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HomeMy Public PortalAbout9527 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 I +.•II �/a/� y'%//�� (''//� DISTRICT NO I PLAIN UK NO PERMIT ND? ADD REIBB / /1 � � /!/// .���•Ci'!7� Y/I LOCALITY /YIL�Y//d RECEIVED BY I DATE OF APPL DATE ISSUED NEAREST OBS OWNER / r.,1yG[y/ , �jJ ADDREIBB / ti� MAILLOCALITY ADDRESS / f �jy��•J NEAREST TEL ��]l/a S CROSS ST 13 OFp ARCHITECTOR TEL JR / ZONE PLANS ENGINEER NO SLOG R NO ADDRESS / /-i SETBACK LINE / APPROVED TEL - CONTRACTOR / f/ NO BY I DATE USE APPROVED ADD E B �f ZONE BY I DATELEGAL I —DESCRIPTION LOT NO BLOCK { CORRECTIONS r TRACT SIZE OF LOT ^Iy / �(J NOW ON LOT USE OF NO OF NO OF EXISTING BLDG FAHIu[a ROOM ` ---� •- -- •-- - ---- DESCRIPTION OF WORK NEW ALTERATION ADDITION y A REPAIR MOVING DEMOLISHso FT 0 SIZE U �{/ ROOMS STORIES / y WALL F COVERING ROO I COVERING ��{7wA•✓ USE OF NEW /� /.J�- _• J/. - "" { BUILDING BUi///� /� /�C�•W/J rG( J '/ YH"�LCIi OU/J OYA�/.LECJ.! 1 I HEREBY ACKNOWLEDGE THAT I NAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORME, MATERIALS ,A•S AND STATE LAWS REGULATING JnBUILDING CONSTRUCTION /FRAME p r l_ // ". ' BRACING,BOLTS SIGNATURE 7 -/2`r–�l IJ RE OF [/ JI/�' �•�Kif/y p PERMITTEE LATH, INT AUTHORIZED AST- �yV LATH, EXT IF 7.6 BA 9<B oes-a !AM ecie $ GQ P C III >"II PLASTER, INT FEE PLASTER, EXT G VALUATION 4 FINAL FEE 7BA638A CE jF BOS 662APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING ,DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A LAMBIE COUNTY ENGINEER NEAREST WILLIAM A JENSEN SUP T OF BUILDING CROSS ST DISTRI T N GROUP TYPE SSED BY . FOR APPLICANT TO FILL CONST FUSE ING j STATISTICAL CLASSIFICATION SE ER MAP ESS CLASS N DWELL UNITS -- � K G O BLOCK WATER NOT REQUIRED RECEIVED CERTIFICATE MAP NmHWAY F LOT Z(� NOWUP ON LOTS NO 'CIRCLE) STATE MAJOR SECOND AL USE ZONE SPECIAL _ F CONDITIONS EXISTING BLDG TEL OWNER NO BUILDING EXIST , ' SETBACK YARD HWY STREET ME WIDTH ADDRESS FRONT ARCH ITE R TEL7 TEL ,F L ENGINEER, NO SIDE a y P L d ADDRESS O TEL V CONTRACTOR NO H ADDRESS DESCRIPTION OF WORK a NE ADD ALTER REPAIR DEMOLISH � SO FT TT NO OF NO OF ? SIZE C/ STORIES FAMILIES USE OF STRUCTURE e SIGNATURE OF APPLICANT VALUATION S Z VA_':v- O ' APPROVALS JOATE IN6pCCTon sel TVpC �. PC PMT d FOUNDATION LOCATION FEE S FEE S FORMS MATERIALS FRAME FIRE STOPS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS T AND BTATE THAT THC ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION 1 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY W NOT EMPLOY A PERS IN VIOLA LATH INT TION OF THE LABOR I E F THE STATE O AL OMNIA RELAT N LNG TO WORKMEN B C E RATION SUTAI LATH EXT SIGNATURE OFi HOUSE NUMBER COR / PERMITTEE RECT AND POSTED ADDRESS / FINAL JOHN F LEWIS PRINCIPAL STRU TURAL ENGIµ ER PLAN CHECK VALIDATION GK MO DASH _ PERMIT VALIDATION DK MO CASH / 3 0 3 2:o APP ,8 1 A 1 1 50- v `; TeAEneACEpeoovs APPLICATION•FO R+BUILDING`PE,RMIT COUNTY OF LOS ANGEl 1.13UILDING DEPARTMENT OF-COUNTY ENGINEER ADDRESS BUIIDING AND SAFETY DIVISION I LOCALITY a JOHN A LAMBIE COUNTY ENGINEERNEAREST, , } 'L..