HomeMy Public PortalAbout4856 GOLDEN WEST AVE_Building__ (2) 76%638ACZ 6
#8039- w APPLICATION FOR E3UILDff4G PER
` COUT-tTY OF LOS ANGELES BUILDING ge
DEPAOTMEIgT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION L O C A L I T Y
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS ST.
0I5TTJ14CT If. 1 GR P 1 TYPE PC S Y
FOR APPLICANT TO FILL IN CONST.
BUILDING _ / STATISTICAL ASSIFICATION SEWER MAP
ADDRESS , �j - A CLASS NO. DWELL UNITS . BKF PG 8v
LOT NO. '#'� f USE ZONE MAP Z
TRACT SPECIAL
yy NO. OF BLDGS. --CONDITIONS
SIZE OF LOT ,�y NOW ON LOT
USE OF
EXISTIN BLDG. 4z, gqC DLOG. SETBACK FROM .
/'l K.5, cA_ OATEL. FRON PROP. LINE OF )
OWNER 'rte NO. TYPE 0 EXISTING SETBACK HIGHWAY + D = TOTAL
HIGHWAY IDTH FROM C.L.
ADDRESS
CITY BLDG. SETBACK FROM
ARCHITECT OR TEL. SIDE PROP. LINE OF (STREET)
ENGINEER NO. -
TYPE OF EXISTING RACK HIO + YARD - TOTAL
HIGHWAY WIDTH FROM C,L.
ADDRESS O
,�,, // ,L �fv TEL. + V
CONTRA CTOR{O--C,�al 7�-" NO
LIC
ADDRESS NO CORNER CUTOFF YES 1:1NO E] O
H
CITY CLASS
SEE REVERSE SIDE FOR SPECIAL APPROVALS w
DESCRIPTION OF WORK r Z
NEW ADD ALTER REW IR DEMOLISH
SQ.FT. NO, OF NO. OF +l�l�,w a ..i'F ♦. Get ��
SIZE STORIES FAMILIES f •'
USE OF
STRUCTURE �,hr.
SIGNATURE OF
APPLICANT
VALUATION
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT.
FOUNDATION, LOCATION
FEE s, FEE$ l' �" FORMS, MATERIALS
FRAME, FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
9U ILDI NG CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR CODC OF THE STATE OF ALIFORN A RELAT-
ING TO WORKMEN'S COMPENSATION INSURANC LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERM ITTEE
OR-PERMITTEE RECT AND POSTED
ADDRESS , 'u FINAL -
JOHN F. LEWIS. PRINCIPAL STKUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O9��CASH
/J.-
6.(_
y/f APPLICATION FOR BUILDING PERMIT 1
APP�`ICANT TO FILL IN (Print or type only)
BUILDINGCOUNTY OF LOS ANGELES
ADDRESS •� rN�rCf' I�r'�- DEPARTMENT OF COUNTY ENGINEER
CITY c i ZIP 'j �b BUILDING AND SAFETY DIVISION
NO.OF BLDGS. ? BUILDING
SIZE OyyFgqLpOT[� bd+ ry- NOW ON LOT
� Lr.J ADDRESS
TRACT/■Q'TZll/ �"�xx=K LO�NgqO66�z LOCAL Y
OWNER �r F+4 C� NOL�c.00` J O CROSS ST
(�'y ASSESSOFT
ADDRES �7 V ad, CN W A''1� C- MAP BOOK PAGE CEL
CITY I'C Cf ZIP ylo DISTRICT I GROUP TYPE FIR P OC SSED BY
n j� CONST. ZO
ARCHITECT R TEL �L/CJ E
ENGINEER NO.
STATISTICAL CLASSIFICATION SEINER MAP
ADDRESS - CLASS NO DWELL.UNITS B PG
CONTRACTOR TEL.NO, ZONE MAP J
LIC. I`/JA^�`/ N O.
ADDRESS - NO. �, SPECIAL
LIC. CONDITIONS
CITY CLASS
ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑
CONSTRUCTION LENDER {
NAME AND BRANCH 4P+L! 13 a BL G.SETBACK FROM
F ONT PROP.LINE OF (STREET).
ADDRESS AAA CIA�JTY Af� _ TOTAL SETBACK FR_OM TYPE OF EXISTING R
SQ. FT. NO. OF NO. OF CHECK IGHWAY } YARD - FRONT PROP. LINE HIGHWAY WIDTH
SIZE STORIES FAMILIES ONE ��--..
