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Home My Public Portal About9438 BROADWAY_Building__ TEMPLE CITY 1Y.f.A CC�eB. I-aI APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILD NG DEPARTMENT OF COUNTY ENGINEER aDDREss '7 44 3� C— ' I� 2ok Q" e1'� BUILDING AND SAFETY DIVISION LOCALITY G JOHN A. LAMBIE. COUNTY•ENGINEER NEAREST ! -WILLIAM A. JENSEN SuP•T OI BUILDING CROSS ST. G C-dl�C ILL L DISTRICT'NO. GROUP TYPE PROCESSED BY, FOR APPLICANT TO FILL IN S-p CONST. Got o�/IC BUILDING ] (/ AD��n 'STATISTICAL CLASSIF'CATION SEWER MAP ADDRESS J O BK PG /✓. T of E. J CLASS. NO.�DWELL. UNITSF� LOT NO. pp f/ BLOCK WATER NOT REQUIRED IX I RECEIVED TRACT / / J - CERTIFICATE: L91 Ll NO.OF SLOGS. MANOP ZUO$ '(CIRCLE'HWAY STATE MAJOR SECOND, CA SIZE OF LOT 'V k IL/7.Y NOW ON LOT S� USE ZONE SPECIAL USE OF J _ _ - CONDITIONS - EXISTING BALDG.. AAu+,�l _ - OWNER /y •/:J K/✓ UY NEOL4 BUILDING YARD HWV STREET NAME EXIST. ADDRESS I/ SETBACK WIDTH FRONT ARCHITECT OR TEL. P. L. (-L, A D 411'`/ ENGINEER NO.- SIDE RP.L. > ADDESS a TEL INSPECTION RECORD O CONTRACTOR NO. ADDRESS O DESCRIPTION OF WORK G w d y NEW AD ALTER REPAIR DEMOLISH Z SQ. . • 3 �l NO.OF NO.OF �IZE /- STORIES FAMILIES USESTRUCTURE P.f r1O /C UO�+ ; SL/�fS STRUCTURE SIGNATURE OF APPLICANT VALUATION$ r 0 P= APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION FEE S FEE $ ✓ J FORMS, MATERIALS FRAME: FIRE STOPS. - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE IS'CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, ' WITH ALL COUNTY ORDINANCESAND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 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 INBVRq NCE - �I SIGNATURE O HOUSE NUMBER COR- PE PRMITTE RECTANDPOSTED LATH,Exr. AODREss — FINAL CLYDE N. DIRLAM, PRINCIPAL STR RAL ENGINEER PLAN CHECK VALIDATION cK. N.G. CASH PERMIT VALIDATION cK. M.O. GASH i `IlD51 8 6 11AY23 1 D 6.00 . TEMPLE CHTY T•;,... Ex.o,.l-el 'APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGTY ENGINEER ELES BUILD[Nc DEPARTMENT OF COUNADDRESS BUILDING AND SAFETY DIWSION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SDP'T OF BUILDING CROSS ST. DIS/Tq ICT NO. G OUP TYPE P SED BY FIILIN I [a C CONST. BUILDING �j ? ,} STATISTICALCLASSIFICAT I ON - SEWER MAP ADDRESS , (/ ( G�'f 7 w 'ZI X BK pf $/C/U CLASS. NO. DWELL.UNITS r- 3 LOT NO. - BLOCK WATER NOT REQUIRED RECEIVED CERTIFICATE: TRACT MAP IGHwAY STATE MAJOR SECOND, L CAL �/ p�NO OF BLDGS. NO. IGI gCLEI SIZE OF LOT 97. 3-Y 061- Z/fI NOW ON LOT ,S` USE ZONE - SPECIAL USE OF c1 ! CONDITIONS EXISTING BLDG. N6/4IF S/� OWNER F• �Z /V TEL /-OZ� BUILDING EXIST. n 77��,,''II NO !O YARD HWY STREET NAME ADDRESS E• o4b W� SETBACK WIDTH' FRONT .s ARCHITECT OR TEL. P. L. 4,�C ENGINEER NO. SIDE - P.L. ADDRESS rEL, INSPECTION RECORD Ou CONTRACTOR -NO. ADDRESS O DESCRIPTION OF WORK G w a NEW ADD ALTER REPAIR DEMOLISH Z SO.FT. NO.OF NO.OF IZE cSTORIES /FAMILIES USE OF STRUCTURE Q0.ND,4 /O.V SIGNATUREOF APPLICANT VALUATION S APPROVALS I/DATE gINSPECTO'R'S SIGNATURE P C. FIAT FEE S `—� FEE $ Q FOUNDATION FORMS.MATE 1�LSO/ FRAMCING, Sr gS://I 1 .