Loading...
HomeMy Public PortalAbout9554 BLACKLEY ST_Building__ 76A638A CE.b8032-63 APPLICATION FOR BUILDING PERM IT-- = , COUNTY IOF LOS- ANGELES BUILDING S' DEPARTMENT OF•COUN,TY:ENGINEER•.- ADDRESS' ' BUILDING-AND SAFETY .DIVISION r LOCALITY JOHN A. LAM BI E.,COU NTY-ENGI NEER NEAREST f .WILLIAM A. JENSEN,•SUP•T OF BUILDING,, - CROSS ST _ ' - DIS`RICT NO � UP .TYPE ROC S BY FOR APPLICANT TO. FILL IN CONST •BUILDING ,r. - STATISTICAL CLASSIFICATION d SEWER MAP ADDRESS _ BK CLASS NO .DWELL UNITS LOT NO - - •BLO K WATER NOT REQUIRED fQl RECEIVED '❑ CERTIFICATE. _ TRACT -NO,OF MAP HIGHWAY,- • NO (CIRCLE)', STATE MAJOR SECON LOCAL BLDGS -SIZE OF LO r • ' ' NOW ON LOT USE ZONE SPECIAL .• _ - `USE OF rrJ C ,� CONDITIONS ' EXISTING BLDG V TEL - OWNE 'N C NO BUILDING •+ EXIST YARD HVJY STREET NAME. ' - w SETBACK NA4E ' ADDRESS G 4� _FRONT - ARCHITEC O TE P L' ENGINEER^• SOCNO OS SIDE ADDRESS. O i ' �T EL // ,/ V C•ON,T RACTO Q R `�JO ADDRESS 0 ,C rmsy3,;/, �}"' ,,e_s� •//�•J�7 te• i'p]; •i O ' .DESCRIPTION OF WORE NEW . •ADD. .ALTER REPAIR, DEMOLISH Z SQ FT _ . -NO OF ', NO OF. - `d'/•`�-�.• .N' >rPe1^'� :},fiSiS;.r.'L>-�i�r +?-F' -'- -- SIZE S,ORIES'' t,:FAMILIES - - .R •• ' _ STRUCTURRSW - - - .t'Lr,.r `S+w..r'•i"(r^:a' •,yfy" /�`�' SIGNATURE / .UG�� (/��Vb�'��✓ C,.' 6�Y'-., •�J'/t7I APPLICANT ✓ •.VALUATION /'^ , (((((SSSS/p//// < </ APPROVALS OAT E' 1.�INSREcro R'sSlGr/Aru, E C - PMT P FOUNDATION LOCATION rJ / FEE. $ FEE $ ti FORMS.,MATERIALS FRAME-.•FIRE STOPS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS o 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 CONSTRUCTION 1 CERTIFY THAT IN:DOING THE WORK AUTHORIZED,HEREBY I WILL NOT EMPLOY ANY'P-ERSON IN VIOLA- LATH. INT TION.OF THE-LABOR CODE OF.THE STATE OF IFORNIA RELAT. - ING TO WORKM COMPENSATION INSURA NC LATH, EXT - SIGNATOR HOUSENUMBER:COR- - .- PERMITTEE RECT AND POSTED, f ADORES FINAL JOHN F,.-LEWIS PRINCIPAL ST URA L;ENGIN ER PLAN.CHECK VALIDATION, cK M D . CASy _ PERMIT VALIDATION(: CK ',.m O CASH ko,p-,Y3 9"12 'SEP18 `2 3 0 - 0.3. 4 O- SEPI 8 :1`;D 1-8�',r_0 v, Ltd r �. I TE.YCPLE CITY r . 76A638A CE,4803 2-63 APPLICATION FOR BUILDING PERMIT ' COUNTY OF LOS ANGELES BUILDING iG DEPARTMENT OF-COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A JENSEN, SUPT OF BUILDING CROSS ST (fj DISTRICT NO. GROUP TYPE P CESSED B�'/ FOR APPLICANT TO FILL IN l - CONST BUILDI STATISTICAL CLASSIFICATION S WER MAP ADDRES �� e - 1 P CLASS NO DWELL UNITS `� BK LOT NO - BLOCK WATER NOT REQUIRED'. RECEIVED 1 77 .. CERTIFICATE. ❑ TRACT %. MAPHIGHWAY STATE MAJOR SECOND _ NO OF BL:DGS NO (CIRCLE) SIZE OF LOT NOW ON,;EV USE ONE SPECIAL USE OF i -• ? CONDITIONS EXISTING BLDG �7 OWNER Qf/ CX,111/ - N0f�1/��Z - PfU?LDI NGEXISTJ' 4Cr �a SETBACK YARD HWY STREET Y NA WIDTH ADDRESS /�JJ Q &C (J FRONT ARCHITECT.OR TEL qq�� P L ENGINEER NO/4�7�G-7Z SIDE I P LC ADDRESS CURB, GUTTER, DRIVEWAY APP - - 0 TEL CONTRACTOR NO AND PARKWAY TREE REQUIRED ADDRESS - O Note:'Permit s for curb, utter, sidew !: j V '-DESCRIPTION OF WORKw sfallations should be taken ouf'af the L. A. Cn. Road Dept., A;hcla' a h NEW AD ALTER REPAIR DEMOLISH Office, or r.