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HomeMy Public PortalAbout5555 HALLOWELL AVE_Building__ ©S 7aA638A'--' _ CE#803(REV.N78) APPLICATION. FOR BUILDING PERMIT COUNTY OF LOS ANGELES r BUILDING AND SAFETY/ DINFOR APPLICANT TO FILL IN ADDDDRRESSESS A BUILDING ADDRESS LOCALITY �] � � NEAREST ��L CITY l�C ZIP L► ® CROSS ST. 'Ile NO.OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL DISTRICTG UP TYPE FIRE ZONE [,--TRO_ ESSED BY TRACT (7 O BLOCK LOT NO. CONST. OWNER L '� Ca� rl// STATISTICAL CLASSIFICATION SEWER MAP ADDRESS .'S� CLASS NO.c;,2/ DWELL.UNITS BK PG � 1 CITY C ZIP �D ARCHITECT OR TEL. VALUATION $ (� ENGINEER NO. ._ ADDRESS BLDG,SETBACK FROM TEL. FRONT PROP.LINE OF (STREET) CONTRACTOR /vl NO, HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING •( V LIC. FRONT PROP.LINE HIGHWAYI WIDTH ADDRESS 7,1 NO. f t�' LIC. + CITY ; r CLASS BLDG.SETBACK FROM CONSTRUCTIOIjLL' NDER SIDE PROP:LINE OF (STREET) NAME AND BRANCH HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING � ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH SQ.FT. NO.OF NO.OF CHECK + = d SIZE ' STORIES FAMILIES ONE DESCRIPTION OF WORK NEW ❑ P.C. Fee$ Permit Fee LL 7`S ADD ❑ Issuance Fee g ���I�LB ���✓I ALTER REPAIR ❑ Total Fee / USE OF DEMOL EXISTING BLDG. ❑ Z APPLICANT TEL C (PRINT) NO. ~ t' BY(SIGNATURE). Q IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Y THAT THE ABOVE IS CORRECT AND-AGREE TO COMPLY WITH ALL ORDINANCES ud AND LAWS.REGULAT I NG BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE S WORK.AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF U THE LABOR CO E OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM. ' 2 PENSATION IN NCE. • - O O A d E SIGNATURE OF # 0 0 0 0 0 PERMITTEE ADDRESS Z 2 o 'o 6 1.0.0 O TEL. �= 0 0 0 6 1,E)0 CITY NO. Q O •I U EZONE MAP -�� 7 Q 0 10378 NO. �'? , > SPECIAL r_ ZJ CONDITIONS oc FINAL) Y d DATE f ©s '76A638A_-,t _ GE#803(REV.6/7W - APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDING ADDRESS BUILDING // L ADDRESS J J LOCALITY NEAREST CITY ZIP CROSS ST. v e NO.OF BLDGS. ASSESSOR SIZE OF LOT (y© ! NOW ON LOT MAP BOOK PAGE I PARCEL DISTRICT GROUP TYPE FIRE PROCESSED BY TRACT 3 0 3a6� BLOCK LOT,NO.. CONST. ZONE OWNER STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NO. DWELL.UNITS BK,? PG CITY ZIP (J ARCHITECT OR TEL. VALUATION $ G�/ Joe ENGINEER NO. / ADDRESS BLDG SETBACK FROM TEL. FRONT PROP.LINE OF (STREET) CONTRACTOR NO.. HIGHWAY + YARD = -TOTAL SETBACK FROM TYPE OF EXISTING LIC. FRONT PROP..LINE HIGHWAY. WIDTH ADDRESS NO. LIC. CITY CLASS CONSTRUCTION LENDER BLDG.SETBACK FROM NAME AND BRANCH SIDE PROP.LINE OF (STREET( HIGHWAY + YARD – TOTAL SETBACK FROM I TYPE OF 1EXISTING ADDRESS CITY SIDE.PROP.LINE 1HIGHWAY1 WIDTH SO.FT. NO.OF NO.OF CHECK + _ SIZE STORIES FAMILIES ONE 29 DESCRIPTION OF WORK NEW ❑ P.C. Fee$ Permit Fee eZ 7, ab ADD ❑ Issuance Fee 7 00 ALTER REPAIR ❑ Total Fee USE OF DEMOL EXISTING BLDG. El Z APPLICANT TEL 0 (PRINT) NO. Q O ♦ J BY(SIGNATURE) Q I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Y THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES WAND LAWS I CERTIFY p IN WORK AUTHORIZEDTING HEREBYI IDING WILLL NOTSEMPLOY ANY PERSONHAT IN VIOLAOTIONTHE OF tJ d 1,p&9.A THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM Z PENSATION INSUR NCE. g 0 0 0 0 0 1 SIGNATURE OF 2 0 0 34,00 PERMITTEE ADDRESS Z o33 0 0 4,0 0 TEL. Or CITY NO. 1. 