HomeMy Public PortalAbout9553 BLACKLEY ST_Building__ 76AS38A CE ADS 6-57 APPLICA"T"ION FOR BUILDING •PER41T ' • 1�
COUNTY OF LOS ANGELES BUIDLDINGREss �� e
DEPARTMENT OF COUNTY ENGINEER AD (X�cil
BUILDING AND SAFETY DIVISION LOCALITY T+
JOHN A.LAMBIE.COUNTY ENGINEER' NEAREST �-
CASSATT D.GRIFFIN,SUP'T OF BUILDING CROSSST.
DISTRICT NO. GROUP .TYPE � SEWER MAP
FOR APPLICANT TO FILL IN � � I CONST.BUILDINGBK G
ADDRESS•') '� L�`�//\//;� STATISTICAL CLASSIFICATION •I
LOT NO. a tel/ BLOCK CLASS NO. DWELL.UNITS
�,. _ MAP / STATE
TRACT V NUMBER (� HWY YES NO
_ - USE ZONE SPECIAL -
� fs , NO OF SLOGS. p / CONDITIONS
SIZE OF LOT - n .. :+s .. t'•`NOW ON LOT
USE OF
EXISTING BLDG. Jam_
BUILDING EXIST.
_t1 f } /� YARD HWY STREET NAME '
OWNER �r✓C-0,8 13 l/Y �/7 V—A�,.
"SETBACK
yWIDTH .
MAILI� ! P L. 00
ADDRESS �y';;/' C+�. Lyy`f S T S!DE
TEL. P L.
CITY T,6Mf--)L)5 c-r/ NO. I
ARCHITECT OR TEL. NSPECTION RECORD"
ENGINEER NO.
ADDRESS '
TELa
O �R_•!t Ar�1. ��� � � A
CONTRACTOR iS�-"i.7,^�.A/I��T N p.(,+,/ z��✓Z, ` '1tEiI L1A A I\ A CS R.�.��-� -
ADDRESS ,�I�.•� A 'a,-SI�.lx' '!/.I',.., - -' d. ���1, I� �....,.. .
DESCRIPTION OF WORK 4=4
_
NEW `' ADD ALTER REPAIR DEMOLISH
SQ. FT. �- NO.OF NO OF
SIZE r+, STORIES FAMILIES/
USE OF STRUCTURE
c� r f:
SIGNATUREOFc . APPROVALS
APPLICANT =�•� - ' I -�
DATE INSPECTOR'S SIGNATURE
ADDRESSFOORMS,rMATERIALS LOCATION
$ P.C. $ •e FRAME: FIRE STOPS.
FEE Od BRACING.BOLTS ,
VALUATION $ 09 FURNACE- LOCATION.
FEE GAS VENT,DUCTS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH, INT. -
_ PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND _
STATE LAWS R ULATING BUILDING C NSTR CTION. LATH,EXT.
SIGNATURE OF HOUSE NUMBER COR.
PERMITTE RECT AND POSTED �__� 4
ADDRESS INAL
JOHN A. LAMBIE.COUNTY ENGINEER. CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL 'NGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION. CK.- M.O._ CASH
�:P C0 3 2 6 2°° JUL- 3 A 1 3.Q 01,L '033AC
1 9 99 JUL 2 9 '. 1 A 2 6.0 0
76A698A.D'65T9 1'�5d i"•-"—r,-»•'� - �i.^ - 'q
'APPLICATION FOR BUILDING PERMIT— ],
DIVISION OF BUILDING AND SAFETY. ADD EISS ��,J �F�G � � N
Department of County Engineer , -+
County of Los Angeles LOCALITY m
W.M.J. FOX, COUNTY ENGINEER NEAREST ///�J �/( >
CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST. 1 1�� �m'r' '^�+�
' DISTRICT NO. GROUP' - MAP Z
FOR,APPLICAPdT TO FILL IN ., �'C / TYPE ll BK PG c
BUILDING CONST^` ISEWER
ADDRESS Y MAPI I STATE YES .NO
_ NUMBER ( l6/ HWY D
LOT NO. BLOCK USE ZONE SPECIAL /I
CONDITIONS
—�jn A
TRACT r�•_/J''�� 'J /� r N
NO. OFBLDGS. —C---
SIZE OF LOT %� Z�SD '� I NOW ON LOT BUILDING EXIST.
