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Home My Public Portal About9665 BROADWAY_Building__ APPLICATION FOR _BUILDING- PERMIT' , �. « COUNTY OF LOS ANGELES' BuaDING C� - DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST.! I d c� DISTRICT NO. GROUP ` s I ESSED BY FOR APPLICANT TO FILL IN TYPE . /f /� � /� 1.. Tconlsr_ ADD ADDRESS - STATISTICAL CLASSI FICATION I S4V R MAPA CLASS.NO^ DWELL. NITS " - LOT NO. '✓;( C I Y _, TBCOCK MAP - STATE NUMBER - HIM YES .. TRACT / 4 .,H .:fit} L"✓: z� USEZONE . SPECIAL,- - /� NO.OF BLOGS. CONDITIONS SIZE OF LOT _ (J Q"I NOWON LO/T�- - EX STOING BLDG. r 6:s D� C{.. BUILDINGEXIST. YARD 'HWY - STREET NAME OWNER' � STEL:, SETBACK - � WIDTH - Y NO.-` FRONT /y ADDRESS SIDE - 41, - ARCHITECT OR - - 'TEL. P.L. ENGINEER No, INSPECTION RECO ADDRESS .�:rr _ CONTRA - - O ADDRESS _ DESCRIPTION OF WORK- O NEWT{/. ADD - ALTER REPAIR' DEMOLISH W SO.FT. ,. -NO.OF NO:OF a 'SIZE' AqO /7 SSTORIESS FAMILIESSE 0 STRUCTURE'' SIGNATURE OF i - APPLICANT " VALUATION$ -- APPROVALS. DATE INSPECTOR'S'SIGNATURE - � FO SN:'LOCATION FE $ FEE $ FORM , MATER ✓ - FRAME: FIRE STOPS, 7 HEREBY ACKNOWLEDGE THAT I HAVE READ THISAP- BRACING, BOLTS d L-A/Z lInlll�� PLICATION AND STATE THAT VE IS CORRECT AND FURNACE: LOCATION. AGREE TO COMPLY WITH ALL COUNT COUNTY•ORDINANCES AND GAS VENT DUCTS STATE LAWS REGULATING BUILDING. CONSTRUCTION. _ 1 CERTIFY THAT IN DOING THE' WORK AUTHORIZED I LATH, INT. - WILL NOT EMPLOY ANY PERSON IN VI LATION OF THE _ WORKMEN'S CO NSATIOPY LAWS �VCCALIFQR fA. 7 - s -�/ �C( / LATH,EXT. 7.! n �7%�ff/ SIGNATURE— HOUSE NUMBER COR- PERMITTEF �eF AM1' RECT AND POSTED ' ADDRESS'- FINAL C LYDE N. DIRLAM, PRINCIPAL ST RAL.ENGINEER - PLAN CHECK VALIDATION cK. M.D. CASH PERMT VALIDATION CK. M.D. 'CASH-. 1 ' DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES BUILDING WM. J. FOX, CHIEF'ENGINEER BU ® I - r P • FOA'APPLICANT-TO FILL IN FOR OFFICE USE ONLY BUILDING n y (�° DZETR O.._ PLANCK. NO. - PERMIT/-NO. ADDRESS 72��' LOCALITY L , 0.. RECEIVED BY ` -DATE OF PPL. DATE ISSUED NEAREST CROSS ST. Y/1. BOILDING OWNER V�LILL IUM�il.1 ADDRESS MAIL n LOCALITY ADDRESS �",1 �j.w NEAREST TEL. CROSS ST. CITY_ (�(_f� �,,,(�,^y� NO. FIRE CAS OF I TYPE I GROUP, ARCHITECT OR - TEL. ZONE PL NS ENGINEER NO. BLDG. ORD. NO. .� - SETBACK LINE ADDRESS ') APPROVED ' •JJ // /, � TEL. '�I BY DATE CONTRACTOR J�'PpgW /ms{/µ. y NO. & USE APPROVED' ' ' I w� (/))) ZONE BY DATE ADDRESS y/a 1 7). �IbW(A- L�i1 / T.G HOUSE NUMBERING LEGAL D E6CRI PTION LOT NO. BLOCK MAP NUMBER FIELD CHECK BY TRACT NO. ASSIGNED BY DATE ND. OF BLDGS. CORRECTIONS SIZE OF LOT NOW ON LOT USE OF - NO. OF _ EXISTING BLDG, FAMILIES DESCRIPTION OF WORK NEW I I ALTERATION I I ADDITION ' O REPAIR I „ I DEMOLITION I I — -. _ _ A_ Sq. FT. NO. OF Ll SIZE ROOMS STORIES - Z D EXT. WALL ROOF r COVERING ICOVERING USE OF STRUCTURE I.�Iti�Z"aLG �./5. o-a-� ��.7" 7,l yuvl n�n..t.e. • , APPROVALS INSPECTOR'S SIGNATURE DATE I 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FOUNDATION: LOCATION PLICATION 'AND. STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS - CORRECT. .1 AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRESTOPS, HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS LAWS REGULATING G NSTRUCTION. I FURNACE: LOCATION, SIGNATURE OF /'�/J .{/ GAS VENT, DUCTS FERMITTEi- t LATH, INT. ADDRESS LATH, EXT. LVA OR IZEn Ant PLASTER. INT. 9OA• OBSHP. C $FEEpLA6TER, EXT. ATION � S O _ FEE FINAL H�2G.