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Home My Public Portal About5940 OAK AVE_Building__ APPLICATION FOR BUILDING PERMIT ] FOR APPLICANT TO FILL IN (Print or type only) BUILDING 4G �� COUNTY OF LOS ANGELES ADDRESS AjiDEPARTMENT OF COUNTY ENG24UR CITY ZIP �� BUILDING AND SAFEAY DIVISION NO OF BLDGS BUILDING � �! SIZE OF LOT O�'2l�o NOW ON LOT ' ADDRESS � - (�iL/Eia.I TRACT Gb5fill, B K LOT NO Z LOCALITY EL jj�3 NEAREST OWNECROSS ST ASSESSOR AD S MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE SSE BY CI Y Q � ��CONST ;r4 ZO ENGINEERARCHrrECTK R 01'►Iblyr 1� NOL 13 � �D� `I STATISTICAL CLASSIFICATION SEWER MAP ADDRESS 157-A"I CLASS NO�DWELL UNITS A#8116-&j�— CONTRACTOR TEL P40USE ZONEFAP LIC O 1 ADDRESS NO �Z PECIAL LIC ONpITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG SETBACK FROM FRONT PROP LINE OF (STREET) ADDRESS CITY _ TOTAL SETBACK FROM TYPE OF EXISTING SO FT NO OF NO OF CHECK HIGHWAY + YARD - HIGHWAY WIDTH FRONT PROP LINE SIZE I STORIES FAMILIES ONE _ W DESCRIPTION OF WORK ti NEW ❑ O CA BLDG *7 pF'F/cF fJ� Fj� __.✓c DD C] SDE PROPEACK L NE OF FROM (STREET) /''y I � LTER HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF 1EXISTING AIL—i EPAIR❑ SIDE PROP LINE HIGHWAYI WIDTH USE OF EXISTING BLDG T 019IRVG IEMOL ❑ + C APPLICANT y � ` VY TEL CORNER CUTOFF YES ❑ NO ❑ (PRINT) { wA'IG/� ANO 13,=e BY (SIGNATURE) � IN OPEN SPADE YES ❑ NO ❑ Q , IN COASTAL ZONE YES ❑ NO ❑ VALUATION 0Q CATEGORICAL EXEMPTION YES❑ NO ❑ 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ IS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON STRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COMPENS ION INSURANCE SIGNATURE OF PERMITTEE ADDRESS /� /�► {� FINAL Y CITY �l�/r�"F] NOLv � DATE / E PMT MAKF CHECKS PAYABLE TO FEE $ FEE HARVEY T BRANDT COUNTY ENGINEER PLAN CHECK VALIDATION 5 M 0 CASH PERMIT VALIDA O cK M o CASH 3 0 Skdm 3 2 3 D - 206110 r 75AG38A CE*803 7/7 �� 13O 0 0 0 ,&!s,* 76A698A CEMa =awvok BG9IY.°APPLICATION FOR BUILDING PERMIT- f1 COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK �� PAGE PARCEL DDRESS BUILDING AND SAFETY DIVISION AS97�'//�,iV Al., gep;✓ • JOHN A LAMBIE COUNTY ENGINEER COLEMAN W JENKINS SUP T OF BUILDING LOCALITY R APL T T FILL IN NEAREST .41 CROSS ST DISTRICT 40-V GROUP T P ESSEDBY BUILDINGG ,S_ADDRESS 4"� CONS STATISTICAL yCCL��AjjSSIFICATI SEWER MAP LOT N 2//� �7 BLOCK CLASS NO_GtCDWELL UNITS BK4 P TRACT (p.� USE ZONE MAP NO OF BLDGS NO SIZE OF LOT NOW ON LOT „� SPECIAL USE OF CONDITIONS EXISTING BLDG ca OWNER NO BLDG SETBACK FROM ADDRESS FRONTPROP LINEOF STREET) TYPE OF EXISTING SETBACK HIGHWAY + Y = TOTAL CITY HIGHWAY WIDTH FROM C L ARCHITECT OR /J TEL + ENGINEER d4a[' O BLDG SETBACK F ADDRESS SIDEPROP LINEOF (STREET) jq TEL TYPE OF EXISTING 8 CK HIG + YARD = TOTAL CONTRACTOR NO HIGHWAY WIDTH C L ADDRESS NOLlc 2 + Lic CITY L 3-3 CLASS - CORNER CUTOFF YES ❑ NO CONSTRUCTION LEN ER NAME AND BRANCH -- SEE REVERSE SIDE FOR SPECIAL APPROVALS W ADDRESS Sq FT NO OF NO OFO W� SIZE STORIES FAMILIES NEW Alf, USE OF ADD STRUCTURE — ALTER , REPAIR❑ SIGNA RE O APPLICANT DEMOL ❑ VALUATION S APPROVALS DATE INSPECTOR 8 SIGNATURE P C PMT . y FOUNDATION LOCATION FEE S FEE S ,.S-o FORMS MATERIALS FRAME FIRE STOP% I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE 18 CORRECT AND AOREE TO COMPLY FURNACE LOCATION WITH ALL ORDINANCES AND LAWS WITH BUILDING CON GAS VENT DUCTS STRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH INT LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMENS COM TION BURANCL LATH EXT 7 SIGNATURE OF HOUSE NUMBER COR PERMITTEE RECT AND POSTED ADDRESS FINAL L PLAN CHECH VALIDATION CK M O cAeN _ JOHN F LEWIS PRINCIPAL STRUCTURAL E N PERMIT VALIDATION CK M o AGN 47;2 f?EG 1 D 2 3.50- 0 PLE �1. _ ��I,'^ . 