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HomeMy Public PortalAbout9664 BROADWAY_Building__ •76A638A CE#803 B-63APPLICATION FOR. -BUILDING -PER.M/1T' COUNTY OF LOS ANGELES BUILDING r 6 /jl rpa ;/uJ4 DEPARTMENT OF COUNTY ENGINEER AooREss BUILDINGL,AND SAFETY DIVISION LOCALITY PBWLS � (2 ,2R Cjj� JOHN A. AMBIE. COUNTY ENGINEER _ NEAREST •/ WILLIAM A.JENSEN. SUP OF DING. CROSS T. 7T-a"2I lew, DISTRICT'NO. GR UP TYPE PROCESSED, Y FOR'-APPLICANT TO FILL IN T CONST. /ylo BUILDING / STATISTICAL.CLASSIFICATION SEWER MAP ADDRESS 9664 Broadway E-2358 BK PG y - 'CLASS. NO. LA ELL.:UNITS LOT NO. .•37.2 10'F 3'OBLOCK WATER ' CERTIFICATE: NOT REQUIRED Its RECEIVED ❑ TRACT 551 Acxe5 'MAP Q• HIGHwpv > - I ' NO. OF BLOCS. NO. 2OD p ' HIGHWAY STATE MAJOR SECOND, LOCAL SIZE OF LOT 3- -A-)'VO NOW ON LOT Z USE ZONE •SPECIAL USE OF _ - I�- CONDITIONS EXISTING BLDG. TEl-,, 1 OWNER7th N ��ryM1 Advent. Waurchgo.� 'BUILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS FRONT ////��11 //'' c) 6 ARCHITECT OR _ .TEL. - :IP.i. O 61104 WR ENGINEER NO: SIDE ."Q ADDRESS . TEL. . ,D ?1t2 l 6 CONTRACTOR NO. j V ADDRESSl - 0 DESCRIPTIONOF WORK u 6 NEW ADD ALTER REPAIR X DEMOLISH' - Z^.•. 50. FT. ` NO. OF NO. OF SIZE DD STORIES FAMILIES - - USTRUOCTU RE: RerO 1� th' iberglaE 2-,fll Pertoa Pl Granite SIGNATURE OF APPLICANT � ••— VALUATION $ i564-00 _ _ -APPROVALS DATE INSPECTOR'S SIGNATURE P,C. _ PMT. . FOUNDATION: LOCATION - FEE I FEE $ 2 • FORMS, MATERIALS _ FRAME: 'FIRE STOPS. I HEREBY ACKNOWUE O GE THAT 1 HAVE READ THIS APPLICATION BRACING. BOLTS " AND STATE THAT THE ABOVE IS'.CORRECT AND AGREE TO COMPLY FURNACE:'LOCATION. WITH ALL COUNTY ORDINANCES pNO .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. J TION OF THE LABORUCODE OF THE STATE 0F2CALIFORNIA RELAT- f ING TO WORKMEN'S COMPENSATI N INSURANCE. LATH, EXT.SIGNATURE-0F, HOUSE NUMBER PERMITTEE RECT AND POSTADDRESS FINAL - Ve - JOHN.F, LEWIS. PR NCIPAL STRUCTURAL ENGINEER , PLAN CHECK VALIDATION _ EK M.O. EASH PERMIT VALIDATION" CK. M'o:, GAB sus 4 a' OCT 14 1. a .1 7.25- T 690A IC E#803 B•BT ,` / / i ,APPLICAT ON ISOR BUI ING PERMIT COUNTY OF''LOS ANGELES BUILDINGC/ DEPARTMENT OF COUNTY ENGINEER ADR .. / 6 iL Z 2 BUILDING AND SAFETY DIVISION LOCALITv. 'JOHN A. LAMBIE, COUNTY ENGINEER - - COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST �'J CROSS ST. Z .A _ FOR APPLICANT TO FILL IN DISTRICT N R P TY ' PR CESS BY (Print.' type only) �,j, �. C T. / ADDRESS • ,V�U 1 ( STATISTICAL CLASSIFICATION J - •SEWER MAP > CLASS NO. -0WELL,UNITS_ BKPG �] LOT NO. /_' .L BLOCK USE ZONE MAP n No oC TRACT M1, 't0 O1' - - SPECIITLCOND - - - v - NO.OF BLDGS; +� SIZE OF LOT 3 X NOW ON LOT F USE OF, /! "TI BLDG. . (- BLDGSETBACK FROM OWNER / V NOL T S FRONT PROP.LINE OF r� - TREET) TYPE OF EXISTING SETBACK HIGHWAY } YARD - TOTAL HIGHWAY WIDTH FROM C.L. ADDRESS �� - n CITY '-) ARCHITECT R TEL. ,BLDG.SETBACK FROM ENGINEER 4I No. SIDE PROP.LINE OF (STREET) SDM�T Qop7r [�+ _ M�i��iZQ �i TYPE OF EXISTING SETBACK HIGHWAY } . YARD - TOTAL ADDRESS HIGH)4AV WIDTH FROM C.L. ��' CONT / TE /J/ } > RACTOR �' ` C NO. 3-1 Q bd a,-,I d ADDRESS') U3( CSI '4{ NO. /2 270 CORNER CUTOFF YES ❑ NO ❑ CITU _42 C( t CLASS I SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION O'F WORK d N W•. ALTER REPAIR DEOA< � 0.'F ' NO. OF NMLISH O:OF SIZE . STORIES FAMILIES USE OF / STRUCTURE _ t F1ljA SIGNATOR OF ' APPLICANT V ALUATION.S /l hjy e6 (OL/4l APPROVALS DATE INSPECTOR'S slcHa TLPF P.C. PML �,5� FOUNDATION: LOCATION FEE S FEE S FORMS, MATERIALS 'FRAME: FIRE STOPS, n r I HEREBY ACKNOWLEDGE THAT I .AyE READ THIS APPLICATION BRACING, BOLTSIw/fS- 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, 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY.I,WILL NOT EMPLOY ANY PERSON IN VIOLA ' TION OF THE LABOR CODE OF THE STATE CALIFORNIA RELAY LATH, INT. ING TO WORKMEN'S COMPENSA AON INSURA CE LATH, EXT, SIGNATURE OF .HOUSE NUMBER COR- PERMITTEE _ RECT AND POSTED ADDRESS IA FINAL // G // JJI / JOHN F. LEWIS. PRINCIPAL ST URAL ENGINEER PLAN CHECK VALIDATION CK. M.D W PERMIT VALIDATION CK.: N D. CASH L 3.52 8 o MAR11 1 D 1725f4 Q AP-PLICATION FOR COUNTY OF LOS ANGELES ulLDING PERMIT DEPARTMENT BUILDNG ANF AFETY DCOUNTY NCGINEER ISION > BUILDING / /' � .F7 `A FOR APPLICANT TO FILL IN ADDRESS ((�(t7 C BUILOI NG4766 rr ^^ 110SS / O ADDRE � LOCA LITV Z, m CITY (, ZIP NEAREST Z CROSS ST'. g t O.OF BLDGS. Q ASSESSOR v SIZE OF LOT Y EY3 NOW ON LOT 3 MAP BOOK PAGE PARCEL S //��'tt DISTRICT GROUP, TYPE FIRE P SSED BY C nllllZ BLOCK LOIN �- AL� _ _ " CONST.— 1 rE �-�:: j TEL. L N OWNER14 r I Of lEY Z D' STATISTICAL CLASSIFICATION I�FICATION _ Scp WER MAP o ADDRESS CLASS NO.