HomeMy Public PortalAbout6115 PRIMROSE AVE_Building__ DEPARTMENT OF BUILDING AND SAFETY ArrLiCiA i awiV run rfrx=L
COUNTY OF LOS-ANGELES ® 0
WM. J. FOX. CHIEF ENGINEER 17
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING DISTRICT ISO. PLAN CK.NO. PERMIT-NO.
ADDRESS G //S Primrose Avenue " 3'D 7 0 _S-6-0 �•
LOCALITY -r'C/ RECEIVED BY DATE OF APPL. DATE ISSUED
CRC8B S. Garibaldi Avenue Tem leC Z- 6-CS
OWNER Meeker Land Company ADD EI88
MAIL 11236 Live Oak Avenue LOCALITY /i G•i
ADDRESS
NEAREST
CITY Arcadia EL-DO-72151 CROSS ST.
FIRE NO.OF TYPE GROUP
ARCENGIiNEERT RO . ssell No�' FL-7 20 ZONE PLANS
BLDG. � x ORP.N
ADDRESS SETBACK-LINE �+SJ 411q�/ G/ -
APPROVED
CONTRACTOR NO. BY DATE
USE APPROVED
ADDRESS ZONE BY DATE
LEGAL 3 BLOCK -2-0 d __3 CORRECTIONS
DESCRIPTION LOT NO.
TRACT 17179 No
�}
SIZE OF LOT 6OX7.g I NOW ON L TOF S' none J
USE TI none I NO.OF I mmor 6 /V ;{y R �J R�•• L, l
EXISTING BLDG. _ FAMILIES ROOMS q � 7 � .r/h Q// / O �'-. ��✓
DESCRIPTION OF WORK
NEW X ALTERATION ADDITION r
REPAIR MOVING DEMOLISH
9q.FT. NO.OF Z
SIZE 1106 ROOMS 6 STORIES l Nn'r ��)v or �s H',L�h >
WALL — r
CORING Plaster I COVERING W. Shgles
B��o N"G ' Residence a p-q-s 1&th, 11 U P-1 IV8 I.
Plan 3-A �.
�2 4=-r. Garage 18 x 20
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION-: LOCATION I CTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS
�=
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
FRAME: FIRE STOPS,
SIGNATURE OF KER L P BRACING.BOLTS I I I
PERM ITTE
LATH, INT. %�(I�Am 3d 1
AUTHORIZE `Q C° ��,� Z 3
LATH, EXT. Ulm.•�1
7GA63BA-3 7-49 $ V 30...E P.0. �' PLASTER,INT.
A /goLe FEE • PLASTER,EXT.
VALUATION % d Q ® . FEE l// FINAL � j'��� f�I v(' 'S(
WORKERS' COMPENSATION DECLARATION
of consent to self
insure, or affirm certif catte of Worke s'tificate Compensation Insurance, APPLICATION F®R BUILDING PERMIT
or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company BUILDING
❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS
❑ Certified copy is filed with the county building inspec- BUILDING
tion department. ADDRESS / t°
//+7 .
Date Applicant CIN v Zip C, o LOCALITY
NO.OF BLDGS. NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST.
COMPENSATION INSURANCE ASSESSOR
(This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL
hundred dollars ($100)or less.) /, TEL. 11
OWNER 54-ep�' NO.�/p 'D/ USE ZONE MAP
I certify that in the performance of the work for which this SPE
permit is issued, I shall not employ any person in any manner ADDRESS &L p SPECIAL a}..
CONDITIONS O
so as to become subject to the Workers'Compensation Laws. I • V
CITY ZIP
Date Applicant ARCHI ECT TEL. DISTRICT GROUP I TYPE FIRE PROCESSED BY U
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. C ST. ZONE
Exemption, you should become subject to the Workers' Q
Compensation provisions of the Labor Code, you must forth- ADDRESS �r%
with comply with such provisions or this permit shall be ) TEL. STATISTICAL CLASSIFIC V APT. CONDO. to
LG�i� Z
� NO.
deemed revoked. CONTRACTOR lJ�!
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. NO.OF NO.OF CHECK
License Number Lic. Class SIZE STORIES FAMILIES ONE
VALUATION
Contractor Date DESCRIPTION OF WORK NEW $ 0'0
—•— ADD ❑ i OOO.
❑I am exempt under Sec. +�' e D ALTER 1:1B.&P.C. for this reason PAIR ❑ $
R_E
Date: E OF
EXISTING BLDG. DEMOL ❑
Signature APPLICANT TEL. FINAL -
OWNER-BUILDER DECLARATION (PRINT) NO. i�
DATE
I hereby off that I am exempt from the Contractor's License
ff
Law for the following reason (Section 7031.5, Business and ADDRESS FINAL I 1
Professions Code): PRESENT By a a R /+�+
ElA �u V
BUILDING
44I, as owner of the property, or my employees with ADDRESS y
wages as their sole compensation,will do the work and e.
the structure is not intended or offered for sale(Section LOCALITY ® 3307 98.63
7044, Business and Professions Code.) MOVING TEL, ITEMS❑ I, as owner of the property,am exclusively contracting
CONTRACTOR NO. r 1 ITE S
with licensed contractors to construct the project (Sec- ADDRESS TOTAL. 913 o 63
tion 7044, Business and Professions Code.) CHECK 9Vo�3
REQUIRED TOTAL SETBACK FROM EXIST. CHECK
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT CHANGE .00
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C.). SIDE
P.L. 0000-0001 11/3 /92
Lender's Name 17-Jf/r! LDMA Ref. # 6742 1 AH�.1:10
B P.C. Fee$ Permit Fee O O
� Lender's Address r '
I certify that I have read this application and state that the Issuance Fee 7— 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 6 3 LDMA Perm. #
and hereby authorize representatives of this County to enter
upont e•above-mentioned pro er�for inspection purpose .
ke yam:yet /'V7--7 /30 Z SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent Date