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Home My Public Portal About9221 LONGDEN AVE_Building__ 11-A988A DBS•8 APPLICATION FOR BUILDING PERMIT II.BS DIVISION OF BUILDING AND SAFETY BULD' S - ADDRESS •'�" ,, Deportment of County Engineer County of Los Angeles : LOCALITY JOHN A.LAMBIE, COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. DISTRICT NO. GROUP SEWER MAP FOR APPLICANT TO FILL IN 1 TYPE ,.-$K PG. BUILDING .ry CONST. '�. ADD ESS Gr �-t'."' MAP STATE YES NO NUMBER HWY LOT NO, r � ^j .y BLOCK USEZONE SPECIAL CONDITIONS TRACT )//" ?.• '/ j- NO.OF BLDGS. pe SIZE OF LOTZ NOW ON LOT BUILDING WEXIST. YARD H USE OF SETBACK Y STREET NAME WIDTH EXISTING BLDG. FRONT / P. L. ` L OWNE v SIDE MAIL {�` / _ P P. L. A°��-.� Jiyd�="c.J O TRACT DWELL. i UNIT TEL 5 INDUSTRIAL CITY jy L-44 NO. 1 -DWELL. i UNIT 6 PUBLIC BLDG. ARCHITECT OR TEL. 2 DUPLEX 2 UNITS ADON.,ALT., ETC. ENGINEER NO. 3 APT. UNITS ADDRESS 41 COMMERCIAL 8 MISCEL. CONTRACTOR NOL . INSPECTION RECORD ADDRESS DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH SQ.FT. NO. OF NO.OF /.F 60 J AIC-, -d a P lel ?.R SIZE STORIES FAMILIES n�{,lr.,�.'f i�'ri ��IP�.C7"F-h if '� rJl�TCI✓rlr✓✓!I� USE OF STRUCTUREek SIGNATURE OF �llr�i..�----...� APPLICANTS APPROVALS ADDRESSft" DATE INSPECTOR'S SIGNATURE $ FOUNDATION:LOCATION f�J P•C. S FORMS,MATERIALS FEE FRAME: FIRE STOPS, VALUATION S BRACING, BOLTS PEE FURNACE: LOCATION, -I HEREBY ACKNOWLEDGE THAT 1 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. LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- I PERMITTRECT AND POSTED ADDRES " r 4& �, :] FINAL J�f!�.5��. ( Y!t•I:LCI+( / IOHN A.LAMBIE,COUNTY ENGINEER VALIDATION1 CLYDE N.DIRLAM, CHIEF BLDG. INSPECTOR CK MO ! G4 .9 9 4 v FEB 1 6.0 0 in 76ANb91na»:� APPLICATION FOR BUILDING PERMIT �. I I.68 DIVISION OF BUILDING AND SAFETY BUILDING Department of County Engineer ADDRESS County of Los Angeles LOCALITY JOHN A.LAMBIE, COUNTY ENGINEER NEAREST • CASSATT D.GRIFFIN, SUPT OF BUILDING CROSS ST. DISTRICT NO. GROUP SEWER MAP FOR APPLICANT TO FILL IN - -��" CONST. eus; of BUILDING / r MAP ADDRESS '; NUMBER y Q 3 HWY YES NO LOT NO. �IQ USS, ONE SPECIAL CONDITIONS TRACT V i/eey� NO.OF BLDGS. i SIZE OF LOTag® _(//A" NOW ON LOT 4 BUILDING EXIST. YARD HWY STREET NAME USE OF SETBACK WIDTH EXISTING BLDG. FRONT «: P.L. OWNER ` SIDE �. MP. L. AIL f� � - ' ADDRESS'Y� ,Zb _ ��•+• �'�"�� O TRACT DWELL. 1 UNIT GtJ"T- 5 INDUSTRIAL TEI-' GG 1 DWELL. 1 UNIT CITY/ n'i*> C..L �K�. NO.G �U�� 6 PUBLIC BLDG. v ARCH ITEC OR TEL. 2 DUPLEX✓ 2 UNITS ) ADDN..ALT., ETC. ENGINEER NO. 3 APT. UNITS i" 8 MISCEL. ADDRESS 4 COMMERCIAL TE CONTRACTOR NOL' INSPECTION RECORD ADDRESS DESCRIPTION OF WORK ADD ALTER REPAIR DEMOLISH •� r,r ,, SQ.FT. NO. OF NO.OF �i A { / SIZE STORIES FAMILIES USE OF.STkZUCTU1i•E bCJ , cr /L' AV; 4 :t h , 729 SIGNATURE OFy`„ AL,4�, APPLICANT G�tcL APPROVALS ` ADDRESS DATE INSPECTOR'S SIGNATURE ` FOUNDATION:LOCATION $ Ae P.C. $ FORMS.MATERIALS FEE FRAME: FIRE STOPS. VALUATION BRACING. BOLTS FEE FURNACE: LOCATION. I HEREBY`ACKNOWLEDGE THAT 1 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. LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRES FINAL IOHN A.LAMBIE.COUNTY ENGINEER VALIDATIQA, CLYDE N.DIRLAM. CHIEF BLDG. INSPECTOR CK MO JH 'Col 3 9 3- OCT 16 1 1,0 0 n f PPUC ATT ON FOR BUILUNG PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILD ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS .�'d or a certificate of Workers'Compensation Insurance,or a certified 9220 LONGDEN copy thereof(Sec.3800,Lab.C.) I CITY ZIP 1780 LOCA TY Policy No. 104 14L�— Company STATE FUND TEMPLE CITY 9 NOW SIZE OF LOT NO.OF BLDGS.NOW ON LOT Ci Z ❑ Certified copy is hereby furnished. NEAREST CROSS ST. XX Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date 11-1-93 Applicant RANDOL ROOFING ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. COMPENSATION INSURANCE MIKE LONGINY 714-964-3062 WITHIN 1000 FT.OF SCHOOL? No (This section need not be completed if the permit is for one hundred ADDRESS dollars($100)or less.) 9443 STSKIN A DISTRICT GROUP P FIRE NE PROCESSED BY CITY ,Q I certify that in the performance of the work for which this permit FOUNTAIN EY ZIP 92708 ��U .3 J/ •rl�� is issued, I shall not employ any person in an manner so as to i become subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO. STATISTICAL CLA�$IF CATION APT CONDO Date Applicant ADDRESS CLASS NO.� DWELL UNITS NOTICE 70 APPLICANT. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR TEL NO SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith RANDOL ROOFING 288-4040 FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO PL LICENSED CONTRACTORS DECLARATION 451 S SIDE CITY LIC.CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 8 C-39 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and S IZ E OF FAMILIES Professions Code,and m license is in full force and effect. NEW ❑ BK PG License Number 45 937 Lic.Class C DESCRIPTION OF WORK ADD ❑ VALUATION > C C Contractor RANDOL ROOF Cate 1-31-94 ROOF HOUSE, ONLY WITH ALTER ❑ $ 4,000.00 C ❑ 1 am exempt under Sec. 30 YEAR CLASS A FIBERGLAS REPAIR H B.BP.C.for this reason SHINGLES. TEAR OFF 2 LAYERS. DEMOL ❑ LDMA P/C# C Date: SElE ,OF EXISTING BLDG. �M [01 1 11,V Signature APPLICANT(PRINT) TEL NO. LDMA Perm# 1 L ❑ I, as owner of the property, or my employees with wages as RANT1101 ROOFING 288-4040 zz ACCT.Q their sole compensation, will do the work and the structure is ADDRESS 0 _ not intended or offered for sale (Section 7044, Business and FINAL DATE a: ,; i1, }..Q.J Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ✓�� c 1 ITEMS OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE M ❑ 1, as owner of the property, am exclusively contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY 0 licensed contractors to construct the project (Section 7044, TOTAL 134 . 25 Business and Professions Code.) YES❑ No❑ WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING CHECK i,:r4.it OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH �{ CONSTRUCTION LENDING AGENCY COAST GUIDELINES.QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR CHANGE .00 I hereby affirm that there is a construction lending agency for YES❑ NO❑ a the performance of the work for which this permit is issued(Sec. I HAVE READ THE W MITTING 3097,CIV.C.) CH CKLIST I UNDERSTAND UMY REQUIREMENTS UND ERS MATERIALS INFORMATION THEOS ANGEUIDE AND THE LESMD ODE, ((yy {{''��r� {� f] TITLE 2,CHAPTER 2 20 SECTIONS 2 20.100 THROUGH 2 20.140 CONCERNING HAZARDOUS 0000-0001 O/2�I'!7 J Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. 0 Lender's Address 1416 1 AM 9-57 0 OV/NER OR AGENT o I certify that I have read this application and state under penalty 0 of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE 10$.60 N with all county ordinances and State laws relating to buil Ing g constr 'tme-Jh eby author! e r esentatives of this Co my ISSUANCE FEE 25.65 C to ve-mention erty for ins a Io r S. co a INVESTIGATION FEE TOTAL FEE S ApV=t134.25 SEE REVERSE FOR EXPLANATORY LANGUAGE