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HomeMy Public PortalAbout10656 ROSEGLEN ST_Building__ DIVISION OF BUILDMG AND SAFETY DEPARTME11T OF COU]Irff ERGO= COUNTY OF L013 ANGELES BUILDING WILLIAM J. FOX, COUNTY SNa1NmR APPLICATION CASSATT D. GRIMM, St7T'T OF SUILDOW FOR APPLICANT TO FII . IN FOR OFFICE .USE ONLY DISTRICT NO. PUH CK.opt R=a.No. PO3HIT NO. BUILDING A (� DDRISS r1 3$ 1 34- m ' RiC[IV M BY DAT'[OF A DAT=ISSU® 7 NIARiST /CROW IFT, ■UILDIN (^ OWNER k- ADDR[Bs C] MAIL ( LOCALITY NXARXST ADDRIES a Ta- CROSB!r. c-3- ARCHIT[CT OR �„ FIRi NO. OF � G]ROUL EN6 N� ZON[ PLANS SLDG. APPRM timACIS LIN[ TQ- US[ AFPROV[D CO MON11 BY ATI .x-' - 9. Blvd, S HOUI BERING LiA aL c1 NUMB '20O. AMCLN[D BY-, D[SCR FTIOH HHE..IONS TRACT SEM OF LOT X NO o�1 USI OF NO. OF HfAMrLXn DffiCRIP`MN OF wxm o — EN V.TMtAnQN ADDQ RIPAIR D ON BR. FT. /or. co STORMS s= OST. WALL ROOF UB[OF STRUCTUR[ APPHOY INSP R'O BIGNATUR[ 13ATR FOUNDANS LOCA.r- TION FORME TI.0O14 1 HKRX39Y ACRNOWLJCDai THAT 1 HAV[ RiAD THIS Al`- FRAMIs FIRX STOM FL.ICATION AND STAT[ THAT TH[ INFORMATION GIVKM IS BRACING COLTS CORRiCT. IAGRa TO COMFLY MATH ALL COUNTY oRDINANCIB GRNACJ[i LOCATIC L iT ANDUCTs D STAT[ LAWS RIauLATlIi1! CUdDING ODNSTRUC'TION. t SIOFR LATH INT. ,fj r ` PERM v / LATH. OCT. ADD PLASTER. INT. AUTHORIZXD AaT. _ PLAST[R, OST. / $ � HOUO[NUMBER COR- (? OR- / ( )N ,r#;:-', [^JCJ R[CT AND FOSTIM VALUATIGN FQ • ✓ FINAL DSS s r-sa I ""3"atace.1-. APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES "U = I . DEPARTIAM OF COUNTY ENGINEER ADD BUILDING AND SAFETY DIVISION LOCALITY C JOHN A. LAMBIE, COUNTY ENgINmR NEAREST J u ST. D IF CT O. GROUP T�pE ED BY FOR APPLICANT TO FIII IN CONST. BUILDING C {� STATISTICAL CLASSIFICATION B ER MAP ADDRESS C .FCdS E S LASS.NO L UNITS `— LOT NO. BLOCK WATER NOT REQUIRED' i RECEIVED CERTIFFIICAATTEI "AyF�- TRACT �� NO.OF DLD68. NOP 0�7J 1(CI RCL[) T STATE MAJOR b OND, OCA SIZE OF LOT. NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS 1EX19TING BLDG. rL!J 1 tJ 6 OWNER O C. IE �Z.AIE oL.GI-d.-$Y BUILDING YARD HWY STREET E EXIST. ADDRESS OGS E 6S L>r SETBACK WIDTH FRONT AR CHITECT0R TEL P. L ENGINEER NO. SIDE P IFE.E DRESS TE INSPECTION RECORD O NTRACTOR D 9 E. �1� Z O.L7T�' �y _+�j 0 DDRESS DSF,61_E DESCRIPTION OF WOBK EW ADD ALTER REPAIR DEMOLISH NO.OF NO.OFS ,1=T. STORIEoFAMILIEB SE QFRUCTURE IrGNATURE OFAPPLICANTALUATIONS ? APPROVALS DATE INSP CTOR'$SIGNATURE C- �� PMT FOUNDATION: LOCAyN FEE FORMS MATERIALS FRAME: FIRE STOPS, J� I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING ISOLTa AND STATE THAT THE ABOVE IS CORR)ECT AND AGREE TO COMPLY FUR NAC : LOCATION, WITH ALL COUH-l7' ORDINANCES AND STATE LAWS REGULATING GAB VT DUCSB BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT TION OF THE LABOR COOK OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMKM'■COMPENSATION INSURANCE �.D r uTri >4cT. SIGNATURE OF Gi HOUB[NUMBHR COR- PERMIT'TE OUS AND POST ADDREGEL MAL, CLYDE N. DIRLAM, PRINCIPAL ST'ItucTURAL ENS PLAN CICS VALIDATION m M-0. CAM PEEMMT VALIDATION we r a aAsa� 9 9.9 1.0 SEP ?) 