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HomeMy Public PortalAbout9538 LIVE OAK AVE_Building__ I ;7 76A888A C6#80910-58 APPLICATION FOR BUILDING PERMIT 1 COUNTY OF LOS ANGELES BUILDING C 1 t DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS S _ DISTRIGT O. GRO I TYPE p E FOR APPLICANT TO FILL IN CONST. BUILDING /ry STATISTICAL C� IFICATION SEWER MAP ADDRESS ` / / BK /iPG CLASS. _ NO. DWELL.UNITS ' �i MAPE LOT NO. i — / BLOCK NUMBER (/© HWY, YES NO USE ZONE SPECIAL TRACT S. CONDITIONS �SIZE OF LOT I NOW ON LOTS / USE OF / EXISTING BLDG. BUILDING EXIST. SETAEIACK YARD HWY STREET NAME WIDTH OWNER l F A 14 eyz PRONTO / MAIL P.L. 2-0 ADDRESS /g/;2 j" SIDE TEL. P•L. CITY � TM INSPECTION RECORD ARCHITECT OR TEL. ENGINEER NO. 'O.N 141 J f✓U/VR=� ADDRESS TEL. L �-• CONTRACTOR NO. ADDRESS DESCRIPTION OF WORE D 7'D F/� .P 61- EEP Lo r - 13it r 7'y A,NegT NEW ADD ALT EPAIR DEMOLISH yc�'!�/�Y. �'4►FT. , OF NO.OF I I� SIZE --tORIIZS FAMILIES Q � J/ USE OF % a(~ /;r'�16 ''LGTs FO i� l L �1S F S UCTURE ? _ ig1&7_2 ZS P V, Z o("177- 6'A/ APPLICANT APPROVALS �!DATEl� INSPECTOR'S SIGNATURE ADDRESS FOUNDATION FORMS,M TE MATERIALS S VALUATION FRAME:FIRE STOPS, BRACING,BOLTS ` I FURNACE:LOCATION, FEE $ I FEE.- $ i,� GAS VENT,DUCTS . I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH.INT. r '� PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITHALLCOUNTY ORDINANCES AND STATE LAWS .EGULATING BUILDING CONSTRUCTION. LATH,EXT. SIGNATURE OF HOUSE NUMBER COR- _ PERMITTEE RECT AND POSTED JI� ADDRESS `h FINAL /Z ® �i CLYDE N. DIRLAM, PRINCIPAL SC URAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERM VALIDATIO �K M.O. CASH . , ,u � 4 6 ,071. N2 1 A ' 3.00 WbRKtRS' COMPENSATION DECLARATION / hereby affirm that I have a certificate of consent to Self APPLICATION FOR BUILDING PERMIT sure, or a certificate of Workers'Compenstion Insurance, or certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Iicy No. Company P Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN ADDRESS SJJ .tom _ Certified copy is filed with the county'building inspec- BUILDINGfn tion department. ADDRESS 9,57- �J(! LOCALITY (� to Applicant CITY Gh7 �� C, ZIP CROSS NEAREST / T. CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OFAOT 7b)(190 NOW ON LOT MAP BOOK I PAGE PARCEL his section need not be completed if the permit is for one USE ZONE MAP TRACT BLOCK•# LOT NO. /2- NO. v7d O ndred dollars ($100)or less.) } TEL. .� , SPECIAL � certify that in the performance of the work for which this OWNER NO. CONDITIONS ermit is issued, I shall not employ an er n in an manner 495-3r g DISTRICT GROUP TYPE FIRE PR ESSED BY P Y Y P y ADDRESS IS 3 V L/0 dP �L CONST. ZONE r as to become subject to the Workers' mpensatio aws. �y,�� Sa atex i�74Z— Applica _ CITY /cit/ C[, ZIP STATISTICAL CLASSIFICATION PT. CONDO. ARCHITECT OR TEL. OTICE TO APPLICANT: If, after maki t is Cert ficate o xemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS 0mpensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP � ith comply with such provisions or this permit shall be / eemed revoked. TEL. BK L PG la 7 VALIDATION CONTRACTOR "eLL I NO. 7:3 f / LICENSED CONTRACTORS DECLARATION hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS/ f/ /D NO. ��Gjf VALUATION commencing with Section 7000)of Division 3 of the Business and % LIC. O 'rofessions Code, and my license is in full force and effect. CITY /� (7A CLASS $ SQ. FT NO. OF NO. OF CHECK icense Numbe 0-� os+ Lic.Class SIZE STORIES FAMILIES ONE t! NEW $ :ontrac Date �"��^i DESCRIPTION OF WORK < ADD I am e empt from the licensing requirements as I am a Qpm }(�j+.� `�p licensed architect or a registered professional engineer ALTER ❑ FINAL G; acting in my professional capacity (Section 7051, [J] DATE REPAIR Business and Professions Code). USE OF DEMOL FINAL EXISTING BLDG. �5� ❑ By r`z ic. or Reg. No. Date APPLICANT /) " TEL. ©�j1 OWNER-BUILDER DECLARATION (PRINT) (a [LL NO. '7 hereby affirm that I am exempt from the Contractor's License aw for the following reason (Section 7031.5, Business and ADDRESS y4v&llGN// 'rofessions Code): PRESENT (� d 7 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 7J 1'0,5 A 7044, Business and Professions Code). MOVING TEL. j, as owner of theproperty, am exclusive) contracting CONTRACTOR NO. Y 9 # 0 0 0 0 0 1 with licensed contractors to construct the project (Sec- PADDRE tion 7044, Business and Professions Code). 