HomeMy Public PortalAbout5076 SERENO DR_Building__ APPLICATION FOR -COUNTY OF LOS ANGELES
' -BUILDING PERMIT DEPARTMENT OF ING COUNTY ENGINEER
BUILDING �7
FB
LICANT TO FILL IN ADDR E59 SO /
�'f.J e /Y O LOCA[ITV4 ZIP NEARESTCROSSSTN OF BLDGS ASSESSOR� ` NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE P SSE BYTRACT /� LOCK LOT Ny.O�pp{� J �_ CONST- ZON ,
OWNER H' /;(/O`, t Q TOLi`/0 /I� 9 STATISTICAL CLASSIFICATION
(` SEWERAfAP
ADDRESS 0> 4 Je A P-1-4 97 CLASS NO.2L_DWELL UNITS----] BK PG
CITY t Ay P.4Q C Y ZIP USE ZONE MAOP 1-7 - .
ARCHITECT OyyTEL
ENGINEER C� &C4, N NO CONDITIONS
[NAME
ESS ROAD DEPARTMENT APPROVAL REQUIRED YES NO ❑
RACTOR
TEL BLDG TRACK FROM
LIC FRONT ROP LINEOF (STREET)
ESS NO NIGNWA + YARD - TOTAL SETBACK FROM TYPE OF EXISTING
LIC - FRONT PROP LINE HIGHWAY WIDTH
CLASS
TRUCTION LENDER +
AND BRANCH ! BLDG SET ROMESS CITY SIDE PROP LIN (STREET)
SQ FT / NO OF NO OF CHECK HIGHWAY + YARD v TOTAL SETBACK TYPE OF E%ISTIHO LL'
SIZE��{� STORIES FAMILIES ONE SIDE PROP LINE HIGHWAY WIDTX
DESCRIPTION OF WORN NEW ❑ + _ird
R _ _ f DD CORNER CUTOFF YES ❑ NO ❑ _
r fGo— N LTER ❑ IN OPEN SPACE YES E] NO ❑
'Vo REPAIREI
USE OF IN COASTAL PERMIT ZONE YES ❑ NO ❑
EXISTING BLDG DEMOL
APPLICANT TEL l< VW(79r QK
(PRINT) NO
BY (SIGNATURE)
1 HEREBY ACKNOWLEDGE THAT I HAVE READ TH15 APPLICATION 1
AMO STATE THAT THE ABOVE Il CORRECT AND AGREE TO COMPLY
WITHALL ORDINANCE/ AND LAW/ REGULATING BUILDING CON-
STRUCTION 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY 1 WILL XEMPLOY ANY PERSON �.
CODE
SL STATE Of CALIFORNINI VIOLATION OF THE
IN RELATING TO
WORKMEN
TO I
SIGNATURECOMPENSATION
M TT OF EMlATIOM IX/U.AMC FINAL BY >^�
PERMITTEE DATE
ADDRESS
�j TEL�I P C Fee$ Permit Fee L
CITY e ( NO .'1
Issuance Fee
VALUATION/ SCOX
Total Fee 2�-
PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION cN No . cA.H
2 1 0PWAY 11 1 s 4 2.0 0
T/AGMA cense n/T. _
V C!
I
DIVISION OF BUILDING 'AND SAFETY $" �( 'I L®I�a G
D•Pm aoW Cd County FaglnG ®fes ,�7l -
wm J FO ofloUA�6� IN[[R BUILDING �(A�PJPLICATION C
FOR APPLICANT FILL IN ADDRESS StO 7L � G/c/oa _
BUILDING 0 LOCALITY I I
ADDRlBS
LOCALITY cm=m
NEAREST DISTRICT NO PIAN CR OR Rab NO PERMIT
MO I
Silnn�rYL.r,� Jam, i vEa�B .
