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Home My Public Portal About6033 ROWLAND AVE_Building__ ruesaAcr,hos s/au APPLICATION FOR BUILDING PER T COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY f JOHN A. LAMBIE, COUNTY ENGINEER NEAREST / f WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRICT No. G. UP TYPE SED BY i �=U , cam/^-� CONST. r BUILDING _ �(� STATISTICAL CLASSIFICATION S ER MAP ADDRESS �. l/�d� ,�� 7�. PG _ j CLASS.NO.�DWELL.UNITS--= LOT BLOCK NUMBER H ATE YES '05 TRACT USE,ZONE SPECIAL �} NO.OF BLDGS CONDITIONS. SIZE OF LOT �// �+ � I NOW ON LOy�T USE OF �j i EXISTING BLDG. `i�t %'`• BUILDING EXIST. TEL ff SETBACK YARD. HWY STREET E WIDTH OWNER i�1.vs1` NO. V� FRONT 4 P.L. t l�%-� ADDR S SIDE ARCHITECT OR ' TEL. - P.L. ENGINEER y No. "INSPECTION RECORD > ADDRESS TEL. CONTRACTOR NO. O ADDRESS V i1ASCRIPTION OF WORK OLloa NEW ADD ALTER REPAIR DEMOLISH SQ.FT �, NO.OF NO.OF SIZE STORIES FAMILIES USE OF _ STRUCTURE SIGNATURE OF APPLICANT i H i VALUATION$ 7w_ - APPROVALS DATE INSPECTOR'S SIGNATURE FEE '$ FPMT EE FOUNDATION:LOCATION FORMS,MATERIALS -2s"90 (/Ji i OLI I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP. FRAME:FIRE STOPS, BRACING,BOLTS PLICATION AND STATE THAT THE ABOVE IS CORRECT AND FURNACE:LOCATION, AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT DUCTS STATE LAWS REGULATING BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED I LATH,INT. WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE WORKMEN'S COMPENSATION LAWS OF CALIFORNIA. LATH,EXT. SIGNATURE OF r HOUSE NUMBER COR - PERMITTE _ RECT AND POSTED ADDRESSFINAL ZS�O CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL 7—H R PLAN CHECK VALIDATION Cr. M.O. CASH PERMIT VALIDATION CK. m'.0. X10 4 2 3 Q JULc p 3.0 0 ®P WIT76A638A CEV803 5-65 A PLICATI®1 tl FOR Bks I L® !tlG' 9 E8 COUNTY OF LOS ANGELES BUILDING �� DEPARTMENT OF COUNTY ENGINEER ADDRESS 61 BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST COLEMAN W. JENKINS.SUP'T OF BUILDING CROSS ST. DISTRIC N G TYPE PR S FOR APPLICANT TO FILL IN CONST. BUILDING r] STATISTICAL C S ICATION _ SE R MAP ADDRESS v 3 ��p �(,� CLASS NO. DWELL UNITS BK PG LOT NO. BLOCK '7 USE ZONE MAP / NO. V TRACT rj SPECIAL /� N0. OF BLDGS. CONDITIONS SIZE OF LOT SO / _ .S! NOW ON LOT USE OF EXISTING BLDG. C'--^" � BLDG. SETBACK FROM _ _ D,, - TEL. / FRONT PROP. LINE OF (STREET) OWNER CV 4l-C�YLi GWi<.N O. b- +Ira TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS p J HIGHWAY WIDTH FROM C.L. CITY L ?BLDG. SETBACK FROM ARCHITECT OR TEL. ENGINEER NO. SIDE PROP. LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. CONTRACTO NOL3G�'s' + ADDRESS v�p CORNER CUTOFF YES NO V CITYZ:p ol._. C c�a SEE REVERSE SIDE FOR SPECIAL APPROVALS O DESCRIPTION OF WORK UW NEW ADD ALTER REPAIR DEMOLISH Z • SQ.FT. NO. OF NO. OF SIZE STORIES FAMILIES USE OF STRUCTURE SIGNATURE O APPLICANT VALUATION$� I� APPROVALS DATE. INSP ECTOR.,S SIGNATURE P.C. PMT. FOUNDATION, LOCATION ' FEE$ FEE$ B FORMS, MATERIALS p� 1 FRAME, FIRE STOPS, Bi 1 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING OLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS SUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY•I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LABOR CODOF THE STATE F CALIFORNIA RELAT- ING TO WORKMEN'7PF NSATION INSURA E LATH. EXT. ; �! 