HomeMy Public PortalAbout6044 LOMA AVE_Building__ DEPARTMENT Of BUILDING AND SAFETY APPLICATION FORPERIVIIT
COUNTY OFLOS ANGELES
WM. J. FOX, CHIEF ENGINEER
FOR APPLICANT;TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PLAN CK. NO: PERMIT
NO.
BUILDING
ADDRESS
�_ f�A ��} RECEIVED-BY DATE OF APPL. DATE ISSUED
LOCALITY Ov1 \.�.yG[R.�xa"'i /P 11:�r� �cs* / fp��/
NEAREST /I! ( !i .. _
CROSS ST. �' ` ,��, .�� B Al,
, on,4,DDRESSRESS / Z,
OWNER �i� '
MAIL
LOCALITY 7 �
VA/ � ---
.ADDRESS ® !! (` NEAREST- ® I � 4
CITY11 �..�G/vc...7 NO. T(O.:3a / CROSS ST. f
ZONE I;NO. OF e)- I TYP I GROUP
ARCHITECT ORY TEL. PLANSFIRE _
ENGINEER .0 E BLDG. ��
. / �� /'�/ ORD. NO.
SETBACK LINE
ADDRESS APPROVED -
- TEL. BY. DATE
CONTRACTOR ', � / ►� NO. USE /� / APPROVED
ZONE/f BY DATE
ADDRESS _ - HOUSE NUMBERING
LEGAL + j)
DESCRIPTION I LOT NO. 3 3 I BLOCK MAP NUMBER MELD CHECK BY
'TRACT D NO. ASSIGNED BY l? DATE
N 1. OF BLOGS. CORRECTIONS
SIZE OF LOT..g ® -I NOW ON LOT - -
USE OF NO. OF _
EXISTING RLDG: /,,,B ,rC+y1.Gf�i I FAMILIES
DESCRIPTION OF WORK
NEW I�..,. ALT•ERATION ( I ADDITION
o
REPAIR I- _ I,DEMOLITION "--A/V 77f ` A-1).71 A ct ,4o O
SO. FTNO OF t .7
SIZE J''.,/. �- ROOMS STORIES / /� /' Z
EXT. WALL /.10l- ( .ROOF C,�.G�j ": I�t�I/�- rD,
COVERING COVERING•� ,. , (;'
USE OF STRUCTURE '
APPROVALS
INSPEC OR'S SIGNATURE DATE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AE= FOUNDATION: LOCATION {/ I�f //'• f
PLICATION AND STATE. THAT, THE INFORMATION GIVEN 0i,`- FORMS, MATERIALS
CORRECT. -
1 .AGREE TO,COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS, �I
HEREON' AND WITH ALL COUNTY.ORDINANCES AND STATE BRACING, BOLTS /A
LAWS REGULATING UILDINC, CONSTRUCTION.
f "�' FURNACE: LOCATION,
SIGNATURE OF \,f /Y4's!��lti� s6' GAS VENT, DUCTS 1 IVftA-
PERMITTE
LATH, INT.
ADDRESS - � o LATH, EXT. � �� J�� �• v '
AUTHORIZED AGT. _
•. w � PLASTER, INT. •
76 X628• DB83 ..10-50' $ �* � P..C. $
O FEE / _ PLASTER, EXT.
VALUATION' FEE $ FINAL �y f�/i r
i
76A68BA CE X80910-58 APPLICATION FOR BUILDING PERMIT 1
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS CLI Z
BUILDING AND SAFETY DIVISION'• LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST.
DISTRICT NO. GFjQL!$ rypE ROCESSED Y
FOR APPLICANT TO FILL IN �CONST.
BUILDING / STATISTICAL C SIFICATION SEWER MAP
/
ADDRESS ' Q L O f} L)E CLASS.NO. DWELL. KG UNITS I
LOT NO. BLOCK N MA ER �, Q HWY.P STATE YES 1
TRACT {' f ZONE SPECIAL
.t NO.OF.BLDGS CONDITIONS
SIZE OF LOT --, X f ~ I NOW ON LOT _3 �
USE OF .7 'woe
EXISTING BLDG. (ie - - - �. BUILDING ti EXIST.
SETBACK YARD HWY STREET NAME WIDTH
OWNER ,1 e a u / LL FRONT ��5y/
MAIL ^ P.L.
ADDRESS y � / VSJ ✓.L- ca!
19 SIDE
TEL. P.L.
CITY-7 fl L E c, 1 T NO. /'53�s INSPECTION RECORD
ARCHITECT OR TEL. —
ENGINEER NO. t
ADDRESSJ/--5'? �`I ��✓S..I� '� �/�.T
TEL.
