Loading...
HomeMy Public PortalAbout6150 OAK AVE_Building__ DEPA►84N�'! OF COUNTT BNGMEM . • --.pmmON OF BUILDING AND SAFETY coven of mm ANGmm ,,., WILLIAM J. FOX. COUNTY ENGINEERS APPLICATION CASSATT D. GRIFFIN, SUPT OF BUILDING FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDINGDISTRII 0. PLAN CK.on REc.No. PERMIT NO. ADDRESS (ApSiO jj � LOCALITY 7 .4 E C j75 E ED BY DATE O APPL,/ D TE SSLL cHEAR e s L v G lt' G L: �t BUILDING I /A � f VIK OWNER !i A �iN ADDRESS ,/ �1 �.m■i MAIL rr i/ LOCALITY ' / (.S / ADDRE+S-S� 10 Y NEAREST CITY 1 L E 6 T ' 9 3 CROSS ST. ARCHITECT OIi " ' 6 ZONE I wUP PLANS I I FIR NO. OFG ENGINEER C7 ADDRESS , n! 1 r •� L 5 T L'a N 'IFL� BLDG. LINE r O• CONTRALTO LES 0 OL• T 3 USE APPROVED ZONE 4. BY DATE ADDRESSOAK r i E LE C � , AHOUB°E-NUMBERING LEGALMAP NUMBER QP�0 3+ NO.ASSIGNED BY DESCRIPTION I LO Id .,/a I BLOCK : , CORRECTIONS TRACT- p. I Via' 17 SIZE OF LOT 57 x NO0.WOF RLDGIr ON LOT /YO 71��/ USE TI NO.OF ��<< UPJ L�(N 1 y F7[n'�` EXISTING BLDG. FAMILIES DESCRZp'1TON OF WORK O - NEW ALTERATION ADDITIONS Z REPAIR DEMOLITION i r SQ. FT. NO.OF -S 614-, �?0 2A.rs Nar­i SIVE, / ROOMS STORIES 'RiI °°oES T v LL COVERING -? �/jh /?R, ,'t��T / �fI4 USE OF STRUCTURE ✓.ems° ��—� /a-1/�3 /�)n—N /Fi�D!! Pte+ s nn n-2 APPROVALS Il v'a INSPECTOR'S SIGNATURE DATE FOUNDATION:LOCATION FORMS. MATERIALS / I HEREBY ACKNOWLEDGE THAT I HAVE,READ THIS AP- _ FRAME: FIRE STOPS, PLICATION AND STATE THAT THE INFORMATION GIVEN IB. BRACING. BOLTS 1 CORRECT. I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE:LOCATION. AND STATE LAWS R ILDING'CONSTRUCTION. GAS VENT. DUCTS SIGNATURE O LATH, INT. 0 . PERMITTE • ° - LATH. EXT. e ADDRESS" PLASTER, INT. AUTHORIZED AGT. ` f PLASTER, EXT. $ ©�� O7 FEE E HOUSE NUMBER COR-'� fff RECT AND POSTED � VALUATION O p FEE s FINAL / r 76AG38A DBS 3 9-Si // - APPLICATION FOR BUILDING PERMIT ' COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN 1 BUILDING ADDRESS / BUI DING ADDRESS ��✓ra I hereby affirm that I have a certificate of consent to self insure, 0 or a certificate of Workers' Compensation Insurance,or a certified Al aA /'f Ve copy thereof(Sec.3800,Lab.C.) CIT C zip / LOCALITY Policy No. Company SIZE OF LollNO.OF BLDGS.NOW ON LOT El Certified copy is hereby furnished. NEAREST CROSS ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' ow TEL COMPENSATION INSURANCE U r S vim' —.2� Yes No 3 WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred A D ESS dollars($100)or less.) �kb Al/ DISTRICT GROUP Tr CONST. FIRE ZONE PROCESSED BY I certify that in the performance of the work for which this permit CITY ZIP �y _ is issued, I shall not employ any person in any manner so as to ARCHITECT ENGINEER EL NO. become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. 1=d I 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 LINE WIDTH Compensation provisions of the Labor Code, you must forthwith AJ 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 EWER MAP (commencing with Section 7000)of Division 3 of the Business andSQ. NO.OF STORIES NO.OF FAMILIES } Professions Code,and my license is in full force and effect. Q NEW BK PG C License Number Lic.Class DESCRIPTION OF RKDD ❑ VALUATION pop- 4.O Contractor Date �' ALTER 11 $ � ~ c: ❑ I am exempt under Sec. -Srti REPAIR ❑ $ co BAP.C.for this reason DEMOL ❑ LDMA P/C# Date: USE OF EXISTING BLDG URM ❑ Ignature APPLICANT(PRINT) TEL NO. LDMA Perm# I,as owner of the property, or my employees with wages as Z their sole compensation, will do the work and the structure is ADDRESS O not intended or offered for sale (Section 7044, Business and FINAL DATE a L,_+_= 1.4 y 0 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL -T OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J -Y�-'•- ❑ I, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? "BY ��licensed contractors to construct the project (Section 7044, YES❑ No _ �''—jBusiness and Professions Code.) _WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDINGOCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH / 4.4"�i„:.•E L2CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FORS( )GUIDELINES ` rjG` nc I hereby affirm that there is a construction lending agency for ves❑ No❑ Q CIA the performance of the work for which this permit is issued(Sec. O� 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. �, r f C+ 9/9- Lender's /�,! CM TITLE 2,CHAPTER 2 20 SECTIONS 2 20.100 THROUGH 2 20 140 CONCERNING HAZARDOUS LIQ i 1�+_I)lil1 ,/f }�/ £- Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD o Lender's Address =-� i j6 C) OWNER OR AGENT o I certify that I have read this application and state under penalty 4 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 m construction, and hereby authorize representatives of this County ISSUANCE FEE // C9 o t r upon the bove- entione perty for inspec �(,C 1 m v INVESTIGATION FEE TOTAL FEE a A�,e v rorni ✓ SEE REVERSE FOR EXPLANATORY LANGUAGE