2 o 2 9 SO 0 CONSTRUCTION LENDING AGENCY YARD HWY TOTAL SETBACK FROM EXIST. PROP. LINE WIDTH hereby affirm that there is a construction lending agency for o o2 9 So 0 c=� -ie performance of the work for which this permit is issued Sec. 3097, ay. C.). Q 3 0 1 -8 2 ender's Name ender's Address Permit Feecertify that I have read this application and state.that the Issuance Fee -5 bove information is correct. I agree to comply with all County ,Fee U rdinances a State jaws relating to building construction, p? �5 Total Fee !Zgd��nspection of this County to entero 'nspection purposes. - - L,;Ys ,?—!gFz— SEE REVERSE FOR EXPLANATORY LANGUAGE ,. ; igna re of App-101n,or Agent Dote ©s i WORKERS' COMPENSATION DECLARATION I heteb fiffirm 4t I h'ave'n cer..tiffcate of consent to self insure, or a certificate of Workers' Compensation Insurance, _ APPLICATION FOR BUILDING PERMIT or a certified copy thereof Sec. 3800, Lab. C.) ��yy COUNTY OF LOS ANGELES BUILDING AND SAFETY PoIiNo. &�S OC�mpany i1SadY�Nt:�° Nt��Clq — L`� Certified co is hereby furnished. FOR APPLICANT TO FILL IN :1 BUILDING (,-�-� r PY Y ADDRESS �� `� ❑ Certified copy is filed with the county building inspec- BUILDING7. I✓ , tion department. ADDRESS i �J� ) j • 2 2Z CITY`y f y� CITY t.l'i ZIP I. V,A. LOCALITY Date Applicant NO. OF BLDGS. CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT - NOW ON LOT NEAREST COMPENSATION INSURANCE CROSS ST.ASSESSOR (This section need not be completed if the permit'is for one TRACT BLOCK �, LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100) or less.) ? �� TEL. OWNER I' "►1-�^r 1 �V� NO. USE ZONE AP I certify that in the performance of the work for which this 1 permit is issued, I shall not employ any person in any manner ADDRESS L SPECIAL a CONDITIONS so as to become subject to the Work Compensation Laws. t w O 2 f� veo��s CITY ZIP U Date oApplicant.� J ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO DISTRICT GROUP TYPE FIRE PROCES BY O Exemption, you should become subject.to the Workers' rY CONST. w Compensation provisions of the Labor Code, you must forth- ADDRESS r a with comply with such provisions or this permit shall be ,r TEL /�, STATISTICAL CLA SIFICATION APT. CON Z deemed revoked. CONTRACTOR NO. ry ,D _ 2 �v LIC. 2 CLASS NO. DWELL. UNITS LICENSED CONTRACTORS DECLARATION ADDRESS J�L C NO.� J I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business �' LIC. and Professions Code,and my license is in full force and effect. CITY U` h� CLASS BK. PG. VALIDATION SQ. FT. f NO. OF N . OF CHECK License Number �,2' Lic. Class SIZE STORIES FAMILIES ONE c y .d VALUATION Contractor l/ Date 22 s/r► DESCRIPTION OF WORK NEW ❑ ❑I am exempt under Sec. /vl vet 'C`Y �T' ALTER 10B.&P.C. for this reason f 1 Y `n 41'k REPAIR ❑ $ Pr USE F !� Date: EXISTING BLDG. DEMOL / tt APPLICANT TEL. / } Signature (PRINT) NO.(1� FINAL /I bWNER-BUILDER DECLARATION DATEt I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINALWI Professions Code): PRESENT By ACCT. _ r t••t� sg Eli•t BUILDING I, as owner of the property, or my employees with ADDRESS / wages as their sole compensation,will do the work and ,5 (E'' 4.011: the structure is not intended or offered for sale(Section LOCALITY l� • J1r 7044, Business and Professions Code.) MOVING TEL. , 1 ITEMS CONTRACTOR NO. I, as owner of The property, am exclusively contracting k .._, with licensed contractors to construct the project (Sec- TOI'AL 2134 m 06 ADDRESS t3 L, tion 7044, Business and Professions Code.) REQUIRED TOTAL SETBACK FROM dWXID"TTH CHECK 23".r'-` YARD HWY CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE I hereby affirm that there is a construction lending agency