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Home My Public Portal About9055 BROADWAY_Building__ 76A638A CEAB03 9.67 •` t 6L"/ / {� APPLICATTON FOR B G PERMIT LJ ` COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER- ADOREss .1E BUILDING ANU SAFETY DIVISION LOCALITY T G ! JOHN A. LAMSIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST CROSS STAle v L NA FOR APPLICANT TO FILL IN DISTRICT NO. I GROUP I TYPE PROCESSED BY (Print or type only) 0 CONST./� C BUILDINGSTATISTICAL Cl,WIFICATION SEWER MAP ADDRESS �J(' CLASS N_DWELL,CJS UNITS_ BK PG LOT NO. C B.rKI USE ZONEI MAP ...VVV NO. O TRACT ! SPEC A NO.OF BLDGS. CONDITIONS SIZE OF LOT,Tj�. X OO NOW ON LOT USE OF EXISTING BLDG. BLD .SETBACK FROM TEL. FRON PROP.LINE OF (STREET). OWNER NO. ,TYPE OF E TING SETBACK T HIGHWAY } YARD = TOTAL ADDRESS HIGHWAY WI FROM G.L. 4 = CITY BLDG.SETBACK FROM ARCHITECT O TEL. SIDE PROP.LINEOF ISTREE TI ENGINEER NO. TYPE OF EXISTING SETBACK HIG ( } YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. ///(/ + _ a CONTRACTOR � C) ADDRESS — (�[' L CORNER CUTOFF YES ❑ N ❑ T"T C CITY c s SEE REVERSE SIDE FOR SPECIAL APPROVALS DES RIPTION OF WORK a z_ NEW ADD ALTER REPAIR DEMOLISH SQ. FT. NO. OF NO. OF SIZE QO STORIES FAMILIES USE OF STRUCTURE A SIGNATURE OF - APPLICANT VALUATIONS 3�00� APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. m�V FOUNDATION: LOCATION FEES FEE 5 T 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. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. LATH, INT. ' ING TO WORKMEN'S COMPENSATION INSURAN / JQ LATH, EXT. SIGNATURE OF ejJ HOUSE NUMBER COR- PERMITTEE' RECT AND POSTED ADDRESS A FINAL JOHN F. LEWIS. PffINCIPAL STRUCTURAL ENGINEER PLAN CHECK-VALIDATION cK. M.D. CAST _ PERMIT VALIDATION Q M.O. CASH 1ALIO-5 1 4 3JV1120 ' 1 D 9.00^' v T9A939A 0953 12-S4 APPLICATION FOR: BUILDING PERMIT DIVISION OF BUILDING AND SAFETY BUILDING Depratment of County Engineer ADDRESS D County of Los Angeles - LOCALITY WM. J. FOX. COUNTY ENGINEER NEAREST T � CASSATT D. GRIFFIN. SUPT of BWLe1NC. CROSS ST. 44 DISTRICT NO. GROUP SEWER MAP FOR APPLICANT TO FILL IN y TYPE BK PG BUILDING Z- 0424 I CONST. L rJ ADDRESS prr '�✓/� `('�/�/lpny�—/J��r' MAP NUMBER /� (J G STATE HWY LOT NO, d� % - BLptK USE,7.OjJE SPECIAL ' c _ .JA"�y� CONDITIONS _TRACT'S' . N ✓i �Q(� I NO. OF SLOGS. SIZE OF LOT NOW ON LOT / BUILDING YARD HWY STREET NAME EXIST. USE OF /1 // _SETBACK - WIDTH EXISTING B11L''D11G. A'/�� CFRONT P. L. s;,/OWNER W� dR 2 A _ SIDE / MAIL ((// - / n �1T _ - P. L. AO DRESS /V - I nTEL / t DWELL. I UNIT 5 INDUSTRIAL _ CITY CT 7^�l, p/EL NO 1' _ 2 DUPLEX—UNIT-L—.6 PUBLIC BLDG. ARCHITECT TE - ENGINEER NO 4 - 3 APT. UNITS 7 ADON.,ALT., ETC. ADDRESS Z U'_J.4P L 4 COMMERCIAL '8 MISCEL. ^ gri CONTRACTOR l../� TEL7 INSPECTION RECORD ADDRESS s�OOTIAJC. 1`O -em rmwmioc. DESCRIPTION OF WORK p r NEW //ADD - ALTER REPAIR DEMOLISH - SO Ij FT. /)! _�QQ NO. OF / NO. OF SIZE _'TIDTI STORIES L FAMILIES USE OF STRUCTURE SIGNATURE OF APPLICANT APPROVALS ADDRESS DATE INSPECTOR'S SIGNATURE NDA$• P. C. S p0 ' F .0o) MATERIALS ION S g S T ^ .. .0 TU / FRAME: FIRE STOPS. (I AA" "— VALUATION (/ / (p�-' FEE S 'e BRACING, BOLTS II FEE - FURNACE: LOCATION. I HEREBY ACKNOWLEDGE THAT I HAVE READ GAS VENT, DUCTS A THIS n APPLICATION AND STATE THAT THERE.IS CORRECT L- I� r AND AGEE SO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. 