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Home My Public Portal About5745 PRIMROSE AVE_Building__ ®s 7GA638A CE 1803(R%V.6/78) ' APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFE FOR APPLICANT TO FILL IN BUILD re-, BUILDING ADDRESS 'r� JAJA 6SJC' LOCALITY NEAREST CITY - ZIP / �f `n cS'/ � CROSS ST. J P SIZE OF LOT "577 x S NOW ON LOT ASSESSOR �� MAP BOOK AGE PARCEL DISTRICT OUP TYPE FIRE 2CESSED BY TRACT �y� BLOCK /-1 -�y,LO ! p CONST.. ZO // OWNE /t77 .V d. i f A TNO�� rP � iI✓) 3 T STATISTICAL CLASSIFICATION J SEWE AP ADDRESS cs S N• //�J R eS4116, v CLASS NO. / DWELL.UNITS .0 Bv13/PG CITY ZIP I Q ARCHITECT Olt TEL. VALUATION $ ENGINEER NO. (J v ADDRESS BLDG.SETBACK FROM TEL. FRONT PROP.LINE OF (STREET) CONTRACTOR NO. YARD TOTAL SETBACK FROM TYPE OF EXISTING LIC. HIGHWAY F = FRONT-PROP.LINE HIGHWAY WIDTH ADDRESS _✓' NO. _ LIC. + CITY CLASS ' BLDG.SETBACK FROM CONSTRUCTION LENDER NAME AND BRANCH AleSIDE PROP.LINE OF (STREET) TOTAL SETBACK FROM TYPE OF EXISTING ADDRESS CITY �_� HIGHWAY + YARD = SIDE PROP.LINE HIGHWAY WIDTH �— - SQ.FT. NO.OF NO.OF CHECK + _ u SIZE STORIES O/VJE FAMILIES 10-& ONE DESCRIPTION OF WORK� t*o i 0,4 NEW ❑ T.C.Fee-$ Permit Fee �— /aryQOOM j�d(/irt ADD Issuance Fee 7 y ALTER REPAIR ❑ Total Fee j USE OF �� EXISTING BLDG. ,X' Vf✓O ODMS DEMOL ❑ V � O APPLICANT TEL IPRINTI a NO VL-g__� BY(SIGNATURE)/, q a 13, j?-T'�, N. { a IHEREBY ACKNOWLEDGE TH I E READ THIS APPLICA N AND STATE THAT THE ABOVE I_ CORRECT A D AGREE TO COMPLY WITH ALL ORDINANCES ) W AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE + 6=7 WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- ' g 2 3 4 9.5 A PENSATION INSURANCE. SIGNATURE PERMITTEE ,�' -- ✓� gird / ry 2 0 0'7 9.Ob vc ADDRESS V (f z 0 0 0 7 9 Q Q v TEL.• ' ii f 0 CITY NO. f p4.Q 2 - 79 U ZONE MAP: �'7��•v / r �^�QV Q >� NO. SPECIAL r F� y CONDITIONS I '`.,�r FINAL �...GP _..O('Z � � DATE l its r' APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES ADDRIIN S $� DEPARTMENT OF COUNTY ENGINEER CITY � - 1 Lh — ZIP BUILDING AND SAF DIVISION OF BLDGS. BUILDING SIZE OF LOT x j i NOW ON LOI, ADDRESS t- TRACT I BLOCK 1VJ T NO. LOCALITYTEL. ,2, OWNER l• `� NO.�G '. �, CROSS ST. ASSESSOR ADDRESS MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE �10RCE, ESSED BY CITY ZIP �, CONST. NE -� ARCHITECT OR TEL. ® _ :_ ,�_ ENGINEER NO. STATISTICAL CLASSIFICATION �SEWE�MAP ADDRESS `' CLASS NO. DWELL.UNITS // �G CONTRACTOR LZ dcj NOOAR; r 49 - '06E Z�NE N O. lam' ADDRESS�� S L19,1464 N l(:+��Z CIALCITY 4- CLQ NDITIONS CONSTRU ION LENDER ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ NAME AND BRANCH BLDG.SETBACK FROM FRONT PROP.LINE OF ISTREETI ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ.FT. NO.OF NO.OF CHECK HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE } DESCRIPTION OF WORK NEW ❑ + — CL O ' ADD BLDG.SETBACK FROM w SIDE PROP.LINE OF (STREET) O ALTER ❑ HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING 13G REPAIR SIDE PROP.LINE HIGHWAY WIDTH USE OF Z EXISTING BLDG. DEMOL ❑ + APPLICANT TEL CORNERCUTOFF YES ❑ NO ❑ IPRINT) NO. IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE( IN COASTAL PERMIT ZONE YES ❑ �+N'O QQ ❑ VALUATION�D � J ®� (F�7 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- PENSATION INSURANC SIGNATURE OF ��/ PERMITTEE ADDRESS JAY _ TEL. FINAL m BY CITY —NO.. 6 DATE j MAKE CHECKS PAYABLE TO: j LFEE � FEET.`P HARVEY T.BRANDT,COUNTY ENGINEER / 25 PLAN CHECK VALIDATION cK. M.O. CASH PERMIT VALIDATION CK. M.O. GASH 538CIZF1PR' 7 2 1.7.5. ®58 Os 76A638A CE#803 3.75' rY V !/! DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES I G WM. 'j. FOX, CHIEF ENGINEER FOR APPLICAM TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLANCK. NO. PERMIT NO. [CROSS UILDING DDRESS q 3' `S CSI �•� OCALITY (b RECEIVED By/ DATE OF ADPL. -'DA-TE ISSUED- EAREST V ST, J ,�M_ ,stjfLDiNG' • � .� ADDRESS .