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Home My Public Portal About9823 WOODRUFF AVE_Building__ '8A636A DB9•89.6 APPLICATION FOR BUILDING PERMIT 1 DIVISION OF BUILDING AND SAFETY BUILDING z - ADDRESS Department of County Engineer County of Los Angeles LOCALITY WM.J. FOX. COUNTY ENGINEER PT OF BUILDING CROSS ST.NEAREST / ir,vs+ I CASSATT D. GRIFFIN, SU GROUP SEWER MAP DISTRICT NO. FOR APPLICANT TO FILL IN r j I CONST. � i TYPE SK BUILDING MAP ^� O STATE HWY YES ADDRESS NUMBER O LOT NO. BLOCK ZON`E, SPECT L � �V CONDITIONS TRACT �'� NO.OF SLOGS. , BUILDING MST. SIZE OF LOT I NOW ON LOT SETBACK YARD HWY STREET NAME WIDTH USE OF FRONT 111 D EXISTING BLDG. P. L. OWNER SIDE P. L.L. MAIL ADDRESS O TRACT DWELL. I UNIT 5 INDUSTRIAL TEL. 1 DWELL. I UNIT CITY NO. 6 PUBLIC BLDG. ARCHITECT OR TEL. 2 DUPLEX I UNIT7. ADDN., ALT.. ETC. ENGINEER NO. 3 APT. UNITS 8 MISCEL. ADDRESS 4 COMMERCIAL TEL. INSPECTION RECORD CONTRACTOR NO. ADDRESS V DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH - L SQ. FT. NO.OF NO. OF SIZE STORIES FAMILIES I/ �;Vrr 7< /' /a/v USE OF STRUCTURE 4= s i Ll lv L.L/A SIGNATURE OF, APPLICANT APPROVALS ADDRESS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION P. C. S FORMS, MATERIALS FEE O _ FRAME: FIRE STOPS. I VALUATION SSSfffll!!lG�� III Alc" BRACING.BLTS FEE f .- FURNACE: LOCATION. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT,DUCTS 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 HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL WM.J.FOX,COUNTY ENGINEER VALIDATION C. N.DIRLAM.CHIEF BLDG. INSPECTOR �t,q kTo As P 13aorc�) i ACO 4 8 9 9`R APR 1 4.0 D in T, .,F WORKERS'COMPENSATION DECLARATION Ti l hereby 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(Set, 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN I, BUILDING ADDRESS Certified copy is filed with the county building inspec- BUILDING " 1,4 tion department. ADDRESS c^ y`rt LOCALITY 'S+ .. e--NEAREST A/ Date Applicant CITY a ZIP CROSS T. 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 USE ZONE MAP 7 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 /� ; : L NO. 13. CONDITIONS permit is issued, I shall not employ'any person in any manner t DISTRICT GROUP .TYPE FIRE PROC ED BY O ADDRESS CONST.. ZONE LJ so as to become subject to the Workers'C tion Laws. _1") � = 1',s V 13 cc Date J Applicant CITY ZIP STATISTICAL CLASSIFICATION APT. CONDO. ARCHITECT O TEL. NOTICE O /APPLICANT: I. after m kin is Certificate of U Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL.UNITS Compensation provisions of the Labor Code, you must forth- ul 0. ADDRESS SEWER MAP with comply with such provisions or this permit shall be Z deemed revoked. CONTRACTOR a NO. .13.1' BK.EL, �G.�� VALIDATION LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS U Rht.✓ NO. _ % O-0 VALUATION (commencing with Section7000)of Division 3 of the Business and LLMC.. $ Professions Code, and m license is in full force and effect. CITY t. ' Lam' 'SQ. . NO.OF NO.OF CHECK , License Number �1� }V Lic.Clas ��' I SIZE STORIES FAMILIES ONE Contractor//[//►2Gif/ �i�s�e� pate tr' r DESCRIPTION OF WORK /; �p NEW 0 $ 1�11 ADD I am exempt under Sec. I N v G v ALTER FINAL B.IiP.C. for this reasonI REPAIR Q 1 DATE USE OF Date: I EXISTING BLDG. DEMOL .❑.n. FINAL Signature APPLICANT TEL. p� OWNER-BUILDER DECLARATION PRINT NO. I hereby affirm that I am exempt from the Contractor's License I' Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): PRE ENT (� / ❑ 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). 