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Home My Public Portal About9451 BROADWAY_Building__ • �� Com. �-�`d- . APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (pd., OI IYP� ODI,) BUILDING 5' G. RPDA ,4 BUILDING _ ADDRESS V /'Trig" (y s. ADDRESS 4 S 1 �• CITY E'ngpLE CiT ZIP ( I � ( C) y NO.OF BLOCS. LOCALITY l/. SIZE OF LOT 330X 447 NOW ON LOT NEAREST t_ � CROSS ST. 2(t J TRACTr•2 •' Y"z BLOC SSOR LOT N�O O .MAASSP BOOK PAGE PARCEL OWNER P-0sI AIJ C/�T�OG(�-G`! NTEL_y�O"SID 1.. DISTRICT GROUP TYPE FIRE P CE E° BY ADDRESS S.3 W T f W .i"T Ji Of�U CONE /^. p,r..w STAT( TICAL CLASSIFICATION SEWER MAP CITY VS ArJ6G'-C-S ZIP ?VVI LASLN \ CLASS NO. ^^DW E•�L L.UNITS /,J 8Kj3 PCI ARCHITECT OR. NOL 216 USE ZONE NOP C �/ U ENGINEER LD '55 iq ADDRESS1313 UV• � S LL`�_�-A. __Lot I� �`�� SPECIAL CONTRACTOR /�. nn �. 1' uL INO 3 T CONDITIONS ROpD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ LIC ADORESSSO . ll / �p O VE2.DU(PO (t I)NO.LTZ T� O BLDG.SETBACK FROM CITY /Jo-i Y(•Ef' CLASS FRONT PROP.LINE OF -ISTREET) CONSTRUCTION LENDERHIGHWAY } YARD o TOTAL SETBACK FROM TYPE OF EXISTING NAME AND BRANCH FRONT PROP. LINE HIGHWAY WIDTH ADDRESS CITY + Y� SO. FT. NO. OF NO. OF CHECK BLOG.SETBACK FROM CD SIZE STORIES. 1 FAMILIES ONE SIOEPROP.LINEOF ISTREETI U ( N NEW HIGHWAY } VA RO _ TOTAL SETBACK FROM TVPE OF EXISTING .CD DESCRIPTION OF WORK DD 'L4�4 ❑ - ® SIDE PROP. LINE HIGHWAY WIpTH U K 34� I OK w' D I'nOP ADD + _ ALTER 12 CORNER CUTOFF YES ❑ - NO ❑ Z R n..-w-f1 EPAIR❑ USOF EXIST NG BLDG. N..Y vI�Y EMOL ❑ IN OPEN SPACE YES ❑ NO ❑ APPLICANT ` l ^ �C TENOL 3_zIG IN COASTAL ZONE YES ❑ NO ❑ (PRINT) L Vry n)_ BY (SIGNATURE) l ENVIRONMENTAL CITE GO RICAL EXEMPTION YES[] NO ❑ Q _ IMPACT EXEMPTION DECLARATION SIGNED-(DATE) VALUATIONS !24p 000 IMPACT REPORT PROCESSED (DATEI HEREBY THAT TH LEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT TWE ABOVE IS CORRECT AND AGREE TO COMPLY wrTH ALL ORDINA NC E5 AND LAWS REGULATING BUILDING-CON- STRUC TI ON. I CERTIFY THAT IN DOING THE WORK AUTHORIZED d�,�....��^�pp HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE I-0 Y /�15.�'Y'!l Y 1 LPBOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMP HSA ON INSURANCE. SIGNATURE OF FINAL BY PERMITTEE L-�yY DATE ADDRESS 3 I - S PMT.$ _� Y3 D ..] 7 TEL tf , V CITY � 'J NO. - •� FEE Y s FEE -� PLAN CHECK VALIDATION CK. M.o. C.S. PERMIT VALIDATIONCH. M.o_ CAsH 528©FEB 723 0 109.66 IA 2u 1 248. d`,'i 76A6380 CE9803A 5/73 C� APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (P.im G. "o. OH10 BW LDING p (� JC_ - ADDRESS -c C" RoA�Dw�As ADDRESS / 4 / _ CITYT_&MP L'G• Ct-rl ZIP �-f- -O'O� LOCALITY L, NO.OF BL SIZE OF LOT 330 ' NOW ON LOTT NEARESTCROSS ST. _ ASSESSOR TRACT BLOCK LOT NO MAP BOOK PAGE PARCEL <'ZY' IZQA.R A�R..1 IC -k TEL. o D GIST RIOT GROUP TYPE FIRE PR CESSED BY OWNER ` Lr. , NO. � Yd-0 'DI �J C d CONST. Z E A DOR ESS ISA I W I QST Cl _ l:• �(YJ � ' STATISTICAL CLASSIFICATION WER MAP CITY ECT +-iT�rOEL.ES ZIP EL CLASS NO.�OWELL_UNITS �8,e, ,3d ARCHITECT OR, C TEL ENGINEER L GA SS NO. 4-83.Z/ USE ZONE MAP NO. ADDRESS 3 10 L�•T' J 1 8 1-�- L._A, ) / / SPECIAL ll.... CONDITIONS CONTRACTOR/,I, T . 7 I L N0 L_27 -�Tv6 �� ROAD DEPARTMENT APPROVAL REQUIRED* YES E] NO ADDRESS-3 OQ VCRb U60 (2 Lp2 d�� BLDG.SETBACK FROM CITY L li C�� CLASS FRONT PROP.UNE OF (STREET( CONSTRUCTION LENDER - HIGHWAY + YARD o TOTAL SETBACK FROM TYPE OF EXISTING NAME AND BRANCH ,FRONT PROP. LINE. HIGHWAY WIDTH - ADDRESS CITY + Y SO IZ FT. NO. OF NO. OF CHECK SLOG SETBACK FROM 512E STORIES I FAMILIES ONE SIDE PROP.LINEOF (STREET) U [C DESCRIPTION OF WORK NEW HIGHWAY + YARD - TOTAL SETBACK FFOMI TYPE OF EXISTING SIDE PROP. LINE I HIGHWAYI WIDTH U NE^� S'u 1T7 To AD�OIrI ADD ❑ + _ ALTER ❑ h 6C�s 1 �L EPAIR❑ CORNER CUTOFF YES 13NO E Z USE EXISTING BLDG. �L EMOL ❑ IN OPEN SPACE � q.. YES ❑ NO ❑ APPLICANTA ( TEL IN COASTAL ZONE YES NO (PRINT) �.� Com\�J ) NO.,Q3 it( � I3 BY (SIGNATURE( �,( �QQ.pENV IPONMENTgL CATEGORICAL EXEMPTION YES NO • Q IMPACT EXEMPTION DECLARATION SIGNED (GATE) VALUATION Y IMPACT REPORT PROCESSED (DATE) I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION' I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO I ' WORKMEN'S COMPE NSA ION INSURANCE. SIGNATURE OF FINAL BY ' PERMITTEE�TDATE ADDRESS `A /3 • ;RP.C. ItQ 0 2 FEE +j �S / FEE Y c� '�— CITY lip J -e/ 7 NO PLAN CHECK VALIDATION C Mo. CASH PERMIT VALIDATION cn H.o. CASH 5 2 7 ffEB 7 � 3 D 4 5.43J� 116�R 303�_'t1AR, 2625 u 61.30 ® � 76AG3813 CER803A 5/73 : City ;of',T emple City :'APPLICATION FOR COUNTY'OF LOS ANGELES, '-S U I-LD I N G PERMIT'" DEPARTMENT OF COUNTY ENGINEER Il' BUILDING AND SAFETY DIVISION ' FOR APPLICANT TO FILL IN none ss n-' BUILDING ADDRESS 451.Broadvlray - LOCALITY . _ NEAREST CITY l ZIP 917so CROSS ST. NO.OF BLOCS. - ASSESSOR ' SIZE OF LOT NOW ON LOT MAP BOOK AGE 'PARCEL DISTRICT GROUP TYPE FIRE - ROC ED BY TRACT No b/,5 LOCK LOT NO CONSTZONE . _ OWNERSt. Luke Catholic Chub Dr /3 STATISTICAL CLASSIFICATION SEWER ADDRESS 9451 CLASS NO. Z ?�DWELL.UNITS BIfI�LPG CITY rppMr)-le CitV ZIP 91780 ZONE MAP ARCHITECT OR ;TEL. NO. Q ENGINEER. NO. SPECIAL SPECIAL - CONDITIONS ADDRESS "' - ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO❑ CONTRACTOR Alhambra Roofine CmEL. -282-1958 BLDG.SETBACK FROM . HC 2531-63163 FRONT PROP:LINE OF ISTREEiI ADDRESS 12 SO. Maren o NO. 3 HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF MISTING LIC. - FRONT PROP.LINE HIGHWAY WIDTH TY -'if- l 'f CLASS CONSTRUCTION LEN ER + O NAME AND BRANCH BLDG.SETBACK FROM - - U ADDRESS CITY SIDE PROP.LINE OF ISTREEiI O SO,FT. NO OF NO.OF CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING rj SIZE STORIES FAMILIES ONE SIDE PROP.LINE IHIGHWAYI WIDTH . N ❑ - DESCRIPTION OF WORK _ l NEW + Z- Bldg., also '3 Car Garage ADD - ❑ CORNER CUTOFF YES ❑ NO ❑ TV 30/SBS ON CS & Hot Asphal IAJTER ❑ IN OPEN SPACE YES '❑ NO ❑ REPAIR USEOFEXISTINBLDG. DEMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑. APPLICANT TEL (PRINT) NO. BY ISIGNATUREI -- IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THESTATE OF CALIFORNIA IN RELATING TO WORKMEN'5 COM - PENSATION INSURANCE. - _ Frank Foulk SIGNATURE OF Y FINAL BY PERMITTEE DATE ' ADDRESS Marengo - y CITY Alhambra, Calif_ no 282-1958 P.C. Fees Permit Fee 3045.00 Issuance Fee 700 VALUATION 3,450.00 • .total Fee 52.00 •.PLANJCHEECICIVA`ttDATTIONQMPEN SAT� "N _ PERMIT VALIDATION �� M.O. CASH z.i z AUG 9 0 5 .0 U ® M POLICY HOLDER: - — 'Lf+�6h639A. 1-{ 3( ©� \ 'Y�iIS')04jc C ,`T- y �E CE 0803(R€V.6/781 1 F 1 ` JJ��// �l 1_ l 111511 . APPLICATION FOR-BUILDING PERMIT COUNTY OF LOS ANGELES " BUILDING AND SAFETY BUILDING FOR APPLICANT TO^FILL I�NL ADDRESS LOCALITY DREss j NEAREST CITY c l: ZIP t. CROSS ST. L� )NO.OF BLDGSPw ASSESSOR SI ZE OF LOT HOW ON LOT.`' _ MAPBOOK PAGE I PARCEL f,+^ DISTRICT GROUP TYPE -FIRE PR CESSED BY T [/~ � [+,./ T.NO. �7�f {✓I CON �7,BfjIE . OWNER L ./�J A/ =-`NON`' _ /tom / /1"13 `17 STATISTICAL CLASSIFICATION SEWER MAP ADDRESS �)I ww CLASS NO.�1 DWELL.UNITS .0 � , CITY l/' - ZIP ARCHITECT OR TEL. VALUATION $ ENGINEER NO. ADDRESS - BLDG.SETBACK FROM T)6FRONT PROP.LINE OF ISTREETI NTRACTOR -CIL SNO.Z f" 2 11 TOTAL SETBACK FROM TYPE OF EXISTING HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH AODREss'306S v o I-D" 3 ' .S?' _ - CITY G , '7 - .F9 i 11 ASS CONSTRUCTION LENDERBLDG.SETBACK FROM , SIDE PROP.LINE OF (STREET) NAME ANDBRANCH ,- HIGHWAY + YARD = TOTAL S ETBACK F ROM TYPE OF EXISTING ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH - O SO.FT. NO.OF NO.OF CHECK + _ V 51 ZE STORIES FAMILIES ONE / O DESCRIPTION OF WORK e"I NEW ❑ P.C.Fee$ Permit Fee F-IZG1 �� W L ADD ❑ d Issuance fee ALTER - gee- USE Z REPAIR TDtal Fee EXISTTIING BLDG. c>-5-t D-e-ti ce- DEMOL' ❑ Z APPLICANT TEL 0 - . - (PRINT) NO. Q p BY ISIGNATUREI I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS'APPLSCA_TION AND STATE Y THAI THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES W AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE V WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN COM_ QZ PENSATION INSURANCE. J 90667A i NATURE OF - PERMITTEE / # e e s e e ADDRESS E q Z p e - 7000 TEL. �/� ; O . CITY. NO. _ C ^ * 7(1005 -. /U/SSEEE ZONE No SPECIA1/f OO > 10.0 6=7 8 / CONDQL� "ey n FINAL BY i DATE t7 -76A63BA- CE NBablREv.6/791 - APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDING ADDRESS -7 s BUILDING L ADDRESS ✓ .N/� LOCALITY NEAREST ' CITY l ZIP CROSS ST. NO.OF FLOGS. ASSESSOR SIZEOFLOT NOW ON LOT MAPBOOK PAGE - PARCEL / DISTRICT UP TYPE FIRE ESSED By TRAC4 � COCK LOT NO. CONS ZONE EL. j vo 3 JG OWNER — .......• NO. - �+ - STATISTICAL CLASSIFICATION $EWERM ADDRE5�3"1 7 '•/� - CLASS NO.=:2L—DWELL UN ITS BK PG CITf �� ZIP ARCHITECT OR TEL. VALUATION gj QQ ENGINEER NO. ADDRESS - BLDG.SETBACK FROM TEL ''�� FRONT PROP.LINEOF ISTREETI CONTRACTOR NO. �:J HIGHWAY + YARD . TOTAL SETBACK FROM TYPEOF EXISTING LIC- / FRONT PROP.-LINE IHIGHWAY WIDTH ADDRESS Z 4, NO A 4 U + - CITY / CLASS BLDG.SETBACK FROM CONSTRiJCTION LENDER SIDE PROP..LINE OF ISTREETI NAME AND BRANCH TOTAL SETBACK FROM TYPE OF EXISTING y HIGHWAY + YARD = ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH 0 O SO.FT. NO.OF NO. LF CHECK + _ V SIZE STORIES FAMILIES ONE O DESCRIPTION OF WORK NEW ElP.C. Fee S Permit Fee / r �• / ADD Issuance Fee y6j ` ALTER Z REPAIR Total Fee USE OF EXISTING BLD � �..+� DEMOL E] Z APPLICANT TEL 1 G (PRINT; NO. Q D BY(SIGNATURE) Q I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Y THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES uVi AND LAWS REGULATING BUILDING CONSTRUCTION.1 CERTIFY THAT IN DOING THE S WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF LN �0 72.3 f1 Z O THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM = J . PENSATION INSURANCE. - Q 6 # 0 6 SIGNATURE OF 2 -- 1, 24.00 24.00 PERMITTEE ADDRESS '2 6 6 1'2 4,0 0 5 TEL O CITY NO. 1 -78 /U�S�E)ZONE NADP G O v\ CJ a `I > SPECIAL N- CONDITION$ , F rc FINAL BY i DATE NOF BUILDING AND SAFETY a o n lJ n 0 n LL,ID N m �l ".r partmee ent of County EnglDr 1 - U County of Los Angeles _ WM. J. FOX, COUNTY END INEER 6 APPLICATION FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTpICT N0. UN Cl. }OR Re`d` o PERMIT tNO. BUILI ADOREBB �J J �J / L10 S '1 IV;DBY / ATE OF AP DATE ISSUED LOCALITY t(�--�•BY 3 NEAREST CROSS 8T. AUILDING DD ESS OWN MAIL LOCALITY 7 ADDRESS �� , NEAREST d TE CROSS ST. CITY N FIRE NO.OF .. I TY - CROUP i J/.-_ ARCHITECT OR TEL ZONE PLANS . ENGINEER NO. BLDG. ORD. N0. SETBACK LINE ADDRESS / USE APPROVED CONTRACTOR O. Od ZON. BY NUL TELA/"' �w� HOUSE NUMBERING ADDRESS '�• �Y�. MApP�NUM)BER'/' l_ed__/ NO. ASSIGNED BY LEGAL CORRECTIONS DESCRIPTION LOT NO. / TRACT N0. OF SLDGIL / a SIZE OF LOT NOW ON LOT USE OF - I NO. OF - EXISTINO BLDD. FAMIIIDB DESCRIPTION OF WORK a 2- 19 S NEW ALTERATION ADDITION REPAIR DEMOLITION - F 6=[ RCOMB STORIES EXT.WALL O I I ROOF COVERING /Q4`[( COVERING � llSSsw A5 . USE OF STRUCTURE 7614 ©t/er12' �'�P''✓.4�a 4 C9G 6 IL G. .< 4 fCv- yC✓ U ON J / INSPECTION FORy /�yr APPROVALS OCCUPANOYAS rw INSPECTORIB SIGNATURE DATE FOUNDATION: LOCATION 1 OE HEREBY ACKNWLEDGTHAT 1 HAVE READ THIS AP- FORMS, MATERIALS PLICATION AND STATE THAT THE INFORMATION GIVEN IB FRAMEI FIRE BTOPB, CORRECT. BRACING,BOLTS 1 AGREE TO COMPLY WITH ALL COU ORDINANCES AND STATE LAWS R TING BUI FURNACE: LOCATION, IN NBTRUCTIO DAN VEST,DUCTS SIGNATURE OF / LATH. INT. I PERMTTI LATH, EXT. S.///'W e. ADDREBR PLASTER, INT. AUTHORIZED ACT. - )... PIASTER. mr. ��C O ��{.. S D HOUSENUMBERCOR- �j.-lO 1 RECT AND POSTED VALUATION J VV_ _ �3 ,-Y. V FINAL2Y�5-3 ►[[ 7"630A DBS a I-52 ' . . . ...DIVISION .. DEPARTMENT F UI COUNTY ENGINEER OD u 0 LID 0 n �• DMSION OF BUILDING AND SAFETY VL`{7 Ill(�V� COUNTY OF LOS ANGELES Gl •` WILLIAM J. FOX. COUNTY ENGINEERAPPLICATION CASSATT D. GRIFFIN. SUPT OF BUILDING - FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. Pun CE.OR Rbc.No. '' 0. BUILDING � !