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Home My Public Portal About9431 PENTLAND ST_Building__ APPLICATION FOR BUILDIN6 PERMIT CO"TY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. DISTRICT O. GROUP TYPE 1' BY 5AIDR APPLICAN TO FILL IN to CONST. V STATISTICAL CLASSIFICATION SEWER MAP CLASS. NO.'O/''✓I DWELL. UNITS BK G YZ BLOCK WATER CERTIFICATE: NOT REQUIRED RECEIVED MAP Q HIGHWAY STATE MAJOR SECOND. OCA No.OF SLOGS. NO. ICDICL[1 NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS EXISTINGBLDG . OWNE i TEL. S UIIDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS FRONT ��/ A ARCHITECT OR TEL. P. L. l_6 ENGINEER NO. SIDE =_'s ;!2t TEL. 7 �I - — O CONTRACTOR NO. LJ ADDRESS Q F DESCRIPTION OF WORK � a NEW ✓ ADO ALTER REPAIR DEMOLISH Z SQ.FT. NO.OF NO. OF —SIZE ORI ES FAMILIES USE OF / A STRUCTURE dif I SIGNATURE OF APPLICANT VALUATION $ O OO APPROVALS DATE INSPECTOR'S SIGNATURE PC. PMT FOUNDATION: LOCATION FEE $ FEE $ Q 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 I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LABOR COD OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S Co. NSA T ON INSURANCE. LATH. EXT. SIGNATURE OF A HOUSE NUMBER COR. PERMITTEE RECT AND POSTED ADDRESS FINAL JOHN F. LEWIS. PRINCIPAL STRUCTURAL EN R PLAN CHECK VALIDATION OR. M.C. CASH _ PERNIIT VALIDATION cK. M.o. cASM ui.0 9 9 1 6 t'o SEP 6 1D 1.00— IDEP,ARTMENT 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�O PLAN L K? PERMIT ADDRESS D LOCALITY RECEIVED BY I. DATE OF APPL DATEIBBU�EJD CROREBT BUILDING OWNER ADDRESS MAIL _ QJ LOCALITY ADDRESS NEAREST NO Jp �/ CROSS BT C FIRE 1 NO OF TYPE GROUP1 ARCHITECT OR TEL ZONE NO OF1 11 W I ENGINEER NO / BLDG ADDRESS ///r/ - SETBACK LINE an I M I A) ORD NO TEL 1 APPROVED 1 CONTRACTOR // I / NOBY I t 1 DATE ^ 'I USEI APPROVED ' ADDRESS ZONE -I BY, I DATE 1 LEGAL CORRECTIONS I DESCRIPTION LOT NO BLOCK 71 I J TRACT / ��J!/ -I— NO SIZE OF LOT (� a /C I(/ �I NOW ON LOTH * I V Y USE OF NO OF NO OF EX19TING BLDG r FAM I LIES ROOMS DESCRIPTION OF WORK NEW ALTERATION ADDITION z REPAIR MOVING DEMOLISH 0 BqFT (, NO OF ,/ - – (+: G_:'J�labi �/. _ SIZE ROOMS '7 STORIES / ). WALLI ROOF r COVERING -1-COVERING + � u USE OF NEW 9+ BUILDING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION LOCATION INBPECTOR GATu[ AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS y� AND STATE LAWS REGULATING BUILDING CONSTRUCTION w�.�1 FRAME FIRESTOPB,SIGNATURE BRACING,BOLTS /L PERMITTEE— I!