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HomeMy Public PortalAbout6270 ROSEMEAD BLVD_Building__ _/ .4__ 19?p Lt e— i -7-1 769638A CE #803 3-69 APPLICATION FOR BUILDING PERMIT /Z4/7 COUNTY OF LOS ANGELES BUILDING �- 270 �� �SFh7�-4 I=� DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUP'T OF BUILDING NEAREST CROSS ST. DISTRICT N0. GROUP TYPE CONST. PROCESSED Y FOR APPLICANT TO FILL IN 5 Q 8 _ _� �jl_ _ (PRINT OR TYPE ONLY) BUILDING1 /� STATISTICAL CLAS IFICATION SEWER MAP ADDRESS -'7j� 1 /� C CLASS N0. DWELL.UNITS BK PG LOT NO. BLOCK USE ZONE MAP Q s ^� N0. TRACT �/ Z SPECIAL NO. OF BLDGS. j CONDITIONS SIZE OF LOT I�- , NOW ON LOT ! _ USE OF ) _�f� EXISTING BLDG. / J / BLDG. SETBACK FROM �.0 TEL. FRONT PROP. LINE OF _ (STREET) OWNER ��_�_ NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL HIGHWAY WIDTH FROM C.L. ADDRESS CITY ARCHITECT OR TEL. B ENGINEER NO. LDG.SETBACK FROM SIDE PROP. LINE OF (STREET) TYPE OFEXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS J HIGHWAY WIDTH FROM C.L. CONTRACTOR r�I'S �( t. /�`� NOL" �® �j + O ADDRESS i2� ) - NO — �LIC7 CORNER CUTOFF YES ❑ NO ❑ rNA Y , LIC tie SEE REVERSE SIDE FOR SPECIAL APPROVALS STRUCTION LENDER ~ E AND BRANCH w CL N RESS Z FT. N0. OF N0. OF STORIES FAMILIESUSE NEW STRUOCTURE &61 �� ADD ❑ ALTER ❑ ,REPAIR ❑ SIGNATURE AN'r (F � y S� �� ,fes a l (� DEMOL ❑ A P P L I C ANS Y6//i`� J/ IVALUATIONa$ ( '�"" APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. Q UNDATIN: LOCATION FEE $ FEE �O'-�^ FOFORMSOMATERIALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME: FIRE STOPS, BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH,ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC- GAS VENT DUCTS TION. I CERTIFY THAT,IN DOING THE WORK AUTHORIZED HEREBY WILL NOT EMPLOjANY PERSON I LATION OF THE LABOR CODE LATH, INT. OF THESTATE Of�ALIFORN IA IN L TING 0 WORKMEN'S COM- PENSATION INSURANCE. SIGNAT RE OF LATH, EXT. PERXITTEE /` T' O �� HOUSE NUMBER CORRECT / AND POSTED ADDRESS FINAL -y Q JOHN F. LEWIS, PRINCIPALS URAL E y/I�NEER/ PLAN CHECK VALIDATION CK. M.O. CASH - PERMIT VALIDATION CK. M.0-1 ASH(/ t� 5 is 5 5R A'1 6 1 D 1 2.00N l J � 7 76A638A CE0803 8-63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING n DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN D I U-R I CT N O T Q COTT. PiRE BUILDING STATISTICAL CLASSIFICATION SEWER MAP ADDRESSto= D O S �✓6 BK PG CLASS. NO. DWELL. UNITS 19'- LOT NO.6 I, BLOCK WATER NOT REQUIRED ❑ RECEIVED ❑ CERTIFICATE: TRACT MAP /,}� HIGHWAY STATE AJOR SECOND, LOCAL NO.OF BLDGS. NO. V (CIRCLE) SIZE OF LOT NOW ON LOT USE ZONE SPECIAL USE OF /_�. CONDITIONS EXISTING BLDG. TEL �e OWNER. N0.9410-61&J " BUILDING YARD HWY STREET NAME EXIST. SETBACK WIDTH ADDRESS )` IQ ijn FRONT ARCHITECT OR TEL P. L. ENGINEER PANO. SIDE O Q P. L. ADDRESS TE d CONTRACTOR \1ppL J' OL.. 