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Home My Public Portal About5755 OAK AVE_Building__ BUILDINM ADDRESS ie ADDRED SS APPLICATION LOCALITY N[AREST DIVISION OF BUILDING AND SAFETY cmoss sr D"artaten of == DISTRICT O. R OEIPT O 5 Iso ZAfmw R33 /07 WM J FOX, COUNTY ENGINEER Wngup DATt [CBIV D DATC IBRIJtD CASSATT D GRIrrIN, SUPT Or BUILDING Z FOR APPLICANT TO FILL IN TYPE�aoNgT O I a /�I�eutD Y OWNER '� cL MAP �/V 8 rAT �(/1�G MAIL _ NUMBER Yen NO ADDRESSUSt Zola SPECIAL 1 TE%Lal CONDITIONS , ARCHITECT OR TEL, ODD EN8INEER ND' BUILDINGD SETBACK EXIST YARD NWY STREET NAMt WIDTH r'`NT CONTRACTOR NO !� V PI L ADD E88 S DAT[ CORRECTIONS INSPECTOR 3 / a / LOT N i ! 3 TRACT Zy 04 NO Or BLDOS. F SIZE Or L O NOW ON LOT USE Or I fun DESCRIPTION OF WORKUJAM a �/ 0 NEW /r ADD ALTER REPAIR DEMOLISH v = SIZE 2TOIl1[8 AMILI Use Or STRUCTURE to/ AdD NO Or _EMPLOYEES _ 1 HERESY ACKNOWLEDGE THAT I HAVE READ THIS A PLICATION AND STATE THAT THE INFCRMATION GIVEN 18 CORRECT APPROVALS INBP[OT 'B SIGNATURE DATE 1 AGR[e TO COMPLY WITH ALL COUNTY ORDINANCES rOUNDAT10Nt LOCATION- AND BTATe LAWS REGULATING BUILDING CONSTRUCTION FORMS MATERIALS %+ rRAMe rime STOPS. 810MATURE Or BRACING BOLTS P�RMITTE rumNACE LOCATION 0AB VENT DUCTS ADDR6 AUTHORIZED ANT LATH INT LATH EXT O ,�� PCS D� HOUOt NUMOBR COR- Q rico RENT AND POSTED / 1 S VALUATION rEE S G� FINAL 76AMEA DM 2 4 54 `� BUILDING ABUILDING DORE" 6 lk v LOCALITY L+ c APPLICATION NEAREST DMSION OF WELDING AND SAFETY DRDBB ST Gage 29*:RADISTRI�CjA0 RECEIPT NO. PERMIT NO g"3 9 S' s'0 s WM J rOX, COUNTY ENGINEER GROUP DATE RECEIVED DATE ISSUED CASBATT D GRIrrIN Bun* or Bummme r �� FOR AFXJCMT TO FILL IN TYPE NBT RECEIVED BYNAJD I ED S OWNS /� _ MAIL NUMSER (/ STAY YES N ADDRESS HWY ZON SPECIAL TY rA It TE U� t CONDITIONS ARCHITECT OR TEL. y0 ENGINEER NO BSETBACK YARD NMK arRttT NAME WIDTH ADDRESS , EL. rR P L.T �- CONTRACTOR NTQ BIDE ADDRESS P L. BUILDIN DATE CORRECTIONS INSPECTOR ADORE s LOT NO V ® D K TRACT NO Or BLDGS. SIZE Or LOY4 0 NOW ON LOT usE Or III RLDn. DESCRIPTION OF WORK 0 NEW ADD ALTCR REPAIR DEMOLISH BO rT NO Or NOOr r SIZE STORIES rAMILIEN USE Or STRUCTURE N y� r NO OF I P HEREBY ACKNOWLEDOC THAT 1 HAVE READ THIS A PLICATION AND STATE THAT THE INFORMATION 81VEN IS CORRECT 'APPROVALS INSPlCTO SIGNATURE DAT! 1ADRB! TO COMPLY WITH ALL COUNTY ORDINANCES rOUNDATION LOCATION AND STATE LAMIS REsu IND BUILDING CONSTRUCTION FORMS MATIRIALB rRAMEi rims STOPsr SIGNATURE O 00, BRACING BOLTS 44 PERMITTt FURNACE LOCATION, ADDR GAB VENT DUCTS AUTHORIZED AST LATH INT f O'8 P C 41 LATH O17' �� --- rtt House RECT NUMBER OCR RECT AND POSTED VALUATION rCC *r[B® rl NAL L67j#AA-11—1 TmweA D083 484 APPLICATION FOR BUILDING PERMIT ' COUNTY OF LOS ANGELES BUILAG 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 J S �AIIL E copy thereof(Sec 3800 Lab C) � CITY IMP�� ZIP -1`.180 LOCA Y Policy No Z �9 s Company S:Tka, SIZE OF LOT NO OF SLOGS NOW ON LOT ULZ ❑ rtifled Copy IS hereby furnished NEAREST CROSS ST —oftleartified copy Is filed with the county building Inspection TRACT BLOCK LOT NO department USE ZONE MAP NO Datea/2y IR514ppllcant MF"VAOM 4X1F1I6-"%M ASSESSOR MAP BOOK PWGE PARCEL Ala 00 SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS OWNER C>P= NO YES NO COMPENSATION INSURANCE - 'C(E� - ?.