HomeMy Public PortalAbout5922 MUSCATEL AVE_Building__ IA689A C8#909.9_e0 APPLICATION FOR BUILDING PERMIT
COUNTY OF.LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
' BUI lNG AND SAFETY DMSION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST.
DISTRICT NO. GRO TYPE ' P D'
FOR APPLICANT TO-FILL IN Q I CONST,
BUILDING / STATISTICAL ClSSIFICATIC S WER MAP
ADDRESS GQ / K� SG
_ CLASS.NO. DWELL.UNITS
LOT NO. TI D • O ' BLOCK , MAP STATE yE5 NO
NUMBER HWY.
TRACT 6-9110 USE ZONE ECIAL
�/ �T NO.OOF LDGS. CONDITIONS
SIZE OF LOT ,�'O J� �S�b I NOW NBLOT
USE OF I '-/
EXISTING BLDG. e-eS Gl• C BUILDING EXIST.
n�y�J TEL.�1 SETBACK YARD HWY STREET NAME WIDTH
OWNER////I. y`//!Ir'S �� ,On /P_I// NO./J T7,5 FRONT
P. L. A01
ADDRESS- off- L e.C + !/4�. SIDE
'ARCHITECT OR ` TEL P:L.
ENGINEER eS NO. 20.3 INSPECTION RECORD
,ADDRESS RJv p ter.
TE
�+ n
il
CONTRACTOR J��7NO
�
r 21111 • .� ..d'.L�/ �.V �.
ADDRESS
DESCRIPTION OF WORK /
.NEW ADD ALTER REPAIR- DEMOLISH to
SQ.FT. NO.'OF NO.OF ?
SIZE ♦'3 .STORIES. , FAMILIES
USE OF '
STRUCTURE e s I C It A.
3
SIGNATURE OF•'
APPLICANT
VALUATION$
APPROVALS DATE 1NSPEtTOR'S SIGNATURE
P C PMT. FOUNDATION: LOCATION .r� 9
FEE $ I I 'FEE S I FORMS,MATERIALS J"GJ /" I i ✓
FRAME:FIRE STOPS,,.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING,BOLTS ry
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO'COMPLY FURNACE: LOCATION, ew/ w \ '•}'. • sy'•"
WITH ALL COUNTY'ORDINANCES AND STATE LAWS REGULATING GAA VENT DUCTS i
BUILDING CONSTRICTION. I CERTIFY THAT IN THE PERFORMANCE
OF THE WORK FOR'WHICH THIS PERMIT IS ISSUED I SHALL NOT LATH,INT.
EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUSUECT
TO THE WORKMEN'S COMPENSATION LAWS OF CALIFORNIA. 7
CATH,EXT. _
SIGNATURE OF HOUSE NUMBER COR.
PERMITTE RECT AND POSTED _
ADDRESS FINAL' �(oo� —
CLYDE N. DIRLAM, PRINCIPAL STRU URAL ENGINEER
'PLAN CHECK VALIDATION im M.o. CASH PERMIT VALIDATION cK.' M.O. CASH
Lf`I�o 3 7 5 8 'o i,1R 10 1 A 9'.00'
DIVISION OF BUILDING AND SAFETY BUILDING
Department of County Engineer 1
County of Los Angeles' APPLICATION
WM. J. FOX, COUNTY ENGINEER
FOR APPLICANT TO FILL IN FOS OFFICE USE ONLY
DISTRICT N N Cr-OR RICA.No. PERMIT
NO.
BUILDING
ADDRESS )
LOCALITY a I RECBiVfD BY DATE OFAPPL DATE IBBUED
NXAREST ��
ROB88T. Ale Mg94
BUILDING
�,
OWNER 1 R S �. � ADDREBB
2 e• ,.
MAIL LOCALITY ee
ADDREBB!' /�7- / UcS, I CE RE rr
CITY V l°/ (GL NO. 9/07'? OR
FIRE I NO.OF TYP OROUPi
ARCHITECT OR TEL I ZONE PLANE
ENGINEER ,, 1�J !.. �I NO. I BTLDG.
