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HomeMy Public PortalAbout4929 PERSIMMON AVE_Building__ (2) v 6A638ACE 803 10-,, APPLICATION FOR BUILDING PERMIT 1 COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A.LAMBIE.COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. " DISTRICT O. GRO P I TYPE 'I PR ESSED BY FOR APPLICANT TO FILL IN CONST. `( BUILDING'/y , STATISTICAL C SSIFICATION I SE\ ER MAP ADDRESS J"/ BK P BLOCK LOT NO. 3/ CLASS.NO. WELL. UNITS MAPSTATE YES O NUMBER HWY. � TRACT ']' / G USE ZONE SPECIAL NO.OF SLDGS. 7 CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLD . BUILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH OWNER q FRONT MAILADDRESS / 0 SIDE TEL. P.L• CITY NO. INSPECTION RECORD ARCHITECT OR TEL. ENGINEER NO. ADDRESS a q TEL CONTRACTOR NO. y�� evADD ES �!A u DESCRIPTI N OF WORE NEW ADD Y ALTER REPAIR DEMOLISH SQ.FTNO.OF NO.OF E SIZE STORIES FAMILIES USE OF STRUCTURE,4.; p • SIGNATURE OF - APPROVALS APPLICANT S y, DATE INSP TOR'S S-IGNATURE ADDRESS 4-7. 3 /LQ FOUNDATION: LOCATION I{ FORMS.MATERIALS $ P.C. S - FRAME: FIRE STOPS. FEE 7 _BRACING. BOLTS VALUATION V d O $ L�� FURNACE: LOCATION. FEE GAS VENT,DUCTS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH,INT. A PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WIT ALL COUNT ORDINANCES AND STATE LAWS REGTING CONSTRUCTION. LATH, EXT.r i SIGNATURE OF - HOUSE NUMBER COR- PERMITTE RECT AND POSTED ADORES FINAL CLYDE N.DIRLAM, PRINCIPAL STR URAL ENGI R PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH sL,O 5 4 9 , Ari P 2 1 A 6.CI 0 11, 7GAE28A DBS-312.54 APPLICATION FOR BUILDING PERMIT 1 DIVISION OF BUILDING AND SAFETY BUILDING Department of County Engineer ADDRESS County of Los Angeles LOCALITY WM. J. FOX, COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST. , FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ITYPE IsESK MAPGT CONST. BUILDING � �t p (� ADDRESS T'�,,(�/ HWY / f1�/l,d.til�C.auta y r NUMAP MBER �O5l TAT Nrr!1 O LOT NO. / //�! 7 1 BLOCK ty USEZO E SPECIAL �// ,�L�-f--/ CONDITIONS TRACT T/ y t/ NO. OF BLDGS. SIZE OF LOT / Age` I NOW ON L.OT BUILDINGI EXIST. USE OF SETBACK YARD HWY STREET NAME WIDTH EXISTING BLDG. 1 i FRONT OWNER SIDE MAIL �!y P. L. ADDRESS I k TEL. I DWELL. 1 UNIT 5 INDUSTRIAL CITU NO. C C 2 DUPLEX_UNIT 6 PUBLIC BLDG. ARCHITECT R TEL. ENGINEER NO. 3 APT. UNITS 7 ADDN.,ALT., ETC._ ADDRESS 4 COMMERCIAL 8 MISCEL. TEL. CONTRACTOR NO. INSPECTION RECORD ADDRESS .,t/`_ ��L � �" ���� DESCRIPTION OF WORK A NEW ADDS ALTER REPAIR DEMOLISH SO S ZE T. �( NO. OF NO. OF 7/ a STORIES FAMILIES USE OF STR�R YYY f SIGNATURE OF C7 APPLICANT APPROVALS ADDRESS 7 I f DATE INSPECTORS SIGNATURE FOUNDATION: LOCATION + P.C. $ FORMS. MATERIALS FEE FRAME: FIRE STOPS, VALUATION $ O O BRACING. BOLTS FEE `� FURNACE: LOCATION, GAS VENT. DUCTS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS —' I APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. AND STATE LAWS REGULATING BUILDIN CONSTRUC- T ONSTRUC- /.) TION. LATH. EXT. l 14 SIGNATURE OF I HOUSE NUMBER COR- PERMITTEE - � RECT AND POSTED ADDRESS- •1` FINAL INK J. FOX, CoutiTY EmamE•O VALIDATION BY #Y7 6 9 MAR 21 $.0 0 n DEPUTY � DEPUTY /t BY BY 0) DEPUTY DEPUTY i 7GA838A CE#80311-57 APPLICATION FOR BUILDING PERMIT Z COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS O` r BUILDING AND SAFETY DIVISION LOCALITY JOHN A.LAMBIE,COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. Iq FOR APPLICANT TO FILL IN DISTRICT O. GROUP SEWER MAP G BUILDING A C 'A / _� TYPE CONST. ADDRESS STATISTICAL CLASSIFICATION �e1c-r-s�L--�-,--L QyV LOT NO. �/D/ 3 BLOCK CLASS.NO.2aDWELL.UNITS MAP STATE YES O NUMBER -� HWY. TRACT `n,,Z / UE ZONE SPECIAL SIZE OF LOT S /r�L NO.OF BLDGS. /J _ CONDITIONS NOW ON LOT USE OF D 0C EXISTING BLDG. BUILDING YARD HWY STREET NAME EXIST. SETBACK WIDTH OWNER G c a r LGLiFRONT MAILP.L. ADDRESS / �'�+-Y`d'�'L� SIDE CI J /�L NO S� P•L. ARCHITECT OR TEL INSPECTION RECORD ENGINEER ��-� NO. ADDRESS TEL. CONTRACTOR NO. ADDRESS DESCRIPTION OF WORK NEW A ALTER REPAIR DEMOLISH SQ.FT. i NO.OF NO.OF SIZE �U T �• STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF APPROVALS APPLICANT �__ DATE INSPECTOR'S SIGNATURE ADDRESS _ v FOUNDATION: LOCATION FORMS,MATERIALS SC P.C. S FRAME: FIRE STOPS. ��0 f FEE