HomeMy Public PortalAbout9861 VAL ST_Building__ :rte$8m g, APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ���
COUNTY OF LOS ANGELES
WM. J. FOX, CHIEF ENGINEER
NO.OF BLDG. ORD:No. DISTRICT NO. PLANCK. NO. ,PERMIT NO.
PLANS SETBACK LINE
FIRE \ APPROVED
ZONE {{ BY DATE RECEIVED BY DATE OF APPL/.. DATE/ISSUED
ZUSEONE 1 APPROVED DATE
APPLICANT PILL IN HEAVILY OUTLINED PORTION ONLY
UILDING
p NAME \ \� ADDREBS 2 4 0 / V A L S
W Z ADDRESS \ \ LOCALITY �'(PL CITY
� n
I7 \ \ NEAREST _ ��� T-
4 STATE V W CITY CROSS B _/ �r-/-�AIR
/ y ./` /(�
LICENSE NO. \
NO. p� NAME /� )f A l\ ' L_F! /? f�
hl MAIL19 214 /5 �JP��f ST
NAME �� _ � ADDREBjjB�� Q p Q
S ADDRESS O CITY lT L�!7 Jl// TEL.
NO.
F �(�
Z \' I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
V CITY _ APPLICATION AND STATE THAT THE ABOVE IS CORRECT
STATE / TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
LICENSE NO. NO. / AND*STATE LAWS REGULATING BUILDING CONSTRUCTION.
ZO LQT NO. I SIZE OF LOT.6 x AL SIGNATURE OWNER OF
d S.
.®.m. NO. OF BLDG �V �h AUTHORIZED
C
Iy a BLOCK NOW ON LOT i •,,�
1� 7 Q�
J W TRACT 2 3 O �, �,CORR CTIONS-
D
USE OF BLDGS. , P� JhA�� l�t v'
NOW ON LOT 'l�� YI ` -I N''
D-EryS�CRIPCTION OF/WORKUSE OF
BUILDING
v
This construction may be in v'.olat:on o
2;u-, fl duction BoMxt c77.31-3. You are
Production BoctrdO11, betoro ccmmenc-
ing the work authorized in this permit, Z
a
� r
NEW 1/ TYPE GROUP .J�.
ALTERATION ROOMS I FAM IES
ADDITION SIZE
REPAIR STORIES
MOVING WALL COVERING S1�L�A/C C n
DEMOLISH ROOF COVERING
Fes$ 4 to-o FINAL APPRPVAL
[ INSPECTOR?$a
V �T
ALUATION 2 FEE el 4 1 DATE I NAME /�`,r-ry�' ��
DEPARTMENT OF BUILDING AND SAFETY ' APPLICATION FOR PERMIT
69UNTY OF LOS ANGELES
�WIVI. J. FOX, CHIEF ENGINEER
am=
FOR APPLICANT TO F71�
FOR OFFICE USE ONLY
BUILDING ��77 �7 DISTRICT NO. PLAN CK.NO. PERMIT NO.
ADDRESS E� /' j� /1`'�
LOCALITY L:�+P✓N/I//f�'C�(` l.+C/ RECEIVED BY DATE OF APPL. DATEIISSUEDDNEARECROSfiB T. BUILDINGOWNER «/ r" Q,+IADDRESS 5�7 •- L /
MAIL
ADDRESS �!/ ,// - LOCALITY
//II r .� " • /
CITY fidj'•� }
al(y(rC Gc'�L/ NO. � ORDSSST s �n l�/Ylss"y If YCa/
FIRE N.C.OF TYP GROUP/
ARCHITECT OR'_
w.v" TEL ZONE �� LANS � y�
ENGINEER �/� ,//J� NO.
+ BLDG. �1 w / /'�' ORD.NO.
ADDRESS SETBACK LINE OCG / •� r� / ��il
APPROVED
TEL. BY DATE
CONTRACTOR NO.
USEJ APPROVED
AODREH8 ! ZONE / BY DATE
f DESCRIPTION ♦ LOTNOO. I BLOCK CORRECTIONS
LEGAL
TRACT / A �(a
r A �- NO.OF SLOSS.