'n�y7 ORD. NO.
f i SEBACK LINE
ADDRESS USE APPROVED
TEL ZONE BY DATE
CONTRACTOR r NO. HOUSE NUMBERING
ADDRESS MAP NUMBER. _NO. ABBIGNED BY
LEGAL •• • �]r !.p f COEMCTIONS
DEBCRIPTION LOT NC6 "a�J ELOOK
_ 4
TRACT 49c 1
Na- OF BLDGB.
SIZE OF LOT.�O'/( /S NOw ON I=
UBE OF NQ OF
EXISTING BLDG. /46mFAMILILY
DESCSIPTION OF WORK
NEW ALTERATION ADDITION Z
i r
REPAIR ,/ DEMOLITION 1
No.or
In
ZE ROOMS STORIES /
C VERINB%W- 13&1 I OOVERINB CD/ 1bSIToi1 1
UBE OF STRUCTURE
AT
INSPECTION FOR APPROVALS
OCCUPANCY AS INSPECTOR'SSIGNATURE DATE
FOUNDATION: LOCATION
rOKMB, MATERIALS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN 18 FRAME: FIRE STOPB,
CORRECT. BRACINB,BOLTS
1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FiJRNACE7 LOCATION,
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.1 BAD VENT.DUCTI
BIBNATURE OF LATH, INT.
PERMITTE
LATH, EXT.
ADDRESS
PLASTER, INT.
AUTHORIZED AMT. 1
PLASTER, EXT.
$ P.C.•
FEE HOUSE NUMBER CDR-
,�7 RECT AND POBTE0 /
VALUATION V F6E l.� ' I FINAL
7GA638A 13138 3 1-88
?oEPARTMENT OF BUILDING AND SAFETY j AYYLICA 11VN r Ult rt.ltmlT
COUNTY OF LOS ANGELES I!U f-t
WM. J. FOX. CHIEF ENGINEER �!r � 4� " BU -1 L D 1 NG%(2�
FOR APPLICANT TO FILL IN 4.4 FOR OFFICE USE ONLY
��� /l , /J DISTRICT NO. PLAN CK.NO. r� PERMIT ND,
[CITY
LDING A\Y! /I!! NO
RESS ! I�SC` �.�� � 7 d Z•/! '] °
_7 Y J
ALITY ��/moi I t�;;.////,�/�OC� ✓ /� RECEIV D'BY DATE OFAPLPL. DATEISSUED
REST / yj' J`Cl I /� J'7"2,11
SS ST. ,i'�}":'.J:F"':`/"`� -
n/! ,-^ /f�' �` BUILDING r l
ER C ` /-f
ADDRESS pp���, r� A�
RESS �d f, 4,F��",MAIL LOCALITY Tl ' °t �/,1 "� !.F L
// //•• �o NEAREST
G-O 1[:7 R f'I� , NOLO ^.a••" CROSS ST..
FIRE NO:OF TYPE GROUP
ARCHITECT OR / TEL % + ZONE �-- PLANS m
ENGINEER J NO. ,
/ ! / BLDG. / ORD.NO.
ADDRESS / i/ ! SETBACK LINE ,g v I /1"I % k � L°1 1. '17, et/
APPROVED r ' f
CONTRACTOR t� BY DATE) ' Q~
/C/Jt�G/J/�/ iwL NOL °a
��ll 7 V r ZONE'USE APPROVED DATE
ADDRE96�-X) l�SS/!J J/ of T, �O .5�
LEGALCORRECTIONS
DESCRIPTION II LOT NO. //0 BLOCK b y �/ F _T
TRACT l"J /:.,/ L r U
;3 C." ,�,�.1 I NO.of BLDGs. .So
SIZE OF LOT NOW ON LOT
USE I NO.OF I NO.OF
EXISTING BLDG. FAMILIES ROOMS 41F
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
O
A
REPAIR MOVING DEMOLISH �
S4•FT. NO..OF
Z
•�
47SIZE ROOMS STORIES y
1 r
WALL � P '/.". A COVERING
�rTr '• '
' COVERINGS .sC' Q v ,...;. COVERING
USE OF NEW
BUILDING
s
'�/e �rc^�rte' �•f` /�C /:�! %� � a�
rr•- r!•-U rr �r�f�; �o�' E� �71�/i`3 Ff�
g' 7W t5 G/7 R,J'C/68701 Y ?6'61V G?i1a.
