPLICATION FOR PERMIT County of Los Angeles _1_,911 recorded in book............. page............, Maps, Records of L. A. Co. BUILDENLIG ............................................................................................... OWNER OR AUTHORIZED AGENT THE BUILDING BUREAU OF THE jRE_GIONAL PLANNING COMMISSION COUNTY OFILOS ANGELES LOT NO. e3 ;7 2 SPECIFICATIONS -BLK. NO.' FOUNDATION EXTERIOR PIERS TRACT MATERIAL TOP SIZE OF BUILDING -THICKNESS BOTTOM SIZE OF LOT HT. ABOVE GRADE y7V A'- STOR.IIES NO.OF FAMILIES BLDG. -DEPTH IN GROUND FIRE DISTRICT SUPERSTRUCTURE TYPE I 71 III IV x SIZE O. C. SPAN USE _*eYo#q,6 a /J R. W.,PLATES NAME ' 9.4,ojoma P__� W 'Ar— W A GIRDERS Z 3: ADDRESS IY,?xn�)dAj'.I/ JOISTS FLOOR 0 44 TEL.M Ij C'S 24- JOISTS-CEILING, NAME BEARING WALLS I W WW XDD'RESS' .n, ,0 _- �11 lu 0 5 CITY TEL. PARTITIONS zz ... ... < w LICENSE NO. ROOF-RAFTERS -NAME ADDRESS COVERING 'Z" CITY TEL. 0 U LICENSE NO. PLANS FILED ./\ Wall Roof//I A APPLICATION RECD BY NATURE OF JOB DATE U REPAIR 14 DESCRIPT16N OF WORK AD AOVING-­---w-_" A- ALTERATION DEMOL-ISH—W= h OG _744J-1 A9 7A 6 0VALUATION $ FEE ';I_ol) A_),;;,71Z�1,20 I01-1-1 &-.It 9&W.0, I hereby state that the above is correct and all County ordinances and State laws governing building'construc- tion will be complied with _�Pom- W I/�- &�-A e 1A Sigl% ................................4............ ....... ............... OR AUTHORIZED AGENT r T�WORKERS'COMPENSATION DECLARATION t v of°cer that.I haver certificate ns consent to.self P L I CAT I F -UILDING PERMIT �re,•or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab:C,) COUNTY OF LOS ANGELES ' BUILDING AND SAFETY Policy,No.- Company ❑ Certified copy is hereby.furnished. FOR APPLICANT TO.FILL IN BUILDING. ADDRESS Certified copy is filed w4h the colnty building inspec- BUILDINGEl //�� / tion department. ADDRESS ,03 //O 14 Date Applicant CITY-{ Li ZIP - LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' Ori + NO. OF BCDGS. NEAREST , r COMPENSATION INSURANCE SIZE OF LOT S 54 NOW ON LOT � CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) - TRACT BLOCK j LOT NO•.�l, y� MAP BOOK• PAGE PARCEL OWNER S` /v NO.v�Sa�`7S USE Z E MAP I certify that in the performance of the work for which this NO. permit is issued, I shall not employ any person in any manner ' / SPECIAL ' so as to become subject to the Worker ' ompensotion La s: ADDRESS �� L/ ion, �O CONDITIONS Z Date 1-2�3 T7 Applica CITY` ZIP c ARCHITECTi TEL. DISTRICT G OUP TYPE FIRE PROCESSED BY O NOTICE TO APPLICANT: Ijer making this Certificate of ENGINEER NO. Exemption, you should become subject to the Workers':. S CONST. ZONE Compensation provisions of the Labor Code, you must forth- ADDRESS G C fy� DSEn1FA 1/ ; W with comply with -such provisions or this permit shall 'be deemed revoked. _ ) TEL.. STATISTICAL CLASSI KATION APT. ONDO. (n CONTRACTOR �/ NO. /'�) z LICENSED-CONTRACTORS DECLARATION LIC. : CLASS NO. 0 DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter.9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and LIC: SEWER MAP o Professions Code, and my license is in full force and effect. CITY CLASS BK PG ( 1 A ' SQ. FT. NO. OF /► NO. OF CHECK License Number Lic.Class SIZ STORIES O( FAMILIES ONE ` 1 DESCRIP•ION75 OF WORK NEW ;ALUATION Contractor` Dote '/C3 ADD. I am exempt under Sec. ❑ �( ALTER B.BP.C. for this reaso $• Date: USE OF DEMOL ❑ EXISTING BLDG. b - / _ Signature APPLICANTTEL. FINAL'- OWNER-BUILDER DECLARATION PRINT) / �✓1 S� U NO- DATE Vy I hereby affirm that,I am-exempt from the Contractor's License / Law for the following reason (Section 7031.5, Business and ADDRESS Q !� /YI FINAL z 8 6 5.3 A Professions Code):. PRE ENT By ° BUILDING # e ° 0 2'3 I, as owner-of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and t " I ° 9 8;1,:1 ^G 1 the structure is not intended or offered for sale(Section LOCALITY' ® _ 7044, Business and Professions Code).- MOVING TEL. °{e 9 8r1;,1.2 ca ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. .I 2 2 3,�8 7 with licensed contractors to construct the project (Sec-' ADDRESS tion 7044,.Business and Professions Code). i '� -T REQUIRED TOTAL SETBACK l CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. t _ § e'• t-o (Sec. 3097, Civ. C.). SIDE 'z✓(,11 tl,/I P.L. :3 Lender's Name' ..