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HomeMy Public PortalAbout9307 DAINES DR_Building__ I� II � °Q:�A0�.N, COUNTY OF LOS ANGELES; LL����� ' � • . 'DEPARTMENT OF COUNTY-IEI�IGIRIEER RM T BUILDING AND SAFE (VISION + BUILDIN 4 ;FOR APPLICANT TO FILL IN ADDRESS BUILDING ADDRESS LOCALITY ; CITY T�.: , NEAREST _. _ ZIP CROSS'ST. �� t •OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL. Q )� DISTRICT GROUP J,TCYC�NST ' FIRE PRO ESSLOCK LO '`� TEL. + Y QWNER ._ NO., SSoo STATISTICAL CLASSIFICATION• SEWER P ADDRESSCLASS NO. DWELL:UNITS ` BK PG CITY, S aQ yZIP U ZONE -MAP ARCHITECT OR TEL. NO.. Q ENGINEERNO. J SPECIAL 4, CONDITIONS M. ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES - -.NO TEL; : .; . ^r BLDG.SETBACK FROM CONTRACTOR NO &/ LIC. FRO T PROP:LINE OF (STREET) ADDRESS Sd SC8 b NO'. f TOTAL SETBACK FROM, TYPE OF i EXISTING c nn LIC. HI HWAY + YARD .FRONT PROP•LINE HIGHWAY WIDTH- CW' `�;• / CLASS - ` l�y�-­CONSTRUCTIONLENDER' NAME AND BRANCH �. 0 BLDG.SETBACK FROM SIDE PROP.LINI'OF=--•— (STREET) �' ADDRESS CITY 0 . SQ.FT- NO.OF NO,OF CHECK HIGHWAY + YARD = TOTAL SET CK. ROM,' 'TYPE OF EXISTING U SIDE PROP.LIN . HIGHWAY, WIDTH - SIZE STORIES;' FAMILIES ONE' a DESCRIPTION OF'.WORK NEW ADD D. ❑ CORNER CUTOFF YES. `'NO. ACTER� LMN OPEN SPACE` YES .❑ NO REPAIR ❑ USE OF-_', ING BLDG. DEMOL' .� =IN.COASTALPERMIT ZONE YES Q NO '. ,APPLICANT TEL' PRINT) 'NO. ��< w r. , BY(SIGNATURE( LHEP,EBY.ACKNOWLEDGE THAT I HAVE'READ THIS A PLICA710N AND STATE THAT-THE.ABOVE IS CORRECT AND AGREE TO COMPL ITH'ALL ORDINANCES r -AND LAWSPREGULATING BUILDING CONSTRUCTION:I CERTIFY THAT IN DOING THE e A WORK UTHORIZED HEREBY-1 WILL NOT.EMPLOY'ANY"PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELA71NGTO WORKMEN'S'COM- - PENSATION INSURANCE. - - SIGNATURE OFFINAL' ) BY PERMITTEE' ' vt ° _ DATE' ADDRESS sa S044 good -__ TEL. l P.G Fee$ Permit Fee CITY �o QIssuo6ce Fee ' VALUATION P 76'. Total Total'Fee /�J PLAN CHECK VALIDATION* CK. nn.o. cases _ PERMIT VALIDATION �ctz� nn.o.' CASH .i 76A638A CE//803A 6/76 `+�PPLICATIO , .FOR COUNTY OF LOS ANGELES DEPARTMENT'1OF COUNTY ENGINEER ` w r. B U L®8 N PERMIT BUILDING'AND SAFETY DIVISION LLLJJJ BUILDING FOR APPLICANT TO FILL IN' ADDRESS 0 7 BUILDING LOCALITY -� ADDRESS, h: !✓ - — r NEAREST CITY' L 4 "C, / 6 ZIP .f CROSS ST. • G - tfO.OF BLOGS. - ASSESSOR SIZE.-OF LOT Q �� NOW ON LOT' MAP BOOK PAGE PARCEL. DISTRICT 'GROUP TYPE .FIRE PRO ES BY - E Ee>!7>C,¢cGF PC'n �� CONST.; zoN TRACT BLOCK LOT NO: '�® ,.�.��. .•'y' -/ •a,�'..� / Y -TEL. /, OWNER �f. ��'��//YfI NO. d�.r6 V If STA TISTICAL'CLASS IFICATION EWER MAP y ,(.. CLASS NO. OWELL,UN,ITS BF pG ..ADDRESS 30 - _� - USE ZONE MAP' CITY.. �.�/17 iL.. ..- �/'7, 'ZIP l NO: ARCHITECT OR ' • TEL. /•- SPECIAL ENGINEER /V rt;/. NO. ./ CONDITIONS ADDRESS ROAD,DE.PARTMEN T APPROVAL REQUIRED YES.[] NO ❑ . TEL _. BLDG,SETBACK FROM'' - CONTRACTOR �q '_!v �jJ�. O; /7d - LIC. FRONT PROP.LINE OF - - - -- (STREET) .ADDR ESS Co 074-4, jLC-Z NO. HIGHWAY. } YARD - TOTAL SETBACK FROM TYPE OF EXISTING .. WIDTH , - LIC. ,•�- - - FRONT PROP. LINE HIGHWAY W - C1TY. r;fA/ - - CLASS g.24p3oj j - CONSTRUCTION LENDER } �. NAME.AND BRANCH BLDG•SETBACK,FROM ADDRESS - CITY SIDE PROP. LINEOF -(STREET) CD SQ. FT. .NO. OF NO. OF CHECK HIGHWAY } YARDTOTAL SETBACK FROM TYPE OF EXISTING O' SIZE STORIES FAMILIES - ONE .,SIDE PROP. LINE." HIGHWAY WIDTH } DESCRIPTION OF WORK' TG(>(J �(,/J/ +NEW ❑ ADD ❑ CORNER CUTOFF, YES'. ,,' NO'[]zv Z J •ALTER ❑ ..: -.. .. •- - fEPAIR'❑ IN-OPEN SPACE •YES .'.NO ❑USE OF - E MOL-❑ IN COASTAL PERMIT ZONE -YES ❑ .NO ❑ EXISTING BLDG. - .. . h APPLICANT/� TEL /i �-y` (PRINT) (5; -NO..�1. . tl 1. 'BY (SIGNATURE) .-' - ;e, mJ ��"✓ I HEREBY ACKNOWLEDGE THAT I. HAVEREAD THIS APPLICATION /�'j ! .©�}� it_`j-•-, ©/` AND STATE THAT THE-ASOVE IS CORRECT AND.AGREE,TO COMPLY' / WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- may. IM1� / �''' ,�J TKA' qN'`{J STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED V&,(4,f- -..+54eLT -77� I— HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE, OF CALIFORNIA IN RELATING TO -WORKMEN'S COM SATS ON SUR E. SIGNATURE OFFINAL _�o�� BY , PERMITTEEDAT E .. ' ADDRESS CITY . NO.L�Z� P.C.Fee$ Permit Fee Q 70-0 - Issuance Fee s _ - VALUATION - - .. Total Fe PLAN 'CHECK VALIDATION CK. M CASH "o PERMIT VALIDATIO cri. �o: CASH 9,� -14PIAR -3 a 1 2.0 0 . 