HomeMy Public PortalAbout9405 PENTLAND ST_Building__ DIVISION OF BUILDING AND SAFETY BUILDING
Department of County FmgfnesT
County of Los Angeles '
WM J FOX, COUNTY ENGINEER ' APPLICATION
wNT BUILDIN Y• (/
FOR APPLICANT TO FILL IN ADDRESS
BUILDING I // LOCALITY —'�^•"^^" '��
NEAREST �/ V
LOCALITY ^CROSS ST
NEAREST l / DISTRICT NO PLAN C- oo=R.O NO PERMIT NO
CROSS r _/) �" i1.C�C 7 `� - 5
OWNER /11/rZ� t
RR(jHjVRD/3Y DATE OF APPL. DATEISSUZD
MAIL
ADDRESS USE ZONE NO
Jgn� TE PLANS OF TYPE GROU
CI � P FIRE ZONE
•/ �_ _
NO W � T
�J
ARCHITECTOR TEL A; ZONING c OwT®
ENGINEER NO AP ROVRD BY,
-
BUILDING �R e
SETBACK LINETEL
DATA
CONTRACTOR G NO B�RDVCD �'
HOUSE NUMBERING
ADDRESS L - `O S
LEGAL _ MAP NUMBER NO ASSIGNED BY"''
DESCRIPTION LOT NO BLOCK `-
_ DATE CORRECTIONS I INSPECTOR
7 TRACT I
NO OF BLDGS t -
SIZE OF LOT O - NOW ON LOT
USE OP NO OF
E%IST NG B 6 A LIES I D
C
DESCRIPTION OF WORK v
NEW ALTERATION ADDITION
REPAIR DEMOLITION
Bo FT
iJ NO OF '
SIZE (1 ROOMS STORIES
E%T WALL I ROOP
1 COVERING COVERIN I
I •USE OF STRUCTURE
T APPROVALS e
INSPECTOR 9 SIGNATURE DATE i
f _
FOUNDATION LOCATION
FORMS MATERIALS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME FIRE STOPS
CORRECT BRACING BOLTS -
I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE LOCATION
AND STATE LAWS REGULATING BUILDING CONSTRUCTION GAS VENT DUCT9
SIGNATURE OF ` ^a LATH INT
Pfi RMITTEE
^ LATH EXT - - -
ADDRESS
AUTHORIZED AG PLASTER INT .
_ PLASTER EXT
FEE S 't; HOUSE NUMB ER COR-
RECT AND PORTED
VALUATION ! t/ IJ FEE FINAL
TOAC38A Dee 9 a-&2 - ^
1 DEPARTMENT OF BUILDING AND SAFETYAPPLICATION FOR PERMIT
COUNTY OF LOS ANGELES r B {I/e e I L D I N G
WM. J FOX. CHIEF ENGINEER I
r
FOR APPLICANT TO FILL INVADDRE�
FOR OFFICE USE ONLY
RICT NO PLAN CK NO PERMIT NO
BUILDING
ADOpEBB o� 6 3 5 / -n '
LOCALITY RECEIVED ABY - 2ATE OF APPnL c DATE ISSUED
IIARIIN�
ING IOWNER FJ ENH MAILLITY 4ADDRESS e
EST CI TELNO �3dN BT /NC OF TYPETARCHITECTOR TEL I PLANS .JL-_ENGINEER NO
ICK LINEADDRESS OVEDCONTRACTOR HO } 1 DATE
UBE APPROVED I I
ADDRESS ZONE -/ BY } DATE '
LEGAL ] t CORRECTIONS { V
DESCRIPTION LOT NO dD
TRACT
(''� r NS /yJ����SIZEOFLOT �J (/ N `/N/�USE OF NNO OFEXIST NG BLDG F OOM DESCRIPTION OF NEW ALTERATIONION D
REPAIR MOVING LISH SqFT /'� N22
O OF - l 91fr' t A J•i =
SIZE p ROOMSIES �
WALLROOF ���-- 44''COVERING y(�(�� COVE �`
USE OF NEW ✓�) - DJ�.II
BUILDING ��i/
I HEREBY ACKNOWLEDGE THAT I HAVE READTHIS ' APPROVALS
APPLICATION AND STATE THAT THE ABOVE IB CORRECT INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION LOCATIONLl
