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Home My Public Portal About9040 BROADWAY_Building__ 76A638A CE#8033-66 APPLICATION FOR BUILD NG P RMI COUNTY OF LOS ANGELES BUILDING 91 DEPARTMENT OF COUNTY ENGINEER ADDRESS 6C G� IC L' BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST _ COLEMAN W. JENKINSSUP'T OF BUILDING CROSS ST. DIST�CT NO GR TYPE P E FOR APPLICANT TO FILL IN L7 Q� CONST. M ' BUILDING STATISTICAL CL SSIFICATIOW _ SEWER MAP. ADDRESS 9040 I.I. Broadway, Temple Cit CLASS NO.=WELL UNITS BK PG LOT NO. BLOCK USE ZONE 'MAP NO. L TRACT / - SPECIAL NO. OF SLOGS. CONDITION SIZE OF LOT NOW ON LOT USE OF l i BLDG. SETBACK FROM -- TEL. FRONT PROP. LINE OF (STREET) OWNER M L. Dvar No. AT 6-9458 TYPE OF EXISTING SETBACK HIGHWAY } YARD' = TOTAL _ ADDRESS ,-3 HIGHWAY DT F M C.L. CITY T mole CitypLDG..9ETBACK FROM ARCHITECT OR TEL. ENGINEER NO, SIDE PROP. LINE OF (STREET) TYPE 01 EXISTING SETBACK HIGHWAY } , YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. TEL. + CONTRACTOR on NO ADDRESS a a NO16o6go CORNER CUTOFF YES NO C O CITY ra T•• CLASS LIG -�; SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK :Lw y a NEW ADD ALTER RXaR DEMOLISH SO.FT. NO. OF NO. OF SIZE - STORIES FAMILIES USEOF C STRUCTURE I. TTn & Garage vrith Comp. Shingles SIGNATURE OF APPLICANT VALUATIONS '00 APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT, / FOUNDATION, LOCATION 6 FEE$ FEE S .00 FORMS, MATERIALS FRAME, FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLT. 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. I 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- INGTO WORKMEN'SC MPF�$ATION INSURANCE. LATH. EXT. irgia SIGNATURE OF �. HOUSE NUMBER COR- PERMITTEE-�14W AA . / �� RE AND POSTED ADDRESS (;M .4- San Rahli-I Can 7= 1'1jSl FINAL JOHN F. LEWIS. PRINCIPAL STR URAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CN. M.D CASH n 2 4 8 6—� CPN 8 1 0 6'.00 .v sAB3E, E;Bo3z-.3 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS q e4o , Bizcr�ovJA ' BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBI E. COUNTY ENGINEER NEAREST q� WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. _/-l.� LT A Q''I A DISTRICT NO. GROUP TYPE PROCESSED BY FOR APPLICANT TO FILL IN p = CONST. ADDRESS 9040 E. - Broadway T,C . STATISTICAL CLASSIFICATION S ER MAP CLASS. NO. DW ELL. UNITS BK PG LOT NO. BLOCK WATER NOT REQUIRED RECEIVED ❑ 1 CERTIFICATE: TRACT ! 1= MAP HIGHWAY NO. OF SLOGS. NO. (CIRCLE) STATE MAJOR SECOND. LOCAL SIZE OF,LOT NOW ON LOT USE ZONE .S ECIAL - USE OF' CONDITIONS EXISTING BLDG. Residence OWNERL. Dyer NO. BUILD"NG EXIST: ADDRESS 9040 E. BroadwayT.y� SETBACK YARD. HWY STREET NAME WIDTH FRONT ARCHITECT OR TEL. P. L. ' ENGINEER NO. -SIDE - P. L ADDRESS I _ d CONTRACTOR Virgin Roof CoWOAT70507 . � . 'ADDRESS 600 S. San. Gabriel Blvd. DESCRIPTION OF WORK San Gab W ' 1 NEW ADD ' ALTER REPAIR DEMOLISH SO FT. NO. NO. OF - ?` SIZE STORIES FAMILIES USE OF STRUCTURE Re-roc ge. 