�/ / c �y ADDRESS J LOCALITY RECEIVED BY DATE OF APPL. DATE ISS ED NEAREST 3-30 CROSS ST. _ BUILDING •/�� /, .� ryry OWNER ADDRESS 5 �i 9�+rY a C✓��I " (D'+'. MAIL �[ LOCALITY o ADDRESS 7 J NEAREST CITAV JoeY CITY TO CROSS ST. G/�J":e ARCHITECTOR TEL. ZONE �I PLANS �I -TY I GROUP ENGINEER NO. I/ ADDRESS BLDG. r /J O SETBACK LINE EL / USE ,Aµ APPROVED CONTRACTOR' HO. / QID ZONE / I r BY DATE ADDRE88 C�✓'.Li HOUSE NUMBERING LEGALMAPNUMBER NO. ASSIGNED BY DESCRIPTION I LOT NO. �`.3✓�"`^' CORRECTIONS TRACT 3/-3> &,,J 9-• To Ci w7a,17 C70n- NO:OF SLOGS. SIZE OF LOT 'I NOW ON LOT �O USEOF NO. OF EXISTING BLDG. FAMILIES p _ DESCRIPTION OF w2M G — D. NEWII��III ALTERATION ADDITION p REPAIR I DEMOLITION �' —�6 -� Z r SG. FT. NO. OF SIZE ROOMS STORIES EXT. WALL - ROOF asa-- COVERING I COVERING Cl USE OF STRUCTURE rrc c o-v APPROVALS INSPECTOR'S SIGNATURE DATE FOUNDATION: LOCATION nft�t'v 04 e 'FORMS. MATERIALS THEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- C FRAME: FIRESTOPS. PLICATION AND'STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS CORRECT. FURNACE: LOCATION. I AGREE TO C it WITH ALL C LINTY ORDINANCES - GAS VENT. DUCTS AND STATE LAWS GU AT G UIL II G CONSTRUC�T/{�1� SIGNATURE OF / • -//[ r LATH. INT. PERM177EP If LATH. EXT- � � C� ADDRESS PLASTER, INT. AUTHORIZED AGT. $ kF . C. PLASTER, EXT. 7 EE HOUSE NUMBER COR- RECT AND POSTED VALUATION S ' n EEf% � FINAL 18A828A 01383 2-02 I o DEPARTMENT OF COUNTY ENGINEER DIVISION OF BUILDING AND' SAFETY . _ _. ....- COUNTY OF LOS ANGELES ED 0 NO �< WILLIAM J. FOX, COUNTY ENGINEER APPLICATION ' - - ,•: CASSATT D. GRIFFIN. SUPT OF BUILDING FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDINGDISTRI PUN CK.OR RBc.No. PERMIT NO. ADDRESS SI LOCALITY RECEI ED BO Y DATE F APPL. DATE ISSUED NEAREST 4 7 CROSSST_ BUILDING 1 OWNER ADDRESS, 9Y / MAIL LOCALITY T ADDRESS TEL. NEAREST RG CROSS ST. ENGINEERZONENO. ZONE , I PLANS II NPE�.y-i I GROURT BLDG. pJ/L/— 'ORD1 O ADDRESS SETBACK LINE Z / TEL. a USE APPROVED CONTRACTOR N V ZONE T BY DAT ADDRESS 4.. NOISE NUMBERING , LEGAL MAP NUMBER NO..ASSIGNED BY DESCRIPTION I LOT NO. —BL-BCK CORRECTIONS TRACT L. I NO. OF BLDGS. 06 SIZE OF LOT _ I NOW ON LOT EX STOING BLDG. C-4- I FAUSEF NoMILDIE9 I - - ' - - - DESCRIPTION OF WO 0. D - A. NEW -I DEMOLITION ; REPAIR SQ. FT. NO. OF SIZE ROOMS STORIES EXT. WALL 64 ROOF COVERING / I COVERING USE OF RUCT E o' APPROVALS INSPECTOR'SSIGNATURE DATE FOUNDATION: LOCATION FORMS, MATERIALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRESTOPS. PLICATION AND STATE THAT THE INFORMATIOPI GIVEN IS BRACING. BOLTS CORRECT. FURNACE: LOCATION. A REG 1 AGREE TO COMPLY WITH ALL - ORDINANCES GAS VENT, DUCTS AND STATE LLA ING B 1 61_NG CCI ONSTRUCTION. 0 ��J SIGNATURE P LATH, INT. PERMITTfi LATH, EXT. ADDRESS PLASTER, INT. AUTHORIZED AGT. - PLASTER, EXT. FEE S HOUSE NUMBER COR- RECT AND POSTED VALUATION FEE ffi OO FINAL TBAW" 0563 Y-OQ City ofAWICATION FOR COUNTY OF LOS ANGELES BUILDING PERMIT DEPARTMENT ENGINEER BUILDING SAFETY N FOR APPLICANT TO FILL IN BAUILDIDbREssG BUILDING - ADDRESS 9L51 Broadway LOCALITY NEARES cITY 'Temple City ZIP ql CROSS ST. ,/ 7 L"N.ti^NO.OF SLOGS. ASSESSOR SIZE OF LOT C.S ^ OW ON LOT MAP BOOK PAGE PARCEL DISTRICT GROUPTYPE FIRE SED BY TRAC -/ LOCK LOT CONST. ZONE I OWNERSt. Luke Catholic Sh.No.L287-01+73 O L STATISTICAL CLAS (FICA TION SEWER AP . ADDRESS 9h5l Broadway p CLASS NO. DWELL.UNITS ef32.PG CITY Temple City, Calif. ZIP 917110 USE ZONE MAP I NO. ARCHITECT OR TEL. Q' U SPECIAL ENGINEER NO. CONDITIONS ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ TEL BLDG.SETBACK FROM uc CONTRALTO lhpynbra 2 M l O NO - Q FRONT PROP.LINEOF (STREET) . ADDRESS P O. 1 HIGHWAY } YARD -_ TO TAL SETBACK FROM TYPE OF E%(STING CITY LIC. FRONT PROP. LINE HIGHWAY WIDTH AlhaMbra, Calif. CLASS CONSTRUCTION LENDER } - NAME AND BRANCH >m. BLDG.SETBACK FROM ADDRESS CITY SIDE PROP. LINE OF (STREET) CSD SO. FT. N0. OF NO. OF CHECK HIGHWAY } YARD - TOTAL SETBACK FROM TYPE OF EXISTING C SIZE STORIES FAMILIES ONE 510E PROP. LINE NIGNWAV WIpTH u DESCRIPTION OF WORK-roof lower NEW ❑ } _ 1 ti Fiat area No. end of NP-Vt 131,UG. ADD C] CORNER CORNER CUTOFF VES ❑ NO Z SiV 30# BS (.TER (I IN OPEN SPACE YES ❑ NO ❑ EPAIR USE OF IN COASTAL PERMIT ZONE YES ❑ NO ❑ EXISTING BLDG. ENOL ❑ APPLICANT TEL IPRI NT) NO. BY (SIGNATURE) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOYE IS CORRECT AND AGREE TO COMPLY WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN GOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE DF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATIGpIyStIRILIICE. Roofing Co. SIGNATURE OF FINAL �J / gy PERMITTEE DATE / L �`• ADDRESS I Alhambra Calif. TEL 228195 P.C. Fee$ Permit Fee -$24r-8e CITY NO. e Issuance Fee VALUATION Y.� n -/oZ.�jo. on y,4o Total Fee PLAN CHECK VALIDATION CK. M.D. CASH PERMIT VALIDATION cK. M.O. CASH 9 1 5iC+EG '28 1 D 2 4.0 0 76AG38A CE080313 12/35 l T1/� � M �� C� ]BAB38AB . A'.803orY .3-BB APPLICATION FOR BUILDING PERMIT I CbUNTY OF LOS ANGELESBUILDING ��// a DEPASTMMT, OF COUNTY ENGINEER ADDRESS -q4s I. L IBJQ0 A A--J BUILDING AND SAFETY DIVISION LOCALITY ( ' G V JOHN A. LAMBIE, COUNTY ENGINEER - `' COLEMAN W. JENKINS, SUF'T OF BUILDING NEAREST /! ,(6 - CROSS ST. ` ' FOR APPLICANT TO FILL IN D1srRICT.NO. GROUP TYP o SSED.BY a is CON (Prior ort DB DnI y) 5 ; ' BUILDING j; STATISTICAL CLASSIFICATION .. jASSIFICATION SEWER MAP ADDRESS ••J CLASS NO.�LDWELL,UNITS_, BKD. PG LOT NO. 2 BLOCK USE ZONE MAP -- - ' TRACT SPECIAL �, - - /' yX . NO.OF BLDGS. CONDITIONS q SIZE OF LOT NOW ON LO �. USE OF �AEXIG W.p f.1 AT m !c] TEL. CA4 t STING BLDG. +e4�FRONT PROP.LINE OF (STREET). OWN 0p NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD _ TOTAL ADDRESS L sT. HIGHWAY WIDTH FROM C.L. CITY LmSAll >-j YeCIZ- L-OC.Q 60 -- + ABLDG.SETBACK FROM ARCHITECT OR TEL. SIDE PROP.LINE OF (STREET) ENGINEER NO. - TYPE OF EXISTING1 SETBACK HIGHW YARD = TOTAL ADDRESS NIGHWAV WIDTH FROM G, ►�ll + _ CONTRACTOR IRS AT RLC2 NO. uqq3 ADDRESS3� k� LO. Z4 5-8 CORNER CUTOFF YES ❑ NO ❑ U �J / LIC. z CITY L /f (p.� CLASS E" 1 SEE REVERSE SIDE FOR SPECIAL APPROVALS U DESCRIPTION OF WORK d NEW ADD ALTER .REPAIR DEMOLISH SO. FT. NO. OF NO. OF -� T~ ^ SIZE STORIES FAMILIES / rY ^JJC /y.., USE C Z A / / JJ /"' STRUCTURE L/ n SIGNATURE OF L(�P APPLICANT VALUATIONS �Z©�� J `A PROVALS DATEINSPc519.1 SIG A URE P.C. �S PMT. 7 § FOUNDATION: LOCATION FEE S I I PEE S2 7 i 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 ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORN AUTHORIZED MEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA-, L / _ 1- TION OF THE LABOR CODE OF T E SJ•AjE O .JFORNIA RELAT- LATH, INT. IND TO WORKMEN'S COMPEN 1 N IISGR FICE. m 'N LATH, EXT. SIGNATURE OF - a HOUSE NUMBER CO OR, RECT AND POSTED Z j. B ILI ADORES � '�S. FINAL JOHN F. LEWIS. PRINCIPALS RAL ENGINEER cK. IT PLAN CHECK VALIDATION M.O. CASH _ PERMVALIDATION cK. N.O. CASH LAC-6 6.8 2 3�2 OCT 11 2 3 D 1 6-.6 5 i _ _LAC06 9 7 ,vs OCT22 ID 2 7.75, Ise 76A638A_ CE#803 REV.11/78) City of Teagile City APPLICATION._ R BU L4�ITId� PERMIT A COUNTY OF LOS ANGELES_ BUILDING AND SAFETY FOR APPLICANT TO FILL IN -. - - BUILDING ADDRESS - - BUILDING, - I ADDRESS gh53 Broadway- LOCALITY CITY Tem le Cit. Ca ZIP 91780 CROSS ST. NO.OF BLDGS. ASSESSOR SI ZE OF LOT NOW ON LOT. MABBOOK - PA PARC TRICT - 'GROUP TYPE FIRE o SEDBY TRACT BLOCK LOT NO. G, CO DINNER t. Luke Church- TEL 287-o473 j`�V `�` / .� _ _ _ _ STATISTICAL CLAS$WCATION SEWERM P ADDRESS T d CLASS Noe�DWELL.UNITS B - CITY' 'ZIP•" ARCHITECT O TEL VALUATION $'2 ENGINEER - - - NO. A135.00 ADDRESS _ BLDG.SETBACK FROM. - TEL. FRONT PROP.LINE OF ISTREETI - ' CONTRACTOR No.282- _ TOTAL SETBACK FRO YRE OF EXISTING . LIC. HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH ADDRESS SO Marengo NO. 25316 CITYAlhambra, Ca. LIC. + CLASS 'CONSTRUCTION LENDER -• - BLDG.SETBACK FROM I NAME AND BRANCH SIDE PROP.LINE OF 1 -ISTREETI HIGHWAY + YARD = TOTAL SETBACK FROM TYPE A EXISTING 0 ADDRESS CITY SIDE PROP.LINE ' HIGHWAY WIDTH, 0- 50.FT. NO.OF 'NO.OF _ CHECK '+ SIZE STORIES - FAMILIES`"' - SONE ❑ USE ZONE MAP DESCRIPTION OF WORK Re-roof Lunch - NEW- NO. 'OO�. •' ((///( No W Arbor roof-W/ Felt over ADD ❑ 1� CONDITIONS - -P1, ood Mo Felt to ALTER ❑ DATE (�, © BY / 2 REPAIR-' ✓ 9--�--`. USE OF Base Sheets 301 CaP DEmoL ❑ EXISTING _ ZO ISNG B APPLICANT TEL �L (PRINT) NO. r BY ISIGNATUREI' HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE. Y THAl THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL.ORDINANCES: _ W AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN GOING THE S WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF 1.1 THE LABOR CODE OF TH E STATE OF CALIFORNIA IN RELATING TO WORKMEN'5 COM- _ _ Z �98b3A PENSATION INSURANCE" 6 # • O O 001 SIGNATURE OF PERMITTEE' 2'• • 4-3 0.0 _ _ _ _ _ ADDRESS Z '. e e 4 3 0 0 U. TEL 282c�958 0 _ CITY Alhambra, CaliS. No. c 04. 1 4'-8 0 P.C. Fee'$ Permit Fee36.00 _ > I � Issuance Fee 7e00 6 43.00_ Total Fee is 98A838AJ�w, CENB0S(FEVle/981 11 1 IL11 , APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT OTTFILL IN • BUILDING __ __ ADDRESS BUILDING , ADDRESS 9451 - p LOCALITYNEAREST .C CITY e t ZIP 1780 CROSS ST. - . NO.OF SLOGS, ASSESSOR .t SIZE OF LOT .NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE" - PROCESSED BY TRACT BLOCK- - LOT NO: � CONST. ZONE OWNER T 'c TEL. J ch ` STAi1STICALCLASS��IIF}F1ICCATION SEWER MAP ADDRESS - CLASS NO.-2?A—DWELL UNITS BK PG CITY yo ZIP 91780 ARCHITECT OR TEL. VALUATION .Q + 39�(I. ENGINEER NO. ) - ADDRESS - r ,� BLDG.SETBACK FROM /• TEL p - p FRONT PROP.LINE OF (STREET) CONTRACTO NO. 282-1 8 - TOTAL SETBACK FROM TYPE OF EXISTING LIC. HIGHWAY + YARD = FRONT PROP.LINE IHIGHWAY WIDTH ADDRESS NO, + _ CITY Alhambra Calif. CLASS CONSTRUCTION LENDER BLDG_SETBACK FROM NAME AND BRANCH SIDE PROP,LINE OF (STREET) . HIGHWAY + YARD = TOTAL SETBACK FROM I TYPEOF 1EXISTING S ADDRESS CITY SIDE PROP.LINE IHIGHWAYI WIDTH O SO FT_ NO.OF NO.OF CHECK + _ V SIZE STORIES FAMILIES ONE OC DESCRIPTION OF WORK Section NEW e' O ❑ P.C.Fee 4 Permit Fee $ e00 U 30# BS-& 80# Asbestos CS & ADD . ❑ 0 N Issuance Fee one SectionALTER ❑ - r Z REPAIR ® Totol Fee 52.00 _ USE OF - DEMOL ❑ EXISTING BLDG. - Z q Z APPLICANT TEL /y^7 'O 4,/ 4,J.6 A: - WRINTI NO. -3L?3& /-79 �• O '# eye!e eFran k IT oulk e , BY(SIGNATURE) - - HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Y THA HE AND LAWSAREOGUE15 ASING BCORRECT (DING CONSiEE 0 RUCTIONOPLY WITH MCERTIFY iHAiLIN000 NG RDINANCHE= 5200 .ESU WORK AUTHORIZED HEREBYrI WILL NOT EMPLOY ANY PERSON IN VIOLATION OFU - - THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TOW'ORKMENSCOM- - = I Q2!6`-79 PENSATION INSURANCE. Fr k Fouglk SIGNATURE OF PERMITTEE ADDRESS 719 - Alhambra Ca. TEL, 282-1958 C CITY NO USE ZONE FNC PA ECIAL NDITIONS FINAL BY W 6 DATE . Temple City APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Prim+or Woe amv) BUILowG - COUNTY 'OF LOS ANGELES ADDRESS -Rrnndwpy DEPARTMENT OF COUNTY ENGINEER CITY Tele Cit 21P 1 80 BUILDING AND SAFETY DIVISION NO.OF SLOGS, BUILDING SIZE OF LOT NOW ON LOT ADDRESS , ✓LEC' TRACT BLOCK LOT NO. LOCALITY NEAREST o...R-St a Luke Catholic Chua41 287-04 CROSS ST. ,.Z.. ASSESSOR ADDRESS 1 BToadw MAP BOOK PAGE L z' DISTRICT COUP ITYPE FIRE IROCESO BY CITY IF /V, ) CONST ZONE 6 ARCHITECT OR _ TEL. ,�r0 ENGINEER NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NO.�ZDWELL,UNITS BK/3 ��" CONTRACTOR NEOL. USE ZONE MAP LIC. N. NO. GI ADDRESS NO. 