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HomeMy WebLinkAbout1624A 1729A __ __ _._ __ __ _ � � woxKeRs'coMe�NSATION DECLARATION � � � �eba�a`�e�,{�a,eofwoke5"�omPe�5�o�5��,��a��e` . APPLICATION-FOR BUILDING PERMIT Il 'cenified co thereot Sec.3800 Lob.C. � � . �. PY ( ' � COUNTY OP LOS ANGELES BUILDING AND SAFETY :yNo. Compony � � ' s,� . Cerfified copy�s hereby fumished. POR APPLICANT TO FILL IN noosess ��/7 �li�--+�—•"�� �. . - Certified copy is filed wilh the county bullding Inspec- BuitDiNG /J �� . tian Cleparlment. � ADDRE55 LOCALITY - Y{,�c.x.-r-�� � NEAREST �� ! Applitanf Citt ZIP CROSS SL �-.�c-ia�� � ' � i. CERTIFICATE OF EXEMPTION FROM WORKERS'� NO.OF BlDGS. ' ASSESSOR ' � COMPENSATION INSURANCE. 5RE OF l07 NOW ON LOT /v1AP BOOK ' PAGE 7aRCEt s seclion need not be completed if tha permi�is(ar one USE ZONE huv dred dollars(b100)o�1es5.) � TRAQ 6LOCK l0T NO. �.- NO. �"' .7�� �� + .. � � +�! ' TEC S7ECIAL Y �rtify that in Ihe peiformpnce of 1he work for.which this OwNER ` - 1 lY NO. �-3 GONDITIONS � 'L . .nit Is(ssoed,1 shall nat amploy any person I n manner � � --- D�STRIGT GROUP TYPE . FIRE P OCESSED BY � � Y ADDRESS I S � 1 D GONST. 2�J0 F ' �V rs lo become sob�ect to 1he Wo�r ers'Co� ensli� Laws.` .__� . .D. „/- _.J � � 1 J 11� . _ . ... .. �) � � r�f� ��� . �! Applicary� � � ;1 1� CITY - Z�P STATiStICAL C1A551FICATION � 'APi. CONDO. �O � � tICE T4�O A Pl�T: If, aft6r makin rnthls ~�'\. ARCHITECT OR . .._ TEI. ... ._ - � ' g (,`ertificala oF ENGWEER � NO. C1A55 NO. �� DWELL:UNITS_ � V � mptian, you should 6ecome subject to the Workers' C � npensolion pro�isions of ihe Lobor Code,you must forih- ADDRESS - - � � SEWER MAP � N 'I � i comply with sucb provisions or this permit ahall be t TE� Z ' med revoked � CpMRACTOR ��L NO. BK. �PG, ' VAIIDATION , UCENSED CONTRACiORS DECLAR,4TION � � ���, - i -reby offiim that I om licensed onder p�ovisions of Chop�er 9 AbDRE55 No. VALUAT O � - - � nmendng with Sedion 7000)of DivisioB 3 of the Business and � � ���, ������ . �� (7'Z,(j A - ' �essions Code,and my license h in full force and eHect. Cttt na.55� E i � . � . ' - � � � '� SC].F. NO.OF NO.OF CHECK ` #� � �'�'��j � . �nsa Number Lic.CIOSS SIZE ' STORIES � FAMIUES ONE - , ; � . . S , �� • •2�Q� . , ' Alactor DOte �ESCRIPfION OF WORK � � (�� ❑ � � . � I om ezempt onder Sec. � � �� AOD�- ❑ '��� �2���v � . AITER � FINAL � . . . 2� 7�S 4 . B.BP.C.f0�ihis�easOn � REPAIR � pATE (0 '� . , Dafe: USEOF � fINAL -. .-. ' � EXISTING e � 13- DEMOL BY L�.�` �f��J APPLI�j1NT `V` V�"r s�g�ar�re aavvr � G . OWNER•BUILDER DECLARATION � �. veby offirm that I om exempt fram fhe Contratror's Licanse � i for fhe following reason(Section 703I.5,Business and /DDRESS �� � �� � �- -��� � �� fessions Code): . � R � � � -� � � � 6WtDING � � . � I, os owner of the property, or�my employees wi�h� qooaE55 � � wages as Iheir sole compensofion,will do the work and � . � - . ' fha strocNre is not inrended or offered for sale(Settion ����TY �� - � �� � � - ( � 7044,Business ond Professions Code). � MOVWG Te�. �. �1 7 2 9 A , „ ,I I,os owner af the property,am exclusively mntracting . � MRACTOR NO. , .., . , ���.