HomeMy Public PortalAbout10030 GREEN ST_Building__ •APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN -.(Print or"only)
COUNTY OF LOS ANGELES
ADDRESSSc 10030 Gzerai4 :E,T DEPARTMENT OF COUNTY ENGINEER
aTy Tem °L6 zip 1 '7 6fl BUILDING AND SAFETY DIVISION.
NO.Of _ o2 BUILDING
SIZE OF LOT 1205 A 23 S NOW ON LOT L• ADORES d
t BLOCK LOT NO. 7 LOCALITY
.S `r 1 O L TF1..,� ,� ,[ + N EA REST
OWNER NO.Y4'T-lit CROSS ST.
ASSESSOR
ADDRESS Y� T MAP BOOK,. PAGE PARCEL
-10 DISTRICT GROUP HRE BY
-zTY . � L.Lf GT ZJP cl I 10 Q CONST. ZONE 1
ARCH IT O TEL O 12
EN&N Ci O - SfATISTICALCLAS5IHCATTION MAP
'4DDRESS i S; 6 A""•�i CLASS NO.Q/--JDWELL UNITS BK , PG,
CONTRACTOR GRp1C Irl- JK K 14 NO. USE ZONE t 0 D
ADDRESppS y�8����.
140.1143(p1 `' SEC
CITY &gACgkVjA� C:V' LICLG�SS�K �� CET4TA-ONS
CQNSTRLKTION DER ROAD DEP MENT APPROVAL REQUIRE YES ❑ NO ❑
NAME AND BRANCH VNILPic W BLDG.S CK FROM
FRONT P.LINE OF (STREET)
ADDRESS ELN TOTAL SETBACK FROM TYPE OF EXISTING
SQ.FT. NO.OF I NO.OF a0� HI AY + YARD RONT PROP LINE HIGHWAY WIDTH
SIZE G, SIO;UES 15AMUESNE
DESCRIPTION OF WORK NEW ❑ +
_ GANG �{.IL rsL/i�$_.
BLDG.SETBACK oc
WOOb •S-rL jos 5-roccO EAT, ADO SIDE PROP.UNE OF (HETI 0
l 1/ ' ALTEk ❑ TOTAL SETBACK FROM EXISTING
I,VpCUL F- WISh wD0b SL I MI15- HIC�I IIYAY + YARD SIDE PROP.UNE HIGHW WIDTH
USE OF `_. _ REPAIR ❑
Z_
EXISTING BI DG. 1?WeL' jAJ�
❑ +
l PR1 NT) C SGL 4+K. H NO. _ t CORNER CUTOFF YES ElNO 11
IN OPEN SPACE YES ❑ NO ❑
BY(SIGNATURE) Q IN COASTAL PERMIT ZONE YES ❑ NO
VALUATk)N$. CJ
DO
H E3iHY. THAT I HAVE READ THIS APPUCATION AND STATE
THAT THE ABOVE S AND AGREE TO COMPLY WITH ALL ORDPIANCB
AND LAWS REG"TING BUILDING C -rKn I C E;MFY THAT JN DONG THE '
WORK AUIII-IORIZE�HEREBY I WALL NOT EMPLOY ANY PERSON IN VFOLATKJN OF .
THE LABOR CODE OF THE STATE OF CAUJ FORK IA IN RELATING TO WORKMEN'S COM- .
PENBATK)PN IN FRANC):,
_SJGNATU OF
PERMITTEE
ADDRESS tzA44A) A-v�" .
S-I � FINAL BY
TEL DATE
cSTY V 1A- No.
MAKE Q NECKS PAYABLE 70 FEE
HARVIrY T.GRAN DT,GQUNTY ENGINE11Rel C 7
PLAN CHECK VALIDATION CX wo. CAAH - PSMT VAUDA11ON r.a CASH
e.-76Ae3e.A CE/BMJ 3-75'
1
78A638A CE 0803 3-69 APPLICATION FOR BUILD NG PIER T
y COUNTY OF LOS ANGELES BUILDING
DaPdRTMEaT OF COUNTY ENGINEER ADDRESS is
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPT OF BUILDING NEAARRECROSS 8T. /� Itis --
FOR APPLICANT TO FILL IN DISTRI N0. GRQJ,JP TYPE OHST. P SED Y
(PRINT OR TYPE ONLY) �S
BUILDING STATISTICAL C IFICATION SEWER MAP
ADDRESS he CLASS NO. - DWELL.UNITS BK 5 PG
LOT NO. BLOCK USE ZONE MO
TRACT 2010
P -
�O NO. OF BLDG3. CONDITIONS
SIZE OF LOT ��A 1 j S NOW ON LOT
USE OF /�
EXISTING BLDG. GAS �pA-4�A BLDG. SETBACK FROM
TEL. FRONT PROP. LINE OF (STREET)
OWNER N0. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS S HIGHWAY WIDTH FROM C.L.
