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HomeMy Public PortalAbout6335 TRELAWNEY AVE_Building__ DEPARTMENT OF BUnMI iG AND SAFETY APPLICATION FOR PERMT COUNTY OF LOS ANGELES ® � WBI. J. FOX. aHimr ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO PLAN CK 9ND PERMIT NO agrz ` r i 9 1 1 71— LCDALITY RECEIVED BY DAT[or APPL. OAT[IBBUED NEAREST e BUILDING TrL OWNER • ADDRESS MAIL �.M a LOCALITY Z 'DDREBB NEARESTCITY C I MD CROWN BT rIR[ NO OF TYPE GROUP ARCHITECT ON TEL ZONE PLANE ENGINEER NO BLDG ORD NO ADDR[BB SETBACK LIN[ 1.401 APPROVED CONTRACTOR S 8L 7" '� NO UB _ DAT[ UB[ APPROVED 20N[ - I er DATE DEBORIPTILEGAL ON LOT Np BLOCK CORRECTIONS TRACT / - NO Or BLOGB SIZE Or LOT v HOW ON LOT Q uB[or N NO Or G DESCRIPTION OF WORK NEW x ALTERATION ADDITION p ti REPAIR MOVING DEMOLISH p ROOMS STORIES WALL ROD► COV[RINC COV[RINB ` New eUILCDIM O I g ' � 0 i 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND BTAT[ THAT THE ABOVE IB CORRECT FOUNDATIONt LOCATION N R DAT[ AND AOR[[ TO COMPLY WITH ALL COUNTY 13RDINAMO[B FORME.MATERIALS 1,2AND STAT[ LAWS R[Ojjj!!!}AATING BUILDIf II]]ONSTRUCTIOM - ` SIGNATURE Or &01 ( �� BRAOINO.BOLTS PERMITTEE LATH. INT n i Au7HORIZ[D A17T ' LATH. EXT. P OB S Ii-0 PLASTER•INT. _ , FTCPLAIrmp.EXT. VALUATION FR • 33 FINAL 3-�L- .57 A APPLICATION FOR BUILDING PERMIT � COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKEWS COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDR I Irnebr affirm that I have a certincate of consent to esti insureGµ,0 .SASS zeez o w6-Y or a certificate of Workers Comperoetlorh Insurance,or a certified ��r 3, T�Q E L f)w/VY �Em�L E C•F/� �i� gj7�a copythasof(aecaeoo,L�c�,rsSdEm.'c6 c°.7r 9/7da LOCALITY pd�,No Q�= 9O Company STA76 1 ✓v SIZE OF LOT NO OF&.DOS NOW ON LOT ❑ Certified copy Is hereby furnished NEAREST CROSS ST Certiffed Copy m filed with the County building Inspection TIIACT BLOCK LAT NO LEmOiy IM ASSESS L13E ZONE MAP NO department Data /°-"'90 Appirant YILZORL NEdAtAtDEt _ r Br 0E �yyoAARbCELL OW N� 2 �-� SPECALcoFminoNs CERTIFICATE OF EXEMPTION FROM WORKERS' /11AL.f YA4 Eignla �LCb -YO;? - YES IAO COMPENSATION INSURANCE WITHIN 1000 FT OF SCHOOL?ADanESs/ (Tits saebon rsetl not be Completed Hint pennrthfor one feuhtlned 633.5" //26LAsV.VEi DISTRICT GROUP TYPE CONST FIREZONE I'ROCFBSED BY dollars({100)or lees) I Cerdfy that in the performance of me work for which this permit Cm TEm.' p'L E L'i TY 7JP 9/7�s !OG -3 h lowed I "I not employ any person In any maraEr w as to ARCHITECT OR ENGINEER TEL.NO become hu b9act to the Workers'Compensation Lews STATISTICAL ClASSI/FFWXrC I APT CONDO Dese Appley1i ADDRESS CLASSNO �1DWELLUNRS NOTICE TO APPLICANT If, after making this Certificate of pq .