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Home My Public Portal About9916 WOODRUFF AVE_Building__ APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) BUILDING COUNTY OF LOS ANGELES ' ADDRESS DEPARTMENT OF COUNTY ENGINEER CITY / IP BUILDING AND SAFETY DIVISION N ,OF BLDGS BUILDING l SIZE OF//��LOT �►�� OW ON LOT ADDRESS 4TRACT f/J� BLOCK LOT NO LOCALITY TE l NEAREST OWNER N V..7 CROSS ST. ASSESSOR ADDRESS MAP BOOK PAGE PARCEL DISTRI GROUP TYPE FIRE PROCESSED BY CITY ,� IP / C / CONST. ZONE ARCHITECT EL. V y� � J ENGINEER NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS N6! / _DWELL.UNITS lfC3 PG CONTRACTOR ' TE USE ZONE MAP .J Ou N0. ADORES$ L ` ..�ox SPECIAL CITYLIC. CONDITIONS CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ N CONS UCTION LEND R NAME AND BRANCH BLDG.SETBACK FRO FRONT PROP.LINE O (STREET) ADDRESS CITY HIGHWAY + YARD TOTAL SETB& K FROM TYPE OF EXISTING SQ. FTJ NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH SIZE/ STORIES FAMILIES ONE DES-CRIPT ON OF WORK NEW ❑ + V �F/ D C ADD LDG.SETBACK FROM SIDEPROP.LINEOF (STREET) ALTER HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING RAIR❑ SIDE PROP. LINE 'EXISTING BHIGHWAY WIDTH USE OF LDG. �` EMOL ❑ + APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑ (PRINT) NO. BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑ Q oe IN COASTAL ZONE YES ❑ NO ❑ VALUATION$ CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIO ATION•OF THE LABOR CODE OF THE STATE OF CALIFORNI IN R ATI TO WORKMEN'S CMf T IONA NOWRANC E. SIGNATURE PERMITTEE ADDRESS FINAL BY TEL. DATE CITY NO. ' MAKE CHECKS PAYABLE TO: F E �� FEE �� HARVEY T. BRANDT. COUNTY ENGINEER 1 PLAN CHECK VALIDATION • CK-) M.O. CASH _ PERMIT VALIDATION CK. � M O. CASH 1 6 9'z-P1AY -58 2 3 0 5,4 0 A,ti 1 7 0ci=1AY 38 1 D 9.0 0 76A638A CE#803 7/73 '— (dJSti 78A888A. CE/803(REV.6/78) APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY BUILDING / FOR APPLICANT TO FILL I ADDRESS Fes _ w BUILDING //'�� ADDRESS 00 LOCALITY /Jr NEAREST d CITY �!/! ZIP CROSS ST. NV.OFBLDGS. ASSESSOR SIZE OF LO O //0 NOW ON LOT MAP BOOK PAGE PARCEL TRACT / BLOCK LOT NO. l- CONST. GROUP TYPE FIRE CESSED BY CONST. ZONE TEL. L/rJ OWNER `�'C.JfgI�/� NO. �foc , .•-c STATISTICAL CLASSIFICATION SEWER MAP ADDRESS E CLASS NO. -121 UNITS BK PG CITY ZIP ARCHITECT OR TEL. VALUATION ENGINEER NO. (/ U ADDRESS BLDG.SETBACK FROM yy�� (� ,,ll FRONT PROP.LINE OF ISTREETI CONTRACTOe/- /ft�C_YC1 � J(1�E0� TOTAL SETBACK.FROM TYPE OF EXISTING LIC HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH ADDRESS II Z= fQ L-0I A NO-3� y/,.5/—LIC. _ + CITY CLASS L BLDG.SETBACK FROM CONSTRUCTION LENDER NAME AND BRANCH SIDE PROP.LINE OF (STREET( HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH SQ.FT. NO.OF NO.OF CHECK + _ u SIZE STORIES FAMILIES ONE IT9 DESCRIPTION OF WORK NEW P.C.Fee$ Permit Fee ADD Issuance Fee ub ALTER `/N-7 REPAIR ❑ Total Fee o OING BL .L/ D tcje DEMOL EXIST ❑ �m O APPLICANT TEL (PRINT) NO. ~ <:R q BY(SIGNATURE) 1,i > IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS LICATION AND STATE 5 0 9.2 A THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY H ALL ORDINANCESbd AND LAWS REGULATING BUILDING CO TRU N.I CE FY HAT IN DOING THE `';i/ a _ .# 0 0 0 0-o 1 WORK AUTHORIZED HEREBY I WILL LO ANY O IN VI ATION OF �� a ] V THE LABOR CODE E STATE OF I IA I RE NG OR EN'S COM- ,{ i,l Z PENSATION INS NC g 2 - - 5'200 '200 SIGNATURE OF �C(% 1 �� f J o o o 5 2 0 0 c5 PERMITTEE / ADDRESSZ 0 6 2 2--79 TEL. O CITY NO. Q O USE ZONE MAP NO. SPECIAL 6`- CONDITIONS FINAL BY d DATE PS 76A638A CH/843(R.