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HomeMy Public PortalAbout9123 BROADWAY_Building__ �'+6A63EA #803.1-SJ APPLICATION FOR BUILDIN PERMIT ' COUNTY OF LOS ANGELES BUILDING 3 _ DEPARTMENT OF COUNTY ENGINEER npDREss ct-' z(' BUILDING AND SAFETY DIVISION LOCALITY /t JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINSSUP'T OF 6w LDIHG CROSS ST. DISre rbNC}�/ GROU TYPE PR B FOR APPLICANT TO FILL IN //SS OOyy CONST. s C BUILDING t �DLL}�YY'� ,.I STATISTICAL C ASSIFICATION SEW MAP// ADDRESS I ` `'� VKLJADwA CLASS NO. DWELL UNITS OK LOT NO. BLOCK USE ZONE MAP /� /l ' fVVVVV/.ffE/ii N . l/G TRACT SUI.INy 'VI@W SECIAL 1— I y C1 x0. OF BLDOS. CONDITIONS (l 512E OF LOT I ^ 5 NOW Ox LOi /, USEOFN 1{ Q SEM73L.Y7 SG,t00 5 LOG. 5ETBACK FROM ONT P. NE OWNER I N CNL' NOL -G2S2 tYpE 01 R0E1N9T x6FBETBACK HIGHWAY AAO = (STREET) ADDRESS I23 E.gIZOAv WAY NIBBWAY WI IROM LL. �y } /� CITY Y ✓l laP-e C.17 '1' , 0 - "C V LOS. SETBACK FROM ARCHITECTOR TEL SIDE PROP. LINE Of ISTRE£T)- ENGINEER yY-�YEIdNK NO' _ & TYPE OF EI'STI NO BE TRACK NISHWAY } YARD = TOTAL ��'• HIONWAY WIDTH PROM C.L. AD DRE55 \ y Q / CONTRACTORP� NO IC ADDRESS - F� NO CORNER CUTOFF YES NO C CITY L10 SEE REVERSE SIDEIFOR SPECIAL�APPROVALS n DESCRIPTION OF WORK "A u n NEW A D ALTER REPAIR DEMOLISH I SO.FT. q NO. OF NO. OF 1 SIZE! 4 ac STORIES FAMILIES -� t STRUCTURE J'I� A M 1% 19 HLUSE OFI/ 1 AAe SIGNA URE OF APPLI VALUATION QO mO0 .00 / ` I ^ APPROVALS DATE -'PECT��OR��•..15IGNATURE P.C. GO PMT. FO FORMS!MATERIALS r/� f�"�Y2 =%I ri3XPl.)�iPwT FEE E FEE$�,/ J C/ FRAME, FIRE STOP.S;i I HEREBY AOK NOWLEOGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS 7 AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE: LOCATION` - } ' WITH ALL COIN OINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS I 9UILOING CO RUCTI I CERTIFY THAT IN OOIN- TME WORK AUTHORIZED EREBY ILL NOT EMPLOY ANYERSON IN VIOLA- LATH. INT. TION OF t bABOq OE OF TATE OF"LIF gNIA flEUT. ''TC11` 1 N. TO W RKMEN'S O PENSA ON SURA LATH. EXT. SIGNATOR HOUSE NUMBER COR- - - /, PE MITTEE RECT AND POSTED I Y - DREBB FINAL �Ctt ,•� JOHN F. LEWIS.+PR INCIP � TR URAL'ENGINEER PLACHECK VALIDATION -GK. A5„ _ PERMIT,,VALIDA DK MD' C;9X (� 2a77� " 182 0 3 90 h d r 1 b, info 4 a 7 10 1 o"'5 7150 P 76A638A CE#8033-68 APPLICATION FOR BUILDING PERMI COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS i' OAl2 BUILDING AND S7LFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST _ COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST. A10 IF DISTRICT NO. GROUP TYPE PROCESSED BY FE3UILDING OR APPLICANT TO FILL IN © CONST.� /b r j �J(Print or type�onnly) s Js /®0 Cl/ ^3As7"f/J� ,�, STATISTICAL CLASSIFICATION SEWER MAP CLASS NO.�DWELhL,UNITSBK PG `,/p /1/ '. LO - BLOCK USE ZONE NOP �✓!/•. 1.3- IS6 _j SPEC _ , N DIL C> Mr — NO. OF B LOGS. SIZE OF LOT ��' OWO/N LOT USE OF EXISTING BLDG. tr/V�r4 - CIL!u� - � BLDG.SETBACK FROM /t d i (STREET). L. FRONT PROP.LINE OF OWNE /'} _ TYPE OF EXISTING SETBACK HIGHWAY + YA TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. CITY AA „ �) ��• �v. t ��/ _ �! BLD ETBACK FROM p r� A (STREET) ARCHITECT R TEL. SIDE PROP.LINE OF V !+ ENGINEER NO. _ TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL ADDRESS HIGHWAY WIDTH FROM G.L. CONTRACTOR / �' NOL O ��'� �/ t �0` - �/ d O ADDRESS LO (/ 2 CORNER CUTOFF YES ❑ NO ❑ V LIC. cC-� CITY. d CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORKLLJ — z NEW ADD ALTER REPAIR DEMOLISH SQ. FT. NO. OF NO. OF I SIZE STORIES FAMILIES USE OF STRUCTURE ./ Ald !v r La SIGNATURE OF APPLICANT VALUATIONS .' O'y - APPROVALS DATE INSPECTOR'S SIGNATURE P.C. jt PMT. +} FOUNDATION: LOCATION FEE S, ^� FEE $ 1-7, + � FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT 1 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. 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 C MPENS TION INS RANGE. LATH, EXT, SIGNATURE OF �� HOUSE NUMBER COR- PERMITTEE- ¢� RECT AND POSTED �+ F ADDRESS FINAL 6�XX '} JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION cK. M.O. CASH - PERMIT VALIDATIO10 M,O. CASH Is C� 7 .4 t'� r, L .� MUND 2-22 3 D 10.351 6 2 31�1*06- SEP 4 11 D 1 72 5- 13 DMSION OF BUILDING AND SAFETY -T Department of County Engineer County oI Los Angeles WM. J. FOX. COUNTY ENGINEER APPLICATION ' £OR APPLICANT TO FILL IN wooRess f/2 3 BUILDING LOCALITY TGr ADDRESS ii NEAREST /j�i / .y�y� LOCALITY - CROSS ST. /�/ � /7 DISTRICT NO. PUN C5. ON RCC. No. PERMIT NO. NEAREST CROSS ST. OWNER /1 I RECEIVED BY DATE OF APPL. DATE SUED MAILADDRESS rf'�1'3 b. (y(.(y�c.ay (/� CITY USE ZONE PLANS I nPE-I GROUP I FI RE ZONE TEL .T -j Dy, �iT�T� G _ ARCHITECT Ovs4 TEL. / (o fJ ZONING - ../J� 4 zirN ENGINEER NO. ZONING APPROVED BY- «C� jrO / BUILDING I OND ADDRESS SETBACK,LINE: 20 /-- CONTRACTOR �.