%�� m1meo-a e y In order to 6v6i SQ FT Qp.. NO OF NO OF a lengthy delay. Survey & Design work t&;e� tim - _ SIZE .Oa STORIES FAMIL Unt1 Permit has been issued. Apply f -; ay free,permit -T,. USE OF L STRUCTURE SIGNATURE APPLICANT i VALUATIONSe-9 60 APPROVALS DATE INSPECTOR'S URE? • P5? FOUNDATION- LOCATION FEE.$ FEE $39 FORMS, MATERIALS FRAME- FIRE'STOPS. I HEREBY 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 CONSTRUCTION 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN,VIOLA- LATH, INT ' TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S COMPENSATION INSURANCE - - LATH, EXT - SIGNATURE OF HOUSE NUMBER COR- - PERMITTEE RECT AND POSTED ADDRESS FINAL ' JOHN F. LEWIS. PRINCIPAL STRUCTURAL"ENGINEER PLAN CHECK VALIDATION cK. `-M GASH ' _ PERMIT VALIDATION GK M.O. CASH 'Ir 4- 0 5 2SEP 2'2 2 3 D 1 9.75A"IlV Y V - r_�`DEPARTMENT'OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES NN � M. J. FOX, CH16F ENGINEER - � -• -'FOR APPLICANT TO FILL IN FOR OFFICE USE ONLYfjoj L4' J DISTRICT NO. PLAN CK. NO. PERMIT NO. BUILDING`' gJ'J ��. / a�p �^ x`76 ADDRESS J /Q O / .7 .v LOCALITY t• RECEIVED BY• h/DATE OF!A�PPL. /DATE ISSUED � NEAREST ' TL /��LLl�'/CXJ2� 6J~ I _e IS IO f'O s CROSS ST. ADDRESS . ��V D. a •�.,, ^'/c ' OWNER 2 (/ .1 J MAIL LOCALITY 6- z op ADDRESS O pal >,-1, NEAREST -� /; /� j CROSS ST. CITNQafn!YL�J �0 .�3 - FIRE [PLANS IJTYPE I GROUP- ; ARCHITECT OR TEL. ZONE PLANS ENGINEER SETBACK ACK LINE ' O. O Rr,DL/N ADDRESS APPROVED - - - TEL. BY DATE CONTRACTO 1.['� Cp QIO. .3 3 USEn APPROVED ' • ZONE A- f BY DATE ADDRESS .G(/Y1"L,�� HOUSE NUMBERING LEGAL••.';• a DESCRIPTI•ON' I LOT NO. I BLOCK MAP NUMBER 2 _FIELD CHECK BY TRACT /q.7 NO. ASSIGNED,BY O 1 6 DATE NO. OF BLOGS.yCORRECTIONS ry� SIZE OF LOT S X 1.2Vel NOW ON LOT /)�tiP EUSEOF XISTING BLDG. I FAMILIES DESCRIPTION OF WORK NEW "I •'•('ALTERATION I I ADDITION 0 REPAIR �!'jI•;• I DEMOLITION I I I -• -- - - A SQ. FT. NO. OF / Z SIZE lI �: ROOMS STORIES a EXT. WALLI ROOF (/� ,^ r' COVERING COVERING USE OF T UCT1.IRE / APPROVAL INSPECT09 S SIGNATURE DA-PE � I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FOUNDATION: LOCATION � LICA PTION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS .•^ CORRECT. O 1 AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS, HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS LAWS REGULATI UILDING CONSTRUCTION. e �y� 1 FURNACE: LOCATION, SIGNATURE OF �p ,. GAS VENT, DUCTS r PKRMITTE . i LATH, INT. ADDRESS ` /J LATH, EXT. M lL-,C5 tir AUTHORIZED AGT. PLASTER, INT. 79Aia6A• DBS9 10-50 $ P. C. $ FEE ( Y PLASTER, EXT. VALUATION •' ,f`� FEE $ ;-/i+15� FINAL APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUIL G ADDR BUILDING ADDRESS G� hereby affirm that 1 have a certificate of consent to self insure, 9554 Bl ckle St. or a certificate of Workers'Compensation Insurance,or a certified CITY ZIP copy thereof(Sec.3800,Lab.C.) Temple Cit 91780 LOCALJrf PolicyNQ. 1330196 —Company Comp. SIZE OF LOT NO.OF BLDGS.NOW ON LOT rC� ❑ Certified copy is hereby furnished. NEAREST CROS6 ST ® Certified copy is filed with the county buildi 0 inspection TRACT BLOCK LOT NO. ,fg USE ZONE MAP NO department.' 