HomeMy Public PortalAbout6203 LOMA AVE_Building__ r _
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76A686A CE#so3. 1-61 -.• /�H ��:1 Cl 1 i�:i�N.�.:�'Q ` �1.1 1 Lm.�,l i��e�..�%y'�ri'Myf.Y�Y S����Y �1. -i ..
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DRESS
DEP' CO?��Ti°t3C.OF LOS -ANG%.LES' Buil
ARTMENT-bF--COUNTY E'NGINIMM`
BUILDING AND, $AFU PY-DTVISION'' Locau rv`
-JOHN A. LAMBIE. COUNTY EM6INEER NEAREST,
WILLIAM A. JENSEN 'SUP•T or BUICDINo CROSS ST.
III! -
FOR APPLICANT TO FILL IN DISTRI T NO. - GROUP TYPEP SSED BY
r1 �/
... -..�L' 9 � 'CONST. ... �._ ..
BUILDING G p •� - STATISTICAL-CLASSIFICATION.. - SE ER MAP' '•
ADDRESS. 62`03 NOro -Loma - K
GLASS.NO. DWELL.UNITS
LOT NO. r7t-. r� -BLOCK WATER NOTREQUIRED •RECEIVED
�• CERTI.FICATE:
TRACT ,. '.J 7'/A• _
MAP --HIGHWAY- MAJOR SECOND,.L CAL
NO.
- NO.OFBLDGS,•--�
' (CIRCLE) '
SIZE'OF LOT KNOW ON LOT USZ ZONE SPECIAL '
• USE OF.. - - CONDITIONS-
EXISTING BLDG. _ House & .Gara•ge �. ..
T TEL.
L
OWNER . E. -Voe°Ssner " NO.. BUILDING. •• - . .T.NAME:�` EXIST.
�T 'T T1 _f�I +. YARD HWY S EE,
ADDRESS' 6203' lY a LOCZ`d �l@C11 le; v u SFRONSK pe�� WIDT}H.,'.
ARCHITECT.OR TEL::♦. `P,..L..
ENGINEER. _ - NO. SIDE
P L }
ADDRESS Virg-in
CONTRACTORRoof C O.dJOI :T70507 INSPECTION RECORD O -
ADbRESs600 S,..San Gabriel Bl.. -S...GA
DESCRIPTION.OF WORK _ w
a: a
NEW .:,.-ADD ALTER. REPAiR DEMOLISH. -
t�
L51AA
.OF . .NO.•OF':ST ---FAMILIES--- - -EA'PL
use Gara e. ..0.. _ :.. ..s 7309._00'. -
,APPROVALS ._DATE INSPECTOR'.SSIGNATURE
P.C. PMT- _ FOUNDATION:r
LOCATION
.FEE FEE s 6 s 00 -FORMS, MATERIALS
FRAME: FIRE STOPS, '
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS,APPLICATION 'BRACING, BOLTS'
AND STATETHAT•THE-ABOVE IS CORRECT AND AGREE.TO COMPLY. FURNACE-
:'LOCATION, �,•y..,
WITH,ALL COUNTY'•ORD I NANCES-AND"STATE LAWS`•�REGULATING GAS"VENT,DUCTS -
THAT�'IN DOING
TION,OF THE LABOR TION..I/F'E E 6 A_OY.ACALIFORNIAPERN'I E WORK
AUTHORIZED "ERE:BY-'1 ILL N EMPLOY ANY'PERSON'IN VIOLA--, �-I•I„1• INT. . ,.
_ T RELAT .
"ING TO WORKMEN' CO / ATION'INSUTtANCE. • - - - ` L
LATH,EXT.
SIGNATUR '' Y. , HOUSE NUMBER-COR-
PERMITTEE _ RECT,ANDPOSTED^ ,1" ••
ADDRESS 600 S. S Gab.ri el Bl.:-. FINAL '..`,. v -If ' 'y
' - a - . - _CLYDE N, DIRLAM', PRINCIPAL STR -TURAL EN_GINEER'- '.
-PLAN CHEC& VALIDATION CK. M.O., CP.SH ', PERMIT: VALIDATIO1Vf CK. M O CASH
L 0 2 5 f2 6 o Ai#G; 3 1, D" , 6".0:('}.r 04
�r
cl
V.