FORMS,MATERIALB �/;v5 - //
AND STATE LAWS REGULATING BUILDING CONSTRUCTION I � \
�
FRAME FIR ,
—
SIGNATURE OF BRACING,BOLTI3 SOLTB
(\
PERMITTEE_ Ll
LATH, INT
AUTHORIZED AOT
LATH, EXT
LDOS7PLANTER. INT
3 SDM SETS $ p C e /'` PLASTER,EXT
LUATION FEE /v CID FINAL
rnAn]BA cE 4 BOi 1 n]
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING �Q E
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DMSION LOCALITY
JOHN A LAMSIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DISTR� NO GROUP TYPE ESSED BY
FOR APPLICANT TO FILL. IN n cy" t
BUILDING ` STATISTICAL CLASSIFICATION S WER MAP
ADDRESS yG✓ SK PG
CLASS NO DWELL UNITS
LOT NO < BLOCK WATER
CERTIFICATE NOT REQUIRED ( RECEIVED
TRACT MAP HIGHWAY STATE MAJOR SECOND C
F BLDGS O (CIRCLE)
SIZE OF LOT I
WON
ON LOT USE ZONE ISPECIAL
USE OF CONDITIONS
EXISTING BLDG
f TEL
OWNER NO BUILDING EXIST
SETBACK YARD HWY TRE T NAME WIDTH
ADDRESS FRONT
ARCHITECT OR — TEL
P L
ENGINEER NO SIDE
P L a7 / L E(✓c� - - d
ADDRESS O
TEL A V
CONTRACTOR NO
ADDRESS
DESCRIPTION OF WORK —u
aw
z
[NEW ADD ALTER REPAIR DEMOLISH ' � Z0O OF NO OFE WJ STORIES FAMILI 'EOFRUCTUGNATURE OF I / G i✓ lO x
APPLICANT
VALUATION $
dO Q
APPROVALS DATE INSPECTOR enIGNwrune
PC PMT FOUNDATION LOCATION
FEE S FEE $ FORMS MATERIALS
FRAME FIRE STOPS `
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMrLOY ANY PERBON IN VIOLA LATH INT
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN SCOMPENB INSURANCE LATH EXT
SIGNATURE OF /` HOUSE NUMBER COR
PERMITTEE PECT AND POSTED
ADDRESS FINAL
11 JOHN F LEWIS PRINCIPAL ST R URAL ENGI EER
PLAN CHECK VALIDATION CK mo GSH PERMIT VALIDATION (3
M O CASH
- LA04367e SEP17 10 22.00- s
76A638A DSS.i t2.04
APPLICATION FOR BUILDING PERMIT 5
DIVISION OF BUILDING AND SAFETY BUILDING
Department of County Engineer ADDREss J '�r �! 1
County of Los Angeles LOCALITY 7/2 f?/JL /7 G/>'1'
WM. J. FOX, COUNTY ENGINEER ST
CASSATT D. GRIFFIN, SUPT OF BUILDING NEARSCROSNEAREST.
DISTRICT NO. GROUP TYPE SEWER MAP
FOR APPLICANT TO FILL IN S" y /�' CONST
Z BK PG
BUILDING 4 `(-�n_T 4 ;
/ dJ��/1 . _ NUMBER 'H-•Y//L/ HWV .
ADDRESS M(,.'w� MAP STATE YES
LOT NO �r.� BLOCK USE ZONE SPECIAL
T� � CONDITIONS
TRACT fes ?
NO. YARD HWY STREET NAME
OF BLDGS.
SIZE OF LOT " '}� Wil/ NOW ON LOT - BUILDING EXIST.
USE
OF / SETBACK WIDTH
EXISTING BLDG. (:'�� J,:_;}-/jr} "ff }9 f'/YGr FRONT
OWNER P. L."` (' i
MAIL _ �.' ! �l �., V L
ADDRESS
TEL DWELL. 1 UNIT 5 INDUSTRIAL
CITY- NO.Al
/+
2 DUPLE%_UNIT 6PUBLIC BLDG.
ARCHITECT OR TEL.
