Loading...
HomeMy Public PortalAbout5226 MCCLINTOCK AVE_Building__ IGA=MGllfim_.w APPLICATION FOR BUILDING PERMIT � 1 CODNTY OF LOS ANCA= ADDR 1NO • DEPASTD�NT SS OF COUM ENGIIIM SIIaAII�iG AND SAFETY DMSION LOCALITY JOHN A.LAMBIE.COUNTY ENGINEER NEAREST C/166A'1'T D.GRIFFIN BUTT OF BUILDINY CROSS D18T11�ICTN0. GROUP TYPE SEWER.MAP FOR APPl.EM TO Fm IN 1 Ira BK ADDRESS V Z�.C�� 1 AknCjkSTATISTICAL CLASSIFICATION CLASS,NO. EL .UNI ~" LOT N0. BLOCK MAP STATE YES O ,TRACT, 3 NURIBER HWY. USE E SPECIAL NO.OF BLDGS. SIZE OF IAT X I IL C I NOW ON LOT I CONDITIONS EXISTING BLOOL v4t O 1AJ6 BUILDING EXIST. q BETHACK YARD HWY STR6 NAMK WIDTH OWNER N V« FRONT P.L' CAP :IDS ' TEL O.Y P.L. ARCHITECT ORTEL •-� ON SECOSD � ENGINEER IVC N0. ' ADDRESS CONTRACTOR O NOL w ADDRESS DFS-ENnON OF WOES o w T� r'- _ NEW ADD ALTER REPAIR DEMOLISH B:&6 G •STORIES FAMILIES USE OF STRUCTURE O vim.-Q 81GNATU APPROVALS ADORES D�►TE INSPEC7ON'a sI81U1TURE FOUNDA ON: LOCATION r FORM:::MA P.C. ; FRAME: G o STOPS. FE6 BRACING.BOLTS VALUATION 0 rjjj[0 FURNACE. LOCATION. FEE GAS VENN' DUCTS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH INT.• i r PLICATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND 8TAT6 T BUILDING NSTRUCTION. LATH Mr. i SI p R6 HOUSE NUMBER CORr RECT AND POSTED ADDR68 �� ��►•��'� FINAL IOHN A.LAMBI COUNTY ENGINEER. CLYDE N.DIRLAM PRINCIPAL STRucrultAL ENGINEER PLAN CEiCE VAL=== Gu. B.o. aASN Pte=VALIDATMOB B.O. cANN o 3--2-SM.AM 28 1 A y8;�fl 2 m. v 76A63BA CE#808 3-66 APPLICATION FOR I.BU I LDI N PERM I- COUNTY OF LOS ANGELESBUILDING a� n DEPARTMENT OF COUNTY ENGINEER 'A D o R E ss� o S O� BUILDING AND SAFETY DIVISION -LOCALITY JOHN A. LAMBIE.COUNTY ENGINEER NEAREST COLEMAN W. JENKINS.SUP'T OF BUILDING CROSS ST. DISTRICT NO. G OUP TYPE PRO B PRE R APPLICANT TO FILL IN CONS . //'� //�� STATIS ICAL C SIFICATION SEWER MAP �.�10 /��Is�iV CLASS NO. DWELL UNITS BK PG BLOCK USE ZONE MAP NO. '/' SPECIAL . OF BLDGCONDITIONS T Q NOW ON LOT /�mC. � ) p r (BLDG. SETBACK FROM /- A JL/JA.FA NOL. //OTYPE OFROE%ISP. ITINGNE FSETBA HIGHWAY + YARO = (S OTAL't�,dnto c//e `�-I�TO cam-/ HIGHWAY WIDTH •F 0 C.L. [ADDRESS TY ��,7 f fes' C/r + CHITECT OR TEL. BLDG.. SETBACK F. M __. GINEER NO. SIDE PROP. LI OF _ dSTREET TYPE OF STING SETBACK HIGHWAY + YARD — TOTAL DRESS HIGHWAY IDTH FROM C.L. • TEL. + NTRACTOR NO LIC CI NO CORNER CUTOFF YES NO CTY CIC SEE REVERSE SIDE FOR SPECIAL APPROVALS cccDESCRIPTION OF WORKW ADD ALTER REPAIR DEMOLISH �/ SQ.FT. NO. OF NO. OF 2S LL�Eff.. SIZE STORIES FAMILIES R• ), USE OF STRUCTURE #A:_. tcf4,Ir ) SIGNATURE O - ���C%�'/J�„ r�•111 .e w_� �� . APPLICANT VALUATION$ ,00 APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION, LOCATION F FEE$ / FORMS,MATERIALS , FRAME, FIRE STOPS,- 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS 13UILDING CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK AUTHORIZED HEREBY-1 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 INSURANCE. LATH. EXT. SIGNATURE CIF HOUSE NUMBER COR- PWRMITTEE ✓✓✓✓✓✓wwwwww i REC AND POSTED ADDRESS F I NAL 99, / ' 'S / - JOHN F. LEWIS. PRINCIPAL STRUCTURAL EONR PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O CASH DEC 8 1 0 6.0 0Nct r , WORKERS'COMPENSATION DECL,42ATIQP-,i e b, hereby affirm that I have certificate of consent e P P L I CATION FOR BUILDING PERMIT . insure, or a certificate of Workers'Compensation Insurance, .a or a certified py thereof(Sec. 3800, Lab. C.) + a s Policy N . Company eemkm COUNTY OF LOS ANGELES -BUILDING AND SAFETY Certified co is