The URL can be used to link to this page

Home My Public Portal About10627 LYNROSE ST_Building__ DEPARTNM OF COUNTY ENGINERR IVISION OF BUILDING AND SAFETY , COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER APPLICATION L1 CA88ATT D. GRIFFIN, SUPT OF BUILDING FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING �/ DISTRICT NO. PLAN CK.OR REc.No. PERMIT NO. ADDRE88 Wl7�+r r r t'1/f�"v N i�cR •: cc r� !o� �J V r RECEIV DBY DATE OF.APYL. DATE ISSUED LOCALITY �/1 9' �_ NEAREST v ®� yj/ / ,�I { CR088 8T a ADDREING BUILD SS '� e OWNERIL a �a ADDRESS Ili Jl.X14 Q MAIL ` LOCALITY • ` I� i NEAREST CITY44-{ !I:• .As�v P. Tag -_- �c ARCHITECT OR TEL. FIRE NO. OF TY2F!' I �aROI�P ENGINEER NO. ZONE PLANS 1 / BLDG. �7 ✓/� I /NO. ADDRESS SETBACK LINE TEL. USE / APPROVED CONTRACTOR NO. ZONE BY DATE 1 ADDRESS HOUSE NUMBERING LEGAL 3� MAP'NUMBER 15;910 NO. ASSIGNED BY DESCRIPTION LOT NO. BLOCK// TRACT C®RRECTIO�TS NO.OF 13LDGS* SIZE OF LOT 7J I NOW ON LOT USE OF NO.OF / EXISTING BLDG. I FANILIE �� b e5 Q & DESCRIPTION OF WORK 0 - _ 8 NEWALTERATION ADDITION Z REPAIR DEMOLITION I I Z r ' SQ. FT. NO.OF o. S_IZIZE �--2� _ ROOM8.�/" STORIES E ' xT.WALL _�,�� I ROOF COVERING tj/GG, COVERING , USE OF STRUCUIRE " •,�L�-ems-G� ��$eM r� APPROVALS INS PECTO •S SIGNATURE_ DATE FOUNDATION:LOCATION l.G FORMS, MATERIALS /. 1 HEREBY ACKNOWLEDGETHAT I HAVE READ THIS AP- FRAME: FIRE STOPS. PLICATION AND SATE THAT THE INFORMATION GIVEN IS BRACING. BOLTS .� CORT. A REE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, G S 1 AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS '_ @•GSIGNATURE OLATH, INT;F G f `e PERMITTE /y LATH. EXT. ADDR PLASTER, INT. AUTHORIZED AGT. PLASTER, EXT. $ �� P. 8 470 HOUSE NUMBER COR- � !/� RECT AND POSED VALUATION FEE 8 FINAL ( +'�''' 7BABB13A DBS 3 9-52 \! dvi 7eAa38A aE0803 e_ea. APPLICATION .FOR EUIL®INC PERMIT. COUNTY OF LO$.'ANGELES -BUILDING ' DEPARTMENT'OF COUNTY.ENGINEER . ADDRESS BUILDING'AND SAFETY DIVISION LOCA'LlTY.'•' ;.JOHN A. LAMBIE.-COUNTY'ENGINEER _ •� NEAREST WILLIAM A.JENSEN,SUP'T OF BUILDING CROSS ST.. DISTRICT NO. 'GROUP I TYPEPWICESSED•BY F_OR APPLICANT TO FILLAN. j, �' CONST�I/ BUILDING STATI'ST.ICAL CLASSIFICATION �— SEWER MAP ADDRESS T 62 7 L nr as e S t o T...r ' CLASS. NO.�DWELL.UNITS.— ' LOT NO. BLOCK' WATER NOT.REQUIRED .� -"RECEIVED CERTIFICATE: TRACT- — Q MAP HIGHWAY - +. - NO:OF BLDGS. NO. , Q (CIRCLE) , STATE MAJOR SECON ,LOCA SIZE.OF LOT NOW ON LOT UAE ZONE SPECIAL', USE OF CONDITIONS EXISTING BLDG. EL ' P..d• O OWNER s •' IO286-391• BUILDING EXIST:, Lionel- Hor a SETBACK' .YARD HWY STREET'NAME' WIDTH ADDRESS t T C.- ''FRONT ARCHITECT OR' ' TEL. P. L.- ENGINEER • L•'ENGINEER .'NO. SIpE P.•L.• ADDRESS TEL. O. V. CONTR'RACTO ADDRESS 600 SnA S' bri •' Blyff., O DESCRIPTION OF .WORK NEW .ADD ALTER REPAIR DEMOLISH Lot Z SQ.FT. ' -NO.-OF NO.OF-: SIZE. STORIES -FAMILIES _.USE OF Reroof house &',.att-o STRUCTURE gar e w •compo. 7 shingle s SIGNATURE OF " •APPLICANT VALUATION $ 2 60.e 001APPROVALS'• DATE •INSPECTOR`5'SIGNATURE P:C.' PMT. FOUNDATION: LOCATION FEE•$ - 'FEE.$ FORMS. MATERIALS ':FRAME: FIRE STOPS,. .1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION' BRACING. BOLTS -AND STATE THAT.THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE:'.LOCATION. - WITH. ALL COUNTYRDINANCES AND;STATE LAWS REGULATING .: ,GAS:VENT. DUCTS- BUILDING CONSTRU TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREB 1 WILL NOT EMPLOY NY PERSON IN VIOLA•; .LATH.