Loading...
HomeMy Public PortalAbout6039 PRIMROSE AVE_Building__ 76A638A CE x8092-69 APPLICATION FOR BUILDING PERMIT COUNTY -OF'LOS ANGELES BUILDING- DEPARTMENT OF COUNTY'ENGINEER ADDRESS- - BUILDING AND SAFETY'DIVISION LOC;aLI'rY JOHN A. LAMBIE:.COUNTY ENGINEER ' NEAREST , WILLIAM A.JENSEN, SUPT OF BUILDING CROSS,ST. - DISTRI. T N GR. U TYPE ESSED BY FOR APPLICANT fi0 FILL IN ' �. CONST, BUILDING STATISTICAL CLASSI I.CATION S WER MAP ADDRESSSCr - f� BK CLASS. NO.�DWELI UNITS_ LOT NO. r - 11BLOCK.' WATER NOT REQUIRED RECEIVED CERTIFICATE: TRACTfkV MAP a ��J� FIIGFIWAY-- STATE'MAJOR SECON LOCAL r NO.OF BLDGS. NO.•of�(l(/ ICIRCLEI: SIZE,OF LOTS O X l S NOW'ON LOT USE-ZONE SPECIAL USE'OF CONDITIONS EXISTING BLDG.' TEL. OWNER NO. BUfLdlNG YARD HWYSTREET NAME EXIST. SETBACK WIDTH ADDRESS a PI'r�11 OSS• FRONT A ARCHITECT OR TEL. P, L. ENGINEER NO, SIDE P..L. ADdRESS gq % O}. TEL. O CONT.RAGTOR NO U ADDRESS DESCRIPTION OF WORK, • v NEW ADD' ALTER ' REPAIR DEMOLISH, rn SQ.FT. NO.OF NO. OF- Z SIZE STORIES FAMILIES " USE OF- ..STRUCTUR r R zi SIGNATURE OF., APPLICANT �� a VALUATION $ .5_" APPROVALS. DATE INSPECTOR'S SIGNATURE P.C. ' PMT, .Sold -,FOUNDATION: LOCATION FEE $ FEE $� FORMS, MATERIALS. FRAME: FIRE STOPS, J9 - 1 HEREBY ACKNOWLEDGE-THAT I HAVE READ THIS APPLICATION' BRACING, BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS V_ENT. DUCTS BUILDING CONSTRUCTION. F CERTIFY THAT-IN DOING THE WORK \ AUTHORIZED,HEREBY TWILL NOT EMPLOY ANY PERSON IN'VIOi'A- LATH. INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- t` ING TO WORKMEN'S COMPENSATION INSURANCE.- LATH,EXT. .l L- SIGNATURE'O HOUSE NUMBER COR= PERMITTEE- ° RECT AND POSTED ADDRESS Y I'NAL Ml l JOHN F. LEWIS, PRINCIPAL ST RAL ENG1 EER PLAN'CHECK VALIDATION CK. 'M.O. CASH ;PERMIT VALIDATION C M.O. CASH L.:!,o."1 2 4 9-6 APR ? 1 D 11.5 0 . )T PL CI 9 76A638ACE#8032-63 APPLICATION FOR BUILDING: PERMIT `• COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ' ADDRESS [J BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST a WILLIAM A.JENSEN. SUPT OF BUILDING CROSS ST. DISTRICT GROUP I TYPE• PRO BY FOR APPLICANT TO FILL IN ONST. BUILDING STATISTICAL CLA.9SIFICATION SEWER MAP ADDRESS Oyu BK CLASS.NO. DWELL.UNITS —A LOT NO. ^$d s ` BLOCK WATER NOT REQUIRED RECEIVED ❑ CERTIFICATE: TRACT IQ� ( MAP /F 0 (CIRCLE) STATE MAJOR SECOND OCAL f b NO.OF BLDGS. NO. (/ SIZE OF LOT Q O� NOW ON LOT USEZONEI SPECIAL USE.OF 1' ! / CONDITIONS EXISTING BLDG. ('FOOU�(C, TIO. NO. 33 BUILDING YARD HWY STREET NAME EXIST.WIDTH _ SETBACK ADDRESS 1.O Q FRONT �qa� O ARCHITECT OR i- TEL. P. L. oC ENGINEER OIJ�% NO. SIDE I a P. L. i ADDRESS I O CONTRACTOR MoArlijaeg PaltKovTEL-. 4T024a I ADDRESS . 1 F-• DESCRIPTION OF WORK 'L a ' I NEW ADD ALTER REPAIR DEMOLISH I Z SO.FT. NO.OF NO. OF SIZE STORIES FAMILIES USE OF STRUCTURE FOR. VQQ 4 v SIGNATURE OF APPLICANT VALUATIONS �-p APPROVALS DATE INSPECTOR'S SIGNATURE �p � FOUNDATION: LOCATION F E S FEES (TV FORMS. MATERIALS' FRAME: FIRE STOPS. f I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS , AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. 2 �� WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS 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 RELAT- _ ING•TO WORKMEN'S COMPENS ON NSURANCE. LATH,EXT.- n. SIGNATURE OF HOUSE NUMBER COR- �� PERMITTEE RECT AND POSTED ADDRESS FINAL wo ? JOHN F. LEWIS. PRINCIPALSRALE'MGIINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATIO : CK: M.O. CASH Ltluo 7 7 2 0-:6 A?R 1 5- 1 D 4.0 ON Ty 76A638A CE#8032-63 APPLICATION FOR 8'UILDING PERMIT , COUNTY OF LOS ANGELES BUILDING Or I DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEARESTj WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST. DIST�i; GROUP TYPE P ESSED BY FOR APPLICANT TO FILL IN V CONST. BUILDINGD / STATISTICAL CLASSIFICATION S WER MAP ADDRES CLASS. NO.