HomeMy Public PortalAbout5606 WELLAND AVE_Building__ 76A630A CE 11803 1/7APPLICATION FOR BUILDIN PERM1�%�
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER :MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION .BUILDING t 0�
ADDRESS
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COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY 1.0'
FOR APPLICANT TO FILL-IN NEAREST -
Print or tvDe only) CROSS ST. /
TYPE
BUILDING ��G �/. (��;���q�v j? �C�G�T 1 DIrSrTRICT,I{��0,. G,$IdCJP CONST. PRO
ADDRESS 'rE O.L a 7- �OS'r�b/ �/ �V Y
LOT NO. BLOCK STATISTICAL CLASSIFICATION SEWER MAP
CLASS NO. g�21' DWELL,UNITS B PG
TRACT USE ZONE MAP O
NO.OF B �j NO.
SIZE OF LOT NOW ON LOT
J SPECIAL
USE Ot��Z'q"PG CONDITIONS
EXISTING BLDG.
T EL.
OWNER ,�. LC9j�T�G'/� NO. 8' G BLDG.SETBACK FROM
ADDRESS 9'� �ll�?/o b �/�/(� FRONT PROP,LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
CITY �jcP/ /if/' �t� C; HIGHWAY WIDTH FROM C.L.
ARCHITECT OR TEL. +
ENGINEER NO. BLDG. BACK FROM
ADDRESS SIDE PROP. F (STREET)
TEL. TYPE OF EXISTING SETBA HWAY + YARD = TOTAL C
CONTRACTOR NO, HIGHWAY WIDTH FROM C.L.
ADDRESS NO + C
LIC. [—
CITY CLASS CORNER CUTOFF YES ❑ NO {`L
CONSTRUCTION LENDER 11, u
NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS E
ADDRESS
SQ. FT. NO. OF NO. OF NEW ❑
SIZE STORIES FAMILIES
USE STRUCTURE�dG HGVS eAo'4 y]ALTER
ADD ❑
❑
SIGNATURE OF / ---REPAIR[
APPLICANT DEMOL ❑
VALUATION S `✓�rJ� APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. FOUNDATION: LOCATION
FEES FEES �� �� FORMS, MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI'C'ATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED ,
HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR INT.
LABOR CODE OF TH TATE OF ICALIFORNIA IN RELATING TO
WORKMEN'S COMPEN A7 IN RANO ESQ \ LATH, EXT,
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE
RECT AND POSTED
ADDRESS 6r'dz
FINAL
JOHN F. LEWIS. PR CIP L STRUCTURAL E NEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VA ATION cK. N.O. CASH
U-Lo 3 5. 9 'WV 22 1 -D 9.0 0-. 1
DEPARTMENT OF BUILDING)AND SAFETY I "rL'L%iA L Lum X va ryaaa as a
COUNTY OF.LOS ANGEELES BUILDING
WIM. J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
ADD EIN Nos A DISTRICT NO. PLAN OK.NO. PERMIT NO.
7A 07/
LOCALITY p 1 ' q'�) Ir` � (/ RECEIVED BY DATE OF APPL. DATE ISSUED
NEAREST . A �' �y �Q= �-A � 7 % � "l
r ADDREBUILDSS Y w7 v Sv VV Al 1 Nt/
OWNER �/MAIL /(P rd �q- �B .
ADDRESS (ad/'�l�1J �j �lgJ LOCALITY `f0'1( �pq
y� ,•, ,q U TEL CROSSST
NrARE ST. !�. A .moi / �/i A S 1
CITY vA F NO.
ARCHITECT OR //Jy //� � a Q TEL ZONE •��� PLANS I TYPE V 1/ GROUp �o
ENBINEER b 4Gd//l NO.
• BLDG. /D ( � /ORD.NO.
