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Home My Public Portal About9529 BROADWAY_Building__ 76A638A CE 4803 4/70 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER -MAP BOOK PAGE PARCE BUILDING AND SAFETY DIVISION JOHN A. LA MBI E, COUNTY ENGINEER ADDRESS ✓ G ./ .L' ��jK'C./ .a COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST ,• '^y�✓C Print art a on CROSS ST. BUILDING DISTRICT NO. GR P. TYPE PF50CESSED BY ADDRESS 5 �I (� L J G l //41 CONST. STATISTICAL C ASSSIFICATION SEWER MAP LOT NO ' Q 8L0 K '\ CLASS NO. OWELL.UNITS� BK�PGJ�4 TRACT 'Dro >. ) 0-kaC US ZONE MAP QQ NO.OF BLOGS. NO. 0 SIZE OF LOT NOW ON LOT .-� CSPECL ONDIIA ONS USE OF EXISTING BLDG. OWNER NO. .2,? -5L- [y BLDG.SETBACK FROM / ADDRESS v,'�n2 ( pq �� FRONTPROP.LINEOF C STREET) I TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL CITY L C . �l HIGHWAY WIDTH FROM C.L. ARCHITECT O EL. ��t } 0 _ ^� ENGINEER NO. BLDG.SETBACK FROM ADDRESS SIDE PROP.LINEOF (STREET) qq p TEL. TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL CONTRACTOR (��r�,/ ` NO, HIGHWAY WIDTH FROM C.L. Y ADDRESS NO } = p U LIC. CITY CLASS CORNER CUTOFF YES ❑ NO O CONSTRUCTION LENDER F•- NAME AND BRANCH N 0 tO e SEE REVERSE SIDE FOR SPECIAL APPROVALS W a ADDRESS to Z_ FT. �_l NO. OF NO. OF NEW USE OF �t,J STORIES FAMILIES ❑ �' �� ADO STRUCTURE ALTER ❑ REPAIR[:] SIGNATURE OF APPLICANT DEMOL ❑ VALUATION $ �� APPROVALS DATE INs vE crOR•s SIGN rUPE P.C. PMT. ^ FOUNDATION: LOCATION 5- 19,1 FEE $ FEE$ G%C FORMS, MATERIALS J FRAME: FIRE STOPS, I 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 ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUC TI ON, I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I 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. LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL C �� U JOHN F. LEWIS, PRI CIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION cK. M.O. CASH _ PERMIT VALIDATION CK. M.O CASH I A! --9 3 6 1N tIAR2 4 1 D 9.00" v r)dNGBBA CE #B031/'APPLICATION FOR BUILDINIt PERM H COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING ADDRESS COLEMAN W. JENK)NS, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL N NEAREST Print tyPS OO CROSS ST, e DISTRICT NO GR -TYPE �- S BUILDING 9 f• f� CONST. ADORES of, 0 LOT NO, BLOCK r�ff STATISTICAL_CL/nS IFI CATION SE R MAP u CLASS NO. (/— DWEL L,UNITS SK-- TRACT USE ZONEI MAP 9 D D NO.OF BLOCS. NO. SIZE OF LOT (J �F 190W ON LOT SPECIAL USE OF CONDITIONS EXISTING BLDG. TEL.,._"Fa�+1- OWNE NO. Y BLDG.SETBACK FROM ADDR SS .Z FRONT PROP,LINEOF (STREET) TYPE OF EXISTING SETBACK. HIGHWAY } YARD = TOTAL CITY HIGHWAY WIDTH FROM L ARCHITECT OR 41 TEL. } _ ENGINEER NO. SLDG.SETBACK M ADDRESS SIDE PROP. LINE OF (STREET) /n �p / r CON TRA CTO 'A/// NOL' �S bl/ TYPE A EXISTING SETBACK HWAY } YARD = TOTAL U HIGHWAY WIDTH FROM C.L. y LIC. ADDRESS �J C NO, } - O LIC. CITY CLASS CORNER CUTOFF YES ❑ NO ❑ w CONSTRUCTION LENDER ` y NAME AND BRANCH '�. SEE REVERSE SIDE FOR SPECIAL APPROVALS z ADDRESS yJ < S . T STORIES FANO. OF OMIOL�ES - NEW ❑USE ov Lf 06 04ef ne pr STRUCTURE �'�' �"'"�-d'7 ADDER ❑ �I //- . �4'-.