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Home My Public Portal About9207 WEDGEWOOD ST_Building__ 76A638A CEk803 9-68 � a��4 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING Q! rJ� DEPARTMENT OF COUNTY ENGINEER ADDRESS //t , BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRICT NO. GROUP TYPE P CESSED BY (Print or type only) CONST. � BUILDING !y STATISTICALCL SIFICATION WE MAP ADDRESS �O /- We j g CLASS NO. DWELL.UNITS EWE PG LOT NO. BLOCK USE ZONEMAP NO. O Q TRACT !'� O(� SPECIAL NO.OF BLDGS. CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. BLDG.SETBACK FROM L. FRONT PROP.LINE OF (STREET) OWNER T1 0 TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS - wedqewv0d HIGHWAY WIDTH I FROM C.L. n + CITY e CI a- f BLDG.SETBACK FROM ARCHITECT O T L. SIDE PROP.LINE OF (STREET) ENGINEER O. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. TE CONTRACTOR C,S MAO NOL .�'jrp3q + ADDRESS 3-j•—j3—S 171;-51 •5/ NO. CORNER CUTOFF YES ❑ NO ❑ LIC. CITY I7 3 'd CLASSC-22 SEE REVERSE SIDE FOR SPECIAL APPROVALS L CONS RUCTION LENDER NAME AND BRANCH e ADDRESS SQ. FT. NO. OF NO. OF NE ❑ SIZE STORIES FAMILIES USE OF 1 / _ STRUCTURE 7 Cy B r~ ALTER ❑ ag-ra-f e l ) REPAIR❑ SIGNAT46RE O APPLICANT 4F DEMOL ❑ VALUATIONS 4 Od �� APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION FEE S FEE S FORMS, MATERIALS FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION- BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE STATE OF 'CALIFORNIA IN RELAtING TO WORKMEN'S COMPE NS�ION SURANCE. LATH, EXT. SIGNATURE OF G� ` �e� HOUSE NUMBER COR- PERMITTEE j RECT AND POSTED ADDRESS 127-13-5-, / C✓ 49, FINAL JOHN F. LEWIS. PRINCI AL tTRUCiTRAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CH M.O. CAnSH 3 9 .5%00" FEB 13 I D x.00 a WORKERS'COMPENSATION DECLARATION / I suherebyaffirm that I have r certificate of consent to self APPLICATION FOR BUILDING PERMIT .insure,ar'a certificate of Workers'Compensation Insurance, nra certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy ND. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS 6?2- � c� Gtl ea( 6c•�''��'�% Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS o-7 W 4M6,*,-e'"`*-� / Date Applicant CITY �� ZIP /F LOCALITY [� CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. i C .a✓Q 7t/� (This section need not be completed if the permit is for one ASSESSOR 9 hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE .J Z PARCEL OWNER G' C., +0 NO, USE Z E MAP I certify that in the performance of the work for which this NO. permit is issued, I shall not employ any person in any manner ADDRESS ccJ (��y'�GcJu�� I SPECIAL so as to become subject to the Workers'Compensation Laws. CONDITIONS /+ U / `c Date Applicant CITY r'i ZIP I �v NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT�Z;l TYPE FIRE PROCESSED BY O Exemption, you should become subject to the Workers' ENGINEER NO. j CONST../ ZONECompensatin provisions of the Labor Code, you must forth- ADDRESS �i�/ V a with comply with such provisions or this permit shall be T STATISTICAL CLASSIFICATION APT. COhDO. fn deemed revoked. CONTRACTOR Z LICENSED CONTRACTORS DECLARATION ' LIC, CLASS NO. y DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWS P (commencing with Section 7000)of Division 3 of the Business and LIC. i Professions Code, and my license is in full force and effect. CITY CLASS BK l� VALIDATION SQ.FT. NO.OF / NO.OF CHECK License Number Lic.Class SIZE STORIES ( FAMILIES ONE VALUATION ` /,)Q Contractor Date DESCRIPTION OF WORK Z A D ❑� / L( I am exempt under Sec. 6 ALTER ❑ (/ 1/ B.BP.C. for this reason REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMOL ❑ Signature APPLICANT TOEL ( R . �/ FINAL OWNER-BUILDER DECLARATION " N ' DATE 0 7 1.7 A I hereby affirm that I am exempt from the Contractor's License ADDRESS Z�J W �a��'�� C FINAL Law for the following reason (Section 7031.5, Business and F o g Professions Code): PRE NT c Y BUILDING 7 I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and ' 09,20-88 the structure is not intended or offered for sale(Section LOCALITY 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 