HomeMy Public PortalAbout5924 RENO AVE_Building__ 76AG38A CE 9803 1/71 �� /v`
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING G 2y Q
ADDRESS ,/ IV-
COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY T E 01 P
FOR APPLICANT TO FILL IN NEAREST
Print ort a onl CROSS ST.
BUILDING ''r DISTRICT NO. GROUP TYPE P SSED BY
ADDRESS L �i- / ) �I �,g vAq- CONST �lj w4v
4 STATISTICAL CLASSIFICATION SEWER MAP
LOT NO / V-0 BLOCK
,_ CLASS NO.Ad DWELL,UNITS BK PG
"RA USE ZONE MAP
r ,A:-_— NO.OF BLDGS. ... NT �)G NOW ON LOT L SPECIAL
_ _ 1 CONDITIONS
EXISTING BLDG �• +
OWNER , S f� I O_�G' +� BLDG,SETBACK FROM
ADDRESSM1• •-� i r , FRONT PROP,LI NE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
CITY ) •1 V HIGHWAY WIDTH FROM C.L.
ARCHITECT OR c TEL. L-0 C_ S�D ) 2Q = '2
ENGINEER NO, BLDG.SETBACK FROM
ADDRESS SIDE PROP.LINE OF (STREET)
TEL. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL d
CONTRACT R„ !? ���•� �� NO, HIGHWAY WIDTH FROM C.L.
C
LIC. _
C
ADDRESS s !ter t�� .yam NO, + Ck
C
LIC. F
CITY CLASS CORNER CUTOFF YES ❑ NO ❑ L
CONSTRUCTION LENDER , a
NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS
ADDRESS 1
SQ. FT. NO. OF NO. OF NEW 7
SIZE USE OF / STORIES FAMILIES
STRUCTURE 4� 1,1114 k C, ADD El,
J ALTER ❑ �� ��
x✓w� REPAIR❑
SIGNATURE OF
APPLICANT DEMOL ❑
VALUATION S (.1 `� APPROVALS DATE INSP CTOq'S SIGNATURE
P.C. PMT, — C7 O FOUNDATION: LOCATION q I
FEE S FEE S j FORMS, MATERIALS L7
FRAME: FISTOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACIRE NG BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTION. IC
THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT.
LABOR CODE OF THE ESTATE OF •CALIFQRNIA IN RELATING TO
WORKMEN'S COMP 5 ION INSURAN E. LATH, EXT,
SIGNATURE OF9/J _ i '/ �/ > >
PERMITTEE. /L' 6..'C HOUSE NUMBER COR-
RECT AND POSTED
ADORES " I'z >-
• FINAL
PLAN CHECK VALIDATION CK. MJOHN F. LEWIS. PRINCIP L STRUCTU AL ENGINEER
O. CASH
PERMIT VALIDATIO CK. M O. CASH
L&o 4 7 421 1 D 15.0 ON c
DEPARTMENT OF BUILDING AND SAFETY r APPLICATION FOR PERMIT
CO TY OF LOS ANGELES
l.y
J. FOX, CHIEF ENGINEER =
' FOR`'aPPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING 1v1 i\ �`p` r\ D18TRICT NO. PLAN CK.NO. c�PERMIT NO.
ADDRESS �`CJ "/ (2�n� ) 1 '' �1
RECEIVE• BY DATE OF APPL. DATEISSUED
NEAREST
CROBS ST.
� , - 4 � BUILDING
OWNER
ADDRESS f4`N
MAIL G+,
DDRESS LOCALITY
A � �. (� �I�O 1; 1..�-..'4t1.+t1 � NEAREST /` C
TECROSSST
CITYse� � /Lf'r—i a�C�!! NOL FIRE NO.OF TYPE ria+ GROUP
ARCHITECT OR TEL. ZONE PLANS
ENGINEER NO. _
BLDG. o
ADDRESS SETBACK LINE �/M L NO.
