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Home My Public Portal About5910 MUSCATEL AVE_Building__ APPLICATION FOR BUILDING PERM • COTINTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS �` O BUILDING AND SAFETY DIVISION LOCALITY 74o,"o/e e' 61 JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST. Qv/JyJQft FOR APPLICANT TO FILL IN DISTRICT NO. GR UP TYPE �• P;PCE BY (Print or type only) O S CONST, Q BUILDING / STATISTICAL C ASSIFICATION S WER MAP ADDRESS_ 4E 9/ Q No, a s� . CLASS t DWELL.UNITS-t— BK/j PG/0 LOT NO. //_ y_Sp O It A1,0Z:SBLOCKVjrZ,, USE ZONE NADP .. D o`"'1� TRACT SPECIAL NO.OF BLDGS. CONDITIONS SIZE OF LOT 6j- X I/(o NOW ON LOT USE OF EXISTING BLDG. C 1 BLDG,SETBACK FROM KQ L/o LG E2rE 7" �33 7 FRONT PROP.LINE OF -(STREET) OWNER "7" TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL �/3 ;' HIGHWAY WIDTH FROM C.L. ADDRESS Y r� /� CITY P e%�p C►L . IM + /G 0 = /G o ARCHITECT ORFROM TEL. SIDE M PROP.LE.SETBACK OF (STREET) ENGINEER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. ' TEL. + _ _ CONTRACTOR NO. LIC. ADDRESS NO. CORNER CUTOFF YES ❑ NO ❑ CITY CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS i CONSTRUCTION LENDER i NAME AND BRANCH L°OS•e C% ADDRESS SQ. FT. NO. OF NO. OF NEW SIZE T9 STORIES FAMILIES USE OF ADD ❑ �1 l' V- STRUCTURE LL, 4 6— Od ALTER ❑ lr 1L1/(i f; i /• q wd REPAIR❑ SIGNATURE O ]J APPLICANT DEMOL ❑ VALUATION S ! APPROVALS DATE INSPECTOR'S SIGNATURE F E S 4 .--M-C. C FEES 2/�V rOFORMS,I MATERIAL TI / FRAME: FIRE STOPS, (p 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS i n AND STATETHAT THE ABO IS CORRECT AND AGREE' TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES N LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED //�� HEREBY 1 WILL NOT PLOY ANY PERSO VIOLATION OF THE LATH, INT, pITJ LABOR CODE OF T STATE OF •C ORNIA.IN "REL6QNG TO ' WORKMEN'S C MPEI ATION INSU 1 \ Q /b LATH, EXT. SIGNATURE HOUSE NUMBER COR- C PERMITTEE l RECT AND POSTED /� k ADbREss" FINAL // -2-0-,Ig 97, r JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION (cK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH i A29 � 0 1 2,5 QN Q L � . APPLICATION FOR BUILDING PERMIT , COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING A RE s I hereby affirm that I have a certificate of consent to self insure, BUILDING ADD RF `D or a certificate of Workers'Compensation Insurance,or a certified 5 copy there(Se�D 97 Lab.C.) A fe �U1q� CIT e /•`� ZIP1 !.>ea 7 J (� / LOCALITY Policy No. F� Company SIZE OF LOT NO.OF BLDGS,NOW ON LOT -� ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. /� USE ZONE MAP NO. Date ?'�`S��Lpplican 1 X ,� ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' YES NO COMPENSATION INSURANCE OWNER f/` ie'SSe1„ T"` a_&? WITHIN 1000 FT OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESS g/ll((O .CJ �dS CG 7,e DISTRICT GROUP TYP ONST. FIRE ZONE PRO SSED BY dollars($100)or less.) CITY ZIP I certify that in the performance of the work for which this permit �/h e e, ;2I rPdp Z is,issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. a rL J become subject to the Workers'Compensation Laws. STATISTICALCLASSIFICATION 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' CONT56tTORT��O Z� g� SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith I /�ff �"O"lle.-s / FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS Z // LIC.N PL 8 •, �'►'f �ae/ /�v� LICENSED CONTRACTORS DECLARATION SIDE CITY LIC.CJ,ASS�� PL I hereby affirm that I am licensed underprovisions of Chapter 9 ��c` [,� EWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FWbqlZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. % / NEW BK PG a License Numbe y'110 Lic.Class C'— D PON OF WOoUS ADD E] VALUATION i C oTla� ciao, C: 5-116 Date z`« `� a�a E be+ Contractor a ALTER 11 O ❑ I am exempt under Sec. eX'S�/: /vd /� a L'd k #� REPAIR 11H C; BAP.C. for this reason //,5f./�t#f %� l x/ p Q/n1, DEMOL ❑ LDMA P/C# LL ��e � D -- /6_ USE OF E ING BLDG. F URM ❑ a Cr Signature / M APPILANT(PRINT) T l.NO. LDMA Perm# OCT8 ❑ I, as owner of the property, or my employees with wages as ��' P/L f d/-22 S' Z 1 ° their sole compensation, will do the work and the structure is ADDRESS �/ _p / 65 not intended or offered for sale (Section 7044, Business and :312 if /7 PIk S!t h _ ICS diG FINAL DATE 1 _ !" +° Professions Code.) HAPPLICANT . ✓ q t ISL LL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ 1, as owner of the property, am exclusive) contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Y Y g licensed contractors to construct the project (Section 7044, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY TIS Er'!L 69. 65 YES 11 No 11Business and Professions Code.) �"[�, t�s: 1'u ``A WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING HE K -i f'L•' OCCUPANT REQUIRE A.PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR � l�` 010 GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ NO❑ W the performance Of the work for which this permit Is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LAS ANGELES COUNTY CODE, 03130-01030 1 yi 161194 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. L�j• •L Af+� 4 y�� o Lender's Address OWNER OR AGENT - O o I certify that I have read this application and state under penalty O of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE N with all county ordinances and State laws relating to building OD construction, W hereby author' a representatives of this County ISSUANCE FEE / m to enter a above- Io d grope ty for inspection purpose . (� pC Z6 �.9,, INVESTIGATION FEE TOTAL FEE � sq,° a or nam oau SEE REVERSE FOR EXPLANATORY LANGUAGE