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Home My Public Portal About10702 LORA ST_Building__ flR. APPLICATION FOR BUILDING PERMIT FOR.APPLICANT TO FILL IN (Print or type only) BUILDING � a � o COUNTY OF LOS ANGELES ADDRESS ��/ DEPARTMENT OF COUNTY ENGINEER CITY - 7 zip BUILDING AND SAFETY ,DIVISION NO.OF BLDGS. BUILDING SIZE OF LOT NOW ON LOT ADDRESS107 62 21. - e)cA t TRACT 6 BLOCK I LOT NO.' LOCALITY TEL. NEAREST OWNER,)& Z/1//RN NO. 33 y? o CROSS ST. �, ASSESSOR ADDRESS JO 0 �O6^/4 MAP BOOK. PAGE PARCEL p DISTRICT GROUP TYPE FIRE PROCESSED BY CITY /. L� ZIP CONST. a. ZONE ARCHITECT O TEL. � j ENGINEER NO. IL STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NO.,_DWELL•UNITS BK PG CONTRACTOR a,., NE.Lr 07 -USE ZONE MAP / 'LicNO. i ADDRESS�2 h/fiC' ` NO.Z�S�'p ,/ CONCIAL DITIONS CITYS. 7}, LIC, 1, /! CLASS D ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONSTRUCTION LENDER NAME AND BRANCH• BLDG.SETBACK FROM' FRONT PROP.LINE OF (STREET) ADDRESS CITY HIGHWAY + YARD - 'TOTAL SETBACK FROM TYPE OF EXISTING SQ. FT. NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH SIZE STORIES FAMILIES •6NE DESCRIPTION OF WORK Chin NEW ❑ ❑ BLDG.SETBACK F M. ' To vv-0— P , ADD SIDE PROP.LINE OF (STREET) OF ALTER ❑ SETBAC.K FROM TYPE OF EXISTING FC- HIGHWAY + YARD = v REPAIR I IDS P P. LINE HIGHWAY WIDTH y� USE OF I I EXISTING BLDG. DEMOL 1:1 + Z APPLICANT TEL _ CORNER CUTOFF YES NO ❑ (PRINT) � �NO.,�,, BY (SIGNATURE) ✓7� IN OPEN SPACE YES ❑ NO ❑ �f IN COASTAL PERMIT ZONE YES ❑ NO VALUATION,$ 7 Q d I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THEF ' LABOR CODE •OF THE STATE OF -CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION INSURANCE. SIGNATURE OF zr PERMITTEE ADDRESS 2 Z/ C 4 E BY CITY- i'llE•7/VIf:.. NOL• a,�MAKE CHECKS PAYABLE TO: FEEHARVEY T. BRANDT. COUNTY ENGINEERppp y� PIAN'CHECK VALIDATION CK. M.O. CASH c PERMIT VALIDATION CK. M.O. CASH ` - = 1.5 6;*DEG V? 1� .12-.0 0 A&u 76AG38A CE#803 5/74 s - DEPARTMENT OF COUNTY - '�'T)IIRSION OF BUILDING AND SAFETY BUILDI ENGINEER -NG COUNTY OF LOS ANGELES A WILLIAM J. FOX, COUNTY ENGINEER APPLICATION " CASSATT D. GRIFFIN,'SUPIT of BUILDING FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING O 7 0 DTIC T NO. Pu:C� R .No. / PERMIT NO. ADDRESS v C4 m6� LOCALITY ESTc RECEIVED BY D TE,/OF7PPL. DATE ISSUED NEAREBT CROSS T. J v ,+.a. / � / S BUILEAR DING q OWNER �3 ADDRESS �.. W l(tet ADDRESS 1 Sp 0- %'MAIL LOCALITY .�.a NEAREST Ud- CITY TG L. i CROSS ST. � �C/1.�+V..�d� ARCHITECT OR TEL. FIRE NO, OF TYPE' GROUP ENGINEERr No. ZONE• .�I PLANS �.I BLDG. ORD. NO. ADDRESS I SETBACK LINE CONTRACTOR L HEL USE APPROVED ZONEA— BY ATE • HOUSE NUMBERING ADDRESS4 LEGAL MAP NUMBER Od 5 0 / NO. ASSIGNED BY DESCRIPTION I LOT NO. BLOCK � CORRECTIONS TRACT NO. OF BLDGS. frI ~ SIZE OF LOT I NO ON LOT Q 4,/ USE OF I NO. OF : EXISTING BLDG. FAMILIEff DESCRIPTION OF WORK a - NEW JX ALTERATION ADDITION Q _II z REPAIR DEMOLITION r SQ. FT. 1 {� NO.OF SIZE •7�u�J ROOMS l0 STORIES @ CO ERING SV C+ c'� I CWALLOVERING COM USE OF STRU URE Y r ,CS APPROVALS INSPECTOR'S SIGNATURE DATE FOUNDATION:LOCATION FORMS, MATERIALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRE STOPS, PLICATION AND STATE THAT-THE INFORMATION GIVEN IS BRACING, BOLTS - �G CORRECT. 