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, °--• APPLICATION FOR BUILDING PIERMIT -- ` DIVISION OF B=ING AND SAFETY Ram O � D.paruntt of County Sagt-4w, County LAIaB E, e Angel" a1N LOCALITY JOHN CA82ATT D.GRIFFIN, •urT of EIL UDIM • NEAREST C O88 BT R MAP FOR APPLICANT.TO DISTRICT NO. GROU TYPE BHry K PG CONST FS1ZEOFLOT&&j2X LDING MAP STATS . RHED NUMBER HWYY6a NO. BLOCK U8 Z N6 SPE IAL CONDITIONS CTNO. OF BLDOB Q EXISTNOW ON LOT &m- BUILDING YARD HWY STRErr NAME UBEOF SETBACK WIDTH EXISTING BLDG. FRONT / P. L OWNER GIDE MAIL P. ADDRESS ~- O TRACT D 1 UNIT �T fl INDUSTRIAL, -T- C1TY T TN 1 D 1 UNIT 6 PUBLIC BLDG. ARCHITECT Olf Tm_ 2 DUPLEX Z UNITG 7' ADDN.,ALT., ETC ENGINE[R NO. 3 APT. e-11- UNTrG ADDRESS 41 COMMERCIAL 8 MISCHL CONTRACTOR NO. E4W ION ORD ADDRESS ULva DESCRtMON OF WORK NEW ADD ALTER 4FEPAIR DEMOLISH SQ. FT. NO. OF NO. OF 1 LI SIZE STO 1 FAMILIES C C U F U RE i SIGNATURE OF APPLICANT APPROVALS- ADDRESD DATE INEPECTOR'S SIG1fATURH FOUNDATION: LOCATION P.C. l �.� FORMS.MATERIALS �[ PAAMH: FIR[STOPS. VALUATION j BRACING. BOLTS �- [ FURNACE: LOCATION, 1 IDG HKREBY ACKNOWLE THAT I HAVE READ THIS GAD VENT, DUCTS APPLICATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT. r AND STATE LAW REG LATINO BUILDING CONSTRUC- TION. LATH. EXT. V u SIGNATU�tIs MOUSE NUMBER COR- PHRM STT RHCT AND POST® ADD -1 C' L� JOHN A.LAMBIE, CouNTY ENGINmR *4JMATION CLYDE N. DIRLAM, CHIQ BLDG. IN2F[CTOR Mo C"H ,0 1-s 4: R X13 1 &00 APPLICATION FOR COUNTY OF LOS ANGELES MM {BUILDING PERMIT DEPARBUMDING AND SAFETY DIVISICOUNTY ON BUILDING ti FOR APPLICANT TO FILL IN ADDRESS / BUILDING /yam ('� ADDRESS /l7 a LOCALITY r. CITY ZIP / / 0 CROSS SNEAREST T. DS 604"1 `'y p� NO.OF BLDGS. ASSESSOR SIZE OF LOT 6'.( I 6 v NOW ON LOT MAP'BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE PROCESSED BY TRACT BLOCK LOT NO. CONST. ZON TEL !© T r OWNER [7 a No. d-�07/ STATISTICAL CLASSIFICATION C� ) SEWER MAP ADDRESS ,E _CLASS NO�DWELL.UNITS BK PG CITY ZIP USE ZONE o. Q 14 ARCHITECT OR 'Y^ AL N� _7Q A—/ CONDIT TIONS ADDRESS aJ s ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ CONTRACTOR/4„ C TENo.L. BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET) LIC. ADDRESS NO. NIGHWA + YARD = TOTAL SETBACK FROM TYPE OF EXISTING CITY t LIC. FRONT PROP. LINE HIGHWAY WIDTH tp CLASS _ CONSTRUCTION LENDER NAME AND BRANCH t *C f Q BLDG,SETBACK FR C, ADDRESS CITY C C SIDEPROP.I INEOF (STREET) SQ, FT NO. OF NO. OF CHE K HIGHWAY + YARD OTA CK CK FROM TYPE OF EXISTING SIZE , Q STORIES FAMILIES ONE 91DE PR LINE I HIGH`WAYj WIDTH' p� DESCRIPTION OF WORK 1:1EW + _ �, !/5 /err DD CO NER CUTOFF YES ❑ `NO'- Z a� .--• C o (. LTER IN OPEN SPACE YE9 ❑ NO ❑ EPAIR USE OFIN COASTAL PERMIT ZONE YES [] i NO ❑ EXISTING BLDG. jet0;j0/4.* it $ EMOL ❑ APPLICANTEL 7 ^! 3L / ��� )DLG �X7���p�U (PRINT) NO. 2, '91 '07./ LADDR GNATURE) EREBY ACK LED E THAT I HAV! REAP THIS APPLICATION TATE TH HE ABOVE IS CORRECT AND AGREE TO COMPLY ALL ORDINANCES AND LAWS REGULATING BUILDING CON- TION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED Y I WILL NOT IMPLOY ANY PERSON IN VIOLATION OF THE CODE OF THE STATE OF CALIFORNIA IN RELATING TO EN'S COMPENSATION INSURANCE. TURE OF FINAL //r �fJ7 BY TTEE DATE SS T E L. P.C. Fee$ (Jj Permit Fee NO. tIssuance Fee ATION 6� L b Total Fee .