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Home My Public Portal About10621 LYNROSE ST_Building__ a<� p ADDREBH APPLICATION • LOCALITY c•�•�-�A,. I NEAREST ['�/J jam/e'- _DIVISION OF BUILDING AND SAFETY cRDes sr. ll ((::.. !F C..� DepartmeIIt QY QOQIIty ]Engineer DISTRICT1I13. RECEIPT'NO. PERMIT NO. WM. J. FOX, COUNTY ENGINEER GROUP DATE RECEIVED DATE 88 ED CABBATT D. GRIFFIN, SUPT OF BUILDING / + FOR APPLICANT,TO FILL.YI1T TYPE h7ECEIYED BY ESUS BY OWNER MAILMAP/ . NUMBER Q 10 SNIAMYEE11^ O V ADDRESS A1C ry f� •\l- e�E •'` �`• M ______NE SPECIAL CONDITIONS CITY /.•h l-Ih-!!-�� -Cf� NO. . ARCHITECT OR TEL. ENGINEER NO. BUILDING YARD HWY STREET NAME EXIST. ADDRESS SETBACK WIDTH TEL. FRONT P.L. ®tet J .nM�L�'�._l 3 CONTRACTOR NO. SIDE ADDRESS' P.L. 'BUILDING ^ DATE CORRECTIONS INSPECTOR . ADDRESS - , i - i' h!_a LOT NO. 3 2 BLOCK dr TRACT // NO.OF BLDGS. SIZE OF LOT 4'. NOW ON LOT / DESCRIPTION OF W6R� -s�' ✓�f';%'r/�✓ Azmw • v NEW A ADD ALTER REPAIR DEMOLISH �' �+ 7 So.FT.Q 2/ �/' h'�' o.or0Q�°dlc�i E No.of /bP N'I r ! r1�Ji.F t��'f v K!!� SIZE JP STORIES FAMILIES 1� /� r.,�� ' "< J - USE OFISTRUCTURE /.[ /// !p r 1PY /+(/.+1 V Ate NO.OF 1EMPLOYEES I HEREBY ACKNOWLEDGE THAT I HAVE-READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS APPROVALS INSPECTOR'B SIGNATURE DATE CORRECT. I AGREE TO COMPLY WITH ALL CDUNTY ORDINANCES FOUNDATION: LOCATION AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMH,MATERIALS J' FRAME: FIRE STOPS, SIGNATURE OF BRAOING,BOLTS PERMITTE FURNACE., LOCATION, ADDRESS �j GAB VENT,DUCTS t ! d6• A�, •.:I_.�f<R... Mf r LATH. INT. AUTHORIZED AGT. LATH, EXT. $ P.C.S O O HOUSE NUMBER CDR- O FEE r /CJ RECT AND POSTED / VALUATION FEE FINAL' 7GA63GA D003 4-84 -�77� 76A688A CE0808 8-69 AI'PLICATI®N FOR BUIL LING! PERMIT COUNTY'OF LOS ANGELES'- BUILDING DEPARTMENT OF COUNTY ENGINEER-'.' ADDRESS : J�(B• 2 I ,L. !SSC BUILDING AND SAFETY DIVISION - -_LOCALITY'. JOHN A. LAMBIE, COUNTY ENGINEER NEAREST . WILLIAM A.JENSEN,-SuP'T-OF BUILDINGCROSS•ST. - 7 DISTRICT O. GROUP TYPE' PR ESSED BY FOR APPLICANT TO FILL IN �.0 1 CONST. d STATISTICAL CLASSI. CATION SEWER MAP- ADDRESS 10621. L 71r o$e a t• T• 'L � UNITS'--. BK PG CLASS. NO. DWELL.UNITS ' LOT NO. , 17T -61 BLOCK WATER NOT REQUIRED � REGEIVED CERTIFICATE:' - TRACT 0 !J!J MAP HIGHWAY STATE MAJOR SECOND CA NO.-OF BLDGS. NO. (CIRCLE) SIZE OF LOT Q. NOW ON'LOT , USE ZONE SPECIAL USE OF r CONDITIONS .-EXISTING BLDG. OWNERLionel Horse "; N0.286-3'91 'BUILDING:- - EXIST. SETBACK YARD HWY STREET NAME, WIDTH ADDRESS 9047 E:. Olive Ste ' T.. Ce 'FRONT ARCHITECT OR TEL. P• L: ENGINEER NO. - SIDE , ADDRESS.i'T CONTRACTVFir in Roof C"o.