SIZE OF LOT 4'� � T� I NOW ON LOT
USE OF I NO.OF / I NO.OF
EXISTING BLDG.) l/0 A i'a. FAMILIES ROOMS
DESCRIPTION OF WORK �f
NEW ALTERATION ADDITION +
O
A
REPAIR MOVING / DEMOLISH
S ZE T. ROOMS 9 STORIES D
WALL %'%f �fl ROOF �A�l f f'
COVERING - /Ills rfi I COVERINGYy I �ih�'�/,sh
USE OF NEW
BUILDING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS "APPROVALS
APPLICATION AND STATE THAT THE ABOVE 19 CORRECT FOUNDATION- LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORD-INANCES. FORMS,MATERIALS
AND TATE LAWS REGULATINp BUILDING CONSTRUCTION.-
^ -
/ FRAME- FIRE STOPS, �1s�
SIGNATURE O / ti.+ BRACING,BOLTS
PERMITT� ^ -�` �Z' �' - - LATH..INT.-
1
AUTHORIZED AST LATH,EXT.-
DSS-3 SUM SETS 7-47 $ P.C-6 PLASTER,INT.
FEE PLASTER,EXT.
L�j S
VALUATION FEE � •i„�,• ^� FINAL
-,r,;, ,_K Stir l I�LI6'L �If� to l9 k`i_ Y IT
DEPARTMENT OF BUILDING AND SAFETY .,
COUNTY OF LOS ANGELES
WM. J. FOX, CHIEF ENGINEER
NO.OF BLDG. ORD.,NO. DISTRICT–,No. PLAN CK. NO. PERMIT NO.
PLANS SETBACK LINE
FIRE APPROVED
ZONE BY DATE RECEIVED BY DATE OF APPL. DATE ISSUED
USE APPROVED . /7/ /d.f `•,
ZONE BY DATE L
APPLICANT FILL IN HEAVILY OUTLINED PORTI N 0&1,,Y
BUILDING
0 T/
0 NAME ADDRESS
I. C �ry
U _Z ADDRESS LOCALITY `�' / `-- l /tee
!- l7
NEAREST
U W CITY CROSS ST. ^�'°�• �- -�
C _
Q ISTATE TEL.
LICENSE NO. NO. E NAME
Itl
MAIL
NAME i 3 ADDRESS
O - - - - -
I.., TEL.
U ADDRESS CITY NO.
C
Z CITY I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
0 APPLICATION AND STATE. THAT THE ABOVE IS CORRECT
U STATE TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
LICENSE NO. NO. AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
OZ LQT NO. SIZE OF LO/ SIGNATURE OWNER OF �. f
'I 1' NO. OF BLDGS. y) +°
Q d BLOCK ..._ NOW ON LOT AUTHORIZED AGT.
J In CORRECTIONS
W TRACT
D USE OF BLDGS.
NOW ON LOT
DESCRIPTION OF WORK
USE OF
BUILDING �..
— 0
Z
NEW TYPE GROUP I"
NO.OF NO.OF
ALTERATION ROOMS FAM!LIES
ADDITION SIZE
REPAIR STORIES
MOVING WALL COVERING -Yy�-
DEMOLISH ROOF COVERING .__...�
s v
P.C.
f FINAL APPROVAL
FEE
$ J INSPECTOR'S
VALUATION FEE DATE NAME
78A6SSA CE#808_e_57, APPLICATION FOR BUILDING -PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTYIENT OF COUNTY`ENGINEER • ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A.LAMBIE,COUNTY ENGINEER NEAREST• f�
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. _ 6�
DISTRICT.NO. GROUP TYPE SEWER MAP
FOR APPLICANT TO FILL IN ��" �' PK PG.
_ CONST_.s� a� "-
BUILDING
6 I STATISTICAL SLASSIFICATION
ADDRESS 17 �/�' D
CLASS.NO. WELL.UNIT
LOT NO... /� BLOCK MAP -. STATE YES NO
TRACT L. NUMBER -_>_990 HWY.
