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Home My Public Portal About9921 DUFFY ST_Building__ APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) BUILDLNG COUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF,COUNTY ENGINEER CITY `Tem 1 e Cit ZIP 9,1780BUILDING'AND SAFETY DIVISION •I ' -� NO.OF BLDGS.,' n BUILDING - �i . SIZE OF LOT NOW ON LOT ADDRESS TRACT G BLOCK LOT NO. LOCALITY . TENEAREST OWNER• NO. CROSS ST. ,iT/✓'Z� ASSESSOR ADDRESS 9 921 E . Duffy Strept MAP BOOK - PAGE ARCEL - DISTRICT 1GROUPITYPE FIRE/ ESSEDBY CITY - ZIP ^,/3�, CONS�T,.� ZO E /JARCHITECT ORTEL. . .`,CJ �� 1,�PRO �s�"� ENGINEER NO. - STATISTICAL CLASSIFICATION SEWER MAP � ADDRESS CLASS NO. DWELL._DWELL,UNI.TS '/ BK3-5 PG TEL: I � CONTRACTOR 'H. _NO. '- USE+ZONE MAP `� ll,l LIC. J NO.L��V . ADDRESS 5 NO. 1• SPECIAL LIC. CONDITIONS CITY, San Gabriel Ca . CLASS ROAD DEPARTMENT. APPROVAL REQUIRED YES[] NO CONSTRUCTION LENDER ' NAME AND BRANCH BLDG.-SETBACK FROM d FRONT PROP.LINE OF (STREET) ADDRESS CITY HIGHW } YARD _ TOTAL SETBACK FROM TYPE OF.EXISTING Y - SQ. FT. .NO. OF NO. OF- - - CHECK FRONT PROP. LINE HIGHWAY WIDTH C SIZE I STORIES -FAMILIES ONE - } _ DESCRI PTION OF WORK NEW ❑ fLv ADD ElBLDG.SE SIDE PROP.LINE OF (STREET)- . ALTER ❑ HIGHWAY } YARD = TOTAL SETBACK F TYPE OF EXIS-TING REPAIR SIDE PROP. LINE KIGHWAY WIDTH USE OF DEMO ❑ } EXISTING BLDG. APPLICANT 'TEL CORNER CUTOFF YES ❑ NO (PRINT) H . N0. Anao BY (SIGNATURE) - IN OPEN SPACE' YES 1:1 NO o Q IN COASTAL ZONE YES NO VALUATION$ 1 000 . - � - � CATEGORICAL EXEMPTION YES� NO �. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE-ABOVE IS'Co RRECT AND-AGREE TO COMPLY IMPACT EXEMPTION.DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LA WS REGULATING BUILDING CON- STRUCTION. 'I CERTIFY THAT INDOING" T WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY-ANY PERSO IN IDLATION OF THE , �OFORNLABOR CODECOFETHE OTING TO SWORKMENOMP SIGNATURE PERMITTEE ADDRESS •7 p p p FINAL�, BY _ 'CITY San' Gabri,e I ''NOL ZHV�YO`F DATE ` J ' PMT. MAKE CHECKS PAYABLE"i` F E FEE 157. 00 =HARVEY T. BRANDT. COUNTY ENGINEER PLAN .CHECK VALIDATION CK M.O. CASH a PERMIT VALIDATIONCK. M O. CASH 76A638A CE#803 7/73 PLICATION FOR BUILDING PERMI T 76A 838A CE 8 3 8-63 AP . COUNTY OF LOS ANGELES BUILDING J DEPARTMENT OF COUNTY ENGINEER ADDREss BUILDING AND SAFETY DIVISION LOCALITY 1 JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. DIST ICT NO. GROUP TYPE OCESSE 3 BY I FOR APPLICANT TO FILL INCONST. BUILDING STATISTICAL CLASSIFICATION EWER MAP ADD ESS , �►. SK G CLASS. NO. DWELL. UNITS LOT L BLOCK WATER C� CERTIFICATE: NOT REQUIRED RECEIVED ❑ TRACT* J NO HCGHWA STATE MAJOR SECOND, OCA NO.OF BLDGS. SIZE OF LOT �r I NOW ON LOT USE ONE SPECIAL USE OF ( CONDITIONS EXISTING BLDG. V \ .