HomeMy Public PortalAbout9425 PENTLAND ST_Building__ DEPARTMENT OF BUILDING AND SAFETY }' APPLICATION FOR PERMIT
' COUNTY OF LOS ANGELES } p11
1, WM, J. FOX CHIEF ENGINEER B' U ' C
FOR APPLICANT TO FILL SIN 1 FOR OFFICE USE ONLYBUILDE
AD IN OISTRIi TNO PLANCK NO PERMIT ND
RE
LOCALITY G// RECEIVED BY I� DATE OFAPPL DATE ISSUED
NEAREST •W'o[-�2 �= 3- 3o-4s y3,�'J" 3ST
BUILDING
OWNERADDRESS
MAILQ ��
LOOALIlY
ADDRESS a/(/
>_
NEAREST
CITY TEAL '3 1,233CROSSBT
FIRE NO OF. TYPE �-rl GR PP
PP I
ARCHITECTOR TEL ZINE .1 PLANS` I/
ENGINEER NO / '
BLDG I - ORD NOI
ADDRESS / , / SETBACK LINE 1CAL, / '4L !
APPROVED i- — rl t
TEL BY DATE !
CONTRACTOR / N❑
ADDRE88
USE - BY, DATE
APPROVED t
20NE � 1
LEGAL �' ! CORRECTIONS !
DEBGRIPTI ON LOT NO / BLOCK (
TRACT l V T i
NO-DF BLOBS- may/ +
SIZE DF LOT (�D i} NOW ON LOT
118E OF NO
DO OF NO OF
LXIBTINB BLFAMiuce ROOM
DESCRIPTION OF WORK
NEW I xt ALTERATION ADDITION "
REPAIR �MOVING DEMOLISH p
SO FT V NO OF _ 1, VU IJe�Ib(v._f. �9ss Z
611E O ROAMS STORIES D
WALL �� ROOF QV N✓'CJ 'Ll a F
COVERING YY COVERING
USE OF NEW
BUILDING
I
' 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE 18 CORRECT FOUNDATION LOCATION INSPECTOR DATE
AND AGREE TO'CCMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS
AND STATE LAWB REGULATS%ING�B�UII/L�DII�N�G�CONSTRUCTION
I�/.LE%v��'Y FRAME FIRESTOPS,
SIGNATURE OF BRACING,BOLTS
-Z9
BOLTS
PERMITTEE- LATH, INT ' S'-3
AUTHORIZED ADT (^ LATH, EXT 'J
f
76.639. 9 RB PLASTER, INT
096 3 ..RIB IS 0-dp-D ® IJb
/
/ FEE PLASTER,EXT
VALUATION FEE /f/,/ d: t FINAL
11940098 SB. APPLICATION FOR. BUILDING PERMIT
>.' � � _
COUNTY OF LOS ANGELES BUILDING AND SAFETY -
N-WORKER S COMPENSATION DECLARATION ' ' ti FOA APPLIC NT TO FILL IN - - BUILD, A ES
. I hereby affirm that khave a o oens to of consent to salt mBUILDING ADDRESS
isfire 9425 Pentland -
w a certificate of VNxkers Compensation Insurance w a certified9425
ZIP
copy thereof(see 3800 Lab CI Tem le Cit 91780
LOCALITY
Pol,cy No PWC250179—O�mpany Golden Eagle slzE of Lor . No of BLDos Now ON Lor r
❑ Caddied copy is hereby furnshetl ' r' ' NEAREST CROSS r
IN Cerhfad copy S filedwith the county Wilding nufI'tion TRACT ' BLOCK LOT NO
department - USE ZONE. MAP NO , _Date,12-9-9 Applicant Virgin Roof Co ASSESSOR MAP BOOK PAGE PARCEL
• SPECIAL CONDITIONS • -
CERTIFICATE OF EXEMPTION FROM WORKERS a4'NER TEL W r D /
COMPENSATION INSURANCE W ema Brunen O WITHIN 2000 FT of SCHOOL' ';ES ND
(This section Reed not be comdeted it the permit is for one hundred ADDRESS
9425 Pentland DISTRICT GROUP. TV CONST FIRE ZONE PROCESSED BY
tlollars 1$100)or less) _ -
ryT TeCIT - - , zIP ��e ��
I cern that ,n the performance of,the work for which this permit!