DESCRIPTION OF WORK ( / NEW ❑ + W
Ort •r, NS' `� DD E:] SSIDEGPROP.LINEO (STREET)
ALTER 11 _ TOTAL SETS ROM TYPE OF EXI8TIN0
r L111'N cads HIGHWAY + YARD - SIDE PROP. LIN HIGHWAY WIDTH'
�.. / - .y c EPAIR❑
EXISUSE TING BLDG. Sf S JC-0"* ENOL ❑ +
APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑
62 ,
(PRINT) /o R� d N0. 77 ��//
BY (910 NATURE) IN OPEN SPACE YES ❑ NO ❑
r IN COASTAL ZONE YES ❑ NO ❑
VALUATION$ �V 01 a
CATEGORICAL SX fiMPTION YES❑ N ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL
AND STATS THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE)
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CIRTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (D ATy)
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LIBOR CODE OF THE STAT! OF CALIFORNIA IN RELATING TO _
WORKMEN'S CO MPE MIAT ON INS URA�NCCE.J
L `
SIGNATURE O
PERMITTEE
ADDRESS '&0614e
**rr)) 11� FINAL rr �7 BY
CITY C; NOL�D♦"CJa7,'0 DATEt v
HAKE CHECKS P: YA13LE "/'O: FEE � FEE
HARVEY T. EIRANOT, COUNTY ENGINEER 00
PLAN CHECK VALIDATION CK. M.O. CASH _ •PERMIT VALIDATIO CK. M.O. CASH
1 1f 3 5 7.73 SEP.2 6 1 D 4 10 1 A
70A630A CE#SOD 12/72
_i
�--"�- APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Print or type only)
BUILDING J' COUNTY OF LOS ANGELES
ADDRESS P .n c KJc�rS DEPARTMENT OF COUNTY ENGINEER
CITY ?'ecvoce C ZIP BUELDING AND SAFETY DIVLSION
NO.OF BLDGS. BUILDING
SIZE OF LOT NOW ON LOT ADDRESS 5� L_Iv_ C
TRACT BLOCK LOT NO. LOCALITY L Cr �� T
/' TEL. NEAREST
OWNER, y(�, / C (/ O. CROSS ST.
ASSES OR
ADDRESS d' L��/[1 (/« S MAP B OK PAGE PARCEL
DISTRICT GROUP IT YPE�� FIRE ED BY
CITY � L= C.. /T ZIP CONSZONE
ARCHITECT OR TEL
ENGINEER NO. STATISTICAL CLASSIFICATION
SEWER P
ADDRESS CLASS NO. R�WELL,UNITS B G
CONTRACTOR TEL, 4 77 ONE MAP
NO.LIC. / NO.
ADDRESS Iib NO �� 6� - SPECIAL
LIC. CONDITIONS
CITY CLASS
ROAD PARTMENT APPROVAL REQUIRED YES❑ NO ❑
CONSTRUCTION LENDER
NAME AND BRANCH BL .SETBACK FROM
FR NT PROP.LINE OF (STREET)
ADDRESS CITY
_ TOTAL SETBACK FROM TYPE OF TINGIXISQU
3Q. F NO. OF NO. OF CHECK HI WAY + YARD - FRONT PROP. LINE HIGHWAY WIDTH
SIZE STORIES FAMILIES ONE —
DESCRIPTION OF WORK NEW ❑ + `U
DD ❑ BLDG,S CK FROM (STREET) v�7
Alzr_ G�i�� SIDE PROP. Z
/ AIR[:]LTER HIGHWAY + YARD = TOTAL SETBACK FROM T OF F,(ISTING
Zz L e 71,2r,9 TV el_c. SIDE PROP. LINE HIO Y WIDTH
EP
USE OF EMOL ❑ +
EXISTING BLDG. ,s ^
AP'RINT)NT �/,y Car7! i1C.L �-J N01.; ,4s 74?J CORNER CUTOFF YES ❑ NO ❑
El(SIONA TORE) IN OPEN SPACE YES ❑ NO
IN COASTAL ZONE YES ❑ NO ❑
VALUATION$ 2(/ `� �/ CATEGORICAL EXEMPTION YES❑ NO ❑
I HEREBY ACKNOWLEDSE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL
AMD 3TATE THAT THE ABOVE ID CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE)
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIiFD IMPACT REPORT PROCESSED (DATE)
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LA SOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO
WORKMEN'S COMPENSATION INSURANCE.
SIGNATURE OF U
PERMITTEE _
ADDRESS UG
FINAL BY
/T
TEL ` DATE
CITY Limit!401-f LC [ NO.
.HAKE CHECKS PAYABLE TO: FEE FEE
HARVEY T. BRANDT, COUNTY ENGINEER ,.(.�yM�r.�
PLAN CHECK VALIDATION CAI- rr+L1MI VON CK. M.O. CASH
3 5 4 073 OCT 11. 2 3 D 1 4 .40•'1
5
7SA6SBA CEGS03 ,2�Tz 1 gr--JUN 14 1 U 2 4.0 0
�`-
z
BUILDING BUILDING
DREHS CJ P
_ APPLICATION A-14CAL.,
fllDIVISION OF BUILDING AND SA Y NEAREST O
CROSS ST.
RECEIPT NO. PERMIT NO
DISTRICT NO.
Department of County Engineer ,.,. , / 4
County of Los A mgeles a: ` `- ` �, 6 92
WM. J. FOX, COUNTY ENGINEEROR P DATE RECEIVED DATEISSUED
CASSATT D. GRIFFIN, SUPT Or BUILDING /f
acv %/r
FOR APPLICANT TO FILL IN TYPE CO T. RECEIVED BY 1 ISSUED BY
OWNER
MAIL (( MAP � STATE YES NO
ADDRESSIM uJF.S I NUMBER HWY
USE ZONE SP A
CITY Pte c Nn T"'�'ci� (� � 1 ON9
ARCHITECT-0 R `� TEL. /
ENGINEER ., J'L, F NO.
BUILDING YARD HWY STR AME EX19T.
SETBACK WIDTH
ADDRESS FRONT
CONTRACTOR .Fe t (= NO.. SIDE
ADDRESS
BUILDING '4'e� P DATE CORRECTIONS INSPECTOR
ADDRESS /� l*f W 3 00 ,o f 14 BLOCK) HOLDFOR INDUSTMAL WASTE LEARaRIM
LOT NO.(�t'(eA/� �y/�' Q
TRACT /�'./1 . q- 2 -91 "?JJ��
NO. OF
91ZE OF LBLDG
OT
IBJ I NOW ON LOTS
Ili
USE OF -
FXIgiTING BLDG.
