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Home My Public Portal About5013 SANTA ANITA AVE_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES �U O �� N G WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING �� DISTRICT NO. PLAN CK. NO. K�PERMIT NO. ADDRESS Y/ Pl��a.l II ` �J�J� t ► `�-� v /G 0_ ' LOCALITY ' RECEIVED BY, DATE OF APPL. DATE ISSUED NEAREST CROSS ST. QL �j'j / >.�G'-� BUILDING �+� lc` ADDRESS `�I�C: / "� .t• / 1 n J ' r OWNER �/�.�I .r _ J/TJ [.sOr�..fi'�7�tw/ �/� r LOCALITY �Jtr-J c_ , MAIL A /7 �� NEAREST . ADDRESS U _ _ ,C'J TEL. ,. CROSS ST. [ •-y v til /'� CITY �.I� ;;.7f'A� �f�.�i NO.� o✓�Q FIRE NO. OF I TYPE I GROUPr ARCHITECT OR' er TEL. ZONE PLANS e d_ ,• ENGINEER NO. ` BLDG. ORD. NO. r SETBACK LINE .-4 ADDRESS APPROVED r . BY DATE ,,� CONTRACTOR .�� , �•� NOTEL.r /sl n - USE ► APPROVED t —. s �+ ✓�/ j �: t ZONE l/� BY DATE ADDRESS fJ ! � / !f ��/,If��i r �!7' „ HOUSE NUMBERING LEGALi DESCRIPTION I LOT NO. �� BLOCK ' MAP NUMBER ► ► r FIELD CHECK BY i ` TRACT I NO. ASSIGNED HY DATE p NO. OF BLDGS. CORRECTIQNS SIZE OF LOT a 1, Q I NOW ON LOT S ► �� USE OF ' NO. OF `/ •�c� _ EXISTING BLDG, j�'j,� �: I FAMILIHS DESCRIPTION OF WORE NEW I I ALTERATION I I ADDITION REPAIR I I DEMOLITION SQ. FT. NO. OF 1 Q SIZE ROOMS STORIES 4 Y EXT. WALL1 ROOF y 1' COVERING I COVERING ` i USE OF STRUCTURE A A Joe �� +`��1�� '+� i NALS SPECOT,O"SIGNATURE DATE I HEREBY ACKNOWL.EDG'E THAT I HAVE READ THIS AP- FOUNDATION: LOCATION ^ l PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS !r COI AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS, g ��vHEREON AND WITH ALL COUNTY ORD)NANCES AND STATE BRACING, BOLTS — Jr Y^', . LAWS REGULATING BUILDING COlASTFfqCTlON. i . FURNACE: LOCATION, SIGNATURE OF Y/ - r .J�/ GAS VENT, DUCTS PERMITTER_{{��{{ a +, A_-) r ! Q I 1► , '� CJ 4 ,/►" f1�I1` `' LATH. INT. t�• �� / ADDRESS s31 LATH, EXT. S �• , (x� AUTHORIZED AGT. nn�% ► t PLASTER, INT. 76ASSBA- D603 10-SO P. C. S ® 4j-C3C-7 ' FEE PLASTER, EXT. // P VALUATION r FEE $ / i r=--' FINAL I 5M SETS 8-M 101111-= t. _ v - _ _ _ _'�ti_-ix, /•;^r___.)�-._.-. .. �- - `-\ 'Z?ARTMENT OF BUILDING AND SAFETY' �1APPLIrwATION OR PERMIT COUNTY OF LOS ANGELES WM. J. FOX, CHIEF ENGINEER B U I L D I N G FOR APPLICANT TO FILL:_4 FOR-OFFICE USE ONLY DISTRICT NO. PLAN CK. NO., PERMIT 7NOBUILDp NG ADDREI89 1/� 5 ,,.r /Ol OLOCALITY DATE OF APPL. DATEISSUED NEAREST . .r rd 4e—CROSS ST. ,BUILDING L � "')OWNER /J . AADDRESS .J � A ADDRESS �a 3MAIL LOCALITY ' p ' TEL. NEAREST ✓V///'i.w(� w/% CITY �//-p CR058 8T. NO. / tom` Geq FIRE NO.Or ARCHITECT OR TEL. ZONE, I PLANS I TYPEe.;v Q�^Z10UP ENGINEER. R -NO. / BLDG. ORD. NO. ADDRESS t SETBACK LINE TEL APPROVED - CONTRACTOR NO: BY DATE 11 USEAPPROVED ADDRESS �1 ZONEA1 BY, DATE LEGAL DESCRIPTION I VLOT NO. BLOCK /� CORRECTIONS TRACT r ��/f ////1./.z•i fi 1/'Y !