'r`'s V ADDRESS DESCRIPTION OF WORK `' '4 v W NEW ADD ALTER REPAIR DEMOLISH H . FT. NO. OF NO. OF Z SIZE STORIES FAMILIES USE OF STRUCTUREco SIGNATURE OF APPLICANT VALUATION $ v VI 0—v APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE $ FEE $ (/ V FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HER I W L NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LABOR CO - OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S C PENSAT N URANCE. LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- PERM ITTEE OR-PERMITTEE RECT AND POSTED ADDRESSav III FINAL v- JOHN F. LEWIS. PRINCIPAL ST CT RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 4 OCT 2 1 D 8.0 tD " 41l - 76A638A CE#803 8-64 APPLICATION FOR BUILDING PERMIT . COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS ST. DIS.IP NO. GROUP1,x PE PRESSED BY FOR APPLICANT TO FILL IN NST. tIf ` ,_yam BUILDING STATISTICAL CLASS FICATION SE ER MAP ADDRESSQ -� BK PG/ • �� CLASS NO. > DWELL UNITS . �! C LOT NO.' �~ ( ` 7 BLOCK USE ZONE MAP Q TRACT SPECIAL NO. OF SLOGS. CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. BLDG. SETBACK FROM TEL. v FRONT PROP. LINE OF r 1 L Z (STREET) OWNER /L NO. TYPE OF EXISTI NO SETBACK HIGHWAY + YARD = TOTAL ADDRESS `�v�i7 b � HIGHWAY WIDTH FROM C.L. / s', CITY BLDG. SETBACK FROM _ ARCHITECT OR TEL. SIDE PROP. LINE OF (STREET) ENGINEER NO. TYPE OF EXISTING ISETBACK H10 - AY + YARD = TOTAL ADDRESS // �^ 7 1 / HIGHWAY WIDTH FROM C.L. � CONTRACTOR L. C" L < f 1 �`lr + _ O V ADDRESS �� ,S ,J� ��61�. �o NO L ✓� ��� CORNER CUTOFF YES NO O LIC CITY -e *I,- c� �'�� CLAS C=/ ° SEE REVERSE SIDE FOR SPECIAL APPROVALS W DESCRIPTION OF WORK N Z_ 4NEW,.- ADD ALTER REPAIR DEMOLISH ' .FT. NO. OF NO. OF SIZE STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF APPLICANT VALUATION$ �� CLr u ' APPROVALS DATE INSPECTOR'S SIG NATURE FOUNDATION, LOCATION FEE$ FEE$ FORMS, MATERIALS FRAME, FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS 9UILDI NG CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'SCnMPENyyy```ATION INSURAA N�CIE LATH. EXT. SIGNATURE OF /C HOUSE NUMBER COR- PERMITTEE / RECT AND POSTED .�i� f ADDRESS 1 1�1�� L �a ri3' G �'_1 FINAL P/r/Qd� _.JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION q-.-) M.o. CASH _ PERMIT VALIDATION(-'-cK:I M.O CASH 76A638A CE#803 8-63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ABUILD DDREI N�� DEPARTMENT OF COUNTY ENGINEER i BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. DISTRICT NO I GROUP TYPE (,. PROCE - D BY FOR APPLICANT TO FILL IN �• CONST. BUILDINGSTATISTICAL CLASSIFICATION ----1� SEWER MAP ADDRESS 70 0� JB'IE,r�rt�R C3.' CLASS. NO. 1 DWELL. UNITS LOT NO. WATER NOT REQUIRED ❑ RECEIVED ❑ CERTIFICATE: TRACT N� o HIGHWAY AT: MAJOR SECOND LOCAL NO. OF BLDG$. v�- SIZE OF LOT 'J X �- NOW ON LOT USE ZONE SPECIAL USE OFCONDITIONS EXISTING BLDG. T 4A G G O L G � TEL. • OWNERt'LG L NO. U UILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS .00 [A FRONT /- TEL. P. L. ENGINEER . ` /✓ . u SIDE ja j _ P. L. d ADDRESS U iL d j E CONTRACTOR OL.. JV �p u ADDRESS 6 -� h/ '•i 0 DESCRIPTION OF WORK W d NEW ADD ALTER REPAIR DEMOLISH Vf SQ. FT. NO. OF NO. z SIZE O FAMI IE$ - USE OF STRUCTURE L O SIGNATURE OF APPLICANT VALUATION $ ""� APPROVALS DATE INSPECTOR'S SIGNATURE FEE $: y�r FEE $ �© FOUNDATION: LOCATION -- FORMS, MATERIALSI FRAME: FIRE STOPS. `ff'°` .f1 ✓ I HEREBY ACKNOWLEDGE THAT I RE HIS APP CATION BRACING. BOLTS AND STATE THAT THE ABOVE ORREC ND AGREE T COMPLY FURNACE: LOCATION. WITH ALL COUNTY ORDI CES AN STAT LAWS GULATING GAS VENT, DUCTS BUILDING CONSTRU CTI . 