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Home My Public Portal About5335 NOEL DR_Building__ APPLICATION FOR RELOCATION BUILDING PERMIT ], DIVISION OF BUwnM AND SAFETY f, /�f ��I� Depo:tmeat of County Eaglae6s ADDREISS t/ /F ' � ( Conaty Of Los Aa4 e pg88 79 WM J FOX COUNTY ENGINEER LOCALITY ' 22 94 CASSATT D GRIFFIN Sup r OF BUILDING NEAREST 46. dIF CROSS ST -i FOR APPLI+CHANT TO FILL IN DISTRICT NO GROUP TYPE CONST PROPOSED -y� I _:c 1 V BUILDINGwe MAPbe ADDRES NUMBER -Z Gf ST LOCALITY UE SPE IAL PRESENT /r CONDITIONS BUILDING AD a LOCALITY BUILDING YARD HWY STREET NAME EXIST SETBACK WIDTH OWNER FPOL T _ •� / �.� Q� ADDRESS < SIDE �Z P L + TEL. CITY NO O 6UND 41 /� OAT ILK 55eR6C D MOVING TEL. BOND s�1C ILK Y CONTRACTO NO CASH DATE REG D DEPOSIT s BILE^ �Y ADDRESS BUILDING 12 TE APPROVALS CONTRACTOR N ADDRESS � � DATE INS ECTOR S SIGNATURE FOUNDATION LOCATION USE OFT FORMS MATERIALS AssoS BUILDING FRAME FIRE STOPS PROPOSBRACING BOLTS IO USE OF ED Q FURNACE LOCATION BUILDING- GAS VENT DUCTS LATH INT NO OF SIZE ROOMS STORIES LATH EXT Z e"a `4� r� l�i�M COVERING I COVERING ROOF HRECT AND OUSE NUMBER COR ►S s LEGAL AA �!' DESCRIPTION LOT NO rd BLOCK � FINAL �— TRACT DISTRICT ENGINEER NO OF BLOCS WORK COMPLETED SIZE OF LOT NOW ON LOT SURETY BOND USE OR + NO of RELEASED EXISTING BLDG RAMILIE8 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS I HEREBY STATE THAT E INFORM ON IVEN IS COR APPLICATION AND STATE THAT THE ABOVE IS CORRECT RECT i AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES SIGNATURE OR AND STATE LAWS REG ING BUI ING CONSTRUC APPLICANT _ TION ADDRESS SIGNATURE OF VALUATION PERMITTEE $ �If PER S ADD FEE S WILLIAM J FOX COUNTY ENGINEER VALIDATION '66803L. aLL1917 1000Am _ G6Y179n AUG 1 6 1200 DEPUTY' DEPUTY e �g Q BY � [�' r BY /� �� ® DEPUTY v ` DEPUTY a.weaswossaaaAPPLICATION FOR BUILDING PERMIT Z DMSION OF BUBMIG AND SAFETY ADDRESS J / _&.�_ Dnxwb o<ent of County Engineer Countr of Los Angeles LOCALITY WM J FOX COUNTY ENGINEER NEAREST CASSATT D GRIFFIN SUP T of BUILDING CROSS ST FOR APPLICANT TO FILL IN DISTRICT jdo GROUP TYPESKW_ER MAP NS BUILDING ` ADDR68S NUMBER rte+ NWY ZoS O LOT NO BLOCK US"ONE SPE rj 1 CONDITIONS r� TRACTZI C7dC NO Ora SIZE OF LOT S NOW ON U09 S°B�ATK YARD NWY STREET NAME WIDTH USE OR F •, / Q EXISTING BL film. POL T V' 0-d �O� OWNER SIDE MAIL 02 A ADDRESS O TRACT DWELL I UNIT m_ 1 DWELL I UNIT s INDUSTRIAL CITY O 6 PUBLIC BLDG ARCHITECT O 2 DUPLEX I UNIT ADDN ALT BTC ENGINEER O DO g APT UNITS 8 MISCEL ADDRESS 4 COMMERCIAL TEL CONTRACTOR Ll NO =BD ADDRESS DON OF WORK NEW DD ALTER REPAIR DEMOLISH SO FT (P X/IO OF NO OR 6126 RIBS FAMILIES US F TURK SIGNATURE OF APPLICANT APPROVALS ADDRESS DATE INSP CTOR S SIGNATURE FOUNDATION LOCATION P C S FORMS MATERIALS / �OU FEE FRAME FIRE STOPS VALUATION S !2 BRACING BOLTS FEN Ar ACE LOCATION I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GA8 VENT DUCTS APPLICATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY TH ALL ORDINANCES LATH INT L d AND STATE LAWS R TING CONSTRUC k TION LATH EXT SIGNATURE OR HOUSE NUMBER C:OR- PERMITTBB RECT AND POSTED ADORES FINAL 1 ►3 vv WM J FOX COUNTY ENGINBBR VALIDATION C.N DIRLAM CHIEF BLDG IN _146 1 8 01S aur 1 1 800 a . l APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL INBUILDING ADDRESS d I hereby affirm that I have a certificate of consent to self Insure BUILDING ADDRESS ��3 O E A V'C or a certificate of Workers Compensation Insurance or a certified Is--asS- ��L r copy thereof(Sec 3800 Lab C) C CRY C/y LCr C r Zip /Z d LOCALITY Policy No Company SIZE OF LOT NO OF BLDGS NOW ON LOT ❑ Certified copy is hereby furnished 0A)/-"""" NEAREST CROSS ❑ Certified copy is filed with the county building Inspection TRACT BLOCK LOT NO 0 E lv Xeos department I USE ZONE MAP NO Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS OWNER TEL NO COMPENSATION INSURANCE 4F .