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HomeMy Public PortalAbout9082 EMPEROR AVE_Building__ "APPLICATION FOR Il BUILDING PERMIT BUILDING FOR APPLICANT TO FILL IN ADDRESS , BUILDING ADDRESS LOCALITY N EA REST _ CITY ZIP CROSS ST NO OF BLDGS ASSESSOR SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL f 1 DISTRICT GROUP TYPE FIRE PRO SSED BY TRACT or S BLOCK LOT NO 0� CO T E I TEL OWNER NO / STATISTICAL CLASSIFICATION �/SEWER RRyMAP ADDRESS CLASS NO DWELL UNITS N BK / %SPG . CITY ZIP l}S�E 7�ONE &PTE, ARCH ECT OR / TEL /�//ENGINEERNO L nn / ,, ITIONS ADDRESS 10 Z'/ ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ TEL CONTRACTOR NO LDG SETBACK FROM LIC RONT PROP LINE OF (STREET) ADDRESS NO HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING LIC FRONT PROP LINE HIGHWAY WIDTH CITY - / ru//,(/ CLASS + CONSTRUCTION LENDER _ } n. NAME AND BRANCH O BLDG SETBACK FROM U SIDE PROP LINE OF (STREET) ADDRESS CITY O SQ FT NO OF NO OF CHECK HIGHWAY + l YARD TOTAL SETBACK FROM TYPE OF EXISTING SIZE STORIES FAMILIES ONE SIDE PROP LINE HIGHWAY WIDTH DESCRIPTION OF WORK NEW ADD ❑ CORNER CUTOFF YES ❑ NO ❑ ALTER ❑ IN OPEN SPACE YES_ ❑ NO ❑ UREPAIR El SE OF U ❑ NO ❑ DEMOL ❑ IN COASTAL PERMIT ZONE YES EXISTING BLDG �d�/ d APPLIC T TEL NI SMrff NO `h710 BY(SIGNATURE) p,// e I HEREBY ACKNOWLEDGE THAT I H E READ THIS APPLICATION AND STATE r � � �S °gee e V - THAT THE ABOVE IS CORRECT AND A E TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CO TRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF t -' THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM PENSATION INSURANCE 1 -fir Gr SIGNATURE OF FINAL {.��6-� BY 'PERMITTEE DATE ADDRESS TEL C Fee$ Permit Fee CITY -� NO { �/ Issuance Fee VALUATION$ �� 't; '✓ L Total Fe PLAN CHECK VALIDATION cK M o CASH _ PE MIT InATION cK mo, cAS. :19 7 L-AUG 15 ,1— D 1 8.6 8 ,&W. �S 76A638B CE 08038 6/76AUG 9 8'-RUG 15 �,'�, ® ,6 22 5 &�8 ©, 7600'� i /7E) I ` 1 ?APPLICATION° FOR BUILDING PERMIT COUNTY OF LOS ANGELES ' ; BUILDING AND SAFETY BUILDING I', FOR APPLICANT TO FILL IN ADDRESS go f3 ADI DRESS LDING LOCALITY NEAREST CITY—_/J5y L1- / ZIP CROSSST r G -7 p NO OF BLDGS ASSESSOR SIZE OF LOT T / k / , / NOW ON LOT Y MAP BOOK PAGE I PARCEL TRACT ZSO BLOCK LOT NO� DISTRICT GROUP TYPE FIRE PROCE ED BY TEL p/ Qct r� S� (f 3 CONST ZO�yE OWNER NO 2 8b-8//v STATISTICAL CLASSIFICATION ER MAP ADDRESS O8z �� CLASS NO gDWELL UNITS BK1�7_11:�G CITY ;Ft d doe/JeEt-AP ARCHITECT OR TEL VALUATION $ ENGINEER NO - ADDRESS BLDG SETBACK FROM jj cc.. • Q _ J 9'7 FRONT PROP LINE OF (STREET) CONTRACTOJA:%%M�S W. 1 o-be'Z NO -;W-- CJ 6 LIC HIGHWAY + YARD = TOTAL SETBACK FROM TY PE OF EXISTING ADDRESS �7 D�l��.A,W,j ?0 NOa7'i 7 AS B FRONT PROP LINE HIGHWAY WIDTH CITY ZI1101b'1A A -1)U®p C ASS " BLDG SETBACK FROM CONSTRUCTION LENDER SIDE PROP LINE OF (STREET( NAME AND BRANCH HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING �" ADDRESS CITY SIDE PROP LINE HIGHWAY WIDTH O SO FT NO OF NO OF CHECK + = V SIZE STORIES FAMILIES ONE O DESCRIPTION OF WORK€A1��2�1` NEW ❑ PC Fee$ Permit Fee 7 —401)ZL �p�t(��( ��� ADD Issuance Fee ❑ � dowse_ `f'o txv i. ALTER i8n ► IAl Z REPAIR ❑ Total Fee USE OFDD`� DEMOL ❑ EXISTING BLDG (.