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Home My Public Portal About10662 LORA ST_Building__ - TEMPLE CIT ISASSSA CIE#803 2/80 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AD°REss .DEPARTMENT OF COUNTY ENGINEER _ BUWING AND SAFETY DIVISION LOCALITY. �J t JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A.JENSEN .'SUP'T OF BUILDING CROSS ST. DISTRICT N G EpE, ES BY FOR APPLICANT TO FII�I.:IN } CONST: L BUILDING STATISTICAL S ER MAP - ADDRESS. 7'C BK C; CLASS.NO DWELL.UNIT LOT NO. ` BLOCK MAP STATE NUMBER 6 HWY. YES •N TRACT USE ZONE SPECIAL / NO.OF SLDGS. CONDITIONS SIZE OF LOT (CIS (/ ly I NOW ON LOT USE OF EXISTING BLDG. BUILDINGEXIST. TE SETBACK YARD HWY STREET NAME WIDTH OWNERAZY N FRONT y S • ADDRESS SIDE ARCHITECT-OR TEL. P.L. ENGINEER No: INSPECTION RECORD ADDRESS a TEL.. CONTRACTOR NO. O ADDRESS. �� DESCRIPTION OF WORg {^y "�' ` �r6/ J t Pl w�: JI.A_Ji/' I�Ji.r.�'�� J.✓'y..b!.Tr�:l�.filam" .4+Y.'!v I 0- NEW ADD ALTIR REPAIR , DEMOLISH ! r' SQ.FT, NO.OF NO.OF SIZE STORIES 'FAMILIES USE OF STRUCTURE A ' IGNATURE OF - APPLICANT VALUATION$ -' � • _ APPROVALS DATE INSPECTOR'S SIGNATURE ®Q FOUNDATION:LOCATION FEE '$ FEE $- FORMS,MATERIALS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME:FIRE STOPS, PLICATION AND STATE THAT THE ABOVE IS CORRECT AND BRACING,BOLTS -� 11 FURNACE:.LOCATION. AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT,DUCTS ' `" /J I CERTIFY THAT IN DOING THE WORK AUTHORIZED. i `EAC13rINT. 1 L' /O �o� WILL.NOT EMPLOY ANY PERSON IN VIOLATION OF THE WORKMEN'SCOMP NSAT1O WS OF CALIFORNIA. LATH,E)CT.-�:' SIGNATURFF HOUSE NUMBER COR- RECT AND POSTED PERMITTE ADDRESS FILIAL .fig/�/r✓ r/, +.� CLYDE7V. DIRLAM, PRI'NCIPAL'STRYJCTURAL ENGIIAEER PLAN.CHECK VALIDATION -L Ik.O. CASH. PEEWT VALIDATION CK. M.o calx. TEMPLE CIT M USA'q#8932/80APPLICATION -}FOR BUILDING . RER II" COUNTY-OF LOS ANGELES BUILDING DEPARTMENT'OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY.DIVISION, LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A.JENSEN SUPT of BUILDING CROSS ST. Wpm gDISTRICT O.' GROUP .TYPE PR CESSED BY'- ,:FOR APPLICANT TO FILL IN �Y coNsr. BUILDING STATISTICAL CLASSIFICATION SEWER MAP ADDRESS D :� �y BK PG CLASS.NO.-..DWELL.UNITS �- LOT NO.. BLOCK 'MAP ,y STATE •YES •NO NUMBER016 /0 HWY.- - TRACT• 2 USX ZONE. SPECIAL NO.OF.-BLDGS. �i CONDITIONS X SIZE OF LOT' NOW.ON LOT' E (STING BLDG. BUILDING EXIST: YARD HWY STREET NAME TE / SETBACK -WIDTH OWNER L N FRONT - P.L. ADDRESS /IJ./.,.h 2 SIDE ARCHITECT TEL. P.L. ' ENGINEER No. INSPECTION RECORD :ADDRESS - TEL. `CONTRACTOR NO. ADDRESS - - � �' - ;:'' � •�:. DESCRIPTION OF WORg- �: O NEW ADD AL.ER REPAIR DEMOLISH NO.OF.' .._ '-NO.' OF_- ' i \ . y_SIZE STORIES FAMILIES USE OF 'L .'STRUCTURE' FI SIGNATURE OF APPLICANT VALUATION$ �� :-APPROVALS* DATE INSPECTOR'S'SIGNATURE P.0 PMT //JJ' FOUNDATION:LOCATION' FEE FEE $i�. . FORMS MATERIALS FRAME:•FIRE,STOPS, / 1 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- BRACING BOLTS. /d .