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Home My Public Portal About9557 LAS TUNAS DR_Building__ 79 ..- APPLICATION [wg ®® •yg®p_�Lpq .pp�pry .,. , . ®gPm g��q g�7�p�pp .�qp,. -. 76A63SA CE#BOS:7.56 A 9 tl.- ��tl'C/lamT I O 0'e, FOR.- BUILDING, -tl, Ism 9 �-PERMIT 8,I �Y' BUILDING AND SAFETY DIVISION BUILDING ` i�j ). ��yy ` , " !"E p�ADORESs Departmeitof_County Engineer C Gouat of Los Aa eles. TYLOCALI JOHN A.^LAMBIE:'COUNYYENGINEER NEAREST : ,L,..•Y - C.4SSATT•D.,GR7FFIN, Sup•r OF BULLo1F1Ca CROSS ST:r..' ! - .• - `ammammEamm - DISTRICT NO.; GROUPyp ,• .r 'SEWER 'TMAP ' - FOR.APPLICANT.TO FILL. IN. _ CONST,. �I BUILDING, -. , ('•.. n/ : . IO ADDRESS �J V V�V/ (/ _ STATISTICAL CLASSLFI A-T. N - CLASS„NO: DWELL. UNITS 'LOT NO.. - BLOCK - • _ ST E - NUMBER HWY .. - - li6B NO --T RACT-.,' ., . ... - USEZONE �` SPECIAL'.: :. .. NO. OF BL'DGSc CONDITIONS' - - - sSIZE OF LOT'�•S`(1�-S-!' NOW.ON LOT .• 2 .USE OF. a.7 _ . EXISTING BLDG. / V_RC. v BUILDING: YARDS �HWY STREET NAME - EXIST:. SETBACK WIDTH- " - /Iy�`� �(/��•. 'i/_l=�s{1 �-`Cv FRONT - - 'OWNER� 'ADDRESS ,. � / 'T 1- `� �lC0_ : SIDE ..- - TEL P:L. CITY -f NO.:'• - ARCHITECT DR TEL_(y� INSPECTION RECORD ENGINEER NO..- 9•� " ADDRESS'n sa C ". -C. 4, •` - - - TEL- ��•3 l _ /�,�J r.a Gam. �'�.� CONTRACTOR - .�"U ."�� NO: 't�'//Cjy ADDRESS/6 '.1.a7Y7. DESCRIPTION OF WORK 1 ^ (' -- •� .DEMOLISH - - W A ALTER REPAIR i �SQ. FT. NO. OF NO.OF. SIZE'. - STORIES ' FAMILIES •'- _ - - •USE OF`STRUCTURE •� t I �4 ash/ T - ! 17- APPROVALS SIGNATURE OF_✓V P. '�f _ DATE-, INSPECTOR'S-• -,APPLICANT SIGNATURE ADDRESS ..I d'�a. / �fJc. '77- ' h��p7 FOUNDATION: LOCATION ' - _ FORMS',MATERIALS - aP.,C FRAME:"FIRE'STOPS. 'BRACING . BOL-TS. V / � FEE' . VALUATION — - may • FURNACE: LOCATION. _ •. _". .,e�►' GAS-VENT,DUCTS FEE. - r .. I.HEREBY ACKNOWLEDGE THAT.I HAVE READ,THIS_AP- •LATH:..INT.. - - "•-PLICATIOWAND STATE THAT THE ABOVE IS.CORRECT AND':" " - AGREE TO COMPLY WITH-ALL COUNTY ORDINANCES AND LATH.!EXT - - STATE,-- LAWS REGULATIN-- BUIL_DI -C N R ION. .. — SIGNATURE-OF /�I1�) HOUSE NUMBER COR'- `� :e'' .f�N��^ ►'l�V RECT AND POSTED..=�.• _ ,':-• PERMITTEE - - ADDRESS . ,. ..FIN;4Ln•.. . _. JdkNV A.LAMBIE. COUNTY.ENGINEER, CLYDE N. DIRLAM, PRINCIPAL-STRUCTURAL ENGINEER P AN CS'EC�K VALID T 7 CK. M:O. 'CASH - PERMIT VALIDATION CK. M.0; CASH - .�•.,. � Yom` ''f�y4 �"/�- g-, , p I c 1 BUIL _ B& mum ' 1.- • '.� ADDRESS APPLICATION LOCALITYNEAREST ,.DIVISION OF BUILDING AND SAFETY CROSS ST. .,rt. - r DISTRICT NO.' RECEIPT NO� PERMIT NO.. Department of County engineer 6— _ - / ` �/ �i County of Los'(Angeles• ( j �j / 8 ., ' WM. J. FOX, COUNTY ENGINEER GROUP DATE RECEIVED DATE ISSUED , CASSATT D. GRIFFIN, SUPT OF BUILDING FOR APPLICANT TO FILL IN TYPE CONST. RECEIVED BY ISSUED BY` OWNER VIJ i—•® Q` t _ • �� MAP STATE YES NO MAIL; v NUMBERv HWY ADDRESS . ® - 1.