U5E ZONE SPECIAL
/ NO.OF BLDGS. CONDITIONS
6
SIZE OF LOT O NOW ON LOT
USE OF ' 111
EXISTING BLDG. BUILDING EXIST.
s SETBACK YARD HWY STREET NAME WIDTH
OWNER FRONT
MAIL P ' P.L:'
ADDRESS L�00 SIDE
L. P.L.
CITY
ARCHITECT OR INSPECTION RECORD
la./
ENGINEER {0 '
ADDRESS
TEL 2.Gt 58` 'l _fL.�7 !%7I/c'FA
CONTRACTOR ' NO.
ADDRESS
DESCRIPTION OF WORE A / nfrJr.�Tia eTic/�
I
NEW-NIADD ALTER' REPAIR DEMOLISH
SQ.FP. )) //// NO.OF NO.OF n /E• Is�I S �l.�1 /%c�!/Y`ti
SIZE ( '% l• STORIES FAMILIES r.�a� �^
USE OFSTRU URE CTDOI2 F10R [SO P R R ! ."RTfi%�l� 7'. .
A/1'lc12r—n
SIGNATURE O APPROVALS Q/v�G 117RI��P, pf�*7--.t
APPLICANT j DATE INSP CTOR'S SIGNATURE 71
ADDRESS b FOUNDATION: LOCATION _7_� �o( ]�I
FORMS,MATERIALS Q- +§ •
$
:C. S FRAME: FIRE STOPS, r
FEE BRACING,BOLTS A"
VALUATION �41® E FURNACE.: LOCATION, ub
FEE GAS VENT.DUCTS
1 HEREBY ACKNOWLEDGE THAT I HAVE'READ THIS AP. LATH,INT.. „
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND (/
STATE LAWS REGULATING BUILDING CONSTRUCTION. LATH,EXT..
SIGNATURE OF HOUSE NUMBER COR.
PERMIT RE RECT AND POSTED
ADDRESS FINAL
JOHN A.LAMBIE..COUNTY ENGINEER. CLYDE N.DIRLAM,PRINCIPAL STRUCTURAL ENGL R
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH ,•
1955 FEB 26 1 n 600 M
76A688A FE0808 8-44 APPLICATION FOR BUILDING.PERMI
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE•.COUNTY ENGINEER NEAREST
COLEMAN W. JENKINSAUP'T.OF BUILDING CROSS ST.
DISTN G OUP TYPET.coNSFOR APPLICANT TO-FILL IN P SSED BY
ADDRESS ING , EV� _ /d '��STATISTICAL CLASSIFICATION SEEKER MPAG
V l f CLASS NO. DWELL UNITS
LOT NO. r BLOCK USE ZONE MAP moi{
NO. ✓ -
TRACT ?j UT SPECIAL
SIZE OF LOT 1p.O �� NOW oNSLOTB O
USE OF
BLDG. SETBACK FROM
n�► TE r FRONT PROP. LINE OF (STREET)
OWNER ,�. MO �1 O ea- NO. �j�+�— TYPE OF EXISTING SETBACK HIGHWAY YARD = TOTAL
ADDRESS lbl — ( G IGWIDTH I-FROM C.L. '
CITY I L� BLDG. SETBACK FROM
ARCHITECT O TEL. SIDE PROP. LINE OF (STREET)
ENGINEER W e r. NO. S TYPE OF EXISTING ISETBACK HIGHWAY + YARD = TOTAL
ADDRESS 9 E V — •C HIGHWAY WIDTH FROM C.L. t
TI .CONTRACTOR I9 �1^ NOL + 0
ADDRESS LI CORNER CUTOFF YES NO
O
LIC
CITY CLAQQ REVERSE SIDE FOR SPEC;OL, APPROVALS W
DESCRIPTION OF WORK -...� -- 1 ' CL
e,�y'.K. z
NEW ADD ALTER REPAIR DEMOLISH
SQ.FT. NO. OF NO. OF
SIZE STORIES FAMILIES
USE E OF / r f7GCe! vim] iifl s v
STRUCTURE
31,4
SIGNATURE OF
APPLICANT
VALUATION$ '� .�
d APPROVALS DATE INSPECTOR'891GNATUR
P.C. PMT. j �"(J FOUNDATION, LOCATION
FEE$ FEE$ / -FORMS,..MATERIAL$,__ Iv�l /r:,Y� `J.•. "' .
