Loading...
HomeMy Public PortalAbout9108 RANCHO REAL RD_Building_1976-07-18 APPLICATION FOR COUNTY OF LOS ANGELES ARTMENT OF B U I L,q rN G PERMIT °BUILD NG AND COUNTY DEV SION R BUILDFOR APPLICANT TO FILL IN • ADDRESSING DDRIESS O ' BUILDING ADDRESS U LOCALITY NEAREST CITY J / ZIP Q CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT Z NOW ON LOT MAP BOOK PAGE PARCEL TRACT I BLOCK LOT NO. DISTRICT GROUP CONST/ F�IORpE�E 12Z OWNER NO.TEL. O - ©� � FJ STATISTICAL CLASSIFICATION SEWER MAP ADDRES iNdi 'CLASS NO. �' DWELL.UNITS BK PG CITYZIP �D US�EZONE NOP .a ARCHITECT OR TEL. /` SPECIAL ENGINEER NO. CONDITIONS ADDRESS i' ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ TEL. CONTRACTOR / NO. BLDG.SETBACK FROM LIC. FRONT PROP.-LINE OF (STREET) ADDRESS NO. HIGHWAY. + YARD TOTAL SETBACK FROM TYPE OF EXISTING LIC,• FRONT PROP.LINE HIGHWAY WIDTH CITY CLASS _ CONSTRUCTION LENDER + O NAME AND BRANCH BLDG.SETBACK FROM U ADDRESS CITY SIDE PROP.LINE OF (STREET. 0 SQ.FT. . v N0.OF NO,OF CHECK HIGHWAY + YARD / = TOTAL SETBACK FROM TYPE OF EXISTING t j SIZE 7 STORIES FAMILIES 4 ONE SIDE PROP.LINE HIGHWAY WIDTH N ': + = Z DESCRIPTION OF WORK NEW ❑ ,4P1 Q .C' ADD CORNER CUTOFF YES ❑ NO ❑ �2- ALTER El IN OPEN SPACE YES ❑ NO '[:1USE OF REPAIR ❑ IN COASTAL PERMIT ZONE YES Q NO ❑ EXISTING BLDG. DEMOL ❑ APPLICANT TEL r- �����_ ��! ��-i.L9�f7 L/ w. • (PRINT I BY(SIGNAT • I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- PENSATION INSURANCE. ��,( SIGNATURE;O J FINAL �v BY PERMITTEE " p� / DATE 7�� ADDRESalk' CITY �J� TEL. ��+ P.C.Fee$ Permit Fee6 NO.246 QQ Issuance Fee VALUATION$ �ea� �� Total Fee PLAN CHECK VALIDATION CK. M.O.: CASH _ _ PERMIT VALIDATION 0.' CASH 2 '6�.11iL Iii -1 43.0 a �3 ®S 76AG38A CE®808A 8/77 l �WORKFPS'COMPENSATION DECLARATION q . y.,offirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT ' ,insure,, o or a,certificote of Workers'Compensation Insurance, 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 IID ;E�2•r_:,L �� ❑ Certified copy is filed with the county building inspec- BUILDING Q tion department. ADDRESSS�(�d� ( .e— ii Date Applicant CITY `��- L -?- C' L`T ZIP 7t LOCALITY I„ CERTIFICATE OF EXEMPTION FROM WORKERS' SCS i O.OF BLDGS. NEAREST / r COMPENSATION INSURANCE SIZE OF LOT �o Z 3e J NOW ON LOT C_ CROSS ST. (,v M A (This section need not be completed if the permit is for one !/ ASSESSOR ,�L hundred dollars($100)or less.) TRACT �. Id BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL. 2. La� � USE ZONE MAP ` OWNER u -wc� Lf.�c:W NO. �S J/7�{ NO. C � (C I certify that in the performance of the work for which this ` permit is issued, I shall not employ any person in any manner 9lj� A i� SPECIAL + so as to become subject to the Workers'Compensation Laws. ADDRESS ll/ CONDITIONS O 7 l�—.C/o -1 r 4�7 r 0 zip `�!o 0 G U Date� � Applicant CITY a, NOTICE TO APPLICANT: If, after makin this Certificate of ARCHITECT OR �,! TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O g ENGINEER �'Il L��t s/e"f NO. -7G-2 qS( CONST ZONE I Exemption, you should become subject to the Workers' / - Q �j Compensation provisions of the Labor Code, you must forth- ADDRESS Z Y� 2r �,4%; `S7 . A/t/"a4 3,q _0 V �� W with comply with such provisions or this permit shall be deemed revoked. CONTRACTOR 0 i ka N zr TEL. STATISTICAL CLASSIFICATION APT. CONDO. NO. LICENSED CONTRACTORS DECLARATION LIC, CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code,and my license is in full force and effect. CITY CLASS BK PG VALIDATION SQ.FT. NO.OF NO.OF CHECK License Number Lic.Class SIZE 2$/Z ISTORIES 21 FAMI/LIES f ONE ` `iii► 0'i NEW VALUATION Contractor Date DESCRIPTION OF WORK 5i�^ Z I ADD ❑ $ ❑ I am exempt under Sec. �5 j =� lL ALTER ❑ O 6 19 A B.