� � � �;�. . with licensed conrractors to constrvct the project(Sec• qD�Re55 � � �tion 7044,B�siness and Professions Code). _ - ' .. I • •Q 2 J�Q ��� �'� REOUiRED TOTAL SETBACK FROM EXIST. ' 'CONSTRUC710N LENDING AGENCY SETBACK YARD HWY pROP.IINE WIDTH � ' �- � ereby offirm Ihat there is u canstroction lending ogency for FRON7 - �- �� � - ��-- � � � ►- � .--� '. . ;�.�• •.G 2'S�� � �i performance�of ihe work.for which ihis permit ii issued � P.L�� � � � O,L 2•��8 4 . rc.3097.Civ.C.)... . . . . � . . ' . ... . , �..SiPfl - . . • �.. �.. .�� , �_ . � . .. - . . � . . . .� . .. ,. .. _. _ . . ,._. : ..;,.: ..._. , .r . :'.. , . , . . . .. . P.L. . .. . . . . � , � ider's Name � � � � � � � �- ider's Addreas - . � P.e:Fea 3 J��C� Permn Fee .t"'� � . . . � .. . . ��� ertify Ihat I have read Ihis opplicatlon and stata Ihat tMe � � � � issu ce Fee� �C��.�� ' " , �L� ove Informafion Is mrrect.I agree ta camply with all County lnves�iga�ion ice �� _ . .. . . . . . -, linonces and State laws reloting io bullding construction, � - � � - �Toial Fae •,j n .r d hereby a�thor'eYep�asentmivas of fhfs County lo enter / � � >.� ��he a6ove�ntione P Perry f r Inspec�lon porposes. � . . . . . ..... -.. ... ..- � . . .. . , � ... . ' ` � , �•�� .SEE REVFRSE FOR E%PIANATORY L�.NGUAGE _. ._ . _ _. __ . � ignature o1 Appl�mnt or Apenr . . Do� � . . ..�f �- �PLAt15 TO APFLILANT : ' � � c. ��� � �INSPECTOR'S NOTES .. ,� i. �OL{�'vFFbIlUILDiiR�DEC7 A,R.4TI0\ . . .: � � , , �-.A hareby affrm Ihat I�om exempl 4rom ihc;Loatmc�or's � � To: , . . ..Rclurnod� . � .. . � . . . . - Litense Low for (he followmg,.recson. �Sac�7031:5) '., � . .:. . . �.,.. .� � Approwd Evrinesser,dPrnfessrm:sCadc:A>:poieyorrount}'+alicb I _._ __ . .. _ ___ ._ ..._..._._ __•... . _ . . _. rox "d�rinli.vl, � No: .�.. ...Dato., Ilo. - Deto - . � � � � , .-.,_ . ',. �� � '': -. . . � �---regaires�n p�rrd:tn t s rimt,cltr;inrp. . nrrepairanystrritlrr fr�r�rtorlseiSe+cnec,ulsoreqairei . _.. ___.__-. _.. ._._._ ._� __. .._.__•._ '._ .._ .. _ ___. _' .__. . . _ . . ._ '_ _ - . _ _ - '.1 ? t'I ' "'tG�applrcaiee J�r sr:cJ penrrtt to file a si,�ned atalr»rrirt � ��__'___'.__.._._._ .___. �-._ . _, � _.._.. �.� ...... _.__ . __ ._y_ ..�......_. _.. ,.�.. . . ..__�_ tlatGerslirensrdpursuanttnlleJ�rorisiunsojtl�eCon• ' i . � � - ,.� � ' tracfnr'sl.rccnscl.ara(CL�apter9J(commcncing�ritGSrc- � . ---�tron-700DJ JU1,�i.ri.��-3'oJtl�e'O�esinessandProJessioes I , _ i � . ,_ CodeJor[bat ho ri cccnipJ 11 crefrone and tl,e basis for 1Le � a!lc,qeJ r ;+�trnn.An}•rinlation ojBrelion]031.S,by � �, . '. . . [aquirad Dst�Receivod �' " � ` �I . ' ant a pfic' t f rc per� tsuGjccis tl e cppl,'cant7o�ariri( : �----'Rpprowl:---'."".�- Yos No �- or Approwd. �� . ...--�-- . � . . "�.- . . . . '.,:. puial V of nnt mnre O+cn fi�•c 1 undred dollars(SSOOJ.J: �� . . ,��.:, . , .__...__ . _ ��. ` � '.'...�� .� .,:�. f,' ...� .. :L: I,osowner�cf,theproperly,ormyemployecswith '. �� Woler Cerflficalc ' - . � , � �wagos os,th�r eote componsefion;will do�he work,and '. � � � � �-���t�-� -� '� �-�������`��` �' ' �- ���- �- - . .� �1he svucture is noi Inven�ed or ofFered for sale(Sac.7044) i , . F�ealih Depe:tmenf �_ :�_. l____. -_.. _.