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HomeMy Public PortalAbout9537 LONGDEN AVE_Building__ '1 V WORKERS'COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT ' insure, or a certificate of Workers'Compensation Insurance, or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING - v� ADDRESS a 3 7 �'• (,��,� �,IL,V Certified copy is filed with the county building inspec- BUILDING p 'r tion department. ADDRESS 7J 37 L LON J PJ1l /TU i/ 1_4 LL �� y/7 V t' Date Applicant CITY-J.-n, L e- ZIP / / F0 LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST J COMPENSATION INSURANCE SIZE OF LOT .J D x1190 NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL 'I TEL. , I certify that in the performance of the work for which this OWNER J /40T /VDVBtf L NO.oINs(03�/ USE ZONE OP permit is issued,1 shall not employ any person in any manner � —� SPECIAL '_- / -hA De.J Ave, CONDITIONS so as to become�isubject to the Workers'Com ensatjiADDRESS t on Laws. O V Date a 1 p 4 Applicant �/ CITY 42 L T ZIP /7O O ARCHITECT OR— TEL. DISTRICT GROUP TYPE FIRE P O ED BY O NOTICE TO APPLICANT: If, after making t s Certificate of ENGINEER L�l�lC 2� NO. —(, CONST/�- ZONE (— Exemption, you should become subject to the Workers' _ 3 a () Compensation provisions of the Labor Code, you must forth- ADDRESS D L' , O m*Ill if(a /' ..,,/ a with comply with such provisions or this permit shall be TEL.a0 q STATISTICAL CLASSIFICATION CONDO. N deemed revoked. CONTRACTOR L$2 C,O/V ST• No. 3�{-b 9/3 Z LICENSED CONTRACTORS DECLARATION AlLIC, �5-/ CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS N. L/iWwoO NO. (commencing with Section 7000)of Division 3 of the Business and LIC y7 SEWER MAP Professions Code, and my license is in full force and effect. CITY V15 A L A-C A-. 9 3 a 9 CLASS 9 1 BK PGVALIDATION SO.FT. NO OF NO.OF CHECK License Nunawr Lic.Class SIZE 39a ISTORIES FAMILIES ONE n VALUATION Contractor Date DESCRIPTION OF WORK /�/»/ti L l al Z `" E] $ ' G lL NEW �G G OC n ADD I am exempt under Sec. ❑ ALTER B.BP.C. for this reason REPAIR ❑ $ 8 9 8 3 A Date: USE OF DEMOL 0 0 0 0 0 1 EXISTING BLDG. ❑ Signature APPLICANT ,��// TEL FINAL �J ° 1 99.88 OWNER-BUILDER DECLARATION PRINT oAer.,t /U©VC.&l NO.o�$S-(o 31 DATE G/ 1 hereby affirm that I am exempt from the Contractor's License �v 00199882: Law for the following reason (Section 7031.5, Business and ADDRESS -13 L'� Low, 1l•el r►1 Le ClT' Professions Code): WRT 0 2 1 9—E 8 BUILDING I, as owner of the property, or my employees with ADDRESS wages ct their sole compensation,will f o the work and / .k/� the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. I, as owner of the property,am exclusively contracting CONTRACTOR NO. n f� �8 8 9.4 A with licensed contractors to construct the project (Sec- ADDRESS J tion 7044, Business and Professions Code). 0 0 0 0 CONSTRUCTION LENDING AGENCY SETBACK YARD HWY TOTAPROP. LINE WIDTETBACK FROM H I hereby affirm that there is a construction lending agency for FRONT 0 9 8 the performance of the work for which this permit is issued P.L. Sec. 3097, Civ. C. . SIDE , , ( ) a ; 9, F8� �I P.L. Lender's Name 1207-µy - /U©UeT('r, I^�', LDMA Ref. q 2—88 m R�� /, Lo tw 11&� AVE!