HomeMy Public PortalAbout6274 GOLDEN WEST AVE_Building__ 78A898A CE f803 3'69 APPLICATION FOR BUIL I NG PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDINGS AND SAFETY DIVISION LOCALITY
12,
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN DIST T NO GR PE ST. Y
OF(PRINT OR TYPE ONLY)
BUILDINGSTATISTICAL ICATION SEWER MAP
ADDRESS `�-- S
CLASS N0. DWELL.UNITS BK PG
LOT NO. BLOCK USE ZONE MAP
N0.
TRACT SPECIAL
NO. Of BLD G9. CONDTIONS
SIZE OF LOT NOW ON LOT
US E OF
EXISTING BLDG. BLDG. SETBACK FROM
TEL. FRONT PROP. LINE OF (STREET)
OWNER 0. - TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
WAY WIDTH FROM C.L.
ADDRESS DP_ e,
CITY
ARCHITECT OR TEL. BLDG.SETBACK FR (STREET)
ENGINEER NO. SIDE PROP. LINE OF
TYPE OF EXIST04 SETBACK HIG + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.
TEL. +
CONTRACTOR N0.
LIC. CUTOFF TOFF YES ❑ NO ❑
ADDRESS N0.
LICCITY CLASS SEE REVERSE HIDE FOR SPECIAL APPROVALS ix
CONSTRUCTION LENDER O
NAME AND BRANCH t 7
ADDRESS
SI FT. N0. OF N0. OF ❑ z
SIVE STORIES f FAMILIES NEW
USE OF ADD ❑
STRUCTURE
G ALTER
REPAIR
SIGNATURE OF DEMOL
APPLICANT q
VALUATION w3i i APPROVALS DATE INSPKCTOR'• ■IGNATUni
P.C. PMT. FOUNDATION: LOCATION
FEE S FEE TERIALS
BRACING, QQLT3
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION FRAME: FIRE STOPS,
AND STATE THAT THE AEOVE 19 CORRECT AMD AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC-
TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I QNS VENT. DUCTS
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE LATH, INT.
OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM-
PENSATION INSURANCE. LATH, EXT.
SIGNATURE O HOUSE NUMBER CORRECT
PERMITTEE f AND POSTED
ADDRE / FINAL 1
JOHN F. LEWIS, PRINCIPAL ST TURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. C"H - PERMIT VALIDATION CK. N.O. CADH
L air 2 8 4 5G NGu24 1D 172-5,;' -v
r.F WORKERS' OOMPQtSAT10N,pECLARATION
her rm thaT I have a dCome of floe Int r self APPLICATION FOR. BUrLDINO Pf
a certFficdte.of•worken' Compensation Insurance, � �IT-
`q'�cagy.therhof (Sec: 3$00, Lab. �j
r, COUNTY.OF LOS AHQELEf UnLDING AND SAOEiY ..
Policy No. ' . s, C6mi:5pny
Certified copy is hereby famished `. "' _ R ALICANT,TO FILL INBLI W
ADDRESS
Certified copy to filed rJlth Yhn coiintyullding I'Alapec- Bl1ILDIBIG
tion department. t. R1S �g r
Dare _Appllcdnt' L ". CITY f Zl� LOCALITY
�. OF BLDGS. NEAREST
.CB;enFICATE OF EXEwnbN FRom wO S'' - S[of IAT �O ON Lo7� CRc&ST:
1 CQMPEN SATI ON I NSU RANGE: ASSESSOR
Is�rrectlon.'rkmd hot be completed•If the pi(,rtitt'Ia'for ond." TRACT B.L. - LOT NO. AGE pp�g,
unfired dollars"($TCC)•of-less.) USE
Z .
I oeftlty that in The pe4prmance of-thp,workjor whirr this.
,perrrjit Js issued, &hall not employ prry-person Ih any�rfdnher ADDI�SS - . - pj
so as to becomq.Aubl4d to fhe Wq[k Ptnsatl•1aw� ! p "OO
0-13' ;, GTTY C . ZIP r.