hereby furnished. . BUILDING ❑ copy y FOR APPLICANT TO FILL'IN ADDRESS Certified copy is filed with t cou y bui ing inspec- BUILDING ` , LYJ tion department. ADDRESS '' �1 Y LOCALITY I/ pz NEAREST Date - a Applicant CITY ZIP Q CROSS ST, CERTIFICATE OF EXEMPTION ROM WORKERS' Q i NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT .NOW ON LOT t' 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 LOT NO.TEL NO. Ti� SPECIAL I certify that in the performance of the work for which this OWNER NO, rr CONDITIONS ',i .permit is issued, I shall not employ any person in any manner ( ��� DISTRICT GROUP .TYPE FIRE PROCESSED BY so as to become subject to the Workers'Compensation Laws. ADDRESS /1/VA1 CONST. ZO i l 3 Date Applicant CITY ZIF STATISTICAL CLASSIFICATION APT. CONDO. F•' NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. Exemption, you-should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL.UNITS wa. 1111111 Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be z deemed revoked. - TEL' . �py BK. PG,• VALIDATION CONTRACTO NO. -V LICENSED CONTRACTORS DECLARATIONLIC, I hereby affirm that I am licensed under provisions of Chapter 9 , ADDRESS&Q� P NO. V LUATION (commencing with Section 7000)of Division 3 of the Business and LIC. " Professions Code, and-my license is in full force and effect. CITY CLASS SQ. FT NO.OF NO.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE 4 DESCRIPTION OF WORK $ 6 Contractor Date NEW ❑I am exempt under Sec. ,I �(�(� C�fi?GQmimij;CBani, T01 ADD ; ALTER' ❑ FINAL B.BP.C. for this reason REPAIR DATE Z—"]4--it Date: USE OF EXISTING BLDG. 8(7B '� DEMOL ❑ FINAL APPLICANT TEL. Signature PRINT C NO. • . 1 OWNER-BUILDER DECLARATION - , -Iv� I hereby affirm that I am exempt from the Contractor's License 5t�`,�g � J Law for the following reason (Section 7031.5, Business and ADDRESS I1i�w`•�••VV Professions Code): PRESENT BUILDING I'I, as'owner of the property, ormy employee's with ADDRESS wages as their sole compensation,will do the work•and .4 the structure is not intended or offered for sale(Section LOCALITY -,"'3 5 0 A 7044, Business and Professions Code). MOVING TEL. ,f o o,o u '�o.' . • I,as.owner of the property,am exclusively contracting CONTRACTOR NO. 01 01 G ,�O with licensed contractors to construct the project (Sec-' I . ADDRESS S• y 'tion 7044, Business and Professions Code). '' c. � REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SETBACK YARD HW$ 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 I P.L. • tSec. 3097, Civ. C.). SIDE. 'P.L. : Lender's Name 3 Lender's Address P.C. Fee$ Permit Fee ' CZ = �� � . ' � I I certify tliat',I have•recid this appl)cafion and stote,that'the ' Issuance Fee above'informaYion is correct.I agree to co m 1 .Ith-all Count _ pp Y Investlgatign Fee: ::,. ... ordinances and.State;lavits relating•to'LitYing;construction; i Notal.Fee.,: and hereby a orzs resentative this County to enter upon th bo ' men on roperty, r,inspection'pur'pbses. ( SEE.REVERSE FOR XPLANATORY LANGUAGE g': : Signature of Applicant or'Agent .Date " ®s• �. . APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES' BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDING ADDR WORKER'S COMPENSATION DECLARATION ELo��i�l iDL'.0 BUILDING ADDRESS Z I hereby affirm that I have a certificate of consent to self insure, E�Ll.�w or a certificate of Workers'Compensation Insurance,or a certified 6-22 (, no C copy thereof(See,3800,Lab.C.),��� CITY 7E-�7aL C C'lTV ZIP 9/7d'� LOCALITY / Policy No. s.