SETBACK YARD STREET NAME WIDTH
USE OF C.y� —�
EXISTING BLDG. 6jRCe1111D&5* S7oAA -51 FRONT
,/ P L.
OWNER' y �,ST ��P.LU U/Gn SC�/CSIDE
Y �
MAIL-
ADDRESS �./�iaC �NwC
yam' /� //�� r�/ -.TEL,n DWELL. 1 UNIT 5 INDUSTRIAL*-
TO
CITY _cA_/01,L� (...J�_/ 7 NO /"�T�����' 2 DUPLEX_UNIT 6 DG.
ASCk14T.ECLOR. TEL'. ,{,/ --- -
ENGINEERt�.�Ej'(1•�• ,QSyU�KC�NO. /I!/•/,(o.S �� -3 APT. UNITS '7 ADDN., ALT., ETC.
ADDRESS�j"v 7 �D• J.��/� /� _ 4 COMMERCIAL
Jva U�vS,Qe;PII� NIq/�R /S `TE Cu / TSI
CONTRACTOR INSPECTION RECORD
ADDRESS.�I. ,2Sq�,r
DESCRIPTION OF WORK '
ADD ALTER REPAIR - DEMOLISH, - i '•`�1 -__
SO FT.� Ol�0 NO. OF NO. OF _ (w t;••
SIZE STORIES FAMILIES
USE OF�STRUCTURE •
fvFI�V7 RoA.46 a�✓ „
SIGNATURE OF I ���rr - �I .•;1 +"� '
.APPLICANT L!J• "i . –APPROVALS'
ADDRESS ,�I,��2 i �• �'Tf�"�w"V/tsr�i � V� ' DATE I INSPECTOR'S SIGNATURE
FOUNDATION:,LOCATION C J
P. C. S 47_U _FORMS. MATERIALS 'a � 1_• -I --Lf�--
FEE _ FRAME: FIRE STOPS, 1
S BRACING, BOLTS
VALUATION % l FURNACE: LOCATION,
-FEE GAS VENT, DUCTS
I HEREBY ACKNOWLEDGE THAT .1 HAVEREAD THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT LATH, INT.
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING -BUILDING CONSTRUC-
TION. 0, /...� LATH, EXT.
SIGNATUREOF fir, HOUSE NUMBER COR- C
PERMITTEE _ RECT AND POSTED 1{
ADDRESSS /-7-s /�.el•• � !SJ FINAL "—
Wfyf- J. FOX. Coumw ENGINEER VALIDATION
.B o 4 6 1 ?. Jn1119- "� 6 5 .0,0 d BY 1. 0.0 0'
DEPUTY ^ rE$ 6 DEPUTY
BY BY
DE UTY �1 EPUTY .
t WORKERS''COMPtr4"SATION bECLARATION R"�• - y' - Y`F: _
t4irm
-.hat
f rt �� acir;3ut cerhfcaaoWokesCLInensdton su, �e, A P P L I CATION FOR . BUILDING_ PERMIT,
or a cerhfied'copy thereof ec. 3800, Lab `C.) -
-wC3C�bS _ G'A D SAF
COUNTY OF,LOS ANGELES BUILDIN N ETY
Pol' •y No. , Company.- --
a •Gertified'copy is hereby furnished •l=.- FOR•APPLICANT TO FILL IN' BUILDING ^ r ^ ��
' ADDRESS 1. l r
•!Certified copy is filed with the county building inspec- BUILDING
LJ `tiontdepartment." t ADDRESS
•
(�ti `�L� nn `
D'ate'� '�-��P 'Applicant f�`G1�
-FOA) CITY C ZIP LOCALITY
CERTIFICATE OF EXEMPTION'FROM WORKERS' X, - '- "" O. OF BLDGS NEAREST » _ -
` "` Y COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST.
