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Home My Public Portal About5136 SERENO DR_Building__ \ DEPARTMENT OF WELDING AND SAFETY APPLICATION FOR PWIIT � h QOIINTY OF LOS ANGELES BUILDING BV, I e6.®I N G WM .I�FOX CHIEF ENGINEERHHR FOB APPLICANT TO FB.L IN FOR OFFICE USE ONLY a (�� DIST RIC7^NO PLANCK NO PERMITHO %DRESY `j RECEIVED BY DATE OF APPPPL DATHIBHUID LCCALITY,�+ I 1 NEAREST CROBB BT, F r BUILDING _ - ADDRESS J J W GJ OWNER MAIL {� LOCALITY —c-�-- ADDRWE ) F S C OBNEAREST T TEL CITY +� NO o97 FIRE NO OF TYPE 6ROU ARCHITRCTOR TEL ZONE PLANS ENGINEER NO �� BLDG R SHTBACKLINE 6I ADDRESS APPROVED + TIL BY DATE CONTRACTOR' { NO II USEAPPROVED q E. ZONE BY DATE ADDRESS U I ^ = HOUGH NUMBERING i LEGAL l DESCRI ON LOT NO BLOCK MAP NUMBER- Q�� PIELD CHICK BY TRACT NO ASSIGN® BY------DAT ' NO OF BLDGS J/ _ CORRECTIONS SIZE OF Lar '5-5 SS 3-7Z. NOW ON LOT USEOF NO OP EXISTING BLDG, -D W e 1 N I 'AMILI[� A 1:10 Yd✓ DESCIlk F WORK NEW I - ALTIRATION:I I ADDITION REPAIR 'I DEMOLITION I I G� _ - _ rJ I (V A SO FT NO OF D SIZE " + ROOMS STORIES / G� EZT WALL �- ROOF r COVERING.. .Lt GG.O COVERING USE I4bQTLuCruRm -r APPROVALS INSPECTOR'SSIGNATURE DATE I HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FOUNDATION LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS _� y CORRECT I AGREE TO COMPLY WITH THE CORRECTIONS LIST FRAME FIRE STOPS, N OIEON AND WITH LL COUNTY ORDINANCES D BT BRACING, BOLTS LAWS REGULATI BUI IN6 CONBTRU FURNACE LOCATION, G SIGNATURE OAS VENT, DUCTS ? PERMITTE - / LATH. INT + LATH. EXT AUTHORIZED AGT ' V PLASTER. TEwEseA G\V loco �G�1/V P C S •- ® .� /IPLASTER. EXT 4� VALUATION (l 1' FHH ��'H'I� FINAL ' �7all� i APPLICATION FOR BUILDING PERMIT- COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby atfum that I have a certificate W consent to self inure BUIIDNC a a certificate of Workers Compensation Insurance or a certified copy thereof(Sec 3800 lab C) - i Policy No company �.= i % it L' LOCAUTY r SIZE OF LOT NO OF BLDGS NOW ON LOT ❑ Cert fed copy Is hereby furnished !I NEAREST CROSS Sr ❑ Certified copy is filed with the county budding inspection TRACT BLOCK LOT NO ' department > USE ZONE MAP NO bete Applicant ASSESSOR IMP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER -- ', , TEL No � COMPENSATION INSURANCE ' I- - ' WITHIN 1000 FT OF SCHOOL? vssr No (The section reed not be completed it the permit 0 for one hundred ADDRESS 1 ) 'I Z f I, A - DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY dollars($100)or loss) {{ I certify that In the performance of the work for which this permit CITY{ ) ZIP I r t 1 J is Issued I shall not employ any person in arry manrcr So Be tor become subject to the WorKM Compensation Laws ARCHITECT OR ENGINEER TEL NO STATISTICAL CLASSIFICATION PPT CONDO Date Applicant ADDRESS CLASS NO - DWELL UNITS NOTICE TD APPLICANT If after making Itis, CertrI of Exerri you should become subject to tfs TEL NO Workers CONTRACTOR REQUIRED TOTAL BETE FROM EXIST A SET BACK YARDHyyy PROP LINE E VADTH Compereatpn ProvsRDrs of the Labor Code you must br[hlwlth comply with such provegrtv or the permit shall be deemed revoked ADDRESS LIC NO FRONT PL LICENSED