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Home My Public Portal About6209 LOMA AVE_Building__ . PLICA`fION FOR, BUILD) PERf� T.. - FOR APPLICA TO FILL IN (Print or type onN)'�`' ` �?''y BUILDING - ti ? COUNTY.OF LOS ANGELES ADDRESS . :. f - _ DEPARTMENT OF COUNTY ENGINEER- city � '' ' �' zIP ��"' BUILDING-AND -SAFETY DIVISION...- r,NO.OF BLDGS. - BUILDING ` - SIZE OF LOT /` � NOW ON COT ADDRESS TRACT BLOCK LOT-NO" LOCALITY �jJ TEL l�f,�,p� �, NEAREST ' OWNER . ,�/, -.. �Y./ e�.NO. ` J 1�.7� CROSS'ST.`. ".: �fl/. '�>s ASSESSOR ADDRESS �,r �6'J- e EMAP BOOK - - '- PAGE PA-RC DISTRICT -GROUP TYPE FIRE PROC -SED BY C.ITY �✓ f r'�'� ZIP '/_ �.. - C-ONST. ,.ZON -.- (j•\ qE, ARCHITECT OR TEL. ENGINEER NO. - - ' _ STATISTICALCLASSIFICATION SEWER MAP, ADDRESS r T CLASS NO.— _DWELL,UNITS BK PG CF ;.TRACTOR' -- - - NO.TEL. 'USE ZONE MA:P ,3 ., . _ LIC. NO. A ,ESS NO. ^� ' SPECIAL - _ LIC. !!! CONDITIONS C -,Y --- -CLASS .. _ ROAD DEPARTMENT APPROVAL REQUIRED YES NO 0 NSTRUCTION LENDER } N ME AND BRANCH BLDG.SETBACK FROM ' d FRONT PROP.LINE OF - (STREET). - C ADDRESS ' - - -CITY' - HIGHWAY } YARD TOTAL SETBACK FROM TYPE OF EXISTING SQ. FT. NO..OF. NO. OF _ CHE'CK.. FRONT PROP. LINE HIGHWAY WIDTH. FC- ;SIZE 6v� STORIES FAMILIES ONE - - U } DESC RIPTION OF WOR NEW " - _ ❑ BLDG,SETBACK,FROM Z ADD .SIDE PROP. LINE OF (STREET) t - ALTER _ TO TA S\ TBAC-K FROM TYPE OF EXISTING H IGHWAY 4-.- -YARD' i HIGHWAY WIDTH .W Ea-6 REPAIR❑ SIDE'P OP. LINE SE OF S2 .EXISTING BLDG. ,DEMO L. ❑ - - ' APPLICANT TEL CORNER CUTOFF. YES NO ❑ (PRINT) NO. - ` IN,OF EN,S PA CE ..,. YES ❑ NO.❑ _ B-YOSIGNA'TUR'E) JYj 9� IN COASTAL ZONE YES❑ NO ❑ - . ..., -- .. VALUATION •V 0 _. .� .. - ...� - -� CATEGORICAL EXEMPTION YES)❑ NO ❑ I HEREBY ACKNOWLEDGE THAT_I HAVE READ THIS APPLICATION ENV9RON MENTAL ANO STATE THAT THE;ABOVE 1S, CORRECT AND,AGREE,TO COMPLY IMPACT EXEMPTION'DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED_ - IMPACT REPORT PROCESSED (DATE) HEREBY I 'WIL.L NOT EMPLOY ANY 'PERSON I'.N VIOLATPON OF.THE LABOR CODE OF THE--STATE OF_CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION I SURA/y�E. Il Y. /vonc6 SIGNATURE OF :AF PERN1ITTEE - ADDRESS 'TEL7.ijy ',I/�'/P` FINAL BY CITY E';d4" .� -NO DAT. P.G.. MAKE CHECKS PAYABLE 70: FEE. PEE l _ p HARVEY T. BRANDT. COUNTY ENGINEER `I, 7 .PLAN-_CHECR_.VALIDATION CK. M.C. CASH PERMIT VALIDATION cK. M O. CASH MAY; 9 1: ID ,2 1.75 A9Z 76A638A- CE#803.7/73 C pp ,r i PERMIT 76;�538A CE�803 5-65 APPLICATION FOR BU ILDI- G _ - � COUNTY OF LOS ANGELES BUILDING/� DEPARTMENT -OF COUNTY ENGINEER ADORESSU� BUILDING AND SAFETY•DIVISION L o C A L 1 r - - - _ JOHN A. LAMBIE. COUNTY ENGINEER' NEAREST COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS ST. - DISTRICT NO. GR UP-. "T -P E,, P C S�E�D Y: -; - FOR APPLICANT TO FILL IN NST. ' 0_ BUILDING /J� lem y�E�� STATIST.ICA--L�7'C�LL4 IFICA,TION ., - SEWE.R'MAP.