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Home My Public Portal About8945-8947 EMPEROR AVE_Building__ 7awe3eACe#9.031." APPLICATION FOR BUILDING _PERMIT 1 COUNTY OF LOS ANGELES BUILDING ADDRESS 8945 East Emperor DEPARTMENT OF COUNTY ENGINEER B=ING AND SAFETY DIVISION LOCALITY Temple City Calif., JOHN A LAMBIE.COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN SUP T OF BUILDING CROSS ST DISTRICT::j GROUPTYPE PROCESSED BY FOR APPLICANT TO FILL IN 5 I I CONST BUILDING SEWER MAP ADDRESS 8945 East F+n Prfir STATISTICAL �^ r BK PG CLASS NO Z DWELL UNITS—Ll— LOT NO S BLOCK , MAP - �Q O / STATE YES NO NUMBER �—/' HWY TRACT USE ZONE SPECIAL NO OF LDGS � j CONDITIONS SIZE OF LOT I NOW ON LOT / USE OF EXISTING BLD BUILDINGEXIST SETBACK -YARD HWY STREET NAME WIDTH OWNER Art, NELSON FRONT MAIL _P L ADDRESS 8945 East Emperor SIDE CITY em zCalif Ca . No 6694 P L INSPECTION RECORD ARCHITECT OR TEL ENGINEER NO, ADDRESS WAA�NMING & HEATING ;! Q a 3232 N. San Gabrievdv, ADDRESS SflLi+i�.S�wfal,�l DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH SO FT. NO OF NO OF SIZE STORIES FAMILIES USE OF STRUCTURE 1-13$000 0QO BTU 11odel F-13 Panel Ray D&1 He -ter. SIGNATURE OF _ APPROVALS I C10*' a V . DATE INSPECTOR S SIGNATURE ADDRESS n (� FOUNDATION LOCATION f' FORMS MATERIALS P C. $ FRAME FIRE STOPS. FEE BRACING, BOLTS / A VALUATION $ FURNACE LOCATION. [ p FEE — GAS VENT,DUCTS t HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH INT PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY BU 1 -ORDINANCES AND LATH,EXT STATE LAWS BUILDING,C TRUCTION. SIGNATURE OF HOUSE NUMBER COR. PERMITTE RECT AND POSTED 3232 No. San Gab ADDRESS FINAL CLYDE N DIRLAM, PRINCIPAL STRUCTURA EER PLAN CHECK VALIDATION CK MO CASH PERbUT VALIDATION CK MO CASH LAC0 6 `6„3; 1, NOV l 3 1 A ?.0 0 'WORKERS' COMPENSATION DECLARATION rtificate of consnt to sf insure, oroafcertif certificate off Workers'firm that I have Compensation eInsuran e, APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified co is hereby furnished FOR APPLICANT TO FILL IN BUILDING copy y ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING ffi tion department ADDRESS tg Date Applicant CITY _ ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' II^,`�` OF BLDGS NEAREST COMPENSATION INSURANCE SIZE OF LOT2.i. lf[� NOW ON LOT CROSS ST / z (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less ) K LOT NO MAP BOOK PAGE PARCEL TEL I certify that in the performance of The work for which this OWNER ? O USE Z E OP permit is issued, I shall not employ any erson in any manner 1 SPECIAL J so as to become subject to the Worker nsation Laws ADDRESS CONDITIONS U Date Applcant - CITY ZIP CL I NOTICE TO APPLICANT If, afte making th Certificate of ARCHITECT OR M TEL`b p� DISTRICT GROUP TYPE FIRE PROCESSED BY 0 ENGINEER 1i V� 1 NO`��`Z�JC.�z CONST ZONE I� Exemption, you should becom o the Workers' !3 Compensation provisions of the Labor Code, you must forth- ADDRESS " f � CL, with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT ONDO N deemed revoked CONTRACTO `t NO Z LICENSED CONTRACTORS DECLARATION LIC CLASS NO DWELL UNITS .:L- — hereby affirm that I am Icensed under provisions of Chapter 9 ADDRESS 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 VALIDATION SQ FT NO OF NO OF CHECK License Number Lc Class, SIZE STORIES FAMILIES ONE VALUATION DESCRIPTION OF WORK NEW Contractor Date — ADD C3 $ Pilo.I am exempt under Sec ALTER [-] B&P C for this reason REPAIR ❑ _ USE OF. Date EXISTING BLDG DEMOL ❑ APPLICANT TEL Signature PRINT NO FINAL 9 9't 6 A OWNER-BUILDER DECLARATION (DATE � 7S-y . I hereby affirm that I am exempt from the Contractor's Licenses' FINAL # 0 0 0 0 0 1 Law for the following reason (Section 7031 5, Business and ADDRESS Professions Code) PRESENT By J 0 o 6 Q 5 0 r-1asI, as owner of the property, or