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Home My Public Portal About9217 WEDGEWOOD ST_Building__ lOABeeA C6#0=10-g9 APPLICATION FOR BUILDING PE.RMIT j;_ COUNTY OF LOS ANGELES BUILDING. A DEPARTMENT OF COUNTY ENGINEER. ADDRESS BUILDING AND SAFETY DIVISION LOCALITY .� JOHNA. LAMBIE, COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. DIST R O. GR!t TYPE Pri FOR APPLICANT TO FILL IN ' �G-'I coNs r'p BUILDING qq STATISTICAL CLASSIFICATION SEWER MAP ADDRESS '? dO f> •w PG CLASS.NO. WELL.UNIT LOT NO: BLOCK NU A ER �Q HWY YES 10 TRACT USE ZONE SPECIAL' CONDITIONS SIZE OF LOT Q I NO.OF.HLDGS NOW ON LOT I USE EXISTINGBLDG. .j BUILDING XIST. YARD• HWY STREET NAME �/ /' SETBACK WIDTH _ OWNER m C-`AP V, 'A LQi s : f i7�Cy FRONT I V �o B MAIL 9 P.L. ADDRESS i I MAW dC&1� SIDE TEL P.L. CITY 7"Eir, LL-. ,% NO.A) r-j �f INSPECTION RECORD ARCHITECTOR' bol TEL. NO. ADDRESS 5��7�pH7 r� CONTRACTOR D u!Xc TEL ,, NO. ' ADDRESS S,7s�� S" lC !G DESC,RRTION OF WORK _ ' NEW AF . /DD ALTER REPAIR DEMOLISH S ZNO.OF NO.OF ET ��f'� STUSE OF �OR ES � FAMILIES ; 6,6C STRUCTURE EI./. / 4 SIGNATURE OF APP_ ICA NT t /J /��,� �f _� APPROVALS DATE INSPECTOR'S SIGNATURE ADDRESS 4f17e��( r G FOUNDATION:LOCATION FORMS;MATERIALS PZ `� f NfliCk'1C.I1• VALUATION.5 FRAME'FIRE STOPS_L'j + BRACING,BOLTS J Z"Z•s-60 pile " PMT /� FURNACE:LOCATION. F E' $' r FEE $(G7 GAS VENT,DUCTS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH.INT. PLICATION AND STATEN T THE ABOVE IS CORRECT AND AGREE TO COMPLY WIT_ ALL COUNTY ORDI NCES AND STATE LAWS REGUL" IN BU DI G C STRUFTION. LATH,EXT. .HOUSE NUMBER COR- - SIGNATUREOF � - RECTANDPOSTED �? PERMITTE9 10 ADORES FINAL CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL EN_GWM4R PLAN CHECK VA TION CK. M.O.. CASH PERMIT VALIDATION °K M.o. cwsti 8 2 7 6 -tn !'410V 3-Q" 1 A 6.0 s APPLICATION FOR BUILDING PERMIT 1 COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I have a certificate of Consent to self insure, BUILDING AD KESS A or a certificate of Workers'Compensation Insurance,or a certifiedTY copy thereof(Sec.3800,Lab.C.) CI /, /!j_ � f � LOCALITY No. Company SIZE OF l•G (� NO.OF BLDGS. ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRA BLOCK LOT NO. � r department. " f /-7r USE ZONE MAP NO. Date Applicant AS SSOR MbP)3gQK RAGE_ PARCEL [/ SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' NER - WITHIN 1000 FT OF SCHOOL? YES NO This section need not be completed if the permit is for one hundred ADDRESS � /�n� ( p P ` 66�� DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY dollars($100)or less.) ��`((({��3333��1111�33 CITY ZIP I certify that in the performance of the work for which this permitd �T 2 is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. ,fes J become su ject to the Workers'Co pensation Laws. ��,��l..✓///!! STATISTICAL CLA4SIFICATION APT CONDO DatepliCant ADDRESS CLASS NO. DWELL UNITS NOTICE TOL160T. If, after ma ng this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONT ACT t ,- - / TE O. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions Of the Labor Code, you must forthwith SO I� 1�7�f1[ E Q-/G7 FRONT comply with such provisions or this permit shall be deemed revoked. ADQRESS _ql ` LIC. PL LICENSED CONTRACTORS DECLARATION �/ l fA)A SIDE clTv LIC.c PL I hereby affirm that I am licensed underprovisions of Chapter 9 1 ffwlf I SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF IES NO.OF FAMILIES Professions Code,and lic�na is in full force and effect. NEW ❑ BK PG POO.- d License Number Lic.Class DESCRIPTION Of WOR . ADD ❑ VALUATION " O Contractor DateAli ALTER � $ ✓ ��d' A( REPAIR ❑ O fYl I am exempt under Sec. U 4, B.&P.C.for his reason E OL ❑ LOMA P/C# W Date: USE QJaXISTING% G. URM ❑ Signature A (CANT(PRNT) TEL NO. LDMA Perm# 1 ❑ I, as owner of h property, or my employees wi ages as s.''' 1-)._s n TL their sole cc p sation, will do the work and t e ructure is ADDRESS �__ not intended or offered for sale (Section 7044, mess and FINAL DA E Q rtil.� Professions de.) �C2 WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL J TT"Tl�ti OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE I�� ❑ licensed as owner of the property, am exclusively contracting 44, ,AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044, YES❑ NO❑ �!