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Home My Public Portal About9636 VAL ST_Building__ SPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN ADo RESS ING ADDRESS E' L ST LOCALITY NEACITY TEMPLE CL ZIP J a CCROOSS ST NO OF BLDGS ASSESSOR SIZE OF LOT 50)t Ea S NOW ON LOT I MAP BOOK PAGE PARCEL TRACT l7 BLOCK LOT NO a3 DISTRICT GROUP TYPE / FIRE ESSED BY ff e _ Sag oc- 3 Ca"5� � OWNER . U VR TEL d ./ STATISTICAL CLASSIFICATION SEWER MAP ADDRESS p� ✓ L CLASS NO DWELL UNITS BK PG CITY f �mFLF C ZIP �� USE ZONE nP aeo ARCHITECT OR TEl ENGINEER NO f SPECIAL �S CONDITIONS ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ TEL CONTRACTOR NO BLDG SETBACK FROM LIC FRONT PROP LINE OF (STREET) ADDRESS NO TOTALSETBACK FROM TYPE OF EXISTING LIC HIGHWAY + YARD FRONTPROP LINE HIGHWAY WIDTH CITY CLASS CONSTRUCTION LENDER + i NAME AND BRANCH BLDG SETBACK FROM CV ADDRESS CITY SIDE PROP LINE OF ISTREETI 3O SO FT NO OF NO OF CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPEOF EXISTING r SIZE STORIES FAMVLIES ONE SIDE PROP LINE HIGHWAY WIDTH DESCRIPTION OF WORK LJ4c-F NEW ❑ + G ADD CORNER CUTOFF YES ❑ NO ❑ ALTER IN OPEN SPACE YES ❑ NOUSE ❑ REPAIR EXSTOING BLDG b V 5 DEMOL IN COASTAL PERMIT ZONE YES ❑ NO ❑ APP(PNN, L ICE7�NQ 4V6-?ds' BY(SIGNATURE( HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTR ION I CERTIFY THAT IN DOING THE WORK AOHDRIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE TABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM PENSATION INSURANCE SIGNATURE OFFINAL a 6 BY PERMITTEE DATE ADDRESS TEL _ PC Fee E Permit Fee a a# CITY NO � ^^ Issuance Fee O O VALUATION s I r`� Total Fee 37 06 PLAN CHECK VALIDATION Cir M o C m PERMIT VALIDATION cK M o c"H 9 0,3�OAPR 13 4 D 3 4,0 U AQm ®L 7eAeeee Ce Oe o e/n TeAS"A CC*802-Io SBAPPLICATION FOR BUILDING PERMIT I BUILDING AND SAFETY DIVAILDING ISION D IIYp@knent OE County Engin— ADDDRESSRESS County of LO/Angela LOCALITY 02 JOHN A LAMBIE COUNTY ENGINEER NEAREST CASSATT D GRIFFIN SUP T Of BUILOINO CROSS FOR APPLICANT TO FILL IN DISTRICT NO GSC1P nPE SEWER BUILDING ? f� ADDRESS OJ STATISTICAL C SSIFICATION CLA39 NO DWELL UNITS LOT NO BLOCK -AAP NUMBER G7 �I.IWy YES NO TRACT ZONE SPECIAL NO OP BLDGS � CONDITIONS SIZE OF LOT I/S I NOW ON LOT 2 USE OFSo EXISTING BLDG BUILDING EXIST ..y 9E'fBAGK YARD HWY STREET NAME WIDTH OWNER • � , g-sr FRONT MAIL ADDRESS ' btr • V BIDE CITY ARCHITECT�R T!L G ON ORD GN9lNGSS NO O ADDRESS _ � Ta,-40-oil 17-1-7 CONTRACTOR 5,grNO ADDRESS DESCRIPTION OF WORK '2 NEW ADD ALTER REPAIR DEMOLISH -SO IT NO OF NO OF HIZE HTDRIES FAMILIES USE OF UCTU E S 441 A PJ a e ;7Arr ri r✓rr�4 '�/� A APPROVALS fI/'PR0Y�0, ,YOTdYE'R3�Co , 91GNAl'U RE OF 1 `; APPLICANT �^ L DATE INSPECTOR S SIGNATURE ADDRESS 3Z L, iw FOUNDATION LOCATION & �r FORMS MATERIALS - J s O O - P C S DO FRAME FIRE STOPS FEE BRACING BOLTS {!� VALUATION f Q FURNACE LOCATION PEE GAS VENT DUCTS 7 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH INT / S PLICATION AND STATE THAT THE ABOVE IS CORRECT ANO AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH EXT STATE LAWS REGULATI BUILDING CONS UCTION SIGNATURE OF HOUSE NUMBER GOR- PERM=! RECT AND POSTED ��f ADDR - FINAL Z-�3-S 7 /, 11r, 111 - JOHN A LAMBIE COUNTY ENGINEER CLYDE N DIRLAM, PRINCIPAL STRUCTURAL EN PLAN CB= VALIDATION CK No CAJIH PERMIT VALIDATION CK X O CAa LACo1820rn AM-291 6 8.00AR { CD 1 9 8 5S SEP 4 1 16.00 R DEPARTMENT OF BUILDING AND SAFETY 2—.3 APPLICATION FOR PERMIT 'COUNTY OF LOS ANGELES ® � ' ® � WM. J. FOX. CHIEF ENDINfeR \ X19 NG FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING ADDRESS Z `v �i GI s DISTRICTPLANCK NO PERMIT NO ZZ�r�va /Y D / LOCALITY G/�/ `J-/� RECEIVED BY DATE OF APP/L OAT[ISSUED MEARCBT ..SN hSc GT��'O • ` ��•T�1 �1'IT� �O QROB9 BT v BUILDING OWNER � ADDRESS MAIL ADDRESSZJJ22 --. NEAREST /J}-/'/� /�[1 NEAREST CI S�' L_^+ q h/ G TEL /4/ _'J73Wl CROBBST arm A— FIRENO Or TYPE GROUP ARCHITECTOR TEL ZONE PLANE ENOINEER NO ORD NO B ADDRESS SETLDG BACK LIN[ APPROVED CONTRACTOR'? ��j/'+ �I YN ,NOTL / �% b I By U06 APPROVED DAT[ D R[ / ` Z��• K L7fJ Uf/CJ ZONE BY DAT[ LEGAL YD 3 CORRECTIONS DESCRIPTION QL/�T HO BLOCK 1r� TRACT /f7UF I / ( SIZE Oil LOT -t^OX 1['� 'S+� NOW ON LOT USE OF NO OF NO D O► MI 1 R 2.7 DESCRIPTION OF WORK NEW 4.