0.3 .1 -7$ USE ZONE MAP Q NO. Z Q D > .06 SPECIAL ►- /�a CONDITIONS 0.1 FINAL DATE ©s 76A638A— ti CE#803 Ev.6/78) APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN ADDRESS,�j"-j~j� BUILDING ADDRESS LOCALITY NEAREST CITY / ZIP CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT 1 Q X 3 NOW ON LOT MAP BOOK PAGE PARCEL a DISTRICT GR UP TYPE FIRE SSED BY TRACT 113 c D. BLOCK LOTNo. . CONST. ZONE OWNER j ,➢}!I . ,) STATISTICAL CLASSIFICATION SEWER MAP ADDRESS � u CLASS NO. CSI� DWELL.UNITS BK PG CITY ZIP ARCHITECT OR TEL. VALUATION $ ENGINEER NO. ! ADDRESS BLDG.SETBACK FROM TEL FRONT PROP,LINE OF —ISTREET) CONTRACTOR NO. HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING LIC. - FRONT PROP.LINE HIGHWAY WIDTH" ADDRESS NO. LIC. + CITY CLASS NDER BLDG.SETBACK FROM CONSTRUCT( NAME AND BRANCH SIDE PROP.LINE OF (STREET) HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING t ADDRESS CITY SIDE PROP,LINE9M HIGHWAY WIDTH SQ.FT. NO.0 JNO.OF CHECK + _ SIZE STORIES F MILIES, ONE ✓ O DESCRIPT N OF VKDR NEW ❑ P.C. Fee$ Perm it.Fee ADD ❑ Issuance Fee p ALTER .� - / m REPAIR ❑ Total Fee USE OF DEMOL EXISTING BLDG. ❑ Z APPLICANT TEL (PRINT) NO. ~ Q D BY(SIGNATURE) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Y ' THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES LU AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE - V . WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF - - ' THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- Z PENSATION INSUR CE. 5 ;243&7A . 9L ' # O'O SIGNATURE OF PERMITTEE. T a'0 5 2 0 0 ADDRESS Z _ ° 'a'� o 5200 TEL '' � CITY NO' QC U/SZONE NAOP.� �!Q O 5'— !"9 Y` (/ a t, SPECIAL r CONDITIONS e . oc FINAL BY d DATE 2—zZ� ov j� e- ` . v ©S 76A638A ~ CE#803(REV.CiV78) ' ' APPLICATION FOR' BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY BUILDING FOR APPLICANT TO FILL IN ADDRESS BUILDING ADDRESS LOCALITY NEAREST CITY IP CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT ( 'rJ JCS Z.-,,d NOW ON LOT. MAP BOOK PAGE PARCEL C- r !l. DISTRICT G3L�UP TYPE FIRE CESSED BY TRACT 23 BLOCK LOT NO. ,4 CONST. ZONE 429-A OWNERQ 3_ V .fJ -3 -�,�. ' STATISTICAL CLASSIFICATION SEWER M ADDRESS ® !/ �� CLASS N%:?,,!L' DWELL.UNITS BK PG r CITY ZIP z®6 ARCHITECT OR TEL. VALUATION $ /S iy® ENGINEER NO. !!L/ ADDRESS BLDG SETBACK FROM TEL. FRONT PROP,LINE OF (STREET) CONTRACTOR NO. HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING LIC. FRONT PROP.LINE HIGHWAY WIDTH ADDRESS NO. _ LIC. + CITY CLASS BLDG,SETBACK FROM CONSTRUCTION LEkOER SIDE PROP.LINE OF (STREET) NAME AND BRANCH TOTAL SETBACK FROM TYPE OF EXISTING HIGHWAY + YARD = SIDE PROP.LINE HIGHWAY WIDTH ADDRESS CITY SO.FT. NO.OF NO.OF CHECK SIZE STORIES FAMILIES ONE 09 DESCRIPTION OF WORK _ NEW ❑ P.C. Fee$ Permit Fee ®® ADD ❑ Issuance Fee ALTER ❑ '7 1 REPAIR ❑ Total Fee Ll o USE OF DEMOL ❑ EXISTING BLDG. APPLICANT TEL — 'PRINT) NO. BY(SIGNATURE) ��i 0 Q IHEREBY ACKNOWLEDGE•THAT I HAVE READ THIS APPLICATION AND STATE Y THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL.ORDINANCES W AND LAWS REGULATING BUILDING.CONST.RUCTION,I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE'OF CALIFORNIA IN RELATING TO WORKMEN'S COM- 'Z PENSATION INSURANCE. �02U,6A SIGNATURE OF PERMITTEE # 0 0 0 0 0 1 ADDRESS 0202500 TEL. r CITY NO' C 0 0 0 2 5 Q o U ZONE MAP l No. a > 09: 14-78 SPECIAL r CONDITIONS' f cc FINAL,//,¢ BY O DATE / v^' /{✓''°�—b.