The URL can be used to link to this page

Home My Public Portal About9154 EMPEROR AVE_Building__ APPLICATION-FOR BUILDING PERMIT FOR APPIJcANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES ' ADDRESS DEPARTMENT OF COUNTY ENGINEER CITY , ZIP j J7,)— BUILDING AND SAFETY DIVISION NO OF SIZE OF LOT NOW ON LOTS 6✓ ADIDRESS /� r TRACT BL J y y OCK LOT NO LOCALITY /� NEAREST OWNER a� [ // EL 2�G'dd� CROSS ST ewz ASSESSOR ADDRESS MAP BOOK PAGE PARCEL Q9 • / ,r s DISTRICT GROUP E FIRE RO ED BY -CITY -F4 ft( � y,.C� ZIP MST =ARCHITECT OR TEL , ENGINEER - NO STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NO DWELL UNITS BK PG TEL CONTRACTOR NO USE ZONE MAP LIC NO 03. ADDRESS NO ,J SPECIAL LIC CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG SETBACK FROM FRONT PROP LINE OF (STREET) ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ FT NO OF NO OF CHECK HIGHWAY + YARD = FRONT PROP LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE >- CL DESCRIPTION OF WORK aC NEW ❑ + O ADD ❑ BLDG SETBACK FROM (STREET( O SIDE PROP LINE OF H ALTER ❑ TOTAL SETBACK FROM TYPE OF EXISTING u HIGHWAY + YARD = SIDE PROP LINE HIGHWAY WIDTH N USE OF REPAIR E] z EXISTING B G D/EMOL ❑ + APPRINTINT �j TELr NO 20 Ae� CORNER CUTOFF YES C] NO ❑ IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE( IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION $ HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE 'v< 1/J /!! • v THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STAT OF CALIFORNIA IN RELATING TO WORKMEN S COM PENSATION INSURANCE - - SIGNATURE O PERMITTEE ADDRESS - �� FINAL /raj w y BY TEL ` DATE CITY MAKE CHECKS PAYABLE TO FEE $ FEr HARVEY T BRANDT,COUNTY ENGINEER J 1216 PLAN CHECK VALIDATION CK M o, CASH PERMIT VALIDATION rCK M o/ CASH 0 3''3 MAY, 2 1 ®i'76A638A CE 0803 3 75 ° DBS-3 ISM BETS 6-46 DEPARTMEN1-6F-BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES WM. J. FOX,rCHIEF ENGINEER_ B ' IS ® I G •' + - I FOR APPLICANT-- TO FILL,IN^ ' FOR OFFICE USE ONLY BUILD INO 7/ /% y� DISTRICT NO. PLAN CK. NOR PERMIT NO. ADDRESS �� G �, V r' 7 LOCALITY REOIEIVED BY DATE OF APPL. DATE ISSUEC NEAREST t ` CROSS BT. ti BUILDING �O pD• r ^ OWNER ADDREB9 MAIL AD RE9B LOCALITY C ' r NEAREST TEL. I�-s� CROSS ST. CITY � NO i ad FIRE # NO OF TYPE GROUP ARCHITECT OR TEL. ZONE .. - I PL+4NS�` A �(, v ENGINEER TEL NO. BLDG - �� I'r /%/� RD. NO. �r ADDRESS SETBACK LINE, APPROVED, f Y TEL: BY DATE ' CONTRACTOR QL O USE APPROVED' �.rr � y ADDRE89 ZONE BY f DATE x ' LEGAL - ' 1 CORRECTIONS w, ` DESCRIP GN I -LOT NO �® Il BLOCK _ >y TRACT NO j OF BLOG9.// SIZE OF LOT / I NO � W ON LOT / °•a ' ' vw �'-1 r^"� - - .+ r USE OFNO OF NO OF x EXISTING BLDG. ` �m I FAMILIts I ROOMS" DESCRIPTION OF WORK ' NEW ALTERATION ADDITION a p REPAIR MOVING - , . DEMOLISH D_ Sq -FT. NO OF fti I r Z SIZE: _ /_ 'ROOMS STORhES�• ti �'• �'� f~ ,r WALL , I ROOF COVERING COVER ��/TsT� /� �, off`+ a 4 `, a -'"'�'`-`•` -r , t ' COVERING - "'- ��' {• <T USE OFA NEW BUILDING - .. ` 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS- • - "� , ` APPROV,AL`S.`I_, ," APPLICATION AND STATE THAT THE ABOVE ISS CORRECT FOUNDATION:+LOCATION. INSPECTOR DATE ORMS " s AND AGREE TO CDCF MPLY WITH ALL COUNTY ORDINANCES �' MATERIALS-, •X �-�-ti � K U AND STATE LAWS REGULATING BUILDING CONSTRCTION z - FRAME: FIRE, STOPS, SIGNATURE OF ,/7, l�/�y�/�J�� BRACING,,B$OLTS s l.,u, r ++ OWNER , :x "�'+" LATH. INT.: " A 1AUTHORIZED ADT' �f. LATH. EXT.: / P. C.II �PL,ABTER, INT. FEE y s D 0 PLASTER,,EXT. 4, •VALUATION' FINAL FEE A t WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self insure; or a certificate of Workers' Compensation Insurance, APPLICATION FOR BUILDING PERMIT *q certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY R 46140 State Fund Policy Na Company ❑ Cef':ified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING J�no ADDRESS (:�C Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS 9154 Emperor 11-1789 Randol Roofing CITY' Temple .City, Ca. Zip 91780 LOCALITY Date Applicant NO. OF BLDGS. NEAREST CERTIFICATE.OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS IT. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT LOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100) or less.) TEL. -4121 USE ZONE MAP OWNER Ed Morales No795 I certify that in the performance of the work for which this SPE CIAL permit is issued, I shall not employ any person•in any manner ADDRESS M4 Em eror CONDITIONS O so as to become subject to the Workers'Compensation Laws. CITY T'Cy' ZIP 91780 U 10-25-89 Randol •Roofing Date Applicant ARCHITECT OR TEL. DIST R CT G OUP TYPE FIRE OCESSED BY Q NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. y�� CONS ZONE ►— Exemption, you should become subject to the Workers' /c/ �It/ U Compensation provisions of the Labor Code, you must forth- ADDRESS / N with comply with such .provisions or this permit shall be Randol Roofi TEL.288-4040 STATISTICAL CLASSIFI ATION APT. CONDO. Z deemed revoked. CONTRACTOR n NO. — LICENSED CONTRACTORS DECLARATION 529 E. Valley Blvd LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. 451937 SEWER MAP LIC. (commencing with Section 7000)of Division 3 of the Business San Gabriel, Ca. C-39 and Professions Code,and my license is in full force and effect. CITY CLASS BK PG. VALIDATION C-39 SQ. FT. NO. OF NO. OF CHECK License Number 451937 Lic. Class SIZE STORIES FAMILIES ONE VALUATION Contractor Randol Roofing Date 1-30-90 DESCRIPTION OF WORK Re-roof rear part NEW ❑ of house with Owen's ADD ❑ $ 2000.00 , ❑I am exempt under Sec. Cornin in ALTER ❑ B,BP.C. for this reason g fiber glas roof g' PAIR E2 $ Date: USE OF aSS O EXISTING BLDG. SFD DEMOL ❑ Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINTRandol RoofingNB88-4040 DATE I hereby affirm that I am exempt from the Contractor's License 529'E. Valley Blvd. S.G. 91776 ADDRESS 1 Law for the following reason (Section 7031.5, Business and FINAL Professions Code): PRESENT By ACC•T.T ❑ I, as owner of the roert em to BUILDING P P Y� or, m Y P Y ees with ADDRESS --�' ........... 3307 49■v= wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 1 ITEMS 7044, Business and Professions Code.) MOVING TEL. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. TOTAL 49 m v1L+ with licensed contractors to construct the project-(Sec- is tion 7044, Business and.Professions Code.) ADDRESS CHECK 49.8 REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. - GHA l .00 CONSTRUCTION LENDING AGENCY SET BACK 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. 1'* (Sec. 3097, Civ. C.). SIDE t�11 -17ti1?1 11� i�v P.L. Lender's Name 651 1 A�110:34 $39.38 LDMA Ref. # P.C. Fee$ Permit Fee , 3 Lender's Address oI certify that I have read this application and state that the Issuance Fee LDMA P/C# 8 above information is correct_. I agree to comply with all County Investigation Fee R ordinances and State laws relating to building construction, Fee .$49.88 LDMA Perm. # and u on repr a tatives of this County t enter up th .oboe ope inspecti po3e •O ✓(( a� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date WORKERS' COMPENSAT40N DECLARATION affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT ",hsur.• or a certificate of Workers' Compensation Insurance, kr ape +fied copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policya.44o. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING P e rp ❑ Certified copy is filed with the county building inspec- [CONTRACTOR DINGtion department. RESSDate Applicant �C31PLOCALITYNO. OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' OF LOT NOW ON LOT CROSS ST. C) COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one CT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100) or less.) ��y/, TEL. USE ZONE MAPNER LL t�R� ' NO 'L�S3 V NO.I certify that in the performance of the work for which this IKSPECIAL permit is issued, I shall not employ any person in any manner RESS i/ � '\ '- / CONDITONS so as to become ssubject to the W r 'Compen do s. OU(l . C7 r ZIP4 2Z Date Appcant YHITECT OR TEL.0 off DISTRICT GROUP TYPE FIRE PROCESSED BY NOTICE TO APPLICANT: If, after making this Certificate of INEER �� {� /IC NO. 3 CONST. ZONE F-Exemption, you should become subject to the Workers'Compensation provisions of the Labor Code, you must forth- RESS rNwith comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. NO. — LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO.LIC. SEWER MAP (commencing with Section.7000)of Division 3 of the Business CIS LIC. VALIDATION and Professions Code,and my license is in full force and effect. BK. PG. SQ. F NO. OF NO. OF CHECK License Number Lic. Class SIZE d STORIES ✓ FAMILIES ' ONE ❑ VALUATION DESCRIPTION OF WORK Q Contractor Date n NEW 1 am exempt under Sec. $ ❑ &21 ox,; I A ADDg' ► _ ALTER B.&P.C. for this reason O "I $ USE OF Date: EXISTING BLDG. D G`LCiC�� DEMOL ❑ / Signature APPLICANT(PRINT) '�'l. (j Gl✓II�TrQiTl'�_: FINAL • OWNER-BUILDER DECLARATION DATE I hereby affirm that I am exempt from the Contractor's License ADDRESS FINAL Law for the following reason (Section 7031.5, Business and Professions Code): PRESENT BY xel BUILDING ❑ 1, 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 7044, Business and Professions Code.) MOVING TEL. W Y I, as owner of the property, am exclusively contracting CONTRACTOR NO. _ C:!with licensed contractors to construct the project (Sec- ADDRESS -= E' = L-. 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 'I the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE Elf ,. ,-? �. P.L. C.J Lender's Name; # _ -m P.C. Fee Permit Feer Lender's Address o C+ o I certify that I have read this application and state that the b Issuance Fee 21D. 50 DMA P/C# 8 above information is correct. I agree to comply with all County Investigation Fee t1, d ordinances and State laws relating to building construction, Total Fee + � J LDMA Perm. # v and hereby authorize representatives oft is County to enter m u he -mea rt �� for ' s ectio urposes. µ � � a Up Bove nti lnp T_ 1` SEE REVERSE FOR EXPLANATORY14AttIJt1AGE efJ �d Signature of Applicant or Agent Date n vj - +L� J _J L►I WORKERS' COMPENSATION DECLARATION insure, or a certif catte of Workers' Compensat on Insurancef APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. 1046140 Company" State Fund BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ® Certified copy is filed with the county building inspec- BUILDING ADDRESS 9154 EMperor, T.Cy. 1780 tion department. 11-1-89 ' Randol Roofing CITY T.Cy• ZIP 91780 LOCALITY Date Applicant NO. OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCE 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.) TEL. OWNER Ed Morales No.286-0536 US ONE MAP a I certify that in the performance of the work for which this SPE permit is issued, I shall not employ an person in an manner ADDRESS 9154 Emperor SPECIAL d P P Y Y.P Y CONDITIONS O so as to become subject to the Workers' Compensation Laws. U 12728-88 Randol Roofing CITY T.Cy ZIP 91780 W Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE / FIRE PROCESSED BY NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. �.�ry �-� CONST+/ 71E O Exemption, you should become subject to the Workers' VQ{( I/�`�� `s/�i u Compensation provisions of the'Labor Code, you must forth- ADDRESS N with comply with such provisions or this permit shall be TEL STATISTICAL CLASON APT. CONDO. z deemed revoked. CONTRACTOR NO. — — LICENSED CONTRACTORS DECLARATION LIC2 . CLASS NO. DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter ADDRESS 59. E. Valey Blvd. SNO. 451937 ISWER P (commencing with Section 7000)of Division 3 of the Business S.G.S.G. 91776 CLASS C-39 and Professions Code,and my license is in full force and effect. CBK PG.