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Home My Public Portal About5741 ROWLAND AVE_Building__ 6A688ACE#00810.50 APPLICATION FOR BUILDING PERMIT = • 1 COUNTY OF LOS ANGELES BUILDING �c-�} Z2,101 / / DEPARTMENT OF COUNTY ENGINEER ADDRESS .�j / / �g�w/� 2,101 BUILDING AND SAFETY DIVISION LOCALITY '222 /o le- &w' AV .f JOHN A.LAMBIE.COUNTY ENGINEER - NEAREST CASSATT D.GRIFFIN,Sup•T OF BUILDING CROSS ST. DISTRIC7epIQ� GROUP n.PE P CESSED BY FOR APPLICANT TO FILL IN � I CONST. BU1L-DING f STATISTICAL LASSIFICATION' SEWER MAP ADDRESS / a..� J' BK PCa CLASS.NO. DWELL.UNITS ✓� 'I LOT NO. BLOCK MAP STATE YES NO NUMBER �� . MW Y. TRACT USE ZONE SPECIAL. NO. SLOGS. 1� CONDITIONS SIZE OF LOT I NOW OF LOT A / USE OF EXIS ING BLDG. >z BUILDING EXIST. + SETBACK YARD HWY• STREET NAME WIDTH MAIL OWNER JJ7p- �/e-A FRONT , ADDRESS �/ YI P.L. �h - SIDE CITY /ri?r�/. (� li TEL. ARCHITECT TEL, INSPECTION RECORD ENGINEER NO. ADDRESS / - CONTRACTOR 11, ♦♦ / T O. `` ADDRESS ��rl' 4' � /C�W1+-� A-6 DESCRIPTION OF WORK NEW ADD r ALTER REPAIR DEMOLISH SQ.FT. NO.OF NO.OF SIZE /Z STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF APPROVALS APPLICANT ��lY 71 2fafW-w-i, uo a FOUNDATION: LOCATION DAT INSPECTOR'S SIGNATURE ADDRESS ' $ l. FORMS,MATERIALS. P.C. $ FRAME: FIRE STOPS, rig /J O- FEE BRACING.BOLTS. b i UVJ -jI VALUATION FEE $ �♦� FURNACE: LOCATION. GAS VENT.-DUCTS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH,INT:', PLICATION AND STATE THAT THE ABOVE IS CORRECT AND , AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULA NG BUILDING .CONSTRUCTION. LATH,EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTE ,I RECT.AND POSTED i FINAL I A CLYDE I DIRLAM.;P,RINCIPAL STRIJCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PFB=VALIDATION CK. •M.O. ' CASH ' L ASR 4$4 6 3-.00 13 n F I i��L /V 76A698A CE#8085.81 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING -7 Cl DEPARTMENT OF COUNTY ENGIIIEER ADDRESS BUIMING AND SAFETY DMSION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A.JENSEN'SUP'T OF BUILDING CROSS ST. DISTRICTNO. GR UP TYPE P ESSED BY FOR APPLICANT TO FILL IN � CONST. BUILDING STATISTICAL CLASSIFICATION S WER MAP ADDRESS J. t ;CLASS.NO.�DWELL.UNITS ��40 LOT NO. 7 Dr BLOCK WATER . NOT REQUIRED RECEIVED CERTIFICAT : TRACT- MAP H1GHltinv STATE MAJOR SECOND. OCA NO.OF BLDGS. N (CIRCLE) SIZE OF LOT NOW ON LOT USE XONE SPECIAL USE OF CONDITIONS EXISTING BLDG. J/p I TEL. Vv r OWNER NO. BUILDING WEXIST. YARD HY STRE NAME Q SETBACK . WIDTH ADDRESSIm L FRONT ARCHITECT R TEL.-,►p//� P.L. ENGINEER �'N0.0 6ft_' ;SIDE P L ADDRESSES INSPECTION RECORD. TEL. I/n a CONTRACTOR NO: (P 0 ADDRESS V • W DESCRIP OOF O an Z N ADD XLTER REPAIR DEMOLISH SQ.FT. NO.OF NO.OF IZE . STORIES. FAMILIES USE OF STRUCTURE SIGNATURE OF APPLICANT VALUATION$ — APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION:LOCATION FEE $ �� FEE $ FORMS,MATERIALS FRAME:FIRE STOPS. �1 4 1 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 / Irl/X,1. I BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING'THE WORK / i AUTHORIZED HEREBY'1 WILL NOT EMPLO NY PERSON IN VIOLA- LATH.INT. . r TION OF,THE'LABOR CODE OF.THE STA .•F CALIFORNIA REL ING TO WORKMEN'S C M EN ATION 1 � � I:ATH,EXT. /� SIGNATURE OF �^�'T HOUSE NUMBER COR- ///P PERMITTE RECT AND POSTED' ADDRESS FINAL ! �^ :J.'J ti CLYDE N. DIRLAM, PRINCIPAL STRUCT R LEN PLAN CHECK VAMATION cK. M.O: CASH PERM VALIDATION CK. M.O. /CASH I , I ' 7-- .'ERg OMPENSATION DECLARATION hereby affirm that I have r certificate of consent to self APPLICATION FOR BUILDING PERMIT � ins�'re,'or,��'certificate of Workers'Compensation Insurance, ora certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. CompanyBUILDING -� ' Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ' � ADDRESS �l Certified copy is filed with the county building inspec- BUILDINGj tion department. ADDRESS b w Date Applicant CITY ''ZIP Q 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 BLOC LOT NO. MAP BOOK PAGE PARCEL J04 C !qC CtN r� USE Z E MAP OWNER NO.oL ��9D I certify that in the performance of the work for which this y / NO, y, permiLl t is issued, I shall not employ a y pSPEC AL CL erson in any manner ADDRESS �/� O Q i'1 '` CONDITIONS O so as to become subject to the Wo rs'Compensation Laws. Date Applican + CITY ZIP 17 Q Im NOTICE TO APPLICANT: If, of making this Certific of ARCHITECT OR TEL. ENGINEER NO DISTRICT GROUP TYPE FIRE ESSED BY Exemption, you should bec a subject to the Workers' CONST. ZONE /fj( Compensation provisions of the Labor Code, you must forth- ADDRESS Vv with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. WONDO. deemed revoked. CONTRACTOR NO. q-/ LICENSED CONTRACTORS DECLARATION LIC, CLASS NO.`f--DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 4u NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY CLASS BK PG VALIDATION SQ.FT NO.OF NO.OF CHECK License Number Lic.Class SIZE d STORIES FAMILIES ONE RU VALUATION DESCRIPTION OF WORK NEW ❑ S7� O Contractor Date ADD $ / f I am exempt under Sec. eaD/� ALTER , B.BP.C. for this reason ' REPAIR ❑ $ USE OF Date: EXISTING BLDG. DEMOL ❑ APPLICANT TEL. Signature FINAL _ OWNER-BUILDER DECLARATION PRINT NO. DATE J J I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL T/ / 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 ' 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 d 4 9 5 8 A tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP.LINE WIDTH # 0 0 0 a 0 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 ° 4 2 2,2 5 Q L. Lender's Name - 422256 /,/� LDMA Ref. # P.C.Fee$ 35 OsV(J Permit Fee V 07.03-86- Lender's Address I certify that I have read this application and state that the Issuance Fee -0 LDMA P/C# pop. above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee LDMA Perm.# u , and ereby authorize representatives of this County to enter u the above-mentio ed roperty for inspection purposes. a SEE REVERSE FOR EXPLANATORY LANGUAGE o Sigature of Applicant or Age t Date