76A638A CE*803B 12/75 AP LicATI®N .FOR BMJ I L®I NG PERM�T FOR PLICANT FILL IN.'(Print or type only) B�ud''DING �. j �! COUNTY' OF LOS ANGELES . A(GORESS DEPARTMENT,'OF COUNTY ENGINEER ` CITY'r, �-- Z I P - BUILDING ANDSAFETY -DIVISION - �qa NO.OF,,BLDGS. BUILDING SIZEp�yOF:LOT D9 � .NOWONLOT L- ADDRESS 9 �'< �N-lN�s �Ie { ..,. . ACT . B G �.�' LOCALITY. n^/ �' _-- TRACT `J' /�, BLOCK ' LOT NO. �J/[J Y�� OWNER AVI !- D/G .r NO. 191T4 .J CROSS STNEAREST. 6 Q I ASSESSOR ADDRESS /✓P� V/ ;"4 �� MAP BOOK PAGE CEL. G DISTRICT - ROUP TYPE FIRE PRZSSED BY _CITY Ls �sL LT� ZIP" d CONIE ' ARCHITECT OR TEL. ENGINEERNO. - r STATISTICAL SE CLASSIFICATION-- W P t���/ ER ADDRESS CLASS NO DWELL,UNITSTE BI PG' CON,TRACTOR< • �G r,D ealy►W HIDZONE MAP ADORESS��t Z � �i / rZ;� NO:'17120 3&7 '� SPECIAL - �+` (y�,�,Qy 'LIC p] •9 r/t7 CONDITIONS *CITY,)/.ral 7/moi✓ ` Cl�' �/7/ J CLASS If�'��. -_ ROAD,�•DEPARTMENT APPROVAL REQUIRED ' YES❑ `NO"❑ CONSTRUCTION LENDER AJ � � NAME AND;BRANCH SLOG.SETBACK-FROM ' - - FRONT ROP.LINE OF (STREET) ADDRESS CITY - - _ ,TOTAL SETBACK FROM TYPE OF, EXISTING HIGHWA } YARD ,SQ: FT.' NO..,OF :/, NO. OF CHECK' , FRONT PROP. LINE' HIGHWAY ,:WIDTH SIZE �® STORIES FAMILIES, 'ONE DESCRIPTIONOF WORK, AA NEW - �CD _ BLDG.SETB v ADD SIDE PRO LINE OF :(STREET)' ,,,CD - `ALTER.❑ - - .T,OTAL SETBACK FROM TYPE OF. EXISTING - ❑ HIGHWAY } YARD' = r IGHWAY WIDTH U REPAIR SIDE PROP. LINE �" O �^ t EXISTING BLDG. �e'"s/D�C.f/C^�- DEMOL ❑ - Z_ APPLICANTEL CORNER_'CUTOFF YES ❑ NO T - - - • (PRINT) a - ' - IN OPEN SPACE.- YES ❑ No BY (SIGNATURE) � �� _� - IN COASTAL PERMIT ZONE YES.[:] 'NO ❑ , VALUATION.;; I .HEREBY ACKNOWLEDGE THAT I HAVE,READ THIS APPLICATION WiN(� •'r^�- ' - AND STATE THAT THE ABOVE IS CORRECT AND.AGR EE TO COMPLY ® � 1 WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- b -' -STA UC TION. 'I'.{ER TI�FY THAT IN DOING_THE WORK AUTHORIZED' _ HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE , LABOR CODE OF TURY STATE OF � ALIFORNIA IN RELATING TO WORKMEN'S COMPE TION- S A E. - - SIGNATURE OF- PERMITTEE _ ADORES $ - - �'T FINAL - BY.. CITY' .v. ,NOTE L�q ljd'4, MAKE CHECKS PAYABLE TO: cPr $ PMT.;$ FEE' FEE _ HARVEY T. BRANDT. COUNTY ENGINEER PLAN'CHECK VALIDATION CK. M.O. CASH e P RMIT VALIDATION CK. M.O. '_CASH . �I 5 5,5.0 7GA638A CE.803 5/74 - _ 78A838A`"�33 9 ° APPLICA If D®[ISI FOR BU� LMNG PERMT - DIVISION OF BUILDING FIND SAFETY. ADD BUILDING Department'of County Engineer � :� County of Los Angeles LOCALITY { .(-P_ JOHN-A. LAMBIE,.COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN, SUPT OF BUILDING CROSS ST. - - .APPLICANT TO FILL IN DISTRICT NO. --FORTYPE GROUP. SEWER- MAP � ,,. �� BK PG BUILDING �� NUMBER ' ADDRESS MAI' - ; STATE AA HWY YE NO " d (j, 66LOCK USE ZO E SPECIAL LOT NO: CONDITIONS J TRACT NO.OF BLDGS. SIZE OF LOT I NOW'QNLOT BU DING. YARD HWY STREET.NAME EXIST.' 14 USE OF - S TRACK - WIDTH' ,EXISTING BLDG. FRONT P. L. P _ OWNEq& SIDEMAIL P. L. ADDRE 17 O TRACT DWELL. \I UNIT IT TEL. 5 INDUSTRIAL ' 1 DWELL 1 UNIT', 6 PUBLIC BLDG.' CITY`. - O - _ .- ARCHITECT OR EL, 2 DUPLEX - '2 UNITS .7 ADDN.,'ALT., ETC. ENGINEER - NO. 3 APT. UNITS - `8 MISCEL: ADDRESS " 4 COMMERCIALw - T INSPECTION:RECORD , 10 rk CO 3 I /DES RIPTION OF WORK �.� S� ;tel'r_Q- NEW ADD ALTER REPAIR DEMOLISH 1. �,/yq f, \ - SO. FL NO. O NO. OF- 1 -e!�'Fn L #4/)c�aa..a...:.__�; SIZE STO ES - F ILIES US TRU'C U SIGNATURE OF APPLICANT - APPROVALS - "v. ADDRESS _ P. INSPE&OR°S SIGNATURE $ ��• - -' FOUNDATION: LOCATION �.. _ P. C. $ a �® 'FORMS.MATERIALS FEE FRAME:FIRE STOPS,. VALUATION' $ .BRACING. BOLTS FEE FURNACE: LOCATION,- - - I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT. DUCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH.ALL COUNTY ORDINANCES .' LATH, INT. - -AND STATE LAWS RE ULATING BUILDING CONSTRUC- - - TION. -• L'ATH. EXT. SIGNATURE OF HOUSE'NUMBER COR- PEER�RMITTEE RECT AND POSTED /oPID1tE� FINAL (lit G'5,,_ JOHN A. LAMBIE, COUNTY ENGINEER VALIDATION CLYDE N. DIRLAM:CHIEF BLDG. INSPECTOR . CK MO CASH - . 7 4, 3 9 JUN 2 6 1 6 2.5 0 � 1 1 0.0 0 �� 760.5A DB5.3 3-55 -- Ax Ih ISION OF BUILDING AND SAFETY BU-LIMNG 30 % �,�, r ADDRESS Deportment of County Engineer County of Los Angeles LOCALITY T0 Nbl'D b )"tom IV . WM.J. FOX. COUNTY.ENGINEER NEAREST , L� 1 CASSATT D. GRIFFIN,.SUP'T OF BUILDING. .. CROSS ST. .