CONTRACTOR NO.
ADDRESS
DES TION OF WORK
NEW DD ALTER REPAIR DEMOLISH
SQ.FT. NO.OF NO.OF
SIZE STORIES FAMILIES '
USE OF /�
STRUCTURE l�L/ LLL. ✓
SIGNATURE OF.
APPLICANT APPROVALS DATE INSPECTOR'S SIGNATURE
ADDRESS FOUNDATION:LOCATION
FORMS,MATERIALS
VALUATION$ •�` FRAME: FIRE STOPS,
BRACING,BOLTS
FURNACE:LOCATION.
FEE •$ I FEE "-I GAS VENT,DUCTS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH.INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING BUILDING CR CT IO LATH,EXT.
SIGNATURE OF., _ HOUSE NUMBER COR-
1)A
OR- -
PERMITTEE RECT AND POSTED
ADDRESS � SST L - FINAL
CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL EpdfRE R
PLAN CHECK VALIDATION CK, M.O. CASH PERMIT VALIDATION CK. M.O. CASH
..._ (p)P
76A638A CE#803 3-66 I ATION FOR BUILDING PE
APDL C Ei!1VIIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS 11
BUILDING AND SAFETY DIVISION LOCALITY ) �� y
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST > >
COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS ST. _
DISTRICTP TYPE P O S Y
FOR APPLICANT TO FILL IN �% 71'
47 1
CONST.,
BUILDING STATISTICAL C A IFICATION SEWER MAP
ADDRESS CLASS NO. DWELL UNITS. BKPG
LOT NO. BLOCK USE ZONE MAP /(
K/�1 / NO. (J
TRACT 1�" I SPECIAL /
/ NO. OF BLDO3. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
I NG BLDG. BLDG. SETBACK FROM
TEL. FRONT PROP. LINE OF (STREET)
OWNER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
+ _
CITY i BLDG. SETBACK FROM
ARCHITECT OR � TF1 • SIDE PROP. LINE OF (STREET)
ENGINEER NO.
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS ? HIGHWAY WIDTH FROM C.L.
CONTRACTO NO� + >-
CL
LIOC +9� CORNER CUTOFF YES NO V
ADDRESS N
CITY CLC SEE REVERSE SIDE FOR SPECIAL APPROVALS a
DESCRIPTION OF WORK 1.1
a
NEW .ADD ALTER REPAIR DEMOLISH
SQ.FT. //�� NO. OF NO. OF
SIZE 'QCJ STORIES MILIF_S
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATION$ •00 APPROVALS DATE INSPE;Ojt!S.S1.GNATURE
hhFOUNDATION, LOCATION �` e
FEE$ FEE$ v FORMS, MATERIALS
FRAME, FIRE STOPS,' /'�`__
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
SUILDI NG CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT•
ING TO WORKMEN'S COMP.N ATION INSURANCE. LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE REST AND POSTED �^
ADDRESS d �� FI NAL
JOHN F. LEWIS. PRINCIPAL STRUCT RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION cK. M.O CASH
Lji-uos 7 7-0 APR;24 1 D 11 .50,
��J 1
76A638A CE#8033-66 APPLICATION FOR ILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS d Q
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS.SUP'T OF BUILDING CROSS ST.
__ ---
-DIST fLI CO -GR P TYPE P C D BY
FOR APPLICANT TO FILL IN c�/ `-l% CONST.
BUILDING / STATISTICAL CL SSIFICATION SEWER MAP
ADDRESS �� CLASS NO.�DWELL UNITS. BK�P
LOT NO. BLOCK USE ZONE NOO. �7Q• L-
TRACT G L SPECIAL
NO. OF BLDOS. CONDITIONS r
SIZE OF LOT ,s NOW ON LOT67
USE OF F.
1 T N BLDG. SETBACK FROM
Tt L. FRONT PROP. LINE OF / (STREET)
OWNER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIID-TTH FROM C.L.
CITY J v +OAC/
ARCHIT CT OR EL. BLDG. SETBACK FROM
ENGINEER NO. SIDE PROP. LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
CONTRACTO ��rr NE r�/[�p' +
ADDRESS /vE NOLlclp'� / CORNER CUTOFF YES NO
CITY cl` 'I SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK a
T
NEW ADD ALTER REPAIR DEMOLISH
SQ.FT. NO. OF NO. OF _
SIZE J v STORIES FAMILIES 7-�
USE OF - .moi 0!��"i➢ �- i`'
STRUCTURE
04
SIGNATURE OF
APPLICANT -
VALUATION$ ,Q0
APPROVALS DATE INSPECT 'S_SIGNATURE
P.C. PMT. rr//�� � �� FOUNDATION, LOCATION p/�y�-
FEE$ FEE$Q�p`- FORMS, MATERIALS G,/ N"y i`��=�.•"
FRAME, FIRE STOPS,'
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT ��
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS "� I
BUILDING CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH. INT.
