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Home My Public Portal About9525 BROADWAY_Building__ �j•v1 I 7GAGA6ACE#S03I-EZ APPLICATION FOR BUILDING PERMI �U1 COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS J BUILDING AND SAFETY DIVISION LOCALITY 'JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. 1) Tr CITAN GR TYPE P D 8 FOR APPLICANT TO FILL IN U _ CONST ADOREISS p[J! T a STATI SF)CAL CL '"CATION K R MAP y�� p / CLASS NO. DWELL. UNITS �/_3 LOT Np'_ } C OV�A �� E TERRTIFICATENOT REgUIRED RECEIVED C : TRACT MAP HIGHWAr a / NO. OF BLDGS. NQ fc IRCLEI STATE MAJOR SEGO D LOCAL ,SIZE OF LOT 5p' NOW ON LOT USE ZONE SPECIAL USE OF ^ CONDITIONS R EXISTING BLDG. LT/I}r J� TE � I OWNERW /': BU LDING EXIST. : I SETBACK YA HWY STREET NAME WIDTH ADDRESS . FRONT /j r1 ARCHITECT OR TEL. P. L (J IJ ENGINEER NO. SIDE ffes�t ADDRESS (}" iL TEL It,- �A Is, i Li.e U CONTRACTOR• ADDRESS U ILI .. NEW ADD ALTER REPAIR DEMOLISH SONO. OF NO. OF . FT. STORIES / FAMILIES / / �^ r / USE OF ` STRUCTURES ^ F .. SIGNATU O J/ 'lW✓ � -7 - �L�!•�PAL./ APPLICANT VALUATION $ / V V R V APPROVALS //D//AT//E'' INSPECTOR SIG-ATUFE BEPMET.$ / jL) FOFORMSI. MATERIALS /!,/9l l9 /✓. /.5fr id FEE $ w FE FRAME: FIRE STOPS. �I HEREBY ACKNOWLEDGE THAT 1:HAVE READ THIS APPLICATIG�l BRACING. BOLTS FANO 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 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH.-INT. !/R f /�.lrn111A TION OF THE.LABOR CODE OF THE STATE OF CALIFORNIA RELAT- I ING TO WORKMEN'S COMPENSATION INSURANCE. I LATH. EXT. Y Iv l % 111 fY` SIGNATURE OF ��` ,,, HOUSE NUMBERCOR- p PERMITTEE i 'SIR! RECT AND POSTED § -,P-(v SA�,* ADDRESS ,FINAL ,t^1 0- /41�.`� JOHN F. LEWIS, PRINCIPAL STIR E.. RAL ENGINEER PLAN CHECK VALIDATION <K. M.G. , CASH _ PERMIT VALIDATION OR. M.O. CASH J:r o4' 3. 3 4e SEP26 '2 3 D 23.256, n 'L_ 0 5 '7 7 DQ� OCT 19 1 D 4 65 0 v A OMPENSATION'DECLARATION APPLICATION pip•' '•': t I"Sve a certificate of consent to self - �Kl� l't�tl�LIF[ �L TIB ® I! UILDI PERMIT a < T icate a:Wy.kers' Compensation Insuronce, _@""CU G _ vZ+9�'� or Zed copy thereof (Sec 3800, Lob.''C.) ! ,t COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS I, y ECertified copy is filed with tRie county building inspec- BUILDING _ LJ tion department. ADDRESS C i Date - �La- Applicant u-+ �/C CITY `- ZIP LOCAL TV e - CERTIFICATE OF EXEMPTION ROM WORKERS' _ - O. OF BLDGS. NEAREST_ /- - - - - COMPENSATION INSURANCE n SIZE OF LOT - NOW ON LOT CROSS ST. ..G{O G r (This section need,nat be completed if the permit'is for one - - -- ASSESSOR - hundred dollars ($100)or less.) --, TRACT BLOCK LOT NO. MAP BOOK' PAGE PARCEL .. ._. OWNER /r/-- 171_1' - NO. P ,4 USE Z NE AAA I certify that in the performance of the work for which this JQ/ ' NO. 'permit is.issued,1 shall not employ any person in any manner _ �(� SPECIAL d so os too,/fbecome subject to the Workers'Co{/mJ�ppensation Laws. . ADDRESS / / \ CONDITIONS - V Date /y Applicant�l2, yr Z9el" !� CITY _ _ ZIP NOTICE TO APPLICANT:,If, after making this Certificate of ARCHITECT OR TEL, DISTRICT GROUP I TYPE FIRE PROCESSED BY - Exemption, you should become subject to the Workers' ENGINEER NO. KQ CON T. ZONE ti Compensation provisions of 4he Labor Code, you must forth- gDDRE55 I\` 3 d W. with comply with such provisions,or this•permit shall be -- 7EL. .5 STATISTICAL C1A /51F`CATION APT. CONDO. Z deemed revoked. CONTRACTOR Al/ NO. ` "� LICENSED CONTRACTORS DECLARATION - - - - LIC. -- CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS G NO. S (commencing vitIn Section 7000)of Division 3 of the Business and - ._ _ - LIC SEWER MAP - Professions Code,-and my license is in full force and effect. CITY �7 c��Lir^i� CLASS - - BK 1./ VALIDATION SQ. FT. r NO. OF NO.OF CHECK / License,Number.5 •� 6 .