►T I �C� - DISTRICT NO. GROUPITYPE SEWER-. MAP ` FOR APPLICANT TO FILL IN I BK_ PG ' CONST. BUILDING'. MAP ✓� ` ' ADDRESS .�� CwvccA.rv^(�.1-a�'r. NUMBER r"°o 0 STATE 'YES 'NO LOT NO. BLOCK USE ZONE. •SPECIAL - (- CONDITIONS TRACT . 7L rNd. OF EiLDG SIZE OF LOT ��'S X h -I .NOW ON LOTS BUILDING EXIST] - SETBACK. YARD - HWY STREET NAME- �• WIDTHUSE OF . EXISTING BLDG. FRONT t 'I/ I OWNER r r SSIDE - MAIL UNIT'O TRACT DWELL. .. 1 ADDRESS f"�l�-tet.. _ _$ INDUSTRIAL. TEL. I DWELL. I UNIT CITY. 4 J:NO. - 6• PUBLldBLDG. _ ARCHITECT OR � TELL 2 DUPLEX 1 UNIT7 ,ADDN.,ALT., ETC.. ENGINEER - NO. - 3 APT. UNITS - - -- a MISCEL. .. _ DRESS 4 COMMERCIAL, r TEL: INSPECTION RECORD CONTRACTOR �I- l� r�4YrddL� 'NO. ADDRESS � /rw , t.yG. j 1.`� �A 'l-'' 'C� C`. �✓ .. � LShAla1�. .'t� DESCRIPTION OF WORK - NEW ADD >S ALTER :REPAIR. DEMOLISHj.�. r� ,.r�,� <$,,. ',�o , SQ. FT. gh NO.OF / NO.OF STORIES J FAMILIES - I S� ry USE OF-STRUCTURE fs9,e. .•�'•^�` SIGNATURE OF t l.. Ij,� �P.L� - - - APPLICANT APPROVALS - DATE INSPE ADDRESS CTOR'S SIGNATURE. FOUNDATION:.LOCATION (,/�+ O P. C. $ FORMS. MATERIALSJIN. (� _Lu't�_... I° "d FEE -FRAME: FIRE-STOPS, ayy/y�/y �y�� e� 0.®. BRACING. BOLTS moi. Co 'x'YYra'LC_1.CAA-44I VALUATION , FEE $ ,e! FURNACE: LOCATION. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT, DUCTS - - - APPLICATION AND STATE THAT THE ABOVE IS CORRECT - ,•/ AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES 'LATH. INT: al�� AND STATE LAWS REGULATING BUILDING CONSTRUC- I •_J, TION. -- - LATH, EXT. SIGNATURE OF E HOUSE 'NUMBER COR- PERMITTEE I RECT,AND POSTED'-•' ADDRESS- FINAL WM.J. FOX,COUNTY ENGINEER VALIDATION C:N: DIRLAM, CHIEF BLDG. INSPECTOR jX04 .8.7 7— APR 1 8.Q C) _ti 76A688A-OBS;e8-b b APPLICATION F,OR BUILDING PERM.OT DIVISION OF.BUILDING AND SAFETY- BUILDING y� Department of County Engineer ADDRESS County of Los Angeles LOCALITY a , WM.J. FOX, COUNTY ENGINEER NEAREST P ®q d CASSATT'D. GRIFFIN SUPT OF BUILDING CROSS ST. - -DISTRICT,NO. [GROUP TYPE SEWER MAP FOR APPLICANT TO FILL IN. _ BK 'PG. „ CONST _I " .BUILDING /y?/�, fD d1 e� MAP ` STATE -YES NO ADDRESS �J.7 /X�� e26=•1 P r .NUMBER HWY NO. ��j - BLOCK USE ZONE- SPECIAL- LOT - - - CONDITIONS - ' TRACT' - NO. OFBLDGS. -BUILDING EXIST. SIZE OF LOT ,�� I. NOW ON LOT- SETBACK YARD HWY .STREET NAME - WIDTH USE OF - - )4 FP14OLNT4(® EXISTING BLDG.TI -GC, E"-- - !r SIDE. OWNER. MAIL- � YS ( -.n...aA:a.. �" v. ADDRESS ,., �,� O TRACT DWELL. .,1 UNIT - r - 5 INDUSTRIAL TEL. 'I 'DWELL. 1UNIT CITY iG..�: ,f � A,}m NO: - +, .. _. -.. .. 6 PUBLIC BLDG. r ARCHITECT OR - - TEL. - 2 DUPLEX 1UNIT .ADDN., ALT.. ETC. ' ENGINEER '"'" - NO. 3" APT:... --UNITS' -- - 8 MISCEL. - - • .. ADDRESS / J , 4 COMMERCIAL TEL - Q : CONTRACTO/R�\ L 1 �,/.P .74'v/t 'N�O�.Q �Pn � ,y'I�fRTSPECTION RECORD '_ - �R. ADDRESS lFI l _��::�'^��I , �Iw►r�i CX S / � C7 DESCRIPTION"OF WORE NEW ADD .A- ALTER�T- . REPAIR - DEMOLISH ..SQ. FT:,cAl NO..OF NO.OF- _ - - SIZE' 6/ STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF - APPLICANT APPROVALS ' ADDRESS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION o, P.C., $ FORMS;'MATERIALS ' o I 'qf s(. U.,��.el.A,, _ FEE FRAME: FIRE'STOPS, VALUATION - - $ R BRACING.'BOLTS 14 FEE �('� FURNACE:"LOCATION, v 'I HEREBY-ACKNOWLEDGE THAT 1 HAVE READ THIS. GAS VENT. DUCTS ` APPLICATION AND STATE THAT THE ABOVE, 13 CORRECT, - - AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH,-INT.AND STATE •LAWS REGULATING .BUILDING CONSTRUC=. TION. (/'�\ - LATH, EXT. - / .L� W. SIGNATURE-OF s HOUSE NUMBER COR- PERMITTEE �`JJJC�dNV a� _ RECT AND POSTED ' ADDRESS FINAL I Ito s,;a WM.J. FOX,COUNTY ENGINEER VALIDATION C. N: DIRLAM, CHIEF BLDG. INSPECTOR COA 8 7 c LN APR 91 I. 0..00_ " , r - '�F BUILDING AND SAFETY r u , rtment of County EngineerD�C N L County of Los Angeles WM. J;—FOX, COUNTY ENGAPPLICATIONINEER ' FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. :PLANCK.oR Rec.No. PERMIT NO. BUILD ADD EISS'750/a I!, DA/Uat DRWE Z-0 � o9i�S' LOCALITY ,c l'ry REEC�EIVED BY. DATEOFAPPL. DATE ISSUED NAIL { .t CROSS ST. L -0q� - BUILDING 9�® � , p� c7 �, /�!�s lam.