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HomeMy Public PortalAbout6658 OAK AVE_Building__ A ROAD DEPT. PER-MIT IS- .RE^U!RED. FOR ANY /MATERIAL 51:RAGE OR WORK DONE IN THE ROAD RIGHT OF WAY. MOM CIC#eoe8.W APPL.ICA`fI®N FOR BUILDING. PE.RMI'T'' �. COUNTY OF LOS ANGELESBUILDING Ao DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING'AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. DISTRICT NO. GROUPTYpE P SSED BY FOR APPLICANT-TO FILL IN CONST._. BUILDING STATISTICAL CLASS(• (CATION S ER MAP ADDRESS HK - , PG CLASS.NO-�DWELL..UNITs I MAP STATE LOT NO: Q4ftw. BLOCK' y NUMBER HWY. YES' O TRACT USE ZONE SPECIAL' NO.OF BLD.GS. �j _ CONDITIONS SIZE OF LOT I NOW ON LOT I USE OFG y�r y_ _ EXISTING BLDG 6 fi �" - BUILDING EXIST. r SETBACK WARD HWY STREET TAME WIDTH OWNER v FRONT MAIL .� P.L. ADDRESS 0A SIDE TEL. P.L. CITY NO• INSPECTION RECORD ARCHITECT OR TEL. .. _ ENGINEER NO. ADDRESS CONTRACTO T6 ADDRESS DESCRIPTION OF WORT{ NEW ADD ALTER REPAIR DEMOLISH q t� SQ. FT. NO. OF NO. OF //YS :� I//1-1JUT /9-/'A1,7_ - SIZE STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF APPLICANT 00� /��1/� APPROVALS DATE INSPECTOR'S SIGNATURE ADDRESS ��//�/ FOUNDATION:LOCATION FORMS,MATERIALS • VALUATION $ 0 I FRAME:FIRE STOPS, BRACING,BOLTS P.C. PMT. FURNACE:LOCATION, FEE $ FEE $ GAS VENT DUCTS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH,INT. PLICATION ANDHWK-SAT THE ABOVE IS CORRECT AND AGREE TO COM Y WIT ALL COUNTY ORDINANCES AND LATH,EXT. STATE LAWS EGU NG BUILDING FONSTRUCTION. SIGNATURE OF / HOUSE NUMBER COR- PERMITTE RECT AND POSTED ADDRESS FINAL 47 7L CLYDE N. DIRLAM, PRINCIPAL-STRUCTURAL EN ER .PLAN CHECK VALIDATION CK, 1A-'o• CASH --1 PERMIT VALIDATION : CK, M'6' - a$ 9S1D . APB, 7 1.A.. G.00 " '0 78A689A C6�908`6.ao APPLICATIONTOR BUILDING: PERMIT.- COUNTY 1E.RMIT -COUNTY OF LOS ANGELES. BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING.AND'SAFETY'.DIVISION LocALI JOHN A. LAMBIE. COUNTY ENGINEER t NEAREST CASSATT D. GRIFFIN_SUF•r OF BUILDING CROSS ST. DISTRI T NO. GR P yYpE PR CESSED.BY FOR APPLICANT TO FILL IN + . . coNsr. BUILDING STATISTICAL.CL%SSIFICATIONSEWER MAP - ADDRESS .• - L, /1 '�.,� BK PG �-• CLASS.NO. 'DWELUNITSI LOT NO. 004 WIN dy 44 BLOCK L MAP -Z�'Q� ' STATE ;YES NO , NUMBER.. HWY. TRA C1 � & USE ZONE SPECIAL. NO.OF BLDGS. CONDIT-IONS SIZE OF LOT I NOW ON LOT. USE OF EXISTING BLDG. BUILDING EXIST. SETBACK• YARD HWY STREET NAME -DDTH W OWNER • I- .' FRONT; �� MAIL i• . . P:L. o�Q :`L+CJ ADDRESS SIDE- d.. TEL. P.L. `... CITY �JAAA A-01Al /t/e. NO. INSPECTION RECORD ARCHIT CT OR r TEL. ENGINEER NO. ADDRESS f n /"/7LAK Am J - ' TEL. n CONTRACTOR '// j N f) %i/ILL -/:fid 1,39 ,R.M.lp, ADDRESS < « .�./ / w'!«' ►II�IL�'f� 'y DESCRIPTION OF WORK ' L.b ISL R, .Y, /�'i j,. o%►' NEWOTD-D—' ALTER, REPAIR DEMOLISH SQ. FT. NO. OF NO. OF SIZE - STORIES • FAMILIES USE OF •STRUCTURE GAO.• - vr- n SIGNATURE.O ,p t APPLICAN 97 f �j^ �- APPROVALS DATE INSPECTOR'S•SIG,NATURE ADDRESS FOUNDATION:LOCATION /,� d,Y /.• ^V, FORMS,-MATERIALS /Z rJ J�/,�;ftf r:.�!.•siti,t_". VALUATION $ I FRAME:FIRES, qq y i BRACING,BOLTS j-21;-f,? FURNACE:LOCATION, '� �i • P.C. PMT. � �� GAS VENT,DUCTS- , T FEE S I FEE S.:l +�••: 1 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 rl _ STATE'LAWS REGULATING BUILDING CFNSTRUCTION. -LATH,EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEFL RECT AND POSTED ADDRES k t FINAL CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL EI�JMV12gR PLAN CHEC VALIDATION CK. M.O. CASH PERMIT,VALIDATION ' CK. M•0 CASH U "' 75"' r 5 c 5 1 �� 3.00 �' APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUIL=ADDRES I hereby affirm that I have a certificate of consent to self insure, BUIVC ADDRESS G or a certificate of Workers'Compensation Insurance,or a certified �� AVC- copy thereof(Sec.3800,Lab.C.) CITY r� n ZIP Q Policy No. Company �c � c C� /go LOCALITY SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACTBLOCK LOT NO. department. 