1 CERT THA IN DOI THE RK y AUTHORIZED HEREBY WILL NO EMPL ANY PE ON IN OLA LATH. INT. s(I TION OF THE LABOR ODE OF HE S TE OF C IFORNI EL ING TO WORKMEN'S O PENS ION I SURANC I-- G ( ' LATH. EXT. ' SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS .✓0 r• V � a 4INAL 6�n� JOHN F. LEWIS, M, NCIPAL STR TURAL ENGINEER PLAN CHECK VALIDATIONO -.-. CASH PERMIT VALIDATION CK. cK. M.O. CASH LI-6160 n � r 21 7 2 3 D 7.5 0 X2587-0 AUG 13 1 0 15.00- a 76A638A CE#803 B-63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY,,. /-� JOHN A. LAMBIE. COUNTY ENGINEER NEAREST / WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. ,/� DICT NO.! GROU. .TYPE P CE SECrBY FOR APPLICANT TO FILL IN CONST. -ate BUILDINGSTATISTICAL CLASSIFICATION ;EWER,, P ADDRESS Q - --mCLASS. NO. DWELL. UNITS-.E�.� WATER LOT NO., BLO CERTIFICATE: NOT REQUIRED ❑ RECEIVED TRACT G MAP HIGHWAY �uJ NO.OF SLOGS. NO. (CIRCLE) S A MAJOR SECOND. LOCA SIZE OF LOT NOW ON LOT USE ZONE SPECIAL USE OF ��^^ .G�+L CONDITIONS ' EXISTING BLDG. GL C ® TEL. OWNER c,)/ NO.' BUILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS jt © ~ (�. + FRONT jl A?PC73TT2'CT'OR'r TEL. P. L. J /<.7-•✓ ENGINEER i (; NO. hO SIDE ADDRESS l '/-2 d EL.. O CONTRACTO NO. $ U ADDRESS Q -+ O .DESCRIPTION OF WORK u W a NEW 4-ADD ALTER REPAIR DEMOLISH SQ. FT. - NO: F SIZE RIES FAM IES USE OF STRUCTURE SIGNATURE O APPLICANT VALUATION $ l APPROVALS DgkTE INSPECTOR'S SIGNATURE. P.C. 5 PMT. FOUNDATION: LOCATION FEE $ FEE $ FORMS. MATERIALS V V FRAME: FIRE STOPS. ° yV I HEREBY ACKNOWLEDGE THAT APPL ATION BRACING. BOLTS AND STATE THAT THE ABO V CORRE ND GREE TO OMPLY FURNACE: LOCATION. WITH ALL COUNTY OR ANCES STATE AWS R ULATING GAS VENT, DUCTS BUILDING CONSTRUCT N. I CE FY THAT DOING HE WORK AUTHORIZED HEREBY WILL N -EMPLOY NY PER N IN VIOLA- LATH, INT. TION OF THE LABOR CODE OF THE STAT OF CA ORN, REL ING TO WORKMEN'S OMPENS TION INS RANC LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED A ADDRESS__40 ell FINAL JOHN F. LEWIS. PRINCIPAL STR URAL ENGIIGEER PLAN CHECK VALIDATION cK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH L,il�o 8 1 6 6-0 APR 27 2 3 D 5.7 ' A- v MpLo 2 5 8 8 nuc 13 1 1 1 .5 0 v C L 78A838A CE#803 8-63 APPLICATION FOIA BUILDING P /IIT ' COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DMSION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A JENSEN, SUPT OF BUILDING CROSS ST DIST RI NO UP T E P OC S D-B ' FOR APPLICANT TO FILL IN / 0� NST• , BUILDING '' STATISTICAL CLASSIFI ATION SEWER MAP ADDRESSXv K iP G-� CLASS NO DWELL UNITS CO I ` - LOT N �- LOCK WATER NOT REQUIRED RECEIVED ❑ CERTIFICATE `. TRACT NO �d ��IGHWAY E) TATE AJOR SECOND, LOCAL NO OF BLDGS CIRCLE) SIZE OF LOTNOW ON LOT USE ZONE SPECIAL , USE OF CONDITIONS EXISTING BLDG TE • OWNER NrJ&7,--713 BUILDING YARD HWY STEXIST _ SETBACK REET NAME WIDTH' ' ADDRESS FRONT ARCHITECT OR EL P L ENGINEER O SIDE ( J ADDRESS TEL 0d CONTRACTORJ ,/ NO ,,- V ADDRESS I,y �//_ ,,/��� OC 0 D SCRIPTION OF WORK ri . Lua NEW ADD ALTER REPAIR