//.fes/✓v(/" �'y LATH, INT AUTHORIZED AST. Yy� LATH. EXT 7eA6 ^ 9-9e .8-3 eDH ecce $ O P C $ �/ 01:2PLASTER, INT FEE PLASTER,EXT J VALUATION FEE V FINAL 4. ^+--�vG`� —/�—e- t+ ys 76" -_• r _ _ _ _ _ - _ C64&M(REV 11/78) d; APPLICA rO 0 BUILDI � RMIT_ COUNTY OF LOS ANGELES _ BUILDING AND SAFETY c FOR APPLICANT TO FILL IN _ U- ASSESSOR ss - �j - - BUILDING ., ADDRESS 3l- 1 a TY _ CITY ZIPT ST O OF BLDGSR 00 SIZE OF LOi OW ON LOTOOK J O - PAGE DOa PARCE LLICT GROUP TYPE FIRE PROC ED BY TRACT 8 BLOCK LOT NO � _ CO O E ""- TELOWNERtr'� h1�� NO1CAL CLASSI FICATI)N SEW ER MAP ADDRESS p CLASS NO _DWELL UNITS BK PG OTY - ZIP— 8O' ( 1 ARC ITEOR TEL VALUATION ENGINEER - NO — !/C/ ADDRESS _ BLDG SETBACK FRO TEL FRONT PROP LINEO ISTREETJ r CONTRACTOR e ou^ ev, NO HIGHWAY + YARD TOTAL SETBACK FROM YPE OF _EXISTING LIC FRONT PROP LINE GHW Y WIDTH. ADDRESS NO CITY '' CLA55 • _• - - _ BLDG SETBACK FROM CONSTRUCTION LENDER _ ' -�*— AME ANDBRANCHSIDE PROP LINE OF T ISTREETI _ N HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING ^ ADD SS CITY SIDE PROP LINE HIGHWAY WIDTH Q, S NO OF NO OF CHECK +" SIZE STORIES FAMILIES —ONE USE ZONE MAP DESCRIPTION OF WORK - - NEW NO 5 SPECIAL fitt�l ADD CONDITIONS 7 44Ar - ALTER FINAL BY REPAIR DATE j USE OF1DEMOL EXISTING BLDG _ _ _ _1_ - _ Z APPLICANT TEL �F y _ (PRINT) OO ;!)91-.:39I t L BY ISIGNATUREI HEREBY AC" W E THAT AVE READ THIS ICATION AND STATE THAI THE ABOVE IS CORRECT AND AGREEJO COMPLY-WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE - WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM _ 1_Z 80629 PENSATION INSURANCE ' SIGNATURE OF C PERMITTEE 2 • • 2.A Q ADDRESS _ lqviU _ • • • 2500 TEL OTY N7 0 0605.--80, d PC Fee E Permit Fee > Issuance Fee 7, Total Fee �3 76516381 I CE#803(REV 11/78) ( i APPLICATION FOR BUILDING PERMIT, ' COUNTY OF LOS ANGELES BUILDING AND SAFETY _ FOR APPLICANT TO FILL IN121 UILDING DDRESS BUILDING ADDRESS �(! OCALITY ` J _ CITY R1r /`c Gam/ ZIPRROOSSST ` NO OF BLDGSSESSOR SIZE OF LOT S NOW ON LOTAP BOOK �t PAGE PARCEL DISTRICT GROUP TYPE • FIRE P ESSED BY TRACT � ! BLOCK LO �� CONST ZONE TEL I V OWNER '�/� N TATISTICAL CLA--SS771FIC//ATION I SEWER MAP ADDRESS CLASS NO DWELL UNITS BK PG CITY ZIP ENGINEERRS OR TEL NALUATION �j �ADDRESS LDG SETBACK FROMTERONT PROP LINEOF ' (STREET) CONTRACTOR , NIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING LIFRONT PROP UNE HIGHWAV WIDTH ADDRESS I J � ( N +CITV p"'L A CLCONSTRUCTION LENDER - - - - LDG SETBACK FROM DE PROP LINE OF (STREET) NAME AND BRANCH IGHWAY + VARD TOTAL SETBACK FROM I TYPEOF JEXLSTING 6 ADCITY SIDE PROP LINE HIGHWAY WIDTH O SO DRESS /,G FTO OF NO OF CHECK + SIZE %V SNI . FAMILIES ONE d USE ZONE MAP O/ DESCRIPTION OF WORK NEW NO 1 Ki / SPECIAL � � ADD CONDITIONS / N CX ALTER FINAL BY Z a3 r rr- REPAIR ❑ DATE USE OF DEMOL ❑ ' EXISTING BLDG APPLICANT TEL P (PRINT) ` NO t � G w BY ISIGNATURE) > I HEREBY AGKOWLEDGE THAT I HAVE THIS APPLICATION AND STATE uYL� THAT THE ABOVE IS CORRECT AND AG O COMPLY WITH ALL ORDINANCES W AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE S WORN AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF V THE LABOR COMOF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM = q PENSATION INSURANCE $O'/ 2 1 A SIGNATURE OF 46/ # 23 PERMITTEE _ ADDRESS — 2 • • 4 3 2 0 TEL - o • •• 4320 CITY NO J 0612=80 ' PC FeeE 3,20 Permit Fee T > 901722A Issuance Fee Total Fee _ _ - r DIVISION OF BUILDING AND SAFETY Department of County Engineer Connty of Los Angeles WM d FOX. COUNTY ENGINEER APPLICATION --"-- - ,r FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILpINp / 1 I DIBTRI�.T NO j PLAN C[ an REo No P RMIT NO ADDRESS L Q LOCALITY e I ./ 0. D EIVEBY DATE OF APPL DATE IB®-Ue,EDD ' G (�KRAREST S.21 —wIS AGI V It 8 111 CROSSST / ADDRESS 1,01 AMAIL '�J LOCALITY \� ADDRESS (� ///��Kl./// NEAREST n y { CROSS BT CITY No I FIRE I A NO Or O P ZONE PLANS _ ARCHITECT OR TEL ENGINEER NO BLDG SETBACK LINE ADDRESS USE APPRQV[D TR ZONE BY DATE CONTRACTOR NO HOUSE NUMBERING ADDRESS MAP NUMBEw 7 / NO ASSIGNED BY �,p LEGAL ✓ CORRECTIONS DESCRIPTION LOT NO ^/ BLOCK TRACT s- r71 Q NO OF BLOB. SIZE OF LOT A NOW ON LOT USE OF HO OF EXISTING BLDG _4 rAMILIV DESCRIPTION OF WORK D A D NEW ALTERATION ADDITION I Z D REPAIR r Y DEMOLITION No or GO ZE /• c;t ROOMS STORIES CO WALL GOOF COi(� COVERING UBE OF STRUCTURE INSPECTION FOR APPROVALS OCCUPANCY AS INSPECTOR'S SIGNATURE DATE FOUNDATION LOCATION FMAMB. MATERIALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME FIRESTOP9, CORRECT SRACING. BOLTS I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATINGFURNACE LOCATION, ) BUILDING CONSTRUCTION GRN VENT DUCTS SIGNATURE OF ^ �C / , I -+-fel LATH. INT PERMITTEE_ ADORES 1 I ( ' �^ ,W( V LATH. EXT AUTHORIZED AOT PLASTER. INT SFrElOE PLASTER. EXT HOUSE NUMBER COR- RECT AND POSTED VALUATION FINAL 7sasaeA oee 3 I ! DEPARTMENT OF BUILDING AND SAFETY ® � ®__®-�_�_�_�_ COUNTY OF LOS ANGELES ® !V WM. J. FOX, CHIEF ENGINEER j APPLICATION FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY _ �- DISTRI NO. { Pun CK OR REO"ND L- PERMIT NO ADDRESS 7�`� A�yA„ ! i RECEIVED BY DATE OF APPL DATE IBGUED LOCALITYNEAREST �L/(^/y1��Z1 ( /J 1 �y CROSS ST �f/ 6/�/ •aA-0� 1&At BUILDING {�''� ADDREBBI 3 L/r'I✓d { DOWNER /!O - .. D TJ. NCI Y / 'i7'Qi/ { r • + ` f / MAIL //��- J, ✓ / - - LOCALITY ! ,ADDRESSY l �L J/��Je T{ ✓/ • /I _ NEAREST! CROSS BT CITY • �.lf'_.-� ,/IJ Jam/ 1 f 1.4, NOLO f� �S�L FIREj NO OF TYRb�+ • P� ARCHITECT OR / / TEL ZONE -- PLANB� ENGINEER l NO BLDG D B ET 9ACKILINE - - . i. _• f ADDRESS USEI,�APYPROV[D TEL ZONE BGATE CONTRACTOR NO HOUSE NUMBERING 1 L ADDRESS MAP NUMBER 2Q/ I NO ABe1GNED BYLEGAL � DESCRIPTION) LOT NO BLOCK ` _ t CORRECTIONS 1 TRACTNO IF I IDI ' tt��/�pS SIZE OF LOT .J I) n NOW ON LOT g _ USE OF 1 a �r1 / - - NO^OF d - - �•�u- 'UT EXISTIN BLOB �lJ d.LlM�I�I,(L1 FA..L¢e / • / DESCRIPTION OF WORK i °n �o NEW ALTERATION ADDITION Z REPAIR DEMOLITION i r - FT NO EDF SI { 812EEXT WALL ROOMS STORIES ROOF COVING +QLft.