-PLAN CHECKVALIDATION M.O. CADH PERMIT VALIDATION M.O. H Fa -14 1D 237.0Cass 0 0-p r im 3 2 3 1 4- .2�° - - - '76AS341A C[lGOS■ 11/79 E ��L dry 7eAe38A CBAEOa 'APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS © Ad 15it BUILDING AND SAFETY DPJISION LOCALITY C(r JOHN A. LAMMIE, COUNTY ENGINEER NEAREST COLEMAN W. JUNKINS, OUF'T OF CUILDING CR089 ST. 70 FEXISTING OR APPLICANT,T FILL DISTRICT NO. GROUP TYPE P OCE9S D BY CONST. Print or A only) �S 1� B BUILDING wS Cq `O l� V STATISTICAL CLASSIFICATION SAYER MAP a CLASS No.--? DWELL,UNITS K X9 BLOCK_ USEZ ONE MAP NO. (J CONDITIONS NO.OF BLDGS: L T O NOW ON LOT LDG, L BLDG.SETBACK FROM ITEL FRONT PROP.LINE OF (STREET) O �7+ �Q a NO. r^D,7, _TYPE OF 1871 SETBACK HIGHWAY + YARD - TOTAL .6 �7 HIGHWA WIDTH FROM C.L.04 Pi(yy BLDG.SETBACK FROM ARCHITECT OR TEL. SIDE PROP.LI NE OF (STREETI ENGINEER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. CONTRACTOR NOL + O ADDRESS NO. f CORNER CUTOFF YES ❑ NO ❑ C3 LIC. O CITY CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS U DESCRIPTION OF WORK NEW ADD 467D REPAIR DEMOLISH SQ. FT. NO. OF NO. OF SIZE STORIES FAMILIES ' USE OF STRUCTURE LIfr 810NATURE APPLICANT VALUATLO APPROVALS DATE INAPECTOR'■ AISNATURE P.C. PMT. �f B FOFORM8 I MATERIALSON FEE S FEE S / I HERESY ACK NOW LILDO[ THAT I HAS[ READ THIS APPLICATION FRAME: FIRE STOPS, BRACING BOLTS AND STAT[ THAT THE ASOKE 19 CORRECT AND AORL[ TO COMPLY FURNACE: LOCATION, WrTH ALL COUNTY ORDINAtfCM AND STATE LAWS RtOULATIP40 GA VENT, UCTS ■UILDI NO CONSTRUCTION, I CERTIFY .THAT IN DOING TH[ WORK AUTHORIZED HUaSY I WILL NOT EMFLOY ANY F[RSON IN VIOLA- TION OF THE LASOR CO OF TH[ OF CALIFORNIA R[LAT- LATH, INt. ING TO WORKMEN'S' TION C[. L ATH, EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDREss Az FINAL JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER I1 PLAN CF= VALIDATfON CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH � 2 3 4 7Z� &EC 2 7 D 9.)O- Q "mmmax to=,Q-•. APPLICATION FOR BUILDING .PERM;IT 1 :COUNTY OF LOS ANGELES AD�R,iBH 5015 Cg�leYYi.a Ave .� DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LocAL JOHN A. LAMWE,COUNTY ENaII5i1= NNEARES1. CAGZATT D.GMFF M fa[TT or Cunmims CROSS DXSTRI NO. GItO �. BY FOR APPLICANT TO FlIl.IN tiler BUILDING' A STATISTICAL IFICATION SEWER MAP-, ADDRESS ' 5015 Camellia. rive-r CIA66 NO r UN K ` LOT NO. BLOCK hlAP / STATQ NUMBER ��r9IG _ HWY. `_.YQE O TRACTi"T USE N SPE ry CONDI'T'IONS SIZE OP LOT NOW ON C�ODT g J U STING.BLDG cn—w & Urarage �1 BSETBAV YARD .HWY .STR�TNAmil WIDTH . OWNER William j IHcil'va'� >?RP°Lrrr �A S ' , . AD'L. bl Cmelli8 Aye. - SIDE Cir, Temple bit Y TE. P No.. INSPECTION-RECORD -ARCHITECT OR - TEU- ENGINVENo. ADDRL.SS - co Oa• Ind - 221. 1 - ADDRa71 Firestone Blvd. , So DESCHIZ?'fION OF WORK ANEW I ADD ALT�_R REPAIR DEMOLISH SO.FT. NO.OF NO.OF - 'SIZE STORIES FAMILIES USE.OF - - STRUCTUR$ Std SIGNATURE-O r APPLICANT y - .�, '5&71 Fl"s -Blvd TE.