DEMOLISH i An Z SQ FT NO OF NO OF SIZE STORIES FAMILIES' USE OF STRU T4JRE y SIGNATURE OF APPLICANT VALUATION $ APPROVALS (DATE INSPECTOR S SIGN TU E PC PMT FOUNDATION LOCATION FEES FEE $ FORMS, MATERIALS FRAME FIRE STOPS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION I WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK I e AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSO IN VIOLA- LATH INT fIf TION OF THE LABOR CODE F THE STATE OF CA RELAT- ING TO WORKMEN S COMTADMINCE 1 •� ,\ LATH EXT SIGNATURE OF HOUSE NUMBER COR- f PERMITTEE RECT AND POSTED ` e ADDRESS (�F INAL JOHN F I EMS PRINCIPAL STRRAL ENGINEER PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M o CASH �7�,0 5540.-0 Nov 4 1 D 8.00- 76A638A CE#B03 8-63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING /1 DEPARTMENT OF COUNTY ENGINEER ADDRESS (� BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. D I-j,I CT NO R P Tj PE D B FOR APPLICANT T FILL IN ONST. BUILDING STATISTICAL CLASS[ ICA [ON ER MAP ADDRESSK— P CLA SS..NO. *DWELL. UNITS LOT NlQhJC�tnnBLOCK WATER CERTIFICATE: NOT REQUIRED 0- RECEIVED ❑ TRACT MAP IGHWA NO. (CIRCLE I STATE AJOR SECOND, LOCAL NO.OF BLDGS. SIZE OF LOT NOW ON LOTUSE ZONE SPECIAL USE OF -- /'� CONDITIONS EXISTING BLDG-S T E l� OWNER N_ - 'j BUILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS _� .c �, FRONT ARCHITECT O /�^ TEL. P. L. ENGINEER f �-�. i NO. SIDE n - _� P. L. ADDRESS d TE I� o CONTRALTO / O/ ADDRESS O DESCRIPTION OF WORK W d NEW ADD ALTER REPAIR DEMOLISH 4A SQ. FT. NO. OF NO. OF SIZE STORIES FAMILIES USE OF STRUCTURE - SIGNATURE F APPLICANT VALUATION $ �/") � _�- v APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION FEE $ � FEE $ `�� FORMS, MATERIALS FRAME: FIRE STOPS, J I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS f BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT. I, TION OF THE LABOR CODE OF THE STATE OF C FORN.IA RE T- ING TO WORKMEN'S COMP A IA ~13 INNC vR/ LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- \ PERMITTEE RECT AND POSTED ADDRESS ` FINAL JOHN F. LEWIS. WRINCIPAL ST URAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH L 110 5541 NOV 4 1 D 6.0 0� 4]' 78A638A CEp�o3 A_b, APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADD RESSf� , BUILDING AND SAFETY DIVISION LOCALITY 1 �� JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN. SUPT OF BUILDING CROSS ST. DISTRICT NO GROUP T PE PR E IBY FOR APPLICANT -61L) j FILL IN oNsr. BUILDING STATISTICAL CLA SI FICATION SE_WERr ,e ADDRESS �j Q A.. i^ Z BK GG CLASS. NO. DWELL. UNITS LOT NO. - ,k/j�.t-/. 9�2 p� - WATER CERTIFICATE: NOT REQUIRED ❑ RECEIVED - TRACT MAP HlcHwnY N OF BLDGS. NO., (CIRCLE) STAT MAJOR SECOND LOCAL SIZE OF LOT J( I NOW ON LOT 3 USE ZONE SPECIAL USE OF "�f _ CONDITIONS EXISTING BLDG. L C; �: G zzib - TEL. . OWNER- e/ NO. V - BUILDING SEXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS 60 �J 7!