HomeMy Public PortalAbout9133 LONGDEN AVE_Building__ 76A638A CE9803 1-67 AI'-;PLICATION FOR BUILDI.NWPERMIT` -
COUNTY OF LOS ANGELES BUILDING / -
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY �-
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,Sup•T OF BUILDING CROSS ST STRI - - J
.FOR APPLICANT TO FILL IN D1 'CDy UP _ CoPE
"T..
BUILDING'G - _ STATISTICAL C SIFICATION _ SEW -R MAP
-ADDRESS _ 4'C CLASS No. DWELL.UNITS -�B,K_, PIG � -
LOT NO.. BLOCK - .USE ZONE --MAP
NO. . .
TRACT c -SPECIAL - -� -
NO: OF ELDIS. CONDITIONS -
SIZE OF LOT 1-36 x -Now ON LOT
USE OF .. - -
NG BLDG, At - BLDG.-SETBACK FROM
OWNER � �' TEL. q., FRONT PROP. LINE OF - .(STREET)
.� NO. / TYPE.OF: EXISTING -SETBACK HIGHWAY.. f' YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L. - -
CITY
ARCHITECT OR - TEL.= BLDG.SIDE PROP. LRE OP.SETLINEACK ROM: - - -. ,
ENGINEER - NO:r- - - � OF - (STREET)
- - TYPE OF EXISTING.- SETBACK -HIGHWAY + YARD' _ TOTAL.-
ADDRESS - - - - - HIGHWAY WIDTH FROM C.L. - - - -
- 'TEL. - - - +.',
'CONTRACTOR a44V - NO - -
ADDRESS LIC
NO .'CORNER CUTOFF.' YES �. NO-� ..
= - - -
s
- LIC
CITY . C SEE REVERSE SIDE_ FOR SPECIAL APPROVALS 1
DESCRIPTION OF_WORK <
NEW ADD ALTER :REPAIR- -DEMOLISH - S
SQ.FT. - -NO. OF NO. OF
SIZE- - STORIES - FAMILIFS �
USE OF l/ 'e.l°�t- �1:4'( C�
STRUCTURE
SIGNATURE O - -
APPLICANT -
VALUATION-$
APPROVALS -DATE INSPECTOR'S SIGNAT URE -
P:C. _ - .PMT.$ , ' FOUNDATION, LOCATION'
-
FEE$ - -FEE I FORMS, MATERIALS. -
FRAME-, FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION - BRACING BOLTS 1•�- � �d.>°�N �.'"7 .��a,.'f.� �
AND STATE THAT THE ABOVE-IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH ALL COUNTY- ORDINANCES AND STATE LAWS REGULATING GAS:VENT.-DUCTS
9UILOING CONSTRUCTION.' I 'CERTIFY THAT IN DOING THE WORK' _
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA-, _ _-LAT H. INT. - -
TION OF THE LABOR CODE OF THE STATE,OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMPENSATION INSURANCE. r _ ,LATH. EXT.
SIGNATURE1r0 - - HOUSE NUMBER COR
PERMITTE -s - - RECT AND POSTED
ADDRESS' - - . .Fl-NAL d ''� 'k't �B e,—l.``�
A
- - - JOHN-F.-LEWIS. PRINCIPAL STRUCTURAL ENGFR
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O CASH
Ll+ o 0 0, 2 1 SEP 2 2
i Vii
COUNTY OF LOS ANGELESI
WM. J. FOX, CHIEF ENGINEER I L D '
FOR APPLICANT XO FILL IN FOR OFFICE USE ONLY
BUILDING DISTRICT NO. ' PLAN CK.NO. PERMIT NO.
ADDRESS cf, 15— (/07
LOCALS RECEIVED BY DATE OF APPL DATE ISSUED
NEAREST ` �/13 . a !p Gvf 11
CROSS ST. yaa(f
ADDRESS/ �' VOWNER ADDRESS Y0EAr AVE,.
MAIL
ADDRESS LOCALITY`
�.,_ n___ __
NEAREST
TEL CROSS'ST. N�. /7-/g S
CITY NO.
FIRE NC.OF I TYPE GROURJ—
ARCHITECT O TEL ZONE PLANS _�
ENGINEER NO.
