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Home My Public Portal About9567 PENTLAND ST_Building__ / BUILDING ' ADDRESS APPLICATION LOCALITY / I � 1 l NEAREST DIVISION OF BUILDING AND SAFETY CR093 ST. r • �C/c.�!/ ..GG// Department of County Engineer DISTRICT NO. RECEIPT NO. PERMIT-NO. County of Los Angeles WM. J. FOX, COUNTY ENGINEER -GROUP DATE PECEIV D DATE 188UE'D CA99ATT D. GRIFFIN, SUP-r of BUILDING FOR APPLICANT TO FILL IN TYPE CONST. ECEI ED Y / HHUED Hir- _. Oy OWNEI�/Y7i1�,:Z /* Q-7- MAP -/ YEH NO MAIL n �j��Jjl NUMBER 6I 6 ® STATE ADDRE88 7 !''.// JAI rtw �'1,e , UB ZON SPECIAL CITY .iSSTEL.,/�e� �j • CONDITIONS ARCHITECT O (/ TEL. ��[/ ENGINEER v NO. •.. BUILDING YARD HWY STREET NAME EXIST. SETBACK WIDTH ADDRESS FRONT f- ' f A /� N13 14t/:C. SIDE ADDRESS/..6�{n �IDi.,.✓-��✓ P.L � ! DATE CORRECTIONS f INSPECTOR BUILDING ADDRESS LOT NO. / 7 - BLOCK _ ; 7� G r ./APs ca ec �---!4t- TRACT h 11 y NO.or SIZE OF LOT /,.� �[ I NOW ON LOTa a USE OF EXISTING BLDG. DESCRIPTION OF WORK as 4 NEW � ADD ALTER REPAIR DEMOLISH Z S .FT. NO. OF NO.OF D D -SIZE h � C.. STORIES � FAMILIES / r USE OF STRUCTURE ��Gi ✓G�� 1, NO.OF EMPLOYEES I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS APPROVALS INSPECT 'S SIGNATURE DATE CORRECT. I AGREE TO COMPLY WITH ALL AND STATE LAWS REGULATING BUILDING CONSTRUCTION.UNTY 13ROINANCES FOUN 1) FORM8,MATER ALS ION d f��Q,},ti.... a.J/_ ,�G%/�� FRAACI FIRE 1 TS A �O / SIGNATURE O� • BRACING,BOLTS PERMITTEE FURNACE: LOCATION, /P f GAS VENT,DUCTS ADDRESSJ LATH, INT. i /,GGI `/ -,r/ AUTHORIZED AOT. — / 7- LATH, EXT. / $ �r I FEEP. .s,(�� HOUSE NUMBER COR- /� / "G RECT AND POSTED n L�i f3f3✓ �r _ VALUATION / ® Q FEE �� 5 FINAL 7GA638A DS8 3 15-63 11q / QJJ 78A.�8BA �E 0e•g.67APPLICATION FOR BUILDIN PERMIT � COUNTY OF LOS ANGELES BUILDING �y P DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY ` JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPT OF BNEARESTUILDING CROSS ST. �Z rBD OR APPLICANT TO FILL IN DISTRICT NO GROUP TYPE PRO BY (Print or type only) a �- CON �✓/ 7 STATISTICAL C IFICATION SEWER MAP a(p / CLASS NO.. DWELL.UNITS B PG BLOCK USE ZONE MAP NO.. SPECIAL - T CONDITIONS NO.OF BLDGS. T NOW ON LOT LDG. BLDG.SETBACK FROM A_ TEL. FRONT PROP.it NE OF (STREET). (JtJ NO. � TYPE OF EXISTING SETBACK -HIGHWAY + YARD = TOTAL ADDRESS-' WAY WIDTH FROM C.L. + _ CITY BLDG.SETBAC OM ARCHITECT OR TEL SIDE PROP.LINED (STREET) ENGINEER NO. TYPE OF EXISTING SETBACK HWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. TELA y CONTRACTOR L(iC G NO. k C .J y Q N - CORNER CUTOFF YES ❑ NO ADDRESS.3 04 7 ,rJ CITY cLnSS. .. SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK "a CA Z NEW ADD ALTER REPAIR DEMOLISH SQ. FT. NO. OF NO. OF SIZE STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF APPLICANT VALUATION$ ��• D� APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. / FOUNDATION: LOCATION FEE$ FEE$ (p'1 O� 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. 1 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 CA IFORNIA RELAT. LATH, INT. ,d ING TO WORKMEN'S COMPENSATION INSVFANCE. � b7 LATH, EXT. 1�. SIGNATURE OF `j OUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS-.Yff I N AL JOHN F. LEWIS. PRINCIPAL ST RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH ca.:. .