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Home My Public Portal About9228 BROADWAY_Building__ ! 76A638A CE 4803 1/]1' '�. • ��✓ '. ;�• .': . APIPLICATI.ON FOR BUILDING PERMIT ' ` COUNTY OF LOS ANGELES ASSESSOR { ' +iDEPARTMENT !DF COUNTY ENGINEER MAP BOOK PAGE PARCEL ' BUILDING AND SAFETY DIVISION BUILDING C� //'!! / ADOR ESS 1. - Y=a OA n WA COLEMAN W. JENKINS,, 5.1 1 of Bm LMNG LOCALITY �- / f,� `✓' NEAREST FOR APPLICANT•'TO FILL IN CROSS ST. , /� PrIO,O. , � OTIVY BUILDING 5�f,; � I DISTRICT NO. GROUP TYPE PROCESSED BY ADDRESS / ® /^'thy r+" CONS T.,/'•1 f LOT NO. BLOCK STATISTICAL�,C.L�ASSIFICATION � SEWER AP CLASS NO.yi—DWEL L.UNITSILJ BICry PG u TRACT ? U}�S11E_ZZ{{ONE MAP SIZE'OF,.L'OT: • ,` `rl \�• „ NOWOON LOTBLOCS. ice— SPEC IA O•Y USE OF CONDITIONS EXISTINGBLDG. T fEL.NO �T OW NE �• O' .. �N%�E � /P/ ' T BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET) _ TYPE OF EXISTING SETBACK HIGHWAY } YARD. = TOTAL CITY ' ,G3 - HIGHWAY WIDTH FROM 0.L. ARCHITECT�O TEL. ENGINEER ' J .6 NO. BLDG.SETBACK FROM 1 ADDRESS` " SIDE PROP. LINEOF _ (STREETI �JN �yrE TEL. TYPE OF E%ISTING SETBACK HIGHWAY } YARD = TOTAL d CONTRACTOR A9I, > /J/J HIGH WAV WIDTH FROM G.L. CD } - O LIC. — CITY D: C CLASS. " CORNER CUTOFF YES ❑ NO w CONSTRUCTION LEN - - NAMEAND BRANCH '-C'" '� SEE REVERSE SIDE FOR SPECIAL APPROVALS Z ADDRESS SO.IZ a2 �6 NO. OF NO. OF NEW " SIZE ..LL STORIES' FAMILIES // Q / '/ ��n F/ USE OF ,J1 - ADD ❑ •.21e ✓/2rnA R.r,p.100 . '�jJ �•j STRUCTURE-/(".,k` ALTER ❑ 7 L REPAIR y SIGNATURE OF LO APPLICANT ., �� / EMO LT.❑ z E. S VALVA TION'S 49; ,•i ,� `:A'� - PROV ALS DATE INSPEC Toq• slcNAngE i FE r ' PMT '� 7 _FORMS MATERCALSON ,.QJ •�k:.I��:r�LC I: FEE Sy,O�.r aO•'+' /(. FRAME:ERESY ACKNOWLEDGE THAT-1 HAV� READ THIS STOPS, I NAPPLICATION BRACING BOLTS \ ' AND STATE THAT THE ABOVE IS CORRECT AND'AGREE TO COMPLY FURNACE: LOCATION, f1 WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STIR UC TI ON. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LA BON CODE OF, THE STATE OF 'CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION INSURANCE. J 7�`� /�/ ..✓✓ �/ l 6 LATH, EXT.S.Qt/LL1/l.0 SIGNATURE OF PERMITTEE �.+IS'�?iC/ ✓ /b + HOUSE NUMBER COR- , ]/• RECT AND POSTED dL AooREss 4L") >/-.._i.l� n+ �,i%�_.>/ =i.f3' T FINAL:. 7� ' - JOHN F. LEWIS: PRINCIPAL STRUCTUR AL'IENGINEER\ PLAN CHECK VALIDATION ' OK`` M.O. C',GH _ PERMIT .VALIDATION CK. MD. Is PERMIT 8r .? ; 4:I uL15 %3 0 �'1 2 -2.70- c Y 'z 4 7 \3� srr21 1 .� 2. 0 4.50� .� { COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS BUILDING ADDRESS NiRy I hereby affirm that I have a certificate of consent to self insure, el Z 2 W �� or a certificate of Workers'Compensation Insurance,or a certifies CITY ZI - copy thereof f�(Sec.3800.Lab.C.) �,_,,�f�,�, _ �-1 Lr C7f 7 (7'G LOCALITY Policy No.W 000 RZ Z�7 Company �'� SIZE OF LOT l.. NO.OF BLDGS.NOW ON LOT I NEAREST CROSS ST. ��r❑y Certified cepy Is hereby furnished. ,9e Certified copy is files With the county building inspection TRACT BLOCK LOT NO. de�partlryennt��y� / USE ZONE MAP NO. Date �L144pplicant ASSESSOR MAP BOOK PAGE PARCEL _ I SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. -VES N6 COMPENSATION INSURANCE 2 O WITHIN 1000 FT OF SCHOOL? ADDRESS (This section need not be completed if the permit is for one hundred CITU DISTRICT GROUP TYPE�./p'NST.' FIRE ZONE OC E Y dollars($700)Or less.) .ZIP n A I /A I certify that in the performance of the work for which this permit . I! � �+ U U (n/�/ 3 Is 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. STATISTICAL CLASSIFICATION APT CONDO Date Applicant CUSS NO. DWELL UNITS NOTICE TO APPLICANT: If,*after makingthis Certificate of Exemption, you Should become subject l0 the Workers' CONT'; REQUIRED TOTAL SETBACK FROM EXIST OR _ TEL NO. SETBACKYARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith (ILL luN O �+ 3 Z� LFRONTcomply with such provisions or this permit shall be deemed revoked. cDDR� E LIC.NO.Zr/LICENSED CONTRACTORS DECLARATION CITY: - Llc.cuss PIL I hereby affirm that I am licensed under provisions of Chapter 9 I(_- a _ C -.39 SEWER MAP (commencing With Section 7000)of Division 3 of the Business and FT SIZE NO.OF STORES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW El I PG CD D U DESCRI ON OF WORK License Number UZ�I Ll 8 C 9 _ ADD ❑ A�LLLL -� ^� � Lit.Class U•Jc c{SGyL V, $UATION �/ M` y ConirectnCLLalaT�^'V T�Date 30 � ALTER ❑ L Z ❑ I am exempt unser Sec. '�• REPAIR BARC.for this reason ( `- '! nS S:. DEMOL ❑ LDMA P/C p Dale: USE OF EXISTI GBLDG. .URM ❑ Signature APPLICANT(PRINT) TEL.NO. LDMA Perm K 1. ❑ I, as owner of the property, or my employees with wages as Oa their sole compensation,will do the work and the structure is ADDRESS F ACCT.T not intended or offered for Sale (Section 7044, Business and Fll A DATE - Q - 0 Professions Code.) O JJv� 93.6-1 - Professions FUTURE eUILDINGOCCUPANr HANDLEAHA DOUSMATERIAL J OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER TIUN ❑ I, as owner tr the property, ru exclusively contracting 044, THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL 7 ITEMS •' licenses contractors to construct the project(Section 7044, YEs❑ No❑ TOTAL f J' a 4 ..