(- REPAIR❑ SIGNATURE O APPLICANT DEMOL ❑ VALUATION S /4" APPROVALS DATE INSPECTOR'S SIGNATURE. P.C. PMT. �J r-� FOUNDATION: LOCATION FEE S FEES 1. ` FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT. DUCTS ST RUC TI O N. I CERTIFY THAT IN GOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF HE STATE OF CALIFORNIA IN RELATING TO p WORKMEN'S CO PE ATION INS LATH, EXT, a�� ,� l^ AAS/ SIGNATURE O HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS W.4titz i—Lj FINAL Q JOHN F. LEWIS. PRIrvcIPA STRUCTURAL ENGI EER PLAN CHECK VALIDATION CK. M.D. GASH _ PERMIT VALIDATION CK. MO. <ASH 1 9 7 7� AUG1 8 1 D 2 1 .75~ APPUC AT90H FOR o M LOM pCROT � 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, BUILDINDDRESS / _ or a Certificate of Wbrkers'Compensation Insurance,or a certified CI7Y ZIP copy thereof(Sec.3800,lab.C.) �iN LE �. �.T !71 -760 LOCAL /L C Policy No. Company SIZE OF�L/OT 7Y NO.OF BLDGS.NOW ON LOT El Certified Dopy is hereby furnished. O � NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRA T 8 O BLOCK LOT NO. / department. USEZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL o / SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' o NER ' S PATEL,NO, d5 1 0 YES No COMPENSATION INSURANCEfa, 2Q7 —GZ Z— WITHIN 1000 FT.OF SCHOOL? ADDRESS (This Section need not be completed if the permit Is for one hundred Sa Rood cc,/Y Y DISTRICT n, GROUP TYPE FIRE ZONE ROCES BY dollars(§100)or less.) .ZIP Dv I certify that in the performance of the work for which this permit Z �F C A'T 1!R• /7S0 ' is issued, I shall not employ any person in any manner so as to ARC ECT OR ENGINEER TEL.NO. become subject to the Workers'Compensation Lam. STATISTICAL CLASSIFICATION AP1 CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT: If, after making this Certificate of CONTRACTOR TELNOREQUIRED TOTAL SETBACK FROM EXIST . . Exemption, you should become subject to the Workers' SETBACK YAflD HWV PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with such provisions orthis permit shall be deemed revoked. ADDRESS LIC.NO. P L LICENSED CONTRACTORS DECLARATION CITY LIC.case SIDE y PL p I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP U (commencing with Section 7000)of Division 3 of the Business and S NO.OF STORES NO.OF FAMILIES O Professions Code,and my license is in full force and effect. NEW ❑ BK PG D U License Number LIC.Class DEB R F WORK ; CO AR ADD ❑ VALUATION W a Contractor Date ALTER LJ $ a 0'e— Z ❑ I am exempt under Sec. REPAIR ❑ $ D t - B.BP.C.for this reason DEMOL [ILDMA 4 k Date: USE OF EXISTING BLDG. URM ❑ Signature APPLICANT(PRINT) TEL.NO. LDMA Paan p L ❑ I, as owner of the property, or my employees with wages as O i";7 their sole compensation, will do the work and the structure is ADDRESS _k ..T [�I c not intended or offered for sale (Section 7044, Business and FINALDA Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUBMATFAIAL ❑ 1, as owner of ther0 ert , am exclusively contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN P P y y conracg THE AMOUNTS SPECIFIE ON THE HAZARDOUS MATERIALS INFORMATION GUIDER FINAL BY licensed contractors to construct the project.(Section 7044, I T`' 105 . 