�O�o WITHIN 1000 FT OF SCHOOL AMI I (This section need not be Completed If the permit Is for one hundred ESS ,�^3 DISTRICT GROUP TYPE CONST FIRE ZONE PROCESS dollars($100)or less) no � t�-�/ Z3 0�P 1 certify that In the performance of the work for which this permit CITY - � M �� LPG,' 11`� c�QB 1�1►� Is Issued I shall not employ any person In arty manner so se to ARCHITECT OR ENGINEER TEL NO become subject to the Workers Compensation Laws STATISTICAL CLASSIFICATION APT CON 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 to the Wbrkers CQNTRACTOR TEL NO SET BACK YARD HWY PROP LINE WIDTH CompensatKm provisions of the Labor Code you must forthwith ��+GG777�-�Q" FROM comply with such provisions or this permit shall be deemed revoked ADDRESS LIC NO PL LICENSED CONTRACTORS DECLARATION Q-1- 1.7 v13a33� SIDE r►'IPUE C_t �L& PL I hereby affirm that I am licensed underprovlsans of Chapter 9 SEWER MAP � (commencing with Section 7000)of Division 3 of the Business and SO FT SIZE NO OF STORIES NO OF FAMILIES a Professions Code and my license Is in full force and effect NEW ❑ BK PG POO. v License Number 4303D3�8�Lic Class C--3R DESCRIPTION OF WORK"{(� -fEjo`�QpF A&I— ADD ❑ w►LuanoN Contractor l�11L�t1[C3M �" Qftate CA-20-RS IJQ+ t R ❑ $ 5, 3 50 'm v TD 'T1'EEaJ Z t.]STl�L.t. 3c ft 5'r� LU CLPAIR ❑ ❑ 1 am exempt under Sec $ CO) +�. BBPC for this reason C .�,�S 11a1 svmllJfaLE MIR t EMOL ❑ LDMA P/C+ Date USE OF EXISTING BLDG URM ❑ Signature APPUCANT(PRnVT) �-_y TEL NO LDMA Perm M ❑ 1 as owner of the property or my employees with wages as AD RESS f A F-� 2�S 9o1� O CTS* their sole Compensation w111 al the work and the structure Is P t�.L- � ,r,v�- � T -- F not intended or offered for sale (Section 7044 Business and �p \, FINAL DA a Professions Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ 1 as owner of the property am exclusively Contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE a licensed contractors to construct the project (Section 7044 AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY Business and Professions Code) YES❑ NO❑ WILL THE INTENDED USE OF THE BUIDUG BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES I hereby affirm that there Is a construction lending agency for YES❑ NO❑ the performance Of the work for which this permit Is Issued(Sec I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTINGa 3087 CIV C) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE TITLE 2 CHAPTER 2 20 HAZARDO Lender s Name MATERIALS REPORTING ANDD O OBTAINING A PERMIT FGH 2 ROM140 4THE SCAOMD CONCERNING US Lenders Address p OWNER OR AGENT g I Certify that I have read this application and state under penalty PC FEE PERMIT FEE of perjury that the above Information Is correct I agree to comply of with all county ordinances and State laws relating to building • i/ �., Agw honze representatives of this County ISSUANCE FEE arled property for mspectlo'n�'rpose ` Ip �s INVESTIGATION FEE TOTAL FEE /1A DO (�/ SEE REVERSE FOR EXPLANATORY LANGUAGE _ A APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGEifS BUILDING AND SAFETY WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDREi •of w I hereby affirm that I have a certificate of consent to self Insure BUILDING ADDRESS AA or a certificate of Workers Compensation