{1 USE ZONE SPECIi4L - - - CITY ' 41 C10'4.0 LtfAX P.0 i L.LL9®" NTEL O;•' (/�' - CONDITIONS - ARCHITECT OR _ - TEL: ENGINEER - :NO. BUILDING EXIST. YARD HWY 8TREET'NAME _ SETBACK 'WIDTH ADDRESS , FRONT " - CONTRACTOR . -®PIC 1.+ 4 �4CN'11;r T`P Ll L, I P..L_. _ - -- - SIDE - ADDRESS. P.L. ... BUILDING' �"{pp{��A•� .. _ Q _ `� ,DATE CORRECTIONS INSPECTOR LOT NO. BLOCK TRACT NO. OF BLDGS. ,} �"--`"!.� /Cfl a /d e C.T' /Q,/'.✓G/•tlC3'P`� _ SIZE OF LOT NOW ON LOT ' USE O F _9-. EXISTING BLDG. > DESCRIPTION OF WORKr'v 0 NEW ADD ALTER REPAIR DEMOLISH . ' s SO.FT. NO. OF NO.OF 6'e- r SIZE - STORIES FAMILIES -• USE OF STRUCTURE p - - !� O=r ( . At A 1;C– eel f r No.of EMPLOYEES - - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS APPROVALS 1NSPECT.OR'BSIGNATURE DATE •CORRECT. - IAGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION ' AND STATE LAWS REGULATING BUILDING CONSTRUCTION.`. FORMS,MATERIALS 1 /wvr FRAME: FIRE�STOPS, ` SIGNATURE OF 1�� 1 �• /� BRACING,DOLTS _ PERMITTE �� ...11Jn�rp� `r w FURNACE: LOCATION, GAS VENT,DUCTS ADDRESS �/r� LATH, INT. AUTHDRIiED AGT. -lam/ J, _ LATH, EXT. d" $: P.C.S - HOUSE NUMBER COR- FEE RECT AND POSTED •/ C VALUATION- III �•� '�,J' FEE ' - d FINAL 76A638A DBS 3 12-53 76A699A C1:f10096.99� APPL�ICA"T'IONFOR BUILDING. PERIVIII' ; �• `.... COUNTY,OF "LOS ANGELES. BUILDIADDR NG L � DEPARTMENT OF COUNTY ENGINEER , BUILDING AND SAFETY DIVISION LOCALITY = JOHN A.L'AMBIE;COUNTY ENGINEER" NEAREST, s CASSATT D.GRIFFIN,SUP•TOF BUILDING CROSS ST. DISTRICT NO. GROUPTYPE nOC SSE.D BY ' FOR.APPLICANT TO FILL IN coNsr: BUILDING �j- - I"SEW R MAP - ADDRESS_ 7 5 -IC-`44.6, rrl/%i//y 5. STATISTICAL CLASSIFICATIOB PG N �j CLASS.-NO. DWELL.'UNITS LOT.NO.. . a�G, '�F� - BLOCK . MAP STATE NUMBER HWY. YES TRACT - �j .7��0 USE ZONE .SPECIAL . ,{ NO.OFBLDGS. / CONDITIONS' SIZE OF LOT�7[.q, }C J�L/ I NOW ON LOT y 9 USE OF_ EXISTING- BLDG. BUILDING0 EXIST. SETBACK YARD HWY TE T ME •WIDTH OWNER -J�/ ,✓. T LJ IY �TEwc,CFa? FRONTMAIL ADDRESS ,)—�� •4F kA s, P:L.. (JZf SIDE .�� TEL./{r P.L. clrY ✓ 1`�"f �%� NO - INSPECTION RECORD ` ARCHITECTOR TEL. _ ENGINEER NO. ' € ADDRESS f ,..i TEL. CONTRACTOR � J -No. DDRESS - - DESCRIPTION F WORK rf �'°� 3cC�� 'NEW ADD ALTE REPAIR DEMOLISH SCl.FT:' NO.OF NO.OF SIZESTORIES: - FAMILIES .. _ USE OF STRUCTURIr Hj a LW S / O p SIGNATURE OF APPROVALS APPLICANT r s '- DATE INSPECTOR'S SIGNATURE ADDRESS FOUNDATION:-- LOCATION - FORMS,MATERIALS P.C S FRAME:FIRE STOPS. FEE BRACING. BOLTS o o s �- VALUATION. li (.` .,$ FURNACE: LOCATION. - FEE 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 A COUNT ORDINANCES D LATH,EXT. ' STATE• LAWS REG U' T N BU G RU N. SIGNATURE OF HOUSE NUMBER COR PERMITiE RECT AND POSTED �- ADDREssFINAL CLYDE N. DIRLAM, PRINCIPAL ST URAL ENGINEER " PLAN'CHEC%VALIDATION CK.' M.O. CASH -PERMIT VALIDATION CK M.O. CASH, 101.2 1 .5 AtiG 13 -1 A. 5'0,0M OF DEPARTMENT OF COUNTY ENGINEER DIVISION OF BUILDING AND SAFETY' u DIN%w .COUNTY OF LOS ANGELES !, . I L WILLIAM J. FOX, COUNTY