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HomeMy Public PortalAbout9552 LIVE OAK AVE_Building__ I � , 7GA689A CF#60310-e8- APPOCA`1`ION FOR bUILDING PERMIT 1 .' COUNTY OF LOS-ANGELES BUILDING DEPARTMENT OF.COUNTY ENGINEER . ADDRESS O� c3 OL l j BUILDING AND DIVISION' LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER' NEAREST CASSATT D. GRIFFIN, SUF'T OF BUILDING CROSS ST. mommakaMmUmmEm DISTRICTNO. I GROUP E0ROCESSEDBY FOR APPLICANT TO FILL-IN 4` Col, I �j BUILDING L�s2 'f ve _© B r d- STATISTICAL CLASSIFICATION = �I E MAP' ADDRESS J I-_ I /T �; -•/�t fJ P T CLASS.NO WELL UNIT LOT NO O r ( % �0 T. LOCK N MABER STATE ' YES O TRACT C /�,fe USEZONE SPECIAL ' NO.OF.BLDGS NO. - SIZE OF LOT S-) X-13 v I NOW ON LOT USE OF •1 EXISTING BLDG. ' - BUILDING 'EXIST. YARD HWY STREET NAMESETBACK, WIDTH- FRONTWNER "Q! YO MAIL i IPL d ADDRESSX) 27 fl 'Yl lir h 0 O�� (� 1SIDE' CITY JA) -Ct� U/h o.. No P L. P �1 - INSPECTION RECORD ARCHITECT OR TEL 1 ENGINEER' NO F _ ADDRESSEL // - CONTRACTOR6` .;_,,lb !J e l Pa.to NO �o�rl ^f ( ? Al ADDRESS 7•Z / Lr Ii Oo/� J�,- -,� �-a 5" - DESCRIPTION OF WORE y 'pR �� ` T-A NEW 4 ADD ALTER- REPAIR' '-DEMOLISH SQ FT NO OF ` NO OF SIZE _, STORIES 1 FAMILIES -'USE OF , STRUCTRE V W h a C!P U h a, c'ii SIGNATURE OF < APPLICANT t = j� APPROVALS DATE INSPECTOR'S SIGNATURE ADDRESS (�h /�fJ FOUNDATION:LOCATION FORMS,MATERIALS VALUATION � FRAME.FIRE + �_ BRACING,BOLTS O C9 PMT "�% I _ _- FURNACE:LOCATION. s/ !b / E FEE t A_ jf GAS VENT,DUCTS !CY°�l^l I HEAEfIY ACKNOWLEDGE THAT 1 HAVIf READ THIS'P:P-_ . -LATH INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND- - AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND � - f I V v V L,0ri rrV-AVL.— , STATE LAWS R LATIN BUILDI CONSTRUCTION. LATH,EXT. ' SIGNATURE O R (/�/F - HOUSE NUMBER COR- PERM ITTE RECT AND POSTED ADDRESS r `"� W Grp 'FINAL ' CLYDE N. DIRLAM;°PRINCIPAL ST RAL'ENGINEER PLAN.CHECK VALMATION aCK�' M O CASH PERMIT VALIDATION- CK M.O. 'CASH' _ ��-O-4 O on: �l' 5 2 3 A 1 -9.5 0 M �. ArQ g 5 8 1 L DEC 7 1 A WORKERS' COMPENSATION DEaARA?10N APPLICATION FBUILDING PERMIT" 1Ll I hereby affirm that 1-.have a certificate of,consent to self OR insure, ar,a certificate of Workers'Compenstion Insurance, or ' a certified copy thereof (Sec 3800, Lab C ) ' - , - COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No ' Company' - - i - - a "Certified copy is hereby furnished FOR APPLICANT TO FILL IN BUILDING \ ADDRESS Certified copy is filed w_ith the'county building inspecBUILDING• Tion departent ADDRESS LOCALITY m �[ 1 O NEAREST T— Dote`, Applicant CITY 1 ZIP CROSS ST c� CERTIFICATE OF EXEMPTION FROM WORKERS' NO OF BLDGS ASSESSOR- - COMPENSATION-INSURANCE SIZE OF LOT l NOW-ON LOT MAP.BOOK PAGE PARCEL (This°section need not be completed-if the permit is for one USE ZONE _ MAPS t/ r hundred dollars ($100)or less-) \ TRACT BLOCK LOT NO NO d SPECIAL CII.' hcertify th'at,in the performance of the work for which this OWNER �( NO - CONDITIONS^ Q permit'is issued, I shall not employ any person in any manner ^^ DISTRICT GROUP TYPE- FIRE PRO ESSED BY V so as to.become subject,to the Workers'Compensation Laws ADDRESS d CONST ZONE OC Q rte ,o$' Q Date Applicant �• CITY , �� ZIP �O V STATISTICAL CLASSI CATION APT ]CONDO V NOTICE TO APPLICANT -If, after making this Certificate of ARCHITECT OR TEL W ENGINEER NO CLASS NO��TDWELL UNITS d Exemption; you should become subject to the Workers' N Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP a with comply with such provision's 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,'ond my license ism full force and effect CITY' CLASS SQ FT NO-OF NO OF CHECK License Number Lic Class SIZE STORIES FAMILIES ONE DESCRIPTION OF WORK NEW Contractor• •Date ADD ham exempt from the licensing requirements as I am a _ licensed architect or a registered professional'engineer q { ALTER = FINAL /^ y '/ acting .in my professional capacity (Section 7051, 69- 3z/ REPAIR DATE O c Business and Profess ians,Code) USE OF 235 0,4 A a _ EXISTING BLDG DEMOL FINAL Lic or'Reg No _Date APPLICANT TEL Y # o to•o o 2 ' OWNER-BUILDER DECLARATION (PRINT) NO ; I hereby affirm that I am exempt from the Contractor's License 2•° ° 5 9,6 4 Law for the following reason (Section 7031 5, Business and ADDRESS Professions-Code) PRE EN o 0 0 5 9,6 4 5' aI, as owner of the property, or my employees with ADIDRESS 4,0'5—8 2 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 J ( CONTRACTOR NO I, as owner of the property, am exclusively contracting , with licensed,contractors to construct the project (Sec- ADDRESS ;-913'5 0,5 A tion 7044, Busmess,and Professions Code) CONSTRUCTION LENDING AGENCY REQUIRED- YARD ' HWY TOTAL SETBACK,FROM EXIST # o o'0 0 0 SET BACK PROP. LINE WIDTH j-he'reby affirm thal there is a construction lending agency for FRONT 2 a ,5 0 0 the performance of the work-for which this permit is issued P L • (Sec 3097, Civ C ) SIDE 0,e-1 1 's 0 0'c=i P.L. Lender's Name• r m - - P C Fee$ �' Permit Fee r J ,0 '0 5F-8'2 Lender's Address w I certify that I have read'this application and state that the Issuance Fee Ed 1 aabove information is correct I agree to comply with all County Investigation Fee. - ordinances and State laws relating to bu_ilding•construction, Total Fee �. �d and hereby authorize representdtives of this County to enter au o the above-mentione property for inspection purposes , m q ur oI a CL_ �S -X__7' SEE'REVERSE FOR EXPLANATORY LANGUAGE Signature of Apfhccint or Agent Date �'_ ©s