'Ll1 SPEC AL LIC. CONDITIONS CITY CONSTRUCTION LENDER CLASS ❑ ROAD DEPARTMENT APPROVAL REQUIRED YES NO ❑ NAME AND BRANCH SLOG,SJETBACK FROM }. FRONT ROP.LINEOF (STREET) - p ADDRESS CITY TOTAL SETBACK FROM TYPE OF E%(STING U SO. FT. NO. OF NO. OF CHECK HIGNwA } YARD _- HIGHWAY WIDTR FRONT PROP. LINE SIZE STORIES FAMILIES ONE O ❑ } = U DESCRIPTION OF WORKIe-rDDf Realer_ NEW w ADD ❑ BLDG.SETBAC H Bldg N 3O BS RC 9 CS RL BOt SIDE PROP, LINEOF (STREET) Z Asphalt. LTERyy❑� HIGHWAY + YARD oTOTAL SETBACK TYPE OF EXISTING REPAIR{AL S1DE PROP. LINE I RP64WAYJ WIDTH USE OF EXISTING BLDG. DEMOL ❑ } APPLICANT TEL CORNER CUTOFF . . YES ❑ _ NO ❑ (PRINT) NO. BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑. Q /�/� IN COASTAL ZONE YES C] NO VALUATION$ 11220 ,00 CATEGORICAL EXEMPTION "YES❑ NO ❑ HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE (SCO RRECT AND.AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO /� f� /J M��A/'JA X WORKMEN'S COMPENSATION INSURANCE. / 6; -Z�i D�r�`a Com+ L r SIGNATURE OF f' , P�i9r2S /!/ PERMITTEE '7/ r� ADDRESS 2 .• - [� o FINAL BY TEL 282-1958 DATE CITY Alhambra, Calif. NO. .tIA IA F. CHECKS P:1)-:1 "-L F E FEE $ HARVEY T. BRAID DT. COUNTY ENGINEER ' PLAN CHECK VALIDATION CN. M.O. =ABH _ PERMIT VALIDATION M:D. cns. 5 4 8,PJUL 21 ' 10 2 4.11 U - 76A63BA CE-003 12/72 - "F GR. 76 A638A CE =803 4/22 APTemple- ION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING . STAKE CHECKS PAYABLE 7'0: .ADDRESS G HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN NEAREST Print or r e only) CROSS ST. B UILOI NO DISTRI nNO. OUP TYPE R ESSED B ADDRESSmay C YC/ ='2, CONST.jf LOT NO. BLOCK .STATISTICAL CLASSIFICATION SEWER P � � � � / C CLASS NO. 2Z DWELL,UNIT$_ P�i3 TRACT USE ZONEI MAP �/;D NO.OF SLOGS. NO. C/ SIZE OF LOT >1, NOW ON LOT II SPECIAL USE OF _ _ CONDITIONS EXISTING BLDG.' - OWNER St, Luke Catholic ChurottL' 287-0473 BL G.SETBACKFROM ADDRESS 2115 1 Broadway FR NTPROP.LINEOF (STREET) TVP OF E%ISTING SETBACK HIGHWAY } YARD = TOTAL CITY HIGH WIDTH FROM C.L. ARCHITECT OR TEL. } - ENGINEERNO. BLDG,SETBACK FROM a ADDRESS) SIDE PROP. LINEOF FEET) O TEL. (TYPE OF EXISTING SETBACK HIGHWAY + YARD = TAL U CONTRACTOR Alhambra RoofingCoat. 282-1958 HIGHWAY WIDTH FROM C.L. C O ADDREss712 So. MarengoAve, NO. 253163 } - W LIC, GO CITU � ' CLASS CORNER CUTOFF VES ❑ NO ❑ _ CONSTRUCTION LEN ER ' NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS ADDRESS Sq. FT. NO, OF NO. OF NEN, ❑ SIZE STORIES FAMILIES ❑ USE OF ADD STRUCTURE Tile - ALTER ❑ �� REPAIR® SIGNATURE OF APPLICANT DEMOL ❑ VALUATION S-924: 3O APPROVALS DATE INSPECTOR'S SIGNATURE P,C, PMT. O[] FOUNDATION: LOCATION FEE S FEE 5 • FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CDN- GAS VENT, DUCTS STRUC TI ON. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE STATE OF •CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION INSURANCE. qTH, EXT, SIGNATURE OF HOUSE NUMBER COR- PERMITTEE F RECT AND POSTED ^ _ ADDRESS 712 So MarPnga AYeimp Alhambra FINAL. C - 3 PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION M.o. usH IAx304273 SEP 5 1 D 15.00A APPLICATION FOR BUILDING-PERMIT FOR APPLICANT TO FILL IN (P,IT+ D, 1YPe Only) City of Temple Cites-, ,BUILDING COUNTY OF LOS ANGELES ADDRESS �Ll5q Broadway DEPARTMENT OF COUNTY ENGINEER c1Tv TeMpIn City ZIP BUILDING AND SAFE Y DIVISION NO.OF BLOCS. BUILDING SIZE OF LOT NOW ON LOT ADDRESS TRACT BLOCK I LOT NO. LOCALIT UrC TEL. NEAREST OWNER ,I,. NO. 297_01 CROSS ST. - - ASSESSOR ADDRESS dl_-.-I Browhyny MAP BOOK j11aCEL DISTRICT I GROUP ITYPIA ,//1 FIRE P SSED Y CITY Temple city ZIP �Op LCON5T,6/ . ZONE ARCHITECT OR - TEL. o ENGINEER NO. STATISTICAL CLASSIFICATION' SEWER M16P ADDRESS CLASS NO. 2-2-- OWELL.UNITS CONTRACTOR OTEL,2O2-'10 O USE ZONE MAP - r of in_ UU U LIC. NO. -ADDRESS712 p Marengo NO. ri l 3 -J� SONO)TI LIC. CONDITIONS CITY . br Calif CLASS Rooflng ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENDER NAME'AND BRANCH at-04.SETBACK FROM - - - FROT PROP.LINE OF (STREET)ADORESS CITU SO. FT. NO. OF NO. OF CHECK— HIGHW Y + YARD = TOTAL SETBACK FROM H1 HWAY Ew OIHG O FRONT- PROP. LINE U SIZE STORIES FAMILIES ONE [C DESCRIPTION OF WORKRP- Q 9 rNEW ❑ W BLOG.SETBAC (STREET) EE T) ti T.T/ � R. Q Ot ADD Li001PROP.LIN E OF _ Z ALTER ❑ TOTAL SETBAC TYPE OF EXISTING Asphalt. T HIGHWAY + YARD = SROP. LINE AY WIDTH REPAIR'® IDE P USE OF + _ EXISTING BLDG. DEMOL ❑ APPLICANT TEL - CORNER CUTOFF YES ❑ NO ❑ (PR NT) NO. BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑ ��ii�� J IN COASTAL ZONE YES NO ❑ ❑. 3 -7 VALUATIO "" 170 /�� CATEGORICAL E%EMPTION YES❑ NO ❑ HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND'STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY .IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED '(GATE) HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR COBE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN•5 C_0 M PE NSATION INSURANCE. SIGNATURE OF - - PERMITTEEADDRESS 712 jgrRngn FINAL BY Alhambra , Calif. N 282-1958 DATE O G 17 , 11..kKl: ( HECI;S 11A)":181-L "10: FEE $ IPmET S 24.00 HARVEY T. BRANDT. COUNTY ENGINEER PLAN CHECK VALIDATION O, M.O. CASH _ PERMITVALIDATIONCK. M.D. CAs. 76A538A CEP80312172 A ROAD DEPT. P WAIT REC;U!RED • FOR ANY h,1ATERiA! S? 'ACE OR \YORK // BONE IN THE RG RIGHT OF WAY- _ �•. APPLICATION F �ro UIL I G PE IT 1 COUNTY- OF LOS_ANGELES - BUILDING DEPARTMENT OF COUNTY ENGINEER Aooaess BUILDING AND SAFETY DIVISION LOCALITY .IOHN A. LAM BI E. COUNTY ENGINEER NEAREST ` CASSATT D. GRIFFIN, SUPT of BUILDING CROSS ST: DIS�T+ICT•NO. OUP rTYP& P CESSED.BY FOR APPLICANT TO FILL IN ✓/ .0 CONST.; BUILDING STATISTICAL CLASSIFICATION SEWER MAP - ADORE (� w - �. i ^K PG H' - CLASS.NO. DWELL.UNITS LOT NO. - '- BLOCK - MAPSTATE ` NUMBER`,cy HWY: YES NO TRACT USE ZONE SPECIAL NO.OF BLpGS. CONDITIONS •y d \ / SIZE OF LOT fl NOW ON LOT USE OF EXISTING BLDG. .(l( - .SC(/o l -,1/6 / /f6 + BUILDING EXIST. , ''II SE?BACK YARD HWY STREET NAME WIDTH OWNER A / /) A,A I FRONT MAIL P.L. ADDRESS .J 7N 5r, SIDE TEL. P.L. _. ary ,Cas No - .b/ = INSPECTION RECORD - - ARCHITECT Op - A TEL ENGINEER ADDRESS p -? J �AW-Ml TIL.NO.CONTRACTOR UO/GNO;k ^ - ADDRESS �- DESCRIPTION OF WORN (A D . ALTER REPAIR DEMOLISH - FT. 06 OF SIZE 0 IT FAMILIES USE OF _ STRUCTURE CON SIGNATURE OF �• APPLICANT APPROVALS 'DATE `9NSPECTOR'S St 6 NATURE ADDRESS F(/00 .9U FOUNDATION: LOCATION // //��//ffjj FORMS. MATERIALS /0-m--L /x�Lur*hh VALUATION $ �'000 I FRAME: FIRE STOPS, - BRACING,BOLTS '1 FURNACE: LOCATION, FEE S s v I FEE _GAS VENT, DUCTS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH, INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND -' STATE LAWS REGULAXING BUILDING.CON RUCTION. LATH, EXT. . .. SIGNATURE OF J t HOUSE NUMBER COR- PERMITTE L �� RECT AND POSTED � PA(��V PIWT/+(.U!/-y�� ADDRESS G �: FINAL $-3D-A6' CLYDE N. DIRLAM, PRINCIPAL ST RAL ENGINEER PLAN'CHECS VALIDATION cK. .O. CASHPERMT VALIDATION CK. M.O. CASH ' r LAC01.41 9' 1-1027 2 3 D 4.50 • n IACo1 4 2-0S E'siY'7 1 D, -9.0 0 M.. TEMPLE -CHTY 1.A63B A CE#8031-62 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING 'DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY , JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN. SUPT OF BUILDING CROSS ST. D I STR`C�yA. ROUP TYPE R ESSEO BY FOR APPLICANT TO FILL IN G+ lE/ _ y CONST. c BUILDING STATISTICAL CLASSIFICATION 5 WER MAP ADDRESS CL ASS. NO—IL I UNITS �K GZ LOT NO. SBLOCK WATER 1:1CERTIFICATE: NOT REQUIRED RECEIVED TRACT S MAP HIGHWAY ,/ NO. F LDGS. IcwcLE1 STATE MAJOR SECOND, LOCAL 512E OF LOTcX NOW ON LOT USE ZONE SPECIAL USE OF y` CONDITIONS EXISTING BLD PR+- �47 aDA TEL. OWNER O. BUILDING YARD HWY STREET NAM EXIST. SETBACK WIDTH ADDRESS FRONT 2C ARCHITECT 9R TEL. P. ENGINEER NO, SIDE I �, ADDRESS TEL. P. L-�G///G�- '/y / W/\ V CONTRACTOR / - t` OC ADDRESS O F DESCRIPTION OF WORK w a 'Al NEW ADD ALTER REPAIR DEMOLISH Z SQ. FT. NO. OF NO. OF SIZE STORIES FAMILIES USE OF t STRUCTURE SIGNATU OF APPLICANT VALUATION $ APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION FEE $ FEE $ �� J FORMS. MATERIALS FRAME: FIRE STOPS. 1 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 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 TON'S COMPENSATION INBUR E. LATH. EXT. SIGNATURE OF HOUSE NUMBER COR PERMITTEE RECT AND POSTED ADDRESS FINAL % JOHN F. LEWIS, P4-U ST R URAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION cK. N.O. CASH LAL�4 9 5 9-� SEP28 1 D 4.,00- v TEMPLE CITY TfiA63.A CE.fI"DD3162 APPLICATION FOR BUILDING PERMIT � •, �; COUNTY OF LOS ANGELES BUILDING l DEPARTMENT OF COUNTY ENGINEER ADDRESS (� BUILDING AND SAFETY DIVISION LOCALIT JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. DIST ' T PRO S BY FOR APPLICANT TO FILL IN Iryp/ INC CT"PEPE BUILDING STATISTICAL CLAS IFICATION ER PO PG J, ADDRESS. S/ Q �- CLASS. NO. / DWELL. U,NIITS—I B�_7 LOT NO. BLOCK WATER NOT REQUIRED, TiC RECEIVED V CERTIFICATE: 'LI TRACT f- ' MAP HWAY NO.OF B D S. NO. l.' ICIRCLEI STATE MAJOR RECON LOCAL SIZE OF LOT NOW ON LOT USE Z NEI SPECIAL USE OF CONDITIONS " 61 EXISTING BLD iqllej, L. O OWNER S NO. e DING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS FRONT /( ARCHITECT O L. P. L 2 .Ii4ZL� V ENGINEER NO. SIDE P. L. ADDRESS 1 r;T u CONTRACTOR O. Z ` OC ADDRESS Q DESC TION OF W RK W d N NEW ADD ALTER REPAIR DEMOLISH Z SO. FT: (�I NO. OF NO. OF SIZE �j STORIES FAMILIES USE OF ' STRUCTURE14c:Ay II SIGNATURE OF APPLICA VALUATION $ ;� V APPROVALS DA/TE/ INSPECTOR'S SIGNATURE P.C. //�� PMT. FO FORMS;MATERCALSON G/✓U/ (��GSH/J�� FEE $`/ / FEE $ _ FRAME: FIRE STOPS. HEREBY ACKNOWLEDGE THAT HAVE READ GRE APPLICATION BRACING. BOLTS ANO STATE THAT THE ORDINANCES IS.CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. WITH ALL COUNTY OROINAN CER ANO STATE LAWS N REGULATING GAS VENT, DUCTS BUILDNG CONSTRUCTION. CERTIFY THAT IN DOING THE WORK -TION THE MLAB R WILL NOT EMPLOY ANY PERSON IN VIOLA= LATH, INT. - ING OF THE LPBOR COPE OF THE STATE NC CALIFORNIA RELAL ING TO RK MEN'S COMPENSATION IN PNCE. � - LATH. EXT. JJ SIGNATURE OF HOUSE NUMBER RECT AND POSTED COR- PER yr ✓LL. ADDRESS FINAL G �� ✓'l/I'/� JOHN F. LEWIS. P IN =IPAL STR rTt�TURAL ENGINEER PLAN CHECK VALIDATION CK. M.D. CASH PERMIT VALIDATION EK. ) M.P. CASH LACo 4 9 6 O� SEP 2 8 2 3 D 5.75 ,5 3 0-6—� OCT 9 1 D. 1 1 .5C r TEMPLE CITY, . )..O..I,t ,-.I APPLICATION FOR BUILDING PERMIT - COUNTY OF LOS ANGELES 91"RE'G DEPARTMENT OF COUNTY ENGINEER DOREss S BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. PR FOR APPLICANT TO FILL IN DlsyBiLTA o P CONST! Bc s BUILDING STATISTICAL CLASSIFICATION l SEWER MAP ADDRESS jBI 1P�l CLASS. NO. DWELL.UNITS .Jl� _ LOT NO. .. BLOCK - WATER NOT REQUIRED ® RECEIVED _ TRACT d 14 CIj C CERTIFICATE: J M0. HIGHWAY STATE MAJORISECON . LOCA NO.O B D s. �^ NQ (CIRCLE) SIZE OF LOT I NOW ON LOT Us- ZONE SPECIAL _ USE OF CONDITIONS EXISTING BLD 4_46 If �h EL. OWNER S (� 10. BUILDING EXIST. s ETBACK YARD HWY STREET NAME WIDTH' ADDRESS FRONT ARCHITEC O TEL. - P. L. ENGINEER AiiNO. - SIDE ADDRESS d e N CONTRALTOE INSPECTION RECORD O ADDRESS f 0 DESCkIPTION OF WOKS v W d N NEW ADD . ALTER REPAIR tDEMOLISH Z Q.FT. NO.OF - NO.OF SIZE O"'a STORIES FAMILIES USE OF I STRUCTUR SIGNATURE OF APPLICANT VALUATION S APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE S FORMS.MATERIALS FRAME: FIRE STOPS. I HEREBY ACKNOWLEDGE THAT I 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- TION THE LABOB COBE OF THE STATE OF CALIF ,IA RELAT- LATH, INT. INC ORKMEN'S COMPENS I , RANO . Pl LATH,EXT. TUB PERMOUSE NUMBER COR- AI TTE E OF HRECT AND POSTED ADORES FINAL CLYDE N. DI RLAM PRINCIPAL ST RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. GBH PERM VALIDATION CK. M.O. CASH j_jJC05 3 0 7—� OCT 9 1 D 4.00~ l APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES ADI02ESS 91'51 Broadway DEPARTMENT OF COUNTY ENGINEER CITY Temnle Cityzip 91780 BUILDING AND SAFETY DIVISION NO.OF BLDGS. BUILDING SIZE OF LOT, NOW ON LOT ADDRESS TRACT , -"15 BLOCK LOT NO. LOCALITY .`"-+ TEL. NEAREST OWNER qt,`j' ` e Catholic CROSS ST. ASSESSOR ADDRESS � + O MAP BOOK PAGE PARCEL -CITY Temple City ZIP 91780 DISTRICT GROUP TYPE FIRE EA-47SSED `� U CON ZONE ' ARCHITECT OR TEL. " V �- ENGINEER NO. STATISTICAL CLASSIF--I�TCLA��TION�— SEWER MA ADDRESS _ CLASS NO.