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Home My Public Portal About10059 RANDWICK DR_Building__ A /l/G1 ` i APPLICATION FOR BUILDIN PERM/ ( L ) 76A638A CE#803 B-64 COUNTY OF LOS ANGELES ABUILDING DDRESS /E os w DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY (L" G/ JOHN A. LAMBIE. COUNTY ENGINEER NEAREST COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS ST. �is DISTRICT NO GROUP TYPE P OC SSED BY FOR APPLICANT TO FILL IN �� J CONST; CL+� BUILDING STATISTICAL�CCLASSIFICATION SE ER MAP ADDRESS /Ov '+� D w is I CLASS NO. y DWELL UNITS / BK PG LOT NO. / BLOCK USE �ZONE MAP SP Qr TRACT �9S(O SPECIAL (/JJ•1/ , N0. OF BLDGS. CONDITIONS SIZE OF LOT j NOW ON LOT USE OF - EXISTING BLDG. BLDG. SETBACK FROM / TEL. Q O FRONT PROP. LINE OF OWNER A // e-f/e/O NO. T 9 TYPE OF EXISTING SETBACK H10HWAY �' YARD = TOTAL ADDRESS / T V HIGHWAY WIDTH Fn OM C.L. CITY.. ff p /e C / e + ARCHITECT OR TEL. SIDE. SETBACK FROM ENGINEER ADO NO. SIDE PROP. LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS- ` HIGHWAY WIDTH FROM C.L. a CONTRACTOR LLSQ/ .0,7,e �LN..OL / 6'E + = 0 ADDRESS �f Ip U/Y SNO � CORNER CUTOFF YES E] NO ❑ O CITY e f I CL sIC — SEE REVERSE SIDE FOR SPECIAL APPROVALS W D SCRIPTION OF WORK v NEW ADD ALTER REPAIR DEMOLISH SQ,FT. NO. OF NO. OF r s- SIZE � [� STORIES FAMILIES/ ^ USE OF ,{ o\'At' e %&T- STRUCTURE T-STRUCTURE es De �v T C. A t 20 SIGNATURE OF LATS- Aous..e< L6C4e-0 APPLICANT VALUATION$ w APPROVALS DATE /NSP CTOR'S SIGNATURE •`i..P.C. 7 (YL1 PMT. D O FOUNDATION, LOCATION FEE$ FEE$ FORMS,MATERIALS FRAME, FIRE STOPS, / I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT 27 (o 6'f " u h.,1 1!_t..", = AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION YAW(, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS !A ( "n 'i.✓�"1�`''" '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 C E ATION INSURANCE. n /� LATH. EXT. r�.� h k., 1,LMA-1—RA SIGNATURE OF� HOUSE NUMBER COR- // ` ) PERMITTEE RE AND POSTED •'z3��S QGEsA/1/./l+�h^'k ADDRESS Fl NAL JOHN F. LEWIS. PRINd1PALfSTR AL ENGINEER PLAN CHECK VALIDATION CK M.G. CASH _ PERMIT VALIDATION CK.:_ M.O. CASH, L,iC08072G FEB 123 D 32.00A "bo . L_�� I6A638A CE 0803 3-69 APFI-CIATION FOR BUILDI G PERMI �I COUNTY OF LOS ANGELES BUILDING 0,5 • DEPARTMENT OF COUNTY ENGINEER ADDRESS 0 BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMSIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPT OF BUILDING CROSSSST. K�p� FOR APPLICANT TO FILL IN DISTRICT NO GRo P PE'�/ONpT. PROC BY (PRINT OR TYPE ONLY) J e 0 0 y BUILDING STATISTICAL CLA KATION SEWER MAP ADDRESSQQ Jj /y/f�v w"ee CLASS N0. DWELL.UNITS BKS PG LOT NO. BLOCK USE ZONE MAP - `^ N0. (/ TRACT �J SPECIAL NO. OF BLDGS. CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. BLDG. SETBACK FROM TEL FRONT PROP. LINE OF (STREET) OWNER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. CITY + J LD .SETACK FR ARCHI ECT OR TEL. SDE PROP• LINE OFM (STREET) ENGINEER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. TECONTRACTOR ¢� NOL )I + ADDRESS ,, �?tJ N0. CORNER CUTOFF YES ❑ NO ❑ CITY wz v? CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS i CONSTRUCTION LENDER NAME AND BRANCH L ADDRESS SQ. FTNO. O •N0. OF . SIZE � STORIES FAMILIES NEW ❑ USE OF ADD STRUCTUR PizC]ALTER S a!J REPAIR ❑ SIGNATURE OF DEMOL ❑ APPLICANT jog VALUATION$ #i APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FO FORMS,M LOCATION FEE S FEE $ �✓�'�j I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME: FIRE STOPS, BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC- GAS VENT DUCTS TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE LATH, INT. OF THE STATE OF CALIFOR IA IN RELATING TO WORKMEN'S COM- PENSATION INSURANCE.1 I LATH, EXT. SIGNATURE OF HOUSE NUMBER CORRECT PERMITTEE AND POSTED ADDRESS FINAL JOHN F. LEWIS, PRINCIPAL STR TURAC ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH - PERMIT VALIDATION CK. M.O. CASH Iff,2 0 7 71a OCT . 