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Home My Public Portal About9320 BROADWAY_Building__ aAe30ACE&aos:l0,6'APPLICATION FOR BUILDINGPERMIT BUILDING AND SAFETY DMSION BUILDING Deportment of County Engineer ADDRESS ' ALL�C-Y• County of Los Angeles - LOCALITY i / JOHN A. LAMBIE, COUNTY ENGINEER NEAREST / I CASSATT O. GRIFFIN. SUPT of BWLOINO CROSS ST. 'I" DISTR FNO. GROUP (TYPE SEWBER MAP PG FOR APPLICANT TO FIL!A3. CONST. BUILDING ADDRESS STATISTICAL CLASSIFICATION' CLASS. NO. DWELL. UNITSLOT NO. .� MAP ll�� ,�yy STATENUMBER yE5TRACT C' � USEZOE SPECAL' HWY�JNO.OCONDITIONS SIZEOFLOT 7X30SPi,k NOW BOUSE OFEXISTING BLDG. /I/ BUILDING E%ISLYARD HWY STREET NAMErr,� �{� q� SETBACKWIHOWNER /Vt/( ^/IAds MQ yc FRONTMAIL P. L. - /DDRESS SIDETCITY NINSPECTION RECORD ARCH ENGINEERT OR/?&,I NO. I �b ADDRESS / 21 d,O 'HTC/GE "'J'� /1 L T I 1 ` CONTRACTO�sR icy ("� b !% NJO ADDRESS DESCRIPTION OF WORK NEWy ADD ALTER REPAIR DEMOLISH SO. FT. { ' NO. OF NO. OF SIZE / STORIES vFAMILIES / USE OF STRUCTURE APPROVALS SIGNATURE OF APPLICANT DATE INSPECTOR'S SIGNATURE ADDRESS - - FOUNDATION: LOCATION FORMS. MATERIALS tOl23IS_Z llic✓�lL— JSY, FEE . S a FRAME STOPS. BRACING. BOLTSI'�• S - ) . VALUATION 3J OOO S J FURNACE: LOCATION, �^ FEE GAS VENT. DUCTS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH. INT. / / l` Y PLICATION AND STATE THAT THE ABOVE IS CORRECT AND J 'Z/ AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND OATH. EXT. STATE LgTINp IB IN C STRUCTION. SIGNATURERE OF OF I/ HOUSE NUMBER COR- PERM ITTEE RECT AND POSTED ADDRESS FINAL JOHN A. LAMBIE. COUNTY ENGINEER, - CLYDE N. DIRLAM. PRINCIPAL STRUCTURAt:,ENGINEER PLAN CHECK VALIDATION - K/ M.C. CASH PERMIT VALWATION cK. m.o. CASH LA 2 4;.!5 6� . se 1191 6 3 0.50 e n" ' Ir 28. 54 CO. 1 S - 61 .00 M .. .vhf '"' , t�--n:�� • ' 76A638A CE 9803 12/69 APPLICATION FOR BUILDING PE MIT fl /� COUNTY OF LOS ANGELES ASSESSOR 4DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL l BUILDING AND SAFETY DIVISION BUILDING �`�7�J / JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS - /Lp .( [ J6Lt COLEMAN W. JENKINS, SUPT OF BUILOIH. /J LOCALITY FOR APPLICANT TO FILL IN NEAREST Print orf a oM CROSS ST. BUILDING DISTRICT NO. GROUP TYPE ESSED BY ADDRESS 9320 East Broadway 5_d _= 'Toy'PE _ l ?n-�'y _o STATISTICAL CLSSIFICATION _ SEWER MAP LOT NO. BLOCK CLASS NO. DWELL.UNITS_ BKbPG(� TRACT USE ZONE MAP q NO.OF BLOGS. NO. 20tn SIZE OF LOT NOW ON LOT SPECIAL USE OF I CONDITIONS EXISTING BLDG. OWNER Mrs. Ernest Marchetti TEL. NO. BLDG.SETBACK FROM ADDRESS 'Same FRO OP.LINE OF [STREET) TYPE OF EXI SETBACK HIGHWAY - + YARD = TOTAL CITY Temple C1tV HIGHWAY WIDTH M C.L. ARCHITECT OR TEL. + _ ENGINEER NO. BDG.SETBFROM ADDRESS SILINDE PROP.LINE OF (STREET) TEL. TYPE OF E%I STING SETBACK HIGHWAY - + D = TOTAL CONTRACTOR Virgin Roof Co. No. 287-0507 HIGHWAY WIDTH FROM C.L. ADDRESs600 S. San Gabriel B1.NLo' 160650 + = a CITY San Gabriel 91776 CL C-39 CLASS CORNER CUTOFF YES ❑ NO ❑ CD CONSTRUCTION LENDER p NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS t3 W ADDRESS h SQ. FT. NO. OF NO. OF ❑ Z SIZE STORIES L FAMILIES NEW STRUOCTURE Reroof 300SSF ADD . ❑ Fiberglas shingles ALTER ❑ SIGNATURE OF REPAIR® APPLICANT OEMOL ❑ VALUATION S 152 .00 APPROVALS DATE INBPEETDR•S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE 5 FEE 5 FORMS. MATERIALS FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE I5 CORRECT ANO AGREE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT. DUCTS ST RUC I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY COW NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH. INT. LABOfl CODE OF THE STATE OFGLIFORN IA IN RELATING TO WORKMEN'S COMPENSAT Uj1 INSURANCE LATH, EXT. SIGNATURE EI. � HOUSE NUMBER COR- P RMITTEE `.J RECO AND POSTED ADDRESS FINAL JOHN F. LEWIS. PRINCIPAL STRU U AC ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT, VALIDATION cK. CASH iJ7 0 1 