Loading...
HomeMy Public PortalAbout5820 PRIMROSE AVE_Building__ 76A688A CE#8085.6IAPPLICATION FOR .BUILDING PERM[ 9i I COUNTY'OF:LOS ANGELES . BUILDING Cp' '���M C DEPARTMENT OF'COUNTY. ENGINMR ADDRESS,7 v 2,a 'BUILDING AND SAFETY.DMSION LOCALITY c JOHN'A. LAMBIE, COUNTY''ENGINEER NEAREST. gg WILLIAM A.JENSEN SUPT of BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRICT N GRO yY�E E BY _ r' (/' CONST. J BUILDING 4LL' /� STATISTICAL CLAS CATION SEWER MAP i4DDRESS`./ IC CLASS.NO. DWELL.UNITS '- BK. LOT NO. 46 BLOCK WATER NOT REQUIRED'` RECEIVED CERTIFICATE: TRACT 65 MAP HIGHWAY. t / ' NO.OF BLDGS. NO. (CIRCLE) STATE MAJOR SECOND OCAL SIZE OF LOT .MS xS NOW ON.LOT USE ZONE S ECIAL USE OF CONDITIONS 'EXISTING BLDG. OWNER0,4 NO. B .IL INC EXIST. . /� /� SETBACK YARD HWY STREET NAME WIDTH ADDRESS PRI A4a(X'E � C`• -FRONT ARCHITECT OR -TEL. ENGINEER NO. SIDE B' _ P.L. 0 ADDRESS' TEL . INSPECTION RECORD � CONTRACTOR NO. O bOQV� o ADDRESS 0"(i&-!MOSStVA MALu 1 / DE'S'CRIPTION OF WORK y NEW ADD r ALTER REPAIR DEMOLISH Z SQ.FT. NO;OF=• NO.OF IZE STORIES FAMILIES USE • 3/� .i7 4J17'fdJ11! ESL/S'J7NG STRUCTURE _ SIGNATURE OF APPLICANT VALUATION APPROVALS :DATE.0. INSPECTOR'S'SIGNATURE P.C. PMT. FOUNDATION:LOCATION-gyp' (1 FEE $ FEE $ (� L+ FORMS.MATERIALS . FRAME:FIRE STOPS, '// d 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ•THIS APPLICATION BRACING.- OLTS h !/� 1A .(//-/.�•,%+^""' AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY. FURNACE:LOCATION. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS / •.r77' BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE'WORK / ' ` AUTHORIZED,HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH.INT. TION OF THE LABOR CODE OF•THE STATE OF CALIFORNIA REL'AT- ' r! : j,. '� ING TO WORKMEN'S COMPENSATION INSURANCE. e./L� LATH,EXT. SIGNATURE HOUSE NUMBER COR- PERMITTEF RECTANDPOSTED ADDRESS FINAL '-/_, V,/ i��..� CLYDE N. DIRLAM, PRINCI}�AL-STR'� RAL EfJGINEER PLAN CHECK VALIDATION ' - cK. M.O. CASH PERMIT VALIDArPION cK. M.o. cnsx OCT19.0:-0 HlI-: Lazo TEMPLE 'CITY FU08.CC#.0:I APPLICATION- FOR BUILDING FERMIT COUNTY OF LOS ANGELES BUILDING' DEPARTMENT OF COUNTY ENGIIUER ADDRESS BUMING AND .SAFETY-DMSION LOCALITY ` JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A.JENSEN SUP'T.OR BUILDING CROSS ST-. W DISTRICT NO. 1. GROUP TYPE Sys BY' FOR APPLICANT TO FILL'IN B © CONST. v . BUILDING STATISTICAL CLASSIFICATION SEWER AP ADDRESS 5820 Primrose. . BK PG CLASS.NO: '" DWELL.UNITS-- LOT NO., NITLOTNO.• BLOCK "' WATER NOT REQUIRED RECEIVED CERTIFICATE: TRACT I MAPHIGHWAY . NO.OF BLDGS. NO:. Od (CIRCLE) STATE MAJOR SECON OCAL SIZEOF-LOT. NOW.ON LOT USE ZONE 'SPECIAL USE OF;' CONDITIONS EXISTING BLDG. OWNER'Nr. M. Adams NO. BUILDING YARD HWY STREET NAME EXIST. ADDRESS Same SETBACK 'WIDTH• FRONT. ARCHITECT OR TEL. P.L. 219 MI-AA ENGINEER NO. SIDE P.L. > . ADDRESS . . . p' INSPECTION RECORD CONTRACTOR Virgin-ROOT CO.NT7O5O7 3 ADDRESS 600 S .San Gabriel0 DESCRIPTION OF-WORK S.G« u LU NEW ADD ALTER' REPAIR DEMOLISH . to SQ.FT. N NO.OF, ? IZE STORIES FAMILIES SE OF STRUCTURE Re-roof SIGNATURE OF APPLICANT VALUATION$287,00 i APPROVALS -DATE INSPECTOR'S SIGNATURE FOUNDATION:.LOCATION: _. .- - - FEE $ FEE $ 6s00 -FORMS:MATERIALS FRAME:FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT I HAVE RfiAD THIS APPLICATION BRACING BOLTS' ..j AND-STATE THAT THE ABOVE IS CORRECT AND AGREE-TO COMPLYFURNACEe LOCATION;'• _ WITH ALL COUNTY ORDINANCES.AND STATE LAWS REGULATING GAS VENT DUCTS ' BUILDING CONSTRUCTION. 