� APPROVALS DAINSPECTOR'S HIGNATURE 'FORiI K°A"T'�IAL nQN VALUAnON S2 �A0 L" FRAME-FIREBiOPIi. BRACING,RCING,BOLTS -FE ; ;FEEPmr ; m� - - GAS VENT DUCTS . 1 HEREBY ACKNOWLEDGE TI-IAT I HA THIS BAP- u,fFl.IN,I,. _ PLICATION AND STATE THAT THE AO I RRECT AND � - AG�tEE TO CO Y 1'f�{ ALL C U O INANCES AND SPATE LAW 71N G CTION." LAVH EXT.` .0 - SIGNATUR HOUSE NUUBEacofi- PERMITTE RECT-AND POSTED ' :ADD FINLLL CLYDEIN. DIRT,AM' PRINCIPALS RRL ENGINEER PIAN G'H= VALIDATION " PERMIT VALIDATION L;� �+�+ "MMA ax Ion,o-_ APPLICATION FOR BUILDING PERM11T Z. COUNTY OF LOS ANGELES ARIL-DIN REZS lJ DEPARTMENT OF COUNTY ENGINEER. BUILDING. AND SAFETY DIVISION, LOCALITY JOHN A. LAMBIE, COUNTY ENGIMII M ' NZAREIVT. CASSATT D. GRIFFIN,futT OF WuILDINO CROSS 8 - DISTRICT O. GROUP ' TYPES IID BY FOR APPLICANT TO FILL IN CQNST. BUILDING HTATIBTICAL CLnLISSI I'll CATION YAP ADDRESS �S/ �Q BK. Pa CLASH.NO YAP STATE LAT NO. BL.007t NUMBER HWY. YE8 O TRACT U8E ZON SPECIAL NO.Ofr BLDGH ,Q�,/ CONDITIONS OF LOT NOW ON LOT /1 USE 6F EXISTING BLDG BUILDIt4a YARDHWY STAME EX18T. SETBACK REET NWIDTH qWNIiR FROM' j MAIL P.L - ADDRESS HIDE L CITY No INSPECTION RECORD ARCH TEL ENGIN-EMR NO. ADDRESS - - TE L CONTRACTOR NO _ . . . ADDRESS _ DESCRIPTION OF WORK NSW ADD ALTER REPAIR DEMOLISH SCI:FT. NO.OF NO.OF - SIZE STORIES FAMILIES ' UHE OF STRUCTURE SIGNATURL OF- APPLICAIIT AFPROVAL.S DATE MSPECTOWS SIGNATURE ADDRESSFOUNDATION:L.OL-ATION FORYS MATERIALS VALUATIONS FRAY L.FI RESTOF8% BRA'ClN BOLTS P.G. P FURNACE:L.00.ATIOtG' FEE t F8, s +� GAS VFN'T DUCTS .I HEREBY ACKNQWLEDGlE THAT 1 HAVE READ THIS AP- , LATH.INT. PLIC,AJION.AND STATE THAT THE ABOVE IS CORRECT AND AaRE TO COMPLY WITH ALL COUNTY ORDINANCES AND ,. STATE LA GULATI UT BUILD a ONSTRUCTION. LATH EXT. HIaNATUR HOUSE NUMBER COR- PERMITTE RECT AND POSTED / ADDR +-I NAL (� CLYDE N. DIRLAM, PRINCIPAL STRiioruRAL ENGINEER PLAN CHECK VALIDATION P$HMIT VALIDATIO CK M.O. CASH LAC0 2 3 4 19% SEP 8 1 -A 2.00 4 �eAeae� �E•°0a °-e7APPLICATION FOR BUILDING PERMI 4 {-CO OF LOS ANGELESBUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS v , BUILDING AND SAFETY DIVISION JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY COLEMAN W. JENKINS, QUP'T OF BUILDING NEAREST CROSS ST. FOR APPLIC T T FILL IN DISTRICT N P TYPE E Print or a only) CONST. BUILDING �•-'�/ `C//' STATISTICAL C IFICATION SEWER MAP ADDRESS J J 'r' CLASS NO A DWELL-UNITS BK PG LOT NO. BLOCK USE ZONE MAP NO. L TRACT SPECIAL NO.OF BLDGS. CONDITIONS SIZE OF LOT NOW ON LOT LLS E O Ff EXISTING BLDG. DG.SETBACK FROM L- TEONT PROP.LINE OF (STREET). OWNER NO. TYPE I8T1 DETRACK HIGHWAY + YARD = TOTAL ADDRESS r HIOHWA TH FROM Q.L. CITY BLDG.SETBACK FROM ARCHITECT O TEL. SIDE PROP.LINE OF (STREET) ENGINEER NO. TYPE OF 1EXISTING SETBACK HIGHW + YARD - TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. _ Y CONTRACTOR '6 A NO.TEL. y'f-4j?