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Home My Public Portal About10229 NADINE ST_Building__ DEPARTKm OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES BUILDING WM J FOX CHIEF ENGINETR FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING DIRTRI0 NO PLANCK NO PERMIT NO ADDRESS C 190 /,6 uD /,6 -3 Q LOCALITY �/ ��T RTC VED Y DATE OF APPL DATE ISSUED Q EAREBT //� /,P/i�V 'v 3'`/6- 3-/T/ -so OWNER GOIIZI �l l6�- �!/`I/yc, ADDREIBS v:7 ! J v I MAIL ADDRESS 't/ ✓ 2v J6�p f i1� LOCALITYNEAREST T� d ��! '! �C/ CI f ,4,1_5 DI-/T� TEL. j�31� now 1 NO or ST ENGINEER OR 141110 /1��+- TEL ZONE Q PLANS TYPE ORO d NO iP BLDGI �"" �4ORD NO ADD EB SETBACK LINE I - APPROVED vv TEL. r BY DATE CONTRACTOR /7AY F NO USE Al APPROVED ^DDRKMB ZONE SY DATE LEGAL CORRECTIONS DESCRIPTION I LOTNOO / / BLOCK [� �} `/� n TRACT //�(/ 2" OF BLDG wim OF LOT r I y O NDW ON LOTS 100140- USE OF NO OF NO OF EXIBTI 9 SLOB FAMILIIB ROOMS DESCRIPTION OF WORK NEW ALTERATION ADDITION O >0 REPAIR MOVING DEMOLISH ,,G SQ FT (/ NO OF � / D SIZE /�jL 6 ROOMS STORIES ,r r WALLRoar COVERING eJJyCC O COVERING AMP A;).e UBE OF NEW BUILDING f3,i Ti}cH� .1� I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS 1 APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION LOCATION INBPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS MATERIALS AND STATE LAWS REGULATING BUILDING CON RUCTION a r FRAME FIRE STOPS. SIGNATURE OF / �/f♦v I ^ BRACING BOLTS G9• /¢/�� PERMITTE LATH INT v AUTHORIZED AGT LATH EXT 00�/ r 76A538A 3 7 48 �D\ P C !p PLASTER INT VV / FEE PLASTER EXT VALUATION FEE FINAL ♦ - /t1 WORKERS COMPENSATION DECLARATION affirm that o have a consent to self r APPLICATION FOR BUILDING PERMIT a certified copy thereof(Sec 3800 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy Nos'S"D 910 - mpany S-A4 to Farr, BUILDING ❑ Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec BUILDING Tion department ADDRESS ZIVOCO114 LOCALITY /►1 �e Date Applicant / /!'t C NEAREST CITY r ZIP / gd CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS i NO OF BLDGS ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE PIAL hundred dollars($100)or less ) TRACT BLOCK �LOiNO OO OWNER// vJ /' a Ii NO ��Y JG.38 / CONDITIONS I certify that in the performance of the work for which this DIMCT GRC.3 UP TYPE FIRE SSED BY V permit is issued I shall not employ any person in any manner ADDRESS �0�2 so as tobecome subject to the Workers Compensation Laws > 8� �0� CONST It ��E O Date Z ` —3AH Applicantokf CITY /Yl le ZIP STATISTICAL CLASSIFICATIONJG—' APT CONDO V NOTICE TO APPLICANT If after makin this C tate of ARCHITECT OR TEL W Exemption you should become subject to the Workers ENGINEER NO CLASS NO DWELL UNITS N Compensation provisions of the Labor Code you must forth ADDRESS SEWER Z with comply with such provisions or this permit shall be deemed revoked TEL BK PG VALI ATION CONTRACTOR NO T LICENSED CONTRACTORS DECLARATION LIC /1 I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC Professions Code and my license is in full force and effectCITY CLASS $ SO FT N OF NO OF CHECK License Number Lic Class SIZE a4w STORIES FAMILIES ONE Contractor Date DESCRIPTION OF WORK InCkii C NEW ❑ E-1am ❑ I am exempt from the licensing requirements as I am a q rJp/ /T GAi/ ADD 1� r licensed architect or a registered professional engineer ALTER riJ FINAL - 7 acting in mREPAIR y professional capacity (Section 7051 ❑ DATE Business and Professions Code) USE OF FINAL ' EXISTING BLDG DEMOL ❑ .�q� By Lic or Reg No Date APPLICANT TEL OWNER BUILDER DECLARATION (PRINT) NO I hereby affirm that I am exempt from the Contractor s License Law for the following reason (Section 7031 5 Business and ADDRESS Professions Code) PRESENT ® BUILDING I as owner of the property or my employees with ADDRESS wages as their sole compensation will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044 Business and Professions Code) MOVING TEL I ❑ I 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) , z 3 5 7 5 A 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 # • • • • • 1 the performance of the work for which this permit is issued P L (Sec 3097 Civ C ) SIDE 2 . 