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Home My Public Portal About9672 WEDGEWOOD ST_Building__ IBA63AA DBS-3 3-S5 APPLICATION FOR BUILDING PERMIT DIVISION OF BUILDING AND SAFETY ADDRESS Deportment of County Engineer County of Los Angeles LOCALITY .t WM.J. FOX. COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN. Sua'7 OF BUILDING CROSS ST. DISTRICT NO. GROUP TYPE EWBEIR MAP Pa FOR APPLICANT TO FILL IN r CONST. BUILDING } MAP STATE Y� ADDRESS iLJ-+( ' NUMBER �-r �'• HWY LOT NO. Q BLOCK USE ZONE SPECIAL l/ CONDITIONS TRACT Z NO. OF BLDGS. BUILDINGEXIST. SIZE OF LOT 3 S`� NOW ON LOT D SETBACK YARD HWY STREET NAME WIDTH USE OF FRONT EXISTING BLDG. / P L. (m OWNER / � l�j (° ,5 SIDE P. L. 1.x AMAIL DDRESS / O TRACT DWELL. 1 UNIT 5 INDUSTRIAL ARCHITECT OR TEL. 2 DUPLEX 1 UNIT 7 ADDN., ALT., ETC. ENGINEER NO. 3 APT. UNITS ADDRESS 4 COMMERCIAL _CONTRACTOR No' INSPECTION RECORD ADDRESS DESCRIPTION OF WORK '? NEW_ ADD A T-R REPAIR DEMOLISH SIZ FT. 5r_� STORIES FAMILIES WO. OF NO. OF SIZE TT�� UOF R CTURE - .. �y /y_re SIGNATURE OF �� *: % J ''.iI APPLICANT- ADDRESS PPLICANT ` APPROVALS . ADDRESS �'�J DATE INS CTOR'S SIGNATURE $ / �` FOUNDATION: LOCATION P. C. S J J fi FORMS. MATERIALS FEE Q QQ FRAME: FIRE STOPS. VALUATIONL LSC*' BRACING, BOLTS FEE !I< T FURNACE: LOCATION. ., 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT. DUCTS a' _ APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. LATH. EXT. SIGNATURE OF - r' - HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS__ FINAL WM.J. FOX,COUNTY ENGINEER VALIDATION C. N. DIRLAM. CHIEF BLDG. INSPECTQR 3038'L,L' MR 1 16 1 6.00 i ,io' x,3 7 4 7 '1AR 5 34.00 r APPLICATION FOR COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING PERMIT BUILDING AN S FETY DIVISION BUILDING FOR APPLICANT TO FILL IN ADDRESS BUILDING I., L ADDRESS CJ��.1 �U00 LOCALIT NEAREST CITY C ZIP CROSS ST. L O +— SSOR � SIZE OF LOT S3 ��/�IS S NOWONL MAPBOOKPAGE PARCEL �j DISTRICT I G YPE FIRE ESSED BY TRACT A 1 X1;3 IBLOCK I LOT NO. STEL. MIG/t OWNER / A►r� i NO. STATISTICAL CLASSIFICATION EWER P ADDRESS 672_ e LDep CLASS NO._3_/ DWELL,UNITS BKJ 11 PG CITY _1' USE ZONE MAP ZIP 1 NO. ARCHITECT OR TEL. SPECIAL ENGINEER Gu K C�'!I'/ NO. "Zi,(,✓ 'W- I CONDITIONS ADDRESS /313 W /1' ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONTRACTOR to" y N., *7} La:i APPLICATION FOR COUNTY OF LOS ANGELES T OF COUNTY '8 U I L D I N G PERMIT DEPARTMBUILDNG AND AFETY DIVISION ENGINEER BUILDING FOR APPLICANT TO FILL IN ADDRESS c BUILDING ADDRESS LOCALITY NEAREST .¢. CITY ZIP CROSS ST, f� ' NO.OF BLDGS. ,. ASSESSOR SIZE OF LOT NOW ON LOT L, MAP BOOK PAGE IPARCEL GROUP TYPE 111R ROCE ED BY TRACT Z l y S BLOCK LOT NO ��d CONS TEL (� OWNER &"NO. STATISTICAL C IFICATION S WER MA ADDRESS 7 /� lc�C� CLASS N DWELL.UNITS Bl/ G _,,j CITY - ZIP USE ZONE MAP d O ( NO. ARCHIT TOR TEL. SPECIAL ENGINEER NO. i) ON DI TIONS ADDRESS ROAD DE ARTMENT APPROVAL REQUIRED YES❑ NO ❑ CONTRACTOR f PA-71r NEELO, 2�289 BLDGS TBACK FROM. FRONTOP.LINE OF (STREET) LIC. ADDRESS _ TOTAL SETBACK FROM TYPE OF EXISTING 21063 NO, �� HIGHWAY YARD - HIGHWAY WIDTH CITY LIC• FRONT PROP. LINE %N/1 C `/ CLASS _ CONS RUCTION LENDER + a NAME AND BRANCH �- BLDG.SETBACK FROM c ADDRESS �- CITY SIDE PROP.LINE OF (STREET) E PEW SO. FT. NO. OF NO. OF CHECK HIGHWAY + YARD = TOTAL 5 BA M TYPE OF EXISTING C SIZE I Z STORIES )T FAMILIES ONE SIDE