_? + GO.. ADDRESS Al NO. CORNER CUTOFF YES ❑ NO U LIC. CD CITY cLAsB SEE REVERSE SIDE FOR SPECIAL APPROVALS 8 DESCRIPTION OF WORKN , z NEW ADD ALTER REPAIR DEMOLISH SQ. FT. NO. OF NO. OF SIZE STORIES FAMILIES USE OF STRUCTll SIGNATURE OF APPLICANT VALUATION h Q jf APPROVALS DATE IK[P[CTOR•e SISMATURE P.C. PMT. FOUNDATION: LOCATION FEES FEE S / FORA6 MATERIALS FRAMES FIRE STOPS, 1 HES REY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE AsoV[ 15 CORRECT AND AORQ TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAW R[OULATINO GAS VENT, DUCTS ■UILDINo CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK RUTH ORIZ[D H[Ia RY I WILL NOT EMPLOY ANY PERSON IN VI TON OF THE LAS011 COD[ OF TH[ STATE OF CALIFORNIA T- LATH, INT. INO TO WORK M[N'�COMP[NSATIO SU RA NC E. • LATH, EXT. 816NATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL � ��T JOHNT�F..�LEWIS. PRI CIPAL STR RAL ENGINEER rL!'!.l\ VrJ.C.t.a VALIDATION C.K. M.O. CASH _ rL.al�lll VA�ATION CK. M.O. GASH i L&0.4 6 4 8�S W28 1D .17-25- IT 76AV36A CE 00603 4/70 ^ ` APPLICATION FOR BUILDING PERMI COUNTY OF LOS ANGELES ASSESSOR ' DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL B=ING AND SAFETY DIVISION BUILDING i JOHN A. LAMSIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS, SUPT OF 15UILDING LOCALITY APPLICANTFOR L NEAREST C R 0TTT6���ttS ST., t BUILDING // D ICj+Tj �J' G CQNST D BY ADDRESS L5a STATISTICAL CL.ASSIFiCATI N 3 ER MAP LOT NO. 2 BLOCK CLASS NO DWELL.UNITS_ BK GPG TRACT USE ZONE MAP NO.OF BLOGS. NO. SIZE OF LOT NOW ON LOT -++ SPECIAL USE OF CONDITIONS EXISTING BLDG, TE OWNER I/�1 L-s-Q.iL..� NOL' ., , �FR LDO.SETBACKFROMADDRESS Q( �� C �. ONT PROP.LINE OF (STREET) YPE Of EXISTINGSETBACK HI¢FtWAY� + YARD = TOTAL CITY HIOHWA WIDTH FROM C.L. ARCHITECT OR TEL, s + = ENGINEER NO. BLDG. ETB CK FROM ADDRESS SIDE PROP.LINE OF (STREET) EL r TYPE OF EXISTING SETBACK HIGHWAY �, YARD = TOTAL CO 646V N J 7 HIGHWAY WIDTH FROM C.L. ADDRESS O 3, �-sso NO + S p CITY �" CLIC. LASS CORNER CUTOFF YES ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH rsf C�1--� f�`� SEE REVERSE SIDE OR SPECIAL APPROVALS ADDRESS -F-'O SQ. FT, NO. OF NO. OF N ❑ SIZE 7 STORIES FAMILI STRUUSE CTURE TURE ADD LTER ❑ REPAIR❑ SIGNATURE OF APPLICANT L y L EMOL ❑ moa VALUATION f L5-5. APPROVALS DATE INSPICr I■ GIGNATUR P.C, PMT.' FOUNDATIONI LOCATION r FEE f FEE f �� FORMSMATERIALS FRAME, FIRE STOPS, I HFREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AMD 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. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PIRSOII IN VIOLATION OF THE LATH, INT. LA EOR CODE OF THE STATE OF 'CALIFORNIA IN RELATING TO WORKMEN'S. COMPINSATION INSURANCE. LATH, EXT, IV SIGNATURE OF liyltrj L HOL18E NUMBER COR- PERMITTEE RECT AND POSTED ,ADDRESS - D FINAL �� JOHN F. LEW15. PRINCIPAL STRUCTURAL ENGINEER PLAN CH= V}ILIDATION cK. M.o. cmw _ PE MT VALMATION CK. m.o. x , 83 84.- JM19 1 D 2 2.5U.++� �� T I i t A P P L I C A T I O N F O R 1 D I N G P E R M I T ] C O U N T Y O F L O S A N G E L E S B U I L D I N G A N D S A F E T Y W O R K E R ' S C O M P E N S A T I O N D E C L A P X I 1 0 N T O ` I F T L 1 I N I N J U M 0 A D D R E S S I S ^ S L , L , V I h e r e t r y a f f i n . t h a t I h a v e a c e r t i f i o e L e o f c o m e r * t o s o f t t l & t r e , F v ����A D D R E S S o r a c e r M c a t s o f W b r k e r s ' C o m p e n e a t i o n I n s u r a n c e , o r e c e r t i f i e d O C d v c o p y t h e r e d ( S e o . 