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Home My Public Portal About9517 GIDLEY ST_Building__ i -MVISION OF BUII.DING AND SAFETY BUILDING Department of County Engineer County of Los Angeles WM. J. FOX, COUNTY ENGINEER APPLICATION BUILDING FOR APPLICANT TO FILL. IN ADDRESS BUILDING - ADDRESS LOCALITY NEAREST LOCALITY CROSS ST. NDISTRICT NO. PUN CK. OR Rise.No. PERMIT NO. EAREST CROSS ST. , OWNER RECEIVED BY DATE OF APPL. DATE.ISSUED MAIL - ADDRESS TEL. NI USE,ZOE NO. OF TYPE GROUP FIRE ZONE " , CITY NO. ARCHITECT OR - TEL. ZONING - DATED ENGINEER NO. APPROVED BY- BUILDINGORD.NO. ADDRESS SETBACK LINE: "`/- •� r TEL. APPROVED DATE CONTRACTOR NO. BY: HOUSE NUMBERING - ADDRESS LEGAL "/`? MAP NUMBER NO. ASSIGNED BY- DESCRIPTION LOT NO. 'r-J BLOCK DATE CORRECTIONS I INSPECTOR TRACT NO. OFBLDGS. v •`� ""� SIZE OF LOT �./ i NOW ON LOT _ -j Z USE "..T FAMILIES _ � f/ t' � _�� j[J �lJ�C1-O EXISTING BLDG. �� r DESCRIPTION OF WORK ( a i NEW ALTERATION ADDITION _ :�I G t.(� iy. si�'y !�! � A-/.ty x REPAIR �) DEMOLITION A SFT. / i:.:J NO. OF SIZE E ROOMS STORIES EXT. WALL ROOF COVERING I COVERING w MHAft Lj� USE OF STRUCTURE // _ —1- •, �mac^� r— m c•rr-�4 `� '''� ! � -__ �b �'�'�y Gr "�s /s � �r►t�, APPROVALS INSPECTOR'S SIGNATURE DATE FOUNDATION: LOCA ' FORMS, MATERIALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- , PLICATION AND STATE THAT THE INFORMATION GIVEN IS :RAMS: FIRE STOPS, CORRECT. BRACING, BOLTS _ 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION. _ GAS VENT, DUCTS SIGNATURE OF _ATH, INT. PERMITTEE ADDRESS _:ATH, EXT. L" ?LASTER, INT. AUTHORIZED AGT. — _-?LASTER, EXT. $ _ P. C.ffi FEE 4OUSE NUMBER COR- _ RECT AND POSTED VALUATION ffi C� FEE � � i=1NAL � 76A898A DBS 3 2-E8 DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES g l! i L D I N G WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING •--, tl DISTRICT NO. PLAN CK.NO. PERMIT NO. ADDRESS S,_` 'em LOCALITY R//E/_CC��EIVED BY /DATE Or APPL. / DATEISSUED NEAREST 17 1 CROSS ST. NG OWNER ADD EISS�Xl ..J 7 .01 MAIL ADDRESS LOCALITY TEL NEAREST CROSS ST. 4 �- CITY NO. FIRE I NO.OF I TYPE I /' GROUP ARCHITECT OR . ,:,,� ,..,� TEL. ZONE ---- - PLANS ENGINEER NO. BLDG. �.{ /��/ /el NO. ADDRESS SETBACK LINE �J .�/ �C.- APPROVED TEL. SY DATE CONTRACTOR � NO. USE APPROVED ADDRESS ZONE - BY DATE LEGAL CORRECTIONS DESCRIPTION .y /LOT NO. BLOCK TRACT `/ NO.OF BLDG9. SIZE OF LOT NOW ON LOT USE OF NO.OF NO.OF - EXISTING BLDG. FAMILIES ROOMS' ` DESCRIPTION OF WORK NEW ALTERATION ADDITION O A REPAIR MOVING DEMOLISH p SQ.FT. ,\ NO.OF O Z SIZE _ -- x CJ ROOF�" STORIES / WALL COV RING � A- COVERING USE OF NEW..' - BUILDING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THIS ABOVE IS CORRECTFOUNDATION: LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCESI FORMS, MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE OF BRACING,BOLTS OWNER oLATH,INT.: AUTHORIZED A LATH,EXT.: DBS-3 25M SETS 1-47 $ P O 6 PLASTER. INT. - d---l� FEE PLASTER, EXT. VALUATION FEE FINAL DEPARTMENT OF BUILDING AND SAFETY APPL CATION FOR PERMIT COUNTY OF LOS ANGELES BUILDING WM. J. FOX, CHIEF ENGINEER • " FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING DISTRICT NO. PLAN CK.NO. PERMIT NO. ADDRE59 LOCALITY RECEIVED BY DATE OF APPL. DATE ISSUED NEAREST .22- t_ 7 CROSS 9T. BUILDING