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Home My Public Portal About8902 ELM AVE_Building__ ' 1 e 3 1`41 25M i APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF'LOS ANGELES ILI :. WM. J. FOX, CHIEF ENGINEER NO.OFBLDG. ? ORD.NO. DISTRICT NO. PLAN CK: NO. PERMIT NO. PLANS 6'� SETBACK LINE T (/ (� FIRE APPROVED' � � \ b 376 ZONE BY DATE RECEIVED BY DATE OF APPL. DATE ISSUED USE• APPROVED /�r 4'°�'�" Z.� ��`�'1 Z..• '�"'L6J W�� ZONE BY DATE APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY a - BUILDING 'w/+ • ! p NAME ADDRESS I- W B w Z ADDRESS - LOCALITY- _ ,.�rE..� c-d- . , H -0 NEAREST � ds U W CITY CROSS ST. a Q STATE TEL. LICENSE NO. - /"t 'NO. NAME !^'1 .•!/Vr� 6L/ !- ///./ i Z MAIL - a NAME � _' 3 ADDRESS O p - ADDRESS A CITY NO.TEL.' ir F Z' CITY �!'l�i �] 1 HEREBY ACKNOWLEDGE .THAT I HAVE READ THIS U ATE /// - --- - APPLICATION AND,STATE THAT THE.ABOVE IS CORRECT LICEN NO.//I / c_ NO.(�/I i,�,(r ,- .iy "��' ATELND,AGREE,TO COMPLY WITH ALL COUNTY ORDINANCES v _ AND STATE LAWS REGULATING BUILDING CONSTRUCTION. ZZ LOT'NO.: �� SIZE OF LOT / SIGNATURE OF J F •� / NO. OF BLDGS. OWNER Q d AUTHORIZED AGT.-. - BLOCK .� - NOW ON LOT . W m TRACT . 4/ J N 3 9 a4 �• CORRECTIONS, • D USE OF BLDGS.' ` < ; NOW ON LOT S Q Ct V`tl.Q 1r^ \,-Ca q v'tiw V. rC'_S DESCRIPTION OF. WORD USE OF BUILDING .f/1 ERA NEW p/ TYPE GROUP�~ CIA// NO.OF - NO.OF - - ALTERATION 'ROOMS FAMILIES ADDITION SIZE L %x6 l;- G d tX int rd v ! REPAIR _ STORIES f MOVING WALL COVERING ns DEMOLISH ROOF COVERING $ P• FEEE FINAL APPROVAL f„y� � $ t �ffi�• �' �/ INSPECTOR'S VALUATION "�'�, FEE l 'DATE // Ir i' NAME DEPARTMENT OF,BUILDING ARID SAFETY APPLICATION FOR PERMIT CQUNTY OF LOS ANGELES WM. J. FOX, CHIEF ENGINEER ' FOR APPLICANT-TO FILL IN FOR OFFICE USE ONLY DISTRIC NO. PLANCK.NO. PERMIT NO. ADDRESS BUILDING/ /� )"/� LOCALITY ��ii �..+ i RECEIVED BY DATE OF APPL. DATE ISSUE NEAREST �/f/� / 2ROS8 ST. f (_�/�,� �i /(/A� l�C�� BUILDING OWNER ADDRESS MAIL (,�f�1G /�. � � - LOCALITYEBB ADDR T. Rj NEAREST CITY /-d�///9�/� - fit /�1�i NOI � :T f' 't�,� CROSS 9T. _ -FIRE. NO.OF TYPEw GROUP �r ARCHITECT OR' TEL. r .ZONE PLANS ENGINEER % NO. BLDG. ^ ^ f DRD�.N/O. ADDRESS �� SETBACK LINE L.,[, APPROVED TEL CONTRACTOR NO. By DATE USE APPROVED ADDRESS (/ ZONE�'�2ysBY DATE LEGAL CORRECTIONS DESCRIPTION I .LOT7 O!7 I BLOCK d� TRACT _;6i,13 NO.OF SLOGS. SIZE OF LOT L NOW ON LOT USE OF NO.OF NO.OF . EXISTING BLDG. I FAMILIES I ROOMS - DESCRIPTION OF WORK NEW ALTERATION ADDITION O A REPAIR MOVING DEMOLISH Sq.FT. NO.OF _ Z —SIZE ROOMS STORIES - D WALL ROOF t- COVERING - I COVERING USE-OF NEW BUILDING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS - APPROVALIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION I .9 ECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS _ AND STATZIF EGULATIN6 BUILD6NQ CONSTR CTION. - -- FRAME: FIRE STOPS, SIGNATURE ��/ BRACING,BOLTS PERMITTVv ``� LATH,INT.: AUTHORIZED LATH,EXT.: DBS-3 5aM sErs 7-47 $ �® P C. PLASTER,INT. r /� //� FEE PLASTER,EXT. VALUATION `J(/ , $ 00 FEE m2 ��` FINAL DEPARTMENT.OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES M. J. FOX, CHIEF,ENGINEER - Q FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY / DISTRICT NO. PLAN CK.NO. PERMIT NO. BUILDING / ( .%� �.� ' ADDRESS -_ v LOCALITY p RECEIV D BY DATE OF APPL. DATE ISSUED NEAREST CROSS ST. BUILDING •� s. OWNER ADDRESS MAIL LOCALITY - ADDRE58 �'� NEAREST O TEL.- '♦Y/' CROSS 5T. �v CITY / ., NO. �.�r FIRE 'NO.OF TYPE T GROUP ARCHITECT OR / "TEL. ZONE PLANS' v ENGINEER /f NO. i BLDG. ( L '_ORD. O. ADDRESS - SETBACK LINE APPROVED _ 'TEL." CONTRACTOR 'NO: BY - DATE USE APPROVED ADDRESS /1 - ZONE�,�. ZBY DATE LEGAL q�A��. �� BLDCKi7 - .CORRECTIONS.- - DESCRIPTION LOT O`p?7 / TRACT ��+Z-3 �(:/P/C.�fK_s(_ �t`,e I - d II I NO.OF BLDOS.2 SIZE/DF LOT �^ ,, /� NOW ONDLOT' . NO*OF EXIST NG BLDGY GR-014LA— `�f� F� Es/ I ROOMS ; DESCRIPTf•N' OF WORK... _ 4 NEW ALTERATION ADDITION- - ' O REPAIR a MOVINO�="z" c'" `DEMOLISH .� SO.FT: L/ NO.OF Z _SIZE .�!'� ROOMS STORIES r WALL ROOF _COVERING I COVER I N G&UALI /G��cs USE OF NEW !I BU LDING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE 'READ THIS _ APPROVALS APPLICATION AND"STATE THAT THE ABOVE IS CORRECT *ISIIITIR AND AGREE-TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION FORMS,MATERIALS AND STATE LAVO REGULATING BUILD ISG CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE O '//j BRACING,BOLTS -• 7 -L�."'�� PERMITTE �`""" G%�!� }�_ ' LATH,INT.: '61AUTHORIZED AG�T! - �� ` ti" 1 _ LATH,EXT.: DBS-3 sora SETS 7-47 $ 9 P C.$ - PLASTER, INT. G-70 0/0� FEE PLASTER,EXT. I VALUATION FINAL FEE WORKERS' COMPENSATION DECLARATION I hereby affirm-that I have a certificate of consent to self,- p p insurer or a certificate of Workers' Compensation Insurance P[PL E CAU�O ll V. F O or a certified copy thereof (Sec.3800, Lab C.) COUNTY OF LOS ANGELES. BUILDING AND SAFETY Policy No.• Company. BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS 8902 -Elm Avenue ❑. Certified copy.is filed with the county building>inspec- BUILDING' ~ tion department., - ADDRESS. 8902 Elm Avenue .. _ CITY Tem le Cit ' ZIP LOCALITY Tem le Citx Date Applicant NO. OF BLDGS. CERTIFICATE'& EXEMPTION FROM WORKERS" , SIZE OF LOT NOW ON LOT NEAREST • CROSS ST. Reno,Avenue, ( COMPENSATION INSURANCE CC _ ASSESSOR . (This section need-hof be completed'if'the°permit is for one TRACT 5387 BLOCK l � LOT NO.