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Home My Public Portal About9926 MILOANN ST_Miscellaneous__ --%l-T 76M444-CE #8Y6 9-68 WSCE A NEO S AFPL5ATn6-wl-,�& CfiUTx OF LOS ANGELES DEa.KRTNENi'OF COUNTY ENGINEER A.D eISS S BUILDING'AND SAFETY DIVISION LOCALITY -7— > , JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W.JENKINS. SUPT. OF BUILDING NEAREST r� �/ ,,//77 .,n_..::.x CROSS ST. )0,49/4(9 1 J7 FOR APPLICANT TO FILL IN DISTRICT NQ GROUP TYPE PROCESSED BY CONST SLw B%-CING Mppr. HIGHWAY AD RESS ,�_- / J�/ NO. (CIRCLE) STATE MAJOR SECOND LOCAL LOCALITY raj 7 " USE ZONE SPECIAL CONDITIONS NEAREST REQUIRED EXIST. LEGAL SETBACK YARD HWY STREET NAME DESCRIPTION I LOT NO ( BLOCK FRONT WIDTH OF TRACT � 2. �, NOW ONBLOT S P.L SIDE USE OF P L SIZE OF LOT EXISTING BLDG. r 37 OWNER MAIL ADDRESS �• % TEL CITY / .� NO. APPLICATION FOR cc. OCOUPANCY ��oe C: INSPECTION L/ SAFETY PERMIT C L TRAILER USE CL V USE OF STRUCTURES OR C1VIC z LIMITED TIME USE DATE DATE 04 1 FROM: TO: APPROVALS DATE INSPECTOR'S SIG NATUR E OCCUPANCY APPROVAL I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GROUP OCC. LOAD APPLICATION AND STATE THAT THE ABOVE IS COR- RECT AND AGREE TO COMPLY WITH ALL COUNTY TRAILER USE ORDINANCES AND STATE LAWS REGULATING SUCH WORK AS INDICATjp HEREON, SAFETY PERMIT SIGNATURE OF PERMITTEE ��• ' Kms' �j TEMPORARY 9 STRUCTURE APPROVED ADDRESS = -� ti� <'t%�A� '� TEMPORARY STRUCTURE REMOVED / FEES %yfxe FINAL APPROVAL ^.�•�t ,�• ..�:\ APPLICATION VALIDATIO SS JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER (NOT A PERMIT) cK� M o CASH PERMIT VALIDATION CK M.o CASH WORKERS'COMPENSATION DECLARATION CE 875(2-80) MISCELLANEOUS APPLICATION I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION insure, or a certificate of Workers'Compensation Insurance,or 'fl a certified copy thereof(Sec.3800,Lab.C.) Policy No. Company BUILDING WT FOR APP LICANT TO FILL IN ADDRESS Certified copy i5 hereby furnished. BUILDIN �gJRE79 f.WLOCALITYEl Certified copy is filed with the county building inspection NEARESTdepartment. LocwLlTr �G��,4PZ6 C/T CROSS sT.Date Applicant NEAREST �G� ..�� DISTRICT NO. GRPRO EDCROSS ST. Sd� K/ O CERTIFICATE'OF EXEMPTION FROM WORKER'S' LEGAL t COMPENSATION INSURANCE DESCRIPTION LOT NO. �� BLOCK MAP HIGHWAY } NO. (CIRCLE) STATE MAJOR SEC D LOCAL d NO. OF BLDGS. (This section need not be completed if the Work involved TRACT �� NOW ON LOT USE ZONE SPECIAL CONDITIONS V by the permit is for one hundred dollars ($100) or less.) aa // USE OF SIZE OF LOT SV x I(eG EXISTING BLDG.. I certify that in the performance of the work for which this ,ter Q permit is issued, I shall not employ any person in any manner OWNER 11,41W�Z 1=5 r7nl1AII UCp/�9z/✓ r V so as to become subject tote Wor Compensation� S. MAILyJ'J` J OCCUPANCY GROUP �3 W Date9T �• ` f ADDRESS ��lG�l�Qf7� Sj' d %�.' "�6_Applicant � Z NOTICE TO APPLICANT: If, after making this rt' . ate of CITY Tem? /Q ! /"z NOL =2 97 —flW ° OCCUPANT LOAD Exemption, you should become subject to the orkers' APPLICATION FOR EXIT HARDWARE: Compensation provisions of the Labor Code, you must forth- with comply With such provisions Or this permit shall be TRAILER USE[] GEOLOGY INSPECTION NO Spec. Knowl. ❑ deemed revoked. Panic Devices El CONTRACTORS DECLARATION OCCUPANCY INSPECTION I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT i.--I (LIST ITEMS BELOW) NO. OF EXITS 9 (commencing with Section 7000)of Division 3 of the Busi- ness and Professions Code, and my license is in full force and fPARKING.effect. ��I ��d 'C,ev�� .SPACES REO'D PROVIDED j �, License Number Lic.Class �r//l7.C� r{/eC CL$ htJ< /4 740 ctdV LIMITED TIME USE Contractor Date A-CDATE DATE ❑ i am exempt from the licensing requirements as I am a FROM: TO: licensed architect or a registered professional engineer SIZE OF NO. OF INSPECTOR'S acting in my professional capacity (Section 7051, Bus- EXISTING BLDG. /z y i STORIES SI NATURE iness and Professions Code). PRESENT USE OF BUILDING r FINAL APPROVAL 3r�? �@ F4�I� tv Lic.or Reg.No. Date NO.OF EXr ISTING BUILDINGS / f HOME OWNER-BUILDER DECLARATION ON LOT AND USE d/a — ! '/7�cISP I hereby affirm that I am exempt from the Contractor's /,. Z ;2 4 2 B 9 A License Law for the following reason (Section 7031.5, Busi- ness and Professions Code): NO. PARKING SPACES PROVIDED # 0 0 0 0 3 0 I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section 1D - 80.50 7044, Business and Professions Code). PROPOSED USE OF BUILDING O CONSTRUCTION LENDING AGENCYDo8a5051 I hereby affirm that there is a construction lending agency 2 5—8 6 for the performance of the work for which this permit is issued(Sec.3097,Civ.C.). Lender's Name PROPOSED MAX. OCC. Lender's Address fi PERMIT FEE70, (J I certify that I have read this application and state that the above information is correct.I agree to comply with all County ISSUANCE FEE U ordinances and State laws relating to building construction. and hereby authorize representatives of this County to enter TOTAL FEE upon t e a mentioned proper r inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permi a Date