�DWELL.UNITS BK PG CONTRACTORTEL. ambra RoofingN0.282-1 58 USE ZONE NMOAP ADDRESS 72 S. Marengo N& 1SPECIAL LIC. CONDITIONS CITY Alhambra Calif. CLASS CONSTRUCTION LENDER ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ NAME AND BRANCH BLDG.SETBACK FROM FRONT PROP.LINE OF ISTREETI ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ.FT. NO.OF NO.OF CHECK HIGHWAY YARD = PAL SETBACK (INE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE _ y DESCRIPTION OF WORK Re—roof W/ 30,F; BS NEW ❑ p & + S @. • ADD ❑ BLDG.SETBACK FROM z SIDE PROP.LINEOF (STREET] O ALTER ❑ TOTAL SETBACK FROM PE OF EXISTING w HIGHWAY + YARD = SIDE PROP,LINE HI WAV WIDTH N USE OF REPAIR Z EXISTING BLDG. DEMOL ❑ + .APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑ (PRINT) NO. IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE( IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION$ 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM. PENSATION INSURANCE. Frank Foulk SIGNATURE OF PERMITTEE ADDRESS ��y, _ a� CITY Alnambra, Calif• No. 282-1958 DATE go Ave FINAI ' -3 /-7 - BY q,, > MAKE CHECKS PAYABLE TO: F E $ FEE T �1 J HARVEY T.BRANDY.COUNTY ENG(NEER E dr (?0 PLAN CHECK VALIDATION CH. M.O. CASH PERMIT VALIDATION M.o. CASH S�iM 22 6 0:0 0 ,&u- (Ps aua(Ps 26A638ACE4805T71 '1 y r 76A638A CEA8035-65 APPLICATION- FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING t7//-/. /f20� DEPARTMENT OF COUNTY ENGINEER ADDRESS 7411 <7 4!5:: BUILDING AND SAFETY DIVISION LOCALITY I E G. JOHN A. LAMBIE. COUNTY ENGINEER NEAREST /me�qq COLEMAN W. JENKINS.SUP'T of BUILDING CROSSST CGDC/LAT L DISTRICT NO. GROU TYPEPROCESSED BY FOR APPLICANT TO FILL IN - S D 8 CONST BUILDINGSTATISTICAL CLASSIFICATION SEWER MAP' ADDRESS J/25-1 .(3ppQCjW{( CLASS NO. DWELL UNIT$ SKR PG/-'7'7-- LOT N� BLOCK USE ZONE, MAP �/J /� A NO. /r TRACT /�S�®d/ _ SPECIAL N0. OF BLDGS. CONDITIONS SIZE OF LOT NGW ON LOT USE OF EXISTING B / - BLDG. SETBACK FROMjJ OWNER �j( L� FRONT PROP. LINE OF /� V'-_ - (STREET) CC��!/ TTPE 01 E%15TING SETBACK HIGHWAY } YAR - TOTAL ADDRESS •` •T� � HIGHWAY WIDTH Fp OM C.L. CITY / C 6i 1�57 } 2.!/ - - BLDG. SETBACK FROM ENGINEER NO. _ ARCHITECT OR TEL. SIDE PROP. LINE OF (STREET] TYPE OF I E%(STING SETBACK HIGHWAY } YARD = TOTAL' ADDRESS _ HIGHWAY WIDTH FROM C.L. CONTRACTOR Ownek NOL } LIC CORNER CUTOFF YES NOIm O ADDRESS NO clTr LIC `SEE REVERSE SIDE FOR SPECIAL APPROVALS G DESCRIPTION OF WORK w a NEW I"' ADD ALTER REPAIR DEMOLISH - y Z SOFT. NORNO OF SIZE SO STORIES � FAM(LI F_S ' USE OF STRUCTURE G SIGNATURE OF APPLICANT p VALUATION$ a Qom) F APPROVALS -W FEE (NSPEC R'S SIGNATURE P. PMT. FO FORMSMATERIA LSON FS®,i°,I�(.*� � FEE 'j FEES . FR BRACING ESTOPS, HEREBY ACKNOWLEDGEABOVE THAT HAVE REPO THIS APPLICATION BRACING BOLT ' AND STATE THAT THE ABOVE IE CORRECT ANO AGREE E COMPLY FURNACE: LOCATION WITH NG CONSTRUCTION TI ORDINANCES CER ANO STATE LAWS REGULATING GAS VENT. DUCTS AUTHORIZED D HEREBY I WILL CERTIFY THATYANY DOING THE WORN RUTHO F THE HEREBY WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH. INT. TION OF THE EN S COO[ OF THE STATEINSURANCE. C CALIFORNIA RELAT. ING TO WORHMEN'S COMPENSATION INSU,R�FNCE. LATH. EXT. /J—GG / T��—• SIGNATURE OF /% Z //�J� HOUSE NUMBER COR- PERMITTEE / L !/ T RECT AND POSTED / 7 ADDRESS -� FINAL JOHN F. LEWIS, P, INCIPAL STRUCTURAL ENG ' R PLAN CHECK VALIDATION CK. M.D. GASH PERMIT VALIDATION CK. NO cpsH Lp.1•o 4385; fluor2.6 lo 1 1 .5 I - COUNTY OF LOS,ANGELES BUILDING AND-SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDINCIADDHESS hereby affirm that I have a certificate of consent to self insure, BUILDIN RISS c or a certificate of Workers' Compensation Insurance,or a certified - L W R , copy thereof ISec. 3800,Lab.0,) IT rr '_ ZIP �p . � L.�. C � 6// 7�(7 'LOCALITY �, Policy No. Company - IZE OF LOT F BLDGS.NOW ON LOT j ❑ Certified c0'by i5 hereby furnished. - NEAREST CROSS ST' ❑ Certified copy is filed with the county building inspection TRACT - -BLOCK LOT N0. f department. USE ZONE MAP Na 1 Date Applicant ASSESSOR MAP BOOK PAGE - PARCEL - " SPECIAL CONDITIONS , CERTIFICATE ER COMPENSATIONINSURA CE ON FROM WORKERS' v / TEL�O*\��—�I _vEs No f ` d-O v7 WITHIN 1000 FT OF SCHOOL? (This section need not be completed if the permit is for orie hundred RES `� dollars($100)Or less.) QQ� yam/ DISTRICT GROUP PEO F ONE PROCESSED BY certify that in the performance.of the work for which this permit �M ZP O D n `� ys' is issued,,I shall not employ any person in any manner so as to 911 OY C- beCome Subject to the Workers'Compensation LBWS. ARCHITECT OR ENGINEER TEL NO. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS - CLASS NO. DWELL UNITS ' NOTICE TO APPLICANT.' It, after making this Certificate Of REQUIREDTOTAL SETBACK FROM EXIST Exemption, you Should become subject t0 the Workers' CONTRACTOR - TEL NO. SET BACK YARD III PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with.such provisions or this permit shall be deemed revoked. gDDREss DC'NO. P L LICENSED CONTRACTORS DECLARATIONSIDE CRY UC.CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 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 force and effect.. NEW ❑ BK PG d LicenseNumber. Lic.Class DESCRIPTION OF WORK - ADD ❑ VALUATION D Q Contractor' Date QQ C No ALTER ❑ $ �' It Cl I am exempt under Sec. 3 SJA REPAIR' ❑ $ BSP.C.for this reason DEMOL ❑ LDMA P/C x - W Date: use of EXISTING BLOC. URM ❑ Signature APPLICANT(PRINT) TEL.NO. LDMA Perm n - Z ❑ 1, as owner of the property, or my employees with wages as Z HLd.T.i their sole compensation, will do the Work and the structure is ADDRESS - O r r C not intended or offered for sale (Section 7044, Business and FINAL DATE C 3307 00.4_1_ Professions Code.) BUILDING WILL THE AP%JCONT OR G A HA ARDOUS MATERIAL UAL T A R GREATER MATERIAL J { ITEM":CM`, �y OR A'MIXTURE CONTAINING A HAZARDOUS MFTERIAL EQUAL TO OR GREATER THAN THE 1 2 C W I, a5 owner Of the property, am thexclusively project contracting 44, -• AMOUNTS SPECIFIED ON THE HPZARCOUS MATERIALS INFORMATION GUIDE'. FINAL BY censed contractors to construct the project (section 70aa, es❑ NO❑ TIJTAL &S m 4 Business and Professions Code.) WALL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING H�``.I/T ;6.45 OCCUPANT REDUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST GUIDELINES QUALITY MANAGEMENT DISTRICT ISCAOMDI SEE PERMITTING CHECKUST FOR CHANGE GCI I hereby affirm that there is a construction lending agency for YES❑ NO❑' t L the performance Of the Work for whichthispermit IS Issued(Sec. )HAVEREAOTHEHAZARWU$MATERIALSINFORMATIONGUIDE AND THE SCAOMD PERMITTING m 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE." 1,(T i jp TITLE 2.CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20140 CONCERNING HAZARDOUS I IJOOQ-OUO1 4/2 i/ Tut Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. „ _ Lender's Address - 93 12 1 .Art 4.4b o wmeA aB iIGExT 0 1 certify that t have reed this application and state untler penalty o POFEE PERMIT FEE o!perjury that the above information is correct. agree to comply D, V N with all county ordinances and State laws relating to building m construction, and hereby authorize representatives of this County ISSUANCE FEE to up the abo e-mentioned property for inspection purposes. m INVESTIGATION FEE TOTAL FEE row Nm� � sa /F/AI �n/�� SeV)SfL'i SEE REVERSE FOR EXPLANATORY LANGUAGE APPUCAMON FOR BULL O PE'RNT it COUNTY OF LOS ANGELES . BUILDING'AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN - BUILDIV A KESS ADESS ' SSI hereby affirm that BUILDING have a certificate of consent to self insure, S1DR& or a Certificate of Workers' Compensation Insurance,or a Certified ' copy thereof(Sea 3800,Lab.C.) CITY ZIP ��}Z-93 • LNb t 6 O ocqury 'Policy No Company SIZE OF LCT NO.OF BLDGS.NOW ON LOT ❑ Certified Copy is hereby furnished. NEAREST CROSS ST. 4S Certified copy is filed with the co y wilding inspection TRACT BLOCK LOT NO. ' dep tme USE ZONE MAP NO. f Date Applicant ASSESSOR MAP BOOK PAGE PgRCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORK ERS' °WNER 1 TEL NO. COMPENSATION INSURANCE K WITHIN 1000 FT.OF SCHOOL? VES No ADDRESS (This section need not be completed it the permit is for one hundred 7DISTRICT7GjROUP TVPE CONST. FIRE ZONE PROCF$SED By dollars (5100)or less.) . ,Icertify that h the performance of the work for which this permitisissued, I Shall not employ any person in any manner so a5 to . . .. �IDMV ORI• become ubje t to the Workers' ensation Laws. ARCHITECT OR ENGINEER F. TEL NO. DateF5 STATISTICAL CLASSIFICATION APT CONDb Applicant ADDRESS CLASS N0. DWELL UNITS A g NOTICE TO APPLICANT. If, atter making this Certificate Of REQUIRED TOTAL SETENIf.FROM' EXIST: Exemption, you should became subject to the Workers' CONTRACTOR T NO. y- SETBACK yggp ryyyy PROP{NJE': WIDTH_ Compensation provisions of the Labor Code, you must forthwith L G. 8.J 1 1 ILI 1 FRONT .comply with such provisions or this permit shall be deemed revoked. ADDRESS LID.N0. P L "' 1. _T T NC' LICENSED CONTRACTORS DECLARATION G{T S^L�c! /.�QWM4 SIDE v , ._s .16 5 �' y�a.4./ LTA A- LG^LAS PL hereby affirm that am licensed underprovisidns of Chapter 9 T 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 force and effect. NEW ❑ BK RG f:HANi.-2E ,1�Ilp License Numb Lic.Class C- 10 DESCRIPTION OF WORK ADD ❑ VALUATION L) EJ Contractor j)j Date ALTER lyr $ 0O0 I nr�I unn 1173I --m ❑ I am exempt under Sec. I REPAIR ❑ $ Ali 14:Ir ' ,U B.BP.C. for this reason DEMOL ❑ LDMA PIC x - - LU Date: USE OF EXISTING BCL LDG L. URM ❑ _' CL Signature APPLICANT-(PRINT) T NO LDMA Perm x - Z —s 1KCR, z4 I z C a ❑ I, as owner of the.property. or my employees with wages as (y ._ •their sole compensation, will do the-vmrk and the structure is ADDRES - O Fiat intended or Offered for sale (Section 7044, Business and ( \/M 6L4FHDPtZ FINAL i - Q il_.`• i+_5,=i Professions Code.) v X7.7 O f,i.�.Er_- • OR THE URE CON OR G A HA BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL l�4 ❑ I, as Owner Of the property, am exclusively contracting with CA A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Q AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDER FINAL Y _ licensed contractors to construct the protect (Section 7044, YES ElNOI ' TOTAL � 1879J m 2 1 Business and Professions Code.) • WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING I.HECK t OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICAipN FROM THE SOUTH ' 1[."I% CONSTRUCTION LENDING AGENCY COAST AIR DUALITY MANAGEMENT DISTRICT ISLAOMDI SEE PERMITTING CHECKLIST FOR - -- -...,. y a, GUIDELINES -!;11it'fl�� - ,i/11 I hereby affirm that there is a construction lending agency for YES El NO the performance of the work for which this permit is issued(Sec. +E: (HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING n 3097,CIV.C.) _ CHECKLI T 1 INDERSTAND My REONREMENTS UNDER THE LOS ANGELES COUNTY CODE. 1901111-000 i i'1 l'T'19-7 7 TnLE II TEq 220 M" TW iNPWGH 220.1<O CONCERNING HAZARDOUS l 12 n Lender's Name M %PORTING AND OR OBTAINING A PERMIT FROM THE SCAOMp -.... ... o Lender's Address +ALL I 1 irf '•I p AEl MAG o I certify that I have read this application and state under penalty o of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE ' with all county ordinances and State laws relating to building m construe hereby authorize representatives of this County ISSUANCE FEE to ente he above- Flared property for inspetion p rposes. 