HomeMy Public PortalAbout6257 GOLDEN WEST AVE_Building__ 76A63SA CE 0603 12/69
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APPLICATION FOR BUILDIN ERMIT fJ
C01ITY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIMBUILDING
VLS
JOHN A. LAMB]I-, T
, COUNY ENGINEER ADDRESS
COLEMAN W. JENKINS, •UP•T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
DISTRICT NO. GROUP YPE ESSED BY
fAD
ING '^ ONST,
ESS , '
STATISTICAL CLASSIFIC ION SEWER MAP
O. BLOCK
CLASS NO. DWELL,UNITS SK PO
TRACT USE ZONE MAP
NO,OF BLOGS. NO.
SIZE OF LOT NOW ON LOT [n/ SPECIAL
USE OF CONDITIONS
EXISTING BLDG.
vne
OWNER TEL
NO. BLDG.SETBACK FROM
ADDRESS FRONT PROP.LINE OF (STREET)
TYPE OF ISTI SETBACK HIGHWAY + r YARD = TOTAL
CITY HIGHWA FROM C.L.
ARCHITECTTEL + _
ENGINEER NO, BLDG.SETBACK FROM
ADDRESS SIDE PROP.LINE OF (STREET)
TEL TYPE OF EXIETIIHO BET BACK HI Y + YARD = TOTAL
CONTRACTOR ,NO, HIGHWAY WIDTH FROM C.L. yy..
ADDRESS Lp + - p
LIC. 8
CITY / S. CLASS CORNER CUTOFF Y ❑ NO
CONS CTI ON LENDER p
NAME AND BRANCH SEE REVERSE SIDE FOR CIAL PPROVALS
LLI
ADDRESS
d
SQ. FT, r�+ � NO. OF NO. OF NEW
SIZE J STORIES FAMILI
USE OF
ADD
STRUCTURE y `b
ALTER ❑
SIGNATURE OF REPAIR❑
APPLICANT ❑
t6'
VALUATIONS5C-%o APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. C� FOUNDATIONI LOCATION
FEE S FEE S / ,Q U FORMS MATERIALS
FRAME: FIRE STOPS,
I HERESY ACKNOWLEDGE THAT 1 HAV[ READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HERESY I WILD. MOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT.
LABOR CODE OF THE STAT[ OF {ACIP MIA IN REL IMG T
WORKMEN'S COMPENSATION INGUR,�NC[. H, EXT.
SIGNATURE O NUMBER COR-
P ERMITTE REIT AND POSTED
ADDRESS
FINAL
JOHN F. LEWIS, PRINCIPAL STRU AL ENGINEER
PLAN CH= VALIDATION cK M.O. wH _ PERMIT VALIDATION CK. .O. CASH
IN, 54549 M1723 D 5.40N 4
I Pr
5.4558 Jml7 1 1) 9.00 a
I -
78ASBBA cErBDD 9-68 TEMPLE CITY
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS G V
BUILDING AND SAFETY DNLSION LOCALITY r
JOHN A. LAMB]E, COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS, SUPT OF BUILDING 'CROSS ST. f
FOR T F L IN DIS GROUP TYPE PROCESSED BY
Print or • owl CONST,
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS 625 yCLASS NO DWELL.UNITS_0 BK L_PG
LOT NO. BLOCK USE ZONE MAP 1
TRACY -� r,� / SPECIAAL_�d
NO.OF BLGS. `/ CONDITIONS
D
SIZE OF LOTO /C 3 NOW ON LOT
USE OF
EXISTING BLDG. BLDG.SETBACK FROM
OWNER t]Qh M e TE
NO, - FRONT PROP.LINE OF (STIHEET)
TYPE OF ISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS 625 Golden HIGHWA WIDTH FROM C.L.
CITYTemple Cit,y , Calif . 91 780 + -
BLDG.SETBACK FROM
ARCHITECT 6R TEL. SIDE PROP.LINEOF (STREET)
ENGINEER NO TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
TEL.