• WILLIAM A JENSEN SUP T OF BUILDING 'd CROSS ST' ♦ OIST�J-CT N G CTYPE ONST P S l Y MD PLICANT TO FILL IN., + tF, ��(, STATISTICA CLA KATION . S ER MAP ' 21 CLASS NO DWELL UNITS PBLOCK WATERNOT REgUIRED RECEIVED CERTIFICATE 4 -12 - J MAP (C Av STATEMAJORSECON LOCALNO OFBLDGS NO V ICIRCLE)c 'N1OW ON LOT USE ZONE SPECIAL I USE OF CONDITIONS EXISTING BLDG TEL OWNER• NO BUILbINGEXIST [t SETBACK YARD HWY , STREET NAME WIDTH ` ADDRESS1JZ1 PCNTIAND Tfmkrfc IT .FRONT , �- ARCHITECT OR TEL P L ♦ _ ENGINEER - NO SIDE ADDRESS - Y, TEL (1/RO/GK {��EG ./ e� ~ /O V CONTRACTOR, NOcd - • `� `+��p�(Y ADDRESS . ¢' , " ,• � y / OF' aAx1 DESCRIPTION OF WORK ' • �^ w HL/4! w NEWS ADO ALTER REPAIR DEMOLISH SO FT NO OFNO OFUSE OF 1 f'Yl SIZE STO`R/IES ' FAMILIES I i STRUCTURE CNG`r— - - q SIGNATURE OF a.. 4 APPLICANT VALUATION $ APPROVALS )DATE, INSPECTOR SNm:NAZJML U _ FOUNDATION LOCATION /, 1 FEE $ FEE $ FORMS MATERIALS ' Y FRAME FIRE STOPS ! C HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS 1 r/Vl�l ANO STATE THAT.THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION 9/al VFf '/' WITH ALL COUNTY ORDI NANCSS AND 3TATE LAWS REGULATING •GAS VENT DUCTS T BUILDING CONSTRUCTION I CERTIFY THAT�JIN DOING THE WORK AUTHORIZED HEREBY I WILL NOT,EMFLOY ANY PERSON IN LA -INT TION OF THE LABOR CODC OF THE STATE OF CALIFORN4IRELPT - ING TO WORKMEN S COMPENSATION INSURAµµccE - 1 .J - / ( LATH EXTM I SIGNATURE OF /`�_ J� „r�•d( + HOUSE NUMBER COR ,-PERMITTEE 6 I RECT AND POSTED ADDRESS9 S��� FINAL -p7 i JOHN F LEWIS PRINCIPAL ST RAL ENG EER PLAN CHECK VALIDATION CK - ,.o MIT- CASH _ PERVALIDATION CK M o = CABH ' L4CO2 5 3.6� AUG12 1 D 2 2.00 APPLICATION FOR Il • BUILDING PERMIT Lu FOR APPLICANT TO FILL IN ADDRESS 50 BU ICING ADDRESS �/ Pin- S LOCALITY NEAREST CITYemn Ic GZI Y" ZIP 17A0 CROSS ST. o (� _ NO.OF BLDGS. ASSESSOR SIZE OF////LOTSa n NOW ON LOT p MAP BOOK AGE PARCEL TRACT/Iy-S 7 2 BLOCK LOT NO. 2� DISTRICT GROUP TYPE FIRE R SED /�� p ��p 7� 5a S CONST. ZONE OWNER /� /// /[ /�// NO. IV 7 T/�( STATISTICAL CLASSIFICATION SEWER MAJ"' ADDRESSY7/ 4. P.94 " S CLASS NO, _DWELL.UNITS BK PG CITY T /Q d/ ZIP 9/7 V EZONE MAP TELj 11 NO. ENGHNEER OR / e' NO '�/7% —/ CONDITIONS ADDRESS O Pasaae/r ROAD DEPARTMENT APPROVAL REQUIRED VES ❑ NO ❑ TEL CONTRACTOR, /JjgQ //Q NO. BLDG. TBACK FROM UC FRON PROP.LINEOF (STREET) ADDRESS USC/A''GY NO. TOTAL SETBACK FROM TYPEOF EXISTING LIC, HIGH AV + YARD = FRONT PROP.LINE HIGHWAY WIDTH CITY CLASS _ CONSTRUCTION LENDER + C- NAME AND BRANCH BLDG.SETBACK FROM U ADDRESS CITY SIDE PROP.LINE OF ISTREETI SQ.FT_ _ NO OF NO,OF CHECK HIGHWAY + YARD TOTAL SETBACKVPE OF EXIST SIZE STORIES FAMILIES ONE SIDE PROP. IDT INw LINE HI Y WHG d N DESCRIPTION OF WORK r O W ❑ + = Z ADO�pgg S CORNER CUTOFF YES ❑ NO ❑ �p a IN OPEN SPACE YES Ll [:1REPPAIR USEOFF /e Q�/� DEMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑ EXISTING BLDG 51 APPLICANT '� TEL /'C1H'mE INS IPRINTI � NO 7. 9 BY ISIGNATUREI I HEREBY ACKNOW E THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS ECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATIN BUILOING 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. PENSATION INSURA SIGNATURE OF -' (.t � y` FINAL BY PERMITTEE DATE ADDRESS CITY P"yy��,,// � '/ TEL 7_ P.C. Fee$ Permit Fee �✓ NO. I Issuance Fee J VALUATION \/ Total Fee PLAN CHECK VALIDATION CK. M o. CASH PERMIT VALIDATION CK. M.G.. CASH . 