A�plloanl ARt}iRE{T. TEL DI _GROUP. TYPE
NO'TI,CE•TO-APPU : if, after making this Cer" ate.of INEt
F?rorrip_lqn;' yod 4hould become •fub�ect to,The-.Wbck6rs x
EgnlpehpTlon proylslgns of the.labbr•.G4de, 5'04 must forth
wltfi comply.wltfi sbch proykslprm.or;thls, perrrilt shpll be. Z
deemdd revoked. AOR d STATI5T]CAL CiFtSSIPICATION AP7.' COTDO:
:. ti' _
b al,t P t(a� &ORS:DEQ ARA,TI CKJ � was T►O. owa+ IJJJ ITS
I herebyvafflrm that 1-am IIcehsec under provl.zlgrr-of GhwPler 9 - NO SEWER MAP
(-m ng wlth,:Sectlop 7000)of Division 1.0 the &Ilrw esLit
andprofesslor*Codq,and my.11c�pse is Ih fulLfgroe brsd.effed. p� �S . g pG VAUDATFON' ' t
5 51 TT: St#ORIES 6 O# T�
li erse Number, �r iU F---�--r�-
= V TION
DESCRIPTION OF WORK NiW
contn�or Date v. ;;...� .66
ADD
01 am exempt adder Sec"
ALTER-
p.& ,C.:for thls.reason
byte: USE OF' _ _..w -
T' - Exisnfv(3 I3LDC. DEMoi.Q
_Signature APPLICANT T� {
OWNI IR-BUILDER'DECL,,RATION � � DAA -
I hereby'afftrm-thaf I am exempt fr6m the Contractors License /�-S�,
t.
Law for ttii followlno recagn (Se4Tlon 703 Y.5 Buslneeri and ADDRESSFINAL'
Profoplons Code)?.
NGq
Q I; 'as'dwhec of the property, or my employees with
�I�ADDRESS-
P.
waged as their sole compensation,.w IFdo the-work and LOCALITY �+ 7 171.'75
the stYi�cfure Is not Intended otofferbd for sale(Soctlon - r
70.44,-BUslndss ano Profeislons Eode.) NG - TEL.
I,m own-er:§f the properfy,_arn exclu4Nely 6ontracting COtJTRACYOR NO.
W*Ilcensed contractors:tp constrgo the•project.($q[-_ ADS - .. - - ? f 4� .�t�Tri 1 .J.. }� .
tion 7044, "Inesa_ar>d.PTof6eslonsCbd�'),
C6NStRL1Cn0n LFlJblNG AG• N& YARD HW
I hereby affirm that there ltj a cor>sir�ctlorL lending Agency for FRONT Jt� I t .00 '.
ttie performdnds of the work f0? which-this permit Is Issued P.L
(Sec. 3097,•Clv. C. SIQE
Lenders Name IMOD-M. .•-10/1J/�
st LDMA Ref. E�r
�' Lenders Address P.C. Tie Permit l=ee o:
1 Certify that-I have read this apphcatton"and state that the- Irwance
above,Informallon Isromed, I agree to oofnp Iy With all County rn�on F«.
ordlhonces and State laws Telating'to building igoastruction, , Total Fse . LDMA Paml, 1111
and hereby authorlxo representatives of this County to enter
upon•thb gbove m I ed proper fy.f�ir Inspeotlon purposes '
-1}` .iii RRVfiRfE POR KXPLAI•IATORY LAlidUAW
r Slgnatu a of Applltj?rtt,or AQent Dose t'
WOReRS'CONIPENSATICrN DEOAPATFON �' r
heraffirm that I have a its of consent to .elf APPLICATION: FOR . B U I LV I NG` PERMIT .
Irtsvre, or a certificate of Work*rs' Compertsatloh Insurance,
J, or a certlf led copy.tbereof(Set: 3800,Lab.C.)
COUNTY Q� LQS ANGELES' dUILDIKG AND SAFETY
Polfcy Nq- Corr pant
CertifiedBUILDING
Dopy Is hereby fuml><fted. FOR.APPLfCf4NT TO FILL IN oboRFss.
�l Certlfied.cgpy li filed with the courity building Inspec- BUILDING ^ `► ' A —t C
LJ tlgln depcirtment: ,4DDRESS e l GaD E%.'YV es-i- AV£ LOGwJTY 1
Do"... Appllcant '. a rn pvt `A Z1P a 1-7 to CR Le n
CERTIFICATE OF MMPTIO{J FROM WORqRS' I NO.Cs ASSESSOR
CC•MPEN.SA I1 OfJ I NSU RAMC! SIZE OF T . NOW O I• BOOK PAGE'': PARC$
USE ZONE MokP
(Th 1a section need hot be com feted If the permit b for one TRACT BLOCK LOT NO. NO. 7�d
hu❑dred dollprs (;100)or less�.
^'_ - TEL y
l: In the performance of the tivoik for which.this OWN62 ,� �vwRt3. S <t41 No.aF{0'Jl3 z CONDMONS' d.
ffY
It Is lssued, I ail not arn to an' person.ln an manner ^ D GROUP TYPE FIRE . L}Y Q
soli tb become bJect to the Wy Y Cc;.m satY n Laws �Ge�.� QD%-0EN 1 OQq AcY'C /�Y �►�T. zONE
—3 Teyi-N ZIP ► I/ IVa 'y� 0
Appl t ARCHITECT Oft TEL. STATf511ClLfl°SSIICA r
N07iCF'.TEI.'APPLICANf: fF,-after,making' thq Certtficate ofNO.