-.G,g _�-!O .3 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9710020016 PHONE: (818) 285-0488 EXT: LEGAL - NO. OF CONST - BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE 9665 BROADWAY STRUCTURE: 0 VN TEMP CA 917803211 ASSESSOR INFORMATTNN—NUMBER: NEAREST CROSS STREET: 8588-010-017 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: RESID USE : R-1 ISSUEDON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 10/06/97 UT 10/06/98 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: COSTANTiNO ANTONIETTA - 1 3,000 r � 9665 BROADWAY I 0 / TEMP 917803211 FEES PAID DESCRI�H/� VOLUNTARY BOLTING ORW� I F FON F R SEIMIC PURPOSES APPLICANT: TEL IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: . SHINE CONSTRUCTION (310) 410N0:-0456- JABLDG PERMIT ISSUANCE 27.75 . ACC STRONG MOTION RESID 3000.00 VAL 0.50 SPECIAL CONDITIONS: ID2 PERMIT W/0 EN-HC. � 000 00 99.15 ETOTpEES VAL 127.40 CONTRACTOR: TEL. NO: I ®� APPROVALS DATE INSPECTOR SIGNATURE SHINE CONSTRUCTION, INC. (310) 410-0456- 1117 W MANCHESTER BLV LIC. NO /d LOCATION AND SETBACKS INGLEWOOD CA 90301 604436 B-1 SOILS,ENGINEER APPROVAL ARCHITECT ORENGINEER: TEL. NO: e FOUNDATION/TRENCH FORMS LIC. NO: - SLAB/UNDER FLOOR RAISED FLOOR FR IN - MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: LMP: p�'+y+�' n' �I ,I17 �-�,r �` UNDERFLOOR INSULATION 147H269 3 01 rL ilI �l`�L L C ke) _ �d___---- ! FLOOR+SHEATHIN N0. OF FAMILIES: DWELLING UNITS: PT/LOND: STAT CLASS: NO 21 �� , H ROOF SHEATHING j� C i SCHOOL WITHIN HAZARDOUS " � ,�� X- ��- SHEAR'PANELS - AIR QUALITY: 1000 FEET MATERIALS ��\�C/ -.y : s- FRAME INSPECTION NO NO NO ` \v\�/ C REQUIRED TOTAL SETBACK ROM EXIST FIRE� _ SP NKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: 1.., �-p �- FRONT DE PL7� V '�,' INTERIOR LAVEATHER RIP LATH/DRYWALL S EXTERIOR LATH RA ED L AS RATEDt WALL ASSEMBLIES RATED,S /�T-- T-BARICEILINGS - - LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 WORKERS' COMPENSATION DECLARATION - hereby affirm that I havecertificate of consent to self APPLICATION FOR BUILDING PERMIT Insure, or a certificate of Workers' Compensation Insurance, or o certified copy thereof (Sec. 3800, Lab'C.) - - COUNTY OF LOS ANGELES ' BUILDING AND SAFETY Policy No. Company ❑ CeBUILDING /J Certified Is hereby furnished. FOR APPLICANT TO-FILL N ADDRESS O Certified copy is filed with the county building inspec- BU RDI NG h / �`E C r on deportment. ADDRESS (J Data - Applicant - CITY i ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BOGS. NEAREST p ' COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST.714—F 14 / G .. C r t y ' �•- (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE I PARCEL • OWNER COS/r �TIMRNO. L�I /7 USE ZONE MAP I certify that in the performance of the work for which this n't p w NO. - permit is issued, I shall not employ any person in any manner ADDRESS `I`FSS �A.'0 FT.