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Home My Public Portal About6390 OAK AVE_Building__ ./APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN ADDRESS 3 ' BUILDING //�� ADDRESS !1 LOCALITY NEAREST CITY ZIP CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT � MAP BOOK PAGE PARCEL // � DISTRICT GROUP TYPE FIRE O SSED BY TRACT BLtk — T NO. ..rte ON ZONE TEL. 02 OWNER NO. _ STATISTICAL CLASSIFICATION SEWER MAI ADDRESS 9, ' CLASS NO. r DWELL.UNITS ' BK L 6 PG CITY ZIP U,SC�IJONE MAP �•D ARCHITECT O TSPECIAL EL. ry.`r /VY� NO. V 7&-'/P'0 / urs' ENGINEER N !,I L) CONDITWd IONS b /&—7J'— ADDRESS G� ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ TEL. CONTRACTOR NO. BLDG.SETBACK FROM LIC. FRONT PROP.LINE OF (STREET) ADDRESS NO. TOTAL SETBACK FROM TYPE OF EXISTING LIC. HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH CITY CLASS CONSTRUCTION LENDER NAME AND BRANCH O BLDG.SETBACK FROM V ADDRESS CITY SIDE PROP.LINE OF (STREET) Ow SQ.FT. NO.OF NO.OF SIDE PROP.LINE HIGHWAAY WIDTH / CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPE EXISTING U SIZE �aOD STORIES FAMILIES ONE a DESCRIPTION OF WOPK dWL!/ O O 4 NEW + Z ADD ❑ CORNER CUTOFF YES ❑ NO ❑ l ALTER ❑ ❑ IN OPEN SPACE YES ❑ NO ❑ USE OF BLDG.OF EMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NOEXI ❑ APPLICANT TEL Q S V�(� CL�% �� D/S ��%/7' (PRINT! NO. BY(SIGNATURE) 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- PENSATION INSURANCE. ' SIGNATURE O ` FINAL �j �� BY PERMITTEEfv�*j DATE ADDRES r (� TEL. ' P.C.Fee$ Permit Fee S CITY � N , O 8 Issuance Fee - VALUATION$ "7—v" Total Fee (J• Jf PLAN CHECK VALIDATIONoK. ; O: CASH PERMIT VALIDATION M.O. CASH 0 0 0 AUG. 5.21 D. ' TJ 1:0 8 ®S 76A836B CE/803B 6/76 .AUG 5 1, D'. 17 ()25.- ®`� APPLICATION FOR i COUNTY 6F LOS ANGELES BUILDING PERM IT DEPARTMENT BUILD NG AND SAFETY DIVISION ENGINEER IN FOR APPLICANT TO FILL IN ADI �G DRESSL5/O1101371C _77,, 1eY&.4 — ADDRIESS -- LOCALITY CITY NEAREST G ZIP CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT MAP BOOK PAGE /1'� _X37 DISTRICT GROUP TYPE FIRE R ED BY TRA BLOCK LOT NO. , O CONS Z� L. qq � q�, OWNER kine STATISTICAL CLASSIFICATION SE ER MAP' ADDRESS 2 CLASS NO. DWELL.UNITS `BK• zsPG CITY ZIP USE ZON9 I MAP ARCHITECT O TEL. a ' NO. ENGINEER SPECIAL CONDITIONS ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ TEL. " CONTRACTOR NO. Q BLDG.SETBACK FROM LIC. FRONT PROP.LINE OF (STREET) ADDRESS NO. HIGHWAY + YARD = TOTAL'SETBACK FROM I TYPE OF I EXISTING LIC. FRONT PROP.LINE HIGHWAY WIDTH CITY CLASS ` CONSTRUCTION LENDER + _ } NAME AND BRANCH BLDG.SETBACK FROM ADDRESS CITY SIDE.PROP.LINEOF (STREET) SQ.FT. ' �f F . NO.OF CHECK HIGHWAY .+ YARD TOTAL SETBACK FROM TYPE OF EXISTING �r11 SIZE �L� S FAMILIES ONE SIDE PROP.LINE HIGHWAY WIDTH, L. — Ln DESCRIPTION QF WORK/ N +EW ❑ ADD CORNER CUTOFF YES ❑ NO ❑ ALTER, ❑ IN OPEN SPACE YES ❑ NOUSE ❑ REPAIR ❑ EX STOF BLDG. RE AIR ❑ IN COASTAL PERMIT ZONE L� YES ❑ NO ❑ OL APPLICANT TEL (PRINT) No. BY)SIGNATURE) ` u[..�r / i 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE ' THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELArING TO WORKMEN'S COM- PENSATION INSURANCE. l _ SIGNATURE OF / — PERMITTEE ' r DATEL 6 BY ADDRESS _ TEL.JSVX? P.C.Fee$ Permit Fee CITY NO. Issuance Fee VALUATION$ _ Total Fee PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION GK. M.O. GASH 8 1 7 C,`2 FEB 24 .J; U 8S 76A688A OE/808A 6/76 APPLICATIQN FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS S7 I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS f OQ f �.,*, 3 q6 N 0 a or a certificate of Workers'Compensation Insurance,or a certified 6 3 ?0 o K copy thereof(Sec.3800,Lab.C.) CITi-- I r+ N1 ZIP �Y11 �—1 r LOCALITY Policy No. Company SIZE OF LOT NO.OF BLDG&NOW ON LOT ❑ Certified copy is hereby furnished. NEAR ST CROSS PT. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. G N S Cif dN department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWCER L p Na a 4ti g ro COMPENSATION INSURANCE C^K r"�'R ° WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS dollars($100)or less.) v5*a/1? DISTRICT GROUP -YRE ZONE PROCESSED BY CITY ZIP I certify that in the performance of the work for which this permitO is issued, I shall not employ any on in any manner so as to ARCHITECT OR ENGINEER TEL NO. O J become subject t0 the Worke 'COm en tion Laws. STATISTICAL CLASSIFICATION APT CONDO 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 Workers' TRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith *3� A,-., NL NN ( � 'cf4c-116 S 3 FROM comply with such provisions or this permit shall be deemed revoked. ADDRESS W 1(fo LIC.NO PL ANO aa SIDE LICENSED CONTRACTORS DECLARATION CITY_A _r LASS G / PL I hereby affirm that I am licensed underprovisions of Chapter 9 I�- �G- r r 'fC SQ.FT.SIZE NO.OF RIES NO.OF FAMILIES f NEW BK PG MAP PG } (commencing with Section 7000)of Division 3 of the Business and I Professions Code, d my license is in full force and effect. cl ' 0. License Nurpker Lic.Class DESCRIpoweFADD ❑ VALUATION C Contractor Date :3 0 r✓ < ��-�o S cc rt r � ALTER ❑ ❑ I am exempt under Sec. REPAIR ❑ $ C BAP.C.for this reason DEMOL ❑ LDMA P/C# W Date: USE QrqISTING BJDG. URM ❑ A.1 CL fie•GSf,d--C — r•r•r a Signature tit•`-•: =a APP T( NT) ( 7—/ TEL NO. LDMA Perm _ ❑ I, as owner of the property, or my employees with wages as v a��^ r'� / r S �._U K��,:_? their sole compensation, will do the work and the structure is ADDRE / / not intended or offered for sale (Section 7044, Business and Sp °�"� `� G�'GL c�, FINAL DATE Q .5 U S51=,::t Professions Code.) if WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL I/ O ..1 T�1=•;+� OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE •:•'=1 i� ❑ I, a3 owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044, I s p YES❑ NO i TOTAL •�••c 4 c ..� 5 Business and Professions Code.) __, _.. WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING � � �. i OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH 1-I E" CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. t•! A IGE a 1".0 I hereby affirm that there is a construction lending agency for YES❑ No W the performance of the work for which this permit is issued(Sec. IHAVE DTHEH DOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING N 3097,CIV.C.) O CH LIST.I UNDER TAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, 9 :-:•,n rr, ' Tn 2,CHAPTER 20 ECTIONS 2.20.100 THROU 2.20.140 CONCERNING HAZARDOUS 111j1i„'—s��!I��, y�,f�!•J� '7'!• Lender's Name E EP N D FOR E IT MD. r Is o Lender's Address owN Aaer 0 oI certify that I have read this application and state under penalty of perjury that the above information is correct.I agree to comply P.C.FEE �� PERMIT FEE /�� p o with,,”unty ordinances and tate laws relating to building (/ Q N m C structd hereby autho' representatives of this County ISSUANCE FEE /h a en po a ab =;%O— for inspection purposes. (p PiC —�jd'—�J INVESTIGATION FEE TOTAL FEE �' SWM—a AWN=t«AWi oma SEE REVERSE FOR EXPLANATORY LANGUAGE