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HomeMy Public PortalAbout6011 MUSCATEL AVE_Building__ 3 p yp pp 'BA696A CE#608,0_88 APPLICATION FOR BUILDING PERMIT �. COUNTY OF LOS ANGELES ADD E1SS ' ✓ r '�. DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY �- JOHN A. LAMBIE, COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN,SUPT OF BUILDING CROSS ST. -i /92•/�-�---V ::....:..:......;. �..:, .•... :..,s.:. DISTRICT NO. GR UP TYPE {-p-I PR_OC,ESSED BY FOR APPLICANT T IN 5 � I CONsr,4\i/� BUILDING STATIS yC4LCLASSIFICATION SEWER MAP ADDRESS Qah CLANO.- WELL.UNITS" I BK PfG 1 tof °65 , L071�0. BLOCK MAP STATE 6 NUM ER ���� �/ HWY. YES NO TRACT ' �'�'+s USE ZONE SPECIAL CONDITIONS NO.OF.BLDGS SIZE OF LOT I NOW ON LOT ' USE OF EXISTING BLDG. BUILDING YARD HWY STREET NAME EXIST. SETBACK WIDTH OWNER FRONT f MAIL P.L. ( J ADDRESS 10,611 SIDE TEL. P.L. CITY NO. INSPECTION RECORD ARCHITECT OR TEL //'' ENGINEER /L- NO./"r ivl 3 r ��l�.ta d 1 u2' -i`r = _ ADDRESS c f R G ld fes.- 9L/ s C TEL. •• ��� _ �I CONTRACTOR NO. �;. �j ADDRESS DESCRIPTION OF WORE CREW ADD CL-E REPAIR DEMOLISH Q.FT. -� NO.OF NO.OF SIZE STORIES FAMILIES USE OF j STRUCTURE J�.�" a 6�/� r` +' �G!/k s�.Clt- (✓, AWdf.. SIGNATURE OF APPLICANT APPROVALS DATE INSPECTORS SIGNATURE ADDRESS FOUNDATION:LOCATION FORMS,MATERIALS l.S VALUATION.5 !j e'e" FRAME:FIRE STOPS, S BRACING,BOLTS �/ 1 P.C. I PMT. a ,I•• f7 FURNACE:LOCATION, FEE $ FEE $C GAS VENT,DUCTS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH.INT. RIrL� PLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING BUILDING CO ISTRUCTION. LATH,EXT. WO 0, -Th SIGNATURE OF 'Nib � c• r HOUSE COR- PERMITTEE RECT AND POSTED ADDRESS "`�'L FINAL CLYDE N. DIRLAM,PRINCIPALS CMRAL ENGINEER 1 PLAN CHECK VALIDATION CK. PERMIT VALIDATION CK. M.O. CASH 7 8 3 4 UNI !-'0-, 2 A 9.00 Or WORKERS'COMPENSATION DECLARATION / hereby affirm that I have certificate of consent to self APPLICATION F ORBUILDING PERMIT insure, or a certificate of Workers'Compensation Insurance, or a certified copy thereof(Sec. 3800, Lab. C.) },Certified co COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No A 016 Company 1&, C* � � !� Of( .ce.�eL"� furnished. BUILDING Py is hereby fihFOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- FsIZE NG tion department. +, p SS G' LOCALITY Date - Z d j Applicant P Alii ©rs-0��� � mmip,ri --rr-i ZIP NEARESTRT. CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE F LOT NOW ON LOTMAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP41 hundred dollars($100)or less.) TRACT BLOCK LOT NO. NO. TEL. SPECIAL ..Q@(L_9,%1 I certify that in the performance of the work for which this OWNER F101'1170 NO. CONDITIONS [. .. a- permit is issued,I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE PR ESSED q. ADDRESS ��>I� CONST. ZONE U so as to become subject to the Workers'Compensation Laws. 5--�C� -� � � Date Applicant CITY y ZIP STATISTICAL CLASSIFICA ION APT. CONDO. 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 LU CL Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be i' v��. TEL. deemed revoked. CONTRACTOR N AZA tc+r+. w NO.'q%d XJ 1? BK. PG, !Q VALIDATION LICENSED CONTRACTORS DECLARATION , LIC. 0J& r/� I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 11304 3 �-Olft is'•L 2t1S43 NO.B7 , VALUATION (commencing with Section 7000)of Division 3 of the Business and �` m c T� Gb. LIC 7� r Professions Code, and my license is in full force and effect. CITY CLASS 1`� $ Z Z ' -7 SQ. FT.p NO.OF NO.OF ` CHECK , License Number 3 /01 6 7 Lic.Class � SIZE p O� STORIES � FAMILIES ! ONE Contractor Date ^Z -'P 3 DESCRIPTION OF WORK NEW ❑: $ ❑ �W7��L'ITI �)I ADD {I am exempt under Sec. ❑` ALTER ❑S FINAL B.BP.C.for this reason REPAIR E] DATE Date: USE OF H 0 V DEMOL ❑ FINAL J y 4 6 a 1 A EXISTING BLDG. APPLICANT TEL y Signature PRINT .gQlu.b'JC.F J 1»[ep/�o 1f y3 ��'1"7 1 ,�y3 n o 0 0 0 1 OWNER-BUILDER DECLARATION �� S I herebyaffirm that I am exempt from the Contractor's License 1 a Law for the following reason (Section 7031.5, Business and ADDRESS 11 3O'f LOW i+JL Q ZuSti o o 6050 Professions Code): PRESENT ❑ BUILDING �,`' ' �, �� I, as owner of the property, ormy employees with ADDRESS wages as their sole compensation,will do the work and ": Q 1, 22-83 the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. j with licensed contractors to construct the project (Sec- ADDRESS x tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY 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 P.L. tSec. 3097, Civ. C.). SIDE -o P.L. Q Lender's Name Lender's Address P.C. Fee$ Permit Fee .SSV f cI certify that I have read t is application and state that the Issuance FeeS� above information is corre :I agree to comply with all County Ligati:oqn:�F:ee ordinances and State:ld relctl obt�il 9 cohstructiori, ; Qc So t 9 andt u.th r reseh tiv s of this County to enter Tafal Fee u a ed.pr for,inspection'purposes. SEEREVERSE FOR EXPLANATORY LANGUAGE e aid Agent Date ®s i