ENGINEER APPLICATION CASSATT D. GRIFFIN, SUPT OF$UILDING FOR.APPLICANT TO`FILL IN - FOR OFFICE USE ONLY NG // ( �7 DISTRICyNO. PLAN CK.OR REc.No. PERMIT NO., ADBUILD DRE /' 2,41 REC I ED BY DATE OF APPL. PATE IS UED LOCALITY CNEAREST ROSS ST. }R• a- /� �1` ' y �� s y BUILDING `. ADDRESS ty OWNER .,LOCA MAIL • LITY_, ADDRESS. Q . /• V - - TEL. NEAREST t _ CITY NO' CROSS ST.. ARCHITECT OR ,Ir ,�,/g TEL.. FIRE NO. OF GRO . ENGINEER v v NO. ZONE PLANS ADDRESS .. BLDG: - ./ O• SETBACK LINE • TEL• (,q •USE C APPROVED CONTRACTO�J,,, /I'A Ei/.%�;gi/¢), ( A O ZS•d+. + ZONE l/i � BY d DATE ADDRESS o'T• '�� .Y 4A 'y •, _ HOUSEMBERING ,�J'�{��Q LEGAL - MAP NUMBER r//J NO.ASSIGNED BY=_� DESCRIPTION LOT N "� LOCK CORRECTIONS TRACT ��//J - SIZE OF LOT r? S/� / I NO. OF BLDGS. NOW ON LOT USE OFryes _moi NO. OF EXISTING'BLDG. �'/ �+ I FAMILIES DESCRIPTION OF.WORE o RE AADDITION IR H`DEMO(TION .I I. I Z r SO. FT. - NO. OF qq SIZE ROOMS. .9e.o< STORIES EXT. WALLROOF' . COVERING' I 'COVERING USEOFSTRUCTURE I ,APPROVALS INSPECT•OR'S SIGNATURE DATE - - FOUNDATION: LOCATION -' Rv FORMS,-MATERIALS '. - 1 HEREBY ACKNOWLEDGE.THAT t'HAVE READ THIS AP- FRAME: FIRE STOPS, PLICATION AND AND STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS 1 CORRECT. I AGREE TO COMPLY WITH"ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE LAWS REGULATING.BUILDING CONSTRUCTION' GAS VENT, DUCTS SIGNATURE OF //�'��(�� Qj� y LATH, INT: PERMITTER ' y�'vl�rldstlW .®r L/ L'6 / �/J LATH. EXT. ADDRESS / 06 L1fHtt ,4, PLASTER,"INT. - ' •AUTHORIZED.AGT. - . - PLASTER. EXT. $ P. C. S HOUSE NUMBER COR FEE �J RECT AND POSTED VALUATION 'FEE S�r/ �:'- FINAL 76ASSOA..089'9 8-8II .. , T3.9-44 .1ZTMENT•OF BUILDIlVG ANIX SAFETY APPLIGATION FOR PERMIT a I , COUNTY-OF LOS'-ANGELES TT •WNI J.'FOX, CHIEFENGINEER rrs• � 4, ly� NO. OF• -B LDG. ORD NO j PL .P ;PLANS SETBACK LINE.-, _ DISTRICT NO, • SAN CK .• PERMIT NO ` ' ,,:�--• APPROVED - RE -ZONE -BY ' DATE IV TE" F DATE ISSUED. ..USE. APPROVED 1 OF A PPL. zoNE. BY APPLICANT FILL IN H•E' � .. DATE �.. . Nx AVILY :OiJ T LIl�1ElD PORI"IO1�1�'ONLY BUILDING 'O lti NAME fid �i: .:,ADDRESS / '�� 6' •`r 'r` 70£L' �S". - 'W Z 'ADDRESS •'_i' "LOCAL ITY 3 I Z. y ` V NEAREST "'. ` ''• . ,UEW CITY - s=, L CROSS ST.' Q. "STATE TEL y j}¢j�)�j LICENSE NONO P Q. NAME {J�.,, .^' r"'V Z MAIL Y NAME. •. - �;.. _ADDRESS T .` , 'ADDRESS •., ,eT. . ,`� �,,.. CITY m�° NO... Q ?- CITY, - C ' �- I HEREBY ACKNOWLEDGE THAT 1�HAVE READ THIS , O M APPLICATION AND STATE THAT:THE ABOVE IS CORRECT U STATE TEL. " AND AGREE,TO COMPLY.WITH ALL COUNTY ORDINANCES LICENSE-NO.:. NO.'. �y- .AND STATE.iLAWS REGULATING BUILDING CONSTRUCTION. Z - -10 LOT NO. SIZE 10F.LOT { ` @ 4'SIGNATURE OF p s OWNER �/ J F, ,. ,. NO. OF:BLDGS.: .!`D .+'v,/ J:• ..w ., '•.,a'�_.,. Q,0. BLOCK - NOW.ON LOT AUTHORIZED AGT. O � _ U tCORRECTIONS W TRACT l.. D USE OF B_ LDG$. r -NOW'OIV LOT �F '� �'e+'E3n1iG-"2 d:x`> �y t�e`t ,.. ,.:; DESCRIPTION'',OF WORK USE OF BUILDING: a ANEW .