DESCRIPTION OF WORK °
a
0
NEW X ADD ALTER REPAIR DEMOLISH Z
Sq. FT. NO. OF NO.OF D
SIZE eq `7' O STORIES FAMILIES r
USE OF STRUCTURE
NO.OF
EMPLOYEES
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN 19 APPROVALS INSPECTOR'S SIGNATURE DATE
CORRECT.
1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS -.t'Cl h —.,,.!-
FRAME: FIRE STOPS, S r.
SIGNATURE OF _ BRACING,BOLTS
PERMITTE URNACE: LOCATION,
GAS VENT,DUCTS
ADDRESS
LATH, INT.
AUTHORIZED AOT. —�—
LATH, EXT.
�. U,l F HOUSE OUSE NUMBER COR-
FEE 7�� RECT AND POSTED
VALUATION
FEE FINAL 71171
76A638A DBS 3 (9b 5-54
DEPARTMENT ENc,INEER / BUILDING
'- •�1SION OF BUILDING
AND SAFETY
COUNTY OF LOS ANGELES l�
WILLIAM J. FOX. COUNTY ENGINEER APPLICATION/ APPLICATION
CASSATT D. GRIFFIN, SUP'T OF BUILDING
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PLAN CK.OR REc.No. PERMIT NO.
BUILDING
ADDRESS �!''` 1C. -tt % ..G- C Cj
�
LOCALITY REC D BY =AP�� DATE. ISSUED
'��NEAREST
CROSS ST. - -
BUILDING
ADDRESS
OW ER
MAILf7 t I LOCALITY
�4 A,
'a ADDRESS NEAREST
.J, CITY TEL- - CROSS ST.., _ y � f
FIRE NO. OF t ZONE P ANS Z TYPE GROUP
-�� ARCHITECT OR TEL.
ENGINEER NO.
ADDRESS BLDG. /"- / OR /
L.A S ET B A K LINE C+-
y CONTRACTOR NQ, �'!T�~��+ ZONE AUSE PPROVED ,A . DAT r J
t HOUSE NUMBERING
�. ADDRESS /
i MAP NUMBER—;90 �%
LEGAL � / NO. ASSIGNED BY
DESCRIPTION I LOT NO.T" +�I BI OCK
db CORRECTIONS
7 TRACT L e�1'��s I 1/! /�CJ /<.✓ �ViOir�{�i 1 c7 7
NO. OF BLDGS. v,
SIZE OF LOT I NOW ON LOT /... f. F7 •'" R'�' ;�„, ""�'/ /,.
USE OF NO. OF
EXISTING BLDG. I FAMILIES O Y
DESCRIPTION OF WORK O -
REPAIR ALTERATION ADDITION IR I I DEMOLITION I r p -7- r ��"""'- Z
Y' D
_ _ r
SQ. FT. NO. OF / - '� '1'� J_ `
SIZE ROOMS STORIES
EXT. WALL I ROOF
COVERING COVERING `
USE OF STRUCTURE
Wes
,4,oQA0 i T7 p d%%t T c1 . /
APPROVALS
INSPECTOR'S SIGNATURE DATE
i FOUNDATION: LOCATION
FORMS, MATERIALS �-
I HEREBY ACKNOWL DGE THAT I HAVE READ THIS AP- FRAME: FIRESTOPS. yy.
PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS
CORRECT. FURNACE: LOCATION,
I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES GAS VENTDUCTS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. , ,
LATH, INT.
SIGNATURE OFa .��j :
PERMITTEE_ I '� ' .o.,.'
as ^.� LATH. EXT. J
ADDRESS t'I ,-/� _ .: �
PASTER, INT.
AUTHORIZED AGT.
//r PLASTER. EXT.
S d FEE $//0 RECT AND POSTED
HOUSE NUMBER COR-
VALUATION 00 FEE $ FINAL 1,1//7/}
76A6Z8A DBS 9 9-62
1
nTV38It7WOF BUILDING AND SAFETY � ' � '
s;r Drtmert of County Engineer ((..�
County of Los Angeles �� 1"'/J � APPLICATIONJ. FOX, COUNTY ENGINEER
R APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PLAN CK. OR REC.No. PERMIT NO.
BUILDING
ADDRESS3 .a�
RECEIVE B DAT OFAPPL. DATE ISSUED
LOCALITY �,.} ! C
NEAREST J ^ J �7
1)4
CRO68 8T. 1' BUILDING rj / N (—c `o G j ' , as
AQDRES9 CJ 5 C� `,7 �. �N �
OWNER
MAIL _ LOCALITY TEM PL.C L
ADDRESS N.EAREBT �+
_ CROSS ST. L L W C 0 C �. G
CITY J Nd � A FIRE NO. OF TYPE.M GROUP
-�-
ARCHITECT OR ��( - TEL. ZONE PLANS
ENGINEER D, /Y1 b�•jdC�(i NO. BLDG LINE -L C� I G ORD. NO.
SETB�ADDRESS USE - APPROVED 7 {/ (t
d W it y `ATJ. G �� ZONE BY p DATd/1/ S
CONTRACTOR tj� 1 HOUSE NUMBERING
ADDRESS A. y' GIh� �'�''., �i MAP NUMBER '� _�'� NO. ASSIGNED BY
LEGAL . PA CCT h1 CORRECTIONS i
_DESCRIPTION LOT NO. 2q�`-r- gSM�K
TRACT r�\ 4�- 1 l �CPf 7
NO. OF SLDGS.
