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HomeMy Public PortalAbout9532 BLACKLEY ST_Building__ 76A638A CE_1#,03 2.63 APPLICATION FOR. BUILDING PERMIT- COUNTY ERMIT COUNTY OF LOS ANGELES BUILDING . ._'DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION ' LOCALITY , JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A.,JENSEN, SUPT OF BUILDING _ CROSS ST. .DISTRI T NO. GRO TYPE P OC SSED BY. FOR APPLICANT. TO FILL IN )-- I coNsr. v BUILDING STATISTICAL CLASSIFICATION SE ER MAP ' ADDRESS 9532 Blackley T.0 CLASS. NO. DWELL. UNITS_-A BK PG LOT NO. BLOCK WATER CERTIFICATE: NOT REQUIRED RECEIVED ❑ TRACT �: �- NO ,% tlCIRCLE) STATE MAJOR SECOND, LOCAL ' NO. OF BLDGS. SIZE OF LOT NOW ON N LOT USE ZONE SPECIAL USE OF CONDITIONS EXISTING BLDG. - TEL. OWNER V. W. Qsior NO. BUILDING EXIST. t� t SETBACK YARD HWY STREET. WIDTH• ADDRESS 9532 Blackley, T, .L FRONT 'ARCHITECT OR TEL.. P. L. ENGINEER- NO. SIDE P. L. ADDRESS _ _ - O CONTRACTORVi rg i n Roop 1J O.NO AT70507 - ADDRESS DESCRIPTION OF WORK w a N. NEW ADD ALTER REPAIR DEMOLISH - - Z SQ. FT. N NO. OF SIZE STORIES- FAMILIES USE'OF STRUCTURE ' Re-roof H' use SIGNATURE OF APPLICANT - VALUATION 5 349.00 APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION, FEE $ FEE $6.00 FORMS, MATERIALS FRAME: FIRE STOPS, THEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION - BRACING. BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. WITH .ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS BUILDING CON RUCTION. I CERTIFY THAT IN DOING THE WORK - AUTHORIZED HE EBY I WILL NOT EMPLOY'ANY RSO IN VIOLA. LATH. INT. - TION OF THE LA OR CODE OF THE STATE OF CALIF NIA RELAT- ING TO WORKMEN' O-PEN SATI N INSURANCE. .�- - LATH, EXT. SIGNATURE O HOUSE NUMBER COR- •PERMITTEE RECT AND POSTED _ ADDRESS 66 S.fan Gabriel Blvd. FINALSan Gabriel JOHN F. LEWIS, PRINCIPAL ST RU URAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION cK. M"O. CASH � * V' ,00 7 2 2 1 SEP 2 6 z. D 6.0 Qr V �d,��eapw bas-a a_ss , APPLICATION FOR BUILDING PERMIT 1 DIVISION OF BUILDING AND SAFETY BUILDING ESS Deportment of County Engineer G County of Los Angeles Locat_1TY WM.J. FOX, COUNTY ENGINEER NEAREST - CGO V� CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST. DISTRICT NO. GRO P ,SPE 8 BER MAP _ FOR APPLICANT TO FILL INBUILDING coNST17:, _ ADDRESS %03 MAP ,C��j STATfi , - - NUMBER r ,Hyyy•- YES O LOT NO. BLOCK US ZONE SPECIAL - - CONDITIONS TRACT - da I NO. OF BLDGS., ' -SIZE OF LOT J�6 ' - /2sO - BUILDING EXIST. NOW ON LOT STREET NAME YARD HWY " SETBACK WIDTH USE T, - �_ -' FRONT 1 ,1 EXISTING BLDG. ��•® P.L. ` 4� OWNER �_I/V• Q,r{y�,.Ici�,, 'SIDE - - C MAIL, -16_22 I �C O TRACT DWELL. f UNIT• ADDRESS _ $ INDUSTRIAL ' /1 � EL.- 1 DWELL. f UNIT l CITY / NO. - 6 PUBLIC BLDG. • 2 DUPLEX f UNIT ARCHITECT O G - TEL. _ 7 ADDN., ALT.. ETC. ENGINEER ��-/" NO. $ APT. UNITS _ MISCEL. G)� `� ADDRESS 4 COMMERCIAL CONTRACTOR y- NO' T S INSPECTION RECORD - - ADDRESS 4, - DESCRIPTION OF WORK NE ADD ALTER REPAIR DEMOLISH - SQ. FT. /4 /� 'NO.-OF NO.OF SIZE '�`` [J STORIES FAMILIES - - - USEOiA�UCTURE ` SIGNATURE O APPLICANT APPROVALS ADDRESS `t.L • - - DATE 'INSPECTOR'S SIGNATURE FOUNDATION: LOCATION $ 1160, P.C. !$ FORMS. MATERIALS O G FEE - FRAME: FIRE STOPS, VALUATION BRACING. BOLTS C yl� FEE $ FURNACE:LOCATION. _ I - t HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT. DUCTS ' - APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT.' AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. / o LATH, EXT. SIGNATURE OF S HOUSE NUMBER COR-` _ PERMITT/E'E /" �'"�� '�[[[ RECT AND POSTED ' ADD RESFINAL �- WM.J. FOX,COUNTY ENGINEER 71ALIDATION C. N. DIRLAM,CHIEF-BLDG. INSPECTOR 4 7 8 2 APR 5 1 8.0 0 !