-. T.YPE. •'$;,. GROUP ..}, .. `, ALTERATION-. ,'ROOM$ FAMILIE§.,r - - 'ADDITION :SIZE eP.wdo • - �x a REPAIR•. " STORIES MOVING' WALL-COVERINGV DEMOLISH ROOF:,COVERINGP.. `•�lG'7,� '.,t�• ` '-,FEE $ FINAL APPROVAL' .. i•. .�'�" $ INSPECTOR'S NAME VALUATION FEE � "' DATE —/I ve,I DBS-3 25M SETS B-45 DEPARTMENT:.OF.BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES - qN WM:"J FOX, CHIEF ENGINEER , 5c 9 l ' < 3 FOR,OFFICE U$E;.ONLY F.OR,.APPLICANT TO 'FILL IN :- t I, DISTRICT NO. PLAN, CK NO -PERMIT NO BUILDING _ i ADDRESS '�. ! "-C? I•:: 65" �. JS g'laf3/" 6 - ,,• J'� 5� a . / , � RECEIVED:•Blf. :DATE OF•APP/Lr.._ DATE ISSl1ED LpGALLT`f ..LI c 1 1 fl NEAREST' CROSS ST. .,t.�t..aLs'+.h� . �.g .f SOILD `•ADDRE'SS "1 �es'I ,^ eL At aC••f� d-e-�Y ,OWNERMAIL ADDRESS '- V3, � ._ . �..�5 e� '�`�' �c �. 'LOCALITY - - • NEAREST CITY'C.�J�P_.C!!K'�f ? _ NOL - ' .'CROSS'_ST ..y"-� •# ` 'y't`"� . �_ .• ` - '-FIRE :AL.TYPE ..GROUP ARCHITECT ORS }-TEL . ZONEz .�'.PLANS "ENGINEER - C u�,NO PLANS •�'=e r ° ORD NO ADDRESS i �'{ �; - :SETBACK LINE..- ` q,cam r ".APPROVED CONTRACTOR' ` ` tX*,`NO. Q+r .: '`BY`.. .. 'USE APPROVE ADDRESS- ` � d � - lSl.:y4.+a'ti. ., �ZONE,d.,- SY �g - �<DATE_ �- _ LEGAL ORR CECTIONS aDESCRIPTION .:''I' LOT'NO.yt' ' BLOCK-"• "'—'---^ - ,TRACT•_.�v - •. i NO. OF SLDGS - F_ •�SIZE-OF.LOT` � ', • I NOW ON_LUT �,':' USE OF ' � � p ". NO..OF .NO. OF EXISTING"BLDG.: ox1 FAMILIES J�I.ROOMS• DESCRIPTION'OF WORK . 9 lit rr► D ' ' NEW r - ALTERATION ADDITION '� `.�.�� `.:�f�LliiiU' f/.rLfiz,9/,/P� ./dJ,/' b•1tF=�7�' :'� REPAIR: MOVING DEMOLI5H, �- LsL,w///Lfn/ �....;/, w".' r' P,r.. -�.f.�-. .A't2h ✓, p_ - r NO. OF _ .':SIZE 'Q ROOMS' STORIES %' �.-r .�^'�i1�,a�� ./�(lf./�t4.,, �.�'fiQ r WALL ...E ,....ROOF`. •COVERING COVERING ' 'USE OF NEW ,,````` - ,'BUILDING7. i AIL 11 Als ' • = -APPROVALS. n k 1. HEREBY ACKNOWLED BE THAT 'Y HAVE. kREAD F<TH15 ' - - - -- 'APPLICi4TION.-AND STATE THAT THE�,ASOVE. IS CORRECT 'FOUNDATION LOCATION, . §� INSPECTOR, ✓'DATE" .-. AND AGREE TO, COMPLY WITH,4ALL COUNTY'`ORDINAN CES -FORMS,--MATERIALS. .• t}.� I;I L f Y AND STATE LAWS REGULATING.BUILDING CONSTRUCTION '.v.FRAME: FIRE-'STOPS-` 1 BRACING BOLTS •6 -� � � SIGNATURE A OWNER. - _r.: LATH, IN-f.- W. `.V I` _ . A d AUTHORIZED. GTS �_ ' .. I LATH,�EXT.IA P. C. I - ... � d ,PLASTER INT. Iwo FEE -,PLASTER,,* EXT. _ �l FEE` FINAL ;VALUAT.ION.. - ,7.6A638A CEu803 8-64 .APPLICATION FOR BU IL I.NG P .t'T-' COUNTY OF LOS ANGELES , t B U I L o I N c:- • DEPARTMENT OF COUNTY ENGINEER AooREss: S ar BUILDING' AND SAFETY DIVISION LOCALITY . E JOHN A. LAMBIE. COUNTY ENGINEER NEAREST COLEMAN W.-JENKINS,SUP'-T.OF BUILDINGCROSS ST. C ' r _ DISTRICT G'ROUR TYPE - PR ESTE BY FOR 'APPLICANT TO-FILL IN 5' CONST: BUILDINGST'ATIST.ICAL CLASSI KATION' 'SEWER MAP ADDRESS - CLASS NO.T9 DWELL UNITS BK '''PG. ' LOT NO.