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE:LOCATION, AND STATE 8 REGULATING BUILDING CONSTRUCTION. C+�VENT, DUCTS SIGNATURE OF LATH, INT. PERMITTE ` l ADDRESS . I LATH. EXT. PLASTER, INT. AUTHORIZED AGT. / PLASTER, EXT. P.LVALLUATION �� f FEE. S 3 S HOUSE NUMBER COR- RECT AND POSTED ffi t� J FEE '�, • �' FINAL 7BASSBA Deas s-ale ' WORKERS'COMPENSATION DECLARATION APPLICATION FOE UILDING PERMIT � I hereby 4ffirm that I have a certificate of consent to self 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 NdP—a y�Company7G L1 s Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING /d ADDRESS Certified copy is filed with the count building inspec- [AUDD DING 1 Q tion department. RESS / LOA RtLf Date Applic �-� ZIP LOCALITY RTIFICATE OF EXEMPTION FROM WORKERS' O.OF BLDGS. NEAREST COMPENSATION INSURANCE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars($100)or less.) CT BLOCK LOT NNsO.. '1/ MAP BOOK PAGE PARCEL NER NO? `q_T/9 - USE Z NE 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 ySPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS CONDITIONS O V CITY ZIP @� Date Applicant : ARCHITECT OR TEL. -' NOTICE TO APPLICANT: If, after making this Certificate of DISTRICT P CONS56yT ZON P OCE 6�1ESSED BY � Exemption, you should become subject to the Workers' ENGINEER( /p-� t� / NO. �3 1L Compensation provisions of the Labor Code, you must forth- ?ADDRESS 9000 `� a �(�/�7✓ 1L with comply with such provisions or this permit shall be 1N deemed revoked. TEL• �rC STATISTICAL CLASSIFI ATION APT. CONDO. CONTRALTO $ I{/C NO.� �Jd LICENSED CONTRACTORS DECLARATIONn!�-� � { LICCLASS NO. DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRES J 0 Z CP lis 1l 94 NO..OL32//( (commencing with Section 7000)of Division 3 of the Business and " � � LIC to SEWER MAP Professions Code,and my license is in full force and effect. CITY i�-t'�L�DJA CLASS C I BK PG VALIDATION `` SQ. FT. qPI NO.OF NO.OF CHECK ♦c License Number 21111 Lic.Class Q(- I SIZE STORIES FAMILIES ONE (n� t VALUATION Contractor Ql6LD F-t1UiM. Datl V DESCRIPTION OF WORK NEW E $ 0 I am exempt under Sec. NS A/ (f ADD 0111".� ALTER B.&P.C. for this reason s REPAIR ❑.; $ 6 9 3 A Date: USE OF EXISTING BLDG. DEMOL ❑•( l # 0 0 0 0 0 Signature / APPLICANT TEL. FINAL Gi PRINT) Q N0 �5 Z� OWNER-BUIL R DECLARATION ' y DATE -Z o49,88 I hereby affirm that I am exempt from the Contractor's License /� ( _ Law for the following reason (Section 7031.5, Business and Y ADDRESS 0J,00 �.1. N-d 013�Q N FIN o o a 4 9 8 8 c� Professions Code): PRESENT BY /l I, as owner of the property, or my employees with ADDRESS 4.2 -87 wages as their sole compensation,will do the work and i 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. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQIREDCONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAPROP. pCK LIINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE o P.L. Lender's Name ? LDMAERef.P.C.Fee$ Permit FeeLender's Address1 certifythat I have read this application and state that the IssuanceFee ..� LDMA r 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. # and hereby authorize representatives of this County to enter upon the ab ov - erttie ed property for inspection p rposes. ` c e �f � SEE REVERSE FOR EXPLANATORY LANGUAGE Signature`of'}CpP icant or Agent Date