-. P.C. Fee$ Permit Fee Lender's Address c_�_T � I certify that I have read this application and state that the Issuance Fee 'C/(. LDMA P/C N above information is correct. I agree to comply with all County Investigation Fee QQ °o ordinances and State laws relating to building construction, Total Fee U� LDMA Perm.ff $ and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. m SEE REVERSE FOR EXPLANATORY LANGUAGE Signatur of Applicant or Agent Date ` . WbRKERS'COMPENSATION DECLARATION r hereby affirm a I have certificate of consent to self APPLICATION FOR BUILDING PERMIT ' insure, or a certificate of Workers'Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS 94.3 � ✓ Certified copy is filed with the county building inspec- BUILDINGQ �o T tion department. ADDRESS 7✓5-3 7 �' GLc �jyi t!ti? qj/ Gr Date Applicant CITY ZIP 7a O LOCALITY r CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT .5-0 X//70 NOW ON LOT I CROSS ST. (_74 (This section need not be completed if the permit is for one ASSESSOR hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL OWNER U s'L�GF�- � NO.TEL' USE ZONE MAP I certify that in the performance of the work for which this / NO. permit is issued, I shall not employ any person in any manner 7 5 3 /v� SPECIAL ADDRESS so as to become subject to the Workers'Compensation Laws. CONDITIONS U all/�� 4, & CITY ZIP �/;7f 1) Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT Off TEL.ENGINEER NO. DISTRICT t GROUP I TYPE FIRE PROCESSED BY O Exemption, you should become subject to the Workers' CONST. ZONE V Compensation provisions of the Labor Code, you must forth- ADDRESS OW. with comply with such provisions or this permit shall be ''// /� TEL.Z19 y — STATISTICAL CLASSIFICATION APT. CONDO. U) deemed revoked. CONTRACTOR /&J__S .3lDkST. NO. -7.34-6191-3 Z LICENSED CONTRACTORS DECLARATION I LIC, C —! CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS .2ASl NIV ,L/ L11s 00.6 NO. ��J SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC, Professions Code, and my license is in full force and effect. CITY V!5At1Jq- C4 '73-111 CLASS —� VALIDATION SQ.FT. NO.OF NO.OF CHECK BK. PG. License Number Lic.Class SIZE STORIES FAMILIES ONE �� tA'1 ^ VALUATION Contractor Date DESCRIPTION OF WORK /► Ci ;qhUeqA DD O $ /- I]I am exempt under Sec. `� '� � � Pfd-TlD CDIIr°t2 ALTER ❑ / c 8 9 8 4 A B.BP.C. for this reason M EART14 u• REPAIR $ ° Date: USE OF ° °° 6&b EXISTING BLDG. DEMOL ❑ 0 0 0 = Signature APPLICANT J]�� TEL. r FINAL ^ b $6 3 PRINT 1JQ Q ©U p• NO. o .I / /G 0 2 1 9-E8 OWNER-BUILDER DECLARATION DATE 1 hereby affirm that I am exempt from the Contractor's License �y Law for the following reason (Section 7031.5, Business and ADDRESS FI Professions Code): PRESENTB 1 ❑ BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and , the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ® I, as owner of the property, am exclusively contracting CONTRACTOR NO. -,P-889. 3 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). # 0 0 0 0 0 REQUIRED TOTAL SETBACK F CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT o o a 3 the performance of the work for which this permit is issued P.L. a(Sec. 3097, Civ. C.). SIDELender's Name ! 