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Home My Public Portal About5540 PAL MAL AVE_Building__ .........If.„o APPLICATION FOR BUILDING PERMIT 1 COUNTY OF LOS ANGELES BUILDIN ADDRESS DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY,- JOHN A.LAMSIE.COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN Burr or Bu1LDING CROSS ST DISTRICT NO. I GROUTypE PR, ESS D FOR APPLICANT TO FILL IN TYN BUILDING STATISTICAL SSI FICATION S WER MAP ADDRESS I BK PG CLASS.NO. DWELL. UNITS LOT NO. BLOCK MAPSTATE NUMBER Q HWY. YES O7 TRACT USEZONE SPECIAL NOF SIZE OF LOT I NOW ON LOTBLDGS Z A—t CONDITIONS USE OF EXISTING D BUILDINGEXIST. SETBACK YARD HWY STREET NAME WIDTH OWNER FRONT 1 MAIL y P.L. P.L. ADDRESS V SIDE I NO. AIT2'j�C ffrn ARCHITECTOR TEL. INSPECTION RECORD ENGINEER NO. ADDRESS TEL. CONTRACTOR NO. L� ADDRESS - DESCRIPTION OF WORK NEW ALTER REPAIR DEMOLISH SO.FT. NO.OF NO.OF SIZE STORIES FAMILI USE OF STRUCTURE G{.- 1 SIGNATURE OF 1 PPROVALS I,!7 APPLICANT DATE IIISPECIOAWSKNATURE ADDRESS FOUNDATION: LOCATION Q� FORMS.MATERIALS IS ` P.C. S FRAME: FIRE STOPS. FEE BRACING.BOLTS VALUATION O s FURNACE: LOCATI ON. FEE GAS VENT.DUCTS v I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH.INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WIM ALL COUNTY ORDINANCES AND STATE LAWS GU NG BUILDI CONSTRUCTION. LATH.EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTE RECT AND POSTED ADDRESS FINAL -4/ CLYDE N.DIRLAM, PRINCIPAL STR URAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PEHMA VALIDATION CN. M.O. CASH �(r59748� 1 1 A 5 (` C, `�C�Y7u2tLn1/ ,a.,=..==x........ APPLICATION FOR BUILDING PERMIT 1 COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS OC BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN, SUPT Or BUILDING CROSS ST. -tel DISTRICT NO. GROUP Ty SED BY FOR APPLICANT TO FILL IN CONST. y BUILDINGJ ` STATISTICAL CLASSIFICATION SE ER MAP ADDRESS J CLASS.NO. _<% �DWrLLL.UNITS r—= K PG L T NO, S CK N MA ER HTWY. YES TRACT USEZONE SPECIAL NO.OF.BLOGS w CONDITIONS SIZE OF LOT NOW ON LOT ,/•Jr r USE OF EXISTING BLDG BUILDING YARDHWY STREET NAME EXIST. OWNER SETBACK WIDTH /� FRONT MAIL I .S G P L ADORE 5 ' SIDE TEL P.L. CITY ARCHITECT OR TEL, L. INSPECTION RECORD ENGINEER NO. ADDRESS CONTRAC TO.- ADOR DESCFhl)TiOfi NEW ADD ALTER)/f REPAIR DEMOLISH SO.FT. NO.OF NO.OF SIZE STORIES FAMILIES USE OF STRUCTUR SIGNATURE APPLIC APPROVALS DATE INSPECTOR'S SIGNATURE ADDRESS FOUNDATION: LOCATION FORMS,MATERIALS VALUATION FRAME: FIRE STOPS. / BRACING.BOLTS � �' Y"J r+i"t f j FURNACE:LOCATION. FEE 3 FEE S 3 �� GAS VENT.DUCTS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- PLICATION AND STATE THAT THE ABOVE IS CORRECT AND LATH.INT. AGREE TO COMP Y WITH A L C TY ORDINANCES AND STATE LAWS TI ING CONSTRUCTION. LATH,EXT. !! SIGNATUR y HOUSE NUMBER COR- PERM[ OR-PERMI RE CT AND POSTED ADORES FINAL CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL EER PLAN CHECK VALIDATION CK. M.G. CASH PERMIT VALIDATION CK. M.o. CASH Lo1 1 3 9 AUG 12 1 A 3.00 ®. /�I�VLtGtiy4l e • F YORKERS COMPENSATION DECLARATION - ^ hereat' affvm that I have lees' Compensation of tion int to ealf APPLICATION FOR BUILD G PERMIT 711131'I 't insure, or a certuficatj of Workeri Compensetion Inswoncs, or a certified copy thereof (Sec 380D, Lab C) COUNTY OF LOS ANGELS BUILDING AND SAFETY PP011CCI NO�$�yCompony gra TG GU r%0 L7 Certified copy is hereby furnished 3-/- P- FOR BWILDINGAPPLICANT TO FILL IN ADDRESS .5 5F4 Q {� A L MAL A V F ❑ Certified copy is filed with the county building tropec- &AIDING ,non department /� 55 d P AvF -M P L P CITY , , Date `J_2Apphcont {ZiCN C.