OWNER ADDRESSMAIL ADDRESS LOCALITY J��•-'tC.... =�"�-'�`-"� Y� TEL NEAREST - CITYNO. CROSS ST. FIRE NO.OF TYPE GROUP ARCHITECT OR TEL. ZONE PLANS ENGINEER NO. BLDG. �D� p({D.1�0. ADDRESS SETBACK LINE TEL. APPROVED CONTRACTOR NO, BY DATE USE APPROVED ADDRESS ZONE / BY DATE LEAL DESCRIPTION I LOT NO. BLOCK CORRECTIONS TRACT r NO.OF SLOGS. SIZE OF LOT NOW_ON LOT USE OF NO.OF NO.OF EXISTING BLDG, I FAMILIES ROOMS DESCRIPTION OF WORK NEW ALTERATION ADDITION O REPAIR MOVING DEMOLISH AG7 Sq.FT. NO. OF Z SIZE ROOMS STORIES y WALL ROOF r COVERING COVERING USE OF NEW BUILDING -y"1 .X ,rr/ <" 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 STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, ^,�►/f SIGNATURE OF BRACING,BOLTS OWNER LATH, INT.: AUTHORIZED AST. LATH,EXT.: DSS-3 2SM SETS 1-47 $ P C s PLASTER.INT. FEE PLASTER, EXT. VALUATION FEE FINAL DIVISION OF BUILDING AND SAFETY BUILDING Department of County Engineer County of Los Angeles APPLICATION WM. J. FOX, COUNTY ENGINEER FOR APPLICANT TO FILL IN _ FOR OFFICE USE ONLY ADDRESS 'S (m a I v[/ h DISTRICT NO. PLAN K. OR Re No. PERMIT NO BUILDING CCJr I, v[r 7! /w 'IY\Jr/X�iUXr` Y LOCALITY_ T iam Ily,P c' 1 jrk✓ R EI Y DATE OF APPL. Dy11=168UED 011 rLEAREST � /`r"F ,/ 1. {-� .n 6 /+•- CRO09 ST. /. Fs //�� 1��[ �,� /� T ADDRESS �� IZ1414 4b OWNER -'iI/'G) 1 dF-E� ' .l tBUILDING Y �i 7-- MAIL LOCALITY . �- ADDRESS /' _�J M�� A NEAREST - CROSS ST. .-� CITY G / ��/ NO.TICL- } FIRE I NO.4F I I I' D,UP ARCHITECT OR f TEL_ ZONE I PLANE ENGINEER /��(. NO. _ BLDG. ADDRESS SETBACK LINE - X(�N/�y> UBE APPROVED CONTI&ift or� /1/ NO �/S 0110, ZONE,4- " I BY DATE y- c- - (,f ,y� HOUSE NUMBERING ADDRESS ! QC I e7 1y. —L /'(� MAP NUMBER NO. ASSIGNED BY LEGAL ��' 91% /y� CORRECTIONS /,d 4.-Ir, 7j DEBQRIPT►�O/t1��j.' LOT/�NO. ' ,yp� BLOC /"I �rrH�= �jFrS�1� +11b� J( 1113' TRACT .r/ !/I ANITA TA �.•�A U 6, ^ NO. OF BLOCS. SIZE OF LOT 4' I NOW Otb LOT _ USE OF NO. OF p EXISTING BLDG. Lq/ ��-�/ FpM1L1E8 ` DESCRIPTION OF WORK A NEW ALTERATION ADDITION Z D REPAIR DEMOLITION r OF BE). ZE T 735' RONO-OMS II� STDRIESEXT.WALL r COVERING 5/ L;C(-i I OOVERING USE OF STRUCTURE INSPECTION FOR APPROVALS OCCUPANCYAS INSPECTOR'S SIGNATURE DATE FOUNDATION: LOCATION FORM% MATERIALS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRE STOPS, 1 PLICATION AND STATE THAT THE INFORMATION GIVEN IS - CORRECT. BRACING, BOLTS I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE LAWS RE ULATING BU LDING CONSTRUCTIO GAS VENT, DUCTS BIGNATURE OF LATH, INT. PERMITTE _ • �j LATH, EXT. ADDRESS IY PLASTER, INT. AUTHORIZED AOT. _ PLASTER, EXT. $ P.CIII Q FEE' Fl,� , HOUSENUMBERCOR- (�/ HECT AND POSTEDVALUATION `�' ot J rEE FINAL �l �1 76A63SA DSS 3 1-52 1 BUILDING BUILDING 5 ADDRESS 42 APPLICATION LOOALITY DIVISION OF BUUMING AND SAFETY OROEB BT DOpwtment Of C(KMty EnenBer DIBTRIOT NO. REO[IPT MO. �[R I �D.,_ Ooun OS Los �r Cly WM. J. FOX, COUNTY CNBII'irKR p DATE RECEIVED DAT[ U[D OAltSATT D. GRIFFIN, Qup'r or ■uILDimm ,FOR APPLICANT TO FILL IN REDEIVED oY IiHUED■Y DW IN / V *' MAIL / Q / MAP O1 STATE ADDR[SB ! h , NUME[R v NWY Ug[ZONE "EDIAL TtX14- ! /t f/r DOHDITION■ ARDHITEOT OR TEL. ENGINEER NO. SUILDINB YARD HWY ET77EET NAM[ EXIBT. EETBACK WIDTH PR L T �. X /`, Lr BIDE OONTRAOTi]R ��t^'I�+,�• �'�iV r - ADr7araE �/ J ,a� � DAT[ OORR[OTION■ INiP[OTOR '', + f a <' LOT NO. � ULOCK TRAOT ]! .