HomeMy Public PortalAbout5571 ROBINHOOD AVE_Building__ �l/A Z&A Dat-s a-s! --
�`� '` ` APPLICATION FOR BUILIDING PERMIT 1
MSIoN OF SUMD114G AND SAFETY ADD DING
D.ParbnlW oa County Engh~
� � LOS Agl" LOCALITY
C=W�
J. Foy.COUNTY I3NGINMM tARElT
T_T D. GRIFFIN.!ur^r OF luumrme
FOR APPLICANT TO FILLL1 IN DI'T�CT Na ROUP sEwER MAP
IADD tM 1V. fT o 1•Jr�4loLW AVEMA STATE
NUMBER G t HVfY O
LOT NO, 11 �8s c yBLOCK USpzONE CON ECIAL�N! '
T7tACT I 404D S� � F
NO.OF BLDGS. BUILDING .
I K OF LOT NOW F LOT SETBACK YARD HWY STREET NAME WIDTH
=STING OF ,)Lc11t114 �t fitQ i FRONT �!/�
P.L. "�
OWNER A I'11 1 i,t BIDE
MAIL 5_1 1`1• r C tta\Vwg0 N`1 E• o TRACT DW 1 UNIT
ADDRESS is INDUST1tIAC.
1P, .E �1N 7 DWELL.' I UNIT b PUBLIC BLDG
ARCI•IITECP OR T]i3_ 2 .DUPLKX 1 UNIT 7 PUSU ALT.,.
ENGINEER NO. ,a AFT. UNITS"
WM
ADDRESS 4 CoMMKR¢IAL
CONTRACTOR NO. 2-ZS INSPECTION M=RD
ti U tux 001b W&
DESt:REMON PFLie
� .
NEW r—.7AL REPAIR DEMOLISH -
SQ. FT. NO.OF L NO: OF
SIZE !TORIES 1 FAMILIE!
USE OF STRUCTURE
SIGNATUREE,OF t
AP*1.1CANTrr nipV, /� - APPROVALS
u
ADDRElS J � , iu koa Flo DATE IKSt=R'E IIGMAT0i7',
FOUNDATION: LOCATION
•�J /'}•� P,O. # FORM! MATERIAL!
b" v FEE FRAME: FIRE OTC".
VALUATIONQ....'
BRACING
KURNAC�E:LOCATION. �y
1 HERLtY ACKNOWLEDdE THAT I HAVE READ THIS G'A'S VWT DUCT!
APPLICATION AND STATE THAT THE ABOVE 18 CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH INT,
AND STATE LAWS REGULATING BUILDING CONSTRUC- ,
TION.
LATH,EXT.
SIGNATURE O HR OUNUMBER COR-
PERMIT
OR- f
PElIMIT,T0—s-'-'} RECTAND POSTED
`M XDDRES! �-•'V J. ��•' L? r�J tl�OylJ �7V�• .
FINAL
4".J.FOX,COUNTY ENGINEER VALIDATION C. N. DIRL.AM,CHIEF BLpG. INSPECTOR
1' r.42 8 JAN 1 1 - 10.00 , 0
BUILDINCII
BUILDING ADDR[SB 0
APPLICATION LaDAL1rr
DIVISION OF HIIING AND SAFETY NEAREar v�
C OBD OT
Departn-m
t of County DISTRIOT NO. REO[IPT N°JPERMIT NC.
County of Los Angeles `'7 J �� / Z
WM. J. FOX, COUNTY ENGINEER GfkOUP DAT
BDODDASBtD
OASATT D. GRIFFIN, Sup'r of Bu1LDiNoFOR APPLICANT TO FILL IN [COMET. SIVDB
OWNER
MAP BTA HO
'LNUMBER HWY
ADDR[HH f
UD[ZONE SPECIAL
T[L. CONDITION■
CITY No.
ARCHITECT OR TEL.
ENGINEER LL NO.
BUILDING YARD HWY STREET NAM[ EXIET.
6[TCADK A WIDTH
D FRONT ZO/S ),(��
P.L �J/
O O NTIZA OTD R
BID[ O
P.
D L
am DATE CORRECTION■ INSPECTOR
■UILDING
ADDR13 O
LOT NIL ' ■LOOK
TRADT
NO.OF
i
■IZ[OF LOT NOW ON VE 2
UB[or
DESCRIPTION OF WORK
0
N[W ADD ALTER REPAIR DEMOLIBH
FT. Nm OF NO.OF
SIZE ■TORI[! FAMIUCE
USE OF DTRUOTURK
r
NO,OF
PM
KMPL
I HEREBY AOKNOWLI DOE THAT 1 HAVE READ THIS AP-
PLIOATION AND STAT[ THAT THE INFORMATION RIVEN 18 APPROVAL) INSPEOTOR'BpIGNATURE DATE
CORRECT.
IAGREE TO COMPLY WITH ALL C DINANDE■ FOUNDATIONS LOCATION
AND STATIC LAWS REl3ULAT1 ■ UOTION. FORM MATERIALS �,ze
FRAMES F"IRE BTOPS,
SIGNATURE OF ■RAOINIII BOLTS
PERMIT-f[ FURNAOES LODATION,
GAB VENT DUOTH
ADDRKPLR
LATH 1 NT.