'SIGNATURE OF APPLICANT VALUATION s145.00,' - - APPROVALS , PATE INSPECTOfl'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE S FEE $ 6.®O FORMS, MATERIALS - _ FRAME: FIRE STOPS. 1-HEREBY ACKNOWLEDGE THAT'I HAVE READ THIS APPLICATION BRACING. BOLTS AMC STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. I WITH ALL COUNTY ORDINANCES AND STATE'LAWS REGULATING GAS VENT. DUCTS BUILDING CONSTRUCTION. I' CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I W" NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LABO CO t OF THE STAT OF CALIFORNIA RELAT- ING TO WORKMEN'S ENSAI ON IN NCE. LATH. EXT. 'SIGNATURE OF / i HOUSE NUMBER COR- - PERMITTEE l/ RECT AND POSTED -ADDRESS 600 Sall abriel Blvd. FINAL JQ/L San Ga riel JOHN F. LEWIS: PRINCIPAL ST f1CTURAL ENGINEER 'PLAN CHECK VALIDATION CK. M.G. DASH _ PERMIT= VALIDATION GK. M.D. CASH I 4 1-8 0z SEP25 1 D ..6..00 pp /I: 76AS38A DBS.a APPLICATION FOR BUILDING PERMIT u.aa DIVISION OF RUMDING AND SAFETY BU ILDIN Deportment of County Englneet: ADDRESSQ County of Los.Angeles - LOCALITY 0, L17 JOHN A. LAMBIE. COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN. SUPT OF BUILDING CROSS E ST. FOR IN BK PG APPLICANT TO FILL DlsrRlc� GROUP TYPE SEWER MAP .S -Ay_ /'p�(� /� \ I� CONST. ADDRESS 61?),q / T�. r R t//] r-n-i-)rj 'IA MAP . D STAT 'YES O \ NUMBER ' BLOCK ` USE ZONE SPECIAL LOT NO. Y 'CONDITIONS fy TRACT NO. OF SLOGS. L SIZE OF LOT I NOW ON LOT BUILDING YARD HWY STREET NAME' EXIST. USE OF BE WIDTH EXISTING BLDG. \ II _ FRONT OWNER ! i, nlJ IA 'e. - SIDE — MAIL -ADDRESS �'-I T/p� /Ji .l�)1� I") r �A'�^ l�t'��.��p O TRACT DWELL; IUNIT CITY ( f/!(/�1 Lr TELj rp�]J(J� 5 INDUSTRIAL DWELL. 1 UNIT 6 PUBLIC BLDG. .ARCHITECT OR / �) TEL 2 DUPLEX 2 UNITS - ENGINEER �I A!/�K NO. 7 ADDN.,ALT., ETC. 3 APT. _UNITS B ISCEL. . ADDRESS - 4 COMMERCIAL CONTRACTOR ,�,� No' INSPECTION RECORD ADDRESS DESCRIPTION OF WORK NEW ADD ALTEBK REPAIR DEMOLISH i 50. FT. NO. OF NO. OF [/_ SIZE STORIES FAMILIES USE OF STRUCTUREA D / - - - � F �i /.'. 2(1 p M�L1 W, An! SIGNATURE OF)., ,, / l� /�Y�T�L/lR/(� APPROVALS APPLICANT ADDRESS I ./i` DATE INSPECTOR'S SIGNATURE -' FOU NDATIONv LOCATION FORMS,MATERIALS FRAME. FIRE STOPS. VALUATION S BRACING. BOLTS FEE / `— FURNACE: LOCATION, I HEREBY ACKNOWLEDGE THAT 1 HAVE.REAO 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. LATH. EXT. SIGNATURE OFY IVA AASJ 0 �� HOUSE NUMBER COR- PERMITTEE _ RECT AND POSTED ADDRESS - FINAL JOHN A. LAMBIE. COUNTY ENGINEER VALIDATION CLYDE N. DIRLAM, CHIEF BLDG. INSPECTOR CK No `GSH i tl�o b 9 5 9 JUN 14. 