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Home My Public Portal About6215 ROWLAND AVE_Building__ t � DERT ENT OF BUILDING AND COUNTY OF LOS ANGELESAFETY BUILDING U1LD1 G WM. J. FOX, CHIEF ENGINEER APPLICATION 000 �FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY sl � _ A DISTRICT NO. PLANK CIC.OR REM.No. PERMIT NO. ANG DDREISS �n sial' ��Ml�sF� r.{. 1� RECEIVED BY DATE OF APPL. DATE ISSUED LOCALITY �Cfy1.lY IAV' C MIC ✓A N S / S NEAREST PLA14 jE2 T V' CROSS ST. V BUILDING / ►/ADDRESSO DO `v /'6 J OWNER / LOCALITYj-��j�,p MAIL ADDRESS NEAREST NEAREST V _/ CROSS ST. CITY NO. FIRE NO.OF I TYPE 1 l GROUP`l ARCHITECT OR TEL ZONE / PLANS ENGINEER NO. BLDG. /,/.g/PRD./ RD. NO. A SETBACK LINE G 1�� ADDRESS USEAPPROVED TEL. �f ZONE � BY DATE CONTRACTOR lC(/�{'%C! A//�g,Fl,NO. j! 1rS� f�,►r' HOUSE NUMBERING ADDRESS � I ! �Er7}�:(es �fr+tisl ;�+� a MAP NUMBERO 0-73 —NO. ASSIGNED BY LEGAL CORRECTIONS - DE9CRIPTICN LOT NO. .`�-j BLOCK ' TRACT /rO Q �•P1 2 O �� NO. OF BLDGS. SIZE OF LOT ` NOW ON LOT USE OF NO. OF EXISTIN BLDG. I FAMILIES 4i DESCRIPTION OF WORK G NEW ALTERATION ADDITION Z D REPAIR DEMOLITION r V.FT. /� NO.OF V. ROOMS STORIES EXT.WALLROOF COVERING `��r/� I COVERING (nkI1?[j Silo USE OF STRUCTURE Vis.'-fry . i4'� r7L`I L � 1 INSPECTION FOR r APPROV*LS OCCUPANCYAS INSPECT 'SSIGNATURE DATE FOUNDATION: LOCATION FORMS, MATERIALS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THI$$$$$$ AP- c PLICATION AND STATE THAT THE INFORMATION GIV I; FRAME: FIRE STOPS, by�I r CORRECT. BRACING, BOLTSV I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT,DUCTS nn d ✓ SIGNATURE OF l :� �,�x, -, ( L1 , LATH, INT. / .4I AA n � 1. PERMITTEE __ _ !• �1 l.r+ u v` .�F ,J' r e LATH, EXT. ADDRESS PryPLASTER, INT. AUTHORIZED AOT. •I PLASTER, EXT. P.C. h FEE J l III LHOUSE NUMBER CDR- VALUATIONRECT•AND POSTED FEE =I / FINAL 7GAr.39A D833 7-51 I ,TEMPLE CITY I'U830A #803.1-61 APPLICATION FOR BUILDING PERMIT COUNTY OF 'LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS B=ING AND SAFETY DMSION LOCALITY . JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST. �� J DIST CT I.P. GROUP 'TYPE ED BY FOR APPLICANT TO FILL IN (O/ CONST. r BUILDING STATISTICAL CLASSIFICATION BE ER MAP ADDRESS K PG CLASS.NO.�DWELL.UNIT LOT NO. BLOCK WATER (� CERTIFICATE: NOT REQUIRED � RECEIVED f�0TRACT X MAPr� ,q 3 HIGHWAY STATE MAJOR SECOND, OCAL QIO.OF BLDGS. NO. r! (CIRCLE) SIZE OF LOT. I NOW ON LOT USE ZONE SPECIAL USE OF y�� CONDITIONS EXISTING BLDG. TEL OWNER r NO. UILDINGYARD HWY STREET NAME EXIST. ADDRESS 'A,45 y� FRONT SETBACK WIDTH' ARCHITECT OR TEL. P.L. ENGINEER NO. SIDE P.L. ADDRESS CL TEL INSPECTION RECORD O CONTRACT05e=mwa I NO _ u ADDRESS 6 � a/ 0 DESCRIPTION OF wolarr W NEW ADD i TEW3 REPAIR DEMOLISH N SQ.'FT. NO.OF NO.OF ? IZE 3' S6RI��E//S FAMILIES USEOF .dy /�/ T f STRUCTURE � ��7?'!i SIGNATUR OF y APPLICA - VALUATION$ a � gr� APPROVALS ./D`A�TGEj a INSPECTOR=S SI.GNA•TURE P C.FEE �� PMT.FEE $ v FOFORMS,MATERIALS LOCATION <1 if FRAME:FIRE'STOPS. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING,BOLTS _le ] fj ,r.: i..'�,+f•% AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE'LOCATION. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS ! BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN•VIOLA- LATH,INT. ` / !1? ��._ / �'S✓/� TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA- RELAT-ING TO WORKMEN'S COWENLSAUQhL INSURANCE. LATH,EXT. SIGNATURE OFHOUSE NUMBER COR- / l PERMITTEP RECT AND POSTED I� / ADDRES FINAL /l�rl , �/. Z✓a"�� CLYDE N. DIRLAM, PRINCIPAL STRU RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION. cK rv.0. CASH Lnbo 4 7 1 6 0 f My 15 - 1 D 1 5.00- • I WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self i APPLICATION FOR BU - N G PERMIT i.insul, or a certificate of Workers' Compensation Insurance, or•. ertified copy thereof (Sec. 3800, Lab-A.