� :- ��e lRp5.3 3.65 �Y > APPLICATION FOR BUILDING -PERM IT 1 DIVISION OF-BUMDING AND SAFETY ABU' DDREISNG S Department of County Engineer County of Los Angeles LOCALITY WM.J. FOX, COUNTY ENGINEER NEAREST /9 CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST. r 1pp/�u DISTRICT O. GP I CONST I SEWER MAPS FOR APPLICANT TO FILL IN / STATE TYPE 9d�P ADDREBUILDING NUM MAP ER ©/ HWY YES NO /JJJ LOT NO. �3 ' BLOCK USE ZONE SPECIAL /� CONDITIONS TRACT Lf 5- rrb/ _ SIZE OF LOT.7 D p f2 s r�� NOW ON LOTS BUILDING YARD HWY STREET NAME SETBACK WIDTH USE OF FRONT' EXISTING BLDG. d=li= P.L. OWNER SIDE P. L. MAIL ADDRESS 3Z O' TRACT DWELL. I UNIT Q EL. I DWELL. I UNIT 5 INDUSTRIAL 'CITY .�/IM.M.(�L NO. 6 PUBLIC BLDG. 2 DUPLEX 1 UNIT ARCHITECT 04 TEL. /ADDN..ALT., ETC. ENGINEER NO. 3 APT. UNITS 8 MISCEL. ADDRESS 4 COMMERCIAL TEL. 7j INSPECTION RECORD CONTRACTOR NO. ADDRESS DESCRIPTION OF WORK r NEWalDDLTER REPAIR DEMOLISH _• ,1,4 SO. FT. O.OF NO. OF > SIZE STORIES FAMILIES USE tvL.tOtnF�4TRonUeC%TU.R�f. / " %Jn/ � wrs Ad Ic 10SAp �* SIGNATURE OF APPLICANT Y APPROVALS ' ADDRESS fl- DATE INSPECTOR'S SIGNATURE $ P.C. $ FOUNDATION:FORMS. MATERIIALSION FEE _FRAME: FIRE STOPS, VALUATION `��' B/}O -� BRACING, BOLTS FEE / FURNACE: LOCATION. I HEREBY ACKNOWLEDGE THAT t HAVE READ THIS GAS VENT, DUCTS APPLICATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREETO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. C LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- • PERMITTEE RECT AND POSTED /1 'ADDRESS FINAL WM.J. FOX, COUNTY ENGINEER _ - VALIDATION C. N. Da1RLAM. CHIEF LDG INSPECTOR LAC0 4 7 8 .1- APR 5 1 1 2.0 0 In ! WORKERS'COMPENSATION DECLARATION _ hereby'affirm that I havecertificate of consent to self APPLICATION P D L I•CAT I®N F O ��I L®I N G. PERMIT insure, or a certificate of Workers' Compensation Insurance„- or a certified copy thereof (Sec 3800, Lab C ) ` Re ublic Indemnit COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No PC988070 Company p y ' Certified copy is hereby furnished FOR APPLICANT TO FILL IN , BUILDING ADDRESS 77 Certified copy is filed with the county bu ing ins c- BUILDING tion department ADDRESS 9532' Blackie Date R-1 -R7`Applicant CITY 'Ixmple city ZIP 91780 LOCALITY ,CERTIFICATE OF EXEMPTI N FR WO RS'' ; NO OF BLDGS NEAREST, COMPENSATION INS ANCE 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 PARdl.' I certify that in the performance of,the,work for which this OWNER Dennis es, Np 286-2811 USE zO E” No AP permit is issued, I shall not employ any person in any manner SPECIALi ADDRESS 9532 Blackie I CONDITIONS (, so-as to become subject,to the Workers'Compensation Laws U Applicant ` Date iCITY t le. Cit zip 91780 NOTICE TO APPLICANT If, after making this Certificate of ENGINEERARC:HITECT OR• none NO DIS7gicT` GR UP TYPE FIRE PRO ED BY O Exemption;' you should becomesubject to, the Workers' i(,JVo/ CONST1l ZO E U Compensation provisions of the Labor Code, you forth- ADDRESS �� y a with comply.with such provisions or this permit shall be TEL STATISTICAL CLASSIFIC TION APT NDO Cn deemed revoked CONTRACTOR United "R60fiM CO. N6213-223-4061 •LICE NSED CONTRACTORS DECLARATION LIC -CLASS NO DWELL UNITS Z I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 1821 Vaal St. NO 137650 (commencing with Section 7000)of Division 3 of the Business and LIC, SEWER MAP Professions Code, and my license*is in full force and effect CITY 1 CLASS C-39eK PG VALIDATION SQ NO OF NO OF' CHECK License Numbe 137 0 L Class C-39 SIZE1900 STORIES One FAMILIES ONE VALUATION Contractor 'Date R-1 R—R7 