�J-23 UIylTCompany 2 l e �'d{�Vi) SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS Certified copy is filed oun building' spection TRACT BLOCK LOT NO. -awd department. USE ZONE MAP NO. Date Applicant )«'� L.fZ1W&Y m SSOR MAP BOOK��7y PAGE PARCEL SPECIAL CONDITIONS 910- 000- © oz/ CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL�NO. COMPENSATION INSURANCE ADDRESS Sa$ A @o Sf^ "7`� t'H'Ia I a WITHIN 1000 FT.of SCHOOL? ves No (This section need not be completed if the permit is for one hundred Z 2L' C LtH c �� DISTRICT GROUP TYPE NST. IRE ZONE PROC SED By dollars($100)or less.) I certify that in the performance of the work for which this permit CITY-b:n1P LC , n l-`TJ ZIP 9 1 7 - /f is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. v J✓1 become subject to the Workers'Compensation Laws. STATISTICAL CLIy�SIFIFATION 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' QTRACTORTEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith �f�EZ+KHiV r��L ivTE�201143t� FRONT comply with such provisions or this permit shall be deemed revoked. `�E �,` LIC.NO. 1 r P L Gd s-la`/z tJ SIDE LICENSED CONTRACTORS DECLARATION CITY _ U21ct P L I hereby affirm that I am licensed underprovislons of Chapter 9 �L aNTt' L SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF SjORIES NO.OF�FAMILIES Professions Code,and my licenseisin full force and effect. 7_6 NEW BK PG , n License Number o7�Y LIC.Class �'-J� DESCRIPTION OF WORK ADD ❑ VALUATION �� I-GzM'VUaCy_i3_R3 P"Gi1Aoac Ex'ss, US IZ.00F LA4L-as. $ .32t�© � C Contractor +—,,.�*r. a,.z Date ALTER El !Y [II am exempt under Sec. /� REPAIR 11 $ B.BP.C.for this reason ±- �b 2o-Y.A.— 86'U Stfifn6Li - DEMOL :❑ LDMA P/C# ll C Date: US EXISTING BLDG. URM ❑ C• Signature ju N L APP�4(CANT(PRINT TEL NO. LDMA Perm# ❑ I, as owner of the property, or my employees with wages as V I L•To z. &S-6-luf p ASC( .s their sole compensation, will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and I k A Z 13 C f+E RV L Z)1L �G7L 114ONT2r FINAL 1) Q 3307 117.90 Professions Code.) q WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL J 4 n ❑ I, 8S owner of theproperty, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Q I I t EMSS Y g AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL licensed contractors to construct the project.(Section 7044, VES[I No 18� a ��i L 117.90 Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING CHECK 117.90 y 17 p 1 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH 'y_A�� 1.fIC4\ i o 7SJ CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR Ste//7J(/J GUIDELINES J i'.LJANGIE' r 'o I hereby affirm that there is a construction lending agency for YES 11 NO 4 1� !IV J athe performance Of the Work for Wt11Ch this permit IS ISSUed(SBC. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTINGLip 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, C.jTITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS (')ry(jr`�('�('�/ry q ,' +) Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. SS..lIItJJI00 iiFFL00 i t 0 Lender's Address 9180 i � 7;L 0 aWNER OR AGENT cI certify that I have read this application and state under penalty 0 of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEEF-.7 N with all county ordinances and State laws relating to building m ucr and her by authorize representatives of this County ISSUANCE FEE aenter upo the -mentioned property for inspection purposes. nI ( �A.v1A /3—QS INVESTIGATION FEE TOTAL FEE s4reave a Aap � r A2., Gme SEE REVERSE FOR EXPLANATORY LANGUAGE