SIZE OF LOT (00 X 3 O U NOW ON LOT _.
USEOF IOW; 1"(p, CPU , NO. 1`/�rb)
EXISTING BLDG. t;J, A,G F_ FAMILOICS
DESCRIPTION OF WORK c�°_�
A
NEW ALTERATION ADDITION - Z
>
REPAIR DEMOLITION r�Z _�
Bq.FT. NO.OF
SIZE ROOMS STORIES !♦
EXT.WALLRDOF
COVERING QOVERING
USE OF STRUCTURE
C
INSPECTION FOR APPROVALS
OCCUPANCYAS INSPECTOR'S SIGNATURE DATE
FOUNDATION: LOCATION
FORMS, MATERIALS 'c.. ,Q y� .� - /`•3
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP-
PL ICATION
P-PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRE STOPS,
CORRECT. BRACING, BOLTS
I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION,
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. OAS VENT, DUCTS
SIGNATURE OF .. 4 f'n LATH, INT.
PERMITTEE ��/
ADDRESg � 6 Q �"1 , _ LATH. EXT.
`r
PLASTER, INT.
AUTHORIZED AOT.
PLASTER, EXT.
FEE S HOUSE NUMBER COR-
RECT AND POSTED
VALUATION sFEE S FINAL
76A636A DBS 3 1-52
-').A&XltACXifpftI1-i7 APPLICATION POR BUILDING PER IT .
COUNTY OF LOS ANGELES ou1LDINd
DEPAflTY= OP ENGMM ADDRHBH
ld -C
BUHMING AND SAmy DrvimON LOCALITY
JOHN A.LAMBIE,CouNTY ENaiNxxR NEAREST
CASaATTD.GRIFFIN Sur[ OF tuILDIms B
D1STR1 NO. plo AP
n,Pg SRWER M ' ;
FOR.APPLICANT .TO FILL ]X ' BK PO .
BUILDINd
ADDRSTATIMCAL CLA"JIVICATION
EGB
LOT NO. /v 7 O , bILOCK CLJ4.9�.NO `a Y
FW
9 N MDER
TACT — _` UWE NE 8 H AL
O.OF 13LDd�8. CONDIT40NJS -
SIZE OF LOT �NOW ON LOT
-
D
BTBACK ETBA H
6 YARD WY GTR NAWIT -
WI -
OWN ER PF20 t�T
MA I L. P.L'
ADDRESS BIDO
Tri P.I-
A RCH TJ'HCT TEL
ON Bl=RD
ENOIN NO.
-
CONTRACfiOR. NO
DESCEWTIOtf OF WORK
NEW' ADD ALTEPf REPAIR DEMO IHH
8Q.F . NO.OF NO.OF
HIZlf STORIES FA11tIL1ES
UB3mor imu RE
r
SIGNATURE OF APPROVALS
APPU C ANT
DAYR IBDPE R'IZIGMATURE
ADDRESSFOUNDATION: LocATIOk
FORMS,MATERIAL6
S. P.C:. S FRAMEI FIRMSTOPS,.
y.��y� F73i DkACINd BOLT19
AL1JA'TiON /.�/vT/ i g6PCI rumI rm 40CATIONr
CSN A� GAB VENT DUCTS,
PLICATION ANHEIRILBY D UTATETHLTEHDAdTHTHE ABOVE 19 CQR RECTI AND LATH INT.
ZUR TQ COMPLY WITH ALL If
�fOUNTY OFFn�DNAA
NCE& ND
STATK LAWS REGULATING DUILDING CO NaTRUCTION_ LATH EXT:
SIGNATURE OF HOU15N NUMB Ft
'.PiRM RECTAND PO J
AD /
CLYDE N. DIRLAM PRINCIPAL STR RAL�N
PW� - Da, = ..oc r+.a .cwsa FSHI¢; cK. ri.o.
98 14Y 1 it FLS 3R :m;
{
78A69"aK/0o2_&-U7 APPLICATION FOR BUILDING PERMIT Z
COUNTY OF IAS ANGELES BUILDING �xT
DEPARTMENT OF COUNTY ENGINEER ADDRESS !J d
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A.LAMBIE,COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN SUPT OF ISUILDINa
DISTRICT NO. G EWER MAP
NT
FOR APPLICATO FILL IN TYPE CONST. BK PIGBUILDING
ADDREBH _ STATISTICAL IFICATION
LOT NO. / ELOCK CLASS NO UNI
MAPSTATE O
71 ACT ^�� / NUMBER /d L }iWY.
YEA`Y' E ZONE SPECIAL
NO.OF BLDGS _ CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF 'o 0
IHTINQ QLIDQ, CA,LC�Y'�� BUILDING YARD STREET NAME EXIST.
SETBACK WIDTH
OWNER FRONT
MAIL P.L'
ADDRESS HIDE
ry " INSPECTION RECORD
ARCHITECT OlF crTBL
ENGINEER NO. -
AIDDREZ6
TEL.
CONTRACTOR NO.
ADDRESS
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLIHH
SQ.FT. NO.OF
SIZE STORIES FAMILIES
USE OF STRUCTURE
SIGNATURE OF APPROVALS
APP LI CAM
DATE INSPECTOR'S SIGNATURE
ADDRESS FOUNDATION, LOCATION
FORMS,MATERIALS
/ O P•C ; FRAME: FIRE STOPS.