DESCRIPTION OF WORK reroof with genst W ❑ , • $ 3630.00 Ar chitect 80 fiberglass ADD' am exe and Sec. ALTER ❑ B.BP C for this'reason lass A Shingle Over existing REPAIR ❑ s Date. - ` USE OF aSGPhalt -Shingle DEMO' EXISTING BLD ❑ -APPLICANT• Td TEL Signature FINAL OWNER-BUILDER DECLARATION PRINT NO DATE I hereby affirm that I am exempt from the Contractor's License Low for the following-reason-(Section 7031 5, Business and ADDRESS 1821 Dalv St. Ths Arleles, to 90031 „INA Professions Code)- WENT BY 278 3,8A BUILDING residence ; I, as,owner of the property, or my employees withADDRESS # o!o o o;o j wages as their sole compensation,will do the work and LOCALITY the structure is not intended or offered for sale(Section 1,x'0;e 6 8,,6 3 7044, Business and Professions Code) MOVING TEL o e+o = CONTRACTOR e NO a I, as owner of the property, am exclusively"contracting 0 9 O e with-licensed'contractors to construct the project (Sec- ADDRESS w tion 7044, Business and Professions Code). ; CONSTRUCTION LENDING AGENCY SETOBACKD' - YARD HWY ' TOTAL OP SETBACK INE 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 PL t 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 10'50 LDMA P/C q above information is correct I agree to comply with all County Investigation Fee' _ o ordinances and State laws relating to building construction, Total Fea 68.63 LDMA Perm q v R and hereby authorize repress atives o is,County to enter m upon the above-m tioned operty inspection purposes , 8-18-87' SEE REVERSE FOR EXPLANATORY LANGUAGE Signa re of licant ,Agent Dote 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 1208270041 PHONE- (626) 285-0488 EXT - ILEGAL ID NO OF CONST BUILDING ADDRESS: - ITR: 14572 LT- 63 SQ FT STORIES TYPE ( 9532 BLACKLEY ST ISTRUCTURE V-B I TEMP CA 917803142 (ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET 18590-007-028 - I - i THOMAS PAGE 596 GRID J4 LOCALITY: TEMPLE CITY CAI ITENANT- - IEXTST BLDG USE SINGL USE ZONE R1 (ISSUED ON PROCESSED BY IEXIST OCC GRP 108/27/12 SR 1 (OWNER TEL NO IBLDGS. NOW ON LOT VALUATION IFINAL EV AL BY , 'L.` CODE - IDYNES DENNIS H,YVONNE M (626) 286-2811- 12,000 ���� �� 1>✓ - 19532 BLACKLEY ST - ITEMP 917803142 FEES PAID IDESCRIPTION OF WORK - - I I -IKITCHEN REMODEL, NO EXTRIOR WORK I IFEE DESCRIPTION - QUANTITY UOM AMOUNT I (APPLICANT TEL NO I IKITCHEN MEDIC (909) 578-6745- IAA BLDG PERMIT ISSUANCE 27 80 16.12 16TH STREET IAB STATE GREEN BLDG FEE 12000 00 VAL _1 00 ISPECIAL CONDITIONS- (UPLAND, CA - IAC STRONG MOTION RESID 12000 00 VAL 1 20 ISTOP WORK ORDER 1 121 PLANCHECK W/ENERGY 12000 00 VAL 234 00 1 - 1 - 122 PERMIT W/ENERGY 12000 00 VAL 275 20 1 (CONTRACTOR TEL NO IFR INV WORK W/O PERMIT 342 20 DOL 342 20 (APPROVALS DATE INSPECTOR SIGNATURE IKITCHEN MEDIC (909) 578-6745- 1 TOTAL FEES 881 40 1 _1 1672 16TH STREET LIC NO (LOCATION AND SETBACKS 1 (UPLAND, CA 826849 - - ISOILS ENGINEER APPROVAL 1 (ARCHITECT OR ENGINEER - - TEL NO - IFOUNDATION/TRENCH FORMS 1 LIC NO (SLAB/UNDER FLOOR 1 1 - (RAISED FLOOR FRAMING I I IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP (UNDERFLOOR INSULATION I 1147H269 - 3 001 ���7 �'� �u��, 1 (FLOOR SHEATHING INO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS I 1 1 NO 21 IROOE SHEATHING SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS (AIR QUALITY 1000 FEET MATERIALS 1 I J NO NO NO 1 (FRAME INSPECTION iIT 1 1 1 (FIRE SPRINKLER HANGERS 1 1 (INSULATION/WEATHER STRIPI I 1 1 (INTERIOR LATH/DRYWALL I - (EXTERIOR LATH I (RATED FLOOR/CELL ASSEM 1 I 1 IRATED WALL ASSEMBLIES 1 I IRATED SHAFTS/OPENINGS 1 I IT-BAR CEILINGS 1 ILOT DRAINAGE IREPORT ID DPR261 ROUTE TO BS0508 I I I I I I I