The URL can be used to link to this page

Home My Public Portal About9237 BLACKLEY ST_Building__ 76AG30A CE#8015//0 APPLICA"T"ION. FOR BUILDING PERMIT 1 COUNTY OF LOS ANGELES B u I LD I J DEPARTMENT OF COUNTY ENGINEER ADDRES 1 BUILDING AND SAFETY DIVISION LOCAL IT<.">&., JOHN A LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A JENSEN SUP T OF BUILDING CROSS ST ` DISTRICT NO P rypE' P CESSED BY GROU FOR APPLICANT TO FILL IN v�`�8 CONSr BUILDING STATISTICAL CLASSIFICATION SEWER MAP a BK PG ADDRESS /�'' CLASS NO � r+WELL UNITS � 6. LOT NO / �`kJBLOCKr MAP STATE YES O NUMBER_V' HWY TRACT USEZONE SPECIAL NO OF BLDGS CONDITIONS SIZE OF LOT I NOW ON LOT ! ` USE OF EXISTING BLDG BUILDING YARD HWY STREET NAME EXIST l TEL SETBACK - "W TH OWNER T -71 FRONT P L ADDRESS SIDE ARCHITECT OR TEL P L ENGINEER NO INSPECTION RECORb ADDRESS TEL CONTRACTOR NO O ADDRESS IWA4 y e r �� I y Je hey a DESCRIPTION OF WORK 7/ND/5/}}}O33Y iN CXY ydd/ NEW ADD ALTE REPAIR D41ES / SQ NO OF ,��✓,��%�"" t'Y'/ SIZE STORIES USE OF STRUCTURE SIGNATURE OF r APPLICANT - VALUATIONS APPROVALS DATE INSPECTOR S SIGNATURE _ PMT UNDATION LOCATION F E $ FEE 'FORMS MATERIALS FRAME FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- BRACING, BOLTS PLICATION AND STATE THAT THE ABOVE IS CORRECT AND FURNACE LOCATION f / AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT, ENT DUCTS STATE LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED I LATH, INT WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE WORKMEN S COMPENSATION LAWS OF CALIFORNIA LATH EXT SIGNATURE OF r HOUSE NUMBER COR- PERMITTE RECT AND POSTED �,,//I ADDRESS FENAL I movv I CLYDE N DIRLAM, PRINCIPAL_STRUCTURAL ENG ER PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M O CASH ` r - U, Or C39 DEC 1 1_ 2.0 0 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS-ANGELES t`=t BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUIL l hereby affirm that I have a certificate of consent to self Insure, BUILDING ADDRES or a certificate of Workers Compensation Insurance,or a certified copy thereof (Sec 3800 Lab C) CITY ZIPI LOCALITY Policy NO Company SIZE OF LpT� NO OF BLDGS NOW ON LOT ❑ Certified copy Is hereby furnished fh/ ,k 40 NEAREST CROSS ST ❑'Certlfled copy Is filed with the county budding Inspection TRACT BLOCK LOT NO department USE ZONE MAP NO ASSESSOR M BO e- PAGE^ PARC / - SPECIAL CONDITIONS EL Date Applicant v CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO COMPENSATION INSURANCE PailO WITHIN 1000 FT OF SCHOOL? ves No (This section need not be completed If the permit is for one hundred ADD}3ESO /•'�+� dollars ($100) or less) 66 /•' v DISTRICT GROUP TYPE CONST FIRE ZONE PRO(,ESSED BY fq T/ I certify that In the performance of the work for which this permit, CITY ZIP 19 SO IS Issued I shall not employ any person In any manner so as to ARCHITECT OR ENGINEER TEL NO v become subject to the Workers'Compensation Laws STATISTICAL CLASSIFICATION APT CONDO DateZ/� Applicant MOAII/FL l�At R ADDRESS -- CLASS.— DWELL UNITS i NOTICE TO APPLICANT If after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you Should become Subject t0 the Workers' CONTRACTOR, q T TEL NO SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith /�/(, 1 / /` FRONT comply with such provisions or this permit shall be deemed revoked ADD ESS i0�t _ttl j!