� NO.OFELDQQ� SIZE OF LOT �^ S NOW ON LDY I I DESCRIPTION OF WORK 5 NEW ADD ALTER REPAIR DEMOLISH E17. FT. NO. OF / HO.OF SIZE rT'DRIER FAMILIEI USE OF ETRUOTURE 4.Kmp No.of I HEREBY AO% EDBE THAT I HAVE READ THIS ^P- FLICATIDIN AND �'TA THAT THE INFO ATIOH BIVIN I■ APPROVALE INSP[OTOR'S RIGNATUR[ DAT[ OORR[OT. I GR[[ �'O O WIT U INANO[B FOUNDATIONI LOOATION AND ATL LA R LA I ITRUOTION. FORM MATERIALS FRAMEI FIR[BTOPS, EIBNATURE OF r SRAOING EOLTE PERMI FURNAOEI LOCATION, `I/]� BAE VENT DUOTE ADDRLMXL. .45 r f LATH INT. AUTHORIZED ADT LATH QCT. / �O( -FE [C•* HOUSE NUMBER -/L QQ R[ T AND POBTID [D VALUATION . FINAL FEE 7GA83MA DY 3 11-L7 , } r WORKB S' NSATK)N pECLARAWN .. .. `�� 4 1 herebt affirm+tbat I k�pye b c�rttficaT. af.corn�nt to aef# APPLICATION F-O-OR.'BUILD I t D�N G PER MIT . lrnupe or q cdrtfftcatra of W,orker�' Comp sctl0 Insumncf," - or a.certlfjed copy:Yhdteof (S&t` 3130% Lab• . .y._ . . ._ 0UUNff`6F-LOS-ANQ'ELES- s-. - BUILDING AND.SAAM,, �olicy No: ' Company-"' BUnDI ❑ . Cert' copy b hrrreby furri(sfied, FOR.APPLICANT-TO:FILL, IN ,woR>55' G,/p ❑ Carttffpdcopy*filed with ther.county bulldlnq Inlpec- BUIL9ING. 1101d � epaa#ment. ADDRESS' tee- Applloaat' .: YID. r%, I LfJG4bTY OF NEAREST, CERTIFICATE OF�AAPTION FR0,M WC0K]iRS' '' gay OF Lor -NOW ON LOT �Sf. TQ.. 9 Lf LQ COAAPENSAT10N INSURMC> .(This section need no be Corti lased If Hie perrTilt Is for one BLOCY LOT NO: AMP BOpy� - f.:<. - PAS PAS" . hundred'dollgnr:($100) br.'less.� . 7g USE MAP a OWNER' NO. .t certlfy.that In.thq pWonpante of the work fat which this perrnk Is Issued, kahall.�oT employ �ann"ir' ADDRESS S�-7Q . if L� • � so as to,bemm i�F�Iecj to t�W Com O „ C1TY- LP U :Date _ Appllcont, ARCHrECT.OR M-445-407 Ei 0 NOTICE TO-APPLICANT: If;,after makl fWt Certificate.of ENGINEER 'NO. D GROUP TYPE. BY p _ oON:57. ' lixemption,,'you should. besorr�..sublect to .The'.WdrViceri' r T� - -Compertiption�rovlslons,of'tha Labor you rpust.fortft A15DRf55 ^1 R �`► ' ' - with .ca.rrtiply with ,uch:proylrlo`n or"this permit shall be Ta STAT15TK1�L aASSIFKCAT" COtpp• deemed revoked. CONTRACTOR �/NO. - - - - z �lgNS#D CONTRACTQgs:�ARATION LIC CASl W. ' UNlTt ]hereby affirm that I am IIcerued under pr'ovlslons of4;bopw,9 UG SEWER MAP'- ng . . {CorrtimenclwltH Secf,lon 7000]of Dlvlslorr3 0#The BwJnew; CffY CLASS and profeulons Code and-my a is In full andsifecr _ PG. VA7IDAT10N ' _ �ry SQ: NO. OFtFAMUESNa. OF- O�CK Licbnse �u bet r• Tc .ClasT_ STOR16' ONE s =. VALIIAnoji Controcfor ON OF WORK NEYV 4 ; ❑I am exempt under Soa r __ � ❑ r ,;''._ AL ❑ B.BP,C. for thls reason �� rRfPA1R ❑ ; Date: y FOSTINC3�LbG' ' kPPL l CANT TEL Slpnatvre r=s, r . lye y. QWt�R-BUILDER bECLARATION DAT! Z thereby affir`ri that I am exempt from the Con iractors'Ucenae_ _ Lav✓for-the igIlowlnfl reasph'{Sedtlon 70�T: „Bilalness and ADDRESS 19NAL 4-< 1 Prafesslarb cads:. ❑' ovkrier of the'prppert ,.of m employee*'with BUILDING +may wopes as their tole Comperwatl0n;wiI[do the work cnd ADD - _ , 3X7 - the struct-yre Is not Intended r offered for sgl*-(Settlon LOCALTTI , i - 7044, Buslrte"'grtd Profewloni Code,) MOVItJG _ ' Tl1 1 Yom'- tJ0 d" 1. , , 0 I,'a's owner of the oroperty, a'm exclusively contracting TOTAL 60-50 with licensed controotor_a to constrict the pro ject•jSec- - tion 7044, 134nos qnd Frgfesslogs Cod4:) - ( (' lP,■5(I. YARD REQUIREDL- - KW AL. 00 Rl1(iMON.LE�40ING ACEN� -.Y _ I hereby affir7n-that.if�»r�e Is a consttuctlon 1endlnp agency for FRONT. the performari(�of•tf e-Work:'for wblch th{w dermilt Is Issued - P•C (Sec 30'47, Cly. C.