+ U 1� 9" ADDRESS OWNER Alf, . LOCALITYMAIL ADDREBB 6527 N® A4 IXY�e-T`4 AVS NEAREST to - _ CROSS BT. SCITY aµ NO. 9- q "'FIRE NO.OF NO JV PLANS ' .I TYPE, rOUPARCHITEC �.s NGINEERTOR �WF- AJ0 E ,�- P"�. BLDG. BETBA K LINE ADDRESSUSE A ' t� pp TQ L: ZONE A,` .ABYPROVED DATE CONTRACTOR 1�d NO. _ ,�„ Q a*' HOUSE NUMBERING ADDRESS �y MAP NUMBER ®'C' NO. ASSIGNED'BY DESCRIPTION LEMAL is L TO O r® BLOCK ' f� ' CORRECTIONS W. TRACTNO. OF BLDG �{J SIZE OF LOT )C+�' ® I NOW ON LOT B.N0A1� TJ OW N USE OF NO. OF EXISTING BLDG. FAMILIES ` DESCRIPTION OF WORK _ A NEW ALTERATION ADDITION / Z • � Ca'+'PtT-O �C'' �uP.fCh �av!x t.T C+� r ,.. REPAIR DEMOLITION NO OF SBZE . .11724 ROOMS STORIES EXT.WALL COVERING STUCCO UCC I COVEROOFRING W/P15 USE OF•STRUCTURE �+ INSPECTION FOR APPROVALS OCCUPANCYAS INSPECTOR'SSIGNATURE DATE FOUNDATION: LOCATION FORMS, MATERIALS/ �y _ t 2!/�gha 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- � f7 PLICATION AND BTATE.THAT THE INFORMATION GIVEN IS FRAME: FIRE STOPB,�'"6 L '�C-.t.- �=�'`�r 1 7 CORRECT. - BRACING, BOLTS 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ACE: LOCATION, AND STATE LAWS REGULATING BUILDING CONS RUCTION. FURNACE:GAS VENT,DUCTS SIGNATURE OFLATH, INT. PERMITTEE- 104,41t LATH, EXT. 's ADDRESS ✓ PLASTER, INT. AUTHORIZED AOT. 4 _ a a. PLASTER, EXT. $ P.C. — ® ® O FEE ,5 .? HOUSE NUMBER RECT AND POSTEDR VALUATION �3 FEE d' FINAL 76A63BA OBS 3 1-52 .. AG PIM C aMON FOR, BU J L HQ PEER ff �l COUNTY OF LOS ANGELES_ BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDING ADDRESS f WORKER'S COMPENSATION DECLARATION' BUILDIN AD RESS `-' I hereby affirm that I have a certificate of consent to self insure, Y> or a certificate of Workers'Compensation Insurance,or a certified CITY_ ZIP copy thereof(Sec.3800,Lab.C.) elkl �! �pky�' 1 ��� C"UkJI 1 l' LOCALITY Policy No. ®'24 ]'' l Company SIZE OF LOT NQAOF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. T ACT BLOCK LOT N ❑ Certified Copy is filed with the County building inSpBctiOn p� � � USE ZONE MAP NO. department. 0 '+ o ASSESSOR MAP 00 PAGE PARCEL Date Applicant 1— SPECIAL CONDI IONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL.NO. _ COMPENSATION INSURANCE'". f- WITHIN 1Lbd FT of SCHOOL? YES NO• ADDRESS �� (This section need not be completed if the permit is for one hundred '� DIST ICT GROUP TYPE CONST FIRE ZONE PROCESSED BY dollars($100)or less.) CITY ZIP l / I certify that in the performance of the work for which this permit is issued, I shall not employ any person.in any manner so as to ARCHITECT OR ENGINEER TEL.NO. V become subject to the Workers'Compensation Laws. -ISATISTICAL SS FICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT. If, E .Nafter making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST T Exemption, you should become'Subject to the Workers' CORACT.OR "SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith 1 � O. FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS .NO: PL is R%G4 SIDE d LICENSED CONTRACTORS DECLARATION CITY p p IC.CLASS P L p� I hereby affirm that I am licensed under provisions,of Chapter 9V SEWER M P_ (commencing with Section 7000)of.Division 3 of the~Business and SQ.FT: E NO.OF ST RES NO.O FAMILIES C Professions Code,a d my license is in full force a d effect. NEW El BK PG %� DESCRIPT N OF WORK-c- - ADD ] VALUATION W License Number ic.Class a 1 Q N Contractor Date a ((��.. ALTER El El am exempt under Sec. r 4z V REPAIR El B.BP.C.for this reason DEMOL LDMA P/C a USE OF EXISTING BLDG. Date: URM. ❑ Signature A LICANT(PRINT) TEL.NO. LDMA Perm R I ❑ 1, as.owner of the property, or my employees with wages as 1,4 ek ri Q p -r s AD E SIz their sole compensation, will do the work and the structure is f V f. C.C.e a not intended or offered for sale (Section 7044, Business and L ! / / FINAL DATE Q -� I ' - s . . Professions Code. .v a.�_, • WILL THE APPLICANT OR FUTURE BUILDI OCCUPANT HANDLE A HAZARDOUS MATERIAL `r J OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUACTO OR GREATER THAN 4 f= ❑ I, as owner of the property, am exclusively contracting With THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY I 1 E E licensed Contractors to construct the.project.(Section 7044, YES❑ NO❑ ..,10TAL. ' 8 Business and Professions Code.) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING. 