CONTRACTORS DECLARATION SIDE CITY LIC CLASS P L I hereby(commencing that inn licensed000)a uMerpr Sof the of Chapter B (Domssioxna with Section 7000)DI Drvapn 3 0l the effect and 50 FT SIZE NO OF 3TOFRE3 NO OF FAMILIES ' NEW ❑ BK SEWER MAP PER O Prolesalars Code aryl my license s In full force and effect 1 � C� �- CI- license Number Ix Class DESCRIPTION OF WORK ADD ❑ $ �UAT (_ F% Contractor Date BIER ll ! lZ ❑ I em exemptREPAIR ❑under Sec $ BSPC for the reason / DEMOL ❑ LDMA P/C I R Date USE OF EXISTING BLDG URM 13 ! Signature " APPLICANT(Pi TEL NO ('' � LD.LA Porn♦ r ' ❑ 4 M OWner of the Property or my employees with wages as i 1 .I "1 L t , V r . _ Z If < < their sole compensation wJl do the work and the structure m ADDRESS T 0 not intended or offered far sale (Section ss 7044 Busineend 1 -t ( — ( S !1, S , { - FINAL DATE FQ »IJ Professions Code) WILL THE AP0.1CN?oR FIJnF£aanwvG orclwur wvgLE A IuvARDars NVT12 l � Z ❑ 1 as Owner of the property am exC1USNely conbrWing with OR A MIXT CONPYRle A HAZAfpOpe WATEm EQUAL To OF1 GREATER T THE licenaed contractors to construct the protect (SOCLKK7044 NSPECIFIED ON HE MDOUS MATERNLS INFTKw GUDE1 FINAL BY Business and P ro f e ssions Code) NES 1:1 NO EI wvl TRE IN ENDED USE OF THE eiPDLING BY THE APFtxvrr OR FUTURE BUILDFIG OCCUFYWT fEQU A PEraAT FCR CONS1RUCipN OR MOOFIC.VINR FRIT TILE sOImR CONSTRUCTION LENDING AGENCY COAST Ae OUAurY W1 W!Vr DISTRICT(SCA AO)ME PERAnTINO CIECKUST FOR » I ITM, OLnEUNEs �pp I hereby affirm that there s agency a construction lending agenfor YEs❑ No0 - I.)trT� J+ the performance of the work for which this pernlrt a issued(Sec IIRAI£RFID TIEINSMDpASIMTER1LL9fFOPo.WT%1NGLWE A1q TIE eGOrn r£RIATTPIO 1 3087 Cr, C) CIECKLVST IWDEPSUID An'REOUPEMENI9 UrCER TIE Los ANGELES COUNTY CODE Ini.`r�, C t�.•' 1 ' MILE 2 GMPTER 220 SECTpNa 220 100THROIeH 220 Ib CONCEWINO HAzxaDoes Lander a Name NMTEndAL9 REPORnNa ANO FOR OeplllNp A PERArt FRL`M TIE 9CAOMD A LFenders Address ••� 1 --� C aMAn m Raw+ 1 certify that I have read the application and state order perlelly _ Of perjury that the above Information s correct 1 epee to r., 1 with all county ordinances; and State laws relatrg m hulldrg PERMIT FEE f !_I.F f-i}l�l�� j•y;; carehuction and hereby auDionze representatives of the County ISSUANCE FEE YI •: to enter upon the above-mentioned property for mspecten purposes r' m 1 ( ILi INVESTIGATION FEE ri TOTAL FEE / SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION FOR BUILDING PERMIT- COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION [� FOR APPLICANT TO FILL IN BUILDING nn OR ss I hereby eHvm that I hale a certificate of consent to sett inure �DGI 3 v� ,^, 1' �e fit n P T 1 � �nf eLn o ( q p. o e CertitK.ete of Workers, Compensatxui Insurance o a certified CITY— N . _ O zlP K ! o D copy thereof(Sec 3800 Lab OF ,,. ? O LocALmv �� " SIZE OF LOT NO OF B S ON LOT ❑ Certified copy s hereby tumshetl NEAREST CROSS ST ` ❑ Certified copy is filed with the county builduq inspection TRACT BLOCK _ LOT NO -- department USE ZONE MAP NO Date Applicant ASSESSOR MAP BOOK PAGE PARCEL _ — _ nM N ONS CERTIFICATE OF EXEMPTION FROM WORKERS' CW?4ER i\ TEL N� 8 _ 1 �Jlz�-�cI COMPENSATION INSURANCE °M� �� o p wmfIN 1000 FT OF SCHOOLI vE •Fq / p (The section need not be Completed If the permit s for one hundred � �E�2 �0.