•}- - - �.yyy��yyy.1 1�.y oa LOr+dpra Name' I�1RJ��LpAJ�!JLRJt i 11/2101/13a 1/2101/13 y - P.0 FM Permh Fee—,64.,-61- LDMA Ref.'f_ OTr77+ L' AM 10:40 Lendees Address , I certt4y that I have read this appllcdtloo and state that the. bauance / LDARA p-/C abov♦Informptlon•la correct.I ogrpe_to cpmpplywlth all Counfy . tnwsitgatbn ^> l ordl and State lawn+ rgkl irtq to budding construction, Total Fsra C/ t LDMA P&r and outhorize.reprownlatl of tht*County to.enter Y above m ntlonb Ipr r.lnspsi�tlon'purooseap.� 11tHUM FOR K)MANATO"LANGUAGE - - - Sip of"lamt or Agent' � . woRl�ts 'cOAnPf lSAnoN pECLaRAnoN ✓ �✓ APPLICATION FOR BUILDING PERMIT I herebk afflrm that I �Zk4 a cyrtlficate of consbnt to self � Insure,or a certificate of Workers' Comper>ratlon Insurance; or a ceytlfied copy theleof (Sec: 3800, Lab C.} . COUNTY OF LOS ANGELES BUILDING BUILDING AND SAFETY Policy No. Company ~ El Certified copy Is hereby furnished. PQR APPLICANT TO FILL IN ADDS 9517 Gidley Street ❑ Ceri fled copy Is filed with the county building Inspec- tion department. 9517 Gidley Street Hate Applicant dTY Temple City ZIP Temple Cit CA CERTIFICATE OF DMAAFTION FROM WORKERS' SIZE OF LOT T ST Q20S5 I NOW ON LOT NEARS S COMPENSATION INSURANCE Temple City B�yd, (This section need net be.cam leted if the permit Is for one TRACT 12�g8 .BLOCK LOT NO. 57 8592 - 002 PARa3 55 hundred dollars (j100)or-less. , BOOK PAGE I unci that In the NO. 115E ZONE MAP 2 certify performa'nce of the work for which this permit U Issued, I:hall not employ any Person In any manner ADDRESS 5304. G1ic Avenue r SPECIAL MONS CL so as to become subject to,the Workers Compensation.Laws � Temple City ZIP 917$0 O' Date) Applloont. Daryl Thomas ARCH rrECT OR TEL NOTICE TO APPLICANT:. If, after making this CertLficate of ENGINEER ICf GROUP TYPE F PROCESSED BY O Exemption, you should become subject to the Workers Oct CONST. ZONE . Compensation provisions of the Labor Code, you must forthDD - ADDRESS 314 a - ' with comply with such oylslons.or thi} mit shall be TEL• u) P Y Pr per STATISTICAL CLti551R(1�T10N APT CONDO Z deemed revoked. coNraa,croR REDI Construction uNco. 5 9�.70�0 aAss� �� UNITS LICENSED CONTRACTORS DECLARATION 1 hereby affirm that I am licensed under prcvisbns of Chapter 9 _ ADDRESS NO. 371644MAP L c� (commencing with Section. B SEWER Q0)of Dlvlslon3 of the Business 56 and PfofesiontCode,and-my license Is In fu)I force and effect. Cr South El Monte CA aASS B1 C10 + f� SQ, Fr. No. OF No. OF a-IECK License Number 371644 I'C, Class B11 10 + SIZE STORIES FA M1 LIES 0 OtE vA1uArioli TOTAL. . Contractor REDI: Cdnstructi� 3=16-89. . DESCRIPTION OF WORK NEW � 1[Lhi.`1r, fir. ❑ : 205,000.00 ► � ; ❑I am exempt under Sec _ . _ .LTJ { �\ ATTER- ED] this reason , FAIR ❑ $ norte:, . EXI oF- idl . EXISII NG BLDGResidential. Denaoi ❑ _ C�C`CI'-00.r4!1 �I�71 c�J SignatureJPRIINNT)Daryl Thomas r TEL 579-7050 Flwu 1960 1 M11:41 OWNER-BUILDER DECLARATION DATE �•2.