HomeMy Public PortalAbout9849 FLAHERTY ST_Building__ 76A638A CE#8035-61APPLICATION: FOR BUILDING 'PERMIT '
COUNTY OF LOS ANGELES " BUILDING 9849 Flaherty St. ,,
DEPARTMENT ADDRESS OF COUNTY ENGINEER Temp i
BUILDING AND SAFETY DMSION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST ,
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST.
DISTRICT NO; F m
TYPE PSSED BFOR APPLICANT TO FILL IN '/ COI`ST,. �-
BUILDING STA STICAL CLASSIFICATION - • SWWER MAP
ADDRESS 9849 Flaherty Ste, .� �BK CIG
CLASS."NO DWELL. UNITS
LOT-NO. 4 BLOCK WATER NOT REQUIRED 77E7CEIVED
14063- CERTIFICATE
TRACT MAP HIGHWAY STATE MAJOR SECOND, O
NO.OF BLDGS. r� NO. ccIRCLE)
SIZE OF LOT I NOW ON LOT G USF ZONE ^SPECIAL
USEHous e & Gar e CONDITIONS
EXISTING BLDG. ag 11 1
H B• Hughes TEL.
O ER H. b NO. BUILD NG EXIST.
.a eT •.9 er►lp e 1 4 YARD HWY S REET AME WIDTH
J SETBACK
DD ESS FRONT
ARCHITECT OR ID' TEL. P. L. C ,L
ENGINEER NO. SIDE
P. L. 0 `
ADDRESS
ACoOR� oo S C•- No. T -Idi INSPECTION RECORD oda
0
AD R S� - are.S one jv • o• e V
W
DESCRIPTION OF WORK N
Z
NEWX ADD ALTER REPAIR DEMOLISH
SQ. FT. NO.OF _ NO OF'
$IZE STORIES FAMILIES
USE OF
STRUCTURE rivate swim ' D oo
0 8 +12
SIGNATURE O
APPLICANT �n -
VALUATION'S 3200 o
/ APPROVALS DATE INSPECTOR'S SIGNATURE
FOUND
FP C.EE ' ' FPMT.EE $ > � ATION: LOCATION
FORMS,MATERIALS
FRAME: FIRE STOPS.. f'9 ! L
I HERE BY 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 GULATIG GAS VENT DUCTS '
BUILDING CONSTRUCTION. I CERTIFY THAT IN DO THE WORNK
AUTHORIZED HEREBY 1 WIL NOT EMPLOY XNY P R N_ IN VIOLA. LATH,•INT.
TION OF THE LABOR COD F THE ST T OF LI O NIA RE T-
ING TO WORKMEN' NSATION RA E.
_ _ LATH,EXT. '
SIGNATURE �, HOUSE NUMBER COR- -
PERMITTEE -AND.P.OSTED
SF estin-7 B1 O• FINAL
CLYDE N. DIRLAM, PRINCIPAL ST
RAL ENGINEER
cK.
PLAN CHECK VALIDATION M.o. CASH PERMIT VALIDATIONM.O. CABN
LA`Cro-9' 9 8 4 lly",F; 2'3 2 S n 5-.7 5
8 5MaR 2 2 0 1 5.0 0 a
76A63*A CE4803,5-65 APPLICATION FOR BUILDING PE IT ! j
COUNTY OF LOS ANGELES BUILDING L
_ DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY-
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W JENKINS,SUP•T OF BUILDING CROSS ST
DI STRRlCT NO. GROUP TYPE PRO SSED-BY
FOR APPLICANT TO FILL IN - � ,p CONST.
BUILDING �`/ STATISTICAL CLASSIFICATION _ SEWER MAP
ADDRESS - .CLASS NO _�DW ELL UNITS BKj PG
LOT NO BLOCK USE ZONE MAP
NO.
TRACT '/'y I SPECIAL
NO OF•BLDGS.
