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Home My Public Portal About9539 PENTLAND ST_Building__ 7GA63 A CE#60-, 9-67 APPLICATION FCCYrR UILD4G PERMIT � COUNTY OF LOS ANGELES •,.4� BUILDING DEPIARTMENT bF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY _ JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST. DISTFjLGT NO. GROUP TYP PROCESSED BY FADDRESS OR APPLICANT TO FILL IN [ co T. (Print or type only) j e _j G y� _ STATISTICAL CLASSIFICATION SE MAP _rN/1AAl�S/ CLASS Ng.�DWELL.UNITS SPECIA A 7 BLOCK USE ZONE MAP i i NO. / 7•� / CONDITIONS NO.OF BLDGS. LOT-4-4-VA`A90 NOW ON LOT G BLDG. ,E'.!/�Fr BLDG.SETBACK FROM ) (STREET) TEL. FRONT PROP.LINE OF /(eIG Q-Vd /DLL L%GC'/R -NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL S ��~� ;POA, `4,Vcl %, HIGHWAY WIDTH FROM C.L. /tea/✓�G { DG.SFROM ARCHITECT OR TEL. ETBK SI L ENGINEER NO. SDE PROP.LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. TE CONTRA CTO iIt're//�H�R'YA, NOL + 7 a- ''JJ / / O ADDRES /*.76//jrAf "/V STNO. /70 74� CORNER CUTOFF YES ❑ NO CITY M6A--76 CLASS ,(� / SEE REVERSE SIDE FOR SPECIAL-APPROVALS _ U DESCRIPTION OF WORK L" a C" 1 � Q� Z NEW DD LTE REPAIR DEMOLISH SQ. FT,°. NO. OF NO. OF SIZE 0�.-• STORIES FAMILIES USE OF STRUCTURE /a!t/a F Z 2 e, 4' !On 1,11f -60 A/r s OW SIGNATURE O APPLICANT 3 9 60 VALUATION$ o S APPROVALS ATE INSPECTOR'S SIGNATURE P.C. ' PMT .+� FOUNDATION: LOCATION FEE$ FEE.$ �,= FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT 1 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- TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT• LATH, INT. 4,4 ING TO WORKMEN'S COO NSATION INSURANCE. LATH, EXT. 01 SIGNATURE O �.- r HOUSE NUMBER COR- PERMITTEE �� RECT AND POSTED gm f elf' ADORES 7 FINAL J ,r• � �-.i JOHN F. LEWIS. PRINCIPAL ST RAL ENGINEER PLAN CHECK VALIDATION K. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH LACo2626JAI41623 D 32.25,1 T " _... .. Ap3259% FB26' 1 D 64:501' c P_ WORKERS' COMPENSATION DECLARATION hereby affirm that I have rk certificate of consent to n elf APPLICATION CATION FOR'. B U I L.D I N G. P.E RM I T insure, or a�c�rtificate of Workers' Compensation.Incur nce; • - . ' or a certified co thereof(Sec. 38 COUNTY OF LOS ANGELES BUILDING AND.SAFETY Policy No.�Company Certified co ns hereby furnished. FOR APPLICANT T F LIN• BUILDING PY Y . ADDRESS •, Certified copy is filed with the county buildin inspec- BUILDING• 2O tion.department: ADDRESS J Date-v'(T Applicant' C9.4id— CI zip, ` �/ LOCALITY NO.OF BL)GS. NEAREST CERTIFICATE OF EXEMPTION•FROM WORKERS'' SIZE OF LOT .. NOW ON LOT CROSS'ST. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit'is for one TRACT ' BLOCK LOT NO. MAP BOOK PAGE PARCEL' hundred dollars'($100)or.less.)' r� TEL ^Q c ( USE'ZONE FSPOEII OWNER V N�[D ��7/v/'certify that•in the.performcnce of the work'.for which this IAL' >- permit is issued, I,shall not employ,any person in any,manner ADDRESS S DITIONS so as to-become subject to the Workers'Compensation Laws: V. CITY ZIP _ .. .• • Date Applicant ARCHITECT OR TEL. DISTRICT• GROUP'TYPE' FIRE PROCESSED BY NOTICE TO.APPLICANT:' If, :after" making this Certificate of ENGINEER.• NO. CONST.