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HomeMy Public PortalAbout6273 ROSEMEAD BLVD_Building__ RTMENT OF BUILDING AND SAFETY -APPLICATION FOR; PERMIT ` � COUNTY OF LOS ANGELES p i WM.�'i FOX, CHIEF ENGINEER b FOlAPPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING /f DISTRICT NO. PLAN CiK..NO. • PERMIT NO. ADDREt.SSSS.^✓•,{ LOCALITY RECEIVED BY wq�DATE OF APrL. DATEISSUED} _ NEAREST CROSS ST. �� Q ��•T,��� BU " ING//� 51 OWNER P'0' o,�'`15 / ADDRESS Y/ MAIL I D /V o � � �I'Y� Q9 . . LOCALITY ADDRESS s '� •,�t ��I ��GOI NEAREST TEL �9 y CROSSST. CITY FIRE NO.OF TYPE 1 OUP ARCH-ENGINEERI7CT ORr 5W4FAAFer E . ;'4 i/G , ZONE .�-� PLANS � ����T��,, F �j ADDRESSK. / ! �/ / � L3�f�`. 1G1 SETBACK LINE �O! d'c/✓vc.L,G'C� GQ_ ,�7U4 O'gb'CEP3�&P ' fb TEL. — / APPROVED CONTRACTOR f � NO. /, BY - DATE AA USE � APPROVED ADDRESS "/ V O uAft®b �T /�. ZONE BY E�7'./(6`K.�M' DATE LEGAL 1 DESCRIPTION LOT NO/.�, BLOCK ii'jr A C CORRECTIONS TRACT 4E-90 90 7` S P,V�` 1 SIZE OF LOT/75)( 7 I NOW ON LOT W/ USE OF I NO.OF � NO.OF EXISTING BLDG. la.� FAMiues ROOMS DESCRIPTION OF WORK NEW ALTERATION ADDITION O A REPAIR MOVING DEMOLISH O S4.FT. � 3®® NO.OF Z SIZE ROOMS STORIES D WALL I O COVERING COVERING Ysa . USE NEW 6' BUILDIDI NG 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT INSPECTOR DATE FOUNDATION: LOCATION AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS // �s�/�'' /J AND STATE LAWS REGULATING BUILDING CONSTRUCTION. (`� FRAME: FIRE STOPS, SIGNATURE OF \\ �uL N BRACING,BOLTS y I l OWNER LATH,INT.: AUTHORIZED AGT LATH,EXT.: n 06S-3 25M SETS 4-47 $ P'C'$ PLASTER,INT. I} FEE _ PLASTER,EXT. / VALUATION FEE J _ - �- FINAL C A638 A,CE #805 12/69 It` APPLICATION FOR E§UILDINd PERMIT f1 .� COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER AODR ESS COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST Print or tvoe onl CROSS ST. PE BUILDING �j /1 ) �/ DIST�OT N.Q. U TpNST, OCE S ADDRESS Z3,3 ' Gs� F9 eCO/V/rOD/61 -'5 (ga�i STATISTICAL CLASSIFICATION SEWER MAP LOT NO. BLOCK CLASS NO.--r DWELL,UNITS_(:'Q, _ BK PG TRACT USE ZONE MAP tLs. NO.OF BLDGS. No. f CTS SIZE OF LOT NOW O Ci� SPECIAL USE OF CONDITIONS EXISTING BLDG. OWNER Fec#4ed Zlve-- No -6 _u BLDG.SETBACK FROM ADDRESS 3 Q� j �(.'�JG' 2 FRONT PROP,LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY HoAM HIGHWAY WIDTH FROM C.L. ARCHITECT OR TEL. + _ ENGINEER NO. BLDG.SETBACK FROM ADDRESS SIDE PROP.LINE OF (STREET) TEL TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CONTRACTOR 5yI A Yl S e—NO. �1 a q ;,f-a HIGHWAY WIDTH FROM C.L. L I C�.� >_ ADDRESS A �. �/ e-7.49 Hf NO°°:f FSI 2 Q,9i + CL. CITY 3akA9.4.4/?_ CLASS C a CORNER CUTOFF YES ❑ NO ❑ C= NAMETAND BROANCHNDER SEE REVERSE SIDE FOR SPECIAL APPROVALS LtJ ADDRESS SQ. FT. NO. OF NO. OF ❑ Z NEW SIZE /. •STORIES FAMILIES USE Oeh STRUCTURE y 1 l?;o o ®�� AD D CE STRUTER El No ' . .t A J"F' _REPAIR❑ SIGNATURE OF APPLICANT t°"L1"i..�'�es MOL ❑ VALUATIO S APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION FEES FEE$ I 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 ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE STATE OF -CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION INSURANCE. LATH, EXT, SIGNATURE O ALAHOUSE NUMBER COR- PERMITTEE—E-- RECT AND POSTED ADDRESS � e � aOA A B,p FINAL JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. —M.O. CASH ( (' 66l0ic;� SEP 12.00f� IF 76A638A Crs #603 4/7APPLICATION FOR BUILDIN6 PERMIT COUNTY OF LOS ANGELES ASSESSOR PAGE PARCEL DEPARTMENT OF COUNTY ENGINEER MAP BOOK BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS e COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY , FOR APPLICANT TO FILL IN NEAREST CROSS ST. Print ort a only) DISTRICT NO G UP T PE PR S B BUILDING SS � D NST, ADDRESS Z 3 e .=/-r iA AL_SLASI FICA TION SEWER MAP LOT NO. 7 BLOCK CLASS NO. DWELL,UNITS BK& PG TRACT f USE ZONE MAP i1 NO.OF BLDGS. I ///ryryry NO. V SIZE OF LOT NOW ON LOT SPECIAL USE OF CONDITIONS EXISTING BLDG. S"5,.,-. y- fo .-r+ TEL. OWNER Q _7;i-1C NO. BLDG.SETBACK FROM ADDRESS O®og- r/G�'S FRONT PROP.LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL CITY HIGHWAYI WIDTH FROM C.L. _.Re. TFgC=^o TEL } _ ENGINEER �J NO. ',5e.3' 4-1 BLDG.SETBACK FRO ADDRESS SIDE PROP.LINE OF (STREET) TEL. TYPE OF EXISTING SETBACK' HIGHWAY } = TOTAL CONTRACTOR NO. HIGHWAY WIDTH FROM C.L. y �. T/Y LIC, CL ADDRESS dQ NO, G �' - U nn LIC. CITY CLASS 3-I CORNER CUTOFF YES ❑ NO ❑ p CONSTRUCTION LENDER v NAME AND BRANCH d SEE REVERSE SIDE FOR SPECIAL APPROVALS a ADDRESS Z_ SO Z FT. STORIES FAMIOLFES ® NEW ❑ SIZE ❑ USE OF ADD ST UCTURE ALTER ❑ c, T REPAIR❑ SIGNATURE OF APPLICANT DEMOL CIA VALUATIONS I? APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. �"� FOUNDATION: LOCATION FEE $ FEES f r FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE OVE IS C RRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINAN S D ULATIN BU DING CON- GAS VENT, DUCTS STRUC TION. I CER IFY T T IN OI G THE RK A THORIZED HEREBY 1 WILL N T EMPL Y NY PER 0 IN I L TI N OF THE LATH, INT. LABOR CODE OF THE STA E OF •CA ORNI R EATING TO WORKMEN'S CO ENSATION N URA LATH, EXT. SIGNATURE O HOUSE NUMBER COR- PERMITTEE - RECT AND POSTED ADDRESS _Zee, � FINAL JOHN F. LEWIS. PRINCIPAL STRjl, URAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATIONCK. M.O. CASH nay210 1 7.2 5 76A638A CE #803 1/71 ' APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES. ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING ADDRESS �2 73 COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITYLG L FOR APPLICANT TO FILL IN NEAREST lox/ Print ort a only)_ CROSS ST. DISTRICT NO GROUP TYPE PROCESSE BY BUILDING `�,.3 - �� �y 5_ CONST: ADDRESS � 1 -'7 STATISTICAL CLASSIFICATION SEWER MAP LOT NO. / BLOCK CLASS NO. D DWELL,UNITS BK PG TRACT 5 �� USE ZONE MAP NO.OF BLDGS. NO. � �© SIZE OF LOT���j/rc � �� NOW ON LOT SPECIAL .USE OF _ CON DITIONS�T T - EXISTING BLDG. - Ly �.7% _ E ,. 7 74-000 TEL. OWNS NO. F— PRONTPROPCK FROM ® LINE ✓�' �-�' � (STREET) ADDRESS TYPE OF EXISTING SETBACK HIGHWAY t YARD = TOTAL CITY HIGHWAY WIDTH FROM C.L. _ ARCHITECT OR f7"/LT£ '�, (� 5 Q t� = 0 ENGINEER L.,.•-7T 3--�"(��� _ BLDG.SETBACK FROM (STREET) y ADDRESS SIDE PROP.LINE OF TETYPE OF EXISTING SETBACK HIGHWAY t YARD = TOTAL O CONTRACT M _ NO HIGHWAY WIDTH FROM C.L. V LIC NO t _ CD CITY CLASS0—­j CORNER CUTOFF YES ❑ NO ❑ w CONSTRUCTION LENDER NAME AND BRANCH SEE REVERSE SIDR FOR SPECIAL APPROVALS z ADDRESS SQ. FT. NO. OF NO. OF NEW © / SIZE STORIES FAMILIES USE OF ADD STRUCTURE ALTER JE SIGNATURE OFREPAIRAPPLICANT DEMOL VALUATION $ APPROVALS DATE INSPECTOR'S SIGNATURE P.C. (� dPMT. / }nFOUNDATION: LOCATION �j FEE S / FEE $/� (J r" FORMS, MATERIALS /" /. r 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 ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUC TI ON. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THEXSTE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPE AI SURANCE. LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL O JOHN F. LEWIS. PRINCIPAL ST - RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIONUK.CK. M.O. CASH JUL 80 �r'�r 8:7 7 AUG 1 p- 1 D 15.00N 76A638A CE#803 4/70 C I T `/ O � E M P UE, Q T- APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCE BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS ..,6 COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST Print or type only) CROSS ST. DISTRICT NO. GROUP YPE ��R�CESSEO BY BUILDING �Q Sy � CONST. ADDRESS Z i os ,ejg ° O STATISTICAL CLASS ICA TI ON SEWER MAP LOT NO. BLOCK CLASS NO. 00 OWELL.UNITS Bif—P'G— TRACT Q .USE ZONE MAP NO.OF BLDGS. j NO. 2C�a SIZE OF LOT �� NOW ON LOT /) SPECIAL USE OF ' G� CONDITIONS EXISTING'BLDG• �_ OWNER C' _.L NO• $=v3/ BLDG.SETBACK FROM ADDRESS Q > FRONTPROP.LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY HIGHWAY WIDTH FROM C.L. A TE + _ ENGINEER NO. S' BLDG.SETBACK FROM ADDRESS L SIDE PROP.LINE OF (STREET) EL, TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CONTRACTOR IS �0 T , NO. j�-i/tv f HIGHWAY WIDTH FROM C.L. >„ ADDRESS (J Ty�i NO r(Y + = p � U LIC. CC CITY CLASS CORNER CUTOFF YES E] NO p CONSTRUCTION LENDER c_:, NAME AND BRANCHP' SEE REVERSE SIDE FOR SPECIAL APPROVALS n N ADDRESS Z SQ. FT. NO. OF NO. OF NEW SIZE STORIES FAMILIES USE OF .G ADD ❑ STRUCTURE ALAp TER 60 ❑ �60C, REPAIR❑ SIGNATURE OF APPLICANT DEMOL ❑ VALUATION $ �'�� APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION S FEE $ ,/o FEE $ FORMS, MATERIALS FRAME: FIRE STOPS• I HEREBY ACKNO DGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT T E A OVE IS C AND AGREE TO OMPLY FURNACE: LOCATION, WITH ALL ORI NCES NAAPEGUTING ILD NG CON- GAS VENT, DUCTS STRUCTION. I C TI FY E WO AU ORIHEREBY I WILL OT EMPL N VIO TI N OF THE LATH, INLABOR CODE 0 THE ST NIA I RE TING TO WORKMEN'S COM ENSATION LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE / - RECT AND POSTED ADDRESS `' —• (' FINAL L'� JOHN F. LEWIS. PR.N (PAL ST R U, AL ENGINEER PLAN CHECK VALIDATION CK. M.0. CASH _ PERMIT VALIDATION CK. M.O. CASH 1 ^r- 8920 FE52623 D 5.40A clY � 4 ^� 9--0 5 9c— f V1R 9 1 D . 9.00- APPLICATION FOR COUNTY OF LOS ANGELES _ - U- I L D I N G PERMIT DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING FOR APPLICANT TO FILL IN ADDRESS � BUILDING ✓7 ADDRESS G LOCALITY J, NEAREST CITY OL�� �.. IP CROSS ST. NO.OP BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE OC ED BY TRACT d BLOCK LOT NO. ^ CONST.' ! �E TEL. • v� V OWNER NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS 1 2j �� GA-uo CLASS NO. DWELL.UNITS NBK v9 -AG CITY {_ ZIP O� USE ZONE jMAP NO. C7'O _ARCHITECT OR TEL. '7 p ENGINEER eevJ � N �C�I CONIAL DITIONS77' ADDRESS -L j7-� vV_ F, - ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ TEL. CONTRACTOR NO. FRONTS ROP.LIINEOF^ O Y) (STREET) LIC. ADDRESS NO. TO AL SETBACK FROM TYPE OF EXISTING LIC. HIGHWAY + YARD - FRONT PROP.LINE HIGHWAYI WIDTH CITY CLASS CONSTRUCTIONLENDER + j`�� J !�� O NAME AND BRANCH BLDG.SETBACK FROM V ADDRESS CITY SIDE PROP.LINE OF (STREET) 0 SQ.FT. NO.OF p NO.OF CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING u SIZE STORIES ` FAMILIES ONE SIDE PROP.LINE HIGHWAY (WIDTH N DESCRIPTION OF WORK 'L , � NEW + ADD ❑ CORNERCUTOFF YES ❑ NO ❑ ALTER ❑ IN OPEN SPACE YES ❑ NO ❑ REPAIR ❑ USE EXISTING BLDG. _ �I� �� DEMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑ APPLICANT TEL 1 (PRINT) BY(SIGNATURE IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE ' WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE ST F CALIFGRNIA IN R'eLAfING TO WORKMEN'S COM- PENSATION INSU RANC SIGNATURE OF PERMITTEE FINAL a � BYDATE ;,If ADDRESS G� i _ TES? '-7 f l P.C. Fee$ (p Permit Fee CITY NO. Q Issuance Fee VALUATION y ,040ii--b Total Fee PLAN CHECK VALIDATION 6K. M.O. CASH' _ PERMIT VALIDATION GK. M.O. CASH 3 5.9 i AUG 17 o-1 U 0 n�� 3 5 2 AUG 17 U. .2 1..6 U ,& --) . ©S'76A638A CE 0803A 8/77 76A638A CE 4803 1/71 V • APPLICATION FOR BUILDIN PERMI �{ COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK P E PARCEL BUILDING AND SAFETY DIVISION BUILDING • ADDRESS COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. Print ort a +only rEXISTING rG-J�-/ // DISTTT NO. G OUP TY COP T. P BY / r� STATISTICAL CLASS FI TION SEWER MAP / BLOCK _ CLASS NO. DWELL.UNITS G Q USE ZONE MAP D NO.OF SLOGS. NO. T NOW ON LOT ( ' SPECIAL OI. z � L/ CONDITIONS LD .