HomeMy Public PortalAbout9700 WEDGEWOOD ST_Building__ 1ADBB•8
I1.55 APPLICATION FOR BUILDING. PERMIT ];
SS
DIVISION OF BUILDING AND SAFETY BUDRESS
ILDING
DepOStment of County Engineer AD (✓
County of Los Angeles LOCALITY
JOHN A.LAMBIE. COUNTY ENGINEER ]
NEAREST-
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST.
FOR APPLICANT TO FILL IN DIST 1 NO, GROUP TYPE SEWER MAP
�e^i p+�`0® �j CONS
BUILDING YE �NO
ADDRESS D O s f! .so NUMBER OO HWY
LOT NO. BLOCK UP20 SPECIAL IVO
1' �
-7 � CONDITIONS Iy
TRACT I :/. �� •
^/ x I a 't I NO.OF BLDGS.
SIZE OF LOT V NOW ON LOT BUILDING EXIST.
USE OF —• SETBACK YARD HW Y STREET NAME WIDTH
EXISTING BLDG. FRONTpa0 s�
P.L. F!
OWNER � �(� / SIDE
-MAIL
ADDRESS
( -P, WELL. i UNIT_ 6 PUBLIC BLDG.
ARCHIT CT OR TEL. 2 DUPLEX 2 UNITS
ENGINEER NO. 7 ADDN.,ALT., ETC.
3 APT. UNITS
8 MISCEL.
ADDRESS 4 COMMERCIAL
CONTRACTOR II,�? ��,, dr TEL L' ,!,/ INSPECTION RECORD
_ I v
ADDRESS �� f .�?y:-w°lr'.. l f•It A C
DESCRIPTION OF WORK =
eze-
NEW ADD ALTER REPAIR DEMOLISH
SO.FT IVO. OF NO.OF
SIZE STORIES FAMILIES
USE OF STRUCTURE 0` `` -
SIGNATURE OF ,-
APPLICANT C !���• ' APPROVALS
f
ADDRESS DATE INSPECTORS SIGNATURE
$ 27FOUNDATION:LOCATION a �
v+. � P.C. $ FORMS.MATERIALS � - S� 0
FEE FRAME: FIRE STOPS.
olUXT ONA0 D 4V Od BRACING.BOLTS
FEE FURNACE: LOCATION,
1 HER A KNOWLEDGE THAT 1 HAVE READ THIS GAS VENT. DUCTS f
APPLICATIO "D STATE THAT THE ABOVE IS.CORRECT
AND AGREE T. COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. / I �I �` ���f J.i.. rJ,.
AND STATE LAWS REGULATING BUILDING CONSTRUC-
TION. LATH. EXT.
SIGNATURE OF i} HOUSE NUMBER COR-
PERMITTEE �� e` RECT AND POSTED z
ADDRESS ^v P FINAL
JOHN A.LAMBIE,COUNTY ENGINEER Ti ON CLYDE N.DIRLAM. CHIEF BLDG. I SPECTOR
1 Cy MO CASH
_�4,C0 5 7 5,/6 PLAY '7 1 6 1 5.0`C Gb6 8 5 6Ln MAY 9 1 2.0 0
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76A63SA CE#6035-61 APPLICATION FOR BUILDING PERM1
COUNTY OF 'LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUIJNG AND SAFETY DMSION LOCALITY
.JOHN A. LAMBIE. COUNTY ENGINEER' NEAREST
WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROUP TYPE P SED BY-
FOR APPLICANT TO FILL IN CONST
BUILDING ,A/ _ f� 'A' STATISTICAL CLASSIFICATION - SE ER MAP
ADDRESS// d d 4 . t2 k �' vv�U CLASS.'NO.�.—DWELL.UNITS "� K PG
LOT NO. SO BLOCK WATER NOT REQUIRED RECEIVED
??77 CERTIFICATE:
TRACT dJ MAP (/HIGHWAY STATE O AL
/�/ NO.OF BLDGS. NO. �' O (CIRCLE) MAJOR SECOND,
_SIZE OF LO-K ) /V I NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
'EXISTING BLDG. �"
OWNER (GNO U BILING EXIST.
OYARD HWY STREET,NAME
WIDTH
ADDRESS !J i 1 FRONT q ,
ARCHITECTOR TEL. P.L. of }
ENGINEER NO. SIDE Z1•
ADDRESS
CONTRACTOR ( ,� �`�- NO r`yb" INSPECTION RECORD • �
0
ADDRESS T D S AA F 4�7/ J Y V
DESCRIPTION OF WORK
Z
N16 ADD ALTER REPAIR DEMOLISH
SQIE.FT.IZZ NO.OF NO.OF'
E STORIES FAMILIES
USE OF '
STRUCTURE
SIGNATURE OF ;�V D
APPLICANT
VALUATION$
APPROVALS DATE' INSPECTORS SIGH TORE
FEE $ FEE PMT.