• ZONE. Exemption, you•should. become, subject.:to the Workers' Compensation provisions of -the-Labor Labor Code, you rnust'forth;. ADDRESS. .. .�(�. 3 'sl rte, a with" comply with,such provisions•or"this permit.shall be Ifl'� TEL STATISTICAL CLASSIFICATION," APT. CONDO. Z deemed,revokes.'. I C6pI1rRA2�elt NO 6 LICENSED CONTRACTORS"DECLARATION• S �..� LIC b�.�Z CLASS NO. DwELI. UNITS — LICENSED hereby affirm that I am licensed under provisions of Chapter•'9 N8a LIC. r SEWER MAP (commencing with Section 7000)of Division 3 of the Business C� and Professions Code,and my license is in full.force n. effect. CITY' CLASS BK PG. VALIDATION `��0 SQ.,FT. No.'OF NO.OE CHECK' Licens'-Number t�O Lic. CI&ss SIZE STORIES FAMILIES ONE: cr"1 , VALUATION•'' Qom. ontractor Date .�^'' DESCRIPTION OF•'WORK NEW ❑ ADD ❑ ► ❑I am exempt under Sec. ALTER ❑' i. BAP.C. for this reason ' $ ' USE OF REPAIR. Date:' EXISTING BL G. , 'DEMOL ' Signature t APPLICANT .1 TEL TEL• FINAL, OWNER-BUILDER•DECLARATION - (PRINT)LK NO � I hereby affirm that I am exempt from the Contractor's License' •I / -�, DATE Law for the following reason (Section 7031.5;,Business and ADDRESS��0 ��N��/l tC ��l FINAL 'Professions Code):. PRESENT By y + : BUILDING ) ❑ I, as owner of;the property, or•my employees with ADDRESS, wages as their`sole compensation,will do the work and - – 3 the structure is not iintended'or-offered for sale(Section LOCALITY , �r31J ." f�+�e r3 7044, Business and Professions Code.) MOVING TEL. » ❑ ,I,as owner,of the property,am'exclusively contracting CONTRACTOR NO. with lieerised contractors to construct the,project (Sec- `r' TOTAL 113 m 63... -tion 7044,'Business•and Professions Code.). ADDRESS -'REQUIRED TOTAL SETBACK FROM EXIST. CHECK 1 CONSTRUCTION LENDING AGENCY SET-BACK YARD HWY PROP. LINE WIDTH I hereby affirm thaf•there•is a construction lending-agency for FRONT CHAHG ,111j- the performance of-the work.for which this permit Is issued :P•L• (Sec. 3097,•Civ. C:). SIDE P.L. Lender's Name D' LDMA Ref. # �JClsry CiLIiJ /tr r P.C. Fee$ Perr iit.Fee ' ( 'a Lt�}` -Lender's Address 4 I certify that I'have read this application and state that the Issuance Fee 7� Poo LDMA P/C# above information is correct. I agree to comply with all County In. Fee 2 / ordinances aria State laws relating to building construction, Totcl Fee J !O 'LDMA Peft.. and hereby authori representatives of this County to ent 1 up the above-m ti ned property for insp6diorl"Putposils. o SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent ate { WORKERS'COMPENSATION DECLARATION hereby at+igrm 1hat. have a certificate ofa consent to self A P P L I CAT I.O N FOR.' BUILDING'• P E RM I T ' insure, or a r�rttficica+te of Workers' Compensation Insurance, •• or cr certified py thereof(Sec. , La C. COUNTY OF-LOS ANGELES BUILDING AND SAFETY . .. a 1..,Policy N 0 rnpanySt� BUILDING . ❑ Certified co +s hereb ,furnished. FOR APPLICANT'TO FILL'IN PY „Y, ADDRESS40 .