�-f TEL OWNER O BLDG.SETBACK FROM A D D R E S FRONT PROP.LINE OF -(STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL CITY 14!!5_5 ' HIGHWAY WIDTH FROM C.L. ARCHITECT OR �/ TEL. - + _ ENGINEER NO. BLDG,SETBACK FRO ADDRESS SIDE PROP. LINE OF (STREET) T L. TYPE OF EXISTING SETBACK HIGHWAY + Y = TOTAL D- CONTRACT p, HIGHWAY WIDTH FROM C.L. U / C IL . _ C) ADDRESS N0.C - + - O CITY / CLASS ' CORNER CUTOFF YES E] NO ❑ LLJ TNAMEAND BIRANCHON NDER ��� SEE REVERSE SIDE FOR SP CIAL APPROVALS z ADDRESS 6p 9 SQ. FT. NO. OF NO. OF NEW SIZE STORIES FAMILIES USE OF ADD STRUCTURE d�l� _ GG / ALTER ❑ C` CJ REPAIR[] SIGNATURE OF APPLICANT DEMOL ❑ VALUATIONS- �D10 APPROVALS DATE INS PEC TOR'S SIGNATURE P.C. PMT, /� FOUNDATION: LOCATION FEE S FEE $ �p (J 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 ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE TATE OF -CALIFORN IN RELATING TO WORKMEN'S COMPEN TI N INSURAN E. LATH, EXT. SIGNATURE OF / HOUSE NUMBER COR- PERMITTE _ RECT AND POSTED ADORESCJ / FINAL 7 JOHN F. LEWIS. PRI CIPAL STC RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION K. M.O. CASH r t� 1 3 7c'- JUL 1 3 1 D 2 3,5 v .r 76;633A r 80312/6APPLICATION FOR BUIL W ING .PE , IT �1 COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING ADDRESS JOHN A. LA MBI E, COUNTY ENGINEER COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST Print ort a onl CROSS ST. �- BUILDING // ri DISTRICT NO. UP PROCESSED BY ADDRESS /�.J J /.�1..�1 ff �J� (/ �, LOT NO. BLOCK STATISTICAL L SSIFIC T� N, SEWER MAP >_ '•`� CLASS NO. ?S DWELL,UNITS BK PG �• TRACT q / USE Z���OjjjNEIND P SIZE OF LOT /7O X�Q. ,j NOWONLOTS � / / �[ ECIAL USE OF (� Q el_)" ITIONS EXISTING BLDG. ,G J•TCtGGO /?- OWNER E" d�CO•-,�.VG. NOL - BLDG.SETBACK FROM ,yam/ FRONT PROP.LINE OF� ADDRESS 5a L�-n��ne_-cr^" (STREET) E �4 V TYPE OF EXISTING SETBACK HIGHWAY } YARD _- TOTAL CITY �. C C A/ .E� HIGHWAY WIDTH FROM C.L. ARCM7TLG �R TEL, 6S- ��/ L } AI, = 1 ENGINEER NO. _ - rN BLDG.SETBACK FROM (STREET) FfDDRE55 NRH SIDE PROP.LINE OF TEL. TYPE OF EXISTING SETBACK HIGHWA•' v+ YARD = TOTAL CONTRACTOR p �� A) NO. 3 - HIGHWAY WIDTH FROM FROM C.L. / ADDRESS / �� sLL. G T VJT NO `� ' ' 7(s' + �iS/ /`�� O CITY L, ,9, CIC.ASS �-� CORNER CUTOFF YES ❑ NO CONSTRUCTION LENDER O NAME AND BRANCH o ni rN ERSE SIDE FOR SPECIAL APPROVALS C-) cl— ADDRESS cn SQ. FT. //�\````Ory NO. OF NO. OF Z SIZE VVV STORIES FAMILIES NEW USE OF � ADD STRUCTURE ALTER REPAIRjSIGNATURE OF (APPLICANT DEMOLVALUATION $ �. ROVALSAT rNSP TOR'SSIGNA uRe FEE $ L JE-- �J� FEE S . 0 NDA T'ON ATERIAASION E STOPS,I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLYLOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- T, DUCTS STRUC TION. I CERT( HAT PINGTHE WOR AUTHORIZED HEREBY I WILLN EMP OYI VI TTHE LATH, INT.LABOR CODE OF TME ST T R N ELATING TO } WORKMEN'S CO PENSATIO I SULATH, EXT, SIGNATURE F HOUSE NUMBER COR- ' PERMITTE RECT AND POSTED ADDRESS r� �� FINAL � JOHN F. LEWIS. PRI CIP L TRUCTURAL ENGINEER j PLAN CHECK VALIDATIONCK. M.D. CASH _ PERMIT VALIDATION CK. M.O. CASH Ar. 8 3.8 IV-- JAN 19 2 3 ? Rr� 8 9 1 5� FE61G 2 3 D 3.15cu q )4 76A631A CE"803 12/69 �. ;,-,,. APPLICATION FOR BUILD NG PE MIT i COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL `i BUILDING AND SAFETY DIVISION BUILDING .o . JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS m ' V COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITYNEARN FOR APPLICANT TO FILL IN CROSSEST. Print or a onl ?� BUILDING / DIST�JC� tip OUR YPE PR ES ADDRESS (O � �� ✓L, V C}!( CONST. STATISTICAL CLASSIFICATION SEWER MAP w LOT NO. BLOCK / CLASS NO._1.rZDWELL•UNITS BK PG -0 C TRACT �L' USE ZONE MAP NO.OF SLOGS. NO. SIZE OF LOT 76 X 8h•3 NOW ON LOTSPECIAL G) USE OF �j' CONDITIONS ' EXISTING BLDG. SG•C�• A cp%11cco /YG p N OWNER G (/G NOL g ' BLDG.SETBACK FROM ADDRESS 3s0 LS leEL✓� FRONTPROP.LINEOF STREET) C TYPE OF EXISTING1 SETBACKHIGHWAY + YARD = TOTAL CITY HIGHWAY WIDTH I FROM C.L. rte .+ TEL. 4--06ryl //�j� + ENGINEER NO.d-f BLDG, ETBACK FROM - q Z-' / —.St /V bDRESS SIDE PROP. LINE OF (STREET) TELTYPE OF EXISTING SETBACK HIGHW + YARD = TOTAL CONTRACTOR g��so,/d��,/p No. . 3 ' 1046 HIGHWAY WIDTH FROM C.L. ADDRESS �fQ (9 Tysi NO �7 + �� d LIC. O CITE' CLASS CORNER CUTOFF YES ❑ NO• U CONSTRUCTION LENDER NAME AND BRANCH dr✓ SEE REVERSE SIDE FOR SPECIAL AP ROVALS a U ADDRESS CIW.. SQ. FT. NO. OF NO. OF NEN Z SIZE STORIES FAMILIES USE OF ADD ❑ STRUCTURE C dIGE ,g T1ji62AJ ALTER ❑ SIGNATURE OF REPAIR❑ APPLICANT DEEMO�L ❑ VALUATIONS APPROVALS: DATE INSPE oa's SIGeTURE FEESZ S PMT. 90,� FOUNDATION: LOCATION �y FEES �J FORMS, MATERIALS /f FRAME: FIRE STOPS, / I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING, BOLTS - AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITHALL OR DI NCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS ST RUC TION. I ER FY TH IN DOING THE WORK AUTHORIZED _ HEREBY I WIL NOT EMPL A ERS0 I VIOLATION OF THE LATH, INT. LABOR CODE OF TH ST 0 LI R IN RELATING TO WORKMEN'S MPENS TIO I A E. LATH, EXT, f Q7�•�/D l�}.�V �.a �p� �. �j SIGNATURE F I- HOUSE NUMBER COR- PERMITTEE - RECT AND POSTED /q L TN ADDRESS ( / DO �• � j• `' FINAL .JOHN F. LEWIS. PRINCI AL STRUCTURAL ENGINEER PLAN CHECK VALIDATION cK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH Ar,8 3 8 0- JAM 19 2 4 5-00A �� FEd 2623 D 9.45- '1626 1 0 9 0.75 "' +3te•.,WORW S'COMPENSATION,DECLARATION + re�Oraafnt to se certP carte of Workersrlificate Compensat oof n Insuran elf APPLICATION FOR BUILDING PERMIT nor a certified copy thereof (Sec. 3800,tab. C.) ` vv� COUNTY OF LOS ANGELES BUILDING AND SAFETY Poli'"ey No. Company in ❑ Certified cpp,.is.hereby furnished. FOR APPLICANT TO FILL IN BUILDING62 /. 