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Home My Public Portal About9574 BROADWAY_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES BUN �? WM. J. FOX. CHIEF ENGINEER �1d"1 G FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING DISTRICT NO. PIAN CK.NO. PERMIT NO. ADDRESS ..3..0C� T�,��t 7y ,,.,.2 �- s� q a LOCALITY �/�"/Y LC �/T RECEIVED BY DATE OF APPL. DAT6198UED NEAREST BUILDING OWNER // ��TL/Q-s��1I ADDRESS. L� MAIL LOCALITY ADDRESS je w .ceevf TAS TE :_DW L�YK CR088 ST. `�" ��okN CITY AN " i No. S S ARCHITECTOR TEL ZONE PLANS - TYPE OR - ENGINEER NO. BLDG. OR ADDRESSBETSACK LINE APPROVED /YoBiGNe/bE �a rEL/ c BY DATE CONTRACTOR f. NO. Q�S�7 p / USEAPPROVED ADDRESS . /1013 EN CA ZONE BY DATE LEGAL 4L0 CORRECTIONS DESCRIPTION LOT NO. TRACT///f1 dib X c'.eC'5IW 4 c rNO.OF SIZE OF LOT 7 Ao��p I NOW ON LODTB Q USE OF NO.OF NO.Or C / EXISTING BLDG. FAMILIES I ROOMS B i F GJ DESCRIPTION OF WORK NEW ALTERATION T`a-ST N C- REPAIR - NO DEMOLISH L"J /IAC A'1A1�f rN .CTL✓/o+ p So.Fr. S/G o.or z SIZE 3� DOME 13 STORIES / CIO r WALL /� },� ROOFS COVERING USE OF NEW I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT INS ECTOR DAT! AND AGREE TO COMPLY WITH ALL COUNTY FORMS.MATERIALS FOUNDATION: LOCATION AND STATE LAWS REGULATING BUILDING CONSTRUCTION. � FRAME: FIRE STOPS, SIGNATURE OF BRACING.BOLTS PERMITTEE2fa_�(��.,2-�6. L F/e /(// , ,'� , LATH. INT. AUTHORIZED AGT "" LATH. EXT. 96A53BA-3 2-50 $ P.C.® PLASTER.INT. /I 3 gV C/ FEE PLASTER.EXT. VALUATION FEE FINAL 7! COUNTY OF LOS ANGELES BUILDING AND SAFETY •\ WORKER'S COMPENSATION DECLARATION FOR APPLICANT To FILL IN. rain US ADDRE 5 I hereby affirm that have a certificate mf consent to self insure, BUILDING AUDIT - or a certificate of Workers' Compensation Insurance, or a certified copy thereof(Sec.3800,Lab. C.) CITY -ZIP - LLOG ITV Policy No� Company SIZ OF L NO.OF BLDGS.NOff ON LOT - ❑ Certified copy is hereby furnished. - .3 - NEAREST CROSS Sq. ❑ Certified copy is filed with the county building irispection TRACT BLOCK - - -LOT NO. department. - USE ZONE MAP NO. ' Date T Applicant ASSESSOR MAP BOOK PAGE; PARCEL, " - - 'SPECIAL CONDITIONS - - { CERTIFICATE OF EXEMPTION FROM WORKERS' OWN R - - T CN,4. - - - ' COMPENSATION INSURANCE - I'1 (V WITHIN 1000 FT OF SCA000 YES No (This section need.not be CURT ted if the permit is for one hundred ADDRESS (( �,7�� - dollars ($100)or less.) Q G DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY CITY / ZIP Q - I certify that h the performance of the wo}k for which this permit _ is issued, shall not employ any.person at any manner so as t0 ARCH CT OR ENGINEER - .TEL N0. - !CA ' become subject to the Workers Compensation Laws. � ,. STATISTICAL CLASSIFICATION APT CONDO _ Dato Applicant ADDRESS a CLASS NO.�� DWELL UNITS 1- NOTICE TO APPLICANT. If, after making this Certificate of REQUIRED .TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR TEL NO. - SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of*the Labor Code, you.must forthwith FROM comply with such provisions or this permit shall be deemed revoked.. ADDRE55 - - - - LIC.NO. P L . LICENSED CONTRACTORS DECLARATIONSIDE CITY LIC.CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division LL 3 of the Business and SQ¢et I NO.OF STORIES NO.OFT FAMILIES NEW Professions Code,and m license is in full force and'effect. 