_'s�AI 12 1-35 Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CHECK �^i n`•' CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR rr-1 GUIDELINES CHANGE I hereby affirm that there is a construction lending agency for YES❑ NO❑ C4 the performance of the work for which this permit is issued(Sec. rn\ I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE: ,� •� +': + J TITLE 2.CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS 13,3130713130 1 1 y,,,•!;f Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. o Lender's Address 3443 i An p OWNER OR AGENT oI certify that I have read this application and state under penalty of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE 1474-1 N with all county ordinances and State laws relating to building construction, ang hereby authorize representatives of this County ISSUANCE FEE / to torn upon thy above-mentioned p rty for inspectio rpos s. 4.7�'ICJ y/ INVESTIGATION FEE TOTAL FEE /. sgnswn :gym oma. SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION FOR qUJL®INQ PERMIT �4 • COUNTY OF LOS ANGELES" `� BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL INquILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS 2 or a certificate of Workers'Compensation Insurance,or a certified ,z/ 'ed .� W� copy thereof(Sec.3800,Lab.C.) C,ITTY/ ZIP �" E a / i � LOCALIT Policy No. Company SIZE OF Lot NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby,furnished. f"`i NEAREST CROSS ST. M ❑ Certified copy is filed with the county,building inspection TRACT BLOCK 'LOT NO. department. �/ USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL / cArif -10 / /(� k—rSPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER s YES NO COMPENSATION INSURANCE U 7�� /K� E WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESS dollars($100)or less.) E1sfe-. DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY I certify that in the performance of the work for which this permit CRY ZIP is issued, I shall not employ any person in any manner so as to becom Ubje to the Workers'.C pensatiOn,LawS. ARCHITECT OR ENGINEER TEL N . STATISTICAL CL S FICATION APT CONDO Applicant. ADDRESS /,rC�o�� CLASS NO. DWELL UNITS t/ NO TO A ICANT. If, after g this Certificate of G REQUIRED TOTAL SETBACK FROM EXIST V Al Exemption, you should become s ect to the Workers' CONTRACTOR:. ; � TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith LJ _ FRONT comply with such provisions or this permit shall be deemed revoked. ADDR S 1/1% 1 ``, �/j PL LICENSED CONTRACTORS DECLARATION t `' SIDE CI LIC.'CLASS P L, } I hereby affirm that I am licensed underprovisions of Chapter g 7� ,IJ /�(• SEwER MAP (commencing with Section 7000)of Division 3 Of the Business and .FT.SIZE NO.OF"STORIES NO.OF FAMILIES a Professions Code,and y lic se is in full force and of t. NEW ❑ BK PG ► CC.' DESCRIPTION OF WORK VALUATION License Number Lic.Class ADD ❑ _ . Contractor DateALTER .❑ C AC a!� REPAIR ❑ I am exempt under Sec. `. $ �� ' C BAO.C.for this reason �. . DEMOL ❑ LL LDMA Pic# LL Date: 3 USE OF EXISTING G. n URM ❑' J 23 z � '.^'SlgnatureV% T APPLICANT( NT) T LDMA Perm# �d I, as owner Of,t e roperty'or my employees with Lomas ? LOAL 0 :• ( i•1F.4 their sole comp n ation, will do the work and the re is DRESS ,`I H 4 t� not intended or fered for sale (Section 7044, B s1 s and �� , s FINAL DATr, �G G ,.•��_ 50.50 Professions CO .), WILL HE APPU NT OR FUTURE BUILDING OCCUPANT HANDLE A DOUS MATERIAL � ��•''J ,• OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR EATER THAN THE I, as owner of the property,•am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY n licensed contractors to construct•the project (Section 7044, ,,�•C -Iv .T Business and Professions Code.) ves El NO❑ �' WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING - ` �+, € �'� Cr,-y� ' OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH.. 3. .'CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR 1 n GUIDELINES �'+t I hereby affirm that there is a construction lending agency for YES❑ NO❑ a' the performance of the work for which this permit is issued(Sec. TOTAL TAL 43.2= 44 m I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, { TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS t rIL ,K •Sj.ti a�•+} Lender's Name MATERW 3 REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. t€ o Lender's Address •Li. OWNER pp AGENT • o cI certify that I have read this application and state under penalty cof perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE a �f a with all county ordinances and State laws relating to building v 1 �7 sa0013-1 01011 111/24/93 9 construction, and hereby authorize representatives of this County ISSUANCE FEE 'f� to an upon th bQLove-mentioned property for inspection purposes. •7-Ff INVESTIGATION FEE TOTAL FEE 4gro1«a of APOi m« ome �• SEE REVERSE FOR EXPLANATORY LANGUAGE