�,1I /,1,�/ w 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOS/V_ I J(1 /'/L�IA AND STATE THAT THE ABOVE'IS CORRECT AND AGREE TO COMPLY FURNACE: LOCSTION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS 1 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- INGTO WORKMEN'S COMPENSATIONIRSURANC� LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE T RECT AND POSTED ADDRESS c 'G FINAL CLYDE N. DIRLAM. PRINCIPAL STAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION 0:M.D: cAsH Lta'6.5 3,u,- DEC ?y s,o. 5,:0:0 T)IVISION OF BUILDING AND SAFETY Department of County Engineer County of Los Angeles t WM. J. FO COUNTY ENGINEER 'pts+ �� <"'" - PPLICATION - EI: FOR APPLICANT TO FILL IN _ADDRESS BUILDING9 G Q� 7Z2 p ".g<� LOCALITYNEAREST BUILDI I tV A Pri/yt[P1 - www 'l LOCALITY C t- LT \ CROSS 6T. ' AZ Y NEAREST DISTRICT NO. PUN CK. OR RED. No. PERMIT NO. cnofi6 BT. Imo} �/ p•L y� �]. R/D`I/+ �' �.5'� G, OWNER ''` P u� / ! �s F/Ilc']. (.T/L ISI RECEIVED BY DATE OF APPL. DATE ISSUED ' AMAI L DDRESS ��V'T RvO.PID W Ar' � p USEZONE NO. OF TYPE GROUP FIRE ZONE CITY , t".L F'L.t, - G..1.-� NO. ^. -O2 t G.L--- ' PLANS I - I I. , ARCHITECT OR - TEL. g6f/I/ ZONING.- /r�J,, ENGINEER NO. APPROVED By BUILDING 1ORD.No: ADDRESS SETBACK.LINE: ISO 'TEL. APPROVED, /J t I , / rA� CONTRACTOR TE BY, C/C_if�' ,J ( HOUSE pQN ADDRESS �'UMBERING p B MAP NUMBER O r+ / LEGAL D d� NO:ASSIGNED BY DESCRIPTION LOT NO./ _7 BLOCK �} DATE .I I CORRECTIONS I INSPECTOR' TRACT /�//SJ�O f`� V/E�Z/G�C.V /-/.0•.•�, ( -� NO. OF SLOGS. SIZE OF LOT I NOW ON LOT - USE OF NO. OF EXISTING BLDG. I FAMILIES ` , Aa n•sl4 - Gp DESC LIMON OF WORK _ ..z.. r � NEW ALTERATION ADDITION oI REPAIR DEMOLITION I /O 3., `rt�U� DyvQ Nn 7u 0 A 4Ir -tJ, O eqe� S ZEA ZO ROOMS NO OF 7 STORIES I /I'7.1 LPs.•,-- ALCOR EXT. WALL c-•r., ROOF (j 1� COVERING J IVCGQ I COVEE./RIING)BO�/./.I^./{�U �t v- OJT' I�JG ✓FSU/�//C/�Jf,�C�.{/ USE OF STRUCTURE iTL . " — , 2Aploar, APPROV 'S INSPECTO ' SIGNATURE AT FOUNDATION:LOCATION �....._. Z/ I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FORMS, MATERIALS FRAME: FIRE STOPS, +'//�/`' PLICATION AND STATE THAT THE INFORMATION GIVEN IB CORRECTBRACING, BOLTS . 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES - FURNACE: LOCATION, L AND STATE AWS REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS SIGNATURE OFF LATH, INT. /f A ..6•✓_ PERMITTEE - 3 S/ J ADDRESS - LATH, EXT. n AUTHORIZED AGLC.$ C PLASTER, INT. PLASTER. EXT. $ P. C.$ V HOUSE.NUMBER COR- RECT AND POSTED VALUATION FEE $�G� FINAL 76A838A -D888 2-88 APPLICATION FOR: BUILDING PERMIT � . . L COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS BUILDING ADDRESS 1 hereby affirm that I have a certificate of consent to self insure, R�A�c✓Ay or a certificate of Workers'Compensation Insurance,or a certified CITY ZIP A copy thereof Lab.C. J /` LOCAL( / (�•7 / N Policy NO ompany - T c)—r-•l N SIZ OF LOT NO.OF BLDGS.NOW ON LOT L le v• • ' ❑ Certified Copy Is hereby furnished. NEAREST CROSS ST. ' 19 Certified 'copy Is'filed With the county building inspection TRACT BLOCK LOT NO. - department. - s USEZONE MAP NO. . Date = pplicen mss/_mss.a.. ^ ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL'No. ' COMPENSATION INSURANCE WITHIN IDOO FT.OF SCHOOL? YES NO ADDRESS (This Section need not be completed if the