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HomeMy Public PortalAbout6121 SAINT JAMES DR_Building_5/11/1965_ v 76AG98A DLPgoe a-SE 4kPPLICATION FOR BUILDeGPER COUNTY OF LOS ANGELESBUILDING ME DEPARTNT OF COUNTY ENGINEER ADDR939 BUILDING AND SAFETY DIVISION LOCALITY / JOHN A LAMBIE COUNTY ENGINHlR NEAREST ' COLEMAN W JENKINSOUP T of BUILDING CROSS BY FOR APPLICANT TO FILL IN D S:RICj N O TYPE- CONST PR Y BUILDING STATISTICAL C ASSIPICATION SEW94 MAP- _ ADDRESS / CLA99 NOOWELL UNITS SK PO LOT NO BLOCK USE ZONE MAP NO & 73 TRACT rl SPECIAL tE'90Y • MO OF BLD01 SI 8 0 L T MOW 0M OT USE OP BLDG SETBACK FROM OWN R P ...�N NOL /O PROMT PROP LIN[OP _ (STINKY) / TTP[ OI [KISTI MO S[TBACE HIGHWAY YARD - TOTAL ADDRESS td� ' _ _I DIN am C } _ CITY O ..t�Q Ra IN CTO No BLDG SETBACK FROM ENGINEER O LA_. NO SIO[ PROP LIME 0/ WREST) / TYPE 0/ [EIETI XB SETBACK HIGHWAY } YARD = TOTAL � ADDRESS ( , HIBHWAY WIDTH FROM C L I y TEL + - CONTRACTOR �.,...� ��,/NNLO ADDRESS CNO CORNER CUTOFF YES NO OE O CITY LIC oAl a^o SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK 7 G—F 77. Z NEW ADD ALTER RlFAI DEMOLIIH _ l- / �. 60 PT NO OF ^ NO OP CU SIZE d 9TORI ES a� FAMILIES/ USE OF LX STRUCTURE / flo C/e.f �G _ 910NATURE APPLICANT VALUATION$ /�h>flV Z 1 (/(J APPRO ALS TE INSPECT P C PMT FOUNDATION, LOCA N FE!$ •C� PEES FORMS, MATERIALS F AME, FIRE STOPS I HEREBY ACKNOWL[OG[ THAT I HAVE READ THIS APPLICATION BRACING BDLT AND STAT[ THAT TWE ASOV[ IB CORRECT AND AGREE TO COMPLY FURNACE LOCATION WITH ALL COUNTY ORDINANCES AND STATC LAWS REGULATING OAS VENT DUCTS SUILDINO CONSTRUCTION I CERTIFY THAT IN DOING THE MLORN AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PCRSON IN VIOLA LATH INT cs- TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELAY ING TO WORKMEN PCNSATION INSURA ,P LATH XT 91ONATTEE O //�J _ _ HORE NUMBER C R- Q T PENMITTEE �iff6�— RH AND POSTED ADDRESS FINAL �y JOHN F I EWIS PRI IPAL STR URAL NOIN R PLAN CHECK VALIDATION CK M o INH _ PERMIT VALIDATION cK M G CASH hl� 0 5 7 8 nPR 1 5 2 3 46.0 0 s 1467 MAY 11 1 n 95.00 Q WORKERS COMPENSATION DECLARATION hereby affirm that [',have ofWo a certificate of consent to self APPLICATI N FOR BUILDING PERMIT - insure or a certificate of Workers Campenstion Insurance or a certified copy thereof (Sec 3800 Lab C ) - COUNTY OF LOS ANGELES BUILDING AND SAFETY _ Policy NoRC—U 77'26ompany Royal Ins , © AD Certified copy is hereby furnished / - FOR APPLICANT TO FILL IN DRE � —00:zSS ❑ Ce"iied copy Is'flled with the county budding mspecgU ILDING nt, on department,--r ADDRESS 1 Jnmps Dr . LOCALITY NEAREST Date 9/23/81 'Apphcan, Lytle Roofing CITYZIP CROSS Sr ' CERTIFICATE OF EXEMPTION FROM WORKERS NO OF BLDG$ ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT 1 MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one 2 USE ZONE hundred dollars (5100)or less ) TRACT B10CK l07 tJ0 ✓ / NO O T TEL (//I� SPECIAL d OWNER Mr . Mel in Young No 286-0146 " CONDITIONS certify i that m the performance of the work for which this V permit is issued shall not employ an pension in an manner DISTRICT" GROUP TYPE FIRE D BY p p y y Pe y ADDRESS D (i CONST / E 09 so as to become subject to the Workers Compensation Lave _ Y 17 7 QU Yr/ Date j' Applicant CI TV ZIP STATISTICAL CLASSIFICATION APT CONDO NOTICE TO APPLICANT If after makingthis Certificate of ARCHITECT OR TEL ENGINEER NO CLASS NO Exemption you should become subject to the Workers -� WorkersDWELL UNITS_ N Compensation provisions of the Labor Code you must forth ADDRESS - SEWER MAP Z with comply with such provisions or this permit shall be IQ ' deemed revoked CONTRACTOR T 5 BK FG VALIDATION LICENSED CONTRACTORS DECLARATION LIC I hereby affirm that I am licensed under provisions of Chapter 9 _ ADDRESS 2948 E .- Walnut FA 86 303 VALUATION (commencing with Section 7000)of Division 3 of the Bininess and LIC Professions Code and my license is in full force and effect CITY CLASS $2000 .0D ' License Number 186303 - tic class 39 So STORIES STOR°s 1-2 FAOMI°ES CHECK , Lytle�Roofin%,. 9/23/81 DESCRIPTIONOFWORK Elk a NEW ❑ s Contractor _ ❑ I om exempt from the licensing requirements as am a Com 1 on Shingles . ADO - _ licensed architect or a registered professional engineer ALTER FINAL acting in my professional capacity (SeEnon 7051 REPAIR ® DATE ( a - Business and Professions Code) USE OF 4 - ,) EXISTING BLDG DEMOL By ' Lic or Reg No 7 Date APPLICANT TEL B -- 71 ' OWNER-BUILDER DECLARATION - -' - PRINT - — N — 1 � , I hereby affirm that I am exempt from the Contractor s License - Low for the followmgireason (Section 7031 5 Business and ADDRESS Professions Code) .: I , aI as owner of the property or my employees with i BURDING ADDRESS 6121 S James- Dr . v wages as their safe compensation will do the work and the structure is not intended or offered for sole(Section LOCALITY - 7044 Business andProfessions Code) MOVING TEL ❑ td ONTRACTOR NO I as owner of the property am exclusively contracting with licensed contractors to construct the project (Sec ADDRESS1 4 4,6 A 44 tion 70Business and Professions Code) REQUIRED CONSTRUCTION LENDING AGENCY $ET BACK YARD HWY TOTAL SETBACK FROM EXISTPROP LINE WIDTH l tt,• . ._ I hereby affirm that there is a construction lending agency for FRONT (JZ 0 the performance of the work for which this permit is issued P L (Sec 3097 Civ C ) - SIDE 2 .�• 3 Q 0 0 ' PL Lenders Name I _ _ A� Lender s Address PC Fee S Permit Fee YY a .'. 3(L,0 0 u I certify that I have read this application and state that the havance Fee D ) Q O 6 i 8 above information is correct I agree to comply with oil County Imesnolion Fee - � d ordinances and State laws relating to building construction To,Tal rQ G d hereby authorize representatives of this County to enter a t 1 u the above me one operty form actioonn purposes ` )Nl - SEE REVERSE FOR EXPLANATORY LANGUAGE n ' SignoNre of AppLtant ar Agent Date (Ibs