CITY C• C 4`Z7 •.� + �j = 2p
ARCHITECT DR TEL. DG.3ETBFROM
SILI (STREET)
ENGINEER NO. SDE PROP. LIOF
JJ TYPE OF EXISTM SETBACK HIGHWAY + YARD = TOTAL
ADDRESS �'C- HIGHWAY WIDTH FROM C.L.
TEL. + _
CONTRACTOR 0.
ADDRESS NO l CORNER CUTOFF YES NO 0
CITY S 5K RHV RSE SIDE ll -PIAL AIRPROVALS °C
O
CONSTRUCTION LENDER
NAME AND BRANCH AZIO /t/ 4
ADDRESS - N
Z
SQ. FT. NO. OF N0. OF ❑ —
SIZE STORIES FAMILIES NEW
USE OF ADD
STRUCTURE4/4 ALTER ❑ I
REPAIR ❑ `
SIGNATURE OF DEMOL ❑
APPLICANT
0� �
VALUATION APPROVALS ' DATE IMSP[CTOM'1 EIQMATUM[
`r' FEE-'s FOUNDATION: LOCATION
FEE
$ R
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME: FIRE STOPS,
I
AND STATE THAT THE AOVA IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTR UC- , -
TION. ICERTIFY THAT IN DOING THE WORK AUTHdRIZED HEREBY I GA-5 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 COW
PENDATION INSU CE. LATH, EXT.
SIGNATURE-OF HOUSE NUMBER CORRECT
PERMITTEE AND POSTED
ADDRESS FINAL
JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER
PLAN. CHECK VALIDATION +CK• m.o. PERMIT VALIDATION «• M.o. CACI+
('� 2 3 9 6 0 OCT 2 4 1 D 9.0 0
De.s 25M SETS 10--a4 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES BUILDING
WM.J.FOX, CHIEF ENGINEER
NO. OF BLDG. ORD.NO. DISTRICT NO. PLAN CK. NO. PERMIT NO.
PLANS SETBACK LINE
FIRE APPROVED r.v --
ZONE BY DATE RECEIVED BY DATE OF APPL. DATE ISSUED
USE - APPROVED
ZONE- BY DATE
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
4' BUILDING
0 E Z /NAME ADDRESS fit? !/lfZQjyt `yY -"
I- W
W Z ADDRESS LOCALITY
F -
2 Z NEAREST C
U Z CITY CROSS ST.
C
Q
STATE
LICENSE NO. C NAME 4La4lel \
w
E z MAIL
NAME
O 3 ADDRESS
U O 4== TEL.
< ADDRESS CITY NO.
ff
F I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
U CITY APPLICATION AND STATE THAT THE ABOVE IS CORRECT
STATE TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
LICENSE NO. �/ NO. - AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
Z LOT NO. A' SIZE OF LOT�J'l3� SIGNATURE OF
JO NO. OF BLDGS. OWNER /�,?
QdBLOCK "r NOW ON LOT AUTHORIZED AG,T "
LE
JW TRACT 'Ai '_ "ZT� CORRECTIONS
D USE OF BLDGS.
NOW ON LOT
DESCRIPTION OF WORK
USE OF
BUILDING
O
O
Z
D
NEW TYPE _. GROUP
NO. OF NO. OF
ALTERATION ROOMS FAMILIES
ADDITION SIZE
REPAIR STORIES
MOVING WALL COVERING
DEMOLISH ROOF COVERING
P.C.s FINAL APPROVAL
FEE
s I INSPECTOR'S
VALUATION / �D FEE DATE NAME
DEPART"ENT OF BUILDING AND SAFETY 'T APPLICATION FOR PERMIT
i COUNTY OF LOS ANGELES OCT 9 t.i 9 rB ' L ® I G 1
WM. .1. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDINGy DISTRICT NO. PLAN CK.NO. PERMIT NO.
ADDREBB � (' _ �. "C'
LOCALITY AI RECJEI� / OY DATE OF APPL. DATE ISSUED
NEAREST
C ROBS ST.
}'�I Q (� / e,/� BUILDING
OWNER �j� �LLLC. S ADDREBB ��F�. -1'i�L•1� ,...
MAILjy/(,� �� LOCALITY
ADDREBB ,/
NEAREST
TEL. CROBB ST. 13 oi )
CITY NO. 3 FIREND.OF TYPE GROUP r
ARCHITECT OR [L. ZONE PLANS 1
_ENGINEER NO.
BLOU. i1 L�' _(-, ORD.NO.
ADDRESS r SETBACK LINE
APPROVED
TEL.