'CHECK .., i 8�._ OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTIONOR MODIFICATION FROM THE SOUTH 'CH CK �+,�e` .9 CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. • I hereby affirm that there is a construction lending agency for YES❑ NO❑ CHAN .011 the performance of the work for which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES m. COUNTY CODE,TITLE2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING / f=l/4E;:)1 � Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD: 000_v aLenders AddressOWN��� � V5 1 AM ia�j o' ENT I certify that I have read this application and state that the above - $ information is Correct. I agree 4o Comply with'all County P.C.FEE PERMIT FEE w• a ordinances and State laws relating to building construction,and n ¢- hereby uthorize re ese tatives of th• County to enter upon ISSUANCE FEE �j thea ntion pro rty for in tion purposes. l._ o G 1' INVESTIGATION FEE TOTAL FEE Cy 'Sq,uwnM a Dem ,� SEE REVERSE FOR EXPLANATORY LANGUAGE APIPUC AMOH FOR BU�LMH0 PERM� COUNTY.OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS BUILDING ADDRESS ^ I hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) __ CIT;.' , zIP V4 I I /_ LOCALITY ���� Policy No. © Ji u G Company 1 � SIZE O LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified Copy is filed with the County building inspection TRACT BLOCK LOT NO. USE ZONE MAP NO. department. ASSESSOR MAP BOOK PAGE PARCEL ` Date - Applicant - SPECIAL CONDITIONS ' CERTIFICATE OF EXEMPTION FROM WORKERS' OWN RTEL.NO. COMPENSATION INSURANCE 2-%T7 WITHIN 1000 FT.OF SCHOOL?. YES NO ADORE (This section need not be completed if the permit is for one hundred r30 DISTRICT GROUP TYPE CONST.' FIRE ZONE ICESSEDBY dollars($100)or less.) CITY ZIP n�np /`� ? I certify that in the performance of the work for which this permit CAI l+ OY .J �•�/� (T is issued, I shall not,employ any,person in any manner so as to ARCHITECT OR ENGINEER TEL.NO. ✓ II 11 become subject to the Workers'Compensation Laws. STATISTICAL CLA�ATION APT NDO Date Applicant ADDRESS. CLASS NO. DWELL UNITS NOTICE..'TO APPLICANT. If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST C RACT TEL.NO- EXemptlOn, you should become Subject t0 the Workers' SET BACK YARD HWY PROP LINE WIDTH Co mpensation•provisions of the Labor Code, you must forthwith �7 � � RONr comply with such provisions or this,permit shall be deemed revoked. ADOrRE(S��c� \ LIC.NO. J ! ! V PL SIDE �• LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS p IL c I hereby.affirm,that I am'licensed under provisions of Chapter 9 SEWER MAP v commencin with Section 7000 of Division 3 of the Business and SQ.FT.SIZE NO:OF STORES NO.O FAMILIES Professions Code,and m license is in full force and effect. �0� NEW ❑ BK PG DE CRIPTION OF WO V License Number a �QL Lic.Class Q`^^� � '1 � LDEMOL vALUATIOk y Contractor �1�-� Date I G , $ z_ ❑ I am exempt under Sec.B.&P.C.for this reason LDMA P/C# Date: USE OF EXISTING BLDG. Signature. APPLICANT(PRINT) TEL.NO. LDMA Perm# ❑ I, as owner of the property, or my employees with wages as p �(` ° their sole compensation,will do the work and the structure is ADDRESS wwl� s 3i_i not intended or offered for sale (Section 7044, Business and FINA TE Professions Code.) ', - WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL _ r` J _ '� I T`E—E ❑ I, as owner of theproperty, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN }:,} Y g THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FI TO I t t1» �5�E �00 licensed contractors to construct the project.(Section 7044, ves❑ No❑' _ Business and Professions Code.) a � ,�_;a;;{� ' WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING ( '.•i E •�. - .OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLISTi'HAN 3E u Lit'.1 FOR GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ NO❑ the performance of the work for which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD , , tip- 2 3`90 m 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES 10 f�- 0 �1 /•y {h m. COUNTY CODE,TITLE 2.CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. s 3* + Lender's Address OWNER o0 ncexriI =LI s I Certify that I have read this application and State that the above- TEFEE PERMIT FEE i O information is correct. I agree to comply with all county ordinances and State laws relating to building construction,and e a. hereby authorize representaWvofhis County to enter•upon ISSUANCE FEE /'� nthe a-men ons gropepection pur os . f (� (f a \.JV - INVESTIGATION FEE - TOTAL FEE 0 SEE REVERSE FOR EXPLANATORY LANGUAGE, WORKERS'COMPENSATION DECLARATION I hereby affirm'that I have a certificate of cons'Llnf'lo NOf � O �( O O p U L D I F E RM nn LLLl�� insure, or a certificate of Workers'.Compenstion Insurance, or [1 1�1J LI L/�� LI LI lJU1J V IJ a certified`�c0opyppttqhereQoff (Sec 3800, Lab. C.)) �ll�g,q,.