•�xemptlon,,you should become subject to.,.the'Yyoricelsr Lih55 NO. DWE11'UNITS�_ •L
Co.mpensatlon pcovlslgns df the Labor Cbdq, you must.ftwt-h SEWER MAP
with nipy-wtttr;)uch provlsl.orts or, this,permff ahalr'bb TE1- _
,"nip
TOR 1 - 9K.- /' PG, VALDATFON,
CONTRACL10ENc&C0NTRACTOR$.DECL4RA,T1bN Ut
I hereby affirm that I aM Ilcinsed under provisions of Chapter 9 ADDRtS5 '• NO, VALUATION
(corrtrrrohring wMh Section 7000)of Division 3 of the Buslhem and LK-
and Professbrn Cod., and my Il4erue is In full force and effect. CTIY CLASS ' $
t]cense Nomber t •LIG ClassFAMLIES
Qom'? STORIES l NG,F �: �
Controdor Iyate DESC`JROF
IPT}ONfOF WORK
QALY NEW
I am exempt.under Sec
.• ADD ®
E.dF:G for thlkredsor, t �r ��sJk ❑
DATE
USE OFF111 I_ .
bate: EXISTING BLDG C'1 DENSOL � L Ao o r� � 8 8
SlgrkFture e�LI .\TN NO. ';Ub�1t3Z o 0 0 Q, Sa,
OWNSR-BUILDER DECLAJ2AMN
I heresy affirm ihaf l am exempt from the Contractors License. V17� ('_ &y��� r et� Q 4 8 3
LqW for.the following.reason ($dctlon 7031.5,'Buslness and
Prof0W'ns Code}:
y I, ¢s owner of the property,'or:my imployess with BUIL
M'C' as thelr sole compahwHon;will do the work and
the strvcturb Is hot Intended pr offered for stile(Section _
7044,_ Bvslnem and Professldns Cods)_ MOVING TEL
I,m owner of the= rP
am exduslvey contracting' ACTOR �'
With licen"d contractors to coAstcuct the prgjec7 (Sec- ADDRESS
tton7044,.Bwlnam and Professions Code). C..
�� YARD HWY'' �Xp$577
CDNMt)CT1CN LENDING i4GETICY SE7 BAIX TOTALSETBACK
U WIDTH
J hereby ufflnh that there-U a coraliuctibn lending opency for. FRONT , .
the performahce of the work for'whlch.thi f p8rtnit,ls Isued P
JSec,3097, Clv.C.) SIDE .
Lenders Name'
Lentfers Address P.0 FM; Permit FeeO _
�. I.certify thdt I f}ave read this dppllcailon and Mate-that the lawdrx� Q '
above Inforrttattort b aomrct. I sopgrreeee to comply wtth,all County Invgflganon'Fee Jr
ordloances-and.5late Paws relating to bullding corrtrKtion, Total Fee
and hereby authoriZl "�
.es of this County to enter
upon a ve rnepry for.lr4apec�bA purposei.
m elfvKMX04 NATPRY_LMOGUA¢!
Signature of A,6pmont«Agent Date
� WORKERS'COMPENSATION DECLARATION -
I.hereby.affirm toot L have a certificate stion n sur ce, or Ap p L I CATION F O I L D I i�G PERMIT'
Insure, or a certlflcate'of Workers'Compenstlon Insurance, or
a certified copy t"reof (Sec. 380x, Lab. C.) I .
COUNl'Y.OF LOS ANGEL •. BUILDING AND SAFETY '
No. Company BUILDING
0 jertLfled copy Is hereby furnished. FOR APPLICANT FILL IN ADOREss
. DA
I__..J •Certtfipd copy I*filed with the county building Inspec- I BUILDING
LJ tion department. ,gppRE55 LOCAL Fry
NEAREST
Date ` Applicant - C Itt, ZIP, CROSS ST.
CFPTIFICA7 OF.EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR
COMPENSATION-INSURANCE' SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
(Thi;secflon'need rtofbe com feted If.the permit Is.for•orte ' _ 115E ZONE
'hundred dollars ($ItG)or less. TRAa BLOCJ( . LOT NO. tJO.
OWN92 NOTEt_. f CONbtTION$ 0
I certify_that In the performance of thprwofk for which this _ O
peftf It Is IssU�d, I shall not a ploy qny person In an rganner 'Pa Rl GROUP TYPE FIRE BY- U
was fo become>4ubject To t�a Wok Corn pe rt Laws. I rB CONST. Z cc
.