TION OF THE LABOR CODC OF THE STATE OF CALIFORNI RELAT.
ING TO WORKMEN'S COMP TION INSU RA CE.
- LATH. EXT.
SIGNATURE OF - HOUSE NUMBER COR- `
PERMITTEE RECT AND POSTED
ADDRESS 3 FI NAL
JOHN F. LEWIS. PRINCIPAL! TRUCTURAL tNGINEER
PLAN CHECK VA ATION CK. M.O. CASH _ PERMIT VALIDATION ^ M.C, CASH
L tl�o
8 1 7 6-0 APR 2 4 1 D 2 2.0 0-
WORKERS' COMPENSATION DECLARATION
rbtconsent e
or a, or a certificate of lNokes' Compensation Insurance, APPLICATION FOR BUILDING PERMIT
rtified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy'kNo. 1 Company BUILDING
❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS 1OHA
❑ Certified copy is filed with the county building inspec- BUILDING
tion department. ADDRESS L
Date Applicant CITY ZIP �1 O LOCALITY
NO. OF BLDGS. --- NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST.
COMPENSATION INSURANCE ASSESSOR
(This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL
hundred dollars ($100) or less.) TEL.
OWNER NO. USE ZONE MAP
I certify that in the performance of the work for which this V O.
permit is issued, I shall not employ any person in any manner ADDRESS I� I SPECIAL d
CONDITIONS
so as to become subject to the Workers' pensa ion Laws. 0
CITY ZIP
Date Applicant ARCHITECT OR TEL. Q'
ENGINEER NO. DISTRICT GROUP TYPE FIRE PROCES ED BY
NOTICE TO APPLICANT:•If, after makin th' ertificate of � CONS . �E U
Exemption, you should become subject t the Workers'
Compensation provisions of the Labor Code, you must forth- ADDRESS 51� C-3 a
with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. I CONDO. N
deemed revoked. CONTRACTOR NO.
Z
LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS
—
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO.
LIC. SEWER MAP
(commencing with Section 7000)of Division 3 of the Business �^
and Professions Code,and my license is in full force and effect. CITY CLASS BK. G PG. VALIDATION
SQ. FT. NO. OF NO. OF CHECK
License Number Lic. Class SIZE STORIES FAMILIES ONE
VALUATION
Contractor Date DESCRIP ION OF WORK NEW ❑ "4,560,
d�
El am exempt under Sec. ADD El
S ►
ALTER ❑
B.&P.C. for this reason REPAIR $
USE F
Date: EXISTING BLDG. DEMOL ❑
Signature APPS ICAN j /, , V TEL. per/ �� FINAL/1
OWNER-BUILDER DECLARATION . PRINT W NO. o, `
�` / �q� DATEf'
I hereby affirm that I am exempt from the Contractor's License ADDRESS U l , hd/�% f-l'1 i
Law for the following reason (Section 7031.5, Business and FINAL �•
Y 9 : ; r ;t
Professions Code): PRESENT B ACCT .AV
BUILDINGEl I, as owner of the property, or my employees with
ADDRESS -+-.
wages as their sole compensation,will do the work and C r,• i ry f / 3307 'gate=
the structure is not intended or.offered for sale(Section LOCALITY pool 1 ITEMS
7044, Business and Professions Code.) MOVING TEL.
CONTRACTOR NO.
❑ I, as owner of the property, am exclusively contracting TOTAL I'�'AL ,�.9® 8�
with licensed contractors to construct the project (Sec- ADDRESS
tion 7044, Business and Professions Code. 49.33
REQUIRED TOTAL SETBACK FROM EXIST. rL���
C:NE{:w
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 4f k-11GE .01E
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.
(Sec. 3097, Civ. C.). SIDE.
Lender's Name, P L I3OL0-110101 V 8/89
m LDMA Ref. # c Q d g11��j
P_C.-Fee-$ P_ermit_Fee _r 5598 1 A o t1
Lender's Address -- — -
0
1 certify that I have read this application and state that the Issuance Fee 10 ,50 LDMA P/C#
8 above information is correct.I agree to comply with all County Investigation Fee
d ordinances and State laws relating to building construction, Total Fee LDMA Perm. #
a and he eby authorize representatives of this County to enter
up a atb e�mentioned proper r ins c'on purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
\\\JJJ Signature of Applicant or Agen Date