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Home My Public Portal About6224 ROWLAND AVE_Building__ APPLICATION FOR BUILDING PERMIT FOR•APPLICANT TO FILL IN (Print or type only) 11 , COUNTY OF LOS ANGELES BUILDING ADDRESS Q DEPARTMENT OF COUNTY ENGINEER CITY r—IM,(� ) z(P BUILDING AND SAF'E'TfY DIVISION 0.OF BLDGS. BUILDING SIZE OF LOT ��( Ob NOW ON LOT ADDRESS , W--t��ki x`_ TRACT' 1't W BLOCKLOTLOT NO. LOCALITY h'�, 4 1 TEL. NEAREST OWNER I �Q NO, CROSS ST. ASSESSOR ADDRESS r JV MAP BOOK PAGE PARCEL I (� t.(:T ZIP DISTRICTLRIOLIP CON �FFIRE CESSED BY -CITY t'"4 - TEL.rr ENGARCHNEER ITECF OR •�• �G� NO.b �� t 1 STATISTICAL CLASSIFICATION SEWER MAf ADDRESS o• V Q �'9V (—ACLASSNO._ DWELL.UNITS BK iL EL CONTRACTOR Z NO j 0- 6 Z NE NSPECIAL IC. MAP Q .Z LIC. C ADDRESS `�� S ��V CONDITIONS CITY CLASS CONSTRUCTION LENDER ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ NAME AND BRANCH BLDG.SETBACK FROM FRONT PROP.LINE OF -(STREET) ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ.FT. NO.OF NO.OF CHECK HIGHWAY + YARD = FRONT POP.LINE HIGHWAY WIDTH SIZE V STORIES FAMILIES ONE } DESCRIPTION OF WORK NEW + O ADD ❑ BLDG.SETBACK FROM ISTREETI of O V SIDE PROP.LINE OF n .sem D ALTER ❑ _ TOTAL SETBACK FROM TYPE OF EXISTING G HIGHWAY + YARD SIDE PROP.LINE HIGHWAY WIDTH ,a USE OF REPAIR ❑ Z EXISTING BLDG. DEMOL ❑ + ADPL CANT / TEL NO 3 VO�i� CORNER CUTOFF YES ❑ NO ❑ IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE) @ IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION$ OT�f�SCsC� 45-69 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES ty AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE IV WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF t THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- PENSATION INSURANCE. _� SIGNATURE OF L6—/LAc,244-- J, PERMITTEE P v 2� GFINAL TJ BY •i J!/ TEL. 3, Z / DATE {+i►`/ CITY CCC NO. MAKE CHECKS PAYABLE TO: P.C.EFEET HARVEY T.BRANDT.COUNTY ENGINEER 2,5, L PLAN CHECK VALIDATION cK M.O. GASH PERMIT VALIDATION (( c� M.O. cASH 723i;JiM-30231.. 25.220 • s 724�� 30 .1.1 � 2.00l� ®s 76A638A CE#.803 3.75• p�l`P- qwT OF;BUILDYNG AND SAFETY0102MILDING COUNTY GAF LbS ANGELES wlM. J. FE3-X' CHIEFENGINEER - 4 APPLICATION FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY /^ �f T D19 •[t1.CT�ND. P R...No. PERMIT NOBUILDIN . ADDRE99G LV L 6 \a,' PT .•q/"1 (lp RE E ED Y DATE OFAPPL. ATE ISSUED LOCALITY Fy ( NEAREST 9 •-� / CRO39 ST. �p 'Lo ® ADDRESS 6 6 J�/V OWNER /YI i; �F NI ,?:S s� gid_ - LOCALITY MAIL /� ADDRESS D�/y/� D NEAREST ' CROSS 8T. CITY qL rx , NO. �� FIRE I NO.OF I TYPE I GROUP ARCHITECT OR TEL ZONE PLANS ENGINEER NO. BLDG. � ww U�+ ORD. NO. . ADDRESS /A�.R b SETBACK LINE GAJ 7 T Y USE�, APPROVED TEL ZONE" o/ BY DATE CONTRACTOR /fN /r=�C��n <�I ' yHOUSE NUMBERING ADDRESS V T M/ W MAP NUMSER. �✓d NO. ASSIGNED BY LEGAL DESCRIPTION LOT NO. BLOCK /�� -�� /�/� CORRECTIONS TRACT r NO. OF SLOGS. SIZE OF LOT r� I NOW ON LOT USE OF I NO. OF ' EXISTIN BLDG. FAMILIES DESCRIPTION OF WORK 00 o_ NEW ALTERATION ADDITION Z D r REPAIR DEMOLITION _ BUT. y NO.OF / SIZE 7j 1� f/ ROOMS tog, STORIES "WALL ROOF COVERING �` ei C_P G O I COVERING (-_Ey Al PQ USE OF STRUCTURE INSPECTION FOR + APPROV S OCCUPANCYAS INBPECTO SSIGNATURE DATE FOUNDATION: LOCATION FORMS, MATERIALS _G"�Gl , C `(' 7 F 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRE STOPS, CORRECT. BRACING,BOLTS (�(i(, ��"`� •Lj L-.s I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACEO LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT,DUCTS SIGNATURE OF LATH, INT. PERMITTEE LATH, EXT. ADDRESS o, PLASTER, INT. AUTHORIZEDgAGJ'r}•" ✓t'J./ t PLASTER, EXT. FEE �� HOUSE NUMBER COR- R ECT AND POSTED LVALUATID � 6 � FINAL wok v( 76A63BA D883 7-51 '-_tA j PPL,ICATCOUNTY OF LOS ANGELES ON.F R DEPARTMENT-OF COUNTY ENGINEER r' U I L®I N Gi .PERMIT BUILDING AND SAFETY DIVISION ~gg FOR APPLICANT 'TO'FILL-IN BUILDSSG AD'BU(DR)ESS L�' i (,ef LOCALITY 6,,Z2:1 • __ .NEAREST . CITY ll ZIP CROSS ST. NO.OF BLDGS. ASSESSOR SIZE.OF LOT /v v NOW ON LOT.' MAP BOOK . . 'PAGE PARCEL �+ y DISTRICT GROUP TYPE FIRE PROC ED BY TRACT/ 00,.I- BLOCK LOLNO. ' / ��OS a; C, ST. E. OWNER ? NO. STATISTICAL CLASSIFICATION. EWER MAP ADDR_& G 2 2 ,0a, e,. CLASS NO. ��jj ,,1'DWELL.UNITS BK PG CITY _� C` ZIP �_ _ l�S . MAP ,Q v, /C�,�NNE NO. •. ARCHITECT OR' TEL .- SPECIAL ENGINEER � NO. Z ONDITIONS O ,O ADDRESS ROAD.DEPARTMENT APPROVAL REQUIRED YES-F] NO❑ TEL. y CONTRACTOR COL " NO. 6663 BLDG.SETBACK-FROM, LIC. FRONT PROP.LINE OF (STREET) ADDRESS A/D /�� NO. S3'. HIGHWAY. + YARD = TOTALSETBACK.FROM TYPE OF EXISTING LIC. FRONT PROP.LINE HIGHWAY WIDTH CITY CLASS G�� __ CONSTRUCTION LENDER' + 0- NAME NAME AND BRANCH BLDCT SETBACK FROM OV SIDE PROP.LINE`OF (STREET) at ADDRESS CITY O SQ.FT. —T—NO. NO. CHECK HIGHWAY' f YARD = TOTAL SETBACK FROM TYPE OF EXISTING SIZE STORIES FAMILIES ONE SIDE PROP.LINE HIGHWAY WIDTH. DESCRIPTION OF WORK NEW QO ADD CORNER.CUTOFF YES- ❑ NO ❑ ALTER ❑ IN OPEN SPACE• YES ❑ NO Cl REPAIR' ❑ ESE OF BLDG. DEMOL' ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑ APPLICANT r, TEL -(PRINT) 4 NO. ''d� BY(SIGNATURE) /% ND LLAREOG EBY ACKNOWLEDGE THAT I.HAVE READ THIS APPLICATION AND STATE THAT E ABOVE IS CORRECT.AND AGREE TO COMPLY,WITH ALL ORDINANCES ING THE THORIZEDAND LAWS THEREBY BUILDINGING WILLL O)T,EM EMPLOY ANY ESTRUCTION.I RSONFY FIN VIOAT IN LATION OF R CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM• i y:�• N INS URE OF t FINAL �(/--lg7 BY + EE'" DATE S ^ ^^t TEL. �{ P.C.Fee$ / Permit Fee _ �! NO.QIssuance Fee TION D O + otal Fee PLAN CHECK VALIDATION dic M.o. CASH-' PERMIT V LI O .CK. M.O. CASH 9 2&MG 15. 21 0, 4.6 3. ®5 ;BAesBA CE p809A 8/78 931-AUG 2 5 1 0 4 .