--1,1�' PLICATION AND STATE THAT THE ABOVE IS CORRECT AND FURNACE:I OCATION, =� ' AGREE TO COMPLY W17 H ALL COUNTY ORDINANCES AND GAS VENT,'DUCTS 'STATELAWS REGULATING BUILDING CONSTRUCTION. ICR 'L�4TH;�INT. 7/�d�'.�JrI -�'/�7r t� r✓.k;S. �' CERTIFY .THAT IN DOING THE WORK-AUTHORIZED I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE t WORKMEN'S COMP NSAT N LAWS F• RN1A., 1=AT'H-EXT SIGNATURE'OF ' i � HOUSE-NUMBER COR- PERMITTEE', % RECT AND POSTED a .. ADDRESS FINAL CLYDE N. DIRLAM, PRINCIPAL STRICICTURAL E PIAN CHECK VAMATION ..ax. ns.o.: "CASH, PERMIT-VAIoIDATIbN;._cx G + :n., APPLICATIOWr6k BUILD&G PERMIT FOR APPLICANT T.0 FILL IN (Print or type only) BUILDITIG COUNTY OF LOS ANGELES ADDRESS 0�p®/�I `Z ��/D ? DEPARTMENT OF COUNTY ENGINEER CITY T6-MPU' CITY ZIP q o78d BUILDING AND SAFETY DIVISION NO.OF SLOGS. DiiSLr BUILDING SIZE OF LOT ! ' NOW ON LOT a ADDRESS TRACT ',_DS BLOCK LOT NO. 2 LOCALITY OWNER �S>r�PMIE�1 .` No. �� cc NEAREST U JO*5 D 7 CROSS ST. ASSESSOR ADDRESS S A MF. MAP BOOK PAGE PARCEL DISTRICT I GROUP TYPE FIRE SSED BY CITY ZIP r-• CONST. Z E i ARCHITECT OR TEL ENGINEER NO. r `STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NOOWELL•UNITS � PG CONTRACTOR NEL' 'USE ZONE MAP LIC. NO.;=:;"2-01U ADDRESS NO. SPECIAL I/ r(� LIC. CONDITIONS 1/ -7 CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONSTRUCTION LENDER �/ NAME AND BRANCH o AFE 6. LA BLDG.SETBACK FROM 'FRON PROP,LI NE OF (STREET) ADDRESS CITY HIGHW Y �• YARD ITOTAL SETBACK FROM TYPE OF EXISTING SQ. FT. NO. OF @ NO. OF I CHECK ' FRONT PROP. LINE HIGHWAY WIDTH SIZ ' STORIES FAMILIES 'ONE DESCRIPTION OF WORK NEW ❑ G BLDG.SETBAC c.7 W g &, rr_: ADD SIDE PROP.LINE OF (STREET) CD CDIJVEkrTc -aairLTER ❑ _ TOTAL SETBACK FROM TYPE OF EXISTING REPAIR HIGHWAY •} YARD - SIDE PROP. LINE. HIGHWAY WIDTHUSE yVj ❑ b \ cn EXISTING BLDG. PESIDtOC-6 DEMOL ❑ + `� z APPLICANT '` TEL ✓� 14 �y CORNER CUTOFF YES ❑ NO ❑ \ (PRINT) IV b, gNO. J•�(� s BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION,$ 27-,_'500 *� I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLYWITH ALL �`i ,.�l�/ , 1�r{Aye 3TRUC TION.ORDCERTICES AND FY THAT LAWS DOpNG UTNE ING BUILDING WORK AUTHORC ED �-/,v O "- Y �" AfA '��yyy/� HEREBY I WILL NOT EMPLOY ANY PERSOW IN VIOLATION OF THE f yy�� / LABOR CODE OF THE STPTE OF •CA IFORNIA IN RELATING TODA C/ -� 'KJ%17, WORKMEN'S COMPENSA ON INSAIRANCE SIGNATURE OF 7"'L PERMITTEE ADDRESS FINAL• BY TEL. CITY NO. DATE', MAKE CHECKS PAYABLE TO: FEE' FEE HARVEY T. BRANDT, COUNTY ENGINEER PLAN'CHECK VALIDATION cK. M.O. CASH o PERMIT V 'Llb'L ATION cK. M.O. CASH 63 2�JUL Z4,2�3� U 8.1 0 s " _ f _ J 0 6 76A698A CE Y.B09 574 •WORKERS'COMPENSATION DECLARATION APPLICATION FOR BUMDING I hereby affirm That I have a certificate of consent to self 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 copy y FOR APPLICANT TO FILL IN BUILDINGCertified co is hereby furnished. ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS l7 /� Date Applicant CITY--ra"PLA cq ZIP 0 LOCALITY �s NO.OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT_/a J NOW ON LOT J CROSS ST. ' COMPENSATION INSURANCE ASSESSOR c� p (This section need not be completed if the permit is for one TRACE ��ao✓ BLOCK LOT NO. � 0 MAP BOOK ��✓ PAGE 03 PARCELoS hundred dollars ($100)or less.) OWNER EUSE ZONE MAP /��/� ��'' NO.NO� -Q NO. I certify that in the performance of the work for which this 11 permit is issued, I shall not employ any person in any manner ADDRESS - SPECIAL CONDITIONS d so as to become subject to the W kers'Co ensati ws. O 1� 1 y CITY ZIP te [ DaApplicarg ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY 0 NOTICE TO APPLICANT: If, ter 4612ing this ifferfificcite of ENGINEER NO. CONST. ZONE Exemption, you should become subject to the Workers' y� I/ Compensation provisions of the Labor Code, you must forth- ADDRESS v 3 Y a with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT. CONDO. u7 deemed revoked. CONTRACTOR® � -� �1Z NO. Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. -. - DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP and Professions Code,and my license is in full force and effect. CLASS BK.40-0 CITY PG VALIDATION SQ. FT. NO. OF e NO.OF ) CHECK License Number Lic. Class SIZE $,r 1 STORIES / FAMILIES / ONE D ❑ VALUATION DESCRIPTION OF WORK NEW Contractor Date $ �� 3 Ddo ❑I am exempt under Sec. ®1jr- Q ADD rs B.BP.C. for this reason AN � OAJE_ 3EDROALTER E]dM REPAIR ❑ $ Date: EXIE OF STING BLDG. DEMOL ❑ Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) yq� ke, NO. I hereby affirm that I am exempt from the Contractor's License DATE Law for the following reason (Section 7031.5, Business and ADDRESS SRl FINAL P_ rofgssions Code): PRESENT By 11J.i� I, as owner of the property, or my employees with BUILDING wages as their sole compensation,will do the work and i LOCALITY the structure is not intended or offered for sale(Section n __- 7044, Business and Professions Code.) MOVING TEL. /( 33,17 ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. (� r - ,-•-�, with licensed contractors to construct the project (Sec- ADDRESS r�S , 0 0 8 i-I tion 7044, Business and Professions Code.) REQUIRED TOTAL SETBACK FROM EXIST. I ICTAL 320 . 46 CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT H�vi _�:, : the performance of the work for which this permit is issued F.L. (Sec. 3097, Civ. C.). SIDE CHR.L. ANG ,`: Lender's Name �J (� LDMA Ref.# P.C. Fee$ Permit Fee Lender's Address I certify that I have read this application and state that the Issuance Fee • LDMA P/C R ® 6325 1 above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee LDMA Perm. ti and he, by authorize representatives of this County to enter upon ti abo r -men ed pro r for inspection purposes. L //'� SEE REVERSE FOR EXPLANATORY LANGUAGE flailature of Applican o ent Date '•'. WORKERS'COMPENSATION DECLARATION ' • I hereby affirm that I have certificate of consent to self A P P L I AT 1 FO B A I L I wQ� PERMIT E I`� insure, or a certificate of Worr kers'Compensation Insurance, lsiF ® or a certified copy thereof (Set- 3800, Lob. C.) % COUNTY OF LOS ANGELES BUILDING AND SAFETY Reality No. Company BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS �C� i ❑ Certified copy is filed with the county building inspec- FADDRESS G g I tion department. /016 Z RA t /� t Date Applicant eA4 6 Cl ZIP I MO LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT 7-W1tl&S NOW ON OT / CROSSSST. 