'z Q a ro INVESTIGATION FEE TOTAL FEE ,x�•�S L. SEE REVERSE FOR EXPLANATORY LANGUAGE r:tha COMPENSATION DECLARATION ,r .. � I F: that I have a certificate of consent to self A\ inside, ono certificate of Workers'Compensation Insurance, (rV P P M CA1r MpRU U S O V G PERM lJsl or a certified copy thereof Sec 3800, Lab. C.) WCj4S70�q COUNTY OF LOS ANGELES BUILDING AND SAFETY. Policy No. Company HISSIDN ' (NJ O• Certified copy is hereby'furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS - r9 G71 Certified copy is filed with the county building inspec- BUILDING �I-C f� A tion department. �j T p ADDRESS q4— S c— I r � O -D WA LOCALITY Date A-2`q_�Applicont A Cho_ CITY TEM PL-E C-L ZIP r� r� NEAREST 9 I / 8 d CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR ' COMPENSATION INSURANCE . SIZE OF LOT 330 X.r{- NOW ON LOT MAP BOOK PAGE PARCEL This section need not be completed if the Permit is for one P/L'2 2 USE ZONE MAP O hundred dollars ($100)or less.) P TRACT -s20�- BLOCK ' t T LOT NO. �O __)i NO. �.� - OWNER ROMAN CATHDL- L•Q 'NO,S qy DIOL �7/%t-CC CONDITION$ 1 I certify that in the performance of the work for which this L 00 '-LI DISTRICT .GROUP TYPE FIRE PR SSED BV O permit is issued, I shall not employ any person in any manner ADDRESS 5 3 W s N IN 1 5 - - ( •� T CONST. ZONE T U so as to become subject to the Workers'Compensation Laws. I y,�� G /J `,' o' /f j / ? _ yy�/ • CITY L'o / �I„G�C..J ZIP -/ O0 a •1 V •J �-^-• K Date Applicant _ STATISTICAL CLASSIFICATION APT. CONDO. O NOTICE TO APPLICANT: If, after making.this Certificate of ARCHITECT OR p� TEL ,( / -Exemption IT you should become subject to the Workers' ENGINEER / TF-�� 5 NO."rS "�-IbS CLASS NO. �"Z '� DWELL. UNITS_ - W IL Compensation provisions of the Labor Code,'you must forth- ADDRESS 13 13 -b.W' ElGff I l! ST CSA. SEWER MAP N with comply with such provisions or this permit shall be rL1/I p . ' ? deemed revoked. CONTRACTOR /VI IT, T CEL 'N' NOLL�- 3-4061 BK. D PG,�-�'Z' - VALIDATION - LICENSED CONTRACTORS DECLARATION q uC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 3 004 1/9?"066 fU NO.. 413 41 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 /Ovo CJC L=s CLASS ' 1 $ SSV D y 13 �{ 1 (1 / SO. Fi.( �{ NO. OF - 1 NO.OF S CHECK - License Number'•t' "i' Lic Class B It S12E �'C STORIES 1 FAMILIES ONE Contractor A•T PZMZLCf� Date^2��8 T DESCRIPTION OF WORK D 1&-6 4 NEW ❑ � ,$ - I am exempt under Sea HOOK ❑ FINAL / B.BP.C. for this reason REPAIR ❑ DATE Date: USE OF EXISTING BLDG. DEMOL ❑ BNA - Signature APPLICANTfi TEL. Y _ OWNER-BUILDER DECLARATION PRINT _SASS NO ¢83^216S I hereby affirm that I am exempt from the Contractor's Licenseq 7 76 5 3 9 9, 0 A - Low for the following reason (Section 7031.5, Business and ADDRESS (31 (JI d'�l`T L-A r OQ� Professions Code): PRESENT BUILDING ❑ I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and O j the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING 1EL. ,',S ,'I Li �l CEJ arc I, as owner of the property, am exclusively contracting CONTRACTOR NO. .L. O with licensed contractors to construct the project (Sec-tion-7044, Business and Professions Code). _ REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWV PROP. LINE WIDTH r I hereby affirm that there is a construction lending agency for FRONT D - the performance of the work for which this permit is issued P.L. (Sea. 3097, Civ. C.). SIDE FD P.L. Lender's Name - 8 �/ P.C. Fee E Permit Fee ' Lender's Address - I certify that I have read this application and state that the Issuance Fee - S—) - above information is correct. I agree to comply with all County Investigation Fee y/ 1 - ordinances and State lows relating to building construction, - - 3 D and hereby authorize representatives of this County to enter total Fee i .. U(Ip,Ion.the/^Iabove-me ntioned pr erty for/in^spe�cttiio�n purposes. d W: Y �(/t'�� l -�� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicani or.Agent Date .®s N _ WORKERS' COMPENSATION DECLARATION �y i p /rte FOR BUILDING p q y Epi y F�. �o Ln Etereby affirm that I hove o <erhfimte of consent to self a YPLI PATI AN F[ 6R X68 BIL! SIiN rr. PLKMI I �jp} N iitass, or a certfficote o1 Workent Compensation Insufonce, A■ f fir/ V��•!!! ! V Y'�/r i!� YYY��-Vr a o cenii�ied copy Ihereof (Sec. 3BOD, Lab. C j COU14TY•OF LOS ANGELES BUILDING AND SAFETY �PoViry Nmpony �(✓NL.L��/t BUItDLNG �- ❑rT�++II Ce;l ieri copy is hereby furnishea. FOR APPLICANT TO FILL IN ADpRESS ��,">'� ' C.1 Certified copy is filed with the county building impec- BUILDING tion department. ADDRESS 57 -9'0"a1=ewA ✓ f Date 7S` Applicant , CITY ZIP LOCAL!" ND. OF BLD. fill NE.4RESi j CERTIFICATE OF EXEMPTIO FROM WORKERS' SIZE OF cOT NOW ON L01 CsP355 Si. v COMPENSATION INSURANCE _ (This section need not be completed if the permit is for one TRACT BLOCK LOT No. MAP BOOK % PAGE 1t PARCEL hundred dollars'X51001 or Less.) - _ TEL. OWNERpt+, USE ZONE IMAP. I certify that in the performance of the work for which Phis 59ECIAl r permit is issued, 1 shall not employ arty person in any manner ADDRESS bye COt1DlTIONS `Z C1 so as to become subject to the Workers'Compensation Lows. .� U Z CI." /G'i 1<%L E. tri ZIP w `. Dore Applicant ARCHRECI :-Lime DISTRICT GROUP 'SPE FIRE PROCESSED BY y s NOTICE TO APPLICANT: If, aper making this Certificate of FNGINffR f%LCiyi �j � NO -C(i�3 cow. ZOFF / I— Ecemptldn, you should become subject to he Workers' /�� .1 �j ;'�f;f j U ADDRESS-1-1Z-1 4/(yGc./l Aril 'K✓i0H� -CG Compensation provisions of 'he LaVior Code, you must forth- J' with comply with such provisions of this permit shall be 71 �/ j TD. SAT:STICAI CLASS.&ICATION - APT. CONDO. a deemed -evoked. CCNTR40OR!/L.1/1"C'.f.<-r- 40. r�+11--t; Lsl LICENSED CONTRACTORS DECLARA71ON `` y. UC. CLASS ND. ' - D'W'ELL. _lN1 r5_ Z - ADDRESS a,J.71 /r LyVAiy � A✓c NO. 7 U t hereby oif;rm that I am licensed urdw provisions of Chopter 9 SEWER MAP (commencingwith Section 7000' of Division 3 of the Business i,. L.C. E 1 CITv L-JJ ptJC+C(1'i ;:11 _7i 7-:y CLASS Fj-/ VALIDATION and Prefessions.Code.and my license is io fu;]force ora effect. BK. PG. 3 3 SC Fi; NO.OF / ;=,IF U'IECTC License NLTrsber �JL�J Lit. class�—� SIS r7 STORIES LIB ONE - 0 .I VKWATTON CLmhoctor l�,UlAlf'rirre Date S' i3 DESCRIxT'ON OF WORK e#_eZdw A[7�*7-1 no f 7i i.Y7Q , p ❑I am exempt under Sec. AJER ti B.BP.C. for this reason - REPAIR ❑ $ C Dote: IXIUSES'RFfG BLDG.. lft /J TEL,%r�_ FINAL M NER-BUILDER DECLARATION ,pRIN11 ,1 L NO. DATE _ - I hereby affirm that I am exempt from the Contractor's License ADDRESS �� ` . _ j .�, FINAL Law for The following reason (Section 7031.5, Business and 'i1 �� Cu Professions Code): ' ESEM BY - A .r T, as ownBVI LONG er of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is nor intended 7 offered for sole(Section LOCAITTY ❑ 7D44, Busineand Professions Code.) MOVING 1FL. SPECIAL ss ' m owner of the property,om exclusively contracting CONTRACTOR NO. INFORMATION ,with licensed conhoctors to construct the project(Sec- ADD;_SS ON REVERSE. - Fon 7044, Business and Professions Code.) JIBED 'OTAL SETBACKFROM EXIST $IAC CONSTRUCTION LENDING AGENCY SET BACK !ARD HWY PROP. LINE WIDTH =.rserebv affirm that there is a corshaction lending agency far FRONT he performance of the work for which this Permit is issued P. - n (Sec. 3097, Civ. C.). SIDE Lenders Nome _ LDMA Ref. N n P.0 Fee 1, O Penni-Fee ► Leaders Address > I certify.that I have read this application and store that the Isivance Fee '.DNA $ above information is correct. l agree to comply with all County Inve .gal,.- Fee ¢Q y hE >rditonoen and Stole laws relating to building construction, :oral Fee J C} LOMA Perm.R S c and isereby aWhori represemotives of this County 1 8 upon tesrif6y�e- toned property for impecrio pun oses.. < I s /�.� '`�' SEE REVERSE POR EX%ANATORY LANGUAGE e`Sgnw.mbf Apphorm,.o•Agem -mea •rte.... APPLICATION FOR BUILDING PERMIT_ COUNTY OF-LOS-ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDI ADDRys/ESS - I hereby affirm that (have a certificate of consent to self insure, G D ESS - �. or a certificate of Workers' Compensation Insurance,ora certified copy'tlieieof(Sec.3800,Lab.C:)- ClT ZII Y Policy'No. Company LOCALIT , SIZEOF LOT ., NO.OF BLDGS.NOW ON LOT. _ ❑ Certified copy is hereby furnished... t - NEAREST CROSS ST ❑ Certified copy is filed with the county building inspection TRACT -BLOCK LOT NO. G LOVE✓ department. USE ZONE MAP NO Date Applicant - '' ASSESSOR MAP BOOK J.PAGE PARCEL ' - SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' TEL No-' '— COMPENSATION INSURANCE - V e.5 �' WITHIN 1000 FC OF SCHOOL? YES _ NO ..(This section need not be completed it the permit is for one hundred ADDRESS _ DISTRICT GROUP SVP C NET FIRE ZONE PROCESSED BY dollars ($100)ohless.) - - .in the , is issued, I shall not employ any.person in any manner so as to ARCHITECT OR ENGINEER TEL NO. become Subject to the Workers.Compensation Laws. STATISTICAL CLAJ$SIFICATION - APT- CONDO ^Date'' Applicant ADDRESS CLASS NO., DWELL UNITS - NOTICE TO APPLIC'ANT.' If, after making this Certificate Of REQUIRED' TOTAL SETBACK FROM EXIST Exemption, .you Should become Subject to. the Workers' CO@TRACTM L_ •7 TEL N0. .- - SET BACK YARD MY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith //��L// /V'•1f". T FRONT comply with such provisions or this,permit shall be deemed revoked. UC.NO. PL - •LICENSED CONTRACTORS DECLARATION S. SIDE rry LIO CLASS P L < I'hereby affirm that I am licensed underprovislons of Chapter 9xLASEWER MAP } (commencing with Section 7000)of Division 3 o the Business.and. SO.FT.SIZE NO.OF STORES N0.OF,FAMILIES a Piofessions Code,and my license is in full force and effect. - NEW BK PG - o - License Number 3 -'Lic.ClaSS DESC�IJ' 10 OF ADD C3VALUATION ' .Contractor - Date ALTER 11I $ o w ❑ lam exempt under Sec. - - REPAIR "❑ $ - - ti Z B.&P.C.for this reason DEMOL ❑ COMA P/Cpl Date: - ^' USE OF EXISTING BLDG. ._ - -URM - ❑ Signature - APPLICANT T�^ / q''J MMA Perm Y - .' J II? •. ILIO it ❑J•.as owner of the property, or my employees with wages as �r• ' W =70SZ ` - Z - ; Tj_I 'their sole compensation,'will do the'work and the structure is ADD RES ''��rr - -y- - : - O not intended'or Offered for see'(Section 7044, Business and • W �WOo - I ''FINAL DATE a TOT 05 - 30 .Professions Code.) - �/ p 1 i M_k V OR THE U RICANT NI FUTURE BUILDING OCCUPANT HANDLE A R GREATER MATERIAL as owner Of the Property. am exclusive) contract) with OR A'MIXTURE CANiNNING A HAZMGOUS MATERIAL EQUAL TO OR GREATER THAN THE J - I C I 11 I'1 D Pe y, Y ng AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY j '�C licensed contractors to construct the project'(Section 7044, - .Business and Professions Code.)' ' - vss❑ eo CHANGE . . .0F l __ OILL THE INTENDED UGERMI THE BUIOLINR BY THE APPLIC9MODIANT OR FROM THEBUILDINGSOUTH OCCUPANT REQUIRE A PERMIT FOR t DISTRICT CAA OB.MODIEIRMITTN G CHECKLIST SOUTH ' • CONSTRUCTION LENDING AGENCY 'COAST AIR NES, UTY'MANAGEMENi DISTRICT ISLAOMDI SEE PERMITTING CHECKLIST FOR "' - - •T - GUloeurvss - i1(1111-Ti111}�, '_:i,"•_'! I hereby affirm that there is a construction lending agency-for vss❑ N01 "the performance of the work for which this permit is issued(Sec: ep'O. f`4!�,'�.c 0 IHAVE READ THE HAZAR60US MATERIALS INFCRMATONGUIDE AND THESCAOMDPERMITTING -1U.L/ 1 . ' ;1 -•JL 3097,CIV.C.) ELKLICH UNDERSTAND MY REQUIREMENTS UNDER�-3;jY�E LOS ANGELES COUNTY CODE. CHAPTER 2.20 SECTIONS 2. TMRO IK20.110 LONCE 1RFARDOUS _ Lender's Name _ R 5 REPORTING PND FOR OB - NG IT F 9M THE S AD o Lender's Address. I _ - o I certify that I have read this application and state under penalty - of perjury that the above information is correct.I agree to comply P' E - PERMIT FEE $ with all county ordinances and State laws relating to.building COOStNCiIOn, alltl hereby aut ¢ fepreffimatlV¢S Of this'CDpnty - $SUANGE FEE � o enter upon the abov enf property tOr ins Cion purposes. ��,��••• - ' STIGATION FEE TOTAL FEE A - SEE REVERSE FOR EXPLANATORY LANGUAGE . 'APPLICATION-FOR BUILDING PERMIT _... COUNTY OF LOS ANGELES - - BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILLIN BUILDING ADDRESS - BUILDING ADDRESS, - 9 S 1 v _ herebytific to that have a-cerCompensatite on insurancconsent.e, o self:insure,. ,/C 1 0,4 w • _ L or a certificate of Workers' Compensation Insurance,or?'certified T J copy thereof.