�DWELL.UNITS �+ BK LOT NO �'p,S BLOCK WATER NOT REQUIRED RECEIVED TRACT &5101 CERTIFICATE: • MAPHIGHWAY NO.OF BLDGS. NO. •(CIRCLE) STATE MAJOR SI GOND, OC t SIZE OF LOT © ,j NOW ON LOT USE ZONE SPECIAL USE OF �7 CONDITIONS EXISTING BLDG. b l - TEL OWNER NO BUILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS 6 0 3 Y e FRONT l ARCHITECT OR TEL. P. L. ENGINEER O. SIDE ADDRESS P L y fw TEL. ' V CONTRACTOR NO. - ADDRESS - • , O D RIPTION OF WOR$ ' Lu n y NEW ADD -ALTER REPAIR DEMOLISH Z SQ.FT. NO.OF NO. OF - -- SIZE STORIES FAMILIES USE OF 1 STRUCTURE L F 410 e APPROVALS DATE INSPE :OR'S SIGNATURE FOUNDATION: LOCATION � l FEE $ _ FEE $ FORMS. MATERIALS } FRAME: FIRE STOPS. /j_ 1 HEREBY ACKNOWLEDGE THAT I HAVE•READ THIS APPLICATION BRACING. BOLTS (l ANC'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 I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT. • ,� �� / �f A TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S COMPENSATION INSURANCE �FY `//,/ % 1 LATH.EXT. SIGNATURE- GCC HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADORES 4 V FINAL JOHN F. LEWIS,,PRINCIPAL STRUCTURAL ENGI R PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.C. CASH L&0QfY4 6 6 SEP 2.3 1 D : 6 OM WORKERS'COMPENSATION DECLARATION hereto self i'n uteboraffirm a certificate of Worgers'Compensat on that I have a certificate of coent Insurance, APPLICATION FOR BUILDING PERMIT or a certifie coy Hereof(Sec. 3800, Lab. C.) y y ��/ fir COUNTY OF LOS ANGELES BUILDING ANDSAFETY Polic No. y om an DCertified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS ❑ Certified copy is filed with the county building inspec- - BUILDING tion department. ADDRESS Applicant QA-- CITY Q d ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' / NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT / NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR .hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL. USE ZONE MAP I certify that in the performance of the work for which this OWNER C NO. SPECIAL permit is'Issued,I shall not employ any person in any manner ADDRESS rcra • R IL so as to become subject to the Workers'C mpensation La S. CONDI.TIO S O Date ZIP Applicant 6 CITY s 4 .� C %r &E NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PR. . ED BYel r Exemption, you should become subject to the Workers' ENGINEER �✓� NO. ,Ir% _ CONST. / ZONE Compensation provisions of the Labor Code, you must forth- ADDRESS Y/ -�/ IL IL with comply with such provisions or this permit shall be" f / TEL. STATISTICAL CLAIF�ATION APT. CO O. deemed revoked. CONTRACTOR �/ / NO. nF _ g g LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS — ja �C�pCC O (commencing with Section 7000)of Division 3 of the Business and r LIC / SEWER MAP Professions Code,and'my license is in full force and effect. CITY a he/ CLASS l-4 BK PGVALIDATION �,r� SQ.FT. NO.OF NO.OF CHECK License Number `�•'V'�"'� Lic.Class � SIZE STORIES FAMILIES ONE VALUATION DESCRIPTION OF WORK NEW Contractor Date �� $ ADD ❑I am exempt under Sec. 04 ❑ , ALTER B.BP.C. for this reason REPAIR ❑ Date: USE OF DEMOL EXISTING BLDG. Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION PRINT NO. DATE 2! I hereby affirm that I am exempt from the Contractor's LicenseADDRESS pl z 6 2 11,3 A ; Law for the following reason (Section 7031.5, Business and Professions Code): R E B BUILDING # 0 0 0 0 0-1 ❑ I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and , I ° ° 6 Q 5 0 the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. 