� L• FRONT A%Te f- '"' TEL. / P. L. I ENGINEER %'N 0 )o ('052 ! SIRE _ / P. L ADDRESS a • /7V L C. J" EL - ` E L. O U -� -v CONTRACTOR L O. ` J A ADDRESS O o AJ,. Y a DESCRIPTION OF WORK '' O ILUCL NEW ADD ALTER REPAIR DEMOLISH ✓ CA SQ. FT. 10 NO. OF � ✓ z SIZE �� C'� STORI ILIE USE OF STRUCTURE r",J 1117 SIGNATUREF APPLICANT VALUATION j57G. , APPROVALS DATE INSPECTOR'S SIGNATURE _ FOUNDATION: LOCATION FEE $ `s FEE $L�� r� FORMS. MATERIALS FRAME: FIRE STOPS. I HEREBY ACKNOWLEDGE T ��� AD THIS PLICATION BRACING, BOLTS AND STATE THAT THE AB IS CO rsx�CT D AGRE TO COMPLY FURNACE: LOCATION. WITH ALL COUNTY O INANCES,"'!`NO ST E LAW REGULATING GAS VENT, DUCTS BUILDING CONSTR UC ON. I C TIFY T T IN D NG THE WORK AUTHORIZED HEREB I WILL OT EMP OY ANY RSO N 40LA- LATH. INT. TION OF THE LAB CODE THE TATE OF ALIF IA EL ING TO WORKMEN' COMPE ATIO I UR ,.C'� �/j l /3 LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS O / L� rFINAL / JOHN F. LEWIS. PRINCIPAL STR TURAL ENGI EER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION M.O. CASH V 2586:- AUG 13 1 D 5 0.0 0 76A638A CE#803 8 63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING �p DEPARTMENT OF COUNTY ENGINEER ADDRESS �v p BUILDING AND SAFETY DIVISION LOCALITY Te/J?7 JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT of BUILDING CROSS ST. DISTRICT NO. GROUP TYPE PROCESSED BY FOR APPLICANT TO FILL INr p g I Pf I CONST. , BUILDING STATISTICAL CLASSIFICATION EWER MAP ADDRESS O S f-yyJPq ;/I K PG` CLASS. NO.//!DWELL. UNITS (C.: LOT • •�� � BLOCK WATER �) CERTIFICATE: NOT REQUIRED RECEIVED ❑ TRACT(/ MAP HJG WAY ST NO. OF BLDGS. NOv7e_ :(CIRCLE) ATE M JOR SECOND. LOCAL SIZE OF LOT NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS EXISTING BLDG. C/Cd / TEL. OWNER + NO. BUILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS �, FRONT ARCHITECT OR TEL. P. L. �- ENGINEER NO. SIDE ADDRESS /,0112re/ !� ✓c�,'fti a CONTRACTOR ADDRESS 6 � aJ O DESCRIPTION OF WORK ci W 0. NEW ADD ALTER REPAIR DEMOLISH Vf SQ. FT. NO. OF z SIZE STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF APPLICANT ' VALUATION $ //) o 00 v APPROVALS DATE _-INSPECTOR'S SIGNATURE yy'� - FOUNDATION: LOCATION E $ FEE $ FE � V FORMS. MATERIALS B �G FRAME: FIRE STOPS. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS L ggpp AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS �J BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK k /' AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT, TION OF THE LABOR CODE OF THE S TE OF CALIFORNIA RELAT- ING TO WORKMEN'S COMPENSATION I " RANCE. d LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE VVV 4 g RECT AND POSTED ADDRESS FINAL JOHN F. LEWIS, PRI'NGIPAL STRUCTURAL EOCASH R PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. LA 4 3 4 7 SEP 2 9 1 D 4.00- WORKERS'C-OMPENSATION DECLARATION ` p e� of consent to self _ APPLICATION FOR BUILDING PERMIT dib heA�k—ItfVfrn that I have a certificate in9ure, ar a certificate of Workers'Compensation Insurance, or a'certified copy thereof (Sec. 3800, Lab. C.) ` COUNTY OF LOS ANGELES BUILDING AND SAFETY v Company' BUILDING Policy No. Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS G 64 Certified''copy is filed with the county building inspec- BUILDING tion departmerit. ADDRESS .Date 07"(0 pplicant � CITY � � ZIP LOCALITY T� 1 C � 1 CERTIFICATE OF EXEMPT_id-FR O. OF BLDGS: NEAREST11 COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. 