- TEL. OWNER Q�� /`,�. NO. LDING EXIST. ADDRESS f- l�/ F'yJ s T SETBACK YARD HWY STRE AME WIDTH FRONT f ARCHITECT O TEL. P. L ENGINEER O. SIDE P. L. ADDRESS fig, v O TEL. A CONTRACTOR Wj NO. `' U ADDRESS DESCRIPTION OF WORKr'' e7uLu- NEW DD ALTER REPAIR DEMOLISH M <�' Itn SO. FT. NO. OF NO. OF SIZE STORIES FAMILIES J ^� (t USE OF - -3- is Ii C. � ' n . —STRUCTURE' r p n Nr,,n, SIGNATURE O - APPLI(C VALUATION $ �D � , _ _ APPROVALS DATE INSPECTOR'S SIGN_AIRE P.C. PMT. FOUNDATION: LOCATION FEE $ FEE $ FORMS..MATERIALS FRAME:, FIRE STOPS. /7 �/�!" I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS I L�Z, AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. V WITHALL COUNTY ORDINANCES AND 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. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S COMPENSATION INSURANCE. LATH. EXT. SIGNATURE HOUSE NUMBER COR- ' PERMITTEE RECT AND POSTED r ADDRESS - 3t C FINAL JOHN F. LEWIS. PRINCIPAL ST; ORAL ENGINEER PLAN CXC(�, cK. ' M.O. CASH PERMIT VALIDATION CK. M.O. CASH Lr`ti v 5 1 9 1-0 OCT 2 3 1 D 1 1.5 0 I • . i ) U 0 L D O [ `M ADD EI NCO OSB -APPLICATION LOCALITY C. -- NEAREST DIVISION OF BUILDING ARID SAFETY CROSS ST. s Department of County Engineer DISTRICT NO. RECEIPT NO. PERMIT NO. County of Los Angeles S / 2 7 0 l WM J. FOX, COUNTY ENGINEER �i80UP DATE RECEIVED DATE ISSUED CASSATT-D. GRIFFIN, HuP'T OF BUILDING FOR APPLICANT TO FILL:IRT TYPE oD T. RECEIVED BY D•BY OWNER ' r _1�-01- MAP / ' AMAILDDRESS �Jp' > . NUMBER O $HwYE tee' 'NO ®'L USE ZONE SPECIAL T L. ,p / CONDITIONS - CITY "yT Gr . N O. l/1 ARCHITECT OR TEL ENGINEER NO. BUILDING YARD HWY STREET NAME EXIST. ADDRESS SETBACK .WIDTH � { FRONT CONTRACTO NO , yY tai• SIDE ADDRESS DATE CORRECTIONS INSPECTOR BUILDING _ _ADDRESS V21 /�7 { - LOT ND.WSy O/ ¢ CYYL6'p 77 9� LOCK TRACT // 1 8 1-5 {'S_ ' SIZE O1140-Jr, F L'1140�� C/ . 1 NOW ON LOTNO.'OF SLOGS I 3. USE OF 1,L. /1 •j _ F.XIATING BLDG. L}C(/► DESCRIPTION OF WORK 1 — A O NEW ADDREPAIR DEMOLISH] Z SQ.FT, OF NO.OF _ D ., SIZE - STOPIES FAMILIES r USE'OF STRUCTURE,,,, ` t' a V k'1 f'c l�E'►. `aKd SeYv� C_ P F' Yc1, . Z�11Sra_lIj — - -'» ew wd 1 �. N O.O F ._ EMPLOYEES I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS APPROVALS INSPECTOR'S SIGNATURE DATE CORRECT. iAGREE TO COMPLY WITH ALL COUNTY ORDINANCESI FOUNDATION: LOCATION AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS, MATERIALS I FRAME: FIRE STOPS, SIGNATURE OFBRACING_,BOLTS PERMITTE �L°�Y•"V - FURNACE: LOCATION, GAS VENT,DUCTS ADDRESS +p� 4,1 / LATH. INT. \ AUTHORIZED AST.— �� v� LATH, EXT. w C9 $ P. C. S - HOUSE NUMBER COR- FEE RECT AND POSTED O K---D'0" vAL.e �:.w:e ::yl...�asr=s �nrrrrtn�ir.,, E'z: FitvQ.L 76A638A DI 3 01,*5-5.1 DIVI.KQN OF BUILDING AND SAFETY , / epartment of County Engineer 1" County of Los Angeles WM. J. FOX, COUNTY ENGINEER - APPLICATION FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY .�/ DIBTRI[CT NO.. PLAN CK. OR REQ.No. PERMIT NO. BUILDADDRESS [�I raa� -nr– rj5 CEIVED BY DATE OFA PL. DATE ISSUED LOCALITY NEAREST CROSS BT. 4 ` BUILDING'g.z CIA '_ j� ADDRESS a OWNER 77 �L MAIL � LOCALITY ADDRESS , NZAREST TEL CROSS ST. t CITY N0. FIREI NO. B I Q,�AUP. ARCHITECT OR TEL ZONE I PLANS ENGINEER - NQ BLDG. ]'�� ' / %) •�f SETBACK LINE ADDRESS USE APPROVED BL. ZONE --I BY DATE CONTRACT O. HOUSE NUMBERING ADDRESS 'MAP NUMBER—'—'O--Q eNO. ASSIGNED BY LEGAL DESCRIPTION LOT NO. �/6�I K RECTION C►�� IVO ''� /^�/ TRACT . Na. OF BLDG& � SIZE OF LOT F NOW ON.LOT USE OF NO. OF EXISTING BLDG. FAMI1.1ir DESCRIPTION OF WORK A 0 NEW ALTERATION ADDITION Z D r REPAIR DEMOLITION - SO.FT. NO.OF 312E ROOMS STORIES 12 1 EXT.WALL RacF COVERING I COVERING ' USE OF ST"13-17LIAE v _ d - INSPECTION FOR APPROVALS OCCUPANCY AS INSPECTOR'S"SIGNATURE DATE FOUNDATION: LOCATION FARMS, MATERIALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRE STOPS,Ly PLICATION AND STATE THAT THE INFORMATION GIVEN IB CORRECT. BRACING, BOLTS I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE LAWS REGUL.ATIND BUILD O CONSTRUCTION. GAS VENT,DUCTS t SIGNATURE O LATH, INT. PERMITTE ADDRESLATH. EXT. S PLASTER, INT. AUTHORIZED AD V' PLASTER, EXT. _ P.C.� e\�Ca HOUSE NUMBER COR- rq ® ® FEE `�' RECT AND POSTED VALUATION FINAL FEE �✓� 76AG38A DBS 3 1-52 APPUCAMON FOR SULONG PERNT COUNTY OF•LOS,ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION ' FOR APPLICANT TO FILL IN BUILD IN D , ESSyGlee - - �/ v ' 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 9921 E. Duff St. _ copy thereof (Sec.3800;Lab.C.) CITY ZIP 285-95 UNIT' State Comp: In Tem le Clt 91780 LOCALITY Policy No. - Company SIZE OF LOT - NO.OF BLDGS.NOW ON LOT - � ❑ Certified copy is hereby furnished. NEAREST CROSS ST. r Certified copy is filed with the ounty butnginspection TRACT BLOCK LOT NO. ti II USE ZONE MAP NO. department. ' Date 12/4/95 Applicant 2 ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS - OWNER � TEL NO.' .. '. CERTIFICATE OF EXEMPTION FROM WORKERS' Manuel Cardelle 818-286=2802 WITHIN 1000 FT.OF SCHOOL? YES No COMPENSATION INSURANCE ' (This section need not be completed if the permit is for one hundred ADDRESS G 99 21 E. Duff S t. DISTRICT GROUP TYPE CONST. FIRE ZONE "'PROCESSED BY dollars ($100) or less.) I certify that in the performance of the work for which this permit clTem le Cit TY ZIP 91780 �06 _ !