'FRAME, FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS �v
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
9UILDING CONSTRUCTION: 1 CERTIFY THAT. IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON-IN VIOLA- 'LATH•:INT. '� Yyr;. �JG��� �'",/frr:.sp1:,.�.•
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMPENSATION SURANCE. h
L=AT•R. EXT. 1.
SIGNATURE OF HOUSE NUMBER COR-• ' d'
PERMITTEE �r '� �7 RE T AND POSTED
ADDRESS D — 1 NAL
JOHN F. LEWIS. PRINCIPAL ST URAL ENGINEEF2
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION=' M.O. CASH
LAo0 1 0 y"" flffl30 1 D . 11.50" v
76ABSBA CE9803 9+87 � 4 C/
APPLICATION FOR BUILDING PERMIT LJ
COUNTY OF LOS ANGELES
BUILDING
DEPARTMENT OF COUNTY ENGIkEER ADDRESS Zftoif7Z..c T
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER gNeCId T
COLEMAN W. JENKINS SUPT OF BUILDING NEAREST /
CROSS ST. ` C 16
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP TYPE P 0���C..ESsssSED BY
!�D CONST. r�
(Print or type only o.7� 1���!lIJJJ.���
BUILDING t j ��E�; STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS [� CLASS NO. DWELL.UNITS BK / PGY
LOT NO. BLOCK USE ZONE MAP v� �.g
NO. RZ
TRACT 0.3 6.8 SPECIAL .
CONDITIONS
NO.OF BLDGS.
SIZE OF LOT 4+U ' NOW ON LOT
USE OF
EXISTING BLDG. C BLDG.SETBACK FROM
OWNER�Z� �I/IJ%(_ Nee OL. FRONT PROP.LINE OF -(STREET).
TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL
ADDRESS ,gyp &A HIGHWAY WIDTH FROM C.L.
CITY t C/ I Il r BLDG. ETS-OCK FROM ~ �j
ARCHITECT OR TEL.. a SIDE PROP.SETBACK
EOF (STREET)
ENGINEER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS �` C 7� HIGHWAY WIDTH FROM C.L.
CONTRACTOR W}LG A10E' /3R NOL 44-1 -IT7-Cj + _ CL
ADDRESS +3 Lh LSSA NO. e71fCl�/Q CORNER CUTOFF YES ❑ NO ❑
CITY -AACq) (' ', e/ 6& CLASS � % SEE REVERSE SIDE FOR SPECIAL APPROVALS 15
DESCRIPTION OF WORK a
z
NEW ADD LEER REPAIR DEMOLISH !
SQ. FT. NO. OF NO. OF `
SIZE STORIES FAMILIES /
USE OF
STRUCTURE r �
SIGNATURE OF
APPLICANT 6 L11°1 1✓/)
VALUATION S Roo.
,r
APPROVALS DATE INS PEC TOR'S SIGNATURE
P.C. PMT. * FOUNDATION: LOCATION
F I FRAME:HEREBY ACKNOWLEDGE THAT 1 HAVE READETHIS APPL CATION BRACINGFSTOPS,
IRE ABOLRTS�
y
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, l /'
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS
BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA-
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT• LATH, INT.
ING TO WORKMEN'Sj�MP ATION IN ANCE. J !/i!
F�` LATH;.EXT.