ADDRESS SETBACK LINE
APPROVED
CONTRACTOR A � 'r/ NO. BY DATE
USE APPROVED
ADDRESS ZONE BY DATE
LEGAL
DESCRIPTION I LOT NO. ® I BLOCK. CORRECTIONS
/�
TRACT f±5 9 6-
SIZE OF LOT !Y I NOW ON LOTUSE OF
EXISTING BLOB.At FAMILNO.OIES ROOMS
DESCRIPTION OF WORK
NEW ALTERATION X ADDITION O
A
REPAIR MOVING DEMOLISH p
Sq.FT. {7�' NO.OF �a / Z
SIZE ®�/, ,s. ROOMS a3v STORIES / r
WALL r /J ROOCPn'1
F
COVERING rl�it.,/.91 COVERING 100
USE NEW �� �
BUILDING A
`/ wL1- h `...'._ _-•.
//1.•...��'-•�C_'Y.')(fin"��/
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVU-S
APPLICATION AND STATE THAT THE ABOVE IS CORRECTINSPECTOR ATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION:LIGATION D
FORMS, MATERIAL
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
/r FRAME: FIRE STOPS,
SIGNATURE OF BRACING,BOLTS
OWNER d� LATH,INT.:
AUTHORIZED AG Lr�'' '�
LATH,EXT.
DBS-3 25M SLTS:-a7 $ C.R PLASTER.INT.
$ cp FEE �
`- PLASTER,EXT.
6 O
/O�O
VALUATION FEE + •. FINAL• r ��
DEPARTMENT OF BUILDING AND SAFETY arrLiUattuN rvx rxxivui
COUNTY OF LOS ANGELES
WM.J.FOX, CHIEF ENGINEER BUILDING 1
NO. OF m BLDG. ORD.NO. DISTRICT NO. PLAN CK. NO. PERMIT NO.
PLANS SETBACK LINE e.
FIRE a APPROVED
ZONE BY DATE RECEIVED BY DATE OF APPL. DATE ISSUED
USE APPROVED �j
ZONE091 BY DATE %` o 2-0— �,
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
BUILDING
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O E NAME /'/ ADDRESS V S ( / -
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W Z ADDRESS / LOCALITY (�[ •,/��1�°1
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z NEAREST `
W W CITY CROSS ST.
Q STATE TEL.
LICENSE NO. NO. E NAME
® z MAIL
E NAMEo / O ADDRESS
O
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Q ADDRESS CITY /mss" NO.
E /•
I- 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
Z CITY APPLICATION AND STATE THAT THE ABOVE 1$• CORRECT
U STATE TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
LICENSE NO. yy �j NO. G AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
Z LOT NO. Pi O SIZE OF LOT A�/� SIGNATURE OF ,
OWNER
//�� NO. OF SLOGS. �� { �
a�• BLOCK /7 NOW ON LOT �+ AUTHORIZED AGT.-` 111•••`.-1 J`�--� r^•.
wu
0 r �a Q
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W
O USE OF SLOGS.
NOW ON.LOT1.�1�`y�. I.aA /
DESCRIPTION OF WORK 11 I a , f1 i��,r1 QV
USE OF X 1
BUILDING
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X
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NEW TYPE GROUP
ALTERATION ROOMS FAMILIES
ADDITION SIZE �]
REPAIR STORIES I ((JJ �•� f /
MOVING WALL COVERING ,pLJfsnN><y �'y .%
DEMOLISH ROOF COVERING ��YW�I/I , �`'• v
P.C.$
FEE .\,\FINAL APPROVAL
$ V1Tj �/ INSPECTOR'S
VALUATION 999 FEE `� DATE I NAME
UZYAS1 XZXT OF BUILDING AND SAFETY J%rra.awa a avr r w&L rsS"Vaa A
COUNTY OF LOS ANGELES BUILDING
' a ® �
1NM. J. FOX. CHIEF ENGINEER ■■1
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING �j 6 j� / DISTRICT NO. PLAN OK.NO. PERMIT NO.
ADDRESS c.� V, // EZI A AM �L 4 � � � � IRS,
LOCALITY —nLl" !- t f RECEIVED BY DATE Or ADPL. DATE IBBUED
CMEA Ear If RCA
OBBST. � / Gl� &A-le � �5 /�� ®
�r / ,/ ` BUILDING
OWNE:/?irint f 94 /1e�MAIL 'G / Z � ADDRESS
ADDRS "' E /� J1/ LOCALITYf ryNEARESTG v-�� 0CITY �h �` / G/ NO.9+�f9 � "fFD CROBB ST.