1 �a'1`/ (This'section need not be completed if'the permit is for oneASSESSOR . .hundred.dollars ($100)or less.) TRACT BLOCK LOT NO. q� MAP BOOK PAGE PARCEL OWNER bou ( -NO� . PC,�l�47 USE ZONE MAP ^ _� I certify,that in the performance of the work for which.this NO. �i(rJ so,a it, issued, lsub subject oat ehmepy ciny person in any manner �� SPECIAL. - p ADDRESS (p`Z 5 Z. N CONDITIONS j � Workers'Compensdtiori Laws. :0 CITY vli :C ZIP 11 Date'' APPlicont NOTICE TO APPLICANT: If, after,makirig this Certificate of ARCHITECT OR TEL. DISTRICT TYPE FIRE... PROCESSED BY'. Exemption, you should become subject to the Workers' ENGINEER NO. CONST.' ZONE V Compensation.provisions of•the Labor.Code, you must forth- �j r [,GROUP 2. 5. LU IL with comply with such-provisions or this permit shall. be _ ADDRESS ��--",, ,nr� TEE - STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. CONTRACTOR [,�,r , (_r L i-!�NO. 2 11 LICENSED CONTRACTORS DECLARATIONIC. -- CLASS NO. _DWELL. UNITS Lhereby affirm that I am licensed under provisions of Chapter 9 ADDRESS Q � O t-7 - 6.,j727 (commencing with Section 7000)of'Division 3 of the Business and _ IC SEWER MAP Professions Code, and ny license is in full force and effect. CITY .TG"�'til PT �'I' SS �� BK ' � VALIDATION SQ. FT. _ NO. OF_ NO. OF _ CHECK License Number 2,30 CRA2-Lic.Class f SIZE STORIES FAMILIES ONE ❑ VALUATION r-� DESCRIPTION OF-WORK '- - NEW Contractor C_rJel KI�1A�i-111/Date�� ����j - Y ADD ❑ S 00 ❑ I am exempt under Sec: - I , ALTER B.&P.C. for this reason ^<- . REPAIR ❑ a Date: USE OF EXISTING BLDG. C 1 Fj DEMOL ❑ '2923 R Signature APPLICANT 1 TEL. V �.C? y FINAL /J # o o a o 2 3 PRINT) is �uQ /� OWNER-BUILDER DECLARATION _ .• ��+,// --77,,•...,,�,pp,- --� ._ e ^._ . _ _. DATE L/ (/ -•• I hereby affirm that I am exempt from the Contractor's License ADDRESSKf/V P C /� /�-s' �'�� 0 1 1 3 1 6 Law for the following reason (Section 7031.5, Business and FIN' Profess ions'Code): PRESENT B ❑ I, as owner of the property, or my employees with ADDR SS- -DING o 0 1 1 3,T b c=� wages as their sole compensation,will do the( Q 1 b='8 5rk and 0 the structure is not intended or offered for sale Section LOCALITY , 7044, Business and Professions Code): MOVING TEL: ! ❑ I, as owner of the property, am exclusively contracting CONTRACTOR- NO. with licensed contractors to construct the project-(Sec- Tion 7044, Business and Professions Code). F _ CONSTRUCTION LENDING AGENCY- BACKREQUIRED. 'YARD.' HWY_-- TOTA SETBA K FR M WIDTH I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued - - - (Sec. 3097, Civ. C.). r, Lender's Name 5 3 R o LDMA Ref. # - Permit Fee0,51 oLender's Address I.certif that I have read this a lication and state that the Y PP - Issuance Fee- O LDMA P/C#above information is correct. I agree to comply with all County eeordinances and State laws relating to building construction, _ _,•_ o o = v and hereby authorize representatives of this County to enter Total-Fee LDMA Perm. # 1 4 3.6 3 5 upon the above-mentioned property for inspection purposes. - - 0919-85 _. a t SEE REVERSE FOR EXPLANATORY