$ ^6 " FOUNDATION:LOCATION'
FORMS;MATERIALS ✓% j� .J i ;���.
FRAME:FIRE STOPS,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACINGift
BOLTS /
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:LOCATION, _
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING-THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH;INT.
TION OF THE LABOR CODE OF.THE STATE OF CALIFORNIA RELAT. _
ING TO WORKMEN'S COMPENSATION INSURANCE LATH,EXT. _
SF�
IGNATURE O /'/J� HOUSE NUMBER COR- '
PERMITTEE ////,, RECT AND POSTED
ADDRESSFINAL p IeC. �y
CLYDE N.DIRLAM, PRINCIPAL STRUCTURAL ENGINEER
PIAN CHECK VALIDATION cK.' m.o. CASH PERMIT VALIDATION cK, M.O. cases
5 . .--%-04 7 1 'ODEC - 5 1 D 3'.0 0
WORKERS'COMPENSATION DECLARATION
ent to sel
insure,boraafcertif cafirm tharte of Worke s'tCompensation Insurance, A F p U CQV MROOM 3UILDING P N T LI IS
or a certified copy thereof(Sec. 3800, Lab. C.)
PoliryNo.RC�137886CompanyROYAT. JOBS 3717 COUNTY OF LOS ANGELES BUILDING AND SAFETY
BUILDING
1:1Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS r
® Certified copy is filed with the county building inspec- BUILDING 9700 PMDM700D ST. �
tioVITT
ca _ent. ADDRESS r LOCALITY
�� CISNEARESTDateAppCITY ZIP91780 CROSS 5T.
CERTIFICATE OF EXEWTIOQ FROM WORK NO.OF BLDGS. i ASSESSOR
COMPENSATIONVINSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
(This section need not be completed if the permit is for one USE ZONE MAP `, 26
TEL.
hundred dollars($100)or less.) TRACT BLOCK LOT NO. R/1 NO. r/
I SPECIAL >
I certify that in the performance of the work for which this OWNER JA Ng4Za CONDITIONS &
permit is issued, I shall not employ any person in any manner DISTRICT I
/► UP TYPE FIRE PROCRSSED BY O
so as to become subject to the Workers'Compensation Laws.
ADDRESS a , V Of� CONST. ZONE
Date Applicant CITY ZIP 72a91STATISTICAL CLASSI�N APT. CON
NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL.
Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS-
Compensation provisions of the Labor Code, you must forth-
with comply with such provisions or this permit shall be ADDRESS SEWER MAP
deemed revoked. BK. PG,TEL' 2 / VALIDATION
CONTRACTOR CAL-PAC ROOFgT1G No.
LICENSED CONTRACTORS DECLARATION LIC.
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO-3795C)3VALUATION
(commencing with Section 7000)of Division 3 of the Business and LIC. 5700.00
Professions Code, and my license is in full force and effect. CITY CLASS $
SQ. FT. NO.OF NO.OF CHECK
License Number 379503 Li,.Class B SIZE STORIES FAMILIES ONE
F $
ntracto DESCRIPTION OF WORK REROOF NEW 1
ADD
I a exempt under Sec. ❑';
ALTER �•_ FINAL
B. P.C. for this reason REPAIR DATE
USE OF +
Date' EXISTING BLDG. T DEMOL B N
Signature APPLICANT TEL. 1/
OWNER-BUILDER DECLARATION PRINT CAL-PAC ROOFII�IG NO800 548 54
I hereby affirm that I am exempt from the Contractor's License 2 5 5 O A
Law for the following reason (Section 7031.5, Business and ADDRESS UPOD]T DR.
2220 S. DAIQAHEIM
0 0 0 0 0 ,
Professions Code): PRESENT
❑ BUILDING 9700 INTE GETHOOD ST. o 087 ,38
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 ale(Section LOCALITY o 0 0 8 73,q x
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- 7,2 6 5
tion 7044, Business and Professions Code). ADDRESS 8
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
the performance of the work for which this permit is issued P.L.
tSec. 3097, Civ. C.). SIDE
o P.L.
v Lender's Name
x .
Lender's Address P.C. Fee$ Permit Fee
7f; R8
rI certify that I have read this application and state that the Issuance Fee
above information is correct. I agree to comply with all County Investigation Fee
ordinances and State laws relating to building construction, Total Fee 87.38
and hereby authorize representatives of this County to enter
u on the above-mentions pa�forspection purposes. SEE REVERSE FOR EXPLAWATORY LAPIGUAGE
Signature of Applican or Agenore ®s