�i1 0. NO. BYPNov6D DATE M ' HOU NUMBERING ADDRESS LEGAL MAP NUMBER 2_00d5�- -NO,ASSiGNED BY ' DESCRIPTION LOT NO. /I /BLOCK 11 , 1 I C TRACT �• � /�J�—! �(p DATE J C/Q/•RRECTIONS INSPECTOR y SJOo T NOW ON LOTNO. OF S I� / SIZE OF LOT // � •c�T EXISTUSE ING BLDG. .(L. FAMILIESP /'Y/ti/X. /A/S/~ /nf//II/4..__�,OI DESCRIPTIO WORE NEW ALTERATION' ADDITION I_ IT r REPAIR DEMOLITION tAPj- PLICATION SO. FT. NO. OF 5SIZE �.7ROOMS al SSTORIESWALCOVNGL(Lq/' ]{M1+J/Y.ROOF COVERINGUSE OF""CTUR v <77i� 7,E/- I APPROVALS INSPECTOR'S SIGNATURE DATE DATION: LOCATION S. MATERIALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIPLICATION AND STATE THAT THE INFORMATION GIVEE: FIRE STOPS, CORRECT. CING, BOLTS 1 AGREE TO COMPLY WITH ALL COUNTY ORDINAACE: LOCATION, AND STATE L WS REGULATING BUILDING CONSTRUCVENT. DUCTS SIGNATURE / . INT. PERMITTE EXT. ADDRESS AUTHORIZED AGT. PLASTER, INT. PLASTER, EXT. $ 5'0 •� P. C.S HOUSE NUMBER COR- FEE RECT AND POSTED 4 �j� VALUATION FEE ^l FINAL 76A638A DBS 3 A-53 7aAe1'dA DBS-3 3-53 FOR BUILDING PERMIT 1 � DMSION OF BUILDING AND SAFETY 'BUILDING ��X C Q�pr7i¢/�Wf} Y Department of Cauaty EDgfneer —DDRESS I_T County of Los Angeles LOCALITY ✓ . C WM.J. FOX. COUNTY ENGINEER NEAREST NO CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST. B r GROUP SEWER MAP FOR APPLICANT TO FILL IN . -1 TYPE BK PG CONST. BUILDING SS 9123 East Broadway NUMBER )-0G � . Hwy ADDRESS ree �o ) N Y LOT NO. Portion 17 BLOCK USE ZONE SPECIAL 7 C IT ON' ' _ 1 '.g TRACT Sunny ,I view r� J SIZE OF LOT66J•641X 181 .7011 NOW ON LOTS BUILDING YARD HWYEXIST.NAME' , %(� WIDTH d SETBACK pp USE OF "[STING BLDG. ReligiousPurposes FRONT l�'L'! r( .. ISL, G7X (iY Church th L t E i Frsv. Lutheran OWNERBPIDE 'I• L.' •!•%/G, 1✓9RIH,�O ADDRESS 9123 East BroadwaMAIL y 9 ` . O TRACT DWELL. ••f UNIT Uaialo y 5 INDUSTRIAL CITY Temple City No'AT6-6282 1 DWELL. 1 UNIT •6 •PUBLIC BLDG. 2 DUPLEX 1�UNIT 9r11jC10f j A RCHITECTT�-�R TEL ... ... .-- • I -ADDN..ALT.. ETC. OwNEERVrr Strange 8lnslee NO.DU 7-3271 3 APT. _UNITS' 101 lonOJ ,7 S H MI4CEL.' 3142 Wilshire Boulevard 4 COMMERCIAL ADDRESS CONTRACTOR IJTt,., - TEL. INSPECTION RECORD . • NO. _` 1 1 ADDRESS ` �� S I I 1 �Ilt —jrr rm Ml1P �� `,4a 1.1� DESCRIPTION OF WORN NEW ADD X ALTER REPAIR DEMOLISH 4•-N-A [�pn7 IV•]Ili.... IJ. I �G NIMC IC 5 ZEFT2 769 STORIES- 1 FAMILIES US!,OF STRUCTUR e t Ious purpose=sj 1. .nn r.n _ 1 SIGNATURE OF : APPROVALS APPLICANT ADDRESS 3142 Wilshire BOule Var DATE INSPECTORS SIGNATURE S��( ��/ ) FOUNDATION: LOCATION �1 /Iy� 530,000•00 FEE/•�(r/.tX/ FORMS, MATERIALS �1V S FRAME: FIRE STOPS. VALUATION S/1 e O BRACING,BOLTS ­=' FEE T FURNACE: LOCATION. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT. DUCTSAPPICATION AND STATE THAT THE ABOVE IS CORRECT \ ANDL GREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. aS 5Ce R '/�Ydl•..../A.. .a AND STATE LAWS REGULATING BUILDING CONeTRUC- TION. LATH:EXT. U Mt SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED , ADDRESS FINAL /�-7/S` N,C WM.-J. FOX,COUNTY ENGINEER VALIDATION C. N. D)RLAM, CHIEF BLDG. INSPECTOR " 3 9 -1 9� OCT2 8 491 6 2.4 .50 e n " ,. ,�o - �io� 3 4 5 5 .110V 28 1 .0 0 lJZVAMTfIdLNT Uk BUILDING AND `3AkW1-Y g41 earra.a�.naava� avati COUNTY OF LOS. ANGELES WM. J. FOX, CHIEF ENGINEER ° lJ 15 0V . FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY/ t BUILDINp7­0 7 DISTRICT NO. PLAN CK.NO. PERMIT NO. ! ADDRE69 0/ 9 q ��/4 LOCALITY l w�/ �y�R/ECEIV(E//D BY DATE OF A'1PPL. DA EIISSUU O7 NEAREST YI 19 lr d/-U/4- / z Xv/ N ARE ST. BUILDING 7 �i'/a A- •, 7q y OWNER ADDRESS (/V T ADDRESS /0 /{� ,SCATL-MAIL. .� ` LOCALITY / / //y NEAREST nq /� ' CITY NOL T, -269+ CROSS ST. 0/,/j]" FIRE NO.OF ' I TYPE . / ORDU `� ,.. ARCHITECT OR TEL. ZONE PLANS �/ LI/4 ENRINEE0. NO. Xj� BLOS. O F /�.0 %49=N 0. ADDRESS SETBACK LINE //��� e TEL APPROVED CONTRACTOR r3urmY NO. BY DATE USE /,�/� APPROVED ADDRESS �V U'lJ`-�� ZONE / / BY DATE LEGAL PT I --{-�_` , A14W 6 CORRECTIONS DESCRIPTION LOT NO. (( I BLOCK c TRACT yryx �/la � aC.v J�/ Ov/'�'� L SIZE OF LOT/�/,�OP VD/ I NOW ON LOT S / h /c 1X.,. /�n tti P >�y�E(/QA3 USE OF No.OF NO.OF E EXISTING BLDG. FAMRIE9 ROOMS DESCRIPTION OF WORK NEW /� ALTERATION I ADDITION REPAIR MOVIN DEMOLISH A O Sq. FT. NO.OF SIZE D ROOMS STORIES / y r WALL ROOF COVERING � I COVERING use of NEW —BUILDING ¢.A ll-/9 1 HEREBY ACKNOWLEDGE THAT 1 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 BUILD I NO CONSTRUCTION. S FRAME: FIRE STOPS, [� SIGNATURE OFF �ti/J�V/f�R BRACING,BOLTS I't OWNER \n7 ]a: Y ItN d- LATH,INT.: AUTHORIZED AGT•.' LATH.EXT.: v - ' Dee-a 25M SETS 1((-41117 $ P.C. PLASTER.INT. � , D�O ` FEE ✓8�O 5� PLASTER. EXT. VALUATION DG FEE / . _ FINAL (. (, /��7_"y� Y5A638A CE±BG3]-63 APPLICATION FOR;•BUIILDI�NIGRERMI. COUNTY OF•LOS ANGELES, ` euILDING 9-0-1 DEPARTMENT OF'COUNTY ENGINEER ADDRESS . q1 912 MAY BUILDING AND SAFETY- DIVISION LOCALITY ; • —JOHN A. LA:MSIE. COUNTY ENGINEER NEAREST - C WILLIAM A. JENSEN. SUP'T`OF BUILDING CROSS ST. 