HomeMy Public PortalAbout9426 EMPEROR AVE_Building__ ' TEMPLE CHTY
fuaaeAce#eoa 1�11 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER p DDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE, COUNTY ENGINE911 NEAREST
WILLIAM A JENSEN SUPT OF BUILDING- CROSS ST
FOR APPLICANT TO FILL IN DISTRIC)N GR TYPE
SE
CONST
BUILDING STATISTICALC IFICATION -SEWER MAP
ADDRESS Z . C K G
CLASS NO DWELL UNITS
�r LOT NO 018 vf T BLOCK WATER NOT REQUIREDRECEIVED
't CERTIFICATE
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TRACT 431q MAP HIGHWAY
NO OF BLDGS NO IRC LE MS ATE MAJOR SECON LOCAL
SIZE OF LOT I NOW ON LOT USEONESPECIAL
USE OF CONDITIONS
EXISTING BLDG
TEL y�
OWNER NO I / 31 aILDING YARD HWY STREET NAME EXIST
p� SETBACK W DTH
ADDRESS 2Co '6FlP Q '1'EHP� C.T FRONT v /
ARCHITECT OR TEL P L
ENGINEER NO SIDE
P L
ADDRESS CL
TEL JNSPECTION�RECORD O
CONTRACTOR NO / ,w '.a-� �p
ADDRESS o/ O
DESCRIPTION OF WORKi
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NEW ADD LTER REPAIR I DEMOLISH Z
SQ FT NO OF NO OF
IZE STORIES FAMILIES
USE OF
STRUCTURE QEDI.Ac6k�'2N6A► Wluatow I.IITrlWluatoW I.)ITrI _ _ _
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SIGNATURE OF
APPLICANT
VALUATION$ 13W 0--�
APPROVALS DATE INSPECTOR S SIGNATURE
PC PMTOQ7t) FOUNDATION LOCATION ,
FEE $ FEE $ FORMS MATERIALS
FRAME FIRE STOPS
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS ,!
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION,
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
I AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR C�NS
STATE OF CAL ORNIA RELATING TO WORKMEN S CO INS NCE LATH EXT
SIGNATURE OC'N HOUSE NUMBER COR- '
PERMITTEE RECT AND POSTED s
ADDRESS Z PA / h
FINAL PLAN CHECK VALIDATION cK. m o cAsit CLYDE P °ERIT VALIDATIONM, PRINCIPAL T/ cic//RMA Lo ENGINEER
ER
f�j'�7 6 9 9 FEB 1 1 p 2.0 0
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
,COUNTY OF LOS ANGELES U q L
WM. J. FOX, CHIEF ENGINEER
OR APPLICANT TO FILL IN FOR OFFICE USE ONLY
I
DISTRICT NO 'PLAN CK NO.' PERMIT NO
BUILDING
ADDRESS
3 3 1 , t
LOCALITY t / RECEIVED Y DATE OF APPL DATEISSUED
-,NEAREST
CROSS ST. 1
b �/ BUILDING
�~ OWNER ply /, a le? ADDRESS ppt�s- v
MAIL LOCALITY
ADDRESS
NEAREST ,
00 TEL CROBB ST. -s
CITY 1 ND. FIRE NO OF TYB GROUP 1
ARCHITECT OR TEL. ZONE PLANS ;
ENGINEER NO. yJ !�
BLDS O
i�. I � R 47O
ADDRESS �w„„ �A 1 SETBACK LINE k
4
�/ Q APPROVED
CONTRACTOR k/I/1 99 16'> 'o NO. ,d/}•�'e �'6 96 BY i DATE
- USE APPROVED �
ADDRESS J r,/ W 77 C V �� ZONE BY DATE
LEGALf , CORRECTIONS
_DESCRIPTION SLOT NO. -/!' BLOCK
TRACT
4
NO OF BLOGS. -
SIZE OF LOT/,%pp 0 's n6 4, I NOW ON LOTUSE
t
EX STO G NO BLDNf� /�+ I NO OF / I NO OF
O a N13 O . ROOMS
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
D
REPAIR _ MOVING DEMOLISH
SQ
NO Or Z
SIZE 9Ityn yJ'R'OOMS / STORIES
WALLRocir
COVERING 109,6P��fi4 J I COVERING r
/per'// J d
BUILDUSE ING W / Kl/le /�'�I Ci !�V /71-L-21 _
E
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION
FRAME:
SIGNATURE OF BRACINGG,,BOLTS
PERMITTEE LATH,INT.:
AUTHORIZED AGT LATH,EXT.:
OBS-3 SOM BETB 1-48 $ C.III PLASTER,INT.
