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HomeMy Public PortalAbout5435 RYLAND AVE_Building__ �. �� TBA69BEM eBPBaBE GI -TY ,•B.UILDIN : PERM APPLICATION FOR; COUNTY OF LOS ANGELES ''BUILDING DEPARTMENT OF COUNTY ENGINM ADDRESS BUILDING AND SAFETY DIVISION LOCALITY G JOHN A. LAMBIE'. COUNTY ENGINEER WEAREST COLEMAN W. JENKINS SUP'T OF BUILDING -CROSS ST.gc7F�zpi QRP TYPE R FOR APPLICANT TO FILL IN co,NST. BUILDING STATISTICAL CLASSIAICATION SEW MAP.. ADDRESS. 5 4 3 5 R v 1 an d (CLASS NO. r/ DWELL"UNITS BK. " -PG LOT NO. BLOCK USE ZONE MAP " Q r •NO. TRACT SPECIAL NO. OF BLOBS. TIONS SIZE OF LOT NOW ON LOT USE OF Dwelling BLDG. SETBACK FROM TEL. FRONT PROP. LINE OF .(STREET) OWNER'Fxank Hellems NO 444-6316 _ TYPE OF EXISTING BE NIGXWAY YARD = TOTAL' - ADDRESS XIGX Y F M C.L. CITY BLDG. SETBACK FROM J%RCHITECT OR TEL. SIDE PROP. LINE OF • •(STREET) ENGINEER NO. TYPE OF EXISTING SETBACK XIOH.WAY. {_ . YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. TEL. 'I• _ CONTRACTOR NO' ADDRES560O S.SanGabriel N 160650 CORNER CUTOFF YES• ❑ NO ❑. CITY San Gabriel CLA 1° Sm C-39 SEE REVERSE SIDE FOR SPECIAL APPROVALS. c. DESCRIPTION OF WORK NEW ADD ALTER RDEMOLISH C SO.FT. NO. OF • NO. OF ' SIZE _ STORIES l FAMILIES USE OF STRUCTURE Re oof House & G aD'e with Coop. Shingles - SIGNATURE OF APPLICANT VALUATION$ 4 i 6 ' '00 APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION, LOCATION FEE$ -FEE$ 00 FORMS, MATERIALS FRAME, FIRE STOPS'. 1 HEREBY ACKNOWLEDOE TWAT I HAVE READ THIS APPLICATION BRACING BOLT AND STATE TNAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS.VENT. DUCTS - SUILDING CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN.V(OLA- LATH. INT. - TIONOF THE LABOR CODE OF THE STATE'OF CALIFORNIA RE T• _ . ING TO WORKMEN'-SI,- PFNSAT�ONol IJ�SU NCE. n xoL TH. EX.T. - v SIGNATURE OF HOUSE NUMBER COR- - PERMITTEE RECT AND POSTED ADDRESS r i FINAL JOHN F. LEWIS. PRINC'IPAL'ST RAL ENGINEER PLAN CHECK VALIDATION. CK. M.O. CASH _.t PERMIT VALIDATION CASH M .o CASH 2 9 5 5 188 FEB 5.. 1 D 9:0 °Q '; ` n4fI DI��w�.. 0 OF BUILDING AND SAFETY 1 ® 1 ( �($Department of County Engineer q + '`l -' -bounty of Los NG WM. J. FOX, COUNTY ENGrmtra APPLICATION ' FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING / DIBTRIO. PI CK. N.. PE%M NO. ADDRESS 1 _4.4•LOCALITY REGI 4ED BY DATE OFaA PL. DATE ISSUED MCA ST 1 CRO9H8T. y �f� ADDRESSDING (� /I/ /� y LR NO OWNER MAIL LOCALITY —r 15m p/-_ n �I r � ADDRE89 , •+ .®e�l s CROW ST. CITY NO' ariRE T ZONE ,__ PI—NL•AN9 ITYPE=J �j-I BROUP,— ARCHITECOR ER f rites J� ENGINEi' NO, BLDG. /� /y D. NO. SETBACK LINE V `T ADDRE88 '( ! / USEAPPROVED �e TEL ZONE - BY DATE CONTRADTOR ;`�.CLJ� Q NO. ( HOUSE NUMBERING ADDRESS MAP NUMBER VQ NO. ASSIGNED BY LEGAL —DESCRIPTION LOTNO. `�_ BLOCK ��t��Lt �.� (CORRECTIONS TRACT SIZE OF LOT J�� I NOW ON was.13T �"� USE OF NO.OF EXISTING BLDG. FAMILIM �- DESCRIPTION OF WORK °av v NEW ALTERATION REPAIR DEMOLITION y 1' El",FT. /-7 �� NO.OF s. .4-�Gl /=1 6�Z�l.vi2lr _SIZE I ROOMS 9TRcar /JORIEB / �Du EXT.WALL C�l f cr O I COVERING ` '(//M pu COVERING V J USE OF STRUCTURE 6WA!�4L/m j • kVI r p' INSPECTION FOR APPROVALS OCCUPANCYAB INSPECTORPBBIGNATURE DATE FOUNDATION:LOCATION FORME, MATERIALS Art/4--l- 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IB FRAME: FIRE STOPS, CORRECT. BRACING,BOLTS I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE LAWS REBULATIMB 8 ILDI G CONSTRUCTION.OJF GAB VENT,DUCTS —.I I BIGNATURE O� LATH, INT. �* PERMITTE v Cha • ADORES ��� LATH, EXT. '4tc ` ,,,�� I- AUTHORIZED AOT. PLASTER, INT. _ PLASTER, EXT.60 i" �� - J� �C FEE HOUSE NUMBER COR- 6�—a � Od S �) RECT AND POSTED �{ VALUATION )d FEE 2 `7' FINAL 76A633A D33 3 1-57 i ' • • 1 '`" • APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY ,�• � o FOR APPLICANT TO FILL IN BUILDING ADDRESS • WORKER'S COMPENSATION DECLARATION � 1•1e7eby affirm that I have a certificate of consent to self Insure. BUILDINGADDRESS r �� j or a certificate of Workers'Compensation Insurance,or a certified CITY ZIP �� )L e'v D •copy thereof(Sec.9800,Lab.C.) �. / Jq Company O LOCALITY C POIICy NO. SIZE OF LO NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. i 'L 120 NEAREST CROSS ST. I_* � ❑ Certified co is filed with the count buildinginspection TRACT BLOCK LOT NO. N �� department.Py y I d USE ZONE MAP NO. Pa Date AppliCamt ASSESSOR MAP COOK ' �� PAGE PARCEL .q�, SPECIAL C NDITiO 3 OWPCERTIFICATE OF EXEMPTION FROM WORKERS' ER _ TEL f/,FS 2f j? I` YES No COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL? ADDRESS" (This section need not be completed If the permit is for one hundred >4� DISTRICT GROUP TYPE CONST.' FIRE ZONE OCESSED BY dollars($hat or less.) CITY Al. .ZIP Y.Y //t� I/` 9�I certify that in the performance of the work for which this permit �� /�• �' '� �BO � ,C` J//� 13 �/I- Is Issued, I shall not employ any person In any manner so as to ARCHITECT OR ENGINEER� TEL.NO. become subject to the Workers'Compensation Laws. �C/ /�/� r 14;j STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT.• If, after making this Certificate o 67 `L ' C REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' OR SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code,you must forthwiFRONT comply with such provisions or this permit shall be deemed revoked. ADDRF4S � LI No. PL LICENSED CONTRACTORS DECLARATION CITY SIDE 23 I hereby affirm that I am licensed under provisions Of Chapter 9 ' SEWER MAP . v I•a v S .FT SIZE NO.OF STORES NO.OF FAMILIES (commencing with Section 7000)of Division 3 of the Business and NEW BK PG 3307 64-7z71Ip Professions Code,and my license is in full force and effect. 74:3 , License Number Lic.Class � DESCRIPTION OF WORK - �• ADD VALU TION Lu Contractor Date Ale / �y ALTER ❑ o � � W _ TOTAL 647 m a €� ❑ I am exempt under Sec. � •� REPAIR ❑ CHECK 647.70 P $ ��A 10 010•-4-0 BARC.for this reason ��1� DEMO- ❑ LDMA Pic a CHANGE GE .00 Date: USE OF EXISTING BLDG. •URM. ❑ Signature APPLICANT IN T L O. s f= ry- LDMAPermN Z 4/ 5/9 103 ❑ I, as owner of the property, or my employees with wages as �vu �� O their sole compensation,will do the work and the structure Is AD 2 a j j'}Zl �!' not Inte ed or offered for sale (Section 7044, Business and Ale• FINAL DATE ry G �`; 1 J 17.4 P ons Code.) S'a p Rl � y T ,��_ WILLTHE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLEA'HAZARDOUS MATER UM 8S owner of theproperty, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN a i t EMS Y g THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY •j licensed contractors to construct the project.(Section 7044, \ YES❑ NO❑ y� TOTA! Business and Professions Code.) c.• WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING `-� r�S� 'i•l j{ •� OCCUPANT REQUIREA PERMIT FOR CONSTRUCTION OR MODIFICATION FROMTHE SOUTH ,/J 10.d CHECK Iist!e i 4 CONSTRUCTION LENDING AGENCY COAST,AIFOR RLI QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST >;"��� CHANGE ,�I t 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. dI HAVPERMIE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD e�`t. �'}1 q i �• •s 9097,CIV.C. �/) GELES COUNTYCODE,TITLE2,CHUAFTER2ZDSEC'nON8NDERSTAND MY �22(L wTTHHROUGH220.140C.ONUNDER THE LOS OERNING Lender's Name 'vv "` HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. p _ �B 3509 1M 9:40 Lenders Address oxmmORAGMT A• o' I certify that I have read this application and state that the abov� PC.FEE PERMIT FEE i Information is correct. I agree to comply with all coun,,y�,�J /1 