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Home My Public Portal About10635 SPARKLETT ST_Building__ Teee�ee cE gemnee APPLICATION FOR R BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS — — ! BUILDING AND SAFETY DIVISION LOCALITY JOHN A LAMBIE COUNTY ENGINEER NEAREST _p WILLIAM A JENSEN SUP T OF BUILDING CROSS ST Lx DISTRICT NO GR TYPE R ESSED BY FOR APPLICANT TO FILL IN . coNsr t BUILDING STATISTICAL CLASSIFICATION EWER MAP ADDRESS _F CLASS NO DWELL UNITS LOT NO BLOCK WATER CERTIFICATE NOT REQUIRED RECEIVED TRACT MAP HIGHWAY STATE MAJOR SECOND OCA NO OF BLDGS �f NO (CIRCLE) SIZE OF LOT �• NOW ON LOT USE ZONE SPECIAL USE OF _ CONDITIONS EXISTING BLDG IL L TEl^ OWNER NOal 2O BUILDING EXIST SETBACK YARD HWY STREET A WIDTH ADDRESS - FRONT ARCHITECT ORM, EL P L ENGINEERNO SIDE P L } ADDRESS r O. TEL J ^ 0 CONTRACTOR NO ADDRESS Q DESCRIPTION OF WORK f NEW ADD ALTER REPAIR DEMOLISH SO FT NO OF NO OF SIZE STORIES FAMILIES USE OF STRUCTURE 1- - SIGNATURE OF I APPLICANT VALUATIONS APPROVAL$ DATE INSPECTOR rune FEE FOUNDATION LOCATION {{�� FEES FEE E `�� FORMS MATERIALS J'� +.L FRAME FIRE STOPS .. 0 I HEREBY ACKNOWLEOGD THAT 1 HAVE READ THIS APPLICATION BRACING BOL AND STATE THAT THE ASOVE IS CORRECT AND AGRKE TO COMPLY FURNACE LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BU ILOINO CONSTRUCTION I CERTIFY THAT IN DOING THE WORK ) AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT TION OF THE LABOR CO C OF THE STATE OF CALIFORNIA RELAY ry INC TO WORKMEN S C E BATION IN9U NCE LATH EXT SIGNATURE OF N HOUSE NUMBER COR PERMITTEE RECT AND POSTED ADDRESS FINAL PLAN CHECK VALIDATION (CMO CASH _ JOHN PERMIT VALIDATION TRCK RM ENc SH R L U0 7 4 a 5 G naR 9 2` 3 D 12.75' L1�07 8 7 5—� .II'R20 1 D 2550- DEP ` °" BIJI LDIIVG DIVISION OF Hor unQ AMID SAFETY --� COONTY Of LOB AtiGffi.S8 WILU M J FOX. COUNTY E[ia1NEER I AMMATION �— CAYGATT D GRIFFIN, SUPT OF BUILDIIIO , FOR APPLICANT TO FQL IN FOR OFFICE,= ONLY ADDRQBB Ob DISTRICT NO . PUN CH On RXC No PERMIT NO LOCALITY 0A / R HIVE BY I DATMOFAPPL DATE I UED NEAREST C I ADDRESS' IJ�e S' OWNER I i MAILLOCALITY ADDRESS54" NEAREST, Q h Tm- _ CROSS BT ARCHfTECT OR TEL FIRM �� NO OF _TYPE -'- GROUP ENGINE ZONE PLANS �� 3 A BLDG SETBACK LING 1G I TEL _ UBe 'F! �� PROVBD I A r L V ON CO ADDRESS �. .J �Iod. I HOUSE NUMBERING LEGAL E ALLI N O MAP NUM8MR 'o /� ' NO ASSIG ED BY DEH L j CORRECTIONS TRACT 1 - , } SIZE OF LAT A fob NO ON LOOT S1 _ ' USE OF ✓ FAMILIES OF 1 Na SIJM DESCRIPTION OF WOM o - NEW D O Z REPAIR DEMOLITION � r BO FT RM OF SIZE 07 ROOMS STORIES OVWALL ERING S'fV I COVERING Ch VWVO, USE OF STRUCTURM APPaov INSPECTO BSI NATURM DAVE FOUNDATION LOCATION FORME MATERIALS / S 1 HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS Al` FRAME FIRESTOPS. PLICATION AND STATS THAT THE INFORMATION GIVEN IS BRACING DOLTS CORRECT 1AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE LOCATION. AND STATE LAWS RMOULATING BUILDING CONSTRUCTION GAS VVITI DUCTS SIONATURM OFc Nv LATH, INT PERM / il� C'. / LATH KXT ADD J ,71 PLASTER. INT AUTHORIZED AOT 1 C� PLASTER mLT F E( d HOUSE NUMBER COR- 1 KV RBCT AND POSTED zy VALUATION E, J� FEE YL FINAL 7"Y 0111114 �'E!1 WORKERS COMPENSATION DECLARATION hereby affirm that I have r