'CL, 1 COMPENSATION INSURANCE (This section need not be completed if the permit is for one2-� ASSESSOR hundred dollars ($100)or less.) TRACT Il,2-W! BLOCK LOT NO. MAP BOOK PAGE PARCEL OWNER $'T�P,F�E �/Ii9 , USE ONE MA P I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner r ' L SPECIAL so as to become subject to the Work Compenon s ADDRESS A4F- CONDITIONS Q Or( U Date f, 1, Applicant s� CITY ZIP or( � NOTICE TO APPLICANT: If, after maki g this Certificate of ARCHITECT OR TEL. DISTRICT GRO P TYPE FIRE PROCESSED BY O ENGINEER NO. CONST. ZONE Exemption, you should become subject to the Workers' � V Compensation provisions of the Labor Code, you must forth- ADDRESS �t V I _D a with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. NDO. N deemed revoked. CONTRACTOR NO. Z LICENSED CONTRACTORS DECLARATION LIC, CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Buiiness and LIC, Professions Code, and my license is in full force and effect. CITY CLASS BK PG VALIDATION SQ.FT. NO.OF NO.OF / CHECK License Number Lic.Class SIZE STORIES FAMILIES / ONE /q y� VALUATION Contractor Date DESCRIPTION OF WORK#4 1 f�®t ` A D $ /1/,llo I am exempt under Sec. 13 / x 13 ! (J(J11 n / ALTER B.BP.C. for this reason �j�)AJy�� 0.4 REPAIR ❑ $ Date: USE OF EXISTINGBLDG. ESt♦ A11gF_ DEMOL ❑ Signature APPLICANT EO — FINAL OWNER-BUILDER DECLARATION PRINTTwp � '�NDATE Z O I hereby affirm that I am exempt from the Contractor's License ADDRESS a��6 ��- e`+T° f'MO CLT Law for the following reason (Section 7031.5, Business and FINAL ff Professions Code): PRESENT By 0 0 9.9 A BUILDING I, as owner of the property, or my employees with ADDRESS # o o a o o wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY t' ° 1 0 6 1 3 7044, Business and Professions Code). MOVING TEL. ❑ CONTRACTOR NO. r = 1, as owner of the property, am exclusively contracting ° ° I J 1 3 v with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). o 7.07-88 CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAPROPL NE WIDTH I hereby affirm that there is a construction lending agency for LInvestigation the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name ") LDMA Ref. # $ Permit Fee �! Lender's Address 1 certify that I have read this application and state that the Issuance Fee LDMA P/C it above information is correct. I agree to comply with all County ee / L T ordinances and State laws relating to building construction, Total Fee (,� i '6 LDMA Perm. H v and her y authorize representativ sof this County to enter $ upon th ave- ention proper f inspectio�np purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE gnat a of Applicant or a Date