-: _ . � .. �+. �� �.,. � ,� Baasii:ess and PrnJessior.s Cnde:T!e Conlractnr's Licenae � , .. .., _...__ .._._.__'__ . . �� �._-�. 1.�_�... ;.,�J'��...�fnur doax.nnt appfv.to en oauncr oJ j�rnperty w6o brsilds �I, _.j F�re Department � ,.. . : � . � . . . ._ �.�.� :.. nr inrpro�re t/erron,n:r!mGdunes�srit/.�i•ork birusclf or , ___.- -'.'-- _. .._.` ..._... ____. ._ __ _ �._�._. . --tl�rriugG-b�. oiio: ru�j,(riCeca. /�rnr ided fl a1 suel'��irri- . ', , . .. . �""�- -�v�drd or o a�i'r l� r sa1;::'f, Grading � � _ .._._... . .__ . ..._. .... .. _.�... _.__._ . ..._ / ents�arc-no. �i .11 f J � . - .. . ....-'-�-��. _. . _ . .... louercr,tlre'baildin�'or ri�,rnr'c�r.rntissolJr��itlin�nior . i . ___._.__ .� �:� _-�.- _... . .. . . Geologieol ' � � � ,Ycar f,mr•pletiw�,.t( n¢mer•Luilder i<•i!!�1 acr the .._ .._ .... .. . . � FLrd:n-nf p. 'rrr�_C r �:or b��lJ or t,:ipro?�f r � Pedestrian Pro�euion - 'r!c purposc a/sqTcJ.� .. �J ' . � �...,,. ; ,. . (Fnncej{CanoPY) S , � . -���.:I,a ownr,rof th prop^�ly,a dueively conlmc- . . . ,�. .-�--� . .. ..' . `.�.� ' � , -�-— � � - - -� � hrx,7 with li<nnsd mm ect rs to mnstruU�ho praject(Sec �. �� � � �. ' � _70eq)��q(�rr<c'�ar��f�'rf .o,..GodrtThe Contrcdnr's _ _ i � Specfol Inspeciion �.' � - .�.._._ . ._... . . _ . (Cone.)(Mosonry�(Welding) � � ;�, � . .. . f,icrnsel.mndoa�nntnjpJtil erou•r.ernffrof+crl,y�u�J�n . �.�.� ..,I�i i , � � � _.. __.huiTd�nr mprn�e,�tlunni.,a.rd i��bq ront-nrtsfnrrucb i ; . . � - ._ .� ... .. • ...... ro'ccts fcitb rs mndc:to s licrqsed �urs ant to;'l1�r �, Lot�Drainage-. � � �� . ��� �' l ��. I .. . � -' '. . .�....__. . _. _ __.. --_--.._........_._._-�— --�Cnnfractnr'.c�l.krnsr I,ctrJ,_ _.. . ,.�....-- i Parking `. ; .. .� . . . � '� .. � ,�I . . . _ '._ _am un cr .. � .� . . thi , _.._.._ __ -__-. _. -. .'-... . ...�. . . �. .. .. _ ....�.�... .-_. ..-��� —�-----��-� LI I - cxemPi d Sec. 88PC tor 't � �. . . -. . - -;.-: _. . . .. .. . _.__ . .'.. .... '. Q�_ _. .. ._._. . .. ._ __ —_-_ � n " __ ... '_.. _ , . . '.� . . _ , , ...... . �� � :.,. - ,,,,�. ' �� 1 '� ,,..'•! ,. . C�: � -_ __._._.. __.-- �---_.. . --.. . . �. - Datc -O�.vner - :!;�n�� - ..� . . , �,.- � . . � . l.pprovals Dafe Impocfer's Slgnatur� � � . .. ..... � —^� iN£F_G70SY5 NbTES �.... . -- Lacation— .....__._. __._. _. __. .. . _ _.. , .. . ,.. . . . .�. � (Selbatk GYards)� �.� E � � ' ��'��" � � Foundation� � �. . - ... . � . r .. ' � . r'_ Slab �� � , . .. _. . . ,. , , . '_. I Frame 1Qoc-"C'�`1 -.I 't`�U 1�.�.1� . I . �.. • .. � - . -. . . � _ � , , . .� �.,� .. i. . � . _ . ___ .. _. .. ._ . . �i I , . f .�., �.. , ..,..�i,^.- : '.� ,�.�,�,. � ' ,� .,�- . ,.,.�. Ene�9Y�lnsolation`i � �� _ ....._._.. _. ... �__. .. .. .. � � . . _ La�h/Drywall— � ' . _. . ' . . � Interior ... �" . �.� .: . � . _ .'_.. ' � Lath—Ezterior � �• '�.. •..' ' , �- . "� ' .�� . � , ' "'._____'___.___ ..__"___. ._` .'_ House Number— - . ....� :�^. � . . � . .-. . ���:��:� �.. .., � . . ,; � ., Correct&Posted . ._....:__ �. _' ..._ .._.._... ._ ._ ..... . __....__... ,. . `�� . ' , Final— . i . . . , . . .. . EMer on Front � . - . . . . " . . . . ' . ... .` � .. . � �