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Home My Public Portal About9516 WEDGEWOOD ST_Building__ APPLICATION FOR BUILDING PERMIT ( e,�a `l FOR APPLICANT TO FILL IN ADIDRESS BUILDING ��/� ADDRESS / efb ige loo Q ! LOCALITYNEAREST c CITY _&J,pv-E ZIP CROSS ST. C / NO.OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL /2 f� DISTRICT GROUP TYPE FIRE PROCESSED BY TRACT/aI O Q BLOCK LOT _/ •� STATISTICACLASSIFICATION V SEWER MAP ADDRESS CLASS NO. 2 DWELL:UNITS BK PG CITY ZIP USE ZONE MAP ARCHITECT OR //�� C TEL. NO. U ENGINEER C.p 5t NO. /9, r SPECIAL CONDITIONS ADDRESS n 7'� ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONTRACTOdi- /RbON` �AlIOS N&3SS BLDG.SETBACK FROM LICa FRONT PROP.LINE.OF (STREET) ADDRESS/13/1 C -L05 �A N&R?-'?//VI HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING 4I0� FRONT PROP.LINE HIGHWAY WIDTH CITY 9&ez),350" CLASS CONSTRUCTION LENDER + _ } NAME AND BRANCHBLDG.SETBACK FROM O U ADDRESS CITY SIDE PROP.LINE OF (STREET) Im O SQ.FT.�JQ'1 NO.OF NO.OF CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING V SIZE s�/vL STORIES FAMILIES ONE SIDE PROP.LINE HIGHWAY WIDTH a DESCRIPTION OF WORK IiIXs��5O`�� NEW ❑ AA600111, OFpAIJO G0Ude:9- wiTtf ADD CORNER CUTOFF YES ❑ NO ❑ ALTER ❑ ��Z�5 REPAIR ❑ IN OPEN SPACE YES ❑ NO ❑ EUSE XISTTIING BLDG.�G7u-1 x)6 DEMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑ APPLICANT EL LADDRESS NATURE) EREBY ACKNO E GE THAT I H READ THIS APPLICATION AND STATE HE ABOVE 15 RECT ANDA TO COMPLY WITH ALL ORDINANCES WS REGUTATIN BUILDING CON UCTION.I CERTIFY THAT IN DOING THE AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF BOR CODE OF THE STATE OF RNI RE.LATI T EN'S COM- PENSATION INSURANCE. TURE OF FINAL T -- I BY TTEE DATE ESS �v Lti""`' TEL. `� 2P•C.Fee$ Permit Fee oIssuance Fee �7ATION / V Z /. / S� _/4� �: 1 Total Fee PLAN CHECK VALIDATION C1c M.O. Cas PERMIT VALIDATION CK. M.O. CASH �C 0l9 7 1.1�v 14 1 0 2 1.7 5 A,o _ OS 76A638B CE/8038 6/76 G S 5� 0 \ITSa BUILDING ADDRESS -- APPLICATION LOCALITY / ,r+ ''_ DIVISION OF BUILDING AND SAFETY CROOSS ST. Department of County Engineer DISTRICT NO. RECEIPT NO. - PERMIT O. County of Los Angeles 5 3 7 WM. J. FOX, COUNTY ENGINEER GROUP DATE RECEIVED DATVIBSUED/ CAS13ATT D. GRIFFIN. SUP•'r OF BUILDING �Yyt 51 61�f FOR APPLICANT TO FILL IN TYPE CONST. RECEIVED BY 1SBUJ56 BY ) MAILER MAP// r,�f.7/y fL=p NUMBER Oaf? STATE YES�fNO'� ADDRESS(SO r (n GSII�(�Jl�lr�irLl (1L i1 �'/�/�[f ( US ZO E SPECIAL CITY .P l/1(YCIG �D NOLO 1,4J7' I!(`I CONDITIONS ARCHITECT O v TEL. ENGINEER NO. BUILDINGEXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS TEL. PR L.T �•_ t� .`"� � � CONTRACTOR NO. SIDE ADDRESS A P.L BUILDINGDATE CORRECTIONS INSPECTOR ADDRESS LOT NO. V BLOCK r TRACT I _+ �•� // (/" 1(� y till I NO.OrBLDGS. SIZE OF LOT !\ C� G NOW ON LOT USE OF r ' 7 LAST~ u✓ ( L.r V EXISTING BLDG. .>�:'�� ► DESCRIPTION OF WORK k 144.I 1 h ti D NEW ADD ALTER REPAIR DEMOLISH y 94.FT. NO.OF NO.OF �I TC�/T � E'_Tc i•ir��,3C1t (- r SIZE STORIES / FAMILIES USE OF STRUCTURE rQtl-1 -I-I ti J 4i r Iwq f c �.. —7,41C S /a S 8LSWni REEL T;Ia�t a A t•('n I s P-L W P"' I - i, r t =,� i r•S i- (5 �c' ,'� !mac'0 NO.OF EMPLOYEES 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN 19 APPROVALS INBPECTORr9 SIGNATURE DATE CORRECT. r 1AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS ,svCfr+• .� r f ' `��I.E A FRAMEC FIRE BLT ~ i'r SIGNATURE OFJ ��sss 1 ' ` BRACING,BOLTS - -r.r C»�� -- PERMIWE FURNACE, LOCATIONr ` GAS VENT.DUCTS e, ADDRESS LATH, INT. AUTHORIZED AMT. — ✓, /�/�� ! �(' r LATH, EXT. P.C.