(�I.-!f Je /7 I COVERING e^A- A f9 USE OF STRUCTURE 1 C�, t �i!-o/Jz_xrrF-�, �I INSPECTION FOR j APPROVALS OCCUPANCYAS INSPECTOR'S SIGNATURE DATE '1 FOUNDATION LOCATION FORMS, MATERIALS /S7—/N4 1 HEREBY ACKNOWLEDGE THAT I HAVE THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME FIRE STOPS, CORRECT BRACING. BOLTS �� M� AGREE TON ALL COUNTY ORDINANCES FURNACE LOCATION, AND STATE LAWSSREGULATING NG BUILDING CONSTRUCTION GAB VENT DUCTS .�[> i SIGNATURE OF LATHr INT E moa PERMITTEE / ADDRESS 9L5e3l 'oa l 11'71I f ♦/q . rp LATH, EXT PLASTER. INT _ AUTHORIZED ABT PUNTER. E%T $ FEE HNUMBER COR- RECT a,o RECT AND PORTED VALUATION 'c'Op ` FEE FINAL P C ! L 7N6YA DBB 3 7-61 V - • WORKERS' COMPENSATION DECLARATION (/ hereby affirm that I havecertificate of consent to self A.P41CATION- FOR BUDDING PERMIT Jnsgre,`or a,certificate of Workers' c kers' ompensation Insurance, or a cgrtified copy thereof (Sec. 3800, Lob. C.) • t COUNTY OF LOS ANGELES+ BUILDING AND SAFETY • Policy No. Company BUILDING ❑ Certified copy is hereby furnished. F APPLICANT�T�OyFI�LL IN ADDRESS ❑ Certified copy is filed with the county building inspec- �jEfT[N/tion department. /J^ ZIP / LOCALITYDate Applicant NO. OF BLDG$. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' NOW ON LOT I CROSSSTCOMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100) or less.) MAP 7EL. _ O OWNER N .yJ USE ZONE I certify that in the performance of the work for which this SPPEECIAL permit is issued, I shall not employ any person in any manner ADDRESS CONDITIONS D. j so as to become subject to the Workers' Compensation Laws. O ,.y CITY ZIP Date-Z2 Pp � EARCHITECT NGINEER OR 7� DISTRICT GROUP TYPE FIRE PR §SED BY 0 NOTICE TO APPLICANT: If, after making is Certificate of (� 7 CONS ZO O Exemption, you should become subject to the Workers' J'0 Q K — K�Ftre Compensation provisions of the Labor Code, you must forth- ADDRESS l; with comply with such provisions or this permit shall be ` TEL STATISTICAL CLASSIFICATION APT. C DO. N deemed revoked. CONTRACTOR <.� - S NO" 73 ? LICENSED CONTRACTORS DECLARATIONL% _ CLASS NO. �/ DWELL. UNITS_ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS� f N _ e- SEWER MAP (commencing with Section 7000)of Division 3 of the Business � 11 LIC e,jc- and Professions Code,and my license is in full force and affect. CITY �'; CLASS BK. PG. y VALIDATION � ��• // SO 4-s §TORIES FAMILOIES ONE License Number Y/e) � Lic. Clan G3 SIZE Imo' /•1 y VALUATION Contractox=, ' r� •^' EDate/J`-�-`� DESCRIPTION OF WORK L"'—�.� NEW ❑ �/ ► ❑I am exempt under Sec ADD ALTER ❑ B.BP.C. for this reason -5 REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMOI ❑ $'gnat r.