2 1 D 12 .0 0 VVORKERS' co&kPEJSA TI ON DECLARAT10-N hereby affirm that:l have a certificate of consent o ": IfInsure, a d of Workers` Compensation Ins4rance, AR P L I CST I O �*KIWILDANG P E Rl IT ctetoth 00UNV'0F LOS ANGELES bU�IjL/E�Nr6 #bAHD SAFETY � olrcy No. Compdny;� - ❑' ,Certlfled copy'Is hereby fupADDRESS FOR APPLICANT TO FILL IN ADDRESS ❑ Cer0ed copy.bfile¢y✓tt the tountYaeilding•Inapec- WILDING tion dbpdrtm.gnt_' ADDRESS Ddte~ 'Applrcant trrY IJP Lp� t CERTIFICATIr QI"E>t WTIOIy Ej20�VCV1K36aRS, SUM OF LOT. Off' �C1OI NOW 0.N-PT . CC PENSATION-INSURANCE b section need not lie com rated ff.the' '� ". '`�� $5$�r O Z .r i (fh P PIt ta.for or» TRACT 4 g BLOCK LOT NO. h1AP BOOK PAGE PARCEL' • •hundred dollars (;C]'00) or.less.)` -� - � USE LONE ,� 4 i NO. I certify that{n.the,perForman4'df,the�wDtk for Which this, t-� d � r perm it ds istued, h afitlll not emptay any, r1•Irl.any Panner APORE55 t O�o�1p s'r -/ ��rr)M so as tp,becbme subled to.the Wodk04 Compensation lbws, Ot crrY TE i-�s ZIP' (718.D,: v Pt" Applltanf. ARC HI EQUOR D) P TYPE. PROCESSED BY � NOTICE TO APPLICAI,IT: If, affer makfng-t Ise•Certfff"_of ENGINEER NO. O -Exemption, you abould i>e4ome'_sub uct to the;W,6rkers �Tj•�� E ,Compensation.proylslgns of the Lobar Code, you'Snvst forth- ADDRESS o 3 /with comply-With such.provlsions•Qr this permit•ahpfl be TEL " STATISTICAL CLASSJFICATK?N APT. 00tA0. deemed revoked. OONTRACTOit — LICENSE1),CCGCTORS bECLXFL i' J., ; LIC CIASS N0 r nMTaJ L1NfT$�, . I hereby affirmt�lam Ilcensod under provisions of.&gpgr 9- - ADDRESS NO SEWER AAAP ( mmrofeung.With Section.70QO)of Dlvson 3 of-the-Buslnsu _ LC _9lonsCode,,andmy licarw )r fu_ ,force,andgffect.' Crry _ BK. PG. VALIDATION 5Sqq. ��FF NO. OF lJcerise NumbCl er. 'lI� ad SJ�E STORIES FA -I IES . OPE Contractor '.y DESCRIPAON OF WORK ' El Vh1LLtATWN O� © . -- �' _ $ I am exempt'and Sec - n .. ' _ ALTER LI - BAP.C,'for-hlt rqa n REPAIR ❑ ; Dat''.' F?�sf1�tJG BLDG:SrNb� It D6Aa EJ $Ignaturo' _ (PRT NTY _ 713 RNA_ -23 OWNER-BUILDEk DECLARATION.. I " DATE J��� A I itst qby affirnl that l am.exempt from the Cbntradora License _ ACCT.ir Law for the following reason_(SeaHon 7031.'5, "riesi and ADDRESS MNAI � ProfesaloRs Codi): f Df. �v.r•. ❑ 'i, of owner of the property, or my empl¢yess with ILDiNG• - / �* 1+ wagesps their sore.compensation,*i l h dg th.etivork'bnd the structure Isnot Inteode d pr-offered#bF sale_(Section 70{4 Bvitr1i"aho professloni:C�.)._.. .. ,:. NES.. - - - . THS .. - L 1 Lh Rk- I, as owner.of the.propevy am ixclw_Ively contracting CONTRACTOR NO. with IlashWd.0ntrodoa to.coMtruct the protect (Soc- ADD tion 7444, Buslns�es.and�ofessions•Coder) - �T CDN$"FRU CTK?N IFNU I AG AI('Y•. YARD- FNVY ." k �E: r � TAL' 204 --19 1 hereby affirmthat there iia coMtruction Iinding,agency fbr PROW. '1 .tt. ti ' p- th• per#drmartcs of-the work#or ivhlth thl$-pernllt Is Issued P (Ser- 3097;CJv. C). _SIDE - - P.L. . ..}-.r `!, OGE i.encler's Name P_C FM Perm it (JG Lend'er's Addfsss *yi��ly ^`1 f C/�� lasua / U)MA P/C , 7� 1 A I u TMJ I certtfy that I k'ava�rwd this.appllcbtlon and state that the ., -` S above Ihfgrmatlon Is cTTect J agree.to comp with alb County Irr4etlgatbn I" . .. ordindncm and'State laws relating to building construction, I Taal FM LDMA Psrm and herby dufhorLm-representativss of this County to enter upon the bov"ntfon grope for Inspgctlon purppsss - - - - —' R l JiA1t t:Rl/11IMi-POR VU LANATM.LANG1 U G4 Slgrxitur of Appl Dutra ' WORKERS'COMPENSATION DECLARXTION ` A h*re, affirm er fico, I fW r certificate of corneum to self APPLICATION F k��UILDING. PERMIT •IMure, or a certificate of Wprkirs' Cgmpsnsatlon Insurance, or a certlf(ed copy thereof'(Sec. 3800,Lab. .