certificate Come of tion In, to nalf APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance, , or a certified copy thereof(Sec 380), Lab C) _ COUNTY OF LOS ANGELES '" BUILDING AND SAFETY Policy No Company BUILDING ❑ Cenifted copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS o 4') r 7/ ❑ Certified copy is filed with the county building inspec- BUDS O f a- Ci / tion department GI Date Applicont CITY NO OF BLDG NEAREST TV CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT NEAREST CROSS ST COMPENSATION INSURANCE ASSESSOR --7 (This section need not be completed if the permit is for one TRACT BLOCK LOT NO MAPK PAGE PARCEL hundred dollars ($100) or less ) TFLOWNER NO Vf4gp USE ZONE MAP NO I certify that to the performance of the work for which this / SPECIAL Y permit is issued, 1311011 not employ any person to any manner ADDRESS /oa 3r s f CONDITIONS 0 so,as to become subject to the Workers'Compensation Laws CITY G ZIP / W K Date Applicant ARCHITECT OR P TYPE I� PROCESSED BY O NOTICE TO APPLICANT If, offer making this Certificate of ENGINEER NO CONST ZONE Exemption, you should become subject to the Workersp r Compensation provisions of the Labor Code, you must forth- ADDRESS 3 5 with comply with such provisions or this permit shall be _TEL STATISTICAL CLASSIFICATION _ APT CONDO Z deemed revoked CONTRA.CTOr- NO LICENSED CONTRACTORS DECLARATION LIC CLASS NODWELL UNITS_ l hereby offem that i am licensed under provisions of Chapter 9 ADDRESS NO SEWER MAP (commencing with Seaton 7000)of Division 3 of the Business LIC and Professions Code,and my license is to full force and effect S ink NO NOC1AS5 CHECK BK PG VALIDATION License Number Lic ClassSIZE I STORIES FAMIUES ONE VALU a.0 Contractor Date DESCRIPTION OF WORK - NEW ❑ S ❑I am exempt under Sec Wrw pop 10 B&P C for this reason REPAIR ❑ $ Dote USE OF EXISTING BLDG DEME ❑ Signature APPLICANT Ta FINAL l� fy OWNER-BUILDER DECLARATION (PRINT) NO DATE �'X /1 i I hereby affirm that 1 am exempt from the Contractor s License Law for the following reason (Seaton 7031 5, Business and ADDRESS FINAL � Pro esatons Code) By owner of the property or my employees with BUILDING ADDRESS wag es as then sole compensation,will do ifte work and 1 ITEM the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code ) MOVING TEL pop TCLT;L 82 . 00 I,as owner of the property am exclusively No CHECK �l•�'I- ely contracting -I with licensed contractors to construct the project (Sec- ADDRESStion 7044, Business and Professions Code ) C.H « ,C�l CONSTRUCTION LENDING AGENCY SET BIPED YARD HW1' TOTALPROP LINEFROM WIDTH IEXIST I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued PL IJI]I]Q—I]QI]1 ��I]�yi (Sec 3097, Civ C ) SIDE P L Lender s Name � 1 11%LI`• [DMA Ref N Lender's Address PC Fee$ Permit Fee �O , � 0 I certify that I have rood the application and state that the [nuance F LDMA P/C N o above mformotton is coned I ogree to comply with all County Invmngarion Fee ordinances and State jaws relating to budding construction, Total Fee z GQ [DMA Perm N and hereby authorize representatives of this County to enter upon theabove-mentioned Property for inspection purposes SEE RIIVQfE FOR EXPLANATORY LANGUAGE ^ Sip atwe o phmnt or Agent Dale - 1.2 _ WORKERS' COMPENSATION DECLARATION APPLICATION FOR BUILDING PERMIT I hereby off irm that I have a certificate of consent to self insure, or o certificate of Workers' Compensation Insurance, er a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy Na Company ❑ Certified copy is hereby furnished FOR APPLICANT TO FILL IN BADoDIss ❑ Certified copy is filed with the county building inspec- INGtion department ADDRESS Dare Applicant a v T zIP acu57- s NOOF BLDG NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT I BLOCK LOT NO PAAP p(GE M061L, hundred dollars ($100) or leu) OWNERFffR ANIL Y11 TEL 115E ZONE MAP NOMro I certify that in the performance of the work for which this SPECIAL a permit is issued I shall not employ any person in any mamer ADDRESS ,r INO CONDITIONS O so,as to become subject to the Workers'Compensatton Laws / U CITY ZIP Dote Applicant ARCHITECT OR TEL DISTRICT GROUP TYPE I PROCESSED By NOTICE TO APPLICANT If, after making this Certificate of ENGINEER NO CONST ZONE O Exemption you should become subject to the WorkersD�j Compensation provisions of the Lobar Code, you must forth ADDRESS /! with comply with such provisions w this permit shall be TEL STATISTICAL CLASSIFICATION APT CONDO N deemed revoked CONTRACTOR NOz LICENSED CONTRACTORS DECLARATION LIC CLASS NO 117Z DWELL UNITS_ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO SEWER AMP (commencing with Section 70DO)of Division 3 of the Business LIC and Professions Code and my license is in full force and effect CITY IT NO OF NO OF CLASS CHECK BK FG VALIDATION License Number Llc Gass SIZE I STORIES FAMILIES ONE VALUATION Contractor Dote DESCRIPTION OF WORK NEW ❑ $ /,.50'0O, Ofl ADD ❑1 am exempt under Sec ALTER B BP C for this reason REPAIR ❑ $ Date USE OF EXISTING BLDG DEMOL ❑ Signature APPLICANT TEL flEp NAL OWNER-BUILDER DECLARATION (PRINT) NO DATE '� s' I hereby off irm that I am exempt from the Contractor's License Law for the following reason (Section 7031 5 Business and ADDRESS (' FINAL Professions Code) PRESENT BYFI:�I .rz. ❑ I as owner o4 the property or my employees with BUILDING ADDRESS " 71, wages as their sole compensation,will do rhe work and - 07 the structure is not intended or offered for sole(Section LOCALITY 7044, Business and Professions Code ) MOVING TEL , 1 1TEh_ LJ I, as owner of theo am exclusive) contracts CONTRACTOR NO with licensed con actor o construct the project (Sec- TOTAL 1a�.rc hon 7044, Business and Professions Code ) ADDRESS CASH r} LI J V.7.' CONSTRUCTION LENDING AGENCY SET WCK YARD HWY TOTALPROP SETBACK FROM EXI I ST hereby affirm that there is a construction lending agency for FRONT (&NGE ,1711 the performance of the work for which this permit is sued P L (Sec 3097, Civ C ) SIDE Lenders Name P L DMI-0001 2/15A 1 - ` TDMA Ref 0 .1669 1 011:07 P C Fee Permit Fee d Lenders Address a I certify that I have read this application and state that the Issuance F �� IDMA P/C It above information is correct I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee LDMA Perm IF < and hereby authorize representatives of this County to enter LYq upon the above-mentiop6d property for inspection purposes SIM REVERLE FOR EXPLANATORY LANGUAGE otur of Applicant w Agent Duro `( W *&& Yv. FU