7.e': ADDRESS 3 � 61 ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS Date Applicant CITY ZIP 917,9-0 LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' '7 O. OF BLDGS. / NEAREST COMPENSATION INSURANCE SIZE OF LOT / NOw ON LOT 7 CROSS SL (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LOT No / MAP BOOK PAGE PARCEL OWNER TEO�I�_.�� - ZONE MAP I certify that in the performance of the work for which this NO. IL permit is issued,.I shall not'e' any person in any manner ,(/ �—Z SPECIAL - - ADDRESS ®7Y CONDITIONS u so as to become subject to the Workers'Compensation Laws. CITY / c ZJP .!< 0� _} cc Dare Applicant ARCHITECT OR T NOTICE TO APPLICANT: If,'after making this Certificate of � DISTRICT .GROUP TYPE FIRE PRO ESSED BY.. p� Exemption, you should become subject to the Workers' ENGINEER CONST. ZONE b Compensation-provisions of the Labor Code, you must forth- Z d ADDRESS y with.comply with such provisiohs or this permit shall be TEL. STATISTICAL CLASSIFI TION APT. CON Z deemed revoked.. CONTRACTOR 6 NO.Ile LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business and 41C. Professions Code, and my license is in full force and effect. CITY CLASSBK VALIDATION SQ. FT.. NO.OF. NO.OF CHECK License Number Lic.Gloss SIZE — ISTORIES / FAMILIES ONE VALUATION Contractor Date DESCRIPTION OF WORK NEW ❑ L ADD $ ❑ 1-am exempt under Sec. if l ALTER ❑ , 2 1'3 2 6 A B.BP.C. for this reason REPAIR ❑ S # 0 0 0 0 0 1 - Date: USE OF DEMOL EXISTING BLDG. a - 6 0.50 Signature APPLICANTTEL.q�3/ G FINAL OWNER-BUILDER DECLARATION PRINT) ( tDat (OJ� DA E I hereby affirm that I am exempt from the�Contractor's License p 0 0 0 6 0.50t Law for the following reason (Section 7031.5, Business and ADDRESS A0 �o / FIN L Professions Code): PRESENT 0 1.1 0-85 ❑ BUILDING 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. I, as owner of the property, am exclusively contracting CONTRACTOR NO. with-licensed contractors To construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQUIRED CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAPREOTPAINEFROM WIDTH ' 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. 3097, Civ. C.). SIDE P.L. Lender's Name meqq^ {��( LDMA Ref. # - P.C. Fee$ Permit Fee ✓ (JI% - - - - Lender's Address ix I certify that I have.read this application and state that the Issuance Fee- tJ� kLDI P/C# Q' above information is correct. I agree To comply with all County Investigation Fee m ordinances and State laws relating to building construction, Total Fee " LDMA Perm.'# v and hereby authorize representatives of this County to enter m upon the bove-mentione pr erty-for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE -- Signature of Applicant or Agent Date O WORKERS'COMPENSATION DECLARATION her affirm that I,have a certificate of,consent to self A P P L I CAT1 O N_ FOR U I L D I N G -PERMIT insure, or a certificate of Workers' Compensation Insurance, or o'certified copy thereof (Sec. 3800, Lab. Cr) _. COUNTY OF LOS ANGELES BUILDING,AND SAFETY Policy No. Company - ❑.. Certified copy,is hereby furnished. FOR APPLICANT TO FILL IN BUILDING 7 ` ADDRESSel ❑ Certified copy is filed with the county building inspec- BUILDING ? �q � tion departm.e.nt. ADDRESS G 7 Date Applicant CITY 1. ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' - NO. OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not bASSEssbR e completed if the permit is for one - MAP BOOK PAGE hundred dollars ($100)or less.,). TRACT BLOCK LOT NO. PARCEL - TEL. USE ZONE MAP I certify that in,the perforrcidnce of the work for which this OWNER NO.r � 1 6 NO. _- permit is issued, I shall not employ'any person in any manner CUrfL*r%1a JWIA1es4C. t i j O, kV /WfOt //'� ?j- SPECIAL - so as to become subject to the Worker' C sation Laws. ADDRESS 1�i- t✓ CONDITIONS V CITY 6'. -',1 ZIP 9 f 772 Z 09 ate U Applicant' •�70TICE TO APPLICANT: If; after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE _. FIRE %%1„ •. P OCESSED BY. ENGINEER NO. CONST. ZONE V {? ."£xemption, you should become..subject to the.Workers' _ W �f pensation provisions of the Labor..Code, you,must forth- ADDRESSIL With comp)y•with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. ? 2deemed revoked. c a as. CONTRACTOR NO. . LICENSED CONTRACTORS DECLARATION ,;: LIC.- CLASS NO_. - DWELL. UNITS I hereby affirm that.l am.licensed under provisions of Chapter 9 ADDRESS NO. ,u- (commencing with Section 7000)of Division 3 of the Business and LIC. SEWER MAP Y}..: Professions Code, and my license is'ir full force and effect, CITY, CLASSBK. PG. VALIDATION SQ. FT_. NO. OF NO. OF CHECK ' y License Number Lic.Class' SIZE STORIES FAMILIES ONE VALUATION . •-- .- ❑ Contractor Date DESCRIPTION OF WORK NEWa 0 �o r ADD ❑ Q�'� ,. ❑ I am exempt under Sec. " ALTER ❑ B.&P.C. for this reason _.- REPAIR ElS Date: USE OF DEMOL EXISTING BLDG. ❑ 238-2. A Signature -" ` ""-' APPLICANT TEL. p .` FINAL 0 0 0 0 3 PRINT) jin(�i'IS NO.0 ,� �t� �7S�i / 0 - 9722 . OWNER-BUILDER DECLARATION DATE I herebyaffirm that.]am exempt from the Contractor's License a o o C'/ 7 2 2 C=.) ADDRESS Law.for the following reason(Section'7031.5, Business and 'SO - �J"' r t"'• IN • F A Profe`!Ssions Code): '. PRESENT - By.. O 1.`1 4-8 6 . BUILDING I, as owner of the property, or my employees with ADDRESS wages as their'sole'cornpensation,will do the work and the structure is not intended or offered for sale'(Section LOCALITY 7044; Business and Professions-Code)r MOVING TEL. - z 3 8 2 1 A. CONTRACTOR NO NT . I, as owner of the property, am exclusively contracting CO # 0 0 0 0 0 1 with licensed contractors to construct the project (Sec- FRIRED tion 7044, Business and Professions Code). 