HomeMy Public PortalAbout10641 ROSEGLEN ST_Building__ } 'TEMPER-CITY
7.A.]E..C!`r60]2-.] APPLICATION FOR BUILDING PERMIT `
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER, ADDRESS
BUILDING AND SAFETY DIVISION ' LOCALITY
JOHN A. LAMBIE, COUNTY ENGIND$R NEAREST
WILLIAM A. JENSEN. SUF'T OF`CUILDING CROSS ST.
DIST N TYPE EBBED B
FOR 'APPLICANT TO FELL IN coNsr.
BUILDING STATISTICAL CLASSIFICATION S ER MAP '
ADDRESS K gn
CLASS. NO. DWELL UNITS,
LOT(JO. 151- BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE:
TRACT MAP /j_
HIGHWAY STATE MAJOR SECONtS. CA
NO.OF 6LDOS. NO. f (CIRC;[)
SIV-7,0F LOT Q NOW ON LOT UNE SPECIAL
USE OF - - - CONDITIONS -
EXISTING BLDG. -
E L - 'y _
OWNER &4%.NO. BUILDING YARD HWY STREET N MF EX
SETBACK WIDTH
ADDRESS , FRON
JIRCHITE OR TE-L. P. L
ENGINEER NO. SIDE Y'
F. L. a
ADDRESS O
TEL I
CONTRACTOR
`I W
ADDRESS
DESCRIPTION OF WORK / a
NEW ADD ALTER REPAIR DEMOI-ISH 2
'SQ. F7. OF NO. OF "
SIZE STO Ri ES FAMILIES f
USE OF
STRUCTURE - 114
•�+
SIGNATURE OF
APPLICANT
VALUATION S '�
APPROVALS DATE IN&-K9rOft'jF■IGNATUIta
P.C. PMT. FOUNDATIO_N: LO ATION - L.-I� 1
.FEE- �� FEE $
•1 FORMS, MATERIALS Y-
FRAME: FIRIf STOPS,
I HEREBY ACKNOWLE [
DGE THAT. I HAVIK RAD THIS Al-PLICBRACIN B LTS
AND STATE THAT THE ABOVE IR CORRECT AHD AGRRS TO COMPLY FURNACE: LOCATION.
WITH ALL COUNTY ORDINANCES AND STAT[ LAW REGULATING PAS VENT,DUCTS
BUILDING CONSTRUCTION. P CIRTIFiL THAT IN DOING THE WORK
AUTHORIZED H[RIQY I WILL NOT EMPLOY ANY PERSON IN VIOLA,- LATH. INT.
TION OF THE LABOR-CQDql OF ;,-A OF.CALIFORNIA RELAT.
ING TO WORKMEN'S COMB INBURANC.
LATH, EXT.
SIGNATURE O HOUSE NUMBER COR "
PLRMITTEE RECT AND POSTED -
ADgRESb " FINAL -7 -7i4-
` - JOHN F. LEW1S. PRINCIPAL STR(7 RAL ENGINEER
PLAN CHECK VALIDATION M.O. cAsH _ PERMIT VALIDATION M.D. CAL,µ,
Lr o =' 1 1 4.- MAY 21 0 15.0 0-
— C
DEPAMM OFDENGMEMBUILDING . — —DMBION OF BIIII•DING AND SAFETYCOU M OF LOS ANG99MWU-UAH .J. FOX COUNTY KN*uao a APPLICATION _..
CASIATT D. GRIFFIN, *UP'T OF ■UILM"
FOR PiPPLICANT TO FILL IN ' FOR OFFICE .ONLY �
DISTRICT NO. PLAIT CA.oR Rm.No. rRI/IT N
■UILDINGAl)
ADD / j
r" RtCRIVlm BY DATE OF APTI_ PATI[IESUm
NEAREST
]BUILDING
ADDRESS e
OWN R
ADD A72
/� `D • 417k. rk/e WARK
N ITY C 1
+ N EAREIT i
MAl/ 7 / CRo"ST
ARCHITtCT OR TEPLANS TEL- FIRE L S GROIJ
KNGI ZONE P1
"DRKIDS
smACK NE
co �] f Uat APPROVED w
oe
/L/ /` .V P HOUn HUY Nd
ADPRXSS
1
LEGAL YAP NU O. ASBIG Kll By
DESCRIPTION ' I HHECTIONS -
TRACT g�'
B iZE OF LOT ON
USE OF NO. OFCl
OF WORK o -
D
REPAIR D OLInON
SO. FT. NO. OF
SI'a /077 W STORIES
COV>OtltiG ROOF
USt OF STRUCTURE
APPHOYS
INBr = 1 d GNATURE 'PE
FOUNDATIONi LOCATION
FORMS, MATERIALB �r
1 HEREIY ACKNOWLEDGt THAT I HAV= READ THIS AP- FRAYtz FIRE STOPS,
PLICATION AND STINK THAT.THE INFORMATION GIVEN 18 BRACING DOLTS
CORRKCT. FURNACEi LOCATION,
1 AGRa To OOiIrLY wITH wLL COUNTY ORDINANC W aAs vENT DUCTS y
AND $Twit LAws RzamAnNo ■uamms OoNsTRuanoN.