- BLOCK USE Z E MAP• NO..; TRACT SPECIAL t .. NO: OF.BLDGS. CONDITIONS SIZE OF LOT -. NOW ON LOT /''•. - :.. _ :: - USE OF EXISTING BLDG. BLDG.'SETBACK FROM - _TEL. FRONT PROP.-LINE OF (STREET) OWNER Z Q O. .TYPE OF_._ .EXISTING SETBA_ HI OH,WAY +.'.,,YARD ,-= TOTAL. ADDRESS L/ .- - HIGHWAY WIDTH 'FROM C. -CITY ! BLDG..SETBACK FROM,... ARCHI ECT R- •TEL. - - vvi ENGINEER U `ONO. 3 -SIDE PROP. LINE OF (STREET) _ TYRE OF EXISTING SETBACK_ HIGHWAY + -YARD'- -TOTAL . ADDRESS b HIGHWAY WIDTH FROM C.L. - ��, _. _ d CONTRACTOR ' UNZ SI /J TNO EL 3 �. / _ \\+ _ �O IADDR.ESS'i rrjO CORNER YES NO - O CITYJJW N cl Ss 'SEE.REVERSE SIDE FOR SPECIAL.APPROVALS u - .. • .. Lu DESCRIPTION`OF.WORK CL Z NEW 'ADD ALTER -REPAIR. DEMOLISH" , SO.FT.. // 'NO. OF NO. OF SIZE (O - -STORIES FAMILIES - - - USE.OF STRUCTURE '•Qi "' - pC c C� S AJ SIGNATURE OF ' -APPLICANT 'PT VALUATION$ l�v♦ _ APPROVALS DATE - INSP.E;TOR'S,S IGNATURE P.C. - 'PMT. O FOUNDATION, LOCATION - - FEE$ FEE$ - 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 9UILDING CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK _ ..AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN'VIOLA- LATH. INT. 'TION,OF THE LABOR CODE OF THE.STATE OF CALIFORNIA RELAT- ING-TOWORKMEN'S IFTP�'T�SATION IN A ICE. LATH. EXT. J SIGNATURE •HOUSE-NUMBER COR- _'-' PERMITTEE RE.CT.AND-POSTED -ADDRESS F I N A L a-'�� ,� by',• • JOHN F: LEWIS..P.RINCIPAL STR T RAL ENGINEER' PLAN�CHECK'VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH +• o 6 t . 0 7 OCT D 4.0 'i WORKERS'COMPEN�SATIA DECLARATION insure, or afcertif carte f°Workers' Compensatioa certificate of n eIInsurance, APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING KS11❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS LOCALITY NEAREST �Dle Applicant CITY ZIP CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR C' COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL d (This section need not be completed if the permit is for one USE ZONE MAP L) hundred dollars ($100)or less.) TRACT BLOCK LOT NO. NO. W TEL. SPECIAL I certify that in the performance of the work for which this OWNER NO. CONDITIONS LL permit is issued, I shall not employ any person in any manner DISTRICT I GROUP TYPE I FIRE PROCESSED BYADDRESS CONST. ZONE � so as to become subject to the Workers'Compensation Laws. Q CITY ZIP Date Applicant STATISTICAL CLASSIFICATION APT. CONDO. 0 NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. (LExemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be ~ deemed revoked. TEL. BK. PG, VALIDATION CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY CLASS $ Poo. FT. NO. OF NO.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE Contractor Date DESCRIPTION OF WORK NEW ❑ $ ❑ I am exempt under Sec. ADD ❑ ALTER ❑ FINAL B.