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Home My Public Portal About9533 PENTLAND ST_Building__ AOeaa 11 55 APPLICATION FOR BUILDING PERMIT 1 11 as DIVISION OF BUIMING AND SAFETY BUILDING Departmmt of County Engineer ADDRESS Co=ty of Los Angeles LOCALITY JOHN A LAMBIE COUNTY ENGINEER NEAREST CABBATT D GRIFFIN SUP T OF SUILOIKa CROSS ST FOR APPLICA TO FILL. IN DISTRICT NO 1775 I _GROUP PE SEWER MAP BK PO CONST BUILDING 7MAP ADDRESS 53J E NUMBER )_ SHWY YES O LOT NO BLOCK U E:ZONE SPECIAL CONDITIONS TRACT ZZ C I'w/I NO OF BLDGB t BUILDING EXIST SIZE LOT (di0 NOW- LOT YARD HWY STREET NAME usE OFOP I SETBACK WIDTH EXISTING BLDGFRONT (49 P L -20 OWNER SIDE MAIL P L ADDRESS S .ice D TRACT DWELL I UNIT TEL / 067 1 DWELL IUNIT 5 INDUSTRIAL CITY NO C B PUBLIC BLDG ARCHITECT OFC TEL 2 DUPLEX 2UNIT9 ENGINEER NO 7 ISC ALT, ETC 3 APT M UNITS 8 ISCEL ADDRESS 4 COMMERCIAL TEL y0 CONTRALTO NO INSPECTION RECORD f�(� ADDRE99 1 fit.. DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH SO FT NO OF NO OF SIZE �� STORIES FAMILIES / UkE OF STR CTUR B / fll fn !e pN ^u mc, �ATW Iwl 1v� SIGNATURE OF APPLICANT APPROVAL - ADDRESS DAT IN PECTOR S SIGNATURE $ P C's �• F FORM STMATERIAlON L310N �V�Q FEE FRAME FIRE STOPS J 11 \ VALUATION a BRACING BOLTS FEE FURNACE LOCATION 1 v 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT DUCTS ` APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH INT I'1 ZZ AND STATE LAWS REGULATING BUILDING CONSTRUC- TION LATH EXT K N SIGNATURE OHOUSE NUMBER COR- PERMITTE P RECT AND POSTED ADDRESS / FINAL JOHN A LAMBIE COUNTY ENGINEER VALIDATION CLYDE N DIRLAM CHIEF BLDG INSPECTOR CK NO CAeH !_Z,,9 2 y 7,2, AUG 15 1 1000 5aaaA D35 11ae APPLICATION FOR BUILDING PERMIT 1 u DIVISION OF BMDING AND SAFETY ' BUILDING _ t Department of CountT Engme ' ADDRESS County of Los Angeles LocA.LITY ' JOHN A LAMBIE COUNTY ENGINEER NEAREST OF CASSATT D GRIFFIN SUP T OI BUILDING CROSS ST FOR APPLICANTJO FILL IN DISTRICT NO GROUP TYPE 6E BK MAP PG CONST BUILDING ��•-7 7 /� MAP STATE YES O ADDRESS i 7.7 C NUMBER HWY LOT NO BLOCK U NE SPECIAL - ' CONDITIONS TRACT' SIZE OF LOT 0 I NOW ON LOTS BUILDING" . EXIST SETBACK WARD HWY ' STREET NAME WIDTH USE OF EXISTING BLDG FRONT P L OWNER SIDE _ "- P L MAIL ,ADDRESS/ n c q O TRACT DWELL I UNIT CITY / [� NO ]r/ QZ/ DWELL Z3 1 UNIT g INDUSTRIAL _ 6 PUBLIC BLDG ARCHITECT O TEL 2 DUPLEX 2 UNITS 7 ADDN •ALT ETC ENGINEER NO 3 APT _UNITS A MISCEL ADDRESS �/./v/�� /1�y 4 COMMERCIAL CONTRAGTO54',,i qn ��,f N//O��Ljj Ad� INSPECTION RECORD ADDRESS - DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH SO FT �/ NO OF NO OF SIZE /-/- D STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF � - APPLICANT APPROVAUS ADDRESS LO %-. 1 DATE NSPkOOR SIGNAOURE OU P C S �- FFORMST MAT RIIALS FEE ION ION Q FRAME FIRE STOPS r' VALUATIONe O BRACING FEE BOLTS I sL - FURNACE LOCATION �* • - 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT DUCTS - APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES- LATH INT I .AND STATE LAWS REGULATING BUILDING CONSTRUC- TION • z LATH EXT SIGNATURE OF HOUSE NUMBER COR- ' PERMITTE RECT AND POSTED _ ADDRES FINAL JOHN A LAMBIE COUNTY ENGINEER VALIDATION CLYDE N DIRLAM CHIEF BLDG INSPECTOR CK NO GBH '1 _AC09 2 4.E .Q AUG 15 1 8b 0 Ir ; f APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES y - BUILDING A D SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDIV ADDRESS I hereby affirm that I have a certificate of consent to sell insure, BUILDING ADDRESS 'iie or a certificate of Workers' Compensation Insurance,or a certified qS 3 3 E. copy thereof(Sec.3800,Lab.C.) C,rM Pic-E-CNi ZIP -% 78d LOCALITY Policy No. Company 5 E OF LOT ��p— NO.OF BLDGS.NOW(ONN LOT ❑ Certified copy is hereby furnished. /3' TT 2 NEAREST CROSS 5 ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSO MAP BOOK PAGE PARCEL Q B9� e1 SPECIAL CONDITIONS — O/ CERTIFICATE OF EXEMPTION FROM WORKERS' O ER //�A EI,�I,,NO. ////' COMPENSATION INSURANCEi4UL � ' �7p.