Insurance or a certified 12ig..A ZIP G�; copy thereof(Sec 3800 Lab C) / D LOCALITY Policy No Company SIZE OF Lar v NO OF BLDGS NOW ON LOT 13 Certified copy is hereby furnished NEAREST CROSS ST ❑ Certified copy is filed with the county building Inspection TRACT BLOCK LOT NO department I USE ZONE MAP NO Date Applicant ASSESSOR PA&� PARC—El.2 SPECIALCONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS OWNER TEL NO YES NO COMPENSATION INSURANCE O O WITHIN 1000 FT OF SCHOOLS (This section need not be completed If the permit is for one hundred ADDRESS DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY dollars($100)or less) hgzj- CITY ZIP I certify that in the performance of the work for which this permit ,rf' Is Issued I shall not employ a�inanyr so as to ARCHITECT OR ENGINEER �/� TEL NObecome�aua to trkers STATISTICAL CLFICATION APT CONDO Date Applicant ADDRESS CLASS NO a DWELL UNITS N077CE PPLIG4NT 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 LINE WIDTH Compensation provisions of the Labor Code you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked ADDRESS LIC NO PL LICENSED CONTRACTORS DECLARATION SIDE CITY LIC CLASS PL I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER 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 license is in full force and effect NEW ❑ BK PG a License Number LK; Class DESCRIPTIOW OF WORK ADD ❑ VALUATION poll- U Contractor Date ALTER s ❑ I am exempt under Sec AM REPAIR ❑ BBPC for this reason a. ex DEMOL ❑ LDMA P/C* Date USE OF EXISTING BLDG URM ❑ ��,/Signature APPLICANT(PRINT) TEL NO LDMA Perm r ACCT s Z , 7 I as owner of the property or my employees with wages as Z 3303 =0 rC ' —(heir sole compensation will do the work and the structure Is ADDRESS F not intended or offered for sale (Section 7044 Business and FINAL DATE a 1 Professions Code) D WILL THE APPLICANT OR FUTURE BUILDING 0CCUR4NT HANDLE A HAZARD0U8 MATERIAL ❑ I as owner of the property am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL EQUAL TO OR GREATER THAN THE C AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES I Q �C 1" 8 licensed contractors to construct the project (Section 7044 YES 13 NO❑ FINAL r 1 I > °i,r30J 1�7 1't Business and Professions Code) WILL THE INTENDED USE OF THE BUIDLNG BY THE APPLICANT OR FUTURE BUILDING ITEfi1�% OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH 2 EC CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES JIARA � 37-.6314 I hereby affirm that there is a construction lending agency for YES❑ NO❑ INFORMATION THE jtJcy 7 a the performance of the work for which this permit is Issued(Sec I HAVE _ M PERMITTING 3097 CN C) CHECKLIST UNDERSTAND MY REQUTHE HAZARDOUS IREMENTS UNDER THE LOS ANGELES COUNTY CODE TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS CHANCE A� ry Lenders Name MATERIALS REPORTING AND FOR OMNING A PERMIT FROM THE SCAOMD C H E J o Lenders Address p OWNER OR aDEW 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 �D S PERMIT FEE 0000-0001 �717,C� $ with all county ordinances and State laws relating to building Q44 1 Fh �I construction �an�.�w�t authorizer meBe tives of this County ISSUANCE FEE L?r m to entfw np677 — bo%me npfO ins Ghon rp as a INVESTIGATION FEE TOTAL FEE / � `� Spat FMO m AM Dat SEE REVERSE FOR EXPLANATORY LANGUAGE