OWNER (%Wt7t vt.I RECEIVE) DAT[OF APPL _ DATEIRS
MAILADDRESS "/ Kl f'A'1:/l�-f WW `
OUR N8 O OR TYPE GROUP FIRN ZEN[
d /_ ' �.V,4nlr ZzmPLAN•
ARCHRECTOR TEL ZONING - __ DATID
ENGINEER NO APPROV=BT- '
BUILDING r
ADDRESSSETBACK LIN[ :2a r I
CONTRACTOR O. A RGYaD ;0/-q
O n
MOOSE NUMBERING
ADDRESS
LEGAL MA►NUMBEa -u0 ABBIO NED BY
DESCRIPTION LOT NO BLOCK
DATE COp=TIONg INSPECTOR
TRACT ok, 6—12 -13
1
SIZE
OF LOT
NO OF SLOGS
NOW ON LOT
UB60P GC 0/_ NO OF
L • I FAMILIES O
DESCRIPTION OF WOM
D
NEW 1,e FA_.
LTERATION ADDITION
REPAIR DEMOLITION _
SO PT NO OF
SIZE ROOMS STORIES
EXWALL_ ROCW I
CLOVE RING I COVERIN✓000,-
USE OF STRUCTUREI
CO/►7P� � .
r
i
I I
fj OVALS
INSPECTORIS SIGNATURE DATE
LOCATION
VI MIOiS� /� S
1 HER RG STOPS
CORERY ACKNOWLEDGE THAT 1 HAVE READ THIS AP• FRAME PI
PLICATION AND STATE THAT THE INFORMATION GIVEN 19 ARAE FI BOLTS A.
RECT
1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE LOCATION,
AND STATE LAWS REGULATING BUILDING CONSTRUCTION GAB VENT DUCTS
SIGNATURE OF
lV14
LATH INT
PERMITTERurN ECT
ADDRESS
[tQ / // O // I
PLASTER INT
AUTHORIZED AOT
FLAB
77QO P�C • NE NUMBER
P
COR-
RECT AND POSTED
•
VALUATION FEE FINAL
7GA62 A ORA a i "
DIajArON;OF BUILDING AND SAFETY - BUILDING
T
dim y ofLos Angelm '
JWM. J. FOX. COUNTY EN13INCER APPLICATION "4c
FOR APPLICANT TO FILL`IN _ _ OFFICE USE ONLY ,
DIHTIUQT N4 PLAM CK ON NEU No PERMIT Md
SUILDINS n D y !q 4 GD/-.B
AD
OBY DAT[O► L DAT[ISSUED
LOCALITY
PROMAT,
S RUILDINO
AIL
MAIL LOCALITY �-4.w /_Jh
M
ADDRESS NEAREST V
ORO®ST.
CITY J4o.A7'Sk479' ►IRK NO.Or TYPE GITOUPT
ARCHTCCTOR TEL ZONE " PLAMI Z j
[NSINKER NILBLDG. Z� „n . NO
S[TSACK LIME `Y7
APPROVED
TLL - i Illy DAT[
CONTRACTOR Nd HOW[ NUMBERING
ADDMM ,
,2. MAP HUMB[P N4 ASSIGNED BY
( /� (� T h L
"UAL
DESCMPTTON LCT N4 SLOOK
Tl — -/L— V — In 55-4 2 (�
N4 Or ILDIM
Ila or LOT NOW ON LOT
�'
USC or N4 Or z - S
EXISTING 81-014 RzIV— FAMILIA M , C Lt- E N Z-0"e o
DESCRIPTION OF WORK
NEW ALTMATION ADDITION
REPAIR DKM13UTION
eo.izic NEI or
ROpMB RToRIEe
WALL ROOT
J
M[WNG COV[RIN (✓
USE or STRUCTURE
INSPECTION rEIR APPROV IT 0l
OCCUPANCYAB IMQPE `BBIOKATURK DAT[
rouNDAT1oN1 LOCATIoN
1 HEREBY ACKNOWLKDGK THAT 1 HAVE READ THIS AF
rORM4 MAT[RIALY
PLICATION AND STATE THAT THE IN►ORMATIoN GIVEI/ IB rRAMEt rIRESTCPI.