✓J�Z SS -g WITHIN 1000 FT.OF SCHOOL? ves No (This section need not be completed if the permit is for one hundre� AD ESS 3 f, �_�TL FJ.V+7� S7 DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY dollars ($100) or less.) � l I certify that in the performance of the work for which this permit` Fy�[G y'TY ZIP �/��Q is issued, I shall net employ any person in any manner s0 as t0`, ARCHITECT OR ENGINEER T ly0. Gf9 become subject to the Workers Compensation Laws. S-2..giLA STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. � DWELL UNITS NOTICE TO APPLICANT.' If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you Should become subject t0 the Workers CONTRACTOR TEL NO. SET BACK yggD HWV PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwit eUll��L FRONT comply with such provisions or this permit shall be tleemetl revoketl. ADDRESS UC.NO. P L LICENSED CONTRACTORS DECLARATION PILE CITY LIC.CLASS P L I hereby affirm that I am licensed underpmVisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO—FT SIZE NO.OFASTORIES NO,OF FAMILIES Professions Code,and my license is in full force and effect. �" NEW ❑ BK PG , a License Number Lic.Class DESO(11 TION OF WOR 91 ADD VALUATIO rrr�U O Contractor Date ALTER ❑ $ � O� x� Cc ❑ 1 am exempt under Sec. REPAIR ❑ $ � B.BP.C. for this reason DEMOL E] LDMA P/C a W Date: USE OF EXISTING SWO. URM ❑ — EL y_ 0 Signature APPLICANT(PRINT) TEL NO. LDMA Perm T aZ ❑ I, as owner of the property, or my employees with wages as Z their sole compensation, will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and FINAL DATE . G Professions Code.) WILL THE APPLICANT 09 FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIA- .M. ++ � OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE �1Ej� as owner Of the property, am exclusive) contracting with Q h I 'T° P Y� Y 9 AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIAl51NFORMATION GUIDE? FINAL BY 7 `•I °t licensed contractors to construct the project (Section 7044, YES El No ElBusiness and Professions Code.) WILL THE INTENDED USE OF THE BUIDUNG eV THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATON FROM THE S H CONSTRUCTION LENDING AGENCY COA uE rvlEsouaury MANAGEMENT olsrRlcr IscAQMo1 PEE PERMITTING cHECKusT FOR ^ E 1 I hereby affirm that there is a construction lending agency for YES El No El TO-;AL 632 - 59 m the performance of the work for which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERwLSINFORMATIONGUIDE AND THE SCAOMD PERMITTING 3097,CIV.C.) 'CHECK CHECKUST I UNDERSTAND MV REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TIRE 2 CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS 3 Lender's Name MATERIALS REPOR TI AND FOR OBTAINING A PERMIT FROM THE SCAOMD. .-_I INi1rv i,fl p Lender's Address FI PI o d NMR d N NT o I certify that I have read this application and state under penalty O of peau that the above information is correct.I agree to comply P.C.FEE �•D f(7 PERMIT FEE r/��a I I(:IOi-000.41 4/' l,t7- $ with ounty ordinance State laws relating to building �J J� �J / AL m cons ion, and her§�1j ZN representatives of this County ISSUANCE FEE / O I_�i� y 'm i >, :.:, < �[O e r on th 4C d property for inspectigipurposeg. m /V f/ /Y/ Hf, 7G INVESTIGATION FEE TOTAL FEE /J q. D a wog ..aem SEE REVERSE FOR EXPLANATORY LANGUAGE J