The URL can be used to link to this page

Home My Public Portal About9430 LEMON AVE_Building__ 76A638A CE#803 5-65 APPLICATION FOR 'BU'ILDI G PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY- JOHN OCALITY-JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W JENKINS,SUP•T OF BUILDING CROSS ST DISTRI['T NO OU TYPE P S FOR APPLICANT TO FILL IN CONST BUILDING STATISTICAL �k�eGSI FIC TION - SEWE MAP ADDRESS S13o GC/ Ort/ _J�' EEK PG CLASS NO DWELL UNITS LOT NO BLOCK USE ZONE MAP NO TRACT SPECIAL NO OF BLDGS CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXIST NG G eSF BLDG SETBACK FROM ' `� TEL - - FRONT PROP LINE OF - (STREET) OWNER �J NO �'� u� TYPE OF EXISTING SETBACK HIGHWAY _-F YARD = TOTAL ADDRESS '/7�� c HIGHWAY WIDTH - FROM C L - - -- T + CITY /G� y� �L r ! BLDG SETBACK FROM ARCHITECT O TEL SIDE PROP LINE OF (STREET) ENGINEERL��,s NO 5A�7� - TYPE OF EXISTING- SETBACK HIGHWAY + YARD - TOTAL ADDRESS , HIGHWAY WIDTH FROM C L CONTRACTOR '- - No - M1S'i4/JJ' + LIC CORNER CUTOFF YES NO Q ADDRESS NO CC CITY C' SEE REVERSE SIDE FOR SPECIAL APPROVALS O F- - ' DESCRIPTION OF WORK W CL EW ' ADD ALTER - REPAIR DEMOLISH jj� _ N SQ.FT / / NO OF-, NO OF o Ly_� �"��' � 0V, SIZE STORIES FAMILIES STRUCTURE S 1 G N A T U R E O , APPLICANT VALUATION$ APPROVALS DATE INSPECTOR'S SIGNATURE P C PMT FOUNDATION, LOCATION FEE$ - FEE$ e"C�/ FORMS, MATERIALS FRAME, FIRE STOPS, - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 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 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- INGTO WORKMEN(S COMPENSATION INSURANCE /�J � , � LATH EXT SIGNATURE OF%, �J /Y/, �1.'�K�� HOUSE NUMBER COR- PERMITTEEQ !ll��/(��! l C.-. C RECT AND POSTED ADDRESS ` E, CE3.�:Li� - • FINAL ,i'f"10�-� •, �, PLAN CHECK VALIDATION CK Mo CASH JOHN F LEWIS PRINCIPAL STRUCTURAL ENG R PERMIT VALIDATION CK M C, CASH [ 5 2 3. 48 OCt11 1 0 2.00- 1 r - " r d / TEMPL„E CITY W, 79 wr6A63SACE 30�4 � - APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING(� DEPARTMENT OF COUNTY ENGINEER ADDRESS / BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. DISTRICT NO GROUP GRR� TYPE P OCE E BY FOR APPLICANT TO FILL IN aQ CONST. BUIL NG STATISTICAL CLASSIFICATION SEWER MAP ADDRE S J PG CLASS. NO. DWELL. UN TTS LOT NO. BLOCK WATER NOT REQUIRED IIXI RECEIVED CERTIFICATE: 1!1 TRACT3,4A4//rA 1-44/ C.G7, MAP HIGHWAY i NO. OF BLDGS. NO. ICIRCLE) STATE MAJOR SECON . LOCAL SIZE OF LOT X NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS EXISTING BLDG. 9ve 12_ TEL. - OWNER O. 41 BUI DI G YARD HWY ST ET NAME EXIST. SETBACK WIDTH ADDRESS FRONT ce ! / ARCHITECT OR - L TEL.. P. L. ENGINEER L. a ADDRESS 0 TEL. ' -� C /C fiE ...ls,e e._<r .;l-1. - V CONTRACTOR �.�/'jl P NO r d ADDRESS I"' • ^ DESCRIPTION OF WORK - �'Vit"i- a NER/ ADD ALTER REPAIR DEMOLISH SQ. FT. NO. OF NO. OF SIZE 0.3-3STORIES FAMILIES USE OF , ,,t,;,� STRUCTURE SIGNATUREOF � APPLICANT r VALUATION $ APPROVALS DTE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION P.C. ', Z�j PMT. FORMS. MATERIALS FEE S U FEE $ [� FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 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 lI^ BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LABOR CODS OF THE STATE OF LIFORNIA RELAT- ING TO WORKMEN'S COMPEN ATION IM URANC j e LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTRECT AND POSTED ADDRESS - FINAL JOHN F. LEWIS. PRI GK. NCIPAL STR URAL ENGINEER PLAN CHECK VALIDATION / M O. GASH _ PERMIT VALIDATION K. M.O. CASH i." 0 8 6 6 OCT 1 23 D 3 0-25A Ljj,0 0 9 2 6G OCT 2 1- D 6 0.50- APPLICATION FOR,r.BUILDING PERMIT- ' -COUNTY-,OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION " FOR APPLICANT TO FILL IN �,- - BUIL ,GlADDRESS rya BUILDING ADDRESS - I hereby affirm that I have a certificate of consent to self Insure, or a'certificate of Workers' Compensation Insurance,or a certified copy thereof(Sec'3800,Lab C) ' _'.lA CITY ZIP 9 7 D ?h TC NA^� 1 sEM LC T �f _ LOCALITY r Policy Na• g�"'Q�;' Company SIZE OF LOT• NO OF BLDGS NOW ON LOT / ❑'Certified copy Is hereby fu'rnlshed