•INT: TION OF THE LABOR O OF•THE fATE" F CALIFORNIA.RELAT. INC TO WORKMEN'S CO ENSATION E - - LATH.EXT. SIGNATURE'OF HOUSE NUMBER COR- ' PERMITTEE RECT AND POSTED- :,' ADDRESS FINAL / • - 'JOHN F. LEWIS, PRINCIPAL ST AL E14GINEER PLAN CHECK -VALIDATION cK. M,O. CASH'. PERMIT.VALIDATION CK. i M.O. CASH 6 6-i- ::402 :OCT 1$: 1 D 6.0 '�`' :.,. . APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUILDNIG AD RES or a certificate of Workers'Compensation Insurance,or a certified �► G copy thereof(Sec.3800 La C.) A C u ZIP SP ` bF .711 ej .)7 LOCALITY Policy No.2 Company `J SIZE OF LOT U NO.OF BLDGS.NOW ON LOT 11M OQe s ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with�he,cc y building inspection TRACT BLOCK LOT NO. Datee�m7pplicant _ USE ZONE MAP NO. r' ' ASSESSOR MAP 800K PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMWORKERS' owr�e�g f C , J� No. _Ss � YES NO COMPENSATIOCE [L, c� �C,/ WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESSr .� 1 DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars($100)or less.) I certify that in the performance of the work for which this permit C,T�Fy� 1 Cl' 19, Z � �C�• Q ,1 �1 �` is issued, I shall not employ any person in any manner so as to / r V 0 0 become subject to the Workers'Compensation Laws. ARCHITECT OR NGINEER TEL NO. STATISTICAL CLASSIFI ATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of [FRONT QUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CO RA 1 I TEL �.�-_/ T BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith �� Y .11,n1 �-(; comply with such provisions or this permit shall be deemed revoked. AD LIC O.LICENSED CONTRACTORS DECLARATION rr 11 12 2_�LI I hereby affirm that I am licensed underprovisions of Chapter. 9 Al ) SEWER MAP (commencing with Section 7000)of Division 3 of the Business and O.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code, nd lice in full force and effect. NEW BK PG a License Number Z $ s Lic.Class �-i� DES 10 OADD F WORK VALUATION ® O ❑ Contractor \ UKS� Date ~` Y – ALTER ❑ $ �CJ s U ❑ I am exempt under Sec. C 65;-57, 79 jj REPAIR ❑ $ Q BAP.C.for this reason – – `� —�� /7 DEMOL ❑ LDMA P/C# W Date: USE F EXISTING BLDG. URM ❑ IL Signature APPLICANT(PRINT) TEL No. LDMA Perm# Z ❑ 1, as owner of the property, or my employees with wages as Z ACCT o AT their sole compensation, will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and FINAL DATE // %/ Q 3303 107.10 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL b—zZ J ' EMS OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE t' 1T�"`'1 ❑ 1, as owner of the property, am exclusively contracting 44, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY n licensed contractors to construct the project (Section 7044, YES El No ElCA\/ TOTAL e 10Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING CHECK 107.10 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR CHANGE a tlry GUMEUNES 4 Iii V V I hereby affirm that there is a construction lending agency for YES❑ NO❑ m the performance of the Work for Which this 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, I]U_ryT-`Li�M 5/24/95 f L /❑ TITLE 2,CHAPTER 2.20 SECTIONS 2 20.100 THROUGH 2 20 140 CONCERNING HAZARDOUS VV UY1 7 5 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. o Lender's Address 0587 i Pri 5:03 C OWNER OR AGENT o I certify that I have read this application and state under penalty 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 i CO constru tion, and here authorize representatives of this Count ISSUANCE FEE y to ent�pon the above-mentioned property for inspection purposes. ��% ro —/ I� INVESTIGATION FEE TOTAL FEEQJ SEE REVERSE FOR EXPLANATORY LANGUAGE