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Home My Public Portal About6122 PRIMROSE AVE_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES g U 1 L D I N G WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY - DISTRICT NO. PLAN CK:NO: - - PERMIT NO. BUILDING �lzz Primrose Ave. - ,3'7073- A � 7 -560 v?— LOCALITY _ T C RECEIVED BY. - DATE OF AP.PL. DATE ISSUED NEAREST Flaherty St., Temple City BUILDING �s �y+ OWNER Meeker Land. Company ADDRE89 MAIL 6811236 E. Live Oak Ave. LOCALITY NEAREST CITYArcadia No D0=72151 CROSS ST. FIRE No.Or TYPE- PGROUP ARCHITECT OR TEL. ZONE PLANE ENGINEER �A_ _R� Q C Ol� NO. FL-7�i..�i.20 BLDG. ®' ORD.NO.., ADDRE89 SETBACK LINE Z& _, • LL APPROVED } TEL CONTRACTOR NO. BY DATE USE APPROVED ADDRESS ZONE BY DATE LEGALDESCRIPTION LOTN ®'BLOdit-�..__ Z0-e3 CORRECTIONS TRACT A rl <—c) C9 o • C NO.OF BLDG9. SIZE OF LOT 5GGX112 NOW ON LOT ' none 7- USE OF" none • NO.OF NO.OF 6 EXIS OLDD. I FAMILIED I ROOMS 13 6- e DESCRIPTION OF WORK _ NEW X ALTERATION ADDITION — O A REPAIR �}ry MOVING ` DEMOLISH r r n} 0 B ZE IT* 110( ROOMS p STORIES 1 a�'Lte�O( F jll_ / r Z �� W��IY�Y 6 r . oar COV RING Plaster I COVERING W.Shgl.es. 1r1CG, �fl.lrblt`f�(� Crdb .S SLP;P or N B�DING Residence Plan 5-C Z F1F.-}'F r 1 C1ei�'RF Garage 18-x 20 S'Ec Iat1' 1NGoMPLF-'rF. -TOLD 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS -� ,Ci RDPROVALS, APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION:LOCATION ECTOR AND AGREE TO COMPLY WITH ALL-COUNTY ORDINANCES FORMS,MATERIALS 1 I v 8-017 AND STATE LAWS REGULATING BUILDING CONSTRUCTION. ll n - FRAME: FIRE STOP_9, l SIGNATURE OFDD *m BRACING,BOLTS PERMITTE SL'LAND 90 ' , rAMAA, ,O i AUTHORIZED A LATH,EXT: 1 oeD-9 6OM acre I-4DC/g PLASTER,INT. 'ZOO FEE PLASTER,EXT. N VALUATION" �� FEE /�-�-� FINAL ri- APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING 4ND4AFETY WORKER'S COMPENSATION DECLARATION F PPLICANT TO FILL IN BUILDING ADDRES 1 hereby affirm that I have a certificate of consent to If insure, BUIL If A D or rtificate of Workers' I pens insurance)ora certified o th .) 1171 1 ZIP LOCALITY [SIZE OF L NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnis NEAREST CROSS ST. ❑ Certified copy is filed with t c0 ty 'ding in pe I TRACT BLOCK LOT NO. department. USE ZONE MAP NO. E PARCEL Date Appll ° ASSESSOR MAP BOOK PAG SPECIAL CONDrIMNS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER /n COMPENSATION INSURANCE ° [(6 WITHIN 1000 FT.OF SCHOOL? YES No (This section need not be completed if the permit is for one hundred ADDRESS DISTRICT GROUP TY ONST. FIRE ZONE PROCESSED BY dollars($100)or less.) CITY ZIP I certify that h the performance of the work for which this permit �Q G `7 ke�, ��0- b issued, I shall not employ any person at any manner so as to ARCHITECT OR ENGINEER TEL NO. Q /� become subject to the Workers'Compensation Laws. STATISTICAL CLAS IFICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS N077CE TO APPLICANT. If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CON 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. q S uC � PL LICENSED CONTRACTORS DECLARATIONSIDE CITY LIC.C PL I hereby affirm th t I am licensed underprovisions of Chapter 9 SEWER MAP (commencing it 1 Division 3 of a Busi and SQ.FT. IZE NO.OF STORIES NO.OF FAMILIES Professions d ,an Ij is in full fort d e NEW ❑ BK PG } License �( C.Clas D I I N R ADD ❑ VALUA N 6 U Contra r ate ALTER $ I ❑ I am exempt under Sec. REPAIR ❑ $ B.BP.C.for this reasone:;241. 7 L` DE-MOL ❑ LDM,Pic# W Date: USE OF EXISTING BLDG. URM ❑ t1 a(- Signature APPLICANT(PRINT) TEL N0. LDMA Perm# 3303 i2S°5Jz ❑ I, as owner of the property, or my employees with wages as o i ITEMS their sole compensation, will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and FINAL DATE G TOTAL IL25 o 55 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ 1, as owner of the OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE CHECK property, am exclusively contracting 44, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY >4 "E � 125.55 licensed contractors to construct the project (Section 7044, Business and Professions Code.) YES 11 NO EI CHANGE .00 WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FORGUIDEU �y(y n��y(�� I hereby affirm that there is a construction lending agency for YES❑NES NO❑ 0000'-0001 Q:2/9:6� CM the performance of the work for which this C,jpermit is issued(Sec. 4350 1 F'hi1��ib OD I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING � 3097,CIV.C.) CHECKLIST,I UNDERSTAND MY REQUIREMENTS UNDER THE UOS ANGELES COUNTY CODE, TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS 3 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. oLender's A ress 0 OWNER OR AGENT oI certify at I have read this application and state under penalty C of perj that the a inform orreCt.I agree to comply P.C.FEE PERMIT FEE q N with ou y 0 In ces and tate ws relating to building 05 < con u ion, nd a by authoriz s ntatives of this County ISSUANCE FEE /J O m to :pont o n' ne ro art for iXM29V / Q INVESTIGATION FEE TOTAL FEE /�� r sgrewre m Apatam a apem 13= QS SEE REVERS FOR EXPLANATORY LANGUAGE