1 1 D 1 2.0.0 APPLICATION FOR BUILDING PERMIT � <r COUNTY OF LOS ANGELES BUILDING AND SAFETY APPLICANT TO FILL_1N, +% BUILDING ADD ESS WORKER'S COMPENSATION DECLARATION BUILDING ADDRESS �DD I hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers'Compensation Insurance,or a certified J cow C�La"' ) / G LOCALITY O. 1' Com, y fG ' SIZE OF L NO.OF BLDGs.NOW ON LOT r,��C_ertified copy Is hereby furnished. NEAREST OSS ST. X�1 Iwified CO is filed with th n building Inspection TRACT BLOCK LOT NO. USE ZONE MAP NO. 1/ ae rt .� v ASSESSOR MAP BOOK PAGE PARCEL Date AppllCant SPECIAL CONDITIONS CERTIFICATE OF EXEMPT FROM WORKERS' OWNER YES NO COMPENSATION 1 SURANCE WITHIN 1000 FT.OF SCHOOL? ADM section need not be completed if the permit is for one hundred' f!(/"ei DISTRICT GROUP TYPE CONST.' FIRE ZONE PROCESSED BY dollars($100)Or less.) ' I CITY ZIP I certify that In the performance of the work for which this permit �-j `/ ke Is Issued, I shall not employ any person in any mariner so as to ARCHITECT OR ENGINEER TEL NO. d'D A ✓ 5 � .-,e+ become subject to the WorkeW Compensation Laws. STATISTICALCCLAS��SIFICATION APT CONDO Date Applicant ADDRESS CLASS NO.110L DWELL UNITS NOTICE TO APPLICANT: If, after 'making this Certificate of CO RACTOR REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become Subject t0 the Workers' SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code,you must forthwith; " e' r G� SCM comply with such provisions or this permit shall be deemed-revoked.I ADDR y NO PL ile-o'i -7 y� SIDE } LICENSED CONTRACTORS DECLARATION CITY n LIC.CLASS � r� IL PL I hereby affirm.that I am licensed under provisions of Chapter 9. SEWER MAP (commencing with Section 7000)of Division 3 of the Business and ' ��lyz 7 NO.OF S RES NO.OFF (LIES NEVA ❑ BK PG• � v O, Professions Code and m II n is in full force andeffeot�Q �j DESCRIPTION OF RK VAWA ON , W License Number Lic.Class b �G 14 ADD ❑ y Contractor Date a CIO �+ ALTER ❑ $ Z 111 am'exempt under 1 ( REPAIR B.&P.C.for this reason -� ¢!� • DEMOL ❑ LDMA P/C!1 Date: USE OF EXISTING BLDG.S URM, 11 Signature APPLICANT(PRIOR_ y NO. 'LDMA Penn# i ❑ I, as owner"of the property, or my employees with wages as -� � _ b p i (_i:: a 7 Z their sole compensation,will do the work and the structure is ADDRESS F _ not intended or offered for sale (Section 7044, Business and. FINAL DATE G �1"1,7 Professions Code.) j !1 �� __ WILLTHEAPPLICANTOR FUTUREBUILDINO OCCUPANT HANDLEAHAZARDOUS MATERIAL 1O 9� l�1� ❑ 1, as owner of,the property, am exclusive) contracting With ORA MIXTURE CO INING A HAZARDOUS MATERIAL ECUAL To OR GREATER THAN i .i. La, Y 9 THE AMOUNTS SP IED ON THE HAZARDOUS MATERIALS INFOFIMATION GUIDE? FINAL BY "L �`_ _ licensed contractors to construct the project.(Section 7044,I 'Es ❑ NO liwi A` s" =sr. _;1: Business and Professions Code.) "" _ OCCUPANT REO REAPERMR FOR COLNSTRUCTIONO MODIFICATION OM THE ISO IUTH •f"I ;.•:�. CONSTRUCTION LENDING AGENCY COAST AIR QUALITY EMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES I hereby affirm that there is a construction lending agency for, 1:1 N the performance of the work for which this permit is issued(Sec. I HAVE READ TH MATERULS INFORMATION GUIDE AND THE SCAOMD 3097,CIV.C.). PERMnTING CHECKLI .I 6—NG STAND MY REOUIREMENTS UNDER THE LOS ANGELES I t COUNTY CODE, SECTIONS 22MlWTHROUGH 22MI4000NCERNING I. 1�� ji0-13I:is1 Fif .t./92 Lender's Name HAZARDOUS MA RANDFOROBTAININGAPERMITFROMTHESCAOMD: 1 Lender's Address cwwmaRAowr - "' pp . �1 Iii ./.1; o° I certify that I have read this application and state that the above P.C.FEE PERMIT FEE Information is correct. I agree to comply with- all county j I ordinances and State laws rel Ing to building construction,and hereby authorize rep n as of this County to enter u n ISSUANCE FEE the above-mentioned p for Inspection �� AI76 INVESTIGATION FEE TOTAL FEE �pnmao otMpka,n �pn,i ome . SEE REVERSE FOR EXPLANATORY LANGUAGE, i