'DISTRICT NO. G UP TYPE P�C�B�D BY. FOR APPLICANT TO FILL IN Q s �� CONST..' T6 W BUILDING _ q�J / �/ STATISTICAL CL�}ASSIFICATION '. SEWER MAP ADDRESS /its .ORd. {f, - - t•y,. K... G CLASS. NQDW ELL�UNITS ' LOT NO. BLOCK - WATER- NOT.REOUIRED•® -•RECEIVED r CERTIFICATE'.. / - .,TRACT. // - , •N O.OF BLDGS. _q�y 6 NOP 0 '�/J �cGA<W EI STATE MAJO SECON . LOCAL SIZ �OT (p X' NOW ON LOT t�7 USE ZONE SPECIAL- USE OF A -I -CONDITION EXISTING BLDG. y - 'p e/, _ J} TE •OWNER� �,GI �•, .O'y L. BUILDING YARD HWP• STREET NAME "EXIST. SETBACK. WIDTH ADORE IS / - .—FRONT- -A -� ARCHIT R P. L. ENGINEER. .•• _ NO. SPI DE L o ADDRESS .. O /C • 'NEL •CONTRACTOR - ADDRESS O S./ .4 DESCRIPTION OF WORK. i a EW 'ADD ALTERREPAIR DEMOLISH S FT. Q Q NO. OF NO. OF SIZE. Jn 1 'STORIES FAMILIES .. yz USEUSE OF' ' STRUCTURE- )' / 2 - Vu 5-IL d XA SIGNATURE OF - - APPLICANT - VALUATION $ OO {r- APPROVALS DATE INSpECTOR'S'SIG NATURE P:C.NO rP PFOUNDATION T. pYJ DATION: LOCATION •'T 7 p/ .FEE $ J.;- FMEE $_ >� FORMS, MATERIALS- FRAME: FIRE STOPS, I HEREBY, ACKNOWLEDGE THAT I HAVE READ�THIS APPLICATION BRACING. BOLTS- - K 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 I CERTIFY- THAT IN DOING THE WORK 'AUTHORIZED HEREBY 1 WILL NOT;EMPLOY ANY PERSON IN VIOLA- LgTH. INT. J TION OF.THE ILABOR CODE OF-THE STATE OF CAL IFORNIA'RELAT- ING TO WORKMEN'S COA NSATION INSURANCE. LATH, EXT. ' SIGNATURE OF - HOUSE NUMBER COR- 1 '/ P,ERMITTEE RECT AND POSTED ADDRESS FINAL`' • JOHNF. LEWIS. PRINCIPAL STRUGTURA L ENGINEER AN- F PLCHECK VALIDATION. et PERMIT VALIDATION. CK. M:O. ,.CASH VLD,9..8,3 3Q SEP" '6 a 4 'D'- .G.OA Q . .:SEP 19: DEPARTMENT OF BUILDING AND SAFETY APPLICATIONFOR PERMIT COUNTY OF LOS ANGELES BUILDING WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY IJ BUILDING , DISTRICTO. PLANCK. NO. PERMIT NO. ADDRESS 5 37cB LOCALITY ' RECEIVED I DATE OF APPL. DATE ISSUED NEAREST � ' T^ BUILD' CROSS ST. �y �, � _ ♦ �� ADDRESS- OWNER�.� G/M.NTV�/h'.6.i1 MAIL LOCALITY - ADDR888 - NEAREST ' / TEL. CROSS ST. CITY . NO. FIRE NO. OF PE TYGROUP ARCHITECTO TEL ZONE IPLG. ANS I �J� I B p ENGINEER NO. SETD ACK LINE 40 ADDRESS APPROVED TEL. BY DATE CONTRACTOR /05 ew/ 7�5 h NO. USEAPPROVED ZONE / BY DATE ADDRESS HOUSE NUMBERING LEGAL / F DESCRIPTION LOT NO.� /7 BLOCK MAP NUMBERIELD CHECK BY - TRACT G v TRACT �y)• Si /�� NO. ASSIGNED BY DATE SIZE OFLOT /-S 3OO't' NOW ON LOT S. CORRECTIONS USS OF NO. OF EXISTING BLDG. _ _ FAWLIaa DESCRIPTION OF WOR% Jfi- NEW I _?S5 ALTERATION I I ADDITION v REE FT. }I I�D)EMOLITION 8 ZEA 3 J /J ROOMS STORIES N `a Z EXT. WALLcc ROOF nn p .. - r " COVERING J'*//L' c- !v COVERING USE OF BTRUCTURE c� Y, L/JSS o-a'-7✓/ F nom,. - ' i �: Tb Coe./rOL• 4­;� v 7-:, A .S G N6-O L e '/_ d.5t n /GA,'. / ar C.a.✓A i-jeo1 T/JV7 n � C Z S e/ APPROVALS A -Pew"'"' � INSPECTOR'S SIGNATURE DATE " 1 HEREBY ACKNOWLEDGE THAT 1 'HAVE READ THIS AP- FOUNDATION: LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN 1'i FORMS, MATERIALS CORRECT. I AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS, HEREON AND WITH ALL COUNTY ORDINANCES AND STATE . BRACING, BOLTS LAWS REGULATING BUILDING BDING CONSTRUCTION. FURNACE: LOCATION, Ur,,, c� Z//r/{.i SIGNATURE OF fP.�,A�� �j�f GAS VENT, DUCTS PERMITTEE III�x-+��s wo4, i — . Q , A7. ' LATH, INT. ADDRHBS .L IL, l( � LATH, EXT. f/ AUTHORIZED AGT. • PLASTER, INT. - 7SAOSaA. Deas 1P50 g /F C• 6 LJ �y0 E / L; PLASTER, EXT. / VALUATION I'�E., — FINAL F DEPARTMENTILDING AND SAFETY- t APPLICATION FOR PERMIT COUNTY OF LOS ANGELES !/ {?' €1 ® f�fl WM. J. FOX, CHIEF ENGINEER _ ( � B I� IJV +'- FOR APPLICANT TO FILL IN FOR OFFICE USE-ONLY D NO BUILDING _ C",��/y DISTRICT NO. PLAN CK. .NNO. (//� PERMIT NO. 7 s -ADDRESS 17 LOCALITY 7-6?/yl7e CJ //�� �• EC`E I/1�DB�� DAT1E 0FF•APP�L.. DATE ISSUED / . CROSS BT.NEAR ST Ci•A C/INIT��1w /I �f+ /� .i W.•�/' /1 7 ILO /V+� �/9 1 OWNER A��RE166� 1 -7 LOCALITY //7x- � �I AE6l7y7 t. ✓I, D / /J EAREST -relw C (flr TEL. NRD666TCTNO. FIRE NO.OF TYPES)'- GROUP ARCHITECTOR TEL. ZONE PLANS ` �a-•�' ENGINEERT-4 /J n G✓/UGFPNo. /yA r,9/ n - - B ,FLDG. � ORD.NO. ADDRESS DZ Aloee/ V LD , �'�a' :ETBACK LINE V APPROVE— /��^ —_ DATE I ,,// TEL CONTRACTOR/YUT BY USE VgpPRDVED DATE / C! ''✓ (Ay ADDRESS ZONE BY LEGAL CORRECTIONS / DESCRI PTI1ON LOT �/ / TRACT JAl^�Y V I Lw IIFGlL BIGf� I (c 1� / E , a F Le fpr. I NO.OF BLDGS. SIZE OF LOTMgY I NOW ON LOT USE OF NO.OF NO.or EXISTING BLDG. FAMMIE9 ROOMS DESCRIPTION OF WORK NEW ALTERATION ADDITION REPAIR MOVING DEMOLISH p 6D"FT. NO"OF Z 61ZE {ilWALL �JJ ^T-q ROOMS STORIES - �W uG T�/f/r• .fDA ��iCwa.✓pLS+ r ROOF COVERING 1'L`V lea., I COVERING WPIQO /1 �•��� USE OF NEW -•B u ILDING .S�f��L- LDG �-/,�/i-b aa,;, /�T— r ...