I ` / CONDITIONS
SIZE OF LOT NOW,ON LOT
USE OF
EX I STI NG BLDG BLDG. SETBACK FROM
J TEL FRONT PROP. LINE OF (STREET)
OWNER NO TYPE OF EXISTING SETBACK' HIGHWAY + YARD = TOTAL
ADDRESS - HIGHWAY WIDTH FROM C L
+
CITY
BLDG. SETBACK FROM
ARCHITECT O TEL SIDE.PROP. LINE OF (STREET)
ENGINEER NO.,
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS �/ HIGHWAY WIDTH FROM C L
CONTRACTOR r , NO�LIC /��-7`/� /e) + 0
ADDRESS / G�YC�J�// NO �%� // CORNER CUTOFF YES NO19
LIC OU
CITY E , � CLASS G �� SEE REVERSE SIDE FOR SP� L APPROVALS O
DESCRIPTION F WORK J-2/- hUT
NEW ADD ALTER REPAIR DEMOLISH Z
SQ.FT. - NO OF _ NO OF
SIZE STORIES FAMILIES '
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATION$
APPROVALS DATE INSPECTOR'S SIGNATURE
FOUNDATION, LOCATION
FEE$ FEE$ FORMS, MATERIALS -
FRAME, FIRE STOPS,
I HEREBY 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
9UILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY.A PERSON IN VIOLA- LATH INT '
TION OF THE LABOR CODE OF THE STATE F 'LIFORNIA RELAT-
ING TO WORKMEN'S N INSU q LATH EXT
SIGNATU RE.O: HOUSE NUMBER COR-
PERMITTEE ^7 RECT AND POSTED
-ZK
ADDRESS �/` � Fl NALza
_ JOHN F. LEWIS. PRINCIPAL STRU AL ENGI ER
PLAN CHECK VALIDATION CK M O' CASH _ PERMIT VALIDATION CK D CASH
�o8 9 8 0� JAN2 . 1 D
UA0 . ' 8.00-
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES SEP 14 . n4B U ' t _
wm. J. FOX, CHIEF ENGINEER •, 71
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
f _ DISTR�NO. PLAN CK.NO: PERMIT NO.
BUILDING
ADDRESS /-�/ r
LOCALITY �Pi�h �.p / �/ RECEIV b°BY DATE OF APPL. DATE ISSUED
• NEAREST /� / / ,e, i / �/I/ /ZG.r ( / �
CROBB ST. V O ` nZ-/11 9 E 7
or V
BUILDING
(� ADDRESS
J �liysf�Filf
OWNER �/ �� 'rC� � 7 T__ J (� �
MAIL
ADDRESS /0 y-,(� - )I/ �(�>4n -A/ /���J 7 � LOCALITY
'TEL/�� /p �y NEAREST A
CITY I-I S A-01 A-- NO.)W 736 /, I CROSS BT.c/�'"f
FIRE' NO.OF TYPE --��r GROUPJ
ARCHITECT OR TEL ZONE PLANS /
ENGINEER NO.
BLDG. ORD q103
,ADDRESS SETBACK LINE
APPROVED
CONTRACTOR
Cr O _;F7_7_ NO..
BY DATE
USE APPROVED
ADDRESS ZONE, BY DATE
LEGAL CORRECTIONS
DESCRIPTION /L�OT�N•O. BLOCK) .� U O
TRACT 7- b
/ .7�� NO.OF LDGS. 1
SIZE OF LOT ((O�•��fb I NOW,'BLOT
USE OF /�.� NO.OFNO.OF_
EXISTING BLDG. ---r I FAMiuee I ROOMS
DESCRIPTION OF WORK
NEW Ix I ALTERATION I I ADDITION
I �
REPAIR MOVING DEMOLISH
Sq.FT. ? NO.OF 5 Z
SIZE // /U ROOMS STORIES / D
WALL ROOF
COVERING O COVERING
USE OF NEW
BUILDING
xA3 '�t'
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.
�_ �_ s' FRAME: FIRE STOPS,
SIGNATURE OF
BRACING,BOLTS
PERMITTEE LATH,INT.:
�
AUTHORIZEDLATH,GAG v
EXT.:
� v
DBS-3 50M.SETS 1-4e $ P.C.S PLASTER,INT.