'HhYIJ-'- AND STATE LAWS REGULAT G BUILDING CONSTRUC• --- TION. LATH, EXT. 4 SIGNATURE OF HOUSE NUMBER PERMITTEE - RECT Al POSTED �� ((ii.I�[LAn ADDRESS 'n0/k; FINAL -/ ��) rle il:I'!G"Y'✓ WM. J: FOX. CG N ENG EER VALIDATION BY :0.0'A IDBY . QDEPUTY - ' DEPUTY ' BY _ O� j' ✓- t�o3:2116.2 n" MAY 2 1 . 2 2.0 0 . i ® .. DEPUTY. " • / '" '� 1 ( DEPUTY COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION -' FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby'affirm that I have a certificate of consent to self insure,' BUILDING ADDRESS I SS V�)12k;,., or a certificate of Workers' Compensatiori Insurance,or a certified gos'5 �D copy thereof(Sec.3800,Lab.C.) CITY ZIP �8 5_tet S"i�>✓FLUlJD TEM QL C-1--N2;tX 1 8� LOCALITY Policy NO. Company SIZE OF LOT O.OF BUDGE.NOW ON LOT ❑ rtifietl copy is hereby furnished. NEAREST-CROSS Si - - ifted copy is filed with the county buikfing inspection TRACT BLOCK. LOT NO. 111111////// departmeent.ee?? /n.�/�� p�.,, •' USE ZONE MAP NO Date 7� 6—/y Applicant /�fk1.L'OA1 ASSESSOR MAP BOOK PAGE - PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' °''YNE-5 TEL NO. _ COMPENSATION INSURANCE - E VE t— F.� Z �I—• d WITHIN 1000 FT.OF SCHOOL z YES NO ASS �P�nP�i,JNkml (This section need act be Completed if the permit is for one hundred DISTRICT GROUP' TYPE CONST FIRE ZONE PROCESSED BY dollars 1$100)or less.) 1 certify that in the performance of the work for which this permit CITY ZIP is issued,I shall not employ any person in any manner so as to E� �""� C''�� `� 80 I/'e— r!'O become Subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO, STATISTICAL CLASSIFICATION APT coNbb Date Applicant ADDRESS CLASS NO DWELL UNITS -NOTICE TO APPLICANT.' If, after making this Certificate of REOUI RED TOTAL SETBACK FROM EXIST Exemption, you Should become Subject to the Workers' CTEL SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith Ir1Vwt".�,1• —�/ FROM comply with such provisions Or this permit shall be deemed revoked. ADPpRESs LIC NO PL LICENSED CONTRACTORS DECLARATION FotZ N` XVP R SIDE CITY LIC,-0IASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 G L C--3 SEWER MAP a (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORIES I NO OF FAMILIES NEW ❑ BK PG U Professions Code,and my licensee is in full force and of cct License Number NSfZgJOsepI Class C__vCt DESCRIPTION OF WORK ADD -11 VALUATION r ^� D Contractor L�i'rnYl ��4ate �� —�L'�" �' FO ALTER ❑ $ x21 16oAoo R W HCU d" (alt t�J 1T lk rn ❑ 1 am exempt under Sec. REPAIR Z $ Z B.&P.C.for this reason '2$ Yom• �l�C..�.a LASS C- n DEMOL ❑ LDMA P/C x Date: USE OF EXISTING BLDG. ' ' URM ❑ - Signature APPLICANT(PRINT) TEL NO LDMA Perm x t - ❑.I,.as owner of the property, or my employees with wages as - Z their sole compensation, will do the work and the structure is ADDRESS not intended Or offered for sale (Section 7044, Business and FINAL DATE y Q _ { Professions Code.) WILL THE MPUGIn OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL — _ ❑ I, as Owner of the OR A MIXTURE CONTAMNG A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J p property, am exclusively COn1niC11Og Wlih AMOUNTS SPECIFIED ON THE HAZARWU$MATERIALS INFORMATION GLADE? FINAL BY j 1 1(L:t-= y licensed contractors to construct the project (Section 7044, J { 'Business and Professions Cade.) YES❑ No❑ - �T �- 12' 1 o 3.5 WILL THE INTENDED USERMI THE BUIDLINBY CONSTRUCTION O ATMLICAM OR FUTURE BUILDING - . _ _ .. _ _ COASTOCCUPAIR REOURE A PERMIT FOR TRICT(SCAQOR EE PERMITTING G CH THE T UTHFOR / / I"H1C('/ !p CONSTRUCTION LENDING AGENCY COAST QUALITY MANAGEMENT DISTRICT I$GAOMD)$EE'PERMITTING CHECK(15T FOR y . . }' G'+�T _ _ !21. vlJ. GUIDELINES 1 hereby affirm that there is a construction lending agency for 'YES NOD '••HMISt - .60 ,v the performance of the work for which this permit is issued(Sec. - - m I HAVE READ THE HAZARDOUS MATE RIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 3097,Civ.G,) CHECKLIST I UNDERSTAND MY REWIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TITLE 2.CHAPTER 2.20 SECTIONS 220IMTHROUGH 2.20.140 CONCERNING HAZARDOUS ('1 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD Flfll'1 I—f iLIV 7r Jl`:IY o Lender's Address o I certify that I have read this application and state under penalty of perjury that the above information is correct.I agree t0 comply P.C.FEE PERMIT FEE RQ ^C with all couand State laws relating to building `7 J m with.2nances by authorize representatives of this County ISSUANCE FEE ��to e-m Zoned property for inspection purposes INVESTIGATION FEE TOTAL FEE SEE REVERSE FOR EXPLANATORY LANGUAGE ...COUNTY'OF' LOS ANGELES TEMPLE'CITY r q 0508 - BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0505250067 PHONE: )626) 2B5-0488 EXT: LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE OCCUP GROUP 9055 BROADWAY STRUCTURE: 544 1 VN R3 TEMP,CA 917802312 ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET��:(( 5387-026-000 OTHER: THOMAS PAGE: 596 G ID: H4 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: USE ZONE: ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 09/23/05 JK 09/18/06 OWNER: TEL. N0: HLDGS. NOW ON LOT: 'VALUATION: F )�TE FL BY: CODE: YEN, SHIRLEY )626) 292-2266- 45,090 / E 9055 BROADWAY TEMPLE CITY CA 91780 FEES PAID DESCRIPTION OF. WORK ADD ONE FAMILY ROOM, TWO BATHROOMS, LAUNDRY ROOM, DINING FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: ROOM 544 SQ FT. APPLICANT: TEL. NO: CAI )626) 429-1BB4- B1 PLANCRECK W/ENERGY 45040.00 VAL 697.03 416 W. AVONDALE AVE AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: MONTEREY PARK 91754 AC STRONG MOTION REBID 95040.00 VAL 4.50 B2 PERMIT W/ENERGY 45040.00 VAL 820.05 TOTAL FEES 1,549.33 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE T 6 W CONSTRUCTION (626) 429-1884- 416 W. AVONDALE AVE LIC. NO LOCATION AND SETBACKS MONTEREY PARK, CA 91754 ]]1180 H SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS - ' L LIC. NO: SLAB/UNDER FLOOR v RAISED FLOOR FRAMING 4 r G MAP NO: SEWER MAP HOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 3 0- 1ST LEVEL FLOOR SHEATH NO. OF FAMILIES: DWELLING UNITS:. APT/COND: STAT CLASS: ' NO 21 2ND.LEVEL FLOOR SHEATH —- SCHOOL WITHIN HAZARDOUS - ROOF SHEATHING AIR QUALITY: 1000 FEET MATERIALS NO NO NO FIRE DEPT. FRAME INSPECT REQUIRED TOTAL SETBACK FROM EXIST BLDG DEPT. FRAME INSPECT / - j A SET BACK YARD: HWY: PROP LINE: WIDTH: / L FRONT PL- SHEAR PANELS SIDE PL- INSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL EXTERIOR LATH LOT DRAINAGE SMOKE DETECTION DEVICES FIRE DEPARTMENT. APPROVAL - REPORT ID: DPR261 ROUTE TO: HS0508 _ e