CONTRACTORH . NO. _40
ADDRESS ND CORNER CUTOFF YES El NO E]
CITY $d h Gabriel C a l . class C-39 SEE REVERSE SIDE FOR SPECIAL APPROVALS
CONSTRUCTION LENDER d
NAME AND BRANCH
ADDRESS
SQ. FT. NO. OF NO. OF NEW ❑
SIZE STORIES FAMILIES-
USE
ElS RUO TURE Re-roof Dwlg & Gar, ADD
w e o comp . ALTER [:1P
SIGNATURE OF REPAIR
APPLICANT L DEMOL
VALUATIONS fin
APPROVALS DATE INS P[CTOR'• IIGNA TL R[
P.C.
PMT. - FOUNDATION: LOCATION
FEE ! GGGS7FEES FORMS MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STAT[ THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE' LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERBON I IOLATION OF THE LATH, INT.
LABOR CODE OF THE ST T[ O -CALlFOpfIA1 IN R LATI TO
WORKMEN'DCAMPS I IIID C[. LATH, EXT.
SIGNATURE F HOUSE NUMBER CO R-RECT AND POSTED
ADDRESS FINAL
JOHN F. LEWIS. PRINCIPAL STR URAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATIONCK. M.O. -CASH
9769 MAY 5 4. D 9.0N
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES
WM. J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PLAN CK.NO. PERMIT NO.
BUILDING
ADDRESS . E ,,. _. _
r7
LOCALITY -k"... '. .,f�C�'f: RECEIVED.BY DATE OFAPPL. DATEISSUED
NEAREST - - _/"/ 1
CROSS ST. l �.
BUILDING j
OWNER ` t w ADDRESS A o e,:, ,[- z.- r
MAIL - .j - LOCALITY
ADDRESS
NEAREST
TEL. CROSS ST.
CITY NO.
FIRE NO.OF TYPE r" GROUP
ARCHITECT OR rn TEL. ZONE PLANS_, •
ENGINEER .—
NO.
BLDG. ORD.NO.
ADDRESS SETBACK LINE
APPROVED
TEL. By DATE
CONTRACTOR _ NO.
USE APPROVED
ADDRESS ZONE •a BY DATE
LEGAL /"„-:� _
DESCRIPTION LOT NO. 14 BLOCK CORRECTIONS
TRACT -'y /
NO.OF SLOGS.
SIZE OF LOT I NOW ON LOT
USE OF NO.OFNO.OF
EXISTING BLDG. I FAMILIES ( ROOMS
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
O
A
REPAIR MOVING DEMOLISH �
Sq.FT. NO.OF _
SIZE ROOMS STORIES y
WALL I ROOF
r
COVERING COVERING
USE OF NEW
BUILDING
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: FIRE STOPS,
SIGNATURE OF BRACING,BOLTS
OWNER / LATH,INT.:
AUTHORIZED AOT f/ LATH,EXT.:
DBS-3 25M SETS 4-47 P C Ii PLASTER,INT.
Q on.
FEE '�►-
PLASTER,EXT.
VALUATION
FEE �� FI NAL
WOk1�72S COMPEI4TJOfJ'bEC1AR 411OtJ `" -�i ti' _T,�4 f„.�_
I.hereby afflrrrt that J have q certNjoate,o consent 10 se ti
Iriwre, or a Certificate bf Workers'Comp�eensation Insurance, = AP LSC "��5 1 .FSR L' G P RJI�IIT, ,4
cr p'cehffled Copy th'ecdof 3800 i�IB: C.) '. ": - - - - - - --
.�' �'�q� /�l� COUNTY OF.LOS ANGELES
$UILDING.AND SAFEYIL
Poll J .Cx�ircipany IRI F,lllli. -
Certtfled.agpy Is+&eby`furnT%b d.•.'.-•,i:,i'` FOR APPLICANT.TO FILL IN a
.CertiflTed'bop5}i>E,filed'Wl�'}tie.cobntyfiu`I[dlnpin"ibec-, -_ BUILDING + - .
tlo rtment,' ,�-. ,. .� t, ADDRESS �- 1
Date `� `� 'Adpllcarit -- (my, - - _LP - I Q LOG111TY
CERT I F IIJATE FxEMFrl ON F RS Y _.. �_ _ ..i_ _._ -pip.OF.BLOGS--. _r. ..r_ NEAREST A-
'' -.• AgO BJSA�ICNJ`INSURANCE':, - SIZE Of 07. NOW ON LO ST.