• :NO.TEL 287-A.5 C V ADDRESS 600 So. San Gabriel Blvd 09 DESCRIPTION'OF'.WORK O NEW . ' ..ADD ALTER' REPAIR "DEMOLISH N�f SQ.FT., NO.OF NO. OF z SIZE STORIES FAMILIES USE OFeroo Ouse,' IJ a ' o gar. STRUCTURE wi 35 compo. shingles SIGNATURE OF, APPLICANT ,VALUATION $2 60.00, APPROVALS DATE INSPECTOR'S SIGNATURE PMT P C. FOUNDATION: LOCATION ' FEE FEE"$6.00 FORMS;MATER 'IAL'S FRAME: FIRE-STOPS, 1 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 CONSTR f TION. 1 CERTIFY THAT IN DOING THE.WORK' AUTHORIZED HEREB I WILL NOT'EMPLOY ANY PERSON IN VIOLA—'. LATH: INT:' ' TION OF THE LABO G DE OF THE STATE OF-CALIFORNIA RELAT _ - ING TO WORKMEN'S PENSATIOyMEN'S INS RANCE' •LATH.EXT. •• SIGNATURE OF HOUSE NUMBER COR PERM ITTEE��.' RECT AND POSTED ' ADDRESS �a' Mae n Se C t�' " ,FINAL JOHN F. LEWIS. PRINCIPALS UCr, RAL EN-INEER PLAN CHECK VALIDATION cK... M.O. CASH PERMIT VALIDATION CK. M.0 CASH 6.,5 6:23':° OCT 18 1 D 6.0,Q 1 03 781688( - n CE 8803(REV:6/78) APPLICATI R: BUS- ING P COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN ADDRESSG(� Z �=- . � ; -e BUILDING ADDRESS 'En e_ LOCALITY.NEAREST CITY 1F-,p J�/, / CROSS ST. NO. BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT MAP BOOK_-. PAGE PARCEL D TRICT GROUP TYPE FIRE OC SED BY TRACT BLOCK LOT NO. CONST. l Z•pl TEL. [� / r` OWNER C�'� _ G25-�y NO.00Z`d : e STATISTICAL CLASS( ATION MAP ADDRESS �_ /);L-<' CLASS NO. _DWELL.UNITS• K CITY a5.4 AL ZIP ARCHITECTTEL. ENGINVALUATION $ r5hi ENGINEERRNO. ADDRESS BLDG.SETBACK FROM ` TEL. a _J FRONT PROP.LINE OF (STREET) CONTRACTOR NO.VIJ d / AL SETBACK FROM TYPE OF EXISTING LIC .— (( .HIGHWAY +.YARD = FRONT PROP.LINE HIGHWAY WIDTH ADDRESS I)JI C 1 13-P NO!� z1 L A/ ,. LC + Chi CITY SfU �f� GJ CLASS ./. FROM CONSTRUCTION LENDER BLDG. OP.LINE OF NAME AND BRANCH SIDE PROP.LINE OF (STREET) HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH SQ.FT. NO.OF NO.OF J CHECK + _ w SIZE STORIES FAMILIES J ONE DESCRIPTION OF WORK, fZ fJ � 7 � / o NEW ❑ P.C.Fee$ Permit Fee ("j ADD ❑ Issuance Fee 7, C �Z/i'c' Yt///7 �y ^ , d E� ALTER El REPAIR ❑ Total Fee ' USE ,� �� EXISTING BLDG.L ✓+` ( / (L DEMOL ❑ Z APPLICANT LL --•• TEL C (PRINT)14 L�t' S(• J NO-7 0/: J ,� G BY(SIGNATURE( A ' �y I HEREBY OWLEJD THAT I HAVE READ THIS APPLICATION AND STATE V THAT THE A IS CORT AND AGREE TO COMPLY'WITH ALL ORDINANCES W AND LAWS REGU TING DING CONSTRUCTION.I CERTIFY THAT IN DOING THE _ ?'9 6[L 8 A WORK AUTHORI D HERE WILL NOT EMPLOY ANY PERSON IN VIOLATION OF U THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- Z PENSATION INSURANCE. g ° ° ° o ° 1 SIGNATURE OF JJ/�� 6 26o3&00 PERMITTEE +u d ADDRESS r p Z o 0 0 j 4I,O O U 1c TEL. 0k- O 1 —RO CITY �:t lel s NO. y•�G Q • O - USE ZONE MAP NO. C� IAL 9,00 r>- DITIONS FINAL., BY d DATE'. `- APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING-AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS / G I hereby affirm that I have a certificate of consent to self Insure, Bu�DaNGgDDR SS or a certificate of Workers'Compensation Insurance,or a certified ((�� mn as LP copy thereof'(Sec.380b. b.C.) ti_! S/ p� �f v T C, LOCALITY • ,� Policy No."E �� Company 's nSIZE OF LOT NO.OF BLDGS.NOW ON LOT NEAREST CRO 11Certified copy is hereby furnished. S'C ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Dat ,/�i Applicant ASSESSOR MAP BOOK PAGE PARCEL ' • �.r� SPECIAL CONDITIONS �/f�� ,D j CERTIFICATE OF EXEMPTI OM WORKERS' R G_ COMPENSATION _'iPA TIEFJ 3G Ao L '�s6 WITHIN 1000 FT.OF SCHOOL? YES No. (This section need not be completed if the permit is for one hundred 1iARCHrrECT ss r l h �� DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY dollars($100)or less.) - - I certifythat in the performance of the work for which this permit 1 P` V is issued, I shall not employ any person'in any manner so as to R ENGINEER�!