FEE BRACING,BOLTS
VALUATION FURNACE: LOCA ION,
E VLATH
ENT,DUCTS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- NTPLICATION AND STATE THAT THE ABOVE IS CORRECT ANDAGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING BUILDING CONSTRUCTION. EXT.
SIGNATURE OF NUMBER COR-
PERM1 AND POSTED
ADD R ^` FINAL
JOHN A. LA B C uNTY ENGIN CLYDE N.-DIRLAM Pg]NCfPAL STRU
PIAN CHBCL VdLMLTION Cx, u.o. CASH PEHKIT VA M&nONcx r o. EARN
a0141D, M22 2 1 A
APPLICATION, FOR BUILDING PERMIT Z
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY -
JOW4 A.LAMBIE,COUNTY ENGINSaR NEAREST
�D.GRI"IN,SUPT
FOR
APPLICANT TOoFILL IN DISTRICT No. I GRp4P . ypil OvAhRx L
,(/ CO
BUILDIN
STATISTICAL CLASSIFICATION
ADCSREHH 2
LOT NO. FLOCK CLAS NO UNIT
MAP 6TATA
TRACT Z 9 NUMBER HWY.. Yl<8 NO m
USE Z N6 SPECIAL
NO.OF BLDGIL CONDITIONS
SIZE OF LdT NOW ON LOT O d
USE OF
B BUILDINQ EXIST.
_ SETBACK YARD HWY STREET NAME WIDTH
W
ONS FRONT /
MAIL L' D 3
ADDRESS BIDS _ -
TEP.L
CI
ARCHITECT OR INSP=ON BECOBD
TE
ENGINEER N
D / e
L `'^
CONTRACTOR
ADDRESS -
DFSCMnON OF WORK
NEW ADD ALTER REPAIR DEMOLISH
SQ.F . NO.OF� 3N v sA PLO)
SIZ
STORIES FAMILIES
USE OF 51UCTURS -
SIGNATURE O APPROVALS
APPLICANT
^ DATE INSPECTOR'S SIGNATUQE
ADDRESS FOUNDATION: LOCATION
S� IF FORMS,MATERIALS
�� P•G � � FRAME: FIRE STOPS,
m FSE BRACING,BOLTS
ad FURNACEi LOCATION.
GAH VENT DUCTS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ 7•HIS AP- LATH INT
PLICATION AND STATE THAT THE ABOVE IS CORRECT'-AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGU Na BUILDING CQNSTRUCTION. LATH EXT.
SIGNATURE OF HOUSE NUMBER COR-
RECTANDPOSTED
PEAY1
ADDR FINAL
JOHN A. LAMBIE,COUNTY ENGINEER CLYDE N.STREAM PRINCIPAL LiiRUCTURAL ENaI
PL&N CHECL VALW AMOX CIC hLO. PER)QT VALTATIOf CX iL0.
UL056'?-3R' m&r 516. A 19.251
_. — rff .1 3 9 519 WAYS 1 A
Lriw
�
_ _ 3 . O �.
i
APPLICATION FOR BUILDING- PERMIT
COUNTY IDF COS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FQA FELL IN Q ADDRESS
I hereby efflrm thbt I Have a certificate d consent to sed insure, V
or a certiftcate Of V%brkera`Compersallon Inourance,of a oertffled16?3 v
copy (3-3800,Lab,C.) CITY Z>P Ten
LOCALITY
��No ry �OF NO.OF BLDGS.NOW ON LOT
Q Certdied cbpY b hN-eby fumistvxi NEAREST CFIOS9 ST.
I
❑ Certffbd copy Is filed with the oomity bui~f9rg kspedlon TRAGI BLOCK LOT NO.
USE ZONE MAP NQ
D01B. APPIICant ASSESSOR AMP BOOK P1�OE HWCEL .
SPECIAL CONQfTIONS
CERTIFrATE OF EXEMPTION FROM WORKERS' OWNER TB_Na
COMPENSATION INSURANCE f:,,r+' S*,,414xr,1,, fk WITW 1000 FT.OF SD-rop.? YES \ 4
M is secdion need not be corrpieted d,the permit Is dr
for one huned
dollars(S-100)or bas.)
S V OU
DISTRICT ORP TYPE CONST. FW ZG E PROCES§Em gY
'
crrY
.. �
I certify that In the periormanoe of the work for which this perrnft p
b based, I Singh not empioy arty Person ki any manner so as ib M46
OR EldOflEER TEL No. DO
t»Oanct b e aib}ethe Vlbricere'Campensetion Laws. S TtSTICI,L CLk9sm1 rK*r APT CONDO
Date Appi{cent ADDRESS DA43 NQ �_ DwEu L*rm
NOTICE TO. APPL0WT.• d, atter rnakkhg this Certificate of FEOUFED TOTAL SETBACK FF" MST
Exemption, you should become aMw-t to the Vtbrkers' CONTRACTOR TEL NO. SET BACK W RD HWY PROP LFE Y1
Gampersefloo provisions of•tie Labor Code, you moat (orthwdh
OOn#y with Such provisions or this permit al of be deemed revoked ADDRESS LIC,NO. FRONT
PL r
LICENSED CONTRACTORS DECLARATIONCrry Lr-CLASS � OU
m
I hereby affirm that I am kerbed underprovWons of Chapter 9
(con arcing with Section 7000)of DMalon 3 of the&twines and SQ FT.'SLM NO.OF STORES NO. Fµ0.E8 R MAP
PrOODSelone Code,and my license b hfuI force and effect. NEW ❑ BK PG O
Lloenee Number Lip.Clews DESORPTION OF yr017tc ADD ❑ W"ft" U
Contractor Date
w� ALTER `X OOO , a
Cn
El am exwo.under Sec. REPAIR ❑ Z
BAP,a for fhb meson DEMOL ❑ LDAM P/C+
s e: URM ❑ y3
APPUCANT(PFNVT) TEL NO. UDMA Pwm• 2 .
