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Home My Public Portal About9409 PENTLAND ST_Building__ 76A9d9AACE'BO D B3 APPLICATION FOR BU ILDI G PERM ` COUNTY OF LOS ANGELES ER BU'Lo ING �— O DEPARTMENT OF COUNTY ENGINEADDRESS BUILDING AND SAFETY DIVISION LOCALITYU JOHN A LAMBIE COUNTY ENGINEER NEAREST _ p COLEMAN W JENKINS BURT OF BUILDING CROSS ST iyZ DISTRICT IN G TYPE PR 5 YB FOR APPLICANT TO FILL IN O CONST_ BUILDING STATISTICAL SSI FIC A TION SEWER MAP'- F AOD RESB P2hlyle �// � _ BK CLASS NO- DWELL UNITS (] LOT NO (p S BLOCK USE ZONE MAP v NO TRACT �`�36/ SPECICONQIAi N SIZE OF LOT / NO OF BLDG9 / 6/ e NOW ON LOT USE OF EIISTLNG BLDG !`E BLDG SETBACK FROM _ _ ) TEL �j FRONT PROP LINE OF (STREET) OWNER NO yJ , TTPE OI I E%13TINO SETBACK HIGHWAY. +i YARD • = TOTAL // ADDRESS S HIO Ax WIDTH F MSC L - CITY / !F . BLDG S BACK ROM - + CHI ARTECT R TEL I1 ENGINEER NO SIDE PROP LINE OF - - " (STREET) J TYPE OF EItISTING SETBACK HIGHWAY + YARD`- TOTAL ADDRESS _ HIGHWAY WIDTH FROM CL TEL _ _ _ + CONTRACTOR -- - NO - O LIC ADDRESS NO CORNER CUTOFF YES O NO ❑^ U CITY — LC L,ID SEE REVERSE SIDE OR SPECIAL APPROVALS O DESCRIPTION OF WORK a NEW /H ADD 4� ALTER /-�REPAIR DEMOLISH - Z SO FT NO OF NO OP SIZSE E OF STORIES FAMILIES U STRUCTURE O/ Y1/-' as P-G SIGNATURE OF APPLICANT VALUATION$ APPROVALS GATE INBPE 9910 NATURE � P C , PMT a, FOUNDATION LOCATION �/ FEES FEES FORMS MATERIALS , FRAMEFIRE STOPS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS 9UILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK - AUTHORIZED HEREBY I WILL NOT EMPLOY.ANY PERSON IN VIOLA LATH INT TION OF THE LABOR COOC OF THE STATE OF CALIFORNIA RELAT ING TO WORKMEN S COOMPENSAAJTIOONN/INSURANCE LATH EXT SIGNATURE OF //" // HOUSE NUMBER COR- PERMITTEE U/LQ'Y RECT AND POSTED ADDRESS �" FINAL JOHN F LEWIS PRINCIPAL STRUCTURAL EN PLAN CHECK VALIDATION CK MD CASH _ PERMIT VALIDATION CK o` CASH ) ;« LnLo 1 6 5 4 APR 2 9 1 D 1 5.0'0— . Iw 1 WORKERS COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to set( APPLICATION- FOR BJUILDING, PERMIT insure or o certificate of Workers Compensation Insurance ^• ti or a certified copy thereof (Sec` 380, Lob C ) s Y• - .. ' - - • COUNTY OF LOS ANGELES- -BUILDING AND SAFETY ~ Policy No �(a Company `JTIL.-1-E h"Lstl7 s ' •❑ Certified copy a hereby furnished ., i!" FOR AP ICANT TO FILL IN ADDRESS ❑ Cenified'copy is filed with the county budding mspec- BUILDING - - - - - - .,hon depa Ment {, _ ADDRESS ,Dare �� 9� Appbcanr CITY ZIP, / lY LOCALITY " _ _ NO OF BLDGS + 1- NEAREST - '1 CERT ICATE OF EXEMPTION FROM WORKERS " ' SIZE OFr LOT NOW ON LOT CROSS ST ' I COMPENSATION INSURANCE I -it ASSESSOR ASSESSOR . (Thin LO section need nor be completed if the permit ii for one TRACT BLOCK_ T NO 'rz t'- +hundred dollars ($100)or less ) r . 1 . TEL MAP BOOK ' r• PAGE PARCEL L ', - OWNER NO ) USE ZONE, MAP ,'I,certify thotan the performance of the work for which this r r NO • permit is issued ,I shall not employ any person in any manner «s - ADDRESS a f 1 CONDITIONS a so as to become subject to the Workers Compensation Laws - ,, _ ` O i i L . r - i' ' CITY -ZIP '- �� ' - � • . s � ) V � Date AppbCantci ARCHITECT OR ` TEL DISTRICT I GROUP, TYPE' FIRE P SSED BY Q M1 NOTICE TO APPLICANT .If after making this Certificate of -• r ENGINEER +r40- '-`'{ _ CONST 1 E v 