permit is for one hundred 2 DISTRICT " GROUP TYPE CONST.' FIRE ZONE OCESS BY dollars($700)of less.) ZIP ►✓ /�V �� ]/ I certify thatthe Performance of the work for which this permit - Q O cJl UD _VST*/L Is Issued, shall not employ any person in any manner 50 as t0 ARCHITE OR ENGINEER TEL O. Ishall become subject to the Nbrkers'Compensation Laws. STATISTICAL CLASSIFICATION APT C NDO Date Applicant ADDRESS ,. - CLASS NO. .DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate Of CONTRACTOR TEL.NO. REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject -t0 the Workers' SETBACK YARD HWY PROPLINE WIDTH Compensation provisions of the Labor Code,.you,must forthwith FRONT - - comply with such provisions or this permit shall bedeemed revoked. ADDRESS LIC.NO. / 7 PL LICENSED CONTRACTORS DECLARATION . UC.CLASS SIDE a PL CIL. oQ I hereby affirm that I am licensed under provisions of Chapter 9 ' SEWER PILMAP (commencing with Section 7000)Of Division 3 of the Business and SQ.FT.SIZE NO.OF STORES NO.OF FAMILIES NEW C3 BK 1 - PG O Professions Code,and my license is in full force and effect. D SCRIPTION OF WORK ® C.i License Number Lic.Class - - ADD C] VALUATION w Contractor Date — -� ALTER ❑ $ L70 y J / - z C1I'am exempt under Sac. - EPAIR ❑ B.&P.C.for this reason _tZ, DEMOL O -LONA PICa ' - Date: USE OF (STING BLD . IJLvU URM ❑ Signature APPLICANT(PRINT) TEL NO. LDMA Peru# 1 ❑ I, as owner of the property, or my employees with wages as - 'O ' Hl•4T.a ' their sole compensation,will do$he work and the structure is ADDRESS -- not intended or Offered for Sale (Section 7044, Business and Fill DATE '� Q ✓Q] 128,541 PFO}BSSIORS Code.) _ WILL THEAPRICANTOR FUTURE BUILDINGOCCUPANT HANDLER HAZAaDOl1s1MTEAlAL 1 ITEM ❑ 1, as Owner Of theproperty, am exclusive) contracting- with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EOUAL TO OR GREATER THAN --EF (�'}} �F project Y ( g THEAMOUNTSSPECIFIEDONTHEHAZARDOUSMATERIALSINFORMATIONGUIDES RN JTA J. O m JC{ licensed contractors to construct the . Section 7044, YEs❑ No❑ -j i c Business and Professions Code.) - WILL THE INTENDED USE OF THE BUILDING BY THE APRICANT OR FUTURE BUILDING O 5ij OCCUPANT REOWREAPERMIT FOR CONSTRUCTION OR MODIFICATION FROM THESOUTH q CHCHECK12'}8.-. CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT FOR GUIDELINESDISTRICT(SCkOMD)SEE PERMITTING CHECKLIST A I_CHANGE C- I I hereby affirm that there is a construction lending agency for - YES ElNoo❑ '. - the performance of the work for which this permit is.issued(Sec. { 9097,CIV.C.). I HAVE READ THE HAZARDOUS'MATERIALS INFORMATION GUIDE AND THE SCAOMD M �QQ Q-0005 4I `19Q"M . .W .QEOLendefs Name WUNTYCODETITLEZCHASTANDInGs HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. Lenders Address 4921 1 AM 7:`4 QYNEAORAOFNT - I certify that I have read this application and state that the above ' information'is correct. I agree to Comply with all county RC.FEE .- PERMIT FEE - ordinances and State laws relating to building construction,and A hereby authorize representatives of this County t0 enter upon ISSUANCE FIE O the above- entioned Drop rty for inspection purposes.' - - ro 5;pINVESTIGATION FEE TOTAL FEE d - � � SEE REVERSE FOR EXPLANATORY LANGUAGE