� VALIDATION SQ. FT. NO. OF NO. OF CHECK License Number 4 5193 Lic. Class C—CIA SIZE STORIES FAMILIES ONE . VALUATION Contractor Randol Roofing Date 1-31-90 DESCRIPTION OF WORK Re-roof house NEW El $ 1995.00 with fiberglas shingles ADD ❑ pop 1 am exempt under Sec. ALTER [EllB.BP.C. for this reason REPAIR S Date: EXISTING BLDG. SFD DEMOLUSE OF A❑ ='i'( _ Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINtRandol 'Roofin No. 288-4040 DATE -- G I hereby affirm that I am exempt from the Contractor's License 529 E. Valley Blvd.S.G. 91776 Law for the following reason (Section 7031.5, Business and ADDRESS FINA zii-s Professions Code): PRESENT BY BUILDING Ci .( tl`y o ❑ I; as owner of the property, or my employees with ADDRESS wages as their sole.compensation,will do the work and ( :>IAt'K.5 .'• the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions,Code.) MOVING TEL. ❑ I, as owner of theproperty, am exclusive) contracting CONTRACTOR NO. _ Y 9 a - ��IE'�i„—j„i_I "i:`::_:.fi with licensed contractors to construct the project (Sec- ADDRESS y,_ �s All o, tion 7044, Business and Professions Code.) ,:_t, REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD WY PROP. LINE WIDTH H 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 LDMA Ref. # P.C. Fee$ Permit Fee Lender's Address ► o 1 certify that I have read this application and state that the Issuance Fee LDMA P/C# 8 above information is correct. I agree to comply with all County Investigation Fee $49.88 R ordinances and State laws relating to building construction, Total Fe LDMA Perm. # I a and he by author' a re a ntatives qJ this County to nter upo o e- enti grope inspecti in ur e SEE REVERSE FOR EXPLANATORY LAN E Signature of A plicant or Agent ate OBS SA 25MSETS 2-47 "g84GAVON FOR PEWW DEPARS itNT OF BtUOING AND SAFETY, COUNTY OF LOS ANGELES ELECTRIC WM. J. FOX CHIEF ENGINEER NAME DISTRICT NO. GRO�ypUP rZONE PERMIT NO. ADDRESS f' RECEIVED BY READY FOR DATE ISSUED DU CITY TEL.NO. FIRST INSPECTION J COUNTY g� �v W CERT.NO. _ IS EXPIRES APPLICANT FILL IN HEAVILY OU'T'LINED PORTION ONLY JOB DESCRIPTION OF WORD ADDRESS PLUMBER OF OUTLETS ON CIRCUITS LOCALITY a LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW.I PLUGS FIXT CROSS ST. � CIRCUIT A S C I D I E F G H Ir NAME Z MAIL a /a 3 ADDRESS O CITY TEL.NO. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ' ANGELES COUNTY CERTIFI AT£ OF QUALIFICATION. �2 — 1_ Awzl�a� ELECTRICIAN. I AM THE&.ECTAL OWNER OF TILE°, PROPEtRTY DESCRIOED ABOVE OWNER. k E # C®RRECTio, LIMA — Q z E3 O ' NOTAL NO. OF OUTLETS —� S B APPROVALS NO. OF FIXTURES $ DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS $ POWER PERMIT FEE $ !�� UTILITYCO.NOTIFIED /' C TOTAL FEE In. H FINAL t WORKERS'COMPENSATION of consent to CE-806G 10/$1 APPLICATION FOR ELECTRICAL PERMIT • I hereby affirm that I have a certificate of consent to self insure, CE-Bose or a certificate of Workers' Compensation.Insurance,or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY ~ t copy thereof,(Sec. 3800,Lab.C.) CANT TO FILL IN JOBO FOR APPLICANT Policy Nq - Company ❑ Certified copy is hereby furnished. New Residential Bldgs.& Pools EACH NO. FEE ADDRESS ❑ _ Certified copy is filed with the county building inspection 1 & 2-Family,Sq.Ft. $ $ 1 LOCALITY department. Multi-family Sq.Ft. NEAREST CROSS ST. Date Applicant Residential Swimming Pools OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec Light Sw. — MAIL COMPENSATION INSURANCE ADDRESS s mom"is t This section need not be completed if the work involved b the First 20 ( p Y Total No. Additional CITY � ' Tel..No. 0, permit is for one hundred dollars($100)or less.) CHECKPLAN I certify that in the performance of the work for which this permit APPLICANT is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Additional Total No. CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO _APPLICANT: If; after making this Certificate of PERMIT I Exemption,you should become subject to the Workers'Compensation Range Heater_ D.W. APPLICANT provisions of.the Labor Code, you must forthwith comply with such Oven Dryer W.M._ ADDRESS' f- 59 NON IS AvC, - provisions or this permit shall be deemed revoked. Top FAU � W.H. CITY e C, Tel.No. ��115qLICENSED CONTRACTORS DECLARATION Hood Fan Other I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR (commencing with Section 7000) of Division 3 of the Business and Disp. R C6nd.d "' "� Class. REG.NUMBER Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT NJ. PR SSED Size& Type HP,KW,KVA,or KVAR / K O License Number Lic.Class Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE VALIDATION O Contractor Date Over 10 to,50 Incl. FINAL V ❑ I am exempt under Sec. Over 50 to 100 Inc. BY kA B.&P.C. for this reason Over 100 Services, Swbd.,MCC &Panelboards ////►►►f (�►nJ Z Date: 0- 200 Amp.Under 600 V j�, Signature 201 - 1000 Amp.Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole& Appurtenances . 3 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ACCT.AV I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits 3307 �L r l Code): "P�°'" Misc.Conduits & Conductors 1 ITEMS I,as owner of the property,will do the work and the structure is not intended or offered for sale (Section 7044, Business Other(See Con Fee�che ule) ► TOTAL 46 . 50 46 . 50 and Professions Code). CHECK I ^hly° 50 CONSTRUCTION LENDING AGENCY ups' n I hereby affirm that there is a construction lending agency for the GAGE °00 performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Civ.C.). ' �t PLAN CHECKING FEE 0000-0001 10/23/E9 Lender's Name PERMIT ISSUING FEE 6348 1 AM11e4E Lender's Address I certify that I have read.this application and state that the above TOTAL FEE information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize repr entat s of this County to enter upon the above-mentioned r erty • i spection purposes. e� SEE REVERSE FOR EXPLANATORY LANGUAGE , Signal 2 Permittee f / Date WORKERS'COMPENSATION DECLARATION 76-60 10/81 APPLICATION FOR ELECTRICAL PERMIT heFeby; affirm that I have'a certificate of consent to self insure, CE-806G or a'certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof•(Sec. 3800,Lab. C.) Policy No._ Company FOR APPLICANT TO FILL IN JOB F-1. Certified copy is hereby furnished. EACH NO. FEE ADDRESS New Residential Bldgs.& Pools LOCALITY ❑ Certified copy is filed with the -county building inspection 1 & 2-Family, Sq.Ft. $ _ $ department. Multi-family Sq.Ft. CROSSSST. Date Applicant Residential Swimming Pools kFIRM WNER OR '/� NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec Z 0 AIL COMPENSATION INSURANCE Light Sw. DDRESS(This section need not be completed if the work involved by the �/� First 20 ITY Tel.N,permit is for one hundred dollars ($100) or less.) Total No.�'�GL_ Additional LAN C CKI certify that in the performance of the work for which this permit � PPLICANT is issued, I shall not employ any person in any manner so as to 0,�0 become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 vADDRESS Additional Total No. CITY Tel.No. Date Applicant Fixed Appliances Not Over,1 HP NOTICE TO APPLICANT: If, after making this Certificate of PERMIT Ran :Heater_ D.W. APPLIC Range—Exemption,you should become subject to the Workers'Compensation 9 provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer W.M.J ADDRESS iflrz provisions or this permit shall be deemed revoked. Top — FAU W.H. —7 LICENSED CONTRACTORS DECLARATION Hood Fan Other_ ` CITY 0L6___5Tel.No. — `� • I hereby affirm that I am licensed under provisions of Chapter 9 Disp. Room Air Cond. LICENSE OR • Class/� (commencing with Section 7000) of Division 3 of the Business and REG.NUMBER Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT NO. PROCE Y Size & Type HP,KW,KVA,or KVAR Q License Number �`lLic.Class �� Up to 1 Incl. FINAL Y� U Over 1 to 10 Incl. DATE X11 VALIDATION 0 Con Date Over 10 to 50 Incl. ❑ FINAL VV U I am exempt under Sec. Over 50 to 100 Inc. BY � Over 100 d d/r _J BAP.C.for this reason VV C/) Services ,MCC& Panelboards S 6 U ® P Date: 0 20 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V F-1Exemption 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. �_'• "'""� """Y "'"" "- �'. SINGLE FAMILY Temp.Power Pole& Appurtenances - - --- - 7 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law Additional Sign Branch Circuits for the following reason(Section 7031.5, Business and Professions -qn. Code): !I VV El 1, Conduits& Conductors •• -- - -«•� -- —^— d•,:... 1 ITEMS I,as owner of the property,will do the work and the structure -l d h S Fee e) ee ceu •� �y is not intended or offered for sale (Section 7044, Business Other (See CompF 5V and Professions Code). ' ' CHECK 70:50 CONSTRUCTION LENDING AGENCY I hereby affirm that there i$ a construction lending agency for the -- �� performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) •�v LLL/ o-0 Civ.C.). PLAN CHECKING FEE1 '11/ 11819 Lender's Name PERMIT ISSUING FEE �� 1 AMID-44 Lender's Address I certify that I have read this application and state that the above TOTAL FEE . information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above-mentioned I�rty for nspection urposes. SEE REVERSE FOR EXPLANATORY LANGUAGE K(J� S Signature of Permittee Pate 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 0711080060 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: ITR: 14396 LT: 9 BL: .001 SQ. FT STORIES TYPE 9154 EMPEROR AV (STRUCTURE: 1800 VN I SGAB CA 917752019 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: ROSEMEAD 1 15382-015-010 I I THOMAS PAGE: 596 GRID: J1 LOCALITY: TEMPLE CITY, Cl I I I I (TENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 11SSUED ON: PROCESSED BY: EXPIRES ON: 1 I (EXIST OCC GRP: 111/08/07 SR 05/06/08 1 I I I I (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFINALvDATE FINAL BY: CODE: 1 (ARAGON VIRGINIA (626) 286-0536- 1 6,000 1 19154 EMPEROR AV ((( ( 1 ISGAB 917752019 1 FEES PAID IDESCRIPTION OF WORK 1 1 I I ITEAR DOWN EXISTING ROOF & REROOF W/30 YEAR CLASS A SINGLES I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: IROOF TIMBERLINE SIENA BLEND COLOR I (APPLICANT: TEL. NO: I I I ISALMERON (562) 884-8476- 1AA BLDG PERMIT ISSUANCE 27.75 1 I IP.O. BOX 624 1AC STRONG MOTION RESID 6000.00 VAL 0.60 ISPECIAL CONDITIONS: I IBELLFLOWER CA 90706 ID2 PERMIT W/O EN-HC 6000.00 VAL 149.40 TOTAL FEES 177.75 1 1 ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1 (ARMSTRONG CONSTRUCTION (562) 884-8476- 1 1_ 1 IP.O. BOX 624 LIC. NO ILOCATION AND SETBACKS 1 (BELLFLOWER, CA 90706 902268 11 I I ISOILS ENGINEER APPROVAL 1 1 I I I I I I (ARCHITECT OR ENGINEER: TEL. NO: I IFOUNDATION/TRENCH FORMS I I I LIC. NO: 1 !SLAB/UNDER FLOOR I I I I i I I I I IRAISED FLOOR FRAMING 1 1 I I I I I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:1 (UNDERFLOOR INSULATION I I I I153H265 3 011 I I I 1 I I IFLOOR SHEATHING 1 1 1 INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: 1 I I I NO 21 i ROOF SHEATHING 1 SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS I I 1AIR QUALITY: 1000 FEET MATERIALS 1 1 1 1 NO NO NO I 1FRAME INSPECTION I i I I I I I I IREQUIRED TOTAL SETBACK FROM EXIST I IFIRE SPRINKLER HANGERS ,I I ISET BACK YARD: HWY: PROP LINE: WIDTH: I I IFRONT PL- I (INSULATION/WEATHER STRIPI I 1 I SIDE PL- I I I I I I 1 11NTERIOR LATH/DRYWALL I I I I i I I I I 1 1 (EXTERIOR LATH 1 I 1 I , IRATED FLOOR/CEIL ASSEM. I I I I I I I IRATED WALL ASSEMBLIES 1 1 I I I I I I 1 1 IRATED SHAFTS/OPENINGS 1 1 I 1 1 IT-BAR CEILINGS I 1 1 I I I I I I 1 LOT DRAINAGE I 1 1 I I I I I I 1 IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I I I