014 as owrsr of the Property, or rW with wApes as ACCT.i
their sob corrpeninabor, wd1 do the the sticture is ADDRESS r f}
not Intended or Offersd for Sale (Section 7044, Buelness and FKAL DAM 33W 50.50
PROfeeelas Code.) - ~. Y&L THr APPLrAw OR FUTURE BULDpO OCCUPANT HA?4 LE A HAZARDOUS WKr ML IZ— 1 .
❑ 1, 9! Owner Of the property, am exdltaMeiy COntY9(,'tinp with ah A LVOIXE CONIW000 A HA ARDOUS 1146nML EOUAL To OR GREATER THANTFE
Iloeneed �aciorS to construct the PrOW (Section 70-44, ❑ ❑ALMXKM off THE HAZARDOUS uaETaue owE� Ft1Ar BY �CT.,r
Bumineae and Profasel rm Code.) 3 165..S9
MP=LL THE ! IBE OF THE F .a L 1 wBY THE APPLICANT OR PUTUE Bl vara
CONSTRUCTKNI LENDINCI AGENCY
coAaT ouALrrr"WF�$�T roF, 1ieCJ�oRo' , aSErrTfNpa ECKimT OR LIOWC�MOU THE�R" ? ITEMS
a.,A.Fa.
I hereby atflm tilt two Is a 6Dnsbi)g#bn {ending agency for ,a❑ ,o❑ T►]T '? 1
tine 7,Civ.canoe a tits work for which this permft b bAw�(ago i rove FOW THE FIAZAFCOUB IA4HiALa MKIVAUION GLIDE Aro THE actino PEFU TTMl /��•�i:
3097,Civ.C) ;,.' AN(19 ED CHECK LI.Fi 1` ,9
' TmF rCl-l�arET7e[cT�ioHBTDTHROI �140 CD ?f+a FiAZArOOL - r'
LOS
Lerlderf Name MATFAAL3 rEPORTFJO AND POR O01YNM A PS tT FROM THE eC.AQW. I i_L/LYSE .fY5
LRS
Lender's Addreser' -' L�'tl
cmw cm Aqua
I car ify that.I have reed this application and aWa •Pensdy
��, �b�elating to PC,FREE NA�dlng0 S FST FSE 3 p 040-(0�i v31I96
hereby auftrize repreaentabyasf«
21-1 . 30 4619 1 PML:16
so
f �9 fNE9TK3ATpN FEF T01)1L FEE '
SEIr REVERSE FOR EXPLANATORY LANGUAGE
• A
Tl _
APPLICATION FOR BUILDING PERM-IT
COUNTY OF LOS ANGELES ., BUILDING AND SAFETY
,WORKER'S COMPENSATION DECLARATION
FOR APPUCANf TO FILL IN 1
I heretry afftm tf>et I has a owttf<cate of connect to eeff kraure GO 1d e n WPB vt;
or.a cefttfioatie of M kers; Corrpecsatl n h9urance, ora owtffled
copy t-09f( 3 �,Iib. ale i /�' o
t
Pollcy Cor„per,y SIM OF LOT OF B1DOq MON,ON LOT
certtfied coPY-h r>areby r d• NEARF-ST CROSS ST.
`a BLOCX 4a 44
Certified copy Is filed with the county bullmnG LOT
r USE IlDr� MAP NO:
r l nPPI IDELOASSE-1,1OR MAP BOCK PAGE
CbfAfIIQNS
CERTIFICATE OF EXEMPTION FROM(WORKERS' TEL
COMPENSATION INSURANCE �pq�g D IJ ;3 Wn-W 1000 FT,OF scl DDS? YES No
{Thfe eec#bn Reed nd be completed ff the permit Is for one hundred /7 q A DISTRCT GROUP TYPE FRE IlDNE PROCE38-ED BY
dodam (5100)or leas.) y
ZIP
certify.tiled In the parforT vp-pce of tt)e work for whklh.tfilb pefmft C,3 �Y /1,Ad 3
Is Issued, I shall not employ arry person In arty manner ao ea to ` VV- 346-3
]J� .O
become eub,ed tO the Vkrkers`Corrlpen8ati0n Law& - y/� _ 3 46-3 gVT07��1-C�L/N�rS�SS$�6�/C-1q APT CONDO
Date Appiloant p �n ! NO. �e_� DWELL U T�---
N OTCE TO APPLr-ANT.. ff, after making this Certfficate Of l [„60� rip �� q � w i•�,C• r ouRED -TOW SE'TBAC<FROM E)6ST_
FxirvHon, you etmId become subject to the Works ' /
MO. 3Ef.6,,CK H1MY
Cornpenaattoc provlelone of the Labor Code, you must kcff wtth G � rFK N7
oompty with such provisions or this permit shall be deemed revoked. Q �,� J O P L 1 ITEt
81DLICENSED CONTRACTORS DIrCLARAT 0IN 1 S P L TO 18—
I hereby aftlrm that I am Ihoerned urderprovblone of Chapter 9 SEWER MAP 1
(cm mw-,c;b wfth Seotipn 70GO)of DMelon 3 of the RArrese,arid SQ FT.S= NO.CF STORMS NO,OF FAWLIES ` J
Profeeaione Code, 6cerme b In full force effect NEW BK F(3
COWLJcerree Lb Clew
c«rtrec6pr ❑ , y OF vocco< ADD �� -� i h/ ;•9�7QV
❑ I am exeunder Seo REPAIR ❑
mpt DEMOL ❑ $ t]79 1. 7.%51
B.&P.C.for this reason tDNA P/C+ i
Dete: LR9E OF 13LD(3 VRM ❑ 1 Com!