SIGNATURE OF���•) A''COF "����,1
PERMITTEE D�p(i _L�,e HOUSE NUMBER POSTED RECT AND POSTED
DR
ADDRESS =� � ' `9. I FINAL
JOHN F. LEWIS. PRI IPA' STRUCTURAL ENGINEER
PLAN CHECK VALIDATION I:K. M.O. CASH _ PERMIT VALIDATIONCK. M.O. CASH
�62s �w. SEP 5 o -17.25' 4
Os 76AG38A '� V
.CE 01303(REV.,9/78)
1
APPLICATION, FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SA ETY
FOR APPLICANT TO FILL IN ADDRIESSS �
BUILDING
ADDRESS ?A6/ LOCALITY
7&rWL� ZIP. NEAREST.CROSSST
•
/ NO.OF BLDGS, r ASSESSOR
SIZE OF LOT Sv(J X /00 NOW ON LOT / MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE SSED BY
TRACT BLOCK . LOT NO.. CONST• ZONE
OWNS dJjP��� f.��L L �t/ it�d�4 -!�s .V! Q 3'
�))AA STATISTICAL CLASSIFICATION SEWER M
ADDRESS. •?�(aI ,(/6!'� s�� � -�`• � CLASS NO.c��DWELL.UNITS BK, PG
CITY �E/fi/�tL�%/rC-iy/�/ ZIP 0 9 0, -
ENGARCIiNEER ITECT OR: vG�/"�iC,� NO. VALUATION $ 3�0
ADDRESS - BLDG.SETBACK FROM
TEL FRONT PROP.LINE OF fSTREETI
CONTRACTOR �' �1! C-.C/ NO. TOTAL SETBACK FROM TYPEOF EXISTING •�
LIC. _ ;HIGHWAY + 'YARD = FRONT PROP.LINE HIGHWAY WIDTH
ADDRESS NO. _
LIC. + -
CITY CLASS BLDG,SETBACK FROM
CgNSTRUCTION LENDE ,yam /e/,/ /�4AI i`
NAME AND BRANCH �A I AJ0 L�f/ �7�'"A' SIDE PROP.LINE OF (STREET)
HIGHWAY +' YARD = TOTAL SETBACK FROM TYPE OF EXISTING
ADDRESS �' /u `/+S CITYgw
`�(� (// SIDE PROP.LINE HIGHWAY WIDTH
SQ.FT./�s� STORIIES FAMINO.OF ILLIES / ONECHEC + -
SIZE 'Tln
DESCRIPTION OF WORK NEW ❑ P.C.Fee$ Permit Fee f 6
AD ER . Issuance Fee 7
❑ Total Fee o
USE OF DEMOL ❑
EXISTING BLDG. 2
APPLICANT, - _ I s! I O
IPRINTI
�f,®,,��, '`�`yam D '
BY(SIGNATURE)`- C%�'!'• r!!/tvc'!f�
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND TATE Y _
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES 5i
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE! S
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSOWIN VIOLATION OF , t 7 ap 6 1 4 7 A
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO.WORKMEN'S COM-' Z
PENSATION INSURANCE. # 0 0 0 0 0 1
��' +� d
SIGNATURE OFC Q aa1� qPERMITTEE
ADDRESSZ 0 0
p TEL.���%(
O
CITY G NO.. 0 8. 1 5—`i''9
ZONE MAP
NO.
�I SPECIAL. _ F
CONDITIONS
FINAL r7 r BY
DATE "--
7GA638A CE#803 8-64 APPLICATION FOR BUILDI G PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,SUP•T.OF BUILDING CROSS ST.
DISE N OUP-' TYPE. PR BJY
FADDRESS
APPLICANT TO FILL IN �, CONST.
T TATISTICAL CLASSIFICATION SEWER AP
`1. �. /�7J17
j �b [ LASS NO.�DWELL UNITS BK PG
/ BLOCK USE ZONE MAP¢ NO. (/L O SPECIAL
NO OR BLOCS. GOND T O S
SIZE OF LOT rj 1NOW ON LOT
USE OF
O
/� C! Ga v BLDG. SETBACK FROM
OWNER Cit pr
TEL
N♦ V �Z�j J FRONT PROP. LINE OR (STREET)
TYPE OF EXISTING SETBACK HIGHWAY YARD = TOTAL
ADDRESS HIGHWAY 'FROM CL. ``
CITY IY (' / J� �J '1' v TJ
,C EL. BLDG. SETBACK FROM
- p.0ZE�0/0 O. SIDE PROP. LINE OR (STREET)
ENGINEER /
TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL
HIGHWAY WIDTH FROM C.L.