�LU r�Y SPECIAL - 'so as to become subject to the Workers'Compensation Laws. CONDITIONS �G p /� �J Dot Applicant CITY / a M! �'r lnr ZIP QI�O Q NOTICE TO APPLI ANT: If, after making this Certificate of ARCHITECT OR, TEL. DISTRICT GROUP TYPE FIRE PROKESSED BY •Exemption, you should become subject to the Workers' ADDRESS NO. -5,091 �9�L (_ CONST. ZONE Campensotion provisions of the Labor Code, you must forth- gpDRE55 �✓Ti > with comply with such provisions or this permit shall be;., TEL. deemed revoked. - STATISTICAL CLASSIFICATION APT. CONDO. CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION LIC, CLASS NO. DWELL. UNITS • I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY CLASS BK PG VALIDATION d, SQ. FT. NO. OF NO..OF CHECK License Number Lic.Class SIZE TORIES FAMILIES - ONE VALUAT ON DESCRIPTION Of WORK NEW ❑ Contractor Date ❑ $ (i'� .. O ADD , 1 am exempt under Sec. - Ife— ��z 0 ' ALTER ❑ Da- 8.8P.C. for this reason Il IES -C of C4J .h 7�3 REPAIR ❑ f 2 /O USE OF ❑ Z Date: DEMOL EXISTING BLDG. Signature ./+ Ie O�Q,Y/� APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION PRINT) NO. DATE I hereby affirm that I am exempt from the Contractor's License - Low for the following reason (Section 7031.5, Business and ADDRESS FINAL Professions Cade): . PRESENT By 1 O ' BUILDING - .. I, as owner of the property, or my employees with ADDRESS ' -i' s wages as their sole compensation,will do the work and n,.41 'T the structure is not intended or offered for sale(Section _ LOCALITY D 7 �..:._ '+s, 7044, Business and Professions,Code). MOVING TEL - �'"t'I")'7 __ I, as owner of the property; am exclusively contracting CONTRACTOR' - - NO. .. 1 ITC I With licensed contractors to construct the project (Sec- - O tion 7044, Business and Professions Code). ADDRESS TI l f{d(_ 4- vv REQUIRED TOTAL SETBACK .t:rnv l y On CONSTRUCTION LENDING AGENCY 'YARD HWY (,h��,E. r, ,_� SET BACK PROP. LINE WIDTH .I hereby affirm that there is atonstruction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.)." SIDE P.L r Lender's NomeLDMA Ref..M - {� 'kjl(—) 1i t 21110/39 Fqg m Lenders Address - - ^ P.C. Fee$ < 0i Permit Fee • /��r 11?5 a i ri I certify that 1 have read this application and state that the Issuance Fee 7 �D LDMA P/C R D above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee , !/ LOMA Perm. If and hereby authorize representatives of this County to enter upon t above- eNion property for inspection Fpurposes.(� - SEE REVERSE FOR EXPLANATORY LANGUAGE - - Signature of Applicant or Agi t i WORKERS' COMPENSATION DECLARATION j J LL--�� . l'ereby,�affirm..shat I hove'a certificate ofconsent to self �� y/� �FL��1p� �F�} �r��-Fps �Lpg1p�((/�� '7Esure„or a cemficote of,Workersr Compensation lnsurance;-p_. .-y A ` CP11��11 V_.,Il OR. BUMD ,0 VG ECUOIIC/ W or o certified copy thereof (Sec 3800„Lab C) :' L - ' 1. -• '. --, COUNfYOF"L6S ANGELES. - BUILDING; AND-SAFETY. . Policy No. Company 1 . r • .- - _ BUILDING y ❑ Certified copy is hereby furnished.. : FOR.APPLICANT TO FILL IN ADDRESS - ❑ Certified.copy is filed with the county bulldmg inspec- ADDR . ._. - • , tion department. ADDRESS /qJ /j CI7V`F &:% ' ZIP .« LOCALITY L/G'vlt-(-Q G' e l t Date• _ - •.Applicant - - ' NO. OF BLDGS. CERTIFICATE OF^EXEMPTION'FROM WORKERS' - SIZE OF LOT X'1' NOW ON LOT' Z NEAREST _ 4r. _ .. CROSS ST. COMPENSATIOWINSURANCE Q. ') ASSESSOR _ - (This section need not'be`completeb if the permit is for one -. TRACT 8 BLOCK �''��- LOT NO. ( MAP BOOK•�� PAGE /O-e` PARCEL / / hundred dollars•($100) or less.)' •.r- ' - TEL . _ OWNER ' - .. NO.