1-CERTIFY THAT IN DOING THE WORK - - AUTHORIZED HEREB 1 WI NOT EMPLOY ANY ERSON IN VIOLA- x TION OF THE LASO `OF THE SuTATE O LIF R91fA RELAT•. '�TI'1,INT. ING TO WORKMEN'S LATH.EXT. SIGNATURE OF HOUSE NUMBER COR= PERMITTEE RECT AND POSTED ADDR.ESOO S.•San' Gabrie•1.Blvd: ' . FINAL e San Gabriel- CLYDE.N. DIRLAM, PkINCIPALrsT5,=TURAL ENGINIEER PLAN CHECK VALIDATION cr... m.O. CASH PEBM VALIDATION/. cm..,. M.b. CASH : :`• :9"36•.63 l•D . : . - . . - . . • - , . � . . . ';; . . . :. • • , .'...•.. -'. . fir:-: .'• - ' A?7L�Z�i�r/ I DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES ®O WM. J. FOX, CHIEF ENGINEER NG FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY FAR NG QQ DISTRICT�IO: PLANCK. NO. QPE�yRMIT N�/O. BAD DRESS • .0�F` �6YA�(d r. i_ ` RECEIVED BY DATE OF APPL. DATE ISSUED ITY ��fI J _/'- 7"� a _fy 6` r„ �/ -7 ST // , P /fc��G f ] �/ W, /—�� ST. t e; 119A.`s7 ' l�) p 1 1 ADDREISS�� A,�i�1 dJ ' =tfl �� ! - `� 1, LOCALITY ,0. Sf NEAREST CROSS ST. ' ,%J/-)� L �/ // NO.!`]/ IiY V FIRE NO. OF L/ TYPEGROUPTECT OR" TEL. ZONEEER NO. BLDG. 7 7 ORD. No SETBACK LINE �O ! y • 1i�, l . 1 L�`Y S_SS APPROVED TEL. BY DATE ! CONTRACTOR NO. USE APPROVED ZONE / BY DATE ADDRESS HOUSE NUMBERING LEGALDESCRIPTION I LOT NO. ;Z BLOCK MAP NUMBER .2411-Z —FIELD CHECK BY TRACT Cos NO. ASSIGNED BY DATE NO. OF BLDGS. CORRECTIONS SIZE OF LOT 'J ,�e,) (� I NOW ON LOT '" USE OF / NO. OF EXISTING BLDG, G�v . <- �i(/�, I FAMILIES DESCRIPTION OF WORK NEW I I ALTERATION I I ADDITION Z j REPAIR I I DEMOLITION I I I _x SQ. FT. / NO. OF SIZE F ,.� ROOMS / STORIES 400 Z EXT.WALLy' ") ROOF ) r COVERING SJ o( ` o I COVERING j�l�( ��)• i USE OFAT�__ j U V- APPROVALS INSPECTOR'S SIGNATURE DATE 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FOUNDATION: LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN 1S ; FORMS, MATERIALS CORRECT. 1 AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME:FIRE STOPS, HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS ai.G r e,/� e _JAD , LAWS REGULATING BUILDING CONSTRUCTION. FURNACE: LOCATION, SIGNATURE OF , GAS VENT, DUCTS PERMITTEE ' / iI ,fl. LATH, INT. ADDRESS / LATH, EXT. AUTHORIZED AGT. PLASTER, INT. 76ABSBA• DOSS 10-60 (2) 6" FEE PLASTER, EXT. VALUATION 0--aFEE FINAL I .� 78A 638A CE#B08 9-87 APPLICATION FOR UILDIN.G PERMIT LI #V::COUNTY OF LOS ANGELES BUILDING DEPARTMENT Off' COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRI T NO. GROUP TYPE PROCESSED BY (Print or type only) S.0� I CONST.� C� BUILDING G STATISTICAL CLASSIFICATION SEWER MA ADDRESS SQ /�G/A9/PrOf� _ CLASS NO.�_DWELL.UNITS BK PG LOT NO. BLOCK (USE ZONE NADPSPECIAL DO TRACT P-3 CONDITIONS NO.OF BLDGS. SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. BLDG.SETBACK FROM TEL FRONT PROP.LI NE OF 1 �'�Ste+ (STREET) OWNER �j, ,V ,OJy'/9S NO. _ TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL ADDRESS��£',,�O /� r�jyr�Qs/� HIGHWAY WIDTH FROM C.L. CITY //i/(// E •G�.// ` BLDG. 6d t ARCHITECT OR TEL. BLDG.SETBACKFROM ENGINEER NO. SIDE PROP.LINE OF (STREET) TYPE OF EXISTING1 SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. CONTRACTOR.O"/J�, e!S'e"s NOLi'�r+ B'DL+S rj o ADDRESS7fJ �es//�° ✓f CORNER CUTOFF YES ❑ NO NO. 333 /� � LIC CITY ps+C +E/7 u. CLASS - A SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK Lu CIO) z NEW ADD ALTER REPAIR DEMOLISH SQ. FT. NO. OF NO. OF SIZE STORIES FAMILIES USE OF STRUCTURE 0-440'040+L /L ` - (J 7 _ SIGNATURE OF / �/ APPLICANT C. LriC VALUATION 5 �' Q O APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE S FEE$ aZ +S FORMS, MATERIALS FRAME: 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. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT• LATH, INT. ING TO WORKMEN'S COMPENS ION INSURANCE. � i LATH. EXT. SIGNATURE OF GG .c HOUSE NUMBER COI F2 _ RECT AND POSTED ADDRESS /�-j "�f 'FINAL JOHN F. LEWIS. PRINCIPAL ST CT AL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH LAGO 4 .9 -9 .3,% JUN 6 1 D 2 2.5 0- V o . . WORKERS'CJMPENS&TION DECLARATION hereby affirm that I have a certificate of consent to self APPLICATION FOR BUILD&G PERMIT insure, or a certificate of Workers'Compenstion Insurance,or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company I - BUILDING p- ` ❑ Certified copy is hereby furnished. ,17 FOR APPLICANT TO FILL IN ADDRESS �J� d ❑ Certified copy is filed with the county building inspec- BUILDING n C tion department. ADDRESS vE— LOCALITY < NEAREST Date Applicant CITY C ZIP Q CROSS ST. A� CERTIFICATE OF EXEMPTION FROM WORKERS' �r j �j NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOTS D / d 6 NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP �1 hundred dollars($100)or less.) TRACT 6 BLOCK LOT NO. T(O /J� NO. v Q y TEL. 06 K SPECIAL I certify that in the performance of the work for,which this " OWNER 9G NOo2p(7� CONDITIONS Q DISTRICT GROUP TYPE FIRE PR ESSED BY U permit is issued, I shall not employ any person in any manner p n/� /� .. so as to become subject to the Workers'Compensation Laws. ADDRESS p�(� /"/C IMItG D U�^ )Jpy� �� CONST.`/ / ZONE 09 Date Applicant CITY_C �/ ZIP fJ S Ail CLASSIFICATION `/ AFT. CONDO. U NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. W Exemption, you should become subject to the WorkersENGINEER NO. CLASS No. DWELL. UNITS— Compensation NITS Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be TEL' Jy deemed revoked. BK. �PG ! / I VALIDATION CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION LIC. 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. h Professions Code, and my license-is in full force and effect. CITY CLASS $ C,•� SQ.FT CC NO.OF NO.OF CHECK License Number Lic.Class SIZE ZJ STORIES FAMILIES ONE Contractor Date DESCRIPTION OF WORK , t NEW ❑ $- ' ❑ I am exempt from the licensing requirements as I am a ADD licensed architect or a registered professional engineer r _ ALTER FINAL,/,—,? acting in my professional capacity (Section 7051, �'L j %� (� REPAIR ❑ DATE " C ( Business and Professions Code)., USE OF 7� w, FINAL Lic.or Reg.No. e _Date EXISTING APPLICANT ��5,10ENC C TEL DEMOL ❑ OWNER-BUILDER DECLARATION (PRINT) /dfdlws' NO.x86-7 I hereby affirm that I am exempt from the Contractor's License -� Law for the following reason (Section 7031.5, Business and ADDRESSV0 jP / . Professions Code): PRESENT BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure isnot intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO. - 2 6 9, C A with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). # a o a a o 1 REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 2 0 0 �] Q O I hereby affirm that there is a construction lending agency for FRONT d the performance of the work for which this permit is issued P.L. 9 (Sec. 3097, Civ. C.). SIDE o r o P.L. Lender's Name 1 0.20-8 'oP.C. Fee$ Permit Fee G� 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 ordinances and State laws relating to building construction, Total Fee g and hereby authorize representatives of this County to enter kon bove-mentioned pr perty for ins ection purposes. ��..