1 ou- BK PG a License Number Lic.Class DES ON OF VJO ADD ❑ VALUATION 6� D O Contractor Date. ALTER ❑ $ 0: ElI.am exempt under Sea REPAIR .❑ $ - 0 BARD. for this reason �® '+�' DEMOL ❑ LDMA P/C a � W Date: .USE QF,EXISTING-BLDG. URM ❑ - - D' Z Signature z APPLICANT,(PRINT} T NO. 'LDMA Perm k - �''+"I '' _ _ Z .� I, as owner of the property, or my employees with wages as L - Z Ij , 5=� _�J their sole compensation, will'do the work and the structure is ADDR 5S not intended or offered for Sale (Section 7044, Business and N `c/ FINAL DATE Professions Code.) WILL THE APPLICANT OR FUTURE L ILDING OCCUPANT HANOLE HAZARDOUS MATERIAL ❑ 1, as owner of the property, am exclusively contracting with ORA MIXNTS URESPE corvTOrvwHE HAZARDOUS US MATERIAL INFORMATION R GREATER THAN THE FINAL BY —� > ' ,� AMOUNTS SPECIFIED ON THE HAZAROUS MATERNLS INFORMATION GUIDE? �- licensed contractors to construct the project (Section 7044, yy--yy YES El ee - Business and Professions Code.) WILL THE 6 OCCUPANT REQUIRE A PERMIT FOR CONSTRUED USE OTHE BUIDUNG CTION OTHER LODIICATION FROMPLICANT ORRTHEUILDSOUTH CONSTRUCTION LENDING AGENCY COAST AIR OUAUTY MANAGEMENT DISTRICT SCAOMDI SEE PERMITTING CHECKLIST FOR _ GUIDELINES hereby affirm that there is a construction lending agency for M1•Es❑ 'No PC - the performance of the work for which this permit is issued(Sec. (lI 11j3,Qv. -i';y j, •}lA i,'y4 m 3097 C. I HAVE READ THE HMATERIALS INFORMATIONGUDE AND THE SCAOMD PERMITTING N ) AZARDOUS CHECKLIST I UNDERSTAND MY REQUIRE TS UNDER THE LOS ANGELES COUNTY CODE, -{ h TITLE HAPTEP 2208 TIO 22 0TH(jOUGH 220.140 CONCERNING HAZARDOUS F' r1 cL'4 3 Lender's Name MATE 5 EPORTING -0 ING A PERMIT FROM THE SCAOMD o Lenders Address —/ /bQ - WiNEN OF AGENT o I certify that I have read this application and state under,penally _of pedury'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 Y mconstruction, and hereby authorize representatives of this County ISSUANCE FEEto e'pl,upon WEd�tlove- ntionetl property for inspection purposes. i"/i.a (//r •{j�1J :C.� INVESTIGATIONS FEE TOTAL FEE oa / j - ie..wreala roo��'� s.�, --/ OiT1-51 -. - /` 7/ SEE REVERSE FOR EXPLANATORY LANGUAGE - " . COUNTY OF LOS ANGELES TEMPLE CITY k 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BE 0508 1310070048 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE 9574 BROADWAY 5479 TEMPL STRUCTURE: V-B TEMP CA 917803153 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: TEMPLE CITY 18588-026-010 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY CA1 TENANT: (EXIST BLDG USE: RESID OSE ZONE: R-3 J1SSOED ON: PROCESSED BY: EXIST OCC GRP: 110/07/13 SR (OWNER: TEL. NO: IBLDGS, NOW ON LOT: VALUATION: FI AL_DATE _ FIS Y: CODE: IPAYNE, RICHARD (626) 221-9711- 1 5,000 _ 1139 N LORETA WALK (LONG BEACH CA 90803 FEES PAID `D SCRI ION F WORK 114 RETRO-FIT WINDOWS FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: 1 (APPLICANT: TEL. NO: CUNNINGHAM DOORS & WINDOWS (714) 258-2500- 1A BLDG PERMIT ISSUANCE 27.80 1 11940 E EDINGER AVE IAB STATE GREEN BLDG FEE 5000.00 VAL 1.00 1SPECIAL CONDITIONS: 1 SANTA ANA CA 92705 JAC STRONG MOTION RESID 5000.00 VAL 0.50 t 1 ID2 PERMIT W/O EN-HC 5000.00 VAL 132.60 �LO •(L� . 