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Home My Public Portal About6417 OAK AVE_Building__ 76A636A CE 0803 12/69 APPLICATION FOR BUILDI PERMIT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL• BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS AW e COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST Print ort a onl CROSS ST. DISTRICTO G 91dP TYPE PR C S BUILDING (�J(% j/ CONST., ADDRESS 6 Oak Avenue 'STATISTICAL CLASSIFICATION SEWER MAP LOT NO. BLOCK CLASS NO. F� DWELL,UNITS BK�P� TRACT USE ZONE MAPZ o NO.OF BLDGS. NO. l/ SIZE OF LOT NOW ON LOT SPECIAL USE OF V CONDITIONS EXISTING BLDG. OWNER Mrs . 0 W. KenniCOtt NO. BLDG.SETBACK FROM ADDRESS Same FRONT PROP.LI NE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY HIGHWAY WIDTH FROM C.L. ARCHITECT OR TEL. + _ ENGINEER NO. BLDG.SETBAC"i'r ADDRESS SIDE PROP.LINE OF (STREET) TELCONTRACTOR Virgin Roof Co. NO. 287-0507 HIGHWAY TYPE OFEWIDTIHG FROM CCL HIGH YARD = TOTAL LIC. ADDRESS O,1 + — c LIC. c CITY San Gabriel CLASS C^39 CORNER CUTOFF YES ❑ ' NO ❑ C CONSTRUCTION-LENDER NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS. ADDRESS SQ. FT. NO. OFNO. OF NEW ❑ SIZEUSE OF STORIES l FAMILIES ADD ❑ STRUCTURE Rel-00f Wi.th hot roof ALTER ❑ materials REPAIR® SIGNATURE OF APPLICANT DEMOL ❑ VALUATION S 48g.00 APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE S FEES FORMS, MATERIALS FRAME: FIRE STOPS,• 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH .'ALL ORDINANCES AND LAWS REGULATING 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 WORKMEN'S COMPENSATI INSURANCE. LATH, EXT, SIGNATURE OF _ � HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL JOHN F. LEWIS. PRINCIPAL STIR RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH - PERMIT VALIDATION CK. M.O. CASH l:A(,-'7 .9 '1� BEC 7 1 D 0.0 'SA 638A CE#808-7.98 APPLICATION FOR BUILDING PERMIT BUILDING AND SAFETY DIVISION BUILDING /' 9 Deportment of County Engineer ADDRESS . County of Los Angeles LOCALITY JOHN A.LAMBIE. COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN.SUPT OF BUILDING C0OSS ST OR APPLICANT TO FILL IN DISTRICT NO. GROUP SEWER MAP. F ITYPE CONST IIf ---BK _W4G BUILDING G STATISTICAL CLASSIFICATION ADDRESS I v I / CLASS. NO. DWELL. UNITS LOT NO. BLOCK MAP STATE NUMBER Hwy YES O TRAC_ J USE ZONE . SPECIAL 17N481 NO.OF BLDGS. CONDITION SIZE OF LOT::rA I NOW ON LOT ] USE OFG jj LrV EXISTING BLDG. �L. BUILDINGEXIST. /� ,/ �r SETBACK YARD HWY STREETNAME WIDTH OWNER .Q11AAL SS //Ef7�J f GfoT I FRONT MAIL / P. L. G•P ADDRESS' !D QA& IJ�TEL // AAp SJDE a CITY I. PZC L'(T y NO.ITI 7H4 I6 P. L. r INSPECTION RECORD ARCHITECT OR TEL. ENGINEER NO. �. ADDRESS CONTRACTOR 14tH D'a TOL-�� " S ADDRESS 6. d Zv 4.-E,L/LfD DESCRIPTION OF WORK NEWyQADDALTER REPAIR DEMOLISH S ZE -9?/ STORIES f FAMILIES USE OF STRUCTURE SIGNATURE OF APPROVALS `9 APPLICANT t DATE INSPECTOR'S SIGNATURE ADDRESS FOUNDATION:LOCATION ��!!�, �!��g� FORMS, MATERIALS 'Z YUIr/L/ L/! FEE $ m 6 4v FRtiFIRE STOPS, 1 BRACING. BOLTS $ ®(� FURNACE: LOCATION, VALUATIOR FEE GAS VENT. DUCTS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH. INT. fY.