1 3• 6135 S]P' : 'I'I I'o? � ' ,. W AIPP 711A619A CC#80S-t-et COUNTY OF LOS ANGELES BUILDING O DEPARTMENT OF COUNTY ENGINEER ADDRES BUILDING AND SAFETY DMSION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A.JENSEN SUPT OF BU LDINO CROSS ST. CT N403 GROUP TYPEP CES BY FOR 1APPLICANT TO FILL IN � CONST. ADDRESS -�/ �! STATISTICAL CLASSIFICATION SEWER MAP �•- BK ' CLASS.NO. VWELL.UNITS LOT NO. 1,-: BLOCK WATER NOT REQUIRED RECEIVED CERTIFICATE: Ll TRACT /SpJp' NOP D (IGHWAI STATE MAJOR SECOND, LOCAL NO.OF BLDG . SIZE OF LOT / //• �fO I NOW ON LOTS USE ZONE SPECIAL USE OF / CONDITIONS EXISTING BLDG. • Of O �L� 9 TEL. T t f OWNE �<74SIZACL OCIfYI(to NO. C / BUILDING EXIST. I * s SETBACK YARD HWY STREET NAME WIDTH ADDRESS Yy�'j (/11P�,J f-7•L ;FRONT / ARCHITECT OR L"'` - TEL. P. L. ENGINEER �• / C'C1 LJ lL•L• NO. � L SIDE P. L. ADDRESS 6-G- ! „J1. �L-a.+ c"M�:.'F rL' I • a- CONTRACTOR(y1�ItC' 4; .��> `- TEL. * ' SPECT�O RECORD 0 ADDRESS c�J DESCRIPTION OF WORK 2 ,/ a NEW ADD ALTER REPAIR DEMOLISH f N SO.FT.. NO.OF NO.OF y d e. r' Z IZE pix. STORIES FAMILIES USE OF C' A,`b' �" /_ a d /t.•' STRUCTURE6lpaiv 04.- �,;:! /r t G I SIGNATURE OF f �' � �'' ' � ^ �'✓IJ , APPLICANT •� �j.'S.[� L'' VALUATIONS j L"4� ;i•(� APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. SQ I'OJNDATION:LOCATION , FEE $10 FEE $ FORMS,MATERIALS I"RAME: FIRE STOPS,._ I - 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING,BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY I URNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTIO P•I:ERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I ILL NOT EMPLOY ANY RSON IN VIOLA- LATH, INT. yr TION OF IHE LABOR OF THE STATE OF IFORNIA RELAT- ING TO WORKME NtAtll N,EXT. SIGNATUR G�ZHOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL CLYDE N. DIRLAM, PRINCIPAL STR RAL ENGINEER PLAN CMCK VALIDATION CK; M.O. CASH PERMIT VALIDATION cK. M.D. CASH WORKERS COMPENSATION DECLARATION 7f 1 hereby affirm that I have a certificate of consent toself APPLICATION FOR BUILDING P E RM I T Insure or a certificate of Workers Compenstion Insurance or a certified copy thereof(Sac 3800 Lab C ) , t Poh cY Nn.�/7ra�l/C �`i TC /r�iJ,� BU WI COUNTY OF LOS ANGELES BUILDING AND SAFETY ompany f"—Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS �� . ❑ Certified copy is filed with thewwty budding inspec BUILDING tion department n ADDRESSSEX 4440 LOCALITY date tts- LApplicant M is<d �lNe� CITYZIP CROSS NEARE STT l CERTIFICATE OF EXEMPTION FROM WORKERS NO OF BLDGSN ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for oneTRACE 810CK LOT NO'3 } USE ZONE NO hundred dollars($100)or less) e TEL ��?�' SPECIAL O I certify that in the performance of the work for which this OWNER , NO 3 �3 CONDITIO � NS permit is issued I shall not employ any person in any manner �2 DISTRICT GROUP TYPE FIRE ED BY V so as to become subject to the Work rs ompensation Laws ADDRESS \ fT 0!