CORRECT IRAOINO,BOLTS �O
1 ABR[[ To OOMPLY WITH ALL COUNTY ORDINAMDEB FugNAO[ LOCATION,
ANp STAT[ LAWS REGULATING SuILDINR CONSTRUCTION PAS VENT DUCTS
S=1-urRE or/1//iwn.u// /T-rr-aaG LATH. INT
P[RMIR
ADD Z Y LATH, 131711. �D�f
E/ PLASTLq INT.
ALITHMSIZED AMT
`` V PLASTER, CIT.
r 0.111
rtt HOUSE ANDER SDCO
RECT/�
VALOATOM v MAL
-mss:
OWN 1-EE '
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORIER9 COMPENSATION DECLARATION FOR APPLICAM TO ML IN _ BUILDM ADDRESS
I hereby affirm that I have a certificate of consent to self Insure D nR
_
nippy certificate M Compensation Insurance or a certified! 1 5OO
a'"�Em LE � /Tr ' . LP
Percy -Company SIZE LOT, , ND Of IlLD(L4 NOW ON LOT LE
❑ CMtlbed Copy le hereby furnished e1�� �qz �. ,1 I NEAREST CROSS ST
❑ CanWad copy Is filed with the county building inspection �l T BLOCK LOT NO E S
department -
ASSESSOR MAP BOOK PAGE MRCEL
DW Applicant: \% • SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS• ovvhr NO
COMPENSATION INSURANCE P WffieN1oodFTOFtlalooLT T� to
' (This eectlon need not be completed lf the permit le for one hundred # //S DISTRICT GROUP carmenT
By
dollars(f10D)or leo) zIv �7(-
I Certify that in the performance of the work for which this penin //`� &bK R-3 -7
Is issued I shell not employ any person In any manner w aeroARCr TEL FID
become sub)eet to the Nbrkere'COmpena barn Lave G ,Q 0 VEZSTATISTICAL FICATION APT
Date-Applicant DI �/ • - - CLASS NO DWELL UNfrS
NOTICE 70 APPLICANT H, after making Mb Certificate of1/9
AILREQUIRED TOTAL SETBACK FROM EXIST
Exemption you should become subject to the Workers', CONTRACTOR SET BUCK YARD HWY PROP LINE WIDTH
fflg
Compenmtlon Provisions of the Labor Code,you must forthwith
Comply with such provisions or thio permit shall be deemed revoked A L t �f//p Uc P�
LICENSED CONTRACTORS DECLARATION crTv O IoFrAl1 E Pf3RK O "C� "� - 23
8
I hereby elflnnl that I em licensed udder provisions nt Chapter 9 FT SIZE NO STORES NO OF v® p� 6�MAP C
(commencing with Section 7000)of DMslon D of the Business and MLLJ
NEW JO BK PG 33'03 7 - 756.732
Professions Code..aand my I le in full force and ,M+ �y� I—
Llcan x,Number�.e-<yj•i_LIC Clan• l` Pn OF WORK ADD ❑ ywuT 1 I I L!S W
Contactor Data QA16: QE F1 06 COdWi ALTER ❑ s 9 46 40 uvloo, , 1%
TOTAL ` 756.7112
❑ I sm exempt under Sec REPAIR ❑ $ L CHECK 756.71
B SPC Weft reason DEMOL 11LDNA P s (� •I3]
Dam SOF EXISTING RI URM ❑
Signature MW( NO '
❑ I, as owner a the property, or my employees wont wages o vo L0M"P`e1• ' , :;� - cr'0000-0001 3/
Mab sole compmmaton,will do the work and the sbuuch re Is
not Intended or offered for Sale (section 7044 Business and VE / POIA/LPA�n ii `1971E 1 AI11O�44
PrOssslorm Code) wunEARVGIfrnrinJllxEelxlaeAT ocpxwNrRAKpEAmuATAmplerATesAL �-F� ZS 9/• ACCT.: '
❑ I. Be owner of thepnpere erContacting with WaBWl9 esaeww��mer
AML BY
licensed construct the project (Beton 7014,
3307
Business and pofessiou Code) "°❑
�L 1 1 ITEMS
vnL TIE cRraam 1194 OF TIE aucunexu m TIE NRccvrrr oR nlrtsE ecanelt
occuwwr®nR4AvesarwRwNemucroxoRwoorawnwmoaTEeoum TOTAL 5
CONSTRUCTION LENDING AGENCY " �aulAaomrr uSnac*tec.00l e44 Pu�lumSa oEaamr f 1,3 •_r
I hereby affirm that there Is a cormtru dw lending agency for