- �" �3' /�'/"'T.'"4'c= APPLICANT F — FINAL v�• (PRINT) �'` `OWNER-BUILDER JJ DATE —Ir / 1 hereby affirm that I am exempt from the Contractor's License ADDRESS /� FINAL Law for the following reason (Section 7031.5, Business and Professions Code): PRESENT BY �'_� ❑ I, as owner of the property, or my employees with ADDRESS at"�"I •T wages as their sole compensation,will do the work and , vvs. the structure is not intended or offered for sale(Section LOCALITY 7�" c 3307 95.63 7044, Business and Professions Code.) MOVING TEL. R ; T❑ ,` CONTRACTOR NO. `(�-sem. ' / i ITEM I, as owner of the property, am exclusively contracting t with licensed contractors to construct the project (Sec- ADDRESS TOTAL 98.63 tion 7044, Business and Professions Code.) 1, p REQUIRED ygRO HWV TOTAL SETBACK FROM E%IST. I.HE4Yt 98.63 CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT CHANGE .00 the performance of the work for which this permit is issued P.I. (Sec. 3097, Civ. C.). SIDE P.L. Lenders Name 0000-17001 12110/92 . s LDMA R.J. H ^ P.C. Fee E Permit Fee Lender's Address ap.n - 3 , 6982 i AM 9L2t.?-t $ I certify that 1 have read this application and state that the Issuance Fee LDMA P/C N above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee LDPAA Perm. X Q and hereby authorize representatives of this County to enter EYq upon above-mentioned roper y for I ction purposes. IQt' ��u,( 1,270_1� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of pplicant or Agent Date ' APPLICATION FOR PERMIT COUNTY'OF LOS ANGELES BUILDING AND SAFETY/7 WORKERS COMPENSATION DECLARATION , ' .FOR APPLICANT TO FILL IN BUILapiG �iRE� "C �.oY . hereby affirm that have a cert10cate,of consent to self insure BUt G ADDRE G� +V n , er a certrficate of Workers Compensation I Nance or a certified • `' ��0 Avip Tcopy thereof I( ec �38"0'"0 L�,,CI �' ZIP - Policy No L-+-764'?" 2,ComPanY� LOCALITY SIZE F Ts NO OF BLDG S NOW ON LOT ❑ Certified copy Is hereby fumes >` rte, NEAREST CROSS I _ ertltled copy Is hletl with the` aunt build n TRACT - BLOCK LOT NO '- .. of j "department , ' . a USE ZONE MAP NO , ' Date AppllcanASSESSOR MAP BOOK I• PAGE PARCEL v , SPECIAL CONDRIONS - t ` CERTIFICATE OF EXEMPTION FROM WORKERS, . ER � wy�y TEL No ' COMPENSATION INSURANCE ppp(((]]]ppp ,/� IrGR/ rwITHIN 1000 FT OF SCHOOL, ves No (This section need not be 6ompletad It the permit Is far one hundred q y O 'AvE DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BV ddlars(5100)or'less) .' ` 1 - _ '- 1a r .. ) C - - ZIP I certify that,ln the'performance of the work for which this permit J� Is Issued I shall note Work anyfperson In arty manner so al to v ) ARCHITECT ENGINEER - TEL NO i tiecome subject to the Workers Compensation Laws ., � _ STATISTIC PL Ct7pSSIFICATION