�ACT- CrtJSr OTY - F C(T QIP LOCALITY NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT OW X 7 NON LOT CROSS ST L 1 y E O A 1i:� . COMPENSATION INSURANCE ASSESSOR � � J1. �f (This section need not be completed if the permit is for one TRACE BLOCK LOT NO MAP HOOK A PARCEL hundred dollars ($IOD)or lass ) L owNER 11` 9 1-14 USE ZONE MLP 1 certify that in the performance of the work for which this hNWO permit is issued, I shall not employ any person in any manner ADDRESS 1554o PAL M A L AJ F ` / ISPECIAL seas to become subject to the Workers'Compensation Lows CONDITIONS O `u CITY OLE C 1 '- ZIP Dote Applicant ARCHITECT OR TELOf NOTICE TO APPLICANT If after making this Certificate of ENGINEER NOrZS -9566 W I GROUP TYPE FIRE PROCESSED By O Exemption, you should become subject to the Waken CONST 3,E Compensation provisions .- of the Labor Code, you must forth ADDRESS 2-225W COMMONW LT AVL .0f /C with comply with such provisions or this permit sholl be TEL y S7ATISnCAt CIASSIFIUTION APT CONDO Z deemed revoked CONTRACTOR COAST 4T'I4 I -J41 LICENSED CONTRACTORS DECLARATION UC CLASS NO Gal UNITS_ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS Tula.p�F(,�pNEALfNo 467641 nor (commencing with Section 7000)of Division 3 of the Business LIC SEWER and Professions Cade,/and my license a to full face and effect CITY A- L% tJ .CRL. CLASSQ'SO NO ri�,.VAgDATION CHECK PG License Number. 6 7641 Luc Clan SIZE STORIES FAMILIES ONE VALUATION � �•`_ Contractor g%CA Cn NSTfTate 1 DFSCRIPnON OF WORK NEW ❑ �.r L El am exempt under Sec N3 BE 000 nooa $ ro I D cc) 110. _)nL 674 - 32 ALTER B 8P C for this reason A Fv1 D G W DF)511 fRE;AIR ❑ $ Date O9c SISI OF BLDG - S 1 DFNC ll DEMa ❑ i I-;N!_ ' -- Signature APFU Ri CH Cc�gST oNslnlo �i-3'}13 OWNER-BUILDER DECLARATION PRttrT DATE -Z Z� ^•`_•- v_ I her affirm that 1 am exempt from the Contractor's License Law for 'v 6 !the following reason(Section 7031 5, Business and ADDRESS AVO«G2 OVF AVe r FINAL Professions Code) BTr +--4 r '-� nN,1L•= ❑ I, as owner of the property, BUILDING -i- - p perty, or my employees with KESS 0 PAL MA-L. Aug- ^•r- [7 'c 72 wages as their sole compensation,will do the work and ` AL the structure is not untended or offered for sale(Section LOCALITY CM'PL C ' ' _ _ 1c. 7044, Business and Professions Code ) MOVING TEL _fit-i J. - ❑ I as owner of the property,am exclusively contracting CONTRACTOR NO with licensed contractors to construct the project (Sac- _ N ]C non 7044, Business and Professions Code ) ADDRESS CONSTRUCTION LENDING AGENCYI D YARD HWY T K FROM EXIST j hereby affirm that there s a construction lending agency for FRONT BACKLN :I_I�_j]-A the performance of the work for which this permit is issued PL (Sec 3097, Civ C ) SIDE PL Lender's Name � �L�{ Q IDMIi.Ref Lender's Address PC Fee A ✓O" pemn Fee OLQ, 7 I comfy that I hove read the application and state that the luaarwe F T 7Pis LDMA P/C If above information is correct I agree to comply with all County Invastpation Fee ordinances and State laws relating to building construction Toro] 1" a LDMA Perm R ss and hereby authorize representatives of this County to enter g Li upon the ab(ove- ntion d prgperfy for inspection purposes R (Nn l -2-7-9z , WE REVEIM FOR EXPLANATORY LANGUAGE nature oT Applic m WAgent Dote