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HomeMy Public PortalAbout4950 ROBINHOOD AVE_Building__ 5 7GA668A CE#80810-88 APPLICATION FOR BUILDING PERMIT :1 �1 COUNTY OF LOS ANGELES BUI EISS 4c: e t e t DEPARTMENT OF COUNTY ENGINEER trzm BUILDING AND SAFETY DIVISION LOCALITY JOHN A.LAMBIE.COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,Supt OF BUILDING CROSS ST. DISTRICT O. �Gj40 I gYpE P SED BY FOR APPLICANT TO FILL IN 4✓gid . coNsr BUILDING �y STATISTICAL CLASSIFICATION R MAP ADDRESS �/ OQ(� >- K PG ' JJ CLASS.NO DWELL.UNIT LOT NO. �(p BLOCK MAP STATE YES O /y NUMBER HWY. TRACT �! .J d USE ZONE SPECIAL NO.OF BLDG SIZE OF LOT X��'Q I NOW ON LOTS CONDITIONS USE OF EXISlItIG BLDG. BUILDINGYARD HWY. STREET NAME IST.•"1 SETBACKI DTH• OWNER �1.�. FRONT RL MAIL LVA P.L. ADDREESS�,j SIDE CITY ARCHITECT OR TEL INSPECTION RECORD ENGINEER NO. �� L\ •'Ci•-� V u.mss L%QDfIESS r TEL. '3 Z� �^N`�: A'Le,�16�. �1•--t� CONTRACTO/� J NO. t' --.mv _ADDRESs�'SfSb t1 _ l ca 5 6 c�a.S ` •1 DESCRIPTION OF WORK ADD ALTER REPAIR DEMOLISH / So.FT. NO.OF NO.OF SIZE STORIES FAMILIES USE OF STRUCTURE �,� = ,r)•� -�,._R.� `'�''' Q�\ �. SIGNATURE OF `� APPROVALS APPLICANT ADDRESS �� C.��S c_agDATE INSPEIaTDR2S.S A'1PRE FOUNDATION: LOCATION , $ FORMS,MATERIALS .15• ." ^ P.C. S () FRAME: FIRE STOPS. FEE `�• BRACING.BOLTS VALUATION S FURNACE: LOCATION. M. FEE GAS VENT.DUCTS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND LATH.INT. n 1. AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND r /� P b STATE LAWS REG LATI BUI 5iG CONSTRU ION. LATH,EXT. . Q. a, !1a SIGNATURE OF i - HOUSE NUMBER COR- �I (f I P? PERMITTEE? — a RECT AND POSTED f W ADDRESS FINAL ' CLYDE N.DIRLAM.PRINCIPAL ST RAL ENGINEER PLAN CHECK VALIDATION c M.C. CASH PEBM VALIDATION CK. 67.0. CASH 4 5 7 5 APR 6 1 A 1 2.0 0 �• BA68BA OB3-e 8•bb .._._ ' APPLICATION FOR BUILDING PERMIT -1 R DIVISION OF BUUMBIG AND SAFETY BUILDING S'� s ADDRESS DepO:Iment Of County Engineer County of LOS Angeles LOCALITY t WM.J.FOX.COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. R andAvenllA DISTRICTNO. GROUP TYPE SEWER. MAP FOR APPLICANT TO F= IN I CONsI'T '�' BUILDING J/g�^ MAP s� d V C) STATE YES, ADDRESS 1.�% J NUMBER oG HWY LOT NO. BLOCK USE ZONE SPECIAL A-1 CONDITIONS TRACT 5000 NO.OF BLDGS. BUILDINGEXIST. SIZE OF LOT' NOW ON LOT SETBACK YARD1. HWY STREET NAME WIDTH USE OFFRONT EXISTING BLDG. n P.L. 1 OWNER KennAth F Williams SIDE P.L. MAIL ADDRESS 4q24 Rnhi nh nnrl13zremij A O TRACT DWELL. 1.UNIT - ...-�-- 5 INDUSTRIAL TEL. ELL. ,�!'fU T CITY T NO. e �� 6 PUBLIC BLDG: ARCHITECT OR TEL2 DUPLEX 1 UNIT 7 ADDN..ALT.. ETC. _ ENGINEER NO." S APT. UNITS 8 M[SCEL. _ ADDRESS 4 COMMERCIAL CONTRACTOR Ab mrA NO.TEL' INSPECTION RECORD ADDRESS - - DESCRIPTION OF WORK ,NEW X I ADD ALTER REPAIR DEMOLISH No S ZE r'1461 STORIES' AML IES USE OF STRUCTURE NnmA lad tb ai i:larhAr3 crarage SIGNATURE O APPROVALS J APPLICANT ADDRESS DATE INSPECTOR'S SIGNATURE FOUNDATION:LOCATION $ O P.C. !