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HomeMy Public PortalAbout9410 BLACKLEY ST_Building__ APPLI ATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN mt or type only) I a COUNTY OF LOS ANGELES ADIDRESS �//O L L I DEPARTMENT OF COUNTY ENGINEER CITY ,9 A C 17—Y ZIP BUILDING AND SAFETY DIVISION SIZE OF LOT 4 S 7tC 4_5 NOW ON-;LOT ADIDRESS G� . TRACT BLOCK LOT NO LOCALITYTEL NEAREST OWNER Az/4 NO (.7132 CROSS ST ASSESSOR ADDRESS Cly/L-) c Zg-y MAP BOOK PAGE PARCEL DISTRICT T GROUP TYPE FIRE PROCESSED BY -CITY rLf C f ZIP CONST ZONE ARCHITECT OR TEL L, -j-- -3 � r ENGINEER NO STATISTICAL CLASSIFICATION SEWER MAP ADDRESSTEL 9q // - CLASS NO DWELL UNITS BK PG CONTRACTOR USE ZONE NO Q LIC V ADDRESS r NO SPECIAL - LIC � CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENCEIR NAME AND BRANCH BLDG SETBACK FROM ' FRONT PROP LINE OF (STREET) ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ FT NO OF NO OF CHECK HIGHWAY + YARD = FRONT PROP LINE HIGHWAY WIDTH SIZE STORIES C FAMILIES ONE DESCRIPTION OF WORK NEW 21 + O BLDG SETBACK FROM ADD -9 SIDE PROP LINE OF (STREET) O ALTER ❑ TOTAL SETBACK FROM TYPE OF EXISTING w HIGHWAY + YARD = SIDE PROP LINE HIGHWAY WIDTH h USE OF REPAIR ❑ Z EXISTING BLDG L L7� DEMOL ❑ + APPLICANT _ / i G TEL 7 CORNER CUTOFF YES ❑ NO ❑ (PRINT) V BY(SIGNATURE( IN OPEN SPACE YES ❑ NO C]- Q IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION $ _ Of I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES - p AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE - � /\GOT L✓ I - �pC//,Sljr?I WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN 5 COM D � �0,107sS PENSATION INSURANCE r3r Cam J �jy SIGNATURE OF PERMITTEE ADDRESS �•G�C L F7 7�?i5 /( �jQOG� `/N�'�� *��s - FINAL +. CITY L f�/'�rR/& G I I7y NO 2 6 DATE MAKE CHECKS PAYABLE TO FEE PC $ FET HARVEYT BRANDT,COUNTY ENGINEER A r PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION CK M o ASH ®S 76A638A CE#803 3 75 6/78) 1 APPLICATION FOR BUILDING PERMIT a COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN ADIDRESS 95/0 ` mtckl - BUILDING ADDRESS 10 / C K t LOCALITYNEAREST ' (� 1 CITY C /7ZIP I �O CROSS STNO OF BLDGS ASSESSOR SIZE OF LOT 13 5-N 7/6 NOW ON LOT J MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE PROCESSED BY TRACT BLOCK LOT N 1. TEL *O'��/ �} /© CONST�� ZONE OWNER��) 4- 25 NICC0'- NOar(plr> 13� ��� -� ` � +�/ �7 r' _ STATISTICALCLASSIFICATION SEWER MAP ADDRESSL� / IC) 11-CK CLASS NO 52i/ DWELL UNITS__j BK PG CITY /C/--1 /t Cl/ ZIP ARCHITECT OR TEL VALUATION $ ENGINEER NO ADDRESS BLDG SETBACK FROM TEL FRONT PROP LINE OF (STREET) CONTRACTOR NO HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING LIC .�� FRONT PROP LINE HIGHWAY WIDTH ADDRESS NO LIC + CITY CLASS BLDG SETBACK FROM CONSTRUCTION LENDER SIDE PROP LINE OF (STREET( NAME AND BRANCH TOTAL SETBACK FROM TYPE OF EXISTING ADDRESS HIGHWAY + YARD = SIDE PROP LINE HIGHWAY WIDTH 0 SO FT G NO OF NO OF CHECK + _ SIZE DO STORIES FAMILIES ONE 99 DESCRIPTION`OF WORK i,o J A, l T o NEW ❑ PC Fee$ Permit Fee zf— E,j,, IL Y © ADDClIssuance Fee 7 ALTER i REPAIR ❑ Total Fee USE OF DEMOL ❑ EXISTING BLDG �/ ZO APPLICANT �1 TEL c'/6 (PRINT( �j-�(,Cj /LJ /UIC.