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Home My Public Portal About9664 WEDGEWOOD ST_Building__ CE*863.10-96APPLICATION FOR -BUILDING PERIIIIIT 1 s BUILDING AND SAFETY DIVISION BUILDING ADDRESS .- Departnient of County Engineer �- County of Los Angeles LOCALITY OtLl JOHN A.LAMBIE. COUNTY ENGINEER NEAREST 001, CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. t . - s= DISTRICT NO. GR UP TYRE SEWER' MAP. -- FOR APPLICANT TO FILL IN l K PG CONsr BUILDING SS �J /� STATISTICAL CLASSIFICATION ADDRE CLASS.NO. DWELL. UNIT + LOT NO.- BLOCK MAP STATE ' YES NUMBER HWY TRACT 2. US Z NE SPECIAL NO.OF BLDGS. CONDITIONS SIZE OF LOT I NOW ON LOT " USE'OF EXISTING BLDG.- BUILDING YARD HWY STREET NAME EXIST. J SETBACK WIDTH OWNER FRONT - MAIL - P..L. ADDRES INSPECTION RECORD ARCHITECT O TEL. ENGINEER NO. ADDRESS CONTRALTO ADDRESS 06% ,_� C� r DESCRIPTION OF WORK � cv NEW ADD ALTER REPAIR DEMOLISH �`' /" NO.OF NO.OFSQE .ZFT USE OF STRUSTORIM FAMILIES CTURE n �. t! APPROVALS SIGNATURE OF �I APPLICAN' DATE INSPECTOR'S SIGNATURE FOUNDATION:LOCAT�AOIV 11 !{ ADDRESS FORMS. MATERIAL$+ �1.4-1 .-1 1 P. ! FRAME: FIRE STOPS. Z �� $ �Q O FEE C. $ .UJ BRACING.BOLTS C`i +� ( ' VALUATION $ ' O FGi48 VENT.DUAGTSN� � FE _ _ L l-HEREBY ACKNOWLEDGE THAT 1 HAVE READ TH-IS AP- LATH. INT! / 'PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH. EXT. STATE LAWS REGULATING BU LDING CONSTR ION. •, SIGNATURE OF - HOUSE NUMBER COR- PERMITTE / RECT AND POSTED• ti _ �' ADDRES FINAL - IOHN A.LAMSIE.COUNTY ENGINEER. CLYDE N.DIRLAM.PRINCIPAL STRUCTURAL ENGINEER PLAN CBE= VALIDATION m.o. CASH PERMIT VALIDATION cK: o.' CASH .. �_.ACo 3 41 6� ccT 16 1 6 2 4.2�5 e M x- -C � - LAGo 3 5 3 8fn ocT 21 4� -8.:5 0� � 76ASSSA-CGO 3-66 F BUlDI G PERM 'APPLICATIONOR L COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS _ BUILDING AND SAFETY DMSION L O C A L I T Y JOHN A. LAMBIE. COUNTY ENGINEER NEAREST COLEMAN-W.•JENKINSSUP'T OF-BUILDING CROSS ST. DISTRICT N U - TYF BY ' FOR APPLICANT TO FILL IN '` G OP.eco sT. _ BUILDING STATISTICAL SIFICATIONSE..W R MAP, ADDRESS {A�iC%G7�' ... CLASS NO. a DWELL UNITS BK PG LOT NO. BLOCK" USE ZONEMAP NO. VV TRACT SPECIAL 0. OF SLOGS. CONDITIO S SIZE OF LOT 'NNOW ON LOT . USE OF ' 1 N ��Gy�,� BLDG. SETBACK FROM OWNER S r1B7>. TEEL. FRONT PROP: LINE OF. (STREET) Q TYPE OF; EXISTING SETBACK NIOHW.AY 'I- YARD + = TOTAL ADDRESSq&&4 f.' 'HIGH Y M.C.L. ' CITY e6 BLDG. SETBACK FROM + _ ARCHITECT OF TEL. ENGINEER NO. BIDE PROP. LINE OR (STREET) TYPE.OR EXISTING SETBACK H.IGHWAY +- YARD _,= TOTAL ADDRESS yyg�� .{ HIGHWAY WIDTH FROM C.L. CONTRACTOR N TOE Lwt3{ + ADDRES5wq#A Met Nil NO I?Igift-1 CORNER CUTOFF YES No ❑ CITY - CICLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS a DESCRIPTION OF WORK NEW ADD ALTER -REPAIR DEMOLISH /r{j ,q SQ.FT. NO. OF NO. OF L7 /``P- " �T _— SIZE STORIES FAMILIES a - Afr USE.OF , '0 ` STRUCTURE il— aa��ww SIGNATURE O APPLICANT t 1 - i VALUATION$ i � i : 1 ��81®i ) ••00 pppROVAL$ DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION, LOCATION FEE$ FEE$ �t "- FORMS,MATERIALS '7 Tri FRAME, FIRESTOPS, 1 N HEREBY ACKOWLEDGE THAT. I 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-I WILL NOT,EMPLOY ANY PERSON IN VIOLA- _ LATH. INT. -' 'TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S COMPENSA .ERR E." • LATH. EXT. SIGNATURE O HOUSE NUMBER COR- PE#tM.ITTEE RECT AND POSTED ADDRESS �� Fl NAL JOHN �+F..