HomeMy Public PortalAbout9145 LONGDEN AVE_Building__ DEPARTMENT OF BUILDING AND SAFETY AYYLIGA 11VN r-vtt JMnb2rr
COUNTY OF LOS ANGELES BUILDING
WM. J. FOX. CHIEF ENSINEER
FOR APP ANT TO FILL IN FOR OFFICE USE ONLY
DISI
BUILDING RIO. PLAN CK.NO. PERMIT NO.
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ADDRESS �
LOCALITY RECEIVED BY DATE OFAPPL. DATE ISSUED((//
NEAREST
CROSS ST.
OWNER Ti(� -ADDRESS DREI✓ / �8�� J-j�lr
ADDRESS
AMAIL J
DDREB N u lg LOCALITY /`f
�O!/
NEAREST
TEL CROSS 9T. 11e./A11?
CITY NO.
QsaFIRE NO.OF TYPE GROUP
ARCHITECT R TEL ZONE PLANS
ENGINEER NO.
BLDG. f ORD.NO.
ADDRESS SETBACK LINE
APPROVED
TEL. BY DATE
CONTRACTO
USE APPR
ADDRESS �L '• ZONE BY DATE
LEGAL CORRECTIONS
DESCRIPTION LOT NO. LOCK
TRACT
NO.OF BLDGS.
SIZE OF LOT NOW ON LOT
USE OF NO.OF NO.OF
EXISTING BLDG. FAMILIES I ROOMS
DESCRIPTION OF WORK
N I I ALTERATION,01/ ADDITION
FO
REPAIR MDVINGdl I DEMOLISH A
O
84.FT. OF Z
SIZE OOMB STORIES y
WALL ROOF r
COVERING COVERING
USE OF NEW
BUILDING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS 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 REGULATING BUILDING CONSTRUCTION.
FRAME. FIRE STOPS,
SIGNATURE OF BRACING,BOLTS
PERMITTE LATH, INT.
AUTHORIZED AGT LATH, EXT.
7A69BA 9-48
0:5-3 Sam SETS P.C.6 PLASTER.INT.
✓ FEE PLASTER,EXT.
VALUATION FEE FINAL ��
• APP TIO1 FGR BUILDING PERMIT
COUNTY OF LOS AWGELd • 43UILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT,TO FILL IN BUILDING ADORE VE
I Hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESSCr
or a certificate of Workers'Compensation Insurance,or a certified .9's �•®N(i.DE.�.I c
copy thereof(Sec.3800,Lab.C.)
Policy No. Company CITYTE�`^P LE' e lTY ZIP RI-790 LOCA C
SIZE OF LOT NO.OF SLOGS.NOW ON LOT
11 Certified CROSS Certified copy is hereby furnished. - - - _ Sir
❑ Certified copy'is filed with the county building,inspection TRACT BLOCK LOT NO.
department. ' USE ZONE MAP NO.
Date Applicant ASSESSOR MAP BOOK' PAGE PARCEL
:• ti,� t• ti •; . • : SPECIAL CONDITIONS
CERTIFICATE OFr•EXEMPTION FROM WORKERS' - OWNER T TEL' O. I
COMPENSATION INSURANCE IT". 1f * 4; SGit-MID,LING-• $[ '2$6r'jS�b WITHIN 1000 FT.OF SCHOOL? YES
No
(This section need not be completed if the permit is for one hundred ADDRESS �tti, " ,� '
dollars($100)or IBSS.) I TS P4G DCIS f;I`VE , s DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY
r.
I certify that in the performance of the work for which this permit CITY ZIP C- cr naso � 3 �
is issued, I shall not employ any person in any manner so as to
become subject to the.Workers'Compensation Laws. - ARCHITECT OR ENGINEER TEL NO.
P STATISTICAL CLA§SI TION APT CONDO
Date Applicant. ADDRESS •TSL, �j(
''j` f�/� •,�� �.• CLASS NO.�"DWELL UNITS
,NOTICE TO APPLICANT If, after making this. Certificate' of 3��' TvY '-`o A y REQUIRED TOTAL SETBACK.FROM EXIST
`Exemption, you Should 'become subject to the Workers' CONTRACTOR ,'n— TEL NO.' SET BACK YARD HWY 'PROP LINE WIDTH
Compensation provisions of the Labor Code, you must forthwith'� e Ze®�J , . ., FRONT
comply with such provisions or this permit shall be deemed revoked:; ADDRESS LIC.NO. } F L•
r .
• •4°s•' ,
LICENSED CONTRACTORS DECLARATION SIDE
clrY uc.Class P L -*-+
I hereby affirm that I,am licensed underprovisions of Chapter 9. SEWER MAP
(commencing with Section 7000)of Division 3 of the BU§iness'and SQ.FT.SIZE NO:OF STORIES NO.OF FAMILIES
Professions Code;and my license is in full force and'effect. 375 NEW BK PG T TAE fir, •_ 9 �}
License Number LIC.Class DESCRIPTION.OF WORK _ D VALUATION 0
A-vv L.AuNv IZoaw $ALT •30Sb 0 �r9h°
Contractor Date ER ❑ CHECK '
rEXTEN4 BebI eM —"'cam. REPAIR ❑ $ CHAINGE
❑ I am exempt under Sec.
B.&P.C.for this,reason S1(Z S 5, !PECK
DEMOL ❑ LpMA P/C# W
USE OF EXISTING BLDG. .`, 6/19/905 1 f��w
- Date: URM 11i3 1 I V�J
SignatureAPPLICANT(PRINT)- TEL NO. LDMA Perm# Q y Z
El I, as owner of'the property, or'my,employees with wages as _ 0 °a
their sole compensation; will do the work and the structure is ADDRESS
not intended or offered for sale (Section 7044, Business and ;FINAL DATE 'G 3303
626.12
Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE'A HAZARDOUS MATERIAL J 1 ITEMS a3 owner of the property,•am exclusively contracting 'with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE +7
AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY
licensed contractors to construct the project (Section 7044, YES 11NO❑ TtaTAL 626 a 12
Business and Professions Code.) CHECK
WILL THE INTENDED USE MI THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING 4HEt;rt • .626.12 2 12
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH yT//�g� L7 ¢°1 n.
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)3EE'PERMITnNG CHECKLIST FOR
GUIDELINES ��J'7�W//•�(S '�su�NGE
. CPA
I hereby affirm that there is a construction lending agency for YES 1:1 NO
❑ °Do
-
I
the performance of the work for Which this permit is lbsued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATIONGUIDE AND THE SCAOMD PERMITTING
o 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE,
a ft(tAA�AAfl i 4/25/96
TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS vtrt.lL! L�VV VV S
Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD..
r 52
Lender's Address 1 AM ge 14
OWNER OR A13ENT
c I.certify that I have read this application and state under penalty'
C1 of perjury that the above information is correct.I agree.to comply 'P.C.FEE' GJ� PERMIT FEE
N with all county ordinances and State laws relating to building,
�. construction, and hereby authorize represen as of this County 'ISSUANCE FEE !10
m to enter the above- ntioned property o inspect' n pur ses.,
INVESTIGATION FEE TOTAL FEE /C;Z
SEE REVERSE FOR EXPLANATORY LANGUAGE