3 8 0 0 , L a b . G ) C T T Y ��M C G D L O O A L r r Y p o k y N a C o r n p a w 8 1 M O F L O T N O . O F N O W O N L O T Q' C e r t i f l e d c o p y I s h e r e b y f u m l a t l e d N E M E 8 T C R O S S S T . Q' C a r o l l e d c o p y i s M a d w i t h m i l e o c u n t y b i A * Q I n s p e c t i o n T R A c r B L O C K L O T N a d e p - t r r n L U S E Z O N E M A P N O . D a t a A p p l i c a n t A 8 8 E 9 8 0 R A 4 A P B O O K P f F 1 3 E P A R C E L . 3 P E C 7 A L C O N D f r l O N d B O / C E R T I F I C A T E O F E X E M P T K N I F R O M W O R K E R S ' O W N E R ��D t T E L N a Y E S N O w 1 0 0 1 0 F r o f S c r a o L �� I O C O M P E N S A T N I N S U R A N C E / �� A D D R E S S I ( f h f s s e c t i o n n e e d n o t b e o o n Q i e t e d t f t h e p e r m i t I s f o r o n e h u n d r e d D t 8 T R l C T G R O U P p E ��8 T F I E Z O N E P R O C E S S E D B Y d o t a r a ( $ 1 0 0 ) o r t e a ) / J �� 1 c e r t i f y t h a t i n i t i s p e r f o r m a n c e o f t h e w o r t s f o r w h i c h , l i t e p e r m i t �� �� / �� �� ��. C 8 b I s s u e d , I & 1 " I n o t e m p t y a r t y p e r a o n I n a r t y m a n n e r s o a s t o b e c o m e s u b J e o t t o t h e W o r k " ' C o m p e c e a r i o n L s w s O R E N G I N E E R T F 1 N O S p a T S T K s L a _ A s T C O N D O D a t e A p p i i c a r d A D D R E S S C L A S S N a . O R / D W E L L U N T B N O T I C E T O A P R X A N T . " I f , a f t e r m a k t l p t h i s C e r t i f i c n E e o f R E Q U I R E D T O ' D L 8 E T R A C . K F F K A A E X I S T E x e m p t i o n , y o u s h o u l d b e c o m e s u b J t o t h e W t x k e r s ' C O N T R A C T O R T E L N O . - - S E T B A C K ) I L M H N y Y P R O P U N E W I D T H C o m p e n s a t i o n p r o v W a v o f t h e L a b o r C o d e , y o u m i s t f o r t h w i t h F R O N T c o m p l y w i t h s u c h p r o v b b n s o r t h i s p e r m i t s h e l l b e d e e m e d n n o o k a d . A D O R E 8 S L I G N O . P L D E L I C E N S E D C O N T R A C T O R S D E C L A R A T I O N P L C f f Y L I C . C L A S S P L I h e r e b y a f f i r m t h a t I a m I b e n e e d u n d e r p r o v b b r w d C h a p t e r B S E W E R M A P } ( c o m m e n c i n g w i t h S e c t i o n 7 0 0 0 ) o f D i v i s i o n 3 d t h e B u s i n e s s a n d 8 Q F T . S U E N O . O F B T O R E B N O . O F F A M L E S N E W Q' B K P G , 8 P r o f e s s i o n s C o d e , a n d m y k e n s e b h f a i t t o r t e a n d e f f e c t L k N x i s e N u m b e r L J a C l a n D E S P V T K ) N O F A D D M L I U m o N [ O C o r T t r a r f o r D a t e N d A L T E R W Q' I a m e x e m p t r r d e r S e o . s R E P A I R Q' $ z B A P . C . f o r t h i s r e a s o n b E L A O L L D A M P i c r D a t E L L O B E O F E ) 0 8 T M B L M U R M Q' 2 7 9 . T . S i g n a t u f e A P P U C . A N T ( " E L N O . L D A M P e r m r E l I a s o w n e r d t h e p r o p e r t y , o r m y e m p l o y e e s w i t h , w a g e d a s K V a o T ��G 7 �� z 1 I T E M S t h e i r s o l e c o m p e n s a t i o n , - w i l l d o t h e w o r k a n d t h e s t r u c t u r e I s A D D R E S S I ' 1 1 A L D u n * O Y ����T A E 2 9 9 - 2 5 n o t I n h w i d e d o r o f f e r e d f o r s a b ( S e c t i o n 7 0 4 4 , B u s l n e s a a n d P r o f e e & b n e c o d a ) ��. ����. D E C K ' ? . 