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HomeMy Public PortalAbout8628 HALDEMAN ST_Building__ 76A638ACE#8032-63-APPLICAT ION. FOR: BUILDING PER IT COUNTY OF LOS' ANGELES BUILID IN'G DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING, AND'SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM-A. JENSEN, SUPT OF BUILDING CROSS ST. �i /• DIST NO. I TYPE ESSE FOR APPLICANT TO FILL ''IN . CONST. BUILDINGd4( �44 4YI STATISTICAL CLASSIFICATION -ADDRESS � WER MAP ? U - BK PG - CLASS. NO. DWELL. UNIT$ LOT NO. 1," BLOCK WATER ❑ � O� ! CERTIFICATE: .NOT REQUIRED RECEIVED . TRACT /! 6 643- MA y HIGHWAY STATE MAJOR SECOND, OCAL « • NO. OF BLDGS. N C (CIRCLE) SIZE OF LOT` f� �e NOW ON LOT USE ZONE SPECIAL H USE OF p ^USE EXISTING BLDG. OWNER Q� •// j ' - EXIST.T -1/ IDI G ADDRESS �" � /']C�(��G�3�-/CI�+ dt�• SETBACK- YARD HWY STR T NAME WIDTH FRONT / ARCH ITECT OR TEL. P. L. `ENGINEER - NO. SIDE , P. L. ly >' ADDRESS _ TEL. cl.C�e�t,lJ-� CONTRACTOR C/NH QC' NO.- , ADDRESS DESCRIPTION OF .WORK / J6�� W u NEW DD ALTER REPAIR DEMOLISH LO Z SQ. FT. NO. OF NO. OF SIZE 30o STORIES FAMILIES USE.OF STRUCTURE / OD OC �al 'O' SIGNATURE OF 'tF 64' !r'i.' o.1Z6- APPLICANT �—•W _ VALUATION $ ; - APPROVAL$ DATEa INSPECTOR'S SIGNATURE P.C. �� PMT. / FOUNDATION: LOCATION FEE S FEE (_C FORMS, MATERIALS FRAME: FIRE STOPS, -1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE ABOVE I5 CORRECT AND AGREE,TO COMPLY FURNACE: LOCATION. WITH ALL COUNTY. ORDINANCES AND STATE LAWS REGULATING' -•GAS VENT, DUCTS • jj n 7 BUILDING' CONSTRUCTION. I CERTIFYgTHIIJ. DOING THE WORKAUTHORIZED HEREBY I WILL NOT•EMPNY PERSONIN VIOLA-TION OF THE LABO OF.THE 5F C IA RELAT- LATH. INT.LNG TO WORKMEN' COM ENSATION INC n + I LATH, EXT. y�"e Al PA SI GNATUREOF HOUSE NUMBER COR- �,� PERMITTEE '"'�-` d RECT AND POSTED' ADDRESS Wd'94l14+ FINAL, ( e ' JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION•' CK'. -M.O. CASH _ PERMIT- VALIDATION . CK. M.O. CASH l.tiuc 76A638ACtO803,8-64 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING- S I I DF-PARTMENT OF COUNTY ENGINEER ADDRESS -H BUILDING AND SAFETY DIVISION LOCALITY .. JOHN A..LAMBIE• COUNTY ENGINEER NEAREST COLEMAN W. JENKINSSUP'T OF BUILDING CROSS ST. - �1 DISTRI O.- GR TYPE-- P D BY FOR APPLICANT TO FILL IN CONST. U !r// I s-+ STATISTICAL,C�±ASSIFICATION SEWER MAP ADDRESS G AL I 5 CLASS NO DWELL UNITS BK• G G41 LOT NO. S BLOCK USE ZONE MAP_ TRACT ' v 0 SPECIAL ONDITIONS NO. OF BLD09. C SIZE OF LOT O NOW ON LOT . USE OF G R, Resp '����XISTLNBLDG. SETBACK FROM - -• �{ uu l i/ J ` 11 S�w�� \�I NOL ATj- FRONT PROP.. LINE OF -(,STREET) OWNER I TYPE OF -EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS GL HIGHWAY 'F M C.L. CITY scv,- i - +. _ -- ARCHITECT OR TEL. BLDG. SETBACK FROM - - - - - ENGINEER NO. SIDE PROP. LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L .d TEL. + - 0 CONTRACTOR(r) /`"C/ NO I V ADDRESS NO CORNERCUTOFF YES NO - 0 H CITY LIc SEE REVERSE SIDE FOR SPECIAL APPROVALS w DESCRIPTION OF WORK n NEW ADD ALTER S REPAIR DEMOLISH /- iG•� �-' N�� � •� S Q.F T. N O. O F N O. O R f jy�",y _ SIZE S ORI ES FAMILIES USE OF I •� A'."