1 MOVING, TEL. I, as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). ADDRESS 2 0 0 P 1, 0 C, REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY � I SET BACK YARD HWY PROP. LINE WIDTH •' ° � I� ^ , I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued f .L. 2, 0 S_ tSec. 3097, Civ. C.). IDE o .L. Lender's Name 3 it $ Permit Fee �* • Lender's Address i e I certify that I have read this application and state that the I Issuance Fee above information is correct. I agree to comply with.all County stigation Fee ordinances and State laws relating to building construction, Total Fee ! s 0 a �} f nd hereby authorize representatives of this County to enter -upon the a Ove-ment'oned property for inspection purposes. €� iSEE REVERSE FOR EXPLANATORY LANGUAGE i ature Applicant or Agent Ote a ®s WORKERS'COMPENSATION DECLARATION insure, or ertif cathSrI have a certificate of te of Workers'Compensation Insuran ent to elf APPLICATION FOR BUILDING PERMIT or a certi ' d',c t ere ,( ec. 3800, X62(:JUV_ �} COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy o. V pony erti ied copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ok ADDRESS Certified copy is filed with the county building inspec- BUILDING dodepartment. ADDRESS O( ''7 Date Applicant C ZIP /ffd LOCALITYr CERTIFICATE F EXEMPTIO FROM WORKERS' NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one �} ASSESSOR hundred dollars($100)or less.) TRACT BLOCK LOT NO. lt' MAP BOOK PAGE PARCEL TEL. USE ONE MAP I certify that'in the performance of the work for which this OWNER NO. NO. permit is Issued,I shall not employ any person in any mannera 3 �r SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESSCONDITIONS O U Date Applicant CIIvA ZI D= NOTICE TO APPLICANT: If, after making"this Certificate of ARCHITECT 09 TEL. DISTRICT TYPE FIRE P$QCESSED BY O Exemption, you should become subject to the Workers' ENGINEER NO. /J CONST ZONE Compensatin provisions of the Labor Code, you must forth- ADDRESS 5 t/ T 177 11 W with comply with such provisions or this permit shall be U- deemed revoked. TEL STATISTICAL CIASSJFICATION APi CONDO. CONT OR NO rj LICENSED CONTRACTORS DECLARATION LIC, CLASS NO. DWELL. UNITS 4 I hereby affirm that I am licensed under provisions of Chapter 9 ADDR NO. QS (commencing with Section 7000)of Division 3 of the Business and LIC. SEWER MAP Professions Code,and my license is in full force an ect CITY CLASS BK PG VALIDATION SQ.FIKA NO.OF I NO.OF CHECK License Lic.Class SIZE STORIES FAMILIES ONE �/�tf/ VALUATION C ntractor ' DESCRIPTION OF WORK NEW ❑ s V — r ADD ' 01111.m exempt under Sec. " /T�7D ALTER ❑ B.BP.C. for this reason e ' 00�• 1 -REPAIR ❑ $ ;9847.,l A Date: USE OF �M EXISTING BLD 'go-" S�D DEMOL ❑ # a a o o,o•1 APPLICANT TEL./'p Signature PRINT �"� NO.V/p� FINAL 0 0 OWNER-BUILDER DECLARATION DATV— 7 a o o I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FI o 0 0 7 a 0 0 czi Professions Code): PRESENT - ❑ I, as owner of the property, or my employees with ADDRESS Z Q-1 `8 7 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). CONSTRUCTION LENDING AGENCY SETBACK YARD HWY TOTAL SETBACK L NE 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. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name LDMA Ref. # Lender's P.C.Fee$ Permit Fee C�f Address I certify that I have read this application and state that the Issuance Fee 14,�V LDMA p/C# above information is correct. I agree to comply with all County Investigation Fee ordinanc nd St laws relating to building construction, Total Fee r LDMA perm.# and h eb rqJKives of this County to enter upon e rty for inspection purposes. 0 l2 SEE REVERSE FOR EXPLANATORY LANGUAGE ignatur f Applicant or Agent Date