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Home My Public Portal About5012 WILLMONTE AVE_Building__ low ,6A696A C8#809,0.88 APPLICATION FOR BUILDING PERMIT 1 COUNTY OF LOS ANGELES BUILDING �•) DEPARTMENT OF COUNTY ENGINEER ADDRESS CJ BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN,SUPT OF BUILDING CROSS ST. + =•+ +• ::• DISTRICT NO. I GROU � PRO SSED B FOR APPLICANT TO FILL IN J I CONST.- I BUILDING -D J , STATISTICAL CLASSIFICATION SEWER MAP ADDRESS / BK PG �, J CLASS.NO WELL.UNITS MAP STATE LOT NOS NUMBER G` HWY. YES USE ZONE SPECIAL TRACT i ! CONDITIONS NO.OF.BLDGS 4 SIZE OF LOT _ I NOW ON LOT USE OF EXISTING BLDG. BUILDING YARD HWY STREET NAME EXIST. SETBACK WIDTH OWNER ev LCI j FRONT –0 MAIL ,�++,, , r P.L. 610 ADDRESS V I ,SIDE P.L. c►TY (s ITvo _ INSPECTION RECORD ARCHITECT O jj TE _ ENGINEER J' , .NO, p ADDRESS CONTRACTOR <--r NOL . , .r/•� TNS rr S.C. XRt!6y-t= Vts.t'T rj ADDRESS �- DESCRIPTION OF WORK ? Q'7 c EW ADD ALTER REPAIR DEMOLISH y SIZET. – NO.OF NO.OF e/a 1 J r 6#Q�n2/�.►c- ��;s'cTv STORIES FAMILIES USE OF Q r S•p� D av STRUCTURE SIGNATURE APPLICAN APPROVALS DATE INSPECTOR'S SIGNATURE ADDRESS �LJ FOUNDATION:LOCATION K FORMS,MATERIALS VALUATION$ FRAME:FIRE STOPS, BRACING,BOLTS FEE $ . .�Ga PMT FURNACE:LOCATIO GAS VENT,DUCTSN. FL-7-'1174 1 HEREISY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH.INT. L PLICATION AND STATE THAT THE ABOVE IS CORRECT AND STATE AGREE LpCOMPLY ULATINGG UOL-N NG COTY ST ORDINANCES CTS N. LATH,EXT. —J— SIGNATURE OF / HOUSE NUMBER CORS PERMITTE RECT AND POSTED $`+� l¢C1 C ADDRESS - , FINAL u CLYDE N. DIRL`AM,PRINCIPAL STRW&VRAL ENGINEER PLAN CHECK VALIDATION CK.. M.O. CASH PERMIT VALIDATION V M.O. CASH 8 3 9 5 9EC 2 3 A 2 4.0 C ',�,8396ff-N) 0EC 2 1 A 48.00 WORKERS'COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT 1IS� insure, or a certificate of Workers'Compensation Insurance, or a certified copy thereof(Sec. 3800,Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company lc.Jzo.rs�_:. Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ' BUILDING ADDRESS I Certified copy is filed with the county building inspec- BUILDING L tion department. ADDRESS y LOCALITY NEAREST Date Applicant CITY ZIP CROSS ST. CERTIFICATE OF EXEMPTI FROM WORKERS' NO.OF BLDGS. ASSESSOR -01" COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT t MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP hundred dollars($100)or less.) TRACT BLOCK LOT NO. NO. TEL. SPECIAL >_ I certify that in the performance of the work for which this OWNER NO. CONDITIONS G. permit is issued, I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE PROCESSED BY O so as to become subject to the Workers'Compensation Laws. ADDRESS CONST. ZONE U ,, g5 Date Applicant CITY ZIP STATISTICAL IFICATION CONDO. d 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 916 Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP IV) with comply with such provisions or this permit shall be �p g .n e. g deemed revoked. CONTRACTOR O&.GJ NO.e�.o BK. PG, VALIDATION LICENSED CONTRACTORS DECLARATION LIC, I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS'q014 NO VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. of Professions Code,and my license is in full force and effect. CITY CLASS $; ► SQ.FT. NO.OF NO.OF CHECK License Number !t 2Z( >_Lic.Class 0-:32 SIZE STORIES FAMILIES ONE ✓f� ~7f. C� c� DESCRIPTION OF WORK NEW $ Contracfo•��'��fs-»_ L- to L 6 T ADD �"�E n ----r�T I am exempt under Sec. ALTER FINAL , B.BP.C. for this reason REPAIR DATE USE OF FIPIN Date: EXISTING BLDG. DEMOL ❑> ' Signature