�OWELL,U NITS _ JBI�PG .e CITY ( �(•(�; ZIP U ZONE MAP 1• - ti /� ( J SPECIAL _ ENGINEERTO .HD W.t'.E NOL SS CONDITIONS ADDRESS5N 1JR. 4. ROAD DEPARTMENT APPROVAL REQUIRED YES NO ❑ CONTRACTOR Q NO SLOG.SETBACK FROM Z _ LIC. FRONT PROP.LINE OF (STREET) ADDRESS - NO. HIGHWAY } YARD _ TOTAL SETBACK FROM TYPEOF EXISTING LIC. 'FRONT PROP. LINE HIGH AY WIDTH CITY CLASS .- CONSTRUCTION LENDERNDN + n L 'NAME AND-BRANCH' C'`-, BLDG.SETBACK FROM I!� SIDEPROP. I NEOF (STREET) O ADDRESS CITU C.A SO. F Q NO. OF NO. OF. CHECK HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OFI EXISTING K SIZE STORIES !I FAMILIES ONE _ SIDE PROP LINE HIGHWAY (•_WIDTH DESCRIPTION OF WORK /aQj�/'r�0 ��' NEW ❑ } Ad CO a - ADD ❑ CORNER CUTOFF YES ❑ NO Z E S ChWO-4Y. ALTER [I REPAIR❑ IN OPEN SPACE YES ElNO ❑ . OF EXIST NG SLOG. G -DEMOL ❑ IN COASTAL PERMIT ZONE YES NO ❑ APPLICANT y TELsoS' / (PRINT) W� O Cc C ..0 L_ .( '. &Z(", BY (SIGNATURE) ' (� / C [r i \ • 1_ K �. \ 'I HEREBY ACKNOWLEOG 1 HAVE READ THIS APPLICATION - ANO .STATE THAT THE S COflRECT AND AGREE TO COMPLY WITH ALL ORDINANC D LAWS REGULATING BUILDING CON- �y_s STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED k�Gz�ii/�'C S' HEREBY I WILL NOT EMPLOY AMY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO - WORKMEN'S CO MP E HSATION INSURANCE. - SIGNATURE OF p.(',l.Z L" L - FINAL4 r/ 3- Q�� BY PERMITTEE DATE Y J � �11r ADDRESS �0 / MF�AI Al" �A TE L. P.C. Fee S /Q Permit Fee .��' CITY NO. 'sr-/7s�Y Issuance Fee VALUATION S/m ewnoio0 Total Fee PLAN CHECKVALIDATION t[N_ M.o' CASH 'PERMIT VALIDATION cH. 'M.O. CASH "3 7-2 M4 2u 23 D 4 3 1.i j e` v 0. ]fi A638A-0EABOIB 12�]! - 15,1�;_['Eln _ l� �� D. 77 V.5 � ��Q 7BA638A OBS-3 3-5B .. APPLICATION FOR BUILDING PERMIT DIVISION OF,BUILDING,AND SAFETY BUILDING � a d. -rL R.m A-c)Ly^-If D9pDTIm2DI,of L'ODDiy'EtlJID98T ADDRE96 'County of Loe--Angele9: - LOCALITY IC - ' WM:J:FOX;COUNTY ENGINEER NEAREST' - _ - CASSATT D. GRIFFIN, SUPT OF BUILDING. CROSS.ST.' D19TRICT'NO. 'GROUP - 'SEWER 'MAP TYPE- FOR APPLICANT TO, ' BK PG` 'FILL IN: cON BUILDING �/A/ / -) y/ .MAP, c/ STATE ADDRESS / (7 T/7 /l-- JI - /•-.-�:"'V NUMBER' �' T HWY YES ®O LOT NO. BLOCK .UBE ONE - SPECIAL ' CONDITIONS' 'TRACT NO. OF SLOGS. . -BUILDING EXIST. SIZE OF LOT `- NOW ON LOT YARD HWY ,STREET NAME SETBACK WIDTH FRONT' P: EXISTING BLDG. .. ^'r P. L OWNER Y IDE L. MAIL ADDRESS .O TRACT DWELL. 1 UNIT 5 -INDUSTRIAL - - - TEL. 1 DWELL 1 UNIT TY NO. 6 PUB CILIC BLDG. ARCHITECT OR - TEL. 2 DUP EX'"q 1'UNIT ,7 ADDN..'ALT.. ETC. ENGINEER - NO. 3 ,APT. UNITS 8 MISCEL. - ADDRESS // - '-- -t .� � 4 COMMERCIAL _ ' CONTRALTO 7/7C- ` L To' �7yZ INSPECTION. RECORD ADDR E99 7 .7 ./I.I�/I � • � � ' iLl��nLwT t' rD al �/�.AJCONS tGI'61214 a(.,-, DESCOIPtION OF WORN NEW - ADD. ALTER .REPAIR DEMOLISH - - $O. FT. NO. OF NO. OF - - SIZE STORIES, FAMILIES U E OF STRUCTURE - SIGNATURE OF APPROVALS APPLICANT ADDRESS DATE INSPECTOR'S SIGNATURE' FOUNDATION EON !MS• MATERIALS - ISk- .J� FEE FRAME: FIRE STOPS, , VALUATION 8 BRACING, BOLTS ,-- FURNACE: LOCATION.. - 1 HEREBY ACKNOWLEDGE THAT 1. HAVE READ THIS - __GAS VENT, DUCTS ,. ' APPLICATION AND STATE THAT THE ABOVE IS CORRECT - AND;AGREE TO COMPLY WITH ALL OUNTY ORDINANCES LATW INT. - - AND STATE LAWS 'REGULAT G" UILDING CONSTRUC TION.- (/y. LATH. EXT: SIGNATURE OF v / �,L"` HOU 9E NUMBER COR- , PERMITTEE - RECTAND POSTED •.ADDRE99- FINAL WM..J.-FOX.COUNTY ENG EE VALIDATION C. N. DIRLAM..CHIEF BLDG. INSPECTOR IkD4',!09'1JAN 11 1 8.0`0 ;m . >6A638AC.E#8.3 7-5eAPPLICATION ,FOR BUILDING PERMIT BUILDING' ,yam BUILDING'AND SAFETY DIVISION ADDRESS1 >�C(�'F1 t 1 l Department of County Engineer, .- County of Los:"Angeles LOCALITY .JO H N•A. LAMBIE. COUNTY ENGINEER NEAREST. I - CASSATTD. GRIFFIN4'SavT ov Bu aolrIid - CROSS ST. ` t• •• +•''�(/ b DISTRICT'NO: 'GROUP TYPE ->cOic BEWBEK. MAP-%.- TOR APPG' 'FOR.;APPLICANT TO FILL IN conlsT:'' BUILDING o I/ - - - - ADDRESS STATISTICAL IJ45SIFICATION LOT NO. 0,��• �(. l.el BLOCK CLASS. LASS NO. ' 'D WELL..0 N ITS�I STATE - MAP YES O -NUMBER ... .Cs- . ''' e HWY TRACT - - USEZONE: SPECIAL - - NO.OF BLOCS. CONDITIONS '... SIZE.OF LOT NOW ONLOT - EXISTING BLDG. - BUILDING EXIST. _ - YARD' HWY STREETINAME' Te ^ IQ C'�� SETBACK WIDTH OWNER Cn�n L ,J ., " FRONT t7� MAILdde.•.--Fr'S�' C`�VYF'� SIDE. \ �t ADDRESS - TEL.' - P.L. 'CITY NO. ARCHITECT_ OR TEL. INSPECTIONRECORD . ENGINEER NO. 'ADDRESS, ':.. / TEL. CONTRACTOR .{ V• 'TF1. ��II J ADORESS AD 2. � 36. l-n ,'�Pt l7"✓t d, DESCRIPTION'OF-WOR% i NEW 'ADD ALTER .. ''REPAIR, DEMOLISH _ 'SO. FT.' i NO: S OF NO. OF• SIZE` - •'STORIEFAMILIES -UIOF-STRUCTURE. ( "- .. "'�F,y Q .int f+j'7�/_�J. - •., - -. � .., , ' -Uhp (z-�Ci( -LC -/ 1 L+ = ..APPROVALS SIGNATURE OF APPLICANT DATE. IN ECTOR'S'SIGNATURE ADDRESS - - FOUNDATION: LOCATION. (I FORMS. MATERIALS 4 j7 $ P. C. 