HomeMy Public PortalAbout9232 BLACKLEY ST_Building__ APPLICATION FOR COUNTY OF LOS ANGELES
.tDEPARTMENT OF COUNTY ENGINEER
;BUILDING PERMIT BUILDING AND SAFETY DIVISION
BUILDING
FOR APPLICANT TO FILL IN ADDRESS
BUILDING •'1 .2 �ZL C� LOCALITY ,Q GJ--}.
ADDRESS ad_-✓ I.J -0/ CLS J
NEAREST ere, Nl r
CITY F,--V-04- c-1 7- ZIP CROSS ST J J
/ NO OF BLDG S ASSESSOR
SIZE OF LOT Q% /,5-0 NOW ON LOT 1, .Y5ljrl " MAP BOOK PAGE PARCEL
DISTRICT IGROUPITYPE FIRE P ESSED BY
TRACT (jj 2--- BLOCK LOT NO
,D� T CONST ZONE
OWNER J -'V [S>¢tiBAe'* NOL STATISTICAL CJL-A-SSSIFICATION ,
� / SEWER AP
ADDRESS �L C CLASS NO ALL-DWELL UNITS BK d;7P G
nl� GPEONEIMAP
CITYJ �'J! J fT ZIP NO
ARCHITECT ORTEL 1� SPECIALENGINEER .�, -.E C'R r/2NO CONDITIONS
ADDRESS 04-Y" 6 t- j p�,,, ��v ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑
TEL L BLDG SETBACK FROM"41
CONTRACTOR - L�,�f �Qy/y G� NO �t/ (y v ' FRONT PROP LINE OF f (STREET)
ADDRESS/f/lkel.,k eA4e y• NO `J/ b �� HIGHWAY } YARD = T`OTAL SETBACK FROM TYPE OF HIGHWAY EXISTING
I OTTHG
LIC FRONT PROP LINE
CITY 14-"- GV J �� • _ CLASS _
CONSTRUCTION LENDER �- +
NAME AND BRANCH BLDG SETBACK FROM O
ADDRESS _-- CITY SIDE PROP LINEOF (STREET) V
SO FT NO OF NO OF / CHECK HIGHWAY } YARD, = TOTAL SETBACK FROM TYPE OF EXISTING
SIZE 1300 STORIES J FAMILIES ONE -1 1 SIDE PROP LINE HIGHWAY WIDTH V
+ -_ W
DESCRIPTION OF WORK NEW N
ADD ❑ CORNER CUTOFF YES ❑ NO ❑ Z
ALTER ❑
REPAIR❑ IN OPEN{SPACE YES ❑ NO ❑
USE
EXISOT NG BLDG 51dV �j EtdOL [:1IttNyyCOASTAL PERMIT ZONE YES ❑ NO ❑
APPLICANT ' //1 TEL
(PRINT) 6kLSG(„� 0 y�567,5�
B Y (SIGNATURE) oa—
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION X07""
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- /D/ }) - /( !1
STRUC TI ON I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY-ANY PERSON IN VIOLATION OF THE
LABOR CoOE OF THE STATE OF CALIFORNIA IN/RELATING TO 1
WORKMEN'S COMPE NS TI INSURANC - I .� ' ' _
��� FINAL
SIGNATURE OF C+�Z '1y�
PERMITTEE _ DATE(J
ADDRESS�- t d
TEL y��°—/�x PC Fee$ .�— Permit Fee
CITY t-G/ . t'7 / L�C�/T NO
1
Issuance Fee
VALUATION$ ^O !J �,� Total Fee Q?Q _
PLAN CHECK VALIDATION cK M o CASH i t1 PERMIT VALID ION CK Mo CASH
e 2 3 ® 1 .,0, 6.2 0 A1-b '
76A638A CE*8038 12/75 >• ' 1r ,
2 s,�s�huG �� �. ® 1 7 /.0
r
FOR APPLICANAOPFPLICILL IATION nt
FOR BUILDING- PERMIT
IN (Por type only)
COUNTY OF LOS ANGELES
BUILDINGf �� J
ADDRESS Z3 2 /Gc.0 J DEPARTMENT OF COUNTY ENGINEER
CITY 7—t C- ZIP BUILDING AND SAFETY DIVISION
LDING 2
SIZE OF LOT. 170`. NOW ON LOT �L ADIDRESS
TRACT BLOCK C% LOT NO. LOCALIT
NOZ�6
/v1 JS SiM � NEAREST
OWNER c"JyZ' CROSS ST.
q
ADDRESS ('7,L(' ASSESSOR OvQ a4wv MAP BOOK PAGE PARCEL
q �y�/ DISTRICT GROUP I.TYPE FIRE ESSED BY
-CITY /Yac'^ 71 a+ 1 ZIP ���/'' {C7 � '� CONST..
ARCHITECT OR TEL. �—
ENGINEER C�OV�� NO.
