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Home My Public Portal About9236 PENTLAND ST_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES ® � WM J FOX CHIEF ENGINEER _ _ _ FOR APPLICANT TO FILL IN ' FOR OFFICE USE ONLY DISTRICT NO PLAN CK NO PERMIT NO Bul Of ADDRESS LOCALITY R1 6 Pentland AvenueS^ 9'/-�0 LOCALITY y RECEIVED BY DATE OF APPL DATE ISSUED NEAREST CRO B T BUILDING 9 I � G N'1 L� co OWNER ADDRESS I L G ADDRESS A..MAIL LOCALITY I , c . NEAResr CI Arcadia Tp DO 6 CROSS BYFIRE ARCHITECTOR TEL ZONE ' PLANS TYPE ��'}• GROUP,,:::, ENGINEER NO BLDG ORD NO ADDRESS SETBACK LINE I Z U LaF ` APPROVED CONTACTOR No BY DATE USE //�� I APPROVED ADDREH ZONE /y BY I DATE DEBCRGAL IPTION LOT NO BLOCK N'+ L V CORRECT*I�ONySf 1 TRACT 1647 5 NO OF BLOBS , SIZE DF LOT 61 x 101NOW ON LOT N USE OF N❑ OF NO OF 1 i EXISTING BLDG No FAHIUCB ROOMS - — - — ----^ DESCRIPTION OF WORK NEW ALIERATIIN ADDITION - ^` —_ AO REPAIR MOVING DEMOLISH � SO FT NO OF Z HIZE O ROOMS BTORI EB �11DD COVEWALLRING Piaster I CpVOERING ,Q infrTq �I l cil r USE OF NEW BUILDING Welling - Attaohed Garage I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION LOCATION I SP CTOR DATE/!� / AND STATE LAWS REGULATING BUILDING CONSTRUCTION FORME, MATERIALS �LL` FRAME B' SIGNATURE BRACING,BOLTS PERMITTEE HM1ES/TN ✓ 6/'110 /LATH, INT AUTHORIZED AGT / LATH, EXT '1RA638A 94 oae-3 mM Brra $ P C • / J� PLASTER, INT FEE /CJ— PLASTER, EXT VALUATION m aY� FEE LJ i FINAL ss WORKERS COMPENSATION DECLARATION hereby affirm cert that of certificate of Garment to self APPLICATION FOR BUILDING PERMIT ^ insure ora certificate of Workers,Com pen of c Insurance, if ' o certified copy thereof (Sec 3800 Lab C ) COUNTY OFLOS-ANGELES • BUILDING AND SAFETY n r Policy No Company ❑'' Certified copy is hereby furnished FOR APPLICANT TO FILL-IN BUILDING, ADDRESS 9236 Pentland Street wCertified copy is filed with the'counly building inspec BUILDING (3236 Pentland street- - ' hon department ADDRESS _ LOCALITY le Cl Call • Date F sAppbmnj ,a CITY Temple Citi ZIP, - ca�ossssT FratusDrlve ' ^ ASSESSOR CERTIFICATE OF EXEMPTION FROM WORKERS SIZE OF LOT., 5814 S.F. NOW ON NO OF LIOTS .- MAP BOOK !/ O PAGE D PARCEL, J 7 r •� ` COMPENSATION INSURANCE ' ` P(This section need notibe completed if the peimit is for one USE ONE MA a, hundred dollars ($100) or less J �, -. , •, TRACT BLOCK LOT NO 3 NO TEL =// SPECIAL y o • '+ OWNER David I�(Jn NO - 111 CONDITIONS- O certify that in the performance of the work for which this - _ - - DISTRICT GROUP TYPE FIRE PROCESSED BY V permit is issued I shall not employ any person in any manner gppRE55 9236 Pentland Street 7 so as to become sublect to the Workers Compensation Laws , i /� ��] _ ZON _ O e CITY TeI City ZIP 91780 (/ v •Data �� • Appl¢ant l� - STATISTICAL CLASSIFICATION APT NDO i ARCHITECT OR 3 TEL ) a W w NOTIC TO APPLICANT If' after making IS Certificate of ENGINEER Chen` & ASsoclateLao 1 CLASS tJ0��.DWELL UNITS_ d Exemption Syou should become subject to ,the 'Workers - y Compensation provisions•of the Labor Code you must forth- ADDRESS 710 S. Garfield Avenue Alh. SEWER MAP Z with comply with such provisions or this permit shall be deemed revoked i r ' - - CONTRACTOR Owner/builder NO- - BK PG VALIDATION \ LICENSED CONTRACTORS DECLARATIONLIC _ I hereby affirm thati am licensed under provisions of Chapter 9A ADDRESS _ ` NO VALUA ION ~ (commenting with Section 7000)of Division 3 of the Business and LIC /2 0 2 2,8 A i Professions Code and my license is'in full force and effect CITY CLASS $ JI[-A # ••• 2323 SQ FT // Q NO OF NO OF CHECK 1 License Number L,c Class SIZE v (f STORIES 1 FAMILIES 1 ONE S 1 • 244.80 Contractor Date s DESCRIPTION OF WORK -Dii& f=_J NEW ❑ a ❑ n r •� -TJ.