�d�LJO�0 ?1cf 3 z7;755A � a BY(SIGNATURE( > 0 0 0 0 0 1 1 HEREBY ACKNOWLEDGE AT I HAVE READ THIS APPLICATION AND STATE UY ' THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE V ' 2,0 - 25.00 WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF C - THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN 5 COM z o o O 2 .h O O U PENSATION INSURANCE 11, 1 4'-7 9 SIGNATURE OFt�� PERMITTEE ADDRESS_qL7eo lock E Z TEL CITY T�f'I7��L G!�( NO. Q _O USE ZONE NAP O �O/ USE Q SPECIAL e7O CONDITIONS :E o� FINAL ef� BY DATE 7 r, A RPL I CATII O N FOR COUNTY'OF LOS ANGELES zDEPARTMENT OF COUNTY ENGINEER ' B U L D I N G PERMIT BUILDING AND SAFETY DIVISION BUILDING FOR APPLICANT TO FILL IN ADDRESS Q / - eo ADDSSBUILDNG �/ 4 r LOCALITY r ' f P NEAREST" CITY C� Z CROSS ST ,� �• NO-OF BLDGS j ASSESSOR SIZE OF LOT NOW ON LOT r/ MAP BOOK PAGE PARCEL DISTRICT GROUPTYPE FIRE CE SEED BY TRACT / BLOCK LOT NO 'CONS ZONE OWNER /LC�UJYINOL eV( a STATISTICAL CLASSIFICATION SEWE MAP ADDRESS ClpcKLt+ CLASS NOG;7Z__DWELL UNITS BK PG CITY- '9 USE ZONE MAP �J !_� �l ZIP �'� f NO ,=, Q� ARCHITECT OfR TEL SPECIAL ENGINEER NO QV CONDITIONS ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES_❑ NO ❑ CONTRACTOR NOL T BLD SETBACK FROM I __ _LIC FRO T PROP LINE OF (STREET)_ ADDRESS - '` NONIGTOTAL SETBACK FROM TYPE OF EXISTING CITY LIC H AY + VARD = FRONT PROP LINE HIGHWAY WIDTH .z _ CLASS CONSTRUCTION LENDER + a NAME AND BRANCH _ _ BLDGSACK FO ADDRESS CITY SIDE PROP ,R ROM (STREET) C) SQ FTS/-15-1NO OF NO OF CHECK HIGHWAY + YARD = SETBACK FROM TYPE OF EXISTING ICC SIZESTORIES FAMILIES ONE SIDE P LINE HIGHWAY WIDTH U DESCRIPTION OF WORK �f �(,` NEW + r �� �� � ADD CORNER CUTOFF YES ❑ NO Z { ALTER ❑ �...._,_ _ - ' 0jo REPAIR[I IN OPEN SPACE YES ❑ NO ❑ USE ✓O NG BLDG L -� DEMOL E] IN COASTAL PERMIT ZONE YES C] NO ❑i - `J C� may{ /y/��iw, p�� A•P P R I NT)ANT , G t�N OL.G / Jor— IA'/-Vyy BY (SIGNATURE SII �� Crl..� 31 I_HEREBY ACKNOWLEOGg57rHAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY K, WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION 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 COMPEN -TION INSURANCE � - P SIGNATURE OF X FINAL ZX7/� IY PERMITTEE �r' DATE I v � r ADDRESS gwe GxCz, •"'� T TEL 2 3 Permit Fee CITY � ' / NO PC Fee$ - Issuance Fee VALUATION-$, Q� - { Total Fee Z �� PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATIO CK M o CASH 5 4 6 rE�AY 26 1 .