The URL can be used to link to this page

Home My Public Portal About9085 WOOLLEY ST_Building__ oe- E;.ass rams sRrs APPLICATION FOR PERMIT ;DFP RTMENT OF BUILDING AND SAFETY ,�j;, •,. �L mr)"� ' COUNTY OF-LOS ANGELES N(34 WM. J. FOX,_'CHIEF ENGINEER ' NO.ORref BLDG. ORD:NO. DISTRICT NO. PLAN CK. NO. PERMIT O,:' PLANS SETBACK LINE FIRE APPROVED r ZONE BY, DATE REC D BY DATE�O' A))PPL. ' DAT 138 ,ED USE APPROVED �IaG�a ZONE ~ BY DATE 111 APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY .'BUILDING p NAME i ADDRESS ++�4?. s ADDRESS • LOCALITY a NEARESTy Z s U W CITY ] CROSS S . STATE TEL. NAME i, a' LAFa,M1 LICENSE NO. NO. W -NAME vMAIL 1C ' � ADDRESS ( e'. � �' +✓ O •� O ADDRESS G1T�[,.'bIl'r'C! 6alpi{� NO. Z CITY '� 1 HEREBYfACKNOWLEIGE THAT (..HAVE READ THIS U APPLICATION AND STATE THAT THE ABOVE IS CORRECT STATE TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LICENSE NO. NO. AND STATE LAWS REGULATING BUILDING CONSTRUCTION. Z /t�/i et SIGNATURE OF ' O LQT NO. SIZE OF LOT i' OWNER j �! 1' NO. OF BLDGS. �� p : �i �Y .1 A l _, - %^ / BLOCK NOW ON LOT (�W► AUTHORIZED AG• ' ��g=;,,r - NOW TRwcT CORRECTIONS D USE OF BLD68. NOW ON LOT DESCRIPTION OF WORK / USE OF f BUILDING -11)9 fF U't'J� r,; n��aA It Jf " -I ti d J r NEW TYPE GROUP ALTERATION ROOMS I FAMILIES r 'I. ADDITION SIZE :x REPAIR STORIES MOVING WALL COVERING DEMOLISH ROOF COVERING P.C.$ iFINAL APPROVAL FEE j I INSPECTOR'S V ALUATION FEE DATE DEPARMENT OF COUNTY ENGEM DWISION .OF BUILDING AND SAFETY BUILDING COUNTY OF LOS ANGEM WILLIAM J. FOX', COUNTY ENGINEER APPLICATION CASSATT D. GRIFFIN, SUPT OF BUILDING - FOR APPLICANT TC) IN FOR OFFICE USE ONLY BUILDING• DISTRICT NO. PLAN CK.OR REC.No. PERMIT 140. ADDRESS O !Zc O'8•s Co.Com• ... LOCALITY RECEIVED BY DATE OF A PL. DAT ISS ED NEAREST a I'` 1 z Z Q� CROSS ST 1 BUILDING OWNER s ADDRESS <J OO MAIL LOCALITY ADDRESS OPIQJ NEAREST. CITY CROSS.ST. Q CJi O, FIRE NO. OF TYPE G ARC ITECT P ENGINEER ZONE' PLANS I � � � BLDG. ORD:NO. ADDRESS SETBACK LINE L•. USE APPROVED- CONT ZONE BY DATE HOUSE, IUMBADING ADDR LEGAL MAP NUMBER NO.ASSIGNED BY DESCRIPTION I LOT BLOCK. TRACT " 'l f ' CORRECTIONS SIZE O I. ON LOT i� USE OF NO.OF EXISTING BLDG. ILIE ON OF WOfto - NEW ALTERATION I ADDITION I S Z REPAIR DEMOLITION •= - r SQ. FT. NO.OF SIZE ROOMS..... STORIES s. EXT.WALL ROOF.. COVERING I COVERING USE OF STRUCTURE APPROVALS I FKcToR,xj3lGNATUR9 DATE wet Xtm FOUNDATION:LOCATION: r * FORMS. MATERIALS I HEREBY ACKNOWLEDGE.TNAT I HAVE READ THIS AP- : FRAME: FIRE STOPS, PLICATION AND.STATE.THAT 'THE INFORMATION GIVEN 19 BRACING, BOLTS CORRECT. FURNACE:LOCATION, I AGREE 1'O COMPLY WITH ALL COUNTY..ORDINANCES•' GAS VENT LOCATION, AND STATE LA 6GULAT G BUILDING CON ION. , SIGNATURE LATH, INT: PER iTTB - . LATH. EXT. PLASTER, INT. AUTkORIZED A6T PLASTER, ERT. , $ pi,C S '2 HO U86 NUMBER COR- RECT AND.POSTED VALUATION 00 , FEE `O FINAL yi'' I l 78A888A •=8 8. 97E2 .. .L APPLICATION FPRtBUILDING PERMIT COUNTY OF LOS ANGELES 1• BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT'TO FILL IN BUILD�IN>G ADDRE I hereby affirm that I have a certificate of consent to self insure, BUIL ADDRESS /�� or a certificate of Workers'Compensation Insurance,or a certified 05 aa� S copy thereof(Sec.3800,Lab.C.) CITY �C ZIP �• OQ Q LO ;LITY//7� Policy No. Company SIZE F L O.OF BLDGS.NOW ON LOT �� El Certified copy is hereby furnished. NEAREST CROS". ell [ICertified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL • SPECIAL CONDITIONS /.l� CERTIFICATE OF EXEMPTION FROM WORKERS' OWNE TEL NO. [� !"