0107�yA v�mr, P.L. 02�aeh,—88 Lender's Address '51-3 7 P.C. Fee$ Permit Fee LDMA Ref. H 1 certify that I have read this application and state that the Issuance Fee O LDMA P/C Poo above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee and hereby authorize representatives of this County to enter LDMA Perm. N upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signatund of Applicant or Agent Date IP APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY ADDRESS UILDI G WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN Bq,�3 7 w. 1 hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS G or a certificate of Vlbrkers'Compensation Insurance,or a certified 9� ` ' L 17 e 0 copy thereof(Sec.3800,Lab.C.) C� . ZIP /7�� LOCALITY Policy No. Company SIZE OF L NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. $y x/ob / NEAREST CROSS ST. , ❑ Certified copy Is filed with the county building Inspection TRACT BLOCK LOT No. USE ZONE MAP NO. department. ASSESSOR MAP BOOK PAGE PARCEL Date Applicant SPECIAL CONDITIONS TEL NO. CERTIFICATE OF EXEMPTION TI N FROM WORKERS' ItARCHITWT ��r'—IO.2 r I WITHIN 1000 FT.of SCHOOL? YES NO (This section need not be completed if the permit is for one hundred DISTRICT GROUP TYPE CONST.' FIRE ZONE PROCESSED BY dollars that or less.) ZIP 50Y �,3I certify that in the performance of the work for which this permit 1 �70 D J is Issued, I shall not employ any person in any manner so as toR ENGINEER TEL.NO. become S bj t t0 the Workers'Co pensath Law A — STATISTICAL CLASSIFICATION APT COND Date d Applicant �� ADDRESS CLASS NO..c=� DWELL UNITS NOTICE TO APPLICANT: If, after making this Certificate ofREQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR TEL.NO. SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code,you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION clTv LIC.CLASS SIDE v C3 I hereby affirm that I am licensed under provisions of Chapter 9 I SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW ❑ BK PG �• License Number Lic.Class D RIPTIQ�NCO R . ADD ❑ vALuanoN o m , y Contractor Date '� If ALTER ❑ $ l O l�O ❑ 1 am exempt under Sea REPAIR ❑ $ BARC.for this reason DEMOL ❑ LOMA PIC N Date: USE OF EXISTING BLDG. URM ❑ Signature APp�pICANT(PRINT) TEL.NO. LDMA perm# 1 ❑ 1,as owner of the property, or my employees with wages as toO U r I otv"43 C ACCT.4 their sole compensation,will do the work and the structure Is ADDRESS L U►1 �p FlNALDA Q t^,j c- not intended or offered for sale (Section 7044, Business and S G 33 07 58.7, Professions Code.) WILLTHEAPPLICANT OR FUTURE BUILDING OCCUPANT HANDLEA HAZARDOUS MATERIAL a 1 ITEMS I, 8S owner of the property, am exclusively contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN Y 9 THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BVf licensed contractors to construct the project (Section 7044, YES❑ NO❑ 5s -'a 5 Business and Professions Code.) ���� �' WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING r OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THESOUTH CHECK 5L.75 CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. CHANGE a GO I hereby affirm that there is a construction