�► 8 4.5 0 78-838- CE*8038 12/75 - "APPLICATION FOR' _BUILDING .PERMIT FOR.APPLICANT TO FILL IN ADIDRESS BUILDING` ADDRESS /(J° _ /) E LOCALITY NEAREST_- Zip // CITY �/ ZIP CROSS ST • S Q i26 + tNO OF BLDGS ASSESSOR - , _- '' SIZE OF LOT_-/ 0 /` '/�// NOW ON LOT /'i MAP BOOK PAGE PARCEL r� DISTRICT GROUP TYPE FIRE PROCESSED BY TRACT )7nL BLOCK ` `O LNO J�/' �� �` CONST ZO .OWNER-(J;4 V V Lcr— O V W.3 _L i 11 �Lo , I - - I STATISTICAL CLASSIFICATION SEWER MAP ADDRESS Q 16/04 lir a f -�' CLASSNOuA_1DWELU UNITS BK PG,J� CITY/�/Yf G �'�'� ZIP / USE-ZOTE MAP ARCHITECT-OR TEL ' -' O Cj ENGINEER NO SPECIAL ' CONDITIONS ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ s TEL CONTRACTOR NO BLDG SETBACK FROM LIC FRONT PROP LINE OF -(STREET) ADDRESS -' NO TOTAL SETBACK FROM TYPE OF EXISTING LIC HIGHWAY, + YARD FRONT PROP LINE HIGHWAY WIDTH CITY` c - - CLASS CONSTRUCTION LENDER 4 + r a NAME AND BRANCH BLDG SETBACK FROM - U ADDRESS CITY SIDE PROP LINE OF STREET) O SQ FT NO OF NO OF CHECK HIGHWAY + YARD T AL SETBACK FROM TYPE OF EXISTING 1' r k DE PROP LINE HIGHWAY WIDTH SIZE STORIES ' FAMILIES - ONE v DESCRIPTION OF WORK ' Q /it/ a NEW E] + ' ��` DD ❑ CORNER CUTOFF YE ❑ NO ❑ ALTER ❑ IN OPEN SPACE YES, NO ❑ � REPAIR � - EUSE XISTING BLDG I DEMOL ❑ IN COASTAL PERMIT/ZONE YES ❑ NO ❑ APPLICANT PRINTILbt r TEL16^;d-40 -N0 1Y/iN! M/i� BY(SIGNATURE( I HEREBY-ACKNOWLEDG AT I HAVE READ THIS APPLICATION'AND STATE THAT THE ABOVE ISCORRECT AND,AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE >( - WORK AUTHORIZED HEREBY IW ILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM PENSATION INSURANCE ` SIGNATURE OF FINAL PERMITTEE' Ln�/%ham w" DATE ADDRESS67 µ Y TEL P C Fee$ Permit Fee CITY NO Q7Issuance Fee J VALUATION$ _ Total Fee ° PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M 0 CASH .00 .a _, ®3-76A638B CE M803B 6/76` WORKERS' COMPENSATION DECLARATION nsure hereby raa ce of caffirT ne of WorkersrlCompensahon Insuran eificate of consent to lf A APPLICATION F®R' �i.;UIL D I N G PERMIT or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company BUILDING ❑ Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS 1#10 r ❑ Certified copy is filed with the county building mspec_ BUILDING tion department ADDRESS Date Applicant CITY NO OF IP � �0 LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS" SIZE OF LOT �% NOW ON LOT NEAREST CROSS ST COMPENSATION INSURANCE I ASSESSOR f! �j„^ p /� (This section need not be completed if the permit is for one TRACT BLOCK LOT NO MAP BOOK U PAGE46tZO PARC¢e hundred dollars ($100)or less ) , TEL _ OWNER NO E ZONE MAP I certify that in the performance of the work for which this NO SPECIAL >_ permit is issued, I shall not employ any person in any mannei ADDRESS CONDITIONS a_ so as to become subject to the Workers'Compensation Laws �] OU e CITY- '' G [! 4= ��� a / Date Applicant ARCHITECT OR TEL DISTRICT GROUP I TYPE FIRE PROCESSED BY NOTICE TO APPLICANT If, after making this Certificate of ENGINEER NO - Dc7 `� CONST ZONE 0 Exemption, you should become subject to the Workers' 3 Compensation provisions of the Labor Code, you-must forth- ADDRESS w o_ with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT CONDO deemed revoked CONTRACTOR NOZ LICENSED CONTRACTORS DECLARATION LIC CLASS NO