0 1 2 &8< TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY`" "YARD HWY PROP. LINE WIDTH. I hereby affirm that there is a construction lending agency for ° 1 2:G 8$v the performance of-the work for which this permit is issued - - (Sec. 3097; Civ. C.). O 1, 1 $bLender's Name R-2— Permit LDMA Ref. #Lender's Address �• R 2 - Permit Fee �Q - .1 certify-that.I have read this application.and.state that,-the Issuance Fee- -161,OrLDMA P/-C.# above information,is correct. I agree'to comply with all County Investigation Fee o ordinances and State_laws relatingto buildingconstruction, _ - - ' v and herebyfte- thori representatives of this County to enter Total Fee- - 2�t� LDMA Perm-# upon the oned property for inspection urp ses. Q v SEE REVERSE FOR EXPLANATORY.LANGUAGE - Si natureo Applicant.or-Agent - Date WORKERS' COMPENSATION DECLARATION I hereby affirm thaFOR BJILDING PERMIT t I have a,certificate of consent to self insure, or a certificate of Workers' Compensation-Insurance, or a certified copy thereof (See. 3800, Lob.`C.') APPLICATION. • . . COUNTY OF LOS ANGELES BUILDINGAND SAFETY Policy No. Company •• Certified copy;is hereby:furnished: FOR APPLICANT TO FILL IN BUILDING 2-7 ADDRESS aCertified copy is filed with the county building inspec- - BUILDING .(.�� - Tion department. ADDRESS r) V•• IK'$QAr�ccC Date .Applicant. CITY Lt ZIP LOCALITY CERTIFICATE OF EXEMPTION=FROM WORKERS' NO. OF BLDGS.- ry - - NEAREST. COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need-not be completed if the permit is for one - ASSESSOR - hundred.dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE' PARCEL TEL. t OWNER, tT� - PlvttL "O�C NO. I 7'�( USE ZONE MAP I certify that in the performance of the work for which this n NO. permit is issued, I shall not employ any pgrsowin arty manner 1( `j"/ SPECIAL CL so as to b co ,e(�ysubject to the Work s'Co pensatidn Laws. ADDRESS 4. 0 ,- CONDITIONS V Date L� v Y Applicant L CITY �^'_�� -A. . ZIP NOTICE'TO APPLICANT: If, after ma in this Certificate of ARCHITECT OR TEL' DISTRICT GROUP TYPE FIRE PRO SSED BY g ENGINEER NO. U Exemption, you should become subject to'`the Workers' CONST. ZONE LU tr rCompensaLU tion provisions of the Labor Code, you.Vmust forth- ADDRESS v � with',comply with.._such'.provisions or this permit shall be Y' rA F - '" TEL:' STATISTICAL CLASSIFICATION APT. ONDO. z deemed revoked.:.'. rtrfr Y CONTRACTOR NO. , LICENSED CONTRACTORS DECLARATION _ -- LIC_ CLASS NO. DWELL. UNITS I hereb'affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and LIC. SEWER MAP Professions Code, and my license is in full force and effect. CITY CLASS BK. PG VALIDATION r SQ. FT. NO.OF NO. OF CHECK i-' License Der Lic.Class SIZE STORIES FAMILIES ONE r . - VALUATION ' Z-S DESCRIPTION OF WORK S w ti� O J 2f J t NEW.. ,Crontractbe Date O $ (� r. ADD , I arri,exempt'under Sec. ALTER &P.C. for this reason REPAIR $ USE OF _. -Date: DEMOL EXISTING BLDG. Signature APPLICANT TEL. FINAL q / 2 3'8'3'2 A (PRINT) L U i*fL�r�l NO. (�— # o '0 0 - 23 OWNER-BUILDER DECLARATION DATE `J C Lhereby affirm that I am exempt from tke Contractor's.License A 2 `Law for the following reason (Section 7031.5,•Business and ADDRESS ��� �• 1Tttv`� `�✓uV�jam+ BIN` V _Profess ions:Code): PRESENT' Aa o 4 1,BU LDING I, asj;owner of the property, or my employees with ADDRESS wages as their sole compensation,Will-do the'work and ' 0 0 0 4, �. i.,4 5 x the structure is not intended or offered for sale(Section LOCALITY •7044, Business and Professions Code). MOVING': TEL. 1 O 1. 5 8 G I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044; Business and Professions Code). +:• •• REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH �3 8 3 3 A I hereby affirm'01,atthere is a cpnstruction lending agency.for FRONT the perforrtbnce,.of thg.work�for-'which this-permit is issued - P.L. --- # 0 0 0 0 0'l (Sec. 3097 Gv C ) <•f"+r�,�.'°°,•F js�' SIDE : • � 2 Lenders Name P L 0.0 5 , o {' LDMA Ref. # 9 . 5, P.C. Fee$ -71,�J- Permit Fee.- - p _ . o.0 0 5�9 2 5 U-- Lender's Address_ ee , gra certify that.+J read:this dpplication and state that the Issuance Fee S -tDNA P/C.# 1.1 5=8.6 above information is correct I agree to comply with all County Investigation Fee m ordmpnces`on Stgfe:a 'ws relatrn to building construction, Total Fee TDMA Perm. # , K and lii{eby d a '" a' ' "resenlatives of.'`this County to enter uponhetabo property for inspection pur oses. AASEE REVERSE FOR EXPLANATORY LANGUAGE 0 Signatpre of ant or Agent. u Date »_ v i WORf!CRS' GOJ&PENSATION DECLARATION APPLLCATION FOR BUILDING PERMIT '1'hereby affirm that I �ntirficate of consent to self nsure, or a certificate of Workt i_' _ompensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C. COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. / Company y;,4 .0 4 real El Certified copy is hereby,furnished. FOR APPLICANT TO FILL IN BUILDING '1Z-7 Q, ADDRESS '` Certified copy is filed With-the county building inspec- BUILDING tion department. - - ADDRESS Date /' IA-S-6 Applicant 1�V// G�(�%�` VJ`• CITY r.✓i : F ZIP �, LOCALITY CERTIFICATE OF EXEMPTIONFROM WORKERS' NO. OF BLDGS. - NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. _04— (This­ need'not be completed if the permit is for one ASSESSOR hundred.dollars ($100)or less,.