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Home My Public Portal About10253 RANDWICK DR_Building__ '7 A638A°CFS#803 3-68 ! ' b ' OPLICATION FOR BUILDIN; PERMI �. COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS 10 I�I(� BUILDING AND SAFETY DIVISION LOCALITY Hyl" JOHN A. LAMBIE, COUNTY ENGINEER NEAREST �A COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST.. /'/ Af DISTRICT NO: GR TYPE PRO SSED-B FOR APPLICANT TO FILL IN ��, ®I� CQ Print ort a only) J. BUILDING f # STATISTICAL- CLASSIFICA' SEWER-MAP r-mf. ADDRESS CLASS NO-!z3ryDWELL•,UNITS BK a� PGAZO LOT NO. BLOCK. US ONE MA NOP G®� 46 TRACT 0 / SPECIAL - / LDGS. . 7�� CONDITIONS SIZE OF LOT / NOW ON LOT USE OF o EXISTING.BLDG, A IIS BLDG.SETBACK-FROM TEL. FRONT PROP,LINE OF (STREET). OWNER NO. TYPE OF EXISTING SE BA K HW D• _ '-•TOTAL ADDRESS HIGHWAY WIDTH FROM CI TY } " BLDG,SETBACK FROM ARCHITECT OR TE SIDE PROP.LINE OF (STREET) ENGINEER NO. TYPE-OF EXISTING1 SETBACK YARD = - TOTAL ADDRESS HIGHWAY WIDTH F TEL } } CONTRACTO NO. ` a_ ADD (� NO. /' CORNER CUTOFF YES ❑ NO ❑ -v ' LIC. CIT CLASS .4 SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK W D_ _ z NEW ADD ALTER REPAIR DEMOLISH FT. NO. OF NO. OF SIZE STORIES 1 FAMILIES, USE OF STRUCTURE !S SIGNATURE F APPLICANT VALUATION$ V APPROVALS DATES INSPECTOR'S SIGNATURE P.C. PMT, �� -FOUNDATION: LOCATION " �' ;ay``.+A FEE$ FEE$ FORMS,-MATERIALS I2f •� ry fA FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS.VENT, DUCTS BUILDING CONSTRUCTION, I CERTIFY THAT IN DOING THE WORK , AUTHORIZED HEREBY I 1 L NOT EMPLOY ANY N IN VIOLA- LATH, INT. TION OF THE LABOR ODS F TH OF CALIF RNIA RELAT- ING TO WORKMEN'S SATION INS RAN LATH, EXT, ' SIGNATURE O HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL G JOHN F. LEWIS, PRINCIPAL ST RAL ENGINEER PLAN CHECK VALIDATION eK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH ' LA005 .2 4•� SEI 2-3 1 -a 2 2.50- i'dA638A,gi180 3-68 •� APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING �� 'DEPARTMENT OF COUNTY .ENGINEER ADDRESS / BUILDING AND SAFETY DMSION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS, SUP'T of BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRICT NO. G P TYPES P ESS' BY CONST.// 1 (Print or type only) �d •--•4�--- BUILDING r STATISTICAL C SSIFICATION SEWER MAP ll ADDRESS .`CLASS NO. DWELL.UNITS BK PG/A5 LOT NO. Ir— BLOCK UAE ZONE MAP ee-) NO. TRACT 23 0 ?2 OU CONDITIONS PECIAL � NO.OF BLDGS. SIZE OF LOT V NOW ON LOT USE OF EXISTING BLDG. e' BLDG.SETBACK FROM TEL a:j7i FRONT PROP.LINE OF (STREET). OWNER L�,NO. 7 TYPE OF EXISTING SETBACK HIGHWAY + YARD = •TOTAL ADDRESS S HIGHWAY WIDTH FROM C.L. CITY �i !O L L �- T 4 BLDG.SETBACK FROM ARCHITECT OR TELF. SIDE PROP.LINE OF ) ENGINEER NO. TYPE OF EXISTING SETBACK HIGHWAY YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM G.L. TEL. _ CONTRA CTOFe, NCS L, NO. + a LIC. CD ADDRESS ff O. CORNER CUTOFF YES ❑ NO C) CITY �� CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS c7 DESCRIPTION OF WORKW / G P &14&2 NEW ADD ALTER REPAIR DEMOLISH f / — SQ. FT. NO. OF NO. OF ��/.i 62�' �� _• ' SIZE STORIES r FAMILIES _ -1 USE OF STRUCTURE00, Arwr SIGNATURE OF_,,;' APPLICANT_ S VALUATION SEMISSIONS APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. �-� FOUNDATION: LOCATION FEE S FEE S - FORMS, MATERIALS FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. ERTIFY THAT IN DOING WORK AUTHORIZED HEREBY 1 WI L OT EMPLOY ANY PERSO IN OLA• TION OF THE LABOR CO F �f1E STATE OF NIA LAT. LATH, INT. INC TO WORKMEN'S COM fON INSUR ' LATH, EXT. SIGNATURE OF -� RMITTEE OUSE NUMBER COR PERECT AND POSTED_j- ADDRESS 11,e FINAL JOHN F. LEWIS, PRINCIPAL STR URAL ENGINEER PLAN CHECK VALIDATION