I HE yY��C W EDG _HAT I HAVE READ THIS, APPROVALS
APPLICATION AND STATE THAT THE ABOVE 16 CORRECT FOUNDATIONI: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS
94
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. ` !
,�,�/ ° FRAME: FIRE STOPS, �-j--
SIGNATI E C IF � �'� ��t I) BRACING,BOLTS �Cr.
PERMITTEErOa�k � 'i/'� 'L!;/�..�i LATH, INT.
/�
AUTHOR,§ZED AGT /` y •f-' ��t '
LATH, EXT. A
76A63BA 9-4B L
DBS'3 SOM SETS $ �LfFEE
C.$ 1 PLASTER,INT.
do
i !
PLASTER,EXT.
VALUATION EE FI NAL
r
Y OF LOS
ELE
vTGAPPLICATI_ON- FOR
DEPARTMENT OF COUNTYENGNEER
.01:.,. 3UILDING PERMIT BUILDING AND•SAFETY DIVISION
�•
BUILDING J
FOR APPLICANT TO FILL IN ADDRESS
BUILDING J� _ _
ADDRESS LOCALITY
I ZIP NEAREST
CITY LA GJ j 7S CROSS ST.
NO.OF BLDGS. ASSESSOR
SIZE OF LOT ,0 j�~y NOW ON LOT MAP BOOK PAGE PARCEL
,} DISTRICT GROUP TYPE FIRE RO SSED BY
TRACT (/ BLOCK LOT NO.p d"�10 7"' CONT � �..._
OWNER �✓� ATO• STATISTICAL CLASSIFICATIONIf SEWER MAP -
ADDRESS CLASS NO.�/�DWELL,UNIT.S / / BKr0
GITY ZIP
_VSE,ZONE MAP
j NO. V
ARCHITECT OR NOL. �,/ CONDITIONSSPECIAL
'ENGINEER. '
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONTRACTOR TEL. " BLDG.SETBACK FROM
NO. FRONT PROP.LINE OF (STREET)
LIC.
'ADDRESS NO. HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
'LIC. FRONT PROP:LINE HIGHWAY WIDTH
CITY U CLASS _
CONSTRUCTION LENDER +
NAME AND BRANCH BLDG.SETBACK FROM
ADDRESS CITY' SIDE PROP,LINE OF (STREET) C.:
SQ, FT NO. OF NO. OF CHECK HIGHWAY + YARD = TOTAL SETBA ROM TYPE OF EXISTING.
SIZE 'STORIES FAMILIES ONE SIDE R L1•N;E YJ WIDTH,
_ V
DESCRIPTION OF WORK NEW El + y
Ll ADD CORNER CUT O YES ❑ NO ❑ Z
ALTER
❑USEEPAIRIN OPEN SPACE YES ❑ NO ❑
FDEMOL
OF IN COASTAL PERMIT ZONEYES ❑ NO EXISTING BLDG, ❑ '
�
APPLICANT TEL O
(PRINT) NO. /2,
BY ('SIGNATURE) ,
I HEREBY ACKNOWLEDGE
THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS' CORRECT AND AGREE TO COMPLY '
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- '
STRUCTION. IC
THAT IN DOING- THE WORK AUTHORIZED -
HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF TME
LABOR CODE OF THE STAIE OF CALIFORNIA IN RELATING TO
WORKMEN'S COMPE TIO NSURANCE , --'')`�
SIGNATURE OF FINpL /r U-// BY
PERMITTEE DATE
ADDRESS
CITY ' NOL• �J P.C .Fee$ Permit Fee / �+
Q Issuance Fee
VALUATION$ lr � 7
Total Fee
PLAN CHECK VALIDATION CK. M.O. CASH P
f�MIT VALIDATION CK: M.O. ASH
76A 638A CE480913 12/7S - - ,
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION 57 271T FOR APPLICANT TO FILL IN BUILDING ADDRF$S
I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS
or a certificate of Workers'Compensation Insurance,or a certified KA M V.1 CA 7 E L V
copy thereof(Sec.3800,Lab.C.) CITY �1� �� ZIP LOCALITY e
Policy No. Company SIZE OF LOT c_Cj NO.OF BLS.NOW ON LOT
❑ Certified copy is hereby furnished. �V1`\, NEAREST CROSS sT.
❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO.
department. USE ZONE MAP NO.
Date Applicant ASSESSOR MAP BOOK PAGE PARCEL
i t SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER L TEL NO.
COMPENSATION INSURANCE L 361S`1 WITHINI7000 FT.OF SCHOOL? YES NO
(This section need not be completed if the permit is for one hundred ADDRESS
dollars($100)or less.)
S 2 N 7W r �S DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY
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 CI g �tr, ZIP ,;V -3fy -3
become subject t0 the Workers' Ompe 8ti0 Laws. ARCHTE R ENGINEER TEL NO.
STATISTICAL CLASSIFICATION APT CONDO
Date-15 95 Applicant o � ADDRESS CLASS NO. V-/ DWELL UNITS
NOTICE TO APPLICANT. If, after making this Certificu of REQUIRED TOTAL SETBACK FROM EXIST
Exemption, you should become subject to the Workers' CONTRACTOR TEL NO.�' SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor Code, you must forthwith IO a`12: FRONT
comply with such provisions or this permit shall be deemed revoked. ADD RES �Q -UC-.NO. FRONT,
o4 0LICENSED CONTRACTORS DECLARATION R SC��?S SIDE
Y LI LASS P L
I hereby affirm that I am licensed underprovisions of Chapter 9 I "" SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and S0. .SIZE I NO.OF STORIES NO.OF FAMILIES
Professions Code,and my license is in full force and effect. S NEW ❑ BK PG }a
License Number`70��7-S Lic.Class CRIPTION OF WORK ADD ❑ VALUATION ® O
ContractoreS1211-6&N!KZ trate S — 15-9 SALTER 11 $ �a 0 U
❑ I am exempt under Sec. Cl12C—9 L4 5 Lk 100 REPAIR X $ 0
BAP.C.for this reason LA co:? ��}Z DEMOL ❑ LDMA P/C#
Date: USE OF FXISTING BLDG. URM ❑ a IL
Signature APPLICANT(PRINT) TEL NO. LDMA Perm# .t Z
❑ 1, as owner of the property, or my employees with wages as z �•�•
their sole compensation, will do the work and the structure is ADDRESS O !ACUCT.ss
not intended or offered for sale (Section 7044, Business and FINAL DATE / aV330-13
» ,; 108.32
Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL TL fir(
OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE I /J ! T(•)L{(�
❑ 1, as owner of the property, am exclusively contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY �� { _
licensed Contractors to construct the project (Section 7044, YES❑ NO❑ r 1 TOTAL ® a m
Business and Professions Code.)
WALL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING I3 CHECK
i ry�F '?
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH 1-t K 108,e 2
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
GUIDELINES ('I
I hereby affirm that there is a construction lending agency for CHANGE °U-
the performance of the work for which this permit is issued(Sec. ves❑ No❑ I
I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING
3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE,
TITLE 2.ender's Name MATERIALS RE TEPOR
AND FOR OBTAINING A PERM T FROM THE SCAOMD.CONCERNING HAZARDOUS 0000000 I •r}/i5/95
.nder's Address 07L,n 1h CIS
OWNER OR AGENT
certify that I have read this application and state under penalty
Of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE
with all county ordinances and State laws relating to building ✓ f '
construction, and hereby authorize representatives of this County ISSUANCE FEE a6 p.r
to enter upon the above-mentioned property for inspection purposes. of
n INVESTIGATION FEE TOTAL FAIZ �\
80�ft e a AM—t a AWnt omaqr/ 6
SEE REVERSE FOR EXPLANATORY LANGUAGE