-: USE ZONE MAP Y P '_.. _ I permit . hot in I'sholl not the.work for which this "� _ p t employ'any person in any manner ADDRESS9YK/ :r - . -. • SPOECIAL } so as to become subject 4o the Wor ers;Compensation Laws: �, /J .. , CONDITIONS CITY C� " ZIP' _ _ - y _ ... _, O Dote 1011 Z Applicant ( -r,)' ARCHITECT R TEL - NOTICE O PPLICANT:.If, after making. this Cenifi a of. V ENGINEER.e _ NO. - DISTRICT. GROUP TYPE FIRE P OCESSED BY 'O Exemption; you should become subject to the Workers' - d CONST ZONE U CO- provisions of.the Labor Code you musi.forth- L� ADDRESS I�- with comply with such provisions or. this permit,shall be 'a� /� �� TEL. - STATISTICAL CLASSIFICATION APT, CONDO. N deemed revoked, _ r - CONTRACTORS ° r6� NO. 305'- h(7 - 'e i Z LICENSED CONTRACTORS•DECLARATION - - '- y�� '�' LIC. - CLASS NO..�� DWELL. UNITS_ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS ZT -IZA0.g_ NO. ,�pp� 1 LIC pp SEWER MAP J�� .. (commencing with Section �)of Division 3 of the Business S SQ. FT. FT NO. OFF F CLAS VALIDATION'- • and Professions Code;and my Lcense.is in full force andeffect. CIN �_ � BK. PG. O. OF CHECK License Number. r -Lic. Class AMILIES- ONE , _ n-��^�,. `��L ,r,. 1, ')� VALUATION ConlractoM^7=[.W`• sr WnRa-•pate f0 qI , \ DESCRIPTION OF WORK Tz /tp - NEW ❑ $ 2^ � n ^ ^ . :ADD- ® JV D ❑I am exempt under Sec. t - �� C/'Rd .�+K,ICt(�lt.�- •. - - - ALTER ❑. __ _. _ 8'.BP.C. for this'reasop. _ aA'iF�.3ts++-' /.$W L.) - ♦ -REPAIR ❑ $ , Date: USE OF _ _ _ -. - - . EXISTING BLDG. f DEMOL ❑ Signature - APPLICANTS^ I'1,,” q TEL 2n�, FINAL - OWNER-BUILDER DECLARATION (PRMT7ryyLd2l'AsJ'wrJYpUtL.O.✓rj NO: �.V �`I I hereby affirm that I am exempt from the Contractor's License T\ Q�,.., r DATE Law for the following reason (Section 7031.5;Business and \ ADDRESS 260 4koxi FINAL Professions Code): PRESENT.. - -- :.. .. - -_.., _ -.By._ _ _ -. , ❑ 1, as owner of the property, of m employees with BUILDING. YADDRESS _ f wages as.their sole compensation;will do the work and _ _ ti hlj` rti r the structure isnot intended or offered fol`sale(Section LOCALITY D - t• _ S -7044, Business and Professions Code.) - - -,., MOVING Y _ TEL ❑ 1,as owner of the property;am exclusively contracting CONTRACTOR +' <t NO. with licensed contractors to cohsiru<t the project (Sec If T `L C' f'I' tion 7044,,,Business and Professions Code.) I ADDRESS. l- 1 - Ci r \` REQUIRED 'TOTAL SETBACK FROM rEX15T.' _ CONSTRUCTION LENDING AGENCY - ` SET BACK YARD;' HWY DROP..LINE WIDTH• -1- hereby affirm that there is a construction lending agency for FRONT • • - - the performonce"of.the work for which this permit is'issued P.L. " � 1,� "SF -•v`^` (Sec. 3097, Civ. C.). - SIDE >ti 3..: . P.L. Lender's Name. '�tc+' LDMA.Ref. If . . .�1i t - PCFee$ 7 d` �� Permit Fee ; ' C-•7'o�� iaD-C�: , - D t. ender's Address - certify that I hcve'read this application and state that the - - Issuance Fee 7-i' LUMA P/C N '� - - ove information is correct. I agree to comply with all County 'finances and State laws relating to.building construction, F. Twt l Fee hereby authorize representatives of this County to enter I the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE D Signature ofAppli t or Agent e WORKERS' COMPENSATIfJN DECLARATION - - - - - - c -I 4iteby affirm that I have a certificate of consent to self O I��/ �/[� D �p}�r,F•�y�//�� nswe or a certificate of Workers' Compensation'Insurance, ' APll ��'CATOOUV FOR BV 0L®ING PLSUOUC 7 or decertified copy thereof (Sec. 3800, Lab. C.) - COUNTY OF LOS ANGELES BUILDING AND SAFETY , Policy No. Company ' - ❑ Certified'copy is.herebyfurnished. FOR APPLICANT.TO