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HomeMy Public PortalAbout9416 LOWER AZUSA RD_Building__ DEPARTMENT OF BUILDING AND SAFETY AYYL1GATIUM r Vlt YWINI1• COUNTY OF LOS ANGELES U 1 L ® 1 N G WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN , FOR OFFICE USE ONLY ` ,DISTRICT NO. Pak .140.' PE MI NO. BUILDING - �• ,1 �j r _,6 ,® s`� 73 / ?� ADDRESS v3��iF��/s i'trl 'F j�e v�y LOCALITY _4�7�/J�P/j7L[� J � ,iA D F L ATE ISSUED KEAREST r �� v r, CRO58 5T. BUILDING A OWNER ,�j ADDRESS � I u ADDRESS d �,pk!�. rL.RG LOCALITY MAIL N)EAREg. a ST CROSSdi CITY .-.f11.�lllr.✓+�/�[ C i� NpL� /1� CROSS ST. FIRE NO.OF GR = ARCHITECT OR TEL ZONE PLANS ENGINEER NO. BLDG. "' D ADDRESS SETBACK LINE / _ t APPROVED CONTRACTOR ,A�e7t/t-/ ����NpLf iJ�f,�p BY + DATE I USE APPROVED ADDRESS i[r,^'-�✓c(/F .K/l�rvrr/ ZON BY DATE LEGAL s CORRECTIONS DESCRIPTION LOT NO. BLOCK TRACT S NO. OF BLDGS. °fes SIZE OF LOT s/��/' NOW ON LOT UBE OrEXISTING SIDG. /� -fj+.p� I F MINO.DL E9 I ROOMSNCCF 1.7 DESCRIPTION OF WORK NEW ALTERATION ADDITION p p REPAIR MOVING I DEMOLISH 51ZE j �i "o ROOMS �n STORIES r WALL ROOF �) —COVERING y�i OAi I COVERINGXA/`�a NEW BUILDING NG Y I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION INS ECTOR DATE AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS, MATERIALS FRAME: FIRESTOPS, '�' SIGNATURE OF BRACING,BOLTS r PERMI': jr4LATH, INT. 1� p' f AUTHORIZED AGT LATH, EXT. f 7GA63BA-3 10-50 $ FFEE C.6 PLASTER, INT. / , f.• �r io � $ V PLASTER, EXT. VALUATION EE ?�_ FINAL ' r7orRTMENT OF BUILDING AND SAFETY AFPLLGATIUM r UR kpZIIMi r - COUNTY OF LOS ANGELES � I WM. J. FOX, CHIEF ENGINEER UG 7194 U I L D 1 N G v jl FOR APPLICANT TQ,FILL IN FOR OFFICE USE ONLY BUILDING �� ' _ ,�'�[ADDRESS ISTRICT NO. PLAN CK.NO. PERMIT NO. ADDRESS w� I V' ? LOCALITY ,s >=d(��.�_ _�� O RECEIVE-D•BY" / DATE OFAPPL. DATEISSUED NEAREST Y CRO BB ST. BUILDING n _iA-tI r e r1 n OWNER I / % � "�r'.'.'� (•r �/1 1ti.� .'�J � �yMAILl to� ,�ADDRESS p e- Jy � � 4' � ICALITYAl .;a ` a• �p''/� p 1 y� NEAREST CITY Al� 33�y l• a.a ti's f.- d�•' r:�{NOL��1rf PJ'�d `� C' RE FIRE NO.OF TYPE GROUP ! ARCHITECT �ECT OR TEL ZONE PLANS __ v ;/— ENGINEER NO. BLDG. / �a ORD.NO. ADDRESS � SETBACK LINE � S G•' �� i_..' •� r _ APPROVED r CONTRACTOR gi,5 G ��J'J •S' ' NO. %i �r`l(-`� BY /Ir- DATE 11 ,( 6 _ 1) 1 JKf "l L USEr APPROVED ADDRESS a� �A l- V�� /`"lrA N n' ZONE/ BY DATE LEGALh ® CORRECTIONS DESCRIPTION LOT NO. BLOCK TRACT �1 "i-[h1 2 2. -- SIZE OF LCT-5-7 X I-;'Jo I NOW ON LOTS�h 4 USE OF I NO.OFI NO.OF r EXISTING BLDG. FAMILIES ROOMS DESCRIPTION OF WORK NEW Ll- ALTERATION ADDITION O A REPAIR MOVING DEMOLISH Sq.FT. NO.OF X-1 n SIZE v' ROOMS STORIES iA%)�` D WALL �` ROOF r COVERING +'• I COVERING,-. USE OF NEW BUILDING it v! h-, .y, t' I- 41 - 1 r - r. r . 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS 1 APPLICATION AND STATE THAT THE ABOVE IB CORRECT FOUNDATION:LOCATION I PECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS.MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTIONj FRAME: FIRE STOPS, + SIGNATURE OF BRACING.BOLTS PERMITTEE ��• LATH.INT. ��AUTHORIZED AGTLATH EXT.: ri DBS-3 SOM BETS :-49 $ P.... PLASTER,INT. FEE 16e PLASTER.EXT. VALUATION FEE ®(,a FINAL �'-P� GL 7 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING R s ��� �Z✓fA BUILDIppDIIIGGG A R SS �/ �� G I hereby affirm that I have a certificate of consent to self insure, ���� C• ��fit/€,L /7zJ3r4 — or a certificate of Workers'Compensation Insurance,or a certified CITY ZIP �E�17�L� ��T v copy thereof(Sec.3890,Lab r au 0 ,� LOCALITY Policy No.Z !1 Company JrArr ' -IV� SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROS . 'Ac a.) LRICertifled copy is filed with the county building inspection TRACT BLOCK LOT NO. i departm nt. �� d USE ZONE MAP NO. Date(Applicant v40-0, 11P �Z' ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OV ER T L COMPENSATION INSURANCE DLA KF Y WITHIN 1000 Fr.OF SCHOOL? YES No (This section need not be completed if the permit is for one hundred �DJES6` dollars($100)or less.) 9416 E . C.O W F–L A Z,i,%ti DISTRICT GROUP TY ST. FIRE ZONE PROCESSED BY I certify that in the performance of the work for which this permit E1�LE CIT" ZIP -lI7 c.. D is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NIOf' become subject to the Workers'Compensation Laws. STATISTICALSSIFICATION 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' �ER �E� ��� `�U TY�©^�,�Lr SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith Iz r� v\ � Gov FRONT comply with such provisions or this permit shall be deemed revoked. ADf1 1S OASU"L L�- LIC.NO. 'Lf P L •�CrJ 7 ZT SIDE LICENSED CONTRACTORS DECLARATION PL I hereby affirm that I am licensed underprovisions of Chapter 9 CITY ,,{A�� /y A uCL SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. 2�0 NEW BK PG a Lice�s Number g67 Z�" Lic.Class D SCRIPTION OF K ADD ❑ VALUATI p� CO tf� L Et W1WF3 Date �' -9 It iMiDUE ]4ST,N(T' eOdV1e- 4OF $ 1� �© U //�� ALTER ❑ � ❑ I am exempt under Sec. fes"4OF W IT+A &A55"A r� REPAIR ❑ $ U B.BP.C.for this reason rm"Sir 6NA(, 4•14"6 L5S - DEMOL ❑ LDMA P/C# W Date: USE OF EXI G BLDG. A)n URM ❑ C ti co Signature APPYJANT( NT) L� T NO. ,(.( LDMA Perm# z ❑ I, as owner of the property, or my employees with wages as V%CT0 ,1 E��� (���V Z their sole compensation, will do the work and the structure is AD , 4 C�t�EM-y LEE /� EL d�a•U Q —,sr: ".153.45 not intended or offered for sale (Section 7044, Business and 1 �A.• FINAL DATE Q L_J= Professions Code.) Y��ZS—q WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL 1 G OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑ I, a3 owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? Q ' licensed contractors to construct the project (Section 7044, Er*- FINALpY > IITA _5 YES❑ NO /tel`/ -I- S liL �-_�3 - 4-5 Business and Professions Code.) _ WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILCHECK DING '��1�u;!•�I OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH i CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES _ %; }`�hIGE I hereby affirm that there is a construction lending agency for YES❑ No A"' 01 the performance of the work for which this permit is issued(Sec. O� IHAVE ZARNo TERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING _ CM 3097,Civ.C.) I ND REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, III i,;l;–I!I II .•r'? TRLE 2,CHAP R 2 20 IONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS .3 !�J(�1-r T Lender's Name TE N F R O INING A PERMIT FRO THE AQ o Lender's Address �'1 J1 1 ' `' 0 OWNER OR AGENT c I certify that I have read this application and state under penalty 4 of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE /n ' ances and State laws relating to building oL reby authorize representatives of this County ISSUANCE FEE �y rWnces ve-mentioned property for inspection purpos�WINVESTIGATION FEE TOTAL FEE ��`0-- •! SEE REVERSE FOR EXPLANATORY LANGUAGE �f WORKERS' COMPENSATION DECLARATION of coent to sel insure,hereby aa certificate of Workers' C mtpensat on Insurance, A P P L I CAT I C)tF U I L D I N G P E RM I T or a certified copy thereof(Sec. 3800, Lab. C.) COQNTY OF LOS ANGELES BUILDING AND SAFETY Policy No6=-Company STAC_113 OD `' ❑ Certified co is hereby furnished. FOR APPLICANT TO FILL IN BUILDING copy � y ADDRESS ❑ Certified copy is filed with the co ty b ilding inspec- BUILDING p tion department. ADDRESS Y� (1��,'lJW Date Applicant CIN !ZOMR `� ZIP LOCALITY � •� (,�U.