CK. M.D. CASH _ PERMIT VALIDATION CK. M.O. CASH LA0 6 8 2 2�8 OCT 11 1 D 9.0 0- TEMPLE CITY IBABBBA C 8 1-BI ��Br APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELESBUILDING .7 DEPARTMENT OF COUNTY ENGINMR ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRICT NO. GRO P TYPE ESSED BY Q CONST. BUILDING �,d� /� STATISTICAL CLASSIFICATION S ER MAP ADDRESS AJDIV/cam ��c. K PG CLASS.NO. WELL.UNITS LOT NO. BLOCK WATER NOT REQUIRED ❑ RECEIVED ❑ CERTIFICATE: TRACT .3(J MHIGHWAY AL / NO.OF BL-DGS. NAP ICIRCLE) STATE MAJOR SECOND, SIZE-OF LOT SZ K (6B I NOW ON LOT r USE ZONE SPECIAL USE OF CONDITIONS EXISTING BLDG. TEL. ON 0.*OWNER NO. . BULL NG EXIST. �� SETBACK YARD HWY STREET NAME WIDTH _ADDRESS �`(o �LLG 07-V 60'40 . FRONT ARCHITECT OR TEL P.L. ENGINEERNO. SIDE P.L. } ADDRESS TEL INSPECTION RECORD O .CONTRACTOR j�U � NO F ADDRESS 5- .Z 'rM-041F QTY ?d/,IO. O DESCRIPTION OF WORK ' W N N ADD ALTER REPAIR DEMOLISH a SQ.FT. �r'� NO.OF NO.OF IZE J G STORIES FAMILIES USE OF STRUCTURE �Arlec SIGNATURE O `A APPLICAN udL+ VALUATION$ Q d %v ,g APPROVALS DATES} INSPECTOR'SSI�GI•IARE �TU FEE $ (/ I PMT. OFO FRMS!MATERIALS FEE $ FRAME:.FIRE STOPS. 1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:LOCATION, \1 I UJ -a."` �''"• WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION. 1 CERTIFY THAT IN'DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH.INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING �j TO WORKMEN'S COMPENSATION INSUR AC LATH,EXT. /I 1elbr OUSE NUMBER CO PERMIITTE TURE OF HRECT AND POSTED 2 . /2 ADDRES 2 C• p 4 FINALS- CLYDE N. DIRLAM:FSRINCIPAL STr RAL ENGINEER PLAN CIMCK VALIDATION cK. M.O. CASH PERMIT VALIDATION cK1J M.C. CASH L�Lo 6 6 2 1 NOV 7 2 3 D 3 0.2 5,& Q UAII,o 7'3 1 1 PJOU 2 3 1 D 6 4.0 0, .01 WORKERS' COMPENSATION DECLARATION APPLICATII" Alt BUILDING PERMIT-.!.hereby affirm that I have a certificate of consent to self insure; y 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 BUILDING EJCertified copy is hereby furnished. 3 FOR APPLICANT TO FILL IN ADDRESS d o2J� ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS .. Date Applicant CITY 64 , ZIP 1? LOCALITYWO.OF i CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT / b' OW ONLLOT NEAREST CROSS 5T. COMPENSATION INSURANCE ASSESSOR P~ C/ (This section need not be completed if the permit is for one TRACE BLOCK LOT NO. MAP BOOK p �^�-� PAGE OU / PARCEL U hundred dollars ($100)or less.) TEL USE zOME MAP -'7 OWNER NO. NO — Z / 3 1 certify that in the performance of the work for which this 17 permit is issued, I shall not employ any person in any manner ADDRESS �' SPECIAL a-O CONDITIONS so as to become subject to the Workers'Compensation Laws. ., U CITY , ZIP Date S Applicant 41:2,-eif 1 ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE ESSED BY M NOTI T APPLICANT: If, after making this Certificate of ENGINEER NO. CONST. ZONE , R Exemption, you should become subject to the Workers' 0 U Compensation provisions of the Labor Code, you must forth- r ADDRESS c a with comply with such provisions or this permit shall be ) TEL. STATISTICAL CLASSIFICA ION APT. CONDO. N deemed revoked. CONTRACTOR NO. Z LICENSED CONTRACTORS DECLARATION F LIC. CLASS NO. / DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 i ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP 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 Elam exempt under Sec. ADD 1:1 ; O U ► ALTER ❑ BAP.C. for this reason REPAIR ❑ $ Date: USE OF EXISTING BLDG. C.s, DEMOL ❑ Signature APPLICANTFINAL OWNER-BUILDER DECLARATION (PRINT) Np, Qf/ / I hereby affirm that I am exempt from the Contractor's License ADDRESS Qf 2S DATE ` ri_-I o T Law for the following reason (Section 7031.5, Business and FINAL V Projessions Code): PRESENT By _ r L - LC-. 