HomeMy Public PortalAbout9240 KENNERLY ST_Building__ .76A638A CE#803 3-68 61T�
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING r�
DEPARTMENT Of COUNTY ENGINEER ADDRESS .CN L
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER 'NEAREST
COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST. TU '
DISTRICT NO. :GROUP TYPE. .. • P,1GCESSED BY
FOR APPLICANT TO'FILL IN CONST. �,
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BUILDING STATISTICAL CLASSIFICATION SEWER MAP,
ADDRESS 92CLASS NO. DWELL.UNITS BK - PG
LOT NO. BLOCK USE=ZONE MAP / 1
n
NO. !o
1-TRACT j K_/ SPECIAL
NO.OFBLDGS. [ , ( CONDITIONS
SIZE OF LOT NOW ON LOT +
USE OF
EXISTING BLDG. BLDG.SETBACK FROM
TEFRONT PROP.LINE OF (STREET)
OWNER A . B NOL.. - TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL
ADDRESS HIGHWAY' WIDTH FROM C.L.
CITY Temple City . BLDG.SETBACK FROM
ARCHITECT OR' TEL. SIDE PROP.LINE OF (STREET)
ENGINEER NO. - ,TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL
ADDRESS HIGHWAY.WIDTH FROM C.L. '
EL. }
CONTRACTOR H T288-4040
O
LIC. C_D
ADD ESS 5 9 NO. CORNER CUTOFF YES ❑ NO ❑
CITY San Gabriel ASS C-3 9 SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORKLu
N
z
NEW ADD ALTER REPAIR X DEMOLISH
SQ. FT.. NO. OF - NO. OF '
SIZE STORIES FAMILIES
USE OF
STRUCTURE
with Ce1otex Compo .
SIGNATURE OF ,
APPLICANT
VALUATIONb599 APPROVALS DATE INSPECTORS SIGNATURE
P.C. J 7 7 PMT. FOUNDATION: LOCATION
FEE S FEES q n n FORMS, MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I 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 DOING THE WORK '
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- '
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- LATH, INT.
ING TO WORKMEN'S COMPENSATION INSURANCE.
/J LATH, EXT,
SIGNATURE OF ' / U/�� HOUSE NUMBER COR-
PERMITTEE �C mit RECT AND POSTED
ADDRESS SA�I_l`II/vS a 0IN AL
• / JOHN F. LEWIS, PRINCIPAL ST URAL ENGINEER
PLAN CHECK VALIDATION CK M.O CASH _ PERMIT-VALIDATIONCK M O.• CASH
i.%A�o'.`?'o ?:..� -OCT 3.0 Q 9.0-0-
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNj`�,JtOE LOS ANGELES
WM. J. FOX. CHIEF ENGINEER BUILDING
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PLAN CK.NO. PERMIT NO.
7
BODRESS 19240 Kennerl.y Street
1
LOCALITY emle City, California RECEIVED By DATE OrAPPL.. DATE ISSUED
NEAREST � � ' 12
� v
CROSS BT. TURNER-
F�Tr*�apt�us Dr�i,�y+�e} -r BUILDING
OWNER 1U�LIt ER-HCYIES--INC. - _ ._ _ ADDRESS
MAILa LOCALITY _T , C '
ADORE 26,-East Santa Clara Ste,
TEL CROSS NEAREST }e ,{Q eP�' E�
CITY lSl"QaLL:La NO.- DO 7-3563 NEAREST. ` v� t
FIRE NO.OF ap TYPE GROUP
ARCHITECT OR TEL. ZONE PLANS
.ARCHITECT
NO.
BLDG. .s.A�� �tf 4 a
41
ADDREBB - SETBACK LINE
APPROVED
TEL.
CONTRACTOR Same NO. U DATE
USE � APPROVED
ADDRgffi ZONE BY DATE
LEGAL ` CORRECTIONS
DESCRIPTION- •' LOT NO. 110 L.BLOCK
TRACT 16475 ^ /0 1 r I
SIZE OF LOT 62 x 100 I NO.OF BLOBS.