the performance of the work for which this permit Is Issued(sec rE9❑ '�❑ O /1 I I Y CHECK
3oe7 car C) rw iq o uroe SrY S samE fie win v1
colertvccoe,rmc;cluvrarssoe4cruort9ae wo,emalgHzm,.ewrCo..Ia r ,•, CHANGE .0•'I
Landers Name KA=ARa011BYATFAIAID R@ORrHa AIO maRaerAlrr.IOAPBnrr mor ruEscvomo � �/
Lenders Address
I certiy,that I have reed MA application and state butt the above al.wm a,�xr V I IJ000-OD01 7/?O/9Q
mnfometion a correct I agree to Comply with all count' PC FEE 9
ordinances and Stam laws,relemg ro building construction,and ,j PERMIT FEE 00,
5 1956 1 AM 10:4`
hsiaby Mm County to mile. upon ISSUANCE FEE I O
Me a spechon purposes 44
INVESTIGATION FEE TOTAL FEE J
SEF REVIEiBE FOR EM ANATORI'LAkOUACLE
' APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELE8 BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BLNLDM ADDRESS
I hereby affirm that I have a certificate of consent to self insureO v7 •
or a certificate of Workers Compensation Insurance,or a ownifted '` �
CITY ZIP thereof(Sec 3800,Lab C) /s/�
Policy No Company SIZE 0 LOT OF BLDQ4 NOW ON LOT Lo" "
❑ CWUW Copy Is hereby furnished NEAREST CROSS ST
❑ Certified copy m Bbd with the county building Irapecbon TRACT BLOCK LOT NO
department I LISEZONE MAPNO
Date Applicsnt ASSESSDR MAP BOOK PAGE I PARCEL
SPECUL CONgTIONSr
CERTIFICATE OF O EMFrnON FROM WORKERS• TEL NO COMPENSATION INSURANCE ADDRESS I vrRHw 1000 Fr of 8C1100LT "ES NO
(The escbon deed not be completed H the permit is for one hundred ms—M T GROUP TYPE FIREZONE PRIF�
dollars($100)or lees.) yj
CRY ZIP �
I grey,that In the performance of the work r«which tits gamut o'W cJ,O� IC J .3 14
Is ensued I shall not employ any penapl In my men e0 es to OR ENGINEER TEL NO
blect the NUrksrs Laws STATISTICAL C�LFA.M��FIICATION APT CgBO
Dais Applicant ADDRESS CLASSNO �DWELLUNITS X
NOTE TO APPLICANT If, g this Certificate of REQUIRED TOTAL SETBACK FROM EnSr
Exemption you should bec0 a eu act to the Workers 7d SETBACK YARD HWY PROP LIFE WIDTH
Compsnsaaon provisions of the LeDor Code You moat forthwith FRONT
�J
comply with such provisions or this permit shall be deemed revoked UC NO FR
V z SIDE Y
LICENSED CONTRACTORS DECLARATION E
P l. –
19
I hereby affirm that I am licensed under provisions of Chapter g • - G MAPSignature
(commencing with Section 7000)of Denson 3 of the Business and NO OF STORES NO OF FAMIUES Proreselo m Code,and my I n full force and NEW BK PG ITEM' �License Number Clava ADD ❑ yAwAT TOTAL 117 - 300ALTER ❑ s ®V� CHECK, 1I7.�IIameK u sec REPAIR ❑ t HANEB SPC the reason DEMOL ❑ LDIAA Pros
w(1 BIRO
Dazs URM ❑ CIODO-0001 �/�'Q/SLI
❑ 1 aro owner or Me property or my employees with wages as � � --d LI��• - _ �6?v 1 A� i,:4�
their sole compensation,will do the work and the structure m F
Code) WKrE1
IW Code)
PrOfesBlonot intended or offered for tale (Section 7061, Business erhtl
I as owner of the propertFaML R /
nm WILLraAAlK',ANTgl n1Fn16e11LLaegocouwWn AINTARDGUB MaE76Al !� �� O '•�•O? 1`_•1• �C
❑ property,'am exclusively contracting with OR A e%nAE COrratAle A NArARoons EQUAL To Ori TIwN
lcerheed contreetere to the THEAY01AR98F OFWONTHENATAi1DgJa IHFOF AnowWW FINAL BY 1 ITEM;:.