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL. USE ZONE MAP certify'that in the performance 'of the work for which this OWNER t✓ `` - NO.iii 8� II NO. } permit is issued, I shall not employ any person in any,manner �, 7 SPECIAL - - so as to become subject to the Workers'Compensation Laws. ADDRESS / 5.f1- r19s22 /9L ,e �� CONDITIONS V „ CITY re,-i JP Ge G l t' ZIP 91 ;1 ('J Date Applicant'' " O NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT,_ GROUP TYPE FIRE PROCESSED BY - ENGINEER NO. 0- NOTICE you-should should become subject to the Workers' j CONST. ZONE W Compensation provisions of the Labor Code,,you must forth- ADDRESS ` ? c4 n' with comply with such provisions or this permit shall beH TEL. STATISTICAL CLASSIFICATION APT. ONDO:. � Z (/ deemed revoked. CONTRACTOR 4_ /") 6v CO NO. 0E _,f;CJ -5 LICENSED CONTRACTORS DECLARATION _ LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS /p(' /j 6� 3 j NO. 'S (commencing with Section 7000)of Division 3 of the Business and �^ LIC SEWER MAP Professions Code, and my license is in full force and effect. CITY C•G j^I'77{a,Jr `j/9. 9,0 CLASS B BK. VALIDATION ' SQ. FT. NO. OF NO.OF CHECK License Number q z1E0 Lic.Class SIZE STORIES FAMILIES ONE ' �^ VALUATION. Contractor /_C/ J/��/ J Date 7�~�~-S DESCRIPTIOMOF WORK '%�/f>!- -/I/l NEW O $ y 00 X44 1 am exempt under Sec. - ��' ' a1 d rCPilo. •� , ;2364'6A � _ B.BP.C. for this reason .REPAIR. D .$. # '0 0 0 0 2 3 Date: USE OF DEMO L Q EXISTING BLDG. Signature APPLICANT TEL. FINAL ° 49,41 -PRINT OWNER-BUILDER DECLARATION 1 Z �$ N.L. , -,�/�cg DATE!? e, - _ ,I hereby affirm that I am exempt from the Contractor's License ADDRESS �O .V l^/T' .�'� C'e'/t�.' 4 G� FIN,!y a 0 0 4 9,4 1 6' Law for the following reason (Section 7031.5, Business and Professions Code): PRESENT BY J 2, 12-85 - ❑ BUILDING 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. ' A I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- " # o'o ° o 0 1 tion 7044, Business and Professions Code). ADDRESS REQUIRED TOTAL SETBACK FROM S . 'CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I © a'6 &.6 3 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. 3097, Civ. C.). SIDE ° ° ° 6 a 6 30' Lender's Name /P1.2I P.L. - . 0 1.08-86 m P.C. Fee$ / Permit Fee - 3 CDMA Ref. # Lender's Address ' I certify that I have.read this application and-state.that the Issuance Fee ,, S 4 CDMA P/C# a above information is correct. I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee LDMA Perm. # - U and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent - - Date WORKERS"COMPENSATION DECLARATION I hereby affirm that I- have a certificate•of consent to self, insure, ora certificate of Workers' Compensation Insurance, A P P L I CAT ION FOR BUILDING PERMIT or d certified copy thereof (Seca 3800;.Lab C.) _ COUNTY OF LOS ANGELES BUILDING AND SAFETY Po icy No `!� V Company •Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS ✓\ Certified copy is filed with the county building inspec- BUILDING tion departmerit. ADDRESS Date �J j ►Apphcant r l CITY'` �� ITV ZIP s LOCALITY CERTIFICATE.OF EXEMPTION FROM'WORKERS' NO. OF BLDGS. NEAREST COMPENSATION•INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need•.not be completed if the permit is for one ASSESSOR; ' hundred dollars ($100)or less.)_ TRACT BLOCK LOT NO. MAP BOOK ' PAGE PARCEL EL OWNER I1 j/ j (C MS NO.` USE ZONE MAP I certify that in the performance of the work_for which this NO. permit is issued, I shall not eritploy any person in any manner l n� �� f '-, (/: SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS O` I �/ CONDITIONS O� Date Applicant CITAD Y. _-. P.L ZIP NOTICE TO APPLICANT: If,'after' making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE P SED BY Exemption,••you should become subject to. the-Workers ENGINEER NO. CONST -. ZONE dJ Compensation-provisions of.the Labor Code, you must forth- ADDRESS ��� 5.? IL LU with comply with such provisions or this permit shall be U111 TEL TATISTICAL CLA$$IFICATION APT. CO O: Z deemed revoked, o OBJ` CONTRACTOR Q S „ LICENSED CONTRACTORS DECLARATION - -- LIC - CLASS NO. DWELL:UNITS — L hereby affirm that.l am licensed under provisions of Chapter 9 ADDRESS Q.Op L,- NO- 3 q5 19 IU (commencing with"Section 7000)'8f,Division 3 of the Business and LIC: SEWER MAP Professions Code,'and my license"is in full force and effect. CITY M) Y1 CLASS. —45 " VALIDATION /� /l SQ. FT. NO. OF NO.OF CHECK BK. PG. License Number �a Lic.Class SIZE STORIES FAMILIES ONE VALUATION _ Contractor to DESCRIPTION OF WORK -� NEW ADD s , :242a3A ❑ 1 am exempt under Sec. P� ALTER ❑ ( - B:&P.C. for this ;#'.o ° o.o23 reason' .• _ f�'1� �L. � REPAIR. ❑ "' S' - - USE OF Date: EXISTING BLDG. Mel- 'C ia-1 DEMOL ❑ h ° o 57.38 Signature _ APPLICANT-(PRINT) T p 3 FINAL' l� 5 7,3 8 c=i . ��.� to 0 0 OWNER-BUILDER DECLARATION r DATE -. I hereby affirm that I am exempt-from the Contractor's License Low for the-following'reason '(Section 7031.5, Business and ADDRESSr)101 9f-f ' FINAL,/'' f` 03. 1 9-•8 6 Professions Code):. K , PRESENT _ g BUILDING 1, I, as owner of The property, or my employees with ADDRESS wages as their sole compensation,will do the work and z 4-2-5.4 A the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. - ' # o 0 0-0 0 1 •- ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the-project (Sec- "- - °'° 7 8,-0 0 tion 7044, Business and Professions Code). ADDRESS REQUIRED. ... TOTAL SETBACK.F.ROM_ EXIST. 7 8 0.0 v CONSTRUCTION LENDING AGENCY SET BACK "YARD HWY' PROP. LINE WIDTH o"o o = 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. - 0-3. 1 (Sec. 3097, Civ. C.). SIDE 9-.