Signature APPLICANT(PFNVT) - T4 NO. UMA PernLt _ _ y ZL_
❑ I,.ae owner of the property, or my employees with wapee z
�FMCCT.T
their dole cornpeneation, wtll do the work and the etruohue Is ADCRESS Fa�aL DAM
Q. 1r rtw 26 '8CI
not Intended or offered for.sale (Section 7044, Business and - d 1 ITEMS
ProfeekSone Code.) %C f tJYUFE oOR FUlDM ocU"Nr RMCCE A RAZAFornis Mae�AL i�
OR A wcruFEA FVZAJ1o006 wjMzWL eau.-l- OR GFFAER THAN
Elf as owner d the property, em e�aduatvety camactirq with A#IDUFhe oN n E FVZAFCCUS VATfft12 Dior+ogoE� T��Ttas 267-80
0
ken,eed oontwturh to mrtruct the•proyxA 1Seckn 7044, ❑ No❑ r� 267.EO
Buidpeas and Protesalone Code.) 4HECY ( }
wLL T1E M@O® uw DF TFE a mxm.eY Tl E AF4uI of Rfniw afLDm. .8.
OCCU*M FC-QLWE A PE�,�� FOR COrgT'Rk'TIOM OR MooAc vun FFCU TT}}EE eOUTH
CONSTRUCTION LENDING AGENCY COAST Ail OUALr1Y rAv DtaT9L`n(s<111 )eeF FffFfTTNO a Ec+0.rsT Fel � '
ra44�'F"Fa
I I-x r affirm that &we Is a aonatLcthn lerdlrq agency for YEs❑ No❑ _
a the performance of the work for which th}e re laaued(Seo MWE n-EOCAC&C
m 3087,Civ.C.) ACHE �r i�MY xo7u2rCL�rr UM)M TI-E os,waM es �MJV t�'1+f+�1 9��/9 S
Lender8 Name LL.-TEP Le RREPORT 2-20
.PT OR o6�sra�io A PERLU FFF"�-n-E�CADW. FN2IFDOUB
1�? 1 Ali 7:51
I_amWs Address C�mmw�
I owffy that 11-;m read t%-appllcabon and state uh6w paratty �� PEl7MT
'T) U perjury that thabove in
e formation re oorrpct.I agree to cony P.G FEE
with ell county ordiwom and State lawsrelating to bu6ding
const ix:ri , and hereby authortre reprssentativee of this County ISSl1A1J(E E�+
to upon ttp property for I L.J
INIO
NESTKiATN FEE 0
SEE REVERSE FOR EXPLANATORY LANGUAGE
WORKERS' COMPENrATION DECLARATION
Va°��° I. � '` e a �'f'��* ti �° �ff APPLICATION FORBUILk.DING PERMIT
uro, or a cerHflcate of Worker' Compensation Insurance,
certified copy theroof,(Sec'.3800,'Lpb. I. _ COUNTY OF LOS ANGELES - BUILDING ANb SAkTY,
. Policy No. -Compdny
BUX:DNO- l
El. Cefttfied copy I, hereby furtilihed. FOR APPLICANT t0 FILL IN ADDS J
❑ "Certified copy Is filed Y46the county building Inspec. BUILDING rr ((����
tlon department. ADDRESSJ �e� ""�'s
Date Applicant d7Y lam q[C 'C.l� ZIP ?1 7SO LAIN
CERTIFICATE QF DMPTIOCmWkREST
(EN FROM WORIS' SIZE OF LOT¢Roy / *NOW ON L T CROSS SATST. LVW�Rt A R 170L0� W
COKAPBJION INSURANCE' r ASSESS(
(Thls'sedion need not be com 19* if'-the permlt,as for one TStACTAEW BCOOC LOT NO., 2 AISSMAP SORBOOPAGE FARM
hundred dollars (;.}00)or lea ��/b (1� (�
cwNER. OTO ., Sa BAP, NO. -/32,6 LIS�ZOt'E I MAP J44r (1
• I ceftffy that Inthe perfoimance of the work for which ffil `/ / �l
permit Is Issued, I shall'not employ a n Ina a ADDRESS 4VI5 /1; -6940�IV '1V,�ST �n _/ SPECIAL
.
OT
so as to become subject to.the W ri O'-'•
CITY T Y� : Cir ZIP- �� .a... .' " .