Temple Cat CA 1780 'I
is issued aI shell not employ arty person ,n any manner,so as to ,
become subject to the Workers,Compensation Laws ARCHRECT OR ENGINEER TEL NO
STATISTICAL CLASSIFICATION A, APT CONDO
Date
Apdaant ADORE55 CLASS NO DWELL UNITS
NOTICE TO APPLICANT If after making this Cenifaate of REWIRED TOTAL SETBACK FROM EXIST
'Exemption you should become subject to the Workers 'CONTRACTOR TEL NO - S SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor'Code'you must forthwith* Virgin Roof Co. 818-287-0507
comply with such provisions w this Permit shall he deemed revoked` ADDRESS LK; NO , FRONT
PLr '
, L
r. LICENSED CONTRACTORS DECLARATION CI Box 1 1 — SIOECITN
I hereby affirm that I am licensed underprowsroru of Chapter 9 San Gabriel CA 91778 ' C3SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and SO FT SIZE NO OF STORIES I NO OF FAMIUES NEW BK PG
-Professrons Code and my l,cense,is,n full force end effect , e d
Laervse Number 160650 La class C39 DESCRIPTION OF YARN ADD ❑ VALUATIONS Q
Cootrector Virgin Roof CQ,te 6-30-95 Tear—off and apply one laver ALTER ❑ $ 3,595.00 ` . U
tY
❑ I am exempt under Sec _ 1130 and Class, "Air Fiber lasSt? REPAIR El $ ' Q
B&PC for this reason Shingles. 14 S s.' DEMOL ❑' LOMA PIG. _ _ W
_4 Date - USE OF EXISTING BLDG ' URM ❑ a
Dwellin 1 dJ
Signature APPLICANT(PiWT) TEAN L NO - LOPerm♦ i � ?
El [,'as owner of the property or my employees with wages as n 8-287-0507 =O
thelr,see.compensation will do the work and the,structure m ADDRESS _ '
not intended or offered forsale (Section 7044'BuSness and P 0. Box 5010 San"Gabriel CA 91778 - FINAL DATE IFF_ 73113 1=7,40
professions Code)
WILL THE AaPuc NT aR FurulE aaowe OCCti Hume A HAZAf+peUS ruTEnlu Q
❑ I as Owner of the property am exclusively contracting with OR A NiXTUE CONTAnmm A nAUARDous NUERI.i Fe TO GR GREATER THAN TIE 4-6.• A ¢ 1 ITEM
AANXMS SPECIFED ON THE 1 RDOUe MATERIALS IWOWMTioN 01 a ? FINAL BY ) >
licensed cnd Professions
toCodeIconstruct the project (Section 7044 YEs❑ No& ,. ,, TOTAL 137 x01
Business and Professions Code)
UNG OCC
THE REEWEO USE OF THE CONSTR BY UCTION THE 00010�iCANTA OR FUTURE BUSOUTH CHECK 137.4CI
CONSTRUCTION LENDING AGENCY ddAa a o LJREQUIRY A KR^NAOEME FOR rR s e cERAarTwc caEpcusT Fog (HI:{t 'E .Illi
„GUDENNEa
' I hereby affirm that there ,s a Construction lending agency for YES❑ NO,�}'µ
the performance of the work for which this permit,s issued(Sec -'
H 4 3097 Cr, C) CHEECCKUST IuwEERST 13 nW REEOUIIREnE" UNDER L09 MGEUES COUNTY CODE . IJfI[�I--rl[t(j 1 3/29/94
A
TITR z xo 20 100 THROUGH 220130 CONCERNING AZA
G HRDOUS ,
Lenders Name LE]ERI R ePIII,ND A + L f9-'
Lenders Address 1 AM 9:211
_o
I certAy that I have read this applcation and state under penally ,
g of perjuay that the above mformaton is Cprrect I agree to comply PC FEE ' PERMIT FEE '
$ with all county onimances and State laws relating to building 111.00 L
- constr Ciron end hereby euthenZa representatives Of this County ISSUANCE FEE ,
and
w-mentioned property for mspectan purposes 26.40
t m 8-29-94 WJESTCARON FEE TOTAL FEE ,
x wise on117-40
SEE REVERSE FOR EXPLANATORY LANGUAGE