BRACING,BOLTS 4- VALUATION $ FURNACE: LOCATION, FEE GAS VENT,DUCTS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP. LATH.INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING BU LD G CONSTRUCTION. LATH,EXT. SIGNATURE O �/ Q HOUSE NUMBER COR- PERMITT /y �� RECT AND POSTED ? �( ADDRESS FINAL _ CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL F79GINE R PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CAS 3 0 9 309 UL 2 2 1 A 4.0 0 ®P ,WORKERS' COMPENSATION DECLARi4TItN, t &PLIC TION FOR WILDING PERMIT Iereb�y affirm that I have•a certificate of consent to self insure, or•ri certificate of Workers' Compensation Insurance, oya certified:copy thereof(Seca, . 33b0, Lab. C.) COUNTY OF LOS.ANGELES •' BUILDING AND SAFETY Policy No. Company ❑ Certified co is hereby furnished. FOR APPLICANT TO--'FILL IN BUILDING PY Y ADDRESS! ❑ Certified copy is filed with the county building inspec- BUILDING ; tion department. ADDRESS 1 f a �, gIV +: CITY / L� G/ r // ZIP / /jg© LOCALITY Date Applicant NO.OF BLDGSNEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OP LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCEASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE d� PARCEL hundred dollars ($100)or less.) TEL OWNER U NO, _ 2 M /S' USE ZONE AP I certify that in the performance of the work.for which this r NO. permit is issued, I shall not employ any. CONDITIONS person in any manner ADDRESS MAI �. SPECIAL so as to become subject to the Workers'Compensation Laws: O CITY 7-� Ci/7 Zip q 7�d 1 V Date Applicant ARCHITECT OR TEL DISTRICT GROUP TYPE FIRE' R CESSED BY O_ NOTICE-TO APPLICANT: If, after making this Certificate of ENGINEER / �6'Z NO. /� , CONST. ZONE Exemption, you should become -subject to. the Workers' Compensation provisions of the Labor Code, you must forth- 1 ADDRESS 4Q� 5� ��7 `# .�� `3 a with comply with' such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. N i2 NO. ' deemed revoked. � CONTRACTOR '� O�✓N�,e- c1l< < Z LICENSED CONTRACTORS DECLARATION LIC. <' CLASS NO. DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS' NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. • and Professions Code,and my license is in full force and effect. CITY. CLASS ` BK PG VALIDATION SQ, FT 40SN OF NO:.OF ,+ CHECK License Number Lic. Class SIZE �© STORIES / FAMILIES / ONE VALUATION I/ Contractor Date DESCRIPTION OF W��O��RK//�� - d��f v(";d NEW ❑ .,� _$ At6.' ADD r.f •••:. El am exempt under Sec. ALTER ❑ B.BP.C. for this reason REPAIR F-1 $ "'"-' • Date:' USE OF EXISTING BLDG. DEMOL ❑ K - -•-• •• Signature APPLICANT�f7 (� TEL.f - ain- PRINT) OWNER.BUILDER DECLARATION FINAL =` ( NO. ti/ • +.I I hereby affirm-that I•am exempt from the Contractor's License �QQ : "/itdX/ ; DATE �y Law for the following reason (Section 7031.5, Business and ADD RE FINAL 3,str7'•. >��i." Professions Code): PRESENT B '^ : �, ,H ❑ I, as'owner bf'the ro erf or m employees with "BUILDING y - ' �' �. P P Y. YADDRESS -+-+ � , r P: wages as their sole'compensation,will do the work and 37307 -7'1 eGz the structure is not intended or offered for saleSection LOCALITY _-; -'•' "F-i ; 7044, Business and Professions Code.) ( MOVING TEL. 0 =�=" `"``l�f ''o+=b CONTRACTOR NO. I,as owner of the property,am exclusively contracting +'1 ITEI'j�t : :I +•__ with licensed contractors to.construct the project (Sec- ADDRESS t tion 7044, Business and Professions Code.) ;;• � a ' � TOTA SET ACK ROM CONSTRUCTION LENDING AGENCY SETT BACK fJ YARD HWY WIDTH I hereby affirm that there is a.construction lending agency for FRONT CHECK 796.20 the performance of the work for which this permit is issued P.L. Hf �� (Sec. 3097, Civ. C.I. SIDE P.L: Lender's Name d P.C. Fee$ �O •�/ Permit Fee �/ v• J �Ma Ref. # t'irY00- 001 2/ 9/9,7 ' Lender's Address l•J ® V,JiVft�� } A 1 I certify that I have read this application and state that the Issuance Fee !i . LDMA P/C# above information is correct.I agree to comply with all County 'Investigation Fee ordinances and State laws relating.to building construction, Total Fee /���` v LDMA perm. # and hereby authorize representatives of this County to enter upip the above-mentioned property for inspection purposes. at z a ;t �� OeZ-ag'93 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date