25 Business and Professions Code.) WILL THE INTENDED USE vas❑ No 71j INT OR FUTURE BUILDING 14 11 rf jj OCCUPANT REQUIREAPERMFTFOR CONSTRUCTION OR MODTHE BUILDING BY THE IFICATION FROM THESOUTH CHECK 2L:'•iC CONSTRUCTION LENDING AGENCY COAST AUR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES CHANGE j Ii I I hereby affirm that there is a construction lending agency for YES El NO 0� ITMI'V the performance of the work for which this permit is issued(Sec. ` 77" I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD 0 3097,CIV.C.). PERMITTING CHECKLIST,I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES !+ '7Jr COUNTY CODE.TITLE2.CHAPTER 2ZA91 SECTIONS 2.20.1110 THROUGH 2.M.MCONCERNING 1313130-017-101]1 z/,1 Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMQ LentleYS Address 214i i Ar. 9e14 0 owueROR.wrNT o I certify that I have read this application and state that the above P.C.FEE PERMIT FEE p information is correct. I agree to comply with all county /I , d ordinances and State laws relating to building construction,and d( 6 heby authorize representatives Of this County to enter upon ISSUANCE e bove-mentioned p operty I pection purposes. n _ 7-31-190 INVESTIGATION FEE TOTAL FEE r 4lMundppv,Ip Pgn1 0.Y SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY OF LOS ANGELES TEMPLE CITY 4 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BE 0508 1205070068 PHONE: (626) 285-0488 EXT: ILEGAL ID INO. OF CONST BUILDING ADDRESS ON FILE I SQ. FT STORIES TYPE : 9529 BROADWAY I _11 STROCTURE: 1100 V-B TEMP CA 917803155 ASSESSOR INFORMATION NUMBER: 1 NEAREST CROSS STREET: 18588-005-017 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, Cl (TENANT: IEXIST BLDG USE: RESID USE ZONE: R-1 11SSUED ON: PROCESSED BY: IEXIST OCC GRP: 105/07/12 SR I I I I TOWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFINIA DATE FINAL CODE: IPACINO STEPHEN A;JEANNE T - 2,000 19529 BROADWAYell TEMP 917E 03155FEES PAID DESCIEPTION OF WORK 1 IHOUSE 1100 SF ONE LAYER ON TOP 30 YR SHINGLES CLASS A FLAT 1 1 IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: ROOF REMOVE INSTALL XL&Z ROOF APPLICANT: TEL. NO: BRAEL DEKEL (818) 652-2138- AA BLDG PERMIT ISSUANCE 27.80 '' V �" I IAB STATE GREEN BLDG FEE 2000.00 VAL 1.00 (SPECIAL CONDITIONS: I IAC STRONG MOTION RESID 2000.00 VAL 0.50 1 ID2 PERMIT W/O EN-HC 2000.00 VAL 82.20 1 TOTAL FEES 111.50 I CONTRACTOR: TEL. NO: 1 - 1APPROVALS DATE INSPECTOR SIGNATURE 1 LA CONSTRUCTION AND ROOFING, INC. (818) 593-8161- 118643 COLLINS ST LIC. NO 1 ILOCATION AND SETBACKS 1 1 1 (APT 8 965125 C39 I_, TARZANA, CA 91356 1SOILS ENGINEER APPROVAL (ARCHITECT OR ENGINEER: TEL. NO: FOL_.DATION/TRENCH FORMS LIC. NO: 1 SLAB/UNDER FLOOR I I I RAISED FLOOR FRAMING (MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: ( - 1UNDERFLOOR INSULATION 1147H269 3 CJI 1 I - IFLOOR SHEATHING INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I ' 0 NO 21 1ROOF SHEATHING I I SCHOOL WITHIN HAZARDOUS SHEAR PANELS 111 (AIR QUALITY: 1000 FEET MATERIALS 1 NO NO NO FRAME INSPECTION I I I IFIRE SPRINKLER HANGERS 1 - _ INSULATION/WEATHER STRIPI 1I I 1 (INTERIOR LATH/DRYWALL I 1 1 IEXTERIOR LATH RATED FLOOR/CEIL ASSEM. (RATED WALL.ASSEhffiLIES I I I IRATED SHAFTS/OPENINGS I I I T-BAR CEILINGS _ ILOT DRAINAGE _ I 1 I REPORT IF: DPR261 ROUTE TO: SS0508 WORKERS COVIPENSATION DECLARATION. 