�`6"L,i/i�L'� SIZE OF LOT I NOW ON LOT 'USE OF y �- NO.OFNO. OF EXISTING BLDG. I FAMILIES .__�ROOMS DESCRIPTION OF WORK ` ' +�C ��• N� ALTERATION ADDITION O • - is REPAIR joMOVING DEMOLISH O SQ. FT. NO.OF SIZEROOMS STORIES 1. WALL RDdF COVERING -;EI COVERING : �QyI^;�v,1p USE OF NEW BUILDING A A 0111 10) f I HEREBY ACKNOWLEDGE THAT I .HAVE READ 'THIS APPROVALS� APPLICATION AND. STATE THAT THE ABOVE 15 CORRECT FOUNDATION: LOCATION,' fA NSPECTOR 'DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES -FORMS, MATERIALS }�,✓ AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE OF BRACING, BOLTS �. OWNER LATH, INT.: AUTHORIZED A13 ' ��n •- LATH, EXT.: - - $ P. C.$ PLASTER, INT. FEE PLASTER, EXT. �) N VALUATION 02 FEE FINAL DBS-3,.2 M"'SETS = �.- ; s. :'AEPARTMENT F BUILDIIiVq ANIj'=:__-_:'; ATION FOR-PERNfIT .� - COUNTY OF LOS'ANGELES � ' �'® �' WM. J. FOX, CHIEF ENGINEER 'FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK.. NO. PERMIT NO. BUILDING ADDRESS �J� -G•` 6' 'l% 11 LOCALITY :+'�al,�f r°� E�ir''='�"� '��'fp• •RE�CEIVED BY DATE OF APPL. _ DATE ISSUED NEAREST CROSS ST. .J"[G "L•C - , BUILDING OWNER r-rI ` L L (: _irl_ + i=t'-C' f ADDRESSMAIL ✓� n� ADDRESS .� 5 (�/[� ^ /f/� LOCALITY c,,(NEARE f %p_' W��`/ OX TEL CROSS ST. ef CITY n K7 z1'(�( c� NO. ,FIRE I NO.OF TYPE � GROUP ARCHITECT Og� // TEL. ZONE �'��I PLANd___ I ENGINEER I��1 NO. BLDG. ORD. NO. ADDRESS \ SETBACK LINE TEL. .APPROVED CONTRACTOR ~�� NO. -BY DATE •USE '/,C J/ APPROVED ADDRESS ZONE-� + r BY DATE .LEGAL ' /NO. ✓ 7 I BLOCK i ,CORRECTIONSn DESCRIPTION I LOT �°: / TRACT A /- /%` G/ I NO. OF OLDGBa�� 4� SIZE OF L'OT -� Cx / NOW ON LOT r'TSL 1 �1 Wilk USE OF NO.0,!r,-. NO. EXISTING BLDG. I FAMILIEI ROOM9 a . 7� ,</l"!! --�-�'• DE�S,CRIPTION OF•WORK a ; NEW -ALTERATION ADDITION I O A REPAIR MOVING DEMOLISH O �! .✓ NOOF D 9 ZE�.�'i! �✓I`'�� .ROOMS -:� STORIES.WALL >� r, Rbor vi COVERING � _�' +dw: I COVERING. •� %^ ;+'�C� USE OF NEW BUILDING -1 r.•. ,rte•r'+�-v_e '0;- .c7`1 `1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION, INSPECTOR.. DATE,•. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. ;FRAME: FIRE STOPS,- SIGNATURE OF BRACING, BOLTS , OWNER LATH, INT.: AUTHORIZED AdT-N,4, LATH, EXT.: P. C. PLASTERr INT. FEE PLASTER, EXT. :.f•• VALUATION FEE a;.' ::FINAL . DEPARTMENT OF -BUILDING AND. SAFETY ArrLviLUA i IUM,r un rzr«Vu i COUNTY OF,LOS ANGELES Q ® S ® I WM. J-FOXP C ®HIEF ENGINEER V F_ OR-•APPLICANT TO-FILL IN-- FOR.OFFICE USE ONLY BUILDING DISTRICT NO.' PLAN OK.NO. PERMIT NO. ADDRESS t� .7 � LOCALITY - RECEIVED BY: - DATE OF APPL. DATE ISSUED CROSS ST INS- OWNER 1 PC ADDRESS MAIL ADDRE69 LOCALITY - TEL NEAREST -f ITY• - NO. - _- -CROSS ST. L FIRE N6.110 TYPE GROUP' - ARCHITECT OR TEL. ZONE PLANS ENGINEER d4t, - NO. - BLDG._ / y0�[ !