-- - —9 WITHIN 1000 FT OF SCHOOLS ves N (This section need not be completed if the permit is for one hundred ADDRESS DISTRICT GROUP 4160,4FF ROC dollars($100)or less) CRY ZIP 08 n I certify that in theperformance of the work for which this permitr` Is Issued I shall not employ any person i any manner so as to ARCHITECT OR ENGINEER TEL NO Ar become subject to the Workers Co p sidion Laws STATISTICAL CLASSIFICATION I APT OCPDO Date r Applicant ADDRESS CLASS NO 2 DWELL UNITS NOTICE TO APPLICANT If after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption you should become subject to the Workers CONTRACTOR TEL NO SET BACK YARD HWY PROP UNE WIDTH Compensation provisions of the Labor Code you must forthwith G,—e- goarrAZ Jl-*'-19/-6-700 FRONT comply with such provisions or this permit shall be deemed revoked ADDRESS LIC NO PL LICENSED CONTRACTORS DECLARATIONN .Ci Vol o- `!gS SIDE CITY �� _ LICCLAS PL I hereby affirm that 1 am licensed underprovlsions of Chapter 9 CI T CSEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ FT SIZE NO OF STORIES NO OF FAMILIES Professions Code/and my licengse Is In full force and effect NEW ❑ BK PG a License Number b�Ss�-/c_ LIC Class C 3 DESCRIPTION OF WORK ADD ❑ VALUATION ► Q Contractor�jGC� &&V-4 Date &00-5c— ALTER ❑ $ C� 111 am exempt under Sec 3� ESC'_ REPAIR 13 BSPC for this reason DEMOL ❑ LDMA P/C s W Date USE OF EXISTING BLDG URM ❑ i Signature APPLI NT(PRINT) TEL NO LOMA Perm* ACCT aT Z ❑ 1 as owner of the property or my employees with wages asRESS C N ON ZO 3W 158.85 their sole compensation will do the work and the structure Is ADDF r7�7u.� not Intended or offered for sale (Section 7044 Business and FINAL DATE a IT Professions Code) � WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE n�y /� ❑ 1 as owner of the property am the prof exclusively (Section With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY TVTr,a.. 1 ® � licensed contractors to construct the protect (Section 7044 Business and Professions Code) YES❑ No❑ ��,K i5$e80; WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REOUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR OWE 00 GUIDELINES I hereby affirm that there is a construction lending agency for YES❑ NO❑ Nthe performance of the work for which this permit is Issued(Sec -�i 7/24/9 O1 I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 3097 CIV C) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE 4sC+Ji TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS JJ��7i�i PM i Lender s Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD iC?�'1 i o Lenders Address O OWNER OR AGENT c I certify that I have read this application and state under penalty of perjury that the above information is correct I agree to comply PC FEE PERMIT FEE N with all county ordinances and State laws relating to building r cons Mcfiol�er�eby%authonze representatives of this County ISSUANCE FP 3am rntioned property for Inspection purposesAA a .-� INVESTIGATION FEE E CO nV 81111 r SEE REVERSE FOR EXPLA RY LANGUAGE