'S - FRAM E:,FI RE STOPS. FEE —� BRACIN G. BOLTS. •a (�-(3-(�j •� $ r. s�IO FURNACE: LOCATION, - - VALUATION GAS VENT. DUCTS. i FEE O I HEREBY-ACKNOWLEDGE THAT 1 HAVE.READ THIS AP- LATH','INT: ' PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL.COUNTY ORDINANCES AND - LATH.-EXT • ' STATE LAWS REGU ATI Gr BUILDING- CONSTRUCTION. ' HOUSE NDMBER COR- SIGNATURE OF 7 `.//.y RECT AND POSTED' PERMITTEE ADDRESS R �- - lti `- 'FINAL JOHN"A.rLAMBIE.COUNTY ENGINEER: CLYDE N. DIRLAM:PRINCIPAL STRUCTURAL ENGINEER PLANiCHECE VALIDATION ' .K: ''`M.O. 'CASH - - PERMIT VALIDATION," -k -m.or - CASH., 58.66 hPR 4 1 , 8.00 ' y� . 1i >......ahI APPLICATIOWFOR BUILDING PERMIT COUNTY. OF LOS ANGELES BvaDING 0 DEPARTMENT OF COUNTY ENGINEER. noOREss BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE,.COUNTY ENGINEER' NEAREST. %. q WILLIAM A. JENSEN SUPT.OF BUILDING CROSS ST. �"n DISTRICT NO. GROUP TYPE ESSED BY FOR APPLICANT TO FILL IN - CONEY LDINGBU' ��(jj // // A/],{Jnn l^1 nnn STATISTICAL CLASSIFICATION I SE ERMAP ADDRESS �LJT I../�V/I ,. ` J9.K /.,jG C...3 ELy jk Zy3 r Ti:E "CLASS.NO. ' DWELL. UNITS I JJ .LOT NO / L BLOCK WATER NOT REQUIRED • RECEIVED „� CW p CERTIFICATE. 1, TRACT M,sjf ,,�1Giy"'y(gc�}V/�/</npTcRsrs' MAP A , HlcHwgv ;STATE MAJOR SECOND,=' OCAL �,,t VI, SIZE OF LOT<•"�J�Z3Jf,yry(/y/,INOW OOF BLDG N LOTS / USE ZONE L' .SPECIAL LEI M'9 USEOF / CONDITIONS • EXISTING BLDG. le Il4�IY� /T Q� - - OWNER S(�ayr-/yT/S/ eN.NQOH TEL NO. . BUILDING .EXIST. YARD HWY STREET NAME ADDRESS - SETBACK WIDTH' t FRONT ��'yLr{ I ”` ARCHITECT ORS IZ C+YV ELL TEL' RS�� .SIDE, �C F'd'I ENGINEER G? W. 1 NO t. - ADDRESS ZU P W. e. CN LO J 1144-,�Lrz c,. P. TEL, •INSPECTION RECORD 11 CONTRACTOR NO. f� - /-4r� n - actif`c' �G oa oo�scq i . m�! • - ADDRESS �, DESCRIPTION OF WORK aoc/1 6 Gv. c /e / % `�lW 6'ee rrec F;on ,i ati G S F� NEW ADO ALTER REPAIR DEMOLISH Z ; SQLF ZETSg1 , STORIES / NAMIOLIES. - C) EOF STRUCTURE CF•IG!'RCH 42 -,: H: SIGNATURE OF APPLICANT ' VALUATION$ " e'L90 I {�+g 10 APPROVALS �/ A INSPECTOR'S ATURE P/��• (•�D; P.C. PMT. FOUNDATION:,LOCATION 0 "; FEE $ FEE $ . FORMS, MATERIALS a FRAMCING;ESTOPS, \ C I HEREBY THAT THE THAT I-HAVE READ THIS APP C COMPLY BRACING; BOLTS J - LL AND STATE COUNTY TH_E ORDINANCES IS AND TATE AGREE TO COMPLY FURNACE: LOCATION. {' " WITH ALL COUNTY N. I AND STATE LAWS REGULATING 'GAS VENT'DUCTS BUILDING I WILL CERTIFY THAT IN DOING THE WORK TION �HEREBY WILL TH.EMPLOY ANY CALIFORNIAVIOLA- ' L'ATH,.INT. I. TION OF THE MEN S,CODE OF THE.ST SU A LIFNA RELAT.' INGTO.WORKMEN'SCOMPENSATION INSURANCE. LATH, EXT. °SIGNATURE OF - HOUSE NUMBER.COR' - - PERMITTEE RECT AND POSTED' ADDRESS FINAL CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENGINEER _ PLAN CHECK VALIDATION, cK M.o." WeR PERMIT VALIDATION .cK MID. CA6H ;I958�98AISB63 APpLFCATIO IV FOR BUILDING PERMIT -� "L DIVISION ,OF'BUILDING AND, SAFETY AooRess 664 G. RoAO W AY 'Deportment of County Engineer �7�— - County of Los Angeles 'LOCALITY I @-iM JOHN.A.LAMBIE. COUNTY ENGINEER NEAREST N - m CASSATT D:GRIFFIN. S_uvT OF BUILDING CROSS ST. T 1 IVP a, FOR APPLICANT TO FILL IN Dls RICcT�D: GROUP TYPE SEWER MAP �+ "'� CONST..'I HR ,£BK PG O BUILDING I�' /_-l �� �!A.� MAP /� _ STATE YES' ADDRESS FF �( C7 tCJ �}- GY cYUca:V NUMBER, L.O� HWY LOTNO.:F_ •z it; 8'�' '• �< BLOCK -USE ZONE SPECIAL " `/ - _ cow N ITIOS- .��. ��.37' uai TRACT'"M lg�i.Ov1•,We_w. A4xwz, L' SIZE OF LOT 3e,,J 7Crj�' NO'NoW F LOT LDGS'I�19r'1Q •BUIL ING yARO. HWY $ EET NAME - - EXIST. rn USE OF SETBACK - f "WIDTH 0 EXISTING BLDG.. �� ,FRONT �^ ! �1 f1 l P: L. o' �oh�.wY -0 EXISTING A OWNER IGVN.n1C �l'4J -7", 0a4 P�ILU. S SIDE `, - z MAIL - P.L ." m 'ADDRESSHvrGVt :O TRACT DWELL, i UNIT TEL. 5 INDUSTRIAL ' CITY�' .NO; -'T DWELL. I UNIT .6 'PU BLIC BLOG:. ARCH 11 ECT OR ii - "TEL. 'p yl icr 2 DUPLEX' 2UNIT5 ENGINEER - O�qu• �C.t'AIN NO. +p111 -o - UNITS 7 ADDN..ALT.; ETC. `i(Z - $ APT. — - 7((�J _H� o,t B. MISCEL. ADDRESS -. t�iM}Kr. yp��[y�" yF"y`Cll'"r 4" COMMERCIAL } � CONTRACTOR �"TNEOL' INSPECTION:RECORD ' NO. Yom., e ADDRESS ,SC DESCRIPTION OF WORK U .t� L�'�< PS ts.- a,:Ic •r,d t�. S'nw... _, NEW ADD ALTER REPAIR DEMOLISH 50. FT. `rs NO. OF NO. OF SIZE <�J ��' STORIES I `•FAMILIES + " :I;C DZ' A- _4 cLs - u" .DLC USE OF STRUCTU RE / SIGNATURE OL -. - APPLICANT APPROVALS A ADDRESS O4" _ ATE. INSPECTO 'S SIGNATURE ,. ) _ FOUNDATION: LOCATION $ Q� � FORMS.,MATERIA LS _C4 "' tf/^•� O' Q V '� FEE ✓' aS .FRAME: FIREISTOPS. VALUATION Y BRACING. BOLTS e�4'Y 'Ml )[..QL_•���� S� _ �— FEE •FURNACE: LOCATION; `1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT, DUCTSAPPLICATION AND,STATE THAT TE ABOVE AND AGREE TO COMPLY W TH ALL COUNTY ISD IINA CORRECT ,. -LATH, INT. AND STATE LAWS:.REGUL TING BUI ' IN ONS UC-" TION. LATH. EXT. SIGPERMITTEEF J • O ECT AND POST'EDR 1�1341a•'-a •� �, N ADDRESSFINAL 1 JOHN A. LAMBIE_.''COUNTY ENG] EER VALIDATION CLYDE N. DIRLAM. CHIEF•BLDG. INSPECTOR +: '- + CK MO CASH _ 66.23 HAY161 '6 3825A,N765,cI 2'.4: JUL 3 , 1 i L ®`` 96A695A DBS-3 9.65 \ _ 6 N 1E�7 kkO V P-- APPLICATION APPLICATION FOR BUILDING PE64M1T 1 z w 'DIVISION OF BUILDING AND SAFETY BuaDwG 3 AURE83 C 'Department of County.Engineer • County of Los Angeles LOCALITY m WM.J. FOX. COUNTY ENGINEER- NEAREST y CASSATT'D.GRIFFIN;SUPT OF BUILDING' CROSS 8T. - -- p seeDISTRICT NO. GROUP 'SEWER MAP FOOR/APP/LIICaANT TO FI�LL-J`IN G _ b-Z I coN I BK PG c ADDRESS �.