HomeMy Public PortalAbout5338 PARMERTON AVE_Building__ e Cr7y {�
7BAS38A EE#8031.67 APPLICATION FOR BUILDING PERMIT LJ
COUNTY OF LOS ANGELES BUILDING s—JJ8 �� BR TO
DEPARTMENT OF COUNTY ENGINEER ADDRESS
41-
BUILDING AND SAFETY DIVISION LOCALITY,° C T'
JOHN A LAMBIE COUNTY ENGINEER NEAREST' - C "
COLEMAN W JENKINSS-1 T OP BUILDING - CROSS-ST L J
D13TRICT NO GROUP I TYPE PROCE9 D pT
FOR APPLICANT TO FILL IN s" p� CONST 3
ADDRESS
S 0 1 STATISTICAL CLASSIFICATION SE ER MAP
CLASS NO DWELL UNITS ' BKS G- PG 6I
LOT NO 19 S_ BLOCK USE ZONE No -2 O S 6_
TRACT 3 nl SPECIAL
MO OF SLOG! • 7zo bCONDITIONS
SIZE OF LOT NOW ON LOT '
USE OF ` p 'r L`1
TELL. SLOG SETBACK L K FROM
TEL 1 L( FRONT PROF LIN[ 01, (STREET)
OWNER�1 1 _ S NO —'oYy _
TYPED' EXISTING f[TSACN MHNWAY YARD - TOTAL
ADDRESS t V NII Y FROM C L
CITT
E G I T � .*/- �/ _ + y a = Z o
ARCHITECT OR TEL SDG 307\AEN FROM '
ENGINEER NO tTD[ PROP LIN! OF (STREET)
TYPE
OF E[ISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
TEL + -
CONTRACTOR NO
ADDRESS NO CORNER CUTOFF YES - NO G
C
LIc . SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK
k n
NE ADD 'ALTER DEMOLISH v
Z_
FT NO NO OP
SIZE 9 ORI
E9 PAMI LI P_S
USE OF
9TRUCT U RE
SIGNATURE O -
APFLICANT
VALUATION$ d 0 o OQ
APPROVALS DATE INSPECTOR'S SIGNATURE
P C PMT ��// FOUNDATION, LOCATION
FEES FEE$ /� 0 D FORMS MATERIALS
FRAME, FIRE STOPS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AMLICATION • BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AOR[[ TO COMPLY FURNACE LOCATION
-WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING GAS VENT DUCTS
'JUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORN
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY R R ON,IN IOLA LATH IN
TION OF THE LASOR CCDC OF THE STATE OF C LI�ORNIA LAT
TING TO WORNMC ONPCNSATI01 NSUR C LATH EXT
SIG NATUR OF HOUSE NUMISER COR-
PE
RMITT
E R C AN POSTED
ADDRESS FINAL
1.
V
PLAN CHECK VALIDATION ` JOHN F LEWISPRINCIPAL STRUCTURAL EN
CK M 0 CASH ER
_ PERMIT VALIDATION CN MO CASH
Lh,�1r2 0 4—� OCT16 1 D x.00;; o
)
ORKERS COMPENSATION DECLARATION
' iwfi'm That hove aue Compo scion Insurance
to self - APPLICATION FOR BUILDING .PERMIT , LS
_insure, or a certificate of Workers'Com pe nstion Insurance or
a certified copy thereof (Sec 3800 Lab C ) •„ , I COUNTY OF LOS ANGELES - BUILDING AND SAFETY
Policy No Company "
O Certified copy is herebylturmshed ' FOR APPLICANT TO FILL IN - BUILDING
ADDRESS
EJ
Certified copy is filed with_the county building irlspec BUILDING /y _ r
Lon department" ., ADDRESS ��s '(/+j"Y}I L- 2J� •-, LOCALITY
r p.` r . s„ , r // /' 1,f NEAREST d «
Date .' A+ -Applicant ''- ` CITY' L C// J'� ZIP !d CROSS ST
CERTIFICATE OF EXEMPTIOWFROM WORKERS - NO OF BLDGS ASSESSOR '
" I COMPENSATION INSURANCE SIZE OF LOT D r NOW ON LOT _ MAP BOOK PAGE PARCEL
(This section need not be completed if the permit is for one , USE ZONE MAP
TRACT ' BLOCK LOT NO NO
hundred dollars ($100)or less ) '' ' Y TEL / SPECIAL 6