ordinances and Sta laws relating to building construction,anjd�71 O hereby autho presentatives of this County to en ronq�. � b ISSUANCE FEE 13 the above-m oned property r ins ion purposes Vzr •'� INVESTIGATION FEE TOTAL FEE /D / SWwWm0fAW&M^1aA9M f SEE REVERSE FOR EXPLANATORY LANGUAGE, ` WORKERS'COMPENSATION DECLARATION r' ereby affirm that I have a certificate of consent to self j 5 ur r a certificate of Workers'Compensfion Insurance,or APPLICATION FORU I L D I N G PERMIT b ze copy thereof( 01 � I COUNTY OF LOS ANGELE BUILDING AND SAFETY b, p d FOR APPLICANT TO FILL IN A�oRess Certified copy is filed th the county building inspec- BUILDING "" tion department. ADDRESS �l J 4 y� d LOCALITY c NEAREST = to Applicant CITY .e vv� 13 Le c 1( ZIP CROSS ST. r CERTIFICATE OF EXEMPTION FROM WORKERS' Nb.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL =his section need not be completed if the permit is for one "ECIAL P d I it ndred dollars($100)or less.) TRACT 1,� BLOCK LOT NO. OWNER v r..a a" TEL. certify that in the performance of the work for which this �'✓� O. NDITIONS Q ermit is issued, I shall not employ any person in any manner f��, �� P DI RIOT GROUP TYPE FIRE CE BY as,to become subject to the Workers'Compensation Laws. ADDRESS CONST. ate Applicant CITY ZIP STATISTICAL CLASSIFICATION iv APT. CONDO. OTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. W xemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS �. ttA ompensation provisions of the Labor Code, you must forth- ADDRESSSEWER MAP with comply with such provisions or this permit shall be / [s _ teemed revoked. CONTRACTOR ' e A �.�( O yp O• T�f) 0 BK. PG, VALIDATION LICENSED CONTRACTORS DECLARATION I i C e� L hereby affirm that I am licensed under provisions-of Chapter 9 ADDRESS LI 3 t✓ t� o v+ l Nf2 -7 ?9 C- VALUATION [commencing with Section 7000)of Division 3 of the Business and Drofessions Code,land my license is in full force and effect. CITY h G a. O G K CLASS $ r9 / s=--6— SQ. FT. NO.OSTO IE FA OF CHECK _ _icense Numb Lic.Clas SIZE STORIES FAMILIES ONE as- -ontractdr o Date � � DESCRIPTION OF WORK &.-,e NEW ❑ $ I am exempt from t e licensing requirements as I am a 2 c t.- + O ADD C1 licensed architect or a registered professional engineer ALTER ❑ FINAL acting in my professional capacity (Section 7051, 6' i r REPAIR DAT / Business and Professions Code). USE OFFINAL EXISTING BLDG. �� o (� ..i DEMOL ❑ By �` �� .ic.or Reg.No. Date APPLICANT TEL. 6WNER-BUILDER DECLARATION (PRINT) NO. 1 hereby affirm that I am exempt from the Contractor's License .aw for the following reason (Section 7031.5, Business and ADDRESS professions Code): P ILSENT DIN z 2 7 4 3 A BUILDING I, as owner of the property, or my employees with ADDRESS � wages as their sole compensation,will do the work and #'o o ° o 0 1 the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. 2 ° 1 1 5 ] I, as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS °'O 1 1 tion 7044, Business and Professions Code). 5.0 0 6 REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH O 1.26-82 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. Lender's Name ��'�} t l ✓ Lender's Address I P.C. Fee$ Permit Fee / certify that I have read this application and state that the Issuonce Fee above information is correct. I agree to comply with all County Investigation Fee �— )rdinances and State laws relating to building construction, Total Fee and hereby authorize re resentatives of this County to enter tpo bove-men o ed property for inspection purp s s: SEE REVERSE FOR EXPLANATORY LANGUAGE Sig °cure of AP- cant or Agent pa Os y APPLICATION FOR BUILDING PERMIT • COUNTY OF LOS ANGELES BUILDING AND SAFETY I + FOR APPLICANT TO FILL IN BUILDING ADDRESS y z'4�I) 0 4 WORKER'S COMPENSATION DECLARATION �G I hereby affirm that I have a certificate of consent to self insure, F11AD R or p certificate of Workers'Compensation Insurance,or a certified ZIP copy thereof(Sec.3600 Lab.C. p�� �d I-rV LOCALITY c •Policy No. 0 Company 5 ?