� ^
i (ALJ 1 /
J O FEE / 0, yV PLASTER,EXT.
VALUATION rakfiammmmimam MINE FEE �7 FINAL ^
p ���
76A638A OE4803 $65 APPLICATION FOR BUILDIN_ 4 -PERM=IT_ _
` COUNTY OF LOS'ANGELES BUILDING a
DEPARTMENT OF COUNTY ENGINEER ADDRESS o
BUILDING AND SAFETY DIVISION L O C A L I T Y
JOHN A. LAMBIE-. COUNTY ENGINEER NEAREST / 1
COLEMAN W. JENKINS,SUP•T OF BUILDING CROSS S
DISTRICT N "GROUP TYPE O B
- '
FOR APPLICANT TO FILL IN T CONST.
BUILDING y= STATISTICAL<SSIFICATION SEWER-MAP-
ADDRESS �G7 P- 1..��E2�Y- - P
CLASS NO DWELL UNITS
~'
EK
LOT NO. - BLOCK USE ZONE MAP '
TRACT 2 NO. 2'O .3 _ -
t �}(�('� - �:� SPECIAL - -
y4;n•r• =/1 NO. OF BLDGS. «j ��'lll CONDITIONS
rl S1': EVOP LIOT C/ NOW SON LOT
1 USE.O F,y3t., PJ Cys'
i�
EXISTIN.ABLDG BLDG. SETBACK FROM•
T•EL FRONT PROP. LINE 0 _20
(STREET)
r�
OWNER � NO. TYPE OF. EXISTING- SETBACK HIGHWAY +- -Y• TOTAL
r 9{ HIGHWAY WIDTH FROM C L
thy(
ARCHITTE`CT OR „TEL BLDG SETBACK-F OM - - - -- --
ENGINEER- NO. SIDE PROP. LINE OF (STREET)
TYPEOF EXISTING SETBACK HIGHWAY + YARD = TOTAL
-A-DD•R•ESST - HIGHWAY WIDTH - FROM C'L '
CONTRACTOR �m` N r� S'"�Sl _0
ADDR ESS 7 : `?,j.6NIG`1� LI 45_T 1 E_i1 CORNER CUTOFF Y CAD V
Cf C-L SEE REVLCY
CITY cLAss 'i ; §Ipa! 93 8fJbU_'YPROVAL.S O
DESCRIPTION OF 'WORK er. ai ® . ./
�►i�rbae n
"la d'tvcwan'
NEW ADD ALTER REPAIR DEMOLISH X01 ®rfl1 t i r d,t, I.. A,
SQ
.FT. ++ +%�� NO OF NO OF r EtllCi {�® 4er.bfl tlu, t_i _ t.,-«�1%S"'ij, ifl' Oradf to dt'-i�
SIZESTORIES FAMILIF_S� ��`� ('®; fl�y.ti!dD , i,,_ 15 fl6 Bi'
USE OF '1 offiol ®P-�r �r pe=lC;fl'S;-F.f ld id�:a5 1,.7E.if,
STRUCTURE '��'Tlt ����^ p - ?t C�
�rrlrif hill) 6 61i
SIGNATURE OF
'APPLICANT
VALUATION Ii�d ��_ _ -
(APPROVALS / ATE INSPECTO 'S SIGNA �AE
PC _ PMT SD _ FOUNDATION,
O LOCATION
FORMS!MA -_
TERIALS
FEE FEE$
FRAME, FIRE STOPS, L •'� U'
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING�.BOLT v �/Y
AND STATE THAT THE ABOVE IS CORRECT AND'AGREE TO COMPLY FURNACE: LOCATION
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING
GAS VENT. DUCTS
9UILDING CONSTRUCTION I CERTIFY THAT IN,DOING THE WORK
AUTHORIZED HEREBY-1 WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH.-INT
TION OF THE LABOR CODE,OF �STF CALIFORNIARELAT-'I O TO WORKMENS COMPENSA TICE LATH EXT
SIGNATURE OF HOUSE NUMBER COR-
PE42MITTEE '« RECT AND POSTED / -
ADDRESS , Fl NAL
PLAN CHECK VALIDATION CK M o ASH _ JOHN F. LEWIS PRINCIPAL STRUCTURAL ENGINEER.