� is issued, I shall not employ any person in any manner so as to. become subject to the Workers'Com ensation Laws. ARCHITECT OR ENGINEER TEL NO. � p N/A . .. STATISTICAL CLASSIFICATION APT 'CONDO Date Applicant ADDRESS- -.. CLASS NO. � DWELL UNITS NOTICE TO APPLICANT If,' after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you, should become Subject t0 ..the Workers' CONTRACTOR - TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith United Roofing Co. , Inc. 213-223-4081 FRONT comply,with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. P L LICENSED CONTRACTORS DECLARATION 1821 Dal St. 1376AS PILE CITY iIC ASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 CEOs Angeles, CA 90031 C-3( SEWER MAP (commencing with Section 7000)of Division 3 of*the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in'full force and effect. 29 1 1 NEW CSI BK PG a License Number 137650 Lic.Class C'-39 DESCRIPTION OF WORK ADD. ' El VALUATION D O Contractor United Roofing)ate 10/31/96 Install dimensional fiber las ALTER ❑ $ 3,560.00 U shingles over existing CiI am exempt under Sec. REPAIR $ BAP.C.for,this reason shingles. DEMOL ❑ LDMA P/C# W Date: USE S OF EXISTING BLDG. URM, El Signature APPLICANT(PRINT) TEL NO. LDMA Perm# 1 Z United Roofin Co. , Inc. -213-223-408'1 Z A ❑ I, as owner of the property, or my employees with wages as g .� AGCTaB ••• their sole compensation, will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and 1821 Daly St. , LA CA 90031 FINAL DATE o 3303 1442.20 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL x�i 3-Q� 9 . ER-COR OR A MIXTURE CON❑ I, as Owner Of the property, am exclusively contracting with AMOUNTS SPECIFIIEDTONI NG THE HAZARDOUS MATERIALSNFORMATA HAZARDOUS EQUALTIION GUDEOR A'ER�THAN THE FINAL BY licensed contractors t0 construct the project (Section 7044, YES ElNO 3303 -1442.20. Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING 3303 � OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH 14 142e20 CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT ITEMS. (SCAQMD)SEE PERMITTING CHECKLIST FOR T CM[� - GUIDELINES. '1 . � I hereby affirm that there is a construction lending agency for YES❑ NO N the performance of the work for which this permit is issued(Sec. HAVE EADTHEHAZARDOUSM RIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING TOTAL 142_20 3097,CIV.C.) GHEC ST I UNDERSTAND MY QUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, - Lender's Name ECC f''�J['('!/ a - TITLE CHAPTER 2.20 SECTIO 2.20.100 THROUGH 2.20.14 EONCERNING HAZARDOUS - C 142.20 3 MAT LS REPORTING ND F OBTAINING A PERMIT F THE SCAQMD. o Lender's Address CHANGE o00 ' OWN OR AGENT O o I certify that I have read this application and state under penalty of perjury,that the above information is correct.I agree to comply P.C.FEE - PERMIT FEE / _ nnnt`► ttnn 6/95-- < o o with all county ordinances and State laws relating to building 1 �� uUV�1—uv1�1 •12/ 6/7c' a con ruction,an reby authorize representatives of this County ISSUANCE FEE �d 3618 1 Al11"29 - m to ter upon the ab ve mentioned property for inspection purposes. , 12/4/95 INVESTIGATION FEE TOTAL FEE Se t re of Approom A c Dale - SEE REVERSE FOR EXPLANATORY LANGUAGE .