^ COMPENSATION INSURANCE �^ S 'cCu WITHIN 1000 FT.OF SCHOOL? YES BJESS NO (This section need not be completed if the permit is for one hundred ADDsFdf dollars($100)or less.) Ja ryD e7W .DISTRICT GROUP TYPE CONST. FIRE ZONEZPROCESSED BY 'CITY ZIP I certify that h the performance of the work for which this permit s" C fc G� �}!/ _ � is issued, I shall not employ any person in any manner so as t0 ARCHITECT O ENGINEER TEL NO. od e 3 bec*, subject tD the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date {•&��P, Appllcant �"T5" ::;55AZ ADDRESS CLASS NO. 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 FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION SIDE CITY uC.CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORIES NO.OF FAMILIES PG NEW ❑ BK Professions Code,and my license is in full force and effect. p�[� , a License Number Lic.Class DESCRIPTION OF WORK ADD ❑ V LUATION�OD O� U Contractor Date ALTER `fr ElI am exempt under Sec. REPAIR $ B.BP.C.for this reason L /tJ �uG EMOL ❑ V LDMA P/C# iL Date: SE OF EXISTI LDG. URM ❑ 1L Signature APPLICANT(PRINT) TEL NO. LDMA Perm# Z ❑ 1, as owner of the property, or my employees with wages as ZO i' their sole compensation, will do the work and the structure is ADDRESS °� `'T'" not intended or offered for sale (Section 7044, Business and FINAL DATE ' G 33103 y-2 .6 c Professions Code.) WALL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL /q OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE r E i)T M;_ I, as owner of the property, am exclusively contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044, 1_2`2 - YES[I No El �f)"rid- �:r�;_ 65 Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING !JJ •�• ••V71 �" OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CHECK i i!i s L•� CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKUST FOR GUIDELINES. T•LIA {'— +'�?'• I hereby affirm that there is a construction lending agency for YES[I NO 13 ,y.!ltll :�� _!Ll W the performance Of the Work for which this permit IS ISSUed(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 1 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, C4 TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUSj )?j i-3 jl{I i i; 5 i9. Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. - o Lender's AddressawwER AGENT34 1 1 } PrI 1.2-,01 j.! 0 Z; I certify that I have read this application and state under penalty f C of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE / �U N with all county ordinances and State laws relating to building OD raepstrdetiehereby authorize representatives of this County ISSUANCE FEE ato enter u a -mentioned property for inspection 6 INVESTIGATION FEE TOTAL FEE / � � aim« �. a• U J SEE REVERSE FOR EXPLANATORY LANGUAGE %-i WrRKERS'COMPENSATION DECLARATION rem'a certificate that' haver certificate of consent to self APPLICATION FOR BUILDING PERMIT e, or a certificate of Workers'Compensation Insurance, _rtifled copy thg eof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY o icy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING /poGG E ST/21=13 ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING ��++ poGL.