�c„— V ' WORKERS' COMPENSATION DECLARATION 1 i _APPLICATION I hereby a certificate I haver certificate of.consent r self F.O R BUILDING PERMIT .insure, or a certificate df Workers' Compensation Insurance, or d'certified copy thereof (Sec. 3800, Lab. C:) - ^-� COUNTY OF LOS ANGELES BUILDING AND SAFETY Policyl4b6 347, 8$ Company. State. " Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDess ® Certified copy'is filed'with the county building'inspec- BUILDING tion department: ADDRESS. 5555 N Hallowell St. Date' -1�26�c ^ Applicant 'Cedar ROOfS. CO. CITY ArCadla' zip 91006 LOCALITY CERTIFICATE OF'EXEMPTION,FROM WORKERS' "' NO:-OF BLDGS. NEAREST. COMPENSA710N'1NSURANCE SIZE OF LOT NOW ON LOT CROSS ST. r (This section need not be completed if the permit is for one ASSESSOR -hundred dollars ($100)or,.less.) TRACT BLOCK LOTNO. MAP BOOK � "PAGE PARCEL TEL. USE ZONE MAP I certify that in the,performance of the work for which this NO. permit;is issued, Lshdll not employ any person in any manner 555rSaN. Ha110WE311 St. 'r'. SPECIAL- any OWNER No:' 75 6- 91-� ADDRESS "' CONDITIONS el St.- .so as to become subject to the Workers'Compensatio"n laws. _ V - CITY Arcadia ZIP 91006 NOTICE TO APPLICANT: If, 'after making this Certificate of ARCHITECT OR TEL. DISTRICT_ G OUP• TYPE FIRE PRO SSED BY O ENGINEER ._ NO. CONST:. Z NE U Date Applicant Exemption, ou should become subject- to the'Workers'' � � ., � Compensation provisions of,the Labor Code, you must forth- ADDRESS - with,comply. with such provisions or this permit shall be" - TEL. STATISTICAL CLASS;ICA ION APT. CONDO. deemed reyoked. CONTRACTOR edar Roofs CO. NO. 284-7167 : LICENSED CONTRACTORS DECLARATION -• - CLAS.51 DWELL. UNITS LIC. 1 I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS P.O. BX87 NO. 157613 (commencing with Section 7000)of Division 3 of the Business and LIG. SEWER MAP Professions'Code, and`my license is in full force and effect. CITYUa CLASS C-39BK VALIDATION 157613 C-39• SQ. FT. NO,OF _ NO._OF CHECK License Number Lic.Class.-._ SIZE STORIES FAMILIES ONE T re-roof--US1ri VALUATION DESCRIPTION OF WORK g ""` NEW ❑ 500.00 Contractor •Ceder 'Roofs CO. Date- 1/2688 ADD ❑ ' am exempt under Sec: #340 GIF flber"CJlass Shg1S. - Res. only ALTER B.&P.C. for this reason REPAIR a 2 8 8-6 4 A r Date: USE OF # 0 0 0.0 0 !J EXISTING BLDG. reslCresidenceDEMOL ❑ APPLICANT TEL. 0 0 " Signature �. • .. .. . _. . (PRINT) Cedar Roofs Co. NQ.284-7167 . FINAL�� �I ' OWNER-BUILDER DECLARATION _..:_ ._ . DATED o-0 0 25= 9,- I hereby affirm that•I am exempt from the.Contractor's License �,Q, BOX $7 Alhambra CA 91802 FI t: �.G7�-. � O ,. Low for the following reason (Section 7031.5, Business and ADDRESS l / Professions'Code) _ '. ° PRESENT �BUILDING I_ 1,.as owner of the property, or my employees with ADDRESS _ wages as their sole compensation,will do the work and' 7 the structure is'not intended or offered for sale(Section LOCALITY -7044, Business-and-Professions Code): MOVING - I, as owner of the property, am.exclusively contracting CONTRACTOR NO. •11 with-licensed-contractors to construct the-project(Sec-" -' " - ADDRESS � c .tion 7044, Business and Professions Code). REQUIRED YARD WWY TOTAL.SETBACK FROM . ..