11L`0b 10 0 2 1.7 5- COUNTY OF LOS ANGELES ,. , , o BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO.FILL IN BUILDING ADDRESS 3� S��^ I hBUILDING ADORES hereby affirm that I,have a certificate of consent to self insure, / e/JV� uX or a certificate of Workers'Compensation Insurance,or a certified copy thereof (Sec.3800, Lab.C.) CITY TG , LOCALITY Policy No. Company SIZE OF LOT NO.OF BLOGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS 5 ,,C El Certified copy is filed with the county building inspection TRACT BLOCK LOT NO J ,department. USE ZONE MAP NO. Date - Applicant ASSESSOR MAP BOOK - PAGE PARCEL - .SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' / /f COMPENSATION INSURANCE O� WITHIN 1000 FT.OF SCHOOL' YES NO (This section need not be completed if the permit is for one hundred ADDRESS �� dollars 1$100)or less.) DISTRICT GROUP T CO ST. FIRE ZONE PRO ESSED BY I certify that CITY � zip issued, performance of the work for which this permit is isetl, shall not employ.any person in.any manner so as to d" become bled he'Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO. �./ /ll.�9x/ STATISTICAL CL9551FICATION APT CONDO Date Applican ADDRESS CLASS NO. �.9 /� DWELL UNITS NOTICE TO APPLICANT.' If, after making this Certificate of REQUIREDTOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR, T NO[J SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith "ex,le .ear/.!�'�p B!— 73r FRONT comply with such provisions or this permit shall be deemed revoked. A / f L N PL LICENSED CONTRACTORS DECLARATION / / SIDE CITY LIC.CLAS 76 P L } I hereby affirm that I am licensed underprovisions of Chapter 9 1 ✓ SEWER MAP � a (commencing with Section 7000)of Division 3 of the Business and S0.FT.SIZE NO.OF$TORIES NO.OF-FAMILIES Professions Code,and my license is in full force and Q(fe t. / NEW ❑ BK PG D U C DESCR ION OF NOR VALUATION License Number ,•,�LLiic..Class ADD ❑ Contract. "" fe — 3 ALTER ❑ $ � REPAIR ❑ $, O ❑ I am exempt under Sec.c. U BAP.C. for this reason DEMOL ❑ W LOMA P/C x - 13- Date: Date: USE OF EXISTING BLDG. URM ❑ i to Z Signature APPLICANT(PRINT) TEL NO. LDMA Perm x1l`T 1 ❑ I, as owner of the property, or my employees with wages as Z ,`_� their sole compensation, will do the work and the structure is ADDRESS O _,.l�h 12th._. not intended or offered for sale (Section 7044, Business and FINAL DATE Q { iq_y,_; Professions Code.) IMLL THE APPLICAM OR FUTURE HAZARDOUS OCCUPANT HANDLE A HAZARDOUS MATERIAE ORA MIXTURE CONTAINING A AZAR O US MATERIAL EQUAL TO OR GREETER THAN THE J I /� {�C ❑ 1, en owner Of the property, am exclusively contracting with44, py0UN1$SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL.�BY// T_L.�TAL 14 9 ® 4_F_r licensed contractors to construct the project (Section 7044, YES❑ NO❑ Nni I_HECIA iYCr. e Business and Professions Code.) WILL THE INTENDED USE OF THE BWDLING BY THE APPLICANT OR FUTURE BUILDING 1 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH �Jt. 71 ob ;:HAF��3E .DCI CONSTRUCTION LENDING AGENCY COAST AIR OVAUTY MANAGEMENT DISTRICT(SGAOMD)SEE PERMITTING CHECKUST FOR GUIDEUNES I hereby affirm that there is a construction lending agency for YES❑ No❑ w the performance of the work for which this permit is issued(Sec. W 3097, Civ.Ci.) (HAVE READ THE HAZARDOUS MATERIALS INFpiMATIONGUIDE AND THE SCAOMD PERMITTING ��- I__1 Q!• _ CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE TITLE 2.CHAPTER 220 SECTIONS 2,20 100 THROUGH 220 140 CONCERNING HAZARDOUS - �'GC x Lender's Name MATERIALS REPORONG AND FOR OBTAINING A PERMIT FROM THE SCAOMD. 