�"' l�G ^9 ��1'��'`C�i7 $TRUCTUR _ l.D �.''t'ID f' / GC�4 IGNATURE OF/ Z� '/f /� ✓ " APPLICANT vv�� Lam/ r� ti VALUATION$ p�,� r _ APP OVALS DATE I NSPECTOR'SSIGNATURE P.C. PMT. FOUNDATION, LOCATION FEE FEE$ FORMS, MATER "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 - - WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS 9UILDI 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 CODE OF THE STATE OF CALIFORNIA RELAT. INC TO WORKMEN'S COMPENSATION INS�URQQ,NC LATH. EXT. SIGNATURE OF- ci HOUSE NUMBER COR; PERMITTEE "1 �/�N RECT AND POSTED 44 ADDRESSrau �A/h FINAL JOHN F. LEWIS. PRINCIPAL ST C , RAL ENGINEER PLAN CHECK VALIDATION CK. M O CASH _ :PERMIT VALIDATION CK. M.O CASH LI-; 2 3� FEB 23 1 k 4.00~ ~" 76A638A CE.8113 5-65 APPLICATION- FOR UILD NG P I -PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS 1, BUILDING AND SAFETY DIVISION LOCALITY _ JOHN A.'LAMBIE. COUNTY ENGINEER NEAREST -Y4 - / COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS ST DISTRICT NO GRyB - TYPE PR S FOR APPLICANT TO FILL IN, CONST-' B UILDING---I,.,' STATISTICAL SSIFICATION7 - SEWER MAP ' S CLASS NO DW EL"L•V NI TS BK -PG. '� -:P- _ -BLOCK _ USE ZONEMAP /j �1 NO.: ; - -- 1 TRACT a�p Z _ �f SPECIAL - NO. OF BLDOS -�% - CONDITIONS ' SIZE OF LOT NOW ON LOT - - - _.+... USE OF " IST,NG B L D Q. L✓/ BLDG SETBACK'FROM / -TEL. 4 T] O FRONT PROP LINE OF 5 EET) OWNER Q/`� C/ NO // TYPE OF EXISTING` SETBACK- HIGHWAY YARD - TOTAL - ADDRESS �I H HWAY WIDTH FROM C.L. - CITY /t/ - - +; _ •. 14 ARC HI CT OR TEL BLDG SEPBACK FROM ENGINEER NO. 06-,Z_1172'6- 'SIDE PROP. LINE OF (STREET) TYPE,OF EXISTING SETBACK HIGHWAY + — TOTAL ADDRESS v�<�,j.�0clgr HIGHWAY WIDTH FROM c L - TEL-7 c� +CONTRACTOR Uv NO - - - - - ADDRESS 6� S 7l. O Jr CORNER CUTOFF YES-� NO O OG CITY CLA SEE REVERSE SIDE FOR-SPECIAL APPROVALS'' G'` DESCRIPTION OF" WORK w a NEW• ADD ALTER .REPAIR DEMOLISH Z SQ•FT NO OFNO OF _ SIZE STORIES FAMI'LIF_S - - - USE OF STR CTURE (j(,y / ° v ` ( Z S I G N A TUR _ APP LICAN VAL ION$ APPROVALS DATE INSPECTOR'S SIGNA? RE P.0 '� PMT FOUNDATION, LOCATION FEE- FEE$ V 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 -" WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS 9UILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK - AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH INT, _ TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. _ ING TO WORKMEN S COMPENSATION INSURANCE LATH EXT ` SIGNATUREOF. HOUSE NUMBER COR- PERM ITT F RECT AND POSTED 42 ADDRESS 3 sv' '� FINAL PLAN CHECK VALIDATION CK M o CASH _ - JOHN PERMIT VALIDATION STRUCTURAL TURM o ENCAS I LAC .9 6 1 9,C) FEB 1 1 •1; A.. 76A638A F#Bo3..61-.APPL(CATION •-FOR BUILDING P R MT COUNTY OF LOS.ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS NT BUILDING AND. SAFETY-DMSION LOCALITY ^' JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. DISTRICT NO. GROUP TYPE P ESSED Y , FOR APPLICANT-TO FILL'IN ' CONST, '- BUILDING STATISTICAL CLASSIFICATION SEWIR MAP ADDRESSa K PG :CLASS.NO_DWELL.UNITS „ -•LOT'NO. BLOCK WATER NOT REQUIRED- RECEIVED CERTIFICATE - TRACT-, MAP / HIGHWAY - NO `' (CIRCLE), STATE MAJOR SECOND, LOC" AL• NO. OF BLDGS. SIZE OF LOT .4 NOW ON-LOT USE ZONE `SPECIAL USE OF - - CONDITIONS EXISTING'BLDG. I oLr4l-c _ TEL. l �' OWNER NO. — BUILDING 'EXIST.. - SETBACK YARD .HV4/Y STRET AME WIDTH ADDRESS ` FRONT ARCHITECT OR' TEL. - P •L: 'J -l1fG2 7G �' ENGINEER' •• .NO., - 'SIDE' P.L. V ADDRESSEL ` INSPECTION RECORD .� CONTRACT,OO. - - O F ADDRESS1rorlwl&la - W DESCRIPTION OF WORE NEW X, ADD ALTER', REPAIR DEMOLISH r SQ.FT. NO OF NO OF IZE �-G� STORIES _ FAMILIES USE OF'IRE � I - • STRUCTURE SIGNATU E C APPLICA - '-• _ VALUATION$ - V - APPROVALS DATE INSPECTOR'S SIGNATURE FPC PMT.EE $ -FEE $ �Q, FOUNDATION: LOCATION, - - FORMS, MATERIALS FRAME: FIRE STOPS, •'I HEREBY ACKNOWLEDGE THAT,I HAVE READ THIS APPLICATION BRACING,-BOLTS AND STATE THAT THE ABOVE,ISICORRECT'AND AGREE TO'COMPLY FURNACE: LOCATION, ' WITH-ALL•COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT'DUCTS ` BUILDING'S CONSTRUCTION 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LFINAL ,•INT. _ TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- , ING TO WORKME MPENSA'IIION INSURANCE. - ,EXT. SIGNATU '=� - E NUMBER COR- - - _ PERMITTEE T AND POSTEDADDRESS ` CLYDE N. DIRLAM;PRINCIPAL STR URAL ENGINEER PLAN CHECK VALIDATION CK. "M:o. CASH PERMIT VALIDATION aK Ia.o. ;CkSH r i 0 7'� .t'I 1 1 k- 6.0 ~ Li ,o . '7tA89lA CEM[09.9 60 APPLICATION FOR BUILDING. ,PE IT COUNTY OF LOSAN BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUII.DING AND SAFETY DMSION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SUPT OF BUILDING CROSS S DISTRICT NO. GRO P• TYPE SSE Y' FOR APPLICANT TO FILL CONST. BUILDING STATIST_ICALCLASSIFICATION S ER MAP ADDRESS K PG r CLASS NO DWELL. UNITS LOT NO. BLOCK MAP NUMBER S�..ITyATE YES O, ` TRACT Q USE ZONE SPECIAL NO.OF BLDGS:" CONDITIONS ' SIZE OF LOT ii ��' I NOW ON LOT USE OF EXISTING BLDG. BUILDING YARD HWYTR AME EXIST. ^�C• TEL. SETBACK WI TH OWNER O e /L NO. FRONT , P.L. ADDRESS SIDE ARCHITECT OR TEL. P L ENGINEER NO. INSPECTION RECORD _ 1" ADDRESS Ad CONTRACTO L/l e r�. O. y ADDRESS L.--• C EL/A7 _ 0 O DESCRIPTION OF WORK W LU N NEW VADD ALTER- REPAIR DEMOLISH Z SQ.FT. /' v NO.OF NO OF SIZE '// (..+ STORIES F�AMILLIIES _ I USE OF STRUCTURE 4/ Ir SIGNATURE OF APPLICANT VALUATION$ APPROVALS DATE INSPECTOR'S SIGNATURE �t FOUNDATION. LOCATION tt F E $ v" FEE $PMT. 0� FORMS, MATERIALS f1 U /� FRAME FIRE STOPS, I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE„•THAT THE ABOVE'IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, >� / WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION 'I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED 'I SHALL NOT LATH, INT. -DfoI 1. EMPLOY ANY PERSON IN ANY MANNER S AS TO BECOME SUBUECT TO THE WORKMEN'S COMPENS TION L OF�ALIFO RNIA _ LATH, EXT. SIGNATURE HOUSE NUMBER COR- PERMITTE RECT AND POSTED ADDRESS FINAL ' CLYDE N. DIRLAM, PRINCIPAL STR URAL ENGINEER PLAN CHECK VALIDATION cK M.O. CASH ._ PERMIT VALIDATION, CK. M.O. CASH LAGo 1.6•.7 5 -0JAI',' 22 7 2 3 A 2 1 .0 0 1o r Ea 3 1 ;, . 