(Thls"ctlon`.heed no't be completdd If the=perthlt lit•for one _ _ i +:•'r'.
hgn0md.�ollars ($In,or less L TRAR BLOCx LOi NO. I1 Map p P
)I
I cerifi`y th4 IrLt o pe _rr-nante of the�'� for vv 4h,thN:_ NOM
p it la.lstg6ti,ritual(not employ any rsbn tn'any tnapner ZS _ O '� _ - , J —� l -
i>3 6b f6.betoPh� ub')eci�o the-Woik' �o�Tt, d Laws I CONDITI
f Qk9TRC7. _. SOUP_- 19RE .'BY
N�FICP 1O' !{]SPt1d41Vf::Jf; rTSakl Ce'rtYfitdte of I T. NO - ~
fxeriiptforY;"•yqe 'should JzecbtTid sublecT to'tthe WBNCeriT., r Z0 L• w. U
omperisatlon provlstona of the LaboFCode, ybv muaif0rth -
wtth Somply.?wltk.tieich-xptgvlslgns or„thls"perrnla:•shalF be -
�veFTled.r4!o�d CONTRACTOR t , _ - STsp511 FK_A ION. I r APT.:
i1_Y T
UCENSED'CflNTl2ACTORS D CiJAfLAIIG)fl, r. , _ -.... _ - - - •bC [f /yam dA NO DW�.1-'UNITS.
I heraby affirm ttlat,l am Ilcgrnec�,under.pfoylslotofiapter9 ADDRESS O NO. 1lW 1 i
(commenolrip�Glfh olY7Q00)of dl qs ,of,"Buslnbwand ���
Prdfesid e ohff�tjy Ilterne Is In,ful) foie aid eff}4t, Cltl .'. CLASS 6^� -! _ _ ..._ _..1_. - .- VALDATiON'�
BK. PG.NO
( I
Ce Num 4 l l I c CStGiflfS-- F ih`�IL16
;YQL 11011. . 0 ' -. _ - —
Ga�tracTor' DES(7�IPT10N of WORK-- - — '- - M11LlN -ADD ram exempt urid+t Sec - - t , + - - - 'I I �•
•„ ,' .. _ '.:; i y. - ALTER
B.8FP,C for thl#reasoh n w1 REPAIR' -
- Uah:' LLSE OF
DUSTING BLDG. �4�-TAMC � 1-'9 4.�I A 4
TEL FKAL
fs qro OWNER-BUILDER bECLARATION ` . _ • - _ �S. �- DATg _ .'_ _;... - ..., O I•'•,• • `} I
4 hereby aff4rm4hcr"am exempt from the.Contabctor's,Llcetase
Law for,the s#Yo�ll�oYrinTrbasoh �Settlpb 709].5, Bwlnew and. ADDRESS r Lam'--� o a'r'f} j
"ProfeiWoris�d)t__� r �— By _ - ,¢cam—r , _..', .PRESENT .
I, a: dwnar of the_ of m em lb with BUILDING ° P I°. 9,2 s.3 .
lxoperty, Y p- y� ADDRSS _ - - - - c,/ _. ..- - - '
woo -cisThicompensatloir,wllldo Tfte woiic and I T � '^� T-2-8-4-
the sfi.lcture It not Intended cr offered for sale(Section LOCALITY
_-7044;•.BusI.r6=and Professlons Cocky i"- Aypy1NG -_-_ ..__ _
I ars owner of the property, am exclusively compacting _ NO'
-with-Ilc�er�d Contractors to conmud the,proje t (Sec- r` .'
it(? 7044, BusIness'and ProfessionsCode). FV y
- ` - CONSTRUCTION LENDING AGENCY L:SETBACK_FROM.