� I hereby affirm that I am exempt from the Contractors License Low for the following rea*on (Settlors 7031.5, Bovines and ADDS FINAL professions Code): PRESENT BY El1, as owher of the property, cr my. employees with BUILDING wages a3theIr sole compensation,will do thework andthe structure Is not Intended or offered for tale(Sectibn LOCALITY 7044, Buslnes and Profemlons Code.) MOVING TEL 1 1 ❑ 1, a;owner of the property,-am exclusively contracting CONTRACTOR NO. RI with licensed contractors to construct the project (Sec- RESS AC�T.i tion 7044, Business and Professions Code.) FRQM7 1 . CONSTRUCTION LENDING AZ,7JCY. YARD I tWY. ll,tu I hereby affirm that there Is a construction lending agency for. FRONT 1 ITM . the performance of the-work for which this permit Is Issued, P.L d t (sec 3097, civ. C). Pi TOTAL �1`�y�r.�` Lenders Name �ECK 1 FZ251 - �y LDMA Ref. f w`� .'313 Lender's Address P.C__ Fee .>b Permit Fee • L17enL Vt1 I certify that-I have read tWls.application and'state that the Issuance Fee / . LDMA P/C f above Information Is correct.I agree To comply wlth'all County' Invesllgat%.. Fee _ �+ lrti� 1 11I OIU crdI and State laws relating to building conitructlon, Total Foe + J LDAM Parra. nd ere authorize representatives of this County to enter ,{, pan a _vo-mentloned o for Inspect[ purposes. 6 1 A111�41. f _ 1 . �'Zw SU RWMU POR E09ANATORY LANGUAGE Slgnatu ,of Ikant or Agent Date �COMPENSATIot�F DEC1ARAnONL/ w` ' herdt afflrrn (hat I have a �rt(f mp of floe Ir ,tonce, APPLICATION FOI" � ILDING PERMIT or a certlflcaTe of Work C�ompurtsatlon Iruurance, •-�, " c�Mfied copy rhiereof,{F, c. 3800, Lab. C) g COUNTI( OF LOS ANGELES BUILDING AND SAFETY Policy No. Com� ❑ Certtfied copy Is hereby furnished. FOR APPLICANT TO FILL IN IILDi Certtfled copy Is filed wtth the county building Inspec- BUILDING s tion department. 'DDRESS Dario 7--k- -.IX1 Applicant LC)ULrrY CERTIFICATE OF WORKERS' OF LOT NOW ON 1bT CRO55 5TH 4 COMPEIslSAWt.4 I w RANGE (This section need not be corn leted-if the permit Is for and, TMCTBLOOC L tyl,ePBOOK PAGEPARCEL \ hundred dollar ( 100}or lessig :; OWNER ZOt� : - • I certify that In the performonce of the work for which this - permit Is Issued, Ishall not gmploy arty person Irl any manner ADDRESS :U 1 �R� to as to become sufject to the Workers' Coo Ir11ztlon Laws jyff t Date—Appllcant- ARCHITECT OR TB_ OC NOTICE TO APPLICANT:-If,.ahs►r making thts.Certtflcate of EtJC31NEERMM jP TYPE RE BY 0 NO. ZONE Exemption,:you should become•.subjetl to the Workers' Compenaatlorr provlslons_of the Labor.Code, you mutt forth- ADDRESS i with comply with such.provislons•ot,,this.permit shall be TEL S7AT�T1�Qs�y ATIC)N APT. deemed revoked. NO _ LICENSID COt�FTRAGfC QECLARAT101F LIC_ C ( CLASS NO. UNITS j hereby affirm thdt I am Ilcenied under provlslons of 9Mbw LIC_ ')Ar µ� UC. s MAP (commencing with Sbcflon 7000)of pjvbion 3.of the B�uspl w L.N. and Professlons Code,and mylicerne Win full force and effect. �" Q �`� G'�r � PG. O }�. VAIIDATFO#1 I y� Sp. No. of/� No OF 'fes CHECKr L..FJ�?3L. 1�r 5l STORIES [i FAAgII6� ONE ` Lrcenab Ni)mtler; TLIL Ck a ' vALUAT10 i ACCT.T Contractor Dat g1- bESCRIPTI ON OF WORK rFw ;Z'L(�lb -a ]7 � ' ❑I am exam under Sec S �/ ADD" , ALTER El ITCI F7 BAP.C. for this reasonN ";�110 REP. ❑ ; TOTAL -255.. 