CONTRACTOR NO. USE
USE APPROVED
ADDRESS ZONE E' BY DATE
LEGAL CORRE=ONS
DESCRIPTION LOT NO. BLOCK
TRACT f✓j J" -2—" I*Q
SIZE OF LOT
'/_X A I NO.OF BLDOS.
is NOW ON LOT d
USE OF I NO.OF I NO.OF I /
EXISTING BLDG. FAM!u[e ROOM. k/ L34 '
DESCRIPTION OF WORK
NEW ALTERATION ADDITION �. O
A
REPAIR MOVING DEMOLISH _ p
3q.FT. NO.OF Z
SIZE ROOMS STORIES .. �46 z' T Ae 4,`,0 r
WALL ROOF
COVERING COVERING
USE OF NEW
BUILDING h' I —� �i± QAi
1✓
/ --
L
.I
I HEREBY ACKNOWLEDGE WHAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IB CORRECT INSPECTOR DAT[
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION
FORMS,MATERIALS
AND STATE LAW REGULATING BUILDING CONSTRUCTION.
FRAME: FIRE STOP
SIGNATURE OF ) f n BRACING,BOLTS S _
I PERMITTEE PY ( LATH, INT. _
AUTHORIZED AOT__ -✓
LATH. EXT.
7SA63BA-3 2-50 $
,3100
P.C.s PLASTER.INT.
1 O v FEE PLASTER,EXT.
ffi
VALUATION FEE FINAL
. .Y� APPLICATION FOR BUILDING PERMIT �]
COUNTY OF LOS ANGELES , . BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION
FOR APPLICANT TO 1`11,L IN. Bu ADDi3E88
ADDRESS 1.
I hereby afftnm that I have a certificate of ooneent to serf tmFe
or a ceftftbate of WwRem. Comperaabcn Insurance,or a certlfied
copy thereat (Sea 3800,Lab.C.)
Pofky No, Cary of G NO.of Now ON Lor NEAREST CROSS❑ Certffted copy b hereby fumbhed.
❑ Cedfed copy is filed with the oounty balding Inepsotbn TRT BUDCK LOT NO.
LrSE DINE MAP NQ
deparUnent
Dete Appfbent ASSE �S `1 Q "UXIEL O33 SPECIAL corn Ns
CERTIFICATE OF EXEMPTION FROM WORKERS' oW44ER YES NO
COMPENSATION INSURANCE t WITI-N 1000 FT of SCHOOL?
Phis 9ectbn need riot be completed If tha permn b V one hundred D f/ �/�j / DSTRBCT GROUP TYPE CON9r. FRE ZONE PROCE3.4ED BY
dcAars ($100) or less) 30
CITY
I certify that fn the performance of the wcxk for which thla parmn c!
18 lsaried, I &hall not employ any person In any manner &o aa to if
ARCHIT�CrIDRENOIAEFA 7E1 NO
become su )act the Workem' tion SV,TIsTcAL G JScN APT CONDO
DeteAPplk�ritI ADDRESS CLASS NO. DWELL UMTS
AOTIICE TO APPLK.ANT- If, making this Certificate of REOUIRED TOU1L SETBACK FROM EXIST
Exemption, you shou6d become Subject ,to the Mockers' CONTFLhCTOR , TEL NO. SET BACK 1TRD HWY PROP UNE WIDTH
Cornpen&ation provleion9 of the Labor Code, you rruSt for Hwft FRONT
oon#y wfth&ugh provWa or thb permft al-di be deemed revoked. ADDRESS Lir.40. PL
BADE
LICENSED CONTRACTORS DECLARATION Crry LIc.C4-AsS P L
I hereby affirm that I am Ifcen9ed urderprovbbm of Chapter 8SFr MAP
(commendng with Section 7000)of Dfvfslon 3 ot the Business and 9a � NO.OF sTOPoEB NO.OF FMtEB
Profession&Code,and my Iban&e b In furl farce-and effeoL (pr NEW ElBK PQ ,
Lbenee Number Lla c#aea OF WORK ADD M Ulaloti.OOC, � O
Contactor Date ALTER Eli(7�
23
ElI am eder xempt unSec. REPAIR El $ - y __
BhP.C.for thb reason DEMOL Q- LDMA P/C t �_• T.T — 50 ,50
USE OF EX1STRr0 BLDQ Date: URM c - 5 •JV■5
Stere APPLICANT(PR/JT) TEL NO. Perm 1P WE - -- 24.7■J11 z-
4 a& owner of the Property, or my employee& wnh wages as r - 0 .00
their gob compensation, wl0 do the work and the sticture b ADDRESS FINAL D,Qe 0 ; �` �i.i.
