HomeMy Public PortalAbout5505 ROBINHOOD AVE_Building__ APPLICATION FO
BUILDING PERMIT
BUILDING
FOR APPLICANT TO FILL FN ADDRSS
AUDORESS NG 6-0 en LOCALITY
N EA RESP
CITY �. ZIP CROSS ST.
NO.OF BLDGS. ASSESSOR
SIZE OF LOT Q NOW ON LOT MAP BOOK PAGE PARCH
/� DtSMCT GROUP TYPE FIRE BY
TRACT IC/ BLOCK LOT. ��OS ) 3ZQNE
a_
OWNER G C f�' STATtSTlCALA$SIFI( IO
CATKN SEW ER MAP
ADDRESS D CLASS NO. DWELL UNITS BK
QTY t ZIP USE ZONE IAO �D
ARG-IITECTOR I TEiL
ENGINE ER NO. SPECIAL
lootipmotts
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
T E3.
CONTRACTOR A N(7. BLDG.SETBACK FROM
LIC FROINT PROP.UNE OF CSTREET)
ADDRESS NO. TOTAL SETBACK FROM TYPE OF EXISTING
LIG HIC;KWAY + YARD FRONT PROP.UNE HIGHWAY WIDTH
CITY CLASS _
CotJSTRUCTION LEN +
NAME AND BRANCH BLDG.SETBACK FROM U
ADDRESS SIDE PROP.LINE OF LST RE ETI p
FT. NO.OF NO.OF CHEIX HIGHWAY + YARD AL SETBACK FROM TYPE OF E(ISTING r
SIZE STORIES FAMILIES ONE SIDE PROP.LINE HIGHWAY WIDTH a�
DESU PT}ON OF Wb RK NEW
f ADD C04ZNER aJTOFf YES .❑ NO ❑
ALTER IN OPEN SPACE YES ❑ NO ❑
USE OF REPA I R ❑
DEMOL IN COASFAL PERMIT ZONE Y6 ❑ NO
EXISTING BLDG.
APPLICANT TEL s,• 6ZJ T.
(PRINT) NO.
BY(,SIGNATUR
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPUCATK)N AND STATE
THAT THE ABOVE a CORRECT AND AGREE TO COMPLY WITH All ORDINANCE
AND LAWS REGULATING BULDING CONSTRIJCTK)N.I CERTIFY THAT IN DOING THE
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON W VH TKJN OF
THE LABOR C OCE OF THE STATE OF CA.UFORNIA IN RELATING TO WORKMEN'S COM,
PENSAT10N INSIRtANCE-
+a
SIGNATURE O DATEFINALI /5
PERMITTEE DATE
ADDRESS '�
EVALUATION
ITT O. s79 P.C. Fee$ Permit Fee o�
2 Issuance Fee Z
$ O L/it Total Fee v
PLAN CHECK VALIDATION cv- 101.0. GADH T PERMIT V DATION cK Y.O. GASH
29 4 0
(s 7eAesae G■f203■8/77
APPLICATION FOR 8UILDYNG PERMITS
COUN`T'Y OF LOS ANGELES QUILDING
PEPA.ETMENT OF COUNTY ENGINEER wDREHH.
BVMDING AND SAFETY DIVMON LOCALITY - r
JOHNA.LAMBIE.COUNW F-NGIN®a NEAREST
CA=A D.GRIFFIN gul-T or,Bu LCIMa
D16i RICTO. GROUP:' 11 PE P ED HY
FOR APPLICANT TO FILL IN CON61.
.BUILDff��11a
ADDREAH STATISTICAL IFICATIQN H F;R MAT '
LOT-NO. CLASH.NO FT
BLOCK MAP. Y_
KUYBER
TRACT UHE ZONE SPECIAL
NO.OF DLDOH. CONDITIONS
SIZE OF LOT�d D. ` NOW ON LOT . .. ..
BUILDING - YARD HWY .HTREST NAI�/E
HETBAcK WIDTH
OWNER /PMAIL ?-+ { A� �0�.
ADDRFH8 �7O.? /y L.
SIDE
TL'L F
ARCHIT CTO TEL,
ON $ECOED .
ENGINEER NO. -
ADDRESS
TE L
CONTRACTOR NO.
ADDRESS 4
DE96MPnON OF W09X `
NEW ADD P ALTER REPAIR DEMOLISH r /
SQ.:FP. NO.OP NO.OF '� ,� CG+,+. 'r
SIZE STORIES FAMILIES
8SE OF STRUCTURE
SIGNATURE OF
—APPROVALS
APPLICANT
jw J,4077 I FF .DATE INSPECTOR'S SIGltATURE
ADDRESS FOUNDATIONr LOCATION
FORMS,MATERIALS
s
p{ P.C. ;. 4�1 FRAMEi FIRM STOPS, ..
FEE BRACING OLTH
VALUATION j FU RNAGB� LOCATIQN.
6A8 VENT DUCTS
I HEREBY ACKNOWLEDGE THAT 1 HAVE RHA THIS AP. LATH INF
PLICATION AND STATE THAT THE ABOVE IH CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND u,m ��, _�����
STATE. LA 15 ULATI G D ILDIN6 CTION.
SIGNATURE OF HOUSE NUMBER COfj• .