'`Date' Appl1can ARCHrfECT OR ' ZIP TEL STAT15T1CA1 CLASSIFICAPON-. CO{JDO. �
CITYva�
NOTICE= TO,.APP41CANT: If, aftet maklnq ihI{ Certificate of
Examptloh you- vhoulq becorrie subl� to the Workers' NO' CLASSNO• DWELL UNITS to
Compensatton prodfslons of'the Labor Code,'you must forth- SEWER MAP Z
ADDIZES�with comply wlth such provlslons or this pemlt -shall be
'deemed revoked. CONTRACTOR Q��i9li;�A Nom rR1. BK. PG, VALIQAT4QN
UC1=NS51�CONTRACTORS D�CIARATIONLIC. _
I hereby affirm that I am Licensed under ptovlslons.of Chaptbr 9 AWRfSS •NO.
I=ner>tlnq with cecfon 7000)of Dlvblon 3 ofthe Buslnoss ohcJ �AL�JAT10�1
Pssions Code and my license 1s In U1 forte and effects GTY UCS
_ FT. _OF NO.OF GH
License Nu �Ic.CI Sl2E STORIES FAMILIES PN
Contra4to Pate t l OF WORK NEW
. ADD
I-1
I'am.e>tempt from ibe Ilcensi5g requlmr'onts as I am a 4-L
- llcen"d architect or d mglstered pfofpsslonal engin A1TER. FINAL
DATE
acting In My professional capacity .(Sectldth 7051., REPAIR � DATE
Business or>dprofesslons Code). SINAL
&_DG. :�. DEMOL
Llc.or Req. No. Date r ICANT r
TEL.
OWNED-BUILDER DECLARATION DINTT
I hereby`affJrm that I am exempt frdm the Contractors License I ,� 7r.
Law,for•1he following reason (Sectlon 7031.5, Business and LSL t
Professlorls Code): ,
BUILDING
J, os owner of the property, or 'Myemproy'ees with ADDRESS
wogbs as their tole compenlatlon,will do the work and r
the sfructUre It-not Intended or offered for sale.(Se;c-tion LOCAL
71 4 , Business pod I!'rgfesston#Code). MOVING- TEL. y
i, as pwner'of the property, am exclGslvelyQ,controcting NO. 2 0 2 A
with licensed contractors tq construct the project (Sec-
tlon 7l)A4, Busfneu and.Proiessions Qocle).� ADbRE55
REQUIREDTOTAL SETBACK FROM EXIST.
CONSTRUCTION LENDING AGENCY gr YARD HVVI PROP. LINE WIDTH 2 io o 4 3100
I hereby affirm that there I$a codstruttlon lendagency for agefor FRONTthe Performance of the work for whlch�hrs permlt Is Issued P. ' 0:010 4 3 00
(Sec.3097,Clv.-C.). SIDE 11 ' •
P.L I J,2 ) 8.}
Lendffr`z_,Kgme -
Lender's Address P.C_ Feet Pwrrn It Fee
I certify•ihcrt.L hgve read thls appllcatlon and state that thq .� ;(��
a
boveinTormatlgn Is correct. L agree.to comply with all County, Invettlpatlon Foo
ordi nd'Stbte Igws relating to bulldlrtg constnlctlon,
and by thoraze pre"AtatIves of 4hls.CouRty to enter Total r i
u bo ed property for Inspection purposes_.
i
y r
SO RE1/ERf&FOR DU'LANATORY LANGUAGE
^ �s
- ,Slpnotun of Applicant or Agent Doti. '
WORKERS'COMPENSATION DECLARATION
hereby affirm that
f haws 4 certffam ofconsent b ,elf APPLICATION FOR BUILDING_ PERMIT
Incurs, or a certificatof Workers'COmpensaTlon Imurance; O
or a-terttfied Copy thereof (Sec 3B00, Lab. C.) COUNTY.OF LOS ANGELES -. BU'LDIMG AND SAFETY
l�ollcy Na. Company _
Certified copy is hereby famished. LDING �7 FOR APPLICANT TO FILL IN AD' S
E] -Certified copy Is filed with the county bullding Inspec- BUILDING
i tion department. ADIJMS LOCALITY
NEAREST
Date ' - Applicant CITY ZIP
a ' CROSSST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIg OF LOT NO.OF ON L� MAP PAGE PARCEL
CE .
CbM ENSA7ION,INSURAN
C(this sedIdn heed not be Gom feted kF the permit Is for,bne TRACT BLOCK LOT ti0. ltSE ZC E tVO.
dollars (;100)or less_ c _
I certify ihdt In the performance of the work for which this OWNER J �' �' / T S a
It Is Issued, I'shal not employ an n In an manner GROUP TYPE FIRE' PROCESS®BY O
Perm c P oY Y sa, Y ADtJAf55 tc U1 V Q. / CONST. ZONE U
so'as to become subject to the Work mpensatlo paws. 1117 W
CITY' ri1 P` ZIP 1, STA 'F �,0., _
NOTICE TO ,a,PPUCANT:. If, after=moking this E_►tti icate of �r OR _ _ _ .. -. r
FxempHorr, you should become. subject to the Workers' nHEER CLASS NO. DWELL UNfTS� UJ
Compehsatiorr provisions.pf the Labor_C , you must forth -.. . t _ SEWER MAP comply .
with such provisions r. is permit shall be _
degmed re.voked. CONTRAC.'TORU�s�r ucY� __.NCO. . _ BK PG, .VALIDATKM
LiCENSED CONTRACTORS DECLARATION - LIC -
I hereby affirm that I am licensed under-pro'vislons of Chc4ler 9' ADDRESS NO. VALUAMN
(oommerbcIN with Sedlon 7000)of DlvWoh 3 of the&W ness and LEG
p.of Cocie. , and." Ilcense.ls In full force and effect- ,. CITY, CLASS Soo
n.