- MAP BOOK ` PAGE PARCEL hundred.dollars"($100)or less.) . CITY OF ,TEMPLE CITY _ TEL 285-2171 usE ZONE MAP I certify that,in.the performance of the work for which this OWNER, N ;_ SPECIAL, O. permit is issued; I shall::notemplcy•any person in any manner ADDRESS 9.701 Las Tunas` Drive R-4 CONDITIONS sous to become subject to the Workers' Compensation Laws. CITY Temple- .Cit}' , ZIP 91780 OU _. U Date Applicant, ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O NOTICE TO APPLICANT:.If, after making this Certificate of . ENGINEER NO. CONST ZONE U Exemption, you-:should; become.subject _to the. Workers' LU Compensation provisions of the.Labor Code:you must forth- ADDRESS 5.08 R-3 .,, with comply with such provisions ori this permit shall be TEL STATISTICAL CLASSIFICATION APT.. CONDO. Z deemed revoked, CONTRACTOR C11ar.H6:Gann NO..681-88 1 — LIC.. CLASS NO. 23 DWELL.`UNITS —1 LICENSED CONTRACTORS DECLARATION ` • 9879 Union St. 192558 . I hereby affirm That I am licensed under provisions of Chapter ADDRESS No. SEWER MAP (commencing with Section 7000)of Division.3 of the Business LIC. and Professions Code;and m license is in full force:and'effect. cITY:Glen -A-Von CA CLASS C-.21 VALIDATION Y SQ`FT. NO. OF NO. OF CHECK BK. M 'PG.•1 OH• License Number Lic. Class SIZE STORIES FAMILIES ONE VALUATION" Contractor Date DESCRIPTION OF WORK' C) NEW E! $ • Elam exempt under,5ec: emoval'of" Foundation and ADD - D ALTER ,E] B.&P.C. for-this reason' REPAIR �, $ USE.OF.: Date "• EXISTING BLDG. DEMOL Signature APPLICANT TEL FINAL e p OWNER-BUILDER DECLARATION (PRIN7j. NO. DATE/ I hereby offirm.that I am exempt from the Contractors License Law for the following'reason (Section 7031.5; Business and ADDRESSAFLS- Professions Code): • PRESENT' By JmCNShe . - - BUILDING " ❑ I, as owner of the property;.or my employees with ADDRESS wages as their-sole compensation,will do the work and 3 iI_ s' the structure is not intended or offered for sale(Section LOCALITY I�hl.s ! I ,j 7044, Business and Professions Code.),' MOVING TEL: - _ ❑ I, as owner of•the property, am exclusively contracting CONTRACTOR No. ' •'''t i'` t P f s with licensed contractors,;to construct The.project<(Sec- ADDRESS' tion 7044, Business and Professions Code,) REQUIRED -TOTAL SETBACK FROM EXIST. 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. " (Sec.'3097, Civ:'C.). SIDE ; P.L. Lender's Name m P.C.-Fee$ Permit Fee LDMA Ref. # Lender's Address D o I certify that Ihave read this application and state that the Issuance Fee LDMA P/C# above information is correct. I agree to comply with all County Investigation'Fee, "8 ordinances and•State laws relating to building consfruction, Total Fee I LDMA Perm. # a and hereby authorize representatives of this County to enter ' upon the above-mentioned•,property for inspection purposes.. SEE REVERSE FOR EXPLANATORY LANGUAGE + Signature of,Applicant or Agent Date