(Seec.3800,Lab.C) - CITY` ZIP Qp 26�.y �'•. - •. E J L CI r ., 17 d D LOCALITY - 1 Policy No. Company - _ ``.[[ SIZE OF LOT NO.OF BLDGS.NOW ON LOT L�• ❑ Certified copy is.hereby furnis '„ '�`�.S'yT - NEAREST,CROSS SL El •� _ Certified copy is filetl with th o my buildin BLOCK LOT NO. department. �� //J inspection TRACT USE ZONE MAP NO y f ✓Date 0 - 4 TWplicant V A55 SfPBOOK P GES{ - PARCEL // • ,,'�O[S, 7 s / SPECIAL CONDITIONS r . CERTIFICATEOF EXE ION FROM WORKERS', OWNER '- -'- TEL No. - COMPENSATION INSURANCE s L 5 .WITHIN 1000 FT.OF SCHOOL? ves , No - (This section need not.be completed if the permit is for one hundred ADDRESS _ - ' 'I DISTRICT GROUP TYPE CONST."FIRE ZONE PROCESSED BY dollars 1$100)a less.) 4 / /3 RDADW . .. CITY - - IP C//' I certify that in the performance of the work for which this permit - rLP/ ey t 9i d v i5 Issued I shall.not employ any person in any manner,s0 a5 t0 ' ARCHITECT R ENGINEER TEL NO. O' Become sublet[ t0 the Workers Compensation Laws; _ + / ^5 .�• / - - STATISTICAL CLASSIFCATION ri APsT . CONDO 'Date__ Applicant - ADDRESS. 'I CLASS NO. DWELL UNIr1 - '-' "� LL, !I ,tj',r NOTICE 70 APPLIGINT.' If, after making this Certificate of Z1. Let,c/ �- /f'pt • /Z /F eA .REQUIRED - TOTAL SETBACK - F{iOIL LIE ,:EXIST Exemption, you Should become. sublBCt.'.10 the Workers' CONTRACTOR nq��LL-- TEL NO. � SETBACK ,YARD HWV PROP LINEi 1'+- =WIDTH 'Compensation provisions of the Labor Code, you must forthwith �•/�L $ t 7/ Q j FRONT TI_TAi - s c comply with Such provisions Or this permit shall be deemed revoked. ADORES G NO. PL- Y. - LICENSED CONTRACTORS DECLARATION �ZI U�/a df- S 7Y SIDE _ �_n. CITY uC.CLASS PL I hereby affirm that I am licensed underprovisions of Chapter 9Ll A l_ (commencing with Section 7000)of Division 3 of the Business and SO.F .SIZE NO.OF STORIES NO.OF FAMILIES SEWER MAP Professions Code;and my license Is m,full force and effect. NEW ❑ SK PG 6603-01,101 - } DESCRIPTION OF WORK , �_� 1 "7 License Number _Sr+S Sr 19 Lk.Class —� _ ADD ❑ ' VALUATION__ t 03.01 jl: r v 2 y� Q Contractor G��M� �/L•'[)ate _ ALTER ❑ $ •' Q999 1 ' AM •4f � ❑ I am exempt under Sea 0 O _ REPAIR ❑ $ - ,..., ._. 77 - B.APC.for this re on - s ,Z/N,4 DEMOL' ❑ LDMA Pica i U ri�iT w Dfit e: L ' USE OF EXISTING DG. - URM ElIF _+.r.�� D- m 33U? ..,.Signature ,�, EA•�� - APPLICANT(PRINT) TEL N0: LDMA Perm# z ❑ I, as owner of the property, or my employees with wages as _ Z I ITEMS their sole compensation, will•d0-the work and the structure Is. ADDRESS r - �•O TOTAL 75 ® 75 `act intended or offered for sale (Section.7044, Business and I FINAL DATE - Q Professions Code.)• ,. - - — QY O `� e WILL THE APPLICANT OR FUNRE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL w—//.. / - J C:HEL. - f � - ❑ as Owner Of the property, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE. FINAL T Icensed contractors to Construct,the project (Section 7044, - 'C:HANGE .QUI Business and Professions Code.) vles❑ rvo❑ - ` - WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING - - - OCCUPANT REQUIRE A PERMIT FOR CONSTRUCT)ON OR MODIFICATION FROM THE SOWH e- '' CONSTRUCTION LENDING AGENCY COAST AIR DUAUTY MANAGEMENT DISTRICT ISCAOMDI SEE PERMnnrvG CHECKLIST FORI1'� { ;aw;%, GUIDELINES r ' UI313OT-0Ul_I1 - 4/ . 7.� . I hereby affirm that there is a construction lending agency for YES El No El - ~' 9372 :- i AM Til%14 [fie performance of the work far which this permit is issued(Sec. _ m .3097,Cy.C.) I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING- CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. TITLE 2,CHAPTER 220 SECTIONS 220.100 THROUGH 2.20.100 CONCERNING HAZARDOUS f ' Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. - - o Lender's Address p OAFEP Om ADEN! . O I certify that have read this application and state under penalty of per y that the above inf rmatiOn is correct.Cagrea to comply P.C.FEE �T PERMIT FEE / a with II county ordinance and.State laws relating to building /5• C/'• - - m CO ru ti0 and hereby Whorize representatives of this County ISSUANCE FEE - - m to t up he ab va_ entiohed properly.for inspection - i�o�-z �3 INVESTIGATION FEE TOTAL FEE SEE REVERSE FOR EXPLANATORY LANGUAGE - - ... -0.•_ APPLICATION;:FO BUILDING PERMIT • - COUNTY OF LOS ANGELES 1 ! BUILDING'AND SAFETY WORKER'SCOMPENSATION'DECLARATION - FOR.APPDCANT TO..FILL IN BUILDING ADDREC - 1 - BUILDING ADDRESS - �f - `J,'•' JL-!S C�•\vf<<-- �: hereby affirm that I have'a certificate of•consent to self insure,,- y �',r0aAQ A Q q I _ or a•certifica[e of workers' Compensation Insurance;•ora certified � copy thereof (Sec.3800,Lab.C.). . ' l_' r. CIT ' - '\ IP - lyse 'fp .,J0. 1 Gni Policy No., 7 2 , Shn�'V:IA Lvov 1G C { ! ` �Q ` .. 1 7� 1 ComPanY' 1 LOCA.]C `G�1n ' •- SIZE -' - N0.OF BLDGS.NOW ON LOT VCertified copy is hereby furnished.' ! NEAREST CROSS ST. _ ❑ Certified.cap y-Is filed with the county builtling,inspection TRACr BLOCK - 'Loi NO. - ' de,�epa'�rt'm��eent. P �z� - •v 11 . USE ZONE MAP NO ,a• Datey TJX Applicant �C - 'y` 17----. _ ASSESSOR MAP BOOK PAGE PARCEL I \ - F - - - - - - "' • SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS A o NNER `'N - TEL NO. �• �- COMPENSATION INSURANCE,. •�• "Vae? `C Jf WITHIN 1000 FT OF SCHOOL? YES ✓ No: (This section need not be completed if the permit is for one hundred "AD o ESS DISTRICT 'GROUP TYPE CONST. FIRE ZONE PROCESSED By- .($100)or less.) - ; „ VI D I .� . . CITY • .ZIP. - ^.� 77 IV _ _ certify that in the performance of the'woik for which this permit - T� L C1 'S,- L �' is issued, 1 shall not employ any person in any manner so as to RCFJIITECT O NGINEER TEL NO. - become•subject_to the Workers'Compensation Laws. w, ,STATISTICAL CLASSIFICATION', APT CONDO Date '• Applicant - - ADDRESS CLASS NO DY✓ELL UNfTG _ NOTICE TO ,APPLI hould If, after making this' Certificate of,i - - REQUIRED TOTAL SETBACK FROM, EXIST ExemptlOo, you should become subject t0 'Ihe Workers CONTRACTOR TELN SETBACK YgRD HWV 'PROP,LINE WIDTH Compensation provisions of the Labor Code you-must forthwith T�C11 \hG. / FRONT complywi[h such provisions or this permit shall be deemed revoketl:' ADOvRE'SS J �{ LJC.N0.- P L.•' - LICENSED CONTRACTORS DECLARATION' . . f&51 SIDE CITV ^ � LIC.CI,gSS 21 P L ,.. ' I hereby affirm that I am licensed urKlerprovisiOns Of Chapter 9 'n F� C� SEWER MAP - - - (commencing with Section 7000)of Division 3 of the Business and SOFT.SIZE O.OF STORIES - NO.OF FAMILIES - -- - Professions Code,and-my license is in full force and effect, NEW ❑ BK PG - } Class Z' DESCRIPTION OF WORK Number Lic. ADD ❑ VALUATION d Contractor / nw Date IN —7-"j --`O � \ .0.o. �+\��11n ALTER .❑ ElICU .. I am exemppunder Sec. - REPAIR ❑ $ Lcl _.B.BP.C. for this reason � j � DEMOL X �O LDMA P/C X - Date: U`�GZSTING LEE. URM ❑ 't . . .1 HErl" f {� �. Signature - •' ' APPLICANT(PRINT) TEL NO. LDMA Perm M I IZT o ? .�_I�HL ❑ I as`owner,of The:property;br my employees.with wages as �•�• Q'•` IV1L. 2 ^6110 - _.. . Z c • their sole compensation, will do the Work and the Structure is 'ADDREBS, 1 .yL r I. ' O CHECt - r<4 not intended or Offered,for sale (Section 7044, BUSih'eSS and. 341 W• - L V f/LvV '-L-/f' FINAL DATE //jj 1 PfOfeSSlOnerCOde.) _ - WILL THE APPLICANT OR FUTURE BWLOING OGGVPANT HANDLE'A MgZAR000G MATERIAL /.�i'I •HHHVE �)�) ❑ I, as owner of the property, am exclusively COOtraChng Wlttl OR A Nd%TORE CONTAINING A HAZARDOUS MATERIAL EQUAL.TO OR GREATER THAN THE 1 {{ "iQ AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS IN-FORMAPOY GUIDE FINAL Y . licensed contractors to-construct the project (Section 7044, Business and Professions Code.) res'❑ hof , ,[.IL_I_I(1—!1Of'�•.. 1l 1`+!'? ' WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT.OR NTURE BUh➢ING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH { // i M E•0:' CONSTRUCT6N.LENDING AGENCY ^ COAST AIR OUAUTV MANAGEMENT DISTRICT ISCAOMDI SEEUG CHECKLIST FOR 1 - 1i•rJ '3" � I _ r - GUPERMUTING IDELINES ' I _ ✓" "I hereby affirm that there is a construction lending agency for YEs❑. No - the performance of..the work for which this permit is issued(Sec_ .. Of _ I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMDPERMHTING 3097,DiV:Cr) E . CHECKLIST.I UNDERSTAND Mr REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. - - - TIRE 2,CHAPTER 2.20 SECTIONS 2.20 100 THROUGH 2.20.140 CONCERNING HAZARDOUS . .Lender's Name MA APORTNfj1.'M O AING A PERMIT FROM THE SCAOMD. " Lender's Address1•Ef Z r' o I:certify thatA have read this application and state under'penalty of perjury that the above information is Correct.I agree to'Comply 'P.C.FEE - - PERMIT FE r - .N with all county ordinances and State laws relating to building SJ construction, and hereby authorize representatives of.this County ISSUANCE FE I to 2gI upon the above-men Red property for Inspection purposes. - •'i (f n(�1 J( �Ih� g-�a�g3 NVESTIGA ON FEE TOTALFEE• M to Nun, ♦ SEE.REVERSE FOR EXPLANATORY'LANGUAGE APPLICATION FOR BUILDING PERMIT • -' .: COUNTY,OPLOS.ANGELES_ - - - ;. BUILDING AND SAFETY ' -- WORKER'S'COMPENSATION DECLARATION FOR APPLICANT TO FILL W ButLOw ADDRESS . ,I hereby affirm.that I'have a certificate of consent to self,insure,. BUI IN,AD A6TS - 1 •, S� ' 6 o or a certificate of Workers'Compensation Insurance,-or a certified .copy thereof S.c.3 0, an. clT - ZIP " ,POIICY1No. � '� omPany' 5 .•-O'..• LOCALITY ' SIZE_ OF LOT I NO.-OP BLDGS.NOW ON LOT a T❑E,T Certified copy is hereby furnished. NEAREST CROSS ST. _ Ue.u,ertified copy is filed with the co tyding to .•eCtiOn TRACT BLOCK LOT N0.' deopa/rt¢J1e�n�t� - USE ZONE '.MAP NO, Date W " APPlicant ASSESSOR AP_B K�i PAGE' _ _ .. . i .d Cj� I .SPECIAL CONDITIONS• . CERTIFICATE OF EXEMPTION FROM WORKERS' NER A ` 'TEL No. �`- / s, . COMPENSATION INSURANCE 't1Y. WITHIN TooD Rr.of scrfoQL? .VEs NO (This section need not be completed if the permit i5 far one hundred ADDRESS t -DISTRICT GROUP TYPE CONST. FIRE Z I E REGGE, By dollars(S 10 or less. ) - t'Y.. p y CITY A ZIP �t OO I O� '� • ' -iIa T certify that in the performance Of the work for which this permit is Issued, I shall not.employ any pers n in an man so as to " become b`lBc t0 the Workers'Co en5a Laws HREGTOR NGI E TECNO. �J to ; _ Ali STATISTICAL CLASSI ATION• APT.-... CONDO; Date Applicant ` gq[�KESS' - CLASS NO. 141 DWELL UNITS NOTI ETO ICANT.. If, after making this 'Certificate of v 6V Idl✓ REQUIRED. . 70TnL SETBACK F ZxIST Exemption, 'you should''beCOR1e�� subject to the Workers' CONT ACTOR I ( hcL I . T L N T SET BACK .•ygRO ,HWY PRO DT Compensation provisions of She labor Codi:i must forthwith .. u 10 'FRONT- comply with such provisions or this permit shall be deemed revoked. ADDRESS {CPR C LIC.NO. P IL E c.1u LICENSED GID CONTRACTORS DECLARATION ITv uc.cLAs HE - CHANGE -I hereby affirm that I am.licensed underprovisions Of Chapter 9 SEWER MAP (commencing with,Section 7000)of Division of the Business and Sq,FT SIZE NO.OF STORIES NO:OF FAMILIES _ Professions Code,and my license Is In full force and effect. Z NEW 13 PG - i �- 166odli DE RIP ON OF YORK � •VALUA N UI QI�_plJl�l VI r 1JFG_0 ' License Number Lia Class ADD' 'T}/Q� � ® `q Contractor Tl 14AM Date �5. 9� ALTER ❑r: $ ' ✓'-� AN 7<<!I� S l ❑ lam exempt under Sec. _ a REPAIR ❑' e&PC. for this reason - Ob DEMOL ❑ LDMA Pic# '- W Date: USE OF EXISTING BLDG. - - URM ❑ - d (n Signature - - APS Ni( Tl nQ ' -- - TEL NO. LOW Penn# - _ j; Z ❑ I, as owner of the.property or, employees with wages as (/ "W - zO A�''�,T a their sole compensation,-wilbdo the'work and the structure is ADDRESS . .. F k •T net intended Or offered for Sale (Section 7044, Business and Fill DATE - C .