1- Exemption, you should become subject to the ,Workers' 2 Z{(W U Compensation provisions of the Labor Code, you must forth- ADDRESS _ _ _ _ - +O� 3 ✓' d with coin with such provisions or thu+ erm,t shall be 1 t P Y \ P 'i P_ 9 pa ' j STATISTICAL CLASSIFICATION y, , , APT CONDO Z • deemed revoked '1 CONTRACTOR OO LICENSED CONTRACTORS DECLARATION J / 11 CLASS NO DWELL UNITS_ / NO hereby affirm that am licensed under provisions ns of Chapter9 .. I SEWER MAP - - (commencing with Section 7000)of Division 3 of the Business, 1 LIC - and Professions Code and my lice se is in full face and effect _ CITy Q - RASS , BK PG VALIDATION _ ,� _ SO FT NO OF NO OF CHECK 'Ucense Number Class SIZE - STORIES FAMILIES ONE ` I , + 1 1 1 - - - - -- - VALUATION Contractor S C' ' 'r Ddte �� Z3 Z _ - DESCRIPTION OF WORK NEW ❑ f , "_�_ •� , ❑I am exempt under Sec s ALTER O_ BSP C for this,! a /n - REPAIR ❑ S 1 r r USE OF _ !- _ EXISTING BLDG DEMOL ❑' ' Signature ' APPLICANT NT) ' - - - - hit LO - FINAL -' r(PRI " r ' OWN -B LDER DECLARATION 4 DATE I hereby affirm that a" exempt from the Contractor s License •• - s •. 1 ' -Law for the follo ingreason (Seciiori 7031 5, Busmess and ADDRESS FINAL ^ AA��.. Professions Cade) _ , . j _ ` , -ey - - - "m+CT • , 4 1 } .f ❑ I, as owner of the property or.my employees with BUILDINGADDRESS 1''• +`' t r �l. l . 1 x-++ 7• • ,+ 1 •7pi wages as their sole compensation will do the work and ° -'"0.s s"'s i`•"• 11°-" e _ the structure is not intended or offered for sole(Section LOCALITY 1 ,-�•\ ^ - _ 1 ITEMS' 7044 Business and Professions Code ) -- MOVING - - - ' - ^TEL - - + - - ' s + -' " f. '..T ' El 1, NO I, as owner of the property am exclusively contracting i •1 TOTAL 158 70 -, with licensed contractors to construcPihe project (Sac '!, - � ' tion 7044, Business and Professions Code ) ADDRESS - - ' i-' irAttl 1 158.73 CONSTRUCTION LENDING'AGENCY - REQUIRED yAjm HN,1,• TOTAL SETBACK FROM EXIST. _ -.-ti•- - ' _ - - T i� .� SET BA PROP LINE WI I hereby affirm that there is a construction lending agency for FRONT •, i _ Y •�� .v -„ -> _�,- �, - _ _ - the performance of the work for which this permit ti,ssued P L"•'s (Sec 3097 Civ C ) SIDE r t . PL` r - - •'^ _. 0000--Ml V 11/23/K'' Lenders Nome ' I� - •� ' •- ' '• •r 1 DMA Ref N L 1 17, Ca154 Lender i Address Prm-Fee 11 terrify that I have read thisapphcabon and sfate.thar the bsuance Fee ' �_, LDMA P/C N above riform941on is correct I agree to comply wit all County Investigation Fee, r, _7 p� 'aril inane s d,Sfafe laws rajah to bwl j� onsfruchon Total Fae -/ O IDMA Perm N ' and h authonze re sent Liv s of 4 ouniy to ter _ • --- T r _ _ , _•_ t„ upo above men n pr y coonn/pur ses "f 1 SE!REVERSE f-0R F%PIANATORY LANGUAGE ,y,_ _ - •_ _ �. , __, noWr� ppl¢an1 or Agent Data X 1 WORKERS COMPENSATION DECLARATION _ r APPLICATION.