PERMIT VALIDATION CH M.O. CASH
Lito8 s 5 1"'00 JAN 17 1 0 1-, 1 .50— v
r'---i&�TMENT OF BUILDING AND SAF Y APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES Ph 1 p,1_q/�� � ' � ® �
WM. J. FOX. CHIEF ENGINEER ,� G
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING ��� L. H E Q„` ��. DISTRICT NO. PLAN CK.NO. PERMIT NO.
ADDRESS /0162
LOCALITY 0-% ' RECEIVED�BY DATE OFAPPL. I�QDATE ISSUED
NEAREST //'' /, �� ✓ /f + y
CROSS ST. e L) � , V ���sss'
/
S G !7 BUILDING
OWNER ADDRESS �a
a
MAIL / / -1 LOCALITY L/
� i
ADDRESS L od-P) {\L tO bel o- L/` W �'.'�S.
NEAREST'
TEL. p a CROSS ST. �� V ';;;•••�•••���Vj �,
CITYS G 'C�1 b. NO. 3G'�D FIRE ' NO.OF ^ TYPE GROUP']
ARCHITECT OR TEL. ZONE PLANS L /Y/
ENGINEER NO. ORD NO.
BLDG.
ADDRESS SETBACK LINE
APPROVED f
CONTRACTOR • .SGOT�NO. A,Q• !3(`pCty BY DATE/
• USE // APPROVED
ADDRESS q-8 • (7 •��{ vu S, ZONE 4e/ BY• DATE
LEGAL 4 CORRECTIONS
DESCRIPTION LOT NO. BLOCK '
TRACT
NO.0F8LDGB, `
SIZE OF LOT Log' X ( '3 NOW ON LOT
USE OF NO.OF NO.OF
EXISTING BLDG. FAMILIES ROOMS
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
REPAIR MOVING DEMOLISH
Sq.FT. p NO.OF - Z
'SIZE 8 ROOMS STORIES y
WALL '�7�.Ap'S. I ROOF r
COVERING COVERING ►-4� '
USE OF NEW -
BUILDING 1 1.l en. E
I HEREBY ACKNOWLEDGE THAT I 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 BTATE LAWS REGULATI G BUILDING CONSTRUCTION.
FRAME:,FIRE STOPS, ,
SIGNATURE OF ---- BRACING.BOLTS
PERMITTEE LATH, INT.
AUTHORIZED AST LATH, EXT.
76A63BA 9-4E
DBS-3 SOM SETS $ P.C. ,/'1y1' PLASTER,INT.
G FEE p PLASTER,EXT.
VALUATION '• FEE �� FINAL
APPLICATION. F.0 ULDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS
1 hereby affirm that I have a certificate of consent to self Insure, B ILDi#ADDRE �! d
or a certificate of Workers' Compensation Insurance,ora certified LAHER 1,
copy thereof (Sec 3800,.Lab C.) 64A/7 k� .G �w q 910
LOCALITY
Policy No Company SIZE OF LOT - NO OF BLDGS NOW ON LOT
'Certified copy is hereby furnished
NEA RE CROSS ST
❑ Certified copy Is filed with the county building,inspection TRACT BLOCK ' LOT NO
_department USE ZONE- MAP No
Date Applicant , ASSESSOR MAP BOOK PAGE PARCEL
.. •jY D p?Jr'_ D� SPECIAL CONDITIONS ,
OWNER - - TEL NO
CERTIFICATE OF EXEMPTION FROM WORKERS' 919)44-S-,5'339 WITHIN 1000 FT OF SCHOOLS YES. No
COMPENSATION INSURANCE L
(This section need not be completed if the permit Is for one hundred ADD Ess Y
.