LANGUAGE a S Date Q i I Wd*ERS' COMPENSATION DECLARATION !,hereby affirm that I have a certificate of consenticto self insure,,or a certificate'of Workers' Compensation Insurance, APPLICATION FOR BUILDING: PERMIT or a certified'copy'thereof 3800, Lab:C .) COUNTY OF LOS ANGELES BUILDING AND SAFETY � �p-� gra-r-- >� Policy N Company BUILDING Certified-copy is hereby furnished. FOR APPLICANT TO FILL INW_�C7 ADDRESS Certified copy is filed the ounty uiI ing inspec- BUILDING i -7 Tion 'd' part erit'. ADDRESS V��{/��lF� � �^v1��" '1✓ � 1 l•�1 r yr e Date I Applicant CITY %�"•VI ✓� ZIP LOCALITY C TIFICATE OF EXEMPTION FROM W -E OF BLDGS. NEAREST ` ' '- COMPENSATION INSURANCE •'- _ SIZE OF LOT NOW ON LOT CROSS ST. l.C/^t N (This section need not be completed if the rmit is f r one ASSESSOR . . hundred dollars ($100)or less.). TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL Mp� TEL. USE ZONE MAP certify that in.the performance of the work for which this OWNER NO. ' NO. Z e Q permit is issued,.I'shalI not employ any person in any manner �� +� SL SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS(Gj!`'-7O CONDITIONS V CITY: I�`r\r `�� T�rZIP OC Date Applicant ARCHITECT OR TEL NOTICE'TO APPLICANT: 'If after making this Certificate of DISTRICT TYPE FIRE, P O ESSED BY F. ENGINEER NO. CONST. ZONE V Exemption, you should- become subject to the Workers' {� WCompensation provisions of the Labor-Code, yowmust.forth- ADDRESSJr �,,GROUP N with comply .with,such provisions or.this permit shall be TEL, ,�f STATISTICAL CLASSIFICATION CONDO. z deemed revoked. : I,,' CONTRACTOR�� 1 D NO� LICENSED CONTRACTORS DECLARATION jz � 1/1( F LIC. /S � I CLASS NO. DWELL. UNITS- I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS G NO. commencin with Section 7000 of Division 3 of the Business and }-� _, SEWER MAP ( 9. ); V�Q� LIC. /50 Professions Code,'and my license is in full force and effect. CITY � CLASS `�" _l --� BK PG. VALIDATION SQ. FT. NO. OF NO. OF CHECK License Number 41 Lic.Class SIZE STORIES FAMILIES ONE 0�/ � Z NEW VALUATION t 11�,,~�y�� � e DESCRIPTION OF WORK" � 690 Contractcr'! flVA� 5� bate E] $: I am exempt under Sec. i ylA�� rJIC"1� ADD ❑ , ALTER B.&P.C. for this reason (�T�'Z'AJIL�LL �l.LJ1fN11.�lsT`—C? $ ,. -_ REPAIR. Date: USE OF DEMOL EXISTING BLDG. Signature - APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) NO. DATER zQ — I hereby-affirm that-I am exempt from the Contractor's License Law for the following.reason•(Section 7031.5, Business and ADDRESS FIN Profess i6ns'Code):, PRESENT B F1BUILDING - .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. ' CONTRACTOR NO. O C I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM 5 . CONSTRUCTION LENDING'AGENCY SET BACK YARD HWY PROP. LINE 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. .L. - (Sec. 3097, Civ. C.). SIDE . P.L. Lender's Name P.C: Fee$- Permit Fee LDMA Ref. }► Lender's Address r oil, I certify That I h r ad this application and state that the Issuance Fee .