-'- ADDRESS. !L+' � G �' V) / CLASS NO. DWELL,UNITS LOT NO. 4 -- �0 BLOCK USE ZONE--. MAP 2- �•.',i NO. TRACT ,5 `r - `: l SPECIAL NO. OF BLDG S' LDGS. r ` CONDITIONS .SIZE OF LOT T� I�'JQ� NOW ON LOT ? USE-OF •�/ 1 - -- - - - - EXISTING BLDG. •/J i/n, ^on d T rage BLDG. SETBACK FROM EL. FRONT PROP. LINE OF - (STREET) OWNER IIS, ii i O• b�3Yf36 TYPE OF •'EXISTING SETBACK- HIGHWAY + YARD --TOTAL - HIGHWAY WIDTH FROM C.L. - - --•- - - ADDRESS, O .r L6 fef C - CITY F/97 I� Ci' C /�,Qy�� - .. ARCHITECT O TEL. BLDG. SETBACK FROM;,., ENGINEER - NO. SIDE PROP. LINE OF B _ .(STREET) r TYPE OF- :EXISTING SETBACK'- HIGHWAY -j- ` YARD' '�-� TOTAL - ADDRESS •� HIGHWAY WIDTH FROM.C.L. TEL. CONTRACTOR NO ✓ - a` LIC // CORNER C U.TOFF :.YES � - NO ADDRESS - NO - _ GL CITY / LIC SEE REVERSE SIDE FOR SPECIAL APPROVALS' OF :DESCRIPTION OF WORK W a: NEW ADD ALTER REPAIR DEMOLISH - Z SQ.FT.. / NO OF NO. OF. I?" k -D _4. r.l'-.-.".. .. .:..•. SIZE J STORIES l'` FAMILIF-S' USE OF / �0� - STRUSTURE Fj •- - ' SI NAT-URE OF AIPPLICANT VALUATION$. 3 o,.-( APPROVALS- -DATE ` INSFECTOR'SASIGNA7ORE P.C. "- .RMT. FOUNDATION; LOCATION- FEE - FEE$ FORMS, MATERIALS.- J' ._ FRAME, .FIRE STOPS, I HEREBY ACKNOWLEDGE THAT.,I HAVE READ THIS APPLICATION I BRACING BOLTS AND STATE THAT THE ABOVE 15'CORRECT AND AGREE TO COMPLY FURNACE: LOCATION WITH ALL COUNTY ORDINANCES AND'STATE'LAWS REGULATING GAS VENT. DUCTS - 9UILDING CONSTRUCTION.- I CERTIFY THAT. IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT-EMPLOY ANY PERSON'IN:VIO LA.' .LATH. INT. ' 'TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S COMPENSATION INSURANCE. oLATH. EXT. •, �I-�G� _ SIGNATURE OF � _ �h/ HO USE.NUMBER COR PERM q - - ! !� RECT AND POSTED y�+ �`° '•�--'�-- .. ADDRESS C/ I/O./ ✓ "• F I NAL /•�3 ..^�✓ "m"�''•^�. - - - JOHN F. LEWIS.'PR,(NCIPAL STRUCTU_RAL ENGI - PLAN CHECK VALIDATION CK:' M.O.". CASHPERMIT VALIDATION ` - � SCK.- ,-M.C• -'- ASH - 76A638A C.E#803 8-63 A e LICA ! IO•I FOR BUILDING II LR,YI.IT .... COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF.COUNTY ENGINEER ADDRESS a .20 v BUILDING AND SAFETY. DIVISION LOCALITY. jyy� JOHN A. LAM'BIE. COUNTY ENGINEER NEAREST 'WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST.., C� 7 - DISTRI�C.^T�' O. GROUP` T PE r PROCESSED BY FOR APPLICANT TO FILL IN 5.t/ CONST.= C� BUILDING C� `� - STATISTICAL CLASSIFICATION. S ER MAP ADDRESS V / i/ (�.�7-L(.✓ .. - _CLASS. NO.'_F_DWELL. UNITS BK _ PG LOT NO.