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HomeMy Public PortalAbout6218 ROWLAND AVE_Building__ 76AG38A DBS-3 I2-54 OLI/�SQ/V APPLICATION FQRF BUILDING PERMIT DIVISION OF BUILDING AND SAFETY 8l1ILD ING ADDRp��rj� ESS. of .O I� L 1/e Department of County Engineer n t County of Los Angeles LOCALITY C WM.J. FOX, COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. a i DISTRICT NO. GRUP, F SEWER- MAP FOR APPLICANT TO FILL IN OPET' BK PG BUILDING ,q r/ f� ♦ 's CONST-y:. G –4f-f) ADDRESS ✓ JS ,G l�G/G�L�� V"e NUMBERRO t� -� STATE YES , HWY LOT NO. B USE ZONE SPECIAL' J �yf�'�+, CONDITIONS ! TRACT /� 0.2 - llC7���I y NO.OF BLDGS. _SIZE OF LOT S'S�l I U NOW ON LOT BUILDING YARD HWY STREET NAME EXIST. USE OF SETBACK WIDTH EXISTING BLDG. 6,, /}.,� �y .FRONT C / OWNER -llA {/ ,9A ;w SIDE ([Jf a✓1. /. MAIL P. L. � ADDRESS , J (/♦'7'1� ��JJ �r y/ CITY //. C/ NO/�r/��gjly DWELL. I UNIT 5 INDUSTRIAL 2 DUPLEX UNIT— 6 PUBLIC BLDG. ARCHITECT OR TEL. ENGINEER NO. g APT. UNITS 7 ADDN.,ALT., ETC. ADDRESS - 4 COMMERCIAL 8 MISCEL. TEL. CONTRACTOR NO. INSPECTION RECORD ADDRESS 7 _9�_,{ / „w/ - - ���-� �'YJ•j' /f//I i(/ //l�- DESCRIPTION OF WORKIre ft NEW ADD ALTER REPAIR DEMOLISH 'r J3r�c r,- S11 � SO.'FT. / - NO. OF NO. OF SIZE ST STORIES f FAMILIES I�-,, AY11/AS... IPA4, 1A. Fr1)d' USE OF STRUCTURE e /a OF a -y� , �;°FY1tI I Ar'7 'LF]rk- rh-r SIGNATURE OF ' APPLICANT ` • /� {� I7+s'� Jeri APPROVALS `- "'/ /� ,rte„ ��N�S'I'�- �•�� �/ w�' ADDRESS ,,23 �J J DATE INSPECTOR'S SIGNATURE $ FOUNDATION: LOCATION ,,,, C. $ f� FORMS. MATERIALS FEE FRAME: FIRE STOPS, p $ BRACING.BOLTS D 1E,ftiLtt,�P�f: VALUATION Qe .FEE � FURNACE: LOCATION,J�Na7�-oA%E PIT ��C�xQ,�Q S?� 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT, DUCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECT Z 1 n,r(' AND AGREE TO COMPLY WITH ALL COUNTY ORDINANC)tS LATH. INT. y Sr vvN/I AND STATE LAWS REGULATING BUILDING CONSTR C. -7 �y ` TION.NATURE OF' f /J�I�,rte !{�� g .g LATH, EXT. (yJ O �� } SIGPERMITI EE `�_Er' �+ "';'• "'�d T I�� � HRECT.AND POSTEDOUSE R ADDRESS— eqV rf+ t " '?., e FINAL WM. J. 'FOX. CouxTY EIrismum VALIDATION , 7_ i? 6 14.0 O �, CoP..�.Y5 9- .FE•1.1 1 '2_ B."O 0 0 • ©��.1-Ss` ^. _ - DEPUTY .. �• "' '- PEPUTYt.�` BY BY DEPUTY: DEPUTY 96911).LZU ED WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers' Compensation Insurance, ArKICATICAMROW BUILDING PERMIT or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING ANDS FETY Policy No. W000-7146Company Beaver Ins. BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS DI Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS 6218 N. Rowland Ave. Date 7-1-89 Applicant Virgin Roof Co. CITY Tem le City ZIP 91780 LOCALITY NO.OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCEASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAIIFtr PARCEL hundred dollars ($100)or less.) TEL. OWNER Mr. & Mrs. Oliason NO. y'USE ZONE MAP I certify that in the performance of the work for which this NO.SPECIAL >- permit is issued, I shall not employ any person in any manner ADDRESS 6218 N. Rowland Ave. ICONDITIONS so as to become subject to the Workers'Compensation Laws. U CITY Tem le City ZIP 91780 Date Applicant ;ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE 2::� O NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST. ZONE U Exemption, you should become subject to the Workers' r- w Compensation provisions of the Labor Code, you must forth- ADDRESS ��v� n with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. CONTRACTOR Virgin Roof Co NO. 287-0507 Z LIC. CLASS NO. DWELL. UNITS LICENSED CONTRACTORS DECLARATION ADDRESS NO I hereby affirm that I am licensed under provisions of Chapter 9 . 160690 SEWER MAP (commencing with Section 7000)of Division 3 of the Business - LIC. and Professions Code,and my license is in full force and effect. <CITY CLASS C39 �, lBK PG VALIDATION 160650 SQ. FT. rNO. OF NO. OF CHECK License Number Lic. Class C39 SIZE ORIES 1 FAMILIES ONE VALUATION Contractor Virgin Roof CO-Date 6-30-89 DESCRIPTION OF WORK Huse G NEW ❑ $ '9855.00 ADD ❑ ❑I am exempt under Sec. 3 Pool ALTER ❑ BAP.C. for this reason USE OF fiberglass shingles. 21 SUS- REPAIR EJ $ 1 Date: EXISTING BLDG. DWelling DEMOL ❑ Signature APPLICANT TEL. g OWNER-BUILDER DECLARATION (PRINT)Virgin Roof Co. NO. 287-0507DAT 1 hereby affirm that I am exempt from the Contractor's License ADDRESS_P.O. BOX J San Gabriel 91778 Law for the following reason (Section 7031.5, Business and Professions Code): PRESENT ' (�/ .-.:� ElI, as owner of the ro ert or m em to ees with BUILDING '• .g P P Y� Y P Y -=ADDRESS � ADDRESS— wages as their sole compensation,will do the work and .6 f �'�',v the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code.) MOVING TEL. ;f F1 IT �' CONTRACTOR NO. El 1,as owner of the property,am exclusively contracting *� with licensed contractors to construct the project (Sec- ADDRESS — a e tion 7044, Business and Professions Code.) ; 1-If-�'�: 59.125 REQUIREDTOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY fi SET BACK YARD HWY PROP. LINE WIDTH [r1GE I hereby affirm that there is a construction lending agency for FRONT _ the performance of the work for which this permit is issued t P.L. (Sec. 3097, Civ. C.). SIDE _ P.L. 1_3_t [ -y;j ilk 1 i,g Lender's Name 8 48.75 LDMA Ref. # P.C. Fee$ Permit Fee N Lender's Address I certify that I have read this application and state that the Issuance Fee LDMA P/C# 3 above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee 59.25 LDMA Perm. # = and hereby authorize representatives of this County to enter uon the abov mentioned property for inspection purposes. 0 ( M1 IMOL3-21-89 SEE REVERSE FOR EXPLANATORY LANGUAGE P SI nature of Applicant or Agent Date