ARCHITECT OR TEL. ZONE PLANE FIRE C.Ur TYPE & BROUP
ENGINEER NO.
BLDG. ORD.NO.
ADDRESS SETBACK LINE
,,QQ�� APPROVED
CONTRACTOR f6 d/A/L EZ� NO. BY DATE
USE APPROVED
ADDRE88 ZONE BY DATE
LEGALy CORRECTIONS
DESCRIPTION a LOT NO..d BLOCK
T
TRAC /V ppt9 O
s� __t71I- w
NO OFBLDG
SIZE OF LOT IS �C •)J�. I NOW ON LOTS ac—�
USE OF ..�+ NO.OF r NO.OF
EXIBTINB BLDG. �i 6i FAMILIES - ROOMS I7�
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
B
REPAIR MOVING DEMOLISH p
Sq.FT. 7 NO.OF s
SIZE K ROOMS STORIES r
WALL ROOF Oe,-Al
y
COVERING COVERING 1-G/II Of)
USE NEW
BUILDING
i
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROV S
APPLICATION AND STATE THAT THE ABOVE IB CORRECT INS COT DAT
FORMS,MATERIALS LOCATION E
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES F /
FORMS, �
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
/
FRAME:FIREv
51GNATURE OF� /�-LJf� BRACING.BOLTS
PERMITTED 01,v-• �" F LATH, INT. -
LFINAL
ORIZED AGT- LATH, EXT.
BA-3 2-50 $ N ..�, ,C, PLASTER.1 NT.
® � FEE PLASTER,EXT.
ATION R
FEE
J Dao u."asm SETS APPLICATION MR PNRRl r.V
DEPARTMENT OF BUILDING AND SAFETY ��������
COUNTY OF LOS ANGELES
WM. J. FOX, CHIEF ENGINEER
NO.OF��
BDG. NO.. DISTRICT NO. PLAN CK. NO. PERMIT NO.
PLANE SETBACK LINB 5 G ?J g
FIRE / APPROVED 1
ZONE Ll M BY DATE RECEIVED BY DATE-OF APPL. DATE ISSUED
ZUBEONE { APPROVED \By - DATECtH , M �4 14- 4'y"
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
BUILDING
Q E NAME \ "•. . ADDRESSUl
c� 7 YV E ^L�hl D
y W ADDRESS LOCALITY E L. M O w-r E ..]J I S TR I CT
Z
NEAREST
U Z CITY CROSS ST. L 'S -To IY R S
STATE \T ,�pp �-�-n l r F`( S S L L
LICENSE NO. NO.•. NAME C.
ZMAIL
E NAME A), ADDRESS S A M
- 3
h 0
TEL.
ADDRESS //!/' CITY NO.
O CITY r\ �j i 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
U
STATE /T TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
LICENSE NO. p NO. AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
ZO LOT NO. Z O SIZE OF LOT n� �( 7-01 SIGNATUREOWNER
OF
I E BLOCK A NO. OF BLDGS. X �' AP/-1-4�r •a,/�
Q NOW ON LOT a AUTHORIZED AGT. _
� CORRECTIONS , l;
. ,� TRACT O 6y � I �l 2` �L•.�i J
G USE OF BLDGS. ``tea' �-t I
NOW ON LOT �Vf E LL1 tJCzS .•�f�l"'1r4 �. i f _
DESCRIPTION OF WORHW/I4 ,� 1 �� = ,
USE OF
BUILDING - X 2 o r`a- S E n R o o MS)
o I p- I hn/Com•
I
Tnis constriction may Pe In vio anon O
War P iIr i n Board ordprs. Yon0
cautioned to con;-Lilt Frith your local Waj W
L./
rl 'LL�.lLU11U.:d-U Vu.L.;J d nv LL A
La ,G,,./
ing the work awhorizcd in this Permit a
r
NEW TYPE wt GROUP
NO.OF NO.OF I
ALTERATION ROOMS LI_ FAMILIES
ADDITION i/ SIZE Z� d
REPAIR STORIES 4
MOVING WALL COVERING cS 1 D 1 IY�S' �-ST l) 200
DEMOLISH ROOF COVERING COMPO
$ FEE $ FINAL APPROy7AL
VALUATION U O r Q Q FE6 6 /{ " INSPECTOR' .:
ri�ATE y I NAME_
o
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDINr2,�_ DR SS J At 19 BUILDIN AD ESS S O w C�V, It
I hereby affirm that I have a certificate of consent to self insure, �,... � � � N�
or a certificate of Workers'Compensation Insurance,or a certified CITY � ZIP
copy thereof(Sec.3800 La .C.) � b ' -QUI Lf�r LOCALITY _
Policy No. d Company SIZE O LOT G� N .OF BLDGS NOW ON LOT
❑ Certified copy is hereby furnished. NEAREST CROSS ST.
❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. I V& U
depart ent. c1 USE ZONE MAP NO.
Date I1M, Applicant C3N - � ASSESSOR MAP BOOK PAGE PARCEL
SPECIAL CONDITIONS /��j ✓J O/
CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER _ TEL NO.
COMPENSATION INSURANCE �}C.C� L� A/� WITHIN 1000 FT.OF SCHOOL? YES NO
(This section need not be completed if the permit is for one hundred
ADDRESS
�`-I� DISTRICT GROUP I TYP ONST. FIRE ZONE PROCESSED BY
dollars($100)or less.)
CITY ZIP
I certify that in the performance of the work for which this permit _
is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO.
become subject to the Workers'Compensation Laws. STATISTICAL CLAS IFICATION APT CONDO
Date Applicant ADDRESS CLASS NO. j 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 TEL NO. , SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor Code, you must forthwith � � C-U/� FRONT
�7Y/
comply with such provisions or this permit shall be deemed revoked. A DRESS /� N LIC NO �Z� P L
LICENSED CONTRACTORS DECLARATION 1r• ' A. f SIDE
CIT �� LIC.CLASS `� P L
I hereby affirm that I am licensed underprovisions of Chapter 8 7 ( ,y SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and SO. I NO.OF STORIES NO.OF FAMILIES NEW LJ
Professions Code, d my license is in full force and effect. BK PG , d
License Number j DES R ION OF WOR ADD ❑ VALUATION
Z Lic.Class 0
Contractor Date l t ALTER ❑ $ �/ ���
111 am exempt under Sec.
REPAIR ❑ $ O
BAP.C.for this reason DEMOL ❑ LDMA P/C# W
Date: USE OF EXISTING BLDG. URM ❑
Signature APPLICANT(PRINT) TEL NO. LDMA Perm# z
❑ I, as owner of the property, or my employees with wages as Z
their sole compensation, will do the work and the structure is ADDRESS
not intended or offered for sale (Section 7044, Business and FINAL DATE II �/ \{/ _ --
�—1 f��J 1T�r-.I1�
Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL L I I LI I:
OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE n �.
❑ 1, 8S owner of the property, am exclusively contracting 4AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 5 .�)�j T AL •;:0 6� 0
licensed contractors to construct the project (Section 70444,, ves❑ No❑ -
Business and Professions Code.) CHECK �!':' 'f
WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING EC t -:n�'
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH r^I,-
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR %CHA N.GE ■
GUIDELINES
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.
0 I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING - -L 1-I
3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, Cull1_-4 I, ,a 2
TITLE 2,CHAPTER 2 20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS
z Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. .i i FM I
O Lenders Address
0 OWNER OR AGENT ^
c I certify that I have read this application and state under penalty
of perjury that the above information is correct.I agree to compl ���G
y P.C.FEE PERMIT FEE
N with all county ordinances and State laws relating to building
mconstruction, and hereby authorize representatives of this County ISSUANCE FEE ���
a to enter pon the ove-m tioned property for inspecti n pu oses.
m �C INVESTIGATION FEE TOTAL FEEqf
/D�•
s97Ap'ry
SEE REVERSE FOR EXPLANATORY LANGUAGE