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Home My Public Portal About6512 OAK AVE_Building__ A ROAD DEPT. PERMIT IS REWREb FOR ANY MATERIAL STORAGE OR WORK p DONE IN THE ROAD RIGH I .OF WAY. 78A898A CE x8098-89 APPLICATION FOR BUILDING .PERMIT 1' COUNTY OF LOS ANGELES BUILDING J 'DEPARTMENT OF COUNTY ENGINEER ADDRESS — BUILDING AND SAFETY DMSION LOCALITY' / JOHN A. LAMBIE. COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN SUPT OF BUILDING CROSS ST. DISTRIC NO. YPE SED BY CSB ) S FOR APPLICANT TO FILL IN � I coNsr C • BUILDING J_ STATISTICAL CLASSIFICATION R MAP ADDRESS 1p P /�J _CLASS.NO.�_DWELL.UNITS ;qEKG LOT NO. ' �� J ( OC ` MAP ryry STATE NUMBER v HWY. YES O TRACT i / USE ZONE SPECIAL sNO.OF BLDGS. Sj /}� CONDITIONS _ 'SIZE OF LOT D A ) 2L0, S I NOW ON LOT USE OF. BLDG. BUILDING EXIST. SETBACK YARD HWY TRE NAME WIDTH OWNER FRONT MAILP.L. ADDRESS .a - ` SIDE TEL. P.L. CITY NO. INSPECTION RECORD ARCHITECT OR .� TEL. .- ENGINEER NO. ADDRESS t CONTRACTOR 1. . NO.TEL / 6 q,19 ' ADDRESS �— DESCRIPTION OF WORK NEW ADD ALTER EPAIR DEMOLISH SO. FT. NO. NO. OF i SIZE STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF APPLICANT APPROVALS DATE INSPECTOR'S SIGNATURE ADDRESS FOUNDATION:LOCATION FORMS,MATERIALS VALUATION $ FRAME:FIRE STOPS, BRACING,BOLTS P.C. PMT2 FURNACE:LOCATION, FEE $ I FEE StJ ate- I GAS VENT,DUCTS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH,INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS EGULATING BU! DING CO ISTRU TION. LATH,EXT. SIGNATURE OF HOUSE NUMBER COR- FERMI Tr RECT AND POSTED % EN C � y ADDRESS-- FINAL y / � A Citil `f�%,7} F�Q CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL F-N PLAN CHECK VALIDATION CK. M.C, CASH PERMIT VALIDATION CK. M.O. CASH LACU 9 9 7 .0 p APR 27 1 A 3.0 0 a®9 rBBBBBA=ryBOB 2/00 APPLICATION FOR BUILDING PERMIT ' COUNTY OF LOS ANGELES BUI ElsN1 / .�` 2 DEPARTMENT OF COUNTY MGM= BUILDING AND SAFETY DMSION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST ; WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRICT NO. G ,=F- TYPE ESSED BY ; d CONST. BUILDING / STATISTICAL CLASSIFICATION S WER MAP ADDRESS ✓' / / BK PQ. �j CLASS.NO. WELL. N•iTS i• MAP 9 LOT NO. BLOCK NUMBER ► � HWY. YES O TRACT USE ZONE SPECIAL .+)-�'%� NO.OF BLDGS. CONDITIONS ( s em #a SIZE O LOT I NOW ON LOT,//s'.4J i � I USE OF +� EXISTING BLDG, hBUILDING YARD HWY STREET N ME EXIST. o+U`JNEOL I�6. SFTBONT WIDTH � h P.L. L. 43 , ADDRESS ,7,9 �s�a-SJ "pvei 13,4 ,jt),IJ � SIDE ARCHITECT OR TEL. P.L. ENGINEER NO. INSPECTION RECORD ADDRESS XCdb gni r�jfso•�4- $c�..a BOL.'— - MP a ADDRESS r� , P JP V DESCRIPTION OF WORK e+ NEW ADD ALTER REPAIR DEMOLISH SQ.FTNO.OF NO.OF SIZE 3 STORIESUSE OF FAMILIES /.-_, y STRUCTURE A SIGNATURE OF �K APPLICANT VALUATION I APPROVALS DATE � INSPECTOR'S SIGNATURE FEE $ FEE $�� "� FOFORMS.MATERLOCATIOAp C. PMT. LS N '3� ) �f /• _ FRAME:FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- BRACING,BOLTS -—2.3 -da I �. I•'( rI'%� PLICATION AND STATE THAT THE ABoOVE IS CORRECT AND FURNACE:LOCATION, AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT,DUCTS 7� n L`I.•J,/ f/k STATE LAWS REGULATING BUILDING CONSTRUCTION. 