•s q r r • .' m LDMA Ref.0 t n 5 '', T i 1 1 6 G 7 5. Lender's Address _ P.C. Fee$ .r Permit Fee lJ r ;. y•_ I 1 certify that I.have read this,application and state that the i Issuance'Fee tDNA P/C# `.1.t1 6 4h 75 F above information is correct. I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee J iDNA Perm. �. 0 3. 04,`- 8 8 6 and hereby authorize representatives of this County to enter W upon the bove-mention d p per for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE /� ignoture of pplica t or Agent Date f'•WORKERS'COMPENSATION DECLARATION 1 hereby affirm that I have a certificate of consent to selfAPPLICATION � �'® FOR ' U I L®I PERMIT insurer,°or a certificate of Workers' Compensation Insurance, ® A or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES -BUILDING AND SAFETY Policy No. Company 0 Certified copy is hereby furnished: FOR APPLICANT TO FILL IN BUILDING ADDRESS ✓ Certified copy-is'filed with the county building inspec- BUILDING tion department. ADDRESS Date Applicant CITY, _ >' !i%. I Y ZIP' /O © LOCALITY •CERTIFICATE OF EXEMPTION FROM'.WORKERS' d _ NO. OF BLDGS.. NEAREST / COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT G` CROSS ST: (This section need not-be completed if the permit.is for one . ASSESSOR' hundred dollars ($100)or less.) - TRACT" (/ BLOCK LOT NO. MAP,BOOK. PAGE- PARCEL ` I certify'that,'in the performance of the work for which this OWNER e i �,r/ NO ��� USE ONE NOP _ permit is issued,,)shall}iot employ any person in any manner A q SPECIAL ADDRESS ©� /J - CONDITIONS so as to become subject to the Workers" mpensation a 1. 0 Date a3- � APPIi an CIT L: / ZIP �/U �. ARCHITECT TEL. DISTRICT GROUP TYPE FIRE PRESSED BY O NOTICE TO APPLICANT: If r aking this Certificate of _ C� ell ENGINEER Q NO. CONST. ZONE U Exemption, ,you. should_ ecame subject to the Workers' — Compensation provisions,:of the Labor!Code, you"must forth- ADDRE " S f R-3 with comply with such provisions or this permit'shall be TEL. deemed revoked. STATISTICAL CLASSIFICATION APT.:CONDO. N CONTRACTOR " NO. Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. 2 DWELL. UNITS I hereby affirm-that I am licensed under.provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP Professions Code, and my license ism full force and effect. CITYCLASS t3K 7r VALIDATION SQ. FT. NO.OF NO. OF CHECK License NumberLic.Class SIZE ISTORIES" FAMILIES ONE O VALUATION DESCRIPTION OF WORK NEW Contractor 'Date _ ADD p $ 8 6 5 2 A I am.exempt under Sec. ''14S ALTER B.&P.C. for this reason REPAIR $ #"ro o 0 0 ®';J - Date: USF.OF / DEMOL I:I''O ° 6 Q 5 0 • EXISTING BLDG. .„ Signature APPLICANT ' TEL. _/� o o"- 60,50' 9 FINAL `Cfc/-.f , (PRINT) e ! / N OWNER-BUILDER DECLARATION. DAT _ I hereby affirm that I am exempt from the Contractor's License "2 23,-87 Law for the following reason-(Section 7031.5, Business'and ADDRESS ( L Pro ssions Code): PRE ENT BUILDING ' 1, as 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.sole(Section' LOCALITY 7044, Business and Professions Code). MOVING TEL. I, as;owner of the property, am exclusive) contractin • CONTRACTOR NO. �• 6 n with'licensed contractors to construct the project (Sec ADDRESS q tion 7044, Business and Professions Code). roe (� i REQUIRED TOTAL SETBACK FT / CONSTRUCTION LENDING AGENCY " SET BACK YARD HWY PROP. LINE WIDTH 1 hereby affirm that there is a construction lending agency for FRONT . 0)� aP, "the performance of.the work for whichYhis permit is♦issued P.L. (Sec. 3097;1 Civ. C.). SIDE . .. P.L. • Lender's Name LDMA.Ref q P.C. Fee$ . Permit Fee Lender's Address certify.that I,have read this application and state that the _ Issuance Fee O LDMA P%C H R above information is correct. I agree to comply with all County InvestigationTee 0 ordinances and State laws relating to building construction, Total Fee. R and hereby authorize representatives'-of this County to enter c S LDMA Perm. . m _ 'upon th above-mentioned pe yinspection purposes. ^• �L �for SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent_- + Date