�LEWIS. ■*PRINCIPAL TRUCTLIRAL.ENGINEER. PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VAIMATION CK. M.O CASH .2:0 0 WORKERc-',COMPENSATION DECLARATION of coent to self insure,or acertificate of Worke s'tificate Compensat on Insurance, APPLICATION FOR BUILDING PERMIT or a certified copy thereof(Sec. 3800, Lob. C.) r. PolicyN 2-3!267 Company_57-1.302--e- f0 ,0 BUILDING COUNTY OF LOS ANGELES BUILDI/NG AND SAFETY ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS r =EXEMPTION filed with the county building inspec- BUILDING ADDRESS D s LOCALITY moi' NEAREST Applicant CITY ZIP d CROSS ST. EMPTION FROM ORK S' NOf OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL hThis section need not be completed if the permit is for one Q� USE ONE MAP J `/ C undred dollars($100)or less.) P TRACT p BLOCK LOT NO. 0 NO. ! `Y 7 Z TEL. SPECIAL 7- I certify that in the performance of the work for which this OWNER �uI>7 NO. CONDITIONS IL permit is issued, I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE ESSED BY O so as to become subject to the Workers'Compensation Laws. ADDRESS A",t ` `'� CONST. ZONE Date Applicant at CITY ZIP STATISTICAL CLASSIFICATION APT. CONDO. U NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. ENGINEER NO. CLASS NO. DWELL.UNITS NM,Exemption, you should become subject to the Workers' IL Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be � TEL, /,V VALIDATION deemed revoked. CONTRACTOR F, NO. -koro BK. PG, LICENSED CONTRACTORS DECLARATION 0do NO.LIC. 1 hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS` -1 VALUATION (commencing with Section 7000)of Division 3 of the Business and 12� LIC. C� Professions Code, and myw �license is in full force and effect. . CITY CLASS 3 / $ , SQ. License NumberY�1 / Lic.Class r SIIZE� �D� STORIJNO.OES QFA��MILLIIES CHECK ONE r- r DESCRIPTION OF WORK -iNEW ❑ $ Contractor Date' � $� 1 am exempt under Sec. d �2�q ��Tf f ADD ❑ ALTER ❑ FINAL B.BP.C. for this reason ,W qXREPAIR ❑ DATE '! USE OF FINAL Date: EXISTING BLDG. DEMOL ❑ By Signatur APPLICANT TEL. OWNER-B DER D LARATION PRINT NO. / I hereby affirm that I am exempt 46m the Contractor's License , Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): PRESENT 1:1 1, I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH , I hereby affirm that there is a construction lending agency for FRONT 0 4 9 A the performance of the work for which this permit is issued P.L. tSec. 3097, Civ. C.). SIDE I # o o ° o 0,1 c P.L. ? Lender's Name I ° 1 2 4,8 8 3 P.C. Fee$ Permit Fee 11V, 3 i ° ° 1 21L 8 83 Lender's Address rI certify that I have read this application and state that the Issuance Fee G• -�� i 0 s 1 8`8 8 I above information is correct. I agree to comply with all County Investigation Fee �j 3 ordinances and State laws relating to building construction, Total Fee Z • �O 9 and hereby authorize representatives of this County to enter uPon a above-mention. roperty for. spection 7pose . ; g9, SEE REVERSE FOR EXPLANATORY LANGUAGE ; Sig re of plicant or Agent Date ea t