��+aaE /�� r a _2L I W Y •NUMBOUIL ER. O HWY _YES,L, NO a LOT NO � � 2p1 0f L-3R BLOCKCONDITIONS -USEZONE SPECIAL" TRACT IN'bypo 4401 , �! NO OF BLD GB. - - m SIZE OF LOT -`f 1C '1�T'O NOW ON LOT 'I BUILDING IX19T. I ' NOYIL YARD HWY STREET NAME: WIDTH .O n, SETBACK ,r. 'BE OF ' ,FRONT p �f E%ISTING BLDG.- , L• /. p SID2 P. L. O MAIL • .ADDRESS O TRACTDWELL. 1 UNIT 5' INDUSTRIAL TEL T .DWELL. I UNIT CITY NO. PUBLIC.BLDG. . ARCHITECT OR '1 TEL. ROVSI� 2 DUPLIX I UNIT .7 ADON.. ALT:. ETC. ENGINEER oA IGM/IIvN .NO. '3 APT. _UNITS '`YI�� _ 8 MISCEL: -ADDRESS `IJ Ib Mon�cN,ar �IosVwarb-` a COMMERCIAL W� �e�at1K Na' INSPECTION RECORD CONTRACTOR - . ADDRESS 17 DESCRIPTION OF WORK NEW .ADD ALTER -REPAIR DEMOLISH SO. FT. - ' NO. OF ' NO. OF , SIZE -�5'Oo STORIES 1 FAMILIES USE OF STRUCTU RE uVIV t lnlUU ' ! Y II t'tt� J fJIVJ.t 33 SIG14ATURE OF APPLICANT '• :APPROVALS. . B31a� ADDRESS .JCC. a'b0(IQ •. ..• ••• •DATE'>•,.IN_SPECTORIS'SIGN ATURE FOUNDATION: LOCATION -• �I `IlG�I S P. C. 9 ��j FORMS.'MATERIALS 1 A-% Odd 1 Bti � -FEE � d' y FRAME. FIRE STOPS t / . . . BRACING. BOLTS VALUATION B / G fSnHl FEE FURNACE: LOCATION �f� (,(1!j�311Q.I .3 S I HEREBY ACKNOWLEDGE THAT I 'HAVE�:READ THIS GAS VENT, DUCTS APPLICATION AND STATETHATTHE ABOVE IS CORRECT ` I.I.. • . .(:. • • AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. �•AND STATE .LAWS REGULATING" BUILDING-CONSTRUC- . ...,...., . ••_• �r• , I.. . . .. ... ., 'TION. LATH, EXT. SIGNATURE OF HOUSE.NUMBER COR- , PERMITTEE RECTANDPOSTED ADDRESS FINAL ' WM..J. FOX,COUNTY ENGINEER- VALIDATION C. N. DIRLAM...CHIEF BLDG.,INSPECTOR T034'. 118SEP15 1 6 33 .50A:N COUN Y 0, eIY ETOS �."JGELES IF BEPARTIJI[-NTOI' CU,%P ,`JG," ;( DIVISION OF BUILDIN8534 EAST G & SF T 'SAN GABR EL,LCALI^Op I AT.-7-5171 -C ITY 76A638AGE;PB031.e2'APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING ! ,ADDRESS 9 ` /(.�(/ \ DEPARTMENT OF COUNTY ENGINEER f/ 0 ,, BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMEIE. COUNTY ENGINEER NEAREST WILLIAM A.JENSEN, SUPT OF BUILDING CROSS ST. DISTRICT NO. G OUP 'TYPE P 84ESSED BY v F_OR APPLICANT TO FILL IN 7 �j Cory T.� BUILDING yZ�+OQQ �� STATISTICAL CLASSIFICATION SE%k R MAP ; ADDRESS 15 EG --/JG CLASS. NO.-OW UNITS %a0 j1U LOT NO..Gr •�/r-+�`,f L� `l 7}/ BLOCK ,WATER NOT-REOUIRED RECEIVED F. ❑ y � CERTIFICATE: r rG TRACT .d _ �.d L(.E- MAP r HIGHWAY w NO.OF FLOGS. ,NO: - (CI RCLEI STATE MAJOR SECOND, LOCALC SIZE OF NOW ON LOT USE ZONE SPECIAL USE OF •��j�• , - J/I CONDITIONS �. EXISTING L.G.BGy✓J^C� - I r OWNER74k. No 176S"¢3 BUILDING EXIST C i t p SETBACK YARD HWY STREET NAME:• WIDTH r ADDRESS•s'4'j+JE ..,w_4---A$ OV6 i FRONT 0 ARCHITECT OR �"f:�/TN ;(�O LUE LGA TEL P. L. J =p-QL" ENGINEER'-ENGINEER )SIV/ )rr 6�/ NO Md;S273 ISSIDE ADDRESSGp .T,,L�. P L TE CONTRACTOR i^.f I -,� + , NO -ADDRESS. .ilg�� � wil�•.• r r{,r y�Q DESCRIPTIONOF.WORK 4 ' �'{ % �! 1 iar iu r+•.y:-�,' t•rA%'l�9A'II���f.'L� �.f✓�.P9n� A �ywt14C�_:'�\Luai NEW ALTER,? 'REPAIR DEMOLISH NO.OF NO. OF STORIES FAMILIES - •w /! �. "i+� T,,,..•/9� '�;,/ 9�) '•+ STRUCTURE•C'N �'+ i� _ rFfO.a�i•5/s >1�'rwyw-7t.1'I.,ISFfJ�a�r+�/ Y 3�I � j�, ,F A{! .�.�w.. .r/Q.Pn.+•lI"u r4''*Y cR-,'�� 1 _:,'V 1SI6NAT6RE O *- F _�G� /1 + , 1 I�I II� tT r •;��: + ,*--,APPLICANT-' ' 'VALUATION $ _ ' •' ^ O� �0. 'APPROVALS DATE INSPECTOR'S SIGNATUR P.C. pry _ a� PMT. ( FOUNDATION: LOCATION ' FEE FEE $ n, FORMS, MATERIALS a FRAME: FIRE STOPS, I I+HEREBYACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS K AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO'COMPLY FURNACE: LOCATION. WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING „GAS VENT. DUCTS BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK ,/ AUTHORIZED HEREBY WILL NOT EMPL Y ANY PERSON IN VIOLA- LTH:'I NT,I j/'r�. / /� /jam' y /�l AW TION OF THE LAP R CODE OF THE BTA E OF CALIFORNIA REI p _ ING TO WORKMEN'S CO MPENSAT N IN4 gANCE. " IV fly •�/ ��{/ I J / !.ATH. EXT. J SIGNATURE OF / / HOUSE NUMBER COR- PERMITTEE_ RECT AND POSTED �] / ADDRESS -FIiNAL 1 • — I (��)p -/• / 7i12 - P JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER P IND C( ]CR VA ATION cK M.G. CASH PERMIT VALIDATION aK.+ M.D. CASH LI 11J"i ?