�(�3 S�e�/ � �'�+..v��, ., OWNER MAIL LOCALITY ADDRESS' -y NEAREST /. TEL. CROSS ST. CITY NO. OJ Q - FIRE NO. OFTYPE GROUP ARCHITECT OR TEL. ZONE'. PLANS I n = ENGINEER NO. BLDG. ORD. NO. SETBACK LINE ADDRESS :APPROVED TEL. BY DATE CONTRACTOR ., � NO. USEAPPROVED ,�ZONE / BY DATE ADDRESS HOUSE NUMBERING LEGAL '; . DESCRIPTION ,I LOT NO. (o�.� BLOCK ; MAP NUMBER FIELD CHECK BY TRACT �- NO. ASSIGNED BY nAT NO. OF BLDGS. CORRECTIONS SIZE OF LOT ti I_NOW ON LOT . USE OF I NO. OF EXISTING BLDG, FAMILIES ' .'DESCRIPTION OF WORK _ NEW I I ALTERATION I I ADDITION I -. O REPAIR ' .I DEMOLITION' I I I � SQ. FT. - NO. OF s %O%IA-r-n Q Bei E SIZE �� ROOMS STORIES ,ee��I Z EXT.WALL ' �(tOOF r COVERING ICOVERING USE OF STRUUR7E APPROVALS INSPECTOR'S SIGNATURE DATE 1 HEREBY ACKNOWLEDGE THAT I 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 AL / OUNTY ORDINANCES AND STATE BRACING, BOLTS LAWS REGULATING B LDING CONSTRUCTION. _ FURNACE:LOCATION, SIGNATURE OF F GAS VENT, DUCTS PERMITTEE LATH, INT. ADDRESS_ r v LATH, EXT. AUTHORIZED AGT. PLASTER, INT. 7EAESOA•0923 to-80 $ _ P. C. $ / FEE °"� PLASTER, EXT. VALUATION FEE FINAL I WORKERS'COMPENSATION DECLARATION .; . I-h Aeby affirm that I have a�cerAYicore of-cons tb sel> ,, AP P L IC'ATION T OBUILDING P E RM I T insure, or a certificate of Workers'Compensation Inwrarice, or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING 2D SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING Certified copy is filed with the county building inspec- BUILDING /� c tion department. i ADDRESS ' LOCALITY Date Applicant i CITY ZIP /�' CROSSST. � CERTIFICATE OF EXEMPTION FROM WORKERS' 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 TRACT BLOCK LOT NO. r. NO. hundred dollars($100)or less.) SPECIAL ?- I certify that in the performance of the work for which this OWNER [� / ij/ TEL 3 (, CONDITIONS fL 01 permit is issued,I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE PRO SSED BY U so as to become subject to the Workers'Compens }ion Laws. I ADDRESS CONST. ZONE Date Applicant ^ Gi CI ZIP STATISTICAL CLASSIFICATION PT. CONDO. NOTICE TO APPLICANT: If, after m n this Certificate of ARCHITECT OR TEL. Exemption, you should become ject to the Workers' �i ENGINEER NO. CLASS NO. DWELL. UNITS A. Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP ta with comply with such provisions or this permit shall be deemed revoked. .. TEL' 46-PG VALIDATION - CONTRACTOR NO. BK.' LICENSED-CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 I ADDRESS NO. VALUATION' (commencing with Section 7000)of Division 3 of the Business and LIC. O+ Professions Code, and my license is in full force and effect. : CITY CLASS $' lJ d Od , SQ FT. NO.OF NO.OF CHECK License Number Lic.Class j R STORIES FAMILIES ONE NEW $ Contractor DateDESCRIPTION OF WORK E] I am exempt under Sec. 1 ADD ALTER ❑ FINAL B.BP.C. for this reason REPAIR DATE ( USE OF Date: FINAL 'EXISTING BLDG. DEMOL ❑. B Signature APPLICANT TEL. Y OWNER-BUILDER DECLARATION PRINT NO. I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): BUILDING : L!.&AI, as owner of the property, or my employees with j ADDRESS :l J ] O ' wages as their sole compensation,will do the work and a the structure is not intended or offered for sale(Section LOCALITY n 7044, Business and Professions Code). MOVING TEL. r_ ° L C Q C 5 I, as owner of the property,am exclusively contracting I CONTRACTOR NO. `l L with licensed contractors to cpnstruct the project (Sec- ' ADDRESS ' tion 7044, Business and Professions Code). I REQUIRED TOTAL SETBACK FROM• EXIST. CONSTRUCTION LENDING AGENCY I SET BACK YARD 'HW PROP. LINE WIDTH 'hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued i P.L. _ tSec. 3097, Civ. C.). SIDE o P.L. L'ender's Name I jt Lender's Address P.C.Fee$ Permit Fee , c 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 / l ordinances and State laws relating to building construction, i Total Fee and hereby authorize representatives of this County to enter i upon the abov -mentioned pr party for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date ..®s - f