�� ' COUNTY OF LOS ANGELES BUILDING AND SAFETY P❑ol cy No.��f3C-®o a"Company 6�1�7r1r6Q/!� I/�/NSoWY� Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING " ADDRESS V c2Cis � Certified copy is,filed with-the county building inspec- BUILDING tion department. ADDRESS f'1�/�G J LOCALITY QQ •' NEAREST (DateilC-IV471"A Dlicantzr�pzl* CITY �/ ZIP CROSS ST. CERTIFICATE OF EXEMPTION M ORKERS' N4. OF BLDGS. ASSESSOR. COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT' MAP BOOK i PAGE PARCEL USE ZONE MAP This section need not be completed if the permit is for one 6110 G TRACT BLOCK LOT NO. NO. hundred-dollars ($100)or less.) 2 y� n, �+ r SPECIAL p}, 1 A1240401- NO.�(( CONDITIONS- I certify that in the performance of the work for which this OWNER O permit is issued, I shall not employ any person in any manner DISTRICT GROUP TYPE _ FIRE PR CESSED BY U ADDRESS CONST. ZONE W so as to-become subject to the Workers'Compensation Laws. _ _ O _ ) ,,, OI - _CITY - i ZIP ' t1 f' Date Applicant STATISTICAL CLASSIFICATION ARCHITECT OR T. CONDO. W .NOTICE'TO,APPLICANT: If, after making this Certificate of TEL. ENGINEER NO. CLASS NO. / DWELL. UNITS CL Exemption, you should become subject to the -Workers' to Compensation'provisions.of the Labor Code, you must forth- rPDDRE55. SEWER MAP with comply with such provisions or this permit shall be deemed revoked. _ � �/� �� TEL. BK. �J PG, VALIDATION CONTRACTOR i NO. LICENSED CONTRACTORS DECLARATION ' LIC." I'hereby affirm that I am licensed under provisions of Chopter 9 ADDRESS/40/ t&di NO. VALUATION (commencing with Section 7000)of Division 3 of-the Business and ,/ LIC. Professions Code, and my license is in full force and effect.' CITY y I�Q' CLASS $ a L SQ. FT NO.,OF NO. OF CHECK Licensee Number °� Lic.Class SIZE STORIES FAMILIES ONE ,0"' "^ ww vw _ -��5� �. DESCRIPTION OF WORK �rL/ NEW- $ Contractor Date ❑ 0 1 am exempt from the licensing requirements as I•om a -ADD licensed architect ora registered professional engineer ALTER FINAL acting in my professional capacity (Section 7051,1 1.d, El DATE Business and Professions Code). USE OF - / c EXISTING BLDG. �r� AJ DEMOL FINAL /� �� c 4 3 9 A BY r/"'' Lic.or Reg. No. _Date I APPLICANT TE . OWNER-BUILDER DECLARATION (PRINT) O. 1Q0� 9'0 o'0 0 2 3 I hereby offirm.that I am exempt from*e Contracto'r's License `� � � �`� �/ 6 00 Law for.the following reason (Section 7031.5, Business and 'ADDRESS! n 2 0 0 0 Professions Code): PRESENT o 0 0 a 6,0 0:C BUILDING - I, as owner. of the property, or my employees with ADDRESS 7 .20 wages as their sole compensation,will do-the work and 0.6 1 'Jr' 8 2 - the structure is.not intended or,offered for sale(Section LOCALITY 7044,'Business and Professions Code). MOVING TEL. 2-/�J ` ` 4/ I; as:owner of the property, am exclusively contracting CONTRACTOR NO. o with.licensed contractors to construct the project (Sec ADDRESS z 4 3 7,0 A tion 7044, Business and Professions Code). t REQUIRED TOTAL SETBACK FROM EXIST. e o 0 0 0 .1 CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 7 ' I hereby affirm that there is a.construction lending agency for FRONT the,performance of the work for which this permit is issuedP.L. 2 ° 4 0 0.0 0 (Sec. 3097, Civ. C.). SIDE P.L: ° ° 4 0 0.0 0 v Lender's Name m - - P.C. Fee$ ;3"/Z Permit Fee Lender's Address �r w I certify that I have read this application and state that the (G . OO Issuance Fee 6 ° above information is correct. I agree to comply with all CountyInvestigation Fee /y 0 ordinances and State laws relating to building construction, Total Fee Q� -' 0 w and hereby authorize representatives of this County to enter U upo above-me oneVpoperty for inspection purposes. a �� '� SEE REVERSE FOR EXPLANATORY LANGUAGE -f �SignaFureofant or Agent Dote ©s WORKERS' COMPENSATION DECLARATIOIy, I'hereby affirm that I ,h1we`a certificate of consent to self, `A•P.I J��C/U�U�O I NU I FOR p U 0 d DD 0 M G PEAWT T jinsure, or.a certificate of Workers'Compenstion Insurance, or L/�1LI LI [/ u u u v -u uU a certifi' hereof ec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY 5r �/0/ e' ���� BUILDING. Policy o. Company