�.2 3 3-G JUN26 -1 D 6.00�" APPLICATION FOR BUILDING rFOR APPLICANT70 FILL IN (Print or type WO FRE ,� h COUNTY OF LOS-ANGELES a '� DEPARTMENT-OF COUNTY ENGINEER/Y) / � IF BUILDINGANDS Y DIVISION . BUILDING 57�� NOW ON LOTNO:6F S ADDRESS SCJ r , // j J = TRACT �-540 BLOCK [LOT NO.' p LOCALITY _ t OWNER Q he �� e'/n NOLOGJ' �' O CROSS SNEARES T. p ASSESSOR ADDRESS / /Q 4 MAP BOOK PAGE PARCEL -y.. DISTRICT IGROUPITYPE FIRE ESSED BY CITY / Ei►'YJ / �f'� ZIP , CON S ^ ZON /ry ARCHITECT OR TEL. rj.'OF} e! - Vim' ENGINEER NO. STATISTICAL CLASSIFICATION WE MA ADDRESS 71 'CLASS NO -0WELL,UNITS CONTRACTORNoZONE MAP ADDRES �� /�'� /SS/�/) NI .o2 J AP-11 �' SPECIAL CITYC)n LIC. 9 CONDITIONS _6L �'/ O CLAS��7 ROAD DEPARTMENT-APP A REQUIRED YES❑ NO L]CONSTRUCTION LENDER NAME AND BRANCH BLDG.SETBACK FROIVf - FRONT PROP.LINE O (STREET) c ADDRESS CITY - 'HIGHWAY + YARD --_ TOTAL SETBACK FROM TYPE OF EXISTING O SIZE SQ•. STORIES FAMILIONE FT. NO. OF NOM OF CHECK FRONT PROP. LINE. • HIGHWAY WIDTH C ES DESCRIPTION OF WORK NEW ❑ /" L/E7 v ADDBLDG,SETBACK FROM SIDE PROP,LINE OF, (STREET) ALTER ❑ HIGHWAY + YARD' = TO_TAL SETBACK FROM TYPE OF EXISTING —REPAIR[-] SIDE,PROP.-L.INE HIGHWAY WIDTH USE EXISOT NG BLDG, l DEMOL El + AP PRIN IN,�V,C"r ®07 -''I N01. O1// CORNER CUTOFF YES ❑ NO ❑ IN OPEN SPACE YES ❑ NO ❑ BY (SIGNATURE) ^• - IN COASTAL ZONE YES ❑ NO ❑ VALUATION$. Jo3 00f ' - LATE GOBI C'AL EXEMPTION' YES,❑ NO ❑ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT ANO.AGREE TO COMPLY. IMPACT EXEMPTION DECLARATION SIGNED�(DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY-PERSON IN VIOLATION•OF THE LABOR CODE OF TH STATE OF CALIFORNIA IN RELATING TO /• WORKMEN'S COMPEN TION [R•ANCE. °'1S/�v��.I ter( •..�4'St.�� '.1S I%'lyl� V, C, . 07 '1 , - - e SIGNATURE OF _ PERMITTEE , r ADDRESS - .. - � �,�/,yp�/ � /�� (-�µp• ,1 CITY . .. .. NONAL . . .• DIA T E •_./,J _ B A \® � � J' MAKE CHECKS PAYABLE TO: FEE �•- .- PMT �. HARVEY T. BRANDT. COUNTY ENGINEER L�Ak PLAN CHECK VALIDATION CK. FM.O. - CASH PERMIT .VALIDATI N CK. M•O. CASH 14 1: D4 3.5 0.®98 76AG38A CE@803 7/73 - a ,�' '76A8SlA 0 �PPL.I.Ci�TI;OI�I 'tJF�: l7 I"ISD PERMIT ' . . . x'; COUNTY- OF LOS 'ANGELES: '_•.. BUILDING v DEPARTMENT :OF COUNTYL-MGWEER-. ADDRESS BUILDING AND..'SAFETY DIVISION 'JO.HN.,A: � •.LAMBLE COUNTY'ENGINHER •' LOCALITY•. COLL�EMAN'.W. JENKINS, sU'P,T' OF Bu1LDING• ' ' NEAREST> -CROSS ST. Y DISTWT GROUP. TY P P S D BY• :FOR APPLICANT TO FILL IN - ( CO Print.ot type.only) V! F.,EXISTIN'G G: '" STATISTICAL ICATIO. E S L C SEW R MAP -25-162:- . &q-7 L CLASS.NO. DWELL..UNITS K BLOCK USE-ZONE MAP NO. TRACT.; '.. `` SPECIAL`. C7. _ 1%0.'OF BLD.GS. CONDITIONS ' LOT .T ' O Now ON LOT . BLDG.' BLDG.-SETBACK FROM -TEL.. FRONT PROP..LINE OF (STREET): S O• - T.YPE OF EXISTING :SETBACK HIGHWAY + YARD- = TOTAL' S -HIGHWAY .WIDTH FROM C.L: = ' BLDG.SETB A CK FROM. o�YJ ARCHITECT'OR 'TEL.• SIDE PkOP..LINEOF (STREET) ENGINEER, NO. 'GI TYP.E'OF"EXISTING SETBACK HIGHWAY .'+. YARD TOTAL . HIGHWAY ,WIDTH FROM.C.L. . ADDRESS �„'C Lp. �', . Cly .i�L•. _ CONTRACTOR IT.I Gf .NO.TEL-O 1.2 LIC: . CD 'ADDRES - NQL#A A UDS NO.. �.,' CORNER CUTOFF YES Q NO y LIC:.: � CITY' V, CLASS`:'' — SEE REVERSE”SIDE FOR SPECTi4L APPROVALS CD DESCRIPTION OF.WORK NESN D REPAIR DEMOLISH 'M1 AY ROACK, — SQ. FT.: ..NO. OF ` NO: OF SIZE; Q STORIES !. FAMILIES' '` ' USE'OF' •... .. STRUCTURE E�Barr►�s far: c si''or, sic,^�•.�•':, •a'J G: p•!'�'P0eS€6a A Ma SIGNAT--URE afire of T,Ci. C:o.'i , as's"C'`��• :tn:':: +::.•'::'t , or4al' 'rO 8v'ai� APPLICANT'.. ii':a r..ld '15'dl 8; IengThyf;��rAr,$ur�,¢y. .s IS'!1 wt `• � .- VALUATION,$ r ' INSP TOR'S SIGN TITRE 1 r� rAPPROVALS .DATE P.C.' :PMT.- ��n 'FOUNDA±TION: LOCATION q FEE, �' FEE$ v�.. FORMS-, MATERIALS.: 7 � ' FEtAME: FIRE STOPS, ! I 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.