PERMITTE RECT AND PORTED
A D D R E • MAL
CLYD N.DIRLAM P NCI AL STRUcru EN
PLAN V TION C?L Wd. CAAH ORf,. cK r.o. ZKH
7402u; JUN 2 -1 n 9.00 ,
1930215 BG APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN
I hereby affirm that I have a certkfcats of consent to sett k.-m , BULDM ADDRESS
or a Ger a of Vlbrkars' Conpaneation lrmurance or a certifled 5505 Robinhood
oopy thereof(Sea 3800'Lab'a) �
�� Na PWC 250179 Golden Eagle Te le Cit 91780
ry
LAY
8CZE OF LAT NO.OF B4 D38 NOW ON LOT
❑ Certffled copy b hereby fumbhed. f�4RFST
11 Certtfled copy Is filed with the qty building Inspection TRACT BLL K LOT NO.
departrrLUSE ZONE AMP 40.
E).be 12-9-94 A ,t Virgin Roof Co. ASSESSOR VAP Book ' — RARCEL
SPECIAL CONOfrVON9
NER
CERTIFICATE OF EXEMPTION FROM WORKERS' CW
Waterman Ttz No wrr w i000 Fr.of scr�ooL� s NO
COMPENSATION INSURANCE
ADCFESS
(This socoan need not be completed k the permit Is for one txlndred 5505 RObinhOOd
D99TRICT ORCUP PROCESSED BY
dol fare ($100)or lees.)
zip
I certify that Ln tl'Ie performance of the work for which this pwnr t Te le City 91780 d m �a _3
Is leaued, I ata l not employ arty person to arty manner so as W AACWTECT 0R ENGNEERR TF1 N0.
become subject bo,the workers'Compensation Lgw(L S MSTr L RPT CONGO
Date AppllcW ADDRE88 CLAS3 NO.��DH LL LUT8
NOTICE TO APRJC4NT k, attar n klnlp this Certificate of REOIIfAED TOIAL SETBACK FROM EXOT
Exemptbn, you should become eub}eot to the VLtxkers' CONTRACTOR TEL 40. SET BACK YARD HWY PROP UNE WDTH
compensation provtalons of the Labor Code, you must forthwith Virgin Roof Co.. 818-287-0507 FRONT
comply with such prorblorm or tide permit shell be deemed revoked. ADDRESS uC.No. P L
P.O. Boa 5010 160650 SIDE
LICENSED CONTRACTORS DECLARATION �-Y } �LA88 PL
I hereby affirm that I am I lcat,aed underprovWons of Chapter 8 San Gabriel C a ( i y �
(oommencing with 3ectlon 700Q)of Dlvlaion,3 of.the Business and Sa FT.SUE Na OF STCW3 N0.OF FAMFUE8
Professions Code,and my Jlc n b In full force and effect 33 1 NEW BK Pa ,
therms N,b., 160650 leo.Cis C39 OF Y#UW ADD ❑ %pLuAnON C�
C,,�� Virgin Roof Dat 6-30-95 Over existingapply ALTER El#30 felt � $3,734.00 ``��
�
El I am sem Class "A" Fiberglass Shin les. REPAIR El
BAP.C.for&Pb reason DEMOL ❑ U30AA PTC I
Date: USE of E)38TM eLoa URM ❑
Dwelling1 Z
re APPUCANT(PRr1T) TEL Na — Pwrn - —
❑ I, as ownar of the property, or my employees with wages as Virgin Roof C o. 287-0507 *O ACM-4
&Petr sole cornperxatlon, wffl do the work.and the stnuctrue b ADDRESS 0 ,(3?, 137.4{1
not Intended or offered.for sale (section 704-4, Bu4nees and � "� J` 1 ITEM
PrOfe681ors Code) NLL THE APPLK.Vrf OR FURS RL■Dw OCCLF T LADLE A I VZAFC10 M,4H3v-
❑ I, as owner of the property, em exduehrely cortUaotinq Wftfi OR A►aTURE CONINN O A HAZARDOU6 LL4ERIAL EQ1Y1 To 4-R----I THAN T C
rk eased con of the r corp, amiict the pro* (Section 7044, MIOLWB SPECIFIED ON THE HAZARDOU6 A44EFULa DFoRAMON GLIDE? FINAL.Br TOTAL 137 _ 4-ID
Buahiese and Profeasbrm Code.) %I- ❑ rrcU �-t��-{/
WLL TFE NTEIOm 116E OF THE Rl ry.alt BY THE APPLICIlIT OR FUm1FE RI■fyafl L•fL�r{l 1.7f.7l!
OCCUF T TEOURE A PEFILU FOR CCWTR1CTION OR►ICCFIC.lUION FTIOY THE 6OUTH f� I
CONSTRUCTION LENDING AGENCY MAST Ail QLWJrY uANAomrT aHrRCT MCAOAot SEE PERMTT�K3 CFEC]G-W FOR lT!L�r ■0�
rrrte,Itea
I hereby aNtrm that there le a c vAn-motion lending agency for vee❑ How -
the performance of the work for whbh this permit FB beued(Seo IH,%E READ THE HAZkFICOLaVATEFIALS lFOR T"GLIDE AND THE eCAaO PEIVArrr (3
3087,Cfv.a) CrEdd_16T. RECUFOE9fM USER THE NIOELEe COUNTY CODE, 00 KHM 1 12/10/93'
Lenders Names z zo r oo THS awn C01�lCwadO HW AFDaJB
Lenders Address 1 Ali 85
0
or.�rn AOr
I certify that I have read this sppkaticn and abate under pww*
of peroy &et the above Information is correct I agree to oomply P.a FTE PEFUT FEE
wtth all cooty ordinances and Slate laws relattrp to buWng $111.00
, and hereby authortze repreeentatKes of thb Canty Is81JAWCE FEE J
the above-mentioned for hapection purpoeee. 26.40
m 12-9-93 rNVESTx3A010N FEE TO"PL FIE
dAp~Q AW DOm $137.40
SEE REVERSE FOR EXPLANAMW LANGUAGE