tion 7044, Business and Professions Code). FROM CONSTRUCTION LENDING AGENCY REQUIRED BACK YARD HWY TOTAL SETBACK ALINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. Z� (Sec. 3097, Civ. C.). SIDE `D P.L. I Lender's Name m P.C.Fee$ Permit Fee 63 LDMA Ref.a Lender's Address pp ' I certify that I have read this application and state that the Issuance Fee t�• S v LDMA P/C 0 above information is correct. I agree to comply with all County Investigation Fee cordinances and State laws relating to building construction, Total Fee 6T/ # / _3 LDMA perm. R N and hereby authorize representatives of this County to enter m upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE A , Signature of Appikant or Agent Date VQRRKERS'COMPENSATION DECLARATION hereby affirm that I have certificate of consent self A P N�p L I CAT� N FOR BUILDING PERMIT insure, or a cbrtificate of Workers' Compensation insurance, •+y�' or a,certified copy thereof (Sec. 3800, Lab. C.) COClN�Y LOS dNGELES BUILDING AND SAFETY Policy No. Company ❑ Certified co is hereby furnished. FOR APPLICANT TO FILL IN BUILDING PY Y ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING ` 7 tion department. ADDRESS Date Applicant CITY / .2- l(' •, ZIP LOCALITY 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 f� PAGE -1-71 PARCEL ZA hundred dollars ($100)or less.) r ti TEL. NO. row 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner ADDRESS C1 7 0 t 4) C' J C,t SPECIAL a- CONDITIONS so as to become subject to the Workers'Compensation Laws. / Ca 3 O CIN 6'•`t •�� 'r T' ZIP 1 ) / . U od Date Applicant ARCHITECT OR . TEL. a0 NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER C- .7 i3 �: 7i6 F5 NO.71 S`J% 4.2 DISTRICT �ROUP TYPE FIRE PROCESSED BY Q 9 CONS ZONE u Exemption, you should become subject to the Workers' �. !l Compensation provisions of the Labor Code, you must forth- ADDRESS / Z, S��•t'tt't`.�ivraa`Q (-' p3 a with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. COND d�`' O. to deemed revoked. CONTRACTOR e _.Z2 ct NO. Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. 10 Z DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP and Professions Code,and my license is in full force and effect. CITY CLASS BK.0 PG.1d7 VALIDATION SQ. FT. NO. OF NO.OF CHECK License Number Lic. Class SIZE STORIES FAMILIES ONE DESCRIPTION OF WORK Z , S 7�./ ��/) NEW ❑ VALUATION Contractor Date $ ❑I am exempt under Sec. ,t)(ter. K �` t S k�: bi--,�-r �.-cJ ADD ► ALTER 1:1 B.BP.C. for this reason b.0 7.r ` (�-;5 Z f3 c_ REPAIR ❑ $ _ Date: USE OF - EXISTING BLDG. ) �' •• DEMOL ❑ 1 Signature APPLICANT TEL. t FINAL (PRINT) NOJ ?C. s C.= L_ ! I a •j Jam" . ��> l( AC 1 eB OWNER-BUILDER DECLARATION DATE ��" Ig •r • •� I hereby affirm that I am exempt from the Contractor's License �` Z ° "LCtt7ct•: Law for the following reason (Section 7031.5, Business and ADDRESS r '"'�C' '"�` FINAL { r Professions Code): PRESENT By _ 1 1=E{`�7 El 1,I, as owner of the property, or my employees with ADDRESS TOTAL �.?�i•7 a 45 wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY , CHECK 1247.45 7044, Business and Professions Code.) MOVING TEL. �VO. I,as owner of the property,am exclusively contracting CONTRACTOR CHANGE .0� with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code.) ' REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE WIDTH 131 { 1 3/ 2/93 I hereby affirm that there is a construction lending agency for FRONT the performance of the w3rk for which this permit is issued P.L. 8.2283 1 AM u:51 (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name 8 / �� LDMA Lender's Address Ref. # C P.C. Fee$ Io Permit Fee , I certify that I have read this application and state that the Issuance Fee + to 6- LDMA P/C# 3 above information is correct. I agree to comply with all County Investigation Fee ��//� ordinances and State laws relating to building construction, Total Fee A Al /�j , 0' LDMA Perm. # and hereby authorize representatives of this County to enter up n the above-mentioned property for inspection purposes. _ SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of App ant or Agent Date