APT CONDO rr Data Applicant ADDRESS - - , `CLASS NO�/ (—_ DWELL UNRis NOTICE TO APPLICANT "If after'meking ,this Certificate�ief ( REQUIRED TOTAL SETBACK FROM EXIST t t Exemption you should become subject to the WOrkersx TRACTOR I- //�� SETBACK YARD .HWV PROP LINE - WIDTH '.. INT Compensartion provisions of the,Labor'Code you'must forthI 23080—0036 " comply with such provisions ortthis permit shall be deemed revoked AD E55 n , N PPL LICENSED CONTRACTORS DECLARATION +T • 1 2 SIDE • , y CITU , UCC P L 14. I tieneby.aHlrm that I am Igen edt underpin IsIons of Chapter 9 _ SEWER MAP a w' (commencing Wrth'Section 7000)of DNlsen 3rof the Business arta SO FT SIZE, NO STORIES NO OFF ILIES `+ Professlorre God and e is in ull force a effect - NEW ❑ BK PG , U r License NuI "A Lc Claes . __- r DESCRIPTION OF WORK ADD - -VALUATION ' , I ALTER ❑ $ �L 0 t '- Contractor Date _ 0 OF c-XIS'f1�1 ❑ 1 Sin-'exempt under Sec - i, - IREPAIR ❑ �$ o _ U ',j BBPC forthlsreasd � n ' n 10t8 DEMOL ❑- _ , d ,• LOW P/C a ' r Date , ,• USE OF EXIST NG BLDG �� - URM ❑ . _ - Signature I ICANT.lPRIATI O • LOW Pai,n''1-1A �, f_l ,,, 1 a t • El 11 as owner of�the properlYn or my ertipbyees with wages as S U►.�• 9.3 = AIT.• ' their sale compensation,willIdo the work end the structure Is 'I ^ ��y� ^y�qy /w.� riot Intended or offered for sale (Section 7044 Businessland �• l I JC/��ILL VE 1� Q FINAL DATE Q , Pias�smns„ wee Code) ty, ' wtL THE APPLICANT aR FUTURE BUILDING 0<cLPANT HAND.E A HA DKXJS WIFERUL. •O , ~ 1 OR A MIXTURE COWNNING A IUZAALUIIS MATERIAL EDINL TO OR GREATER TRAN THE Y 1 . 0 as owner of the property em exdusrvely contracting with , _� 'Q licensed'contractors to construct thefproject (Section 7044 MIpUNs sFEciFIEDyuTHE HAZARpOus MATERIALS WFORMATION GUIDE>, FINAL BY �� yyl. I .4 Business and Professions Code) . YES❑ "No✓I , Y t 3303 WI TIE INTENDED USE OF THE&ADUNG BY,TRE APRJGANT OR,FIRURE RI +' ' L ' I' Z .000LF1Wr REQUIRE A PERMm)FOR CONSTRU ON OR MOOIFICAION FROM THE SOUTH J7 — -. I . - CONSTRUCTION,LENDING AGENCY COAST MR QUALITY Ww GEn NT DsmncT SGMCJAD)SEE PEPWTNG CHECKUST FOR L ITEM_ ' GUIDELNES C. 1 hereby affirm that there is`e construction lending agency f«, . ' .+• T11TA' 2bO .,3 t ES❑ NO a the performance of the work for which this permit is rssuetl(Sec - ' °'r Y 3097^Cry C) , IH/ME REAonEH srnA SwF M 0 DE THE SCAOMDPERMITTNG t- - - - _ 4� (HE Yt _ prECKLIST UNCE D MY FE R 0.S GELES COUVTY CODE' _ ' 'TREE 2 CH<PTER SE S 2 IA ERNWG HAZAHUUS �1� T Lenders Name ` MATEPoAS RE A /�� ^ • '” CfInAHVG , ,, ' AID I.Senders Address o 411atIhave read this application and'state under penally {otheaeinformalIsCoileIPC FEE " PERMIT FEElO�iR' ysa to lawsrelaad " Sem8lrveISSUANCE FEEtpartyinspINVESTIGATION FEE I r SEE REVERSE FOR EXPLANATORY LANGUAGE+ O