� � [ ,xrr} / APPROVED
CONTRACTOR ; �F�� 6 �-G NOLJ,'� tC'l BY DATE
USE APPROVED
ADDRE88r � /2i'uJ/(4�C1`iJvGZt t �J L•. ZONE N BY DATE
LEG
DESCRIPT/ON• LOT NO. / f I BLOCK _/� t� (� CORRECTIONS
TRACT / y� / y�
/�� !� !✓ , I NO.OF B.
SIZE OF LOT,- NOW ON LOT
USE OF
I x
O BLDG.� ktPI ROOMS
/
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
O
A
REPAIR MOVING DEMOLISH -
Sq.FT. J i/ h-/� NO.OF Z
SIZE !1 JC l O ROOMS STORIES D
WALL .G" �0 I ROOF ! r
COVERING)) COVERING I� w
BUSE OF NE
U LDING W 1e1���'�2.hi'S �?A!l`�1(--t,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE 19 CORRECT FOUNDATION: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS f
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
FRAME: FIRE STOPS,
SIGNATURE O��I ,/p , BRACING,BOLTS ry 70
PER IF LATH,INT.:
AUTHORIZED Ai%
LATH,EXT.:
V
DBS-3 sone sETs 7-47 % P.C. PLASTER,INT.
t FEE PLASTER,EXT.
VALUATION FINAL I Cyr' 10�b ".(!
FEE +'
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COtWTY OF.LOS ANGELES p
)7 . J.•FOX, CHIEF ENGINEER del
FOR.APPLICANT TO FILL IN FOR OFFICE USE ONLY ,
BUILbINGMe VL`llv%� DISTRICT NO. PAN CK.NO. PERMIT NO.
ADDRESS Vti f
LOCALITY RECEIVED BY DATE OF APPL. DATE 11 UED
NEAREST �a c� --I `
CROSS ST.
BUILDING
OWNER
�r ADDRESS CD �o
YYYY
MAIL � � �� J ��� LOCALITY
ADDRE98 ]off,4r�� NEAREST
CITiLi�NL /r!It P TEL. CROSS ST.
NO.
FIRE No.or
ARCHITECTOR TEL. ZONE PLANS TYPE GR �
ENGINEER (J. -No.
BLDG. gg''�� /,'f' L/fR O.
ADDRESS SETBACK LINE C9- 19 ' I RI— `�
qq qq / Q APPROVED.
�. NOI.'R��i,��% BY DATE
CONTRACTOR /.fUSE �,{(] 1
ADDRESS V V � '�sR ��� ri�►�` /ef>!1"!J / \ I PROVED
ZONE BY
DATE
LEGAL - �[Q CORRECTIONS
DESCRIPTION#�{ LOT NO. /T 0 I BLOCK.
TRACT /,4{I y� l r
SIZE OF LOT,//JO i1 db I NOW ON LOTS D
USE TI 71. _-_/i_• NO.OF / NO.OF
EXISTING BLDG FAMILIES ROOMS
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
O
A
REPAIR MOVING DEMOLISH 0
5q.FT. // NO.OF / Z
91ZE / T✓° ROOM8 ! STORIES D_
WALLROOF
COVERING (s(il.�� II COVERINGS . r
USE or ME
BUILDING W tl��/ft N°';'c1• `� W►(J.C��� I '/
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION 1' 9PECTOR DATE
AND AGREE TO'COMPLY WITH ALL'COUNTY ORDINANCES FORMS,MATERIALS i l�" (/
AND STATE AWS REGULATING BUILDING CONSTRUCTION. r/moi rr
FRAME: FIRESTOPS, Alyk/ - 3' '/
SIGNATURE OF BRACING,BOLTS /��?