-.�. r ea• ,.t= 1 HEREBY ACKNOWLEDGE THAT 1 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 YJ AND STATE LAWS .yR/GULAT/ G ILDINRUCTI N. U N 1I G CON /Q C. yFR STOPS, -�r: SIGNATURE OF< ' •k � BRACINGBOLTS ' OWNER �['}yp7_�j, LATH, INT.: t� AUTHORIZED AST r� `K o• ^'-'^"^ LATH,EXT.: Des-a 25M SETS 4-49 $ '(oil P.C.$ 1 49/ PLASTER,INT. CJ F FEE PLASTER,EXT. VALUATION FEE /. -^ 'i FINAL �4lb `-TEMPLE CRTY >•A<••. Ea••• 1 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER >DDRESS BUILDING AND SAFETY DIVISION LOCALITY i` i✓� / `C2 JOHN A. LAMBIE, COUNTY ENGINEER NEAREST ( / WILLIAM A. DENS EN BDvT op BUILDING CROSS ST. DISTRICT N G O -TYPE S BY FOR APPLICANT TO FILL IN �, L cot sr. BUILDING (� / STATISTICAL CLASSIFICA N_\ SEWER MAP ADDRESS y� Fc CLASS. NO. DV!>ELNIT�I/�` ` BK_ PG LOT NO. ��j BLOCK WATER NOT REQUIRED 'h,l'RECEIVED CERTIFICATE: TRACT yam/ MAP J� HIGHWAY STATE MAJOR SECO LOCAL NO OF BLDGS. NO, V (CIRCLE) S IZEOF L0T.�6� A'66/ (NOW ON LOT USE ZO PECIAL , USE OF /, i CONDI IONS EXISTING BLDG. Gf/U.e C/J/.. (.. OWNER /PST Cf/NO. BUIL LNG YARD HWY STREET NAME EXIST. + SETBACK WIDTH ADDRESS 0l TG FRONT p. ARCHITECT OR TEL. P. L. ENGINEER NO. SIDE ADDRESS / P L No S2 1 INSPECTION RECORD T/ O ADDRESS &1 9 3 e�l 49 ,,FO{ll 5� & DESCRIPTION OF WORK � a Rmv / / 6 NEW ADD ALTER REPAIR DEMOLISH / Z SQ.FT. pv NO.OF / NO.OF SIZE Zqp STORIES / FAMILIES USE OF '/ Y STRUCTURE SIGNATURE OF yri -/l " �✓(/ ✓w.J/)� <�jW(/ // APPLICANT VALUATIONS V 4' o' C APPROVALS (/ DATE INSPECTOR !'S',SIG_iNATfu RE F E $ I FPMTEE $ I V FOUNDATION: LOCATION vyp( FORMS. MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING, BOLTS ANO 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- ING TO WORKMEN'S COMPENSATION.INSUR ANCE. ' LATH.EXT. SIGNATURE OF HOUSE NUMBER COR- RECT AND POSTED ADDRESS/DS3__y E ©�JOy TC FINAL CLYDE N. DIRLAM. PRINCIPAL STRUCTURAL EN MYEER PLAN CHECK VALIDATION cK. M.O. GASH PERMIT VALIDATION OK. M.O. , CASH ' Lk0 1 4 3 2' FEB 2 7 1 D 8 r Q— ti � s / VRR®N1 Ybtl IL B l.6. bey �1 FEB 2^7 1961SOr0 psi �a sY _ TY....CX aeV,✓eC ,.APPLICATION_ FOR BUILDING PERMIT : COUNTY OF LOS ANGELES BUILDING j DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DMSION LOCALI JOHN A. LAMBIE. COUNTY ENGINEER NEAREST .✓" WILLIAM A. JENBEN BUP'T OF BUILDING' CROSS ST.. - DISTRICT NO. I GROUPTYpE - P CESBED BY FOR APPLICANT TO FILL IN �� CONST. m, i BUILDISEWER MAP a SS �'� NG ;�i ID dry �+ / STATISTICAL CLASSIFICATION SE ADORE c ` `r .BK''� - �/ NO. .�D ELL. UNITS � LOT NO. � / BLOCK MAP NUMBER a Q NATE YES NO V TRACT USEZONE SPECIAL f I NO.OF BLDG SIZE OF LOT S. / CONDITIONS NOW ON LOT > D USEOF EXISTING BLDG. BUILDING YARD HWY STREET NAME EXIST.' TEL. SETBACK WIDTH •i OWNER C. NO. FRONT /� ` / O ADDRESS SIDE - 'c ARCHITECT J / w A P. L. ENGINEER V ]� INSPECTION RECORD ADDRESSI/,/2 i j� -A EL CONTRACTOR ADDRESS 714 P U DESCRIPTION OF WORE NEW ADD ALTER REPAIR DEMOLISH l NO.OF NA 0. SIZE STORIES FAMILIES // - / y USE OF �t1.d'W♦ /SGon sr,... Oe„orc1+�kC.. -f/r.r—j STRUCTURE ` - ' :T/JQw f.� C�rS.So...R Co.. r w���9 C� (•lwZCh4_ ��j SIGNATURE OF A_ 3/l0ii, Err �. F}�v,e Se c-_ APPLICANT VALUATION$ Q APPROVALS DATE, INSPECTI7R'S SIGNATURE q FOUNDATION: LOCATION FEE $ 11 FEE $ FORMS, MATERIALS �/ v I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME: FIRE STOPS,BRACING, BOLTS Ate'// PLICATION AND STATE THAT THE ABOVE IS CORRECT AND FURNACE: LOCATION. AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT,DUCTS /I STATE LAWS REGULATING BUILDING CONSTRUCTION. - 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED 1 LATH. INT. A, � WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE v WORKMEN'S CO ENSATION LAWS OF CALIF RN LATH.EXT. m �' SIGNATURE OF HOUSE NUMBER COR- P OR- PERMITTE RECT AND POSTED _ �7, w -//� /n ADDRESS fir- FINAL f/ CLYDEN. DIRLAM. RIN IPAL$TRU URAL ENGINEER PLAN ClIEC% VALIDATION cK. 'M.O. CASH PERMIT V ATION CK. WO. ' CASH ! 2764 ( 3 D 1 17 .75x :, . ®, 0-6,4 A?l :?[� 1 D l 5.5 0 •WORKERS''pCO PENSATION DECLARATION ' µoiroaedfc,ertficTaT�i`of fW.,(gokes'tCompensaificate of ,on5 Insurance, 'APPLICATION FOR BUILDING PERM_ IT or.p I.fiUU2f48U-I UDecl 3800, Lab. C.) - COUNTY OF LOS ANGELES BUILDING.AND SAFETY Policy No. Company Nati 6nwi de Mutual Ins. Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING 91;z Certified is filed with the county building inspec- BUILDING //� n�r�• T ADDRESS J tion department. nt. ADDRESS V9Dote,3f V9 7 Applicant -1471-OW AJSSc, 7,CS CITY G ZIP I > LOCALITY CERTIFICATE'OF EXEMPTION FROM WORKERS' - -' - NO. OF BLDGS. - NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for,one - ASSESSOR .hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL OWNER T L' USE NE MAP I certify that in the performance of the work for which this /7,JQ NO. 1V7-A1-,2P-5_ y -N' r permit is issued, I shall not employ any person in any manner K � , SPECIAL - - d so as to become subject to the Workers'Compensation Laws. ADDRESS ' ` CONDITIONS O --- _ - CITY. - ZIP t OC Date Applicant I ARCHITECTO TEL. O NOTICE TO APPLICANT: If, after making°this Certificate of Tf4 DISS�RICZ_, U TVPE FIRE PROOF ED BY Exemption, you should become subject to the Workers' ENGINEER _ ��¢¢�� E//1KJ CONST /•�// ZONE V Compensation provisions o4 the Labor.Code; you must forth- ADDRESS iA%, AvF-,- AJC s _ V"` . with comply with such provisions or this permit shall be - - - - -- EL - - " STATISTICAL CLASSIFICATION APT. NDO. N deemed revoked. CONTRACTOR NO. Z LICENSED CONTRACTORS DECLARATION -- LIC - CLASS NO. DWELL. UNITS_ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS SEWER MAP (commencing with Section 7000)of Division 3 of the Business and - II ! c _ - Professions Code, and my license is in full force and effect. CITY ^ i =Sl "/$ LASS BK 1445" - VALIDATION Q. FT p NO.OF NO. OF _ CHECK A License Number 499909 Lic.Class IlB°` SIZE/� /,j� STORIES FAMILIES ONE . . N r� 1 - ,_VALUATION 1 0 e 1 (6x,44 8 Contractor/r/�7�GIl I��$CClA7EJ 3/�s7 DESCRIPTION OF WORK NEW ❑ O O Y 4 O Date' ADD s l� SSD , e e I am exempt under Sec - � � ❑ ALTER B.BP.C. for this reason REPAIR ❑ - $ 4 6 (18 A USE OF Date: EXISTING BLDG. �l ❑ DEMOL # ° e ^ ^ 23 Signature - APPLICANT (� Z�, y TEL. •1 FINAL �f OWNER-BUILDER DECLARATION PRINT) "1 1� NO. DAT 11,89 1.46 I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FI - e 1.8 9 1,46 6 -Professions Code): ` " PRESENTB O508-86 O I, as owner of the property, or my employees with BUILDING _ ADDRESS_ wages as their sole compensation,will do the work and - - - the structure is not intended or offered for sole(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). CONSTRUCTION LENDING AGENCY REQUIRED TOTAL SETBACK _ q 6 SET BACK YARD 'HWY PROP. LINE WIDTH 2429.2 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. -- - - -e (Sec. 3097, Civ. C.). SIDE Q (� 9, P.L. .r Lender's Name P.C. Fee$ Permit Fee oc �p,7`j LDMA Ref. N T Lender's Address a I certify that I have read.this application and state that.the ( ♦✓J r tr Issuance Fee n above information is correct. I agree to Comply with all Count b•5v- LDMA P/C# 9 PY Y Investigation Fee a ordinances and State laws relating to building construction, _ Total Fee 19—(y - ys 1DMA Perm. M - and hereby authorize representatives of this County to enter m upon t above-m/entio ed property for inspection purposes. o _3`eA 7 •.'l.l, Cj/(•j� SEE REVERSE FOR EXPLANATORY LANGUAGE ' Signature of Applicanr or A- nt APPLICATION 'FOR. BUILDING PERMIT • �' .,COUNTY.OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION r . - FOR APPLICANT TO FILL IN ,;� {. BUIL G AOD�ES T`� BUILD �A DRESS ' " I hereby affirm that 1-have a certificate of consent to self.ms Ire, "^ --27• R 3' wn& or a certificate sof Workers'Compensation Insurance or a certified d- - - v . . Pq I copy thereof(Sec.3800,Lab.C.) J`/ LOCALITY - Policy No. Company - /� �� B SNOW ON L0T - El Certified copy Is hereby furnished. NO.OF NEAREST CROSS ST. ❑ Certified copy Is'hled with the county biuilding,inspectlon TRACT -'BLOCK - LOT NO. department. USE ZONE MAP Ni , Date Applicant ASSESSORMAPBOOK l,r(, -PAGE a -- PARCEL -I -` - _ 1 SPECIAL CONDITIONS, CERTIFICATE OF EXEMPTION FROM WORKERS' o R J - L `TEL NO. - - vE5(J .No COMPENSATION INSURANCE .r�C Zi �" ,WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one.hundred , ADO SS�^f •� - - - - - 510.16 dollars($100)or less.)" I d.7 -DISTRICT .GROUP TYPE CONST: FIRE2pNE PROCESSED BY I certify that ihall n the,performance of the work for which this permit" C'-- ��•(- _ ZIP 7,�0. O p l2 �fl 3' IT•�y' �. is Issued, I snot employ an p on an manh s0 as b' ARCHITECT R ENGINEER - - TEL NO. 0 pyl. become su6ect��'ttttt1/nnnnp`pep Workers' O e aw5. ` AD S f CLASS NO L'DWELL UNITS �� /J STATISTICAL CLASSI ICAiION 'APT CONDO Da % .A plicant• .00 NOTICE TO'APPLICANT: If, .after making this*Certificate of REQUIRED TOTAL SET 0 1 VAD EXIST Exemption, . you should become subject to the Workers' T CTO T QLL NO. -r' f SET BACK yggD HWY, PROP TIE/ 5/95 Compensation provisions of the Labor Code, yow must forthwith Qt�A7. Jos 211 Z FRONT i _ 8:54 comply with such provisions or this permit shall be deemed revoked: A RES�S1 r 1, LIC.140. -7 p L _ LICENSED CONTRACTORS DECLARATION - ' r �""' "—r SIDE .1 CI ^, ` 2 �. C LICCL - PL I hereby affirm.that I am licensed uncerprovisions of,Chapter 0, /'v/V f - SEWER MAP ,!J commencin With Section 7000 of Division Of the Business an SO.F.SIZE NO.OF STORIES NO.OF FAMILIES 9 d ' B NEW ❑ BK PG )- Professions Code,and my licens is In full force an - bt. - t�G•.T=a a '< DESCR ON OF WORK VALUATION -+c D License er C .CIa s pppp �� AD ❑, B,p ® X3(1' _ -'G t.,O a f �c f.