HomeMy Public PortalAbout9888 WENDON ST_Building__ DIVISION OF SVINNG AND SAFETY
* Department•of County Engineer BUILDING
County of Los Angeles OCT 15 15152 APPLICATION
WM- J. FOX,`COUNTY ENGINEER
FOR 1kPPI:ICANT TO FILL IN FOR OFFICE USE ONLY
^ q� DISTRICT NO. PLAN NOOK.OR�RREG.No. PERMIT NO.
BUILDINGADDRESS l� �� VI ����''t-FG�/!/l� 5' V 3 J d I Z 7
LOCALITY SA/V Ar LA�A" YL - il Vv� RE E VED Y DATE OF APPL. DN EST 16—lo
AT ISSUED
CR08SST. BUILDING '
ADDREBBP01
OWNER _ t
MAIL L�{DALITY
ADDRESS /_. - Y Al 1 EAREST Cl
tCROHa ST.
CITYLLLL L/4i / TO. �� 'i FIRE NO.OF JL I TYPE I GROUP T
ZONE ` PLANS �4
ARCHITECT OR TEL
ENGINEER NO. BLDG. RD. NO.
BET®ACK LINE 6
ADDRESS APPROVED
CONTRACT /� .yelf� ��" �,A ( 'ZONE BY DATE
HUBE NUMBERING
O
ACCESS �� ,� �IIJ / � MAP NUMBER- � � NO. ASSIGNED BY
XIW CORRECTIONS
DESCRIPTION /9LOT/{NO.. 1,BLLOrCK
TRACT �V (/
SIZE OF LOT .� I NOW ON LOT&rbH.
' V
USE OF I NQ OF
EXISTING BLDG. FAMILIES
DESCRIPTION OF WORK a
NEW ALTERATION ADDITION
REPAIR � DEMOLITION
SQ.FT. NO.OF Y?Ac3D '/ f)1 e�h',i'� !a/1C�f u
SIZE �� ROOMS STORIES I ,��/IF,f7`F/a, 70
EXT.WALL f ROOF
COVERING tip✓ I COVERING b° � iC brACd/jGHlMs�n+y'
UBE OF STRUCTURE �/1sy.L��'�
7 U t /Al 7-D r✓C-1 d A1.7' _ lqe- ',O
291 f� /.l'T �'�`Vii'�+�7 �"1C.�'�f a f. .Yi •7' n�.]i� a t,;,1
INBPECTI FOR / n APPROVALS /2-/ Co 1U 6Z
t.:P:-,INSPECTORIBBIGNATURE DATE(aft
FOUNDATION: LOCATION`'� -/ � r r1, 7�
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP-" FORMS, MATERIALS -�•� 1, I G/ 7 .
PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRE BTOPB,
CORRECT. BRACING,BOLTS
ANDEn
AND STATE LAWS REGULATING BUI DOING ONO AGREE TO COMPLY WITH ALL TRUOTION.
FURNACE. LOCATION,
GAS VENT,DUOTS
r
BIGNATURE OF LATH, INT.
PERMITTP y
/� ,_ Gam(f� - r LATH, EXT. V �%
ADORES '�+ �/
J � 1. /� PLASTER, INT.
AUTHORIZED AGT. 'E �/ � " � ®I
//coo p O y� FEE HPLASTER, EXT.
q C.!B y. OUSE NUMBER COR-
�s FRECT AND POSTED �A VALUATIO D FEE �; FINAL
yv-p
\76AG38A G8B3 1-82
WORKERS' COMPENSATION DECLARATION
hereby affirm that I have certificate of consent to self APPLICATION FOR BUILD IJV G PERMIT
insure, or a certificate of Workers' Compensation Insurance, I
or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES ,•BUILDING AND SAFETY
Policy No. Company BUILDING
❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN y �y ADDRESS ���
❑ Certified copy is filed with the county building inspec- BUILDING
e�e.(R! ���V / /rs�
tion department. �/
Date Applicant CITY % Z� C1Tj ZIP O LOCALITYNO OF BLDGS.
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT sJf✓ NOW G��ON LOT NEAREST
CROSS ST.
COMPENSATION INSURANCE ASSESSOR
(This section need not be completed if the permit is for one TRACE ��� BLOCK LOT NO. MAP BOOK PAGE PARCEL
hundred dollars ($100)or less.) r TEL.g USE ZONE MAP
OWNER NO!5 �� NO. / �� ca
1 certify that in the performance of the work for which this �r
permit is issued, I shall not employ any person in any manner ADDRESS �l�Gnjy li �!�^ `� CONDITIONS EL
so as to become subject to the Workers'Compensation Laws. �y/,` pay Q
CITY/v c `/y <10 ZIP %,0179 V
Date Applicant ARCHITECT OR TEL. ad
FIRE
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. DISTRICT GROUP CONST ZONE ZONE PROCESSED BY Q
Exemption, you should become subject to the Workers' f� 0
Compensation provisions of the Labor Code, you must forth- ADDRESS •99 -� V J L a
with comply with such provisions or this permit shall be G TEL. N APT. .
CONDO
STATISTICAL CLASSIFICATION
deemed revoked. CONTRACTOR / ` NO. CLASS NO. DWELL. UNITS-
hereby
LICENSED CONTRACTORS DECLARATION ADDRESS NO.
I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP
(commencing with Section 7000)of Division 3 of the Business LIC.
and Professions Code,and my license is in full force and effect. CITY ��)) //� CLASS BK PG-.6 f VALIDATION
License Number Lic. Class SIZE�1 70 STORIIEES (f/V� FAMILIES Oil/ ONE
K
VALUATION
Contractor Date DESCRIPTION OF WORK� NEW ❑ is0
<ji O �O"� �v® ADD ❑ IN
V
Elam exempt under Sec. ALTER y❑�
BAP.C. for this reason cO , r1� /el r L 6- REPAIR,LrSI I$
USE Date: EXISTING BLDG. ®���� DEMOL ❑
Signature APPLICANT TEL. �J
g OWNER-BUILDER DECLARATION (PRINT) �Laa4E� / NOO��y p� DA EFINAL i
I hereby affirm that I am exempt from the Contractor's License ADDRESS�����/j lir (� ���7
314
Law for the following reason (Section 7031.5, Business and FINAL
P,iofessions Code): PRESENT BY __
I, as owner of the property, or my employees with ADDRESS
wages as their sole compensation,will do the work and R _
the structure is not intended or offered for sale(Section LOCALITY __ `• '�:■
7044, Business and Professions Code.) MOVING TEL. ; r
❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO.
with licensed contractors to construct the project (Sec- `+-+' A' -t•�_- _
ADDRESS i_ q_p o e�
tion 7044, Business and Professions Code.) i
REQUIRED TOTAL SETBACK FROM EXIST. �'! t''% C:;
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 't��-='' S-■'�'=
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. =•FtH'i3t .t(_
(Sec. 3097, Civ. C.). SIDE
P.L.
Lender's Name I ,'_I-tTI' - • =/,��
3 fi (DMA Ref. # i-(+_ r s .4 _
Lender's Address P.C. Fee$ Permit Fee •�CJ _v-, Al
' I certify that I have read this application and state that the Issuance Fee 76 LDMA P/C#
above information is correct.I agree to comply with all County Investigation Fee /
3 ordinances and State laws relating to building construction, Total Fee `d. 46 CDMA Perm. #
c and hereby authorize representatives of this County to enter
��upon the above-mentioned pry erty for inspectio /pur ses. i
^ jt.Z � V Q��� SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent Date i