-8,6 .. P.L. r,t Lender's Name o LDMA Ref. # _.. P.C:-Fee$ V _ Lender's Address a Permit Fee I.certify that I have read this application and-state that the _ 1. __. Issuance Fee 5t`/ LDMA P/C# �. above information is correct. I agree to comply with all County Investigation Fee m ordinances and State laws relating to building construction, Total Feen u and hereby authorize representatives of this County to enter LDMA Perm:: u n tLeabove-'ei;Z pro y for insp coon purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE r - Signature,of Applicant or Agent •. Date- - -- -• _-- - - — - -- - - - - - - - �° � WORKERS"COMPENSATION DECLARATION I hereby-bffirm that I have a certificate'of,consent to self insure, or a certificate of Workers' Compensation Insurance, APP_ L I CATION "FOR 'BUILDINGPERMIT or 6 certified copy thereof'(Sec. 3800, Lab. Ct)Company COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Y5+5'. _� AI L'► =�4 ' T '' —c' - Certified copy is"hereby furnished. BUILDING FOR APPLICANT TO'FILL IN ADDRESS Certified copy is filed with the county"building'inspec- BUILDING � tion department.•` ADDRESS f.f.'A /�'�St7vW c�•�,� � Date Applicant CITY L�'v OfsTt+ % J ZIP, LOCALITY CERTIFICATE OF.EXEMPT FROM WORKERS' NO. OF BLD s- NEAREST SIZE OF LOT NOW ON LOT O' CROSSSST. i z COMPENSATIO INSURANCE (This section need not be completed if+the permit is,for one ASSESSOR _,. ` hundredtdollars ($.100)or,less.) TRACT BLOCK LOT NO. MAP BOOK PAGE f PARCEL TEL. USE ZONE MAP �j ^ OWNER VLS�� >'Ut�"�✓' NO. ICJ I certify that m the performance of the work' for which this NO. } permit is issued 1 shall not employ any person in any manner rr SPECIAL-' C so as to become subject To'the Workers'Compensation Laws. ADDRESS /�y� SCS t�f' � Z CONDITIONS O Date APPlicant n. .CITY .E'.Y'\lia Y1 ZIP /_rGl. 0. NOTICEt'TO'APPLICANT: If;•after making This Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PRO_ESSED.BY _ Exemption; you should become-subject to the Workers' ENGINEER NO. CONS ZONE Compensation provisions of The Labon Code,.you,must forth- L7��� - ADDRESS L. with comply«.with such provisions or.this permit shall be T Z deemed revoked.. EL. STATISTICAL CLASSIFICATION T.WCONDO: . , CONTRACTOR F ct pn NO. '1`'I _ LICENSED CONTRACTORS DECLARATION • - LIC. CLASS NO.7 b1 D ;uNIrS I hereby affirm that I am licensed under.provisions of Chapter 9 ADDRESS 6/T8—e6 NO.3/09�L (commencing with Section'7000)of Division Sof The Business and _ G` LIC. _` SEWER MAP Professions Code, and'my license is in'full force and effect: CITY t<��� ` CLASS . VALIDATION SQ. FT.., NO. OF _ NO.OF CHECK. BK. PG. License Num'er' O Lic.Class ?r SIZE % STORIES " �ry FAMILIES ® ONE �'� C,•""� $A ; _ VALUATION, jf l4_ _ -, '$�- 9'o 0 0 0 d "" DESCRIPTION OF WORK. '`le-44-d 6`T NEW � ' Con Trac Date ADD_ ; ��v" 1 °�° 8 t/,3 8 q I atrr tempt under Sec. ALTER o -'8 7,3,8 B.BP C for This reason REPAIR $ -0-1;24'-'8 5- USEOF T Date: EXISTING BLDG. 111 LS let-R-4'A DEMOL _ Signature " APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION PRINT) NO. DATE - - hereby affirm that,l am.exerrtpt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL 'Professions Code):" PRESENT - _ By �Z . BUILDING I, 6s owner of-the property, or my-employees with ADDRESS r 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. I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to-construct the project (Sec- .tion 7044, Sec-.tiom7044, Business and Professions Code). ADDRESS REQUIREDTOTAL SETBACK..FROM IST. -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. - a (Sec. 3097, Civ.,C.): SIDE m P.L. _ o Lender's Name o LDMA Ref. # P.C. Fee-$ .. .. - Permit Fee. _ Lender's Address ' I certify that_.I.have.read this application and.state that the Issuance Fee V LDMA P/C#-- a above information is correct. I agree To comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee rLDMA Perm. # v and hereby authorize representatives of this County To enter m upon ab ve-menTio d property for inspection purposes. /�� SEE REVERSE FOR EXPLANATORY LANGUAGE gnature-of Applicant or Agent - --Date .,WORKERS'COMPENSATION DECLARATION hereby affirm that I fT`shaver certificate of consent to, self APPLICATION F O•R' BUILDING PERMIT iure, or b certificate of Workers' Compensation Insurance, _ or a certified copy thereof (Sec. 3800; Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No� ompany [�Q3g14��1 ❑ Certified copy is hereby furnished. F R APPLICANT TO FILL IN BUILDING ADDRESS Certified copy is,filed with the county building inspec- BUILDING /y Tions department.' ' ADDRESS /Jr V56�b Al Date Applicant '' CITY ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' - NO. OF BLDGS. NEAREST, COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST: (This ASSESSOR section need not be'completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or, less.) e _ TEL. USE ZONE MAP I certify that in the performance of the work for-which this OWNER L L NO. NO. 1- per'mit is issued,'I shall not employ any person in any manner (� ^) SPECIAL o' - sas to become subject to the Workers'-Compensation�Lows. ADDRESS- V� o c - �' CONDITIONS 00 CITY - ZIP Im Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP I TYPE FIRE PRO ESSED BY O 0 U Exemption, you should become subject to the 'Workers' ENGINEER NO. CONST. ZONE•. '1 Compensation provisions-of the Labor Code, you!must forth- ADDRESS with comply with-such provisions orThis permit.shall, be \ TEL ))�� STATISTICAL.CLASSIFICATION APT. CONDO. deemed revoked. CONTRACTOR ( l� cN W LICENSED CONTRACTORS DECLARATION LIC. n CLASS NO. 2� DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS ,� �. NO. L (commencing with Section 7000)of Division 3 of the Business and LIC. SEWER MAP Professions Code,''ond my license is in full force and effect. CITY b CLASS G - BK PG- VALIDATION � SQ. FT. _ NO. OF NO. OF CHECK License Number •]1��/+�`� Lic.Class� SIZE STORIES FAMILIES ONE . • VALUATIONCW NEW 239 1.2 A AD�+v�✓Z �"�'Date DESCRIPTION OF WORK ADD ❑ $ Contractor , ❑ I.am exempt under Sec. # o - 23 ALTER ❑ 8.8P.C. for This reasonI REPAIR .