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Home My Public Portal About9135 PRIMROSE AVE_Building__ ,APPLICATION FOR COUNTY OF LOS ANGELES OF COUNTY BUILDING PERMIT DEPARTMENT BUILDING AND SAFETY DIVISIONER BUILDING FOR APPLICANT TO FILL IN ADDRESS � C,� � BUILDING J -I ADDRESS/ �- �aVC c� �+]L C� LOCALITY NEAREST CITY L.e_ ZIP CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE PROCE D BY TRACT I .1! ' BLOCK LOT NO. �y CONST,/ Z OWNER •p 3� NOLTE ; 4j/I� STATISTICAL CLASSIFICATION , SEWER ADDRESS � LLt( CLASS NO, DWELL,UNITS % G CITY�� _� ZIP US ZONE MAP e • tl NO. ARCHITECT O TEL. SPECIAL ENGINEER NO. 7.1 CONDITIONS ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ 'NO❑ CONTRACTOR NOL' BLDG.SET BACK FROM I FRONT PROP.LINE OFA ��t-1O, (STREET) LIC. ADDRESS NO. HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING LIC. FRONT PROP. LINE HIGHWAY WIDTH CITY CLASS _ CONSTRUCTION LENDER - + .2- 0 NAME AND BRANCH 13 LOG.SETBACK FROM ADDRESS CITY SIDE PROP.LINE OF (STREET) v SQ. FT, NO. OF NO. OF CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING I= SIZE STORIES FAMILIES ONE SIDE PROP. LINE HIGHWAY WIDTH O DESCRIPTION OF WORK NEW ❑ + /0 SSS y ADD ❑ CORNER CUTOFF YES ❑ NO ❑ Z i ALTER ❑ EPAIR N OPEN SPACE YES ❑ NO ❑ USE OF IN COASTAL PERMIT ZONE YES ❑ NO ❑ EXISTING BLDG. DEMOL ❑ APPLICANT TEL (PRINT) NO. ..�L��•� BY (SIGNATURE) 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THISJ".NHE ION AND STATE THAT THE ABOVE IS CORRECT AND AGRLY WITH ALL ORDINANCES AND LAWS REGULATING N- STRUCTION. I CERTIFY THAT IN DOING THE WORED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLHE LABOR CODE OF THE STATE OF CALIFORNIA INTO WORKMEN'S COMPENSATION INSURANC . / SIGNATURE OF FINAL J6 X77 BY PERMITTEE DATE ADDRESS TEL, C.Fee$ Permit Fee �a'L CIT /� /�/ NO.Q Issuance Fee VALUATION Total Fe o J PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH 2 2 5 Ada 18 �; 0 1 2.0 0 a�-j 76AGSOA CK#808B 12/78 - APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BU({pING ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS `� or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) ,7yy�'i'1 Y Zip Policy No. Company SITZE OF LOT �7 NO.OF BLDGS/�LOT LOCALITY ,_ ❑ Certified copy is hereby furnished. � NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNERTEL O. YES NO COMPENSATION INSURANCE 2�� WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred D� S � O DISTRICT GROUP TYP CONST. FIRE ZONE PROCESSED BY dollars($100)or less.) 4A G�J� I certify that in the performance of the work for which this permit CIT �iicZ zip „7� �:] O is issued, I shall not employ any person in any manner so as to / �DO become subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO. STATISTICAL CLASSIFICATION 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 NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith �Lf-/tC FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC,NO. PL LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS P L SIDE I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ. SIE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. 1 NEW ❑ BK PG ® } DESCRIPTION OF WORK VALUATION Q License Number Lic.Class , ADD ❑ 6 Contractor Date ALTER ❑ $ REPAIR ❑ O ❑ 1 am exempt under Sec. $ �F-- B.&P.C.for this reason 00JI41 DEMOL ❑ LDMA P/C# 1 W Date: USt_QF EXISTIN G. /� � URM ❑ YA�Cb7CTT1�STEMS -f ah, �/�tgnature APPLICANT f /G TEL NO. LDMA Perm# 4�Day�- -70�(�y�1'z L!Q I, 1 owner of the property, or my employees with wages as Z CHECK 70080 their sole compensation, will do the work and the structure is ADDRESS 0 not intended or offered for sale (Section 7044, Business and rFINALL TE a CHANGE 000 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL J OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑ 1, as owner of the property, am exclusively contracting 44, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES I 0 licensed contractors to construct the project (Section 7044, Business and Professions Code.) YES❑ NO❑ ( d 0000-0001 11/ 3/95 MLL THE USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BDING OCCUPANTINTENDED REQUIRE A PERMIT OR CONSTRUCTION OR MODIFICATION FROM THE SOUTH 3139 1 PM 12 a 01 CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES I hereby affirm that there is a construction lending agency for YES❑ NO❑ 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 a 3097,CIV.C.) 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 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. o Lender's Address C OWNER OR AGENT o I certify that I have read this application and state under penalty 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 construction, and hereby authorize representatives of this County ISSUANCE FEE m to ant o e-mentioned property for inspection purposes. a m INVESTIGATION FEE TOTAL FEE � Spciuo Ap,,.�m A� D:io d SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN B/u��,��ppING ADDRESS t I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) IT_,,Y�� 7 ZIP / Policy No. Company may/ LOCALITY SIZE OF LOT NO.OF BLDGS N W ON LOT ❑ Certified copy is hereby furnished. �w S& NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. USE ZONE MAP NO. department. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL O. COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred AD9RE S DISTRICT GROUP TYP CONST. FIRE ZONE Of; PROCESSED BY dollars($100)or less.) I certify that in the performance of the work for which this permit CIT t�7icZ ZIP /77� r J /� , is issued, I shall not employ any person in any manner so as t0 ARCHITECT OR ENGINEER TEL NO. J �d' F-1GCL°e�—��G become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. 'p-/ 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 NO. 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. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATIONSIDE CITY LIC.CLASS PL I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ. SqIzE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. � 1 NEW ❑ BK PG License Number Lic.Class DESCRIPT1bN OF WORK ADD VALUATION 0_ E] Contractor Date ALTER ❑ $ ��' d� 0 X ❑ I am exempt under Sec. REPAIR ❑ $ 177 BAP.C.for this reason j2Wild -- DEMOL ❑ LOMA Pic# 1 W Date: U52.EXISTIN G. /� URM ❑ ACCTWTEHS ZM, gnature APPLICANT f � /G TEL NO. LDMA Perm# 70.90 IL V�as owner of the property, or my employees with wages as zo CHECK 70.80 their sole compensation, will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and FINAL DATE Q CHANGE .00 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 property, am exclusively project contracting 44, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044, YES❑ NO❑ Q�Dd"��d 1 11/ 3/95 IMUL THE Business and Professions Code.) f � INTENDED USE OF THE BUIDUNG BY THE REQUIIRE A PERMIT U FOR CONSTRUCTION OR MODIFlICATION FROR OM FUTUREBUILDING OCCUPANTSOUTH 3139 1 Pik 12 o Q 1 CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES I hereby affirm that there is a construction lending agency for YES❑ NO❑ 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.) 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 i Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. ❑ Lender's Address o OWNER ON AGENT o I certify that I have read this application and state under penalty o P.C.FEE PERMIT FEE of perjury that the above information is correct.I agree to comply .� N with all county ordinances and State laws relating to building s construction, an hereby authorize representatives of this County ISSUANCE FEE " n m to ent r� o e-mentioned property for inspection purposes. INVESTIGATION FEETOTAL FEE CO Q r Sbn�uro Ap xont Aprn Dao SEE REVERSE FOR EXPLANATORY LANGUAGE