�..-... -' ADD ® ,• • 244805 I ce exempt from the hcensmg prole mens as am a� 1LLJ1111 Addition I¢ansed architect or a registered professional engineer _ - � s ALTER` ❑ FINAL � - acting in my professional capacity (Section 7051DATE / Business and Professions Code) - r - USE OF REPAIR ❑ - ,� 7 9.a 8 EXIsnNG aLD� ' Single-Fam11 House DEMOL ❑ e NAL Ior Reg No Date APPLICANT TEL T OWNER-BUILDER DECLARATION '' - PRINT) aMil & ASSOC.. NO282 hereby affirm that I am exempt from the Contractors License Law for the following reason (Section 7031 5'Business and ADDRESS 710 S. Garfield Av6riue A•1 L. _ Professions Cade) PRESENT f 12 9, 0 BUILDING 9236 HT • • JpI' 5•V I as owner of the property or my employees with v 'ADDRESS tt �'I •`2 9 a \ wages as their sole compensation will do the work and Y ' '� x1 r! -' the structure,s not intended or offered for sole(Section LOCALITY le City,- lfOrnla _ ' r . } a `\ 1 • ,4's•` • • 2 9 a rJ O 6i 7044 Business and Professions Code) MOVINGI TEL . �s 'T` z T ` 1 209,-86 1 r,• ® I as owner of the property, am exclusively contracting CONTRACTOR + OwnerOwner/builder .tip `i •- -with licensed contractors to construct the project (Sec ADDRESS .hon 7044 Business and Professions Code) -- _ - - "•= CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP'LINE WIDTH REQUIRED TOTAL SETBACK FROM EXIST n I hereby affirm that there is a cosiruUion lending agency for=• FRONT 1 ",\� N \" ,�' y the performance of the work for which this permit is issued . P L s - \ \�.\ (Sec 3097 Gv C ) r SIDE- _ _ .. _ _ _ ._ _ \s \ �+ \ - Lender s_Name n '.L \�`.Lj�\Yr s SM�,`�� $ - - P C Fee$ O( Permit Fee' O h``, y��1"I� _•,l'�a s Lender s Address w' I certify that lihave read this application and state that the Issuance Fee a < above Informohon is correct I agree to comply with all County Invesogaoon Fee_ ordinances and State laws relating a budding construction �^ Q and hereby authorize representatives of this County to enter Total Fea V 1 n "�u�1p�,on the abo re mentioned property for inspection purposes � �l 51N ~~ J 1'S. I((��yy ( ~ ~ SEE REVERSE FOR EXPLANATORY LANGUAGE , �` `-i { T , j f 1 Signo4I of LLL Applicant or-A ent IF Dote V ' `�� • , 'vtr`4`••� r 1 ®s WORKERS COMPENSATION DECLARATION 'y + • - r - ' - APPLICATION FOR SUILDING`�PERMIT hereby affirm that I have a certificate of consent to self '\ ' insure oro certificate of Workers Compensation Insurance ` 'fl ,, or a certified copy thereof (Sec 3800 Lab'C ) •' - ' • " r I COUNTY OF LOS ANGELES , BUILDING AND SAFETY Policy No Company - - C D Certified copy is hereby furnished FOR APPLICANT TO FILL IN gppRE55 �ij r p ST, Certified copy is filed with the county building inspec n , BUILDING Z2 f .ND 72�Cc� L / on department ' ' ADDRESS /'O y„ �f}� 417�aDore Applicant CITY 'N IF �� / ZIP LOCALITY t CERTIFICATE OF EXEMPTION FROM WORKERS NO OF BLDGS r p NEAREST COMPENSATION INSURANCE SIZE OF lOT rj ( NOW ON LOT ROSS ST G/Q 7 s 'D y,� ^ (This section need not be completed if the permit is for oneTRACT - BLOCK LOT NO 7+" AS,�SSOR r Z3 hundred dollars ($100)or less ) MAP BOOK -! 