The URL can be used to link to this page

Home My Public Portal About9933 NADINE ST_Building__ DEPARTMENT OF HVII.DING AND SAFETY APPLICATION FOR PERMIT - COUNTY OF LOS ANGELES WBUILDING M. J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK.NO. PERMIT NO. AUILDING DDRESS -Z r �� 9:2//;7 YI 3�.a, J(/ LOCALITY z 7/d RECEIVED BY DATE OF APPL DATE ISBUED BUILDING OWNER- ADDRESS MAIL LOCALITY / NEAREST - - C CROSS BT: ITY FIR[ NO.OF TYPE GROUP ARCHITECT OR TEL ZONE PLANS ENGINEER NO. BLDG. r .. - . .. ORD.NO. ADDRESSSETBACK LIN[ AP �G O`A - 3� PROVED CONTRACTOR BY DATE USE APPROVED A D �r ZONE BY, DATE DESCRIPTION LOT NO. I� BLOCK c �y�,p LEGAL CORRECTIONB TRACT 7 D � ✓ ��/�..a z z 3 Z. fS. . SIZE OF LOT 10 Z NOW OFBLDGSON LOT UBE OF NO.OF NO.OF EXIBTI P i i6B ROOMS DESCRIPTION OF WORK NEW ALTERATION I I ADDITION TFO __ A REPAIR MOVING - DEMOLISH G EO•PT. NO.OF / /►q Z SIZE ROOMS 6 STORIES v//� D _ r WALL ROOF COVERING t COVERING USE Or NEW i BUILDING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS, ' APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATIO14: LOCATION INBPEC OR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORME,MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, 3 1 SIGNATURE OF BRACING.BOLTS 1 /� PERMITTE I� LATH, INT. /! AUTHORIZED AGT ;irLATH, EXT. / P 3 G 76A63BA-3 7-49 $ P.C.S PLASTER.INT. _ FEE PLASTER.EXT. S •• VALUATION - - FINAL FEE " WORKERS' COMPENSATION DECLARATION insure herebi$' affcertif cairm ne of Workers' Compensation eInnt to suran elf APPLICATION FOR BUILDING, P E RM I T �pr`a certified copy (Sec. 3800, lab COUNTY OF-LOS ANGELES BUILDING AND SAFETY P No. Company LDING ❑" Certified copy is hereby furnished. .: . FOR APPLICANT TO FILL IN ADDRESS •Certified copy is filed with t county buij�'ng inspec- BUILDING — tio de artment. / ! ADDRESS a/C Date L Applicant /Lf,1t � CITY.. C ZIP LOG4LiTY _ NO. OF BLDGS. NEAREST RT KATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT ' CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if The permit is for one TRACT BLOCK LOT NO. Map BOOK ]PAGEPARCEL hundred dollars ($100)or less.) �yTEL. 2 OWNER S1CI NO. 7 USE ZONE MAP NO. I certify that in the performance of..the work for which this ,,6 SPECIAL permit is issued, 1.shall not employ any person in any manner ADDRESS 7N CONDITIONS CL so as to become subject,to the Workers'Compensation Laws. O CITY << ZIP u Date Applicant ARCHITECT OR TEL. DISTRIFIRE SSED BY O CT GROUP NOTICE TO APPLICANT:.If,'after making this Certificate'of ENGINEER NO. CO T. Exemption, you should become subject to the Workers' ' Compensation provisions of the Labor Code, you-must forth- ' ADDRESS 5,0 e, I N with comply with. such provisions or this permit shall be (r�Ir1s+TEL. STATISTICAL CLASSIFICATION APT. CONDO. Z LW deemed revoked. . CONTRACTOR OT/LI/((r NO. _ . _ LICENSED CONTRACTORS DECLARATION uC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS �' SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. and Professions Code;and my license is in full force a d•effect. CIN CLASS 6 BK PG VALIDATION _ SQ. FT• NO. OF NO.-OF'- CHECK License Nu bar Lic. Class / SIZE STORIES FAMILIES ONE =a4°foo o Contractor/ Date DESCRIPTION OF WORK NEW ❑ ,� ! ADD Elm I aexempt under Sec. C/Iv • ALTER ❑ • 11011. B.&P.C. for this reason REPAIR ❑ $ Date: USE OF �+ EXISTING BLDG. DEMOL ❑ Signature APPLICANT / c�r� U TEL. ! FINAL OWNER-BUILDER DECLARATION (PRINT) NO. p �j ,,�,/� �f p DATE ' I hereby affirm that I am exempt from the Contractor's License . ADDRESS N r �I(7C `I G Law for the following reason (Section 7031.5, Business and FINAL 1 Professions.Code): ESENT BYIR +n ❑ I, as owner of the property, or m employees with BUILDING4�.a P pertY� Y , ADDRESS � � • wages as their sole compensation,will do the work andLOCALITY - 7 26.1? the structure is not intended'or ciffered for sale(Section ` - 1 TY - - 7044, Business and Professions Code.) MOVING TEL. ❑ I, as owner of the property, CONTRACTOR NO. p p ty,am exclusively contracting _ r ,�QT� 256 a 13 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code.). �C�( 26.13 UIRED TOTAL SETBACK FROM IST. CONSTRUCTION LENDING AGENCY SET Bq YARD HWY P LINE I hereby off irm that there is a construction lending agency for FRONT cma the performance of the work for which this permit Is issued P.L. (Sec. 3097, Civ. C.). SIDE. -7/gyp P.L. IJUTAJ—VtiVi 11/1llit7 Lender's Name . ��t� /� P.C. Fee E Permit Fee LDMA Ref. # 6U4 1 AM 8:35 V�J•t Lender's Address , I certi at I have read this application and state that the luuance Fee LDMA P/C# abov 'nfU correct. I agree to comply with all County Investigation Fee . ordl a cee laws relating To building construction, Total Feeas LDMA Perm. # + _ and e e representatives of this County-to enter upbA thtioned property for.inspection pur ses. - SEE REVERSE FOR EXPLANATORY LANGUAGE. - Signature of Applicant w'AgentI Date