//�' �r D CONST ZONE S v Dote1� ';��L Applicant ARCHITECT OR CITY ZIP EL STATISTICAL CLASSIFICATION APT CONDO W NOTI TO APPLICANT If after ma g this Certificate of Exemption you should become su jecf to the Workers ENGINEER NO CLASS NO-,Z-,'2_- DWELL UNITS IL Compensation provisions of the Labor Code you must forth ADDRESS SEWER MAP with comply with such provisions or this permit shall be deemed revoked CONTRACTO JA-JAPAdG o — BK LPG VALIDATION LICENSED CONTRACTORS DECLARATIONLIC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS O✓ NO ALUATION (commencing with Section 7000)of Division 3 of the Business and LIC Ov 6 Professions Code and my license is in full force and effect CITY lr/4 CLASS $ / SQ FT NO OF NO OF CHECK License Number / Lic Class_ SIZE STORIES I FAMILIES ONE ❑ $ /..�� DESCRIPTION OF WORK M 61 S-4 .ei NEW Contract Date ADD ❑ 1 am exempt froo4e licensing requirements as I am a L eA-- J%piretiC licensed architect or a registered professional engineer ALTER FINAL DATE i,.��' acting in my professional capacity (Section 7051 REPAIR ❑ Business and Professions Code) USE OF EXISTING BLDG DEMOL ❑ FINAL Lic or Reg No Date APPLICANT TEL By OWNER BUILDER DECLARATION PRINT NO 1 hereby affirm that i am exempt from the Contractor s License Law for the following reason (Section 7031 5 Business and ADDRESS Professions Code) i�3 BUILDING El I as owner of the property or my employees with ADDRESS G wages as their sole compensation will do the work and LOCALITY y Q the structure is not intended or offered for sale(Section 7044 Business and Professions Code) MOVING TEL -23837A E] I as owner of the property am exclusively contracting CONTRACTOR NO y17'+�Z with licensed contractors to construct the project (Sec ADDRESS #r• • • • • 1 tion 7044 Business and Professions Code) + CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAL SETBACK FROM WIDTH 2 ie 1 8r7 0 0 I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued PL '!• 187005 (Sec 3097 Civ C ) SIDE PL � 04,30,-82 $ Lender s Name i � ) { �PC Fee$ ate" �O Permit Fee i 1 D i I Lender s Address I certify that I have read this application and state that the Issuance Fee sV above information is correct i agree to comply with all County Investigation Fee ordinances and State laws relating to budding construction Total Fee 7, B and hereby authorize representatives of this County to enter upon the above menti ed property for inspection purposes L/ SEE REVERSE FOR EXPLANATORY LANGUAGE �i pC Q G 7 7/ Signature of Appli or Agent Date ®s • - _ APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUItAING DD SS 1 hereby affirm that I have a certificate of consent to self Insure BUILDING GESS a or a certificate of Workers Compensation Insurance or a Cortf N CLA44 AVE-: copy thereof(Sec 3800 Lab C) �YTV•a.,, rc LP Q(7780 LocA 7 Policy No l Can SIZE OF LLOT'It'� NO OF BLDGS NOW ON LOT ❑ Certified copy Is hereby furmshed NEAREST CROSS 87 ❑ Certified copy is filed with the county building Inspection TRACT BLOCK LOT NO � K p _f USE ZONE MAP NO Date plicant ASSESSO4 / '00 Q :L�v SPECIAL CONDITIONS / CERTIFICATE OF EXEMPTION FROM WORKERSOWNER NO COMPENSATION INSURANCE S 'P4-C