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 LOCALITY ;j_ i�a �u 7044, Business and Professions Code.) MOVING TEL. ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. 1 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code.) CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAPROPLINEFROM JEX I hereby affirm that there is a construction lending agency for FRONT -I_I the performance of the work for which this permit is issued P.L. _I_ (Sec. 3097, Civ. C.). SIDE 4--4 - �'�+� P.L. - Lender's Name �fLender's AddressP.C. Fee$ PermitFeeDMA Ref. # I certify that I have read this application and state that the Issuance Fee DMA P/C# above information is correct.I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, 'I Total Fee QDMA Perm. # r 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 �r - WORKERS'COMPENSATION DECLARATION T , elf insure,or afciertificatethcit lhave,a of Workers'Coicate mpenstion Insuranceconsent to s or APPLICATION F O R B U I L®I N G .PERMIT . ;if' 1: py}}h^^e'rre�of�. 380 Lab. C) / m COUNTY OF LOS.ANGELES �y BUILDI FET w� CompanLV , 1 t✓o�� Certified copy is hereby furni ed. A BUILDIN ADDRESS Certified copy is filed with the county b tfig inspec- BUILDIN tion depart ent. ADDRESS • ALITY { NEAREST Date IApplica - CITY ` ZIP CROSS AT. RTIFIC E OF EXEMPTION FROM WORKE S' SIZE OF LOT tJp O)F BLDGS. ASSESSOR OT MAP BOOK PAGE PARCEL COMPENSATION INSURANCE p (This section need not be completed if the permit is for one J / USE ZONE MAP hundred dollars ($100)or less.) TRA v ,J BLOCK LOT NO. / a NO. d (/ TEL. ��f SPECIAL CLOWN R CONDITIONS d certify that in the performance of the work for which this O r DISTRICT GROUP TYPE FIRE PROCESSED BY permit is issued, I shall not employ any person in any manner 1J so as to come bect to the Workers'C ation aws. ADDRESS / CONST. ZONE CITayS,o ¢N 3 t, y -0-115M-e—' b Date ApplicanSTATISTICAL C SSIFICATION PT. CONDO. NOTICE O APP ICANT: If, after making this Certificate of ARCHITECT OR TEL. Exemption, you should become subject to the Workers' - ENGINEER NO. CLASS NO. DWELL.UNITS a Compensation provisions of the Labor Code, you must forth- with comply with such provisions or this permit shall be ADDRESS SEWER MAP C deemed revoked. ` t TEL' V� -,y P�/� VALIDATION CONTRACTOR N BK, LICENSED CONTRACTORS DECLARATION IC. RC7 I hereby affirm.that I am licensed u6cler provisions of Chapter 9 ADDRESS O. VA UINION (commencing with Section 7000)of Division 3 of the Business and LIC. �11 O Professions Code, nd my licQense is in full force an effect. CITY CLASS $ L/ �V/ /Q��, SQ. NO:OF . NO.OF CHECK License Number Lic.Class SIZ STORIES I FAMILIES ONE ' ^ \� l NEW $ Contract `�Dot- CJS. DESCRIPTION OF WOR. I am exempt from the licensing requirements as I am a ` C ADD licensed architect or a re istered professional en ineerfl2ALTER FINAL 8 acting fn my professional capcity (Section 7051, �'� REPAIR ❑ DATE ( ; Business and Professions Code). USE OF DEMOL FINAL EXISTING BLDG. ❑ B F cF- S L k111- Lic.or Reg.No. Date APPLICANT TEL. y 'OWNER-BUILDER DECLARATION (PRINT) NO. 4 3 4 4 A I hereby affirm that I am exempt from the Contractor's License ' Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): PRESENT # 0 0 o a ,2-1 BUILDING [,,as 2 c u 5 5 4A 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 LOCALITY u c 5 5 4 /1 x 7044, Business and Professions Code). MOVING TEL. I, as owner of the property, am exclusively contracting CONTRACTOR NO. 0 J. 1 .0—8 1 with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). ADDRESS 4 3 F REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT v�d O D !f ` o a o 0 0 1 the performance of the work for which this permit is issued P.L. - (Sec. 3097, Civ. C.). SIDE 2 0 1 0600 P.L. Lender's,Name c,0 1 0 3i Lender's Address P.C. Fee$ 5 S Permit Fee 0310-81 ' I certify that I have read this application and state that the Issuance Fee Sabove information is correct. I agree to comply with all County Investigation Fee 3 ordinances and State'laws relating to building construction, ('� and hereby authorize representatives of this County to enter Total Fee the abov - ntioned property for inspectiosi pur o es. Q.