PLASTER,EXT. n
VALUATION
LIFEE �� FINAL
DS-3 1,-40 SSM 89TS "PLICATION FOR PEPMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES BUILDING
WM J FOX, CHIEF ENGINEER
NO OF BLDG ORD NO DISTRICT NO PLAN C O� PEER/MIT NO
PLANS SETBACK LINE („p77
FIRE APPROVED i
ZONE BY DATE ECEIV Di BY DATE OF APPL DATE ISSUED
USE APPROVEDI � �� /A.
ZONE BY DATE ry S�
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
C BUILDING 2 a
p NAME ADDRE86 p
yUj = ADDRESS LOCALITY
~ C1 NEAREST
V Z CITY CROSS ST
Q STATE TAME �(/C,/•B+V, '�
LICENSE NO NO
MAIL - -- o
x NAME e � ADDRESS ! � r
k p TEL
ADDR886 CITY NO
F v
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS,
U CITY APPLICATION AND STATE THAT THE ABOVE IS CORRECT
STATE TEL AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
LICENSE NO NO AND STATE LAWS REGULATING BUILDING CONSTRUCTION
Z r
O LOT NOkY 8126 OF LOT&�+ !! if SIGNATURE OF
OWNER • e
d f NO OF BLD G8 AUTHORIZED AGT
2 - BLOCK NOW ON LOT
TRACT 5` CORRECTIONSUSE OF
D
NOW ON LOT SLOGS / t`
DESCRIPTION OF WORK
USE OF
BUILDING A
RBVING1
This constructlon mayViolation o
War Production 0
cautioned to consult with your load War ;U
ibefolecumumuc-
irm
the worked in the t. Z
D
NEW TYPE !9GROUP [-
NO OF I NO OF
ALTERATION ROOMS J FAMILIES
ADDITION SIZE / /� 4
REPAIR STORIES
MOVING WALL COVERING
0000
DEMOLISH ROOF COVERING I �
t9+O P c $ a FINAL-APPRC6L,/
FEE
r 8 I �,/y (� I INSPEC OR'8 �
VALUATION FEB ��®� DATE / NAME
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS
BUILDING ADDRESS
I hereby affirm that I have a certificate of consent to self Insure, 9•I'le- c ����2 Av r�/_ Eli� h� t/�
or a certificate of Workers'Compensation Insurance,or a certified �((p e/�C/ Y
Copy thereof(Sec 3800,Lab C) CITY M�Lc c(�..y ZIP q/790
LOCALIT'Y' L�
Policy No Company SIZE OF LOT NO OF BLDGS NOW ON LOT
El certified copy is hereby furnished &3 yC q 3 NEAREST CROSS ST
❑ Certified copy is filed with the county building Inspection TRACT BLOCK LOT NO
USE ZONE MAP NO
department
ASSESSOR MAP BOOK PAGE PARCEL
Date Applicant SPECIAL CONDITIONS
OWNER A&wei Tr/9 TEL NO YES NO
CERTIFICATE OF EXEMPTION FROM WORKERS' L�,1i(2c',tka $rci/�NS .;7� -(r
COMPENSATION INSURANCE WITHIN 1000 FT OF SCHOOL?
ADD ESS
(This section need not be completed If the permit is for one hundred ��db fM��� DISTRICT GROUP TYPE CONSTFIRE ZONE OCESSE Y
dollars($100)or less) CITY _ ZIP �7 01
I certify that in the performance of the work for which this permit ��/y/�t c �� 9 /Kc)
is issued, I shall not employ any person In any manner so as to ARCHITECT OR ENGINEER TEL NO
become subject to the Workers'Compensation Laws Or✓AJt��' STATISTICAL CLASSIFICATION APT CONDO
Date Applicant ADDRESS CLASS NO DWELL UNITS
NOTICE TO APPLICANT If, after making this Certificate ofREQUIRED TOTAL SETBACK FROM EXIST
Exemption, you should become subject to the Workers' CONTRACTOR TEL NO SETBACK YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor Code, you must forthwith 0, , I
LIC NO FRONT
ADDRESS
comply with such provisions or this permit shall be deemed revoked PL
SIDE
LICENSED CONTRACTORS DECLARATION CITY LIC CLASS P IL U
I hereby affirm that 1 am licensed under provisions of Chapter 9 SO FT SIZE NO OF STORES NO OF FAMILIES SEWER MAP OZ
(commencing with Section 7000)Of Division 3 of the Business and1 9NEW BK PG O
Professions Code,and my license Is in full force and effectF-
DESCRIPTION OF WORK ADD ❑ VALUATION
License Number Llc Class
Contractor Date QAR �OR ALTER ❑ O z
REPAIR ❑
❑ 1 am exempt under Sec
B&P C for this reason DEMOL ❑ LDMA P/C#
Date USE OF EXISTING BLDG URM ❑
Signature APPLICANT(PRINT) TEL NO LDMA Perm N