BLDG. I D �
AD6RE98 SETBACK LINE r
L
APPROVED
CONTRACTOR O. BY DATE
USE APPROVED
ADDRESS ZONE �.� BY DATE
LEGAL
DESCRIPTION L�O•T^NCORRECTIONS'O. � � I BLOCK '—�'�'•
TRACT / a Q
NC.OF BLDGS. ey
SIZE OF LO� X NOW ON LOT 6s
USE OF NO.OFN
EXISTING BLDG. A.✓!,,2� /y, 1 FAMILIES R M9
DESCRIPTION OF WORD
NEW x ALTERATION ADDITION D
8
REPAIR OMDEMOLISH
-NO
y 0•
el EFT � ! �/ ROOMS ® STORIES / r
WALL OO
COVERING R
I COVEFRIN
USE OF NEW
BUILDING
I HEREBY ACKNOWLEDGE THAT I HAVE READ T1418 APPROVALS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS
AND STATE LAWS REGULATING4fUILDING CONSTRUCTION.
FRAME: FIRE STOPS,
SIGNATURE OF BRACING,BOLTS
OWNER
' LATHv INT.:
AUTHORIZED•AST. LATH,EXT.:
DBS-3 25M Secs 1-47 $ / P.C.N PLASTER.INT.
f FEE
4M PLASTER,EXT. =
VALUATION b
r1- .• �... �.,�.. FEEC2 FINAL lli t
aj�g1,fl6 lI�IG.. � "�9E
76A688A CE#808.8-68 A G, LIC 1 ON. FOR 9.�:UI,�®IN-G" G ivRe -
COUNTY..-OF LOS ANGELES; 13UILDING.
DEPARTMENT OF COUNTY ENGINEER AD°REss
BUILDING AND7 SAFETY DIVISION uo.cALITY
JOHN A. LAMBIE. COUNTY ENGINEER '-NEAREST ."V
WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST.
D.ISTR T O. .,: .GROUP TYPE ESSED BY
Fok,APPLICANT TO;. Fm-L.IN. coNs _ -
BU ILDI NG STi4TISTICtiL-CLASSIFICATION EWER'MAP
ADDRESS f�' 'CLASS.•NO. DWELL.-UNITS BK,, G '
LOT NO. BLOCK , WATER NOT REQUIRED / RECEIVED• '
CERT.I F I CATE': •
TRACT " MAP OW 'HIGHWAY
NO.OF-BLDGS
J S.
NO. . (CIRCLEj. TATE.MAJOR SECON LOCAL'
SIZE-OF LOT o �O,JC:^ NOW O_ N'LOT,• USE Z NE - SPECIAL
USE OF " CONDITIONS
EXISTING BLDG.
T
OWNE Ni' U N YARD IiWY REETN E :':EXIST.
SETBACK WIDTH
ADDRESS r FRONT
'
TEL.
ARCHITECT OR P•.L• - -
ENGINEER I SIDE
ADDRESS , •, O
TEL. LJ
CONTRACTOR + NO. ;
ADDRESS
'•ESCRIPTION OF WORg' .
NEW 7 ADD ALTER -REPAIR DEMOLISH -
SQ.E FT, /_I NO.OF j. ' NO.OF
SIZ
USE OF
'STRU.CTURE
IF
z
SI'GNATURE!OF.
APPLICANVALUATIONT
APPROVALS, DATE INSPECTOR s SIGUA7'yftE
P.C. ��� PMT.- FOUNDATION: LOCATION
-FEE $ s FEE S.—7 - FORMS, MATERIALS O"ry/ r� .• �' ppd
FRAME: FIRE STOPS;
I 'HEREBY ACKNOWLEDGE THAT I HAVE(READ THIS'APPLICATION 'BRACING. BOLTS f i
AND STATE THAT THE ABOVE 16,CORRECT SAND AGREE TO COMPLY 'FURNACE- LOCATION,
WITH ALL COUNTY 'ORDINANCES AND'STPTE LAWS'REGULATING .':GAS VENT. DUCTS �
BUILDING CONSTRUCTION [,CERTIFY THAT IN DOING THE,WORK
AUTHORIZED HEREBY I"WIL-L NOT EMPLOY ANY PERSON-IN:VIOLA-
LATH. INT: t
TION OF THE LABOR CODE OF THE'STATEI OF CALIFORNIA RELAT-
I
NG TO WORKMEN'S CO TION IIVSU NCE.' - ,ir
LATH.EXT. I r
S.IGNATU:R OF i HOUSE NUMBER COR-'
PERMITTEE :RECT.AND POSTED ' v / .1''••' �" _
ADDRESS.