NOW ON LOT No
USE OFNO.OF NO.OF _
EXISTING B DO. FAMILIES ROOMS
DESCRIPTION OF WORK
NEW X[ I ALTERATION ADDITION O
REPAIR MOVING DEMOLISH
ME i^nT G/NROO.OOFS T STORIES' _ + Z
1• D
r
WALL ROOF m .
COVERING Plaster COVERING
BUILDING Dwelling
Y
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS_
APPLICATION AND STATE THAT THE ABOVE 19 CORRECT FOUNDATION: LOCATION IN PECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS
t AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
FRAME: FIRE STOPS,
SIGNATURE OF TTTpp>'Lrp VOMES Nay• BRACING.BOLTS
PERMITTE lJi�t ER H V LATH, INT.
AUTHORIZED AOT LATH, EXT. Z'
76w63A-3 a-sa $ -� P.C.$ 5.63PLASTER,INT.
B '
FEE 22.50 PLASTER.EXT.
O -
VALUATION FEE 28-13 FINAL
DING
BUILDING /ti {� �j�v/ kl e r lv
ADDRESS
APPLICATION + LOCALITY
NEAREST
DIVISION OF BUILDING AND SAFETY CROSS ST.
Department of County Engineer DISTRI�,T NO. RECEIPT NO. PERT NO.
County of,Los Angeles S '—
WM.
WM. J. FOX; COUNTY ENGINEER O$$$QQQ���P DATE RECEIVED DATE ISSUED
CASSATT D. GRIFFIN, SUPT OF BUILDING / /'0 _/ 3 -
FOR APPLICANT TO FILL,IN TYPEST. RECEIVED BY ss BY-
OWNER i /7 i ��/ Cj !� ^
MAP �f/� � STATE'�--
MAIL - ,� ---yyy��� NUMBER HWY M' NO
ADDRESS ��p �C.�A//(Q(;
- � USE ZONE SPECIAL
.,/ TEL. /► _ / CONDITIONS
CITY �t'" _ LLS 1e 1 C NO. �7
ARCHITECT OR TEL. + 5*&w
ENGINEER NO.
.. BUILDING YARD HWY 'STREET NAME EXIST.
SETBACK �j WIDTH
ADDRESS FRONT. J/'1.' l�•�h,n� r JV �� /
CONTRACTOR
SIDE
P. L.
ADDRESS
DATE CORRECTIONS INSPECTOR
BUILDING L / Q` J -
ADDRE59L. �l. • [n�
1 2 I- ',`F
LOT NO. l� Co BLOCK
/
TRACT (p 7 0 `
/ NO. OF BLDGS.
SIZE OF LIT (p C� �C t'D `y NOW ON LOT /
USE OF =-
-FXIRTING BLDG.
DESCRIPTION OF WORK - °
T N z L o
EW ADD-. ALTER _ REPAIR DEMOLISH_ Z
S Q.FT. N O. O F N O.OF `-�""---' r
SIZE K- STOPIES FAMILIES i
USE OF STRUCTURE
' roc i d Pv� r •� - .
NO. OF
EMPLOYEES
1 HEREBY ACKNOWLEDGE THAT I .HAVE READ THIS AP-
PLICATION
PiPLICATION AND STATE THAT THE INFORMATION GIVEN IB APPROVALS IN SP TOR'S SIGNATURE DATE
CORRECT.
IAGREE TO COMPLY ALL COUNTY ORDINANCES. FOUNDATION: LOCATION
AND STATE LAWS REGU _S ILDING CONSTRUCTION! FORMS,MATERIALS
FRAME: FIRE STOPS,
SIGNATURE OF BRACING, BOLTS
PERMITTE FURNACE: LOCATI ,
GAS VENT, DUCT
-ADDRESS
LA-H. INT.
AUTHORIZED AOT.
LATH, EXT.