for FRONT C-HANGE ,5.1,,1 the performance of the .work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name0000-0001 /23 . _ m l LDMA Ref. N it �! ; P.C. Fee$ Permit Fee i1i j�Lender's AddressI certify that I have read this application and state that the Issuance Fee LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee � 2ordinances and Stat 5 relating to building construction, Total Fee '�`.l LDMA Perm. # yandher utho ' e presentatives of this County to enter tea ovef e%, �ed pr erty for inspection purposes. a (�� f 740 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date - APPLICATION FOR BUILDING PERMIT �l COUNTY OF LOS ANGELES. BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that 1 have a certificate of consent to self insure, BUILDING ADDR SS or a certificate of Workers'Compensation Insurance,or a certified L. copy thereof(Sec.3800,Lab.C.) QLTY ��Ty ZIPLOCALITY Policy No. Company SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified co is filed with the count buildinginspection TRACT v��,ltr BLOCK LOT NO. department.copy y p //��D� /�1761 /Z, tk_ ZONE MAP NO, JH n AS ORM OOK PAGE PARCEL �( Date Applicant ®® �d SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' TEL.NO. YES NO COMPENSATION INSURANCE ADDRESS _ HIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred DISTRICT GROUP TYPE CONST.' FIRE ZONEROCESSED dollars($100)or less 9-3 ' 1I certify that in the performanceCI ZIP ormance of the work for which this permit 5r� I/,,'�. Is Issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL.NO. become subject to the Workers'Compensation Laws. 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' TRACTOR TEL.NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwithep"/✓ a FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS �L�IC.NO. PL } 73 7 /7 SIDE LICENSED CONTRACTORS DECLARATION CITY LICf�,Is PL ;aMewI hereby affirm that I am licensed under provisions of Chapter 9 D /F rr�— SEWER MggqP V (commencing with Section 7000)of Division 3 of the Business and S IZE NO TORES NO. F A ILIES / O Professions Code,and my license is in full force and effect. + NEW ❑ BK LPG DE CRIPTION OF WORK ADD ElVALU I , W License Number Lic.Class Q a Contractor Date ALTER 11 $ �� z ❑ I am exempt under Sec. REPAIR B.BP.C.for this reason DEMOL El LDMA P/C# Date: USE OF EXISTING BLDG. URM ❑ Signature APPLICANT(PRINT) TEL.NO. LDMA Perm# AULT T k1, as owner of the property, or my employees with wages as 1O i°,i(�� ......... ­58.75 their sole compensation, will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and FIN,7/11A G ITEMS Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL J F OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN eQ P I_sT(�j_• � 183 m — ❑ I, as owner tr the property, ru exclusively contracting with THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL licensed contractors to construct the project.(Section 7044, ves❑ No❑ > {•���•�� � s°r'.'I. ' Business and Professions Code.) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING - +'.;-�FiNGE � -" n 1_{.1 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. ' I hereby affirm that there is a construction lending agency for YES❑ NO❑ the performance of the work for which this permit is issued(Sec. 0000-0110' `3/1213/911 I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD a 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MV REQUIREMENTSUNDER THE LOS ANGELES is; 20 .7 n / m. COUNTYCODE.TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING i•-;r � Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. LL. ender's Address OR AceA r o 1 certify that I have read this application and state that the above R information is Correct. I agree to comply with all county RC.FEE PERMIT FEE 14 ordinances and State laws relating to building construction,and ' a. hereby authorize representatives of this County to enter upon ISSUANCE FEE / the abov a tinned property for inspection purposes. a � INVESTIGATION FEE TOTAL FEE 3, 00 son ma Apel «Apeni Dery SEE REVERSE FOR EXPLANATORYLIANGUAGE,