JOHN F. LEWIS..PRNOPALSTRUCTURAL EttCWgER
PLAN CHECK'VALIDATION. GK... ,ra:d.' cAsw PERNIIT .VALIDATION CK. M.O. CASH
-2'.4%10 DEC 1 15'-. `1,. D . 4.00r-
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. • ' ' - .'" , - •. ; , ., '' .. - Vim• ... . .
'l'6A638A CE9803 5-65APPLICATION FOR BUILDI G PERMI ' • � • L1.
COUNTY OF LOS-ANGELES BUILDING /
DEPARTMENT OF COUNTY ENGINEER ADDRESS• �/✓G
BUILDING AND SAFETY DIVISION LO C A L•I T•Y•- '
JOHN A. LAMBIE-. COUNTY ENGINEER- "NEAREST +! i
COLEMAN W. JENKINSSUP'T OF BUILDING CROSS ST:
DIST CT O G P TYPE.••• P O .S Ys
FOR APPLICANT TO FILL IN CONST.
BUILDING // STATISTICAL L SSIFICATION' S - .ER AP
ADDRESS V � 6 � .'B'K _PG �.
CLASS NO: DWELL UNITS
LOT NO. BLOCK USE ZO E MAP `
.-, N O. ®.
TRACT �1 �' SPECIAL '
NO. OF BLOBS. .p�� l CONDITIONS _ •I 1. _
SIZE OF LOT NOW ON LOT
USE OF
E ISTING — G' BLDG. SETBACK FROM - -
OWNER e /� � ;0/ NOL FRONT PROP. LINE OF - _ - (STREET)
TYPE OF EXISTING SETBACK '•HIGH AY. + YARD TOTAL
ADDRESS 4` 33•.AoluG&aN v
HIGHWAY' WIDTH 'F OM C.L.
CITY 7F /4 f!^f 7r AoA �.
ARC HI TELT OR TEL. BLDG. SETBACK FROM
ENGINEER NO. SIDE PROP. LINE OF '(STREET)
TYPE 0•F EXISTING SETBACK. . HIGHWAY '} -YARD = NOTAL
ADDRESS / HIGHWAY WIDTH FROM C.L.
&OAllEL.R71'C l Goo + _ . k
CONTRACTOR)?,[� p
ADDRESS Q S3 ��/ NO S s ! CORNER CUTOFF. - YES "NO--.[:]"' OU`
CITY
G) Af,�
.1 c�As"s B' I •'SEE REVERSE SIDE FOR SPECIAL APPROVALS 0
DESCRIPTION OF WORK W
NEW ADD r ALTER REPAIR •' DEMOLISH - - 0
z
SQ.FT. s� NO. OF NO. OF -
SIZE .'� �0 STORIES FA ILIF_SUSE - - ••
STRUCTURE �C ,V-
GNATURE OF
APPLICANT
VALUATION$ a— APPROVALS :DATE IN-AT/R'S SIGNATURE
FEE$ 'FEE$ 0 FOUNDAT
FORMS!MA�TERIIALSON
FRAME, FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT ) ✓w
AND STATE THAT THE ABOVE IS CORRECT-AND AGREE TO COMPLY FURNACE: LOCATION Y N• ��
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS /
9UILDING CONSTRUCTION. 1 CERTIFY THAT. IN DOING THE WORK /
AUTHORIZED HEREBY'I WILL NOT EMPLOY ANY PERSON IN- VIOLA- LATH. INT. `� - y
TION OF THE LABOR CODE OF THE STA EF CALIFORNIA RELAT-
ING TO WORKMEN' .NSA INS R CE. i / w• - "
LATH. EXT.