$G] / S� FORMS,MATERIALS /5, '©O FEE OC_ r FRAME:FIRE STOPS. S,. LE BRACING,BOLTS VALUATION -�. F Fm E URNACE:LOCATION. ACKNOWLED I HEREBY GE THAT 1 HAVE READ THIS GAS VENT.DUCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECT '/ AND AGREE TVLALSEGULATING N WITH ALL COUNTY ORDINANCES LATH.INT. w AND STATE BUILDING C NSTRUC-.TIQN. /�`/�? J�9�^�D LATH.EXT. lei�SIGNATURF�OJ HOUSE NUMBER COR- PERMIT E RECT AND POSTED sr - ADDRESS FINAL R •WM.J.FOX.COU TY ENGINE VALIDATION C.N. DIRLAM,CHIEF BLDG. II•ISPECTOR i [.ACb 4; 5 0 OR SEP 1 '] 2 3 A 2 1 .�i_ 5 L SEP LACo 5 0 0. 7,� 19 1 A 4 3Q e5 . M . WCORKERS'COMBENSATION DECLARATION nt to self Insurebo'rPu certif carte of Worke s'tCompensat on eInsurance, APPLICATION FOR BUILDING PERMIT or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furZ?o'.�nt1C'.,n. . FOR APPLICANT TO FILL IN BUILDING �D t 'ADDRESS Certified copy is filed with ec BUILDING d� D AJ /Od�tion department. ADDRESS a f'i Date�7 � Appli ant ®iG CITY L P_ 06 ZIP .LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' O.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 ASSESSOR hundred dollars($100)or less.) EL*TRACT 1 BLOCK LOT NO. MAP BOOK PAGE PARCEL OWNER gd b ei fO NO. y ` U ON� NMOP I I certify that in the performance of the rk for which this i permit is issued,I shall not employ an p son in any manner e� c�� cc SPECIAL so as to become subject to the Work omp ns ' Laws. ADDRESS ''/ �+ u c� r CONDITIONS c. d� CITY ZIP Date App scant ARCHITECT OR TEL. NOTIC TO APPLICANT: If, Of r making thi Certs a ENGINEER NO DISTRICT GROUP . TYPE FIRE P ED BY Exemption, you should become subject to the Wor ers' CT CONV Z E Compensation provisions of the Labor Code, you must forth- ADDRESS L 8 R-5 J y with comply with such provisions or this permit shall be TEL. STATISTICAL C (CATION APT. CONDO. deemed revoked. CONTRACTOR �C� o. LICENSED CONTRACTORS DECLARATION q �, NO` CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS l �I qO 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 �A CLASS BK PG. VALIDATION 9®Y QCT C8 Uc.Class 16 V/ SIE ISTORIES AMILLIIES , CHECK License Number ONE g! '70 /� ,[ VALU TION Contractor 4e-,o P [��4 Date �e ��" DES OF WORK AD ❑ $ CIO ❑I am exempt under Sec. w G ALTER V B.BP.C. for this reason REPAIR ❑ $ -2 4 6 4 7 A Dote: USE OF S� ®� DEMOL ❑ ; # a o 0 0,0 EXISTING BLDG. Signature APPLICANT TEL• FINAL � ' 'I a a 6 8,6 3 (PRINT) Tom' NO. y r Io�O DATE OWNER-BUILDER DECLARATION 0 0 0 6 8 6 3 I hereby affirm that I am exempt from the Contractor's License � < 6 Law for the following reason (Section 7031.5, Business and ADDRESS �oSc FI Professions Code): PRESENT �iC.�� - (--f:] 4—8 6 ❑ 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. EJI,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 SETBACK YARD HWY TOTAPREOTPAINE RO 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 3 P.L. Q Lender's Name ] LDMA Ref.# P.C.Fee$ Permit Fee Lender's Address J �) r I certify that I have read this application and state that the Issuance Fee l •5 `� LDMA PSC# z above informat1ow is correct. I agree to comply with all County nvestigation Fee �( ` ordinances an tate laws relating to building construction, Total Fee Ki+� • 6� LDMA Perm.