FILL IN BUILDING ADDRESS ❑ Certified'copy is.filedwith'the•county building inspec- BUILDING tion departme_n 1:' Y ADDRESS J l W Pl •�((�� Date �• Applicant CITY J ` ZIP S70L� LOCALITY - NO. L CERTIFICATE OF EXEMPTION FROM WORKERS' ' SIZE OF LOT V X 1351 NOW ON LOTS C OSSSST. COMPENSATION'INSURANCE (This section need not be completed if the permit,is for one . . ASSESSOR - hundred dollars ($)00)or less.) TRACT BLOCK ' LOT NO. - MAP BOOK PAGE PARCEL /l TEL' /� USE NE MAP 'I certify that in the performance of the work for which this OWNERC, NO p- NO. -permit is is issued, I shall not employ an person in on manner i SPECIALi P P Y Y P y . ADDRESS. �� UJ CONDITIONS so alto become subject to the W�Xo"rke 'Com eniat i'o'n L�o.(w.,s. •(I'� �" / U t.07Y6(4f. CITY. Lt+. - ZIP Date Applicant NOTICE ENGINEER TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL'NO. DISTRICT GROUP TYPE FIRE PROCESSED BY �- Exemption, you should become subject to 'the Workers' CONST.y Compensation provisions of the Labor Code, you must forth. ADDRESS ✓ ZOE LU with comply with such provisions or this permit'sholl be - - dr deemed revoked. > -. • TEL.' STATISTICAL CLASSIFICATION APT: CO N CONTRACTOR NO: s ' Z LICENSED CONTRACTORS DECLARATION LIC_ CLA55 NO. DWELL. UNITS_ I.hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS U NO. (commencing with Section 7000).of Division 3 of the Business and _ LIC SEWER MAP . Professions Code, and my license is in full force and effect. CITY CLASS BK. pG, 3 VALIDATION SQ. FT.�p�+. NO. OF NO. OF CHECK License Number Lic.Class SIZE $�z• STORIES '/ FAMILIES I ONE • -PLACE }- VALUATION Contractor - Date DESCRIPTION OF WORK 'P t; r ac NEW Q $ ADD ❑ I am exempt under Sec. �DrWROJr, FJCI St- C, 5 A BITER B,BP.C, for this reason - _ REPAIR ❑ $ Date: • USEOP DEMOB Q' E%ISTING BLDG.�!/ - ILIQ Signature APPLICANT TEL. - FINAL _ ;207&2A. OWNER-BUILDER DECLARATION PRINT 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 FINA ` 't rofessions Code)' PREgEnT - RT ; r' I • - 68.63 BUILDING I, 05 owner of the property, or my employees with ADDRESS ! • • .� b 8 6 3 cit wages as'theii sole compensation,will do the Work and W J !-�' t '• f.T r _ the structure is not intended or offeredfior sale(Section LOCALITY t 7044, Business and Professions Code), MOVING TEL - ( ' O 9,'23. 8 8 ❑• "1 I, as owner of the property, am exclusively contracting CONTRACTOR NO.- t' 1 with licensed contractors to construct the project (Sec- " - `' 'A tion tion 7044, Business and Professions Code). ' ADDRESS y '•t tv. _ "REQUIRED TOTAL SETBACK _� •S 1. J +� �. s1 CONSTRUCTION LENDING AGENCY - SETBACK YARD 'HWV PROP. LINE WIDTHS I hereby off irm that there is a construction lending agency for FRONT - - -the performance ofthe work for which this permit is issued P.I. (Sec. 3097, Civ..C.). SIDE P.L. Lender's Name -''• `•. . /. LDMA Ref-#. + - "- - ,Lender's Address P.C. Fee$ - Permit Fee - ' Y PP Issuance Fee LDMA P/C# I-certif that I have read this application and state that the above information is correct. I agree to comply with all County ' Investigation Fee .. - ordinances and State laws relating to building construction, Total fee TDMA Perm. # and hereby authorize representatives of this County to enter - $ u n e ab mentioned property for inspe bn purposes. t SEE REVERSE FOR EXPLANATORY LANGUAGE Sltp<ture of Applicant or Agent -_ Date - - -