63 USE OF e' E)USTING BLDG. DEMOL ❑ � .u:• SIgrwturo F APPLICANT t TEL FINS QWNER-BUILDER DECLARAnON J NO. •I� DATEI hereby affirm that 1 am exempt from the Contractors License y Law for'the following'reason.(Mian 7031.5, Business dhd ADDRESS MAL �Professibns Code): - tiDOD---"w1 2/23/510 + I, ds owner of'the�7 - Elemployees with AAp� 'AM 9:31 wages ds thblr sole illdotheworkand: the structure is not Ied for sale(Section QTY ,7044, Bolnesrande.) MOV1N G TEL 1 ❑ r, as owner.of property, am exclusively contracting CONTRACTOR hi0. with Ilse cQntrdctors to constryct the project (Sec- ADDRESS �j1{}+17 tlon 7044, -Buslrjess and Prdfoulons Code.) X17 EONSTRUChON LENDING-AGa4CY PUIRED YARD HwY 1 ITS I hereby affirm that there Ls a construction lending agency for the Performance of the work fir which this permit Is Issued P.L.: TOTAL 3 16 . 17 (Sec 3W, Ov. C. Sao,. P.L ` GFfG#4 315.17 Lender's Name �,ry L)MA W. i �a Inln+ .Jt� Lenders Addrsrs ' P.C_ Fee Permlt Fee _ o `�I urilfy that I have read this application and state that the I.nuan LDMkP/Ci �y-�-� nl ove Information is correct..l agree to comply with all County Investigation FTe U1.P.Jt1--L'r�1 �� 7/913.. o).lnances and.State laws relating to bullding,construction, Total Fw LDMA Perm. Oj :DA and hereby authorize'repre"ntativus of this County to enter upon the v'e-m tionod property for Inspectlon purporrea. fa RIfN=S&XW 07LANATOIrY ULNG lAg4 g Rant or Apeht .-:71' Clf3tg — r WORKERS' COMPENSATION DECLARATION insure, or afcertif certificate of Worke srlificate Compensation of cotnt o self APPLICATION FOR BUILDING PERMIT 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 9517 Gidley Street ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS idStreet CITY Zip LOCALITY Temple Cit CA Date Applicant NO. OF BLD S. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT t w NOW ON LOT CROSS ST. ( v COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT 12998 BLOCK LOT NO. 57 MAP BOOK $392 PAGE 00 PARCEL 55 hundred dollars ($100)or less.) TEL. OWNER NO. 579-7050USE ZONE MAP I certify that in the performance of the work for which this NO. P employ Y P Y 530�F Glicictn Avenue SPECIAL permit is issued, I shall not em to an person in an manner ADDRESS CONDITIONS so as to become subject to the Workers'Compensation Laws. >_ CITY Temple City ZIP 91780 a Date Applicant�l ThOMAIS ARCHITECT OR TEL. O NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER 8 " DISTRICT GROUP TYPE FIRE PROCESSED BY CONST. ZONE J Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS 314 t I st Avenue, Arcadia with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. > deemed revoked. CONTRACTOR FE)Z Construction: NO.579-7050 LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. ' DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 2411 Seman Avenue NO 4 O (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP CL CITY South E1 Norte CA CLASS B1C10 and Professions Code,and my license is in full force and effect. BK PG VALIDATION H SQ. FT. I NO. OF NO. OF CHECK License Number 371644 Lic. Class H-1 C10 ♦ SIZE 11248 ISTORIES 2 FAMILIES ONE � Z Constuacti 3-16-89 1. r7ti VALUATION Contractor DESCRIPTION OF WORK COILCr+2 �iIOC NEW LJ ��e ADD ❑ $ 205,000.00 ❑1 am exempt under Sec. industrial building-, poll.❑ B.