4 .. . 7SAQ99A CC}1809-9;60 APPLICATION FOR BUILDING, PERMIT 'COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER, ADOREss BUILDING AND SAFETY DIVISION LOCALITY ` JOHN A. LAMBIE, COUNTY ENGINEER NEAREST f WILLIAM A. JENSEN SUPT OF BUILDING CROSS S DISTRICT NO. GROUP TYPE• , PRO JESSE Y FOR APPLICANT TO FILL IN CONST.',' BUILDING /D U; N (�' , .STATISTICAL OSSIFICATION SEWER MAP; ADDRESS QQ ��Gl d ((1�� - _ I •B _PG J CLASS.NO. DWELL.,UNITS LOT NO. BLOCK MAP STATE YES O NUMBER O 45HWY. TRACT © USE ZONE SPECIAL {. �/ NO OF BLDGS. CONDITION SIZE OF LOT NOW ON LOT USE OFR ,. ��Y[ EXISTING B DG. ',... & C e. BUILDI G YARD - STREET N M EXIS . ' ` -13H 0%4 ER - .'�bN(�N- i- •NO. 7_ SETBACK/ FRONT ^` .• - / P. ADDRESS -z h'- SIDE ARCHITECT OR - TEL. _ p L - ENGINEER NO. - 'INSPECTION RECORDCL ADDRESS - - �TEL'. CONTRACTOR :�"� •NO. / i ADDRESS \ O DESCRIPTION OF,WORKLu • Q � '�'�� G NEW L D ALTER REPAIR DEMOLISH Z• SQ FT.- NO.OF NO OF ( ; f '•, ..n1.n C�/'!I'!� Q �.+ SIZE �® STORIES FAMILIES Jg.I p(: / 'N��• - - USE OF, STRUCTURE SIGNATURE OF APPLICANT j_e �1 1 VALUATION$ - '/ I Yee APPROVALS - "DATE INSPECTOR:S SIGN E , PMT. FOUNDATION' LOCATION , FEE FEE $. FORMS, MATERIALS ' i FRAME FIRE STOPS, I KT HEREBY ACNOWLEDGE.THAT I•HAVE READ APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE. LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION I CERTIFY THAT IN THE RFORMANCE' - ' OF THE WORK'FOR WHICH THIS PERMIT IS 'SSU SHAL NOT' O EMPLOY ANY PERSON IN ANNER SO AS TO OME U r LATH, INT. , TO THE WORKMEN'S C PEN ATION LAWS OF C OR ,n - LATH,-EXT �•� I "SIGNATURE OF - + �.. / HOUSE NUMBER COR- - PERMIT -EF (!"r RECT AND POSTED _ ADDRESS FINAL - CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL EN PLAN,CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH l�o a .3' 5 AIN ?2 1 A ' I r. APPLICATION FOR BUILDINGPERMIT ; • _ , COUNTY OF-LOS ANGELES ' _ BUILDING AND SAFETY WORKER'S•COMPENSATION DECLARATION FOR APPLICANT TO FILL IN Bul I G�DYESS I hereby affirm that I have a certificate of consent to-self InsureBUILDIN DDRESS ,. or a certrficate of Workers' Compensation Insurance,or a certified ZIPCITY copy thereof (SEC 3800;Lab C) - - LOCALITY Policy No /Y / C� cer Company . SIZE OF LOTNO-OF BLDGS NOW ON LOT - 0 Certified copy Is hereby furnished _ NEAREST CROSS S ❑ Certfied copy is flied With the county budding inspection TRACT BLOCK. -• --• LOT NO . department USE ZONE - MAP NO - " - ��L 111 P // .f/�� _ Date�l2 L—` /jAPPlicant C� C� 1 �, ,ASSESSOR MAP BOOK PAGE = PARCEL- I _ - - 'SPECIAL CONDITIONS ' CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER - - TEL NO - COMPENSATION INSURANCE. Z Tff/L- WITHIN 1000 FT OF SCHOOL'? YES NO w This section'need not be completed If the permit is for one-hundred. ADDRESS - ( P P � � DISTRICT "GROUP. TYP�,CONST FIRE-ZONE ".PROCESSED BY .' dollars ($100) or'less) _ `� l c �/ ; CITY '_ - - ZIP --• - ,�• - SfiC/ . I certify that in the performance of the work'for which this permit is,issued, I'shall not employ any person in any manner.so as to, ^ ,"3 ri r ARCHITECT OR ENGINEER- - --•• - -TEL-NO c become'subject to the Workers'Compensation Laws t STATISTICAL CL"AS IFICATION APT. - CONDO Date ApplicantADDRESS - - - t .. CLASS NO 'DWELL UNITS - - NOTICE 'TO­ APPLICANT- If, after making.this 'Certificate .of - _ - - REQUIRED' �.-I TOTAL'SETBACKFROM - EXIST' Exemption, you­ should become',subject to- the --Workers CONTRACTOR o TEL'NO SET BACK- YARD, HWY PROP LINE WIDTH Compensation.provisions,of the.Labor.Code, you,,must forthwith [Liz((,6/L /Lu 30 —[ ,fes--�- FR_ONT - • Comply with Such provisions or this permit shall be deemed revoked. ADDRESS LIC NO' P L LICENSED CONTRACTORS DECLARATION 3? 3 SIDE CITy� - _ - LIC CLASS 'P L _ I hereby affirm that I.am licensed underprovisions Of Chapter 9 v`J t'���`�d� C'-3 SEWER MAP (commencing with Section 7000)of Division 3 pf the Business and SQ'FT SIZE NO OF STORIES NO OF FAMILIES _ �= Professions Code,and my license is in full force and effect NEW. BK 'PG :a J License Number 1 —�2 3 Llc Class l DESCRIPTION'OF WORK, ADD '❑ , VALUATION ,_ h- Q b)LLS,/ : ", 1 - 2. �� 2r, /L—r- 'a'iJn^ 2 Rr-i 57-' . $ B-O U Contractor - Date" 1 ALTER , _❑ ��" �• C�,LA p o C'17, a S r•F r Lct 2, i Lr' Q ❑ I'am exempt under Sec l REPAIR ❑' F_ B&P C for this reason GV ). .60,r tF F -j q^ /l DEMOL e LDMA P/C#,'.,• a1• �• a Date" .USE OF EXISTING BLDG. ,/i!y/f�ilG-[i-1Q SN•- /t `� ~URM ❑ C0 Signature APPLICANT_(PRINT) .1 - . TEL NO - ' LDMA Perm# Z ❑, l,'as owner of the,property, Or my employees-with'wages as '\f Ii_ their sole compensation, will do the work'and,the structure is ADDRESS not Intended or offered-for sale (Section 7044, Business'and - _ - ,FINAL DATE ~ `,�l; s' a; l1t• PfOfeSSIOnS Code) WILL THE APPLICANT OR FUTURE BUILDING,OCCUPANT HANDLE A HAZARDOUS MATERIAL • -- ! �� _ t- ,, '-{ •r T r OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE _ t J.'3.i EMS ❑ I, aS owner of the property„am exclusively contracting WI{h AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS'INFORMATION GUIDES. FINAL BY licensed contractors,to construct the project (Section 7044, !! —; '� Business and Professions Code) YEs❑ -No.❑ - - • t ! _ !k�- ®?v • ,WILL.THE INTENDED USE OF THE BUIDLING BY THE APPLICANT'OR FUTURE"BUILDING - x ^• ttL—r "�— -3! _ OCCUPANT REQUIRE A PERMIT FOR'CONSTRUOTION OR MODIFICATION FROM THE SOUTH., - C•i ILC• 3.•.?-?''u'J'- CONSTRUCTION LENDING AGENCY COAST AIR QUAUTIYMANAGEMENT DISTRICT(SCAQMD),SEE.PERMITTING-CHECKDST FOR' GUIDEUNES CHANGE L hereby affirm that there Is a construction lending agency for YES❑ -,,No❑ " T w the performance of the work for which this permit is Issued(Sec O 3.097,Civ C I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING ' CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER JHE LOS ANGELES COUNTY CODE„ $ w _ • -TITLE 2•'CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140,CONCERNING HAZARDOUS - 4rf._!!