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No..'"awidAcIny BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the counyy buildi gin pec- l' BUILDING tion department. r-syk0- M L I.A.4 AD-DR�ES'S 40 -Date 5. 6_ R 1 �licant C � CITY/�I ` 1ZIP LOCALITY PP ,c� NO.OF BLDG . NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT�V - I NOW ON LOT CROSS ST. COMPENSATION INSURANCE / ASSESSOR l.!/2 A (This section need not be completed if the permit is for one TRACT / � BLOCK LOT NO. MAP BO E RCEL hundred dollars ($100)or less.) M�d c% EL- USE ZONE MAP I certify that in the performance of the work for which this �/ 77 NO. permit is issued, I shall not employ any person in any manner ADDRESS a SPECIAL >_CONDITIONS O so as to become subject to the Workeys'Co n doQ La s. , b e/I� ri(bOC frKeCITY C �j ZIP V J" C-91 j V�t, ARCHITECT OR TEL Date Applicant��(((/�e-• oe O NOTICE TO APPLICANT: If, after cooking this Certificate of ENGINEER NO. DISTRICT GROUP TYPE FIRE PROCESSED BY Exemption, you should become subject to the Workers' CONST.�/ ZONE ri Compensation provisions of the Labor Code, you must forth- ADDRESS vF -3 y 9Js a with comply with such provisions or this permit shall be __ TEL. N 1 STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTOR tJ NO. / _ LICENSED CONTRACTORS DECLARATION rrPf�. LIC. -1 CLASS NO.�DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS J 5«� dArera+a, NO. LIC. SEWER MAP (commencing with Section 7000)of Division 3 of the Business (� � fwd � gjldl�CLASS and Professions Code;and may license is in full force and effect. CITY BK PG VALIDATION License Number J.X ', L+' ! SQ. FT. NO. OF NO.OF CHECK _Li. Class SIZE STORIES FAMILIES ONE Q /� ��y VALUATION Contractor Suit uk CollJnj'+i Date e J DESCRIPTION OF WORK /Wdt�( 4 NEW ❑ $ � x)00 ❑I am exempt under Sec. tt/I 4V 4f ,( - ADD pool 01 BAP.C. for this reason REPAIR ❑ $ a e: USE OF EXISTING BLDG. DE MOL El �(,(Jj// C APPLICANT FINAL Signature TEL. OWNER-BUILDER DECLARATION (PRINT) NO. I hereby affirm that I am exempt from the Contractor's License DATE Low for the following reason (Section 7031.5, Business and ADDRESS FINAL Professions Code): PRESENT By s EJ 1, or m I, as owner of the property, employees BUILDING P P Y Y P Y ees with ADDRESS i''-C`•.I = wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY , 'E'Su I 7044, Business and Professions Code.) MOVING TEL. ❑ 1,as owner of the property,am exclusively contracting CONTRACTOR NOt i I LI I with licensed contractors to construct the project (Sec- T ";' ''2 ' ADDRESS i. I('ti _,._04 ��'_2 tion 7044, Business and Professions Code.) Lj CONSTRUCTION LENDING AGENCY SET BACK YARD HWY TOTAPROPALINE FROM WIIDSTH ;;�j-jLECK I hereby affirm that there is a construction lending agency for FRONT U +,' _i )i the performance of the work for which this permit is issued P.L. '"r'Li' (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name [Ilii I i--�Ir; I'I 5'+i '775,! P.C. Fee$ Permit Fee LDMA Ref. # T i AIN .21.31.3 Lender's Address 'ay s //2 I certify that I have read this application and state that the Issuance Fee !� 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 eA / LDMA Perm. # � and hereby authorize re resentatives of this County to enter g u th •ov me rt or inspection purposes. � J SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant int D to ..,�'"'