4/4/95 ASSESSOR MAP BOOK PAGE PARCEL Date Applicant SPECIAL CONDITIONS If� OWNER TEL.NO. O CERTIFICATE OF EXEMPTION FROM WORKERS' Debbie Franklin 818/268-0208 ves No COMPENSATION INSURANCE WITHIN 1000 FT OF SCHOOL? ADDRESS (This section need not be completed if the permit is for one hundred 9554 Blo ckl e S t. DISTRICT GROUP TYP NST.' FIRE ZONE PROCESSED BY dollars($100)or less.) CITY ZIP I certify that in the performance of the work for which this permit Temple -City 91780 i3 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. None. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. C;2/ DWELL UNITS NOTICE TO APPLICANT. If, after making this ,Certificate of CONTRACTOR TEL.NO. ' REQUIRED TOTAL SETBACK FROM EXIST Exemption, you Should become subject to the Workers' Inc. 213/223-4081 SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith United RoofingCo. , FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL 1821 Daly St. 137650 SIDE o LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS PL I hereby affirm that I am licensed under provisions of Chapter 9 Los An eles CA 90031 C-39 SEWER MAP v (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORES I NO.OF FAMILIES NEW ❑ BK PG Professions Code,and my license is in full force and effect. 23 1 ► v License Number 137650 C-39 DESCRIPTION OF WORK ADD ❑ VALUATION w Lic.Class CL Install 3 tab composition $2,487.00 Contractor United Roofingate 10/31/96 ALTER ❑ z shingles over 3 tab compositio — ❑ I am exempt under Sec. REPAIR © $ B.BP.C.for this reason DEMOL 11LOMA P/C# Date: USE OF EXISTING BLDG URM ❑ Signature APPLICANT(PRINT) TEL.NO LDMA Perm# United Roofing Co. , Inc. 213/223-4081 z ❑ I, as owner of the property, or my employees with wages as O their sole compensation,will do the work and the structure is ADDRESS - not intended or offered for sale (Section 7044, Business and 1821 Dalv St. LA - CA 90031 FINAL DATE a Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ I, as owner of theproperty, em eXCIU31Ve1 contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN Y g THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY > T€1, S .3.2_% licensed contractors to construct the project (Section 7044, YES❑ " NO Business and Professions Code.) (-��; °"27, ;=1 WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING ti•I iL\:i 1�=='_ OCCUPANT REOUIREA PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THESOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES �'i 1�''•~�• I hereby affirm that there is a construction lending agency for YES❑ NO the performance Of the work for which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD 3097,CIV.C.). pER TTING CHECKLIST.I UNDER ST D MY REQUIREMENTS UNDER THE LOS ANGELES 1''—I - 9 COU TYCODE,TITLE2,CHAPTER2. ECTIONS2.20100THROUGH22014000NCERNING I_7�IL' Ti V Lender's Name RDOUS MATER LS R RTING ND FOO OBTAINING A PERMIT FROM THE SCAQMD. d :la4 1.. LJil ender's AddressOWNEAQR ` -s 1 0 AGENT N 1 certify that I have read this application and state that the above FEE PERMIT FEE information is correct. I agree to comply with all county P.C. ordinances and State laws relating to building construction,and he by authorize repr sentatives of this County to enter upon ISSUANCE FEE L� th above ent' ned roperty for inspection purposes. 4/ F 4/4/95_ INVESTIGATION FEE TOTAL FEE ` / SEE REVERSE FOR EXPLANATORY LANG A E,