S FEE HOUSE ER
RECT ANN POSTED
VALUATI ON MlTff FE` FINAL
76A638A DTb 3 Gib 5-54
RKERS'COMPENSATION DECLARATION r t 1• I I L � �/
t ,`Yi he, affirm that I have r certificate,of consent to Self APPLICATION 'FOR R LL D I N G PERMIT' ,
Insure,/or a certificate of'Workers' Compensation Insurance,
or a certified copy thereof (Sec. 3800, ' '
�/ —•� COUNTY OF- LOS.ANGELES BUILDING AND SAFETY '
Policy o. Company
❑ Ce ' ed copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING
ADDRESS t
Certified copy is filed with'the county building inspec- BUILDING' C
do department. ADDRESS C c1
Date w.Applicant ! CITY ZIP ® LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS' 4 O.OF BLDGS. NEAREST,
COMPENSATION INSURANCE• SIZE OF LOT OW ON LOT CROSS ST. 101,
(This sectiomneed not be completed if the permit is for one ) �("] ASSESSOR
hundred dollars (5100)or less.) TRACT ld�f ( BLOCK LOT NO. IO MAP BOOK PAGE PARCEL
TEL.
OWNER '7 _p 2 USE ONE P
C. O
I certify that'in the performance of the work for which this f NO.
permit is Issued, I shall not employ any person in`any manner Qd f ADDRESS SPECIAL
so as to become subject to the Workers'Compensation Laws. �/v— CONDITIONS , 0
Date Applicant CITY ZIP
PP r' ., TEL.'
NOTICE TO APPLICANT: If, after makingthis Certificate of ARCHITECT OR DISTRICT G UP TYPE FIRE PROCESSED BY O
-Exemption, you should 'become subject,to the-Workers' ENGINEER (S NO. CONST,. / ZO E ' f—
Compensotion provisions of,th-e Labor'Code;you muit forth- ADDRESS I W
with comply with such provisions or this permit shall be =
deemed revoked.
TEL. 7 �y STATISTICAL CLASSIFIC(TION APT. . CO Cn
CONTRALTO - NO. J d Z
LICENSED'CONTRACTORS DECLARATIONLIC CLASS NO. DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO.Y �0a SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and LIC. �/
Professions Code, and my,license,is in full force and effect. CITY, CLASS VAL)p�q 0 IA
2 n /�_ SQ. FT. N O NO. OF CHECK BK �'' ,U I-)
License Number 3�31Lic.Class-1 •J / SIZE STORIES FAMILIES ONE
DESCRIPTION OF WORK• -�{y Y NEW
Contractor Date i ADD $ I ° - 60.57
3
I am exempt under Sec. ' 11 ALTER ❑ r ® o o.0 6 Q 5 7
B.BP.C. for this reasonREPAIR/) ❑ $
•I7'_
Date: USE OFr # 6,•
EXISTING BLDG. rLSt Q CL7�- DEMOL ❑ .
Signature APPLICANT ��_ j t NO �� FINAL I ° 34298
OWNER-BUILDER•DECLARATION PRINT DATE'•
I hereby affirm,that.I am exempt from the Contractor's License
Law for PRESENT B the following reason (Section 7031.5, Business and ADDRESS �' —+ FINA ' o`• 3 4 2 9 8,�
^ r'
Professions Code): BUILDING' y O S27-8-8,
❑ 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(Section LOCALITY
7044, Business and Professions Code). MOVING TEL.
❑ 1, as owner of the-property, am exclusively contracting CONTRACTOR NO
With licensed.contractors to construct the'project (Sec- ADDRESS' �'�9 b 7 A .
tion 7044, Business and Professions Code)
REQUIRED TOTAL SETBACK e.o • • e
CONSTRUCTION,LENDING AGENCY SET BACK YARD HWY• PROP LINE WIDTH 'S #' i iJ
I hereby affirm that,there is a construction lending agency for FRONT: I • 4.8 5.2 5'" +
the performance'of the work for which this permit is issued . P.L. ! '
(Sec. 3097, Civ. C.). SIDE e • 4 8 S,2 5 6'
PL
Lender's Name ul Q'2,1 8'8
LDMA Ref, M
m Lender's Address
PC Fee S• t Permit Fee
I certify that,I-have read,this application and state-that the t v,/ Issuance Fee LDMA P/C#
g above information is correct. I agree to comply with all County Invests 'ation Fee
S ordinances and State'lows relating to building construction, g f
and hereby authorize representatives of this County to enter Notal Fee' 1 LDMA Perm. q - A •`J
up talleae boned property for,inspec' n purposes.
y`•C� SEE REVERSE FOR EXPLANATORY LANGUAGE O 91
gnature of Applicant or Agent Date V