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HomeMy Public PortalAbout10645 LYNROSE ST_Building__ i DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES B U I L D I N G. ,. WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING DISTRICT NO. PLAN CK. NO. PERMIT NO. ADDRESS Al Ao, -f y 91151 c p(, / d 44 RAVED By DATE OF APPL. DATE ISSUED r, LOCALITY r7-� /e I 3 / 3 2 NEAREST CROSS ST. . 11 ge Q�Q BUILDING ADDRESS OWNER s,,, LOCALITY/ /lip ADDRESS Cj A t.9 Mil, � NEAREST' �+ CROSS ST. CITY C .,r . NO• FIRE NO. OF TYPE GROUP ARCHITECT OR TEL. ZONE PLANS ENGINEER NO. BLDG. q ORD. NO. SETBACK LINE /y 9 y ADDRESS APPROVED TEL. BY DATE CONTRACTOR NO. USE APPROVED ZONE� BY- DATE ADDRESS HOUSE NUMBERING LEGALA�j DEBCRIPTION I LOT NO. P�3 2-,, BLOCK MAP NUMBER 01% L FIELD CHECK BY TRACT 51;ft- f', NO. ASSIGNED BY_Sl�AT /6S`X JBE—DGS--A--.—NO. OF CORRECTIONS SIZE OF LOT NOW ON LOT ` USE OF NO. OF p1 ./r of AoO EXISTING BLDG. -ps FAMILIES �^ s•G 9 1,. C' o M T — JDESCRIPTION OF WORK r a NEW I X I ALTERATION I I ADDITION I M �, .56m REPAIR I I DEMOLITION I I Ip y 15 t 9 2 I nl G, (1/9 m'i'1 'r,0.w s t- f 3 ZE y3� ROOMS STORIES / PL C 17 SC- H C S T1� 13LISn EXT. WALL ROOF m COVERING S3;We C V I COVERING �p/77 G DIE J-I'/1 FK eleO 1 f4 6r 1✓'. USE OF STRUCTURE ye L_ra.Ski APPRbvALS ,A -c INSPECTOR'S SIGNATURE DATE 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FOUNDATION: LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS CORRECT. I AGREE TO COMPLY WITH THE CORRECTIONS LISTEDFFRAME:FIRE STOPS, HEREON AND WITH ALL COUNTY ORDINANCES AND STATE G - Z LAWS REGULATING BUILDING CONSTRUCTION. LOCATIONSIGNATURE[ O 1--7 AS YEN DUCTS PERM TH, INT. ADDRESSTH, EXT. �J AUTHORIZED AGT. PLASTER, INT. I 7OA63aA•VHS3 10-50 P C. $ ® 11 O FEE/ , PLASTER. EXT. VALUATION Q EE '�� FINAL APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES I BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS � &f-4_5-e_, ��t� I hereby affirm that I have a certificate of consent to self insure, BUILDINC�,AD RES or a certificate of Workers'Compensation Insurance,or a certified �� ' Z LOCALITY copy thereof(Sec.3800 Lab.C.) -gyp Policy N___S r�� Company - 1 '" �h ` /+ p SIZE OF NO.OF BLDG&NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the count building inspection TRACT BLOCK LOT NO. dep tme tUSTE MAP NO. Date ZApplicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONSCERTIFICATE OF EXEMPTION F WORKERS' R TEL o��COMPENSATION INSUR CE O J' 00 FT.OF SCHOOL? YES NO (This section need not be completed if the permit'isfor one hundred ADDRESS � �� GROUP TYPECONST. FIREZONE PROCESSEDBY dollars($100)or less.)1 certify that in the performance of the work for which this permit CpFn /� J e C ZIP 1� � . � ��is issued, I shall not employ any person in any manner so as to AR HITCE/CIT O'ENGINEER TEL NO. f� become subject to the Workers'Compensation Laws. STATISTICAL CL SI CATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT• If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CON C1�TO J L / SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith Y t l it ",� �6 FRONT comply with such provisions or this permit shall be deemed revoked. ADD SNO. ZC� P L LICENSED CONTRACTORS DECLARATION ` SIDE I hereby affirm that I am licensed underprovisions of Chapter 9 PL Y ��A�� � SEWER MAP (commencing with Section 7000)of Division 3 of the Business and scLIFT.SIZE NO.OF STORIES NEOFILIES Professions Code,a d m licens is in full force and effe NEW BK PG a�/© DESCR O OFWOR ADD ❑ VALUATION O License Number ��c.Class / Contractor F_Ohate '' � ALTER ❑ $ b V a-xAg gr'�-S n � ❑ 1 am exempt under Sec. 2L1/ EPAIR ❑ BAP.C.for this reason DEMOL ❑ LDMA PIC# W Date. USE OF EXISTING BLDG. URM ❑ IL Signature APPLICANT(PRINT) TEL NO. LDMA Perm# g Z [1I, as owner of the property, or my employees with wages as Z (�� T°s their sole compensation, will do the work and the structure is ADDRESS F3303 �Q�° i not intended or offered for sale (Section 7044, Business and FINAL DATE G 10 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL 6�ZG ITEMS OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE "'I ❑ 1, as owner of the property, am exclusively contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY TOTAL 10-7 v licensed contractors to construct the project (Section 7044, YES 11 NO ❑ Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING CHECK 1017■10 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR GUIDELINEQUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKUST FOR 1 CHANGE ° 0 I hereby affirm that there is a construction lending agency for YES 11NO❑ N the performance of the work for which this permit is issued(Sec. I HAVE READ THE MD PERMITTING N 3097,Civ.C.) CHECKLIST UNDERASTAND MY REQUIRDOUS REMENTS UNDER INFORMATION GTHE LOS ANGELESUIDE AND THE OCOUNTY CODE, 0000-0001 5/24/95 TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS y y c C Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. 593 i pil o Lender's Address V 7 C OWNER OR AGENT cI 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 S N with all county ordinances and State laws relating to building construction, and hereby authorize representatives of this County ISSUANCE FEE m to ant �on the abo -mentioned property for inspe ion purposes. S INVESTIGATION FEE TOTAL FEEff /L 0 slam ApptlC°4, m V SEE REVERSE FOR EXPLANATORY LANGUAGE 76A688A-CE*608 B-63 APPLICATION FOR BUILDING ERMM I.J COUNTY OF LOS ANGELES BUILDING / s DEPARTMENT OF COUNTY ENGINEER ' ADDRESS G BUILDING AND SAFETY DIVISION LOCALITY L�� JOHN A. LAMBIE, COUNTY ENGINEER NEAREST. WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST. - DISTRICT NO. r GROUP TYPE PR ESSED'BY FOR•APPLICANT TO FILL IN 5710,3, 1Y_� S. CONST,I21 �' BUILDING STATISTICAL CLASSIFICATION SEWER MAP ADDRESS 10645 L rose Sts T, C. —� BK PG CLASS. NO.. DWELL.UNITS LOTNO. BLOCK WATER NOT REQUIRED -ElRECEIVED ❑ CERTIFICATE: TRACT . 2 D MAP HIGHWAY STATE MAJOR SECOND NO,OF BLDGS. NO. 619 (CIRCLE) SIZE OF LOT (p(� NOW ON LOT USE ONE. PECIAL USE OF CONDITIONS EXISTING BLDG. LL.cc��p OWNERLionelHorsey NOF86-39.1 BUILDING YARD HWY STREET-NAME EXIST. SETBACK WIDTH ADDRESS 9047 E. Olive St.', T. IC • FRONT ARCHITECT OR TEL. P. L. ENGINEER NO. SIDE P. L. ADDRESS d TELC CONTRACTOR Vir in Roof db.No.'2:87-05 v .ADDRESS 600 So. San Gabriel. Blvd. DESCRIPTION OF WORK Lu n. NEW ADD ALTER REPAIR DEMOLISH N z SQ.FT. NO.OF NO. OF SIZE STORIES FAMILIES. USBTU E Reroof-•house & att. gar. STRi compo. s ing es SIGNATURE OF 'APPLICANT VALUATION s 2 60.00 APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE $ FEE s 6 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 CON STR CTION. i CERTIFY THAT IN DOING THE-WORK AUTHORIZED HERE Y I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LAB DE OF THE STATE F CALIFORNIA RELAT- -ING TO WORKMEN'S MPENSATION-If4SURA LATH.EXT: SIGNATURE OF HOUSE NUMBER COR- PERMITTEE rillRECT AND POSTED . /] ADDRESS Z FINAL 1G JOHN F. LEWIS,PRINCIPAL ST RAL EN I'NEER PLAN CHECK VALIDATION Clc. M.O. ,CASH -PERMIT VALIDATION CK. M.O. CASH 1 `4: L&6 15 1 .612 OCT' 1 6.0-0-f 0