= e "��{, Q�•_ qIP BLOCK WATER - CERTIFICATE: NOTRECEIVE D' El TRACT MAP NO E (CIRCLE) STATE'MAJOR SECOND,-'LOCAL IGHWAY NO. OF BLDGS. SIZE OF LOT NOW ON LOT USE ZONE SPECIAL USE OF _ CONDITIONS EXISTING BLDG. .. TEL. OWNER - NO. / //31- BUILDING EXIST. SETBACK WIDTH- YARD HWY" - STREET NAME ' ADDRESS FRONT ARCHITECT OR -TEL - P. L. - ENGINEER NO. 'SIDE P. L. ADDRESS - - d TEL. CONTRACTOR 0.. ADDRESS • °� - 0 DESCRIPTION OF WORK W NEW` A ALTER - REPAIR DEMOLISHCL -C SQ. FT. NO. OF NO. OF SIZE STORIES FAMILIES USE OF r STRUCTURE SIGNATURE OF APPLICANT- VALUATION APPROVAL'S - DATE _ INSPECTOR;,S SIGNATURE P.C' - PMT. FOUNDATION: LOCATION FEE S. FEE S U FORMS..MATERIALS FRAME: FIRE STOPS. ' -- � .., ' I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING: BOLTS AND STATE THAT THE ABOVE ISCORRECT AND AGREETOCOMPLY FURNACE: LOCATION. WITH ALL COUNTY ORDINANCES AND 'STATE LAWSREGULATING GAS VENT. DUCTS - �j+p/'/: - At"-„o Off BUILDING- CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK T. AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING 70'WORKMEN,SCO ATION INSURANCE. i LATH. EXT. : SIGNATURE OF _ HOUSE NUMBER COR- PERM ITTEE OR PERMITTEE ll a�+��)� RECT AND POSTED + - ADDRESS �A•9ra _3�-tC,44cla/. / 4 FINAL JOHN F. LEWIS. PRINCIPAL ST URAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK. M.O. CASH Lata 5 6 2 6G NOV � � 0ro WORKERS"COMPENSATION DECLARATION I ea affirm that I have a certificate of consent to self insure, or a eertificate of Workers' Compensation Insurance, AP LICATION, ®R �'Iee®I N C� P ER T .� 3800'Lab. a., ' or d ceFtified-copy thereof{Sec:' ) ` '. � • 1. • COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No6ompany l S•�f l`- .�li D _.. - BUILDING ' ri Certified,;copy is.hereby'furnished•. FOR APPLICANT TO FILL IN ADDRESS 't W )� Certified copy is filed with the county building inspec- BUILDING / . ' tion department? w ADDRESS Yj2-6 Lo^ z- l L.r l C (T I + i �i CITY �1 .. 'G _ ZIP c (J .,`. Date '(S ' "Applicant" LOCALITY y -'NO. OF BLDGS: -- NEAREST. CERTIFICATE OF EXEMPTI N FRO WORKERS'` "� COMPENSATION'INSURANCE SIZE OF LOT NN ON LOT CROSS Sr. (This"section'need'not,•be+completed if'the per, is for one -• - - - ASSESSOR ;; V y 'tu hundred,dollars ($100)or less.) O Y PAGE PARCEL _ _ TRACT BLOCK LOT NO. MAP BO K c OWNER'��' ( �� NO:�n-� I 1. USE ZONE OP I certify that in the performance of:the,work for which this +" ' 3 permit is issued,'I shall"not employ any person in any manner (} I-}a I i -• SPECIAL so as t i become subject to the.Workers'Compensation"Laws.' ADDRESS ( �a 1f 1��ti. t''•r CONDITIONS O.. „ .c .;< .. •• CITY Date Applicant NOTICE TO APPLICANT; If, after`making 'this`Certificate of ARCHITECT OR TEL, O ENGINEER NO. O a_ V Exemption, you''sHould become subject.to'the'Workers' R/�� • ,.DIST v GROUP_;.,TYPE :•.FIRE _ PR CESSED BY 7 CONST:' -ZONE _ Compensation provisions of the Labor Code, you must forth-. ADDRESS l f. 1 CL 'n Lf_ R � with comply with:such provisions or this permit.shall be ;•. - TEL �' STATISTICAL CLASSIFICATION APT. CONDO deemed revoked.'' - CONTRACTOR NO.Z LICENSED CONTRACTORS DECLARATION.,. - LIC: CLASS NO. _DwEll. UNITS I hereby affirm that I am licensed under provisions of Chapter ADDRESS �r ( �' NO. Z (commencing with Section 7000)of Division 3 of the Business and' _ _._ _: _LIC--- '--- - ---•' SEWER MAP Professions Code, and my license is,ln full force and effect. CITY �L L ,Girt~ CLASS _ 'VALIDATION 1 License Numbe 42'7. Lic.Class , o STORIES FAMILIES CONEK SQ. FT, BK - SIZE VALUATION ` �/' (— DESCRIPTION OF WORK eIAJ NEW ---7 ; Contractor Date+ v ADD a � O� 4 ❑ I am exempt under-Sec. ( �.Y�..� �' P ❑ ®. _ Y.. ALTER B.BP.C. for this reason _. REPAIR ,i 0 Date: USE OF DEMOL Q EXISTING BLDG. - , _. _ APPLICANT .TEL 'e; ,Signature - ZU FINAL. ��},�1 NO. 285 ?5225A OWNER-BUILDER DECLARATION (PRINT) C v ��`�1`� DATE - •1 hereby.affirm that-I am exempt from the Contractor's License �{� Law for the following+°reason (Section 7031.51Business and ADDRESS I� 71� TSVC ' T C FINA• y , #'o e o o0 1 Professions Code) '' PRESENT + BUILDING �_ e.E, h �' I, 'as owner of the property or my employees-with ADDRESS _-.••_ _ r ` I ;_ 28.2.00 wages as'their sole compensation,will do the work'and t\h `F`� ` r ' o 2 c=i the structure is not intended or offered for sale(Section LOCALITY �! - 2.0 0 ` -7044, Business and Professions Code): '' - MOVING" - °" ."" `.-""TEL. - • _ �{ -.__ _ u_ < - •- 8 I, as owner of the property, am exclusively contracting CONTRACTOR NO. +1 1 `8 6 ❑` with licensed contractors to'construct:lhe project(Sec- 0 8,11 ADDRESS f t t tion 7044, Business and Profess ions-Code). +N REQUIRED. YARD' HWY' TOTAL SETBACK .FROM.. EXIST. CONSTRUCTION LENDING AGENCY SET BACK PROP: LINE WIDTH:. I hereby affirm that there is a construction lending agency for FRONT E l !F` % r++ + the-performance of the work for which this-permit-is-issued P:C'- � . .(Sec. 3097,.Civ. C.).. SIDE 5_ , • r lendeLender's Name 4 _ -. -..._ ...r - '•° P.C:-Fee$.._f...�, - _..... PermiiFee lS TDMA Ref.'# Lender's Address' w J certify that.l have read this;application.and,state,that the _`_ :M.Issuance-Fee• LDMA•P/C-'# -• " --••-- �= j above information is correct. I agree to comply with all County Investigation Fee /�q) ordinances_and' o State laws relating-to building cnstruction Total Fee p�-_g: -tU +�-' CDMA Perm-#,- - - - - d and hereby auth rize representatives of-this County to enter T t upon the ob vel ent' property for inspection purposes. l L� ti SEE REVERSE FOR EXPLANATORY LANGUAGE _ . -. 'Signature of-Applicant or ent'• .. Date