ZAC1/12ArC� �Q ST✓�A1S ��7'6��,z Z ( a
I, as owner of the property, or my employees with wages as O AC'(1 a'
their sole compensation,will do the work and the structure is ADDRESS
not Intended or offered for sale (Section 7044, Business and H
9`>1vT 4 c FMPzieo.2 -72pRtr e47- FINAL DATE a ;LI�,7
�
Professions Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE AHAZARDOUS MATERIAL J { ITEMS
Cl I, as owner Of the property, y contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN Q 1 ITE `j
p perty, am exclusive) g THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? F19
licensed Contractors to construct the project (Section 7044, YES❑ NO❑ TOTk 58 - 75
Business and Professions Code)
WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDINGCi
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CHECK
t \ 5J•7CI
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST
FOR GUIDELINES CHANGE e Oct
I hereby affirm that there is a construction lending agency for YES❑ NO❑ `
the performance of the work for which this permit Is issued(Sec .erw-)
I HAVE READ THE 3097,Civ C) PERMITTING CHECKLIST II UNDERSTAND RDOUSi MLY REQU INFORMATREM AND
UNIDER THE LOWANGE ES
m
COUNTYCODE TITLE2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20140 CONCERNING
Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD
Lender's Address ,,�«„ 1: Z 1 l� 3:04
AGENT
0 1 certify that I have read this application and state that the above PC FEE PERMIT FEE
information Is correct I agree to comply with all county
ordinances and State laws relating to building construction,and
hereby authorize representatives of this County to enter upon ISSUANCE FEE 0
a '
theve-mentionedrppe or inspection purposes l!
4--/3-90 INVESTIGATION FEE TOTAL FEE t`
a Appll�t Asw� Dae
SEE REVERSE FOR EXPLANATORY LANGUAGE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9804090005
PHONE (818) 285-0488 EXT:
--LEGAL . OF CONST BUILDING ADDRESS
TR: 4314 LT: 8 SQ. FT STORIES TYPE 9426 EMPEROR AV
STRUCTURE 0 VN TEMP CA 917801301
ASSESSOR NEAREST CROSS STREET
5382-010-053 THOMAS PAGE: 596 GRID: J1 LOCALITY: TEMPLE CITY
EXISTG USE RESID USE ZONE R-1D .
EXIST OCC GRP: 04/09/98 UT 04/09/99
OWNER. TEL. NO BLDGS. NOW ON LOT: VALUATION. FINAL DATE F L CODE
STEVENS LAURENCE R;HENRIETTA (818) 287-6862- 1 3,300 2�_Q
9426 EMPEROR AV U
TEMP 917801301 FEES PAID DESCRIPTION OF WORK
TEAR OFF AND INSTALL 1/2" PL OOD, GAF CLASS A COMP SHINGLE
FEE DESCRIPTION QUANTITY: UOM: AMOUNT (HOUSE AND GARAGE)
APPLICANT 0-
WEATHERITE ROOFING (626) 446-1106- AA BLDG PERMIT ISSUANCE 27 75
AC STRONG MOTION RESID 3300.00 VAL 0.50 SPECIAL CONDITIONS-
D2
ONDITI S-D2 PERMIT W/O EN=HC----' 3,300-00 VAL 116.10
F L ETOTA ES 144 35
CONTRACTOR ROOFING TEL. N287 0669- d � APPROVALS DATE INSPECTOR SIGNATURE
WEA4016 TEMPLE CITY BLVD LIC NO LOCATION AND SETBACKS
ROSEMEAD CA 91770 423177039
SOILS ENGINEER APPROVAL
i
ARCHITECT ENG TEL. ; �� �- �� FOUNDATION/TRENCH FORMS
LIC. NO: /
SLAB/UNDER FLOOR
�; _ , � �1 1111 �1
RAISED RAM
UNDERFLOOR MAP N0: S L OR INSULATION ER MAP BOOK: PAGE- FIRE ZONE. CMP,: ,� i I��; , �/ � �� r �. I � � ,
153H265 3 01 i ����7 `�' ��i, �_�� ��i '� SHEATHING
OF FAMILIES- W=LNG UNITS AP CLASS
NO 21 � 7 �, t; ' �� �� 00 SHEATHING
�,
SCHOOL IN HAZARDOUS \ ' j i - , ;i '� //� NELS
AIR QUALITY: 1000 FEET MATERIALS \ _
NO NO NO FRAME INSPECTION
REQUIRED0 SETBACK FROMEXIST ` ` \ / NGER
SET BACK YARD: HWY: PROP LINE: WIDTH-
FRONT
IDTH FRONT PL- v " INSULATION/WEATHER STRIP
SIDE PL- -
- - N R ALL
EXTERIOR LATH
RAT D WALL ASSEMBLIES
RATED SHAFTS/OPENINGS
T-BAR CEILINGS
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508