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Home My Public Portal About10733 LYNROSE ST_Building__ ,eAB,aA�e .o„o APPLICA`T'ION FOR BUILDING COUNTY OF LOS ANGELES BUILDING 07, DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND :SAFETY DMSION LOCALITY JOHN A.LAMBIE.COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN SUPT OF BUILDING CROSS ST. DISTRICT NO. GROUPI�.pE D BY. FOR APPLICANT TO FILL IN coNsr. BUILDING �f SE ER MAP ADDRESS /�/ �3 ,�y�/iQ�s STATISTICAL CLASSIFICATION /� BLOCK BK PG , / /�/4y �LaY,f CLASS.NO.-NO—DWELL.UNIT LOT NO. Jam+ MAP STATE YES' NO- `w � � USE ZONE SAL _ HWY. TRACT - NO.OF BLDGS. CONDITIONS SIZE OF LOT ITaX ClY1111- I NOW ON LOT USE OF EXIS I G.BLDG. BUILDING YARD HWY. BEET NAME EXIT. SETBACK _ WIDTH' OWNER /Q�F+CJ/i{6-A! Z 7— d9,Q P FRONT MAILPs Le ADDRESS/C� � Zo(=Y� 1%2-1-ISA SIDE , P.L. CI - ivo / ' / SPECTION-RECORD ARCHITECT OR TEL ENGINEER NO. ADDRESS TEL. CONTRACTOR NO. Ari? . I l ADDRESS At- c� 6�✓ `,"a.r�-�o' � .jLc� DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH :� �.•• i� FT. NO.OF NO.OF SIZE STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF APPROVALS APPLICANT DATE INSP IGNATURE. ADDRESS FOUNDATION: LOCATION FORMS,MATERIALS P..C. $ � FRAME: FIRE STOPS.' pp��'� FEE .� BRACING.BOLTS p /. VALUATION /y�0 V $ oQ FURNACE: LOCATION, FEE GAS VENT.DU S 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH,INT. PLICATION AND STATE THAT THE ABOVE IS.QPRRECT AND AGREE TO COMPLY ITH ALLUNTY LACES AND LATH.EXT. STATE LAWS RE ILD( STRUCTION. SIGNATURE OF HOUSE NUMBER COR. f, PERMITTE RECT AND POSTED hl ADORES FINAL - CLY E N.DIRLAM,PRINCIPAL.ST RAL ENGINEER; PLAN CICS VALWATION cK. M.o. CASH Point VALIDATION f CK. M.O. CASH 4 9 3 8 APR 13 2 3 A '2 2•.5 4 Or AGO 4 9 3 9 u; „PR'13 :.A 4 5.0 0; c 741%6360i 11100 6.62APPLICATION FOR BUILDING PERM CrGUM OF IAS ANGMM BUILDING DEPARTMENT OF OODNTY LNGMEER ADDRESS r•' BUMMG AND SAFETY DMSION ; LOCALITY ' JOHN A. LAMBIE.COUNTY ENGINEEREAREST . WILLIAM A.JENSEN,SUPT OF BUILDING CROSS$1'. C,4M.A. O G iN DISTGROUP TYPE P SSED BY FOR APPLICANT TO F= IN RI CON$r_92� BUILDIND STATISTICAL CLASSIFICATION BIMJER MAP ADDRESS ' CLASS.NO. DWE UNITS "'�' OKA& LOT NO. {: BLOCK WATER r NOT REQUIREOU RECEIVED f CERTIFICATEi '' TRACT •� NOPVAV NO.OF BDGS. e7 O CCI C ZLZ)• STATE M OR SECOND.LOCAL • �,1 L SIZl�OF LOT NOW ON LOT USE ZONE •' SPECIAL r USE F QONDITIONS ' EXISTING BLDG pw TEL N z/ BUIL06M SETBACK YARD HWY ' EE'r NE WI UAYDTH 'AD S 'FRONT AR TELT TEL P•L ad ENOINEER NO. SIDE P. L ADDRESS TEL. � � CONTRACTOR '� NO. ADDRESS 1 •�'� DESQRpTtON OF WOBH 'L � '' y1 `� P P . "•. ri��f •� •..}.:`7• r +• :moi. ''•' IL NEW D ALTEII. . REPAIR DEMOLISH SQ FT. NO.OF SIZE FAM I LI ES USE OF ' •• ' STRUCTURE VA SIGNATURE OF APPLI - VALUATION S APPROVALS DATE INEFECTOR•i SIGNATURE P.C. PMT. FOUNDATIONI LOCATION FEE E�r FEE E ` FORMS MATERIALS t FRAMEI FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION B L1. !4J AND STATE THAT THE ABOVE JS CORRECT AND AGREE TO COMPLY PURNACW LIO lON. - WnW ALL OOUMTY ORDINANCES AND STATE LAWS REGULATING" OAS VENT,DUC'1'8 BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE•TXMX AUTHORIZED RENEW I WILL NOT EMPLOY ANY PERSON IN VIOLA- '-LATH.INT. TION OF THE LAWN CODE OF THE STATE OF CALIFORNIA REI+AT• INC TO WORKMEN'S COMPENIATION ININJONC E. LATH.EXT. ' SIGNATURE OF ( '/wR+/ i HOUSE NUMBER COR- Pi RECT AND POSTED ADDRESS FINAL M �R�/�� T/ JOHN F.F.