2 5 / �� W L L T H E A P P U G J r r O R D U L D f q O C C U P N I f H A �%O L C A H A Z A F D O I ! & S u e ! o w n e r d t h e p r o p e r t y , a m e x c l u s i v e l y c o n t r a c t i n g w i t h C R A ��r r t F ��c o N w a r o A N n z A F c a A k K r n e a v L T O o a O P E W I m n o w A N O I f l T B - O N T H E F i A Z A F D O I I s I f ��4 E i i 1 1 & l F O F r l 4 1 0 N C F L C T F I N A L B Y I l c e n e e d C O r 1 t r e C Z D r e t 0 C O n a t r U C t f i l e p r o j e c t ( S e c t i o n 7 0 4 4 , Y C & E l N D A n e s e a n d P r o f e s s i o n s C o d e . ) Y i L L T H E N T M D E D U S E O F T H E a W L N O s Y T H E A P P L I C A N T O R F U T U R E B U I L D I N G C C Q R R N T A k . ��A P U F O R C O l m T R U C T I O N O R N O C M A M N F R O M T H E S O U T H C O N S T R U C T I O N L E N D I N G A G E N C Y D a W A S o u K r n u A x , m 6 r r D M T I C T ( W A Q W S E E P E " r r M n O - e a a r a T F O R �� ] 1 5 / 2 9 / 9 O L I C E . E & I h e r e b y a f f r m t h a t t h e r e I n a c o n s t r u c t i o n l e n d l r g a g e r x y b r Y E e 1 7 N O X ` _ 4 h J 1 A M 9 : 3 2 1 t h e p d i a m a n c e o f t h e w o r k f o r w h i c h i h b p e r m i t i s b s u e d ( S e a / i K E R E A D T H E A E F O K c A L s w < F w i N o u D E A N D T H E w A O 1 D P u w r n 3 0 8 7 , C h s . G n ) Q a S C H e c r a . r a r . I U r D E S V M W R E O U F E �%E M a U N D E R T H E L O B A N G E E S C O U N T Y C O D E . . L e , n d e l ' s N a m e T T f L E z P O R 2 - M 1 0 1 0 M + A Z A u o o l b S C A Q U a L e n d e r s a d d r e s s B . S ��f ��, r - 3 _ - 5 Q �� I c e r t t l y t h a t I h a v e r e a d f b a p p l i c a t i o n a n d s t a t e u n d e r p e n a l t y a . . l O f p e r J r y t h a t t h e a b o t i e I n f o r l a t l o n I s c o r r e c L I a g r e e t o O o m p l y P C P E F W F E F w i t h a l l c o u n t y o r d k w e c e e a n d S t a t e 6 " r e i a t t l g t o b u k k Q ��[ L t ( c o n s t r u c t i o n , a n d h e r e b y a u t h c r i z e r e p r e s e r t a t i v e s o f t h i o C o u n t y < t ��B U A N C E F F r E m e r " p r D p e t t y f o r l n s p e c t l ��n r J V E S r I a A T I O N F E E T O U I L b �� r Q A p . 7 S E E R E V E R S E F O R E X P L A N A T O R Y L A N G U A G E 0 M WORKERS' C6NIPEN.WON DECLARATION l I h7 affirm fiat of a certificate a1 consent r a.l, APPLICATION FOR BUILDING PERMIT kl , or a certificate of Workers' Compenaatlbn Insurance, or a certffled copy thereof Sec 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY r'Policy No.0 �/.�?,*4A-Umpony'T s Cc '.• F efb ❑ Certified copy Is hereby furnished. FOR APPLICANT TO FILL' IN ADDRESS Certified copy Is filed with the county building rrapec- -BUILDING tion department. ADDRESS Date �" Appllcant L.-IL,) yvt E C£/�7E/2 CITY 'NO.