lending agency for YES❑ NO❑ 4rli!'il9 L iJ the performance of the work for which this permit is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD 3W7,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES �. COUNTYCODE,TITLE2,CHAPTER 22DSECTIONS 220.100THROUGH 220.140 CONCERNING II1,JI]—I�(I)1 � j� 3 Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. Lenders Address S[Lf ���� ?9r 17 1 AM 7:27 0 1 Certify that I have read this application and state that the above P.C.FEE PERMIT FEE information is correct. I agree to comply with all county ordinances and State laws relating to building construction,and oO hereby authorize representatives of this County to enter upon ISSUANCE FEE the ove-ment ned p operty for Inspection purpo INVESTIGATION FEE TOTAL FEE �+ C' sgectum M�ppea««Ape ous ' �J SEE REVERSE FOR EXPLANATORY LANGUAGE Cir Y, r 76A638A CE 808162 APPLICATION FOR BUILDING PERMIT _ COUNTY OF LOS ANGELES BUILDING r DEPARTMENT OF COUNTY ENGINEER .ADDRESS �$ 7 LoN G D BUILDING AND SAFETY DIVISION LOCALITY Tpq rL-E- C 1 i JOHN A. LAMBIE, COUNTY ENGINEER NEAREST + WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST. _44 7 FOR APPLICANT TO FILL IN DISTRICT NO. G^R-��O-UP TYPE PROCESSED BY 57,0-2 .�1. CON STr.-_ G o Lo V c C� BUILDING STATISTICAL CLASSIFICATION SEWER-MAP ADDRESS �� B PG CLASS.NO.�DWELL.UNITS t 3O` LOT NO. E. 6J ' o r w' �`t 6LOCK WATER CERTIFICATE: NOT REQUIRED RECEIVED TRACT SAW!It A Al I j A L-.t ND 0 11���77h�� NO.OF BLDGS. NO. �-003 (CIRCLE) STATE MAJOR SECON LOCAL SIZE OF LOT �( .Or NOW ON LOT / USE ZONE SPECIAL USE OF I� CONDITIONS EXISTING BLDG. / , TEL. OWNER ��e.(Y,{� NO. BUILDING YARDHWY STREET NAME . EXIST. SETBACK WIDTH ADDRESS 'FRONT1 /� r ARCHITECT OR TEL. P. L. ZO Po ENGINEER NO. i SIDE / / 3 ADDRESSIL _ - - TEL.p l! +�/o 1. 4-�l7 mss• / r�•�': 1• f f"�-_ CONTRACTOR / NO.JY�79�5 / /�J � V ADDRESS 6 r2 CLL�Q . C //lf 1" lf% DESCRIPTION OF WORK / / I; w NEW ADD ALTER REPAIR DEMOL SH !/ f z SO.FT. NO,OF NO.OF i `'/E+^f /���.+r.',��� SIZE /��- STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF f �� ✓f/iI A✓f `,b`` �Irf1�. .C'as frlr��A fey` APPLICANT = ' r/ •�i ��`�.�/ul` /ts�'LsiX j1'I.:/.�i7 J.•:/r i�`�Iri`"G��.0'�.n� /,' .., VALUATION $ �A. i i X jJr� PPROVALS / DAT INSPECTQR'SfSIGJJATURE P.C: PMT. FOUNDATION: LOCATION FEE $ FEE $� FORMS, MATERIALS 'FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- / ING'TO WORKMEN'S COMPENSATION IN URANCE. ' - ` I '� /• LATH,EXT: ) SIGNATURE OF -HOUSE NUMBER COR- PERMITTEE- OR-PERMITTEE .7.i! ,RECT AND POSTED _-- ADDRESS /���iasrf=� 'C.- FINAL JOHN F. LEMS,'PIFINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK' M.O. CASH 4 9: u' 0 5 .0 V 1,!,till � .� 11 Li "' c 76A66SA CE#SOS5-61APPLICATI0N FOR BUILDING PERMIT. COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION I OCALITY ' JOHN A. LAMBIE, COUNTY ENGINEERNEAREST ' WILLIAM A. JENSEN-SUP•T OF BUILDING CROSS S , DIST ICT'NO GR TYPE FOR APPLICANT TO FILI.IN CONST' BUILDING �i STATIS ICAL C SiFICATION SEWER MAP ADDRESS d 3� L-C11" j-6E W SK ' ^�Gjy i. CLASS.NO. DWELL.UNITS LOT %N2 LOCK 7 WATERNOT•REQUIRED ❑ RECEIVED rFl TRACT �� t� GO CERTIFICATE: NO.OF BLDGS. NO.