The URL can be used to link to this page

Home My Public Portal About9929 LOWER AZUSA RD_Building__ 76A63 *803 7.56 APPLICATION FOR BUILDING PERMIT �. BUILDING AND SAFETY DIVISION BUILDING Department of County Engineer ADDRESS County of Los Angeles LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN, SUPT OF BUILDING CROSS ST DISTRICT NO. GROUP PE SEWER MAP FOR APPLI TO FILL IN BK PG . CONST. BUILDING ADDRESS STATISTICAL CLASSIFICATION CLASS. NO.—/ DWELL. UNIT LOT NO. BLOCK MAP , STATE NUMBER Y YES O: TRACT U Z NE SPECIAL NO.OF BLDGS. CONDITIONS SIZE OF LOT 3 I NOW ON LOT USE OF EXISTING BLDG. BUILDINGEXIST. SETBACK YARD HWY STREET NAME WIDTH OWNER FRONT t MAIL P. L. Q,• I ADDRESS SIDE , ' I TEL 0 D CITY NO INSPECTION RECORD ARCHITECT OR TEL ENGINEER NOr ADDRESS TEL CONTRACTOR NO egL8 ADDRESS �_x DESCRIPTION OF WORK 1 NEW ADD ALTER REPAIR DEMOLISH SQ. FT. NO. OF NO.OF SIZE STORIES FAMILIES ' USE OF STRUCTURE 17 APPROVALS SIGNATURE O APPLICANT DATE INS ECTOR'S SIGNATURE ADDRESS FOUNDATION: LOCATION FORMS. MATERIALS rtIs FRAME:P. FEE STOPS. $ BRACING.BOLTS VALUATION s FURNACE: LOCATION. FEE ^"+ GAS VENT DUCTy� I HEREBY ACKNOWLEDGE THAT I HAVE.READ THIS AP- LATH. INT. f i / .• PLICATION AND STA E THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ITH ALL COUNTY ORDINANCES AND LATH. EXT. 1� STATE LAWS RE LATIN BUILDING CONSTRUCTION. SIGNATURE OF HOUSE NUMBER COR ECT RECT AND PO TED ADDRES 2 FINAL 1? (SZ JOHN A.LAMBIE.COUNTY ENGINEER, CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENGI PLAN CHECK VALIDATION M.O. CASH PERBUT VALIDATION CK: • M.O. CAB' F lAGo6 70 l APR 2 1. 6 10.0 0: M6962 1 APR g 1 20.00 '^ WORKERS'COMRENSATION DECLARATION I er certificate of Workers'Comoffirm.that I.have a pensation oe of n eInsuran nt to e, APPLICATION FOR BUILDING PERMIT or o certified copy thereof (Sec. 3800, Lob. C.) PolicyNoJZ'1195a9 Company izSTV-- INS.A61O Jd7 COUNTY OF LOS ANGELES BUILDING AND SAFETY Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING qlq .� ADDRESS 0 Certified copy is filed with the county building Inspec- BUILDING / �,J tion department. ADDRESS / (�& Ae Date Q'23'gD APPlicont RI04&e-0$•T11VWL- CITY GAG ZIP D LOc�LlrrLttQ CERTIFICATE OF EXEMPTION FROM WORKERS' & NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one �WO �? ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LO NO. MAP BOOK PAGE PARCEL I certify that in the performance of the work for which this OWN p. _ USE E NO permit is issued, I shall not employ any person in any manner �� i� SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS (/ CONDITIONS C� •23 9D p�iCrll� B•TCTUt6rr„ P l 72- 6P Date Applicant CITY ARCHITECT NOTICE TO APPLICANT: If, after making this Certificate of RCMITENGINER DISTRICT G UP TYPE FIRE PROCESSED BY 0 Exemption, you should become subject to the Workers' " CONST. ZONE Compensation provisions of the Labor Code, you must forth- ADDRE � a with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFI TION APT. CO deemed revoked. CONTRACTOR NO. r. 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 Business and LIC. Professions Code, and my license is in full force and effect. CITY CLASS BK PG VALIDATION SO. NO.OF NO.OF CHECK License Number X515'1 Lic.Class SI STORIES FAMILIES ONE VALUATION �B ContractorMLOM4 CtIOSTIZ MICh Date `I' DESCRIPTION OF WORK r NEW S ,2 , ;20 7 S 3 A ADD 7 3 I am exempt under Sec. VALTER # e e e e 2 3 B.BP.C. for this reason REPAIR : I e 5 a C 7 Date' USE OF EXISTING BLDG. D Signature APPLICANT L.No. _ FINAL / 2 e * 51 a Q 7 t OWNER-BUILDER DECLARATION DATE GO y�� 1 hereby affirm that I am exempt from the Contractor's License ADDRESS FINA ��/!✓ 09,2 3—88 L Law for the following reason (Section 7031.5, Business and L Professions Code): FRMNI BY BUILDING 1, as owner of the property, or my employees with ADDRESS 1 Wages as their sole compensation,will do the work and s LOCALITY the structure is not intended or offered for sale(SectionACCT.