� C ZIP o LOCALITY : CERTIFICATE OF EXFJrAPTION FROM WOOURs' OF LNEAMSTOT NOW ON LOT CROSS ST.COMPENSATION INSURANCE (This section need not be completed If the pe�mtt is for one TRACT BLOCK LOT NO. ASSIESSOR MAR BOCK PAGE PARCEL hundred dollars ($100) or leas.) TEL USE Z MAP. OWNER ff NO. I certify that In'the performance of the work for which this SPECLpermit Is Issued, I shall not employ any rson In arty manner ADDRESS j0 � so as to,become subject to the Workent�Compertsation Laws. CONIDff10N5 O p U Date 41/9'-J l: ,gpp l l ca n t 4`�Lai Hy M F C OXIT R ARO-I rTECT OR LP TEL .7D TYPE R F11,1 �BY Ld 10 Q NOTICE TO APPUCANT: If, after making this Certificate of ENGINEER NO. CptST ZONE Exemption, you should become ariblect to the Workers Compensation provislons of the Labor Code, yoU must forth- ADDS �f J with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION CONDO. deemed rovoked. CONTRACTOR lJ C NO. - Z LICFNSEIJ CONTRACTORS DECLARATION )) uC CLASS NO. DWELL UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS .Z 4- /LN5 O. SEWER MAP ( mmencing with.Section 7000)of Division 3 of.the BusinessU-- and ProfesIons Code,and,my license Is In full force and effect. crry S ,1 CLASS Bk PG. VALIDATION SQ. FT. NO. OF NO. OF. CFECK Ucense Number .2'D SJ s/v Llc Clds 6 / SIZE STORIES AWLIES orE VALUATION Contractor ,C-I LJ h4;yWi C&AEk4Date DESCRIPTION of woRx Els J' ❑I am exempt under Sec. 6H ADD ❑ ALTER B.BP.C. for this rpason REPAIR ❑ : Date: USE OF EXI-ST'�.c. ',�1 '�— — ' APPI-NG BLDG. DEMOL ❑ FlHAL �] Signature --- APPLKANT TEL � , OWNER�UIIDER DECLARATION PRI NO. DATE 'LQ I hereby affirm that I am exempt from the Contractor's License Law for the fdllowing reason (Section 7031.5, Buslnes and ADDRESS FINAL 1 Profeslons Code): BY. ❑ IDING I, as owner of the property, or my employees with ADpAC:CT.i wages as their sole.compensatlon,will do the wait and LOCALITY 171. the structure Is not Intended or offered for sale(Sectlon tF1e 7044, Business and Professions Code.) MOVING TELWNTRA1 TEM ❑ I, as owner of the property, am exclualvely contracting �� ND. I with licensed controctors to construct the proles (S-c- ADDRESS TOTAL 171 - 75 tion 7044, Business and Professions Code.) AL FROMri 171.75 CONSTRUCTION LENDING AGENCY YARD FI1VY I hereby affirm that there Is a cbnatructlor'lending agency for FRONT I� the performbnce of the work for which this permit Is Issued P.L, (Sec- 3D97, Civ. C.). SIDE. P.L Lender's Name 0DOR-QW1 wivsq LDMA Ref. 1 Linde(s Address P.0 Fee Perm Fr , 760.4 1 AM11:23 o I certify that I have read this application and state that the Issuance Fey LDMA P/C 0 above Information Is correct. I agree to comply with all County InvestLpatlon.I" ordinances and State laws relating to building construction, I Total Fee LDMA Perm. and hereby authorize representatives of this County to enter upon the mentioned property Inspection purposes. re ��/t r�C�` IZ���� 50IffVMU POR DWLAP4ATORY LANGUAGE Signature of Applicant or Agent Date i COUNTY OF LOS ANGELES TEMPLE CITY 0508 BUILDING.PE!RMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS RESIDIENTIAL ADD BUILDING AND.SAFETY / LAND DEVELOPMENT TEMPJE CITY.CA 91780 PHON : (818) 285-0488 EXT: QL D508 9809170018 LEGAL ID.