057-6EIFIGO 1 48.75 • ILII t, 76A6388CE 0903136/76 I © vV WORKERS'COMPENSATION DECLARATION li � col,/e T�f � / _ =[ / 1 ereby affirm that I hove a certificate of consent to self ,`/N' in we, or a certificate of Workers'Compensation lnsarance, APPLICATION F O R L D I N d"ERMli/ � o a certified copy thereof (Sec. 3800, Lab. C'.�)� (� cyNA'S7 O hl ComponK3( Tic COUNTY OF LOS ANGELES BUILDING AND SAFETY WIN Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS -e � !NS Certified copy is filed with the county building inspec- BUILDING IJ tion department. ADDRESS LOCALITY Date�^ ." Applicant ` CITU ZIP CROSS ST. V CERTIFICATE OF EXEMPTION FROM WORKERS' OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT WON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP hundred dollars($100)or less.) TRACT BLOCK LOT NO. NO. CQ 11 TEL - I SPECIAL > I certify that in the performance of the work for which this OWNER O .I CONDITIONS D_ permit is issued, shall not employ any person In any manner -1 DISTRICT GROUP TYPE FIRE PROCESSED BY O so as to become subject to the Workers'Compensation Laws. ADDRESS T ✓1 �� �� CONST. DONE ®� V hS d CITY Q CL ZIP Date Applicant STATISTICAL CLASSIFICATION APT. CONDO. H NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR V DWELL UNITS_ W Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. isl 1 Compensation provisions of the Labor Code, you must forth- ADDR SEWER MAP N with comply with such provisions or this permit shall be TEL Z deemed revoked. CONTRACTOR NO 'ae��� BK. `PG, VALIDATION LICENSED CONTRACTORS DECLARATION LIC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS (y N VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC Professions Code, and my license is in full force and effect. CITY CLASS C- q f o2r)o ► SO. FT. NO. OF NO.OF CHECK License Number`r�Ct Lic.Class "/� '�q�z SIZE STORIES FAMILIES ONE Contractor '� Date Q e26 ^� DESCRIPTION OF WORK 4'E NEW ❑ f I am exempt under Sec. 4 Vl 4 ADD ALTER ❑ FINAL B.BP.C. for this reasoner DATE REPAIR ❑ Date: USE OF x STING BLDG. S. {- DEMOL ❑ sty AL Signature APPLICANT TEL. OWNER-BUILDER DECLARATION PRINT lOL NO. i3ce•-42 Z I hereby affirm that I am exempt from the Contractor's License ��• �in / L , , T / � Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): BUILDING5 4 1.6 A El1, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and ji'• e . . . ) the structure Is not intended or offered for sole(Section LOCALITY r , 7044, Business and Professions Code). MOVING TEL. 2 5 9, 2.5 ElI, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- . 5 9 2 5 tion 7044, Business and Professions Code). ADDRESS REQUIRED L SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY TOTAPROP. LINE WIDTH 01111. 1 hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. Sec. 3097. CIV. C.). SIDE 0 P.I. Lender's Name t� _ Lender's Address P.C. Fae S Permit Fee 41O p�f/ s I certify that I have read this application and state that the Issuance Fee 0 1 5 tJ above information is correct. 1 agree to comply with oil County Investigation Fee _ ordinances and State laws relating to building construction, Total Fee r Z�✓ and hereby authorize representatives of this County to enter the above mentionel4worperty for inspection purposes. . SEE REVERSE FOR EXPLANATORY LANGUAGE n Signature of Applicant or Agent Dole !s