00,00 p Q USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL S322- 636 SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWN TEL NO. COMPENSATION INSURANCE IIV C fy Wi�N WITHIN 1000 FT.OF SCHOOL? VES NO (This section need not be completed if the permit is for one hundred ADD S r AY 1. dollars($100)or less.) 9 6J 8 ©A Avg • DISTRICT GROUP CONST. IRE ZONE PROCESSED BY I certify that in the performance of the work for which this permit ( C CITY ZIP XTYf^�7` �'o A is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. �J become subject to the Workers'Compensation Laws. STATISTICAL CLAS IFICATION I APT CONDO Date Applicant ADDRESS CLASS I DWELL UNITS NOTICE 70 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. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION SIDE CITY LIC.CLASS PL I hereby affirm that I am licensed underprovisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES SEWER MAP C Professions Code,and my license is in full force and effect. I NEW BK PG , C DESCRIPTION OF K VALUATION License Number Lic.Class _ ADD ❑ Contractor Date Q ® Q ALTER ❑ D�1 O d C❑ I am exempt under Sec. b - REPAIR ❑P BAP.C.for this reason wood DEMOL ❑ U _ USE OF EXISTING BL LDMA P/C# ` Date URM ❑ AIX all,- u Signature APPLICANT( NT EL NO LDMA Perm# 11 u I k c w 4 663 I, as owner of the property, or my employees with wages as Z their sole compensation, will do the work and the structure is ADD E S ' jam 7^ 1 i�'EM_, not intended or offered for sale (Section 7044, Business and k AVS. /�' p(er Cr C FINAL DATE Q _ Professions Code.) f �/J�� 1 I t;AL 67 .20 WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL 1!+l v/ ❑ I, as owner of the property, am exclusively contracting with ORA NTS SPE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Q r 20 f AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY � C;HE[;�'� t!7 a iL' licensed contractors to construct the project (Section 7044, Business and Professions Code.) Yes 11 NO❑ 19t3G�J.I ISI-) }},�� WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING �:f1 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES y I hereby affirm that there is a construction lending agency for YES❑ NO❑ `}s It-ILi—IJi.;�l N the performance of the work for which this permit is issued(Sec. W I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING ^e ) 1 ! a ? a 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. i 11 1 e t,i i i 1 TITLE 2,CHAPTER 2 20 SECTIONS 2.20.100 THROUGH 2.20 140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. o Lender's Address p OWNER OR AGENT c 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 '30�, N with all county ordinances and State laws relating to building Q V 9 construction, and hereby authorize representatives of this County ISSUANCE FEE J t_,t c' /gyp enterupon the above-mention�roperty for inspection purposes. f!