HomeMy Public PortalAbout9114 BROADWAY_Building__ APPLICATION FORS COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING PERMIT BUILDING AND SAFETY DIVISION
BUILDING ^
FOR APPLICANT TO FILL IN ADDRESS / /L6 CL 6LG2/{
BUILDING (71,171
WH
ADDRESS ��1 I /' ZIP /'Y LOCALITY
CITY-1-F-MP.Cr l NEAREST
CROSS ST. 4J
`' f. NO.OF SLOGS. ASSESSOR
SIZE OF LOT (((! y /SV NOW ON LOT MAP BOOK I PAGE PARCEL
(� n DISTRICT GROUP TYPE FIRE PROC ED BY
TRACT/ BLOCK rJ LOT NO jJ /OB 'T CONSTV Z-1E µ
(/� / TEL. aJ i- .3
OWNER /4/ (,Q I C NO. STATISTICAL CLASSIFICATION
SEWER ryMA P
ADDRESS -2/ U
CLASS NO. � DWELL, NITS )- SK-7 PG
CITY ZIP USE ZONE MAP -
NO. 7 0
ARCHITECT OR TEL. SPECIAL
ENGINEER NO. CONDITIONS
ADDRESS //�� ��II�S II�� ((��,,``ll11 ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONTRACTOR [•6",b)c lArK l77UFEL j7o BLDG.SETBACK FROM
LIC.,'/ p ] FRONT PROP.LINE OF (STREET)
ADDRESS , .SAf/f/l- Ali NOrW HIGHWAY } YARD TOTAL SETBACK FROM TYPED EXISTING
LIC. FRONT PROP. LINE HI Y WIDTH
CITY RC4 I CLASS 'I
CONSTRUCTION LENDER }
NAME AND BRANCH a
BLDG.SETBACK FROM >
ADDRESS CITY SIDE PROP.LINEOF (STREET) C.D
SO. FT. ;pq NO. OF NO. OF / CHECK HIGHWAY } YARD = TOTAL SET CK FROM TYPE OF EXISTING
SIZE STORIES / FAMILIES ONE SIDE OP. LINE HIGHWAYWIpTH O
El } d
DESCRIPTION OF WORN NEW "
AOA TvU^y �nTO d A g ADD ❑ CORNERT F VES ❑ NO ❑ Z
'J CULTER ❑
col u5F //v &04/!:
V h REPAIR❑ IN OPEN SPACE YES ❑ NO ❑
USE �(75/ J1 �� EMOL El COASTAL PERMIT ZONE YES C] NO ❑
EXISTITI NG BLDG. //ZZ .J U
APPLICANT I,ry TEL ���
(PRINT) /Y/CGO�DR�l`l� {Cell( NO. Q
BY (SIGNATURE) \ / _,L- Y) J�O S Z
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION, I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STATE Of LIFORNIA IN RELATING TO
WORKMEN'S COM
PE TION IN\SVR N _
SIGNAPERMITURE OF YN✓ /�rW FINAL /111 BY
DATE
ADDRESS r Q r > /�/�� �I/ •••/ �rllrllll��I���` t �F61/
r
TEL. P.C. Fee$ Permit Fee 3
CITY NO.,
Q Issuance Fee
VALUATION_$ �/{JC
VV VV Total Fee
PLAN CHECK VALIDATION DK, M.D. CASH _ PERMIT VALIDATION ca- M.O. CSH
4 1 7 SRM'-30 1 0 3.0 0 A56
7GA630A CE#803B 12/75 ,
APPLICATION FOR BUILDING PERMIT
•FOF APPLICANT TO FILL IN (P,iNr D:tYPB ..IY)
ADDRESS O W - COUNTY OF LOS ANGELES -
DEPARTMENT OF COUNTY ENGINEER
CITYTF-IV7 Cx' C/Ty ZIP BUILDING AND SAFETY DIVISION
NO.OF BLDGS. . BUILDING p f r
SIZE OF LOT O >(I-!Ta NOW ON LOT Z, ADDRESS J I / 4 f
qq
TRACT /dBLOCK LOT NO. LOCALITY
��/ /J TEL. NEAREST
OWNER,8, /VL- � ICI - -NO. CROSS ST.
,1 C ASSESSOR
AT
.
ADDRESS NIA, MAP BOOK PAGE" PARCEL
DISTRICT I GROUP I TYPE FIRE Pft CESS D BY
CITY F � ZIP ' CONST. ZO E
ARCHITECT OR TEL. ('D
ENGINEER NO.