❑ $ ° - 41.45.- Date: USE OF EXISTING BLDG. DEMO ❑ a a o}/#' /�I+ _ APPLICANT TEL. i 3 y J U Si'g`nature t 3 z FINAL /���' PRINT NO. G -' O 1,'G 0 0 L J OWNER-BUILDER DECLARATION ^ _ DATE # ..hereby affirm that l am exempt from the Contractors License ADDRESS a�ZS . ��`� Vt�`d FIN: ° 0 0 0 Law for the following reason (Section 7031.5, Business and Professions Code): PRESENT BY •❑ BUILDING I, as owner of the property, or my employees with ADDRESS _ wages as their sole compensation,will do the work and ��+� /yG/`f�y ° ° ® 1 5 9 3 c) the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. 0-205"86 ❑ f, as owner of the property, am exclusively contracting CONTRACTOR NO. --with licensed contractors To construct the project ADDRESS tion 7044, Business and Professions Code). REQUIRED 3 9 8 4 A _ CONSTRUCTION LENDING AGENCY SETT BACK YARD " HWY TOTAL SETBACK AINEFROM WIDTH I hereby affirm that there is a construction lending agency for FRONT # 0 0 0'a 0 1" --the performance-of the work for which this permit is issued - - P.L. - (Sec. 3097, Civ. C.). SIDE I ° ° 7 0 0 P.L. m .-. . .. _ .. _ Lender's Name C5 o .�\/+ � LDMA Ref. # 0 0 0 7 8.0 0 v ._. P.C. Fee$ V Permit Fee �l v" - - -- - - Lender's Address _ -0 > / 2 020-5'=86 I.certify.that I have read this application and state that.the .� /Si 13 Issuance Fee - V V LDMA P/C#- a above information is correct. I agree to comply with all County Investigation Fee ordinanc s and St fe laws relating to building construction, Total-Fee $ LDMA Perm. # U re y autha a pr entatives of this County to ent r m upon bo _mn ie roperty for inspectionPC rpos s. a SEE REVERSE FOR EXPLANATORY LANGUAGE ' �a 1� Signature of App'ca or Agent - Dat \ 1, .WORK, 'COMPENSATIOF; ECLARATION 62k IJ 6 ^,7 Ill b� /3 b"Z7�/ , s �. : or afcertifecatte o aWoraEi&�tificote of ke s' Compensationconsent.rance, APPLICATION FOR B U I L D I N G PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company copy v FOR APPLICANT TO FILL IN BUILDING ❑ Certified co is hereby furnished. ADDRESS ❑ .Certified copy is filed with the county building inspec- BUILDING tion'department. ADDRESS' 6_Zr2-2- Date -2-Date Applicant CITY �QVA�>CJS E'_*k_qJk ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS" / NO. OF BLDGS. NEAREST -COMPENSATION INSURANCE' SIZE OF LOT 7 SO NOW ON LOT CROSS ST. (This section need not be-completed if-The permit'is for one ASSESSOR hundred dollars ($100)or less.) , TRACT BLOCK LOT NO. MAP BOOK' PAGE PARCEL ✓� TEL. P13� USE ZONE 2 MAP I certify that in the performance of the work for which this OWNER 'ei / �./Q/jGr�1���(i�� n N0. (iCJ y permit is issued, I shall not employ any person in any manner ADDRESS 3 r! S�, Z SPECIAL so as to become subject to the Workers'Compensation Laws. j�A / /� CONDITIONS V® Date' Applicant CITY.. 14 ZIP 9�(J Y Q IM NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR /' TEL. DISTRICT GROUP TYPE FIRE PR ESSED BY 0 ENGINEER (.e $ NO. CONST. ZONE10 Exemption, you should become subject 'to the'Workers' ( _ y / Comperisation•provisions of the Labor Code,•you,must forth- ADDRESS L Alla -lj� J 15, 08' � � with comply•with such provisions or this•permit shall be deemed revoked. TEL. STATISTICAL CLASSIFICATION APT. CO O.• CONTRACTOR NO.. LICENSED CONTRACTORS DECLARATION -LIC. CLASS NO. DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS - NO.- (commencing vvith Section 7000)of Division 3 of the Business and LIC. SEWER MAP Professions Code, and'my license is in full force and'effect. CITY - CLASS BK VALIDATION SQ. FT. _ NO..OF NO. OF CHECK License Number Lic.Class SIZE �. STORIES / FAMILIES — ONE' IVALUATION a DESCRIPTION OF WORK "'� Q T NEW- E Contractor Dot!!'._ ADD ❑ I am exempt under Sec. of 90-nCi ALTER E] B.BP.C. for this reasonREPAIR ❑ $ z 23.2A Date: . USE OF q� r EXISTINGBLDG. )e444Q ( �/fA2i ID�AL ❑ 0 0 0 0 2 3 Signature APPLICANT r TEL. // / FINAL -. PRINT) e c,{J ". q uZ{7 �lG OWNER-BUILDER DECLARATION DATE � ) 1,Q-6 1, -�4 1 hereby affirm-that I am exempt from the.Contractor's License ]to Law for the following reason (Section 7031.5, Business and ADDRESS ?.37 �IC � S7• %G�3 e- �* FIN x Profession's Code): PRESENT I _ - J BY 1,061,4.46 BUILDING a 3 S P/�?'LfZ�P� ❑ I, as owner of the properly, or my employees with ADDRESS � 1 2 1 4.`8 41 wages as their sole compensation,will do the work and LOCALITY the structure is not intended or offered for sale(Section 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). ADDRESS E REQUIRED `TOTAL SETBACK FROM ST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 1 6 Z 2 A hereby.affirm that there is a construction lending agency for FRONT v �- the performance of the work for which this permit is issued P.L. 0 0 0 o a 1 - (Sec: 3097, Civ. C.). SIDE � �+ in P.L. i ;.�•\.\-. 1. i I.1.2-5 9 2 5 Lender's Name - 1,2 5 9,2 5� o l..` LDMA Ref. # Lender's Address P.C. Fee$ f Permit Fee 2 //(77/�{[!� % - o 71 1 certify that.l..have read this application and state that the �'h- ; lss'udnce Fee '11016-0 1016 �/ LDMA P/C'# ;) 1 a 4 ' s`'': 03, 1 2 -85 a above information is correct. I agree to comply with all County Investigation Fee o ordinances and State laws relatingto buildingconstruction, u a er by authorize representatis of this County to enter - Total Fee [ �� TDMA Perm. # 1 pon th above-ment' op�rty for inspection urp ses. d a SEE REVERSE FOR EXPLANATORY LANGUAGE _ Qvi Sig"tur 'of A I",nt or Agent ate -