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Home My Public Portal About9325 BROADWAY_Building__ I I3A5J9.CE .U] 3-63 APPLICATION FOR BUILDING PERMIT - COUNTY OF LOS ANGELES Ru'Lo'NG /L DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE,'COUNTY ENGINEER NEAREST WILLIAM A. JENSEN: SUPT ., a.11.114. CROSS ST. DISTRIC NO. "GROUP YPE P=E ED BY FOR APPLICANT TO FILL IN CONST. BUILDING � STATISTICAL I�ySE ER MAP ADDRESS CLASS No UK G / / Q _ FICATION LOT NO. BLOCK WATER NOT,REQUIRED JO RECEIVED. ' / CERTIFICATE: LL]I TRACT I(I MAP HI GBwAv STATE MAJOR SECOND. OCAL NO.OF BLDGS. NO. p ICIRCLEI SIZE OF LOT NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS E%ISTING JBLDG. Q _ �/ TEL OWNER . f + ' v- /`GfM NO. /. st�1 BUILDINGEXIST. SETBACK VARD. HWY STREET NAME WIDTH - ADDRESS p .�L'_ FRONT a ARCHITECT ORT L. P. L. SCJ ENGINEER O. SIDE .a P. L. ADDRESS O TEL. V CONTRACTOR ADDRESS Q �S KlfYS I �l H DESCRIPTION OF WORK w I N NEW ADD LTER REPAIR DEMOLISH SO. FT. IN OF NO. OF SIZE STORIES FAMILIES USE OF STRUCTURE oL �O PS E C �K/• SIGNATURE OF APPLICANT VALUATION 6�/`D APPROVALS DATE INSPECTOR:S SIGNATURE P.C. ` PMT. `— FOFORMSI.OMATERIALSON / 1 FEE S FEE 3 FRAME: FIRE STOPS. HEREBY THAT TH LEDGE THAT I MACE READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE DIVA IS CORRECT AND AGREE E COMPLY FURNACE: LOCATION. WITH ALL COUNTYCONSTRUCTION. TI O. INCES AND STATE LAWS REGULATING GAS VENT. DUCTS BUILDING CONSTRUCTION. CERTIFY THAT IN DOING THE WORK / 1 VIOLA- TION HEREBY R WILL NOT EMPLOY ANY PERSON IN LATH. INT. - OF THE LABOR CODE OF THE STATE OF C ORNIA PELAT- ING TO WORKMEN'S C PE SPTION INSURANC� LATH. EXT. SIGNATURE HOUSE NUMBER COR- PERMITTEE Nt RECT AND POSTED 4q \_ ADDRESS D S i FINAL 31- j /Z,/� JOHN F. LEWIS. PRINCIPAL STRWE RAL ENGINEER PLAN HECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH Lr;t o G 7 7 �. P'u„ 1 1. D sw o _ q • WORKERS'CGMPENSATON DECLARATION Lyra certificate 1-have r certificate df consent to self ; 0PUC�Q�.p N FOR o URONG P[�Q6�n1�� or a certificate of Workers' Compensation Insurance, - f - o a certified copy thereof (Sec. 3800, Lab. C.) • Policy No. Company COUNTY OF LOS ANGELES BUILDING AND SAFETY • ' Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING I ADDRESS S .Certified copy is filed with the county building inspec- + BUILDING 9-3-;z5 tion department. - I ADDRESS tJ GI /AJ0. LOCALITY 7202 Q Cc NEAREST4 / Date Applicant CITY ZIP -� CROSS ST. C1wt VPv _ CERTIFICATE OF EXEMPTION FROM WORKERS' I -' NO. OF BLDGS. r� ASSESSOR COMPENSATION INSURANCE SIZE OF LOT, NOW ON LOT f— MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one j USE.ZONE MAP , n hundred dollars ($100)or less.) TRACT �� BLOCK LOT NO. . ., NOREAL �y OWNER cZQ G ol A14r NO -4f6 � CONDITIONS g certify that in the performance of the work for which this I DISTRICT GROUP TYPE_,:. FIRE jPSSED 1 0 permit is issued, shall not employ any person in any manner ADDRESS � 315 ✓J We CONST.. ZONE so as to become subject to the Workers'Compensation Laws. v3Date A licant CITY vpp ZIP JSTATISTICAL CLASSIFICATION DO. 0 NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. V Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS_ 'c d Compensation provisions of the Labor Cade, you must forth- ADDRESS SEWER MAP N with comply with such provisions or this permit shall be TEL 12-3 9 a deemed revoked. CONTRACTOR ryp. BK PG,/�7 VALIDATION LICENSED CONTRACTORS DECLARATION LIC ` I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. ,•�! . Professions Code, and my license is in full