ADDRESS �6e �0 (� d
' J TEL. � + = O
CONTRACTOR (vy�.p NO r7i V
ADDRESS S:A P NO. CORNER CUTOFF YES E NO El O
V
CITY S cIc s ;'SEE REVERSE SIDE FOR SPECIAL APPROVALS u,
DESCRIPTION OF WORK �- f¢7 Z
�.-
NE ADD ALTER REPAIR DEMOLISH
SQ.FT. x NO. OF NO. OF _ •M�'
SIZE A�iS �G STORIES FAMILIES
USE OF Y 4�.I CCr►... Lf"
STRUCTURE
SIGNATURE OF /r's�f.1!! �� d6tti d fLft
APPLICANT
VALUATION$ _� Q—Q
APPROVALS DATfE INSP ECTOR'3 SIGNA,TI;RE
P.C. PMT. /� FOUNDATION, LOCATION f-
FEE$ / � FEE$ 14-50 FORMS, MATERIALS /(
FRAME, FIRE STOPS,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS /
13UILDING CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK
AUTHORIZED HEREBY-1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COM EN TION INSURANCE. LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR-•
PERMITTEE RE.CT AND POSTED
ADDRESS FI NALivz `"
Eft f ZP'r.h. .:t �J •:
JOHN F. LEWIS. PRINCIPAL STRUCTURAL E R
PLAN CHECK VALIDATIONI��- M.G. _ PERMIT VALIDATION CK. M.O. CASH
Xo_1-7 3.6 1--• My 1$ 2 3 D 9.2 5 c
LAC01 7 3 7 Wky1$ 1 D 1 8.5.0
7OA638A40*803 a 4 APPLICATION FC6R: BUILD G FERMI
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS. ReP112 /
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE-. COUNTY'ENGINEER NEAREST
COLEMAN W. JENKINSAUP'T.Or BUILDING CROSS ST.
Tr_lDISTRIC N' U TYPE, P
FOR APPLICANT TO -FILL IN .CONST.
BUILDING +0`/ � it s STATISTICAL •L SIFICATION SEWER) P
,_ Kit((��((+�9 CLASS NO. DWELL UNITS /L__ G
LOT NO. BLOCK USE ZONE MAP
NO. ..
TRACT $,3�0 SPECIAL
N0. OR BLOGS. -CO
NDITIONS
SIZE OF LOT X NOW ON LOT
USE OF'
_XLSTI .ESS BLDG. SETBACK FROM
r�. TEL. ` FRONT PROP. LINE OR (STREET)
OWNER / �r NO.' .Z��-'FTYPE OR 6X18TIN0 96TBA9K HIGHWAY YARD = TOTAL•
ADDRESS-m/ irvj s'/ HIGHWAY WIDTH
IDry� FROM C.L.
CITY cil
ARCHITECT OR TEL. BLDG: SETBACK FROM
Z�;i i
ENGINEER b P'rJ! NO. SIDE PROP. LINE OR (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL }
ADDRESS Q �r� -11
HIGHWAY WIDTH FROM C.L. O.
CONTRAC.TORITC(�' aJ/ !' NOL + u
ADDRESS. NO r CORNER CUTOFF YES NO O
C C V
cl Y SEE REVERSE SIDE FOR SPECIAL-APPROVALS ' IL
DESCRIPTION OF WORK // n
V�(!/ I b Z
NE ADD ALTER REPAIR DEMOLISH
SQZ•ET• // /�� / NO. OF NO. OF
STORIES FAMILIES
USE OF /
STRUCTUREggn 40
SIGNATURE OF
APPLICANT
VALUATION APPROVALS DATsE ! INSPEC,TOR'.'SSIGNATURE
P.
FEE$a�� FE'E$ LOATI
�• U C. PMTFOFORMS!MANDATON�TERIALSON d✓ 1
FRAME, FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT 1 HAVE'READ THIS APPLICATION BRACING BOLT A` s
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION • I
WITHALL COUNTY. ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS r
9UILDING CONSTRUCTION. 1 CERTIFY THAT. IN DOING THE WORK ! I 3
AUTHORIZED HEREBY•I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. 6I tY
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
INC TO WORKMEN'S P ATIO E. LATH. EXT.
SIGNATURE O Lam' HOUSE NUMBER COR_
•
PE,RMITTE RE _ AND POSTED
ADDRESS FIN A L .�`~�►
` JOHN-F.-L-EWIS. PRINtIPA&STRUCTURAL ENR"
PLAN CHECK VALIDATION CK. M.O. -CASH PERMIT VALIDATION CK. M.O. CASH V
'. 1 7 7 .2:o MAY 18 1 D 7,0 Q^ tr
• i WORKERS'COMPENSATION DECLARATION
I nh affirm that I have certificate of consent to self
insuv;,' or a certificate of Workers' Compensation Insurance, APPLICATIO Ar• Pi O'
R WILDING P E RM I T
or a cettified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS A0GELES BUILDING AND SAFETY
Policy No. Company BUILDING I
❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS 6 1 -7
❑ BUILDING Certified copy is filed with the county building inspec- ADDRESS �� � ! Q
tion department. 1 p
CITY !P 001 6 C/f ZIP r 7J d " LOCALITY
Applicant NO. OF BLDGS. NEAREST
CERTIFICATE OF.EXEMPTION FROM WORKERS' SIZE OF LOT ' NOW ON LOT CROSS ST.