&P.C. for this reason REPAIR ❑ $ Date: USE OF Residenti€Ll DEMOL ❑ EXISTING BLDG. - Signature APPLICANT TEL (PRINT)Daryl Thomas NO. 579-7050 FINAL OWNER-BUILDER DECLARATION DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS 2411 Seaman Avenue. So. El Mmte FINAL Professions Code): PRESENT By ❑ BUILDI I, as owner of the property, or my employees with NG 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. ❑ 1, 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 YARD HWY TOTAL SETBACK FROM ;WXl.D,'STTH . CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE 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 I 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 Investigation Fee 0 ordin sand Slate laws relating to building construction, Total Fee LDMA Perm. # agond ery authorize representatives of this County to enter °upo theiabove-mentioned arty for inspect'o purposes,�.y o +`�` � '�> SEE REVERSE FOR EXPLANATORY LANGUAGE '.3 Signatur of Applicant or Agent Dote WORKERS' COMPENSATION DECLARATION ent to sel insure, or a certif catte of Workers' CompensatioI have a certificate of n Insurance, APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING r, C ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING ,5) / i' Ir:1 tion department. ADDRESS 11 `�. ) 1 ZIP i T 4 r t� PST t CITY { l ti. LOCALITY LL i 1 Date Applicant /� X� NO. OF BLDGS. V CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT A NOW ON LOT , NEAREST CROSS ST. .. C..V+113 COMPENSATION INSURANCE -, f ASSESSOR (This section need not be completed if the permit is for one TRACT s } BLOCK I LOT NO. 57 MAP BOOK I PAGE PARCEL hundred dollars ($100)or less.) TEL. y OWNER : S ` NO. / i)`~}{ USE ZONE MAP NO. I certify that in the performance of the work for which this )t SPECIAL permit is issued, I shall not employ y person in any nner ADDRESS i{ (::? , ) !�} {1( CONDITIONS a so as to become subject to the Wo ets'Compens io 1"Laws. �y CITY Vr [ � )'i ZIP O Date`° _"i> Applicant -� �'y" ARCHITECT OR r TEL., LL 7 DISTRICT GROUP fPE FIRE PROCESSED BY J NOTICE TO APPLICANT: If, after makin6 this Certificate of ENGINEER V i NO. 3 NST ZONA Exemption, you should become subject to the Workers' .�. ,- r ADDRESS •- ` =! ' t 1a _,.. }, Compensation provisions of the Labor Code, you must forth- 0. with comply with such provisions or this permit shall be l,. r�.r, TEL. { STATISTICAL CLASSIFICATION APT. CONDO. deemed revoked. CONTRACTOR" l L 1hi a r _�,Ic".- a NO. LICENSED CONTRACTORS DECLARATION 1 '7 LIC. CLASS NO. DWELL. UNITS O I herebyaffirm that I am licensed under provisions of Chapter 9 ADDRESS r � "' ( 7 NO. ��(yD ¢a¢ P P /y �G (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP CITY � " )`f' �-��I`. � j , CLASS t VALIDATION ~ and Professions Code and my license is in full for and effect. BK. PG. SQ. F . NO. OF NO. OF CHECK License Nu, be rLic. Class SIZE ry ' STORIES FAMILIES ONE VALUATION DESCRIPTION OF WORK NEW ❑ Contractor i��..�3 Date _ $ ❑ "' ADD ❑ ,I am exempt under Sec. t _ ALTER ❑ B.&P.C. for this reason = f" f` 'C-- ` a ti 4r -r r� REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMOL Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) NO. 