/7` �^ 5 'DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY
'dollars'($100)or less') 11 vv
I certify,that m the performance of the work for mance this permit C�y��LE _I-Y ZI 0
Is issued, I shall not employ any person in any manner so as to ..
become subject to the Workers'Compensation Laws ARCHITECT OR ENGINEER TEL NO
j p STATISTICAL CLASSIFICATION APT CONDO
Date Applicant• ADDRESS' '' CLASS NO 7 DWELL UNITS
NOTICE TO APPLICANT If, after making this Certificate' of REQUIRED TOTAL SETBACK FROM EXIST
Exemption, •you should 'become subject to the' 'Workers' CONTRACTOR�I TEL NO SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions of•,the Labor Code, you must forthwith FRONT
comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC NO PL
LICENSED CONTRACTORS DECLARATION PILE
CITY LIC CLASS P L
I hereby affirm that I am licensed uederprovisions of Chapter 9SEWER MAP
(commencing with Section.7000)of Division 3 of the Business and SQ FT SIZE NO OF STORIES- NO OF FAMILIES y�+/ a
Professions Code,and my license.is in full force and effect NEW BK' PG O , O
License Number Lic.Class DESCRI TI N OF WORK ADD :VALUATION V
Contractor Date lT7 a r ALTER ❑ $"� OOIx
❑ 1 am exempt under Sec REPAIR ❑, $
p U
BBPC for this reason / DEMOL ❑ LDMA P/C# LU
Date us F Ewe�!�Ncy�LD
'�•G"sG URM ❑tv, y_ N
Signature 2
- APPLICANT(PRINT) TEL NO `LDMA Perm# '
❑ 1, as owner of the property, or my employees with wages as Z
their sole-compensation, will,do the wADDRESS
and the structure Is . :j=,:,' ,_;_i,.s�_•
not intended or offered for sale (Section 7044, Business and FINAL DATE
rOfeSSIORS Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL
77Q/
( OR A MIXTURE CONTAINING'A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAWTHE j_i
aS owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE'S FINAL BY 5 i.r
licensed contractors to construct the project (Section 7044, ; �ja •
VES El NO Elf
_
Business and Professions Code) -.r• �"'-""';.b .�y�j+'
WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING S="-f"•'+- �I 7 ; = ''-"'8
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CHEM
.i�.•-•�.f: C"j';s j-
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR HE: -f t:n._
GUIDELINES `
I hereby affirm that there Is a construction lending agency for YES❑ No❑ _ iea��1�`
C4 the performance of the work for which this permit is Issued(Sec IHAVEREAD THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING T. n
3097,CIV.C) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, '
TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING'HAZARDOUS
Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMDT- =
0- Lender's Address : :j=
OWNER OR AGENT ::�-�5_�
icl•E 4 a j
o I certify that I have read this application and state under penalty I
of perjury that the above Information is-correct I agree to comply PC FEE �Di�� PERMIT FEE �
o with all county ordinances and State laws relating to building7-
<
/
< construction, and hereby authorize epresentatives of this County ISSUANCE FEE
to enter upon the above-m tioned operty for Inspection purposes
nINVESTIGATION FEE TOTAL FEE
syaaw.a of Aopl— Agent •Dale + p( O�
SEE REVERSE FOR EXPLANATORY LANGUAGE
APPLICATION FOR BUILDING. PERMIT
COUNTY OF LOS ANGELES - BUILDING AND SAFETY-
WORKER'S
AFETY"WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUIL ES J �w
I-hereby affirm that I have a certificate of consent to self insure, 'BUI ING ADD ESS
or,a certificate of Workers' Compensation Insurance,or a,certified �4 T—_ A H S
copy thereof thereof (Sec 3800,Lab. C) CITY rr zIP ff n
�Il�{ (�� • G 1,T r%A '� 1 + 0 LOCALITY
Policy'NO Company SIZE OF LO NO OF BLDGS NOW ON LOT G••'
❑ Certified copy is hereby furnished NEAREST CROSS
El Certified copy Is filed with the county building inspection TRACT BLOCK LOT NO
department ° USE ZONE- MAP NO
' - 'ASSESSOR MAP O PAGE PARCEL
Dater Applicant 0 O f / SPECIAL CONDITIONS '
CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER " TEL NO
WITHIN 1000 FT OF SCHOOLS YES ;, NO
COMPENSATION INSURANCE • v_—b'� WU �—!�'tLSS3 ;
I ADDRES - - '
(This section need not be completed if the permit,is for One hundred DISTRICT GROUP TYPE CONST- FIRE ZONE 'PROCESSED BY
dollars($100)or less). .