1'625 1 AN 7'4t Q Lender's Address 0 p4NEG OR AGENT o I certify that ) have read this application and state under penalty 0 of perjury that the above information is correct.I agree to comply PC.FEE PERMIT FEE �2a o with all county ordinances and State laws,relating to building construglion, and hereby authorize representatives Of this County ISSUANCE FEE m t0nclbpyg-mell�iOped per`f' Isp rI PgTP INVESTIGATION FEE TOTAL FEE SEE REVERSE FOR EXPLANATORY LANGUAGE WORKERS' COMPENSATION DECLARATION gyp} I�y�r �{•y�•�)p�p� PUNT y�1 I hereby affirm that I have a certificate of consent to self APPU l AQ TMN .,II ,O USI. BURR U UC - P1=��II CYO�.11 insure, or,o certificate of Workers' Compensation Insurance, - �7 r or a certified copy thereof (Sec. 38 Lab._C.) .- COUNTY- OF LOS ANGELES --- BUILDING AND SAFETY Policy No o��--''ompony�- 1 ��f� - - BUILDING, �enified copy is hereby furnished. O��-'�. FOR APPLICANT TO FILL IN _ ADDRESS LJ Certified copy is filed with the county building'inspec- - BUILDING a - r - tion department. `n^ r ADDRESS 2y—\ \fL\ ► ]1R�W O Date Applicant CIT —, ZIP LOCALITY OF BLDGS. NEAREST - CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT - NOW ON LOT - CROSS ST.- COMPENSATION INSURANCE - ASSESSOR (This section need not be completed if the:permit is for one '" TRACi "' - BLOCK LOT NOi - MAP BOOK' PAGE PARCEL' `- hundred dollars ($100)or, less.) - - TEL _ - OWNER -NO. USE ZONE OP 7 I certify that in the performance of the work for which this _ a P employ Y P Y I�LUfA SPECIAL - CL Cas tis issued, shall not th to an Crimp in an manner ADDRESS / CONDITIONS O so as to become subject to the Workers'Compensation Laws. . _ V CITU-. ZIP' • . Date ad � Applicant ARCHITECT OR TEL. DISTRICT. -GROUP TYPE FIRE PROCESSED BY O •NOTICE TO APPLICANT: If, after-makingthis Certificate of ENGINEER NO: r CONST. ZONE V Exemption, you should become subject to the Workers' p w Compensation provisions of the Labor Code, you must forth- ADDRESS •Qe -'3 - - L� a with. comply with such provisions or this permit shall be ` TEL STATISTICAL CLASSIFICATION APT. CONDO. h Z cnadeemed revoked. - t CONTRACTOR NO ` LICENSED CONTRACTORS DECLARATION. LIC. CLASS.NU.-i?:V—/ DWEU. UNITS_ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS LIC. SEWER MAP (commencing with Section 7000)of Division 3 of the Business `� VALIDATION and Professions Cade,and my license is in full force and effect. CITY ` CLASS BK. PG. e►Y��(� � ��jj SQ. FT. O. Of . OF CHECK - _ License.Number� �<_Lic. Class SIZE ' STORIES FAMILIES ONE (('�� , ^� - VALUATION - Controcto 'Date` lL-GrA-1:N` DESCRIPTION OF WORK NEW El $ � � - _ ADD ❑1 am exempt under Sec. ALTER - - - B.BP.C. for this reason _ \ REPAIR ❑ $ IDS ate: USE OF' � ' - - • " EXISTING BLDG. DEMOL ❑ Signature—N& — — _ APPUCANT TE% L FINAL OWNER-BUILDER DECLARATION - (PRINT) O. DATE I hereby affirm that I am exempt from the Contractor's License gDDRESs 2 V - �� s Law for the following,reason (Section 7031.5, Business and FINAL Professions Code): - PRESENT , - .. - BTBUILDING HCC q ❑ I, as owner of the property, or my employees with ADDRESS 77 wagesasiheir sole compensation,will do theworkand the structure is not intendLOCA or offered for sale(Section D -F - 7044, Business'and Professions Code.) � MOVING _ TEL. f.II. • ❑ I, as owner of the property,am exclusively contracting -CONTRACTOR NO. •yi with licensed contractors to construct the project (Sec- ADDRESS ' tion 7044, Business and Professions Code.) CHECK it 7.6 REQUIRED- .. TOTAL SETBACK FROM EXIST. • _ - CONSTRUCTION LENDING AGENCY SETBACK YARD' HWY PROP. UNE 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. '" (Sec. 3097, Civ. C.). - SIDE. P.L. Lender's Name P.C. Fee S Permit Fee LDMA Ref. q Lender's Address - - _ .. _ ., - - . D I certify that I have read this application and state that the Issuance Fee 5� 5!7S. LDMA P/C If , Sabove information is correct. I agree to comply with all County Investigation Fee - - ordinances and State laws relating to building construction, - Total Fee 119 ,45 LDMA Perm. R and hereby 1 arise resentatives of this County to enter up t e oba e- a do d property for inspection purposes. a` '� zvtl' SEE REVERSE FOR EXPLANATORY LANGUAGE - Signature of Applicant or Agent' ' Date - l•