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Home My Public Portal About5534 1/2 PAL MAL AVE_Building__ p ��s3�z Tewesaw ce#eos-w-se APPLICATION FOR BUILDIN P RMIT I BUILDING AND SAFETY DIVISION BUILDING Department of County Engineer ADDRESS County of Loa Angeles LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN, SUPT of BUILDING CROSS ST FOR APPLICANT TO FILL IN DISTRICT NO. GROUP TYPE � YB�Z^ J(-- CONST. BUILDING ADDRESS r7 PAL MAL A V E• STATISTICAL CLASSIFICATION LOT NO. $O• /OI OF PORT. 3�BLOCK CLASS. NO.�DWELL. UNITS / MAP Q STATE YES NO TRACT E.Jr* BALDWIN ' S ADDIT . R S . F u MB HW E S'.ECIAL Y SIZE OF LOT r 0 X 330' NOW ON LOTNO.OFS COI�PITION3 USE OF RESIDENTAL 00 EXISTING BLDG. BUILDING EXIST. YARD HWY STREET NAME SETBACK WIDTH OWNERG.L.J O HN S O N FRONMA T ADDRESS3035 S SO. EIGHTH ST. L —I SIDE CIT' ARCADIA NO.TELP. L. INSPECTION RECORD ARCHITECT OR NONE TEL. ENGINEER NO. ADDRESS CONTRACTOR F A I RL I NE CON. CM:'E D.9950 ADDRESSPO BOX 46 COVINA DESCRIPTION OF WORK NEW X. ADD ALTER REPAIR DEMOLISH SO. FT. 743NO. OF 1 NO.OF SIZE STORIES FAMILIES USE OF STRUCTi1 G{�pE S I D E N T I A L ATTATCHED GARAGE -" APPROVALS SIGNATURE OF APPLICANT �� DATE INSPECTORS SIGNATURE ADDRESS P D O X 46. C O V I N A FOUNDATION:LOCATION FORMS. MATERIALS s e O p S FRAME: FIRE STOPS. qq , P. C.�FEE ' BRACING. BOLTS Li� ' VALUATION�/ OO O s .- .SU FURNACE: LOCATION. /L `4'7FEE GAS VENT. DUCTS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH, INT, PLICATION AND STATE THAT THE ABOVE I5 CORRECT AND If_ AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH. EXT. STATE LAWS G UL/yfING BUILDIDI CONSTRUCTION. SIGNATURE OF/"LO_-�{f�l�r.... )11- HOUSE NUMBER EZ) OR- PERMITTE RECT AND POSTED aDDRESs P BOX 46, COVINA I FINAL -'7- )HN A.LAMBIE. COUNTY ENGINEER. CLYDE N.DIRLAM. PRINOIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION K. M.O. CASH PZR=VALIDAIIOM CK. M.O. CASH ..: 4 6 3 0-� NOV27 1 6 1 1 .75 A M !r/,.I !/, ;,, r/ L g 4 8 3 3 C't ' ! 2 3 .5 0 "' )NQRKERS COMPENSATION DECLARATION inure, o affum that I have a cenCome of consent to .elf APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers Compensanon Insurance, or a certified copy the Sec 3800 Lab C COUNTY OF LOS ANGELES BUILDING AND SAFETY Polity N gmpony E ❑ Cemhed copy is hereby furnished FOR APPLICANT TO FILL INHaA rC'`(T❑ Certified copy is filed with the county bulldl Q t BU� 1/ /L IDSADDRESSDare CITY C zip LOCALITY CERTIFICATE OF EXEMPTION OM WORKERS' SIZE OF LOT �ON LOT NEAREST COMPENSATION IN URANCE CROSS ST ASSESSOR (Thu section need not be completed rf the permit a for ons TRACT BLOCK LOT NO MAP BOOK pAGF PARCEL hundred dollars ($100)or Isrss ) 115E ZONE MAP OWNER u �+ No I certify that In the performance of the work far which this permit is issued, I shall not employ any pe on in any manner ADDRESS SPEOAL CONDITIONS so as to became subject to the W ers' ampemanon Laws O CITY ZIP u Dateg s f"1—Applicant ARCHITECT OR TEL I G TYPE IRE PROCESSED BY O NOTICE TO APPUG4NT If, aftIng this Nr if a of ENGINEER NO CONST Z G Exemption, you should becom subject to the Workers q � IP J Compensation provisions of the Labor Code, you must forth- ADDRESS 1I-J N with comply with such provisions or this permit shall beTa SAX> TATISTICAL CLASSIFICATIONZ deemed revoked CONTRACTOR co LC� 0 �� _DWELL UNITS_ LICENSED CONTRACTORS DECLARATION I hereby affirm that l om licensed under provisaru of Chapter 9 ADDRESS NO SEWER MAP (commencing with Section 70DO)of Division 3 of the Business LIC and Professions Code,and my license is In full force and effect CITY CIC CLASS C,.3/ BK PG VALIDATION r SO FT NO NO OF CHECK n License NumbsrUc Class C—! SIZE STORIES FawUES ONE VALUATIO 6e Contractor e-c r Dab ^ ^ Z DESCRIPTION OF WORK NEW ❑ $ ElI am exempt under Sec 6c ADO ❑ , ALTER ❑ B dP C for this reason / r ^�� REPAIR ❑ $ Dole USE OF EXISTING BLDG DFA10l ❑ Signature APPLICANT T% p OWNER-BUILDER DECLARATION (PRINT) '� NO JcS� f FINAL / I hereby offmm that I am exempt from the Contractor s License Law for the following reason (Section 7031 5, Business and ADDRESS FIN Professions Cade) BY ❑ 1, as owner of the property, or my employees withDIN wages as their sole compensation,will do the work and I the structure is not intended or offered far sale(Section LOCALITY 7044, Business and Professions Code ) MOVING TEL pool ❑ 1,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 I YARD I HWY I TOTALPiRALCK FROM I EXIST,NE WIDTH - - I hereby affum that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P L - - - (Sec 3097 Ov C ) SIDE PL Lenders Name 1 LDMA Ref Y ZLenders Address P C Fee f permit Fee I I certify that I hove read this application and state that the luvanc 7S LDAIA P/C F ► - _- above information is correct I ogres to comply with all County In~iganon Fee /V p ordinances and State s te lowrelating to buildup construction, Total Fr - I LDMA Perm R < and reby thwize repr rsenatrves of this County to enter $Y u e a e-mentionedpro for inspection purposes / Z-- ie {@ tFNERfE FOR EXPLANATORY LANGUAGE sire o Applicantor t