FT. NO:"OF iJQ.Or - C1fC1C
License Nlumber Lic Chef Sl'ORI6 EAMI — OtE
p DESCRIPTION OF WORK NEW
Corttrnctor Date
11I am Sec exempt under SeADD Q ,
ALS
B.aP.C- for this reason - REPA1 R
° ATE
USE OF
Date:; sac iNG kbr,-- D6�oL ❑ rte
. �.
Slgtiatur� APR)ANT TEL'
OWNER43UILDER DECLARATION (PRINT) NO.
I hereby affirm that+am exempt from tP»Conmpciors 1,1cense ,
Law for the following reason (Se0lon 7031.¢, Business and
fesslons Code):
1, as owner of the propetfy, of my employees-with ADDR NG '
2'8 8 1.4 A
wage*ae then•toie gompensatloh,wlll do the work and
the struttura,is riot Intended or offend for pole(Section LCA11TY # o'u'a i'0 1 _
7044, Bwtineet and Professions Code}. MOVING TEL
EJ. ,J, as-owner of the.property,am ex[luslvefy contradlnQ �' u', (o`a
with licensed contractors to construtf the prole t.(Secr
tion 70.44, Business and,Professions Code). ADDRESS ''O 3 Q tri
CONSTRUCTION LENDING AGENCY' gT I YARD F11M1 TOTAL FROM �i0 t�l0 8
I herby affirm tfwt there Is'a constructfon lerdfng agency for . �T _ , .
e perforrnQnce of the work for which this permit Is issued P
3097, Clv_C
SIDE
P.L.
Lenders Name _
tenders Address P.C. Fee Permit Fee
` I certify that I have t4od this application�dnd state that.the. '�
above Inforrn¢Non is cared. I agree to comply with aII County I on Fpe
ordlnances and ,Stats laws ralating to building constructlon, Total Fee • ��
and hereby authorize ntatly"of this County to.enter
upon abov�&-mentlo� hadj0t)rop"for Inspection pw'potei
W A KW EG1LAl1(►T0[Y 1,ANG rAq&
Sl is f of Applk&nt or Agent N Ms - ..
WQRKERS' COMPENSATION DECLARATION
I ureby,.ctffl�m:[cat-I have 6 aertlfr a of.consent tco, or , �rAPPLIC�TIQN FOR BUILDING PERII�IIT
lnaere, ora certificate of Workers' m nstlon Insurance, or .
a certlfled'copy thereof (Sec-3906, Lab.,c.)
. , - . ' .. COUNTY OF LOS ANGELES BUILDING AND SAFIFTY .
Policy No__Compgny
0',.Cprtlflocopy Is hereby furnlsha�. = R APPLICANT TO FILL IN Bu Z
Certlfled'copy.ls filed WItM the county bulldln3�'rnspec- BUILDING
tion depdrdment. ADDRESS VIII LOCALITY 4
Dale Applicant CTY ZI P EROSS
CERTIFICATE OF EXEMKiON R2G3M WORKERS'. OFASSESSOR
' COMPENSATION INSURANCE' SIZEOF•LOT:. NOW ON MAPB.00K PAGE PARCH D
(This sbctlon.nged not bd.completed,If the•perrtl.lt Is for onpUSE ZQNE
hbh&..od dollars (f100).or less.). ,, .r. TRACT OCK LOaNO / a� a
OWNER - Nb. CONDITIONS
I c¢ctlfy that Ji,•th,e pgrfofmarl�.of the work for whlcft�ihls _ _ -. - DISTRICT GROUP FIRE PRQCFS$ED - 0"
SPECLAL
tmIt Is Issued, 1-rhgll hof employ qny- n In,any manner
arto become'sublecT fo,the Wo r4� n Laws. - 0 Q✓ ,(� '' CONST' Z
(f (Vf ad
,�. CFFy ,ZIP Ia .
Dote _ APPllcght � ARCH �� TEI L. .., STAnSTK�,L a�.SSIFrCArFON APT.. �CIDNDC,.