COMPENSATION INSURANCE ASSESSOR
(This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK A 3T 3 PAGE PARCEL
hundred dollars ($100)or less.) TEL. USE ZONE MAP
OWNER �. L " O. NO.
I certify that in the performance of the work for which this "�
SPE
permit is issued, I shall not employ any person in any manner ADDRESS V.4 d__ �J SPECIAL
CONDITIONS
so as.to become subject to the Workers'Compensation Laws. p O
// CITY ," 4e Zip . j O V U.
Date7`69_2 Applicant A&CY r F-2?�, ARCHITECTOR TEL. O
NOTICE TO APPLICANT:.If, after making this Certificate of ENGINEER NO. DISTRICT GROUP TCYOPNST. ZON OCESSED BY H
Exemption, you should become subject to the Workers' 7 0 �U
Compensation provisions of the Labor Code, you must forth- ADDRESS , QV o
with comply with such provisions or this permit shall be �6,�` TEL. STATISTICAL CLASSIFICATION APT. CONDO.
deemed revoked. CONTRACTOR 12, 0C1A? Z
NO. d - /Z4 Z
LICENSED CONTRACTORS DECLARATIONLIC. CLASS NO. DWEU.. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS Vat AJ., F11,e L NO. ®' -SEWER MAP
(commencing with Section 7000)of Division 3 of the Business LIC.
and Professions Code,and my license is in full force and effect. CITY CLASS 115-X7
BK. PG. VALIDATION'
SQ. FT. NO. OF NO.OF CHECK
License Number_615P07 Lic. ClassC-3�'/ SIZE STORIES FAMILIES ONE
VALUATION
Contractopa iC• 6&20-117? Date •:2-/Q-�'l DESCRIPTION OF WORK ��Q Q [($Q NEW ❑ $; }
�I am exempt under Sec. Z O�i< s•�s Oke • �'!St<4CL �� ADD ❑ d
� � .2'+as'Wc- e,4455 ALTER
B.&P.C. for this reason ❑
r REPAIR
USE..OF ❑ $
Date: 7" EXISTING BLDG. DEMOL ❑
Signature , hya � /1 APPLICANT TEL,
OWNER-BUILDER DECLARATION, (PRINT) %ZlG�C gip. �C�i-2[2� FINAL"
DATE
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and ADDRESS FINAL
Professions Code): PRESENT By
❑ BUILDING
I, as owner of the property, or my employees with
ADDRESS S-'it..ci ,�
wages as their sole compensation,will do the work and _
7 7 s
the structure is riot intended or offered for sale(Section LOCALITY 2:i��,� W-3 4D.
7044, Business and Professions Code.)- MOVING TEL.
❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO.
with licensed contractors to construct the project (Sec- ADDRESS ; 5
tion 7044, Business and Professions Code.)
i s rk �-..�- 25
CONSTRUCTION LENDING AGENCY SEET BACK YARD HWY TOTAPROP LCINE FROM WIDTH CASH 11317.Z"
I hereby affirm that there is a construction lending agency for• FRONTF.;
the performance of.the work for which this permit is issued P.L. wi" +� (l� LU
(Sec. 3097, Civ. C.). SIDE -.
. .
i
Lender's Name P.C. Fee$ Permit Fee �'�r Z� LDMA Ref.# i-��Ij{3`I)_-) 1 ;:4-Jif`i 1
Lender's Address �• �� , _ AM 7727
I certify that I have read this application and state that the Issuance Fee LDMA P/C#�
above information is correct. I agree to comply with all County Investigation Fee
ordinances and State laws relating to building construction, Total Fee �/��`� LDMA Perm. #
and hereby authorize representatives of this County to enter
�. upon the above-mentioned property for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent- Date'
A.