�Lic.Class/ SIZE /JU STORIES -Z• - FAMILIES I ONE VALUATION Contractor /&� Dote DESCRIPTION OF WORK NEW ❑ $ /l r/ ," C�d1_d ADD v ® t am exempt under Sec. - ❑ ALTER B.BP,C. for this reason _ - REPAIR ❑ $ - - z 6 6 9. 2 A Date: USE OF EXISTING BLDG. DEMOL 8S Z��x7 . ❑ # s o - - 23 Signature - - - APPLICANT/. d /r O �. {�•fv0 FINAL PRINT L OWNER-BUILDER DECLARATION - ' - - _ DA7 ' v - -( o 1 7 CIA 1• ' I hereby affirm that 1 am exempt from the Contractor'sLicense 77 C/77 �/'- - `' - Law for the following'reoson (Section 7031.5, Business and _ ADDRESS FIL Y o 1 76916 Professions Code): ' " ' -` PRESENT aBUILDING _ 0'3 1 8-87 I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). - MOVING - - TEL I, as owner of the property, am exclusively contracting CONTRACTOR NO, r with licensed contractors'to construct the project (Sec- ADDRESS ' tion 7044, Business and Professions Code). - REQUIRED YARD HWY TOTAL SETBACK FROM EXI - - CONSTRUCTION LENDING AGENCY - SET BACK 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. - - - - - - - -mg 7 4 5 7 A. (Sec. 3097, Civ. C.). SIDE q7 e a o e tb }I P.L. _ I o 2 1 8:6 J s Lender's Name ' LDMA Ref. # . - 2 1 a 63' P:C. Fee'$" ,(J Permit'Fee OL V - Lender's Address /^1 17. 1 3t-8 7 t 1 certify that,_I_have read this application..and state that the - Issuance Fee / 0,50 r-5O` LDMA P/C•#. Q above information is correct. I agree to comply with all County Investigation Fee ' ordinances and State laws relating to building construction, v and here b authorize re resentatives of this County to enter Total Fee m upon th bove-mens' ne property for inspection purposes. a c� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent' ----r--�DatEs-r-'14 c/� - '_ - - _ --' - - '" - - n COUNTY OF LOS ANEELESTEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIS WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0005250026 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE 9525 BROADWAY STRUCTURE: 0 VN TEMP CA 917803155 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: TEMPLE CITY BLVD 8588-005-016 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: RESID USE ZONE: R ISSUED ON: PROCESSED BY: E%PIRES ON: EXIST OCC GRP: 05/25/00 UT 1121100 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: /7 CODE: GARIBAY MARINA A;BURROLA EUSTOLIA - 1 1,800 r 9525 BROADWAY NA` -gyp .TEMP 917803155 FEES PAID DESCRIPT ON OF WORK NEW CLASS A FIBERGLASS SHINGLES OVER ONE LAYER OF ASPHALT APPLICANT: TEL. NOFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SHINGLES TO HOUSE AND GARAGE : - STEPHENS - AA BLDG. PERMIT ISSUANCE 27.75 10503 DEVERON DR AC STRONG MOTION RESID 1800.00 VAL 0.50 SPECIAL CONDITIONS: 1 WHITTIER, CA D2 PERMIT W/O.EN°HC= 1800.00 VAL 82.20 GEI_Ec TOTAL: FEES 110.45 CONTRACTOR: TEL. N0: /S ('�1i�.., APPROVALS DATE INSPECTOR SIGNATURE SPECIALTY ROOF (562) 698-7628- ,f/ y�_ `\J, `,• 10503 N DR LIC. NO /!� �r r} �'� LOCATION AND SETBACKS WHITTIERER, CACA 90671 329764 { (te1 ` SOI LSENGINEER APPROVAL ARCHITECT OR ENGINEER: rEL. N0: 3 JJJ ++ \ FOUNDATION/TRENCH FORMS LIC. NO/ SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CM[P �; S-✓�"��\ i .�JS��I"'r)�;�U UNDERFLOOR INSULATION 147H269 3 1101 �� \- �/VE ��J FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/L ND: STAT CLASS:-— -- -- _� + NO 21[(C' -" - -- Gj�-n � �r . VVV � / I ( ROOF SHEATHING SCHOOL WITHIN HAZARDOUS ` \ \ 1C, / SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS O Li NO NO NO FRAME INSPECT-ION REQUIRED TOTAL SETBACKEXIST FROM �!i/J �! `\ J LJ 1 FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: �f/eq 1O /✓� INSULATION/WEATHER STRIP FRONTPL- P�- Service _ih - 1-- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508