-4.6A8) APPLICATION FOR. BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN ADDRESS cL 6F—v--. LDING ADDRESS ,(/O I LOCALITY NEAREST CITY f _ l ZIP CROSS ST. N OF BLDGS. ASSESSOR SIZE OF LOT Vr ,/(/IO NOW ON LOT MAP BOOK PAGE PARCEL DISTRICTM&ST FIRE SSED BY TRACT BLOCK LOT rZON OWNER G)06 L d, I N L STATISTICAL CLASSIFICATION SEWER MAP ADDRESS /%� CLASS NO. DWELL.UNITS BK PG CITY ZIP ARCHITECT OR TEL. VALUATION $ ENGINEER NO. ADDRESS BLDG.SETBACK FROM '� FRONT PROP.LINE OF (STREET) CONTRACTOR TOTAL SETBACK FROM TYPE OF EXISTING �^ LIC ) HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH ADDRESS // L /07 NO. LIC. + CITY , G 01041 CLASS BLDG.SETBACK FROM CONSTRUCTION LENDER SIDE PROP.LINE OF (STREET) NAME AND BRANCH HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING � ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH SO.FT C1 NO.OF NO.OF CHECK + _ SI Q STORIES FAMILIES ONE DESCRIPTION OF WORK JNEW 0 P.C.Fee$ Permit Fee ' r� c ADD Issuance Fee 7.• on a��i /�•••J "r�/ �1( bS4la LTER o D REPAIR ❑ Total Fee USE EXISTING BLDG.X01 /4100 I D w DEMOL ❑ ` Z O APP(PRINT) f L r/// 6e o BY(SIGNATURE) I HEREBY ACKNQ DGE THAT I)} E READ THIS APPLICATION AND STATE x THAT THE ABOVE ORRECT AND 9 EE TO COMPLY WITH ALL ORDINANCES W AND LAWS REGU ING BUILDING C STRUCTION.I CERTIFY THAT IN DOING THE V WORK AUTHORIZED EREBY I WILL NOT EMPLO NY PERSON IN VIOLATION OF THE LABOR CODE T STATE OF CALIFORNI LATI ORKMEN'S COM• 2 PENSATION INSU NCE. g IL SIGNATURE OF [I• S 9. 17 P PERMITTEE ADDRESS 14 Z ? 0 0 0 0 r. 1 TEL. O 2 ° ° CITY (.�`[ .� 6►9yr/ NO. II/ Q ^ I, D lE ZONE MAP NO. V � SPECIAL 0 u 1 6—/ 9 CONDITIONS 1+... u�i DATE L �� BY ®S 76A688'A-.,r, OLE#808(REV.6/78) APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING ND SAFETY INIJ FOR APPLICANT TO FILL IN ADIDRESS BUILDING ADDRESS LOCALITY all P 03 NEAREST CITY Z. v CROSS ST. [) NO OF BLDGS. , ASSESSOR SIZE OF LOT �/ ' NOW ON LOT//�� MAP BOOK PAGE PARCEL TRACT 6J / BLOCK 1.0 � DISTRICT GROUP TYPE FIRE SED BY CONST. ZONE TEL. D OWNER +S�S STATISTICAL CLASSIFICATION SEWER MAP ADDRESS � CLASS NO.,A� DWELL.UNITS BK PG CITY ZIP ARCHITECT OR TEL. VALUATION $ ENGINEER NO. OV ADDRESS BLDG.SETBACK FROM TEL. FRONT PROP.LINE OF (STREET) CONTRACTOR NO.. HIGHWAY + YARDTOTAL SETBACK FROM I TYPE OF EXISTING LIC. - FRONT PROP.LINE HIGHWAY WIDTH ADDRESS APY NO. _ LIC. + CITY MN CLASS CONSTRUCTIO ND R BLDG.SETBACK FROM. NAME AND BRANCH SIDE PROP.LINE OF (STREET( HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH O SQ.FT. NO.OF NO.OF CHECK + _ (� SIZE STORIES FAMILIES ONE 0 DESCRIPTION OF WORK NEW ❑ P.C.Fee$ Permit Fee /S 9 _elADD ❑ d ❑ Issuance Fee' y ALTER Z REPAIR ❑ Total Fee USE p �— s�d—�9 E ISTTIING BLDG 3 ' DEMOL El Z APPLICANT TEL C IPRINTI R 7 W a O. J.t�g,� C j BY(SIGNATUREI' Q I HEREBY ACKNOWLEDGE4AU T I HAVE READ THIS APPLI TION*AND STATE Y THAT THE ABOVE IS CORRECD AGREE TOCOMPLY WIT ALL ORDINANCESAND LAWS REGULATING BUILCONSTRUCTION.I CERTIFY HAT IN DOING THEWORK AUTHORIZED HEREBY I NOT EMPLOY ANY PERSON IN VIOLATION OF 5'4 2 A THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- Z PENSATION INSURANCE. 