NOTICE TO-APPLICANT: If,'.after m6king this'Certificate of W
Exemption, You _should become 'subleSt to the,Workers' : NEER NO. OASS NO. DWELL UNITS d,
Compensation p�Qvlslona of the Labor Code,.you must forth �
ADDRESS
with,comply
Compensation. provlslons-br this.permit shall be
deero,ed revoked, ' : - CONTRACTPG T/ `'/Ai1DATkON
LJC015ED CONTRACTORS'DECLAWOto, C
J hereby affirm that I am Ilcensad under'provlslons of ter 9 ADDRESS td0. YALU T10fV Y
(commencing with Section 7(�E10)of Plvlslgrl 3 of The�tdlness and f
Pr6fesslons C9de,•and my flcense is.in full force.arx�`effect. CITY CLASS _ ;
SO. `Ft O.OF NO. OI'- C,l-IEC, '
LrcepseNsummber ' 11c.Clais-. ' S17E - STORIES 7 FAMILJES. ONE -
Con4ddo�\ a T pa�5' —� DESCRIPTION OF 1NORK S iz_f
am exempt from the Iloentlrp re9ulrements as 1 am a ADD
censed archltecT of a regls�ergdprgfeuloppl enpinber; ALTER FINAL`a4tlap In rry pfofesslonal capacity (,Section 7051, DATE /Q
REPAIR
Business and Profession}Code). _ USE OF
DUSTIf3G BLDG. DEMOC SINAL
Lk.or Reg. No' - Date AP9U ANT TEL �'
OWNEK--BUILDER DECLARA-norr- (PO I NO.
I h&eby affirm that ram exempt from the Conrraotgr's Ucense. • v. `s
haw for
following rea&,9n_{Se-dIon.7031.5, But1ness and ADDRESS C%
ProfesslorN{odp): (/79�
BUILDING .
I, as owner '6f+the prbperfyor-my employees with ADDRESS
wages as their sole compensdtlon,'wlll do the work and -
"-thevmctoro Isnot lgtended or offered for sale(Section LOCALITY
7044, Bwlneu and Professlons Crode). MOVING TES
I, as owrier.of-thp prdperty,'am exclutively Gonttdcflrlp CONTRACT_ LA
NO. 27 0 9 A t,
with Ilcensed.contraVors tQ-tonstruct•the-project (Sec- . _
flop 704.4,"Buslndss orld Professlons.Code} : - #ie o-o 0 0
kED
CONSTRUCTION U INDING AGENCY YARD "Y TOT�F" Ex STM .
hereby-cffl�m that there'is,a construcflon lehdlrlg agency fdr 2 i-.'-'S 2 0 0'
he performance of the work for which.this.perhtlt Is Issued
Sec_3097,..CIv:.C.). .. ._. -
°,4 -.52,0 0.6-
-
ender s Ndme Q':�,���- -2
ender's Addreucertify that I have read thls'appllGatlon and state that the Issuance FeeboveInformationIscorrect. 1.agree to comply-with 4-Countyye.
rd 11 and State'laws relating to bulldTr19 consfructlort, Tgtol Faro �-
nd rob thorJ a representatlybs 9f fhis Count 10 enter
a toned property for(6spectfon purposes,
1^�.-7 SIM REVOtM FOR EXTORY LANGLIAGR
Slprwturo of Applicant cc,Agent - Date
COUNTY dF LOS ANGELES TE#PLE CITY f 0508 -T BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS RESIDENTIAL ADD/ALT/REP
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9808240022
PHONE: (818) 285-0488 EXT:
LEGAL ID: NO. OF CONST NEW :BUILDING ADDRESS:
ON FILE SQ. FT STORIES TYPE OCCUP GROUP 6274 GOLDEN WEST AV
STRUCTURE: 320 1 VN R3 TEMP CA 917801701
ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST ORD% STREET:
5385-022-027 OTHER: THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY
TENANT: ENIST BLDG USE: USE ZONE: I MED ON: PROCESSED BY: EXPIRES . -�
EXIST OCC GRP: 08/31/98 UT 08/31/99OWNER: TEL. NO- BLDGS. WN ON LOT: VALUATION .
FINAL DATE I I NAL E:
HUI FAI JOHNNY - 1 23,980
6274 (OLDEN WEST AV Z'� 8
TEMP 917801701 jFEES PAID OF WO$tK
�
NEW BEDROOM'AND BATHROOM (4TH B Opo AND 3.�ATH)
FEE DESCRIPTION: QUANTITY: UOK: AMOUNT:
APPLICANT: TEL. Nio:
y,
LUMINA DESIGN L CONSTRUCTION, INC. (626) 574-9969- AA BLDG PERMIT ISSUANCE 27.75
5634 HALIFAX RD. AC STRONG MOTION R .00 VAL 2.40 .
ARCADIA, CA AX BUILDING R 54.70
B2 PERMIT GE L 496.98
CONTPACTOR: TEL. 5 581.83
LUMINA DESIGN i CONSTRUCTION (626) 574-9960-
5634 HALIAX RD. LIC. NO:
ARCADIA, CA 7518948
wirwamER APPROVAL
ARCHITECT OR ENGINEER: TEL. NO:
JI TRENCFTWW`
LIC. NO3 llllllSLAB
1AIS1E ii FLOOR FA RT96- —
MAP NO: SEWER MAP BOOK.- PAGE: FIRE ZONE:
3 � L C V V �R"K3 INSULATION
NO. OF FAMILIES: DWELLING UNITS: APT/QOND: STAT
NO 21,'
SCHOOL WITHIN HAZARDOUS ROOF �HE�THING
O a
AIR QUALITY: 1000 FEET MATERIALS ❑
NO NO NO FIRE DEPT.' FRAME INSPECT
lb
R EQU I R ED TOTAL SETBACK FROM EXISTBLDG DEPT. F0NrTff9n'ff
FET BACKYARD: HWY: PROP LINE: WIDTH: Ser Thst�Qt
ROM - VMC6
SIDE PL- �'-7'49 INSULATIONNEATHER STRIP
14
wk I-
JAAA: q ,I��-.
l � •y-� `�--�
REPORT ID: DPR261 ROUTE TO: BS0508
COUNTY OF LOS ANGELES TEMPLE CITY f 0508 BUILDING PERMIT
DEPARTVMT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0107110007
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO OF LIM51 NEW BU I LD
ON FILE SQ. FT STORIES TYPE OCCUP GROUP 6274 GOLDEN WEST AV
STRUCTURE: 270 1 VN U1 TEMP CA 917801701
ASSESSOR INFORMATION NUMBER-. GARAGE: NEAREST CROSS STREET: LOMGDEN
5385-M-G27 OTHER: THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY
TE]KANT: Mn3T_90WUSE- USE ZONE: lssa� ON: PROCESSM BY: EXPIRES ON:
E)(IST OCC GRP: 07/11/01 JK 01/07/02
U�tK: TEL. IU-- BLDGS. NOW ON LOT: VALUATION: F I NAL DAIT E CODE:
HUI FAI JOHNNY (626) 286-3337- 1 700
6274 GOLDEN WEST AV � v
TEMP 917801701 FEES PAID bmipi-ION OF WORE,,,,
1BIX151 OPEN PATIO (ORI INALLY AS ENCLOSED PATIO
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT! BY OCCUPANCY INSPECTION ONLY FOR SAFETY PURPOSES)
APPLICANT: TEL. NO:
SAME AS OWNER AA BLDG PERMIT ISSUANCE 27.
AC STRQMG MOTION B_UI 700.00 VAL 0.50
AX BUILDINGEVrEW--F 54.70
D2 FERMI E LES VAL 43.65
S dp �� 126.60
CONTRACTOR: TEL. NiO: APPR17ALS DATE INSPECTOR SIGNATURE
SANE AS OWER - / '�►,
LIC. NO LOCATIOIN AND SETBACKS
UMTr=OR ENGINEO: TEL. 40; - es
LIC.SEWER MAP BOOK: PAGE: FIRE ZONE: . , T1I 11111
. 1] CEJ
W. OF FAMILIES: DWELLING UNITS: APT/COIND: STAT
NO 21I / ZND kEVEL FLOOR SHEATH
AIR QUALITY: 10� FEET MATERIALS INO
FIRE DEPT. FURS79P=
SET BACK YARD: WY: PROP LINE: WIDTH: ~ fj�IC Qpt Z t
FRONT PL- ` .�ABt
SIDE PL-
SerVICA
{
REPORT ID: DPR261 ROUTE TO: BW508
COUNTY OF LOS ANGELES TEMPLE CITY NR 0508 BUILDING PERMIT
DEPARTMEINT OF PUBLIC WORKS 9701 LAE TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0301310001
PHONE: (626) 285-0488 EXT:
LEGAL ID: 90. OF CONST BUILDING
ON FILE SQ. FT STORIES TYPE 6274 GOLDEN WEST:AV
STRUCTURE: VN TEMP CA 917801701
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN
5385-022-027 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY
J
TENANT: EXIST ILDG USE: RESID USE ZONE: RI I osm ON: PRCXESSEDTT—' — EXPIRES ON
EXIST OCC GRP: 01/31/03 JK 01%26/04
FINAL BY CME:
HUI PAI JOHNNYGOLDEN 00
WEST AV - 4,8
6274
TEND 917801701
CONVERT EXISTING COVERED PATIO TO ENCLOSED PATIO ICM19DP
