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HomeMy Public PortalAbout6342 TRELAWNEY AVE_Building__ ��/J71�� 4e_ C� 1 >. @Aczgmly« APPLICATION FOR BUILDING PERMIT Z COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRE88 RUnDING AND SAFETY DIVLMON LOCALITY < JOHN A LAMBIE, COUNTY ENGINKER NEAREST 1 A JENSEN. OU"OrBull-OtmaCROSS 8T FOR APPLICANT TO FILL IN DIFCT NO GROUP n pg en BY �Q CONSTMR BUILDING STATISTICALC FICATION SEWER MAP ADDRESS PG �+ CLA89 NO WELL UNITS �+ LOT NO J BLOCK NU BER ITA R y� N TRACToff USEZONB SPECIAL I NO OF BLDG; CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG BUILDING YARD HWY RE NAME EXIST TEL SETBACK WIDTH OWNER O FRONT P L ADDRESS SIDE ARCHITECT OR TEL p ENGINEER NO INSPECTION RECORD ADDRESS TEL CONTRACTOR N 1 0 ADDRESS V DESCRIPTION OF WORN - �'f' '"+ O s / M Fs� / NEW AD ALTER REPAIR DEMOLISH SO FT NO OP NO OF I 1 CS- SIZE ;TORIES FAMILIES USE OF STRUCTURE 4 /�// SIGNATURE OF PT • z/ APPLICANT VALUATIONS oo APPROVALS DATE INSPECTOR;SIGNATURE PC PMT d FOUNDATION FORMS MATERIALS LS FEE FEE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME FIRE STOPS PLICATION AND STATE THAT THE ABOVE IS CORRECT AND BRACING BOLTS "L FURNACE LOCATION, AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT DUCTS STATE LAWS REGULATING BUILDING CONSTRUCTION 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED 1 LATH INT 0 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE WORKMEN S COMPIENSATIO W8 O CALIFORNIA. LATH EXT SIGNATURE O HOUSE NUMBER GOR- _ PERMITTE RECT AND PoSTED ADDRES FINAL CLYDE N DIRLAW,PRINCIPAL STRUCTURAL PLAN CBFJ= VALIDATION No c PERIMT VALIDATION cK. mo cAnK LAC09884!S DEC 16 1 D 12.00 Wim, I I _ APPLICATION F913-BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER S COMPENSATION DECLARATION FOR APPLICANT TO RLL IN - Bull-g(yp�� I hereby affirm that I have a certificate d consent to self insure �e� or a certificate of Workers Compensation Insurance or a certified copy thereof (Sano 380 LLabb�C) `. 4' Nye ,� Cm G` ZIP POIIL/Ngo `_—� C.anPsM,St '��' " I17CAIJTy SIZE OF LOT NO OF SLOGS NOW DI LOT ❑ Certified copy is hereby furnished I NEAREST CROSS ST ❑ Certified copy,is filed with the county buildup inspection TRACT BLOCK LOT NO rat '(/n, D C�t� �( USE ZONE MAP NO Date Applicafll ! e-Rf,, �) — ASSESSOR AAP 8001( PAGE PARCEL N I SPECIAL COMMONS CERTIFICATE OF EXEMPTION FROM WORKERSTEL NO GWN R COMPENSATION INSURANCE YnTFUN 1000 FT OF SCHOOL' YES NO ADDRESS (The section deed not be completed d the permd afar one hundred �• 1 DIStAICr GROLP CONS! FIRE ZONE PROCESSED BY dollars($100)or, less) CITY ` LP I certify that In the performance a the work far which tins permit �O� is riled I shall not employ arty person In ary manner so m to ITE&RCHOR ENGINEE TEL NO M*Lbecome subject to the Workers Compensation Lawn SVTRSnCALCLAM AD AI'T CONDO Date Appllcafll ADDRESS CLASS NO 1 UNITS NOTICE TO APPLICANT It after making this Certificate of REOIIIRED TOTAL SETBACK FROM EAST Exemption you should become subject to the Workers �, TEL NO_ SET BACK YARD HWY PROP LINE WIDTH Compensationrs provsloof the Labor Code you mat forthwith FROM comply with each provslons or the permit shall be deemed revoked LIC nq P L LICENSED CONTRACTORS DECLARATION �" SIDE LC PL I hereby affirmthat I am licensed underprovelons a Chapter 9 — SEWER MAP (commencing with Section 7000)of Dnnslorl 3 of the Business and SO FT S17E NO OF STORIES NO OF MtUES Ips Professions Code(�and my license a in full force and a NEW PqC BK PG , d License Number i--A-T"'Q' Lc Class �� DESCRIPTION OF�K ADD ❑ vALOAnON _ O Contractor to �� %emOU ALTER ❑ $ U 4 � ❑ I am exempt under 11 under Sec � $ 1 RBPC for the reasonCNS t. DEMOL ❑ LDMA PRC• AL l ' .i W Date USE OF FXf nhQ TO URM ❑ - l (- L 313 037 yJS.1Q) Signature TI � / NO LDMA Perm• Z n nsa l LJA� O I1 EM z 1 ❑ 1 as owner of the property or my employees with wages as TOTALTL 1i - 1 j thesole compensation will do the work and the structure E S not intended or offered for sale (Section 7044 Business and1-6jWyA1 FL r FINAL DATE G PrCHE ie7.Professors Code) WILL L TIE APPUGM OR a -W occURWr w DIE A INZAiDOIIs WTEPA- �j n . K c ❑ 1 as owner of the properly am exclusmey contracting with OR A MorruE coNwMING A IlA7AMWe MAT COUAL To OR prEATEe T TIE FIN9a AMOlM9 6FECiID ON TIE NAZMOOUa IMTEPW.4 NFC0.MATI6n ouDFINAL licenseBusid contractors, to construct the project (Section 7044 mss❑ No 4b NANVE .CL) M4 THE MENDED USE OF TIE BUpLNO BY THEAPPLICAM On FUTURE BULLDNO COAST AIR OUAIIiY AInI GEI.ENT pQrBICT IeCAD l am PEawTNAE C1 Muv Poo I CONSTRUCTION LENDING AGENCY ouDEV a )71JU-1!1!1)1 4/1�i5! I hereby affirm that there Is a construction lending agency for YEs❑ No W is i nM 9:23 the performance of the work for which the permit a Issued(Sec m 3087 CN C) ciEau l'"EirDEesDa+D w a u a TINE t uioEUE�s�Dcotp rY cooE Lender a Nerve w 2 rwE xn WcnoNs z rico A cI ouiAToiEec oA�'io"16IUZAr+oas Lenders Address 0 I ceNity that I have read the application and state under penalty g of perkuy that the above information 9 correct I agree to Comply PC FEE PERM T FEE / /.Q with all county ordinances and Sate Laws relating to buildingG ✓S S trucign and hafeby aulhome repnesentatws of mis County ISSUANCE FEE 21 r P n t B nT aratl property ar ma 1 r V�•I/(O s I INVESTK3ATION FEE TOTAL FEE m a J o.. SEE REVERSE FOR EXPLANATORY LANGUAGE