�G 5 6, ' /� 1 COUNTY OF LOS ANGELES - TEMPLE CITY g 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0506 1202080046 PHONE: (626) 285-0488 EXT: ILEGAL ID: - NO. OF CONST BUILDING ADDRESS: 1 I ON FILESQ. FT STORIES TYPE 9664 BROADWAY 1 I 11STRUCTURE: 0 V TEMP CA 917803206 1 ASSESSOR INFORMATION NUMBER: - NEAREST CROSS STREET: 18588-023-031 _ THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY I (TENANT: (EXIST BLDG USE: CHURL USE ZONE: R-1 JISSUED ON: PROCESSED BY: IExIST OCC GRP: 102/08/12 RE TOWNER: TEL. N0: IBLDGS..NOW ON LOT: VALUATION: (FINAL DATE FINAL BY: CODE: ITEMPLE CITY SDA CHURCH (626) 497-7227- 1 2 7 15,500 19664 BROADWAY II _' - Y 1 ITEMPLE CITY CA 91780 1 FEES PAID 1'E111 TI0N OF WORK I IRE-ROOF 46 SOFT OF ROOFING NO NEW SHEATING NEEDED TO DOE TO J IEEE DESCRIPTION: QUANTITY: DOM: AMOUNT: 1 (2) 2 X 6 MEMBER USED AS SHEATING 30 YR COMP SHINGLES 1 (APPLICANT: TEL. NO: I 1 - 1 JUAN, SANCHEZ (626) 625-5200- AA BLDG PERMIT ISSUANCE 21.80 1 11 I 1AB STATE GREEN BLDG FEE 15500.00 VAL 1.00 ISPECIAL CONDITIONS: 1 jAC STRONG MOTION RESID 15500.00 VAL 1.60 1 1 IDS PERMIT W/O EN-HC 15500.00 VAL 318.30 i I IFS INV WORK W/O PERMIT 257.00 DOL 329.70 ' CONTRACTOR: TEL. N0: TOTAL FEES 678.40 (APPROVALS' DATE INSPECTOR SIGNATURE J POWER ELECTRIC AND CONSTRUCTION (626) 625-5200- 1 12300 S SYCAMORE AVE LIC. NO ILOCATION AND SETBACKS ILOS ANGELES CA 90016 942023-8 + I J ISOILS ENGINEER APPROVAL i., ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC NO: ISLAB/UNDER FLOOR I {xn.IsrD FLOOR FRAMING 1 I I I I MAP NO: SEWER MAP HOOK: PAGE: FIRE ZONE: ORE: JUNDERFLOOR INSULATION 147H269 3 1 11 1 IFLOOR SHEATHING I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I � 0 NO 22 ROOFO SHEATHING _� SCHOOL WITHIN HAZARDOUS SHEAR PANELS JAIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION I (FIRE,SPRINKLER HANGERS I I I INSULATION/WEATHER STRIP (INTERIOR LATH/DRYWALL 1 - I IEXTERIOR LATH I I I P II I I RATED'FLOOR/CEIL ASSEM. 1 1 I i I I I I JESTED WALL ASSEMBLIES IRATED SHAFTS/OPENINGS iT-BAR CEILINGS + ADDITIONAL DATA ON FILE L0T;DRAINAGE . _ IREPORT ID: DPR261 ROUTE TO: DS0506 --" - COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS NEW COMMERCIAL ., BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0211120006 PHONE: (626) 285-0488 EXT: LEGA NO. OF CONST NEW BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE OCCUP GROUP 9664 BROADWAY STRUCTURE: 0 0 VN U1 TEMP CA 917803206 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: TEMPLE CITY 8588-023-031 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: USE ZONE: R-1 ISSUED ON: PROCESSED BY: N: CINGULAR WIRELESS EXIST OCC GRP: 01/03/03 JK 12/29/03 OWNER: TEL. N0; BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: SO CAL ASSN OF 7 DAY ADVENTISTS (818) 546-8400- 100,000 1535 CHEVY CHASE OR �)- GLEN 912064107 FEES 15AID DESCRIPTION OF WORK INSTALLATION OF EQUIPMENT OF CELL SITE IN CONCEALED RM AT FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: BASEMENT LEVEL & NEW ANTENNA INSIDE EXISTING TOWER APPLICANT: -T-EU-NO- JACKSON O:JACKSON (323) 938-2336- D1 PLANCHECK W/O EN-HC 100000.00 VAL 1,095.48 5670 WILSHIRE #1600 AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: LOS ANGELES 90036 AC STRONG MOTION•RESID�'100000.00 VAL 10.00 D2 PERMIT W/O-EN-HC 100000-00 VAL 1,295.85 P�uELESTOTALIFEES 2,429.08 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE BROOKSTONE TELECOM (909) 694-4114- 27450 YNEZ ROAD, SUITE 300 LIC. NO LOCATION AND SETBACKS TEMECULA CA 711591 B _ / SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TR N FORMS W E JACKSON CORPORATION (213) 938-2336- 5670 WILSHIRE BLVD, SUITE 1600 LIC. NO1!'iJI—I/ ,111111 SLAB/UNDER FLOOR LOS ANGELES, CA 90036 C9857 L RAISED Fl-OO-R--FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP.: n n p n n UNDERFLOOR INSULATION 147H265 D 132 3 '01:�� : 11 C �//1`(/OR` 5 �1 UL-� �W v fill ILlI IJ �1 FLOOR ��,�..-•N;s .2.G,�� 3 .� y N0. OF FAMILIES: DWELLING UNITS: APi/L ND: STAT CLAS -- NO20 Vl - A ROOF HEATHING SCHOOL WITHIN HAZARDOUS `�\ O 0jti.st '1 SHEAR, PANELS FRAME INSPECTION PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO A 0 5 U i 3 // Ej FIRE PRINKLER HANGERS Service That INSULATION/WEATHER STRIP INTERIOR RYWALL EXTERIOR LATH RATED FLO ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS _ T-BAR CEILINGS LOT DR INAG REPORT ID: DPR261 ROUTE TO: BS0508 J WORKERS' COMPENSATION DECLARATION - F� p /,a �Ipglp� ��}a I�^(s Qp{� �FI��Ip�[/`�m ER �F��gp��L� hereby affirm er that haver certificate of consent to self /D\ PP I AQ �� N Il ®Il�l L�.lwl P L D P V V PLS U�IU PJ O�� insure, or a certificate of Workers' Compensation Insurance, !/'l\Il LS ��VVV--- - , or/a eyyppifll������erof (Sec, 3800, Lob. C.) + •wt t.