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Home My Public Portal About4930 ROBINHOOD AVE_Building__ '6A838A CE*808-10.88 APPLICATION FOR BUILDING PERMIT 1 BUILDING AND SAFETY DIVISION BUILDING Department of County Engineer ADDRESS ESSS ,mss County of Los Angeles LOCALITY `C' � �' C.• I JOHN A.LAMBIE. COUNTY ENGINEER NEAREST - � /} CASSATT D.GRIFFIN, SUP'T OF Bl1ILDING CROSS ST. ) let I� DISTRICT NO. GROUP I TYPEI SEWBK MAPPG CONST. FOR APPLICANT TO FILL IN BUILDING v I ADDRESS cJ STATISTICAL CLASSIFICATION LOT NO. BLOCK CLASS.-NO. DWELL. UNITS / MAP STATE YES /Q NUMBER HWY• TRACT // USE ZQNE SPECIAL 1/�U v I NO.OF BLDG3. / CONDITIONS SIZE OF LOTy✓(�/t NOW ON LOT 6 n USE OF EXISTING BLDG. ,C� BUILDING YARD HWY STREET NAME EXIST. OWNER / O /-/.S' (�4 , d 4 ge17 SETBACK WIDTH �J FP.RONT ��- MAIL ADDRESS oG a (� !�� /Q Cs! +t/' f�y SIDE SG `` ) ,r�� ,/ SIDE _ CITY 1 e Q C+ it' NO./j,� 6' 110/7 P. L. Y '," ARCHITECT OR TEL. { Y'J INSPECTION RECORD ENGINEER NO. /; L� N A/ d _ 6v- ADDRESS CONTRACTO//R-j' /' s�L fk C/s/J�L `�L� NO ADDRESSI 10.3 5 S "'Q•`W •!✓ I� Y'C„ [1 �� DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH SQ.FT- / NO. OF l NO.OF SIZE , d 6 STORIES ! FAMILIES USE OF STRUCTURE APPROVALS SIGNATURE OF APPIJCADATE INSPECTOR'S SIGNATURE NT ADDRESS FOUNDATION:LOCATION / �/ / FORMS. MATERIALS ,vim b / �ls�'�'� , f C✓Q^ P.C. g FRAME: FIRE STOPS, p I' / ✓f V FEE /Z �� BRACING.BOLTS 1 lam'.•/' FURNACE: LOCATION, c_ VALUATION FEE $ GAS VENT, DUCTS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH. INT. JJ 1' Ii �/-I-1 1-.✓�.��_ �� PLICATION AND STATE THAT TH_E BOVE._IS CORRECT AND /j AGREE TO COMPLY✓ ITH AL-^-CO NTV ORDINANCES AND LATH. EXT. //(.! i. •� ✓ STATE LAWS RE �71 B DII� ONS RUCTION. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE �'•'7f" RECT AND POSTED I. `,. 6 ,l 1 ✓ ►I.t�C, I t , ADDRESS G FINAL !f`j'� r�'�/ 1�r`� OHN A.LAMBIE.COUNTY ENGINEER. CLYDE N. DIRLAM.PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION K. M.O. CASH PERMIT VALIDATION CK: -M.O. CASH F1'�a9534� SM 21 1 6 17.50Av "AP.09 6 5 7'u'; JUN 2 6 1 3 5.0 Q � APPLICATION FOR. BUILDING. PERMIT �1 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, BUILD DDR h Co or a certificate of Workers'Compensation Insurance,or a certified ZIP �, copy thereof(Sec.38k00. ti.% 7'FLOCALITY Policy No. Compo SIZE OF LOT N .OF BLDG .NOW ON LOT ❑ Certified copy I.hereby furnished. —��^ NEAREST CROSS ST. Wertiffed copy is filed with th buildingInspection TRACT BLOCK LOT NO. Pmt USE ZONE MAP NO. dap t. ASSESSOR MAP BOOK PAGE PARCEL -73 Date Applicant / SPECIAL CONDITIONS I - ,CERTIFICATE OF EXEMPTION FROM WO ERS' ; OWNER ` L NO. WITHIN 7000 FT OF SCHOOL? YES NO COMPENSATION INSURANCE ADDRESS (This section need not be completed.ff the permit is for one hundred DISTRICT GROUP TYPE CONST.' FIRE ZONE PROCESSED BY dollars($100)or less.) CITY zip I certify that In the performance of the work for which this permit fi,G. 1196 Is issued, I shall not employ any,person in any manner so as to ARCHITECT OR ENGINEER TEL NO. v become subject to the Workers'Compensatlon Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO.�DWELL UNITS NOTICE TO APPLICANT.• If, after making this Certificate of 4 REOUIRED TOTAL SETBACK FROM , EXIST Exemption, you Should become subject to the Workers' EL' SETBACK 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. ADgaESS LIC. o. /-�7 P L SIDE LICENSED CONTRACTORS DECLARATIONcI `� lC LIC' ` PL CD I hereby affirm.that I am licensed under provisions of Chapter 9 Ate// /.] `� SEWER MAP CA (commencing with Section 7000)of Division 3 of the Business and so'FT SIZ NO.OF STORES NO.OF FAMILIES rof{essiofode, nal my lice s i in full forma I NEW ❑ BK PG ++LANG �� I0.CIaSS QWWIPTION OF Rl7 ADD ❑ VALUATION pop- W� Contractor Date ; r ALTER 11 REPAIR ❑ 1 am exempt under Sec. B.&P.C.for this reason r• DEMOL ❑ LDMA P/C N Date i USE OF IXI?T G URM. ❑ _ Signature • APPLICANT(PRINT) TEL.NO. LDMA Penn M ,f a`•s l ❑ I,as owner of the property, or my employees with wages as L Z their sole compensation,will do the work and the structure is ADDRESS I j 'r not intended or offered for sale (Section 7044, Business and FINAL DATE G DOTAL 0 Professions Code.) WILLTHEAPPLICANT OR FUTURE BUILDING OCCUPANTHANDLEAHAZARDOUSMATERIAL 'J zi r. I, a8 owner of theproperty, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN _HECK 105.25 Y 9 THE AMOUNTS SP IFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY ; licensed contractors to construct.the project.(Section 7044. rEs❑ No. �L ' PHANGE Business and Professions Code.) • _ ' WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REOUIREA PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THESOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST _ FOR GUIDELINES. I (�I�j�—(jj O:''7 i'/� 1 1 hereby affirm that there is a construction lending agency for YES❑ No G/2" . the performance of the work for which this permit is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD 8761 1 AM � 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES �. COUNTYC E,TrLEZCHAPTER2ZOSECnONS220.100THROUGH2 D.14000NCERNING 3 Lenders Name HAZAR A TING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. Lenders Address oxR+WSe AW o I certify that I h d this application and state that the above I p�FEE PERMIT FEE , information Do . I agree to comply with ali county ordinances d aws relating to building construction,and here au ori ntatives of this County o eller upon ISSUANCE FEE the e i y for inspection INVESTIGATION FEE TOTAL FEE- 6- ffgnefareaf AWwda,AgW 9 - J ' SEE REVERSE FOR EXPLANATORY LANGUAGE.