1 TOTAL FEES 161.90 �) CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE CUNNINGHAM DOORS AND WINDOWS, INC. (714) 258-2500- 11940 E EDINGER AVE LIC. NO 1LOCATION AND SETBACKS SANTA ANA, CA 92905 736026 * 1_ I I 1SOILS ENGINEER APPROVAL (ARCHITECT OR ENGINEER: TEL. N0: FOUNDATION/TRENCH FORMS LIC N0: SLAB/UNDER FLOOR 1RAISED FLOOR FRAMING I I I MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 1 (UNDERFLOOR INSULATION 3 001 I I I FLOOR SHEATHING N0. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I NO 21 1 ROOF SHEATHING I I SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS I AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION 1FIRE SPRINKLER HANGERS I • INSULATION/WEATHER STRIP( 1 I (INTERIOR LATH/DRYWALL (EXTERIOR LATH RATED FLOOR/GEIL ASSEM. RATED WALL ASSEMBLIES I I I RATED SHAFTS/OPENINGS I I I IIT-BAR CEILINGS ` ADDITIONAL DATA ON FILE 1LOT DRAINAGE I I I 1REPORT ID: DPR261 ROUTE TO: BS0508 1 I .. COUNTY OF LOS ANGELES TEMPLE CITY g 0506 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0506 1310210096 PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST BUILDING ADDRE-' ON FILE SQ. FT STORIES TYPE d 9574 BROADWAY (STRUCTURE: V-B "`� - TEMP CA 917803lb3 (ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: TEMPLE CITY 18586-026-010 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY CAI II (TENANT: JEXTST BLDG USE: REBID USE ZONE: R-3 IIISSUED ON: PROCESSED BY: I (EXIST OCC GRP: I10/21/13 SR I IOWNER: TEL. NO: IIBLDN GS. NOW ON LOT: VALUATION: IF ATE FI AL BY: CODE: J PAYNE, RICHARD/WENDY (626) 221-9711- II 900 1139 N LORETA WALK (LONG BEACH CA 90803 1 FEES PAID ID SCRIIPTION OF WORK I (REPAIRING EXISTING COVER .. .M NEW STUCCO REPAIR, CHANGE J _IFEE DESCRIPTION: QUANTITY: HEM: AMOUNT: JEXT-STING WOOD DOORS TO METAL PREHUNG FRAME INTO TWO NEW JAPPLICANT: TEL. NO: I JWINDOWS 1 MIKOLASKO, DAN (626) 338-0055- IAA BLDC PERMIT ISSUANCE 27.80 1 j 5118 CALMVIEW AVE JAB STATE GREEN BLDG FEE 900.00 VAL 1,00 (SPECIAL CONDITIONS: I BALDWIN PARK 91706 JAC STRONG MOTION REBID 900.00 VAL 0.50 i ID2 PERMIT W/O EN-HC 900.00 VAL 65.40 3 1 TOTAL FEES 94.70 �6+(�'C'�� Q�r ,vV SiT"e. AlA'(e I I-IS-1] F CONTRACTOR: TEL. NO: A PRO LS— D TE INSPECTOR SIGNATURE JDAN MIKOLASKO CONSTRUCTION INC. (626) 338-0055- 15118 CALMVIEW AVENUE LIC. NO ILOCATION AND SETBACKS BALDWIN PARK CA 91706 B55601 * 1 (SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. N0: Ii � FOUNDATION/TRENCH FORMS I I I LIC. N0: I JSLA?!UNDER FLOOR I I_ 1 1 IRAI_En FLOOR FRAMING (MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( UNDERFLOOR INSULATION 3 001 __ FLOOR SHEATHING INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS I I1 NO 211 ROOF SHEATHING _I 1 AIR QUALITY: SCHOOL WITHIN HAZARDOUS (SHE R PANELS 1000 FEET MATERIALS NO NO NO 1 1FRAFIE INSPECTION 1 I (FIRE SPRINKLER HANGERS 1�1 1 'IIINSULATION/WEATHER STRIPI I I I ( I INTLRIOR LATH/DRYWALL IEXTERIOR LATH I I I RATED FLOOR/CEIL ASSEM. 1 1 ( IRATED WALL ASSEMBLIES I I I RATED SHAFTS/OPENINGS T-BAR CEILINGS 1 J* ADDITIONAL DATA ON FILE ILOT DRAINAGE 1 (REPORT ID: DPR261 ROUTE T0: HS 0508