� 5 !1 ,,\ DISTRICT GROUP TYPE CONST FPE ZONE PROCESSED BY dollars($100)or less) C I ce" that in the performance of the work for which the permit crrY msedvii.r; p Z1 l '� 6 y - �0� e issued I shall not emrty ploy arty person in amanner so as to become subject t0 the Viii Comptwn Laws ARCHTECT OR ENGINEER TEL NO ` STATISTICAL CL�AAS�SIFICAPON APT CONDO Date Applicamt ADDRESS CLASS NO OCs_ d LE UNTS NOTICE TO APW_X/1NT if after malting the Certificate of REQUIRED TOTAL SETBACK FROM EXIST A Exemption you should become subject to the Workers CONTRACTOR TEL NO SET BACK YARD MY PROP UNE WIDTH Compensahon prowslons of the Labor Code you must forthwith Comply with such provzK=or the permit shall be deemed revoked ADDRESS UC NO PSL NT LICENSED CONTRACTORS DECLARATIONSIDE CITY LIC CLASS - PL I hereby affirm that I am licensed underprwsprs of Chapter B y (commencug with Section 7000)of DNsion 3 of the Busureas and SO FT SIZE NO of STONES NO OF FAMILIES NEW ❑ 81( R MPP PD - U Prufesspre Cole and Try license rs In full force and effect License Number LIC Class DESCRIPTION OF VA7RK - ADD ❑ WLTIARON ' Contractor Dale ❑ I em exempt under Sec REPAIR ❑ a = BAPC for this reason DEMOL ❑ CDMA PIC A Date USE OF EXISTINO BLDG _ arw URM ❑ , mature APPLICANT IP9N EL NO LDMA Perm 9('ISV. owner of me property Or my employees Wim wages es A E c9 8 -0� z ACiT.v ' thea sole cornpereati n will do the work and the structure s - not intended or offered for sale (SactwAnOREssn 7044 S=nes3 and z S_ Otik V ATn C I Z FINAL DATE professions Code) W U-TIE APPLKAM OR FUTURE BUL ODLL{MNT HANpLE A HAZMDW S NArEH ❑ 1 as OWrer Of the property am excIUSNRty Contracting with OR A MxTLnE CONTA➢!IO A HAZML`p1S MATERIAL EQLAL TO OR GREATER THAN TIE 1 NW ANTS SPECFIED ON THE HAZAnocus MATE( NRoa m GUIDE, FINAL rat' kDenSed COritraCIM to Corstrucl the project (Section 7044 rEs❑ _,_,ra �i4.l T.r Business and Professions Coda) r+T rTi - r'_ WILL IliL o USE CF THE eUDN LG BY THE A UCANT OR FUTURE BUILDING JSV DGCLP/wT nEOMREA PERMIT FOR CCNSTI U KM CA MppIF X*FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AR cuurmY MuuC,EMENT((STRICT(c Dl SEE PERIWTTNG Ca CKUW For+ GUCEILWES I hereby affirm that there Is a construction larding agency for mss❑ No the perfonnarca of the work for wtv h the permit s issued(Sec TOTAL 1 :L8 e ?0 m IHRIE REAP TIE HAZARNus NATEr3Al911FORAMTpN ouCE ANp THE sUCNp FERKTTl1] N 3097 ON C) C CKUST I UNpE AND MY REOUREIENTS HOER TIE LOS ANGELES COUNTY CODE Larder a Name TMUE� s2 l;00 ATH�� .�+n HAiARD00a •.HEC id Au NpNaE r Lader s Address aN.ca�.orm _o I Certify that I him read the apphi abort and state udder penalty g of perAury that the above Irlfamnatxn is Correct I agree to con" PC FEE PERMIT FEE 'R, with with all coumrty, ordinancesws and State larelatng to budding 7�7 r , ♦In construction and hereby authorize repfasenlatnes Of the County IASSUANCE FEE �Z l� C222 Up enterthe above-mermloped property for Irspectgn purposes INVESTIGATION FEE /D TOTAL FEE SEE REVERSE FOR EXPLANATORY LANGUAGE