Loading...
HomeMy Public PortalAbout9452 LIVE OAK AVE_Building__ 76we36A DB9.3 3.118 ' APPLICATION FOR BUILDING PERMIT T' 1 DIVISION OF BUILDING AND SAFETY BUILDING Deportment of County Engineer ADDRESS County of Los Angeles LOCALITY WM.J. FOX,COUNTY ENGINEER NEAREST CASSATT.D.GRIFFIN,SUPT OF BUILDING• CROSS ST. DISTRICT O. O'ROUPI TYPE SE BK MA PG FOR APPLICANT TO FILL IN JrCONST. Ll BUILDING MAP D O STATE O . ADDRESS NUMBER HWY LOT NO. (}/7/ V r BLOC USE ZONE SPECIAL / l n� � CONDITIONS TRACT NO.OF B S. BUILDING - EXIST. SIZE OF LOT�7 O �� I'NOW ON OT SETBACK YARD HWY STREET NAME WIDTH USE OF FRONT EXISTING P.L. OWNER - SIDE P.L. MAIL ADDRESS O TRACT DWELL. I UNIT 5 INDUSTRIAL TEL. I DWELL. i UNIT CITY NO. 6 PUBLIC BLDG. - ARCHITECT O� - TEL. - 2 DUPLEX - I UNIT ENGINEER NO. 7 ADDN.,ALT.. ETC. r - 3 APT. UNITS - 8 �MISCEL. ADDRESS - 4 COMMERCIAL - CONTRACTOR - INSPECTION RECORD 70p R ADDESS DEC TION Of WORK EW ADD ALTER REPAIR DEMOLISH - Sp. FT. NO. OF NO.OF SIZE STORIES FA 1 ES ' USE OF STRUCT REfJ - GNATUREOF _ APPLICANT APPROVALS - ADDRESSLT DATE INSPECTOR'S SIGNATURE $ FOUNDATION: LOCATION - / � P. C. $ FORMS. MATERIALS FEE FRAME: FIRE STOPS, VALUATION $- BRACING,BOLTS FEE FURNACE: LOCATION. ' I HEREBY ACKNOWLEDGE THAT I* HAVE READ THIS GAS VENT, DUCTS ' APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. - or LATH, EXT. SIGNATURE OFF HOUSE NUMBER COR- - PERMITTEE R T AND POSTED - ADDRESS f - NAL �v ' WM.J. FOX,COUNTY ENGIN ER VALIDALCF r ION C. N. DIRAM, HI BLDG. INSPECTOR ' I N;�C 9 2 6 2 OCT 21 1 _ ,Q Q . N WORKERS' COMPENSATION DECLARATIONLAP I +�' -herebyaffirmthat I have certificate of consent to self insure,-ora certificate of-Workers' Compensation-Insurance, A P P L_I CATION tOR-SUILDING PERMIT ,• or-a certified copy thereof•(Sec 800, L b' C) COUNTY OF-COS ANDELES BUILDING'AND SAFETY Policy Nq�s.�l�C�pony ©/'✓�N/ � - - ' Certified copy is hereby furnished ,. BUILDING e FOR APPLICANT TO FILL•IN ADDRESS 9 �2 v' Certified copy is filed with the'county building Ihspec- BUILDING tion a/par ent.• ADDRESS �Y i,A/ll CITY V ZIP . '�.��� LOCALITY Date Applicant NO OF BLDGS ;L NEAREST - ERT ICATE OF EXEMPTION,FROM WORKERS' - SIZE OF LOT'" - NOW ON LOT' CROSS ST COMPENSATION INSURANCE ASSESSOR �i�r pa`s (This'sechon need not be completed if the permit is for one TRACT BLOCK LOT NO MAP BOOKd> PAG�� PARCEL hundred dollars ($100) or less ) / /I G TEL OWNER ! J4 ' C. ��'1. NO USE ZONE MAP -Z fes. NO' I certify that in the performance of.the work for which this `/ SPECIAL permit is issued, kshall not employ any-person in any manner. ADDRESS CL v`~� CONDITIONS O soros to become subject to_'the Workers'Compensation Laws _ U CITY ZIP -* Date Applicant. ARCHITECT OR TEL DISTRICT GROUP TYPE FI t t I °VROCESSED BY 0 NOTICE TO APPLICANT df„after,makingthis Certificate of ENGINEER �. r .• NO CONST �� ZONE, Exemption, you•should become, subject to the-Workers' �- r: ��(J�_ ! •1_.' i- ° Compensation'provisions of-the Labor Code, you must forth- ADDRESS C-�- with comply with such provisions•or this permit shall be TEL STATISTICAL CLASSIFICATION AW ONDO, Z deemed revoked• CONTRACTOR NO _G — r LICENSED CONTRACTORS DECLARATION— LIC 'CLASS NO DWELL UNITS ' I;AL °der 6-® ,j”' I hereb affirm that I am Iicensed'under rovisions.of Chapter 9 ADDRESS Q NO ; Y P P SEWER MAP f; s (commencing with'Section 7000),of Division 3 of�the Business ` LIC' - _ _f.' and Professions Code,and my license is•m full force and effect CITY (� CLASS r� BK e_PG �Z L.L �/ IDATION SQ FT NO OF NO OF CHECK License Number' Lic .Class ' SIZE �7 STORIES FAMILIES / ONE _/�r VALUATTIION ('� //��L• Date DESCRIPTION OF WORK t �/L NEW ❑ s t�V Contractor i J L --- �; "r• - Lw ADD ( -e:-.- �d! ❑I am exempt under Sec WAr1T�O0�r . �, ALTER ❑ , l _ t H 13i B&P C for this reason REPAIR ❑ s USE OF s Date. EXISTING BLDG �/ DEMOL ❑ APPLICANT TEL t Signature `_ FINAL t• t OWNERBUILDERDECLARATION (PRINT) NO DATE - I hereby affirm that I am exempt from the Contractor's License Law',for the following reason (Section 7031 5, Business and ADDRESS' FINAL - -t�;°L: Professions Code) . - " = IPRESENT BY'- ❑ 'I,.as'owner of the ro ert or m employees•with BUILDING M P P Y. YADDRESS I t-((r . , - wages as their sole compensation,will do the work and m w= a' the structure is not intended or offered for sale(Section LOCALITY t s 7044, Business and Professions-Code ) MOVING - TEL , " CHECK I, as owner of the property, am exclusively contracting CONTRACTOR NO 11 4GE with licensed contractors to construct the project (Sec ADDRESS �- tion 7044, Business and Professions Code ) - REQUIRED TOTAL SETBACK FROM EXIST ' t, CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE WIDTH 't c .' . , ,• � • ,, � `'LI�t!E1 ir-€f!!1 t;L 0i i•J: , 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 t i. 61f _c't ;U.-C,;:C= (Sec 3097, Civ C ) SIDE •1`, � r t I, PL Lender's Name LDMA Ref # } a PC Fee$ (�`~U Permit Fee �� Lender's Address _ I certify that I have read this:application and state that the Issuance Fee ' O't7 LDMA P/C# 8 above information is correct I agree to comply with all County Investigation Fee p ordinances and State laws-relating to building construction, Total Fee d LD MA Perm # t a and hereby authorize-reesentatives of this County to enter upon the abov2zawemVned pro arty for inspection p rpos no J SEE REVERSE FOR EXPLANATORY LANGUAGE ! Si ature of Applicant r AgentDat