-EXIST.. CONSTRUCTION LENDING AGENCY," SETBACK PROP. LINE WIDTH' I hereby affirm that there is a construction lending agency for FRONT -.ttie performance of the:work for which this-permit is issued'- - P.L. (Sec. 3097, Civ. C.). SIDE _ P.L. Lender's Name C mUl��l LDMA Ref..# Lender's Address P.C. Fee$- - - Permit Fee certify that.I have read.this.application and stole that the _ Issuance Fee :J0 V LDMA=P/C#- •-- '.- -- - a above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating.to-building construction, Total Fee LDMA perm. # U and hereb authorize representatives of this County to enter upon the b f. -mentioned property for inspection purposes. _ a ` SEE REVERSE FOR EXPLANATORY LANGUAGE Si ature of Applicant or-Agent- .. Da WORKERS' COMPENSATION DECLARATION zi re bor affirm ce of catte of Workers''l have a lCompensat on eto Insuran of A P_P L I CATION FOR BUILDING PERMIT I 'oro certified.cop thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES t.: BUILDING AND SAFETY Policy Ncr�Company� wwt:7�— yo Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec_ BUILDING tion department. ADDRESS GI/ s CITY o ZIP Date .rte 'Applicant , M l � k (Z LOCALITY TfJki NO. OF BLDGS. NEAREST �/"� A i -� CERTIFICATE OF EXEMPTION FROM WORKERS' IZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCE - ASSESSOR / (This section need not be completed if the permit is for one 1 TRAC OCK r' LOT NO. MAP BOOK! PAGE �r/� PARC E 3� hundred dollars ($100)or less.) ^U TEL USE ZONE MAP OWNER NO — NO. I certify that in the performance of the work foi which this W �`D SPECIAL permit is issued, I shall not employ any person in an manner ADDRESS CONDITIONS CL so as to become subject to the Workers'Compensation Laws. r -q O CITY ( ZIP < U Date Applicant ARCHITECT OR TEL. W NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO DISTRICT GROUP TYPE FIREg;OCE�SSED BY Exemption, you.should become subject to the Workers' , CONST'. / ZONE u Compensation provisions of'the Labor Code,.you must forth- ADDRESS �� iC`.� b✓ G-L/�s a with comply with such provisions or this permit shall be TEL. //�� STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTO LU-49­1 NO. _ LICENSED CONTRACTORS DECLARATION �L� LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing-with Section 7000)of Division 3 of the Business ' J —C(4 LIC. SEWER MAP CITY, e� A/ and Professions Code,and my license is in full force and effect: l� CLASS BK. /t! PG. VALIDATION SQ. FT. NO. OF NO. OF CHECK License NumberL �• Lic: Class SIZE STORIES FAMILIES ONE VALUATION Contractor 1M 0 Date `G." ` DESCRIPTION OF WORK NEW ❑ ❑1 am exempt under Sec. V ADD ❑ ; ► ALTER ❑ B.BP.C. for this reason REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMOL Signature APPLICANT TEL. - (PRINT) FINAL OWNER-BUILDER DECLARATION NO. I hereby affirm that I am exempt from the Contractor's License DATE Law for the following reason (Section 7031.5, Business and ADDRESS FINAL �i Professions Code): PRESENT By BUILDING ❑ I, as owner of the property, or my employees with ADDRESS `!'�' t =s wages cis their sole compensation,will do the work and LOCALITY ••"fit F E 1 j the structure is not intended or offered for sale(Section 7044, Business and Professions Code.) MOVING TEL. .-. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS 't_Iik)_ S 0 R_L• tion 7044, Business and Professions Code..) REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. ( w;f:, ,Mn ;! CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE WIDTH 1 hereby affirm that there is a construction lending agency for FRONT {• ,_-} os`1_i the performance of the work for which This permit is issued P.L. (Sec. 3097, Civ. C.): SIDE P.L. Lender's Name. E`si[ —hi! m LDMA Ref. # - P.C. Fee$ Permit Fee S'==Lli al- as' Lender's Address 10 1 certify that I have read this application and state that the Issuance Fee LDMA P/C It 8 above information is correct. I agree to comply with all County Investigation fee R ordinances and State laws relating to building construction, Total Fee — LDMA Perm. # m and hereby authorize representatives of-this County to enter a upon t bove-me �d fioperTy for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE \ Signature o (icanT or Agent Date rWORKERS' COMPENSATION.DECLARATION .F.. jeby affirm that I have a certificate of consent to SelfAPPLICATION FORAMILDING PERMIT e, or a certificate of Workers' Compensation Insurance, cerRfied copy thereof (Sec. 3800, Lab. C.) 6y COUNTY r5� P Y 7 � COUNTY OF LOS ANGELES BUILDING AND SAFETY I:alit No. Com an C /TKO ❑ Certified copy-is hereby furnished. FOR APPLICANT TO FILL IN Ao�REsS:J:�56 Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS f, Date ~D Applicants:'✓ 7 ` CLTY' ci ZIP ��t1 LOCALITY —�G �y NO. OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM-WORKERS' SIZE OF LOT t! 3 C NOW ON LOT �" CROSS ST. - COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) - T � EL. r7� USE ZONE • OP �1 OWNER }� NO. 7 L• �3 I'certify that in the performance of the work for which this SPECIAL permit is issued, I shall not employ any person in any manner ADDRESS ��� �' CONDITIONS O so as to become subject to the Workers'Compensation Laws. U Y � CIT . ZIP Date Applicant ARCHITECT OR TEL, DISTRICT. I GROUP TYPE FIRE PROCESSED BY NOTICE TO APPLICANT: If, after makingthis:Certificate of ENGINEER NO. s CONST. ZONE O Exemption, you ,should become subject to the Workers' //�� Q w Compensation provisions of the Labor Code,-you must forth- ADDRESS. _4s IG' L with comply with such provisions or this permit shall be TEL.rtyG �L, STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. CONTRACTOR NO. Z LICENSED CONTRACTORS DECLARATION, LIC. CLASS NO. /19 UNITS _ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS re _ NO.46 , (commencing with Section 7000)of Division 3.of the Business LIC. ff SEWER MAP and Professions Code,and my license is in full force and effect. CIT � ( CLASS 6' 1 BK PG LIDATION /` e� _ SQ. F NO. OF NO. OF CHECK License Number y JL�y Lic..Class� SIZE STORIES FAMILIES ONE -`=`r _-f VALUATION i - - mc Contracin�o ���Rr Date DESCRIPTION'OF WORK NEW ADD ❑ �/ c , _•i 3�L "'i 6 a ,3 F Elam exempt under Sec. _ ,, _ ALTER ❑ � - i'=•ins_'`' __ ..