�upon j SEE REVERSE FOR EXPLANATORY LANGUAGE r Signature of Applicant or Agent w,k4ERS'COMPENSATION DECLARATION I herr;''affirm that I have a certificate of consent to self ' insure, pr a certificate of Workers'Compensation Insurance, APPLICATION F®R BUILDING PERMIT s or a certified copy thereof(Sec. 3800, ab. C.) MP bf Company L'!F/C t&%QrC,.N171n! Z� COUNTY OF LAS ANGELES BUILDING AND SAFETY PolicyNo. 1t Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING �3 4 G ADDRESS C ® Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS /0283 dculdutilne be- Date Applicant L'D.t/S7�ClLT/dp1 CITY 7271,01E ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one �) y ASSESSOR hundred dollars($100)or less.) TRACT 2,73 BLOCK LOT NO.. [ MAP BOOK PAGE PARCEL OWNER ellA,E G HOW- NO.ANF-01IS USE NE MAP I certify that in the performance of the work for which this -� NO permit is issued, I shall not employ any person in any manner SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS CONDITIONS O U Date Applicant- CITY ZIP NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O Exemption, you should become subject to the Workers' ENGINEER NO. � CONST, / ZONE W Compensation provisions of the Labor Code, you must forth- ADDRESS ! +)// with comply with such provisions or this permit shall be 0- I TEL. STATISTICAL CLASSIFICATION APT. ONDO. U) deemed revoked. CONTRACTOR /Y� CO/!/S%,N/IG�D/v NO.SrJ • 7303 LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO.316 3 3 19 (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 Aee,+014 CLASS BK PG VALIDATION SQ. FT. NO.OF NO.OF CHECK License Number :5.2/03 Lic.Class H SIZE STORIES FAMILIES ONE VALUATION k'� C`aeJSTprlcTlAtif pate (p-a/'LCit DESCRIPTION OF WORK Fi/?� 6#G. leM,411E NEW ❑ $ fo��Od, Contractor 6 n 6.9/ei9GEr /)xv P eac ADD1010 11 I am exempt under Sec. ALTER B.&P.C. for this reasonREPAIR $ Date: USE OF DEMOL EXISTING BLDG. FINAL Signature APPLICANT TEL. P9910 p J OWNER-BUILDER DECLARATION PRINT #c NO. DATE , 0 0 0 0 0 1 1 hereby affirm that I am exempt from the Contractor's License ADDRESS FINA / ° o87,38 Law for the following reason (Section 7031.5, Business and Professions Code): PRESE T By ' 0 0 0 8]3 8 c�i ❑ BUILDING I, as owner of the property, ormy employees with ADDRESS wages as their sale compensation,will do the work and LOCALITY c621 -88 the structure Is not Intended or offered for sale(Section 7044, Business and Professions Code). MOVING TEL. 001 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). CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAPROP. LINE 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 P.L. Lender's Name LDMA Ref. q Lender's Address P.C.Fee$ Permit Fee C < t I certify that I have read this application and state that the Issuance Fee 01S LDMA P/C q Opp, above information is correct. I agree to comply with all County Investigation Fee ordinances and tate laws relating to building construction, Total Fee LDMA Perm. q and hereby oriz representatives of this County to enter upon thea v - i ned pr er for inspection purposes�y '41, �'s2/gyp? SEE REVERSE FOR EXPLANATORY LANGUAGE Signotur Applicant or Agent Date