- ALTERATION I ADDITION O a REPAIR / MOVING / �(DEMOLISH /� E p 812E O 1 or ROOMS 11 STORIES/l m e > WALL � / /� car r o• COVERING J 7(A COVVERINO '� .U,.,.o Pf, 1� GG G6iGE 1 HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STAT[ THAT THE ABOVE IB CORRECT INSPECTOR DATE FOUNDATION. IALB ON AND AOR[[ A COMPLY EGUL WITH ALL COUNTY ORDINANCES IORMB,MATEi11ALB AND BTATL LAWS REGULATING BUILDING CONSTRUCTION _ /�/�� / j7� ►BRAOINO BOLTS Z OP66 SIGNATURE OF / r /! PERMITT[r LATH. INT AUTHORIZED AOT- O �• -0 '�� LATH. EXT 7"6 -a 9-49 •�L ��.B-Q Pa • PLASTER.INT i / r[c f0 PLASTER.[xT. VALUATION 7 D O S 2 Fe[ G FINAL . r • ^ WORKERS'COMPENSATION DECLARATION i hereby affirm that I have insure, of content to Fel, APPLICATION FOR BUILDING PERMIT iure, or a certificate of Workers' s' ComCompensation Insurance, or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company ADI Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS 3 0 Conified copy is filed with the county building mspec BUILDING Q 6 3 G L �AL S tion department ADDRESS / / LOCALITY♦ Date Applicant CITY J CiN/9;e LG CI GI}'ZIP 4 7£r� CROSSNSTT CERTIFICATE OF EXEMPTION FROM WORKERS' , L/X ��p 3 NbW ON& ASSESSOR COMPENSATION INSURANCE SIZE OF LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit Is for one / �( USEAZ '� hundred dollars ($100)or less ) TRACT p" BLOCKr /" ' LOT NO Ty -, /� SPECIAL I certify that in the performance of the work for which this OWNER Alt NcsT1 • AlLtr.t TNLp*f-3Q0z M—a CONDITIONS G perms is issued I shall not employ any person m any manner DISTRICT GROUP TYPE FIRE D BY 0 w os to become subject to the Workers'Compensation Laws '�� 'SA.•+C� �vOt fi'3 CONST / ZONE ad Date Applicant AIRCNITECT OR TY ZIP TEL STATISTICAL CLASSIFICATION V 3 APF CON O NOTICE TO APPLICANT If after making this Certificate of ENGINEER NO CLASS NO DWELL UNITS_ Is! Exemption, you should become subject to the Workers ty Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP W with comply with such provisions or this permit shall be .I deemed revoked CONTRACTOR 094✓✓✓ 0A_ NO BK /`IPG / VALIDATION LICENSED CONTRACTORS DECLARATION UC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC �/� 0 Profenlof4 Code, and my license s in full force and effect CITY FT�p -��a CLASS $ `f License Number LIc Class S12E J/� STORIIES FA"G,MI�S D� 1 7 9 6 A Contractor Date DESORPTION OF WORT( Rg-�`s.1 v e a l NEW ❑ T ❑1 am exempt under Sec aS B /N S//)� /✓�✓ ADD ❑ /Z�/ I • • 4 9 8 8 B 8P C for this reason �JsE''� �8 /Y OST G �� REPAIR ❑ DATALTER E3 6'-` Z • * 49886 Dais USE OF EXISTING BLDG DEMOL ❑ FINA 04,04-85 Signature APPLICANT TEL OWNER-BUILDER DECLARATION PRIM NO I hereby affirm that I am exempt from the Contractors License 11011.Law for the following reason (Section 7031 5, Business and ADDRESS FPLrooffession&Cade) BUILDING I, as owner of Me o y employees ADDRESS -T prop", w m em to ees with ADDRESS wages os their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7041 Business and Professions Code) MOVING TEL 1, as owner of the property, am exclusively contracting CQNTRACTOR NO with licensed contractors to construct the project (Sec- ADDRESS tion 7044 Business and Professions Cade) TOTAL QFROM CONSTRUCTION LENDING AGENCY 2 07UR YARD � ��LIWIDTH I hereby affirm that there iso construction lending agency for FRONT , Meperformance of the work for which this permit is issued P L ZSec 3097, Civ C ) SIDE PL Lender's Name Lender's Address