� ORD.NO. ADDRESS SETBACK LINE TEL APPROVED-' CONTRACTOR NO. BY DATE U5E APPROVED -_ ADDRESS ZONE 444 BY DATE LEGAL ( I " ' CORRECTIONS _ DESCRIPTION LOT NO. y BLOCK ' TRACTZ- NO.OF BLD S. / SIZE OF LOT I NOW ON LOT _ LSS 10V4 !J/. V !n USE OF NO.OF NO.OF J EXISTING BLDG FAMILIES ROOMS LtM) DESCRIPTION OF WORK- NEW- ORK NEW- ALTERATION ADDITION _ O• REPAIR MOVING• DEMOLISH p S4•FT. Ar NO.OF SIZE ROOMS ST.ORIEB _ Z WALLROOF• ' 7 Y r COVERING I COVERING _�.� � .. USE OF NEW BMILDI ! !_p 1 HEREBY ACKNOWLEDGE THAT •I HAVE' READ THIS APPROVALS. -APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION:LOOATION' INSPECTOR DATE AND AGREE TO COMPLY WITH ALL-COUNT_Y\3RDINANCES FORMS, MATERIALS AND STATE LAW9-REGULATING U DINGO 5?4 C 1 �/Y� BRACING BOLTS FRAME: FIRE STEWS, SIGNATURE OF'f , • OWNER LATH,INT.: AUTHORIZED AST. - LATH.EXT.: t B9.3 95M BETE 1-47, P.C. �� PLASTER.INT. �D �• ' FEE PLASTERv EXT. _ ',VALUATION - FEE n ;FINAL 'WORKERS'COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self i APPLICATION FOR BUILDING PERMIT insure,or a certificate of Workers'Compensfion Insurance,or � a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. 5 901 CompanyS t a t e C6 m n e n s at i.o BUILDING + ❑ Certified copy is hereby furnished. �n$, Fund I FOR APPLICANT TO FILL IN ADDRESS- i i aCertified copy is filed with the county building inspec- BUILDING tion department. ADDR ESS 50.13 Santa Anita LOCALIT NEAREST Date�,_1_$0 Applicant CITY ZIP CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' s NO.OF BLDG& ASSESSOR COMPENSATION INSURANCE SIZE OF LOT 47L N NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZO E MAP hundred dollars ($100)or less.) TRACT BLOCK LOT NO. TEL. SPECIAL �, I certify that in the performance of the w k for which this - OWNER NO. CONDITIONS D TRIG UP TYPE FIRE RO SSED BY (� permit is issued, I shall not employ any e n in any manner 5 013 'Santa A n 1 t a CONST. ZONE r so as to become subject to the War s' ens ion L w ADDRESS' jJIM Date o 9. O n' Applican ' 17.4 CITY Tem 1 e C 1 t ZIP .917K STATISTICAL CLASSIFICATION ' / APT. CONDO. ARCHITECT OR TEL. NOTICE TO.APPLICANT: If, of maki g his CeUJ rtific a of ENGINEER NO. CLASS NO. DWELL. UNITS Exemption, you should become subject to the Workers' ' i y� Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be TEL deemed revoked.- CONTRACTOR H o wa r d L R a n d o l NO.2 8.8-4 0 4 0 BK. PG,. VALIDATION LICENSED CONTRACTORS DECLARATION LIC._ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. i VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY -San* G a b r i e 1 CLASS C•`-3 9 j$ a 6[2 a SQ. FT. NO.OF NO.OF CHECK License Number-186086 Lic.Class C-39 SIZE STORIES FAMILIES ONE Contractor Howa r d L.Ran d�a}e C 0.. 