CC ` JJ Certified copy is hereby furnished. ...FOR APPLICANT TO.FILL IN ADDRESS' 07 G. ® Certified copy'is filed with thecounty building,iinspec- BUILDING 0307 Dame S Drive ,,tion department. ADDRESS 7 LOCALITY NEARE Date •'O Applicanf�-J• w� CITY TemPle• c1 tY ZIP CROSS ST. ' CERTIFICATE OF EXEMPTION FROM,�WORKER NO.'OF-BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK : PAGE PARCEL (This section need not-be completed if the permit is for one USE ZONE MAPa� r/ -hundred dollars ($100)or less.) TRACT BLOCK LOT NO. / NO. d a �R TEL - SPECIAL I certify that in the performance of the work for which this OWNERl'lanUel Pedrini No 28 •- OO CONDITIONS O permit is ts'sued, l shall not employ any person in any manner Same DISTRICT GROUP TYPE FIRE PROC SED BX. V so as to become'subject to ihe.Workers'Compensation Laws. ADDRESS: S�o� n CONST ZONE O CITY Same' ZIP ' Vim` . 7 I.- Date mDate Applicant STATISTICAL CLASSIFICATION" PT. CONDO. U NOTICE TO'APPLICANT: If, after making this Certificate of ARCHITECT OR. -- TEL. LU —DWELL. UNITS tL Exemption, you should become subject to the, Workers' ENGINEER NO. CLASS N0. y Compensation provisions-of the Labor Code, you must forth- o ADDRESS SEWER MAP with comply-with ,such provisions or, this permit shall beTEL. deemed revoked.- ` CONTRACTOR Dwyer Constr, NO.281--9041 BK PG VALIDATION LICENSED CONTRACTORS DECLARATIONLIC. I hereby affirm that I am licensed under provisions of',Chapter 9-.,. ADDRESS.P 4 0, BOX 493,. No.347 1•. 3 FYVALUATION _ (commencingwith Section 7000 of Division 3 of the Business and Professions Code, and my license is in full force and effect. CITY Alhambra a CLASS B1 SQ. FT., NO. OF - NO. OF CHECK License,Numbep�,P`/3 Lic.-Class / SIZE STORIES FAMILIES ONE LTJ $ �/ DESCRIPTION OF WORK Bathroom NEW Contracto' � •- ✓ Date ��` ADD ❑ I am exempt from the I c using requirements as I am ct Licensed architect ora a istered professional engineer ALTER ❑ DATEFINA , actin in m professional capacity Section'7051, ( ❑ DATE 9 Y P P Y ( � REPAIR Business and Professions Code). USE OF FINAL y EXISTING BLDG. ` Garage DEMOL ❑ B Lic:or Reg. No. Date APPLICANT. TEL. Y r OWNER-BUILDER DECLARATION (PRINT) NO. /' l I hereby affirm that I am exempt from the Contractor's License (p Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code); �. PRESENT BUILDING 1, I, os owner of the property, or my`employees with ADDRESS wages as their sole compensation,will do the work and- the structure is not intended or offered for sale(Section b LOCALITY 7044, Business and Professions Code). MOVING TEL. z 0 1 4,8'A I, as ownerrof the property, am exclusively contracting CONTRACTOR \ NO. with.licensed.contractors to construct the project (Sec- ti Sec- ADDRESS . tion 7044, Business and-Professions Code). REQUIREDTOTAL SETBACK FROM EXIST. 2,°1°tb 1, 0.0 CONSTRUCTION LENDING-AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT o o,o the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE0 3.0,-8 1 P.L. - - Lender's Name mP.C. Fee$ Permit Fee Lender's Address > I certify that I have read this application and state that the Issuance Fee above information is correct.I agree to comply with.all County Investigation Fee' a ordinances and State'laws relating to building construction, $, 9 9 Total Fee r , u and hereby authorize representatives of this County to enter a "Lpon the abov men oned property for inspection purposes. a �r• �r� SEE REVERSE FOR EXPLANATORY LANGUAGE n ©s Signature of Applican or Agent Dote - APPUCAMON FOORBULDNG PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO.FIL IN 'i5UILDING ADDRESS n 4� r�� BUI G ADDRES IV -4 Die— or r O I hereby affirm that I have a certificate of consent to self insure, t } a certificate of Workers' Compensation In rance, a c ed copy thereo[ .��8(Q�0 Lab.C.) . CITY- - e �� ZIP a!��n� LOCALITY Policy No. U Compan SIZE'-/Ur LLOTm NO.OF BLDGS.