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Home My Public Portal About5637-5639-5641 NOEL DR_Building__ IO�eN OF n8tMotLoao�tGy Ea�gin�AFETY � BUILDING Qonnty Of Los Angeles �rT 1 _ jq52 APPLICANT - WM. J. FOX, COUNTY ENGINEER ON FOR "PLICCANTT TO FILL IN FOR OFFICE USE ONLY ADDRESSI • / - T' Qe� R DISTRICT 0. PL^N CK.OR RSO No PERMIT NO x-49 1 /Z y r 2. t LOCALITY r*w Tpor PL. DATE ISSUED IteAReEr 9 30 �Z-" r O � ��•L OBBBUILAD OWNER C 3 e I O L OWNBR I MAIL �r A OCALITY T ADDREBB $ .i (j CRIOEE BT TTY ' Nal• ZOring No or NE PLANETY SROU ARCHITECT OR TEL ENGINEER NO, LDIL SETBACK LINE „� • /`��, ORD NO ADDRESS OR / m. ZCNB + 3 B DAT d PROVED CONTRACTv �� HOUSE NUMBERING ADDRESS MAP NUMBER ZG O r- NO ASSIGNED BY DESCRLEGAL IPTIy ON I LOT NC.-_ RRECTMONS BLOCK / S TRACT , `�, NO. OF ELDGE. SIZE OF LOT Wir_ NOW ON Lar USE or NO.EXISTING BLDG F MlLn $, aEsaaTPTTox of woag S � NEW ALTERATION ADDITION A REPAIR DEMOLITION /Q ,� r "O.FTNO.OF ft G / SIZE "DOME STORIES r EXT WALLI ROOF _ allWMNO COVERINGez UBE O URE a0X INBPECTIOH FOR APPROVALS OCCUPANCYAE INSPECTOWS SIGNATURE DATE FOUNDATION LOCATION _ rM MB, MATERIALS THAT I HAVE READ THIS PLICATION AND STAR THEREBY HAT THE INFORMATION GIVEN B FRAME FIRE STOP% CORRECT BRACING,BOLTS I AGREE TO COMPLY WITH ALL COUNTY GROINANC® FURNACE LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION BAB VENT.DUCTS SIGNATURE OF LATH, tNT `. PERMITTEe ADDRESS ; LATH, DIT PLANTER, INT. AUTHORIZED AST. FAZO12altr IN PLAItITERr DLT L - $ FEE IN Z HROUBE ECT ANUMBER ND PORT DR VALUATION FEE vLpZ QQ ,FINAL M'5�a' 76^630^ D06 3 1-04 ' WORKERS COMPENSATION DECLARATION •� insI have a certificate of consent to uab4racertifcarteofWorkers'CompensatonInauranelf APPLICATION FOR BUILDING PERMIT or a certified copy thereof(Sec 3800 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company ❑ FOR APPLICANT TO FILL IN BU ADDRESS 5� Certified copy is hereby furnished ❑ Certified copy is filed with the county buddmg'tnspec- BUILDING 3 �! tion department '- ADDRESS C L D I UI✓ Date Applicant J CITY ZIP LOCALITY I CERTIFICATE OF EXEMPTION FROM WORKERS NO OF SLOGS NEARESTCOMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST (This section need not be completed if the permit is for one I ASSESSOR hundred dollars($100)or less) TRACT BLOCK LOT NO P BOOK t PAGE PARCEL OWNERIV00.' �'//�� NE ' I certify that to the performance of the work for which this NO permit is issued,I shall not employ any person to any manner t� SPECIAL so as fo become subject to the Workers'Compensation Laws ADDRESS 57037 fry JX 1/ CONDITIONS Date--61-5 "Applicant '9b�$ � CITY ZIP NOTICE TO APPLICANT If, bfter making this Cerfifcate of ARCHITECT O TEL DISTRICT - UP TYPE FIRE PROCESSED BY Exemption you should become subject to the Workers' ENGINEER NO /7 CONSTI! ZONE Compensation provisions of the Labor Code you must forth Appy �v a �I. with comply with such provisions or this permit shall be �- TEL STATISTICAL CLASSIFICATION APT NDO N t V deemed revoked CONTRACTOR s NO $7f�XZ LICENSED CONTRACTORS DECLARATION LIC y�22..�� CLASS NO DWELL UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS Lr NO 32'2 7 (commencing with Section 7000)of Division 3 of the Business and LICSEWER MAP Professions Code and my license is in full force and effect CITY - CLASS BK VALIDATION PG n SQ FT NO OF NO OF CHECK License Number*3 q7 64 Lc Class C �� SIZE STORIES I FAMILIES ONE 1 C� Q �C VALUATION Contractor Abed V1 q�5 Date J� 13��q9% DESCRIPTION OF WORK C O ' Y N� l 01 -(elf -- hQl CA f s A ADD $ ❑1 am exempt under Sec - ❑ ALTER B 8P C,for this reason 5$ s REPAIR ❑ $ Date EXISTING BLDG DEMOL 8 7 Q 8 A Signature APPLICANT TEL FINAL # • • • • • OWNER-BUILDER DECLARATION (PRINT) NO DATE 1 hereby affirm that I am exempt from the Contractor's License ADDRESS FIN • • 4 9.8 8 Low for the following reason (Section 7031 5, Business and Professions Code) - rKtatol e • • 4 g 8 8 5 13I, as owner of the property, or my employees with ADDRESS - S as their sole compensation,will do the work and Poo 0 1. 1 3-88 the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code) MOVING TEL ❑ 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) 5ETRACK FROM CONSTRUCTION LENDING AGENCY SET BACK YARD HWY roTAPROP LINE WIDTH 1 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 SENSE - B - IDMA Ref Lender's Address PC Fees Permit Fee Pool1 certify that I have read this application and state that the Issuance Fee LDMA P/above information is correct I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction Total Fee LDMA Per ' $ and hereby authorize representatives of this County to enter upon�e above-mentioned property for inspection purposes - J"Z / I BO SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of App ant or Agent Date