1 l SIGNATUR O HOUSE NUMBER COR- PE4tMITTE RECT AND POSTED t� ADDRESS FI NAL JOHN F. LEWIS. PRINGIPAL'STRUCTURAL EN ER PLAN CHECK VALIDATIO CK. M.G. CASH _ PERMIT VALIDATION GK. M.O GASH _. LF1,or7 5 5. NDV 24 1 D 6.00- q tlWORKERS'COMPENSATION DECLAPATION re affirm that I have ceifjcate of consent to self suP P L I CAT I F® U I L®I N G PERMIT sure,4;or a certificate of Workers' compensation Insurance, or a certified copy thereof'(5ec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAF TY • Policy No. Company Certified co is hereby furnished. BUILDING /®2 2 ❑ copy y FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- [ARCHITECT ING tion department. E�S-St—fob-3 N. gi�erz Date Applicant I ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' r.•�� NO.OF BLDGS. NEAREST COMPENSATION INSURANCE F LOT Q x oGLf NOW 6N LOT CROSS ST. (This section need not be completed if the permit is for one C / ASSESSOR, hundred dollars($100)or less.) 5 Lp BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL USE///��NE MAP I certify that in the performance of the work for which this n �{— NO. / N0. permit is issued, I shall not employ any person in any manner SS r SPECIAL � so as to become subject to the Workers'Compensation Laws. CONDITIONS O Date 5�T21o•41 Applicant ZIP is O TEL.NOTICE TO APPLICANT: If, after making s Certificate of DISTRICT GROUP TYPE FIRE PR CESSED BYEER NO.Exemption, you should become subject o the Workers' 'It �j�( CONST. ZONE `yCompensation provisions of the Labor Code, you must forth- �/U a�� "`with comply with such provisions or this permit shall be ESS y deemed revoked. WAR / �1 TEL. STATISTICAL CLASSIFICATION APT. CONDO. g rADDRESS RACTOR A V �7 NO. -'�'ga LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter9 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. CLASS VALIDATION SQ.FT. NO.OF NO.OF CHECK BK. PG. License Number Lic.Class SIZE STORIES FAMILIES ONE VALLA ION _` Contractor Date DESCRIPTION OF WORK NEW ❑ D/C] C/Jl ADD $ ❑ I am exempt u rir�Se� / ' n�� ALTER ❑ B.BP.C. for this reason �/J REPAIR $ Date: USE OF . ' DEMOL ❑ �7 1 0,6 A EXISTING BLDG.—P Signature .APPLICANTS TEL. FINAL # 0 0 0 0 0 1 OWNER-BUILDER DECLARATION PRINT) NO. I hereby affirm that I am exempt from the Contractor's License y� (� DAT 1 - 27375 Law for the following reason (Section 7031.5, Business and ADDRESS U . •�1.0bliaF'T LLL FIN Professions Code): PRESET By - 0 2 7 3.7 5 3 BUILDING 19 I, as owner of the property, or my employees with "ADDRESS 5 2 7=$7 wages as their sole compensation,will do the work and , Q the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. QI,as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors-to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). eREQUIRED TOTAL SETBACK FROM I T. , CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP.LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. i Lender's Name P.C. Fee$ Permit Fee R63a . LDMA Ref. # Lender's Address //� _ ; I certify that I have read this application and state that the Issuance Fee l o � LDMA P/C# 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. # i and hereby authorize representatives of this County to enter Upon the above-mentioned property for inspection purposes. ::� SEE REVERSE FOR EXPLANATORY LANGUAGE Signatur pplicont or Agent Date 0 10, APPLICATION FOR•' BUILDING PERMIT � COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDING ADDRESS WORKER'S COMPENSATION DECLARATION I ' S I hereby affirm that I have a certificate of consent to self Insure, 0 B ILDNG ADDRNwtjuo or a certificate of Workers'Compensation Insurance,or a certified I 33 copy thereof(Sec.3800,Lab.C.) IbApt—& CM ZIP -l�OV _! LOCALI Policy No. Company SIZE LOT A NO.OF BLDGS.NOW ON LOT �� ❑ Certified copy is hereby furnished. 