0 PAGE I PARCEL �T _ 8 USE ZONE y 6' I cemfy that in the performance of the work for which this OWNER /9y/) L �lS zkV /' V _ NO �L� S permit is issued I shall not employ any person in any manner g00RE55 Z S7T�ee / •�/ SPECIAL so as to become sublect to'th'e Workers Compensation Laws CONDITIONS O Date '_ Applicant 9 _ b _' CITY ZIP 7 r r • - •trt t d' NOTICE T APPLICANT Ifafter ma 1 n Certdicat of ARCHITECT O TEL � f DISTRICT GROUP TYPE FIRE $SED BY O Exemption you should become'subt ct to the Workers �f i F Compensation provisions of'the Labor Code you must forth ADDRESS 7 (7 �" /E Rti) I ��U ./Z � TcY Wv with comply with\such provisions or this Permit shall be `a' deemed revoked TEL • STATISTICAL CLASSIFICATION - API CONDO N CONTRACTOR TN - _ t• LICENSED CONTRACTORS DECLARATION LtC CLASS NOS DWELL UNITS_ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO (commencing with Section 7000)of Division 3 of the Business and • LIC SEWER MA Professions Code and my license is in full foice and effect CITY CLASSBK- VALIDATION EFT I(7 NO OF NO OF CHECK PG License Number Uc Class O STORIES- FAMILIES ONE - - v, VALUATION M _ Contractor �' 1 DESCRIPTION OF WORK NEW ,<)✓/1 p Data ADD a ❑ I am,exem t under Sec - ✓' C • I}'t, o • P ALTER i❑ , 1 B 8P C for this reason REPAIR Date USE OF y EXISTING BLDG DEMOL s Signature ` APPLICANT TEL m - FINAL OWNER-BUILDER DECLARATION (PRINT) _ _ NO - DATE 1=- I hereby affirm That I am exempt from the Contractor s License - Low for the following reason (SectioBusiness n 7031 5, and ADDRESS ' ` FINAL Professions Code) - 'By ❑ es n BUILDING - •� as owner of the property or my employees with ADDRESS wagthesola comped or f on will the work and - - T ' . �•'`} �:L _� �`, ' , i�.�'�� c�a f. ' f ' the structure a ure not intended or offered for sole(Section LOCALITY 7041 Business and Professions Code) MOVING TEL t - - • I, as owner of the property am exclusrvely,controcting TRACTOR L NO y with licensed contractors to construct the protect (Sec ADDRESS r c s tion 7044 Business and Professions Code) 1 �+ ` ♦ ♦\P� . REQUIRED TOTAL CK " � �' •�� x�._� CONSTRUCTION LENDING AGENCY SET BACK YARD •HWY PROP LINE WIDTH ♦ �•�"�:. ` % ' I'hereby off um that there is a construction lending agency for • FRONT ```t { w• ^ y '- the performance of,the work for which this permit is issued P L r ec 3097 Civ C ) SIDE N * ,� , (S \\ •�• l \\ Lender s Name '•, w �.,- • i m •I t LDMA Ref N Lender s Address - PC F.$ Permit Fee- �,/�r•Q - I certify that t have read this application and state that the Issoonce Fee .O! 'J O LDMA P/C N above information is correct I agree to comply with all County InvesuRotmn Fey -- 8 ordinances and State taws relating to budding construction, total Fee a. ( 0 LDMA perm N R and hereby authorize representatives of this County to enter up n the above-mentioned pr party for inspection purposes ' m ` I&A` D /2 'ez SEE REVERSE FOR EXPLANATORY LANGUAGE t r +Signal o Plicant a Agent to R