force and effect. CITY CLASS $ d`p QOO -. SO. FT. NO. OF NO.OF CHECK D- License Number Lic.Class SIZE NO FAMILIES .ONE $ Contractor Dote DESCRIPTION OF WORK ,a. , a NEW ❑ <•3 8 9.7 A I am exempt under Sec. ✓ a ADD • ALTER ❑ _FINAL $. o s e o a J. B.BP.C. for this reason ,ti y - ❑ - DATE I USE OF REPAIR [ =-2 7 O.7 5'-'- Date. EXISTING BLDG. DEMOL E] FIN Signature APPLICANT TEL. •8 • 0 2 7 D.7 5 U OWNER-BUILDER DECLARATION PRINT NO. I hereby affirm that I am exempt from the Contractor's License D 0 7.22-8 3 Low for the following reason (Section 7031.5, Business and ADDRESS ' Professions Code): PRESENT ' j� fC�! 1, as owner of the property, or my employees with BUILDING wages as their sole compensation,will do the work and , . the structure is not intended or offered for sale(Section.. LOCALITY - "- 7044, Business and Profesiis Code). MOVING TEL. on ElI, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY REQUIRED TOTAL SETBACK FROM EXIST. - _ / I hereby affirm that there is a construction lending agency forr SET BACK YARD HWY PROP. LIN WIDTH pFRONT O b�� D l the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name P.C. Fee$ Permit Fee Lender's Address _ I certify that I have read this application and state that the Issuance Fee (JY 5 d above information is correct. I'ogree to comply with all County Investigation Fee nves .� ' ordinances and State laws relating to building construction, Total Fee - and hereby authorize representatives of this County to enter upon tFA above-mentioned�pr er(tj�for inspection purposes. c /p�9a _.r SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent c Dale .®r �+ C08NTY 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 0107120046 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CO BUILDING TR: 12410 LT: 11 SO. FT STORIES TYPE 9325 BROADWAY STRUCTURE: 2300 VN TEMP CA 917802404 ASSESSOR R ON BER: NEAREST CROSS STREET: 8588-002-011 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY TENANT: B : SFR D USE ZONE: XX ISSUED ON: PROCESSED EXPIRES ON: EXIST OCC GRP: 07/12/01 UT 01/08/02 OWNER: T L. N0: B DGS. NOW ON LOT: VALUATION: FINAL DAiE FINAL BY: CODE: WANG, STEVE (626) 286-6727- 7,000 AJ - 9325 BROADWAY / LLL l TEMP 917802404 ES SPC F K ��—� TEAR-OFF INCLUDING SHEATING APPLY PLYWOOD 1/21, LIGHT WEIGHT APPLICANT: TEL. NO: FEE DESCRIPTION: QUANTITY: LOM: AMOUNT: TILE FRONT HOUSE, GARAGE COMP. SHINGLES 25 YEAR 'A' DIAMOND ROOFING (909) 861-7663- AA BLDG PERMIT ISSUANCE 27.75 3970 VALLEY BL #C AC STRONG MOTION RESID___ 7000.00 VAL 0.70 SPECIAL CONDITIONS: WALNUT CA 91789 02 PERMIT W/O-WHC_ - '_`7000.00 VAL 166.20 - 1C�1 E$TOTAL FEES 194.65 CONTRACTOR: TEI. N0: ��.� C APPROVALS DATE INSPECTOR SIGNATURE DIAMOND ROOFING (909) 861-7663- ' 3970 VALLEY BLVD. #C LIC. NO �tiLOCATION AND SETBACKS WALNUT, CA 91789 693092-C39 /`� ;3 r �� "f' �� AA�. • SOIL ENGINEER APPROVA ARC C OR E EER: �.. FOUNDATION/TRENCH FORMS SLAB/UNDER fL00R RAISED FLOOR�FTaFR f— MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: tMP7 -� -:. �� "'j UNDERFLOOR INSULATION XX 3 1 01 ' FLOOF SHEATHING NO. 0 WE NG : A / : S CL - - - NO 21\A� i ROOF SHEATHING S OOL SAAR PANELS ARD \ AIR QUALITY: 1000 FEET MATERIALS `\�� I �l I NO NO NO ;� r '-! FRAME INSPECTION S REQUIRED TO L S C 0 X[S O / SET BACK YARD: HWY: PROP LINE: WIDTH: �� RI GER ��C _ ♦ i FRONT PL- S SIDE PL- �O;`-� PViCB —INSULATION/WEATHER STRIP INTERIOR LA H/D ALL EXTERIOR LATH RATED FLOOR/CEFLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATEDHA S/OP INGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508