&P.C. for this reason AAA, 911PJA REPAIR ❑ $ .# 0o io 2;1 USE Date: EXISTOING BLDG. DEMOL ❑ I o 0 8.1890 Signature APPLICANT j7 \ TEL. a~ FINAL g PRINT -a U+'-'ate-t k-. NO. 2&2-7 77 0 9, 11—8 8 OWNER-BUILDER DECLARATION DATE I hereby affirm that I am exempt from the Contractor's LicenseF Law for the following reason (Section 7031.5, Business and ADDRESS�sY 3 t e 14iG4 b ! FI Professions Code): PRESENTB ❑ BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not Intended or offered for sale(Section kADDRE 7044, Business and Professions Code). TEL. ® I,as owner of the property, am exclusively contracting CTOR NO. 1 1 0 4,2 A with licensed contractors to construct the project (Sec- . - # o e�0 0 2 3 tion 7044, Business and Professions Code). ED YARD HWY TOTAL SETBACK / I a 2 5 0,5 4 CONSTRUCTION LENDING AGENCY CK PROP. LINE WIDTH c 2 5 Q 5 4 c=i I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued 1 1.0 1 8 8 (Sec. 3097, Civ. C.). c 10 4 3 A Lender's NameLDMA Ref. R # o 0 0 0,0 1 $ . Permit Fee , Lender's Address I o 89&75 1 certify that I have read this application and state that the �� uance Fee li.f IssJ LJ LDMA P/C p a above information is correct. I agree to comply with all County Investigation Fee °,o 8 9 4 7 5 5 ordinances and State laws relating to building construction, Total Fee 5 LDMA Perm. a I ■, �� and hereby authorize reprQO tatives of this County to enter 1. 01 -88 i upo a above- ti t!pr pectgion purposes. t 2 —ey SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date :WORKEPS'COMPENSATION DECLARATION !'I hereby affirm that I hovecertificate of consent t a• elr)B I N G PERMIT , insure, or a certificate of Workers'Compensation Insurarice, APPLICATION OR �I`D or a certified copy thereof (Sec. 3800, Lab. C.) ( COUNTY OF LOS ANGELES BUILDING AND-SAFETY Policy No. ' Company Certified copy is hereby furnished. FOR APPLICANT TO,FILL IN BUILDING Pol ADDRESS ❑ Certified copy is filed with the county building-inspec- BUILDINGC//Ot -e-J4 l � tion department. ADDR�EESSS!( Date Applicant CITY L e � E ZIP ����� LOCALITY 17 CERTIFICATE OF EXEMPTION.FROM WORKERS' NO.OF BLDGS. NEAREST SIZE.OF LOT IDZ. 8� NOW ON LOT CROSS ST. / COMPENSATION INSURANCE (This section need'not be completed if the permit is for.one //a ASSESSOR hundred dollars($100)or less.) TRACT (/ BLOCK LOT NO. MAP BOOK PAGEPARCEL TEL. W U ZONE OWNER NOMAP I certify that in the performance of the work for which this man-�� .Z��7R7 NO. (p permit is issued,I shall not employ any person in any manner ADDRESS 5 ( 3 l���a��x1 C , SPECIAL + so as to become subject to the Wor Campion L ws. ` CONDITIONS Date / Applicant CITY c'►a l ZIP '/ d NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT G UP TYPE FIRE PROCESSED BY Exemption, you should become subject to the Workers' ENGINEER NO. CONST. , ZONE Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or this permit shall be deemed revoked. STATISTICAL CLASSIFICATION APT. CONDO. CONTRACTOR �N&CONTRACTOR NO. -LICENSED CONTRACTORS DECLARATION / LIC. CLA55 NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS ! NO. (commencing with Section 7000)of Division 3 of the Business and . LIC, SEWER MAP Professions Code, and my license is in full force and effect., CITY CLASS BK � VALIDATION }: SQ. FT NO.'OF NO.OF CHECK t1 License.Number Lic.Class SIZE STORIES FAMILIES ONE" • + ❑ � VALUATION ' NEW Contractor Date DES OF WORK $ ; I am exempt under Sec. Q O ���s �t ADD ❑ ( ALTER ❑ B.BP.C. for this reason• REPAIR' ❑ N USE OF Date: EXISTING BLDG. DEMOL z Signature APPLICANT TEL. FINAL / OWNER-BUILDER DECLARATION