rlGtlw Of -y [ LATH INT.
n LATH. K[T. >/ ,
ADD
• rLASTR, INT.
AUTHORIZm AOT.
_ PLASTER, QT.
s T-
P. C. t `rO HOUSt NUMNR COR-
F= R[CT AND POSTtD
VAL.UATIOM FQ S.��� �'� FAL 1
7*A 34A DOSS 9-" P
7CA696A CER603 6-66 APPLICATION FOR BU ILDI G PERMI
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINSOUF'T OF BUILDING CROSS ST.
DISTJ3LC NO O:r I TYPE P
FOR APPLICANT TO FILL IN CONST.
DUILDING STATISTICAL IFICATION SEWS AP
ADDRESS ;FZ CLAS NO. DWELL UNITS BK PG
LOT NO. BLOCK USE ZONE MAP _ v
NO.
TRACT SPECIAL
pp NO. OF ■LDSS. CONDITIONS
SIZE OF LOT L'� NOW OR LOT
USE OF
EXIBLDG. SETBACK FROM
TEL. FRONT FRO-P. LIRE OF (STREET)
OWNER r TYPE OF EXIETI N/ SETBACK HIGHWAY YARD - TOTAL
ADDR E3S HIGHWAY WIDTH FRQM CL.
11
CITY ! `�/ BLDG. SETBACK FROM +
ARCHITECT TEL. SID[ PROP. LINE OF1TR[[T)
ENGINEER NO.
T YF[ OF EXIITIN6 /[TRACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
TEL. + _
CONTRACTOR NO ^
LIC / CORNER CUTOFF YES NO yV•(
ADDRESS 1 NO 3
LIc SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTfON OF WORK qN,
NEW D LT REPAIR DEMOLISH _
.Q.FT. ++�� NO. OF NO. OF
SIZE Z.f+ STORIES FAMILIES "
USE OF
STRUCTURE
.IG ATURE OF
A LICANT
VALUATION$ L �
APPROVALS DATE INSPECTORIS 61/NATURE
P.C. PMT. FOUNDATION, LOCATION
FEE$ PEE$ I (/ (/ FORMS MATERIAL.
FRAME, FIRE STOPS,
I HEREaY AC KNOW L[DOC THAT I HAVE REH
AD THIS A"UCATION BRACING DOLT
AND STAT[ THAT THE AROV[ IS CORRECT AND AGR[[ TO COMP-LY FURNACE: LOCATION
WITH ALL COUNTY ORDINANC Ano TI-19 WORK LAWS REGULATING GAS VENT. DUCTS
•UILDINO CONSTRUCTION. I C FY THAT. IN DOING T [ WORK
AUTH ORIZXD HERESY I WILL N EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE S
LABOR CODT OF THE TATE OF CALIFORNIA RELAT
ING TO WORKMEN'S COMPEN ION II'IB U RA II CIL -
i / LATH. EXT.
SIGNATURE O HOUSE NUMBER COR-
PERMITTEE10' RE T AN STIED
ADDRESS Fl NAL -
JOHN F. LEWIS. PRINCIPAL STR L ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O CASH
�i s a. s4 rov 15s o 5.0 0- � -
7 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPUCAxT TO FL1 IN
1 hereby affirm that I have a certfM1Gato of consent to self Iraj%
or a certlTfcate of Workers' Compensetbn Insurance,or a oertfffed zP
copy thereof(Sec.3800,Lab..C.) r LCCALm
Poacy No- COQ' OF Lor NQ OF BLDOS.NOW Ot4 LOT
❑ Certified Dopy Is hereby fumfshed NEAREST CROSS ST. jF
////�XCertffled copy b flied with the pointy buedhip htspection BLOCK LOT Na
��J____ 1��"p�p USE Z1Df� M,�W No.