YARD IhAR1 PROP. uNE —
I hofeby affirm,that there is a corutructlon lending aabncy for FRONT
the-perfotmance-of--the-work for which this-permlt.ls Issued
(Sac-.3D97; CN,-.Q.): SIDE I' n• , 1
'Lendees Name LDMA
Lender'sddreu - PC Parmk Fee
l certify thpt have lead_ks.appllcatlon.and stop that iM.. - -- . -- -+swanc•r..- D--- LDMA-P�c F - - -
q==Ion b correct. I.agree to mmply with all County Inwattgattpn Fe•.
a�di nS-And.*p& Ora';.rplating to building cynst-ctlpn, '_ _ .. .
aodhreby authorIte`represenTatives of•thli County to enter To1vt LDAAA Perm. /- c----{ -
upon th abov Ion property for Insped Ionpurposda
- 12 l Isco WMM POtt EUTA IATOCY IJ IiAO!
OMJ
-Sly Ikarrt or AQ•rrt -^- Date- t , •4 _.- _ •m+
J )
W RS' COMPENSATION DECLARATION"'
hereyy affirm that'I have a certificate of cansant to salt -APPLICATION FOR BUILDING P ERMIT
Insure, or a certificate of Workers'Compenstlon Insurance, or
a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BADDD
❑
Certified copy Is filed with the county building Inspec- I
G
tlon'departmbnt. S Ae LOCALITY
NEAREST .
Data Applicant ry ZIP CROSS ST.
CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF NDGS, ASSESSOR
COMPENSATION INSURANCE LOT P Z NOW ON LOT MAP BOOK PAGE PARCEL
(Thls'sectlon need not be completed If'the permit Is for one GD LtSE ZONE hundrNO
ed dollars (;100)or less.) BLOCK LTEL SPECIAL aI certify.that In the performance of the work for which this CONDITIC*4S O
permit Is Issued, I shall not employ anypersonIn any mannerDISTRICT GROUP TYPE FIRE Y U
tooma subje the WoPkers'Lornpensatlon Laws. ADDRESS ZONE CK
G
ZIPDat Ilc{n� �' STATI CAL CLASSIFICATION AFT. CONDONOT] TO AP. If, after making this CertFflcate of E{T OR TEL W
WEER V W CLASS NO. DWELL uN175 a
Exemption,' you should bbcome subject to the Workers' H
Compensation provisions of the Labor Code, you must forth- [PRINT)
ESS SEWER MAP Z
wlth..comply with such provisions or this permit shat] be
deemed revoked. RACTOR t TEL
BK. PG, VALIDATION
LICENSED CONTRACTORS DECLARATION LIC
I hereby affirm that I am licensed under provisions of Chapter 9 ESS NO. VALUATION
(commencing with Section 7000)of Division 3 of the Business and UC. 0�
Pcofesslons Code, and my license Is In full force and effect. CLASS $ �-3 S
T. NO.OF NO. OF CJ_T C
Llcense.Number Llc Class STORES FAMILIES ONE
Contractor Data
IPTION OF WORK NE* ❑
El am exempt from the licensing requirements as I am a ADD
Q
Ilcensbd architect gr a registered profbulonal engineer ALTER ❑ FINAL
i
acting In my professional capacity (Section 70.51, �t'•In �6'�' REPAIR � DATE ��' /L''!
Business and Professions Code). F A.
NG fi e!/1 P 64 C- DI MOI ❑ FINAL
Llc.or Rep.No.� fZq�e CANT TEL.. BY — ~
/! VWNER-BUILDER DECLARATION - I ICd'SU►•�1
I hereby affirm_that I am exempt from t e nfroctor's Llcense ADDRESS GLr6 OV Ila ►���y ✓�s
Law for the following reason (Section 7031.5, Business and
Professions Code): BUILDING
❑ I, 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�Sectlon LOCAtrTY
7044, Business and F�rofesslons Code). - MOVING TEL
I, as owner.of the property, am exclusively contracting CONTRACTOR NO. # o o 0 0 o 1
with licensed contractors to cpnstruct the project (Sec-
tion.7044, Business and Profeulons Code). ADDRESS 2 • 2 41.'0.0.'