�C���� -� ' 2 APPLICANT TEL - PRINT W ` o N0 3 r JZ 71. 4q3 & 0-7- 77 o s BY ISIGNATU E Q -ISH REBY A NOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE {{Y� y ' TH THE AB EIS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES id , AN LAWS GULATING BUILDING CONSTRUCTION ICERTIFY THAT IN DOING THE S WOR HORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF v V THE LABOR CO OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM z,ON , I NSATUR SU CE / t -4'6,9 t O'A GN PERMATT REO V 0 0 0 00�2 ADDRE S �Al ��� �� F . z _ yp�j o ;2 0 1 24.00 CITY A • NO Z ��J O l o o 1 2 4 U P oP > 0'9,27-79 SPKIAL ONDITIONS FINAL BY oc DATE DIVISION OF BUILDING AND SAFETY ��� IL N Department of County Engineer BUILDMG — County WM J FOX, COUNTY ENGINEER ENGINEER Gjeles � '•APPLICATION FOR APPLICANT TO FILL-IN ADDRESSBUILDING /� �j ADDRESS [/Q 2- - LOCALITY NEAREST a • ,. _ . _ - s LOCALITY CROSS ST DISTRICT NO PLAN CK OR'RacNo PERMIT NO -- - NEAREST' 1 _ ,��..` �J X/z <� CROSSST _/►�,�7 � a / p f 0 OWNER /(.X ! { RECEIVED BY DATE OF'AP L - `DATE ISSUED' MAIL ADDRESS — ` USE ZONE RO OF TYPE GROUP .FIRE ZONE _ PLANS CITY NO LTJ `� I , i ARCHITECT OR TEL ,,,��'^ /���g <��}�ZONING -, —7_ �jD�AT.ED ENGINEER NO r!Js� Y .Z (/VI/ APPROVED BY- �` GL7 BUILDING .`� D' O ADDRESS /� c SETBACK LINE G� � CONTRACTOR p T O dC�r 04574 BYPROVED � DATE 11, HO SE NUMBERING � ADDRESS EI � - LEGAL J MAP NUMBER_ ,3 - NO ASSIGNED BY!�� DESCRIPTION LOT NO p� BLOCK I ' " `� DATE- ,CORRECTIONS INSPECTOR TRACT 1,2 S ® NO OF BLDGS SIZE OF LOT NOW ON LOT r✓ CC°z�GGi✓�- USE OF I NO OF EXISTING BLDG FAMILIES tte�rr - p DESCRIPTION OF WORK 3.3 Q-ST�t p NEW ALTERATION ADDITION N�7G11 — (��()7' /Vn� r�,�JF1�y Z r REPAIR DEMOLITION / ,I X17 R � lilt ,NO OF �\_/,�E1� -SZEA ROOMS STORIES EXT WAL �-�IJfj�,'�"J��ISF1�...1J J'./ COVERINGL . I COVERINGROOF U-0 t1i�Vr►'�f�G,L Yi USE OF STRUCTURE /� V a �/ , 3�� �►7 IRS O /�'-. OVALS— ',�Pn��' INSPECTOR'S SIGNATU E DATE ' FOUNDATION LOCATION' 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AFRAME FIRE STOPS, PLICATION AND STATE THAT THE INFORMATION,GIVEN I S RRECT FORMS, MATERIALS BRACING, BOLTS COI AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION GAS VENT„DUCTS SIGNATURE OF p V � � LATH, INT PERMITTEL E /V 111 �1��� /� r �l - ADDRESS1e,\ '-►�./ .,�►.,0.4.� � _ LATH, EXTV .V T PLASTER, INT AUTHORIZED AGT PLASTER, EXT A _ - // !