1 5 1 0 0 PL Lender s Name • * 151001 Lender s Address P C Fee$ Permit Fee 1 2 3 1 X 8 0 W i I certify that I have read this application and state that the Issuance Fee above information is correct 1 agree to comply with all County Invests otian Fee ordinances and State laws relating to building construction g Total Fee S (�O and hereby authorize representatives of this County to enter ` upon the above mentioned property for inspection purposes o ✓�%S_(/ (/^�J' 4z—31-8Q SEE REVERSE FOR EXPLANATORY LANGUAGE ^ SigOWure of Appl 416off or Agent Date s APPLICATION FOR BUILDING PERMIT • COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS 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 T copy thereof(Sec 3800 Lab C) CITY ZIP Policy NrIJJ?,C 06-297- ompany ,TrArw irtuwo Tit oft p4, C!10"W 9/ 2' 2' o LOCALIT 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 /C1. USE ZONE MAP NO Date Applicant/�cJ�Z. ASSESSOR MAP BOOK PAGE PARCEL • SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS OWNER TEL NO COMPENSATION INSURANCE V'� wYM 'l cS G 3 W WITHIN 1000 FT OF SCHOOL" ves No (This section need not be completed if the permit is for one hundred ADDRESS dollars($100)or less) /O a NA s/ DISTRICT GROUP T ONST FIRE ZONE PROCESSED BY CITY IP I certify that In the performance of the work for which this permit /p A E C/r-./ �� Is Issued I shall not employ any person In any manner so as to ARCHITECT OR ENGINEER TEL NO Oil become subject to the Workers Compensation Laws \ STATISTICAL CLAS;;IFIChTION APT CONDO Date Applicant ADDRESS CLASS NO ��•/ DWELL UNITS NOTICE TO APPLICANT If after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption you should become subject t0 the Workers CONTRACTOR TEL NO SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code you must forthwith A M7— ka O/�/Ai C lyC Z/V34 2"A'477 FRONT comply with such provisions or this permit shall be deemed revoked ADDRESS LIC NO PL LICENSED CONTRACTORS DECLARATION 029AJfA0JJuAL61 &.r 472 707 SIDE PL I hereby affirm that I am licensed underprovisions of Chapter 9 CITYCt4�`�q /�� 9/$y LIC CLg�S 3 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ FT SIZE NO OF STORIES NO OF FAMILIES G Professions Code and my license is In full force and effect NEW ❑ VA PG , a- License Number "7,p0 7 LIC Class C -32 DESCRIPTION OF WORK ADD ❑ VALUATION 0 Contractor hoS Ay"Sr u rt Date if-42-9 3 P O F s ALTER ❑ $ 90 O V It IA0❑ 1 am exempt under Sec AMC REPAIR 11 $ B8PC for this reason Sffi vCLC DEMOL ❑ LDMA P/C#0q 0 W Dat USE OF EXISTING BLDG URM ❑ AV w'LZ-4 A-4C Z co Signature 10 APPLICANT(PRINT) TEL NO LDMA Perm• Z ❑ I as owner of the property or my employees with wages as Z tit i T a their sole compensation will do the work and the structure Is ADDRESS O �- -,9 not intended or offered for sale (Section 7044 Business and FINAL DA E Professions Code) 1TE�! WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL L ❑ 1 as owner of the ORA MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE property am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDESQ licensed contractors to construct the project (Section 7044 FINAL BYsf TI ITp�. 135® c Business and Professions Code) ves E] No❑ WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING I HEL� CONSTRUCTION LENDING AGENCY CODEPAIR OREQUIRE A PERMIT FOR CONSTRUCTION D) MODIFICATION FROM THE SOUTH COAST AIR OUAUTV MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR J CHANGE C 1 hereby affirm that there Is a construction lending agency for YES❑ NO❑ a the performance of the work for which this permit Is Issued(Sec p1 I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING N 3097 CIV C) CHECKLIST I UNDERSTAND MV REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE �y- TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS Lenders Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD C3 Lender s Address 1 i AM J O OWNER OR AGENT F, I certify that I have read this application and state under penalty 0 of perjury that the above Information Is correct I agree to comply PC FEE PERMIT FEE /d N with all county ordinances and State laws relating to building CD construction and hereby authorize representatives of this County ISSUANCE FEE L/A m to ent upon the above tioned D rty for Inspection purposes TMJ m /.i7—,9 INVESTIGATION FEE TOTAL FEE sm i A p w I Abe VG • SEE REVERSE FOR EXPLANATORY LANGUAGE