-17J) LIC NO PL L✓ SIDE LICENSED CONTRACTORS DECLARATION CITY LIC CS P L I hereby affirm that I am licensed underprovisions of Chapter 9 �`i1 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ FT SIZE NO OF STORIES NO OF FAMILIES Professions Code,and my license Is In full force and effect NEW 13 BK PG , License Number 6(? nCl(CL LIC Class� DESCRIPTION OF WORK �� L� ADD X VALUATION M rpB:67�- 7 G � d o Contractor Date �-/'� ALTER ❑ � ❑ I am exempt under Sec O ZD21 V' REPAIR El $ 0 B&PC for this reason DEMOL ❑ LDMA P/C# uJ Date USE OF EXISTING BLDG r URM ❑ i_ � Signature ' APPLICA PRINT) N TEL NO �1- MA Perm# r- t� ,Z El 1, as owner of the property, or my employees with wages as + I Z `I`_ i a a their sole compensation, will d0 the work and the structure IS ADDRESS/� I�y�� FINAL DATE _ O �' t` not Intended or offered for sale (Section 7044 Business and b F/ Yi /� Q `_ Professions Code) _ WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL Cf= �� r -� .� ❑ I, as owner of the property, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE �(J Q P Y g AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE licensed contractors to construct the project (Section 7044, YES❑ NO� FINAL BY ,� , > Business and Professions Code) f - WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING _`_I_ _ OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH71 CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR r GUIDELINES i• 1 I hereby affirm that there Is a construction lending agency for YES El NO I f n 71-;{t- 398 - 35 N the performance of the work for which this permit Is Issued(Sec I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097,CIV C) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE -.7. , +C N TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS -'� "- 3 Lenders Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD sk i n, o Lender's Address - _ i'�L OMJER OR AGENT oI certify that I have read this application and state under penalty o PC FEE PERMIT FEE LLL of perjury that the above Information Is correct I agree to comply O �a/ 7 J t 1(11_{{-+_t,19 J. with all c my r Inances and State laws rel"tobuilding 7construct and by aut orize representativeISSUANCE FEEID to enter on e ned property for Ins -a INVESTIGATION FEE TOTAL FEE SEE REVERSE FOR EXPLANATORY LANGUAGE t APPLICATION FOR BUILDIP4,G PERMIT COUNTY OF LOS ANGELES 'i BCJILvrING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT.TO FILL IN. BUILDING ADDRESS 92. `' I hereby affirm that I have a certificate of consent to self insure, BUILDING ADORES$ or a certificate of Workers' Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) CITY ' �t 7 ZIP � LOCALITY ' l Policy No. Company SIZE OF L Q (�� ) N0.OF-BLDGS.NOW ON LCOTT ❑ Certified copy is hereby furnished. ` NEAREST CROSS ST �y •� ❑ Certified copy is filed with the county building inspection TRACT Z BLOCK LOT NO. q department. USE ZONE MAP NO. ASSESSOR AP BOOK PAGE- PARCEL Date Applicant 0 C► SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER J TEL NO. _ N / COMPENSATION INSURANCE - &k i" �� WITHIN 1000 FT.OF SCHOOL? ves No (This section need not be completed if the permit is for one hundred ADDRESS � i/ DISTRICT GROUP TYPE CONST. FIRE ZONE' PROCESSED BY dollars ($100)or less.) 80_ )C - � I certify that in the performance of the work for which this permit CITY ZIP C-/f` 1 O is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. become Subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date.G`�� Applicant V G�4 B%i�57 9 ADDRESS CLASS NO. DWELL UNITS �N 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. P L SIDE LICENSED CONTRACTORS DECLARATION CITY LIC.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 SQ.F IZ NO.OF STORIES NO.O FAMILIES _ Professions Code,and my license is in full force and effect. NEW ❑/ BK PG , d License Number Lic. Class DESCRIPTION OF WORK ADD loft VALVA ION O Db ? !'i i� Contractor Date ALTER ❑ $ - o U v REPAIR ❑ 0 ❑ I am exempt under Sec. U B.&P.C.for this reason DEMOL ❑ LDMA P/C# (1J Date: USE OF EXISTING BLDG. URM ❑ — .a- Signature APPLICANT(PRINT) TEL NO. LDMA Perm# j`1% _iZ I, as owner of the property, or my employees with-wages as their sole compensation, will do the work and the structure is ADDRESS :r:; not intended or offered for sale (Section 7044, Business and FINAL DATE -�C`= `F t "- d ` Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE a, ❑ 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, vEs 11 No 1-1 r11L.E. — Business and Professions Code.) - _ r ;M; WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING - _•_'•t :. OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH �•' _ CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR 4 jFTEMS GUIDELINES. '" I hereby affirm that there is a construction lending agency for YES❑ NO❑ ':L. � ,�- N the performance Of the Work for Which this permit Is Issued(Sec. IHAVEREAD THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THESCAQMD PERMITTINGr� 3097,Civ.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, '+ T _ _: TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. •t is C' n1-11-1 o Lender's Address OWNER OR AGENT , O o I certify that I have read this plication and state under penalty O <� P.C.FEE _� PERMIT FEE _: 1= d of perjury that t abo 10 ation is correct. I agree to comply L O �77 �gr )`I1 i.='`y.E N with all count ordi and State laws relating to building `J t7 - m construe n, d he b u ri representatives of this County ISSUANCE FEEI I'`{ " to u o he n r erty-for inspection purposes. vv� AMI10 i a , INVESTIGATION FEE TOTAL FEE r Signatur I and or ge v Date O' SEE REVERSE FOR EXPLANATORY LANGUAGE i COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT • DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0102260006 PHONE. (626) 285-0488 EXT: LEGAL ID NO OF CONST NEW BUILDING ADDRESS, TR: 11492 LT: 14 BL: A SQ FT STORIES TYPE OCCUP GROUP 9237 BLACKLEY ST STRUCTURE- 0 1 VN R3 TEMP CA 917803137 ASSESSORINFORMATION GARAGE: NEAREST CROSS STREET: ENCINITA 8590-001-017 OTHER: 360 1 VN U1 THOMAS PAGE- 596 GRID: J4 LOCALITY: TEMPLE CITY ANT: EXIST BLDG USE USE ZONE ISSUEDPROCESSED BY: EXPIRES ON EXIST OCC GRP 