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Home My Public Portal About9432 LEMON AVE_Building__ S- 4 76A638A CE.j#8031-62 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 DICTR IC„T G P TYPE FOR APPLICANT TO IN U CYPE BU.ILDING STATISTICAL CL SIFICATION SE R MAP ADDRESS Ni CLASS' DWELL UNITS pts LOT N WATER CERTIFICATE NOT REQUIRED RECEIVED TRACT i MAP e `� HIGHWAY NO STATE MAJOR SECOND;LOCAL / 0L) NO OF BLDGS (CIRCLE) SIZE OF LOT ,j� NOW ON LOT USE ZONE SPECIAL USE OF - CONDITIONS r EXISTING BLDG TEL / el 3 Y OWNER NO { / BUILDING SETBACK `YARD HWY STREET NAME EXIST WIDTH ADDRESS 212 � FRONTS O D ARCH ITEC OR TEL P L ENGINEER NO SIDE P L ADDRESS d TEL .s% O CONTRACTOR NO V ADDRESS / O DESCRIPTION OF WORK W N NEW ADD ALTER e REPAIR DEMOLISH Z SQ FT L NO OF NO OF - SIZE - -'STORIES FAMILIES USE_OF STRUCTURE J - - - - - - - -• - -- _-, IGNATU OF APPLIC T + I VALUATION0-0 $ APPROVALS DATE INSPECTOR'S SIGNATURE `` PMTit FOUNDATION LOCATION (� 4/-%//,� F E $,� . J FEE $ �J FORMS, MATERIALS }( •j /,�j>�///� wQ FRAME FIRE STOPS. V I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLT$ /II T 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 I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT I �w�' / � TION OF THE LABOR CODE OF THE STATE OF LIFORNIA RELAT- ING TO WORKMEN S COMP ATION NSURAN LATH, EXT I A. SIGNATURE OHOUSE NUMBER COR- PERMITTEE, RECT AND POSTED _ ADDRESS FINAL - : cnsH _ JOHN F LEWI , PRINCIPAL ST eYl RAL ENGINEER PLAN CHECK VALIDATI6NO M- PERMIT VALIDATION M O CASH L 'o3691;a i#iR23 23 D 37.25 Li'io 5 3 3 5 111 MAY 228 1 D 74,50- AP_PLICATION. .F.OR,,BUI.LDING PERMIT, n COUNTY OF LOS ANGELES `BUILDING'AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I BUILDING ADDRE S - 3� here6y'affirm that I have a certificate of,consent to self in�ure, J� LA or a certificate of Workers' Compensation Insurance,or a certified 3- m - copy thereof(Sec,3800,Lab C) • CIT , ZIP ' / -� o ` y. L LOCALITY Policy No �—"—L)U 7 V Company S l�+Tr YM p _ •• SIZE OF LOT NO OF BLDC�S NOW ON LOT ❑ Certified copy is hereby•furnished ( NEAREST CROSS ST �J ❑ Certified TRACT BLOCK LOT NO copy Is filed with the county,building inspection USE ZONE MAP NO departmentQ �— C^ Date L - — AppIICBnt `I(� s s 1i / ASSESSOR MAP BOOK PA ' PARCEL L ' V SPECIAL CONDITIONS Is:- R12 CERTIFICATE OF EXEMPTION FROM WORKERS' ow 03 R 1 TEL No COMPENSATION INSURANCE_ W F14 p 1 N G- WITHIN 1000 FT OF SCHOOLS YES No t ADDRES ' (This section need not be'completed If the permit Is for one hundred C m O DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY dollars-($100)or less)-' ' I certify that In the performance of ttie work'for which this�permlt CITY^ I— , C� ZIP h r D is issued, I shall riot employ any person In•any manner so as to 7 IJ ell✓� become sublect't0 the Workers'Compensation Laws ARCHITECT OR• NGINEER TEL NO • 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 Exemption, you should become Subject to the Workers' CONTRACTOR TEL NO t� SET BACK• YARD HWY, PROP LINE WIDTH Compensation'provisions of the Labor Code, you must forthwith" SSI C_ k,d CT`F -3 !0 FRONT Comply with such provisions or this permit shall be deemed revoked ' ADDRESS LIC NO P L 0 F R r r_2'. S•�• � � 3 SIDE CL LICENSED CONTRACTORS DECLARATION CITY 'F uc c�Ss' 3� P L - 0 I hereby'afflrm„that I am licensed underprovisions of Chapter 9 =m SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO FT SIZE NO OF STORIES NO"OF�FAMILIES I Professions Code,and my license Is in full force and effect NEW ❑ BK PG 4 License Number Q� ` LiC CIdSS • C�3 DE RtPTION OF WORK ADD " ❑” VALUATION , U W Contractor �SSIC en�•�f Date >� GADO C��SS ALTER ❑ $ � D �dU a. ❑ 1 aim exempt under Sec L ov ^i '��e 1 VU�l� REPAIR ❑ Z 68PC for this reason V(> SN/gK� a �PEMvvr s y K3D EMOL ❑ LDMA P/C r Date USE OF-EXISTING BLDG - URM ❑ Signature " ACCT o g ,. APPLICANT(PRINT) _ TEL NO LDMA Perm# 3303 242.85 0 I, as owner of the property, or my employees"wdh.wages as = their sole compensation, will do'the work and the structure Is ADDRESS 0 ITEMS not Intended or offered'for sale (Section 7044, Business and FINAL DATE Professions Code) ---�8 QO TOTAL , '? - 8 ' - WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL •��/' �6 -J ❑ 1, as Owner of the property, am exclusively contracting 'th OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Q 242,85' AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE1 FINAL B CHECK r licensed contractors to construct the project-(Section 7044; ves ElI No❑ �.H�i 17E r n Business and Professions Code) x ' WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING .. V _ OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH _ CONSTRUCTION LENDING AGENCY - COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKUST FOR GUIDELINES n n'nr'•I r5 ,hereby affirm that there is a construction lending agency for YES❑ NO❑ - - 00no—` 001 4/ 4 f 76 the performance of the work for which this permit Is issued(Sec I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING > 7 7" 2 3097,Civ C) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, 570 +_ py ' TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS ,• .,Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD 1� Lender's Address OWNER OR AGENT 3 1 certify that I have read this application and state under penalty " of perjury that the above Information IS correct I agree to comply PC FEE PERMIT FEE /in with all county ordinances and State laws relating to building m construction, and hereby authorize representatives of this County ISSUANCE FEE •° —rr to enter n the ab ve-ment oned roperty for Inspection purposes � ,.3 0 ' _ b 4—q_1� INVESTIGATION FEE TOTAL FEE .p _ - N i 1_ 0-1 a Agent Dale ' ' SEE REVERSE FOR EXPLANATORY LANGUAGE