Date' Applltant ARC}1f�ECT()♦2 Ta. 0
NOTICE TO APPLICANT: If, after kin this-Certificate of EtJC31NE$Z NO. - Q D CL P �TYPE FIRE. PROCESSED BY
COMM ZONE
Exemption, you should become sub Led� toa the Workers' t�//1�w I �1 ivy 2
Compensation pravl�Io of the Labor Code,.you must.forth- ADDRESS *:Wf K QDI AR EF �•//XML
with comply with sucks provisions pr this permit-shall be STATTSTK.�1 C1r.55lRCJ�TION APT. OO1D0
d6ekmad revoked. CONTRACTOR NO. Z
LICENSED CONTRAItiTORS•DECLARATION CLASS uNITST_
I hereby affirm that[am licensed under provlslor1safC�iter9. ADDRESS
SEWER MAP
(commencing with Section 000)of Division 3 of the.Business � �, ❑.FESS
and professions Code,and my license IsJnfull.forceand effect. gK.' PG.
VALDATION
Sp: FT 'OF. / NO.OF. (]IEC]C'
License Number Llc Cass SIZE O STORIES / FAANUES O oNE
- VALUATION
r DESCR1PilON OF WORK NEW ❑
' ,Conhncfor Doti '
❑I am exempt under Sec S/ORRGE SN06D
ADD ;
AL
►- -
$:&P.G for This reason' - } iyl -
REPAIR 4-
D05TING`t3L�C3: DEMOL ❑
Signature NH2 9UILD92 DE(lARATJbfJ APPUC.�Ni O �R TEL �Y-9oI3� �
`�! DATE
I hereby affirm that l am exempt from the Conttactori License �i`J�8 . �� �A�A9� -
Law-for;the following reason (Sedlon 7031,5, Business and ADDRESS 19NAL
Professions Code):_
I, as owner of the prgperty, or my employees with ADDREZ
BUILDING - 9CT.$
wages as their sole compensatlgn,wlll dq the work and
the strut ure-Is not Intended or offered for sale{Section L()ULffY , •
7W4, Ouslnes and professions Code.) MOVING. TEL.
_ T
❑ 1, as owner of the property,-am excluslvely contrading NO. 1 ITEMS ,
with Ilgnsed-coniractors-to construct the project.(Sec- TOTAL .
4r
ADDRESS _ O
tion 7044 .�uslr�s and Professions e. _
God _
609tl kuCTION LENDING AGENCY YARD FiW1 FRAM !>ECK, ` . 40.50
I hereby affirm that them Is a construction lending agency for
the performance of the work,for'whlch this permit Is Issued P.L " - _ .- _. _
00
(Sec 3097, -I v.,.G SIDE. �yy y-��yyy i L /p p
P.L '. 11 00101 r_ MJ 1. �I T/07
Lenders Name �- p tp
P.C Fie Perm M Fee O LDMA Ref. i'.. :' TIJ04 AM O:T 7
Lenders Address
I certify that I have read this appllcatlon and state that the, -.. .. Tswana LDMA P/C i
o above Information Is correct. I agree to c"ply wlth all County Inge gbtforl Fen
es
!4i ordinancand State laws.rolatfng'to"building c�dnstrudian,' Total Fee v l V LDM,A Perm:
. and here t unt�
upon I IFsea ' '
SO R VUIU POR RXPLANATORY LANGUAGE
&9 of Appkani or Ag�0, Date
w„ COUNTY OF LOS ANGELES TEMPLE CITY NR 0508 BUILDING PERMIT
.J DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS
BUILDING AND SAFETY ! LAND DEVELOPMENT TEMPLE CITY CA B TERDTIONI
PHONE: (818) 285-0488 EXT-
LEGAL ID: NO. OF CONST BUILDING
ON FILE SO. FT STORIES TYPE 4856 GOLDEN WEST:AV
STRUCTURE: 192 VN TEMP CA 9178SM5
OR 0INFOR14ATION NUMBER—10 NEAREST CROSS STREET:
858E-0
THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY
TENANT:
MUM9EWOKETCHURC USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: 04/22./% UT 04/22/99
OWNER: TEL. NO: SLOGS. NOW ON LOT: VALUATION: FINAL DAT�,
FIRST SOUTHERN BAPTIST CHURCH OF (818) 286-9320- 1 1,900 O
4856 GOLDEN WEST AV
TEMP 917803935
STORAGE SHED 192 SNi FT - PREFAB
FEE DESCRIPTION; QUANTITY: UON: AMOUNTAPPLICANT: TEL. NO: :
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75
D2 PERMIT 4U0 EM H 00 VAL 82.20 SPEC�AL CONDITIONS:
109.95
EI ESqi
O��
PONTRACTOR: TEL. NO:
SAME AS OWNER - f �.Q ► APPROVALS DATE INSPECTOR SIGNATURE�
LIC. NO LOCATION AND SETRACKS
SOILS ENGINEER APPROVAL
ARCHITECT TEL. *0: �
LIC. N0: X1`1,11
144H269 3hP NO: S PAGE: FIRE ' 0 C� J I ;�s II II n ��All(� ��
NO. OF FAMILIES: DWELLING UNITS: Apvr/5Wff--9TAT CLASS:
-1
FL5� SHEATHING
NO 22ROOF SHEATHING
�1��, ,.� �/ A
9EM WITHIN HAZARDOUS
SHEAR PANELS
AIR QIMLITY: 1000 FEST MATERIAL8REQUIRED TOTAL SETBACK FROM B(ISTF I R E SP R I
+� �_� ii4 �;��
No *0 FPAME INSPECTIN-
SET BACK YARD: HW`Y: PROP LINE: WIDTH:
FRONT PL-
PL- `� &rt'ICc3 —i,,.'/
' _— ���
t
REPORT ID: DPR261 ROUTE TO: BSO508