&P.C. for this reason ❑ DATE REPAIR Date: USE OF FINAL EXISTING BLDG. DEMOL ❑ By Signature APPLICANT TEL:" OWNER-BUILDER DECLARATION PRINT NO. I hereby affirm that I am exempt from the Contractor's License , Law for the following reason (Section 7031.5, Business and ADDRESS 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 the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY REQUIRED TOTAL SETBACK FROM EXIST. 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. z (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name Lender's Address P.C. Fee$ - Permit Fee I certify that I have read this application and state that the Issuance Fee a above information is correct. I agree to comply with all County Investigation Fee f ordinances and State laws relating to building construction, Total Fee u and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. o SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date ®s I -APPLTION FOR BUIL®ING PERMIT ' ,_ C NI, OF ES �4 —� BUILDING AND SAFETY OU ,LOS ANG . = FOR WPPLICANT TO FILL IN t. �D ADDRESS WORKER'S`COMPENSATION.DECLARATION - - S . `3J Rte- 7 ..'. � BUILDING ADDRESS' I:tiereby,affirm that I have a certificate of consent to self insure, t•' T } ` 6t 55-1: .x. L � a►�1 or a certificate of Workers' Compensation Insurance,.or a certified CITY S' ZIP c copy thereof"(Sec.3800,Lab.C:) , EM�L� C /] ' C� LOCALI Policy IN 1 Company,...S��E w�� - SIZE OF.LOT - ,- N0.OF BLDGS.NOW.ON.LOT ❑ Certified Copy is,hereby furnished. - - - NEAREST CRO ST. - ertlfied'copy is filed with the county building inspection TRACT •" BLOCK LOT NO. �` -USE ZONE MAP NO. - :department.' ' •` Ca - ASSESSOR•MAP BOOK " -PAGE"- PARCEL - _ - Date L—13 tSApplicant NPILA�'i� F' C�•` V SPECIAL CONDITIONS - . . - -OWNER - - TEL NO._..- - CERTIFICATE OF EXEMPTION FROM WORKERS' p CQ ~G COMPENSATION INSURANCES NE STl'fJF} ZB�.- (J v WITHIN•1000 FT.OF SCHOOL? YES 'NO ADDRESS (This section.need not be completed if the permit is:for one'hundred DISTRICT GROUP TY CONST:"FIRE ZONE PROCESSED BY dollars($100)or less.) q5 S-1 E' —Tt�1JS �IZ, : . •> CITYZIP- I certify that in the.performance of the work for which this permit is issued, P stiall not employ-any person in any manner so as to �'L L 1�� D� ' mss• become subject,to'the Workers'Compensation Laws: ARCHITECT OR,ENGINEER TEL NO. - '" STATISTICAL'CLASSIFICATION T - - -- `APT CONDO ' Date'VAe SAPplicant ��Yd�L�IuL�l�ar ADDRESS CLASS NO. DWELL UNITS NOTICE .TO ,APPLICANT.' If,.after making this Certificate-.of. REQUIRED TOTAL'SETBACK FROM 'EXIST Exemption; you should .-become subject, to, the Workers' CONTRACTOR TEL NO. - - SET BACK YARD HWY PROP LINE" VNIIDTH Compensation provisions of the• Labor-Code, you must forthwith � L Y►1 Z`LS— [C)l` FRONT. comply with such provisions or this permit t shall be deemed revoked. ADDRESS LIC:NO. P L LICENSED CONTRACTORS DECLARATIONiZZ V-.5 + SIDE CITY" - - LIC.CLAS—SSC PL I hereby affirm that I am licensed underprovlsions of Chapter 9 em LE C- C SEWER MAP. > (commencing with Section 7000)of Dlwsion'3 of the'Business and SQ.FT.SIZE NO.OF STOR S NO.OF FAMILIES. O Professions