(Thjss'ection need riot be completed if The permit is for'•one -• - . ___ _._ _ _- _ a,.._ _ ASSESSOR , +'
hundred,dollars ($100)or less.) TRACT - BLOCK LOT N^^O. MAP BOOK PAGE PARCEL -
:;t•t OWNER'C O NOP.-6G-
that S
U E ONE MAP
I;certify in the performance of the work for,whrch,this � I - SPOECIAL d
permit is,issued, I shall not employ any person-m any manner c C __
so as;to become sublect to the Workers'Co'mpensahon'Caws. ADDRESS ' 'c7 `T ��. C�� CONDITIONS z.•. , O
CITY �UQQ C'. . _ ZIP ®t:
Date` " Applicant ' " „" ARCHITECT OR TELO
NOTICE -'APPLICANT-'•If, after making this Certificate of DISTRICT - GR UP, TYPE , FIRE ePRCSED BY
ENGINEER_.-. t ~
NO. _ CONST ZONE
Exemption, you should. 'becom'e' sublect ato_'the"Workers' /�x `
COMM of the Labor Code;you-must forth- _ ADDRESS ,• `�' V V ✓ ✓'
wtth'.coinply with such .provisions or this-,-permit shall.'be, rA
deemed revoked. TEL 7^� STATISTICAL CLASSIFICATION APT. NDO.
' CONTRACTOR
LICENSED CONTRACTORS DECLARATION - •- c Q CLASS NO. DWELL UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS d s O 8A-212V7 1 _
(� SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and _ - - LIC.
Professions Ccde_and my license is,in full force arid*effect CITY J G e V�� CLASS 7� / BK P VALIDATION
SQ NO OF....; •_ NO. OF',_ CHECK ;•
LtcenseNumberaa-7d-79' , � .c.Class SIZE p STORIES 1 FAMILIES ONE { "
q VALUATION
M:n���ICPCQ& 'QL-�- ' (aO DESCRIPTION OF WORK �L ,. NEW -
Contractor rule• ADD $
�.1 am exempt under Sec: - •'
ALTER r
B.&P C. for this reason __._ _ _ �•„ _ L-� - REPAIRUSE F
Date- EXISTQING BLDG. E p., /V G DEMO' p 14e.-2 i5.1,8 2 ».
APPLICANT / A TEL FINAL
Signature PRINT C G , WANO.
OWNER-BUILDER DECLARATION _ .. __ DATE G
I hereby affirm that-l-am exempt from the.Contractor's License _0 st tc--Ai 9b ' y
Law for the following reason (Section 7031 5, Business and ADDRESS FINAL
O ?_-,64-H 6
Professions Code BUILDING -By.. i y
); L/ /��
I, as owner of'the property, or my employees with ADDRESS _
wages as their sole compensation,will do the work and ' :t- �� _,
the structure,is not intended or offered for sale_(Section LOCALITY w 0.4,0 9,•5 A "
7044, Business and'Professions Code). MOVIN - -' - TEC:
- � 1, as owner of the property,,am exclusively contracting CONTRAC —'- •# Q.,q ° ° 0'1
with licensed'contractors to construct the'pioject (Sec-
tion 7044, Business and Professions Code). ADDRESS ;
REQUIRED =TOTAL SETBACK-FROM - T =,= -�.jA -
CONSTRUCTION LENDING AGENCY- •SET BACK YARD" "HWY PROP LINE '• WIDTH ) I•° ,3,0 b 7,•5,, 5
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 "" "' ', .r� °"° 3 0 7.5_U
(Sec 3097, Civ C.). SIDE
_ - PL . - - - 0228
0
•Lender's Name b. = .
�,/t ) •� �^ LDMA Ref #.