* 7044, Business and Professions Code). MOVING TEL. n C31, as owner of the property,am exclusively contracting CONTRACTOR NO. X307 969.01 with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). REQUADDRESS L ` t I 1 ITECIS CONSTRUCTION LENDING AGENCY SET BACK YARD HWY TOTALPROP LINE WIDTSETBACK FROM H TOTAL 969-O 1 I hereby affirm that there is a construction lending agency for FRONT 969.01 the performance of the work for which this permit is issued P.L. OECK (Sec. 3097, Civ. C.). SIDE •( j P.L. Lender's Name �) LDMA Ref. N P.C.Fee$ �� V Permit Fee r Lender's Address 1 423790 1 certify that I have read this application and state that the Issuance Fee 13 # 00 kLD P/C 4j45 1 9• g above information is correct. I agree to comply with all County Investigation Fee $ 35 ordinances and State laws relating to building construction, Total Fee 1 LDMA Perm. N R and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. 4 '23•?IV SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Dote WORKERS' COMPENSATION.DECLARATION hereby affirm that I have a certificate of consent to self APPLICATION F OR B U I L D I N G PERMIT insure, or a certificate of Workers' Compensation Insurance, or a.certified copy thereof (Sec. 3800, Lab. C.) . I. - R COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUIL 1:1Certified-copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS + .❑ Certified copy is filed with the county building inspec- BUILDING RESS C(/l. tion department. . R_ CITY QWL C' ZIP LOCALITY Date Applicant CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE'OF LOT 1, N OF BL NOW ON LOOT T NEAREST 7� CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need'not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) OWNER /h �yL�)� N L USE ZONE MAP I certify that in the performance of the'work for which this SPECIAL >_ permit is issued, I shall not employ71p4cimp son in an manner ADDRESS CONDITIONS v.so as to become subject-to the W on Laws ^J' CITY �'� 1 n�L ZIP 'Date Applicant ARCHITECT OR' TEL. Exemption, TO APPLICANT:.should If, c r making Thi Certificate of ENGINEER - NO DISTRICT Gt�UP TYPE� � /'_S,S�D BY O ,Exemption, you should become subject .to the Workers' Kr/ . CONST. E `/J/L Compensation provisions of the Labor Code, you must forth- ADDRESS 61 N with comply with such provisions or This permit shall be TEL. TISTICAL CLASSIFICATION APT, CONDO. Z deemed revoked. CONTRACTOR c NO. — _ LICENSED CONTRACTORS DECLARATION �� lCLASS NO. DWELL. UNITS - 1 hereby affirm that I am licensed under provisions of Chapter 9 ADDRE (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. CITY GL CLASS3&41 /7✓ BK VALIDATION SQ.rr. I NO. OF NO. OF CHECK License Number Lic. Class SIZE STORIES FAMILIES ONE VALUATION .Contractor Date - DESCRIPTION OF WORK �EW ❑ $ ElDD ❑ ► I am exempt under Sec. Vl. . p Li; ERJ B.&P.C. for this reason V REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMO L El Signature APPLICANT r' AL (PRINT) 6 7` . OWNER-BUILDER DECLARATION DATE I hereby affirm that I am exempt from the Contractors License . ®� �� 746 1 Law for the following reason(Section 7031.5, Business and ADDRESSFINAL Professions Code): PRESENT B ' r ACCT-18,111' Cry El 1, as owner:of The BUILDING property; or my employees with ADDRESS. 3307wages as their sole compensation,.will do the work and LOCALITY the structure is not intended or offered for sale(Section ► 1 ITEMS 7044, Business and Professions Code.) MOVING' TEL. .. " ❑ I,as owner of the property, am exclusively contracting CONTRACTOR NO. TOTAL 6G�50 with licensed contractors to.constructthe project (Sec- ADDRESS TOTAL I tion 7044, Business and Professions Code.) �� 40.5 REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BA YARD HWY P. UNE WIDTH ::....._......_...._.. . .::...00 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, P.L. 00OD-0001 10/23/39 Lender's Name LD.MA Ref. # 6M1 i PM12:12 P.C. Fee E Permit Fee • , Lender's Address I certify that I have read this application and state that the Issuance Fee �' LDMA P/C# aboy ormation.is correct. I agree to comply with all County Investigation Fee or no es and State laws relatin to building construction; Total Fee LDMA Perm. # d :eby a ori represent ryes of this County to enter p th e- ntioned pro4rty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicont or Agent Date