STATISTICAL CLASSIFICATION SEVER MAP
ADDRESS / ^ S ✓ ' CLASS NO-27 OWELL.UNITS BK PG
TE
CONTRACTOR EyUA,�R/C/L NOLE PFJ ..�'
ADDRESS 3(J /+ILIC
A y}A)r'/{� NO. • 3 TI DEC
CITY C
CONSTRUCTION LENDER �N/` CLASS CONOTIONS
I- ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑
NAME AND BRANCH BLDG.SETBACK FROM.
FRONT PROP.LINEOF IST EET)
ADDRESS CITY
HIGHWAY . } YARD -_ TOTAL SETBACK FROM T EOF EXISTING
SOFT NO. OF NO. OF / CHECK FRONT PRO . LINE IGHWAY WIDTH
SIZE & STORIES ( FAMILIES / 'ONE
Lk
} - Y
OESCRIPTION OF WORK � NEW ❑ 60
tZI
57u/> F /CpJOji? ADD BLDG.SIDE PSETBA KEFROM
SETB LINOFM
_ (STREET) C
d / /FH T pr,�/� LTER ❑ HIGHWAY } YARD o TALI TB�CK FROM TYPE OF EXISTING
CIL
IF
REPAIR 51D PF'o P. LINE HIGHWAY WIDTH yU
E%EST NG BLDG. /y S I F/VICE EMOL ❑ } - cz
Z
APPL
)CAN;B .A/, )).D R[ 4 NOL -1 S� b, CORNER CUTOFF YES ❑ NO ❑
BY (SIGNATURE) ' l✓ / 1/ �.y IN OPEN SPACE YES NO
NO
qq ✓L C IN COASTAL PERMIT ZONE YES C] NO
VALUATION$ QQ(/ � y .qy
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON-
ST R UC TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED o _
HEREBY I.WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE ��" y C '1
LABOR CODE OF THE ST(TE OF IFORNIA IN RELATING TO U/U'r/(- �L pEJ'�/Y1(�'S' �y G017•AT IMFi lre4
WORKMEN'S COMPEN ION INSU NC
SIGNATUREOF i).,1 G=YI- CoAiV• ✓_�`+\
PERMITTEE L!/�✓ / J
ADDRESS -rA / n 1) I
/r �Z/�
TEL FINAL �J�� BY
CITY /TP�I'F(/1A NO. 7_ DATE `, 'V
JIA F:E CHECKS PA YA 13L E"/'O: PEP.CE V FEE/'S
HARVEY T. ERANDT. COUNTY ENGINEER J
PLAN'CHECK VALIDATION CK: M,D. CASH PERMIT VALIDATION CH. 0. CASH
I
2 O IAUG 27 1 1 0 9.5 0 As
76AS38A CEC803 5/76 / n /
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES n a a ® � �n
WM. J. FOX. CHIEF ENGINEER V IJV
FOR APPLICANT TO FILL cIN -FOR OFFICE USE ONLY
DISTRICT NO. I PLAN CK.NO. PER^/MIT NO`/�)/,
ADDRESS
LOCALITY �/ RECEIVED BY DATE OF APPL. DATE IBSUED
NEAREST --2
CROSS ST.
(/ )Y/ � � ^ - ADDREBUILDSNG
S
OWNER ! -�/y 2 i �/ (,(.P/(f-�([
MAIL
ADDRESS / / V LOCALITY ✓ j��pV//,_J/��
' NEAREST ,'---'! (� ''✓�
CROSS ST.
CITY
FIRE NO.OF / TVPE GROUP
ARCHITECT O� TEL ZONE PLANS
ENGINEER NO. _
GLDG. ^ / ORD NO.
ADDRESS SETBACK LINE /SIJ /TT
APPROVED
BY ' DATE
USE a APPROVED '
A ZONE BY, DATE
LEGAL �'' CORRECTIONS
DESCRIPTION LOT NO. BLOC i
TRACT / / L D / G. �. •/ �V[ y.. .
//�A NO.OF ELDGS. 92 7
SIZE OF LOT; NOW ON LOT
USE OF1t ('� NO.OF NO.OF
_EXISTING BLDG. " T�1\ FAMiu Es /I ROOMS
DESCRIPTION OF WORK
NEW ALTERATION ADDITION D
I A
REPAIR .� /. iMOVINp DEMOLISH 0 '
T4/
" -L__'11NOy.OI�FSqZEFJJ(\ �I�L+�vJ"Q/IL�,l.✓1
Z
SI � D
WALL ROOF � F
COVERNNRIIG
USEOFNEW 52
BUILDING
� c
t
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
SIGNATURE OFiiiFRAME: FIRE STOPS,
//( _ D' BRACING,BOLTS -�N� �--ate-�-j-/"V
PERMITTEE //' /�Wi��� '�`� '^t LATHS INT. /v
/
AUTHORIZED A LATH. EXT.
