HomeMy Public PortalAbout10622 KEY WEST ST_Building__ . -APPLICATION FOR BUILDING PERMIT
rOR APPLICANT TO FILL IN (Print or type only)
BUILDING COUNTY OF LOS ANGELES
ADDRESS ZZ- J DEPARTMENT OF COUNTY ENGINEER
CITY Cc ZIP BUILDING AND SAFETY DIVISION
NO.OF BLOGS. r� BUILDING /
SIZE OF LOT 7'5< -/6)D NOW ON LOT' G. ADDRESS
TRACT ZIBLOCK I LOT NO Z' .L OCA LIT
• �G{{�f �. NOL. ' NEAREST
OWNER IZ�Co CROSS ST
ASSESSOR _
ADDRESS - S MAP BOOK PAGE CEL
DISTRICT GROUP TYPE- FIRE PROC SED Y
CITY ZIP _ }� CONST. �'' ZONE
ARCHITECT OR -T - TEL. (��,-
ENGINEER NO
STATISTICAL C''L))ASSIFICATION - SEWER MAP
ADDRESS CLASS NC �_DWELL UNITS .BK PG
TEL.
CONTRACTOR p2 NO 3 Z, (a (/U5��1 ZONE NO. •`�
ADDRESS O �`'„ yL�) (LA _ NO LIC-ZZ.IOIaJ "` ` SPECIAL '
LIC, u� CONDITIONS
CITY'\rj_S' ,& CLASS ie { ROAD DEPARTMENT APPROVAL REQUIRED YES.[] NO
CONSTRUCTION LENDER }
NAME AND BRANCH BLD .SETBACK FROM C
FR T PROP.LINE OF (STREET) L;
ADDRESS 'CITM HIG WAY- + YARD TOTAL SETBACK FROM TYPE OF EXISTING
SQ FT NO. OF NO. OF CHECK FRONT PROP LINE HIGHWAY WIDTH
SIZE STORIES I FAMILIES 'F ONE - C.;
❑ + a
DESCRIPTION OF WORK br j2!jf^,L NEW O/,
BLDG SETBA OM Z
o ADD ❑ SIDE PROP. LINE O (STREET)
-ALTER ❑ HIGHWAY + YARD = TOT ETBACK FROM TYPE OF EXISTING
REPAIR❑ SIDE t2 . LINE HIGHWAY WIDTH
USE
EXISOT NG BLDG. ' !� DEMOL ❑ .+
APPLICAN TEL --77 CORNER CUTOFF YES ❑ O ❑
(PRINT) (� N0. 53 /Zt(o
1 /L� ' IN OPEN SPACE YES ❑ NO
BY (SIGNATURE)
-IN•COASTAL ZONE YES ❑ NO ❑
VALUATION s 5qco�
CATEGORICAL EXEMPTION YES❑ NO E]I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL
AND STATE•THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT . - EXEMPTION DECLARATION SIGNED (DATE)
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- ,
STRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE)
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STATE OF CA / q !f 'y �/ ,l �fy7 a•�
WORKMEN'S COMPENSATION INSULIF NIA IN RELATING TO
RANCE �`1 -.t I -'7`I i�(
SIGNATURE OF �_ SAF ('0���/
PERMITTEE
ADDRESS _ //L� p'� I�-7-1OI!>Or
FINAL • - "BY _
TEL. DATE
CITY ' - NO. Q
'MAKF_ CHECKS PAYABLE_ TO. FEE FEE I '
HARVEY T. BRANDT. COUNTY ENGINEER
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION c M O ' CASH
6 1,'4 .APR 22 1 -U; • 3 5.2 5 ®°
76A638A CE#803 7/73 _ .�
DEPARTNBNT OF COUNTY ENGINEER
DMSIO OF O DIN ANGELSAFETY BUILDING
WILLIAM J. FOX, COUNTY ENGINEER APPLICATION
CASSATT D. GRIFFIN, SUPT OF BUILDING E I
FOR APPLICANT TO FILL IN FOR OFFICE USE .ONLY
BUILDING �. DISTRICT NO. I; PLAN CK.OR REc.No. PERMIT NO.
ADDRESS D q11
LOCALITY / RECEIVED BY. - DATE OF APPL. DATE ISSUED
"4 D3 3
NEAREST -
CROSS ST" ', ' A
BUILDING }
OWNER i
C U ADDRESS' O (p L
• i -
MAIL ! r LOCALITY
ADDRESB -, .d NEAREST]
CITY S V1"�`� W/ pL' _ CROSS ST. K'L�•�
OF i . y SY.P_E,.�� GROUPS"
ARCHITECT OR TEL. FIRE NO
ENGINEE NO. ZONE k PLANS
ADDRESS BLDG. - - / "} - �. O�D NO.