SIGNATURE•OF � •' � HOUSE NUMBER COR-
RECT AND POSTED
..ADDRESS S FINAL
JOHN F. LEWIS. R INCIPALS.R!CK,
TU. AL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATIO • M.o CASH
(..F`tt;o 0 3.0 4 Zoo. MAR 9 1 D :.T-.'.1.550~; I
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TQ FILL IN BUILD G ADQRES
I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS JCJ _
or a certificate of Workers'Compensation Insurance,or a certifiec 1 71-
d
copy thereof Sec.3800,Lab.C.) CITY 1 zIP
1 C1 y y A r `(1 �'� p, & , `� LOCALITY
Policy No. pany GL (i SIZE OF LOT NO.OF BLDGS.NOW ON LOT
❑ Certified Copy is hereby furnished. NEAREST CROSS ST.
❑ Certified copy is filed with the county building,inspection TRACT BLOCK LOT NO.
depa en U USE ZONE MAP NO.
Date l� / Applican ASSESSOR MAP BOOK PAGE PARCEL
SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER ^ `I O ,toS.cf TEL NO. �� YES NO
COMPENSATION INSURANCE L or–) 31 '�-S WITHIN 1000 FT OF SCHOOL
(This section need not be completed if the permit is for one hundred ADDRESS
DISTRICT GROUP TY CONST. FIRE ZONE PROCESSED BY
dollars($100)or less.)
CITY ZIP G `� lj
I certify that in the performance of the work for which this permit 0 ,//S
is issued, I shall not employ any person in any manner so as to
TEL NO.
become subject to the Workers'Compensation Laws. ARCHITECT OR ENGIN STATISTICAL CLAS IF CATION 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' CONT CTORTEL NO.2310 SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor Code, you must forthwith P_:T O R 3 FRONT
comply with such provisions or this permit shall be deemed revoked. ADDRESSC.N PL
LICENSED CONTRACTORS DECLARATION kr. P_�'S C� .0 y»° SIDE
CITYLIC.CLASS PL
/�
I hereby affirm that I am licensed underprovisions of Chapter 9 , r T 90 -3 SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORIES NO.OF FAMILIES
Professions Code,and my license is in full force and effect. NEW BK PG , a
License Number Y? Lic.Class "19 E;RIPTI NO OF WORK. ADD ❑ VALUATION / C
Contractor Uf�►A Date all 1 4-- U .t!'l�'' -rG ALTER 11
D
El 1 am exempt under Sec. T 6ff="-14-SJ7A00A-1•� REPAIR ElC
B.8 for this son (St> b�eQ 1� c,'4� - DEMOL ❑
LDMA P/C# u
ate: YSE OF XIST G BLD t- -T C i'' ! URM ❑ a
S at � � �• + �• L
APPLI T PRINT) _ EL NO I LDMA Perm#
❑ I, as owne of the prop rty, or my employees with wages as �� !G ���d- f�1:1:I oa
their sole compensation, will do the work and the structure is ADDRE j / R
not intended or offered for sale (Section 7044, Business and /Q._ 1r' �v1li ��'3/ FINAL DAT Q 3303 14 F.333
Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL J
❑ I, a5 owner of the property, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ITEt1L
AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 0 ,t
licensed contractors to construct the project (Section 7044, YES 11 No ElTOTAL 149_85
Business and Professions Code.)
WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BU,LD,NG '•' t^ �C
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH �- �// ���JJJ CHECK K `�•�a is�i
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR �� ��
GUIDELINES !• �G�V/ ���///
I hereby affirm that there is a construction lending agency for YES❑ NO❑
iA the performance Of the Work for Which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING
a 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, �+- +
TITLE 2,CHAPTER 2 20 SECTIONS 2 20.100 THROUGH 2 20.140 CONCERNING HAZARDOUS 13000-1!111 11 V/1L!•�!3
Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD
a 1�7t� �;M LI `
o Lender's Address OWNER OR AGENT
0
o I certify that I have read this application and state under penalty
o P.C.FEE PERMIT FEE
0 of perjury that the above information is correct.I agree to comply ,
a with all county finances n tate laws relating to building
co Aruction, nd he-r-- au oriz presentatives of this County ISSUANCE FEE ��. '/a
M t t the above- ent property for inspect, purpos 7v
n 2/ INVESTIGATION FEE TOTAL FEE
syr_; o a ARy cm a nxm oy. � L •7
SEE REVERSE FOR EXPLANATORY LANGUAGE