/ FEEa HOUSE NUMBER COR-' ` RECT AND POSTED i �j' M VALUATION - FEE S FINAL 76A638A^ DB8 3 2-53 + ' i_•+3:.). ,.a.. .,�C. . - ,tr.�¢tdZiA ..n.,-, cr y + COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS DEMOLITION BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0708230040 PHONE (626) 285-0488 EXT ILEGAL ID I NO OF CONST I BUILDING ADDRESS I ITR 12504 LT 36 I SQ FT STORIES TYPE I 9088 EMPEROR AV 1 I ISTRUCTURE I SGAB CA 917752066 I (ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET LOMA I 15382-018-024 I I THOMAS PAGE 596 GRID H1 LOCALITY TEMPLE CITY, Cl I I I I (TENANT IEXIST BLDG USE SWIMM USE ZONE (ISSUED ON PROCESSED BY EXPIRES ON I 1EXIST OCC GRP 108/23/07 SR 02/19/08 I I I I I (OWNER TEL NO IBLDGS NOW ON LOT VALUATION IFSNAL DAT FIN Y CODE I ILINCHI, TSENG (626) 287-1699- 1 1,000 1 I 19088 EMPEROR AV I I I ISGAB 917752066 1 FEES PAID I SC3IPTION OF WORK I I I IDEMO SWIMMING POOL I I IFEE DESCRIPTION QUANTITY UOM AMOUNT 1 I (APPLICANT TEL NO I I I ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27 75 I I I 102 DEMOLITION INSPECTN 163 50 ISPECIAL CONDITIONS I TOTAL FEES 191 25 I I I I I I I I I I ICONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE 1 ISAME AS OWNER - I I I I I LIC NO I 1PEDESTRIAN PROTECTION I I I I I I I I I I ISEWER DISCONNECTION I 1 (ARCHITECT OR ENGINEER TEL NO I (ABANDON PRIVATE DISPOSALI I I I - I I I I I I LIC NO I 1UNDERGRND STRUC I ct (AND SOIL RECOMPA ION V I I IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP I I T I I 1153H265 Oil 1 1-1 1 INO OF FAMILIES DWELLING UNITS APT/GOND STAT CLASS I I I I I NO 24 I I I I I I I I I _I I I SCHOOL WITHIN HAZARDOUS (AIR QUALITY 1000 FEET MATERIALS NO NO NO I I I I I ! I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I IREPORT ID DPR261 ROUTE TO BS0508 I I I I I L I I I I WORKERS' COMPENSATION DECLARATION hereby affirm tcertificate consent f APPLICATION FOR BUILDING P E RM I T insurer a certifiate of WorkesCompensatoInsurance, or,a certified copy thereof (Sec 380Lab C ) /-Uwr J . . I COUNTY OF LOS ANGELES- BUILDING AND SAFETY y Policy No—Company-,5T C� �❑j��Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS ��� '&J Certified copy is filed with the county building inspec- BUILDING tion department ADDRESS /� l yy Date�Applicant L�.vL CITY V 12%!%6-L ZIP ! t LOCALITY �f�l�✓ � C--��� ' _ NO OF BLDGS NEAREST CERTIFICATE OF EXEMPTION FROM WORryKER_ SIZE OF LOT NOW ON LOT CROSS ST COMPENSATION INSURANCE _ r ASSESSOR (This section need not be completed'if the permit is for one TRACT BLOCK LOT NO MAP BOOK PAGE PARCEL hundred dollars ($100) or less ) iTEL o- ' OWNER L y ( NO O�r USE ZONE, „ MAP I I certify that in the performance of the work for which this NO permit is issued, I shall not employ_ony person in any manner