0 0 0 6 0,5 0 50' F! I, as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS 1 231 -86 tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAL SETBACK LINE WIDTH 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. (Sec. 3097, Civ. C.). SIDE 'a P.L. Q Lender's Name LDMA Ref. # P.C.Fee$ Permit Fee ✓ r!J(J ' - Lender's Address rI certify that I have read this application and state that the Issuance Fee 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 () LDMA Perm. # and hereby ou orize representatives of this County to enter upon the ab e-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 0 Signature of Applicant or Agent Date WbRKERS'COMPENSATION DECLARATION insureborahee '�fcertifcateeff''WokerY.CompensatonInsurance, APPLICATION FOR BUILDING PERMIT or a certifieo cogy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY PolicyNo"`�6 ISG�Company � 1kr , F] -Certified d o3 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN C ADDRESS ❑ Certified copy is filed with the count building inspec- BUILDING LO39 PRIM OSE tion department. ADDRESS V ✓ 1 19 Date Applicant 00 •D �` CITY • G. ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' I,O0 NO.OF BLDGE. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT �' CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars($l0U)or less.) TRACE� �� BLOCK LOT NO.Z MAP BOOK • PAGE PARCEL TEL, USE ONE MAP I certify that in the performance of the work for which this OWNER -Sip V NO. NO, ,5U- >. permit is issued,I shall not employ any person in any manner CC ��/ t�f SPECIAL t. so as to become subject to the Wor�zvl� ensation Laws ADDRESS —• w VV AAT �� CONDITIONS 0 Date�e/�y, ad Applicant t.e'l4�s✓ CIN • C• ZIP I /� O NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR `-w� EE NO r DISTRICT GROUP TYPE FIRE PROCESSED BY G Exemption, you should become subject to the Workers' C�P44WSER IrW L /l(� �!� CONST. ZONE W Compensation provisions of the Labor Code, you must forth- ADDRESS3657 • R +v dCAL- y with comply with such provisions or this permit shall be OrEL. STAf ISTICAL CLASSIFI A ION APT. I C NDO. Z deemed revoked. CONTRACTOR NO. 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 and LIC, /� Professions Code, and my license is in full force and effect. CITY CLASS BK VALIDATION ,/ SIOHECK — Z S ORIOES Z FAMILOIES CONE 9 4 3 4 9 A License Number kfC�IC A Lic.Class I /�' IP OF VALUATION Contractor " / ate J'ii •- D pT{O OF OR V N E O NEW $ .t��' 1D,r)OV # 0 0 0 0 2 3 dr ❑I am exempt under Sec. OWN Ome"J ALTER ❑ADD ,J V , ( - 59a62 B.BP.C. for this reason REPAIR ❑ $ ° - 5911625 Date: USE OF EXISTING BLDG. Z I JAJ&Le Jf0tJ56�$ DEMOL ❑ Q 4 0 1 -S 6 Signature APPLICANT gAv� 45 TEL FINAL OWNER-BUILDER DECLA TION PRINT 4 NO. DATE I hereby affirm that I am exempt from the Contractor's License �.B�VP.r Law for the following reason (Section 7031.5, Business and ADDRESS FIN Professions Code): PRE E By E] I, as owner of the property, or my employees with ADDRESS BUILDING �; Fv1AA P,0% wages as their solecompensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. 6 2 I.2'A ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- # 0 0 0 0 0 57 tion 7044, Business and Professions Code). ADDRESS CONSTRUCTION LENDING AGENCY SETBACK YARD HWY TOTAL SETBACK LICNE R WIDTH 0 81 11,7 5 I hereby affirm that there is a construction lending agency for FRONT 1 ' / ° 0 8 7 5';) the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE �O1 1 23 ­66 a Q Lender's Name / LDMA Ref.# 6 P.C.Fee$ 2— Permit Fee .2S Lender's Address ' rI certify that I have read this application and state that the Issuance Fee �' 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 i?-/ Y. 5 LDMA Perm. # and hereby authgrize representatives of this County to enter upon the above entioned property for inspection purposes. I �'/r4h( SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date