OWNER .� %M N0�7S Z7 CONDITIONS Ot
I certify,that„in'the performonce,of the work fb� which this r ,
permit¢issued, I shall'not employ any person In any manner G (STRICT GROUP TYPE FIRE PROCESSED BY U
so as to become.sublect to the Workers Compensation Laws ADDRE / Y�'F'✓!/T � CONST ZONE ,l Im
CITY / ZIP - o h
Date ^ Apph conte ` ` _ STATIST( L C SSIFICATION PT CONDO + U
NOTICE.TO APPLICANT If'aftar making this Certificate of ARCHITECT OR I TEL W
ENGINEER W Q NO CLASS NO _DWELL UNITS__ d
' Exemption you 'should' become subdact to the' Workers 'y
Compensation provisions of the'Labop Co de syou must forth ADDRESS SEWER MAP ` Z
with comply with'such provisvoos or this permit shall be +
..deemed revoked - v , TEL BK PG VALIDATION ,
o CONTRACTO e - G It
-`+ LICENSED CONTRACTORS DECLARATION LIC -,• - ^
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO - - VALUATION �{/ . . •
(commencing with Section 7000)of Division 3 of the Busmess and V LK
Professions Code mdlhr license is in full force and effect CITY CLASS f
_ L SOOF NO OF CHECK -
L¢ense Number Lic Class SIZ S ORIES FAMILIES `ONE
DESCRIPTION F WORK NEW ❑ f� +- ,
Contractor+
•' f ' Date` _ I - • .t
I am exempt from the bconsini requirements as I ani '+ ° s�� �d - ADD ❑ „ I T
licensed architect or a registered professional engineer „ ALTER ❑ FINAL Z -
.e t acting in my professional,copoauty,(Secbon 7051 ❑ DATE
REPAIR
_ Business and Professions Coda) , USE OF ''p
_ _ EXISTING BLDG v c DEh10L'-❑ By AL
Lic or Re'q No - 'Dote - APPLICANT TEL
'- - OWNER BUILDER DECLARATION PRINT �- ' /' S�s�'7 ` '
Khere affirm that I am exempt from,the Contractor,s License gDDRES Q� /C/ - xis s ^the following reason (Section 7031 5 Business and '.� r.
ns Code) BUILDIN airowner of the property or my employees with ADDRESS ' �4 94 7 Al
ages as their sole compensation"will do,the work and-e structure is not intended or offered forsale(SectionLOCALITY44;Busmess and Professions Code) MOVING " TELCONTRACTOR No " " '43 00as owner of the property am exclusively contra(ting 2 •
with licensed contractors toess,o ns cf the project (Sec- ADDRESS ' .. }
,-/ bion 7044-Business+a nd'Professia ns Code)' - ' "-`14 a Cr
O
REQUIRED TOTAL SETBACK FROM. EXIST IST - ` 1,
+ CONSTRUCTION LENDING AGENCY SET BACK YARD HWY -. pgOp LINE` WIDTH
I hereby offirm'that there is a construction lending agency for FRONT r ' 5r_$.2 I
the performance'o'f the York for which this permit is issued 1 P L T
(Sec 3097*Civ C )' k+ - .1 - SIDE
J v . PL
+ Lender s Name , ' •. - - '
S
PC Fee$ Permu Fee
Lender sfAddress . 1 "_ _ _ , ,• / �. r
I aerhfy (hat have read thi opphcation and state that the Issuance Fee r _ • ' - - '
have information is correct agreedo comply with alllCounty Imestigm,on Fee -
ordinances and State la relating to budding'construction Total Fee
and In a` home r resenlabves of thus unty to enter
Up e a e m' ned property for ins a io urposas . _ t
_ SEE REVERSE FOR EXPLANATORY LANGUAGE
^ '� )Q SignaNre ppl ant Agent
Deter