�c REWIRED TOTAL SETBACK FROM EAST Exemption you should become subject to the Workers J J L TEL NO GQs SETBACK YARD INN PROP LINE MOTH Compensation provisions of the Labor Code,you must forthwith M1, C comply with well provisions or tills pwmd shell be deemed revoked LIC NO r FRONT 11.943 �iicL/An[ ST- cy�Sy PL LICENSED CONTRACTORS DECLARATION CITY 6 (+<I- LIC L"-3 9 Pl. S I hereby affirm that I am bDwtwd under piovldons of Chapter B L /. aevr SEWER MAP (commencing with Section 7000)of Dtrmm S of the Business end BE) FT SIZE NO OF STORES NO OF FALILES z Prolroeions Code end my I s In futi fo1Ce ere eftxt /Soo / / NEW ❑ BK PO , License Number .Jb 72Y3 � pan e-391 D�RIPNON OF WORK ADD ❑ VALUATION Contractor [bemZ //FaA4,x /O-P2-90 EMO✓E �vJri�v� 20✓F�✓B ALTER 11 _ /S-00 z .zE-JA/EE7 .200E w/. '!Jr /TL1 Iff ❑ I em REPAIR exempt under Sec ❑ $ B aP C for this reason &,4Jcv' �300OltJN•• ASJ :4� vBce-t DEMOL 119E OF Mr BLDG IDMA P/C �e APpLICwJr/fryL/mENgL,L.�/ `° URM ❑ Sia ovin \he-va 1C - 4Ee2n1 350— 26 r LDMARem e 1 AT ❑ I, ee owner of the property or my employees with wages m ACtT.r nottheirsale ed or tloRh for do the work and the aWCWro b F not Intended a ortered nor eels (Section 7GaA, Business and 1925 kIu-I.aAr EC rtfd.t,7-� !�A- rouLDATE 7� a X007 79.3 profeeNam Code) rias„s,anucwn.wwhurseuunwaoccz.eNTNua.sAhavAnaoumNArwAL /D 30 — 2`L� ° oR A FmnhxRs wNrA..n A rhANu+Doue rArvBAi EQUAL ro oa orEATEB rFhAN 1 ITD;- ❑ I ns ower or the property, am exC11mW'eelY COntraCting with MAMIxIMaSPEaT®aN TIEIWMDDIm FrArFinae lNfCxiWll(:11 WADl9 FIIW. ') licensed contractors to construct the project ISecdon 7044 Yrs❑ w❑ FEL D TOTAL 70 . 38 Business are Profeaalons Code) rn.L THE RNhvIBEn vee or rhE ewuolNo er rhE AIRIGVIT w nRruE IxROerO CONSTRUCTION LENDING AGENCY occuswrrRcrouaa:APEmrrwacorsrFORW� VCTMCA L"SCE wrleNnw,.saourN �� CHECK �U.�_ Corer AE olasLm•.•�:sT<,.c:CrBmRCr terwaol SCE relNrrnq CFIeCatsr 1 hereby affirm that there is olerhdi a construction ng agency for YES 11M❑ I.HANE me perfomunca of Urs work for which tNe permit b homed msec I Hove READ TW huZMDOIE uATBWLLa erPoIBLATON ouDE AIO THE SCADND 9097 CIT C) PrseTnexi CFECAIer I lxWmrAND rrr BaOUTETe31re HOER TIE LOB ANDEIEe Lender's Name LendsYs Address w.uaAmT 3435 1 A1110::4 0 1 certify that I have read this application and sada that the allows Infornedon Is correct I agree to comply with all County PC FEE PERMIT FEE ordinances and Slate taws relethg to building mnwu ction and nNwAze representatives Of this Courcy t0 ether upon ISSUANCE FEE / \1 a ew a Toperty for Inapectlon PnuDDees IO r,Z-9J INVESTIGATION FEE TOTAL FEE ..... ._ p. o. D. at BEE REVERSE FOR EXPLANATORY LANGUAGE