De1e�Applbent le
T �� S BOOK E R,f7CE1 SPECL.AL CONDFrK)7S
CERTIFICATE OF EXEMPTION FROM WORKERS' J
COMPENSATION INSURANCE y y wTm tow F-LcF w4-�Q�7 YES NO
dc1k section need not be completed H the permit to for one huldredMA4Ss g� few`
USTRK7 13 OOIJP CONST. FIRE ZCkF PROCESSED BY
dollars (5100)or leas) _
I certify that In the performance of the work for wh1ch ails permitCTfY 1231/790 pool
Is Issued, I ahaD not ernpioy any person In any manner so as to a" 3
become aubject to the Workera'Compensatbn Lewis. �TECT OR EtJ6WEEA TElNO.
sv,TtsTicu a_AssrF,astloN APT CONDO -
Date Applicant SSS CLASS NO.—P-/ DmaL Umn
NOPCE TO APPLr- NT.. If, after making this Ceftlfioata, of RECORED TOUL SETBACK FROM E)GST •i
Exemption, you should become subject to the Workera' TEL NO. 797T SFr BACK vu-fl HWY PROP LNE wDTli
Ccmperaatbn proVhbrca of the Labor Code, you moat forthwithFRONT
comply with such provisos orthis permit shall be doomed revoked. tLIC.NO. f P L
LICENSED CONTRACTORS DECLARATIONP L
I hereby affirm that I am Ibensed underprovlebne of Chapter 8 SEWER MAP
(commencing wtth Sect1co 7000)of DNiebn 3 of Una Bushreae and SQ FT.SUENO OF STORIES NO,CF FAMILJES
Profeasbna Code and my b Lnfullforce and
NEW ❑ BK Pe ,
LicenseNL"�'Jg Uc.Class ORKADD [:] AI
Y►LLION Q
Contractor Data 7'�6"y ALTER ❑ $ r— (�
❑ I am exempt under Seo REPAIR ❑
BAP.C.for th>s reasonu d r DEMOL E] LDW PSC f
W
Date: USrz of r==TW BLoti URM ❑
Slgr,atL,re1
A (PWO TEL NO. LDA4A Perm f
El1, as owner of the property, or my ampbyeee w ffi wages as O ACCT.T
then sole coa pensatim, wet do the work and the structire b 7 O
not Intended or offered for sale (SectkxT 7044, Bueinees and 1 1 11U.R
Profesabne Code) V LL TFE APPLr-WT OR FUTlFE EIiDNe CXS.II"NT Fi4pLE A F1�ZIFDOU9 Al4EFlA_ P!NAL
1 ITEhkS
❑ 1, as owner of the property, am e7 dudlvey contraOtfnp with CR A NCCFFE coKWANe A FIA:AFDOIA 1MFEWL EOlY1 tooa OFEIXER Tww THEIbwmed contractors to construct the pro}eat (Secrion 7044, 0 oN THE FIAYARDOUB MAffWILB wcFLw'r_N a DEv
BuWr* s and Profeeabna Code.) TOTAL 11,E_ 65
YLL TFE MENDED USE OF THD BLIXM aY THE APPLI Ahrr OR FUTUFE w.DW
OCLFIMOM
.. //''y�{/ p
OWT FEItEOIA PEF"T FOR CjDN8WXTI0H OR MFC.4IOH FR
OCOM THE SCLn-H L�CCK 110■
65
CONSTRUCTION LENDING AGENCY GAA a�Aury WHACErBir DrerRot icT cecsaaeE PgwH°r aEGaieT FOR
r�UCEU
rim.F s X
' I hereby affirm that there b a cormthucfion len �El ding agency for
nthe performance of the work for which this permit Is bared(Sec. .. - .
o I FAA_READ TFE PfrFWAION OI;DE AND TEES AaW PU*KF HO
a 3087, Ctv.C.) C3-ECKL?6T -RUOIlDDER THE Los AN3E Fq COUNTY
LarJWB Name CHMPT67 00 2FF"AEacicMD. OOX�- 1 7/26/93 3
Landers Address 093D 1 Ali 9:4�'
O - C"M�
RR I certffy that I have read this application and state wrier penalty
of perjury that the above Infomctbn IB oor wt I agree b corpy P.C.FEE PERMIT FEE /yti
wthl all county ordtnanCee State lave relating to•buiking /
DortatT,criDn represartativee Of this County ISSOA KE FEE �G
for Irmp9ctbn purposes.
F;WSTK3ATION FEE TOp1 FEE 1 /
���+ SEE REVERSE FOR EXPLANATORY LANGUAGE G•