+1i Professions Code.) - MILL THE APPLICANT-OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL - J _ ORA NTS SPE IFIED ONI THE HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑ 1; en owner of, the property, am exclusively contracting with G t. L ITtM' AMOUNTS SPECIFIED ON THE HAZARDOUB MATERIALS GUIDE? FINAL B � 1 licensed contractors to construct the project (Section 7044, YES❑ No❑ - - �' - I 1 Business and Professions Code.) �(,HL 303 ® 20 ' WILLTHE INTENDED USE OF THE BUIDLING'BY THE APPLICANT OR FUTURE BUILDING . - OCCUPANT REOUIRE=A PERMIT FOR'CONSTRUCTION OR MODIFICATION FROM THE SOUTH 1 t:HE_�� 7 r41 CONSTRUCTION:LENDING AGENCY COAST AIR OUAIDY MANAGEMENT DISTRICT ISCAOMDI SEE PERMITTING CHECKLIST FOR - JUJ GUIDELINES cHNN(]E II I hereby affirm that there is a construction lending agency for YES❑ NO El * 0- tne'performance of the work for which this permit is,issued(Sec: pp - HAVE READ THE HAZARDOUS MATERIALSINFORMIMONGUIDE AND THE SCACMD PERMITTING _ • ? - N 3097,CIV. C.) 'CHECKLIST I UNDERSTAND MY REOUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, - - TITLE 2.CHAPTER 220 SECTIONS 2.20.100 THROUGH 220.140 CONCERNING HAZARDOUS -0.0 (f�l(Ilhfl(IU 5 �,��r� _ Lender's Name ` MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCACMD.' ll l 1 `o Lender's address - wmeAw wervT - 07`6•' 1 Al1>;, o, - - �. o' I:certify that I have read this application and state under lienalty o. P.C.FEE PERMIT FEE G N of'perlury that the above informaf is correct. agree to comply J ' with all conn Cron nces and tate laws relating to building - - - donsUuctio Pd he o representatives of this County ISSUANCE FEE m I. enter u thea a-m i roperty for inspec tigq [o r - OY INVESTIGATION FEE - TOTAL FEE O J lo: SEE REVERSE FOR EXPLANATORY LANGUAGE - WORKERS' COMPENSATION DECLARATION /�- .,. •I-FMMb• ffirm that I have a certificate of ci■!,sent I, self O IIII �( MM II�} �r�II�L�yTs' II^�,��r�TLL IPnIII IfPpI� IPI �Ip��(l�.�r �p}I��(��Lp�/L�� - iasure, o a certificate of Workers' Compensatilfn•In ce, APPUC��O.UV ,u �uV' VV�LS��11VV �IS UNYVII�� or a certmpy ifierjthereof (Sec:3800, Lob. C.) .,,...�.• �•� / - - COUNTY OF LOS ANGELES t' BUILDING AND SAFETY Policy No 38 Company _ - ❑ Certified copy is hereby furnished...- ter ��-y�` . - �. ' "FOR APPLICANT TO FILL'IN� BUILDIADDRESS NG �'`��. �. • ®. Certified copy is filed with the county building inspec- BUILDINGC1 r_ �nr,� �, /t . . . : - . .. ti partment. ADDRESS 1 1 .�. KIvi.JYYi'► � ,� ,3 - CITV� L.G.. G ZIP �O LOCALITY CSC - D'a ,Applicant• NO. OF BLDGS. - CERTIFICATE OF EXEMPTION R WORKERS' SIZE OF'LO7 NOW ON LOT D - NEAREST - CROSS OR COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT` - BLOCK LOT NO. 'a. MAP BOOK PAGE hundred dollars ($100)or less.) - TEL USE'ZONE - MAP .. E - NO NO. �T 7�aGS I certify that in the performance of the work for which this permit is issued, I'shall not employ any person in any manner ADDRESS - ' / ISPECIAL CONDITIONS d so as to become subject to the Workers'Compensation Laws. 11 �rs� [ 0 CITY {.L� gess, ZIP• r•.PI I Date Applicant ' Oc ARCHITECT OR TEL. DISTRICT .,GROUP TYPE FIRE �Y�YppP��ROCESS-�ED.�BVI� NOTICE TO APPLICANT: If, after.making this Certificate of ENGINEER r>C, NO CONST. ZONE Exemption, you should become subject to the Workers' /��•• � Compensation.provisions of.the Labor Code, you must,forth- ADDREASIO with complywith such provisions or this a p permit shall be E�•� TEL. STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. . - CONTRACTORy NO. - - z LICENSED CONTRACTORS DECLARATION UC �L�y CUSS NO. DWELL. UNITS_ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO'.7 f9/&5)0 - (commencing with Section 7000)of Division 3 of the BusinessSEWER MAP ' , and Professions Code,and my license is in full force and effect. CITU�'�s a CLASS BK PG. VALIDATION �L�J / NO. OF NO. OF� CHECK, License Numberl,236m t Lic. Class SIZEF4-�� STORIES FAMILIES LIC.Q ONE:; -- '� nI �,,,C�BJ/ l0 p� } NEW VA UATIO Contractor ' Date N DESCRIPTION OF WORK fGN1.� .�N� -$ ADD ,❑ _ 1 VW .' ❑I am exempt under Sec. Ar� c'.re� ALTER ❑ - - rn`_'_I .r BAP.C. for this reason W e �L 1 W� REPAIR ❑ s - t USE OF Date: _ _I_! O:Com.•,_:' EXISTING BLDG. DEMOL"❑ �+ 5 n t re - %`- APPLICANT TEL - _ 1 r`'+O OW - ILD R DECLARATION (PRINT)- , _ c _ ..NO _ - FINAL�L— I) _9LI TOTAL t L I hereby affirm that I am exempt from the Contractor's License •rt'"` �.-N v t t .� A,Jf DATE O( 1 Low for the following.reason (Section 7031.5, Business and ADDRESS t 1 T FINAL 1 10/y�Jx. - tHF�_F� 07 -t �- Professions Code): PRESENT By Vri.. ��Z"'- - t, I} BUILDING -; 't �rl:j� ❑• 1,'as owner of the property, or my,employees with ADDRESS /T.3 1� wages as their sole compensation,will do the work and - the structure is,not intended or offered for sale(Section _ LOCA LI7V hG . 7044, Business and Professions Code.) MOVING �.TEL.;.' -• �pi0 7q. CONTRACTOR NO i ❑ I, as owner of the property, am exclusively contracting _ 0'110-00011 1 with licensed'contractors to construct the project (Sec- " . ' _ 11 4 tion 7044, Business and Professions Code.) ADDRESS ! IIS 'c h ` t cr=�� REQUIRED TOTAL SETBACK FROM EXIST. v G,`( ... �C f s_ CONSTRUCTION LENDING AGENCY - SET BACK YARD HWV PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for '.s FRONT, --�.• - �1/7* s the performance of the work for which this permit is issued P.1.4 • tJ .,J, T..rl >t� - -C - �•� S cK c` 1 (Sec. 3097, Civ. C.). \SIDE :)^ r"_` �__< {b,t`arC. ,L,.•;v;J Lender's Name Cit O( _• Fri " ID MA ReC)< . L7, .".rC+ •Jr . Lender's Address P.C. Fee E / �(O Permit Fee 22 /J�y C5 I certify that I have read this application and state that the P/Cle above information is correct. I agree to comply with all County Investigation Fee 7SS5� u'' R ordinances and State laws relating to building construction, '7uml.Gec LDMA Perm. N and hereby ut pQrize representatives of this County to enter 3 upon the v >(nenl tined property forinspection u uses. - - - 3 a ^J V Val SEE REVERSE FOR EXPLANATORY LANGUAGE w of p icont or'Agent - ole WORKERS' COMPENSATION DECLARATION I hereb 'affirm that I have a certificate of consent to self Op'1/��))pn�7p' 'pp 'nip �p�U��y� O app RO �pM�� insure, or a certificate of Workers' Compensation lnsuran �PPL0•C.�T1ON -4- 0R ✓U��MIG PL�L+�MIr oro cerhfiev copyggthereof (Sec. 3800, Lab .) - `COUNTY OF LOS ANGELES... .. _ BUILDING AND SAFETY - Policy No.�3`SJappg7Compony "��"��a "5' • . . _ BUILDING.` / �❑ Certified copy is hereby furnished.. "F.OR'APPLICANT'TO'FILL N ADDRESS s LJ Certified copy is filed with the county building inspec ` BUILDING / _AJ tion department. ADDRESS �'� Gam�///' ' G- - LiTVT Date f0 j"B yApplicant CITY7 ZIP NO. OF BUDGE. - LOCANEARES - 'CERTIFICATE OF EXEMPTI FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS T, - COMPENSATION INSURANCE _ ASSESSOR �G (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. _ MAP BOOK 40565 PAGE PARCEL 6 'hundred dollars ($100)or less.): TEL. USE ZONE MAP , ,/7 OWya�3 • N I certify that in the performance of the work for which this NER NO. �1 ` NO. permit is issued, I shall not employ.any person in any manner ADDRESS /' SPEC AL _ .._ CONDITIONS _ O so as to become subject to the Workers'Compensation Lows. V CITY .O .ZIP - - z l Oc Date - Applicant. ARCHITECT OR TEL .DISTRICT GR P TYPE - _ FIRE PROCESSED BY O NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER C, NO. CONST. ZONE � Exemption, you should become. subject to the Workers'. // - �' ? w Compensation,provisions of the Labor Code, you must forth- ADDRESS '� � &/,,eOpd ezcez) J1 .I J CCn d with comply with such provisions or•this permitshall be 4-/ C ,NO. /3 f s STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. CONTRACTOR LV _X,1 - - - z LICENSED CONTRACTORS.DECLARATIONLIC. - CLASS NO. DWFLc. UNITS - I hereby affirm that I am licensed under provisions,of Chapter ADDRESS d/ NO. 36 (commencing with Section 7000)of,Division 3 of the Business y� LIC. SEWER MAP and Professions Code,and my license is in full force and effect. CITY S CLASS BKrlJ- PG VALIDATION SO. FT. - NO.OF NO.OF 'CHECK License Number Lic. Class SIZE - STORIES FAMILIES ONE - VALUATION. . . Contractor �/4 Dote' 8 DESCRIPTION OF WORK _ O NEW ADD ❑ D ❑I am exempt under Sec ALTER ❑ - - - B.BP.C. for this reason - REPAIR ❑. S Date: - USE OF - EXISTING BLDG. DEMOL ❑ Signature- APPLICANT • „ _ . - TEL - FINAL OWNER-BUILDER DECLARATION '(PRINT)' NO. , DATE I hereby off irm,that I am exempt from the Contractor's License - Low for the following reason (Section 70305, Business'and ADDRESS - FINAL Q �yyfzvyO - .Professions Code): PRESENT _. .. -. By ❑ I, as owner of the property, or my employees with BUILDING wages their sole compensation,will Bothe work and SS - ADORE LOCALITY the structure is not intended or offered for sale(Section a __ ❑ 7044, Business and Professions Code.) MOVING s TEU. 1, as owner of the property; am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- - - - - - . . r1+=. C ' .r.-' -"'z'=--- F—.� tion 7044, Business and Professions Code.) ADDRESS k r -- REOUIRED- TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY .SET BACK YARD HWV PROP. LINE WIDTH ^' 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:-' _ - , (Sea 3097, Civ. C.). - SIDE _RL Lender's Name - - _ - - I'"'-� "';I�f• z If�j1'i LOMA Ref. N 11"` P.C. Fee 5 Permit Fee Lender's Address - ('certify that I have read This application and state that the - Issuance Feet- ?� LOMA P/C W - - - 8 above information is correct. I agree to comply with all County Investigation Fee R ordinances and State laws-relating to building construction, Total Fee e'� 3-� d LOMA Perm. R and hereby authorize re�ppresentatives of this County to enter upon th bov- men'6/fed property For inspection purposes. - i L _ 7 SEE REVERSE FOR EXPLANATORY LANGUAGE ignature&OApplicant of Agent Do e COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS -"I hereby affirm that I have a certificate of consent to self insure, B{pLD N ADDi9S 99eA .J or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) CIfammra—TY1..'_ - / ZIP �� LOCALI PDIICy No.65S73-7-07- 9-1Company� �—�y�0 SIZE OF LOT •�1� NO.OF BLDGS.NOW ON LOT El Certified copy is hereby furnished. (yr4YI -C— fj. �7 NEAREST CRO T JUertlfled copy is filed with the county building inspection TRACT BLOCK LOT NO. '+ department. ///7/ //•J USEZONE MAP NO, Date TiS`9Y Applicant L/L ( ��'1 ASSESSOR MAP BOOK PAGE PARCEL H^AAT01W AD �J_/ SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER RprobA Ci 14 TEL NO. K COMPENSATION INSURANCE r7' WITHIN 1000 FT.OF SCHOOL? vas ruo ADDRESS �,�.,L 1 (This section need not be completed if the permit is for one hundred ('� IN. T V� u DISTRICT GRDUP TYPE CONST.' FIRE ZONE PROCESSED BY dollars($100)Or 189x.) CITYV. .ZIP •• � /V6 2 I certify that in the performance of the work for which this permit NSF5 is Issued, I shall not employ any person in any manner so as t0 ARCHITECT OR ENGINEER TEL NO. &14bt� Y become Subject to the Workers'Compensation Laws. TA JSOSZ STATISTICAL CLASSIFICATION APT CONDO Dale Applicant /ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT.- If, after making this Certificate ofte J "— REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' , TEL.NO. (�fCd SETBACK YARD HWY PROP LINE WIDTH CONTRACTOR Compensation provisions of the Labor Code, you must forthwith L�- FRONT comply with such provisions Orthls permit shall be deemed revoked. ADDRESS LIC.NO. F L LICENSED CONTRACTORS DECLARATION clTv ! - LIC.CLASS SIDE Y .01v,P�+ P L CD I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP cp (commencing with Section 7000)of Division 3 of the Business and SD.FT SIZE NO.OF STORES I NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW BK PG D 2C' U DESCRIPTION OF WORK 'License Number � S� Lid Class 8-1 ADD ❑ VALw GN ContrectorD_AVj�y� 1:5'-- • $ F'�, �r5C tit:C.j _r n' �Q.Date 7 9 2.