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HomeMy Public PortalAbout5700 PRIMROSE AVE_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES rm ®� WM. J.• FOX, CHIEF ENGINEER NG FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY �� I DISTRICT NO. PLAN CCK NO. PERMIT NO. BUILDING d,� _ ADDRESS RECEIVED BY DATE OF APPL. DATE ISSUED LOCALITY NEAREST p CROSS ST. ,y � �j_ BUILDING ADDRESS V OWNERr- MAIL "" LOCALITY + rn a_zo [ j ADDRESS (���.- r�• NEAREST TEL CROSS ST, l 1.boo•'l 0 fa..-_ , CITY j/_r/(}i?JLC NO. FIRE NO. OF ZONE PLANS I TYPE L, I GROUP ARCHITECT OR TEL. ENGINEER NO. BLDG. f { D. NO. SETBACK LINE /5-1 41 ADDRESS APPROVED ' BY DATE TEL. CONTRACTORi�Ji L/ice��i..'•' 'i�� NO• USE �f� APPROVED �r ZONE(/{ '" BY DATE ADDRESS ,^, �7y(/i HOUSE NUMBERING LEGAL VL DESCRIPTION I LOT NO. s BLOCK MAP NUMBER G p FIELD CHECK BY TRACT NO. ASSIGNED BY DATE �j NO. OF BLDGS. d) CORRECTIONS SIZE OF LOT J�IL Q7 I NOW ON LOT �e USE OF / NO. OF EXISTING BLDG, 4S T �t�jyi FAMILIES i DESCRIPTION OF WORK NEW I I ALTERATION I I ADDITION REPAIR I /\I DEMOLITION I XI I Y p SQ. FT. NO. OF Q SIZE ROOMS STORIES Z EXT. WALL /I`1�J"`` / I ROOF 01 r COVERING/-, -.- C��•�=� COVERING, Z �( i USE OFT CTURE -. f' f APPROVALS INSPECTOR'S SIGNATURE DATE 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FOUNDATION: LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS CORRECT. 1 AGREE TO COMPLY WITH THE CORRECTIONS LISTED ) FRAME: FIRE STOPS, HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS LAWS REGULATING BUILDING CONSTRUCTION. � FURNACE: LOCATION, SIGNATURE OF x< �1 lam•/_•.5r GAS VENT, DUCTS PERMITTEE^ "s• 1 A, `�_�' LATH, INT. ADDRESS 'w') 1 :'I,°% 7.. !-J ��a R LATH, EXT. AUTHORIZED AGT. // - PLASTER, INT. A 7SAS9SA• Gess to-80 P. C. © 5�) FEE PLASTER, EXT. VALUATION $ -�--�� l.,' ,' FEE FINAL ��,�_•G: rr— fQ/J� WORKERS' COMPENSATION DECLARATION hereby d certificate that I have certificate of consent to self P P L I CATION FOR BUILDING P E insure, or a certificate of Workers' Compensation Insurance, RMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No.01223829 Company state Comp Ins. BUILDING El Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS J",-:;7 Certified copy is filed with th county building inspec. r BUILDING Tion depar%nent. ADDRESS 5700 PRIMROSE 7��Q1 : CIN ZIP 91780 LOCALITY Date7/�23/91 Applica t NO. OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FR� WORKERS' SIZE OF LOT NOW ON LOT 1 CROSS ST. LAS TUNAS COMPENSATION INSU ANCE ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK 8587 PAGE 016 PARCEL O26 hundred dollars ($100)or less.) TEL. OWNER JOHN MCGINLEY No,286-3005 USE ZONE MAP I certify that in the performance of the work for which this NO. permit is issued, I shall not employ any person in any manner ADDRESS JOB ADDRESS SPECIAL CONDITIONSCL so as to become subject to the Workers'Compensation Laws. O CITY ZIP Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE P OCESSED BY fY NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST, ZO E Exemption, you should become subject to the Workers' �i r/ Compensation provisions of the Labor Code, you must forth- ADDRESS 83:8 ��(� /L- ✓ a- a with comply with such provisions or this permit shall be i TEL. STATISTICAL CLASSIFIC TION APT. I CONDO. N deemed revoked. ,: CONTRACTOR TYTTE ROOFTNG M NO.—299-51 Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 2948 E. WALNUT ST NO. 186303 SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. and Professions Code,and my license' in full force and effect. CIN PASADENA CLASS Q9 BK PG VALIDATION SQ. FT. NO.OF NO. OF CHECK License ber 186303 Lic. Class C39 SIZE STORIES FAMILIES ONE _ VALUATION Con Date' 7/23/91 DESCRIPTION OF WORK NEW El ❑I am exe pt under Se HOUSE & GARAGE ADD El OO ALTER ❑ B.BP.C. for this reason REPAIR ® $ Date: USE OF EXISTING BLDG. DWELLING DEMOL ❑ APPLICANT TEL. Signature APP(PRINT) LYTLE ROOFING CO NO. 792-5171 FINAL OWNER-BUILDER DECLARATION DATE I hereby affirm that I am exempt from the Contractor's License ADDRESS 2948 E WALNUT PASADENA 91107 FINAL Law for the following reason (Section 7031.5, Business and Professions Code): ;.,PRESENT By BUILDING ❑ I, as owner of the property, or my employees with `ADDRESS • wages as their sole compensation,will do the work and ® ' the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code.) MOVING TEL. CONTRACTOR NO. I,as owner of the property,am exclusively contracting • with licensed contractors to construct the project (Sec- ADDRESSI hL 0 o 3u tion 7044, Business and Professions Code.) O REQUIRED TOTAL SETBACK FROM EXIST. t CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH �.'IGs.I� f I hereby affirm that there is a construction lending agency for FRONT _ _ the performance of the work for which this permit is issued P.L. t��('IFf03E ' (Sec. 3097, Civ. C.). SIDE NONE P.L. Lender's Name `' - I 57.38 LDMA Ref. q t�l+.11i�_i�J �i i_•/i_ ' P.C. Fee$ Permit Fee Lender's Address ® �' I P1,q '7:71 I certify that I have read this application and state that the Issuance Fee 3 0O LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws rel ati to building construction, Total Fee LDMA Perm, q and eby authorize a resent es of this County to enter upo above- ed pr erty for inspection purposes. 7/23/91 SEE REVERSE FOR EXPLANATORY LANGUAGE Sig ure of Xpplicag Agent Date