❑ Certified copy is filed with the ounty building inspec- [AUD'D NG tion department. SS Q C, e . Date o' Applicant ZIP LOCALITY NO.OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION'FROM W KERS' F LOTNOW ON LOT CROSS ST.COMPENSATION INSURANCE ASSESSOR ((Thissection need not be completed if the permit is for one ' '. BLOCK LOT NO.. MAP BOOK PAGE ' PARCEL hundred dollars ($100)or less.), . � ♦r NoUSE ZONE MAPR NO.1 certify that in the performance of the work for which this permit is issued, I shall:not employ'any person.in any,manner SS :� Yy�,Q.• �„/ SPECIAL r a CONDITIONS' so as.to,become.subject to the Workers'Compensati0 'Lows, •.• .• O . CITY ZIP 1 U Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE &ROCESSED BY , NOTICE TO.APPLICANT: -If, after. making this.Certificate of ENGINEER _ NO. CONST. E �O Exemption,.'you should become,•subject to the- Workers' Uj G Compensation provision's of the,Labor'Code, YOU must forth- +. ADDRESS ;DO '3 N with comply-with,such .provisions or this permit.:shall be' : C TEL. STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked.: : CONT _ NO. _ _ LICENSED.CONTRACTORS DECLARATION a IC. CLASS NO. lop � DWELL. UNITS ,I hereby affirm that I am licensed under provisions of-Chapter 9 ADDRESS SEWER MAP (comrriencing With Section.7000)•of,Division 3•.of the Business ' ti LIC. ++ and Professions Code,and my license ts.in full force.and effect: i. CIN 1Q (jK'G✓ CLASS BK. PG VALIDATION ' SQ. FT, NO.OF a NO.OF CHECK Lil; um er. ic. Class, . SIZE I STORIES Y. FAMILIES ONE - „ • ,• , . _ ' I DESCRIPTION•OF WORK C ; NEW ❑ VALUATION Contractor Date s. Poo, ADD' '❑ • ► ❑I am exempt under Sec. 0 • ALTER ❑ ; B.&P.C. for this reason $ REPAIR ❑ Date: USE OF EXISTING BLDG. DEMOL D ' Signature _ APPLICANT TEL. FINAL ; -OWNER-BUILDER DECLARATION (PRINT) = E NO. DATE •lZ"�—�.� I hereby affirm that I am-exempt from the Contractor's License, ADDRESS �QV'vA- O O r Law for the following-reason (Section 7031:5, Business and `FINAL Professions Code): PRESENT B ' BUILDING y (��•�• e A ❑ I, as owner,of the property,'•or my employees with• ADDRESS wages as their sole compensation,will do-the work and LQ 23 "53' the'structure is not intended or offered fcr'sale(Section LOCALITY 7044,•Business and Professions Code.) `.: MOVING TEL. 1- LTEN] CONTRACTOR NO. ❑ I;.as owner of the property,,am exclusively contracting, "53 • with licensed contractors to construct the project (Sec- �f �� ' '_:_°+=r ADDRESS _ _ tion 7044,'Business.and professtons.Code.) ,�. , (+'HECK iL?v.O " REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY ; SET BACK `LARD HWY PROP. LINE WIDTH I hereby affirm that there.is a construction lending agency for FRONT•• +: CHANGE the.performance'of.the work for which.this permit is issued P.L. ' (Sec..3097, Civ. C;),-. SIDE f t ,�y5 ,�y itt P:L:.• I3(J10I.i-100301. 10111V/1 Lender's Name - ' $ LDMA Ref. # Lender's Address P;C. Fee$ Permit Fee .moi�/• /7O 94 1 1 AN 8 efj`, 'I-certify that.) have read this application and state that the Issuance Fee :o /�./�' LDMA P%C# '- above information is correct.I agree to comply with all.Cburity Investigation Fee ordinances and State laws relating to building,construction, total Fee C;�� • Lb"Perm. # and here outhortie representatives of this County to enter 2 upo a ove-mentioned properiy.for inspection purposes. L ob ' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature If Appliconf or Agent Date