DWELL UNITS_741o I hereby affirm that I am licensed under provisions of Chapter 9 _ ADDRESS NO SEWER MAP (commencing`with Section 7000)of Division 3 of The Business a LIC and Professions Code,and,my license is in full force and effect CITY CLASSBK VALIDATION- SQ FT/� NO OF NO OF CHECK PG License Number Lic Class SIZEOf�� STORIES FAMILIES ONE VALU/TION Contractor Date - DESCRIPTION OF WORK Ajl� NEWDD $ C/O ❑ ,❑I am exempt under Sec � ;+ J ALTER EJ B 8P C for this reason REPAIR ❑ $ Date USE OF EXISTING BLDG DEMOL ❑ Signature APPLICANT ?EL FINAL a OWNER-BUILDER DECLARATION (PRINT)1 NO DATE I hereby affirm that I am exempt from the Contractor's License - I - �} Law for the following reason (Section 7031 5, Business and ADDRESS FINAL Qtr a P of sions Code) PRESENT- By BUILDING j, as owner of the property,-or my employees with ADDRESS V, 1�v.�S wages as their sole compensation,will do the( LOCALITY `7 work and r �` t ITEMS the structure is not intended or offered for sale Section 7044, Business and Professions Code ) MOVING - - TEL , ^ TOTAL ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO �+ r O 229 — :15 with licensed contractors to construct the project (Sec- ADDRESS r CHECK -229.15 tion 7044, Business and Professions Code ) , REQUIRED YARD HWY TOTAL SETBACK FROM �JZD ' CHANGE - .00 CONSTRUCTION LENDING AGENCY SET BACK PROP LINE s I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this pefmit is issued P L (Sec 3097, Civ c ) SIDE GWO-0001 7/11/96 96 P L '" Lender's Name ' , L Q 9 � .�JrG Ref # i�� • r �'•`', r(j7't 1 AM 14 a� P C Fee$ t:/�' Permit Fee � Lender's Address I�certify that I have read this application and state that the Issuance Fee P/C# move information is correct I agree to comply with all County Investigation Fee ordinances and State laws relating To building construction, Total Fee Perm # a and hereby authorize'representatives of this County to enter A upon the above-mentioned pro erty for inspection purposes V14 B r SEE REVERSE FOR EXPLANATORY LANGUAGE gnature plicant or Agent Date , 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 1310310083 PHONE (626) 285-0488 EXT DUPLICATE ILEGAL ID NO OF CONST BUILDING ADDRESS ITR 14572 LT 46 SQ FT STORIES TYPE 9410 BLACKLEY ST ISTRUCTURE 1800 V-B TEMP CA 917803140 1 IASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LA ROSA 1 18590-008-013 THOMAS PAGE 596 GRID S4 LOCALITY TEMPLE CITY CAI ITENANT 1EXIST BLDG USE RESID USE ZONE R-1 (ISSUED ON PROCESSED BY EXIST OCC GRP 110/31/13 SR JOWNER TEL NO 1BLDGS NOW ON LOT VALUATION IFINAL DATE FINAL BY CODE 1 ICHEN, PETER G (626) 380-5353- , 6,500 I 19410 BLACKLEY ST I 1 ITEMP 917803140 1 FEES PAID ID RIPTION F WORK 1 I 1 ITEAP OFF REROOF WITH LIGHT AGHT TILE I I IFEE DESCRIPTION QUANTITY UOM AMOUNT I (APPLICANT TEL NO I1 SAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27 80 JAB STATE GREEN BLDG FEE 6500 00 VAL 1 00 ISPECIAL CONDITIONS JAC STRONG MOTION RESID 6500 00 VAL 0 70 1 ID2 