� Ay, COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company__C - �❑ Certified copy is hereby furnished. �� % '''F,,O� 11R APPLICANT TO FILL IN ADDRESS' 9��� G. Lf-•�-.�r_us� Certified copy is filed with the county building inspec- _!. gDDRE55 , !��!'�1'".`,h �/ +. r• - /Ilion department. lY�I (J�jj Y - ..! �V +_f;� iia �e/� - .tr•. ,.!'Svl }•lu �f�j�!"�v_ L , LOCALITY �J7G �i f. Date .Applicant NO. OF BLDGS. NEAREST. _ CERTIFICATE OF EXEMPTION F OM WORKERS' SIZE OF LOT - NOW ON LOT CROSS SL - • COMPENSATION INSURANCE - ASSESSOR " (This section need not be completed if the permit is for one TRACT - BLOCK LOT NO. - MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) - _ - TEL OWNE� e lL. NO. - USE ZONE MAP I certify that-in the performance of the work for which this ` ' i �O ,A ]NO SPECIAL ._ permit is issued, I shall not employ any person in any manner ADDRESS X0`1 CONDITIONS so as to become subject to the Workers'Compensation Laws. O CITYM r eL,\ ZIP I1J U Date- Applicant ARCHITECT OR - TEL, NOTICE TO APPLICANT::If, after making this Certificate of ENGINEER NO. DISTRICT GROUP OY ,PE ZONE P OCESSED BO Exemption, you should becomesubject to the Workers' - - u Compensation provisions of the Labor Code, you must forth- ADDRESS ��� with comply.with such.provisions or this permit-shall be �7 6` NO STATISTICAL CLASSIFICATION - APT. CONDO. Z deemed revoked. CONTRACTOR" O f\... - - - LICENSED CONTRACTORS,DECLARATION LIC. [� CUSS No.��" t DWELL. uNliS I hereby affirm that I am licensed under provisions of Chapter 9 ADORES 6 (C6 O I NO. - - LIC. SEWER MAP (commencing with Section 70(N))of Division 3 of the Business ? - and Professions Cade,.and m license is in full force and ect. _ _ CITY OMD Ak CLASS C_7 BK PG. VALIDATION ���s�nfg' SQ. FT ' n NO. OF NO. OF CHECK _ License Number Lic. Classes SIZE IS UO STORIES FAMILIES ONE _ VALUATION DESCRIPTION OF WORK fContractor Data El I am exempt under Sec. ADD -❑ a,b D _ _ ALTER [:1 " B.BP.C. for this reason REPAIR F-1 $ Date: USE OF - - - - _ EXISTING BLDG. DEMOL ❑ / TEL Signature APPLICANT ' ., OWNER-BUILDER DECLARATION "IPRINTjFINAL' NO. DATE I hereby affirm that I am exempt from the Contractor's License - Law for the following reason (Section 7031.5, Business and ADDRESS FINAL Professions Code): � PRESENTy ACV.T ❑ 1, as owner of the property, or my employees with BU ILDING ADDRESS JJQ3 414.15 . -wages as their sale compensation,will do the work and 1 ITEMS 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. TOTAL _ y�_ 4 14 ® .. 5 with licensed contractors to construct the project (Sec- ' ADDRESS - CHECKS 414.15 tion 7044, Business and Professions Code.) `1 _ 7REQUIRED TOTAL SETBACK FROM EXIST. CHANGE .Ou CONSTRUCTION LENDING AGENCY SET BACK YARD - HWY 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. - - n n ti t IS 3097, Civ. C.). SIDE .. 0000-0001 b/11/96 . - ._P.L. Lender's Name. fi84Q' 1 Atlll=0.� - P.C. Fee$ - Permit Fee (/p_ SMO' ReEA - Lender's Address `y o I certify that I have read this application/and state that the - Issuance Fee /- LDMA P/C N D 8 above information is correct. I agree to,comply with all County Investigation Fee ord' es Stote laws relating to building construction, Total Fee /. - J LDMA Perm. p ^ a her b a thoriz epresentatives of this County to enter u 'n th ve-me ti nnecl property for ins pec/I n r�pjps/e^s - Vtr'�` v✓ (s(' SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of Applicant or Agent Date . COUNTY OF LOS ANGELES TEMPLE CITY 05.08 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9702070009 PHONE: (818) 285-0488 EXT: LEGAL ID: - NO. OF CONST BUILDING ADDRESS: ON FILE SO. FT STORIES TYPE 9664 BROADWAY STRUCTURE: 0 V TEMP CA 917803206 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8588-023-031 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: CHURC USE zo-N-E-.--R7-- ISSUED ON: PROCESSED EX ES ON: EXIST OCC GRP: 02/07/97 TC 02/ 7/98 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: SO CAL ASSN OF 7 DAY ADVENTISTS (818) 546-8400- 2 3,000 1535 CHEVY CHASE DR GLEN 912064107 - FEES PAID DESCRIPTION OF WORK 0'%^1 a INSTALL ONE EXTERIOR 36" DOOR W/P IC RAR & HANDICAP ACCESS FEE DESCRIPTION: OUANTI,T,Y:,UOM: /0^ AMOUNT: APPLICANT: TEL- - +n kx� �-d G.P. ROLLIN CONSTRUCTION (818) 354-4155- AA BLDG PERMIT ISSUANCES 27,-75 AE STRONG MOTION (OTHER 3000-00-VAC- '0.63 SPECIAL CONDITIONS: D2 PERMIT W/0 EN=`HCS 3000C00'VAL 99:15 `O a TOTAL FEES 127:53'. CONTRACTOR: TEL. NO: A1' � O APPROVALS DATE INSPECTOR SIGNATURE G P ROLLIN CONSTRUCTION (818) 355-4155- `1' ,) 351 N. GROVE ST. LIC. NO '� �'. Q p LOCATIO4 AND SETBACKS SIERRA MADRE, CA 91024 692168 B )415.. om rl9nd SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. N0: 'V¶' OU)=HDA1[ON/TRENCH FORMS LIC. NO: ' Lllit O SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 7 UNDERFLOOR INSULATION 147H269 - 3 01 C ) FLOOR SHEATHING OF FAMILIES: DUELLING UNITS: APT/COND: STAT CLASS: NO 22 ROOF SHEATHING --SCHOOL WITHIN HAZARDOUS SHEAR L / AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATION/WEATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE �`. REPORT I0: DPR261 ROUTE TO: BS0508 -APPLICATION..