76"663 '0i61 APPLICATION FOR ELECTRICAL PERMIT �1 hereby affirm thatPl'have ave a certificate of consent to self insure, CE-8060 or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab. C.) Policy No. Company _ FOR APPLICANT TO FILL IN JOB �S� QW g ❑ Certified copy is hereby furnished New Residential Bldgs & Pools 2EACHN.O. FEEADDRESSCarl ified 'copy 6 filed with the bounty'building inspection 1 & 2-Family, Sq.Ft. $ LOCALITY'NEAREST department. Multi-family S i m CROSS ST TEiy /E C>Resitlenfial Swimming POOIS ,OWNER ORDate Applicant FIRM NAME {� RISCERTIFICATE OF EXEMPTION FROM WORKERS'' - MAILOutlets:Rec Light Sw. —•. ' ' 'COMPENSATION INSURANCE ADDRESS S�9 ,B dti�(This section need not be tom leted if'the work involved'b 'the Additi 00p v ary T j Tel.No..2$N2p 2 ,permit is for one hundred dollars ($100) or less.). Total No. Additional Epi lE Cr I certify that in the performance of the work for which this permit _ PLAN CHECK APPLICANT is issued, I shall.not employ any person in any manner s0 as t0 become subject to the Workers'Compensation Laws. Lighting Fixtures First 20, ADDRESS _ a. In Additional s rYl!',��//./2`� Total No. CITY T N Date-s'—s-87 Applicant Fixed Appliances Not Over 1 HE PERMIT y NOTICE TO APPLICANT: after making this Certificate of APPLICANT Exemption,you should becomee subject to the.Workers'Compensation Range_ Heater_ D.W. + 441 provisions of the Labor Code, you must forthwith comply with such Oven Dryer_ W.M. _ ADDRESS / provisions or this permit shall be deemed revoked. Top FAU _ W.H. _ LICENSED CONTRACTORS DECLARATION Hood Fan Other_ CITY _ Tel.No. I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond'. ?�V LICENSE Class. (Commencing with Section 7000) Of.DlVialOn 3 of-the BUSIneSa and REG.NUMBB ER Professions Code,and my license is in full force and effect. DISTRICT NO. '/ PROCE E eV Power Apparatus 8 Large Appliances ^"� (v) }' Size& Type HP,KW,KVA,or KVAR �c O 0 License Number LIC.ClassU Up to 1 Incl. .(/U FINAL _ - T Over 1 to 10 Ind. DATE VA DATION 0 OContractor Date Over 10 to 50 Incl. FINAL ❑ am exempt under Sec. Over 50 to 100 Inc. By LU B.&P.C. for this reason Over 100 12 N Services,Swbd.,MCC& Panelboards ^� Z Dale: - 0- 200 Amp,Under 600 V D Signature- _ _ 201 - 1000 Amp.Under 600 V ' ❑ Over 1000 Amp.or Over 600 V Exemption for Reg.Mains. Elect.- SINGLE FAMILY Temp. Power Pole&.Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit b 9 Q,7 Q I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions " Additional Sign Branch Circuits + Code): 'sere s e 0 �41 Misc.Conduits & Conductors 1 ,^I^ 5 Q 5 0 I,as owner of the.property,will do the work and the structure isnot intended or offered for'sale (Section 7044, Business . Other(See Complete Fee Schedule) and Professions Code). D e,e a 5 Q 5 0 5 CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a construction lending agency for the performanceof the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Civ.'C.). PLAN CHECKING FEE - - Lender's Name PERMIT ISSUING FEE Lender's Address I certify'that I have read this application and state that the above TOTAL FEE _ 5D information is.correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above-mentioned property for Inspection purposes. � SEE REVERSE FOR EXPLANATORY LANGUAGE ' Z - 5-8-87 Signature of Pe dtee Date