/q� ■/, /per pe F� B lJ 1 N C PERMIT
76A633A CE*803.3=63, A.PP➢_ICAT'lO
'COUNTY OF LOS ANGELES, '' BUILDING
DEPARTMENT OF COUNTY ENGINEER
ADDRESS
t,. BUILDING' AND .SAFETY DIVISION LOCALITY:
car,°
JOHN•A. LAMBIE COUNTY ENGINEER NEAREST
,W.ILLIAM'A. JENS_EN, Sup'T'OF BUILDING - CROSS STs .� �� -
DISTRICT NO. GROUP ,TYPE - PROSE S D BY
,CONST. ., I .1• f.
FOR' APPLICANT TO FILL IN � • '_
BUILDING- /1 :- STATISTICAL CLASSIFICATION SEWER MAP�''
ADDRESS •s��'V :. .; .. '�j ] . BK P
_ - -CLASS:NO.r-�`��) DWELL. UNITSr7191,
—
LOT.NO. _moi. j'- G/&.,: BLOCK .WATER NOT REQUIRED ?" RECEIVED ❑
CERTIFICATE: ,'
TRACT... _ , 'MAP..' 77. - HfGHwnv -
.. NO.OF BLDGS. 4--D -O, cIR
NO. ( CLE) '. STATE MAJORS ECOND_' CaAd
•SIZE OF:LOT - NOW'ON,LOT% „USE ZONE SPECIAL _
USE OF '
CONDITIONS
EXISTING-BLDG. 61[xiL.- % i `.
_ TEL. �. ..
OWNS /` /.3.�,�•
NO. �.� UItDING *" EXIST::
^ - SETBACK
YARD H,WY �'' STREET NAME WIDTH
PHE
s, �S' J i /fit/ / _ FRONT -, -,i' •I -
ECT.OR TEL. : P. L. - 'U ✓C� %/
ER. - .. NO. _ SIDE
. P. L'S TEL. Q.
CTOR p NO. S _ r S iODESCRIPTION OF WORK_ IADD' ALTER ' REPAIR DEMOLISH.- -J` NO. OF - NO. OFZ-STORIES. FAMILIESe' - ' - ... -
STRUCTURE -
..SIGNATURE OF` -
APPLICANT_ .- , - - - -
ci n
VALUATION 5," /./J/ _ -
si ✓ v - APPROVALS - DATE .'INSP V'S SIGNATURE
na-
P.C. PMT, f �� • 'FOU.NDATION LOCATION ,�
�j
u FEE $- _ FEE„$ �- .FORMS, MATERIALS �` .
'FRAME: FIRE STOPS.
1:HEREBYACKNOWLEDGE�THAT'•1 HAVE READ TH I S.APP-LICATION ' ^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
'BUILDING +CONSTRUCTION: 1 'CERTIFY THAT IN DOING THE WORK -
2. AUTHORIZED'HEREBY I WILL'NOT::EMPLOY ANY 'PERSON.IN:VIOLA: LATH*, INT.
TION OF THE LABOR CODE OF THE STATE-OF.CALIFORNIA RELAT -
INC TO WORKMEN'S COMPENSATION'INSU NCE. •O!"T J
,;. ` 'LAT,H:EXT. . / / E
.r
SIGNATUREKa
_ FFINAL
USE NUMBER COR /� // /PERMITTEEry ECT AND,POSTED P ! ,! ”" 8-/110,
�C?
,.
[.vslJ
JOHN F. LEWIS,'PR.INCIPAL STRUCTURAL ENGINEER
PIAN CHECK VALIDATION ". cK M.o.. cAsi+ PERMIT' VALIDATION CK. M.O. CASH'',
APPLICAMOH ,FOR:. ING PERM ].
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WOR KER'S:CbMPENSATION"DECLARATION.
FOR APPLICANT TO FILL IN ' BUILDING ADDRESS
1'hereb affirm-that I have a certificate of consent BUILpII�{,ADDRESS `
y ' • ". t to self insure; �®�J in'",1 iV" '•� "
or a.certificate of Workers'Compensation Insurance,•or a,certified
copy thereof(Sec.3800,Lab.,C.) CiR_ ` ZIP '
p • . ; Vv� Q .• /f�f LOCAL
Policy No. ' 101fGJ r.7 !) •' Company;'`I � SIZE OF LO NO.OFBLDGS.NOW ON LOT
Certified copy is hereby.furnished NEAREST CROSS ST
0 Certifiedcopy is filed with the county building inspection TRACT BLOCK LOT NO.
department. USE E MAP NO:0A -i
1���,.�,,, ,p E ZON
Date i2 Applicant 0A—i "��� t ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS
OWNER TEL.NO..