•FOR' BUILDING PERMIT I hereby affirm that I have a certificate of consent to self insure or a certificate of Workers Compensohon nsurance / - or a certified copy thereof ((Se 3800 Lab C )a /^�7,�f '1 Policy No,/0333agM-r �y 276Z ___ COUNTY-OF LOS ANGELES _' , BUILDING AND SAFETY Cerirfied copy is hereby furnished, a FOR APPLICANT.TO'FILL IN - / BUDDING J T ' ❑ I - 1" ADDRESS ItTdN'1' Certified copy Is filed anti the county6wlding inspec- BUILDING � �^ tion deparimerit ADDRESS - _ LOCALITY- Date� ApplcZ� CITY ZIP , CROSSSST CERTIFICATE OF EXEMPTION'FRbMWafA SNO OF5 ' ASSESSOR E 6 0 LOT /`/Oe'/ NOW ON LOTS 1 MAP BOOK PAGE PARCEL COMPENSATION INSURANCE USE ZONE (This section need not be.completedrif the permit`is for one s / — hundred dollars ($100)or leA )' y TRACT LOC BK LOT NO 6 NO v TEL" -I d•� _'. SPECIAL "1 I certify that in the performance of the work for which this ° OWNER Ef O 3cw I ' 'CONDITIONS O DISTRICT GROUP TYPE FIRE PROCESSED BV permit is issued shall not employ any person in any manner ADDRESS _ i / CONST ZONE V so os to become aubled to the Workers Compensohon Laws Dote Applicant CITY ~ ZIP v STATISTICAL CLASSIFICATION APT CONDO H NOTICE TO APPLICANT If after making this Certificate of ARCHITECT OR L ryc7 W Exemption you should become subject to the Workers a ENGINEER CLASS NO_J_DWELL UNITS_ d Compensation provisions of the Lol:6 Code you must forth- ADDREss S b ,. _ �_ SEWER MAP , , Z with comply with such provisions or this permit shall be f ? , deemed revoked - CONTRACTOR ✓ S'1_ NTEO S3S� ' "BK-�PG 6 VALIDATION LICENSED CONTRACTORS DECLARATION ILIC ' I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS X_2- e NO�� ' VALUATION (commencing with Section 7000)of Division 3 of the Business and _ LIC Professions Code and my license is in full force and effect CITYUS CLASS _ t Q(� _ k �j�� // ` SO FT" NO OF- / NO OF— % '_ -CHEIX� . , License Number be CjossL SIZE STORIES FAMILIES ( ONE p-� c Contract Dote , Q 5 DESCRIPTION OF WORK n NEW ❑ ADD ❑ Q l am exempt under Sec 1 V r Ili � T� ALTER FINAL _ �' O A �• + . DATE # e • • i2 'i B 8P C for this reason REPAIR / / }' i Date USE OF FINAL �1 2•• - 2002 EXISTING BLDG -J�f� _ ter.+- -n. DEMOL ❑ By Signature _ + APPLI�NT . 99A-6.�/S f NO A�g 7 - o • --20026 OWNER-BUILDER DECLARATION - _ 1 hereby affirm that I am exempt from the Contractor s License ' ~ t I y Q 1 ADDRESS �'Z ELL G S/ - Low for the following reason (Section 7031 5 Business and Professions Code) / d • �`Ry�- `r r ^ - - z9727, 1 A ❑" ttBUILDING _ _ _ _ __ _ _ Y "y ,'s - - -. .'i 1 as owner of'the property or my employees wrth ADDRESS - # wages as Keir sole compensation, will do the work and the structure is not intended or offered for sale(Section LOCALITY s _ t ! 2 • 5025, 7044 Busmess and Professions Code) ' MOVING ' TEL , _ ' ! , I"as owner of the property, am exclusively contracting CQNTRACTOR 'r O P .� ^- - r! '•,•+• 5 9 2 5 t z with Icemed contractors to construct the project (Sec- ADDRESS P ' y tioni7044,'Business dnd Professions Code) '- �„�,,, _ J n ' REQUIRED YARD HWV TOTAL SETBACK FROM EXIST ' °' r( C 0 , -T8`j + ' CONSTRUCTION LENDING AGENCY SET BACK PROP LIN WIDTH ' hereby cffirm that there is o construchori landing agency for FROM. - -a,-- - - •- - . ^ - the performance of the work for which this permit is Issued + PC (Sec 3097, Civ C ) _ SIDE .. 1- m Landis's Nome �i Dr O�� Permit Fee t Lender s'Address P C Feat " �+ 1`certifyi thatxhave read this application and state that the' above information is correct I agree to comply with all County Invesogahon Fee _ - 'or`dmances and State jaws relatingrto budding construction _Toml Fee _ •.Z'�"F .� - ^ D and hereby a`u ar representatives of,this County to enter r e- ned property for inspection purposes -. / n? 'SEE yREVERSE FOR,EXPLANATORY LANGUAGE J-„_ Signature of A Date—