The URL can be used to link to this page

Home My Public Portal About9840 MILOANN ST_Building__ IVISION OF BUILDING AND SAFETY Department of CaJ B. gineer �� - Lw County of Los Angeles WM. J. FOX, COUNTY,-ENGINEER APPLICATION FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK.CR REC.No. PERMIT NO. � BUILDING /A I(�e®{�I� -5- �&?7' ,� X/6 ADDRESS i R CEIVFD.B DATE orAPPL. DATE ISSUED LOCALITY N'EARE9Tpq11 CR09S 9T. 6Q ob DFN ��`�' BUILDING ADDRESS OWNER eIcLogynim MAILLOCALITY @ T C, ADDRESS Lj0JhTEL CROSS ST. CITY OZYNO. FIRE NO.OF TYPE GROUP ARCHITECT OR TEL ZONE I PLANS ENGINEER kicrkw NO. BLDG. r ORD. NO. SETBACK LINE Ld ADDRESS ® USE APPROVED APPROVED ZONE DATE CONTRACTOR/�ppA� �P�� NO. Ar6(cn HOUSE NUMBERING ADDRESS �Y�4 • ® lin MAP NUMBER 2-t2l"' � NO. ASSIGNED BYLEGALr DESCRIPTION I LOT NO. a BLOCK CO CYTONS ��d TRACT 2-G Co 25 p NO. of BLDGS. SIZE OF LOT �� ` ® I NOW ON LOT J� UBE OF ry EXISTING BLDG. CI@�Il @��@ �qa. FAM. Es �� LTIC�nQ:/fl Floc @ L-fl r I.E DESCRIPTIO K F WORKM s Goch G NEW ALTERATION ADDITION A� �® � f? � �� is D /�L T �P r F A ; REPAIR DEMOLITION . acl a t i (6 9q.FT. NO.QI 'i - . @ Y Y SIZE ®� ROOMS STORIES EXT.WALLRocw COVERING ,��14�`P� I COVERING USE OF STRUCTURE Cf INSPECTION FOR APPROVALS OCCUPANCY AS INSPECTOR'SSIGNATURE DATE FOUNDATION: LOCATION 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AW FORMS, MATERIALS PLICATION AND STATE THAT THE INFORMATION GIVEN 19 FRAME: FIRE STOPS, / J CORRI_`CT. BRACING,BOLTS / 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FURNACE: LOCATION, GAB VENT,DUCTS C c+ SIGNATURE OF LATH, INT. PERMITTE ADORES LATH, EXT. ��;/ PLASTER, INT. AUTHORIZED AGT. PLASTER, EXT. �0 FEE f'�� HOUSE NUMBER COR- RECT AND POSTED ✓._ VALUATIONREE •3® ' FINALg/'� 76AS36A DBS 3 1-32 ' � ;• 'APPLICATION• FOR• BUILDING PERMIT 1� APPLICANT TO FILL IN (Printo';type Only)' B ILDING Q�,,� ��.� COUNTY OF. LOS ANGELES ADDRESS :„o)60.U�J DEPARTMENT OF COUNTY ENGINEER 1't ZIP -DIVISION CITY NO.OF BLDGS. BUILDING Q SIZE OF LOT-76Q JW NOW ON LOT ADDRESS TRACTIZ S BLOCK I LOT NO. 3�. LOCALITY L NEAREST OWNER M&C&OM MILT EF40 TENO. , CROSS ST. ASSESSOR IV ADDRESS '. �. MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE ESS BY CITY ' CENT'-. ZIP .0CON ` ARCHITECT 0T.EL. ��IS J � ENGINEER g till No STATISTICAL CLASSIFICATION SEWER MAP ADDRESS fq Na ArV 0Zp.•yfwd«. CLASS NO.�' rDWELL,UNITS I BK G CONTRACTO ' TEL �70NE MAP / LIC MAADDRES LIC d SPECIAL An� pp LIC. CONDITIONS CITY AIWAD[A" CLASS g� ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONSTRUCTION LENDER P3. NAME AND BRANCH BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET) ADDRESS. CITY r HIGHWAY + YARD = ITOTAL SETBACK FROM TYPE OF EXISTING SQ.'FT NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH SIZE STORIES FAMILIES 'ONE CL DESCRIPTION OF WORK NEWBLDG.SETBACK FROM C= (IV DD SIDE PROP.LINE OF (STREET) 1V ALTERm _ TOTAL SETBACK FROM TYPE OF EXISTING t wc.a HIGHWAY + YARD - V REPAIF20 SIDE PROP. LINE HIGHWAY WIDTH y� _ CL EXISTING BLDG. ( �jQOI� DEMOL ❑ + Z APPLICANJZTEL +, CORNER CUTOFF YES ❑ NO ❑ .