( NO.OF BLDGS. NEAREST s CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT 1' NOW ON LOT ''1� CROSS ST. COMPENSATION INSURANCE ASSESSOR �i GGpr� (This section need not be completed if the permit is for one TRACT BLOCK LOT O. MAP BOOK l,✓L PAGE ®9 PARCEL �+� hundred dollars ($100)or less.) !�" TEL G OWNER ��+ta N 110 USE ZONE OP /-/49 ! certify that in the performance of the work for which thisSPECIAL F >_permit is issued, I shall not employ any person in any manner ADDRESS �9�9.! LtCs NIX CONDITIONS a- so as to become subject to the Workers'Compensation Laws. O CITY ZIP Date Applicant ARCHITECT OR 4 TEL. DISTRICTGROUP TYPE FIRE PROCESSED BY fu NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST. ZONE O Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS -3 � a with comply with such provisions or this permit shall be �t�, TEL C t STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTOR ' dvu ltNO p' y LICENSED CONTRACTORS DECLARATION NO. CLASS NO._,421 UNITS - I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS C�1r O 76 SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. �4 and Professions Code,and my license is in full force and effect. CITY pdt��NO. OF11 CLASS BK.4 PG. VALIDATION �/J`� SIZE STORIES l FAMILLIIES ONE VALUATION License Number '(�"�OCCZii(��,g/[,Lic. Class Contracto 14D OUJ6 Date �✓� DESCRIPTION OF WORK �( 5 'jQ NEW ❑ $AL1(o zoo ❑I am exempt under Sec. 4 59OJ.w G ADD ► fl ,� � ALTER ❑ B.&P.C. for this reason 4 L REPAIR ❑ $ Date: USE OF _ EXISTING BLDG. �Si DEMOL ❑ APPLICANT TEL. • -p Signature (PRINT) G( NO. `'G� FINAL O ER-BUILDER DECLARATION 1} DATE �A I hereby affirm that I am exempt from the Contractor's License ADDRESS w{ v 5r FINAL Law for the following reason (Section 7031.5, Business and .y Professions Code): PRESENT By ., �� El BUILDING I, as owner of the property, or my employees with ADDRESS � ��!' ,Q t CCT wages as their sole compensation,will do the work andr? E the structure is not intended or offered for sale(Section LOCALITY ® 1,0 4E.75 7044, Business and Professions Code.) MOVING TEL. ❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO. � b with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code.) °g .;yi0 Z9 REQUIRED TOTAL SETBACK FROM EXIST. '* , CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH ,5�(. ,y 1.6 v t, I,hereby affirm that there is a construction lending agency for FRONT _ ITEMS the performance of the work for which this permit is issued P.L. P P ia.v -at, (Sec. 3097, Civ. C.). SIDE P.L. •f► tiff!e+J9' Lender's Name LDMA Ref. q P.C. Fee$ 7� Permit Fee c�'�cl'�/ / CHANG .]0 A Lender's Address 7� ► I certify that I have read this application and state that the Issuance Fee ✓4 /� LDMA P/C q above information is correct. I agree to comply with all County Investigation Fee /q 0000001 ordinances and State laws relating to building construction, Total Fee.-IT •J / LDMA Perm. q -0 iI 3/93 and h eby u horize repr entatives of this County to enter 75511 1 AM10:139 u n ab v _tions property for inspection purposes.p 8 - / 5 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent s-=Date