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Home My Public Portal About6410-6412 TRELAWNEY AVE_Building__ WORKERS COMPENSATION DECLARATION 1 hereby affirm that I ,f W r ars Come of consent to self APPLICATION FOR BUILDING PERMIT insure or a certificate of Workers Compensation Insurance or a certified copy thereof (Sec 3800 Lob C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the c unty budding mspec BUILDING / �. /ynion/department ADDRESS /�� / /,q�^/� Dote// I / ,�Apphcon� CITY 71-x' L s ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS NOW OF BLDGS NEAREST COMPENSATION INSURANCE SIZE OF LOT ON LOT CROSS ST (This section need not be completed if the permit Is for one ASSESSOR hundred dollars ($100)or less ) TRACT BLOCK LOT NO MAP BOOK PAGE PARCEL TEL USE ZONE MAP I certify that in the performance of the work for which this OWNER NO SPECIAL OY. permit is Issued I shall not employ any person in any manner ADDRESS 0(7 w CONDITIONS O so as to become subject to the Workers Compensation Laws l! Dote Applicant 21 Y ZIP K NOTICE TO APPLICANT If, after making this Certificate of ARCHITECT OR TEL DISTRICT GROUP TYPE FIRE SS-D BY O Exemption, you should become subject to the Workers ENGINEER NO CONTri Z W Compensation provisions of the Labor Code you must forth ADDRESS / ul O. with comply with such provisions or this permit shall be to TEL STATISTICAL CLsSSIFICATION deemed revoked ONDO Z CONTRACTOR SU NO LICENSED CONTRACTORS DECLARATION /a LIC / (J CLASS NO DWELL UNITS_ I hereby offum that l om licensed under provisions of Chapter 9 ADDRESS NO (commencing with Section 7000)of Division 3 of the Business and LIC /s SEWER MAP Professions Code and my license is in full force o.Fid effect CITY CLASS `' BK PG VALIDATION /F�� Q7 SO FT NO OF NO OF CHECK License Number ii'L L Lic Clan L SIZE STORIES FAMILIES ONE /,��) VALUATION Contractor ust) " ' Date DESCRIPTION OF/WORK ; �/ ` NEW $ 00 0 I am exempt under Sec L ` ALTER B BP C for this reason REPAIR $ USE OF Date EXISTING BLDG DEMQ Signature APPLICANT TEL FINAL OWNER-BUILDER DECLARATION PRIM NO DATE S 1 hereby affirm that I am exempt from the Contractor s License 7_ Law for the following reason (Section 7031 5, Business and ADDRESS FINAL Professions Code) By J F1BUILDING I as owner of the property, or my employees with ADDRESS wages as their sole compensation will do the work and C 3 2 7 A the structure is not Intended or offered for sale(Section LOCALITY 7044 Buslnesa and Professions Cade) MOVING TEL pool • o . O1 as owner of the property, am exclusively contracting CONTRACTOR NO with licensed contractor to construct the project (Sec ADDRESS non 7044 Business and Professions Code) _ CONSTRUCTION LENDING AGENCY MIRcSETBACK FROM MST KK YARD HWY T PROP LINE WIDTH o ) r I c' C I hereby affirm that there Is a construction lending agency for FRONT the performance of the work for which this permit Is issued PL C 9—P 4 (Sec 3097, Civ C ) SIDE g PL Lenders Nome $ O TDMA Ref TI Lender's Address PC Fe.