5 # oo0•001 SIGNATURPERMIT OF1�12 21200 ADDRrj,ef �+f ZO o;o 2 2 0 0 H CI Nle 0 71 6—7 9 UONE MAP SPECIAL t- CONDITIONS. X o� m FINAL /f7/ / ✓' p DATE �- APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND .SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDIN DD ESS I hereby affirm that I have a certificate of consent to self insure, BUILDING A DRESS Err- or a certificate of Workers'Compensation Insurance,or a certified Wdop copy thereof(Sec.r38y0000,/,Lab.C.) CI, l� ZIP II:i d+-/� 'fi Sfi�E FU 10 Ilogo LOCALIT Policy No.,, Company SIZE OF LOT NO.OF BLDG&NOW ON LOT ❑ Certified copy is hereby furnished. -7— —IF-4 NEAREST CROSS ST. L Certified copy is filed with the county building inspection TRACT BLOCK t LOT NO.,e department. �//1 �� b a USE ZONE MAP NO. Date �l— 3`�3 Applicant ASSESSOR MAP BOOK PAGE 3el" PARCEL 1-h Cr ST V i SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER NO. COMPENSATION INSURANCE 1 G 'Z S S+(t�9 S WITHIN 1000 Fr.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS t� W Q Q J DISTRICT GROUP TYPE CON FIRE ZONE PROCESSED BY dollars($100)or less.) CITY ZIP� I certify that in the performance of the work for which this permit C O / is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER v`TEL O. O � � become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. C42 I 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. iG�yri SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith 2-S& �'lQ d FRONT comply with such provisions or this permit shall be deemed revoked. i ADDRESSioio — LIC.NOb P L LICENSED CONTRACTORS DECLARATION 3 S :30 �'�3 SIDE CITY ` Gl„y_ LIC.CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 1 ` SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF RIES NO.of AMILIES Professions Code,andmylicense is in full force and effect. 0 NEW BK; PG , License Number 3% Lic.Class L-3 DESCRPTION OF WORK ADD ❑ VALUATION C C Contractor C.Lft6iC 90111 Date Ll-13 R E- koe) xd e—omps ALTER ❑ $ C ❑ 1 am exempt under Sec. G n F SF—'u 1•' REPAIR ❑ $ H B.BP.C.for this reason DEMOL ❑ C. LDMA P/C# LL Date: USE OF EXISTING BLDG. URM ❑ D. 1 Cr Signature APPLICANT(PRINT) TEL NO. LDMA Perm# ❑ I, as owner of the property, or my employees with wages as Z ACCT-4 their sole compensation, will do the work and the structure is ADDRESS 0 iLl��- 2� -S5 not intended or offered for sale (Section 7044, Business and FINAL DATE C 1T EMS Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL f -Z�'4�i3 J j`E ❑ 1, as owner of the property, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Y g AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? i' FINAL BY TOTAL �� m 3-5 licensed contractors to construct the project (Section 7044, ves[I No 11Business and Professions Code.) N� �t �(�- ' WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH. GUIDELINES ..,. CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FORHAhlGE -0 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. f I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING N 3097,CIV.C..) I 'CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. 0000-0001 4/13/9 1J//yam 3 TITLE 2.CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS I Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. J 186 1 AM i I J- 3 0 Lender's Address 1 O OWNER OR AGENT o I certify that I have read this application and state under penalty i O of perjury that the above information is correct.I agree to comply 1 P.C.FEE PERMIT FEE N with all county ordinances and State laws relating to building d CO construction, and hereby authorize representatives of this County ISSUANCE FEE M to Pon the bove-me io ed property for inspection purposes. a 4�L3-fI] INVESTIGATION FEE TOTAL FEE n Sy,uW AOpmn or Apm,l 0-0 SEE REVERSE FOR EXPLANATORY LANGUAGE