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Home My Public Portal About5729 ROWLAND AVE_Building__ 71 'UniA C6#8032/00 -APPLICA`T'ION FOR BUILDING• PERMIT �- 1 COUNTY OF• LOS. ANGELES BUILDING DEPARTMENT OF COUNTY ENGIIVEER ADDRESS BUILDING AND-SAFETY' DMSION L6CALITY JOHN A. LAMBIE, COUNTY ENGINEER 1 NEAREST WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST: DISTRICT NO. GROUP TYPE P ED BY FOR APPLICANT TO FILL IN coNST. 1 7=ADDRESS- STATISTICAL CLASSIFICATION SE ER MAP S/�- N' • . CLASS.NO.�WELL.UNITS LOT NO.- 4 V 3 _ d� ed,'BLOCK' NUMAPMBER HTwv YES TRACT (LIS(P USE ZONE SPECIAL cc NO.OF BLDGS. CONDITIONS SIZE-OF LOT v O X O NOW.ON LOT p USE OF r , EXISTING BLDG.- k BUILDING'' EXIST. r TEL. SETBACK YARD HWY STREET NAME. WIDTH OWNER GIS W, �O l NO.AT FRONT I ` r P.L. ADDRESS : 7z�q _SIDE ARCHITECT OR TEL. -1'•L. ENGINEER No. INSPECTION RECORD ADDRESS TEL. • .. Qi CONTRACTOR -NO. f _ 'ADDRESS. DESCRIPTION OF WORK . f� �" �` /� ? � 4�� j'e 0 EW . 'ADDALTE REPAIR DEMOLISH n C / NO..OF NO.OF- rJ�il9f� :I'T!G'.Vs^ SIZE 1"�'��l. ,STORIES RAMILIES ' USE OF 'STRUCTURE-, SIGNA REOF `_i ✓ f/'' 9/�r'��I V APPLICANT ''ll �J��J�'D VALUATION'So V 77 APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. Ql FO:IFONDATION:LOCATION FEE FEE $ �'� RMS MATERIALS ' IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME:FIRE STOPS, PLICATION-AND STATE THAT THE ABOVE IS CORRECT AND BRACING BOLTS FURNACE:LOCATION. AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND CTAS VENT DUCTS STATE LAWS REGULATING BUILDING CONSTRUCTION. I CERTIFY' THAT IN DOING THE WORK AUTHORIZED •I' ,LATH,INT. SGfFF�� aCK WILL NOT. EMPLOY ANY PERSON IN VIOLATION OF THE m ��r WORKMEN'S EN LAY.H,EXT TION LW(j OF CALIFORNIA. a�y (�,/) . tS •� (.•'ifR "`L�Id.C(,r�lf F SIGNATURE HOUSE NUMBER COR- PERMITTE W RECT AND POSTED g I ADDRESS S� )jF114AL CJ .=CLYDE N. DIRLAM,PRINCIPAL STRUCTURAL EN ER - PLAN MIEC$ VALIDATION or. M.G. CASH PERMIT VALIDATION or. M.C. cAslt _.) �,�, :; 1BA638A CE#803 8.63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS S: BUILDING AND SAFETY DIVISION LOCALITY /f t JOHN A. LAMBIE, COUNTY ENGINEER NEAREST • WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST. 0 ' DISTRICT P TVPE f BY ooO L FOR APPLICANT TO FILL IN CONST. V r BUILDINGQ.� STATISTICAL CLASS ATION ER MAP ADDRESS �•� CLASS. NO. DWELL.UNITS LOT NO. lJ `3�• cTBLOCK WATER �+ r ) CERTIFICATE: NOT REQUIRED ❑ RECEIVED TRACT W .7 G/ MAP HIGHWAY STATE MAJOR SECO,D LOCAL NO.OF BLDGS. NO. (CIRCLE) SIZE OF LOT Q '/ 6 NOW ON LOT USE ZONE YPECIAL USE OF CONDITIONS EXISTING BLDG. h6M TEL n y�I/ OWNER ' 'C 1L' 1 Q Q NO��/p711� BUIL ING EXIST. 1. ; 7 SETBACK YARD HWY STREET NAME WIDTH ADDRESS' d W I Q.6A. , \ FRONT , ARCHITECT OR ``� TEL P. L. ENGINEER W IV a NO. SIDE P. L. ADDRESS CONTRACTOR 0 W (� e y TEL.NO. } , Q PARKWAY TREE REqUIRED ADDRESS IN DESCRIPTION OF WORK Ham; Permits tar cu-r , gu , ' -•• ••'• .- driv y approach hen out at the L. A. Co- R. d Japt•, Altad n� NEW ADD ALTER REPAIR DEMOLISH .4allaiwas A-64 he SO.FT. NO.OF NO. OF Office, or T. C. Co. Enginaor's O'Cce i7raecialc:y In or er o av I SIZE a' TORIES / FAMILIES J a eng y way, ury 1 '"- not s+a USE of zw mfll Permit has been issued. Apply for parkway tree permit at T. C. STRUCTUR aCity Hall. SIGNATUR OF APPLICANT VALUATION APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FO ! MATERIALS FRAME: i' FEE $ FEE $ FORMS FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 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. 