$ Permit Fee , I certify that I have read this application and state that the Issuance Fee LDh1A P/C Y above Information Is correct I agree to comply with all County Im,.I,gahan Fee ordinances and State jaws relating to budding construction TotalFi;,16? v LDMA perm P and hereby authorize nepresentahves of this County to enter upon abav no pr nspection purposes f0 RiVFRSf FOR EXPLANATORY LANGl1AG! Signature of Applicant or Agent Dote DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES WM. J. FOX. CHIEF ENGINEER BUILDING FOR APPLICANT TO FILL IN I FOR OFFICE USE ONLY ADO REIBSI DISTR ICT NO PLAN NO PERMI HO J LOCALITY 'JfI �� RED IVED Y DATE OF APPL DATE ISSUED NEAREST Dan ST. • 1 UING �7 OWNER S/Q J ABDDRILDESS / J ADDRESS Q]� �• �� S LOCALITY NEAReST am nw TEL L CROSS ST FIRE NO OF TYPE GROUP ARCHITECTOR �-- TEL ZONE PLANS I ENGINEER NO BLDG ORD NO ADDRESS _— =BACKLINE Z� � TEL APPROVED 1 1 r CONTRACTOR ✓ NO BY I I I DAT[ ' USEA�j APPROVED ORES ZONe BY DATE LEDAL CORRECTIONS DESCRIPTION LOTNO BLOCK 013 TRACT CO V ' _ NO OrBLDOS SIZE CF LoTdfb X 3-tk 7 NOW ON LOT / USE BOF ;cAft NO OF NO OF um O DESCRIPTION O'P WORK NEW ALTERATION ADDITION O a REPAIR MOVING DEMOLISH � BG FT / O OF 812E L/ NOUNS STORIESWALLROOF SF COVERING COVERINGA.S. UBE CF NEW I BUILDING n 10- it 1 � I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION LOCATIO INSPECTOR DATE AND AGREE TO COMPLY WITH ALL OUHTY OR DINANCEB FORMS.MATERIALS AND STATE LAWS R[OJ.ILATINp BU NO CONSTRUCTION FRAM[ FIRE STOPS, SIGNATURE OF BRACING,BOLTS PERMITTE 1 LATH, INT Alr& AUTHORIZED AOT LATH. [XT lml-3 a 4 9-vB O BG-3 eW eETe $ p p PLASTER.INT FE[ l� PLASTER.EXT. .41 / V v / VALUATION FEE ' FINAL DEPARTMENT OF BUILDING AND SAFETY i APPLICATION FOR PERM COUNTY OFLOS ANGELES WM .1 FOX. CHIEF RIGIHEER BUILDING ' FOB APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO PLAN CK NO PERMIT NO BUILDING / Z / -7 ' / ADDRESS b /✓ IICC W LOCALITY = RECEIVED D EOF APPL AT[ISSURD nuRser C/N 'pl —73- 7- 52.. CROSS ST BUILDING ADDRESS OWNER N MAILLOCM-ITY E `/T ADDRESS Q NEAREST / C 0 ) / d TEL CROSS ST L..G A /O CITY NO Ao Q FIR[ NO 0/ TYP GROUP ARCHITECTOR TEL ZONE PLANS ENGINEER NO BLDG O D O SETBACK LINE G I= L ADDRESS -APPROVED •TEL BY DATE CONTRACTOR NO USEAPPROVED YON[ BY DATE ADDRESS HOUSE NUMBERING LEGAL 7 G O hQ r1ELD CHECK BY D[HCRIPf10N LOT NO BLOCK MAP NUMBER TRACT NO ASSIGNED BY DAT NO OFBLDGS CORRECTIONS SIZE OF LOT NOW ON LAT USROF NO OF EX ISTING BLDG FAYILIir �/ -� /J.,rf. _ QO C `✓��Lj DESCHUMON OF WO F ✓ / (�f��"� om ' NEW ALTERATION ADDITION Z ♦♦ SL .L�60 F - L76C. O REPAIR DEMOLITION I A SO FT NO OF Ta2)-v O_ SIZE ROOMS STORIES ♦ Z LL O WALL ROOF CVB<JINO COVERING USEOFSTRUCTUR[ Ll sz/ Lt -r PMr &zuteu C, iA_ YE APPROVALS INSPECTOR'S SIGNATURE DATE 1 HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS AR FOUNDATION LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALSMk CORRECT 1 AGREE TO COM Y WITH TH CORR[CTIONB LISTED FRAME FIRESTOPS, /I N[REDN AND WITH A CpUNTY INANCED AND STATE -BRACING, BOLTS r LAWS REGULATING ILpINO C R JON FURNACE LOCATION, SIGNATURE OF Y GAS VENT, DUCTS PERMITTEE LATH, INT wDovEej ' LATH. EXT AUTHORIZED AOT PLASTER INT TMOEA OrY WW s P C j FEE PLASTER, EXT VALUATION FEE j OV FINAL 7aAG28A"#a03-a-W APPLICATION FOR BUILDING PERMIT AV1 COUNTY OF LOS ANGELES BUILDING �EaL �J DEPARTMENT OF COUNTY ENGINEER ADOR EBB B=ING AND SAFETY DIVISION LOG LITY a JOHNA LAMBIE CouNTYENGINEER NYJIREST CASBATT D GRIFFIN SUrT OF BuILOINo CROS ST DISTRICT G OUP TYPE y SEWER MAP FOR APPLICANT TO FILL IN CONST/pl BUILDINGSTATI6TICALC IFICATION ADDRESS LOT NO BLOCK CLASS NO=DWELL UNIT MAP �T STATE TRACT 70 NUMBER oC 0 6 0 HWY YES O USFZQNEL SPECIAL NO OF BLDGS L� NDITIONB SIZE OF LOT NOW ON LOT ,1 USE O NG BLDG UIG YARD HWY STREET NAME EXIST OWNER 6FlTBALK WIDTH FflONT Q i MAIL SI L ADDRESS � SIDE CI �L�1/ NO ? L ARCHITECTOR TEL INSPECTION RECORD ENGINEER NO ADD E r CONTRALTO To ` /L /? P1 l ADD Z e . < PYr� ray /.rv, rdu�rr n- DESCRHMON OF WORK ^F Qg all,/)Jqjr r, TI )�cr' 7F!/ST » AAS NEW ADD ALTER REPAIR DEMOLISH 60 FT NO OFNO OF V P,4 vnrrin SIZE STORIES FAMILIES USE OF STRu 1 I T?FF SIGNATURE O� P' 1 APPROVALS APPLICAN ADDREB / DATE INSPECTOR S SIGNATURE FOUNDATION LOCATION _ a FORMS MATERIALS Z / P C. FSAME FIRE STOPS CR "' FEll BRACING BOLTS VALUATZ f 4olU FLRNACE LOCATION FEE GASVENT DUCTS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH IRT 3-S-5a PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH LL COUNTY OR NCES AND STATE LAWS REGU UILDIN STRUCTION LATH EXT 3 u c i SIGNATUREOF USE NUMBER COR PERM ITTE RECT AND POSTED ADDRES FINAL JOHN A LAMBIE C ENGINEER - CLYDE N DIRLAM PRINCIPAL STRU URAL ENGINEER PLM C3iwc VALWAT1O cK. w o wN PERbUr VAL=nO11 mo CATH ACo 4 6 2 8V-, NOV 2 7 1 6 3 1 .0 01 rM4.6 2 9In NOV 2 7 1 6 8.00i $ ��'"�"`®'• 5059 DEC12 1 7800 �r w T)6-� rze.% APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES - BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILD!N I hereby affirm that I have a certificate of con9ant to sell Insure BIA.DBNO ADDRESS L I r(-6, (,L or a c"cate of Abrkers Corrrxensatwn Insurance ►Ca certAieJtl/ COpY the ( /'1 _(T\'i-N —1 G / LP w� L- L_ LOCALITY Pdlcy NO� CO Pal y SIZE LOT OF BLDGS NOW ON LOT ❑ Cert is hereby fumished NEAREST CROSS ST filled copy th the cou Y bulldirg�n9pect TRACT BLOCK LOT NO („r� USE ZONE MPP NO Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CE41FICATE OF EXEMPTION FROM WORKERS OWNER , TEL NO COMPENSATION INSURANCE A WITHIN 1000 FT OF SCHOOL'S YES NO This section need not be completed If the permit is for one hundred ADDRESS L !I Z 5 (^/q DISTRICT GROUP TYPE CONST FIRE ZONE PROCEBSED BY dollars ($100)a Las) y— A� I I certry that n the Perfarrtlance of the Work for whch this permit Cm &A Zip