STATISTICAL CLASSIFICATION SEWER'MAP
ADDRESS �11I/ t TEL. CLASS NO. _DWELL.UNITS BK PG
CONTRACTOR NO. y�NE MAP !7 J
LIC. NO,
ADDRESS NO. SPECIAL
LIC. CONDITIONS
CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
CONSTRUCTION LENDER j0( ^/�,— /�
NAME AND BRANCH r,�°a�.L SSI IIt► �VING� BLDG.SETBACK FROM
,per,p FRONT PROP.LINE OF (STREET)
ADDRESS CITY F CH CK' __ TOTAL SETBACK FROM TYPE OF EXISTING
HIGHWAY + YARD
SQ.FT. �y� STORIES
IE NO.OF CHECK FRONT PROP.LINE HIGHWAY WIDTH
SIZE (,F/ STORIES FAMILIES ONE
_ r
DESCRIPTION OF WORK NEW ❑ + O
ADD ❑ BLDG.SETBACK FROM �
�-Si (��
UacO xv 1 1 r-j 6 SIDE PROP.LINE OF (STREET) O
ALTER [3 HIGHWAY SETBACK FROM TYPE OF EXISTING Y
6u L S� HIGHWAY + YARD. = SIDE PROP.LINE HIGHWAY WIDTH . N
USE OF r REPAIR ED - Z
EXISTING BLDG. �1S C DEMOL ❑/ +
APPRIC TSA ��� San TELNO�/ ( CORNER CUTOFF YES ❑ NO
I ❑
+Y1 IN OPEN SPACE YES ❑ NO ❑
BY(SIGNATUR , IN COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION $
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES '
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM-
PENSATAON INSURANCE.
SIGNATURE
PERMITTEE
ADDRESSFINAL
TEL.)
CITY ,�'`�_ NO. DATE �j
MAKE CHECKS PAYABLE TO: FEE' aL FEET.EIF P.c f PMT
HARVEY T.BRANDT,COUNTY ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION AGK `�M.o. CASH
1 0 2wJAN dei 1 D 9.0 0 m
®s 76A63BA CE#803 3-75
v/a-
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1106060048
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
1TR: 11492 LT: 6 BL: C SQ. FT STORIES TYPE 9232 BLACKLEY ST
(STRUCTURE: 18 V-B TEMP CA 917803136
(ASSESSOR INFORMATION NUMBER: 1 1 NEAREST CROSS STREET: 1
18590-009-007 1 1 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, Cl
1TENANT: 1EXIST BLDG USE: RESID . USE ZONE: R-1 (ISSUED ON: PROCESSED BY: I
1EXIST OCC GRP: 106/06/11 SR 1
I I I I
(OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: 1FINAL TE FI BY: CODE: 1
1LIEOU ALICE (949) 206-1189- 1 5,100
19232 BLACKLEY ST j
I
(TEMP 917803136 I FEES PAID IDLnCRIPfION OF WORK 1
I IT/O OLD ROOF INSTALL 30 YR OMP SHINGLE 1
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( I
1APPLICANT: TEL. NO: I I I
1ALFRED LAU (626) 285-9016- IAA BLDG PERMIT ISSUANCE 27.80 I
14533 SHIRLEY AVE IAB STATE GREEN BLDG FEE 5100.00 VAL 1.00 (SPECIAL CONDITIONS: 1
1EL MONTE CA 91731 iAC STRONG MOTION RESID 5100.00 VAL 0.50 I
1 ID2 PERMIT W/O EN-HC 5100.00 VAL 149.70 1 I
I I TOTAL FEES 179.00 1 1
(CONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE 1
(GOLDEN KEY INC. (626) 285-9016- I I I
14533 SHIRLEY AVE LIC. NO j 1LOCATION AND SETBACKS I 1 I
IEL MONTE, CA 91731 775115C39 I I I I
I (SOILS ENGINEER APPROVAL I
(ARCHITECT OR ENGINEER: TEL. NO: IFOUNEATION/TRENCH FORMS I I
I
I LIC. NO: I ISLAB/:.IDEA FLOOR I I
I I I 1-1 I
(RAISED FLOOR FRAMING I
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: ; (UNDERFLOOR INSULATION
I 1 I
1147H265 3 00i 1 1 I
I 1FLOOR SHEATHING I I
1NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 1 I I I
1 0 NO 21 1 1ROOF SHEATHING (
1 SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS I
1AIR QUALITY: 1000 FEET MATERIALS I I I
1 NO NO NO I IFRAME INSPECTION I 1
1FIRE SPRINKLER HANGERS I
(INSULATION/WEATHER STRIPI I I
I I I I
(INTERIOR LATH/DRYWALL
I I I I I I
�. 1EXTERIOR LATH
I I I
I I 1RATED FLOOR/CEIL ASSEM. 1 I I
I I I I I I
I (RATED WALL ASSEMBLIES
I I I
(RATED SHAFTS/OPENINGS I
I I I I I I
IT-BAR CEILINGS I I
I I I I I I
ILOT DRAINAGE I I
I I I I I I
IREPORT ID: DPR261 ROUTE TO: BS0508
I I I I I I