# I and hereb a orize presentatives of this County to enter upon the a-men' prope or inspection purposes. c � �14 4t' SEE REVERSE FOR EXPLANATORY LANGUAGE Si nature of Ap ica or Adent Date WORKERS'COMPENSATION DECLARATION hereby affirm that I have certificate of consent self APPLICATION FOR �U I L D I N G PERMIT insure, or a certificate of Workers' Compensation kers' Cpensation Insurr ance, or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. - Company ElBUILDING �V Certified copy is hereby furnished. pFOR APPLICANT T TO FILL IN ADDRESS � ❑ Certified copy is filed with the county building inspec- BUILDING // O M YIO� AM - CITY department. 1 CITY O �ri 1-e C�`/ ZIP Cs . /7� LOCALITY Date Applicant O.OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCE ASSESSOR Q s7 ((This section need not be completed if the permit is for one TRACT BLOCK LOT O. MAP BOOK PAGE PARCEL v/ ftundred dollars($100)or less.) — TEL. n OWNER (r►� NO. d�1/.I� USE ZONE 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 ADDRESS ���� SPECIALIL so as to become subject to the Workenf Compensation Laws. �J CONDITIONS O CITY +,e4 /-e L T ZIP CSI, f Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST. Z NE Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS / '3 ��A___ -9 a with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION AP . CONDO. Z deemed revoked. CONTRACTOR NO. �7yLp LICENSED CONTRACTORS DECLARATION LIC. CLASS 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 LIC. SEWER MAP and Professions Code,and my license is in full force and effect. CITY / CLASS BK PG J VALIDATION SQ. FT. NO. OF NO.OF CHECK License Number Lic. Class SIZE I STORIES FAMILIES ONE VALUATION Contractor Da}e DESCRIPTION OF WORK NEW ❑ $ El ❑ , I am exempt under Sec. ADDALTER ❑ BAP.C. for this reason REPAIR ❑ $ USE OF EXISTING BLDG. DEMOL Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) NO. DATE ;Za 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS M FINAL i Professions Code): PRESENT a By i �L�LYJ BUILDING p�t.•:i ev I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and y- the structure is not intended or offered for sale(Section LOCALITY 3-''' 17 7044, Business and Professions Code.) MOVING TEL. ® ❑ I,as owner of the property,am exclusively contracting CONTRACTOR ENO. with licensed contractors to construct the project (Sec- !I t i A 170 .25 ADDRESS tion 7044, Business and Professions Code.) r t { REQUIRED TOTAL SETBACK FROM EXIST. 1.'. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I herebyaffirm that there is a construction lending agency for FRONT HANI F 9 9 Y t� ry f�1_ the performance of the work for which this permit is issued P.L. (Sac. 3097, Civ. C.). SIDE i P.L. Lender's Name 13 11-J,-,_I_C 9/29/97 3 t LDMA Ref. # Lender's Address P.C. Fee S Permit-Fee 5-7 15 ;, AMID:13 ' I certify that I have read this application and state that theIssuance Fe LDMA P/C# 3 above information is correct. I agree to comply with all County Investigation Fee / � a�/ ordinances and State laws relating to building construction, Total Fee LDMA Perm. # and hereby authorize representatives of this County to enter u on the above-mentioned operty,for inspection purposes. o J SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applic nt or Agent Dote