• .HIGH—EI STATE MAJOR SECOND, CAL SIZE OF LOT-50 it tci O NOW ON LOT 1 USE ZONE' SPECIAL USE OF I� �- CONDITIONS EXISTING BLDG. I\ IL.S , TEL. OWNER /111 I III Sc 5742 1 C E-4- NO. 1.11 -A9 BUILDI G EXIST. � YARD HWY •STREET NAME SETBACK. WIDTH ADDRESS X537-�7 !J: Gan.-,II i vim. FRONT' ARCHITECT OR. TEL. P.L. ENGINEER NO. SIDE O ADDRESS --m TEL. INSPECTION RECORD: CONTRACTOR c%"-) NO. O ADDRESS V W DESCRIPTION OF WORK- CN iW ORK' 916NEW ADD ALTER REPAIR DEMOLISH SO.FT. NO.OF NO.OF IZE 'Go STORIES FAMILIES USE Or, b 1 J`. STRUCTURE ca SIGNATURE OF G LQ J APPLICAew NT VALUATION$ I f !/,/ APPROVALS /DAT INSPECTOR'S SIGNATURE FC. PMT.EE $/' FEE $ FOUNDAIION:.LOCAf10N -7114162k. �` �itrLT' FORMS.MATERIALS f MOLT'/t/ FRAME:FIRE STOPS,• fl I 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY. FURNACE:LOCATION, •_ WITH ALL'COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING.CONSTRUCTION. 1 CERTIFY THAT IN DOING'THE WORK _ AUTHORIZEDIHEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA• LA'T'H,INT. TION OF THE LABOR CODE OF-THE STATE OF CALIFORNIA RELAT- _ ING TO WORKMEN' OMPENSATION INRSUCE. E �j'jIV9 �-c- LATH.LATH,EXT. SIGNATURE OF i HOUSE NUMBER COR- PERMITTE mss,2 "RECT AND POSTED ADDRESS.2j "f &.c ftma II.a �m+r7�I�SCI�11 ,17 •�A f �- FINAL 1,:� ,awlv/� CLYDE N. DIRLAM,'PRINCIPAL STRURAL ENGINEER PLAN CHECK VALIDATION. cK. M.O. CASH PERMIT VALIDATION c16 M.O. CASK , LQ 1.5 9,2 Q4 JUL16 1 0 6..GO .9 BUILDINGBUILD NG ADDRE189 APPLICATION LOCALITY f � DIVISION OF BUILDING AND SAFETY NEAREST ,�•---� �• � �y f. 6ROBB ST. Department of Comity Engineer D113TRICT NO. RECEIPT NO. /PERMIT NO. Comity of Los Angeles WM. J. FOX. COUNTY ENGINEER GROUP DATE RECEIVED DATE-ISSUED/ OABSATT D. GRIFFIN, SUPT OF BUILOINO FO1R" APPLICANT TO FILL I1,N /► /^ TYPE OO ar. RECEIVED BY �� �UED.B.YY� OWNER , MAP `"� r•`y STATE YBB NO MAIL B v� -;IP w /eta NUMBER ��✓� •HWY v S E.Z�O�N,E 8PDIAL CODITIO NB gyb 4 r CITY ii 4/1'/", _ ARCHI ECT OR ' // TEL. ENGINEER f/ NO. v BUILDING YARD H1AIY STREET NAME EXIST. AD E68 SETBACK WIDTH TEL. _ FRONT - CONTRACTOOjR�•N-I, '/,NO. O P.L. V J_ ADORDE ES$ .y,'l A 1 1'.. . Pte: 1M�1 r/�P lrl/ t'—�f P.L ABUILD ' !V DDREIN � �f�J�slit l✓ DATE CORRECTIONS INSPECTOR LOT NO. l" // v !/ BLOCKL� TRACT v,//`!t �._!� f/> -/--!S NO'OFELOBIts /S H I W a 812E OF LOT ♦ n NOON LOT UBE OF EXISTINGELOG. DESCRIPTION OF WORD a NEW ADD - ALTER REPAIR DEMOLISH Z 90.FT. NO.OF NO.OF a 812E STORIES FAMILIES r USE OF STRUCTURE NO.OF EMP.LOYEEB I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS• APPROVALS INSPECTOR'S SIGNATURE DATE CORRECT. 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION! LOCATION AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS /I FRAME! FIRE STOP96 SIGNATURE OF �l��r BRACING,BOLTS PERMITTE �J rt l.Is. . A. +.d_aG�r L. ✓. 1 FURNACE! LOCATION. r ADOREGAB VENT.DUCTS S�\�t�- . 1 / Ait_-,A� �.�.t-t .ff.•��'� f� LATH. INT. AUTHORIZED AMT. f LATH. EXT. $ / P.