1 1 .0 0 `, WORKERS' COMPENSATION DECLARATION �I ..,,Mfirm affirm thdl I have a certificate of consent to self //p�� O (/(� //p�� M FOR O �I��Ip�(/��-r O 1ISI lure,o�'a certificate of Workers' Compensation Insurance, WPPLO`y AT OU'�1 Il' OIl l �� D 11 V V/ PIS U�IUV D� 0 'or a certified copy thereof(Sec. 3800, Lab. C.) - - COUNTY OF LOS ANGELES . BUILDING AND SAFETY Policy No. Company y Certified copy is hereby furnished. - - FOR APPLICANT TO FILL IN BUILDING ADDRESS O ❑ Certified copy is filed with the county building inspec- BUILDING C7D - - tion department. ADDRESS LOCALITY NEAREST Data Applicant CITY ZIP Q(/ CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' / [-/ NO.OF BLDGS. "� ASSESSOR ,COMPENSATION INSURANCE SIZE OF LOT J _ NOW ON LOT MAP BOOK PAGE PARCEL (This.section need not be completed if the permit is for one USE ZONE ' MAP hundred dollars ($100)or less.) TRACT BLOCK LOT NO. NO, _ TEL �� SPECIAL } I certify that,in the performance of the work for which this OWNER NO. CONDITIONS d permit is issed,'I shall not employ.ony person in any manner DISTRICT GROUP TYPE FIRE ESSED BY _ O so as to become subject to the Workers C Pensati n ws: ADDRESS a 0 /` U CONST. 1 ZONE V FIM Dater�s�Applica CITY ZIP STATISTICAL CLASSIFICATION ART. CONDO. - O Cr ARCHITECT OR TEI. _ NO E TO APPLICANT: If, after maki this Certificate of >>''// V Exemption, you should become subject to the Workers' ENGINEER NO. CIA55 NO.�DWEll UNITS_ d Compensation provisions of the Labor.Code, you must forth- ADDRESS - SEWER MAP E _ 7 With comply with such provisions or this permit shall be deemed revoked. CONTRACTOR Np. BK. PG,t_-// VALIDATION ' LICENSED CONTRACTORS DECLARATION UC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC Professions Code, and my license is in full force and effect. CITU 0 CLASS $ SQ. FT./''7, INC. OF NO.OF -CHECK License Number• Lic.Class SIZE ✓v STORIES FAMILIES ONE Contractor Date DESCRIPTION OF WORK X 24 / NEW ❑ $ - . I am exempt under Sec. ADD ALTER ❑ FINAL 8.8P.C. for this reason C3 DATE//-' REPAIR - USE Of Date: . EXISTING BLDG. Q DEMOL ❑ 9y Signature APPLICANT TEL. - s - OWNER-BUILDER DECLARATION :<. PRINT NO. _ I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS , 'Professions Code): PRESENT T�7L BUDDING I, as owner o4 the.property, or my employees with ADDRESS t wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY .- 7044, Business and Professions Code). MOVING TEL. I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). - ;95 5 6 6 A CONSTRUCTION LENDING AGENCY REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. H SETBACK PROP. LIN WIDT hereby affirm that there is a construction lending agency for FRONT e'• e •,� ' the performance of the work for which this permit is issued P.L. " (Sec. 3097, Civ. C.). SIDES • 11 5 5 0 1 . P.L. Lender's Name • •.� 5 5 O p' P.C. fee$ Permit Fee U, b - - Lender's Address - O 1.06-186 I certify that I have read this application and state that the , Issuance Fee above information is correct. I agree to comply with all County Investigation Fee g ordinances and State laws relating to building construction, Tolal Fee (J G and hereby authorize representatives of this County to enter. m upon th ove-mentione� pyr p� arty for in pe Ion purpose - - - e � }z[z� �O 6J-O SEE REVERSE FOR EXPLANATORY LANGUAGE �� SJ40rature of Applicant or Agent