®C SO LDMA P/C ii-- - a ab v 'nformatio s c rrect. I agree to comply with all County Investigation Fee Wem to aws relating to building.construction, Total Fee s d i LDMA Perm. N U ze epresentatives of this County toenter nti a property for inspection urp es. ' �� SEE REVERSE FOR EXPLANATORY LANGUAGE p Iicant or Agent Date WORKERS'COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers' Compensation Insurance, 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 furnished. FOR APPLICANT TO FILL IN ADDRESS �� - Certified copy is filed with the'county building inspec- BUILDING tion department. ADDRESS ? r ° LOCALITY � NEAREST Date Applicant CITY—;k ZIP CROSS ST. CERTIFICATE OF.EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR0�7 COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP –� G 3 hundred dollars ($100)or less.) TRACT OC LOT NO. NO. G� L TEL. C' SPECIAL s� OWNER NO. CONDITIONS c7 I certify that in the performance a the work for which this DISTRICT GROUP TYPE FIRE P O ESSED BY O permit is issued, h shall not employ any person in any manner ADDRESS CONST. ZONE r. U so as to ecome subject to the Wor rs' pensatiorL Laws. 0� �� `,�� /. 0 r xDate Applicants CITY \.V�: ZIP STATISTICAL CLASSIFICATION APT. CONDO. NOTIC TO APPLICANT. If, after making this Certificate of ARCHITECT OR TEL. Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS Compensation provisions of the Labor,Code, you must forth- ADDRESS SEWER MAP with comply.with such provisions or this permit shall be r– deemed revoked. a TEL. 1 '1 _ BK. L'PG,�p VALIDATION CONTRACTOR - NO. i f� LICENSED CONTRACTORS DECLARATION LIC' I hereby affirm that I am licensed under provisions of Chapter 9 •AbDRES /� NO 3 VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. let Professions Code, and my licensels in full force and effect. CITY r CLASS ► SQ. FT. NO.OF NO. OF CHECK License Number��_��}/ Lic.Class SIZE STORIES FAMILIES ONE i1.6�`�" 8 �lOj". NEW $ Contractor Date DESCRIPTION OF WORK r i , ADD 7 1 am exempt under Sec. v ALTER FINAL B.BP.C. for this reason fit¢ E] DATE REPAIR Date: USE OF FINAL EXISTING BLDG. DEMOL BY Signature APPLICANT TEL. OWNER-BUILDER DECLARATION PRINT NO. I hereby affirm that I am exempt from the Contractor's License /✓ ' Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): PRESENT ❑ BUILDING 0 5 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_ # 0 0 0 0 0 7044, Business and Professions Code). MOVING TEL. ` I, as owner of the,property,'am exclusively.contracting CONTRACTOR NO. 2',o'o 6 Q 50 with licensed.contractors to construct the project (Sec- ADDRESS o.o o (�0,5 0 6 tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM dEX l7 1 7_8 4 CONSTRUCTION LENDING-AGENCY. SET BACK YARD HWY PROP. LINE 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. polo (Seca 3097, Civ..C.). SIDE ,o P.L. e Lender's Name Lender's Address P.C. Fee$ Permit Fee 1 I certify that I have read this application and state that the Issuance Fee U above information is correct. Iagree to comply with.all County Investigation Feeordinances and State laws relating to building construction, Notal F u and hereby authorize representatives of this County to enter aupon the C ov - ntio ed property for,inspectionrpos SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date ®s