� o te' �S- I•tji If ei �i N in gra �� $ �agp. a.7.L- U Contract " / / ALTER ❑ �� CJR 7�1/1If{1t1� i ITEi1 0 ❑ I am exempt Sec. REPAIR ❑ -r. 0.8P.C. for this reason DEMOL ❑• $ Til I AL 397 s 35 U D LDMA P/C♦ .•i + ✓ - jq7-35 W iEf USE OF EXISTING BLDG. 1 URM '' ❑ L1 - D_ Signature40 APP A (PRI 1 'L:(.(/ - 1 ;D- LDMA Perm x _ Z �•�ArYGE _ 1 •Qn Z ❑1, as owner of the property, or my employer ith wages as /VL3IF their sole compensation, will'do the work,andtthe structure is ADDR L/ ,¢ _ _ r I O c not intended or offered for sale (Section 7044, Business and FINAL DATE / a uuuu-,0001, e V i95 ProfE5S100S Code.) WILL?HE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL _ /._Z / O 0'1 +, Am .I ti OR A MIXTURE CONTNN,NG A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J L1GOJ � 1 IYI 1.LO°lt' ❑ I, as Owner of the property, am exclusively Contracting with FlNA>L 1 > i AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIOE9 r , t licensed.contractors to construct the protect (Section 7044, Yes❑ ❑ - - _ _ 1 I 1 _ Business and Professions Code.) , WILL THE INTENDED USE MI THE BONSTR BY THE MODIFICATION ON FROM T BUILDING OCCUPANTOASTIR REOWReA PERMIT FOR CONSTRUCTION D) MODIFICATIJN CH THE SOUTH FOR CONSTRUCTION LENDING AGENCY GUIIGUIDE AIA QUALITY MANAGEMENT DISTRILT(SCAOMOf SEE PERMnTING CHECKLIST FOR - - LINES I hereby affirm that there is a construction lending agency for vas❑ No❑ the performance Of the Work for which this permit IS ISSUBd(SDC. I HAVE READ THE HAZARDOUS MATERIALSINFORMATIONGUIDE AND THE SCAOMD PERMITTING n 3097, QV,C..) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. ' • .TIRE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 220.160 CONCERNING HAZARDOUS Lender's Name- MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMID ' o Lender's Address - - - o _ wmEP on wer+T - Q 1 certify that I have read this application and State under penalty - O of perjury that the above information is correct.I agree to comply PC.FEE a3,7� •PERMIT FEE $ with all county ordinances and State laws relating to building i m con tion, an leregl authorize representatives of this County ISSUANCE FEE t t n r It h 5bo entioned property for inspection purpo s. 3 6 n �� INVESTIGATION FEE ' TOTAL FEE / - v<aM+anv i SEE REVERSE FOR EXPLANATORY LANGUAGE , APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILD G ADDRESS Jc�, I Hereby affirm that I have a certificate of consent to self insure. BUIL G ADDRESS - C or a certificate of Workers''Compensation.Insurance,or.a certified C.. J copy thereof.ISec.3800,.Lab.C.) / ZIP - - ��-� �NLOCALITY Policy N0. Company SIZE OFF LOT NO.OF BLDGS NOW ON LOT ❑ Certified copy is hereby furnished., NEAREST CROSS ST. - - - ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT,NO. " USE ZON department. - E MAP NO S Date Applicant - ASSESSOR MAP BOOK PAGE: PARCEL ,r -- (!� /^✓�// / SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' ER TEL No. . -. COMPENSATION'INSURANCE A,: ,yls'7 79'-- WITHIN 1000 FT OF SCHOOL? - - YES, NO (This section need not be completed if'the'permit is for one hundred ADDRESS^. dollars ($100)or.less.) DISTRICT GROUP T E CONST. FIRE ZONE I PROCESSED,BY' I certify that in lhe.pertormance of the work for which this permit I Y zIPq j7WJ is issued, I shall not employ.any person in any manner so as to - /-E'J //T t,�¢.0 Q•�,J become Subject to the Workers'Compensation Laws.' ARCHITECT OR ENGINEER" TEL NO- -STATISTICAL CLASSIFlGATION APT CONDO Date Applicant - ADDRESS - CLAS5 NO, DWELL UNITS NOTICE TO APPLICANT.. If,, atter making this Certificate of REQUIRED' TOTAL SETBACK FROM EXIST - Exemption, you should become .subject, t0 the Workers' CONT TOR _ TEL NO SET BACK YARD" HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith �—L FRONT comply with Such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. P L ' LICENSED CONTRACTORS DECLARATIONCRY LIG.CLASS P L,SIDE - - _ I hereby affirm that I am licensed underprovisions of Chapter 9 - SEWER MAP d (commencing with'Section 7000)of Division 3 of the Business and 'SO.FT.SIZE NO.OF STORIES NO,OF FAMILIES •• CD -Professions Code,and my license is in full force and effect. NEW 1 BK' _RIG• "U License Number Lic.Class DESC TION OF WORK 'ADD ❑ -VALUA11O�N ,. p Contractor Date ALTER ' ❑ $Z.jG2%'� - w a '❑ 1 am exempt under Sec. /M REPAIR ❑ $ - - Z BAP.C.for this reason DEMOL ❑. CDMA P/C w - - Date: - USE OF EXISTING BLDG. URM ❑ Signature. APPLICANT(PRINT) - TEL NO, LOMA Perm Y _ fid:1„as owner of the property; or my employees with.wages as Z their sole compensation, will Co.the work and the Structure is 'ADDRESS - O not intended or offered for sale (Section 7044, Business and FINAL DATE Professions Code.) WUL'THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR AMIXTURE COMNNING A HAZARDOUS MATERIAL EOIAL TO OR GREATER THAN THE ❑ I, as owner of the property, am.exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY T < Cv C licensed contractors to construct the project.