` 5 66 ' WORKERS'COMPENSATION DECLARATION .elh_y-y j affirm that.I have a'certificate of consent to self APPLICATION FOR BUILDING PERMIT in:4 e.,or a certifibte of Workers'Compensation Insurance, or a certifieI9 copy thereof(Sec:3800, Lab. C.) I. COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS 6 a a E] Certified copy is filed with the county building inspec- BUILDING ed,, tion deportment. ADDRESS as� ,L Date Applicant CITY ZIP 9/7tc, t LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' ' NO.OF BLDGS. 7_ NEAREST COMPENSATION INSURANCE SIZE OF LOT SS'O o NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR TRACT BLOCK LOT NO. hundred dollars($100)or less..) MAP BOOK PAGE, PARCEL TEL. /P I certify that in the performance of the work for which this OWNER L± =•+ NO. 6o6C USE ON)E O. permit is issued, I shall not employ any person in any manner ADDRESS , 1 SPECIAL A. so as to become subject to the Worker ompensati n Laws. CONDITIONS- V 09 Date Applicant. CITY ZIP O NOTICE TO APPLICANT: If, after makIqf this Certificate of^ ARCHITECT OR TEL. DISTRICT GROUP I TYPE FIRE 795MED BY Exemption, you should become subject to the Workers' ENGINEER O• tJ� CONST. ZOt�JE tJ/{ //� 6Y Compensation provisions of the Labor Code, you must forth- ADDRESS ` ®' with comply with such provisions or this permit shall be in TEL. STATISTICAL CLASSIFICATION APT. CONDO. • Z deemed revoked. CONTRACTOR A I NO. LICENSED CONTRACTORS DECLARATION .LIC, CLASS NO. DWELL. UNITS - LICENSED hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 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 �` STORIES 0•�� FAMILIES ONE VALUATION Contractor Dare DESCRIPTION OF WORK NEW E] $ OL a d ❑1 am exempt under Sec. �� "' r . ALTER ❑ , B.&P.C. for this reason REPAIR ❑ $ USE OF Date: EXISTING BLDG. DFMOL ❑ APPLICANT TEL. Signature FINAL OWNER-BUILDER DECLARATION PRINT NO. DAT I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS IN 'Professions Code): PRESENT B rviBUILDING 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 ' ' z[ ?4.9 A 7044, Business and Professions Code). -MOVING TEL. ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. #' 0 0 0 o e 1 with licensed contractors to'construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). -1 a ('1550.. REQUIRED TOTAL SETBACK FROM CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP.LINE WIDTH o 0 1 1 5 5 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. -d3 1 8-86 (Sec. 3097, Civ. C.). SIDE m P.L. _ e Lender's Name S /' LDMA Ref. # P.C. Fee$ Permit Fee (l ' • Lender's Address _ it I certify that I have read this application and state that.the Issuance Fee Q J Q LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee a ordinances and State laws relating to building construction, Total Fee ,� LDMA Perm.# d and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. adl3 ..-/�'_�� SEE REVERSE FOR EXPLANATORY LANGUAGE n S' nature of Applicant or Agent Date �°