AUTHORIZED ADT�
LATH QCT.
z- HOUSE NUMBER OOR-
VALUATION
[ R[OT AND POSTED
� � * i B
FEE FINAL
7a.ai D"7 17-7.7
L _
r
WORI�' COMPENSATION DECLARATION
hereby affirm that I 'have a'cQrtfftcate of consent to self APPLICATION
FOR ,B U I L D I N G PERMIT 1
Insure, or a certlficate•bf.Workers:Cgtnpensatlon In'surancs,
or a certtfled coR31 thereof (Sec ''BW, Lab. Q.) OF LOS ANGELES -.MLDING AN) SAFETY
Policy No. Company
BunDlNG
❑ Certified copy 14 hereby furnished. FOR,Am. 1CANT TO FILL IN .Dp
❑ Certified lafiled with+e.bounty building Irnpec- BUILDI
tlon deRartment. �m
Date Applicant zip hoca
;
NO,OF
CE3MFICATS'OF _
f)�MPTIQtN FROM YVORtCH2S'' SIZE OF LOT NOW ON LOT ��' ' e ,
COMPENSATION I NSU RANCF • An
ASSESSOR
�fhl&.section need-not be com leted if-the permit is foror$e TRAGI69S7 I BLOCK LOT NO fyye�P PAGE PARCEL
hundred dollar (j100) or leas..? MAP
owrFR f.� - USE�►
I certlfy,that In the performance of the work for which this
permit Is Issued; I shall not employ oriy neon In arry mpnnsr _ SPECIAL- - -
I so as to be4o&m subled.to the lyorkpn�Corimpensatton taws COt�f1TON5 O'
Date�1 �Appllcanr -fit Ate
dd� ARCHITECT OR _ `' Tg TYPE
NOTICE TO APPEI H,•dfter ma is CertE // 40. r-�— _ DISGROUP ODNST: 'e E O
Exemption, you should become -subject to the,,Workers'.
Compensation provisigns of the Labor Code, you must forth.. ADOQESS
with comply with'-such proylsiors or this-permit shall be STATISTIUI-CUASSIFtCATION AFT. C01Ip0.
dstmed revoked. CONTRACTOR V I`► NO. �.
LICENSED CONTRACTOR$;DLi"1 TION, ur- CLASS NO. DIAIRL UNgST_
I hereby affirm that I am licensed under prgvl4loroof-Chapter 9 ADDRESS NO.
(commICencing with Section 7000)of DlvWpn 3 of the Business LSEWER MAP
.and Professions Cop,and my license Isin full force and effect. CTfY CLASS pG VALIDATION
54'Ff.r�r+ NO." NO. OF C]tECJC
Ucensb Numbiw' LLiq
'r,C �� � Sig
i /a STdRI FAMIUE$ Ott
/+ y •VALUATION
Contractor ,pate. DESMPT10N OF LI� �r{1 NEW
❑I am exempt under Sec
o
ADD
: v2 �3 ►
_ ALTER..❑ � _ .
BAP.C. for this reason" /�. b �� ��'� ALTER.REPAI ❑
Date:
USE OF
EXISTI BLDG. �r DCAhC� ❑
Signature APPLICANT TEL ryPjAl'. - -
OWNER-BUILDER Xa RA-nON NO.
DATE .
I hereby affirm that I am exempt from the ConirGdor's Ucense
Law for the follovOng reason {Sectlpp 7031.5, Business and ADDRESS FINAL.
ons Code): PPEUNTBY t- -
I; as owner of the o or sm I BUILDING ACCT.
Pr Pa!Y, my. P.oyees Wlth ADDRESS
wages as their sole compensation,will do the work andLOCALffV 3307.T - .25
n
the structure Is ot Intended'or offered for-sale(Section _ ��essssC� . .
7044, Business and Rrofealons Code.) - MOVING TELCONTRACTOR .. - 1 1 1 iJ 17
❑ I, as owner of the property,-am exclusively contract ing NO. ;
with licensed cohtradan'to-conM-ud.the protect (Seo- , -TOTAL X90 M'25.
Non 7044, $usiness and Pnofealors Code.) DDRESS .
25
l�
CONSTRUCTION L1NG A0ENCY - YARD' IhV1 -
I hene6y afflrm.thafthen Is a corstructlon lending agency for FRONT
the performance-of,the.work for which this'perrriIt Ii Issued P.L.(Sec. 3097, Civ. C)'_ SIDE .P.L.
Lenders Name T 010011-M1 '8 23 '
P.C. F« Perm h Fee ?S LDMA Ref. I
Lenders Address
40
Ali
. 1 .' Ali 7
e I certify that 1 h6v-read thl4 dpplleation and state that the lowonce LDMA P/C
above infgrmation is correct. 14gfee to corri ly with all County Invest44atlon Fee
ordlr;a x and Stats laws relatirig.to building construction, 1 Total Fee LDMA Perin.
and hereby authorize representatives of this County to enter
u thea ntl ed'prop"for Inspecflon purposes.
(2���,� aOd/ r M WVIN POR Man AIUTORY L 0U#0 A)4
re of Appi n hit Dale