-C.R HOUSE NUMBER COR- E FEE RECT AND POSTED VALUATION !1 ✓ (/ FEE FINAL 7&AWBA DHS 3 4-54 TEMPLE CITY feAssej'aehos.1-61 APPLICATION FOR BUILDING PERMIT ' COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGRIMER ADDRESS BUnDING AND'SAFETY DIVISION LOCALITY JOHN A. LAMBIE,'COUNTY ENGINEER NEAREST WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST. D4&1,RICT GV, TYPEP FOR APPLICANT TO FILL.IN Q. CONST. BUILDING V�•j f / ,g STATISTICAL C ICATION SEWER MAP ADDRESS 7 �C a NG CYGN 15/VC vt' CLASS.N_O. �LDWELL.UNITS LOT NO. !-OrG-ION 140e'-d BLOCK WATER L CERTIFICATE: NOT REQUIRED RECEIVED TRACT vf++Qi!!�i dL /�w/is& �/iitlC� ��. MAP /� HIGHWAY NO.OF BLDGS. . NO. �J (CIRCLE) STATE MAJOR SECOND, LOCAL SIZE OF LOT. NOW ON LOT USE ZONE SPECIAL USE OFr CONDITIONS EXISTING BLDG. +/ .OWNER C'. 7,16d, Nb7-d-Jawl BUILDING WIDTH'EXIST. SETBACK YW ARD HY STREET NAME ADDRESS FRONT ARCHITECT OR TEL. P.L. ENGINEER NO. SIDE _.P.L. ' } ADDRESS. TEL. XSI�ECTION RBCORD ! v 0 CONTRACTOR NO. �ff f` �jf—� ��rr � ADDRESS DESCRIPTION OF WORK + '`' a NEW ADD' ALTER REPAIR DEMOLISH / Z SQ.FT. NO.OF NO.OF / - $IZE STORIES FAMILIES USE OF I /- STRUCTURE (,/ Lia 3o OO o 4 7e SIGNATURE OF APPLICANT VALUATION 5 O ti O O APPROVALS - DATE INSPECTOR'S SIGNATURE FOUNDATION:LOCATION F E $ FEE $ s FORMS.MATERIALS FRAME:FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE'LOCATION, ' WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH,INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO'WORKME MPENSATION INSUUtANCE. , - LATH.EXT.-. SIGNATURE HOUSE NUMBER COA- / PERMITTE. RECT AND POSTED ADDRESS �'r ' FINAL CLYDE N. DIRLAM, PR CIPAL ST RAL ENGINEER PLAN CHECK VALIDATION cK. M.o. cAsx PERMT- VALIDATION cK. M.O.- cAsm LAU95 1 5 G i1AY 25 1 0 4. 0�' 78A888A CE9808 9-87 ,/ /•� /� AF . APPLICATION"FOR--BUT-LO, RMIT COUNTY,OF LOS ANGELES BUILDING 'DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION G JOHN A. LAMME, COUNTY ENGINEER LOCALITY COLEMAN W. JENKINS, SUPT OF BUILDING, NEAREST CROSS ST.DST CT NO. GROUP TYPE PROCESSED BY FOR APPLICANT TO FILL IN � y CO (Print V r BUILDING p STATISTICAL CLASSIFICATION SEWER MAP ADDRESS , 7 Gj G'l�cr CLASS NO.�DWELL.UNITS BK'PGO LOT NO. BLOCK USE ZONE MAP NO. TRACT Zia�/ Co. ^ :SPECT L NO.-'OF BLDGS. 1.CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. G.SETBACK FROM L. FR T PROP.LINE OF (STREET) OWNE NO. TYPE OF SETBACK HIGHWAY + YARD = TOTAL ADDRESS -S 7HIGHWAY WIDTH M C.L. CITY + BLDG.SETBACK FROM ARCHITECT ORVI TEL. SIDE PROP.LINE OF (STREET) ENGINEER NO. TYPE OF EXISTING SETBACK HIGHWAY + D = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. T _ CONTR N + 7 O ADDWU&Z 'iJO. CORNER CUTOFF' YES ❑ NOCD ❑ CITY 0? Q.,` CLASS S SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK oW N Z NEW ADD ALTS • REPAIR DEMOLISH SQ. FT. NO. OF NO. OF SIZE ST RIES FAMILIES USE OF - .r STRUCTURE SIGNATU AP f VALUATION$ APPROVALS DATE INSPECTORS SIGNATURE P.C. PMT. m� FOUNDATION: LOCATION , FEE$ FEE s p.� FORMS, MATERIALS FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE'READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK •AUTHORIZED HERESYI WILL NOT EMPLOY ANY PERSON IN VIOLA- TION OF THE LA ODE OF STATE OF CALIFORNIA RELAT• LATH, INT. TNG TO WORKM E INSURANCE. LATH, EXT. �y(p SIGNAT HOUSE NUMBER COR- PS RECT AND POSTED it ADORES FINAL // (TY JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION. CK. M.O. cnSH LAGo 2. 6%0 JUN 2 6 °0 1 -2•. 3 0 N