�L,MIS.fe dNfC ■AL$'TRU RAC ENO NEER PLA CEME K A - CK. M.O. WH riaDiL�iii YALMATION CIC. M.O. CASH Leo 4 5 6 1* MAY 1.0 1- D WORKERS'COMPENSATION DECLARATION hereby affirm that I have a certificate of consent toself APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers'Compenstion Insurancc e, or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No.C�4 4ompany �� ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING `v?7 L Certified copy is filed with the county building inspec- BUILDING ADDRESS tion dep tment. ADDRESS (O, 3 L, L, N . 0s 5 E LOCALITY ri /e I- NEAREST Date Applica CITY ` Oil ZIP 8 C OSS ST. ' C TIF ATE OF EXEMPTION F .R M WOR ERS' fNO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT J/0)(Iva, NOW ON LOT Z• MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP hundred dollars($100)or less.) TRACT BLOCK L T NO. NO. l L. /I SPECIAL CLCL OWNER Pe �fL •-C7 fr O. —O CONDITIONS 0 I certify that in the performance of the work for which this ISTRICT GROUP TYPE FIRE PROC SED BY O permit is issued, I shall not employ any person in any manner V so as to.become subject to the Workers'Compensation Laws: ADDRESS L- N L5 �� CONST. ZONE r - l-� Q t t y Date Applicant CITY 1 ZIP ��`p O V ��- i O STATISTICAL CLASSIFICATION APT. CONDO. NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. i W ENGINEER W. •t( NO. ��L CLASS NO. c DWEL'L. UNITS_ Exemption, you should become subject to the Workers' �{ IlL Compensation provisions of the Labor Code, you must forth- ADDRESS 4toc0 ,% ;+w SL p.LpNj�-, SEWER MAP with comply with such provisions or this permit shall be TEL. w,' deemed revoked. TRACTOR �ppl -t,7-�3� �! CONTRACTOR NO• BK. PG, �` s VALIDATION LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRES j NA NO. 107— VALUATION (commencing with Section 7000)of Division 3 of the Business and Lit. / Ob t Professions Code,,and my license is in full•force'and effect. CITY SAN Q.le CLASS Ci'S3 $ p SQ. FT - NO.OF NO.OF CHECK License Niimber l TTS OZ Lic.Class l�s SIZE LO STORIES FAMILIES ONE Confrcicto � b' b,fnDateBIS1 DESCRIPTION OF WORK NEW $ ❑ I am exempt from fh lic rt;i 0 requirements as I am a 51ti.✓t rAS(11 L3 47 Tel ADD ❑ licensed architect or a registered professional engineer D LTER ❑ FINAL acting in my professional capacity (Section 7051, �¢ ( - a. 1EPAIR ❑ DATE �Q ' �� Business and Professions Code). USE OF —I ' EXISTING BLDG. C -DEMOL ❑ FINAL ��./,�� Lic.or Reg.No. Date APPLICANT TEL. L� OWNER-BUILDER DECLARATION PRINTI N No. - LS 0 6 8 I hereby affirm that I am exempt from the Contractor's License ' 76 b Law for the following reason (Section 7031.5, Business and• ADDRESS8$0 L.&.% �IN hs Professions Code): ` PRESENT ❑ BUILDING 2 ° ° j 0 j.0 I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do t)te work and LOCALITY ° ° J Q 1 z the structure is not intended or offered for sale(Section 7044, Business and Professions Code). MOVING TEL. n ❑ ICONTRACTOR NO. 0 O 07—8 1 , as owner of the property, am exclusively contracting t with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. I -'0 6 8. z n CONSTRUCTION LENDING AGENCY SET BACK' PROP. LINE WIDTH -I hereby affirm that there is a construction lending agency for FRONT ; ° ° the performance of the work for which this permit is