� ALTER ❑ y ❑ lam exempt under Sec. REPAIR ❑ $ T4,t�, 11 .I Fu 8.8P.C.for this reason DEMOL ❑ Date: - USE OF EXIST GBLDG. .URM ❑ LDMA P/Cp //�t"j'�`;_ Signature Date: (PRINT) TEL.NO. HRIK LOMA Perm M ❑ I, As owner of the,property, or my employees with wages as IY' =O �:ri''!L` their sole Compensation, will do the work and the structure is As D�S ^ not intended or offered for sale (Section 7044, Business and T&� • �Y FINAL DATE// /y G Professions Code.) WILLTHEAPPUCANTOR FUTUREBUILOINGOCOUPANT HANDIEA HAZARDOUS MATERIAL / _/ / -9 / Q {jlhjwi—I j(I(I f OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN ❑ 1, as owner Of the property, am exclusively contracting with THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINALE p /�(�/•�-{��. _ licensed contractors to construct the project(Section 7041, Z11n _ .7(. $ fiu ES 11 NO❑ // Business and Professions Code.) WILL THE INTENDED USE OF THE tUOINS NG BY THE APPLICANT IO fFROM THE OCCUPANT REQUIRE PERMITFONT DISTRICT ORMODIFI PERMITTING FROM THESOUTH CONSTRUCTION LENDING AGENCY FOR GT AIR QUALITY MANAGEMENT DISTRICT ISCAOMDI SEE PERMITTING CHECKLIST r FOR GUIDELINES. ANT. _.y•I y I hereby affirm that there is a construction lending agency for - YES 11 No El - - _ the performance Crv.C.). Of the WOfk for WhlCfl 1h13 permit IS Issued(Sec, I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMp !`-j7 (- �'`•"1 3097.Cw.C.). q PERMITTINGCHECKLISTIANERZMA MY REQUIREMENTS UNDER THE LOS ANGELES • , HAZARDCOU�OUS REPORTING NDFOR SBTAINI GAPER IT FROM SCANINGOMD. j ;y'1- • a Lenders Name HAZARDOUSMATERIALSREP011TINp AND FOR OBTAININGAPERMIT FgOM THESCAOMD. 1 1fi r I Lenders Address A _ _j . d GAT+EA W bLNT TOT ,i L o- I certify that I have read this application and state that the above CHECK R information is correct. I agree to comply With all County P.C.FEE p PERMIT FEE --7^ `. G5- hereby C :1-t•1: v'•'- FZi ordinances and State laws relating to building construction,and G a 7 a/ 14 Yr• 'G 5- ¢. hereby 8 IZe representatives Of this County 10 enter Upon ISSUANCE FEE �? thee ve-m do ed pro rty for inspection purposes. 2 ¢ INVESTIGATION FEE TOTAL FEE ? `7-I 1 •3C7 i�Ij_i ij;—?Jill; . 7./i.�i�i? SEE REVERSE FOR EXPLANATORY LANGUAGE. $4_3 APPUCAMON FOR BULWNG PERNT COUNTY.OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDINGJjDDRE 1.hereby affirm that I have a certificate of consent to self insure, BUILD G ADDCRE /7/7•/A!/ or a certificate of Workers' Compensation Insurance,or a certified 5 R LEJ Coppy('tp/eere0 e .3 ID C. .S ,�#`'�( CITY C'T` ZIP LOCALITY POhc�i Ao� r�1Company �'/L•� '� MYryR V SIZE OF LOT I NO.OF BLDGS.NOW ON LOT ❑ Certified Copy is hereby furnished. - NEAREST CROSS S. Certified Copy is filed with the County bwldif91y)inspection TRACT BLOCK LOT NO, de art ant �/Iy1 1�{r�1 p��/��./�/� USE ZONE MAP NO. _ Oafe�Appllcant `jJ[ L ASSESSOR MAP BOOK PAGE ' PARCEI. SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. ` COMPENSATION INSURANCE 'S r E 12C WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS yr /� dollars($100)or less.) ' S � t V ui/TT DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY CITY ZIP - I certify that h the performance of person in for which this permit e LE �L�s�-.C. is issuetl. Shall not employ any person at any manner SO a5 to 'ARCHITECT OR NGINEER TEL NO. G' become SU61eCt to the Workers'Compensation Laws. Tj\G _ �J STATISTICAL CLASSIFIICq��jp�N. CONDO Date Applicant ADDRESS - CLASS NO —DViE'LL�NIT z NOTICE TO APPLICANT.' It,' after making this Certificate of 1 LU i,V%,QSS(D JZ�7�y REQUIRED TOTAL SE1$ACK_FROM EXIST Exemption, you Should become subject t0 the Workers' CONTRACTOR TEL NO. SET BACK. YARD HWy PRQP --y` WIDTH . Compensation provisions of the Labor Code, you must forthwith U� ^ tel_ 1 q e-'PS- Q FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS IF I LIC.NO. PL 330 .1' LICENSED CONTRACTORS DECLARATION 5 W % O#�/ Zac?745 BIDE 1 ITEIS CIT yT �1t .^•^^ �� UC�L�S\ PL 1 hereby affirm that I am licensed underprovisions of Chapter 9 A pAyi ` SEWER MAP 421 - 13 y y (commencing with Section 7000)Of Division 3 Of the Business and SO.FT.SIZE NO,OF STORIES NO.OF FAMILIES _ TOTAL T2 1 - 1J' Professions Cade,and�n y licen a is in full force and eff c NEW BK PG } �Zv�^1 $I CHECK 421.130 License NuLmbe'r-U. clJ-J-O LiC.CIaS r ` DESCRIPTION OF WORK ADD 0 VALUATION - D Contracto � Piaf,pate 1 1 ALL - 2L' ALTER O $ B'�• vv _ CHANGE O!I U cc ❑ 1 am exempt under Sec. - $ .SIJ I - __ . 3171.E ,O REPAIR ❑� ^^i c7il cc BSP.C.for this reason DEMOL �.... - - ��O I y. K C..) LOMA PIC# 1 _ LIJ Date: USE OF EX TING BLDG - URM ❑ "' V`ro M l' .I T d Signature ome TOTAL 53b .; co APPLICANT(PRINT? TEL NO. r - LDMA'Perm#--"'-"' I _� :� Z El 1, as owner of the property, or my employees with wages as -CU T �1r lS- Z CHECK _ _ _ =1.0.7 their sole compensation, will do the work and the structure is ADDRESS/ 1 O �thl not intended or offered for sale (Section 7044, Business and /-55 1 0 FINAL DATE _ Qu CHANGE - Professions Code.) ' - 9_ 1 , WILL THE U RJCANT IN FUTURE HAZARDOUS OCCUPANT HANDLE q HAZARDOUS MATERIAL I 1 1 J ❑ I, as owner Of the y, y g OR A MIXTURE CONiAIMNG A HAZARDOUS MATEgWL EQUAL TO OR GREATER THAN THE 1' {{ / property,co am exclusively project contracting 44, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATON GUIDE? D FINAL V / I)OOD-I}I)O1 ,�( 91r-3 licensed contractors t0 Construct the project (Section 7044, YES El NQ - Business and Professions Code.) - 9141 1 AM1014^ WILL THE INTENDED USE OF THE BUIDUNGCONSTRUCTION BY THE APPLICANT OR FROM T BUILDING OCCUPANTOSTIR REQUIRE A PERMIT FOR CONSTRUCTION Ofl MODIFICATION FROM THE SOUTH FOR ............... CONSTRUCTION LENDING AGENCY COAST AIR Ququry MANAGEMENT msrgzT tscgon7m SEE PERMITTING cHECI<usr FOR cmoaurves I hereby affirm that there is a construction lending agency for YES❑ NO V1 a the performance of the work for which this permit is issued(Sec. OpIHAVE READ THE HAZARCOUSMATERIALSINFaRMATION GUIDE AND THE SCAOMO PERMITTING ` N 3057,CIV.C.) CHECKLIST.I UNDERSTAND MV REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TITLE 2.CHAPIW 2 20 SECTIO 2a 100 THROUGH 2,20.140 CONCERNING HAZARDOUS Lenders Name MATERIALS "' a. BTAININ ERMIT FROM THE'SCAOMD. 0 Lender's Address Q OWNER OR PGuu o I certify that I have read this application and state under penalty 4 0l perjury that the shove information is CorreCl.Fagree to comply P.G.FEES �I PERMIT FEE Dnty ordinan s M State laws relating to building 1W (' m Coand hereby a rize repesenatives Of this County ISSUANCE FEErto a ov -me Ion t for ins pe do ( ,5.�' RR A INVESTIGATION FEE TOTAL FEE 6pp,un d bplcnl a/gzn, pa,e SEE REVERSE FOR EXPLANATORY LANGUAGE APPUCAMON FOR BULMNG PERNT L COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN 8 DING ADD: l I hereby affirm that I have a certificate of consent to self insure,- BUILDI G ADD ESS _ „p) �i-tAL or a certificate of Workers' Compensation Insurance,or a certified div copy t (Sec.3800,Lab.C.) No0' G�•fes./ Z� ^1LOCA Ty Y /J, Policy No. Company SIZE OF LOT ' l NO.OF BLDGS.NOW ON LOT /meq [],Certified copy is hereby furnished. NEAREST CROSS ST. IF ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department: USE ZONE MAP NO. Date Applicant ASSESSOR MA BOOK PAGE PARCELQ n - ' l6MR.-I e;b 0 O'L1 r / " SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER T G �+ COMPENSATION INSURANCE i I '�17LY, 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 TYPE CONST. FIRE ZONE PROCESSED BY CITY N � 1�� ZIP r .. I certify that h the performance of the work for which this permit ✓f�JL �P •A�TJ �I J _ D O bissued, shall not employ any person at any manner so a5 t0 ARCHITECT OR ENGINEER EL N0. O 2u'GZ'h� become�TO /CC't t0 a WOrkeis' penSafiOn Laws. STATISTICAL CLASS (CATION APT CONDO 14 Date J Applicant ADDRE CLASS NO.. DWELL UNITS I C APPLICANT: II, aft making this. Certificate of Y'' i CJ � REOUIRED- TOTAL SETBACK FROM EXIST Exemption, you should becom subject t0 the Workers' CONRACTOR — TEL No SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. qp g LIQ NO. p L LICENSED CONTRACTORS DECLARATION SIDE CIT LIC.CLASS P L hereby affirm that I am licensed un vision viof the of Chapter 9 S C I SEWER MAP Y (commencing with Section 7000)of Division 3 of the Business and SIFT.SIZE. NO OF STOP"' NO.OF FAMILIES � Professions Code,and my license is in full force and effect. NEW ❑ BK PG U DESCRIPTION OF WORK D, O License Number 7 b 62r1 Lic.Class ADD VALUATION Contractor DPF�! 1-�rc-. I F Date ALTER $ 0iy,L�T H ❑ 1 am exempt under Sec. �p REPAIR ❑ $ z B.BP.C.for this reason (p DEMOL B' DMA P/C# Date: USE OF EXE�rin� DAG. _ URM ❑ Signature - APPLICANT PRINT) - T L 0. LDMA Perm# �= ❑ I•.as Owner of the property, or my employees with wages as •�r Sw .2 1l,, f.T L ADDRESS O Ft="'lea • 'their sole compensation, will do the work and the structure is � ,I not intended or offered for sale (Section 7044, Business and �p FINAL DATE I� Professions Code.) WILL THE APPLIGPNT OR FUTURE BUILDING OCCUPANT HANDLE A HA2AFOCUS MATERIAL /��(� �• 1 ❑ 1, as owner Of the property, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE - licensed contractors t0 construct the AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY Protect (Section 7044, YES❑ NO❑ - I n Business and Professions Code.) +� =T (� WILL THE INTENDED USE OF THE BUGLING BY THE APPLICANT OR FUTURE BUILDING ' OCCUPANT REWIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH '412 CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT ISCAOMDI SEE PERMITTING CHECKUST FOR - 1 GUIDELINE'S .y TS I hereby affirm that there is a construction lending agency for "YES❑ No E3 ' THj the performance Of the work for which this permit is issued(Sec. o UTAL C F m11UVE READ E HAZARDOUBA4IIER10. TH SINFORMATIONGUIDE AND E SCAOMD PERMITTINGK _8 = 29 3097,CIV.C.) - CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. •"f�{..- • _ -- TITLE 2 CHAPTER 220 SECTIONS 230.100 THROUGH 2.20.140 CONCERNING HAZARDOUS CHECK _ - 7 s�`i 2 t Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. e 0Lender's Address ClAh}t7t .=LIU 0 W EPMn ENT o I certify that I have read this application and state under penalty oN PC.FEE PERMIT FEE of perjury that the above information Is correct.I agree to comply PE ! / G/ / _•. with all county ordinances and State laws relating to building ��✓• V �D b 2a I113III m construction, and hereby apthprize representatives of this County ISSUANCE FEE . Q to(((yypggyttt\\\er upon the above- T Fhe ed property for inspewpupos 411/_ �� c�� tAY ,._ INVESTIGATION FEE '� TOTAL FEE ewveT (A SEE REVERSE FOR EXPLANATORY LANGUAGE Lr COUNTY OF LOS ANGELES - TEMPLE CITY 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9711200080 PHONE: (818) 285-0488 EXT: LEGAL ID: NUMBEROF SIGNS: I BUILDTN—G--ADDRESS: ON FILE SIGN DESCRIPTION: MARQUEE SIGN 10' X 5' 9451 BROADWAY TEMP CA 917802455 ASSESSOR INFORMATION UMBER: NEAREST CROSS STREET: 8588-004-018 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: ISSUED N: PROCESSED B EXPIRES ON: EXIST OCC GRP: 11/20/97 UT 11/20/98- OWNER: TEL. O: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: ODE: ROMAN CATHOLIC ARCHBISHOP OF L A - 4,000 t� 1531 9TH ST - (` '0 LOSA 900151112 FEES PAID DESCRIPTION ORK MARQUEE SIGN-FOR ST. LUKE'S CHURCH AND SCHOOL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: A AN SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AE STRONG MOTION OTHER 4000.00 VAL 0.84 SPECIAL CONDITIONS: AX BUILDING REVIEW—FEE 54.70 D2 PERMITW/O EN'HC�. 1 ETOTAOLIOFEES�� 199.39 CONTRACTOR: TEL. N0: P (V•+' L �V APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER .. - LIC. NO LOCATION AND SMACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. 0: O FOUNDA ION/ R FOR PT-TIE LIC. NO: SUPPORT STRUCTURE MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: PUBLIC U e B LI C WOR KSJ NO. OF FAMILIES: DWELLING UNITS: 0 D: CLAW.'. NOOI11 D a9 'Q (� SCHOOL WITHIN AZAR OUS — AIR QUALITY: 1000 FEET MATERIALS '� 0 ,a1 NO NO NO Q �O\ ice REPORT ID: DPR261 ROUTE TO: BS0508