APPLICANT TEL. ' 1#11ER-1131.11LDER DECLARATION PRINT NO. I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): 'PRESENTC,' n ❑ BUILDING I, as owner of the property, or my employees with ADDRESS 0 0 0 0 0 wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY C a o S•E• 7044, Business and Professions Code). MOVING TEL. I,as owner of the property,am exclusively contracting CONTRACTOR NO. i 0.0 067 5_ with licensed contractors to construct the project (Sec- ADDRESS F_ R 11 tion 7044, Business and Professions Code). ADDRESS C REQUIREDTOTAL SETBACK FROM EXIST. 1 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 P.L. i e Lender's Name aP.C.Fee$ Permit Fee Lender's Address 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 i ordinances and State laws relating to building construction, Total Fee and hereby authorize re resentatives of this County to enter upo he above-meT1 property for inspection purposes. o $' SEE REVERSE FOR EXPLANATORY LANGUAGE Signatu of Applicant or Agent Date as WORKERS'COMPENSATION DECLARATION' hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT ILIS insure, or a certificate of Workers'Compensation Insurance; or a certified copy thereof(Sec. 3800, Lab. C.) 'I COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy A-1 /. CompanyOnl't, BUILDING ,� f Certified co is hereby furnished. ADDRESS So jZ P W 1 L-_'mON M �Z4 copy y FOR APPLICANT TO FILL IN � / �( Certified copy is filed with the county building inspec- BUILDING.�^ s i y�� L�.c1�llon department. \ ADDRESS 91Z /v w,u—mO/�p7� LOCALITY`�f�v1Q�YL�L% "?7-y ` 1' Date 5I ApplicantACITY ! Z I ZIP l p 0 CROS NEARECERTIFICATE T. L-ow rr- CERTIFICATE OF EXEMPTIO FROM WORKERS' NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one A Q� USE ZONE [SPECIAL P hundred dollars ($100)or less.) \R TRACT O�v BLOCK LOT NO. 025 / !� TEL. p 0 f I certify that in the performance of the work for which this OWNER L�-� N 3 &39 NDITIONS d permit is issued, I shall not employ any person in any manner DISTRICT GROUP TYPE ADDS CONST. FIRE PRO ESSED BY O RESZONE u so as to become subject to the Workers'Compensation Laws. _ _5 PIZ Date Applicant ` CITY ZIP STATISTICALCICATION / 'APi. CONDO. 11- NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DWELL. UNITS• f Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO._ G, Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be deemed revoked. CONTRACTOR ` _1Q ]� L02 �TEL 3S�t�sp BK PG 6 VALIDATION LICENSED CONTRACTORS DECLARATION LIC, ��r I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS�l 7 W �/4�Zi4 NO.3 J 9 77 VALUATION (commencing with Section 7000)of Division 3 of the Business and / LIC. Professions Code,and my license is in full force and effect. CITY G CLASS Ae $ R SQ.FT. NO.OF NO.OF CHECK License Nu/mbet,55% Lic.Class SIZE STORIES FAMILIES ONE Contractor7_-L/�yL-P� Date ^ \' DESCRIPTION OF WORK Ej(/677 NEW ❑ $ ❑ 1 am exempt under Sec. � ) W 6 a� &Mb (56 t/IFF- /e D ADD Iroi c �C /� p LTER ❑ FINAL } - o•_ 0. 1 P B.&P.C. for this reason S�rQ�� 5 f" r I EPAIR ❑ DATE:�G( Z_er O O O O 2 v .' USE OF /� Date: _F]S DEMOL C] By AL ISTING BLDG. _l L ° ° 419, 1 EX � V Signature APPLICANT tit. OWNER-BUILDER DECLARATION PRINT - .7w GD NO. I hereby affirm that I am exempt from the Contractor's License III Law for the following reason (Section 7031.5, Business and ADDRESS r- Professions Code): PRESENT ❑ F. BUILDING 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. 