CITY
I certify that in the performance of'the work for which this permit ��' u� ZI,P
is Issued, I shall not employ ariy person many manner SO asO
t0 ARCHITECT OR ENGINEER TEL N " 1 C.
become subject to the Workers Compensation Laws STATISTICAL CLASSIFICATION APT CONDO
Date Applicant ADDRESS, CLASS NO DWELL UNITS
NOTICE TO APPLICANT- •If, after making this, Certificate of. REQUIRED TOTAL SETBACK FROM EXIST
Exemption, you should become subject*- to the Workers' CONTRACTOR ,17 TEL NO SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions'of the Labor Code, you must forthwith Q w/��y— FRONT
comply with such provisions or this permit shall be deemed revoked ADDRESS LIC NO P L
LICENSED CONTRACTORS DECLARATION -SIDE
CITY • LIC CLASS PL
.I hereby affirm:that•I am licensed'underprovisions of Chapter 9 SEWER MAP
(commencing with Section 7000)of Di4lsion'3.Of,the Business and SO FT-SIZE ' NO OF STORIES NO OF FAMILIES
Professions Code,and my license Is In full force and effect., NEW ❑ BK' PG d
License Number Lia Class DESCRIPTION OF WORK ADD VALUATION �J n
O
Contractor' Date ALTER r El . ` O`er
CT
,AGC.'Ir SSOf� _,ST REPAIR 1:1ElI am exempt under Sec.
B&PC.for this reason Wood.¢ JCITLH r-;Q t'711- I.-I&I DEMOL ❑
LDMA P/C'#
Date USE OF EXISTING BLDG URM ❑
Signatures=
-APPLICANT(PRINT) -- TEL NO - LDMA Perm# %4 ,f,-'J i-�„ • . _ _ Z
❑ I, as owner of the property, or my employees with wages ds, Z °--
their sole compensation, will do the work and the structure Is - ADDRESS O not intended intended or'offered for sale (Section 7044, Business and FINAL DATE
,,Professions Code)`
Code)` WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL "� �� ' ,"i-��„?_�•` °q OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE V
I, as owner of the property, am exclusively contracting with
_ AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDEI
licensed contractors to construct the_project (Section 7044, FINAL BY
Business and Professions Code) YES❑ NO`❑
' WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING ..- .L3'.•: '
r OCCUPANT REQUIRE A PERMIT FOR_CONSTRUCTION OR MODIFICATION FROM THE SOUTH
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR —
GUIDELINES _ - - .f I Ys L�t'°i c -_'' -_1
I hereby affirm that there is a construction lending agency for ves❑ No❑ =, ? ''—
w the performance of the work for which this permit is-issued(Sec ' ` ='•` - °°�-
WI HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING ,L
3097, CIV C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE,
TITLE 2.-CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS
.3 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD -
o - Lender's Address
OWNER OR AGENT
A o I certrfy that I have read this application and state under penalty
+'• o PC FEE PERMIT FEE
of perjury that the above information Is correct I agree to comply
y with all county ordinances and State laws relating to building !/ �� • --' -`
< Construction, and hereby uthorize representatives of this County ISSUANCE FEE
to enter upon the ove ntioned property for inspection purpo
2INVESTIGATION FEE TOTAL FEE 3 Q -
r Sgnalu, APPlicanl or AQ,*M I Date
SEE REVERSE FOR EXPLANATORY LANGUAGE
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 0511140034
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
TR: 14063 LT. 4 SQ. FT STORIES TYPE 9849 FLAHERTY ST
STRUCTURE: 3500 VN TEMP CA 917801711
