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Home My Public Portal About6423 OAK AVE_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES B V i L D I N G WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK.NO. PERMIT NO. BUILDING ''/ ADDRESS 11,9 4�Jn �)�IY e ( �/1�^• f, d Z 1 �.r /� �•� 3 LOCALITY J fY Jyf f�L/ ( 'f / �r+ RECEIVED BY /DATE OrAP/P�L.` �DATE ISSUED NEAREST GROSS G ' +�� I , ,' YJ`ri r�\, / K1 -7 J /1 (/�� /n -� '--p . BUILDING OWNER 1" + YY. f� .L')V/V .(a Q fir ADDRESSMAIL �• C��+ J'� l t./ /,C �. // y'� ADDRESS ��Y +' ,�I� 7 J)" J , /i' LOCALITY / f // f NEAREST r r1 / l I+` CROSS 9T�a,! CITY f TEL. 1 ® FIRE NO.OF TYPE GROUP- ARCHITECT OR TEL _ ZONE PLANS ENGINEER NO. r( J� ADDRESS ��(/1 SETBACK LINE y(� / fir/ -� . d?V ! 0 � APPROVED CONTRACTOR fff AIAj LJI4N .jTJJ j��,? BY DATE • ' a i USE / APPROVED r •y� i r �� °a �'�t'.` ZONE-'-�C3.0303Y DATE r1 ADDRESS ,+ LEGAL CORRECTIONS DESCRIPTION I LOST NO. -BLOCK K TRACT NO. F BLDGS. SIZE GF LOT O I NOW ON LOT EXISTING BLDG. 7rE_ !-tgy.,lF•AM L Ea I Rooms DESCRIPTI6WOF WORK NEW ALTERATION ADDITION O REPAIR MOVING DEMOLISH Bq. NO.OF Z :22 E' n ROOMS STORIES D WALL rf L��° ROOF `A' [°`/I r COVERING ,',YUBE OF NE /'. •+�4r`1/l, •f/�i yI COVERING( A�J-j �%rq—; ,• BUILDINGW 1? H / --A Cl r— /l.L�l��lL✓t(� I HEREBY ACKNOWLEDGE THAT 1 HAVE READJRRE APPROVA S APPLICATION AND STATE THAT THE ABOVE 19 COFOUNDATION: LOCATION ECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINFORMS,MATERIALS + f/ AND STATE LAWS REGULATING BUILDING CONSTRU .: FRAME: FIRE STOPS, / SIGNATURE OF �,.}• BRACING,BOLTS PERMITTER 85—« n � � r7AUTHORIZED AOT ( !L r LATH,EXT.: DBS-3 SOM SETS 7-47 $ P.C.IN PLASTER,INT. FEE PLASTER,EXT. 1150- VALUATION ( FEE .0 O FINAL 'SA698A CE#'805.7-S6 Ir°`►0 PL I C AT I O 0 V FO R' BUILDING 0 E Lq M..17, BUILDING AND SAFETY DIVISION BUILDING ` c Department of County Engineer ADDRESS _ County of Los Angeles LOCALITY JOHN A.LAMBIE. COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN. SUPT OP BUILDING CROSS ST. DISTRICT NO. GROUP TYPE SEWBEK MAPPG BUILDNG FOR APPLICANT TO FILL IN // / � - I CONST. ADDRESS 672 a p j/I /r e• STATISTICAL CLASSIFICATION LOT NO. BLOCK CLASS. NOJ-LLDWELL. UNITS-1 . NUMBER' .&6 STATE YES N TRACT USE,ZOIdE, SPECIAL ,p. Yy / J NO.OF BLDGS. • rS/JIj�J tt� CONDITIONS SIZE OF LOT,?p p X /7h NOW ON LOT r USE OF 6n"v EXISTING BLDG. Sl L BUILDINGEXIST. SETBACK YARD HWY STREE .NAME WIDTH OWNER G ® FRONT ADDRESS .�493 AL 9)CA 141 SIDE —� CITY TEArrloL-_ 0 rl� TNo INSPECTION, RECORD ARCHITECT OR TEL. ENGINEER NOo ADDRESS Z�m _ TEL.• 7.7'f7 //rd_ CONTRACTOR p�T NO.Cts/ ** 3 ADDRESS)99V6 ;&J-0Ll//5x A.T-//S.4�IJ1 tL Oh? DESCRIPTION OF WORK NEW A"/ADD ALTER. REPAIR _ DEMOLISH SQ.FT. NO.OF NO.OF SIZE STORIES FAMILIES USE OF STRUCTURE rl�X4o DBu BGS �i94Pi4(st . APPROVALS SIGNATURE OF IL L APPLICANT DATE. INSPECTOR'S SIGNATURE ADDRESS L7i' FOUNDATION:LOCATION FORMS, MATERIALSIV i ASC/ l P.C. g FRAME: FIRE STOPS. '� ✓ Q FEE BRACING.BOLTS VALUATION FURNACE: LOCATION, FEE ^" GAS VENT. DUCTS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH. INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT ANDn (�7�� AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH. EXT. .L STATE LAWS REGULATING BUILDING NSTRU ON. SIGNATURE OF HOUSE NUMBER COR- PERMITT RECT AND POSTED ADDRES FINAL 7- G Z IOHN A.LA BIE. COUNTY ENGINEER, CLYDE N. DIRLAM. PRINCIPAL STRUCTURAL ENGINEER PLAN CHWK VALIDATION CK. M.O. CASH PERMIT VALIDATIONK. M.O. CASH LAC0 7 3 9 9- rR 2 2 1 8.00 WORKERS'COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self APPLICATION F®R BUILDING, P E RM I T insure, or a certificate of Workers'Compensation Insurance, , or a certified copy thereof (Sec. 3800, Lab. C.) 