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Home My Public Portal About9700-9702 LONGDEN AVE_Building__ ®S'76A639A.•. GE/603(REV.6/78) APPLICATION FOR* BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN A�DRFss BUILDING / ADDRESS 7d-O•- d,Z -iCQ�9 A LOCALITY J NEAREST CITY _ / ZIP / CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT / MAP BOOK PAGE , PARCEL �,(�yii DISTRICT GROUP TYPE FIRE 0CESSED BY TRACi3�7 BLOCK LOTffO. CONST. ZONE TEL. OWNER �f ./� N0 2Z ;Z STATISTICAL CLASSIFICATIONSEWER P ADDRESS n em CLASS NO. �.i=DWELL.UNITS-t24BK PG CITY eM 1. ZIP �f � ARCHITECT O TEL: 7/4i� VALUATION ' ENGINEER NO. _e ADDRESS ti CI _ BLDG.SETBACK FROM TEL. FRONT PROP.LINE OF �� (STREET) CONTRACTOR �- ' NO. HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING /H �G LIC12 FRONT PROP.LINE HIGHWAY /WIDTH ADDRESS / LIC. + CITY CLASS CONSTRUCT( LENDER BLDG:SETBACK FROM NAME AND BRANCH 9 SIDE PROP.LINE OF. (STREET( TOTAL SETBACK FROM I TYPE OF EXISTING !/ } Cd dia. HIGHWAY + YARD = SIDE PROP.LINE HIGHWAY WIDTH , . ADDRESS •/ion M GliCITY SO.FT NO.OF } NO.OF CHECK + _ SIZE STORIES I FAMILIES. ONE DESCRIPTION OF WORK [;dh O NEW P.C.Fee$ ,dpo Permit Fee •- LM hADD ❑❑ Issuance Fee11601 ALTER ,y /Azb C4001d H 4 am REPAIR• ❑ Tdtal Fee \J •� USE OF EXIST El- APPLICANT TEL a L 2- 93 C (PRINT( O• Sayr a� 3 O OV BY(SIGNATURE) // :5 1HEREBY KNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE �' (��_ /tel �L !C THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES uVt AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF' _J U THE LABOR CODE OF THE STATE OF CALIFORNIA IN RE ING WORKMEN'S COM- �—�� Z PENSATION INSURANCE. g r SIGNATURE OF �� PERMITTEE ADDRESS CM 04/e % •" Ylb . TEL CITY NO. G USE ZONE MAP NO.. Z SPECIAL CONDITIONS BY FINAL DATE (f O ' ®S 76A638A GE#8031REV.6/'S8) APPLICATION- FOR BUILDING- PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY BUILDING FOR APPLICANT TO FILL IN ADDRESS BUILDING �"' ADDRESS k'° ? l� (t� LOCALITY �y NEAREST CITY _ ZIP - / (/ CROSS ST. NO OF BLDGS. ASSESSOR SIZE OF LOT !�2 QJ NOW ON LOT �� MAP BOOK / PAGE PARCEL ' DISTRICT GROUP YPE �111,aRE2ESSED BY TRACT BOCK LOT NO. �, CONST.TEL. OWNER' _. t ldd'. NO. �_. STATISTICAL CLASSIFICATION --SEWER M ADDRESS _ / fV� s CLASS NO.�DWELL.UNITS BK PG �' �/��v CITY C-JK & Cr / ZIP ARCHITECT OR TEL• VALUATION � ENGINEER v/1 NO. (� ADDRESS BLDG.SETBACK FROM TEL. FRONT PROP.LINE OF (STREET) CONTRACTOR A . . A NO. HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING LIC. - FRONT PROP.LINE HIGHWAY •WIDTH 1 ADDRESS / NO. LIC. + CITY CLASS CONSTRUCTION ENDER BLDG.SETBACK FROM NAME AND BRANCH SIDE PROP.LINE OF (STREET) HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH SQ.FT. NO.OF NO.OF CHECK + _ u SIZE STORIES FAMILIES ONE all DESCRaUW PF WOK NEW .C.Fee$ Permit Fee 2- ADD ❑ Issuance Fee EPAIR ❑ Total Fee USE OF DEMOL ❑ EXISTING BLDG. ZO APPIPRIANTI C`' C �[�A Ni o Q BY(SIGNATURE) IHEREBY LEDGrE THAT I HAVE READ THIS APPLICATION AND STATE uY THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES __ -• AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE. WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF _ THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING WORKMEN'S COM- z PENSATION INSURANCE. �• f/ 4 SIGNATURE OF PERMITTEE ADORESI � _ C% TEL. C CITY �• —� L NO. Q D USE ZONE MAP NO. Lf. SPECIAL CONDITIONS _ FINAL / �JBY DATE - APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES` BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADyDRESS ADDRESS ` /` /= I hereby affirm that I have a certificate of consent to self insure, r / O N�> , or a certificate of Workers'Compensation Insurance,or a certified "V LZ- (� i copy thereo S .3800,Lab.C.) CITY J e LOCALITY Poli. o ' C. SIZ OF LOT NO.OF B GS.NOW ON LOT Certified copy is hereby fu4eu ihdNEAREST CROSS ST. ❑ Certified copy is filed with bui Ing ins coon TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS O CERTIFICATE OF E. FROM WORKERS' OWNER TE�,(JQ�vG�� YES NO COMPENSATION INSURANCE - F1% WITH)N 1000 FT.OF SCHooL7 (This section need not be completed if the permit is for one hundred ADDRESS dollars($100)or less.) q v 1;10z)-e r L,J • DISTRICT GROUP TYP ONST. FIRE ZONE PROCESSED BY I certify that in the performance of the work for which this permit / r f�y is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER -{✓ TEL Nb. •'/( become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO.r2 Z DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of , r - REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' C RACTOR / TEL / SET BACK YARD HWY PROP UNE WIDTH Compensation provisions of the Labor Code, you must forthwith V/.?l V� `-c FRONT comply with such provisions or this permit shall be deemed revoked. S u P L. LICENSED CONTRACTORS DECLARATION CITY C ��7 SIDE .CUSS-� PL I hereby affirm that I am licensed underprovisions of Chapter 9 (-�15 C+ SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.F SI7EP NO.OF STORIES NO.OF FAMIUES Professions Code,and y licensee i in full force and effe _CJ' NEW ❑ BK PG } License Number - / •c.Class RI N OF W09K ADD ❑ VALUATION �` O L�- + ZDate ALTER El , Contractor � '� ❑ 17 I am exempt under Sec. 0 REPAIR,, 0 E- B.BP.C.for this son DEMOL ❑ P/C W U40EXIST14NLD URM ❑ �- Signature APPLICANT(PRINT) TEL NO. LDMA Perm-# 3 z ❑ I, as owner of theerty, or my employees with wages as Z f{(;CTA their sole compensation, will do the work and the structure is ADDRESS O �r r ;f,._ r not intended or offered for sale (Section 7044, Business and FINAL DATE C ..30� 21(-1,2 y 1.ill Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL s �j OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE /J FIEMS ❑ 1, as owner of the property, am exclusively contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044, TI_I CITAL 202= I =E Business and Professions Code.) Yes 11 No 11 WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING CHECK 202.05 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR I 5-:, {� �-� GUIDEUNES i�A 3L e riri LI 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. M . I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 3097,CIV.C) I q d q 1 a 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 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. �4 646 0 Lender's Address C OWNER OR AGENT c I certify that I have read this application and state under penalty cof perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE l a with all county ordinances and State laws relating to building !� CO cons ct n, and hereb uthorfze repres tatives of this County ISSUANCE FEE �,I�/� ro toe er pon the abo boned prop for inspe n rp sas. TC> '�/ INVESTIGATION FEE TOTAL FEE O D n n ai Appli®nt Gw SEE REVERSE FOR EXPLANATORY LANGUAGE