ENGINEER NO. 9 APT. IINITG ADDN., ALT., ETC.
ADDRESS q COMMERCIAL 8 MISCEL.
CONTRACTOR r.' j// I• j NO.
INSPECTION RECORD
ADDRESS
DESCRIPTION OF WORK
NEW _ ADD ALTER REPAIR_ DEMOLISH _
SO. FY. NO. OF NO. OF
_SIZE STORIES FAMILIES
USE OF STFjIICT.IIRE{
SIGNATURE OF
APPLICANT _ APPROVALS
ADDRESS / - DATE INSPECTOR'S SIGNATURE
FOUNDATION: LOCATION
E / P. C. S _FORMS, MATERIALS
/ )C) FEE FRAME: FIRE STOPS, - -
-VALUATION S ,�a�- BRACING, BOLTS
FEE FURNACE: LOCATION. -
GAS VENT. DUCTS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT.
ANO STATE LAWS REGULATING BUILDING CONSTRUC-
TION. _ LATH. EXT.
SIGNATURE OF, HOUSE NUMBER COR.
PERMITTEE - RECT AND POSTED
ADDRESS +� FINAL
,WM. J. FOX, COUNTY ENGINEER VALIDATION
t
BY `6i_" s I� J 'Y_ vN F.IJ�PIr :a. 4 .:'► .T�./y
DEPUTY - - bEPUTY
Iow
BY BYry� c��A �`..y. . �'
DEPUTY - • '� DEPUTY
t •' a .NOr KERS',COMPENSATION DECLARAAON ` �• s +
hereby affirm that I have a certificate of consent to =elf APPLICATION . FOR. BUILDING 'PERMIT
insure or a certificate of Workers-Compensation Insurance,-
or o certified copy thereof (Sec 3800\Lab C ) _1. _ ��
COUNTY OF LOS ANGELES ;j r 'BUILDING AND SAFETY
Policy No Company
t r BUDING n/ _ t
i
Elcertifieddopy is hereby furnished , � , , - FOR APPLICANT TO FILL IN 'F ADDRESS
Certified copy is filed with the county budding inspec- BUILDING
hon department _ •• ADDRESS �6 '
Applicant Q- ��K3�1 CITY ZIP ~aki ' sr
LOCALITY
+ NO OF BLDGS NEAREST- G;--- - - •^ -
'CERTIFICATE OF EXEMPTION FROM W KERS, SIZE OF LOTS NOW ON LOT CROSS ST '
' COMPENSATIONANSURANCE ,1.,, ASSESSOR _
(This section,need not be completad'rf the permit is for one TRACT -- BLOCK LOT NOZ` MAP BOOK '»» r• PAGE PARCEL It Y a
-hundred dollars ($100)or less ) '— » - TEL
Y, OWNER - USE ZONE _ MAP s _ , '
,d-certify that,in the,Performance of the work for which this - NO .
F _ • T _ -__ _ Q
permit is issued, shall noi,em to an arson in an manner- ADDRESS - -- - SPECIAL _ i 'd
P P Y any Y
so as to become subject to the Workers Compensation Laws CONDITIONS_ _ + `a _ O
.!, � " , . . C - , CIN ZIP
+Date• Applicant ARCHITECT OR TEL DISTRICT- GROUP ,TYPE FIRE - PROCESSED BY O
NOTICE TO APPLICANT IF, after making this Certificate of ENGINEER r tJ0 ✓Uf' CONS ' ZONE U
Exemption you should become,subject to the Workers ,/�jS/�q p w
Compensation provisions of,the Labor'Code you must forth- . ADDRESS K �� ^;'c-/ (1 _ ( a_
with comply with such provisions or this Permit shall be • TEL 1• STATISTICAL CLASSIFICATION _ APT CONDO N
deemed revoked .y rt• CONTRACTOR i - Z
LICENSED CONTRACTORS DECLARATION (ADDRESS
LIC
-- 4Qwc CLASS NO-DWELL UNITS_ 1
I hereby affirm that I am licensed under provisions of Chapter 9�- _ _ C SEWER MAP
LI
(commencing with Section 7000)of Division 3 of the Business
and Professions Code and my license is in full force and effect CITY CLASS — ( BK PG r _ VALIDATION
` SO Fr NO OF NO OF _ CHECK I-
License Number Scb56�13 L,c Cloys' SIZE STORIES,
FAMILIES ONE , _
- - - - - VALUATION ,. "O7 , 124.dL
LST q�-� Date DESCRIPTION OF WORK v NEW ❑ ,$- :pol .