'l�/'7/'7� Company �j��C_-*�� COUNTY OF LOS ANGELES ! BUILDING AND SAFETY Policy No.2-9 i . Certified copy is-hereby furnished. II FOR APPLICANT TO FILL IN BUILDING ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING / n tion department. ADDRESS Date S— Applicant I CITY ZIP LOCALITY �t ` f CERTIFICATE OF EXEMPTION F M WORKERS,' NO.OF BLDGS. NEAREST COMPENSATION INS RANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars($100)or less.) • TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL' ff (� TEL. USE ONE ) MAP I certify that'in the performance of the work for which this OWNER a S V 1� S' NO. 2 Y6��✓� NO. permit is issued, Vshall not employ any person in any manner s SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS !!!!��` CONDITIONS O j U Date Applicant CITY ZIP NOTICETO'APPLICANT; If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O ENGINEER NO. Exemption, you should become subject to the Workers' `� CONST. ZONE U Compensation provisions of the Labor Code, you must forth- ADDRESS �` W with comply with such provisions or this permit shall be 0- deemed revoked. riskee+f &/&I. t' d'y TEL. j a 8'S STATISTICAL CLASSIFICATION A CONDO. Z CONTRACTOR /Q,p Cc/ NO.yy LICENSED CONTRACTORS DECLARATION CLA55 NO. 2 DWELL. UNITS /%f / LIC. /� p I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS U Z f7V tr�Le/OD q NO.Z 1�7 0�� (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP Professions Code, and my license is in full force and effect. CITY �, C - CLASS C 9 2� VALIDATION A BK. ePG. �✓�9 tT 6O L' 3 SIZE TOR ES FAMIOLIES CONE License Number Lic.Class F,s (A e,s• W'k t -e/�N VALUATION DESCRIPTION OF WORK 44Z, NEW t ❑ 0_6Contractor /too •F C� Date 9 f Jia .-- • ADD 13 ❑ 13I am exempt under Sec. ❑ 9 5 6 A ALTER B,BP.C. for this reason REPAIR ❑ $ # e e"o 0 0 Date: USE OF DEMOL ❑ EXISTING BLDG. Signature - yv�a�J APPLICANT , TEL. ( -'o49.88 PRINT t d . F, t?v- NO. �-�-z 2 P$ FINAL .� OWNER-BUILDER D RATION n / DATE 0 0 0 4 9,8'8 5 I hereby affirm that I am exemp rom the Contractor's License ADDRESS �� Air Y v W d�( •`' Law, for the following reason (Section 7031.5, Business and FIN Professions Code): MUNIBy 0 5.Q Jr''8 8 ❑ BUILDING I, as owner of the property, ormy employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAL SETBACK 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. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name s� ?J LDMA Ref. it Lender's Address P.C.Fee$ Permit Fee J i 1 certify that I have read this application and state that the Issuance Fee �D " kA P/C# above information is correct. I agree to comply with all County Investigation Fee ? ordinances and State laws relating to building construction, • and hereby authorize representatives of this County to enter Total Fee / LDMA Perm. fi i upon the ve entioned proper, for i ection purposes. o SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applica Agent Date