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT;
APPLICANT: TEL. NO:
CROCKER (714) 258-1314, AA BLDG PERMIT ISSUANCE 27.75
706 4 TUSTIN AVE AC STRONG MOTION R89ID 4800-W VAL 0.50 SPECIAL CONDITIONS:
ORANGE 92567 D2 PERMIT W/0 .00 VAL 132.60
GEELE E s 160.55
APPROVALS WE— INSPECTbR SIGN.ATURE
ALL PRO RENDDELING (714) 288-1314- ��� ��
706 N TUSTIN AVENUE LIC. NO \ LOCATION AND SETBACXS
ORANGE, CA 92567 574698 BSOILS ENGINEER APPROVAL
\�
ARCHITECT OR ENGINEER: TEL. NO: FOUKDATIW/TRaXT-Mfflff-
LIC. M SLAB[UKDER FLOOR
RAISED FLOOR FRAMING
' 111111
MAP NO: S=-MAP PAGE: FI E ZONE
UNDERFLOOR IN&XlrrW-
153H269 3: MKS L`93❑ C, W 0
1,7 FLOOR SHEATHING
10. OF FAMILIES: WELLING . INC 21HAZARDOUS
SCHOOL UITHIN O ROOF SHEATHING
8 SHEAR PANELS
AIR QUALITY: 1000 FEET MATERIALS
NO NO MO / FRAME INSPECTION
It EQU I R ED TOTAL SETBACK FROM EXIST ��.gf r J
FIRE SPRINKI ER RANGERS
SET BACK YARD: HWY: PROP LIME: WIDTH: \`t ❑ Vv01(
FSIDE PL-RONT PL- SQrVICO a/ -WEAIHER STRIP
IltTERIOR LATH/DRYWALL
EXTERIOR OUP
RATED WALL ASSEMBL-IE5
RATED SKAFTS/OPENINGS
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BSD508
COUNLR OF LOS ANGEJ,&S TEMPLE CITY 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPARR
BUILDING AND SAFETY / LAND DEVELOPMENT TD?PL5 CPPV CA 91780 - BL 0508 1201050040
PHONE: (626) 285-0488 ETT: �.
LEGAL ID: NO. OF CONST BUTLDI1fG ADDRESS:
ON FIDE SQ. FT STORIES TYPE 6274 GOLDEN WEST AV
STRUCTURE: 3000 V-B TEW CA 917801701
ASSESSOR INFORMATION NUMBER: NEARE<4Tr CROSS STREET:
5385-022-027 TAOM S PAGE: 597 GRID: A2 LOCALITY: T24PLE CITY, C
TENANT: EZIST BLDG USE: RFSID USE ZONE: R-1 ISSUED ON: PROCESSED BY:
EZIBT OCC GRP: 01/05/12 SR
OWNER: TEL. NO: BLDGJ. NOW ON LOT: VALUATION: FINAL DATE F BY: CODE:
HUT FAI JOHNNY (951) 710-7261- 10,280 11
6274 GOLDEN WEST AV 1
TEMP 917801701 FEES PAID DESCRIPTION OF WORK
R&?TJVE CDMP 4 WOOD SElai ROOF SHEEP 1/2q OSB SHEATING 4
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: INSTAU DINEN,9IONAL CLASS A COMPOSITION
APPLICANT: TEL. NO:
RICHARD GRSE00 (626) 893-0259- AA BLDG PERMIT ISSUANCE 27.80
841 FOXWORTH AVE AB STATE GRffii BLDG FEE 10280.00 VAL 1.00 SPECIAL CONDITIONS:
LA PUENPE G 91744 AC STRONG MOTION RESID 10280.00 VAL 1.00
D2 PERMIT W/O EN-HC 10280.00 VAL 234.00 l '
TOTAL FEES 263.80 -'
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGlVkTURE
FEDERAL BUILDING AND ROOFI (909) 877-0238-
841 FOKWORTH AVE - LIC. NO LOCATION AND SETBACKS
LA PUE= CA 91744 374153-C39
SOILS EROINE3R APPROVAL
ARCHITECT OR ENGINEER: TEL. NO: FOUNDALTION TRENCH FORMS
LIC. NO: SLAB ER FLOOR
RAISED FLOOR FW24ING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION
153H269 3 00
FLOOR SHEATHING
NO. OF FAbg- TRS: DWEJ-TNG UNTT9: APTCON - STAT CLASS: -
0 NO 21 ROOF S¢ATWINO
SCHOOL WITHIN HAZARDOUS SHEAR PANHIO
AIR QUALITY: 1000 FEET MA.TERT2 M
NO NO NO FRAME INSPECTION
FIRE SPRINTLER HANGER2S
INSULATION/WEATHER 9TRIP
INTERIOR LATH DRYWALL
Frraar R LATH
RATED FLOOR/CELL ASSEM.
RATED WALL AS_9FJ9.LIFS
RATED SHAFTS OPENINGS
T-BAR CEILINGS
t ADDITIONAL DATA ON FILE
LOT RATNAGE
REPORT ID: DPR261 ROUTE TO: BS0508
f