2L 0 Z NEAREST CR SS ST. ❑ Certified copy is filed with the county building inspection I TRABLOCK LOT No. I department. _zL:W, USE ZONE MAP NO. Date Applicant ASSESSOR MAPEOOK �,� �! PAR&f SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OW 5�� / (� ! T_. CJ�iIJO� YES No COMPENSATION INSURANCE � Com. f rml dJ�G,NB�� 1 WITHIN 1000FT.OFSCHOOL? . • (This section need not be completed if the permit is for one hundred ADV 3 1J. 2(JUIG*gJ,,0 � DISTRICT GROUP TYPE CONST.' FIRE ZONE P CEssED dollars($ or less.) CI AZ On zIP V� I certify thathat in the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to ARCHITEF9RiDIGINEER yLO.,� become subject to the Workers'Compensation Laws. (Zr TAW STATISTICAL CLASSIFICATION APT 0 CUNDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT.• If, after making this Certificate of I REOUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRA �� TEL.NO. SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code,you must forthwith � FROM comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS SIDE CL C" PL O I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP (commencing,with Section 7000)of Division 3 of the Business and SO.FT.SIZE No.OF TORIES NO.OF y4MILIES 0 Professions Code,and my license is in full force and effect. ( 7DU BK Po License Number Lic.Class DE �� K r ® y Contractor Date ❑ I amexempt under Sec. I REPAIR 11 B.BP.C.for this reason DEMOL ❑ LDMA P/C# Date: USE OF�x�TlyeµdpG� URM ❑ Signature AP N P I D C �2 LDMA Perm# Z t ❑ I,as owner of the property, or my employees with wages as ✓ O � [. o s their sole compensation,will do the work and the structure is AD 3 nl , //�11,/J!d„r M. Ft A Q c not intended or offered for sale (Section 7044, Business and U� lu vo��vr� y 33,07 • 8035 Professions Code.) � -� " / c ITEMS WILLTHEAPPUCANTOR FUTURE BUILDING OCCUPANT HANDLEAHAZARDOUS MATERIAL J ❑ I, as owner of the property, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN Y g THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL B licensed contractors to construct the project.(Section 7044, YES❑ NO❑ > TOTAL 58.75 Business and Professions Cade.) 58.75 I WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING CHECK �1 a�.•,1 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROMTHE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST 1 �I FOR GUIDELINE3. CHANGE n0 I hereby affirm that there is a construction lending agency for YES ❑ NO❑ the performance of the work for which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD j �y f 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES 0000-0010 1 4!iUir COUNTY CODE,TITLE2,CHAPTER 220 SECTIONS 220.100THROUGH 220.14000NCERNING Lender's Name I HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. 2467 1 AM 7:47 a47 Lender's Address opmmenAeevr o I certify that I have read this application and state that the above PC,FEE PERMIT FEE information is correct. I agree to comply with all county ordinan and laws ting to building construction,and h uthori prase vas this County to a ter upon ISSUANCE FEE pbm ant ed pr f Inspection pu1-3-00 mZ �� INVESTIGATION FEE TOTAL FEE nl or Apart Dd. I I SEE REVERSE FOR EXPLANATORY LANGUAGE