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Home My Public Portal About6126 ROWLAND AVE_Building__ R`A PLICANTAOPFPLICIATI OWN (Prnt orYN FOR BUILDING PERMIT. COUNTY OF LOS ANGELES ADDRBUILDIESSNG - DEPARTMENT OF COUNTY ENGINEER CITY ZIP BUILDIN ND SAFETY DMS N . r O.OF BLDGS. ' 'E BUILDING SIZE OF LOT/4:UNOW ON LOT ADDRESS 1 TRACT BLOCK LOT NO. LOCALITY TEL. NEAREST OWNE , NO. CROSS ST. ASSESSOR ADDRESS MAP BOOK PAGE PARCEL xx DI TRICT GROUP TYPE FIRE PROCESSED BY CIT ZIP (J� - 06 ' CONST. / Z ARCHITECT t T L. ENGINEER � ` NO. fry STATISTICALCLASSIFICATION J SEWER MAP ADDRESS 2T Af" CLASS NO. � C] - DWELL.UNITS � / SK PG TEL. CONTRACTOR NO. USE�ONE NO. _00-:3 ""� e_�' LIC . �V1 /[�+/ ADDRESS w�"uC NO. W CONDITIONS CITY ASS SPECIAL LIC. �I ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENDER j NAME AND BRANCH i BLDG.SETBACK FROM FRONT PROP.LINE OF �~ (STREET) ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ:FT. U NO.OF ./i NO.OF CHECK HIGHWAY •i YARD = FRONT PROP.LINE HIGHWAY WIDTH SIZE T STORIES FAMILIES •ONE DESCRIPTION OF WORK �J(f NEW + O ADD ❑ BLDG.SETBACK FROM (STREET) O' SIDE PROP.LINE OF ALTER ❑ TOTAL SETBACK FROM TYPE.OF EXISTING HIGHWAY YARD = SIDE PROP.LINE HIGHWAY WIDTH h USE OF REPAIR ❑ Z EXISTING BLDG. DEMOL ❑ + APPLICANT i /� TEL CORNER CUTOFF YES C] NO ❑ (PRINT) 1� W NO. , }�� IN OPEN SPACE YES F] NO 13BY(SIGNATOR (/( Al IN-COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION Of 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.1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO RKMEN'S COW. 0Vi �. PENSATION INSURANCE. J�GC 's�fl�k% (Jq J CMZ SIGNATURE OF PERMITTEE L ADDRESS FINAL TEL. DAv CITY NO. ��^ MAKE CHECKS PAYABLE TO: F E'•$ FEE HARVEY T.BRANDT,COUNTY ENGIN=EER 6-3 PLAN CHECK VALIDATION CK M.O. CASH PERMIT VAL�ATNGK M.O. CASH 2 7f'.DEC' 10 .2. 3 'U 2.4. 0 ; 501NFE8 9 m 0 D 8438e= ®s 76A638A CE#803 3.75 r 6 0 n FEB 9 4+1 0 3 4 /�/ .O 3 B'"_ ' WORKERS'COMPENSATION DECLARATION {� hereby affirm that I have a certificate of consent to self 1 APPLICATION,• FOR BUILDING PERMIT insure, or a certificate of Workers'Compenstion Insurance,or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES i BUILDING AND SAFETY Policy No. Company BUILDING.I Certified copy is.hereby furnished. t FOR APPLICANT TO FILL IN ADDRESS 126 N.. ut L (4u(7,. ❑ Certified copy is filed with the county building inspec- BUILDING J �� _ r— t ion department. ADDRESS I Z(I N,. �-U L"r V E LOCALITY I � /V� L C e- ��. , NEAREST , Date Applicant CITY CM Lam . c�T'J ZIP CROSS ST. ( l G -L !�CERTIFICATE-OF EXEMPTION FROM WORKERS' _ NO.OF BLDGS. ASSESSOR', COMPENSATION INSURANCE SIZE OF LOT 9S NOW ON LOT MAP BOOK PAGE PARCEL (This section need not,be completed if the permit_is for one J/ USE ZONE:' MAP hundred.dollars ($100)or-less.) TRACT �Q4 Y BLOCK LOT NO. NO.. I 'TEL.. rr /l I SPECIAL I certify that in.the performance of.the work for which this ;• OWNER 4! L�/V_ 1 N Vt=LO$LNO.z-a� L CONDITIONS o r DISTRICT GROUP TYPE FIRE PR SSED�BY 0 permit is issued, I shall not employ any' erson in any manner '� .r ADDRESS ZIp r\, . ow -A N �V� CONST. ZONE so as-to become object fo'ihe Workers Comp nsatia Laws. rr,,�� Se Q� ®C Jd i 1 CITY C C' !T t 1 ZIP o �Dafe "App--. ^r"` STATISTICAL CLA FICATION APT. CONDO. (, NOTICE tOAP LICANT: If, after making this Certificate of ENGINEER ARCHITECT OR '.TEL.NO. - v�-y � Exemption, you..should become subject to the Workers' 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 ,/ deemed revoked. TEL' CONTRACTOR NO. BK.IV PG -VALIDATION _ LICENSED CONTRACTORS DECLARATION ` LIC. , I hereby affirm that I am licensed under provisions of Chapter 9 \ ADDRESS NO. VALUATION (commencing with Section.7000)of Division 3 of the Business and I LIC. Professions Code, and my license is in full force and effect. `. CITY CLASS _ SQ.FT. NO.OF NO.OF CHECK License Number Lic.Cldss SIZE STORIES FAMILIES ONE Contractor Date DESCRIPTION OF WORK . AD ,; , ❑ i am exempt from the licensing requirements as I am aIle licensed architect or a registered professional engineer + ALTER `E] FINAL' acting in my professional capacity (Section 7051, t ❑ DATE REPAIR Business and•Professions Code). USE OF FINAL' EXISTING BLDG. DEMOL ❑ By Lir.or Reg.No. 