78
A639A 9-48
095-3 50M SOTS $ _^ P,C.$ PLASTER, INT.
UFEE PLASTER.EXT.
I VALUATION V V
FEE ��i FINAL
DA-3 21-43 ASM SOTO ! APPLICATION FOR PERMIT .
DEPARTMENT OF BUILDING AND SAFETY I
COUNTY'-OF LOS ANGELES BUILD
���°
WM. J. FOX. CHIEF ENGINEER
NO.OF •�•� BLDG. \ ORD.NO. DISTRICT NO. PLAN CK. NO. PERMIT NO.
PLANS SETBACK LINE JC
FIRE APPROVED
ZONE BY DATE RECyE�IVED BY DATE OF APPL. DATE ISSUED
USE I APPROVED
DATE e, n M �7
ZONE I`31— UU' rI'31-44
APPLICANT FILL IN HEAVILY OUTLINED"MING ^PORTIION ONLY
p NAME
\ ADDRESS I 1 �C 9 t=�'"R R n a-p w R Y
a
ADDRESS \ LOCALITY TF MPLi_
Su
UZ
CITY- \ CS
ROSSST. BST L..O {a-rt' 'L FII�FI
aSTATE TEL.
_' 11
Q LICENSE NO. NO. NAME
Z MAIL �+
a NAME A 3 ADDRESS
O
TEL.
6 ADDRESSp.. CITY NO.
T,r
�
CITY �/) 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
U APPLICATION AND STATE THAT THE ABOVE 13 CORRECT
STATE TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
LICENSE NO. NO. AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
Z LOT NO. R SIZE OF LOT I�OX I"I b SIGNATURE OF
O OWNER
NO. OF BLDGS
NOW
BLOCK ON LOT . ,�, -�,� AA��
< 6 AUTHORIZED AGT. ""�-�L
D � _
1 J U
0 �'y I g a CORRECTIONS
TRACT 1
D UBE OF BLDGS.--D. X L Q. ! � I
NOW ON LOT YV 1 1Y / y
DESCRIPTION OF WORN -
BUILDING 5T0 R F R nnM
WARN I GI
HIM s nl I'
a e in i lal
War Production Board orders. You are 0
cautioned to consult with your local War
ing the workauC.orized in this permit. D
T r
.NEW t TYPE � I GROUP �J
NO.OF NO.OF
ALTERATION ROOMS FAMILIES _
ADDITION _ SIZE
REPAIR STORIES
MOVING WALL COVERING SIDING
DEMOLISH ROOF COVERING CO M pQ
$ FEE $ FINAL APPROVA((((L
r S INSPECTOR S'
.VALUATION �J . 0D 'FEE 2 .6e) ATE �' I 'NAME O �,
r
WORKERS'COMPENSATION DECLARATION /� I� �j� �(�� 1� {I
hereby affirm that I have r certificate of consent to =elf A 11 LOClrLlTM V— FOR o M C�5,NG ,PC�RM57 LI IS
insure, or a certificate of Workers' Compensation Insurance, ,
or a certified copy thereof (Sec. 3800, Lab. C.) - t
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company BUILDING
❑ Certified copy is.hereby furnished. FOR APPLICANT TO FILL IN ADDRESS
❑ Certified copy is filed with the county building inspec- BUILDING L/ s •��
tion department. ADDRESS T G Y LOCALITY
NEAREST
Date Applicant CITY C-C& ZIP 6V CROSS ST.
CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BO 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. j• NO.
TEL ��j SPECIAL' -
I certify that in the performance of the work for which this OWNER rfQ OD 'f.-- N07 ri"4 p,J0 ^/ CONDITIONS O
DISTRICT .GROUP TYPE FIRE PROCESSED BY
permit is issued, I shall not employ any person in any manner (1 ( CONST. Z E U
so as to become subject to the Workers'Col*tpensption Laws. ADDRESS I� /� r
-L ^�
CITYJ -CSZIP qt 7D 0 O
Dot Applicant STATISTICAL LAS5IFICATION APT. CONDO.
NOTICE.TO APPLICANT: If, after akin this Certificate of ARCHITECT OP - TEL. U
g ENGINEER NO. W
Exemption, you should be subject to the Workers' CLASS NO. _DWELL UNITS_ IL
W
N
Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP Z
with comply with such provisions or,this permit shall be
deemed revoked. TEL' .BK. PG, • VALIDATION
- CONTRACTOR NO.
LICENSED CONTRACTORS DECLARATION LIC. _
,— I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. ILLATION(commencing with Section 7000)of Division 3 of the Business and - LIC Q�
Professions Code, and my license is in full force and effect CITY CLASS >t D
51. FT. NO.OF NO.OF CHECK -
License Number Lic.Class SIZE STORIES FAMILIES ONE .