PRINT NO. DATE 1 0 4 4 A . I hereby affirm that I am exempt from the Contractor's License Low for the following reason (Section 7031.5, Business'and ADDRESS FIN Professions Code): PRESENTBy' ❑ I, as owner of the property, or'my employees with ADDRESS BUILDING ( o,0.6 Q 5 0 wages as their sole compensation,,will do the work and the structure is not intended or offered for sale(Section LOCALITY _ 7044, Business and Professions Code). + MOVING TEL. � 6 Q 5 0 v, I, as owner of the property,am exclusively contracting CONTRACTOR NO. +," ( 1,Q 1 '`8 8 D with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). ADDRESS REQUIRED TOTAL SETBACK F G" CONSTRUCTION LENDING AGENCY SET BACK YARD. HWY PROP. LINE WIDTH .I hereby affirm that'there iso construction lending agency for FRONT the performance of the Work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. Lend'er's Name' A LDMA I P.C.Fee$ Permit Fee Address Ref. M Lender's ' I certify that I have read this application and state thatl the Issuance Feel � kLD P/C# ? above information is correct. I agree to comply with all County Investigation Fee L i ordinances and State laws relating to building construction, Total Fee 4.J 'L 'LDMA Perm. N 3 and reby orize represe tatives•of this County to enter 3 upo he abav - enf' operty for inspection purposes. e SEE REVERSE FOR EXPLA ORY LAN UAGEv Signature of Applicant or Agent Date � /3 • i � �� �� '�-4�/,�r� Jul�lf 7:7 4 UVC:RKERS'COMPENSATION DECLARATION Y affirm that I kava certificate of consent to self insure, A P P L O c ;-��'0 O N FOR BUILDING PERMIT n ior a certificato of Worr kers' Compensation Insurance, or a certified copy thereof(Sec 3800, Lab C.) COU-MTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN Certified copy is filed with the county building inspec- BUILDING /�tion department. ADDRESS %loa �, ,h 0Date Applicant CITY41 f, ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEARESTCOMPENSATION INSURANCE SIZE OF LOT /NOW ON LOT ]ADDRESS CROSS sr. QJ (This section need not be completed if the permit is for one TRACT BLOCK � LOT NO. MAP BOOK PAGE ASSESSOR PARCEL hundred dollars($100)or less.) 1 TEL. Y dCj I certify that in the performance of the work for which this OWNER r `E' J a ll a �, vfINO.I``�'(G J I USE ZONE OP - o permit is issued, I shall not employ any person in any manner ADDRESS 7 _ LZ O Yf SPECIAL so as to become subject to the Workers'Compensation Laws. y CONDITIONS V 29 Date Applicant CITY Q / �Q•bC ZIP 4/7/ NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR r, ` /7 TEL. DISTRICT GROUP TYPE FIRE PRO SED BY g ENGINEER W ` NO. CONST. ZONE Exemption, you should become subject to the Workers' � Compensation provisions of the Labor Code, you must forth- ADDRESS �50 A with comply with such provisions or this permit shall be TEL. STATISTICAL CLAS IFICATION A CONDO. 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 PG VALIDATION SQ. FT.�A NO.OF NO.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE J( y� VALUATION DESCRIPTION OF WORK � C[ /Lj /i NEW ❑ (� Contractor Date �jFI- ADD $ � r�00 ❑ I am exempt under Sec. .!5q" aq a 19 J ALTER E:] , �l F, B.BP.C. for this reason REPAIR ❑ $USE OF )" o c Date: EXISTING BLDG. DEMOL ❑ Signature APPLICANT //// TEL. p FINAL ( o o ! - OWNER-BUILDER DECLARATION PRINT eCP 6(�-f� NO•°Z S3�`g 7 . DA )��?j �R I hereby affirm that I am exempt from the Contractor's LicenseCa / a a c Law for the following reason (Section 7031.5, Business and ADDRESSJ.J Le I` Cw 7' V-6,_ 5.Co F Professi ode): PRESENT U r, r,— BUILDING I, as owner of the property, or my employees with ADDRESS 10 wages as their sole compensation,will do the work and ' the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). QIREDCONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAPROP .pCK L NEFRO WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE o' P.I. Q Lender's Name � LDMA Ref. # P.C. Fee$ Permit Fee09139 Lender's Address r I certify that I have read this application and state that the Issuance Fee S0 LDMA P/C# r 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 authorize representatives of this County to enter I u thea enti property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Sign a of App icant or Agent Date n 1 WORKERS'COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT � insure, or a certificate of Workers'Compensation Insurance, or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING f/�j /� � u%tJ!' ADDRESS 1 V ❑ Certified copy is filed with the county building inspec- BUILDING /C)& � G tion department. ADDRESS Y®J /s Vr Date Applicant CITY ;GmAee C !T C,�'ZIP 9�/7t�C�J LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. l NEAREST �j�, COMPENSATION INSURANCE SIZE OF LOT(0 NOW ON LOT 1 CROSS ST. Wyy (This section need not be completed if the permit is for oneTRACT �I BLOCK , t LOT NO. ASSESSOR hundred dollars($100)or less.) MAP BOOK PAGE PARCEL TEL ++ USE NE MAP I certify that in the performance of the work for which this OWNER i NO.�9� / NO. >_ permit is issued, I shall not employ any person in any manner , ��.+ so as to become subject to the Workers'Compensation Laws. ADDRESS � J � }fZc p. ! CON DTIONS 00 CITY /Zoft C•C' Cie 0/p. ZIP �l/O Date Applicant ARCHITECT OR T TEL. NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER �0�1 A1C)�,raS ll N0.28O—bwo DISTRICT GROUP TYPE FIRE PRO SSED BY V¢ Exemption, you should become subject to the Workers' I CONST. ZONE Compensation provisions of the Labor Code, you must forth- W with comply with such provisions or this permit shall be ADDRESS l� ZZ S Cji0r(ZI�.� ✓"�'�, 1EL. '{� �t ✓ y deemed revoked. CONTRACTOR ® Ji--e� NO.ZQ(ff / STATISTICAL CLASSIFICATION APT. C DO. 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 SQ.FT./� NO.OF , NO.OF y CHECK License Number Lic.Class SIZE / ?0d STORIES FAMILIES 1 ONE NEW VALUATION 10Contractor Date DESCRIPTION OF WORK ►'/ /�/� ❑ I am exempt under Sec. ��� d, / .e ADD ❑ $ ( (/V , ALTER ❑ B.BP.C. for this reason REPAIR ❑ $ Date: USE OF EXISTING BLDG. e t�@C•�6> DEMO' 171 614.8 A Signature APPLICANT TEL. # 0 0 0 0 2 3 g OWNER-BUILDER DECLARATION (PRINT) h ONfty L() (),p�'Tt4 NO. �5�?�I DATEFINAL I hereby affirm that I am.exempt from the Contractor's License ADDRESS T4s ���^'2�SQ /e� ��•���a<� 1 - 60435 Law for the following reason (Section 7031.5, Business and FINAL Professions Code): PRE ENTBY 0 - 60111,355 Q ❑ BUILDING '`(CFS G L4 � I, as owner of the property, or my employees with ADDRESS �J 12;A-86 {�Si 8 6 wages as their sole compensation,will do the work and ® 'I the structure is not 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. i with licensed contractors to construct the project (Sec- ADDRESS p tion 7044, Business and Professions Code). 1; n REQUIRED TOTAL SETBACK FRO EXIST. J, CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP.LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT A the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE o P.L. Lender's Name O`Jt 2 LDMA Ref. # P.C.Fee$ —( 3 Permit Fee ' - Lender's Address I 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 3 ordinances and State laws relating to building construction, Total Fee LDMA Perm. # and hereby authorize representatives of this County to enter ;( upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date Qi