(PRINT,) W AAfXt, Milo N0. �/ I • IN OPEN SPACE YES ❑ NO ❑ BY (SIGNATURE) IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION,$ \ 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION 7:9LOW .,' V 7-Z>AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- .4:—"7z STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL 90T EMPLOY ANY PERSON IN 'VIOLATION OF THE LABOR CODE OF THE STAT OF -CALIFORNIA IN REL INC TO WORKMEN'S•COMPE TION URAN SIGNATURE OF m r PERMITTEE �,. p �: ADDRESS /4- cwCT I��/' Y-+T�� tE CITY 4,/�� .. NOL DIATE �/17/! :K BY hIAKE CHECKS PAYABLE TO: FE FEE $ . LHA RVEY T. BRANDT. COUNTY ENGINEER G aID PLAN'CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIO CK. M.O. CASH G O A rE-8 - 5 2 3 D l :;ems ..,%a ri 7 3 81- U .12 3.0 '0 71i�Jl 76A638A C8.#603 574 •, ti 14 �= APPLICATI®N 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, BUILDING ADDRE MW �` or certificate of Worke 'CQ pansa' Ins re e,or rtifie o00�� !!! GCl J C t ( e . 0 ) CIT ZIP N O 6*6 LOCALITY C SIZE OF LCT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished NEAREST CROSS ST ❑ Certifid with the un uilding in p n TRACT BLOCK LOT NO dep a USE ZONE MAP NO. Date AppliCan • ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' o NE G_ C/ COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS DISTRICT GROUP TRE CONST FIRE ZONE PROCESSED BY dollars ($100)or less.) CITY ZIP I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to 10, become subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO. STATISTICAL CLASSIFICATION 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' CO R T SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. ADD1*� LIC P L LICENSED CONTRACTORS DECLARATION SIDE CITY l /J� LIC.CLAS'9' P L I hereby affirm that I am licensed underprovisions of Chapter 9 6h (�� SEWER MAP > (commencinMOM 700 ) f ivision 3 of the Busines and SO.FT SIZE NO.OF STORIES NO OF FAMILIES a Professions e s I In full force a eff NEW ❑ BK PG C License NLic.Class q VALUATIONContracDate o1 TER ❑ $ C ElI am exempt under Sec. REPAIR 11 BAP.C.for this reason DEMOL ❑ LDMA P/C# a - - "' ' W Date: USE OF EXISTING BLDG. - - _ URM ❑ Signature pru s APPLICANT(FRNT) TEL NO. LDMA Perm# ❑ I, as owner of the property, or my employees with wages as Z their sole compensation, will do the work and the structure is ADDRESS 0 not intended or offered for sale (Section 7044, Business and FINAL DATE Q Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL •12 3 J ❑ I, as owner of the property, am exclusively contracting with ORA MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE a AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINALY licensed contractors to construct the project (Section 7044, YES El NO 111 Business and Professions Code.) - .7 WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING •�,,;, OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDELINES I hereby affirm that there is a construction lending agency for YES❑ NO❑ athe performance of the work for which this permit is issued(Sec. W 3097,CIV.C.) I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING a CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TITLE 2.CHAPTER 2 20 SECTIONS 2 20.100 THROUGH 2 20 140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. o Lender's Address 0 pyNEp OR AGENT 0 1 certify t t I have read this application and state under penalty 0 of perjur that the above inf on is correct.1 agree to comply P.C.FEE PERMIT FEE / tJ N with coun ordinan and ate laws relating to lull / m cons ion hereby a thorize presentatives of his Co ty ISSUANCE FEE G / a to r m, ned p party for in n p v g rp INVESTIGATION FEE TOTAL FEE aam ao Of CJ SEE REVERSE FOR EXPLANATORY LANGUAGE