0.L A ❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS 14 ° ° ° ° ° 1 tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST. n CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH ° ° S R F G I hereby affirm that there is a construction lending agency for FRONTtoo- the performance of the work for which this permit is issued P.L. , n o (; ^ (. 2 tSec. 3097, Civ. C.). SIDE P.L. 'r Lender's Name P.C.Fee$ Permit Fee CY0 Lender's Address I certify that I have read this application and state that the Issuance Fee �, .fir 0 above information is correct. I agree to comply with all County Investigation Fee I ordinances and State laws relating to building construction, g i and hereby authorize representatives of this County to enter Total Fee i up�he a ve-mentioned property for inspection purposes. i SEE REVERSE FOR EXPLANATORY LANGUAGE • -r Signature of Applicant or Agent g Date ®s WORKERS'COMPENSATION DECLARATION . 'I her#by affirm that I have a certificate of consent to self { APPLICATION FOR U I L D I N G PERMIT insure, or a certificate of Workers'Compensation Insurance, or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ,^ ❑ FOR APPLICANT TO FILL IN BUILDING f Certified copy is hereby furnished. ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS LOCALITY ✓ NEAREST Date Applicant CITY % ZIP CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL. (This section need not be completed.if-the permit is'for one , /r'� r USE ZONE MAP / hundred dollars($100)or less.) TRACT f F. BLOCK LOT NO. .�„�y' NO. TEL. SPECIAL 16- I certify that in the performance of the work for which this OWNER f �6= NO. (�:ib'� 111!!i CONDITIONS �✓ I� permit is issued, I shall not employ any person in any manner . ' DISTRICT GROUP TYPE PROCESSED BY O so as to become subject to the Work Compensation Laws. ADDRESS /J �U:LL Lr�'lf .LSC ? / �/ CONST. Ed ✓may(p'S `/J�i�_ CITY %��`, ZIP Date/��` �'� Applicant �^ ^^ ' t 9U-�-r� r STATISTICAL CLASSIFICATION APT. CONDO. U NOTICE TO APPLICANT: If, after m king this Certificate of�,J ARCHITECT OR TEL. 'Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS d Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP 44 with comply with such provisions or this permit shall be TEL. Z deemed revoked. CONTRACTOR 'v NO. BK.6 PG, � VALIDATION LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed-under provisions of Chapter 9 ADDRESS NO. ' VALUATION (commencing with Section 7000)of Divisiort 3 of the Business and LIC. Professions Code,and my license is in full force and effect. CITY CLASS $ �Qa , SQ.FT. NO.OF NO.OF CHEC;r] License Number Lic.Class SIZE STORIES FAMILIES ONE Contractor Date DESCRIPTION OF WORK ,Q (,�,:,„�'. NEWF - t f� i ADD ❑I am exempt under Sec. 7 ALTER ❑- FINAL G B.BP.C. for this reason REPAIR ❑:. DATE C1 Date: USE OF FINAL EXISTING BLDG. DEMOL ❑ By y Signature APPLICANT TEL. OWNER-BUILDER DECLARATION PRINT NO. I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): PRESENT ❑ 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. rn J h Ii, CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT 0 0 0 0 c the performance of the work for which this permit is issued P.L. tSec. 3097, Civ. C.). SIDE o ., i 7 J C D P.L. i Lender's Name o r ? t P.C. Fee$ ermit Fee j 2 i Lender's Address I certify that I have read this application and state that the Issuance Fee y above information is correct. I agree to comply with all County Investigation Fee �® ordinances and State laws relating to building construction, Total Fee and hereby authorize representatives of this County to enter upop-he above-mentione property for inspection purposes. i. 3� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Ag tT- Date ®s