PC Fee f Permit Fee 3 3 I certify that I hove read this application and state that the Issuance Fee Q Sd bove information is correct 1 agree to comply with all County InveYlgotion I" (/ ordinances and State jaws relating to building construction Total Fee D nd hereby authorize representatives of this County to enter u the above-mens ed property for Inspectionpurposes ^ ✓s+.c�/ // 7 $0 tlV4iE/OR EXPLANATORY LANGUAGE Signature tol Applicant or Agent Dixie r _ WORIERS'COMPENSATION DECLARATION l�ureb affirm that I have r certificate of Lament to sal, APPLICATION FOR BUILDING PERMIT `�nsura or a certificate of Workers' Compensation Insurance, or a certified copy thw"f (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No—Companyyfurs BULLRING ❑ / 2 Certified ed copy hereby furnished FOR APPLICANT TO FILL IN yiDpgEu 1.� ...) ❑ Certified copy is filed with the county building mfpec- BUILDING / i/� / 5T tion department ADDRESS c0 (� C -7�. Dote Applicant Clio /�rh //G/T ZIP / 7 O LOCALITY �n ' CERTIFICATE OF EXEMPTION FROM WORKERS SIZE OF LOT 0 x/(O �ON LOTS G� CROSS ST COMPENSATION INSURANCE (This section need not be completed if the permit a for one TRACT BLOCK LOT NO ASSESSOR hundred dollars ($100)or less ) MAP BOOK PAGE PARCEL NO S" I MAP 1 certify that in the performance of the work for which this OWNER E Alls aL AJL OZ NO 3 f b permit is Issued, I%hall not employ any peUS' - in any manner S. ` - I SPECIAL w as to become subject to the Workers'Compensation Laws ADDRESS CONDITIONS U Date SWIG- Applicanl�'y—" /, CITY ZIP NOTICE TO APPLICANT If aper making this Certificate of ARCHER OR FO DISTRICT GROUP TYPE FIRE BY O Exemption you should become subject to the Workers ENGIADDRESS IS-, M[ r 7) U Compensation provisions of the Labor Code you must forth- LaRJ with comply with such provisions or this permit shall be 14 , TEL STATISTICAL FI N APT LI) deemed revoked CONTRACTOR Z LICENSED CONTRACTORS DECLARATION LIC CLASS NO DWELL UNITS_ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO (commennnp with Section 700D)of Division 3 of the Business mid U I LIC Professions Code, and my license is in full face and effect CITY CLASS p q VALIDATION SO FT 1/ NO OF NO OF CHECK License Number Llc ClassSIZE /� STORIES S / LFR �Ald. l -FJ✓A,t NEW VALUATION DESCRIPTION Of _ Contractor Don /Coe F /y �G � A0° 17 ci A- I am exempt under Sec ooe ALTER / 8 9 64.4 A B 8P C for this reason REPAIR >{ 6/ vod DIV 10111, # e e ie e e ' Dale EXOF ISTING B a^"OL +I - - 87,38 Signature APPIIUNT TEL FINAL OWNER-BUILDER DECLARATION PRIM a��E DATF I • • • 87385 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031 S, Business and ADDRESS RN U Ex 2 O"8 8 Professions Code) BY 1, as owner of the B ILDING property, or my employees with DRESS wages as their sole compenwtion,will da the work and y 1 s C• s the structure Is not Intended or offered for sale(Section LOCALITY 7044 Business and Professions Code) MOVING TEL ) I, 3 �. I, as owner of the property, am exclusively contracting CONTRARa' NO with licensed contractors to construct the project (Sec- ADDRESS r Hon 70", Business and Professions Code) ` CONSTRUCTION LENDING AGENCY um YARD HWY FRONT UNE WID H I hereby affirm that there is a construction lending ogenc for •` _>\ the perfortmnce of the work for which this permit is issued F (Sec 3097, Civ C ) SIDE Lender s Name 8IDMAL Ref I` - tender s Address P C Fee f Permit Fes > I certify that I hove read this application and slot* that the Itwonce Fee t LDMA P/C R i C above Information a correct I agree to comply with all County InveYpMion Fee 8 ordinances and State laws relating to building construction, Total Fw IDMA P«m Y - R and hereby authorize representatives of this County to enter upon the above-mpe-ntioned operty for inspection purposes/ 111111111 MVBU FOR EXPLANATORY I ANGUAGI - S,g t of Appiiwm«Agent Dote '