Code,and my license is in full force and effect:' NEW ❑ BK PG, " O License Number Lk-3-S33Lic.Class 'C- DESCRIPTION OF,WORK ADD, ❑, VALUATION O Contractor Av11GC rr'i Date' Z' 13 9 S "i F ALTER. ❑ $ `1 L S t e/LJ v 5 Alla I�S �U1L REPAIR ❑ CL w El I am exempt under Sec. Z BAP.C.for this reason >Jp FI$ M(:)p :SPEMDEMOL El LDMA P/C#, . Date:" ,z � URM.. .D Signature P LICANT(PRINT) TEL NO. LDMA Perm# - f s 1 ❑;I,:as owner of the property, or my employees with wages as .-• �0 CAD 12-f5!-17* ` Z 'their sole compensation,:will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and '�12 U C• \t /OZ� FINAL DATE Q 1 Professions Code.) - +-� ,_F i • - WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A;HAZARDOUS•MATERIAC �. _ -J - J • OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑1, as owner-of the property, am exclusively cOntractmg With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? Q s 5 licensed contractors-to construct the project (Section 7044, FINAL BY > -. )q YES El NO 1:1, -..I.y 4.I:i_«.. Business and Professions Code.) ; IT(�t� WILL THE INTENDED USE OF THE BUIDLINGBY THE APPLICANT OR FUTURE BUILDING - - •• OCCUPANT REQUIRE A'PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING` AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR -. GUIDELINES. hereby affirm that there Js a.construction lending agency for YES❑ No❑ L;i )�3_ 4 'iso 1�.•-_ ' -'� the peffofmanCe Of the Work for which this permit IS ISSUed(Sec. .I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING - --. - .'-eLE _, - . I"' 3097,CIV.C.) - - - CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. _ _ _ ..lii_� _ ., a - - TITLE 2,CHAPTER 2.20'SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS - Lendef SI Name _ - MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. o Lender's Address O - - OWNER OR AGENT , o I certify that I`have read this application and state under penalty O .of perjury that'the above information'is correct. -agree to comply 'P•C.FEE - PERMITTEE - - - o with all county ordinances and State laws relating to building �s✓�( constru ereby authorize representatives of-this County ISSUANCE FEE co er u n the ove-me n"ed property for inspection purposes..' 2 INVESTIGATION FEE - - TOTAL FEE " , 3 SRnat—d APPIK m m Agent Date - SEE REVERSE FOR EXPLANATORY,LANGUAGE WORKERS' COMPENSATION DECLARATION I here,y affirm that I'have a'certificate of'consent to self PPLICATION FOR BUILDING PERMIT . insure, or a certificate of Workers' Compensation Insurance • 'e or'a certified copy thereof'(SSeCec:3800, Lab. C:) - - �i37�?npany i0 PolicyNo. . 