/T�r `��� SIZE OF LOT �/ // NO.OF BLDGS.NOW ON LOT �� �G c �� ❑ Certified copy is hereby furnished. NEAREST CROSS ST. Certified copy is filed with the n building In TR^QT BLOCK LOT NO. 9 p USE ZONE MAP NOS — / department. I _ / - 73 Date -JZ� PIICent MAP BOOK PAR�� SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NQ. YES NO COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL? ADDRESS Q (This section need not be completed if the permit is for one hundred / DISTRICT GROUP TYPE CONST.' FIRE ZONE PROCESSED BY dollars($100)or less.) CITY ZIPS}` ,y n >_ Q I certify that in the performance of the work for which this permit01 7 rJ ✓ �Qd is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. become subject to the Workers'Compensation Laws. STATISTICAL CLAffll.FICATION A" CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT: If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR TEL NO.^/ SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code,you must forthwith FRONT comply with such provisions or this permit shall be deemed'revoked. AD ESS LIC. O. PL ��?�� SIDE LICENSED CONTRACTORS DECLARATION CITY LIQ P L I hereby affirm that I am,licensed under provisions of Chapter 9 —� SEINER MAP (commencing with Section 7000)of Division 3 of the Business and SQ 7.SIZE NO.OF ORES NO�OF�INILI a O Professions Code,and my license is i full force and effect. J NEW ❑ BK PG License Numbe © - ;CIS' Z DESCRIPTION OF WORK ADD ❑ VALUATION 1410 GUS6ALTER ❑ $ z Contre g�/ ❑ I am exempt under Sec. ( �W19A -� REPAIR ❑ BARC.for this reasonDEMOL LDMA P/C N Date: USE OF EXISTING BLDG. URM ❑ Signature APPLICANT.(.PRI T) TEL N �f�,,Q LDMA Perm# Z 1 ❑ I,as owner of the property, or my employees with wages as .�-�/ '"' ' "y p r•r1 s their sole compensation,will do the work and the structure is D S A`'"=•I not intended or offered for sale (Section 7044, Business and � � �� F FI ATE { (j� J 330. . 88.00 e I� Professions Code.) WILLTHEAPPLICANTORFUTUREBUILDINGOCCUPANTHANDLEAHAZARDOUSMATERIAL r U _ OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN i ❑ 1, as owner of the property, am exclusively contracting with THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FIA"Y i j E licensed contractors to construct the project.(Section 7044, YES❑ NO❑ I AL 88 0 13 Business and Professions Code.) TIC ' WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REOUIREA PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THESOUTH r CHECK £her uu o LILI CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST ��,ii L1� FOR GUIDELINES. • C-PIANGE a 013 I hereby affirm that there is a construction lending agency for TEs❑ NO❑ the performance of the work for which this permit is Issued(SBC. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD 3097,Civ.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES 011010-900 COUNTY CODE,TITLEZ CHAPTER Z20 SECTIONS 2.20.IWTHROUGH 220.140 CONCERNING CJ !t{' �' �"• { +'e 1-rf Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING APERMIT FROM THE SCAQMD. 1 11011-9I001 IJ/12/`s_; Lender's AddressOWN��, , ice=EI , 1'j 8-3 o I certify that I have read this application and state that the above PC.FEE PERMIT FEE g information is correct. I agree to comply with all county Q ordinances and State laws relating to building construction,and hereby authorize representativeV!n my to enter upon ISSUANCE FEE the ab B me t'l�ned proper y-f urposes. �Z- INVESTIGATION FEE TOTAL FEE mW=olAppOmgaApaM SEE REVERSE FOR EXPLANATORY LANGUAGE