02/26/01 UT 08/25/01 OWNER: TEL NO: BLDGS. NOW ON LO • VALUATION FINAL DATE BY CODE: PASTOR DENIS;VILLALOBOS MARIA CRIST (626) 285-4159- 1 10,330 9237 BLACKLEY ST �' TEMP 917803137 FEES PAID DESC TIOI OF WOW I NEW STORAGE SHED -360 SQ FT - NOT FOR HABITATION OR FOR FEE DESCRIPTION: QUANTITY UOM• AMOUNT- RENTAL-COVENANT RECORDED AT COUNTY RECORDER'S OFFICE APPLICANT: TEL. 0 SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27 75 AC STRONG MOTION RESIDE 10330.00 VAL 1 03 SPECIAL CONDITIONS: AX BUILDING,REVIEW-FEE- \ 54 70 D2 PERMIT W/O;EN;HC Ri;_� (10330`00 VAL 233 40 TOTALFEES\\ 316 88 CONTRACTOR. TEL. 0: / ? \ APPROVALS DATE INSOR SIGNATURE SAME AS OWNER y�\ LIC. NO / ,r✓"�� \\ LOCATION AND SETBACKS SOILS ENGINEER APPROVAL �� ARCHITECT 0 R: TEL N0: DA I C 0 LIC NO -�- `llilllli SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE M ,' i - r %/ i� UNDERFLOOR INSULATION dI 1STLEVEL FLOOR SHEATH 0. OF FAMILIES: 5WELLING UNITS PT/COND STAT CLASS.- NO 21 2ND LEVEL FLOOR SHEATH SCHOOL WITHIN HAZARDOUS �� ` �/� ROOF SHEATHING AIR QUALITY• 1000 FEET MATERIALS i NO NO NO ` V ' �� iFIRE DEPT FRAME INSPECT REQUIRED C FROM EXIsT-- BLDG DEPT C SET BACK YARD: HWY: PROP LINE WIDTH. A0.` FRONT PL- SHEAR PANELS SIDE PL - I NSUL T A R STRIP INTERIOR LATH/DRYWALL EXTERIOR LATH LOT DRAINAGE SMOKE DETECTION FIRE DEPARTMENT APPROVAL REPORT ID: DPR261 ROUTE TO. BS0508 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 9908250011 PHONE: (626) 285-0488 EXT: LEGAL . OF CONST BUILDING-ADDRESS: TR 11492 LT: 14 BL: A SQ. FT STORIES TYPE 9237 BLACKLEY ST STRUCTURE: 0 VN TEMP CA 917803137 ASSESSOR INFORMATION UMBER•_ NEAREST CROSS STREET: ENCINITA 8590-001-017 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: SD E Z . R ISSUED ON: PROCESSED BY: EXPIRES . EXIST OCC GRP 08/25199 UT02 1/00 11) OWNER: TEL. 0: BLDGS NOW ON LOT: VALUATION- INAL DATE FINAL BY• CODE: PASTOR DENIS;VILLALOBOS MARIA CRIST (626) 285-4159- 1 6,000 2 moo 9237 BLACKLEY ST 2 3 TEMP 917803137 � FEES ID DE 1PTI0 0 R RELOCATE BATHROOM IN EXISTING SQ F - CREATE NEW BEDROOM FEE DESCRIPTION: QUANTITY• UOM: AMOUNT: TOTAL12 BATHROOMS AND 3 BEDROOMS APPLICANT: TEL ; SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 6000.00 VAL 0.60 SPECIAL CONDITIONS: AX BUILDING REVIEG_FEE--�-�� 54.70 B2 PERMIT w/ENERGY GE E c 6000:00 VAL 164.34 ply TOTALFEES 247.39 CONTRACTOR: TEL NO: ? �c3 ��. APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO LOCAT10N AND SETBACKS f SOILS4ENGINEER AP OVAL ARCHITECT OR ENGINEER: TEL 0: OUNDATIOFORMS LIC NO: 1111111 SLAB/UNDER FLOOR RAISED FLOOR FRAMING i M47H265 SEWER MAP BOOK: PAGE: FIRE 20N3: CM01L�n D WC `\n�J O UNDERFLOOR INSULATION �, IluJ) �v OORIS G 0 OF FAMILIES: DWELLING U PT STAT CLA' S:= NO 21h �' ROOF SHEATHING SCHOOL WITHIN HAZARDOUS19 EAR PANELS AIR QUALITY: 1000 FEET MATERIALS 0 NO NO NO i El ® ® F M 'INS CTION _ /A REQUIRED AL FROM EXIST WIDTH: �4b/j ❑ w1OQ�� ?PR ANG SET BACK YARD: HWY: PROP LINE: �11`tl� FRONT PL- C Service this INSULATION/WEATHER ST P SIDE PL- ` INTERIO LATH/D L � EXTERIOR LATH RATED, FLOOR/CEIL ASSEM. RATED,WALL ASSEMBLIES { RATED SHAFSOP � l T-BAR, CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508