- - _FOR BUILDING PERMIT . •z COUNTY-OF LOS ANGELES.- - .. BUILDING AND SAFETY' hereby affir_KER S COMPENSATION DECLARATION' " D 5 f �. yypp FOR'APPCICANT'TO FILL IN BUILDING ADDRESS 4+ ' - A BUILDIN ODRESS y m that I have a Certificate'of consent,to self'.Insure,. 'or a cerfificate,of Workers' Coinperisation Insurance,or a certified' copy JhI(Sec 3800, Laos C) `' CITY (�� ZIP / _ Policy, 0 Company r .r / cOCALfI'v- .` 1 e by furSIZE OF LOT = NO.OF SLOGS'NOW ON LOT, ❑'C - ertdied copy Is herenished.: -' _"' - ,. ,. ., .. ,,, ,.'• ,.NEAREST GROSSST. : 1. ❑ Ce 4fiedcopy is filed with the county building inspection TRACT BLOCK LOT NO ,f' _ d\Dlartment. ' - USE 20NE. MAP NO. ' "'-- , = - ASSESSOR MAP BOOK -- PAGE, �i PARCEL I Date �1 - Appli.ent ' I NDITIONS� OER7IFICATE OF EXEMPTION FROM WORKERS 'GWNE � / '"TEL - � � - 4 COMPENSATION INSURANCE AUG — T WITHIN i_000 FT OFCHOOLP YES No _ {This section need not be DOTItediif-the permit is for'one,hundretl ADDRESS - � . .. Sollars(slob).Or less.)., ..� - .. ,u' D e _ DISTRICT,. GROUP, TV 'C FI NE PROCESSED BY . ` `CITY' i ZIP 3. , .� Iberfify that in the,performance of the worklfor which this'.permit, becomelsu�ctt to the Workers y person at'any manner^s0 as to: ARCHITECT OR ENGINEER TEL NO. Is issued ihall'mot em to a�mpensa Cl OND Date_� 5 App _ ADDRESS. - CLASS OLC CATIDWELL:U TS . : ... ,I APT - O.. . FI G :NOTICE TO "APPLICANTIf, after making- this' Certificate` of - _. - REQUIREDL11WY TOTAL SETBACK FROM EXIST Exemption you Should become sublBCt• f0 the IWOrkefS CONTRACTOR - TEL NO: SETBACK: -PROP LINE 'WIDTHCoinpensanon provisions of^the Labor. Code. you must forthwith �G�/ � (r Ti^ LMONTcomywithsuch provisions or this permit'BUSH be deemed revoked ADDRESS LIC:NO LICENSED.CONTRACTORSDEcLARATION �� ✓L /l- . + " 'CITY LIC:CLAS I hereby affirm that I.am licensed underprovisions off Chapter 9 F„ _ ✓"}— _ASEWER MAP - (commencing with Section 7000)of Division 3 of the Business•and SO.FT.SIZE - NO.OF STORIES 'NO:OF FAMILIES -` _ Professions Code:and m license Is In full force and effect. NEW BK PG _ )- License Numbe LIC Class . 12 DESCRIPTI N OF WORK - ' ' ADD ❑ VALUATION ,- a D_ Contractor^�e��Te �! Dated + ..ALTER ❑ _ s _ $' /d7D0 o `C - T [Ia REPAIR El �$ 0O I am exempt imder Se ^' '' - �� _ -� - 6&P C-for this reason., • - v - ' EMOL ❑ U D LDMA P/C d - •' Date: + ,USE OF EXISTING BLDG: - URM ❑ y\ ... +. ,♦ 'A " L d . Signature' " t^I^ - - ,A z - APPLICANT.(PRINT) - TEL NO:, - LDMA Perin d '�, ! R J el - ❑ as owner of the.property, or my employees with.wages as, - - r ! th ,;..0 eir sale'compensation,.will do the work and the structure Is.. ADDRESS -'not Intended or offered for sale(Section 7044; Business+and - FINAL DATE ry_ 3307 _G c0, PFOfeSSlonS.(`.OdE.) 'WILL$HE'APPLICANT.OR FUTURE BUILDING OCCUPANT HANDLE,A HAZARDOUS MATERIAL _ OR A MIXTURE. UNFAILING A HAZARDOUS MATERIAL EQUAL-TO OR GREATER THAN THE J I 1 i ❑ as owner of the property, am'Exclusively contracting With �gMOUNT5 SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE2 -. FINAL E ` `� J J/' 10 �101 l ice tractors to construct the,project (Sed!ion..7044,E YES El NI - rY � 7 i- Business and Professions Code.) ` - - +' - , ..,MLL_THE INTENDED USE OF THE BUIDLING.BY'THE APPLICANT OR FUTURE BUILbING� I iEl�� ' '. . . ... TION OR MODIFICATION FROM M SOUTH • A TOTAL 5 2 U� CONSTRUCTION LENDING AGENCY'` "YEA❑NESNo❑ CAOMDI SEE,PERMITTING CHECKUSTFOR � I hereby affirm that there-'is a constructionNendmg;agency for OCCUPANT mANncEImEF�pDi�aseius I I -CHECK _. the performance of the:work for which this permit.is issued(Sec - - ♦ I ((�^�,1 m. IHAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THESCAOMD PERMITTING lIT(1,V!v�E 3bg7,.CIV.C.) CHECKLISTd UNDERSTAND MV.REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE w . .�' C'. TITLE E;CHAPTER 2.20 SECTIONS 2.20:100-THROUGH 2.20.140 CONCERNING HAZARDOUS., 3 Lender's.Name MATERIALS REPORTINGAND FOR OBTAINING A.PERMIT FROM THE SOAOMD. o Lende'r's Address- I . ' T ' OWNER OR AGENT G�4G-01G1 rtS Int I certify'thal I have read this application.and state under penalty, o' - PC.FEE PERMIT FEE - �ialJ ;v:fG o` of perjury that the above.lnformation Is correct I agree X.comply !7l ./ / ' •1^ F�� 'w,th.all county ordinances and.State laws relating to building. �v - m '- construction, and hereby authorize representatives Of this County " ISSUANCE FEE to enter u e above- ention- property for inspection purposes. - a` I " ✓,�?3.3 INVESTIGATION FEE TOTAL FEE s : a � � Dom?