The URL can be used to link to this page

Home My Public Portal About10152 NADINE ST_Building__ A 76 V E 0808 1/71 �/v �-- e_ / '� - APPLICATION FOR BUILDING PERMIT COUNTY bF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DMSION BUILDING ®ls Z VA b //Vi!� ADDRESS COLEMAN W JENKINS SUP T OF BUILDING LOCALITY FIV 7/-0L �y FOR APPLICANT TO FILL IN NEAREST f�i 4 ` /L,* � Print r t nl CROSS ST !/ BUILDING DISTRICT NO GROUP TYPE PROCESSED�BY ADDRESS . 6--, v6 = CONST LOT NO BLOCK STATISTICAL CLASSIFICATION SE R M&p � S� TRACT #OJWe 7j 86 2- 3 .0.,g CLASS NO DWELL UNITS L/ �- 3USE ZONEMAP NO OF BLDG S -� NO it / SIZE OF LOT D NOW ON LOT ---- SPECIAL USE OF ZdO CONDITIONS EXISTING BLDG TEL OWNER NO BLDG SETBACK FROM IVA- ! ADDRE46- SS V FRONTPROP LINEOF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY HIGHWAY WIDTH FROM CL ARCHITECT OR TEL It®C 5 C,.f + Zm = R(:7 ENGINEER NO BLDG SETBACK FROM ADDRESS SIDE PROP LINEOF (STREET) TEL TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CONTRACT NO HIGHWAY WIDTH FROM C L V LIC ADDRESS NO + = CI... LIC i0 CITY CLASS CORNER CUTOFF YES ❑ NO ❑ ,,, CONSTRUCTION NAME AND BIDER BRANCH d SEE REVERSE SIDE FOR SPECIAL APPROVALS z ADDRESS SO FTNO OF NO OF NEW SIZE O STORIES FAMILIES USE OF ADD STRUCTURE ALTER ❑ SIGNATURE OFJOIL EPAIR❑ APPLICANTq. DEMOL ❑ VALUATION$ � BO APPROVALS DATE INSP TORS 91GNATU RE PMT$ �d� FE FEE ES FORMS MATERIALS PC FOUNDATION LOCATION all Z_ FRAME FIRE STOPS 1 HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, RACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON GAS VENT DUCTS STRUCTION 10 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH INT LABOR CODE OF THE STATE OF CALIFORNIA IN RELATI,IIG TO WORKMEN S COMPETION INSURANCE LATH EXT SIGNATURE OF C� HOUSE NUMBER COR PERMITTEE RECT AND POSTED ti ADDRESS FINAL L� PLAN CHECK VALIDATION M o cnsH _ JOHN F LEWIS PRI CIPAL ST AL EN EER PERMIT VALIDATION CK CASH UL 454242 F02 23 D 94.05er.le 9}j,p 4 9 4 7-" vm 15 l D 1 5 6 7 5, v a 4 &APPLICATION FOR BUILDING PERMIT CdONTY OF LOS ANGELES BUILDING AND SAFETY WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that 1 have a certificate of consent to self Insure BUILDING ADDRE 1 ; or a certificate of Workers Compensation Insurance or a certified �f copy thereof:(Sao 33800 Lab C) ,,` ,{ ISL• ZIP O� 4V Vk71• / Company'�'�`"� 11 14-14 I 7dW LOCALITY SIZE OF NO OF SLOGS NOW ON LOT CKertilled copy Is hereby furnished % NEAREST CROSS ST ❑ Certified copy Is filed with C ty Aldi sP TAT BLOCK LOT NO dr*" USE ZONE MAP NODatapiK ant ASSESSOR MAP BOOK RAGE PARCEL SPECIAL CONDITIONS �� Q CERTIFICATE OF NO I EXEMPTION FROM WORKERS ER I WITHIN 1000 FT OF SCHOOL? YES NO COMPENSATION INSURANCE '� (This sedan need not be completed d the permit m for one hundred ADDRESS �- DISTRICT GROUP PE CONST FlRE ZONE PROCESSED 13Y dollars($100)or less) I certify that In the performance of the work for which this permit „tp /� t ZIP D� Q Is Issued I shall not employ any person In any manner so as to E OR ENGI EER TE ✓ become t0 the Workers Compensation LevIB STATISTICAL CLASSIFICATION APT CONDO Date plicant ADDRESS ^ � CLASS NO �_ DWELL UNITS N0710E ApLICANT If after making this Certificate of 6L REOUIRED TOTAL SETBACK FROM EXIST Exemption you should become subject to the Workers CONTR TELAO SET BACK YARD MY PROP LINE WIDTH Compensation provisions of the Labor Code you must forthwith � FRONT comply with such provisions or this permit shall be deemed revoked ADDR LIC P L } SIDE a LICENSED CONTRACTORS DECLARATION ( % P L O 1 hereby affirm that I am licensed underprovisions of Chapter 9 t QV FT (commencing with Section 7000)of Division 3 of the Business and SEWER MAP Ob OF STORIES NO OF FAMILIES ir Professions Code and irM licenseInse Is In full force 8r1/d�effe t l NEW BK PO O License Number Lie Class v� RIPTION Of WORK 1 �( ADD ❑ VALUATION w Contractor to ALTER ❑ $ 70�� a N ❑ 1 am exempt under Sec rA dgm96&1REPAIR ❑ $ Z B&PC for this reason 4— DEMOL ❑ LIMA P/C Date USE OF EXISTING BLDG URM ❑ Signature APPLICANT(PRINT) TEL NO LDMA Perm• 1 ❑ 1 as owner of the property or my employees with wages as f I z AUT T $ their sale Compensation will do the work and the structure is ADDRESS F 33[13 192.4 not Intended or offered for sale (Section 7044 Business and FINAL DATE ci Professions Code) WILL THE APPLICANT OR FUTURE BULDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ��1y-ml1 ITEMS E3 1 88 owner, Of the property am exclusively contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE licensed contractors to construct the project (Section 7044 AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY YES $ TUTAL 192. 45 Business and Professions Code) NO❑WILL ArilC`n 192.4` THE INTENDED USE OF THE Bl11DLDiG BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AM QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR CHANGE 00GUIDELINES 1 hereby affirm that there Is a construction lending agency for YES❑ NO❑ the performance of the work for which this permit is issued(Sec IHAVEREADTHEHAZARDOUSMATERIALSINFORMATIONGLIDEANDTHESCAOMDPERMnTNG n 3097 Civ C) CHECKLIST 1 UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE moa-Cool 2/27/79pL TITLE 2 2 20 100 CHAPTER 4DG HAZARDOUSLender a Name MATERIALS REPORTING AND FOR OBTUNING ATHROUGH FROMTHE SCAOMM9036 1 AM 11 09 t Lender dress a2 ONMER OR AWNT 4Phcm)nty I have read this ap atKXn a state under penalty PC FEE PERMIT FEE at the above In tKXn Is I agree l0 compy (Q orifi s nit Sta relating to building a nz sentatives of this my LSSUANCE FEE0the property for Ins1 �// '� INVESTMAATION FEE TOTAL FEE a A..A Del i A SEE REVERSE FOR EXPLANATORY LANGUAGE