•4:e..moi! a.. tiz_� BAP.C. for this reason REPAIR ❑ $ Date: USE OF .'l �t:zl_ EXISTING BLDG. DEMO, ❑ APPLICANT TEL. Signature (PRINT) NO. FINAL L OWNER-BUILDER DECLARATION DATE f(_#;+''� %�`-`"`= I hereby affirm that I am exempt from the Contractor's License La for the following reason (Sectiori 7031.5, Business and ADDRESS FINA` /�/ t _=1 S Ar " '�5 Professions Code): PRESENT By ❑ I, as owner of the property, or m employees with BUILDING P P Y� YADDRESS .. , wages as their sole compensation,.will do the work.and the structure is not intended or offered for-sole(Section LOCALITY 7044, Business and Professions Code.) MOVING TEL. CONTRACTOR NO. ❑ I, as owner of the property, am exclusively contracting ' with licensed contractors to construct the project (Sec- ADDRESS y s tion 7044, Business and Professions Code..) REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the'work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE e..,y �' . w P.L. "re Lender's Name, t�; I w o P.C.,Fee$ t Permit Fee rrT �P+ a Lender's Address o I certify that I have read this application and state that the Issuance 77 Fee LDMA P/Cf�' t 8 above information is correct. I a ree to comply with all Count Investigation Fee. 9 P Y Y g C Gt R ordinances and State laws relating to building construction; Total Fee ��J LDMA Perm. # a �Rove authorize representatives of this County to enter - 'on d. ro art for ins action ur oses. �P P Y P purposes.k11ti. ' 1��.�/J - SEE REVERSE FOR EXPLANATORY LANGUAGE Y'wY, _ � Signature of Applicant or Date"'-- i - •,i:f '- a )) n.r s COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0809150056 PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST BUILDING ADDRESS: ITR: 30308 LT: 9 SQ. FT STORIES TYPE 5555 HALLOWELL AV 1 (STRUCTURE: V-B ARCD CA 910078418 IASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: DAINES 1 18586-015-032 THOMAS PAGE: 597 GRID: B3 LOCALITY: TEMPLE CITY, Cl TENANT: JEXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 109/15/08 SR 03/14/09 1 OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IFINAL DATE FI Y: CODE: IGAMBOA, MR/MRS. JOHN - 1 16,000 �' 1 15555 HALLOWELL AV Aa ARCD 910078418 FEES PAID IDESCR PTIO OF WORK I I MASTER BATH REMODEL 1 I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 (APPLICANT: TEL. NO: 1O'LEARY - IAA BLDG PERMIT ISSUANCE 27.75 1 15827 AGNES AVENUE 1AC STRONG MOTION RESID 16000.00 VAL 1.60 ISPECIAL CONDITIONS: 1 (TEMPLE CITY CA 91780 1B2 PERMIT W/ENERGY 16000.00 VAL 349.14 TOTAL FEES 378.49 I ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE ITOM O'LEARY CONSTRUCTION (626) 287-0927- 1 1 I 15823 AGNES AVENUE LIC. NO 1 ILOCATION AND SETBACKS I 1 I ITEMPLE CITY, CA 91780 489354 B-1 I I I I ISOILS ENGINEER APPROVAL 1 I (ARCHITECT OR ENGINEER: TEL. NO: 1 1FOUNDATION/TRENCH FORMS I 1 I LIC. NO: ISLAB/UNDER FLOOR I II 1 IRAISED FLOOR FRAMING IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP; ( (UNDERFLOOR INSULATION I 1150H273 3 011 I I I I (FLOOR SHEATHING I INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: 1 I I I NO 21 IROOF SHEATHING 1 1 SCHOOL WITHIN HAZARDOUS 1 (SHEAR PANELS 1 1AIR QUALITY: 1000 FEET MATERIALS I- 1 NO NO NO 1 (FRAME INSPECTION I 1 IREQUIRED TOTAL SETBACK FROM EXIST 1 (FIRE SPRINKLER HANGERS I 1 ISET BACK YARD: HWY: PROP LINE: WIDTH: _ I IFRONT PL- 11NSULATION/WEATHER STRIPI I I SIDE PL- I I (INTERIOR LATH/DRYWALL 1 I I I 1 (EXTERIOR LATH 1 I 1 (RATED FLOOR/CEIL ASSEM. I 1RATED WALL ASSEMBLIES 1 I 1 (RATED SHAFTS/OPENINGS I I 1 1T-BAR CEILINGS 1 1 ILOT DRAINAGE 1 IREPORT ID: DPR261 ROUTE TO: BSO508 I I