i1.UY1 -3 3 s Issued I shall not employ any person In any manner so a9 to ✓✓ VV become wbfect t0 the Workers Compensatcn Laws -ARCHITECT ORE INEER TEL N STATISTICAL CLAS�IFIGATION PPT Date Applicant ADDRESS CLASS NO (� D`NELL UNITS NOTICE TO APPLICANT If after making this Certtlicate of REQUIRED TOTAL SETBACK FROM EXIST 1 Exemptcn you should become Subject to the Worker, SET BACK YARD HWY PROP UNE WIDTH Compesatcn provisions of the Labor Code you must forltlwlth con4lY wah such provslons or this permit shall be deemed revoked FRONT NS D 21)3 SIDE LICENSED CONTRACTORS DECLARATION l.As _ I hereby affirm that I am licensed urderprovscrs W GTY Chapter B d � Lr- cs PL L Lltr,p >- (commencing with Sectan 7000)of Dwlson 3 of the Business and SO FT SIZE NO OF STORIES NO OF FPMIUES SEWER d I Pmfesslane Coda I Is In lull face and eff NEW ❑ BK PG , V I.cense Number LIc Class / ` DE ION OF WORKC _Vbnj ADD ❑ VALUATION Cmtracta a ALTER ❑ $ -l7 `J O xempt under Sec �v V El I am e REPAIR $ BSPC for this reason DEMOL ❑ W LDA"P/C• Il Date USE OF EXISTING Sir� � URM ❑ r 2 I(In Sature APPLICANT P!A^!i, I LDMA Per . — ❑ 1 m Owner Of the Property or my employees with wages as V z liT.i thar sole comptembon will do the work and the structure is ADI /0 N FINAL DATE F not mWKW a offered for sale (Section 7044 Business and (J Q - Professions Code) WALL THE GPRXJNT OR FUTURE BULLWC OGLIFNNI IIMOLE A IMZAILg45"TERN /2-7-93 1 ITEM- ❑ I as owner of the property am exCIUSNBIy contracts With OR A W%TOPE CO W A HAZAnWUs MATERIAL EQUAL TO OR GREATER TIMN T T' ( �-y licensed contractors to eagtrl t the project (Sects n 7044 � M�CFl O ON THE HATMOGl19 MATERIAL,!FORMATION OUIDEW FINAL BY TOTAL AL 137-{ 40 81181x1899 end Profes9lob('iOdO) w T MENDED USE OF THE RHOU NG EY THE AP.IJGNT OR FUTURE BIACrA f ITE 1(.4-' OCCUR TEOURE A FERWT FOR G]KRTRUGTbN OR MODIRCATION Fn THE SOUTH CONSTRUCTION LENDING AGENCY coNST AR OUADTY NANAOEMErrt MTRCT(SCA WD)ME PERIATTI NG CHECKLIST FOR GUDEU ES I hereby affirm that thane is e construction lending agency for Yes❑ No❑ o the performance of the wok for which this permit Is Issued(Sec IN,wEREM TIEHWAY!OLlSAN1ERNLSINFOnMATIDN GUIDE AND TIE scullmvERMnTINo 3097 CN C) CHECKLIST I UDER9PND W REOUPEAEHI9 UNDER THE LOG ANGELES COUNTY CODE TITLE T CHAPTER T Za SECTxJN9 T?a 1 W THROUGH Z TG tad G]NCERNWG HAZARDUS Lender 8 NameWTETNL,q TECaTTWq,WATT FOR DaARLNp A PERA1n FRLYA TH&$C/-0Wl Lenders Address 0 O.IFA di/mRT I Gerdy that I have read thus application and state order Penalty i�EI:I� '_=�'•+I_ $z� W perfry that the above information is correCl I e17ee t0 C PC FEE PERMIT FEE F with all county ordinances and state hews relakrg fo Minging •�� ,:HANT and reby autfonZ representatives of this County ISSUANCE FEE e ve-rtsmon property la Inspect p/nI/�y-a/may G.kO•T�+ �� INVESTIGATIONFEE TOTAL FEE !m v .—,--r- 1131 ,140 1,a00-13001 iI�13"Q= i( SEE REVERSE FOR EXPLANATORY LANGUAGE nt,[16