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 s. BY BUILDINGEl I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and LOCALITY , the structure is not intended or offered for sale(Section 7044, Business and Professions Code.) MOVING TEL. ❑ I, as owner of The property, am exclusively contracting rDDRE NO. with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code.) TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec. 3097, Civ. C.).Lender's Name9 Permit Fee ' LDMA Ref. # Lender's AddressPoo. , I certify that I have read this application and state that the Issuance Fee el LDMA P/C# tion Fee .q 8 above information is correct. I agree to comply with all County Investi g „ } R ordiraces and State laws relating to building construction, Total Fee LDMA Perm. # a and(hhereby authorize representativ of this County to enter upFe above- ntionM prop f�ffor inspection p rposes. f �1 C U" SEE REVERSE FOR EXPLANATORY LANGUAGE Signaturo of Applicant or Agent Date WORKERS' COMPENSATION DECLARATION hereby 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 ❑ Certified co is hereby furnished. FOR APPLICANT TO FILL IN BUILDING PY Y ADDRESS ❑x` Certified copy is filed with the county building inspec- BUILDINGADDRESS tion department. CITY r" ZIP 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 OWNERNO „'. USE ZONE MAP . I certify that in the performance of the work for which this INC. permit is issued, I shall not employ any person in any manner ADDRESS s...'-- i SPECIAL >_t CONDITIONS d so as to become subject to the Workers'Compensation Laws. ,. ,� O CITY ZIP # U Date Applicant ARCHITECT OR TEL. DISTRICT GROUP ITYPE FIRE PROCESSED BY LU NOTICE TO APPLICANT: If, after makingthis Certificate of ENGINEER NO. CONST -' ZONE Exemption, you should become subject to the Workers' E- LL, Compensation provisions of the Labor Code, you must forth- ADDRESS "t } with comply with such provisions or this permit shall be �?., TEL STATISTICAL CLASSIFICATION APT. CONpO.' deemed revoked. CONTRACTOR NO. LICENSED CONTRACTORS DECLARATIONLIC. CLASS NO. DWELL. UNITS a I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 'r NO. _ (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP and 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 Lic. Class SIZE I STORIES FAMILIES ONE VALUATION Contractor Date DESCRIPTION OF WORK NEW $ ► s ADD ❑` ElI am exempt under Sec. ALTER ❑ B.BP.C. for this reason REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMOL El Signature APPLICANT } NO. DATE TEL."` FINAL OWNER-BUILDER DECLARATION (PRINT) I hereby affirm that I am exempt from the Contractor's License Law for The following reason (Section 7031.5, Business and ADDRESS FINAL Professions Code): PRESENT By ❑ I, as owner of the property, or my"employees with BUILDING P P Y� 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. I, 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 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 the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). rInvestigotion Lender's Name f' f � „_� � 1 "Y LDMA Ref. # Permit Fee Lender's Address , I certify that I have read this application and state that theIssuance Fee LDMA P/C# above information is correct. I agree to comply with all County r 1.Rordinances and State laws relating to building construction, Total Fee 1 LDMA Perm. # a and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. a SEE REVERSE FOR EXPLANATORY LANGUAGE Signaturetf Applicant or Agent Date