. . . . �l NEW ❑ S
Contractor ------Dale DESCRIPTION OF WO
I am exempt under Sec. I _ A
LTER FINAL /D_/Z
B.BP.C. for this reason O UQ REPAIR ❑ DATE a
USE OF FINAL -
Data: EXISTING BLDG. - DEMOL ❑ By
Signature APPLICANT TEL.
OWNER-BUILDER DECLARATION PRINT _ NO.
I hereby affirm that I am exempt from the Contractor's License D
Law for the following reason (Section 7031.5, Business and ADDRESS
Professions Code): PRESENT
❑ .. _
I, as owner of the property, or my employees with BUILDINGADDRESS
wages as their sole compensation,will do the work and 3,�9 A
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. •# e s e o
with licensed contractors to construct the project (Sec- ADDRESS 2 e,e 4 Q 5 O
tion 7044, Business and Professions Code).
REQUIRED TOTAL SETBACK FROM EXIST. yR� q 1t nU
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT - D - - -
the performance of the work for which this permit is issued PL.
.
(Sec. 3097, Civ. C.). SIDE
-' 'PA.
Lender's Name
foLender's Addressrmit Fee P.C. Fee$ Pet
i
I certify that'I have read this application and state that the Issaonce Fee
a above information is correct. I agree to comply with all County Investigation Fee
ordinances and State laws relating to building construction, Total Fae. d• -
O and hereby authorize representatives of this County to enter
. upon the above-mentioned property for inspection purposes. - - - -.
/ T SEE REVERSE FOR EXPLANATORY LANGUAGE
SOure of Applimnt or Agent Dd.e
COUNTY OF LOS ANGELES TEMPLE CITY N 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 HL 0508 1201300002
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
ITS: 11218 LT: 8 BL: B I SQ. FT STORIES TYPE 9114 BROADWAY
STRUCTURE: 22 V-B TEMP CA 917802304
ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: ROSEMEAD
15388-002-008 I THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, Cl
1_.
TENANT: IEXIST BLDG USE: RESID USE ZONE: A-1 JISSUED ON: PROCESSED BY
IE%IST OCC GRP: 101/30/12 SR
OWNER: TEL. NO: BLUGS. NOW ON LOT: VALUATION: IFIHA`L DA1TE F `AL BY: CODE:
IKOK, KENNY (626) 975-2961- 6,800 1\ - \� (�^^
9120 BROADWAY 1__ R �/
TEMP 917802304 FEES PAID (DESCRIPTION OF WORK
NEAR OFF INSTALL OSB RADIANT BARRIER PLYWOOD INSTALL 30 YRS
IEEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ICOVPOSITION SHINGLES CLASS A
APPLICANT: TEL. NO: i1
AA BLDG PERMIT ISSUANCE 27.80
CHHEANG, VES (323) 979-7369- {
111619 HALEWOOD RD. IAB STATE GREEN BLDG FEE 6600.00 VAL 1.00 (SPECIAL CONDITIONS:
LEL MONTE, CA 91732 IAC STRONG MOTION RESID 6800.00 VAL 0.70
ID2 PERMIT W/0 EN-HC 6800.00 VAL 166.69
TOTAL FEES 196.10
CONTRACTOR; TEL.TEL. NO: - (APPROVALS DATE INSPECTOR SIGNATURE
IS N S A ROOFING CO. (323) 979-7369- 1: C _I
111614 HALLWOOD DR LIC. NC
LG CATION AND SETBACKS
EL MONTE CA 91732 791430 C39 I
SCILS ENGINEER APPROVAL
(ARCHITECT OR ENGINEER: TEL. NO: 1FCJNDATION/TRENCH FORMS I
�-
LIC. NO: SS148/UNDER FLOOR
RATSED FLOOR FRAMING
(MAP NO: .SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( .UNDERFLOOR INSULATION I I '
1147H265 3 001 !' I
_1 ;FLOOR SHEATHING
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I 1,IT,-
I 0 NO 21 1 .3F SHEATHING
D
SCHOOL WITHIN HAZARDOUS 15HEAR PANELS
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO IFR9ME INSPECTION
i
'FIRE SPRINKLER HANGERS
I
INSULATION/WEATHER STRIPI
(INTERIOR LATH/DRYWALL
1EX-=IOR LATH I
RATED FLOOR/CEIL ASSEM. -
CRATED WALL ASSEMBLIES
I
IRA IED SHAFTS/OPENINGS
I
T-BAR CEILINGS
I
LOT DRAINAGE
I_
REPORT ID: DPR261 ROUTE TO: DS0508
I