1. COUNTY OF LOS ANGELES BUILDING AND SAFETY Certified copy is hereby furnished: FOR APPLICANT-TO FILL IN ' ., «�--, q�oaess' - Certified copy is.filed'with`thb coun y building inspec- BUILDING //' ^ tion dep Tment. -. ADDRESS' / [ ' -• ;Dw,-9-S LOCALITY> NEAREST e ( K,c n G9 CITY C ZIP !J Oz CROSS ST. CE I CATE OF,EXEMPTION FROM WORKERS' NO OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF.LOT NOW.ON LOT MAP BOOK. PAGE PARCEL ' hun(This sec ti n need not be completed if the permit is for one. ONE MAP hundred.dollars ($100)or less:) TRACT - BLOCK.' LOT NO. s-7,u NO: r - .. T `- i (�_ SPECIAL ' USE Z OWNER NO / CONDITIONS d 1 certify':that.in the performance.of.the work for which this _ permit is issued, I shall not employ any person in any manner ADDRESS �(J.f/ DISTRICT .GROUP' TYPE,' FIRE . PR E ED'BY O so as to,become subject to the Wor s'Ciom ati Laws. C `�(� CONST ZONE CITY r—� ZIP 12 0 J Date Applican "� STATISTICAL CLgrrrS+++SIFICATION_•-. fiu'v APT. C DO. 0 . NOTICE TO APPLICANT: If,. after making'this Certificate.of ARCHITECT OR TEL: V ENGINEER O. , CLASS NO.- �/�' 'OWELL.UNITS u1 Exemption, you should.become subject to' the Workers' 9L Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP,1 with comply with.such provisions or this',permit, shall be ' TEL: VALIDATION deemed revoked' CONTRACTOR NO. BK. PG; 'LICENSED CONTRACTORS DECLARATION•'' Tic. I hereby affirm•that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION .: (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code,-and my license is in full force and effect. CITY CLASS $ �� SQ::FT; °`NO.OF NO. OF CHECK ; License Number Lic:.Class SIZE STORIES FAMILIES ONE ` /T�I� NEW• $ Contractor Date DESCRIPTION OF WORK lit/ ,`��, ADD....Q I am exempt under Sec. >i1a _ ALTER � FINAL+ D`A7E B. C: for i j reaso l _ REPAIR. ,3.8 5 4-A& GLe.1 vYN Date: /J � USE OF DEM # o!a'0 0.'2 3. ' EXISTING BLDG. -. FIN .: , ignature APPLICANT' �' TEL.. _ I ° ® 3.7,.5 0, ey OWNER-BUILDER DECLARATION PRINT '� lir�f NO. J hereby affirm that l am exempt from the Contractor's License 3 Q' Law for the:following reason (Section 7031 5-Business,.and ADDRESS 5 7' Professions.Code): : PRESENT BUILDING ADDRESS 0 86. F; as owner of the property,,or my employees with 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 exclusively contracting CONTRACTOR NO. with Itcerised•contractors to construct the project'-(Sec- FADDR tion 7044, Business and Professions Code). �.3(� .Q TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING.AGENCY-' YARD HWY PROP. LINE WIDTH #'o,°,e ° °tA( I hereby.affirm that there is a construction,lending agency.for. - r - - `o,0 4 Q 5.'Q the performance of the work for which'.this permit is issued • o.o Q Q`fJ (Sec...3097, Civ. C.). (� p1,24 i} .Lender's Name• .. - Permii Fees3��d _ Lenders Address' I certify that I have,'read this application and state that the. Issuance Fee Id t J above information is correct. I a ree fo com I with,all Count � •` 9 comply Y Fee 2 g ordinances and'State laws relating to.building construction', Total Fee v d and hereby authorize representatives of,this County to enter upon thea mentio " d propert f iPspection purposes. <.. L / �� SEE REVERSE FOR EXPLANATORY LANGUAGE ig ature "-®3 of Applicant or Date -