CERTIFICATE OF EXEMPTION FROM WORKERS' /Yi,y tir �"� f�'�►� "��f�S WITHIN 1000 FT OF.SCHOOL? YES NO
COMPENSATION INSURANCE ADDRESS
.ry ��( .
(This section need not'be completed if the permitis for one hundred 7 A (2/V%-A— /,vd DISTRICT GROUP TYPECONST' FIRE ZONE P OCESSED BY I`F,�
dollars($100)or less.) CIZIP
I.certify.that in the performance,of the w0rk for which this'permit is Issued;I Shall not employ any person in any manner So aSt0 AOR ENGINEER - - - TEL.NO. -
become subject to'the Workers'CompenSation Laws., STATISTICAL CLASSIFICATION APT CONDO
Date - Applicant
ADDRESS CLASS NO. DWELL UNITS
NOTICE.TO APPLICANT: If, after making this ,Certificate of REQUIRED TOTAL SETBACK FROM EXIST
CONTRACTOR TEL.NO.
Exemption, "you"Should become Subject to the Workers' f� SETBACK YARD HWY PROP LINE WIDTH
Compensation provisions.of the Labor:Code, you must forthwith I'.�r� n-ti 1��. �� �' FRONT
Comply with such provisions or this permit shall deemed revoked. A DRESS_ �9 A' LIC:No. P L
��? P..C�ii /" oY S s 31-1 SIDE
LICENSED CONTRACTORS DECLARATION
CITY _ LIC.CLASS PL o
I hereby affirm that I am'licensed"under.provisions of Chapter 9 3 SEWER MAP r,
(commencing with Section 7000)Of-DivisionF3 of the,Business and SO. SIZE NO. STORES NO."OF FAMILIES _. C
Professions Code,and my license.is in full force and effect. NEW ❑ Bic• PG v
OF WORK
License Number s-� tic.Class . 3�
DESCRIPTION „� _ 3 ADD " . ❑ _ j
VALUATION. W
.^�
a
Contractor(/��'t+44— Date ��=Z' (( ALTER
J
REPAIR ❑
❑ I am exempt under Sec. , ..- _
B.&PTC:for this reason w' DEMOL ❑
LDMA'P/C#
Date: USE OF EX19 TING BLDG. - _ URM. ❑
APPICANT(PRINT/) �•� TEL.NO LOMA_Penn# 9
❑ their-I' aswneco f the
property,
rtII'Or
my the employees
and twith.,wages as. �7 C' `' �� 'it .�fa7� G
p he structure is ADDRESS
not intended or offered for sale'(Section 7044, Business and $J' �� ✓ FINAL DATE Q -7-7 7 .
PfOfeSSIOf1S'Cod@.j - - - WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL '' " _ J
❑ I, as owner of theproperty, am eXCIUSIV@I COntraCtln with ' OR'A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN / ITEMS
Q
Y•, g THE AMOUNTS SPECIFIED ON THE HAZARDOUS,MATERIALS INFORMATION GUIDE? FINAL BY
licensed contractors"to construct the-project.'(Section.7044, y
4 i 8 �.+�P 9�F
_ YES❑ NO❑ - - a,"5..
Business and Professions CO _ - WILL THE INTENDED,USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING. "
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH' YCHECK
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST
FOR.GUIDELINES. - r-
I-he' b affirm that there is a construction lending agency for WANK
Y 9 9 Y YES❑ NO❑ :"
the performance of the work for which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATI
QMD
3097,CIV.C. .' ON GUIDE AND LOSTHEANGELES .
) � ,-�' � � PERMITTING�CHECKLIST."I UNDERSTAND MV REQUIREMENTS UNDER THE LOS ANGELES -
co. - COUNTY CODE,TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING ._ 013003-000
., ., i'")"' 6.114/'901
Lender's Name _ HAZARDOUS MATERIALS REPORTING AND.FOR OBTAININGAPERMIT FROMTHESCAQMD. - _IJ0I_ LeI,•r01
a Lender's Address I-a _cy�
.d OWNER OR AGENT AM ICj='t
a I certifythat I have read this application and state that the:above
g information is.correct. 1:agree:to Comply with all county P.C.FEE 'PERMIT FEE r
N ordinances"and State laws relating to building construction,and
a. hereby authorize representatives of this County to enter upon ISSUANCE FEE
' the abov mme t' ned/property for inspection purposes (�
a E! 'T✓ S� �C� E. ._. TOTAL FE -
INVESTIGATION FE E' .
&gnat.W Applicam r Agent
SEE REVERSE FOR EXPLANATORY LANGUAGE