Contractor /� ADC; 1 I I En '
tit '
❑I am exempt under Sec �- ALTER ❑ - i 1 'ISI yi I� 00
L
B 8P C for this reason REPAIR ❑ $ _
Date USE OF n - - W {t}E[(� - a.i4._.(
EXISTING BLDG OEMOI ❑ s
'Signature APPLICANT O /'���r TEL , . t in ',1,11
• - FIN
ag OWNER-BUILDER DECLARATION (PRINT) CD � tJ0 ,DATEAL
,
I hereby affirm that I am exempt from the Contractor s License
Law for the following reason (Section 7031 5, Business and ADDRESS G �^ FINAL-
Professions Code) PRESENT - -- -• - - • + By
❑ BUILDING - .1 «_y: 1" rkt '`•Oi
1, as owner of the property or my employees with ADDRESS !;• jWA.
I -VV J(
wages os their sole compensation,will do the work and `>' •• ' S { t t t ! I,
the structure is not intended or offered for sole(Section LOCALITY ♦,�1 �( '• lr " lJ , !' L
❑ 7044, Business and Professions Code )- - MOVING' - - - TEL +- - `^1 ,
1 as owner of the property,am exclusively contracting CONTRACTOR NO `� 1 a with licensed contractors to construct the project (Sec -"
hon 7044 Business and Professions Code ) ADDRESS
REQUIRED _ TOTAL K FROM ' EXIST-?
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PSETBACINE �"S-.`R'..r ,hr- '
I hereby affirm that there is a construction lending agency for FRONT �„ �_, _
the performance of the work for which this permit is issued P L t a„Yy \ 1-4,_ . r
(Sec 3097, Civ C ) SIDE i •' - r_ t `. W ver `' _ ,
PL
Lenders Name
Pe - j LDMA Ref-N�a
PC Fee S rme Fee .•(�•
Lenders Address -
1 (
I certify that I have read this appbcation and state that the Nuance Fee �.V Q LD_MA_ P/C N L
8 above information is correct I agree to comply with all County _ Ingestigahon Fee - _ _ _ _ _ .. '
lZ ordinances a e aws to budding construction Toiaj Fee LDM4 Perm N '
an e y outhwi r a t es,
s of this County to enter - _ - ,_
on iheal5a - i for inspection
SEE REVERSE FOR EXPLANATORY LANGUAGE i
SignaWre of'
Ap� on,or Agenl
r _ t
( ` WORKERS COMPENSATION DECLARATION
_e
inAPPLICATION FOR SUIWING PERMIT
hereby affirm that IL have a certificate of c:onSent tb self '
sure or a'certifi<ate of Workers' Compensation Insurance '
or a certified copy thereof (Sec 3800 Lab C ) ` r'
r - ES
s, f COUNTY OF LOS ANGEL , s BUILDING AND'SAFETY ;y .