�' HOUSE NUMBER COR- '' FEE RECT AND POSTED VALUATION c1 -i-U^ FEE �� FINAL 7&A635A DBS -53 l .y. APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES "' BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUIL gEss 1 herby affirm that I have a certificate of consent to self insure, BUILDING /� or a certificate of Worker;Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) CITY 37 1 ZIP G O LOCALITY Policy No. Company SIZE OF LOT O.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Cedepartment.rtified copy is filed with the county building inspection TRACT BLOCK LOT NO. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER vLil COMPENSATION INSURANCE J WITHIN 1000 FT OF SCHOOL? YES No (This section need not be completed if the permit is for One hundred ADD SS �� / S DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED 13Y dollars($100)or less.) JL �/ CITY ZIP Q �� s, I certify that h the performance of the work for which this permit CZ[ G'/�/ � - ✓o{ �f is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. ARCHITECT,OR ENGINEER TEL NO. p STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO.� DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR ,l �, TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisiohs of the Labor Code, you must forthwith �v�/ZJ FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL > LICENSED CONTRACTORS DECLARATION SIDE C CITY LIC.CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing With Section 7000)of Division 3 of the Business and SQ.FT SIZE NO,OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW ❑ BK PG FC - License Number Lic.Class DESCRIPTION OF WORK ADD ❑ VALUATION , L $ �� LLCIL Contractor Date ALTER ❑ fr ❑ 1 am exempt under Sec. 'uf REPAIR ❑ $ Z BAP.C.for this reason DEMOL ❑ LDMA P/C# Date: USE OF EXISICNG BLDG. URM ❑ Signature APPLICANT(PRINT) TEL NO. LDMA Perm# i ❑ I, as owner of the property, or my employees with wages as Z 1 their sole compensation, will do the work and the structure is ADDRESS O AC:�T 'L not intended or offered for sale (Section 7044, Business and FINAL DATE a 'Tr 2 ? �^ ; acts 00 Pr fessions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL Vim' � 1.It a 1.I �s owner of the property, am exclusive) contracting Wifh OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Q y y g licensed contractors to construct the project (Section 7044, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY > 1 ITERS Business and Professions Code.) YES 11 No ElTOTAL 1-58 835 WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING G o � OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH LI �� Q� CONSTRUCTION LENDING AGENCY COAST AIR DUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKUST FOR CHECK 1.I.8_I GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ 140❑ CHANGE .00 the performance Of the work for Which this permit is Issued(Sec. 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 Lender's Name MATERIALS REPORTING AND FOR OBTAINING THROUGH M T FROM THE SSCC CONCERNING HAZARDOUS 0000-0001 1/10/96 Lender's AddressIr OWNER OR AGENT 4203 1 F M 12 p y/? 3 I certify that I have read this application and state under penalty a c of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE W with all county ordinances and State laws relating to building m construction,and hereby authorize representatives of this County ISSUANCE FEE y G' to enter upon the above-mentioned roperty for inspection purposes. �J/ Q y C� /'—/c,r INVESTIGATION FEE TOTAL FEE (J • U .7 cgeel a >AgeM Odle SEE REVERSE FOR EXPLANATORY LANGUAGE