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HomeMy Public PortalAbout6334 TRELAWNEY AVE_Building__ 9 M' • T„��/� C � 7-7 ISABGBA CE#003 5 GIAPPLICATION FOR BUILDING PERMIT COMM OF LOS ANGELES ADDRl6s 1 6 ? DEPARTMENT OF COUWfY ENGIIIEER BUIWING AND SAFETY DIVISION LOCALITY 7-- C JOHN A LAMBIE, COUNTY ENGINEER 11 NEAR ST WILLI M JENSEN OFB NO CROS ST AJ V DISTRICT NO GROUPnpE PROCESSED BY FOR APPLICANT TO FILL IN COST 1/21 uin el BUILDING STATISTICAL CLASSIFICATION SItWFR MAP ADDRESS // BK PG CLASS NO HOWELL UNIT - LOT NO 1, ATT L, BLOCK WATER NOT REQUIRED RECEIVED CERTIFICATE TRACE p NO OF BLDNOP �o O 3 Heil WA STATE MAJOR SECOND OCAL/ SIZE OF LOT 0 0 Y NOW ON LOTGB &CA, USE ZONE SPECIAL USE OF J-b0 C1 CONDITION O Z I EXISTING BLDG TEL e I OWNER /1 �[ t C NO HI �'�•I BUILDING EXIST I YARD NWY STREET NAM! CI_I LYGI- C:G 6ETBACK WIDTH ADDRESSLRN ARCHITECT CHP l i TEL FP OLT I CC h- ,,7 ENGINEER NO HIDE P L V ADDRESS TEL INSPECTION RECORD CONTRACTOR S NO Q^ ADDRESS ry DESCRIPTION OF WORK I't- J N f C x t o F0, 1rf 3� NEW ADD ALTER REPAIR DEMOLISH 1* NO OF NO OF I (i -, Ze I OS STORIES USE OF STRUCTURE 1 `C 1 E G - /Q SIGNATURE OF APPLICANT VALUATION$ 3- Q .�- APPROVALS •` AT INSPECTORS SIATTIRE P C L�^ PMT FOUNDATION LOCATION• /1 FEE $ U l FEE S �� FORMS MATERIALS 7 L FRAME FIRE STOPS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STAT[THAT THE ABOVE IS CORRECT AND AGR[[TO COMPLY FURNACE LOCATION I • / WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HER[EY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH, INT TION OF THE LABOR CODE OF THE STAT[ OF CALIFORNIA R[LAT IMO TO WORKMEN COMPENSATION INBURANC �- n f 7 HOU eNT SIGNATURE OP ,[ e (d` HRECTANMBERCOR- PERMITTE RlCf'AND POSTED � ADDRES FINAL �\ CLYDE N DIR PRINCIPAL BRAL ENGINEER PLAN CHECK VALIDATION � r o T.E.x PERMIT ALIDATION( aLA r SH o CA �1 5-6 1Cd JM13 2 3 D 3 025' Q �/ LRL;o4 2 5 2-� SEP12 2 3 D 525 • p lAL,0 4 2 5 3 0 SEP 12 - i D 7 1.00- tl WORKERS COMPENSATION DECLARATION �I I hereby affirm that I have a certificate of tionconsent to Insurance APPLICATION OR BUILDIN PERMIT LI IS Insure or a certificate of Workers'Compensation Insurance or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company BUILDING Certified copy Is hereby furnished FOR APPLICANT TO FILL IN ADDRESS A rs y6. Certified copy Is filed with the county building mspec- UILDING �J,, tion department DESS T • 16 i A.44&4 AV& LOCALITY M, CLTJ, CA CNEAREST Dote Applicant CITY E \ ZIP CROSS ST CERTIFICATE OF EXEMPTION WORKERS' OF BLDGS ASSESSOR ^� COMPENSATION I SIZE OF LOT NOW ON LOT MAP BOOK 3 a PAGE �• PARCEL (This section need not be comp) t permit Is one U ONE P hundred dollars ($100)or less ) TRACT BLOCK LOT NO NO 0.� TEL t SPECIAL Y I certify that In the performance f a work for whlc a OWNER A. NO CONDITIONS d permit is Issued 1 shall not emplo n person In any manner DISTRICT GROUP TYPE FIRE PROCESSED BY O so as to become subject to the Wor mpemaho awe ,ADDRESS 134 N' AP / (� CONST ZONE V l� 1'L/•b Y� D 3 ILT 'T 0 Dal ��.?lpphcant KjqCAIR�CH <TECT=M 1 , ZIP �L STATISTICAL CIASSIFICATI N APT CONDO (— NOTICE TO APPLICANT If, after making this Certlflccte of �j—' V Exemption you should become subject to the Workers' ENGINEER NO CLASS NO DWELL UNITS_ d Compensation provisions of the Labor Code, you must forth- ADDRESS A SEWER MAP Z with comply with such provisions or this permit shall be TEL _ deemed revoked CONTRACTOR J r NO SK PG VALIDATION LICENSED CONTRACTORS DECLARATION LIC I hereby offlrm that I am licensed under provisions of Chapter 9 ADDRESS NO VALUATION (commencing with Section 7ODD)of Dlvluon 3 of the Business and LIC ..w.� Professions Cade, and my licerue Is In full force and effect CITY CLASS $ ar , 50 FT NO OF NO OF CHECK License Number Llc Clas• SIZE STORIE�S((77 FAMILIES ONE DESCRIPTION OF WORK' OZ e- O NEW ❑ $ Contractor �° W ►)C ' " ❑ I am exempt under Sec ADD ❑ B 8P C for this reason ALTER DATE FINAL REPAIR Date USE OF FINAL EXISTING BLDG DEMOL ❑ By U ICANT TEL v SI naNre OWNER-BUILDER DECLARATION PRINT NO I hereby affum that I am exempt from the Contractor s License , Law for the following reason (Section 7031 S Business and Professions Code) Y employees BUDDING 1, as owner of the property, or m elo to ees with ADDRESS -'6306A wages as Their sole compensation well do the work and the structure Is not Intended or offered for sale(Section LOCALITY ur 7044, Business and Professions Code) MOVING WTEL ttI• x I I as owner of the property am exclusively contracting CTOR NO 2 • • 7800 11w with licensed contractors to construct the project (Sec- ADDRESS tion 7044 Business and Professions Code) . • • 7 8 0 0 60 CONSTRUCTION LENDING AGENCY �B IX TOTALCK FROM WIDTH YARD HWY I hereby affirm that there Is a construction lending agency for FRONT , 1'0 25-83 the performance of the work for which this permit Is Issued P L Sec 3097 Civ C ) SIDE PL Lender s Nome ►7 ��y) 8 PC F"$ Permit Fee Lenders Address I certify I have rood this application and pate that the Issuance Fee rr04�� above In atron Is coect I agree to comply with all County Inveppotwn Fee �y rF1�n ordtnanc all a State laws, relating to building construction, Total Fee OLSF LJ V and her aorize repr ntattves of this County to eater u n t v -menti/o�ned r perty for Inspection purposes ,C�'7 SEE Ri FOR EXPLANATORY LANGUAGE n of Applicant or Agent Data 0s