Poli No&a�)_ � Company - -�
Certified copy is hefeby furnished _ FOR APP CANT TO FILL IN ADDRESS•tC'y
� 'Cerhbed copy is filed with the county building inspec ' BUILDING ^`s
F hon department n , X ADDRESS.v LOC?.LITY
yDate%-%?,_ iZ Applicant.` ` crryxA, ZIP ca�ossssT
'CERTIFICATE OF EXEMPTION FROM WORKERS - t OF BLDGS ASSESSOR `-
.* ✓<•"COMPENSATION INSURANCE ,- SIZE OF LOT' NOW ON LOT - MAP BOOK . PAGE s PARCEL
,(This iecho`n need not be,c`ompleted rf'the perm n'isrfor one• -r USE LONE^ MAP
hundred dollars ($100)or Jess`) ^ TRACT BLOCK LOT NO _ , NO r
• , . TEL •� I SPECIAL `- - .r• j
I certify that'in the performance of the work for which this OWNER - CONDITIONS' r s 6
permitis issued, I shall not employ any person in any manner D STRICT GROUP TYPE FIRE t PROCESSED BY O
so as to become subject to the Workers Compensation Laws ADDRESS , t CONST Z E V
1
Dote
y _it 'i+ - CITY ZIP r =O
Dote Applicant STATISTICAL CLASSIFICATIOfJ AW CONDO H
NOTICE TO APPLICANT If 'offer makingthis Certificate of ARCHITECT OR �E TEL '1 � \ t U -
✓ i Exemption, you should become subject to,the Workers ENGINEER NO CLASS NO j+—DWELL UNITS_ ` t W
'Compensation provisions of the Labor Code you must forth-" r ^ ' 4s6i1
ADDRESS, ' SEWER'MAP
t 'with comply with such, provisions or tfus"permit shall be s Z�'
deemed revoked. �'� - ; , CONTRACTOR TEL
'�, BK PG VALIDATION
< 1 LICENSED CONTRACTORS DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS LNo IC VALUATION .,
c (commenarg with Section 7000)of Division 3 of the Business and • " - `. . - - _ r
'Professions Code, and my license is imfull force aidaffed= +` CITY , 'TLCp,S�S� 'if'` ?-
.�RSS\� SO O OF FA OF CHECK
1°-.. License Number L¢ Class SIZE STORIES FAMILIES ONE � }
Contractor \ �•\A.• •fl i�Date'�'12r�� r DESCRIPTION OF WORK t- \
NEW\
$
_ / _
( ❑ I am exempt under Sec ADD `
_ ALTER E] FINAL
- syn
B 8P C for this reason - REPAIR DATE � 2,�; p F, ,
` iUSE OF 1 _
Date EMSTING'BLDG l DEMOL FINAL
' r Signature - ' APPLICANT TEL Y '
' OWNER-BUILDER DECLARATION PRINT - - '
I hereby offirmithat I am exempt from the Contractor's License
Law
for the following reason (Section 7031 5 Business and ADDRESS
�4466A
'Professions Code) - "td`'"i . --
❑ r BUILDING , • .t� ,
I as owner,of-;he property or`my employees with ADDRESS • e • • • •'• 1,�
wages as their-;ole compensation will do the,work and I , r
lthe structure4me
s not'inded cr offered for sole(Sechc n LOCALITY - - ,Z • 1 999
7044 Business and Professions Code)° _ L�� MOVInIG � • . TEL I r
El —1Sat owner of theiproperty, am exclusively contracting RACTOR NO j t • • 1 9,9 8 8 6
with licensed contractors to construct the proleat,(Sec-• r 3•
;hon 7044 Businessond)ProfessioA Code), \Y ADDRESS - t .+ 0 a 1 2:8 3'
REQUIRED - TOTAL SETBACK FROM EXIST
'-� CONSTRUCTION LENDING AGENCY tiro , SET BACK YARD FIWY ' PROP UK WIDTH ? +�
'l,hereby affirm that there is a construction Iendingtagency for FRONT r
the performance of the work for whmhithis permit is issued P L - r -
(Sec 3097, Gv C ) - SIDE -i'�° r
t s P L .-
Lenders Name
n +�
r Lender s Address y x ~ T F PC Fee S J Permit Fee ZY, „� •,
- . �.
LL I certify`thatTl Fiave'reod,th is appl motion an'd'state tha the t`: 1 ,� s , • 4' Ixi�an2e Fee - e
S
above mformohon is correct I agree to comply with all County” Inveshpabon Fee.
and hereby outhonze representahve's of this County to enter
o 'ordinances and State laws relating to bwFee
ldin6 construction- S `s ' , Total
tl
upon the above--{{Q�enhone roperty for nspection,purposes
'D \ \�V/\\ `r` +X•� QRZ k•+ -SEE REVERSE FOR EXPLANATORY LANGUAGE'
+ Signotare of Applicant or gent` -Dote - It •i^ , , t es