PERMIT W/O EN-HC 6500 00 VAL 166 20 TOTAL FEES 195 70 ICONTRACTOR TEL NO - (APPROVALS DATE INSPECTOR SIGNATURE I ISAME AS OWNER - I- I LIC NO LOCATION AND SETBACKS ISOILS ENGINEER APPROVAL 1 1ARCHITECT OR ENGINEER TEL NO IFOUNDATION/TRENCH FORMS I I 11 LIC NO ISLAF/UNDER FLOOR 1 I 1 IRAIELD FLOOR FRAMING 1 1 I I I I IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP 'I JUNDE.RFLOOR INSULATION 1 3 ocj I-- I I IFLOOR SHEATHING I 1 INO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS II _ 1 NO 21 1 IROOE SHEATHING I 1 SCHOOL WITHIN HAZARDOUS I ISHEA . PANELS I rAI JAIR QUALITY 1000 FEET MATERIALS I I NO NO NO I (FRAME INSPECTION I IFIRE SPRINKLER HANGERS I I (INSULATION/WEATHER STRIPI I I (INTERIOR LATH/DRYWALL 1 1 (EXTERIOR LATH I 1 1 IRATED FLOOR/CEIL ASSEM I I IRATED WALL ASSEMBLIES 1 1 IRATED SHAFTS/OPENINGS I I I IT-BAR CEILINGS 1 1 - ILOT DRAINAGE IREPORT ID DPR261 ROUTE TO BS0508 I 1 I I I I I h i\ 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 0712200014 PHONE (626) 285-0488 EXT ILEGAL ID NO OF CONST BUILDING ADDRESS ITR 14572 LT 46 SQ FT STORIES TYPE 9410 BLACKLEY ST I STRUCTURE 66 VN TEMP CA 917803140 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET ALESSANDRO 18590-008-013 THOMAS PAGE 596 GRID J4 LOCALITY TEMPLE CITY, Cl ITENANT 1EXIST BLDG USE RESID USE ZONE R-1 (ISSUED ON PROCESSED BY EXPIRES ON 1 (EXIST OCC GRP 112/20/07 SR 06/17/08 I 1OWNER TEL NO IBLDGS NOW ON LOT VALUATION IFINAL DAT BY CODE 1 LIU, XING TI (626) 780-6452- 1 1,320 EXPIRM 19410 BLACKLEY ST ITEMP 917803140 I FEES PAID IDESCRIPTION OF WORK I I (ADD FRONT PORCH 66 S F I IFEE DESCRIPTION QUANTITY UOM AMOUNT 1 (APPLICANT TEL NO I 1 (LIU (626) 780-6452- IAA BLDG PERMIT ISSUANCE 27 75 I 19410 BLACKLEY ST 1AC STRONG MOTION RESID 1320 00 VAL 0 50 ISPECIAL CONDITIONS 1 ITEMPLE CITY CA 91780 IAX BUILDING REVIEW FEE 54 70 1 ID2 PERMIT W/O EN-HC 1320 00 VAL 82 20 TOTAL FEES 165 15 ICONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE 1XINGTI LIU (626) 780-6452- 1 19410 BLACKLEY STREET LIC NO ILOCATION AND SETBACKS I ITEMPLE CITY, CA 91780 NONE I I_ I 1 ISOI-S ENGINEER APPROVAL I 1 (ARCHITECT OR ENGINEER TEL NO I 1FOUNDATION/TRENCH FORMS I I LIC NO I ISLAS/UNDER FLOOR I I I RAI3ED FLOOR FRAMING I I I I I I IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP I (UNDERFLOOR INSULATION I I 1147H265 3 071 1 'I I I FLOOR}SHEATHING INO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS 5- NO NO 21 1 IROOF SHEATHING 1 1 I 1 SCHOOL WITHIN HAZARDOUS ISHEA.R PANELS I I 1AIR QUALITY 1000 FEET MATERIALS NO NO NO FRAME INSPECTION IREQUIRED TOTAL SETBACK FROM EXIST I IFIRE SPRINKLER HANGERS 1 1 ISET BACK YARD HWY PROP LINE WIDTH I I IFRONT PL- INSULATION/WEATHER STRIPI SIDE PL- 1 _ (INTERIOR LATH/DRYWALL IEXTERIOR LATH I 1 I IRATED FLOOR/CEIL ASSEM I I I I I I I 1I (RATED WALL ASSEMBLIES I I 1 i I IRATED SHAFTS/OPENINGS 1 1 I I I I I I T-BAR CEILINGS I 1I ILOT DRAINAGE I I I I I I IREPORT ID DPR261 ROUTE TO BS0508 I