} ppyy}} COUNTY OF LOS ANGELES BUILDING Ak0-,SAWY Policy ZQQ��Q���Company Certtfled copy Is hereby fumis ed. FOR APPLICANT TO FiLL IN BUILDING Iffed copy Is filed'wlth t county IYdlnt}Inspec- . BURDING tion departvte4t. ADDQESS J 1- LOCALITY NEAREST Dat•�O` ` ppl Icant CITY tg_ ZIP CROSS ST.- Na OF BLDGS. ASSESSOR CQMPENSAT}ON INSURANCE . SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCH (Thlt��sectron-ne-ed not be cpm leted If Ilio-permlt Is for orte _ USE ZONE hundred dollars (tl.OQ)or leas,. TRACT BLOCK LO NO. SPEClA1 } I cbrI%tbat In t" perfdrmanCe bf:fhst work for which this CMR CONDLtfONS Perm li Issued,.]andll notamploynny n In shy manner - DISTRICT GROUP TYPE FIRE- _BY O to as to became sublect to the Worker Mperuatlon Laws: T' ZONE V Date, Applicant -' STATISTICAL CLhSSI1`14�ATION AFT. JCONDP.- MIOWNOTICE TO APPLICANT. 1f after making this Certtfi�afe,of � � i G . Exemption,' you. should become subject to:thb Workers, CLA$SNO. UNfrS WfL Compensation provlslons of the Labor Code, you must forth RESS '. _ _ SEWEftMAP L y" �vlth 'coMply with.such provltlons of this permit.shall be EL deemed'revoked. CONTRACT g� PG ), K�K LICENSED.CDNTRAC'TORS DL4AIZXPQ J I hereby dn that i am licensed under proytslof,Chapter 9 ADDRESS NO. �I VALUAT}ON f#trroro (commer dng wNh Settbn 7000)of Dtvlaloe Sof the Buslrtbss and y*•' Pro#ealons Code, arnc my Ilcdrue Is Tn`full force and effect.- CCITYLAM ; i . &a. FT_ NO.OF NO.OF License Number- �t♦��s Lk- SIZE STORIES FAM LES � ONE Co n trd cto r?<n rl k: Date 0'7 "O T'IO PN OF WbR1C NEW ❑ i - l ,4D a I am exempt under Sec.' ❑ FINAL ALTERf=/ B.&P. f?r this reason' - REPAIR 15ATfa I Date. ELP5E OF XISTING BLDG. Slgrtature APQLKC" I sV TEL UILDER DECLARAT10N I here affirm that I pm exempt fr9m the C-0ntractor's U'cense " Law for the,following reason (Section 7031.5, Business and thR professions Code): PRESENTO BUILDING I, as awner-of the or m em I ebs with ADDRESS - t ..vv "as theli.sole coMp"sation,will do the worn and' - the stnx`tere'Is not Intended or offered for sole(Sectlon, L #'deo b e - . 704A,:Buslhetr.and Professlo'ns Cbde). MOVING TEL. I,'as owner df the property, am excluaLvelymn}roolrttt with ilcensed contrattt to corlstrucr the projoct.(Sec; 2 0 • 5 Q 0 or tion 70", Busings artd Profbsslons Code. ADDRESFROMpp�T o.0.015 a,.0 0'5 CCxJMUCT1QN LENDIN4i AOg4CY ' YARD HOMY PROP« WIDTH r 1 I hwreby.affirm that.t.flere Is a corutruction lending agency for FRONT fhb performance of-the work for whichp this p"It N lisued 3097, Clv. }'. SJ bE o P.L. (encim's NQ ,j Lenders'Addresi SCF••; PsrmttF9+ �] I certify that l have rood this application drid stat•,that the r I,•uarx•Fee d above linformation Is correct. I agree to comply with all County Inwstlpatton Fe• ordl n and ,Statb laws relatlnq to building conshvctlon, and,h a representatives of this County to enter To+aI.F•• upon e v ntloned pr for Irapection purp4sea m n PM DITLMMTbRY LM1¢l1AW 'af Appl400nt or Ment Lot.. _.bs