• 3 D ' SEE REVERSE FOR EXPLANATORY LANGUAGE' I J/�y WORKERS'-COMPENSATION DECLARATION _.��•,-'•c.lC - - . .` „- . _. .,....,. _`' i 1 ereby affirm that I have a certificate of.consent,.to self //p�� I�}�l �[/,i r�1��p� �E�} I��y 'F�ry{p�(,(y��. spy orae, or aI ert thereof.(Secgp0� Insurance, /rpPll ��CAM, 0Vy 11 OR �UP�®�11V`Y PIb U�IIIUD�� Poli No. m n ?' COUNTY OF LOS ANGELES BUILDING AND SAFETY insure or a ceiti icate o or ers om ensahon 64 Certified co is•hereb furnished. . . _ BUILDING / � /— - Py v FOR APPLICANT TO FILL IN ADDRESS Fj 25 ❑ Certified.copy'is.filed with thecoubty building•inspec- BUILDING lion l a tmenf - t ' tY "1 r ADDRESS /./ch•(% t i _ �j Dote% 4!1Applica i .V�r/�/"� CITY JET ZIP / 7�s' LOCALITY 7;;;_ l! ti CERTIFICATE OF EXEMPTION FROM"WORKERS - "' "' - "' " "' -'- NO. OF BLDGS. -- - NEAREST _ ;^ ' OT NOW ON LOT CP` CROSS,ST. _ EOMPENSATION'INSURANCE. �'�t' SIZEOF LL ~(' (This'section-need-notbe'completed:if the permit,is+for one - - - - -- - - ASSESSOR L t •„�-'t,q hundred dollars ($100)or less.). , TRACT BLOCK LOT NO MAP BOOK• PAGE, PARCEL .. �`' �1' TEL - _ USEZONE MAP " ' - .4 i tlrt: r t OWNERVI V C�" NO. hcertrfy that id the performance of thework for which this` permit ps issaed, I shall not employ'any person in any-manner // �r-y-,r \y' SPECIAL so as*,to becomesublect to the Workers'COmpensd lion Laws. _ ADDRESS' C ' ''j-'G �J CONDITIONS ;' rr O �. , tic t 1^,=. t •., , - ' ' L.. :..� V n rt. t. .>~_ CITY �i '( ZIP- . 7,f Date "' - Applicant ARCHITECT OR _ TEL. ' O NOTICE TO APPLICANT If,:after making this Certificate of ENGINEER NO. ,DISTRICT GR UP 'JYPE FIRE BY u- PROCESS Exem tion lou- should become I subject to the,-Workers' IT �7{y / U CONST ZONE 1 Compensate n,provisionstof.the Labor Code, you must forth- ADDRESS ✓-•�t/- -/'-. - - - - •� - ---- M d'with comply with such,provisions or.this permit shall be TEL yy,� STATISTICAL CLASSIf(CATION APT. CONDO: ` deemed,revoked .,. r', :- . r r t• ;n . CO HJd•. GjC.CR-. NG. Gv+•' - _ __ " LICENSED CONTRACTORS DECLARATION,•,,r - - -- - CT LIC." - r CLASS NO. 1 DWELL UNITS_ I hereby affirm that I am licensed under,provisions of Chapter 9 ADDRESS &;O Q s.J NO. SEWER'MAP (commenting with Sechon7000)of Division 3 of the Business and _ .. p'-{� -_ _ _...LIC; _ L _ _ Professions Code, and my license is in full force and effect - CITY {wry.�� CLASS -^ -9K— �; VALIDATION J..� R N OF HECK 1. 4'`•J •7 + f/r�/ - .._. _. SQ. FT. r O. _ .. FA OF _ �C e SIZE STORIES. FAMILIES ' ONE - License Num Lic..Class - t_VALLIATIN_ t. �"' DESCRIPTION OF WORK - NEW ConlraclA ' ' i ate ''y` pp j ADD E] s `z V Oa/ ' _.. /� ` ALTER -❑ ¢ D 1 G.2 9 A I am exempt under Sec. B 8P C.for-this reason / ZC�C.y'�� REPAIR s "- - - # +_..Date: _ _ USE `© ` iy DEMO( ❑ +� . EXISTING BLDG 1 �c..� - i ( X 2'1 -�,'t3 + r'• APPLICANT TEL.. -" "Signature '- PRIM .qy.1g FINAL /q� ' OWNER-BUILDER DECLARATION F p _ O^ ` ���� •DATE- ( - - --,1- ---t--'-� 2�1.Pa 6 3•s- >.I.hereb affirm.thatd amexempt'.from the Contractor.'s.License .,/� , Law for the followingreason Section 7031.5, Business and ADDRESS -Z f% FIN Y v `-" •' 0129=`8'S "Professions'Code).' - -' PRESENT _ " "�" - •� �•` y BUILDING vi r I, as owner of the property, or my employees with ADDRESSt�b-3 wages as thir esole compensation, tlI cl the work and n k thestructure is not intended or offered for sale(Section LOCALITY 7044,Business and Professions Code). MOVING'- "'- ' ' '- TEL.- as EL as owner of the property, am exclusively contracting CONTRACTOR _ - NO. l ❑` with l icensed-contractors to construct the project (Sec- -'" ADDRESSt ~ -. .P t t non 7044, Business and Professions Code). - J r '� (t, .REQUIRED. TOTAL SETBACK,FR M I T .y: "'- "- CONSTRUCTIONS LENDING AGENCY' - SETBACK YARD'" HWY PROP LINE WIDTH t - . I hereby affirm that there is a construction lending agency for FRONT _ C, t1' 1'• '• +-the'performance of the work for which this permit is issued - - P:L.-^ - - --: - -- - - - -"- - .t -�^`'• �• '_'t's. •` t 'r ^" (Sec. 3097, Civ. C.). d. - SIDE - m P.L. _ _ - _ ._. _-. .. _ ". Lenders Name - t. -. P,C. Fee$- _ Permit Fee Lenders gddress_ .I_cerhfy.that „have read this appliwtion.and.state_that.lhe _ :_. - - Issuance fee - cI� LJ; -CDMA PTC#- a above information is correct:)agree to comply with all County InvestigationFee L3. ; ordinanc sand State laws relatin - ,6uilding.consvuction, - Totalfee - -- b -U CDMA Per,I-#-. '`f , '•1-- -- i ' -� -• - and y authorize r f es oft rs County to enter J - � 1 a e o 'e e i e p erty fo spection urpo es. - + SEE REVERSE FOR EXPLANATORY LANGUAGE -' - -Signature of-Applic for AgeN•^ .__. -. e__ _ _ __ __ . _ _._ _ .. . _ _. -•. ___ ..-. _. _._._ _ _ - .