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Home My Public Portal About10143 NADINE ST_Building__ y + 76xb3sA CE 08034/7 APPLICA ON FOR4§UILDING PERMIT fl ►, COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGIIWM MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING / C� MAKE CHECKS PAYABLE TO ADDRESS / HARVEY T BRANDT COUNTY ENGINEER LOCALITYNEAREST �j T FOR APPLICANT TO FILL IN CROSS ST �J�J rBD DISTRICT NO GROUP TYPE P ESSE BY • �O CONST BLOCK STATISTICAL CLASSIFICATION SEWER MA 8CLASS NO�DWELL UNITS BK PGQ USE ZONE MAP � NO OF BLOGS MAOT,J A�C/ NOW ON LOT CONECIAL DITIONS BLDG OWNERM4 :Sib T NOLe�jb"� � BLDG SETBACK FROM ADDRESS/&/d/ FRONT PROP LINE OF (STREET) E� �'� TYPE OF EXISTING SETBACK HIGHWAY YARD = TOTAL CITY HIGHWAY WIDTH I FROM C L ARCHITECT OR TEL + _ yy ENGINEER NO BLDG SETBACK FROM p. ADDRESS SIDE PROP LINE OF (STREET) TYPE OF EXISTING S CK HIGHWAY + YARD = TOTAL CONTRACTO Q NOL HIGHWAY WIDTH OMC K ADDRESS- AA No +LIC CITY (�!�/� / CLASS CORNER CUTOFF YES ❑ NO ❑ Z CONSTRUCTION LENDER NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL PROV LS ADDRESS SQ FT NO OF NO OF NEW ED • SIZE STORIES FAMILIES USE OF ADD STRUCTURE ALTER ❑ LAPPLICANT F / RE Z. DEMOL ❑ QQ APPROVALS DATE IN5ZfCTOR S GNATURE P C PMT FOUNDATION LOCATION lo!?FEES FEES FORMS MATERIALS FRAME FIRE STOPS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY FURNACE LOCATION WITH ALL ORDINANCES AND LAWS REGULATING BUILD NO CON GAS VENT DUCTS STRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED w HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH INT {/0- LABOR CODE OF TNF TATE OF CALIFORNIA IN LATINS TO WORKMEN S C;�WTIINSURANCE LATH EXT Ch/7 3 SIGNATURE O HOUSE NUMBER COR PERMITTEE RECT AND POSTED ADDRESS FINAL PLAN CHECK VALIDATION CK M 0 CASH _ PERM VA TION CK M 0 CASH ,�.fJ eo /3.2o m� �. w D �9 75 70ws36w Do*a a as APPLICATION FOR BUILDING PERMIT 1 DIVISION OF BU=nfG AND SAFM mul"O 8 1 D Dep=l al =17="49 oB 2 a 49 LOCALITY WM J FOX COUNTY ENGIRSCR NEAREST IF TlialAntam CA88ATT D GRIFFIN SUP T OF BUILDING CR088 8T DISTRICT NO GROUP ,SPT 8 BER MAP FOR APPLICANT TO FILL IN 5 1 CON BUILDING NUMBER �i{yAyTyS YES NO ADORE86 / LOT NO BLOCK 'USE SPECIAL CONDITIONS TRACT r SIZE OF LOT NOW ON LOT8 BUILDING YARD HWY STREET NAME EXIST 8 BACK WIDTH YSE OR FRONT t USK O G BLDG ,v OWNifiemeth IRS Williams, j SIDE L. MAIL ADDRES8 10111 F+ 01106 St O TRACT DWELL f UNIT 8 INDUSTRIAL TEL 1 DWELL f UNIT CI NO r 6 PUBLIC BLDG 2 DUPLEX f UNIT ENGINEER OR TEL NO 7 ADDN ALT ETC S APT 6 MISCEL ADDRESS 4 COMMERCIAL TEL CONTRACTOR Ab O NO INSPECTION RECORD ADDRESS DESCR1pTION OF WORK NEW 3r ADD ALTER REPAIR DEMOLISH SQ FT NO OF NO OF SIZB STORIT8 FAMILIES USE OF STRUCTURE Home SIGNATURE OR APPLICANT APPROVALS ADDRESS25 ;C/- DATE INSPECTOR 8 SIGNATURE OUNDATION LOCATION $ 13 74:;p D P E /G RAMS MATERIALS FEE Q FRAME FIRE - ..- *17 VALY TION 8 a� BRACING BOLTS FE FURNACE LOCATION 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT DUCTS r APPLICATION AND STATE THAT THE ABOVE 18 CORRECT r AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH INT �J AND STATE LAWS REGULATING BUILDING CON8TRUC f TION 1p LATH EXT 1 1 SIGNATURE OF HOUSE NUMBER COR PERMITTT 0 RTCT AND POSTED ADDRES Lk FINAL WM J FOX 60UPITY ENGINEER V MATION C N DIRLAM CHIEF BLDG INSPECTOR _N*'r,O p 4 ti^ JUL 9 1 6 1 8 Q J a w LAU0 0 1 I � 125 1C0 0 1 e, OIL- JUL 12 1 4� 1 U 0 �' V ' '+ WORKERS COMPENSATION DECLARATION y ,. I e# affirm that I have a certificate of consent self APPLICATION FOR BUILDING PERMIT Il 1�insuraure o or a certificate of Workers Compensation Insurance or a certified copy thereof(Sec 3800 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company BUILDING ❑ Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS 3 E Certified copy is filed with the county building mspec gUILpING [' ti de rtmen� ADDRESS ` t1 d t h `P LOCALITY NEAREST Date Appiican CITY C 1.v► lb Ls ZIP CROSS Sr CERTIFI TE OF EXEMPTION FROM ASSESSOR WORKE SIZE OF LOT NO ON OIF N TS MAP BOOK PAGE PARCEL COMPENSATION INSURANCE (Thea section need not be completed if the perml is for one USE ZONE MAP TRACT BLOCK way hundred dollars($100)or less) LOT NO J NO /� �' TEL r I SPECIAL >_I certify that in the performance of the work for which this OWNER ` e N _J CONDITIONS IL permit is issued I shall not employ any person in any manner `n s DISTRICT GROUP TYPE FIRE P D BY O so as to become subject to the Workers Compensation Laws ADDRESS V a'^r++ '! CONST ZONE V (/ OG Date Applicant • ARCHITECT OR ZIP TEL STATISTICAL CLASSIFICATION APT JCON NOTICE TO APPLICANT I{ offer making this Certificate of ENGINEER NO CLASS NO�/�DWEU. UNITS W Exemption you should become subject to the Workers j>L Compensation provisions of the Labor Code you must forth ADDRESS SEWER MAP in Z with comply with such provisions or this permit shall be C TEL c, r VALIDATION deemed revoked CONTRACTOR e • �. NO 7y/ BK LICENSED CONTRACTORS DECLARATIONj� i LIC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS.R • d b 1 N VALUATION (commencing with Section 7000)of Division 3 of the Business andLIC Professions Code and my license is in full force and effect CITY [ k-1 CLASS $ 4f SQ FT NO OF NO OF CHECK License Number Class_ SIZE STORIES FAMILIES ONE -427(14ANom, $ -427(14AContractor � b + Date 1 DESCRIPTION OF WOR / C + t— ❑ ❑I am exempt under SecA I &: * 6k p e p ADD ❑ FINAL # • • • • • B&P C for this reason LA K 4 G c �, d G+. ALPA R 0 ALTER DATE 1 L/�z� ) • • 7 a o o USE OF / Date EXISTING BLDG f DEMOL ❑ Br NA • e • 7$Q Q v Signature APPLICANT TEL OWNER BUILDER DECLARATION PRINT NO ► cal 4-85 1 hereby affirm that I am exempt from the Contractor s License Law for the following reason (Section 7031 5 Business and ADDRESS Professions Code) BUILDING ❑ 1 as owner of the property or my employees with ADDRESS wages as their sole compensation will do the work and LOCALITY ' the structure is not intended or offered for sale(Section 7044 Business and Professions Code) MOVING TEL ❑ 1 as owner of the property am exclusively contracting CONTRACTOR NO with licensed contractors to construct the project(Sec ADDRESS tion 7044 Business and Professions Code) CONSTRUCTION LENDING AGENCY REQUIRED TOTAL SETBACK FROM EXIST SET BACK YARD HWY PROP LIN WIDTH , I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P L (Sec 3097 Civ C ) SIDE PL Lender s Name Lender s Address PC Fee$ Permit Fee V I certify that I have read this application and state that the Issuance Fee above information is correct I agree to comply with all County Investigation Fee ordinances and State laws relating to budding construction Total Fee and hereby authorize representativof this County to enter u the abo coned prop for mspectio purpoa i o SEE REVERSE FOR EXPLANATORY LANGUAGE n Signature of Ap 11ccint or Ag Dote t es