WORKERS'COMPENSATION DECLARATION
I•hereby affirm that I have certificate of consent to self APPLICATION FOR U I L®I N G P E RM I T
iris�re, or a certificate of Workers'Compensation Insurance,
or, certified copy thereof(Sec. 380..0.,-.L�ob. C�.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy NoZlalfn pony ll�� BUILDING d
� liified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS O#
LT Certified copy is filed with the county building inspec- BUILDING
tion department. ADDRESStmL i
Date(-��Applicant�vs"s 117/1
�,4d� CITY zIP LOCALITY
'' NO.OF BLDG . NEAREST OIL
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT' 6i CROSS ST. ' 123 W
COMPENSATION INSURANCE ASSESSOR 1
(This section need not be completed if the permit is for one TRACT ®19 BLOCK LOT NO. MAP BOOK = PAGE 07-57 PARCEL ®11
hundred dollars ($100)or less.) ' TEL• USE ZONE A a�
OWNER NO.
I certify that in the performance of the work for which this ��/ 10.
SPECIAL }
permit is issued, I shall not employ any person in any manner ADDRESS CONDITIONS a
so as to become subject to the Workers'Compensation Laws. �y O
CI ` ZIP V
Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE P CESSED BY aC
NOTICE TO.APPLICANT: If, after making this Certificate,of ENGINEER NO. COV SONE O
'Exemption, you should become subject to the Workers' (� _3 `./( b
Compensation provisions of the Labor Code, you must forth- ADDRESS � O ✓ a-
with comply with such provisions or this permit shall be TEL.. STATISTICAL CLASSIFICATION APT. CONDO. N
deemed revoked. CONTRACTO NO.!W7 _Z
LICENSED.CONTRACTORS DECLARATION LIC. CLASS No..121 DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESSJft Ak925W NO.
(commencing with Section 7000)of Division 3 of the Business i LIC. SEWER MAP
and Professions Code,and my li nse is in full force and eyed. CITY CLASS BK PG VALIDATION
SQ. FT. NO. OF NO. OF CHECK
License Number Lit Class r SIZE STORIES FAMILIES ONE
VALUATION
Contractor Date DESCRIPTION OF WORK NEW ❑ $ /
ElI am exempt under S &P2 6W&I21
ADD ❑ ►
ALTER
B.BP.C. for this reasonREPAIR El $
USE OF ,�
Date' EXISTING BLDG. V DEMOL ❑
Signature APPLICANTTEL• FINAL
OWNER-BUILDER DECLARATION (PRINT) . NO. i p/I
��11 7�-
I hereby affirm that I am exempt from the Contractor's License DATE
ADDRESS rv/L� FINAL
Law for the following reason (Section 7031.5, Business and ---�-
Professions Code): PRESENT B
_ijlf -:,16.o 1.
❑ I, as owner of theproperty, or m employees with BUILDING Y T-—
YADDRESS l t i E.I fS
wages as their sole compensation,will do the work and _.,
the structure is not intended.or offered for sale(Section LOCALITY ® I(I E-AL 3 16 m 17
7044, Business and Professions Code.) MOVING TEL. `.0--`f
El1, NO.I,as owner of the property,am exclusively contracting "t"U-K 316.it
with licensed contractors to construct the project (Sec- CHANGE. 1'I
tion 7044, Business and Professions Code.)
ADDRESS e_
CONSTRUCTION LENDING AGENCY
REQUIRED
YARD HWY TOTAPREOTPACNE FROM WIDTH
I hereby affirm that there is a construction lending agency for FRONT [I[ILJi t—�(Clsa Cr;`l1J�,d
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C.). SIDE1_l i A i e
P.L. '-'
Lender's Name
LDMA Ref.#
Lender's Address P:C. Fee$ Permit Fee 2
' PIP
I certify that I have read this application and state that the Issuance Fee �J' LDMA p/C#t
above information is correct. I agree to comply with all County Investigation Fee
ordinances and State laws relating to building construction, Total Fee J/ LDMA Perm. #
and herebygothorize representatives of this County to enter
upo ove- icwe property for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature pp scant or A Date