issued P.L. ° ° (Sec. 3097, Civ. C.). SIDE 9 7, Lender's Name ��IG�OW . P.L. (:l 0 as ° 97,( C a P.C. Fee$ Permit Fee Lender's,Address ' I certifythat I have read this application and state that the o8,07--81 PP Issuance Fee - = above inform tion is orrect. I ee to comply with all County Investigation Fee 3 ordinances nd laws r a ng to building construction, Total Fee 7 $� and ere out riz repr a fives of this County to enter 0 on t a ov e i p perty for inspection pur oses t SEE REVERSE FOR EXPLANATORY LANGUAGE ° Signatur of Applicant or Agent ote Os • -WORKERS'COMPENSATION DECLARATION • .I here o;a off cthat.ertificate I haver certificate of consent to self APPLICATION FOR BUILDING PERMIT � irtture, or a certificate of Workers'Compensation Insurance, ar-q certified copy thereof(Sec. 3800, Lab. C.) PolicyNa4j7,�13-d�1 Company �' of+' COUNTY OF LOS ANGELES BUILDING AND SAFETY ®, Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING / ADDRESS *A4st AX AL ❑ Certified copy is filed with the county building inspec- BUILDING .7 tion department. ADDRESS '7.3 ra15e �• Date /3/ S" Applicant r1/� , !• cITYTp /& ZIP LOCALITY —S-57 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 ASSESSOR hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL L' USZ NE P I certify that in the performance of the work for which this OWNER N%e O. AHA O permit is issued,I shall not employ any person in any manner SPECIAL d so as to become subject to the Workers'Compensation Laws. ADDRESS CONDITIONS CITY ZIP Date Applicant OC NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PRO ED BY Exemption, you should become subject to the Workers' ENGINEER NO. �fJ CONST. ZONE Compensation provisions of the Labor Code, you must forth- ADDRESS t 3 W with comply with such provisions or this permit shall be 7 deemed revoked. '/" /moi• TEL STATISTICAL CLASSIFICATION APT. CONCI, CONTRACTOR r1 J• • L. LICENSED CONTRACTORS DECLARATION - - / LIC, L, CLASS NO. DWELL. UNITS 1 hereby off.irm that I am licensed under provisions of Chapter 9 ADDRES .7 =4 A%4 N . 7 fS66r (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP Professions Code,and my license is in full force and effect. CITY WOO ��°�� CLASS 154. BK �� VALIDATION I /� SQ.FT. NO.OF NO.OF CHECK Utense_Number ��bJ L15Xlassy I 1 SIZE STORIES FAMILIES ONE E] VALUATION Contractor Q T G!4$�+�V Date — DESCRIPTION OF WORK NEW $ ADD C] ❑I am exempt under Sec. ALTER ❑ Al 4 6 0 A B.BP.C.for this reason c REPAIR ❑ $ # 0 0 0 0 0 USE OF Date: EXISTING BLDG. DEMOL ❑ I e 124.88 Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION PRINT NO. DATE 0 0 12 4.8 8_ I hereby affirm that I am exempt from the Contractor's License U Low for the following reason (Section 7031.5, Business and ADDRESS FI Professions Code): PRESENT 1,3 -$Jr ❑ 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 7044, Business and Professions Code). MOVING TEL. ❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 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. v Lender's Name TDMA Ref. # Lender's Address P.C.Fee$ Permit fee r .l certify that I have read this application and state that the Issuance Fee LDMA P/C# c above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee LDMA Perm.# and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. 1 1 � SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date