not fnterded or offered for sale (Section 7044, Bu&hlea& and
30
Profeaslor» code.) wu THE APPLICANT OR FUT FE rot■n..o CCC PANT ANA-E A rIAzraooue L&Kr —/ — - 'I
L ❑.I, as owner of the property, em exdRlehety COntl9Ctlrlg With OR A LEXTIFE CONRMq A HAZAFDOU&N 91!FWL EQUAL To CR eFEA67 THAN TFC � � �• Ir,1R]I�
licensedtraofors to oorRstrLnct the project (Seaton 7044, '�^Os ePECF�ON THE F AZAFDOU&►USTFNLB lFOR49lON OL DET FfNAL BY ,r'. _ 0 +�. 8■
Business end ucbm one Coos) YES❑ NO❑ I t��-.J `•AM6
YLL THE M@O® 082 OF THE B I LM aY THE APPUGMIT OR FUTURE rot.DING - —/ -TOTAL-- 45- 7--,60
COCUMNT FEQUM A Pearn FOR CCNSTRucna+oR MooAGVON FROM THE same
CONSTRUCTION LENDING AGENCY co sr GUIDEUw OLULnY Mwvoo� DrarFrcT W-,c•D)AEF PEFMTTNO a-eaa.mT FOR
I hereby affirm that there Is a oonetructbn "rig agency for YF8❑ NO❑
CA the performance d the work for which thb permit ie beued(Sec. i HwE READ THE HAZAHoale MQErav_s WCFDAUX)N DUDE AND THE r•^•D PERLC-FM
eTM
�•yL,
cv 3087,CIV.C.) CFEO7Q78T.I UNDE]zSDVC WY REoUM64E TTS UNDER THE L09 ANDES COUNTY CCOF-HAZkRD0us - - - �:�� —1W■iJ$J
L,erd9{s Nana s REPORTING AN-E? CHAPTER 220 D�o6VaNW A Phar �7FEE SCS'..
Lenders Addreas - \t
o - arm a err
I certify that I have reed this app8cation and state under penalty
d perjury that the above fnformetion is correct I agree b comply P.C,FEE Yb �FEE
co
with all county ordVorKcee and State lews reiating to buOdirp /J li
c"lruction, and hereby authortze repreeentsily" of this County r8Sl1A14CE FEE l�
Loon the for
MIEST)GAnCIN FEE TO-PL FEE
SEE REVERSE FOR EXPLANATORY LANGUAGE
COUNTY OF LOS ANGELES TEMPLE CITY NR 0508 BUILDING PERMNIT
'r'•` DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS _ o RESIDENTIAL ADD
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA Bt 0508 9702180078
PHONE: (818) 285-0488 EXT:
LEGAL ID: NO. OF CONST NEW UFLDING ADDRESS:
ON FILE SG. FT STORIES TYPE OCCUP GROUP 0030 GREEN ST
STRUCTURE: 2,62 1 V IR3 TEMP CA 917803331
MGARAGE: NEAREST CROSS STREET: BALDWIN
MSO-00 -033 OTHER: i-.-THOMAS PAGE: 597 GRID; 94USE ZONE: T99um-w-- PROCESSED BY: LKES UP:
LOCALITY: TEMPLE CITY
EXIST OCC GRP: 02/18/97 TC 18/96
06MER: TEL NO: BLDGS. N()W ON LOT: VALLATION: FI M DATE FI OWE:
;00OI A,LTOMASA HERNANDEZ (818) x.54-1137- 2 6,000
003300 GREEN v
TEMP 917803331 FEES PAID DESCRIP11UN OF WPRK
262 W. FT. SToRAr.E SHED (NOT F HABITABLE USE OR RENTAL
FEE DESCRIPTION: TIa. o AMOUNT:
APPLICAWr: TEL. NO:
SAME AS 06MER - AA BLDG. PER}NIT ISSUA)IQ �2 5
AC STRONG MOTION R D / -V SPECIAL CONDITIONS:
AX BUILDING REfII
D2 PERM I T W/0 eIN
SAMNE AS 06MER - rN,*
!, FE�
LIG. NO �J - pTIUN AND SETBACKS
SNuo H 5 _oi-isnd
LIC. NO:
Ito: SEVER MAP BOOK: PAGE: FIRE
3. 01
NO 21Ittoo�MO. OF FAM,ILIES: DWELLING UNITS: APT/C0NP: STAT CLASS. � ZND LEVEL FTW SHEAR
��
AIR QUALITY: 10DO FEET MATERIALS
NO NO NO FIRE DEPT. FORFTOPM
TOTAL SETBACK FROM EXIST BLDG DEPT.
SET BACK YARD: HWY: PROP LIME: WIDTH:
FRONT PL-
SIDE PL-
INSULATIONNEATHER STRIP
INTERIOR LATH/DRYWALL
EXTERIOR LATF
LOT DRAI)LAGE-
FIRE DEPARTRERT-APPANXI
REPORT ID: DPR261 ROUTE TO: BS0508