PERMITTEE meq'//�� LATH,INT. f
9 7
AUTHORIZED AGT • � "��`f ATH,EXT.: / '1��yf'
D85-3 5oM sETs 7-a fir,-n' � O P.C.6 PASTER,INT. / Q
t�/J /dam m®
i FEE PASTER,EXT.
a ^ (�
VALUATION , a FEE FINAL FINAL
I
WORKERS'COMPENSATION DECLARATIOt
hereby affirm that I have certificate of consent to self A P P L I CAT I O �U I L D I N G 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 I
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING �y L
ADDRESS
❑ Certified copy is filed with the county building inspec- BUILDING IC ���/ '7!�
tion department.' I ADDRESS Al. c�fY LOCALITY L / '
NEAREST
Date Applicant CITY �kAF G2 ZIP q I-35 O CROSS ST. c
CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR
COMPENSATION INSURANCE SIZE OF LOT O NOW ON LOT MAP BOOK PAGE PARCEL
(This section need not be;completed if the permit is for one ' �9 USE ZONE MAP001-1
hundred dollars($100)or less.) (I TRACT. �� BLOCK LOT NO. f NO. ��
��/ TEL. a[ SPECIAL
I certify that in the performance of the work for which this i
OWNERB2111/ G�/�- S NO. v� CONDITIONS IL
permit is issued,I shall not employ any"son in any manner DISTRICT GROUP TYPE FIRE PROCESSED BY U
ADDRESS Il�
so as to become subject to the Worke omp ation Laws. t� CON Z
IONE jig
`G.
Dat _I Applicant CITY ZIP STATISTICAL CLASSIFICATION APT. CONDO. Q
ARCHITECT OR TEL. �— u
NOTICE TO APPLICANT: If, after �ma6kllnggs Certificate of ENGINEER NO. a CLASS NO. � DWELL.UNITS LU
U
Exemption, you should become subject to the Workers' CL
Compensation provisions of the Labor Code, you must forth- ADDRESSSEWER MAP
with comply with such provisions or this permit.shall be
deemed revoked. I CONTRACTOR NO. BK. �PG, 9F 4 VALIDATION
LICENSED CONTRACTORS DECLARATION LIC.
I hereby affirm that I am licensed under provisions of Chapter 9 I ADDRESS NO. VALUATION
(commencing with Section 7000)of Division 3 of the Business and I ;.ri LIC,
Professions Code,and my license is in full force and effect. CITY CLASS $ ,
SQ.FT. NO.OF NO.OF CHECK
License Number Lic.Class SIZE STORIES I FAMILIES ONE
Contractor Date. DESCRIPTION OF WORK NEW ❑ $ 0 5 4 A
I am exempt under Sec. I �� N 75 ALTER —VP'ElFINAL ^ �9 ' I 0. 0.a'a.
B.&P.C. for this reason REPAIR 7
` (� S ❑'. DATE �� CSL. t7 r.. :;9l, L
� "E
Date: USE OF OL FINAL. ! L u 5 O
EXISTING BLDG. ❑. By 2
Signature ° APPLICANT L.
OWNER-BUILDER DECLARATION PRINT ) 10, 1 7-
I-hereby affirm that I am exempt from the Contractor's License I
Law for the following reason (Section 7031.5, Business and ADDRESS
Poo
Professions Code): PRESENT
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 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).
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 Llne !
the performance of the work for which'this permit is issued
tSec. 3097, Civ. C.).
"o
a Lender's Name
a Permit Fee
Lender's Address
I certify that I have read this application and state that the I Issuance Fee
above information is correct:I agree to comply.with.all County ee
3 o�her
nd tote., aws'relatirig•to'bJilding construction
j .author' `representatives of this County to enter Total.Fee.0v ' e ioned property for.inspection urpos s. ;
f
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature IApplicant or Age4t D e Abs
. - APPLICATION FOR BUILDING PERMIT �l
COUNTY OF LOS ANGELES BUILDING AND SAFETY
• : WORKER'S COMPENSATION DECLARATION
FOR APPLICANT TO FILL IN BUILDING ADDRESS
I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDS E,S�S�
or a certificate of Workers'Compensation Insurance,or a certified 157 9�� "�' ��'c!d /ode 04 —
copy thereof(Sec.3800,Lab.C.) ^_ n
a//y ZIP 7�d LOCALITY--rVf 1�� v j
Policy No. Company SIZEOF}J-OT NO.OF
El Certified copy is hereby furnished. /l®DDd BLDGS.NOW ON LOT NEAREST CROSS ST.