��'•�ilY i�i�i'' PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE.TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH. EXT. STATE LAWS REGULATING BUILDING COCTION. SIGNATURE OF ` HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADORES AVIII/ FINAL 'OHN A.LAE.COUNTY ENGINE R. CLYDE N. DIRLAM, PRINCIPAL STRU URAL ENGINEER 1LAN CHECK VALIDATION CK. M.O. CASH PEELMIT VALIDATION C M.O. �-CASH L� 7 if 0 0 APR.2.2 1 6 1 2,0 0 d la �U LACO7 5 0'2 APR.24 1 2 4.0 D in V.7RKERS'COMPENSATION DECLARATION hereby affirm that I have a certificate of consent -self APPLICATION FOR B U I L QI-aJ-G PERMIT . - insure,or a certificate of Workers'Compenstion Insurance,or '1,/ a certified copy thereof(Sec. 3800, Lab. C.) Policy No. Company N COUNTY OF LO AN � � AND SAFETY BUILDING / Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS 6 Certified copy is filed with the county building inspec- BUILDING - tion department. ADDRESS / A/ 09L LOCALITY NEAREST .Date Applicant CITY ZIP 91,,J ,:�, CROSS ST. O!t/ �/i'✓ CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ,.ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL '..(This section need not be completed if the permit is'for one USE ZOf�E MAP a hundred dollars ($100)or less.) TRACT BLOCK LOT NO. �i 3 NO. 1 TEL. _Aq// U SPECIAL I certify that in the performance of the work for which this OWNER , p Gly/ NO. l�l�� CONDITIONS O permit is issued, I shall not employ a rson in any man r D STRICT "GROUPTYPE FIRE PR E BY (� ADDRESS2 IV so as to become subject to the Wo ers' orrpensation s. L ¢ e17 P CONST. ,,, Date 1.2-_V_ U Applicant CITY ZIP STATISTICAL CLASS ACATION APT. CONDO. `NYU NOTICE TO APPLICANT: If, after making this Certificate of � ARCHITECT OR TEL. Q=`% LU Exemption, you should become subject to ,the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS CL Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be deemed revoked. - TEL. y /r BK. PG, VALIDATION CONTRACTO %� NO.7l J Lam✓ LICENSED CONTRACTORS DECLARATION `i O /J�/ LIC, �+� I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS �' U L° dJ NO.�j � VALUATIO (commencing with Section 7000)of Division 3 of the Business andr LIC. / ` r se ® ' Professions Code, and my license is.in full force and effect. CITY r/LCG' !fa / CLASS G C:�/ $ . S� /�� C& SQ. FT... NO.OF NO.OF CHECK License Number j� Lic.Class SIZE STORIES FAMILIES ONE Contracto O69!9.r "L Date./Z 4� G DESCRIPTION OF WORK Af,6 q� !� NEW ❑ $ ' I ��^ ADD. I am exempt from the licensing requirements as I am a . ' �' ALTER FINAL ; lAl icensed architect or a registered professional engineer' z acting in my' professional capacity (Section 7051, np, _41' 0—j_ REPAIR '❑ DATE•� �J .¢usiness and Professions Code). USE OF DEMOL FINAL • � EXISTING BLDG. 'y,2—� ❑ By ' Lic.or Reg.No. Date APPLICANTTEL. OWNER-BUILDER DECLARATION (PRINT) _ d°/1� `� NO. L-J k p I hereby affirm that I am exempt from the Contractor's License 3 3 0, A Law for the following reason (Section 7031.5, Business and - ADDRESS �(� r ►'w' Professions Code): PRESENT #,° °. ° ° 2 3 BUILDING as ' I, as owner of the property, or my employees with ADDRESS 2 ° ° 2 �,6 0 wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 3 7044, Business and Professions Code). _ MOVING TEk 0 0 0 21.60 I, as owner of the property, am exclusively ontracting CONTRACTOR NO. ❑ S 1-2,04-80 with licensed contractors to construct the project (Sec- ADDRESS. tion 7044, Business and Professions Code).. REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. t (Sec. 3097, civ. C.). PIDE 233 0.2 A Lender's Name e o•0 0 0 P.C. Fee$ Permit Fee �/ if _ Lender's Address — I certify that I have read this application and state that the Issuance Fee 2 ° ° 3 4 0 0 above'information is correct. I agree to comply with all County 0 0 Investigation Fee Y 3 1LO O ordinances and State laws relating to building construction, o 1 and h au orize representatives this County to enter Total Fee upo he mentioned op t or insp on purposes. �� SEE REVERSE FOR EXPLANATORY LANGUAGE -Signature of Applicant or Agent Date ®s