1 CERTIFY THAT IN DOING THE WORK - AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. y TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. __^ ING TO WORKMEN' OMPENSATION INSURANCE. LATH.EXT. / An SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL JOHN F. LEWIS, INCIPAL'ST A RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERBUT VALIDATION CK. M.O. CASH 8 5 5 8c- why 15 1 D 2 2.00~ t a. APPLICATION FOR. BUILDING PERMIT L COUNTY OF LOS ANGELES ' BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS C�,s I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRES /�. or a certificate of Workers'Compensation Insurance,or a certified copy thereof'(Sec.3800,Lab.C.) CITYZIP L r 1 o LOCALITY Policy No. Company SIZE OF NO.OF BLDGS.Now ON LOT ❑ Certified copy is hereby furnished. I NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. COMPENSATION INSURANCE WITHIN 1000 FT.of SCHOOL? Yes No (This section need not be completed if the permit is for one hundred ADDRESS DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars($100)or less.) V6L,,iL4At-p AUR CITY r ZIP _ 'I certify that in the performance of the work for which this permit _� is issued, I shall not employ any person in any manner so as to — G 1 0 O� Jj become subject to the Workers'CO pensation ws. ARCHI ECT OR ENGINEER TEL NO. L�� i STATISTICAL CLASSIFICATION APT CONDO Date '14d Applicant `, ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT. If, after making this Certratre of I REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to thes�, CONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must,forthwith g' _ FRONT comply with such provisions or this permit shall be deemed revoked! ADDRESS LIC.N P L SIDE LICENSED CONTRACTORS DECLARATION crrY LIC.class PL I hereby affirm that I am licensed underprovisions of Chapter 9 Cs 7SEWER MAP (commencing with Section 7000)of Division 3 of the Business anc SQfT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and of ct. -(dan NEW BK PG a License Numb Lic.Class `i ADD /j� DESCRIPTION OF WORK�• ❑' VALUATION WMOL&SDate � Contractor Date s ALTER 11 $ U 1922 a"Z 1 ❑ I am exempt under Sec. REPAIR 2' $ B.BP.C.for this reason DEMOL ❑ LDMA P/C# W Date: US OF EXISTING BLDG. URM ❑ ii 0- Signature APPLICANT(PRINT) TEL NO. LDMA Perm# 1 Z ❑ I,•as owner of the property, or my employees with wages as ZO CC i�a their sole compensation, will do the work and the structure is ADDRESS �__ not intended or offered for sale (Section 7044, Business and FINAL DATE Q 3319-113 137.40 ProfeSSIOTIS Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL 'l✓ d i i C OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE i C ❑ I, 8S owner of the property, am exclusively contracting With MS AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL licensed contractors to construct the project (Section 7044, YES❑ NO❑ , TOTAL 137-40 Business and Professions Code.) I WILL THE INTENDED USE THE BUIBY THE APPLICANT OR FUTURE BUILDING CHECK 137.40 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY I COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. CHANGE .00 I hereby affirm that there is a construction lending agency folo. YES 11 NO❑ C4 the performance of the work for which this permit is issued(Be 0 1 HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 3087,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, e r TITLE 2.CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS 0000—�(OO L �/ 01/,'7!(. Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD, Lender's Address aaEM 6771 1 Ai.10=3U o O I certify that I have read this application and state under penalty 4 of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE % &V cm with all county ordinances and State laws relating to building ' m construction, and hereby authorize representatives of this County ISSUANCE FEE t� to ter upon the ab -mentioned property for inspeUon rpos . ;2�� P INVESTIGATION FEE TOTAL FEE• /� �?1 r• SEE REVERSE FOR EXPLANATORY LANGUAGE r V