HomeMy Public PortalAbout8603 WORTHINGTON DR - Building - 1960-04-01 a 28ACs#6=6-'8 ' APPLICATION FOR BUILDING PERMII 1
COUNTY OF LOS ANGELES BUILDING
. �
DEPARTMENT OF COUNTY ENGINEElf ,
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A.LAMBIE,COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN SUPT OF BUILDING CROSS ST.
DISTRrNO. GROUP TYpE P. SSED BY
F
OR APPLICANT TO FILL IN CONSTT'P.
L�s�
STATISTICAL CLASSIFICATION SE ER MAP
Worthington Dr I BK PG
CLASS.NO. DWELL.UNIT
LO_ T NO. ® BLOCK MAP STATE �
NUMBER i HWY. YES NO
TRACT 25541 USE ZONE SPECIAL
65 X $0 I NO. 0 CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
EXISTING BLDG. _ v_ BUILDING EXIST.
SETBACK YARD H STREE NAME WIDTH
OWNER Jack Kil�eon FRONT
MAILP.L.ADDRESS 102 SIDE '
c�TY• Tujunga rTio'?'- 38273 P.L. I
ARCHITECT OR TEL. SPECTION RECORD
ENGINEER NO.
f�.+'O!? cd ,a"�' :,'/"I.I.A /!.•u Q.e' e..-r �r.'n S'
ADDRESS / r'
TEL t r ir1 v -a C(.a / 0 H _I A fi :r '/J 9
CONTRACTOR Jo.ok Killen 1 38973 .. A
FI';rte/ ,,
io (1t,7r
ADDRESS 7o� .7 rarova Avn_ Tni�p;Q t",
DESCRIPTION OF WORK 7-t/
NEW X ADD ALTER REPAIR DEMOLISH r
NO.OF
S ZE 1400 NO.OF G F1 C7
STORIES l FAMILIES 1
USE OF STRUCTURE )
SIGNATURE OF APPROVALS
APPLICANT
DATE INSPECTOR'S SIGNATURE
ADDRE FOUNDATION: LOCATION
• Ill W ERIALS r/9 —/P 97-
P.C. S J6 FRAME: FIRE STOPS.
rj U � FEE rs BRACING.BOLTS.
VALUATION FURNACE: LOCATION. LI/ %/(
FEE "" GAS VENT.DUCTS l
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH,INT.
PLICATION AND STATE THAT Tk E ABOVE IS CORRECT AND yr ry/ .%
AGREE TO COMPLY WITH AL OUNTY OR NCES AND LATH,EXT. b �( v
STATE LAWS REGU TING BUILDIN TRUCTION.
SIGNATURE OF , HOUSE NUMBER COR- -1 !D
PERMITT RECT AND POSTED (9 f/� r
ADDRES FINAL
CLYDE N.DIRLAM.PRINCIPAL STWCIVRAL ENGINEER
PLAN CHECK VALIDATION cK M.O. CASH PERMIT VALIDATION CK. M.O. CASH
lJZ0 7 5 0 6.00 MAR 2 3 A 2 4.0 0
��Ax 6 63 2 o ii{an � 1 A 5 1 .0 0 K®.
b5-2db7 RMC
WORKERS'COMPENSATION DECLARATION
hereby affirm that I have certificate of consent to self APPLICATION F O R � B 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.)
Po�P ji N'o -2135 Company�ONr INDEMNITY COUNTY OF LOS ANGELES BUILDING AND SAFETY
❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING
'i ADDRESS v r
X ❑ Certified copy is filed with the county building inspec- BUILDING
tion department. ADDRESS 86o3 E WORTHINGTON DR.
Date 11.11.185 Applicant RIGID MFG. COMPANY CITY SAN GABRIEL ZIP LOCALITY
CERTIFICATE OF EXEMPTION 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. MAP BOOK PAGE PARCEL
OWNER ERV BECKER USE ZONE MAP
I certify that in the performance of the work for which this Kr NO.
permit permit is issued, I shall not employ any person in any manner ADDRESS 860 E WORTHINGTON DR.
CIAL 911.
so as to become subject to the Workers'Compensation Laws. t CONDITIONS O
t�
Date Applicant CITY SAN GABRIEL CA ZIP
ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PRESSED BY
NOTICE TO APPLICANT: If, after making this Certificate of
ENGINEER NO. CONST
Exemption, you should become subject to the Workers' s �w /Ir ._ / ZONE qJ
Compensation provisions of the Labor Code, you must forth- ADDRESS 9Y �I[` V 3 IL
IL
with comply with such provisions or this permit shall be
CO
deemed revoked. CONTRACTOR RIGID MFG.COMPANV �
O.L 81 a STATISTICAL CLASSIFI TION APT. N
LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDREq37 S. WOODS AVE. NO SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and LIC.
Professions Code, and my license is in full force and effect. CITYLOS ANGELES, (A 90022 CLASS C-39 BK PG VALIDATION
SQ.FT. NO.OF NO.OF CHECK
159+96C-39 SIZE STORIES FAMILIES ONE
License Number Lic.Class
M. 8 RE-ROOF KITH GERA EW- VALUATION
GID
Contract6Y` �MPANY Date 5/ 5 DESCRIPTION OF WORK ❑ � 1 6�3 a
.
EITASS tr rr MATERIAL
ADD El I am exempt under Sec.
ALTER ❑' # o 0 0 0 0
B.BP.C. for this reason ICBG#3859 I REPAIR ❑ $ 1 ° - 96,75
Date: USE OF
EXISTING BLDG. RESIDENCE DEMOL ❑
Signature APPLICANT TEL. FINAL / ��/7 ° ° - 9675'
OWNER-BUILDER DECLARATION PRINT NO. DATE 6 0213-85
1 hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and ADDRESS r FI
Professions Code): PRESENT
❑ 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.
❑ 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 SETT BACK YARD HWY TOTAL SETBACK
LINE FRO 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
io P.L.
Lender's Name
$ LDMA Ref. #
P.C. Fee$ Permit Fee '
— Lender's Address
I certify that I have read this application and state that the Issuance Fee LDMA P/C#
above information is correct. I agree to comply with all County Investigation Fee
ordinances and State laws relating to building construction, Total Fee LDMA Perm. #
u and hereby authorize repress �forinspection
County to enter
pon the above-mentions r purposes. �/r��
a C 1
11/85SEE REVERSE FOR EXPLANATORY LANGUAGE �/
n o
Signature of Applicant or Agent Date j 3 is'