(� 7 m I/�� INVESTIGATION FEE TOTAL FEE r V 4lpuwm of n1« Ome (v SEE REVERSE FOR EXPLANATORY LANGUAGE APPLI ,JRPUILDING PERMIT COUNTY OF L _ __.i �' '' UILDI G AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDR t� I hereby affirm that I have a certificate of consent to self insure, F13UI1,DING DDRESS h J or a certificate of Workers'Compensation Insurance,or a certified � r copy thereof(Sec.38,00,Lab.C.) r � ` ^� Z 61 LOCALITY Policy N0. ! Company COT, SIZE-01:LO NO OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST- ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. USE ZONE MAP NO. de,p�'art.��m,e��.n.t`�.T& i Date Applicant V-10 1-4-1, �1, OE ASSESSOR MAP BOOK PAGE PARCEL VIII 1111I SPECIAL CONDITIONS / CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO COMPENSATION INSURANCE figAlbla WITHIN 1000 FT OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred A DRES� l L l �� J7 DISTRICT GROUP TYPE. FIRE ZONE PROCES dollars($100)or less.) C1W ZIP 7A9 I certify that in the performance of the work for which this permit is issued, I shall not employ any person in-any manner so as to ARCHITE OR ENGINEER TEL NO. become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO._A,17 I , DWELL UNITS NOTICE 70 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 forthwithFRONT comply with such provisions or this permit shall be deemed revoked. ADD SS LIC.NO. PL }• LICENSED CONTRACTORS DECLARATIONIL ITY — LIC.CLASS PILE C) I hereby affirm that I am licensed underprovisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business and SO.FT. I N .OF S O ES NO.OF FAMILIES SEWER MAP s J M Professions Code,and license is in full force and effect. �- NEW ❑ BK PG ACCT.v O License Number Lic.Class 3, DESCRIPTION OF WORK ADD VALUATION , 33 -+ c c tU Contractor Date Z D" _ Arin ALTER ❑ �,� � ITE�ifi 1 OC► 119 a. .� •❑ 1 am exempt under Sec. REPAIR ❑ $ TOTAL 1005.59 BAP.C.for this reason I = DEMOL ❑ H LDMA P/C# CHECK 1005.59 Date: OF EXISTING'/'H'k>�OGG�l URM 11 }}f�`HAHGE .0ti0 Signature APPLICANT(PRINT) T L LDMA Perm# +• El1, as owner of the property, or my employees with wages as ai Z their sole compensation, will do the work and the structure is ADDRE k-teonot intended or offered for sale (Section 7044, Business and FINAL DATEQeys � `Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL \��� AL 0011. '4+ TTCF11 `` l a i•� OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE 1 ITEMS 17 ❑ 1, as 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, YES❑ NO❑ TOTAL AL 12??a3` Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING {� � OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CHECK 1i.-+.a 3C CONSTRUCTION LENDING AGENCY COAST.AIR QUAUTY MANAGEMENT DISTRICT ISCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES CHANGE .00 I hereby affirm that there is a construction lending agency for YES❑ NO❑ the performance Of the work for Which this permit is Issued(Seo. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING ' 3087,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, �{�,-j{y�ry(-�r,•i 4/30/96 TITLE 2,CHAPTER 2.20 SECTIONS 2 20.100 THROUGH 2 20.140 CONCERNING HAZARDOUS 4 0001 �VlLtllt0 J rreP333� Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. e; Lender's Address OWNER OR AGENT b 119 1 AM 10°57 G: I certify that I have read this application and state under penalty P.C.FEE PERMIT FEE of perjury that the above information is correct.I agree to complyf�0 a-� w with all county ordinances and State laws relating to building J .7 m construction,and hereby authorize representatives of this County ISSUANCE FEE to enter upon the abpve-mentioned property for inspection purposes. �• o �' INVESTIGATION FEE TOTAL FIEa a - S m Aoa l �• / SEE REVERSE FOR EXPLANATORY LANGUAGE