- No. or CONST NEW BUILDING ADDRESS: TR: 14467 LT: 31 SQ. FT STORIES TYPE OCCLP GROUP 5015 CAMELLIA AV ASSESSOR INFORMATION NLWER: STRUCTURE; 0 1 VN R3 TEMP CA 917803854 8589-014-018 GARAGE: NEAREST CROSS STREET: LA ROSA OTHER: 216 1 THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY TEXALNT 'M ON EXIST BLDG USE: USE ZONE: IS$ PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 09/17/98 UT 7/99 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: F I NA-L DAT E F I N.Al CODE: GERA JOHN WiB RBARA E (818) 286'0714- T 3,0005015 / r TEMP 917503854 /" ATTACHED COVERED OPEN PATIO - 16 SQ. FT. 4PTION OF WORK SEE DESCRIPTION: QUANTITY: UDM: ANOINT: APPLICANT: -Tn. NO: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION R .00 VAL 0.50 . AX BUILDING R 54.70 D2 PERMIT / ��GE L 181.95CONTRACTOR: TEL. NO: , APPRPVALS DATE INSPECTOR Sl!��E SAME AS 06INER - �s T}. LIC. NO ION AND SETBACKS i SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER-. NO: FOUNQATIDNl7TRr9CT-FC0W- LIC. N0: 111111 3° UEBL C W0 K8 NO. OF FAMILIES: DWELLING UNITS: . J No 21 SCHOOL WITHIN HAZARDOUS 0 Q ROOF 'SAEATHnff- AIR QUALITY: 1000 FEET MATERIALS O ❑ NO N0 NO REQUIRED TOTAL SETBACK FROM EXI W BLDG DEPT. FURE79PM SRET ONT BACK- MA YARD: Y: PROP LINE: WIDTH: S,e at��t SHEAR PANELS SIDE PL- rVIC 9 1 REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS AYGELYB TEMPLE CITY # 0508 BUILDING PERFQT DEPARTMENT OF PUBLIC WORKS 9701 LAB TUNAS ALTERATION/RKPAIR BUILDING AND SAFETY / LAm DMVELOPMItT TZKPLE CITY CA 91780 BL 050E 0610110071 PHONE. (676) 285-0488 LEGAL IDS NO. 01 COAST BUILDING, ADDRESS: TR: 14467 LT: 31 SQ. FT STORIES TYPI 5015 CAMELLIA AV STRUCTURE, VI TEMP CA 917803854 ABS=SSOR IITORMATION NUMBER. NIARSBT CROSS STRXX T� LA ROSH 8589-014-018 T OMM PAGIM, 597 GYID. AS LOCALITY: TReLE CITY, C TSNAITi EXIST BLDG USM: REBID USE E01NI R-1 ISSUED ONt PROCESSED BY. EXPIRES ON: EXIST OCC GRP. 10/12/06 JK 10/07/07 OMNER: TML. 10: BLDGS. NOM ON IAT: VALUATION: FINAL DATE F BY CODMI GERA JOHN W;BARBARA S (626) 786-0714- 7,500 5015 CAXXLLI.A AV �C TEMP 917803854 FEES PAID DMSCRIPTION OF MORE BATHROOM REMODEL FEE DIBCRIPTIONi QUANTITYs UOX. AMOUNT: APPLICANT: TEL. NO: L i M LISCHEN i BATHS (626) 787-1131- AA BLDG PERMIT ISSUANCE 27.75 8817 LAB TUNAS DR. AC STRONG MDTION RMBID 7500.00 VAL 0.75 SPECIAL CONDITIONSz SAI GABRIEL CA 91776 B2 PERMIT W/ZFHRGY 7500.00 VAL 201.30 TOTAL FEES 229.80 CONTRACTOR: TIL. NO APPROVALS DATE INSPECTOR SI®1TURE L AND W KITCHNI AND 13ATHB (676) 287-1131- 8012 LAB TUNAS DR. LIC. NO LOCATION AND BrTBACXS SAI GABRIEL, CA 91776 20534413 SOILS ENGINEER APPROVAL ARCHITECT OR EWGLNSSRi TEL. NO FOUltDATION TRENCH FORMS LIC. NOt BLAB SNR FLOOR RAISED FLOOR FRAMING ' MAP NOS SMMMR MAD BOOL: PAGE: P122 ZONE: CMP: UID'?RJI,OOR INSULATION 144H769 3 01 FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT COND: STAT CLASS. NO 21 ROOF SHIMMING SCHOOL WITHIN HAZARDOUS SEI'.R PANELS AIR QUALITY: 1000 7= MATIERTLLS . NO NO No FRAME INSPECTION REQUIRED TOTAL SETBACK FROM III ST FIRE BPRIJnaJM HANGERS SST BACK 7XIMt HWY: PROP LINM: WIDTH: FRONT PL- INSULATION WEATHER STRIP SIDS PL- MMRIOR LA DRmT.T. =ZTFRIOR LATH RATED FLOOR CEIL ABSSM. RATS WALL AB82341BLII8 RATED SHAFTS OPENINGS T-BAR CAMINGS LOT DRAIIAGH REPORT ID: DPR261 ROUTS TOi B80508