NEAREST CF:FOSS S7 t 12rCerUfied copy Is filed with the county building Inspection TRACT BLOCK LOT NO , .department �V�,fv �AI/ 7 /�J1 USE ZONE MAP NO Dated 17/7l� ApOicent 7�[�f /'1 f pur _ ASSESSOR MAP BOOK PAGE PARCEL ' SPECIAL'CONDITIONS CERTIFICATE OF, EXEMPTION FROM WORKERS' ` COMPENSATION INSURANCE.', ' OWNEq�� l` WITHIN 1000 FT OF SCHOOLS YES NO ADDR `SSS (This section need not;be completed if-the permit Is for one hundred O CAST. �� -4 V&. DISTRICT GROUP TY E CONST FIRE ZONE PROCESSED BY dollars($100)or less),! CITY ZIP I certify that m the performance of'the work for which this permit IFivyp`E CZT Y Ot 7 �� `� Is Issued, I shall not employ any'person in any manner so as to become subject to the Workers''Compensation Laws ARCHITECT OR ENGINEER TEL NO STATISTICAL''CL�hAySS''IFICATION 'APT CONDO Date Applicant ADDRESS CLASS NO � DWELL UNITS NOTICE TO -APPLICANT If, after .making this Certificate of REQUIRED TOTAL SETBACK FROM ' EXIST Exemption, you should become Subject t0 the Workers' CONTRACTOR - ��C. TEL NO SET BACK YARD HWY PROP LINE WIDTH Compensation.provisions of the Labor Code, you must forthwithI. %Tvq=� / 3 -,S6I FRONT comply with such provisions or this permit shall be'deemed revoked ADDR S LIC NOS p p P L,. } 56.7 NeAVt 11ZK� 41✓E C b J I D SIDE a LICENSED CONTRACTORS DECLARATIONQ _ 1 CITY LIC CLASS P L - _ I hereby,affirm that I am licensed underprovisions of Chapter 9 +I P14 FA) -3 SEWER MAP U (commencing with Sectio-n-7000)of•Dlvision 3 of the Business and SOFT SIZE NO OF STORIES I NO OF FAMILIES Professions Code,and my license is In full force and effect (p I /, NEW ❑ BK PG O �4 p LIC CIBSS DESCRIPTION OF WORK License Num�ber S_ ,D `r G--'S ADD ❑ VALUATION , W Contractor F� loikY 'FWrSA�6Y pale • f 0 31 {o �16AP—OFF II !�'F 0� l7K ALTER $ El Cn E 1uSveL� �i1 C.4.X P1 Y wce0 LE— ❑ $ Z r I am exempt under Sec REPAIR ❑ B8PC for this reason ~- -- o - t� G�-S5 A • - _ ,, --� Lon R �r �2 yt. LaMp SNx�IfjIES PFrcN y DEMOL ❑` LDMA P/C Date _ ,• USE OF EXISTING BLDG URM ❑ Signature M T • AP AN7(PRINT)-„ _ TEL NO LDMA Perm ❑ I, as,owner of the property, or my employees with wages as _< �� AW'Z T"�AJ 33 3—S- •5 Z tt c c their sole compensation, will do the work and the structure Is 'ADDRESS O .a 0 17•!a rt.,,i not,intended or offered for sale (Section'7044, Business and D A)"--rN yKS� 14✓E pgEgJ�� y FINAL DATE F Professions Code) f,�'L l.� O I ITEMS WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL J ❑ 1, as owner'Of the property, am exclusive) contract) OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE _ T1-75 �_ g p p y, y ng with'% AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE, FINAL BY > TOTAL� a licensed contractors to construct 'the project (Section 7044, _ - - � i-jcn�c- Business and Professions Code) YES❑ NO {:NECK!• ! )' WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING - (' OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH ., . .. . NAME 'e 00 CONSTRUCTION'LENDING AGENCY COAST AIR QUAUTYMGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES I hereby affirm that there Is a construction lending agency fors YES❑ No - - the performance of the work for which this permit Is Issued(Sec - �ry(�I c r O. 3087,CIV C (HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMDPERMITTING 0000-0001 •-1! 71 i CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, _ Ir� Lender's Name TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS +'�L{'� AF 1 e G, MA RIS EPOR ANf�FQR OBTAINING A PERMIT FROM THE SCAOMD L1.a.OIJ Lender's Address ��►T"!�� O"ER OR AGENT I certify that I have read this application and state under penalty p of perjury that the above Information Is correct I agree to comply PC FEE - PERMIT FEE �` - with all county ordinances and State laws relating to buildingAXi ✓�! M construction, and hereby authorize,representatives of this County ISSUANCE FEE iy Oa to e��pon,t►1e above-mentioned property for Inspect) ;u poses vc $, ,IM�Q-,�t.•�/ INVESTIGATION FEE TOTAL FEE - ,ve�u<e a APOY « Dale ' SEE REVERSE FOR EXPLANATORY LANGUAGE