-(Section 7044, YES❑ NG lg' T[i.� 1 -`• e f .Business and Professions Code.) ,WILL THE INTENDED USE OF THE BUIDUNG BV THE APPLICANT OR FUTURE BULpNG OCCUPANT REOUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH_ _ �� .CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT ISCAOMDI SEE PERMITTING CHECKLIST FOqt_� GUIDELINES {_H('tl`]_ I hereby affirm that there is a construction lending agency for YES N012F, w the performance of the work for which this permit is issued(Sec. rp IHAVEREAD THE HAZARWUSMATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 'T 3097, ('iIV,('i.) CHECKLIST.I UN ERSTAND MV REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, j ji��j)�I�I li ll!f a” / (.�"]'1 TITLE 2.CHAP FING SECTIONS 2.20.100 TkSOUGH 2.20.140 CONCERNING HAZARDOUS Lender's Name Mw OnRS2,AND FOR O 6'1rPERMIT FROM THE SLADMD. _ Lender's Address n t'.ic 1 AN I-77- I certify that have read this application and state under penalty 6of perjury that the above information is correct.1 agree to comply PC.FEE PERMIT FEE - P, with all count, ordinances and State laws relating to building ✓. m constfuctioy5and hereby authorize representatives of this County ISSUANCE FEE / �0 't on the above-me property for inspection purposes. < (� INVESTIGATION'FEE TOTAL FEE ' n Aou: SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION FOR BUILDING PERMIT COUNTY OF LOS'ANGELE_S BUILDING AND'SAFETY FOR APPLICANT TO FILL IN BUILDING ADDRES WORKER'S COMPENSATION DECLARATION- L� BUILD?AR D ESS hereby affirm that Lhave kers a.certificate of consent to self insure, /L w or.,certificate of Workers'Compensation Insurance,or-a certified n - - copy thereof.(Sec.3800,Lab.C.) Ill /', ZII'C}� C/ -/ LOCALITY Policy No. ' Company =, i •A •SIZ O L �/ - NO.OF B -NOW ON'LOT ❑ Certified copy is hereby furnished. - �- NEAREST CROSS ST. ❑ Certified copy is filed with the County building iRedaction 'T ACT `BLOCK LOT NO: - • department. - - USE ZONE_ MAP,NO. Cafe - Applicant - .I ASSESSORMAP BOOK - PAGE y PARCEL - - SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS'"A OW R EL NO. ves No COMPENSATION INSURANCE as l C(.I��w WITHIN 1000 FT.OF SCHOOL? . (This section need not be completed if the permit is for one hundred Aj1DRESlS �-. - - - LA FIREZONE PROCESSED BY C� - DISTRICT GROUP TYPE ONST. dollars SI 00)or less.) ,certify that in the performance of the work for which thispermit, is issued, I shall not employ any person in any manner'SO .S to CHI E OR ENGINEER - TEL NO. - ✓✓„d// U6i become subject to the.Workers'Compensation Laws.' - _ STATISTICAL CLASSIFICATION - APT CONDO Date Applicant' , ADDRESS CLASS NO. DWELL UNITS - . NOTICE TO APPLICANT. If, after making this Certificate 'of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become-.subject to' the Workers' CO A OR J T=Ey/�N(p - - SET BACK ypRD HWY PROP LINE WIDTH Compensation Provisions of. the Labor Code; you must forthwith, L m/✓V w����� FRONT comply with such provisions or this permit shall be deemed revoked. p E S" - - uC.N P L _ LICENSED CONTRACTORS DECLARATION ALL tL"!-t/ SIDE P L C Uc CIAS I,hereby affirm that I 'am licensed underprovisions of Chapter"0 SEWER MAP ' (Commencing with Section 7000)Of Division 3 Of the Business and SO.FT.SIZE. NO.OF STORIES NO.OF FAMILIES Professions Code,and my license Is in full farce and effect. - NEW BK PG , d License Number Lic.Class - DEBCRIPTON OF WORKx -. ADD- - ❑' -VALUATION 6� 'Q Contractor Date. ALTER ❑ ❑.I am exempt under Sec. _ REPAIR , ❑ $ - O BAP.C.for this reasonDEMOL ❑ LOMA P/C x _ LU LL Date: USE of ExlsnnlG BLDG. CL URM' ❑ 23 (>). Li Z Signature p (. NT T �1@ .•�/O _ ,DMA Perm �;+ AAA///���///��� L " ❑-I, as owner of the property, or my employees with wages as �. c^'�'-' — 0 4(O -Z I �* '50.50 their sole compensation,.will do the work andthe structUre,iS, ADOR not intended or Offered for sale (Section 7044, Business and FINAL DATE Q 1 D� Z� o Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL -Q( - ❑ I, as Owner of the property, am exclusive contracting with OR A MIXTURE CONTAINING A H RDCIUS MATERIAL ECUAL TO OR GREATER THAN THE /�(�(•T p pe y. y g AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 5 A 1•T licensed contractors to construct the project (Section 7044, Business and Professions Code.) ' vas El NO CT - - - - -' 3303 ,ITFJIS•.' ;142.70 ANLL THE INTENDED USE OF THE aUIDUNG BY THE APPUCA,F OR FUTURE BUILDING OCCUPANT 1J OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH ' CONSTRUCTION LENDING AGENCY .COAST AIR OUAUTY.MANAGEMENT DISTRICT ISCACMDI SEE PERMITTING CHECKLIST FOR GUIDELINES. i TOTAL ,193_2O I hereby affirm that there is a construction lending agency for ves❑ rvo❑ GECK _ �] ' the performance Of the Work for Which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMO PERMITTING �^ECK IF5.20 °i 3097,Civ.C.) CHECKLIST,t UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, r�A`1 '- TITLE 2 CHAPTER 2.20 SECTIONS 2LOS CVM GE THROUGH 2.20.140 CONCERNING HAZARDOUS Eel GE .00. 