� � REQUIRED TOTAL SETBACK FROM EXIST. '
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH
I-hereby affirm that there Is a tonstructlon lending agency for FRONT ° ° 2' �, 0 0 H
the performance of the work for which this permit Is Issued P.L
(Sec. 3097, Clv. C.). SIDE 0 7. 0 '1 8.2
P.L -
Lender's Name - ^]
$ Lender's Address P.0 Fee f Permit Fee a-C`3�. �r U
I cert that I have read this application and state that the Imuonce Fee
abov Information Is correct. I agree to comply with all County nyiWlg-oflon Fee �•,
ordln ces and State laws rel Ing to building construction,
Tonal Fee
and reby outha repr n tives of this County to enter
upon' he above- a toned o arty for Inspection pu
r
771 . Kr fit REVERSE FOR EXPLANATORY LANGUAGE
n
Iqn n of Appllca Do - �s
COUNTY OF LOS ANGELES I TBPLE CITY f D508 } BUILDING PENIT
DEPARTMENT OF PUBLIC WORKS 19071 LAE TU hS ALTERATION/R AIR
BUILDING AND SAFETY / LAND DEVELOPR.B(T TEMPLE CITY CA i, BL 0508 9711180025.
PHONE: (818) 285-0488 EXT:LEGAL ID:- OF CONST. BUILDIWG
�.
ON FILE SO. FT. STORIES TYPE 6257 GOLDEN.WEST:AV
STRUCTURE: 0 VN f,ERP CA 917801705
ASSES= INFORMATION NUMBEIL: EAREST CROSS STREET:
5385-021-009 PAGE: 597 GRID: A2 LOCALITY: TrMPLE CITY
TENANT: �XIST BLDG tZE, RESID USE ZONE: R-2 I SSUED�ON PROCESSED BV Kh3
EXIST OCC GRP: 11/18/0,7 UT 7/18/9B
OWNER. TEL. NO: 905N77ST-M LOT: VAL LIXT I ON FINAL
3ATE
HIROS IMI TSLIYOSHI;MASAMI (818) 292-7582- 1 6,200 1_2J' .
6257 GOLDEN WEST AV
TEMP 917801705 FEES PAID 'OF WOM
RPNOVt'AND RECOVER WITH 1/2• PL 30 YR. GAFTIMIIERLIN�
FEE DESCRIPTION: QUANTITY: WN: AMOUNT,
APPLICANT: TEL. NO:
CLASSIC ROOFS (626) 286-6990- AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION RESID 6200.00 VAL O.62 SPECIAL ITIONS-
02 PERMIT W/0 EN-H DO VAL 166.95
tLET ° 195.32 CONTRACTOR ?jkL$ -
CLASSIC ROOFS (818) 286-6990-
1060.3 FREER ST LIC. NO
TEMPLE CITY CA 91780 382938 C39
SOILS PCINE ER APPROVAL
ARCHITECT TEL. NO: FOUNDAT CH FORMS
LIC. NO: SLAB/IdNDER FLOOR
IZAISE� FLOOR FRAMING
MH269 . .AU MAP WW: PAGe: FIRE ZONE!, UNDERfECOR M-KIDOW
3 01 PUBLIC WORKS
NO 21 00F /.
SCHOOl WITHIN KkZPaDOUS SHEAR'PANELS
AIR QUALITY: AODO FEET MATERIALS Q O.�` F� ��
NO NO 1NO. L J t INSPECTION
t
TOTAL SETBACK FROM EXIST
SET BACK YARD: HWY: PROP LIME: WIDTH:
FRONT PL' qsh�!,
SIDE PL- '^p
l..�i .�e++rr
EX`TER.lOR LATH
RATP�FLOW
l - CEILINGS
' REPORT ID: DPR261 ROUTE T0: BS05DB
I.
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