�3 SEE REVERSE FOR EXPLANATORY LANGUAGE Sig Lure of p icant or Agent Date ®s APPLICATION FOR PUILDING PERMIT COUNTY OF LOS ANGELES i BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION S�FOR APPLICANT TO FILL IN BU a DREILDINGOADDRE �� I hereby affirm that I have a certificate of consent to self insure, r� /1 or a certificate of Workers'Compensation Insurance,or a certified /f(/ copy there/of(SSCceeef(c.3800,Lab.C.) Z LOCALITY Policy No.A 9-1 ¢� Companys/0/ye.r � SIZE OF LrOT, NO.OF DGS.�� OT ,�rtified copy is hereby furnished. NEAREST CROSS ST ❑ Certified copy is filed withoth, ty building' Spection TRACT BLOCK IAT NO.de rttment. USE ZONE MAP NO. ApplicanD ASSESSOR MAP BOOK PAGE PARCEL — / SPECIAL CONDITIONS /J O CERTIFICATE OF XE O INSURANCEORKERS' E M' /gym_ FROM /" /7 l�/ WITHIN 1000 FT OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred AD RESS dollars($100)or less.) R� � DISTRICT GROUP TYP CONST. FIRE ZONE PROCESSED BY I certify that in the performance of the work for which this permitCITY . / n ZIP / � .NO. ` is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER /� TEL become subject to the Workers'Compensation Laws. STATISTICAL CLASS[ CATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR TEL SET BACK YARD HWY PROP LINE WIDTH Compensation.provisions of the Labor Code, you must forthwith � � FRONT comply with such provisions or this permit shall be deemed revoked. ADDRE LIC.NO. PL LICENSED CONTRACTORS DECLARATION "� 13 22 SIDE �� C.CLASS PL I hereby affirm that I am licensed underprovisions of Chapter 9 /a'a SEWER MAP (commencing with Section 7000)of Division 3 of the Business and I SO.FL SIZE Lf_> NO.OF STORIES I NO.OF FAMILIES Professions Code,and my license is in full force and effe -�S NEW 11 BK PG , License Number RoZ3l7 Lic.Class DE IPTION OF WORK ADD ❑ VALUATION O Contractor4O/fOr-AP? /''/t?!(–Date S o ALTER 11 $ U ❑ I am exempt under Sec. REPAIR BAP.C.for this reason , DEMOL 11 DMA P/C# D e: U§EgOF EIRSTING BLDG. URM ❑ IL i Signature APPLICANT(PRINT) TEL NO. LDMA Perm# Z ❑ I, as owner Of operty, or my employees with wages as Z r•r•^ a. their sole comp ation, will do the work and the structure is ADDRESS O not intended or offered for sale (Section 7044, Business and FINAL DATE G I `14 j_ Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J '1 TT rr ❑ I, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY - licensed contractors t0 construct the project (Section 7044,1 YES❑ NO❑ qS 'L"- ' � Business and Professions Code.) ; I ' WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING � •r.r OCCUPANT REOUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CHUM 1565 e I_5 CONSTRUCTION LENDING AGENCY I COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES !•:i3,y;• I hereby affirm that there is a construction lending agency for; YES 1:1 NO❑ _Tr kINGGE ,013 a the performance of the work for which this permit is issued(Sec.' I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING N 3097,CIV.C.) I CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TITLE 2.CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS e[(�lvl— [C 1`:e? 7.+ 'i A?E; Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAGMD. - 0 Lender's Address—TK(.. avNEa on AGENT ="1 y rif'�;. li{ O — o I certify that I have read this application and state under penalty, �� �Q � of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE N with all county ordinances and-State laws relating to building m constru ' n,and hereb uthorize representatives of this County ISSUANCE FEE / O m to ent u n the a ntioned proper or inspection (p Q a INVESTIGATION FEE TOTAL FEE /r / sqrutun o1 PyWiram nt SEE REVERSE FOR EXPLANATORY LANGUAGE