PROP. LINE4Q4.HWAY WIDTH DESCRIPTION OF WORK NEW 1:1 + r ADD CORNER CUTOFF YES ❑ NO ❑ Z ALTER ❑ REPAIR❑ IN OPEN SPACE YES ❑ NO ❑ USE OF IN COASTAL PERMIT ZONE YES ❑ NO ❑ EXISTING BLDG, EMOL ❑ APPLICANT - TEL (PRINT) III AL ACI! 0. �. BY (SIGNATURE) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF TME STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION INSURANCE. ' t, SIGNATURE OF FINAL ��r'27 PERMITTEE DATE ADDRESS V7 CITY ., NOL• - P.C. Fee$ Permit Fee Issuance Fee VALUATION �`� �� ` Total Fee `" PLAN CHECK VALIDATION CK M.O. CASH _ PERMIT VALIDATIO CK. M.O. CASH ca,,i EBJ:::; c.5 U 76A638A CE#8038 12/75 - O z $+� WORKERS'COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers'Compensation Insurance, or a certified copy thereof(Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING W17— �/�� !n 1:1Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS [[7 Certified copy is filed with the county building inspec- BUILDING _� tion department. ADDRESS 7 jrl� 91790 _f Date Applicant CITY _ ,,7 ZIP LOCALITY .Sd4L - 0 T CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST COMPENSATION INSURANCE 512E OF LOT NOW ON LOT 1�' iL CROSS ST. ,e S (This section need not be completed if the permit is for one ASSESSOR hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE I PARCEL TEL' USE Z E MAP OWNER r, _ NO. ��( 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 / SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS tO 1' ! CONDITIONS 0 Date Applicant Sz�Old•�7i'GL•-��i1 � dJ CITY ZIP NOTICE T APP ICANT: If, after making this Cer ificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O , Exemption, you should become subject to the Workers' ENGINEER NO. �-� � 2 CONSTZONE U Compensation provisions of the Labor Code, you must forth- ADDRESS £W W with comply with such provisions or this permit shall be Cn CONTRACTOR deemed revoked. 9kSTATISTICAL CLASSIFI Z TION APT. CONDO, LICENSED CONTRACTORS DECLARATIONLIC, CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY CLASS i BK PG VALIDATION SQ. FT. NO.OF NO.OF CHECK License Number Lic.Class SIZE ISTORIES FAMILIES ONE VALU, TIO�� v Contractor Date DESCRIPTION OF WORK F G - NEW ❑ $ U✓ ADD ❑ , I am exempt under Sec. O'G E ALTER ❑ B.BP.C. for this reason A2 Gce /t�kZ M c"/7 REPAIR $ Date: USE OF DEMOL EXISTING BLDG. ❑ Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION PRINT NO. DATE f `� Al O O Q 2 A 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS F # 0 0 0 0 0 Professions Code): PRESENT BUILDING ° ° 6 8 6 3 I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and ° ° ° 68.6 3 x the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. O 628-88u 28-8 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 FRO CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued PA. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name Lender's Address P.C. Fee$ Permit Fee /a LDMA Ref. p I certify that I have read this application and state that the Issuance Fee (/ �� EA P/C N above information is correct. I agree to comply with all County Investigation Fee / ` ordinances and State laws relating to building construction, Total Fee �b LDMA Perm. N d and hereby authorize representatives of this County to enter S upon the above-mentioned property for Inspection purposes. o fL'16}L ALT !L! 4 i LG sl SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant o Agent Dafe