_li!—_!i!�:? ,1%,i=j•';/ C Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM SHE SCAQMD - "' '' ' o Lender's Address _ - ?_sI - _ 1' PM 12, ' O G NER O AGENT - • - o I certify that I have read this application and state under penalty O of perjury that the above ihformatlon.is correct I agree to comply PC FEE - - PERMIT FE, E^ o with all county ordinances and State laws relating to budding ~ r' co construction, and hereby authorize,representatives of.this County ISSUANCE FEE - " to enter upon the abovp-menti ed property for Inspection purposes �\ � LY—r/!' INVESTIGATION FEE TOTAL FEE+- '• •` > SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP _ BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 _ BL 0508 1403050040 PHONE: (626) 285-0488 EXT, ILEGAL ID: 1 NO. OF CONST NEW BUILDING ADDRESS: ITR: 26026 LT: 5 SQ. FT STORIES TYPE OCCUP GROUPI 8628 HALDEMAN ST I ISTRUCTURE: 0 1 V-B - R-3 I SGAB CA 917752637 IASSESSOR INFORMATION NUMBER: GARAGE: 1 NEAREST CROSS STREET: 1 15386-007-056 ,OTHER: THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY CAI I I (TENANT: IEXIST BLDG USE:.- USE ZONE: (ISSUED ON: PROCESSED BY: I 1 IEXIST OCC GRP: 103/05/14 SR 1 (OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: FIDjfL DATE F BY: CODE: 1 IWAN, ANTHONY (323) 240-7707- 1 24,000 1 1 18628 HALDEMAN ST I ISGAB 917752637 1 FEES PAID IDE CRIPTION OF WORK 1 I - (KITCHEN AND TWO BATHROOMS REMODEL (1) 3'X3' WINDOW (RETROFITI IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: () (1) 6'X6'8" SLIDING DOOR SAME SIZE AND LOCATION 1 (APPLICANT: TEL. NO: I I IDE LA ROSA, GERARDO (213) 305-5535- IAA BLDG PERMIT ISSUANCE 27.80 1 1 1460 S LA VERNE AVE IAB STATE GREEN BLDG FEE 24000.00 VAL 1.00 ISPEC3AL CONDITIONS: ILOS ANGELES CA 90022 1AC STRONG MOTION RESID 24000.00 VAL 2.40 1 IB2 PERMIT W/ENERGY 24000.00 VAL 497.00 1 IFR INV WORK W/O PERMIT 344.00 DOL 344 00 CONTRACTOR: TEL. NO: - TOTAL FEES 872 20 (APPROVALS DATE INSPECTOR SIGNATURE IDE LA ROSA CONSTRUCTION (213) 305-5535- 1 1460 S LA VERNE AVE LIC NO 1 (LOCATION AND SETBACKS 1 (LOS ANGELES •CA 90022 855010 I ISOILS ENGINEER APPROVAL 1ARCHITECT OR ENGINEER: TEL. NO: 1FOU9DyTION/TRENCH FORMS I LIC NO: ISLAB/UNDER FLOOR I I I I I - (RAISED FLOOR FRAMING 1MAP NO: SEWER MAP BOOK PAGE: FIRE ZONE: CMP I (UNDERFLOOR INSULATION I 1 3 001 1 1 ' I (1ST LEVEL FLOOR SHEATH I INC. OF FAMILIES: DWELLING UNITS. APT/COND: STAT CLASS- I 1 0 NO 21 1 12ND LEVEL FLOOR SHEATH 1 SCHOOL WITHIN HAZARDOUS I IROOF SHEATHING 1AIR QUALITY: 1000 FEET MATERIALS I I I 1 1 1 NO NO NO I IFIRE DEPT FRAME INSPECTI I I I (BLDG DEPT. FRAME INSPECTI I I i I I I 1I (SHEAR PANELS I 1 i I I I I I (INSULATION/WEATHER STRIPI I I I (INTERIOR LATH/DRYWALL I _I I`y'E ' 1 _ IEXTERIOR LATH I' l I I i I 1 1 I I ILOT DRAINAGE I I I • ISMOKE DETECTION DEVICES I I I I I I I I I I - I IFIRE DEPARTMENT APPROVAL( 1 1 i I I I I I 1 _ � _ '•� '_ - IREPORT ID:-DPR261 ROUTE TO: -BS0508,