OWLCIFL�LSS. -1 -(WI WITHIN 1000 FT OF SCHOOL? ' No AIRRE88 DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY (Thar sedan need not be completed d the permit Is for one hundred 34.GCA. �_ CAVIA�� x.11 t dollars($100)or lase) I certrfy that in the performance of the work for which this Fermat CITYT ASA ZIP 6171 (( O ,„ / Is Issued I shall not employ any person in any manner so as t0 , ,//r become Subject t0 the Workers Compensation Laws ARCHITECT OR ENGINEER TEL NO QA'N Vic SZWC^A0 '404Sbr/ F71,4 771-617$ STATISTICAL IFICATION APT CONDO Date Applicant ADDRESSSTC L - g CLASS NO DWELL UNITS NO710E TO APPLICANT If after making than Certificate of IAO N 4+0'N eoU Awa REQUIRED TOTAL SEE��II��CCKK FROM EX18T Exemption you should become subject to the Workers CONTRACTOR TE N SET BACK YARD HWY PROfi-iTNE WIDTH Compensation provisions of the Labor Code you must forthwith ` 18 FRONT ACC f.AT comply with such provisions or this permit shall be deemed revoked ADDREE— uC NO �� P L LICENSED CONTRACTORS DECLARATION SIDE66W -461 S CITY LIC C PL I hereby affirm that I am licensed underproviSarE of Chapter 9 at SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO FT SIZE rNO OF STORIES NO OF FAMILIES Professions Code and m3L lowse is in full force and NEW ❑ SK PG ► 1 1ITAL 432.9'—t NWnber La Class DESCRIPTION OF WORK ADD ❑ TrAtaMONj CHECK �r� . t. C VI°��gt� ALTER ❑ $ 8� DO , ArCc.EtftfSltl'��/ E3 am exempt under Sec REPAIR ❑ B&PC for this reason DEMOL ❑ $ ICE GQX A GT t0 y SLOG LDMA P/C# 1,1 oft, DatA1 — - USE OF E> ny-C OPFtGE URM ❑ � AM1i a Signatu21 re CANT IPRINTI TEL NO LOMA Perm# COO 131 as owner of the property or my employees with wages as S 1k IL r t 777 lr77 f Z their sole compensation will do the work and the structure is ADDRESS O TOTAL 1544-58 rat Intended or offered for sale (Section 7044 Maness ars O N C1x![ S'Ca. 20 FINAL _ CHECK 544 98 Professions Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MNERIAL ❑ 1 as owner of the property am exclusively contractmg with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE QCMGE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY > .10 licensed contractors to construct the project (Section 7044 YES 13No❑ Business and Professions Code) WILL THE INTENDED USE OF THE rUIDlA10 BY THE APPLICANT OR FUTURE BUILDING &90-V CONSTRUCTION LENDING AGENCY D��REQUIRE A PERMITFOR CONSTRUCTION DR MODIFICATION FROM THE soR on-owl 11/ 9/94 COAST AW QUALITY MANAGEMENT DISTRICTQM (BCAD)SEE PERMITTING CHECKLIST FOR GUIDELINES I hereby affirm that there is a construction lending agency for 76Q 1 PM 12°29 w the performance of the work for which this permit is Issued(Sec YES[3 No❑ IHAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMRTN9 N 3097 CIV C) CHECKLIST I UNDERS`MD MY REQUIREMENTS UNDER THE LAS ANGELES COUNTY CODE Lenders Name M rEERIAL REPORTIING AND�0 2B LININ i00 ERRMMIT GH 2F�4T CONCERNING HAZARDOUS E SCAOMD Lender a Address o OWNER OR MEM I certify that I have read this application and state under penalty 8 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 construction and hereby authorize representatives of this County ISSUANCE FEE ter on the above mentioned property for Inspection purDoses p� m 1q INVESTIGATION FEE TOTAL FEE , .061 t 1 %5 SEE REVERSE FOR EXPLANATORY LANGUAGE