Buttrhem and Professions (Section low,
❑ RG❑ v TOTAL 151 . 95
vAu ra erreaO®use of ra eundNo sr ra APPl1CJNI aR R1nlF BlAnee
c° r "Mnu�uavm r „uQMM SIM Fenm„a�namr CHCHECK
CONSTRUCTION LENDING AGENCY oAffiFaaauioe��
I hereby arm that there m a construction lending agency for ,2,❑ nnG❑ 1.HANGE ,IJEj
the performance of the work for which this permit Is issued(Sec 11w rain ra nrA:Anaous over wwlMArroN Gum ANO ra srAnm
®e 3057,CN C) 1 l 13 aTErAasC 1 U+0 IILH) - E011rorBR8 can THe Los ANGHEB �[f–�C11 iiE��4�7"l'
e Lenders Ntme r�pG TRIS2oMPI61Ym T10fL4]A 1m THR an�IOOGMLEIwIIq _ n
rv1[An\W YIFIm®1RG A)iVi`OEWIYIq aT FliGMT1E 8CAGYD
Lenders Address oaawa Ase 3473 1 AM E.41'
1 certify that I have road this application and state that the above aPo I� •' PFAAVT FEE p G
Information m correct I egree to comply with all county J /
ordunces end Stete taws relating to building caabuctlon and
hereby sUthorlie repnesenatM1ls of this County toenter upon ISSUANCE FEE
the aoovwtnendonsj property or inspection 77
INVESTIGATION FEE TOTAL FEE
o.
SEE REVERSE FOR EXPLANATORY LANGUAGE
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKERS COMPENSATION DECLARATION FOR APPLICANT TO FII IN -` BUILDING ADDRESS ,
I hereby alflnn that I have a cartrflrate of consent to sell Insure, BUILDING ADDRESS GQ s meff UO D 2-
or a oerldluts of Workers Compensetron Insurance,or a certified J E,
cops thereof(Seo 9800,Lab C) cl7v ,T I _ ' , LP LOCALITY
PolicY Pent SIZE OF LOT OF BLDGS NOW ON LOT
❑ (.arUfetl Copy IS hereby furnished NEAREST CROSS 3T
❑ CarNfled Copy b Bled with the county building Inspection TRACT4 BLOCK LOT NO USEZONE MAP NO
MleM 11 _
depar
' Day Applicant ASSESSOR MAP BOOK _ I PAGE PARCEL SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' OWNS D G Aa TEL NO VIfTWN 1tlW FT OF BCNOOL7 Y� NO
COMPENSATION INSURANCE ADDREI� F� I: A q'
(This asecction)needor dnnot be completed If to permn Is for one hundred I � � \ ((Ic� Yvdolla • DIStNICf/Y //G�IRDUP TYPES//CfO�Nsr FIRE zorE
CfTV 11'' LP Of
// /"�) • 2
I rer4ty that M the performance of the work for which this permit 12 QK- , ;V71 '[` ✓ J
m Issued I shall not employ any parson In any manner so as t0ITECT OR N TEL
become sublect to the Workers COrnpersation Laws Q { STATISTICAL CLASSIFICATION APT DO
Date ApplicantADDRESS kb(xOLASS NO DWELL UNITS
NOTICE TO APPLICANT If after making this Certificate of QI ^ �" REOUIREO TOTAL SETBACK FROM EXIST