8 r21-8 0 DESCRIPTION OF WORK NEW ❑ I $ ❑ ADD ❑ I am exempt from the licensing requirements as I am a of h0 u.s e only Illi Z t h � C 011] 0 licensed architect or a registered professional engineer ALTER ❑ FINAL acting in my professional capacity (Section 7051, $ n 1 e REPAIR ® DATE 7�(f Business and Professions Code). USE OF FINAL f_.- EXISTING BLDG. DEMOL ❑ By F—�-•- Lic.or Reg.No. Date APPLICANT L OWNER-BUILDER DECLARATION (PRINT) Howard .L .Randol :�,� 288-404 I hereby affirm that I am exempt from the Contractor's License ADDRES5.5 29 'E V a 11 a 6.1 -S .-G. !/ Low+far.-the following reason (Section 7031.5, Business and • ProfessYons.Code): PRESET G`� BUILDING ❑ 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 ; 7044, Business and Professions Code). MOVING TEL. ❑ 1, as owner of the property, am exclusively contracting CONTRACTOR NO. i with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). ADDRESS REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. z 1 8 6 9 A CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for I FRONT # a a o a a the performance of the work for which this permit is issued I P.L. (Sec. 3097, Civ. C.). SIDE 2 0 0 3(j 0 P.L. - Lender's Name a o o3IL006 ' Lender's Address P.C. Fee$ Permit Fee I ' I certify that I have read this application and state that the Issuance Fee 0825-800 8 2 5—8 0 S above information is correct. I agree to comply with all County 'I Investigation Fee 3 ordinances and St a laws relating to budding construction, Total Fee $3;4.00 and here ut r' sentatives• this County to enter " I upon o - e d p - erty r inspection urpose SEE REVERSE FOR EXPLANATORY LANGUAGE S ®S natur Applicant or A nt Dote Ij WORKERS' COMPENSATION DECLARATION hereby affirm•that I have certificate of consent to self APPLICATION FOR BUILDING P E RM I T insure, or a certificate of Workers'Compensation Insurance, `or a certified copy thereofec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY }}�66 r�od 90 Policy No.1Company rja:d4JC .6/e.-163 ❑ Certified co is hereby furnished. 7Z�ele R APPLICANT TO FILL IN BUILDING ` PY Y 7 ADDRESS ❑ Certified copy is filed with the county building inspec- FADDRESS tion department. Date f 2 Applicant �`� t e� / ZIP 1 79d9 LOCALITYNo.OF ?L CERTIFICATE OF EXEMPTION FROM WORKERS' [ADDRESS OF LOT �o� X� S NOW ON LOT �. CROSS ST. 6-1 COMPENSATION INSURANCE ASSESSOR Q/�/ �y7C (This section need not be completed if-the permit is for one CT BLOCK LOT NO. MAP BOOK 65 PAGE �L" PARCEL hundred dollars ($100)or less.) TEL, NER G N �� )' USE ZONE MAP I certify that in the performance of the work for which this �1 ,[� NO. SPECIAL >_ permit is issued, I shall not employ,any person in any manner RESS �� S C /4/7/�d CONDITIONS CL so as to become subject to the Workers'Compensation Laws. .