�y S k6�' tion department. ADDRESS �fJ� / / Date Applicant CITY TGtiI L e,-IT ZIP C,t• F/79 O LOCALITY 'NO.OF BLDGS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSSSST. G/)//iy 4V 4= (This section need not be completed if the permit is for one TRACT � �¢ BLOCK LOT NO. ASSESSOR hundred dollars($100)or less.) u / / MAP BOOK PAGE PARCEL OWNER /� � �� TEV — dab USE ZONE NOP �p,¢�r ¢U I certify that in the performance of the work for which this SS � ) �} /, }; permit is issued, I shall not employ any person in any manner ADDRESS 37 /VR II,t�Tq SPECIAL T1. so as to become subject to the Workers'Co pensation Laws. (� 6 I CONDITIONS p CA f CITY M t 1 G/ . + R ZIP 4P Y7 Date Applicant ARCHITECT OR !�`/ // TEL. DISTRICT GROUP TYPE FIRE PR SED BY O NOTICE TO APPLICANT: If, after making'this Certificate of ENGINEER �X ZS'0 �7y(0 NO.4,42—el"/00Z CONST. ZONE i" Exemption, you should become subject to the Workers' CQ� , 13 Compensation provisions of the Labor Code, you must forth- ADDRESS , with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. . CONDO. deemed revoked. CONTRACTOR NO. Z LICENSED CONTRACTORS DECLARATION I LIC, CLASS NO. DWELL. UNITS `4 I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and I LIC. SEWER MAP Professions Code,and my license is in full force and effect. CITY CLASS BK PG VALIDATION SQ.FT. NO OF / NO.OF CHECK License Number Lic.Class SIZE 21,91 Lr STORIES / FAMILIES ONE VALU TION. Contractor Date DESCRIPTION OF WORK A D ® $ ❑I am exempt under Sec. �� T�I�I�M' BiYGtrOS�r�hE , �� _`� � ❑ B.BP.C. for this reason ALTER $T REPAIR ❑ i Date: USE OF EXISTING BLDG. J.DEMOL Signature APPLICANT L J �/ ` / TEL.(., FINAL •� � PRINT r7��/� ��L-! NOS 7b-4 OWNER-BUILDER DECLARATION DATE - I hereby affirm that I am exempt from the Contractor's License 33 6XE` A 6-FA ��i Law for the following reason (Section 7031.5, Business and ADDRESS 6YI 7 FINAL Professions Code): PRESENT By Q8� �/dOLL.EY S'r,�ET I, as owner of the property, or my employees with j ADDRESS BUILDING , wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section- LOCALITY 7044, Business and Professions Code). MOVING TEL. / ❑ I,as owner of the property, am exclusively contracting ' CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS �;� tion 7044, Business and Professions Code). p q CONSTRUCTION LENDING AGENCY REQUIRED BACK YARD HWY TOTALSETBACKWIDTFI I hereby affirm that there is a construction lending agency for FRONT A the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE a y P.L. Lender's Name 2 LDMA Ref. # u P.C.Fee$ Permit Fee J Lender's Address I certify that I have read this application and state that thee Issuance Fee � LDMA P/C# above information is correct. I agree to comply with all CountyI Investigation Fee ordinances and State laws relating to building construction, Total Fee v and hereby authorize representatives of this County to enter TDMA Perm.# $ upon the above-mentioned property for inspection purposes. I SEE REVERSE FOR EXPLANATORY LANGUAGE n Signature of Applicant or Agent Date