SET
Exemption you should become subject to the Workers' aQ Q��n ^ 'nd, �� D BACK YARD trwv PROP LINE WIDTTr
mdn
CompenBpnwfelors of the Labor Code you must lorthwlth
comply with such provnslons or this permit shall be deemed revoked _ �
PL
LICENSED,CONTRACTORS DECLARATION CITY OSlePDE a
�- s
I hereby affirm that I em licensed under provisions;of the of Chapter 9 NO CA tp Ca ooh OF STORES No OF FAMILIES BEwer MM
vn
(conencap with section 7000)of Division n 9 the Business and NEW ❑ BK ro
Protnsrma Code and my license is In IWI force and effect
Lkemse,Number LIC ClaesIPrION OF NSR _ ADD ❑ VALUATION pop.ConnectorDate - U ALTER El $ z
❑ I am exempt under Sec REPAIR ,�❑! $
BBPC forthis eascn nL
DEMOL Lout Pica
Date USE OF ExiSnNG BLDG URM ❑
Signature APPLICANT(PRINT) , TEL NO , LDMA Fix e 1
❑ 1 as owner of the property or my employes with wiWas as ' ACCT.i
their sole compensation wdl do the work and the structure s ADDRESS
not intended or offered for safe (section 7044, Buanness and / POML 33,707 8+•00
Proyesrane Code) wKLTR�APr.,GN.mRn„ �,anaraDNTNN�EANA=Aann�aMA�aAL 1ITETiS
❑ I, ss owner of the am exd ContracB with OR A 1mmuRs mNTAwq A MATAnOpID MATFnAL COUAL To OR aRewTel TPnAN
ProP�Y �mIe ng TI�ANCMiiH ePmF®aN nc RAallopuPwTelwesasomrArroNN auov FDIALw >
1R:smsed contraaore to corulnlct the project (Section lou ,�❑ ,p❑ - - , , TOTAL 88 . 00
Business and Professions Code) wu nc ertoo®use or T�euanwo eY Tri,Awurwr aR nmxe euanaq MC* 88.00
oco117 MR QUAUTYA PElbar PoRCOH8rRl1CiMC Cm D)SEE ADCNIr10YTIEBpnN
CONSTRUCTION LENDING AGENCY �T AIR ^'M"N"�Er^I�TMCT IecAaNDI eI �TTI� *
FaRoulmlraEs ( .00
I hereby eRkm Net Cera b a construction IerMtrng egsnuy for Try❑ Pro❑ _-
the performance of the work for which this permit Is Issued(Sec i IWAD TNe NASAADaA"TEiiWD arrCmLATICN GUM Aro rNE SCAor)
3697,CiV C) PEroarnre aerw.Isr I IAOEIerAro.rr REOWR90rre uNCBI TI!Loa ANDELID
LerKW%Name � ;,o,a ODaO-0001 5/23/90
I_endees Address OE90 1 AM 9:54
awe,o..mrr
I car*that I hate reed the eppliceCon and state Cut the above _ —
nrfomlation Is correct 1 agree to comply with all county PC FEE PERMIT FEE
ordmancee and State teras..Ialb g to buildingwns6vction and r
t eMaeefrtaUVee V, Dols C :rrr to'6¢�eIOB��upon TOTALISSUACE FEE -3' h
¢sJ property forlrsPec6on lw�!—� (�
INVESTIGATION FEE TOTAL FEE
SEE REVERSE FOR EXPLANATORY LANGUAGE