1 CERTIFY THAT 1N DOING THE WORK AUTHORIZED I LATH,INT. 42/,/7,,P7 4 WILL NOT EMPLOY NY PERSON 1 LATION OF THE s o frvr�eCeue�j WORKMEN'S, NSATIO F LI ORNIA. LATH,EXT. SIGNATURE HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ! r r U ADDRESS � (� C/ i �Ji•�v�F'( .A'�� C YD D�r LAM, PRINCIPAL TRRAL ENGINEER PLAN_CMCK VADDATION cK f M.O. CASH PE UT VALIDATION r M.O. CASH L :'�os. Zeta 1 2 3 0 2 5.5 0 ®P Uliruo Q u �...fiat�� .2)8 s D 51.0303 . APPLICATIOWFID' R BUILDING PERMIT COUNTY OF LOS ANGELES I BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS or a certificate of Workers'Compensation Insurance,or a certified copy thereoLab.C.) / TY Ca C LOCALIT Policy ' Compan SIZ OF LOT NO.OF BLD SNOW ON LOT C� ertifiEd copy is hereby furnished. NEAREST CROS ST. ❑ Certified copy is filed with the c tll y building i ection TRACT BLOCK LOT NO. de rt. ent. USE ZONE MAP NO. Da pplicant �Pi�/ ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS ERTIFICATE OF EXEMPT ROM WORKERS' ER COMPENSATION INSURANCE �0 WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred D S DISTRICT GROUPCONST. FIRE ZONE PROCESSED BY dollars($100)or less.) //'`` �� /� CITFy�C_�l ; Q 22 ZI O� I certify that in the performance of the work for which this permit p� is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. ARC ITECT OR ENGINEER TEL STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS N07ICE TO APPLICANT.• If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you Should become subject to the Workers' CONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. SS IAC.N . PL LICENSED CONTRACTORS DECLARATIONSLO& j� SIDE CIT LIC.Cl ly$S �. P L I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ. .SIZ� NO.OF STORIES NO.OF FAMILIES NEW ❑ BK PG Professions Code,and my license is in full force and elle License Numbe —� Class 1.� P?I�OF WORK /,�� ADD ❑ VALUATION �j b /� Poo. 0 Contractor ate .36 �J tel/ (T ALTER ❑ $ "�/ !! El am exempt der Sec. / f � REPAIR Q BAP.C.for this reason 1%/V 77 �� DEMOL ❑ LDMA P/C# V Date: USE OF EXISTING LUG. URM ❑ a. Signature ]CANT(PRI _ TEL N LDMA Perm# AC-C-1 .0Z ❑ I, as owner of the property, or my employees with wages as -2-11117 their sole compensation, will do the work and the structure is ADD ESS —��/ ? O �� lc•"e's5 not intended or offered for sale (Section 7044, Business and G2C-91C7 FINAL DATE G i 1',f=r Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL - rr OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J ' I k_j i AL 15o a 45 ❑ I, as owner of the property, am exclusively contracting 4AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL B licensed contractors to construct the project (Section 70444,, /. EE 1 1 C Business and Professions Code.) YES 11 NO❑ C F� f; 1 o=t WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING 1 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH l•�-}fTNUE CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ NO❑ t^ cm the perOf the Work for Wf1ICh this permit IS ISSUBd(SBC. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING ' ?(11 -0011, 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. i [� TITLE 2•CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS 6�16 i fi!1 I a Ij 1 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD, ❑ Lender's Address C OWNER OR AGENT o I 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 N with al county ordinances and State laws relating to building OG const r ctI n,and here authorize representatives of this County ISSUANCE FEE ro tQe r u n the abo entioned p rty for' ction ur es. !O T ro INVESTIGATION FEE TOTAL FEE r` sonwuibw� as � s SEE REVERSE FOR EXPLANATORY LANGUAGE