ADDRESS SPECIAL CONDITIONS so as to become subject to the Workers'Compensation Laws O_ t I I i � I I I CITY S�/V(�/7`�'��' ZIP U Date Applicant ARCHITECT OR TEL � � % DISTRICT GROUP TYPE FIRE LPCESSED BY Q NOTICE TO APPLICANT If, after making this Certificate of ENGINEER NO CONST—_--_,P-- E I-' Exemption, you should become subject to the Workers' U Compensation provisions of the Labor Code, you must forth- ADDRESS M �'D� - ;/ � N with comply with such provisions or this permit shall be /� r TEL �Cg STATISTICAL CLASSIFICATION _ APT CONDO Z deemed revoked CONTRALTO i'1� /Ga-41�/� NO — LICENSED CONTRACTORS DECLARATION , 1/ LIC CLASS NO DWELL UNITS — LICENSED hereby affirm that I am licensed under-provisions of Chapter 9 ADDRESS "�� . lV NO , (commencing with Section 7000)of Division 3 of the Business LICA SEWER MAP and Professions Code,and my license is in full force and effect CITY CLASS C:- j BK pG VALIDATION - SQ FT NO OF / NO OF CHECK License Number/-";;?'q-q-__-!� Lic Cla �ssa: SIZE STORIES / FAMILIES ONE ❑ VALUATION Contractor/.>�/TDL'1100C1�i9 4 Date -aV —el DESCRIPTION OF WORK EW ❑ $ 1 am exempt under Sec �r� s����� ADD ❑TER IL r (/� V ► j7L�G\� X19:$ C[ REPAIR B&P C for this reason $/ ' Date L� S USE OF BLDG . DEMOL I ❑ APPLICANT EL (PRINT) / !�S �I 6� NO • y , FINAL \ OWNER-BUILDER DECLARATION DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Sechon 7031 5, Business and ADDRESS] ! V� FINAL' 1 I` Professions Code) PRESENT - By a 1 BUILDING i ❑ 1, as owner of the property, or my employees with ADDRESS /�� a wages as their sole compensation,will do the work and > WCTeT the structure is not intended or offered for sale(Section LOCALITY , 3M7 113.63 7044, Business and Professions Code ) MOVING TEL T p E] 1, as owner of the property, am exclusively contracting CONTRACTOR NO 1 I 1 EMS with licensed contractors to construct the-project (Sec- ADDRESS T rl�T �� tion 7044, Business and Professions Code ) REQUIRED TOTAL SETBACK FROM "EXIST I{�. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE WIDTH CHECK t I hereby affirm that there is a construction lending agency for FRONT _ the performance of-the work for which this permit is issued P L CHANGE (Sec 3097, Civ C ) s SIDE , ,P L Lender's Name' Refq -0001 11/-20/52/'i0/749 �p LDMA P C` Fee$ Permit Fee (/ - Lender's Addressi i f LDM9:5F a AM 1 certify that I have read this application and state that the Issuance Fee 7� A P/C# , 8 above information is correct I agree to comply with ail County Investigation,Fee /��' / R ordinances and State laws relatind to building,construction, Total Fee LDMA Perm #, a and h authorize representatives of this County to enter " n t e db e-mentioned r- ty for inspection purposes �V„ SEE REVERSE FOR EXPLANATORY LANGUAGE Sig Lure o Applican or Age Date _