my employees with ADDRESS = wages as then sole compensation,will do the work and o 0 -6 Q5 0 v the structure is not intended or offered for sale(Section IP OCALITY 044, Business and Professions Code) MOVING TEL �'6 1 7 a 8 8 as owner of the property, am exclusively contracting ONTRACTOR NO IrA with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code) CK - CONSTRUCTION LENDING AGENCY SETBACK YARD HWY TOTAL ET ALINE 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 PL Lender's Name , LDMA Ref # m C FeeS Permit FeeLender's AddressI certify that I have read this application and state that the Issuance Fee LDMA P/C# above information is correct I agree to comply with all County nvestigation Fee 0 ordinances and State laws relating to building construction, Total Fee LDMA Perm # R and hereb authorize representatives of this County to enter m upon t -mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature f Applicant or Agent Date WORKERS'COMPENSATION DECLARATION sureby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance, 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 &— ❑ Certified copy is filed with the county building inspec- BUILDING MA,r tion department ADDRESS Date Applicant CITY ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' ; NO OF BLDGS NEAREST COMPENSATION INSURANCE SIZE OF LOT . r NOW ON LOT CROSS ST (This section need not be completed if the permit is for one 1r ASSESSOR hundred dollars ($100)or less ) RAT LOT NO( B OCK MAP BOOK PAGE PARCEL TEL USE NE MAP '1 J I certify that in the performance of the work for which this OWNER NO permit is issued, I shall not employ any person in any manner � ww SPECIALi so as to become subject to the Work tion Laws ADDRESS 7tJ CONDITIONS 0 Date Applicant CITY ZIP NOTICE'TO APPLICANT If, after making t s Certificate of ARCHITECT OR TEL DISTRICT GROUP TYPE FIRE PROCESSED BY O Exemption, you should become sub ect the Workers' ENGINEER //�� h 1 NO CONST, / ZONE F— Compensation provisions of the Labo I e, you must forth- ADDRESS Wq LA with comply with such provisions or this permit shall be TEL Fp STATISTICAL CLASSIFICATION APT DO C!1 deemed revoked CONTRACTOR NO loO Z LICENSED CONTRACTORS DECLARATION LIC .�s I CLASS NO ��- DWELL UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO d r 7 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 M PG � 7 VALIDATION SO FT NO OF NO OF CHECK License Number Lic Class SIZE STORIES k I FAMILIES ONE VALUATION DESCRIPTION OF WORK NEW El Contractor Date ADD ❑ $ pill.I am exempt under Sec R n ALTE ❑ B 8P C for this reason REPAIR ❑ _ USE OF Date EXISTING BLDG DEMOL ❑ Signature APPLICANT TEL FINAL OnAlOWNER-BUILDER DECLARATION PRINT NO DATE I hereby affirmthat I am exempt from the Contractor's License ADDRESS �1$�s FINAL Low for the following reason (Section 7031 5, Business and Professions Code) PRESENT BY ❑ BUILDING I, as 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 LOCALITY 044, Business and Professions Code)- - MOVING TEL ( ° ° 6 Q 5 0 , as owner of the property, am exclusively contracting CONTRACTOR NO with licensed contractors to construct the project (Sec- _ ADDRESS tion 7044, Business and Professions Code) REQUIRED A d t (� CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAL SETBACK ALINE JE U 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 r PL Lender's Name + Ref tYP C Fee S Permit Fee Lender's Address I certify that I have read this application and state that the Issuance Fee P/C N o above information is correct I agree to comply with all County Investigation Fee ordinances and State laws relating to building constructionTotal Fee Perm q and hereby authorize representatives of this County to enter upon the entioned property for inspection purposes J SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o Applicant or Agent Date