❑ Certified copy is filed with the county building Inspection TRACT BLOCK LOT NO.! D
department. USE ZONE MAP NO.
ASSESSOR MAP BO yK PAGE PARCEL
Date Applicant J 8� �� 045 SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' NER /L No7B'.f 3•f/,yr WITHIN 1000 FT OF SCHOOL? YES NO
COMPENSATION INSURANCE ADDRESS /I
(This section need not be completed if the permit is for one hundred S a Sf.�0. E/Cf� %4d.L DISTRICT GROUP TYP��NST.' FIRE ZONE ROC ED BY
dollars($100)or less.) CI _ ZIP
I certify that in he performance of the work for which this permit /�Elyl�G� airy 9/7.fd _Y_ �3
Is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. ✓✓✓
become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO
Date Applicant ADDRESS CLASS NO. 91%t DWELL UNITS
NOTICE TO APPLICANT. If, after making this Certificate of CONTRACTOR TEL.NO. REQUIRED TOTAL SETBACK FROM EXIST
Exemption, you should become subject to the Workers' SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor Code,you must forthwith
ADDRESS LIC.NO. FRONT
comply with such provisions or this permit shall be deemed revoked. PL
LICENSED CONTRACTORS DECLARATION CITY LIC,CLASS SILDE
(commencinaffgrm withat I am Section17000of Division provisions under of the Business and SEWER MAP +'.v
ter 9 SO.FT.SIZE NO. STORES NO. FAMILIES 3307
i I,j°1,
Professions Code,and my license is in full force and effect. %��� NEW ❑ BK PG 0
License Number Lic.Class DESCRIPTION OF WORK ADD VALUATION ® _ 1 ITEMS
bi
Contractor Data La ALTER ❑ $ O� TOTAL 57 o _'2_V)
❑ I am exempt under Sec. A S7 p `E RPAIR ❑ $ lob
0 CHEF:K 5735°1�B.BP.C.for this reason 6f 0,sP xC ppm DE ❑ CHANGE °(ILA
USE OF EXISTING BLDG. LDMA P/C#
Date: [UEMOL
RM ❑ 1I�m �1 f
Signature APPLICANT(PRINT) TEL NO. 3000-�11]1 4/ 4/90
� LDMA Penn N
❑ I,as owner of the property, or my employees with wages as A R�LP/'A5/7• .e'JS 'JS/.� p Vf!O I AM 90-11 ,
heir sole compensation,will do the work and he structure is �— 0
not intended or offered for sale (Section 7044, Business and oZ �a, F_-c/D F11aO� T / p FINAL DATE �� / a
Professions Code.) WILLTHEAPPLICANTORFUTURE BUILDING OCCUPANTHANDLEAHAZARDOUS MATERIAL
/ �'� � °4,L
OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN
❑ 1, as owner of the property, am exclusively contracting with THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY �y 1 1TEll'S
licensed contractors to construct the project (Section 7044,
Business and Professions Code.) WILL L 11 No TOTAL 4
WTHE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING
OCCUPANT REQUIREA PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THESOUTH ��J{ i t}i
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST CHECK 41°7
CONSTRUCTION GUIDELINES.
I hereby affirm that there is a construction lending agency for YES❑ NO 14 CHANGE .011
he performance of the work for which this permit Is Issued(See. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMO
3097,Civ.C.). PERMITTING CHE�CCKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES
COUNTYCOOfeYITLE 2,CHAPTER 2.20 SECTIONS02M THROUGH2.2M14000NCERNING �.+ �
Lender's Name HAZARDOU IALSREPORTINGANDFORO ING ITFROMTHESCAQy10.
Lenders Address ®��. (J��__.� • okt��•�I QI�01�-�� 1 11•�>r:J
Asp 1305 1 AM 9°+t t
0 1 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 e o
ordinances and State laws relating to building construction,and
hereby authorize representatives of his County to enter upon ISSUANCE F
the above-mentioned property for Inspection purposes. �'t+
m INVESTIGATT , �� TOTALFEE I i
r �[
°IM04a,naApmt Oro
SEE REVERSE FOR EXPLANATORY LANGUAGE 9