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 6Y6•�y GG��j
5385-025-014 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY; C
TENANT: EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: 11/14/05 JK 11/09/06
OWNER: TEL. NO- BLDGS. NOW ON LOT: VALUATION: FINAL T FINAL BY: CODE:
CHENG, YAWEN (626) 695-1200- 7,000 /p�(J
9849 FLAHERTY ST _
TEMP 917801711 FEES PAID DES RIPTION OF WORK
TEAR OFF TO EXISTING SOLID DECK, INSTALL 30 LB FLET AND 50
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: YEAR ELK AND HOT BUR ON FLAT 35 S.F. CLASS A
APPLICANT: TEL. NO:
SIERRA PACIFIC ROOFING (909) 949-7663- AA BLDG PERMIT ISSUANCE 27.75
1042 N. MOUNTAIN AVE AC STRONG MOTION RESID 7000.00 VAL 0.70 SPECIAL CONDITIONS:
UPLAND, CA 91766 D2 PERMIT W/O EN-HC 7000.00 VAL 166.20
TOTAL FEES 194.65
CONTRACTOR: TEL. NC- APPROVALS DATE INSPECTOR SIGNATURE
SIERRA PACIFIC ROOFING (909) 949-7663-
1042 N MOUNTAIN AV B 383 LIC NO I LOCATION AND SETBACKS
UPLAND, CA 91786 627233 C39
SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS
LIC. NO: I SLAP/UNDER FLOOR
RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:l UNDERFLOOR INSULATION
153H269 3 Oil
FLOOR SHEATHING
NO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: t -
NO 21 ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS SHEAR PANELS
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION
REQUIRED TOTAL SETBACK FROM EXIST I FIRE SPRINKLER HANGERS
SET BACK YARD- HWY: PROP LINE: WIDTH:
FRONT PL- I INSULATION/WEATHER STRIP
SIDE PL-
INTERIOR LATH/DRYWALL
EXTERIOR LATH
RATED FLOOR/CEIL ASSEM.
RATED WALL ASSEMBLIES
RATED SHAFTS/OPENINGS
T-BAR CEILINGS
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508
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 0611090017
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
TR: 14063 LT: 4 SQ. FT STORIES TYPE 9849 FLAHERTY ST
STRUCTURE: VN TEMP CA 917801711
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
5385-025-014 - THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY, C
TENANT: EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: 11/09/06 JK 11/04/07
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FIIvL TjA� FINA - CODE:
YA WEN CHENG (626) 922-8105- 6,900 `fJ(�,FJ
9849 FLAHERTY ST
TEMP 917801711 FEES PAID DESCRIPTION OF WORK if
C/0 (9) WINDOWS & (1) SLIDING DOOR
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
APPLICANT: TEL. NO:
SEAR HOME IMP. (800) 807-9889- AA BLDG PERMIT ISSUANCE 27.75
10395 SLUHER DR. AC STRONG MOTION RESID 6900.00 VAL 0.69 SPECIAL CONDITIONS:
S.F.S. 90670 D2 PERMIT W/O EN-HC 6900.00 VAL 166.20
TOTAL FEES 194.64
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
SEARS HOME IMP. (800) 807-9889-
10395 SLUSHER DR LIC. NO LOCATION AND SETBACKS
SANTA FE SPRINGS CA 90670 721379 B
SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS
LIC. NO: SLAB/UNDER FLOOR
RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION
153H269 3 01 _
FLOOR SHEATHING
NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: _
NO 21 ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS SHEAR PANELS
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION
REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- INSULATION/WEATHER STRIP
SIDE PL- _
INTERIOR LATH/DRYWALL
EXTERIOR LATH
RATED FLOOR/CEIL ASSEM.
RATED WALL ASSEMBLIES
RATED SHAFTS/OPENINGS
T-EAR CEILINGS
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508