�-� �pn 0 /� ✓ ZIP 9J/DODate Applicant HITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY WNOTICE TO APPLICANT: If, after making this Certificate of INEER NO. CONST. ZONEExemption, you should become subject' to the Workers �Gf� 9 !urns LUCompensation provisions of the Labor Code, you must forth- .d• J with comply with such provisions or this permit shall be / J STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTOR 11&,1-,41b1 N 1 `/✓/ .� ' — LICENSED CONTRACTORS DECLARATION •77�� t LI � CLASS NO.cDWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 6920 4 e� /d NO.�LIC. SEWER MAP (commencing with Section 7000)of Division 3 of the Business CIN /q�/�/f?✓ �2 `� CLASS ACC I ° and Professions Code,and my license is in full force and effect. _ ) BK. PG VALIDATION _ _r 3iyri� f� SQ. FT. / 7 STORIES OF J1 FAMILIES / ONE "t 3 i jt°•:= License Number `7/ Lic. Class 1 SIZE (O �!_: JJ Q/j j� � �� VALUATION y 1T� Contractor��IV/` RS47Di ate DESCRIPTION OF WORK �� 72 NEW ❑ $ ° elwdlel '�4 eA err�6� ADD ;I.ITrtL 67-4 - 32 ❑I am exempt under Sec. % ► - 'r, P ALTER ❑ 'CNEC K 0 r At°•.•: BAP.C. for this reason •7 REPAIR ❑ $ USE OF ' / / L •� rf � E Dot EXISTING BLDG. yItlj/h/ DEMOL ❑ APPLICANTSignature /' (PRINT) FINAL 1 71 OWNER-BUILDER DECLA ON DATE '-Z �� 00CILI-CItKil 1.L% •moi`.` 1 hereby affirm that I am exempt from the Contractoes License ADDRESS �� Td GJ�, l��L�� .�(^J�� 't Law for the foHowing reason (Section 7031.5, Business and FINAL - �30 1 t ill 9:132 1 Professions Code): PRESENT By �t.• T s 0 I, as owner of the property, or m em to ees with BUILDING yt. I°s P P Y� P Y ADDRESS _ wages as their sole compensation,will do the work and 3L)j i '325.7 72 the structure is not intended of offered for sale(Section LOCALITY 7044, Business and Professions Code.) MOVING TEL. 1 I)Errs ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. P. - th licensed contractors to construct the project (Sec- ADDRESS TOTAL 8325 m 72 } ti n 7044, Business and Professions Code.) REQUIREDTOTAL SETBACK FROM EXIST. r CHECK sty°r7t CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I herebytaffirm that there is a construction lending agency for FRONT CHANGE °013 the perfcVmcnce of the work for which this permit is issued P.L. (Sec. 304 , Civ. C.). SIDE Lender's Name P.L. (IQCICI—VCIJS 11i] :°��' %7 LDMA Ref.# 1 �'fy�y°i P.C. Fee$ (f/ / .�� Permit Fee ° Lender's Address n e 1 certify that I have read th0application and state that the Issuance Fee LDMA P/C# , above information is coSrect. I agree to comply with all County Investigation Fee Q / ordinances and State lbws relating to building construction, Total Fee O a._1'Jr..7., LDMA Perm. # a and hereby authorize.representatives of this County to enter upo �te ab ve- toji d r perty for inspection purposes. , L ' SEE REVERSE FOR EXPLANATORY LANGUAGE SignSturg of )Splicant or Agent ° Date -, d