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Home My Public Portal About10146 LYNROSE ST_Building__ 41/ 76A638A CE#803 8.63 APPLICATION FOR BUILDING PERMQ COUNTY OF LOS ANGELES. BUILDING o DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE: COUNTY ENGINEER NEAREST / WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. DISTRiCT IN G. UP 'TYPE C S B FOR APPLICANT TO FILL IN CONST- BUILDING ONST. BUILDING^/ / 6 STATISTICAL CL(((ASSIFIC TION WER MAP ADDRESS 1 �O BKPG X CLASS. NO. DWELL. UNITS — CJ LOT NO. gtf BLOCK WATER NOT REQUIRED ❑ RECEIVED ❑ CERTIFICATE: TRACT MAP i) / HIGHWAY STATE MAJOR SECOND LOCAL NO.OF BLDGS. NO., C/ C/ (CIRCLE) SIZE OF LOT NOW ON LOT USE ZONE "SPECIAL USE OF j CONDITIONS EXISTING BLDG. TEL. OWNER L2 ..�- r NO. BUILD NG YARD HWY STREET NAME EXIST. // SETBACK WIDTH ADDRESS /,I/ ft /�y (JS�. FRONT 0 6m -"I . J ARCHITECT OR - TEL P. L. ENGINEER NO.A �� SIDE _ �J�^ aa �^ �f- P. L. ADDRESS s� p-J djf/ S S� 11 _ ogafmoms;2V-- TEL. O CONTRACTOR (1/f p NO. ADDRESS n 1 O DESCRIPTION OF WORK 0 v uj N ADD ALTER REPAIR DEMOLISH I y SQ. FT. NO. OF NO. OF SIZE dv STORIES FAMILIES USE OF L♦ 44'IA( STRUCTURE P� �r �/ `j '�7f'� Y Q-I.iL� qM SIGNATURE OF ,j°y-/,{ �Z "�� ' •� APPLICANT I�✓ VALUATION $ 29o4. yy APPROVALS DATE INSPECTORS SIGNATURE FEE $ �/� PMT'$ �V'�/9-f) FOUNDATION: LOCATION FEE FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT ING TO WORKMEN'S COMPENSATION INS U ANCE. LATH. EXT. SIGNATU REO HOUSE NUMBER COR- PERMITTEE RECT AND POSTED +? ADDRESS FINAL '7�1'3p JOHN F. LEWIS. PRINCIPAL ST R 4A URAL ENGINEER PLAN CHECK VALIDATION cK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH . :COO 5 8 3-2 'JUN29 2 3 D 7050. 0.V LLo.0 5.8 41 JUN 2 9 1 D 15,00- DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERS COUNTY OF LOS ANGELES �•- -- .-• WM. J. FOX. CHIEF ENGINEER FOR OFFICE USE ONLY BUILDINS /'' FOR APPLICANT TO FILL. INDISTRIBT NO. PLANCK.NO. PERMIT NO. ADDREBB Baldwin Avenue 3 - / ( LOCALITY Los Angeles County RECEIVED BY DATE OF APPL. DATE ISSUED ' NEAREST /7 C.' 3 •— 2 b — CROBS ST. T—A Ve Oak Ayenn e BUILDING UWNER ADDRESS (� ` MAILcf B LOCALITY ADDREBB 232 So. everly Drive. NEAREST CITY Beverly Hills, Calif TEL-(;R 5--'4455a CROSS BT. FIRENO.OF TYPE GROUP ARCHITECT OR �+ L,, TEL. ZONE PLANS ENGINEER Same as above NO. a. BLDG. �t ORD.NO. ADDRESS SETBACK LINE APPROVED ,,,� /j Same as above TEL. BY /! DATE _CONTRACTOR NO. U4E /) APPRCpV ;- AD RE ZONE�j-�� BY DATE DESCRIPTION LOT NO. 1�� BLOCK LEGALCORRECT%OSS TRACT 16957NO.OF tt 9 SIZE OF LO `T q X I Q7(A'oNOW ON L13TBNOne USE OF NO.OF NO.OF EXISTING SLDq. I FAMtLiEe I ROOMS DESCRIPTION OF WORK NEW TION REPAIR MOVING DEMOLISH p Bq.FT. NO.OF Z SIZE 1.29 ROOMS 6 STORIES r WALL ROOF COVERING St17C(:O I COVERING mood Shs.nl;j s BUBE Or UILDING Dwelling and attached garage P Plan 109 CQ ales- 27676 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS,? APPLICATION AND STATE THAT THE ABOVE IS CORRECTFOUNDATION, LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS '� � �� Yl� AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE OP BRACING,BOLTS Lint3P Fi nAne o R. nsa-vro ,,,,,,,c,.,+ r' PERMITTE �---- LATH, INT. orp o Al THORIZED AGT fid L' Dt3P dill Pn V !.i nrl c n c Pr. i d a + LATH, EXT. 41, r 7SA63BA-3 2-50 $ P.C.S 4 PLASTER,INT. m FEE PLASTER,EXT. �- n VALUATION v �ro / �v FINAL t. �*0-1 �i Y :6 FEE �� p• WORKERS'COMPENSATION DECLARATION / I. hereby affirm that J have a certificate of consent,to self O O��nI �O O�Ind �(�I D D //�� insure, or a'certificate of.Workers'Compenstion Insurance, or A P IJ L��CAU M U V. FOR LI V LJ v��:D�LI V O ��LI V LI a certified copy tF er'eof (Sec. 3800, lab. C.) COUNTY OF LOS ANGELES. BUILDING AND SAFETY Policy No.`' . Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FfLL IN BUILDING 9 14 T"6 .�d/$aSE •. S To � ADDRESS ❑ Certified copy is`filed'with the'county building inspec- BUILDING t C �^ • tion department. ADDRESS 16' 1 � L �� `�Y o LOCALITY Date Applicant - CITY �C= -�LC ZIP + -7 Q NEAREST �Q E f` L n K �n CROSS ST. lR C.! ✓"[ 'CERTIFICATE OF,EXEMPTION FROM WORKERS' NO, OF BLDGS. ASSESSOR -a3�� PAGE 54.2 ARCEL COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT 2 MAP BOOK (This section need not be completed if the•permit,is for oneUSE ZONE MAP -hundred dollars ($100) or less.) TRACT BLOCK LOTNO. 113 8. NO. C;2'iA® �j�y� C n '7 y SPECIAL I certify that iri the performonce of the.vvo& for which this OWNER M0HAMM,9- /�CIm L& 574zF!W t I. CONDITIONS• O Permit is issued, I shall not employ any person in any manner S ^' n I' \ ( _ C� -,h DISTRICT GROUP TYPE ' FIRE PRO ESSED BY u ADDRESS �J•X/dy}2 CONST. ZONE' SO.as to become subject to the Workers'Compensation Laws. _ ; •� O 4 •Dat'e ' Applicant CITY ZIP STATISTICAL CLASSIFICATION APT. CONDO. �. =J ARCHITECT OR TEL. NOTICE•TO` PLICANT: If, after saki is Certificate of Lu ExemptioIn', you"should-become s lect to the Workers' ENGINEER NO. CLASS NO. DWELL..UNITS 0. Compensation provisions of the Lab Code; you must forth- - ADDRESS SEWER MAP z with comply .with such.provisions or„,this permit shall be deemed revoked'. , .SJELF, QWd/�; BK. PG,Cj VALIDATION CONTRACTOR LICENSED CONTRACTORS DECLARATION , (� _�� ,, LIC” I hereby affirm that I dm licensed undenprovisions of Chapter 9 ADDRESS 5 A NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. Professions and'my license*is-in full force and effect. CITY CLASS $ SQ. FT. NO. OF 7 NO, OF T CHECK - License Number Lic.Class SIZE STORIES 1 FAMILIES 1 ONE Contractor Date DESCR,IIPTTIIOQN;OF WORK ,C(!�- NEW ❑ I'am`exempt from the licensing'requirements` s I am a ADD ❑ licensed architect.or a registered professional engineer, ^- , '- LTER E] FINAL acting in .my professional capacity (Section 7051, y f�.�. T 0 DATEGI��— . PAIR Business and Professions Code). USE'OFfes',` - - _,/1 r FINAL IST EXING BLDG. 1�QDEMOL ❑ B Lic.or Reg. No. Date APPLICANT TEL. Y OWNER-BUILDER DECLARATION (PRINT)Ma ,rq.. 4YRa L x:74--9 I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS AS I 'Professions Code): PRESENT a. BUILDING I, as owner of ,the property, or my employees with ADDRESS wages'as their sole compensation, will do the work and the structure is not intended or offered for sale.(Section LOCALITY•l 4µ2 A 7044, Business and Professions Code). MOVING TEL.. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. #'0' 0:0 ;o o .1 with'.licensed contfactors to construct the project (Sec- ADDRESS ' tion 7044,rBusiness and Pro fessians,Code.). - 2.°: ° 3 k 0 0 REQUIREDTOTAL SETBACK FROM' EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I herebyaffirm that there,is a construction lending agency for fO. ° ° '3 cy>- 9 9 Y FRONT ID 1 ��/ U O the performance.of the work for which this permit is issued P.L.. (Sec..3097, Civ. C..). SIDE . O 9.2:5-8 1 P.L. - Lender's Name Lender's Address P.C. Fee$ Permit Fee ` I. certify that l have read this application and state that the Issuance Fee i ,Q above information is correct. I agree to comply with oll,County Investigation Fee. 0 ordinances.and State laws relating to building construction, Total Fee Es and hereby authorize representatives of this County to enter V upon the above-'mentioned propertyy for,insl5eetion purposes. -SEE REVERSE-FOR EXPLANATORY LANGUAGE "attire of Applicant r Age t �� I Dote Os 9� Q P