`N`OW.ONLOTIT..Nh VI'Vertified Copy is-hereby furnished. - - NEAREST CROSS ST . ertified copy is filed with th county build' inspection ' -TRACT BLOCK LOT NO. - department. USE ZONE MAP NO. ASSESSOR MAP BOOK }� PAGE PARCEL C Date Applicant O ��� 07 SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WOR(E+' OWNER• + . p TEL NO COMPENSATION INSURANCE �0 13 WITHIN 1000 FT.OF SCHOOL? YES NO This section need not be completed if the permit is for one hundred ADDRES (, P P - � DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars ($100)or less.) CITY ZIP v I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to ARCHITECT ORE IN TEL NO. become subject to the Workers'Compensation Laws. AllSTATISTICAL CLASSIFICATION APT CONDO Date. Applicant - ADDRESS - - - - - CLASS NO. DWELL UNITS NOTICE'• TO APPLICANTIf, after making.,this Certificate of '.REQUIRED TOTAL SETBACK FROM EXIST Exemption, you Should become Subject t0 the Workers CONTR T TEL SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith _ FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESSLIC.N R PL LICENSED CONTRACTORS DECLARATION A SIDE CI Y _ LIC. SSSS PL I hereby,affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.slz NO.of STORIES NO.OF FAMI S Professions Code, d my license is in full force effect. NEW ❑ BK- PG D a License' er - Lic.Class DE IP ON OF W ADD -�Fy VALUATION - O Contract0 ' Date ALTER ❑ $ zoo cc ❑ I am exempt under.Sec. J REPAIR ❑ $ 0 BAP.C.for this reason ` ��� �, DEMOL ❑ LDMA P/C'# W Date: USE OF EXI NG BLDG. URM ❑ - d Signature - APPLIqANTAqFWTEL NO. LDMA Perm# El T I, as owner of the property, or,my,employees with wages as S ZO ;'_;' �� their sole compensation, will do the work,and-the structure is ADDRESS not intended or offered for sale (Section 7044, Business and FINAL DATE Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL 2 Al J i ORA MIXTURE CO NG A,HAZARDOUS MATERIAL EQUAL TO OR.GREATER THAN THE El I, as owner of the•property, am exclusively contracting with AMOUNTS SPECIE THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044,' Business and Professions Code.) YES❑ No ir WILL THE INTE DED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING ' ' —' OCCUPANT REQ RE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH h s_. CONSTRUCTION LENDING AGENCY COAST AIR QUA Y MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDEUNES. •� I hereby affirm that there is a construction,lending agency for YES❑ N _ - ifa a the performance of the work for which this permit is issued(Sec. . ::}•�` ;`.•6- � _9u O1 IHAVE REA E AZARDOUS MATERIALS INFORMATION GUIDE ANDTHEjff�a+ "�3097,CIV.C.) CHECKLI UNDERSTAND MY REQUI EMENTS UNDER THE LOS ANGTITLE 2, TER .2-SECTI OUGH 220.140 OONC - 'j�,:,•.;• j•1-Lj!t .,_: 3 Lender's Name MATE PO O G A PERMIT FROM 1A _ OWNER OR AGENT d l-HA G e 3 t3 1 o tender's Address � _ - r . o I certify that I have read this application and state under penalty o P.C.FEE PERMIT FEE - of p 'ury that the above information is correct.I agree to comply -;L3 �d yri N wi II county ordinances and State laws relating to building� —J- < -�- c ns uction; and he by authoriz representatives of this County ISSUANCE FEE �� ,,,;I d -I ro to er p t e - en Ione rop ty f r inspection purposes. ' 4�t a� �`(�ry'y� , INVESTIGATION FEE TOTAL FEE - 1 If App�p,p,AgpA, D- - / AO SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS - ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0512010030 PHONE: (626) 285-0488 EXT: " LEGAL ID: NO. OF CONST BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE 9307 DAINES DR _ STRUCTURE: 2200 VN TEMP CA 917803111 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: CLOVERLY 8588-030-051 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, C TENANT: _ EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 12/01/05 JK 11/26/06 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: CHIU TSAU H;HWANG YUEH H (626) 309-0118- 9,000 9307 DAINES DR TEMP 917803111 FEES PAID DESCRIPTION OF WORK REMOVE CAL SHAKE ROOF, INSTALL PRO-TEX SHAKE ROOF FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: GONZALEZ (626) 962-0611- AA BLDG PERMIT ISSUANCE 27.75 16035 BALLENTINE PL AC STRONG MOTION RESID 9000.00 VAL 0.90 SPECIAL CONDITIONS: COVINA, CA 91722 D2 PERMIT W/O EN-HC 9000.00 VAL 199.80 TOTAL FEES 228.45 CONTRACTOR: TEL. NO: - APPROVALS DATE INSPECTOR SIGNATURE GONZALEZ CONSTRUCTION, CO. (626) 962-0611- 16035 BALLENTINE PL. LIC. NO LOCATION AND SETBACKS COVINA, CA 91722 579590 B-1 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. NO: - SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP.NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 147H265 3 01 FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS 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 ID: DPR261 ROUTE TO: BS0508