'Date APPLICANT TEL. OWNER-BUILDERR-DECLARATIOIV (PRINT) NO. I hereby'affirm that I am ekempt from the Contractor's License Law for the following reason (Section 7031.5, Business and 1' ADDRESS Professians•Code):.. PRESENT ❑ BUILDING I, as owner of the property, or my employees ith ADDRESS w 1 1 5A A wages as their sole compensation,will do the work and , the structure-is not intended or offered for sale(Section LOCALITY I 1 1 # o a o a a '1. 7044, Business and Professions Code)., I� MOVING � TEL. CONTRACTOR NO. ❑ I, as owner of the property,am exclusively contracting 2 °'O 34.00 with licensed contractors to construct the project (Sec- i ADDRESS tion 7044, Business and Professions Code). ,0 ' c v ,O O REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH , I'hereby affirm that there is a construction lending agency for FRONT / } j C: 1 C)-81 the performance of the work for which this permit is issued P.L. Q ae9 • 6 (Sec. 3097, Civ. C.).' SIDE P.L. Lender's Name s� $ Lender's Address P.C. Fee$ Permit Fee .1 t W I certify that I have read this application and state that the Issuance Fee I cabove information is correct. I agree to comply with all County Investigation Fee I ordinances and State laws rela.fing to building construction, W and.hereby out orize re resent ives of this-County to enter l Total Fee J upon the above mention d prop, ty'foe inspection purposes. I n./ �• It� /F SEE REVERSE FOR EXPLANATORY LANGUAGE J' i Signature of Applicant or Agent 'Date I 1 ®s WORKERS'COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers'Compenstion Insurance, 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 BUILDING ADDRESS 6 I Zoo N. L_'^ J 'U-- ❑ Certified copy is filed with the county building inspec- BUILDING tion department. :ADDRESS 6 12—G W. 7 C 4U L f}rt LOCALITY I .Date Applicant .CITY CM CL GLT`'J ZIP CROSS r. PaZ1 6? 1-1 1 IJ �— CERTIFICATE OF EXEMPTION FROM WORKERS' _ NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT 9•S NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one V -•� USE ZONE MAP hundred dollars ($100)or less.) TRACT ort `f BLOCK LOT NO. � NO. I—A40a- TEL /( /l SPECIALCL OWNER LL f7&3` L�)H vL Lpscw6--—O J�L� !:• CONDITIONS 0 I certify that in the performance of the work for which this r DISTRICT GROUP TYPE FIRE PRO SSED�BY U permit is issued, I shall not employ any person in any manner ICi CONST. ZONE so as to become subject to the Workers Comp nsatio Laws. ADDRESS .,� Z� N , .Q+`v L/�R1 r fV 0 CITY ) C ;}1{�(-t C iTv ZIP a Date Applicant STATISTICAL CLA FICATION APT. CONDO. U NOTICE O APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. q //' LU Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO.�_DWELL-UNITSIL Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with,comply with such provisions or this permit shall be deemed revoked. TEL. CONTRACTOR NO. BK.'✓PG, VALIDATION LICENSED CONTRACTORS DECLARATION ` LIC. I hereby affirm that I am licensed under provisions of Chapter 9 \ ADDRESS NO. VALUATION (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 \ SQ. FT. NO.OF NO.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE $ Contractor Date DESCRIPTION OF WORK NEW ❑; El ! ADD I am exempt from the licensing requirements as I am a licensed architect or a registered professional engineer ALTER `❑k FINAL. acting in my professional capacity (Section 7051, 1 REPAIR DATE' Business and-Professions Code). USE OF FINAL' EXISTING BLDG. DEMOL ❑.: By r�� Lic.or Reg.No. Date ; 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 I, as owner of the property, or my employees with ADDRESS 5 jl r A wages as their sole compensation,will do the work and LOCALITY 'the structure is not intended or offered for sale(Section c a o a a 7044, Business and Professions Code). I MOVING TEL. ❑ I, as ownCONTRACTOR NO. I owner of the property, am exclusively contracting 2 a 0. 311 0 r with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). C. r)f�-J REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH , I hereby affirm that there is a construction lending agency for FRONT v r' the performance of the work for which this permit is issued P.L. @7 (Sec. 3097, Civ. C.)." SIDE P.L. Lender's Name P.C. Fee$ r Permit Fee r� P Lender's Address I certify that I have read this application and state that the Issuance Fee above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee and hereby aut orize re resent fives of this County to enter „ ( upon the above menttion�d prop for inspection purposes. J [ Lyy// 1� e ( SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date - ®s