•1 CERTIFY' THAT. R IN DOING THE WOK - AUTHORIZED HEREBY I' L'NOT EMPLOY ANY PERSON IN VIOLA- - - - TION OF%THE:LABOR COD OF THE STATE OF CALIFORNIA RELAT- LATFI;•INT ."'�•' IN.G TO WORKMEN'SC M NSATION INSURANCE. -' - j -LATH,.:EXT. SIGNATURE OF HOU SE'NUMBER COR •,� PERMITTEE' • :kECT AND POSTED ADDRESS FINAL . ,. ' r JOHN•F. LEWIS. PRINCIPALSTnCK. AL ENGINEER "'PLAN' CHECK' VALIDATION. dke%"" M.G: .i CASH : PERMIT VALIDATION U M.O. ' CASH LA . WORKERS'COMPENSATION DECLARATION to f insure, ora affirm certif carte of Workers' Compensat on I have a certificate of coent Insurarr InsuranceAPPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800 b. C. , COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy N �V Company BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS F-1CO --7 1-01 [Z,,<e—rtified copy is filed with the county building inspec- BUILDING tion department. ADDRESS LOCALITY G � NEAREST Dateg DL Applicant iC� CITY ZIP CROSS ST. CERTIFICATE OF EXEMPTION FROM W RKERS' NO. OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON 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. 7� TEL. SPECIAL } I certify that in the performance of the work for which this OWNER d �� CONDITIONS d permit is issued, I shall not employ any person in any mannerDISTRICT GROUP CONST.TYPE RE PROCESSED BY V so as to become subject to the Workers'Compensation Laws. ADDRESS , f� Date Applicant CITY ♦�-7 ! C L / ZIP STATISTL C5-, LAS51 ICATION APT. CONDO. V NOTICE TO APPLICANT: If, after making this Certificate of ARCH TEOR TEL. Exemption, you should become subject to the Workers' ENGINEERR NO. CLASS NO. DWELL. UNITS Compensation provisions of the Labor Code, you must forth- ADDRESS . SEWER MAP N with comply with such provisions or this permit shall be TEL ? deemed revoked. CONTRACTO /' Q" / O 33 BK. PG, VALIDATION LICENSED CONTRACTORS DECLARATIONLIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. 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 3 ` $ D r SQ. F NO.OF NO. OF CHECK pop. License Nu er ` • Lic.Class SIZE STORIES FAMILIES ONE T ❑ $ Contract G�. Date Q-'oZ;L DESCRIPTION OF WORK NEW, ADD ❑ I am exempt under Sec. iw FINAL ALTER B.BP.C. for this reason REPAIR ❑ DATE J r �. USE OF FINAL Date, EXISTING BLDG. DEMOL ❑ By C.J Signature APPLICANT TEL. OWNERmexeE Eom o-Co PRINT NO. I hereby affirm that I am exenp�from ontractor's License Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): 'PRESENT 22 4 6 6 2 A ❑ BUILDING I, as owner of the property, or my employees with ADDRESS # • • • • • J wages as their sole compensation,will do the work and • • 15 the structure is not intended or offered for sale(Section LOCALITY 2 5 9,2 c 7044, Business and Professions Code). MOVING TEL. CONTRACTOR NO.I, as owner of the property, am exclusively contracting NO • • • F+ 9,2 S Cl) with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). Q 8,,2 2-83 REQUIRED TOTAL SETBACK FROM EXIST. - CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH polo 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 m P.L e Lender's Name _ P.C. Fee$ Permit Fee Lender's Address I certify that I have read this application and state that the Issuance Fee �� above information is correct. I agree to comply with all County Investigation Fee B ordinances and State laws relating to building construction, Total Fee and hereby authorize representatives of this County to enter upon the above-menti ed propert or nspection purposes. o ' 3 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Ap c t or t ~Date Os