� TEL NO. I �� r �/��v"'� become subject to the Workers'Compensation Laws. STATISTICALTION APT CONDO Date Applicant ADDRESS CLASS NO. p�CL65SI ICADWELL UNITS NOTICE'TO APPLICANT. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST, Exemption, you should become subject to the Workers' TR 1jL / SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith <e n Pi I N FRONT comply with such provisions or this permit shall be deemed revoked. . A!rr yo .NO PL LICENSED CONTRACTORS DECLARATION E�7CC000U .(/)C,3 S`Z t SIDE I hereby affirm that I am licensed underprovislons of Chapter 9 CI � LI L-S SEWER MAP (commencing with Section 7000)of Division 3 of the Business.and SIZE N6.3F9EFEq NO.OF FAMILIES Professions Code, d m en Is in full force and effect. NEW BK PG , a m J DESC ION OF WORK VALUATION License Number Lic.Class ADD El $ /.561U Contractorss�-f� d sBicnDate ALTER ❑ b ❑ 1 am exempt under Sec. 1, REPAIR ❑ BBP.C.for this reason U } �� ' DEMOL ❑ LDMA P/C'# I� Date: SE OF EXISTING BLDG. URM ❑ CL Signature APPLICANT(PRINT) TEL NO. LDMA Perm ❑ I, as owner of the p erty, or.my employees with wages as Z A �. ,a their-sole compensa on, will do the work and the structure is ADDRESS 0 not intended or offered for sale (Section 7044, Business and FINAL DATE 3303 107 010 G Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL Z ` j ITEMSOR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE V J s ' ❑ 1, as owner of the property, am exclusively contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044, YES 11 NO 11 ` TFJTAL A(37 _ :.13 Business and Professions Code.) WILL THE INTENDED USE,OF THE B BY THE APPLICANT OR FUTURE BUILDING CHECK 107.10 OCCUPANT REQUIRE A PER.Mfi FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY 'COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. CHANCE .00 I hereby affirm that there is a construction lending agency for YES[INO❑ a the performance Of the Work for Wt11Ch fh13 permit IS ISSUed(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING ' N 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, 0000-0041 5/24/95 I TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS i! U LlR3L1 T Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. _ 0. Lender's Address a�uNER«+AGENT 0585 1 PM 5:03 0 0 1 certify that I have read this application and state under penalty c of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE N with all county ordinances and State laws relating to building construction,and hereby authorize representatives of this County ISSUANCE FEE c ato ent on the above-m oned property for inspection purr oses. ro 5�! INVESTIGATION FEE TOTAL FEE / n sld. nae -PPS' SEE REVERSE FOR EXPLANATORY LANGUAGE