�J Business and Professions Cosa.) WILL THE INTENDEDQUIRE USE OF THE BUILDING BY THE APPLICANT IO FUTURE BUILDING ( OOASTAIRg QUALITY MANAGEMENT PEIWITFOR DISRICT(ONORMODIFICEIIONFROM CHECKLIST V CHECK �Je9J CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOM01 SEE PERMITTING CHECKLIST // , '1)I) FOR GUIDELINES. III//` CHANGE'I hereby affirm that there is a construction lending agency for YES❑ NO❑ _ l flFll'1 the performance of the work for which this permit Is issued(Sec. 3097,CIV.C.). I HAVE PERMITTI G CHECKLIST.EAD THE II UNDERSTANDIJS I MY REOUIREM ALS TON ENTS UNIDE DERAND THE THE LOS ANGELES Lenders Name HAZARDOUS MRTERIALS REPORTING AND FOR OBTTAAINIING A PERMIT FROM THESCAOMD. OOULI-OQGI S'�1JJ]U Lenders Redress � 0166 1 AM 8:28 o I certify that I have read this application and state that the above me n Is DOfr0Ct. I agree to Comply With all county P.C.FEE PERMIT FEE Ord' and State le ! to building construction,and VL J�hereby thodz resantativ i this County to ant Up00 ISSUANCE FEE O O the a e- tiorietl pe or inspection purpgsey /7/ INVESTIGATION FEE TOTAL FEE SEE REVERSE FOR EXPLANATORY LANGUAGE. 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 BL 0508 1202270069 PHONE: (626) 285-0488 EXT: (LEGAL ID: NO. OF CONST BUILDING ADDRESS: ITR: 19341. LT: 80 BL: .001 1 SQ. FT STORIES TYPE 9228 BROADWAY STRUCTURE: V-B TEMP CA 917802401 1 TASS ESSOR INFORMATION NUMBER: . . NEAREST CROSS STREET: ENCINITA 18588-030-049 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, C TENANT: (EXIST BLDG USE: RESID USE ZONE: R-1� + ISSUED ON: PROCESSED BY: 1 1 (EXIST OCC GRP: �` 103/19/12 SR 1 TOWNER. LcELLOO Jq TEL. N0: 1BLOGS. NOW ON LOT: VALUATION,000 IFINAL TE FI L B CODE: CHANG, Q 19228 BROADWAY ITEMP 917802401 FEES PAID IDE+' iP IOF WORK I - 11—n— R F•MOUNTE KW PHOTOVOLTAIC SYSTEM I IFEE DESCRIPTION: QUANTITY: UDM: AMOUNT: I � (APPLICANT: TEL. NO: IHIRSCH, JAY A (310) 621-1728- ID7 ADONL PLANCHECK FEE 1.00 HOU 109.40 1 563 .31ST. ST. IAA BLDG PERMIT ISSUANCE 27.80 SPECIAL CONDITIONS: IMANHATTAN BEACH IAB STATE GREEN BLDG FEE 16000.00 VAL 1.00 1 I ID2 PERMIT W/O EN-HC 16000.00 VAL 109.40 I I TOTAL FEES 247.60 ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE INEW ENERGY CONSTRUCTION, INC. (310) 621-1728- + 1563 31ST ST LIC. NO ILOCATION AND SETBACKS MANHATTAN BEACH, CA 90266 90903IRC10 I F 1ISOI S ENGINEER APPROVAL I ARCHITECT OR ENGINEER: TEL. NO: �FOONDATION/TRENCH FORMS I I - I I LIC. NO: - SLAB/UNDER FLOOR RAISED FLOOR FRAMING I 1MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:1 - ' 1UNDERFLOOR INSULATION 147H265 3 001 . ..�• 1 1 1 FLOOR SHEATHING IND. OF, FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I + - 1 0 NO 21 1 ` (ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QDALITY: 1000 FEET MATERIALS ]w� 1 NO NO NO FRAME SPECTION T 1 IFIRE SPRINKLER HANGERS INSULATION/WEATHER STRIP( I _ INTERIOR LATH/DRYWALL I IEXTERIOR LATH I 1 1 1RATED FLOOR/CEIL ASSEM. T T T (RATED WALL ASSEMBLIES 1 IRATED SHAFTS/OPENINGS T T T T-BAR CEILINGS I* ADDITIONAL DATA ON FILE T ILOT DRAINAGE I_ •� 1REPORT ID: DPR261 ROUTE TO: BS0508 I I I I