3 Lender's Name _ MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SGAOMD. - o Lender's Address - - - -- - MEA w Acenr ' w 8/21/95 • o certify that p have read this application and state under penalty 0000-0001 _ _ o PC.FEE PERMIT FEE -with perjury that the above information is correct. agree to comply �D,LS� /�,�� - 1914 1 -AM 8'21 � with all county ordinances nd State laws relating to building _ a COOSU n, itd h by t Drize representatives of this County' -' ISSUANCE FEE _ to e e D ve- an oned ropedy for IRSe 'on ur�Se r.'4 - a 7 3 0 ' INVESTIGATION FEE - TOTAL FEE / i/�• � f - - r_ SEE REVERSE FOR EXPLANATORY LANGUAGE 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 0008010003 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE 9123 BROADWAY STRUCTURE: 0 VN 'TEMP CA 917802301 ASSESSOR NFO MATION NUMBER: ,NEAREST CROSS STREET: ROSEMEAD 5387-021-002 D{THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: COMM S ZONE: R- I SUEON: PROCESSED B : EXPIRES ON: EXIST OCC GRP: 08/01/00 UT 01/29/01 - OWNER: TEL. N • BLDGS. NOW ON LOT: VALUATION: FINAL DAT FINAL BY. CODE: FIRST LUTHERAN CHURCH OF TEMPLE CIT (818) 287-0968- 1 71800 .. 9123 BROADWAY (ir TEMP 917802301 FEES PAID DESCRIPTION OF OONK INSTALL RAFTER/SLEEPER TO SLOPE EAST AG ROOF OVER CLASSROOM APPLICANT: FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: INSTALL NEW BUILT-UP ROOF (23 SQ.) L. N ROBERT E NEWMAN (626) 285-2602- AA BLDG PERMIT ISSUANCE 27.75 9144 SOUTHVIEW AC STRONG MOTION RESID 7800.00 VAL 0.78 SPE IAL CONDITIONS: SAN GABRIEL, CA 02 PERMIT W/O EN-HC7800.00 VAL 183.00 , PNGELE$TOTAL-FEES 211.53 CONTRCo ROBERTCE NEWMAN (626)TOR: TEL. N285-2602- �0O: C �/YTy APPROVALS DATE INSPECTOR SIGNATURE 9144 SOUTHVIEW LIC. NO LOC ION AND SETBACKS SAN GABRIEL, CA 91775 432157 B SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: L. NO: / FOUNDATION/TRENCH ORMS LIC. NO 1/: � 1111111 SLA /UNDER FLOOR l—/<• RAISED B FRAM NG 147H265 SEWER MAP BOOK: PAGE: FIRE ZONE: c"",,0 O�I1 ^ IT n n O��n n UNDERFLOOR NSULATION JU ILIA D(wj- \\ll/l1\\f(/ ��LJ❑j IDJ�(C�S) FLOOR SHEATHING N0. OF FAMILIES: DWELLING NTS: A T COND: STAT CLAS NO 22 h, f R ROOF•—SHEATHING TC W TH N HAZARDOUS \� O O }.Y.�1�` �;- S R P N rLS AIR QUALITY: 1000 FEET MATERIALS O 0 NO NO NO A ❑ ®14(}`a�®y FRAME INSPECTION SETTUIRED BACK YARD: HWY: OTAPROP LINE :FROM WIDTH:CK EXISTOb// ❑ -„1p3� FI SPRINKLER HANGERS FRONT PPL-L- C Service Tha'L INSULATION/WEATHER STRIP IDE INTERIOR LATH/DRY AL EXTERIOR LATH RATED LOOR/CELL SSEM. RATED WALL ASSEMBLIES RATED SHAFT S/OPEN RTGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9610080013 PHONE: (818) 285-0488 EXT: LEGAL ID; NO. OF CONST BUILDING ADDRESS: ON FILE SO. FT STORIES TYPE 9123 BROADWAY STRUCTURE: 0 V TEMP CA 917802301 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: HOWL 5387-021-001 - THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: CHURC ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 10/08/96 TC 10/08/97 FIIRST LUTHERAN CHURCH OF TEMPLE CIT (818)TEL. 287-O968- BLDGS. NO3 ON LOT: VALUATION:O0 FINAL �C}/ FINA �Y�� CODE: 9123 BROADWAY 1! I TEMP 917802301 FEES P D DESCRIPTION OF WORK , WEST SIDE OF CHURCH -RE-ROOF WITH TORCH DOWN 6 ROOF VENTS FEE DESCRIPTION: QUANTITY. UOM. / AMOUNT: APPLICANT: T L O: ISAME AS OWNER - AA BLDG PERMIT ISSUANCECJ g ��27.75 AE STRONG MOTION OTHER 7800.=0 8OO. OVAL 1'•64 SPECIAL CONDITIONS: D2 PERMIT W/O EN-HC 7800-00-VAL\183190. pOV TOTAL FEES 213(29-y CONTRACTOR: TEL. NO: Y APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER / 'O p LIC. NO rrAA .a "JIB' 0. O LOCATION AND SETBACKS �_ •_ - S m ori e n d SOILS ENGINEER APPROVAL ARCHITECT OR ENGI \CJI R:ET L. NO: Q.n�l�`��}� FOUNDATION/TRENCR FORMS LIC. NO: � SLAB/UNDER FLOOR .0 ul RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: LMP: 9 UNDERFLOOR INSULATION 147X265 3 01 `O f� 1 v SH EAT INS N OF FAMILIES: DWELLING T A /GOND: STA C ASS: � C ' NO 22 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS ^ SHEARPp ESL AIR DUALITY: 1000 FEET MATERIALS 1 /13��y� NO NO NO VVV V\� a/ FRAME INSPECTION REQUIRED OTAL SETBACK FR EXIST FIRE SPRINKLER HANGERS SET- BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATION/WEATHER STRIP SIDE PL- 7FTl ERtOR L H/TSD WALF_ EXTERIOR LATH RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BSO5O8