Lender's Address -
P.C. Fee$'- �� Peim t Fee
f
-I.certify that I have read-this application and state,that the -- --•- Issuance Fee - U r SU'•, LDMA P/C# L
above iAatcorrect. I agree to comply with all County Invest,gat,on Fee
ffl or i aws relating to building construction, _ ..._ Total Fee / v LDMA Perm #U an �n't
tatives of this County to enter mhtioperty for inspection purposes
d 3
aSEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of ppl,cant or Agent Date••'/amu' - • ' - - ' -' -`_ "' _ - _ '_ - - __. _ ._.. Qv'�,r
= �Irs 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 0908050005
PHONE. (626) 285-0488 EXT.
ILEGAL ID: 1 NO. OF CONST I BUILDING ADDRESS: 1
ON FILE I SQ FT STORIES TYPE I 9553 BLACKLEY ST
(STRUCTURE: 400 V-B I TEMP CA 917803143
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET: CLOVERLY 1
18590-006-018 I THOMAS PAGE: 597 GRID: A4 LOCALITY- TEMPLE CITY, Cl
1TENANT: 1EXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: I
I 1EXIST OCC GRP: 108/65/09 SR I
(OWNER: TEL. NO: JBLDGS. NOW ON LOT: VALUATION- IFIPATE FINAL BY: CODE: I
ICAMPOS SARA R (626) 285-5991- 1 2,600 1 1
19553 EL?CKLEY ST I�I
ITEMP 917803143 1 FEES PAID IDESCRIPTION OF WORK I
I I 1PARTIAL ROOF REPLACEMENT TEAR OFF & REROOF WITH COMPOSITION I
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ISHINGLES 400 S.F. I
JAPPLICANT: TEL. NO: I I 1
ISTP ENTERPRISES INC. (626) 287-7544- IAA BLDG PERMIT ISSUANCE 27.75 1 1
15454 TEMPLE CITY BLV JAB STATE GREEN BLDG FEE 2600.00 VAL 1.00 ISPECIAL CONDITIONS: I
ITEMPLE CITY CA 91780 JAC STRONG MOTION RESID 2600.00 VAL 0.50 1
ID2 PERMIT W/O EN-HC 2600.00 VAL 99.00 I I
I TOTAL FEES 128.25 I
1CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I
1STP ENTERPRISES, INC. (626) 287-7544- 1 1 1
15454 TEMPLE CITY BLVD. LIC. NO I ILOCATION AND SETBACKS 1 1
ITEMPLE CITY, CA 91780 598157BC36 I I -•
I I ISOILS ENGINEER APPROVAL I
(ARCHITECT OR ENGINEER: TEL. NO: I IFOUNDATION/TRENCH FORMS I I I
I LIC. NO: I (SLAB/UNDER FLOOR I I I
I I IRAISED FLOOR FRAMING
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:1 1UNDERFLOOR INSULATION I I I
1147H269 3 001 1 I
I I IFLOOR SHEATHING 1
INO. OF FAMILIES: DWELLING UNITS: APT/GOND- STAT CLASS. I I 1 I 1
I NO 21 1 IROOF SHEATHING
I I I I I
I SCHOOL WITHIN HAZARDOUS j _ 1SHEAR PANELS 1 1 I
(AIR QUALITY: 1000 FEET MATERIALS 1 I 1 1
NO NO NO JFRAME INSPECTION
IREQUIRED TOTAL SETBACK FROM EXIST I IFIRE SPRINKLER HANGERS I
ISET BACK YARD: HWY: PROP LINE: WIDTH: I I 1
IFRONT PL- I JINSULATION/WEATHER STRIPI I I
I SIDE PL- 1 1 -1-1 1
1 (INTERIOR LATH/DRYWALL I I I
I 1EXTERIOR LATH I
IRATED FLOOR/CEIL ASSEM.
I IRATED WALL ASSEMBLIES I 1
IRATE? SHAFTS/OPENINGS 1 I
I T-BAR CEILINGS I I I
ILOT DRAINAGE I I 1
1 i I
(REPORT ID: DPR261 ROUTE TO: BS0508
I I I