SETBACKILINE f
V
TEL. ! USE `/ BAYPROVED ; A
CONTRA OR t C ZONE
ADDRESS p0/'d BAld,
HOUSE NUMBERING
• LEGAL I MAP NUMBER
__i NO. ASSIGNED BY
DESCRIPTION LQTN2. BL K' i
CORRECTIONS--
TRACT
SIZE OF LOT I NO. OF BDGS.
NOW L
ON LOT I .
USE OF NO. OF
EXISTING BLDG. FAMILIE
DESCREMON OF WORK o -
NEW ALTKRATION �_&DDITION'
r
REPAIR DEMOLITION a
SQ. FT. / I� NO. OF '
SIZE �tS�J ROOMS STORIES
EXT. WALL - ROOF
COVERING CG I COVERING
USE OF STRUCTURE
v`d-G
APPROV4,Zb.
INSPECT S SIGNATURE DATE
FOUNDATION: LOCATION ,r(
FORMS, MATERIALS X.,
i HEREBY ACKNOWLEDGE'THAT 1 HAVE READ THIS AP- FRAME: FIRE STOPS,
PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS
CORRECT. FURNACE: LOCATION,
1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES GAS VENT, DUCTS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
SIGNATURE OF P /, } LATH, INT.
PERMITTER
LATH. EXT.
ADDRESS / "
' PLASTER, INT,
AUTHORIZED AGT. r�/
PLASTER, EXT. I �ll
P.$ S/LJ �• I- F6 c. $ 6-, HOUSE NUMBER COR- A.RECT AND POSTED IVALUATION E $:i- ` " FINAL , L -
78A88GA 086 2 G-BII
i{ 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 1009200020
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: I
ITR: 19189 LT: 112 I SQ. FT STORIES TYPE I 10622 KEY WEST ST I
I ISTRUCTURE: 24 V-B I TEMP CA 917803464
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: PAL MAL - I
18585-025-015 I THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, Cl
1TENANT: IEXIST BLDG USE: RESID USE ZONE: R-1 TISSUED ON: PROCESSED BY,: ' J
IEXIST OCC GRP: 109/20/10 SR 1
(OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: I NAL DATE FIN BY: CODE: J
ISCHWARTZ ALFRED - i 4,000I
110622 KEY WEST ST IN
TEMP 917803464 FEES PAID JDL9CRIPTION OF WORK
IRE ROOF HOUSE AND GARAGE 3 YEAR COMP SHINGLES OVER EXISTINGI
(FEE DESCRIPTION: QUANTITY: UOM- AMOUNT: ( I
JAPPLICANT: TEL. NO: I I - I,
IBRIAN KEEFER'S (909) 608-0622- JAA BLDG PERMIT ISSUANCE 27.80 1
I JAB STATE GREEN BLDG FEE 4000.00 VAL 1.00 1SPECIAL CONDITIONS: I
I JAC STRONG MOTION RESID 4000.00 VAL • 0.50 I I
-I ID2 PERMIT W/O EN-HC 4000.00 VAL 116.00 1
I 1TOTAL FEES 145.30
(CONTRACTOR- TEL. NO- (APPROVALS DATE INSPECTOR SIGNATURE
IKEEFER'S ROOFING (909) 608-0622- 1
11216 BEGONIA COURT LTC NO ILOCATT_ON AN.T) SETBACKS J
UPLAND CA 91784 760903 C39 J
" ISOILS ENGINEER APPROVAL
I I I I I I
JARCriITECT OR ENGINEER: TEL. NO. IFOUNDATION/TRENCH FORMS
I LIC. N0: JSLAB/UNDER FLOOR _
I I I
(RAISED FLOOR FRAMING
I I I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE CMP•:J JUNDERFLOOR INSULATION I I - -
147H273 3 OOI 1 11
•IFLOOR SHEATHING 1
NO. OF FAMILIES: DWELLING UNITS: APNO/COND: STAT CLASS- J
I •- IROOF SHEATHING
I I I
J SCHOOL WITHIN HAZARDOUS (SHEAR PANELS
JAIR QUALITY: • 1000 FEET MATERIALS
1 NO NO NO (FRAME INSPECTION I I
I I I
I IFIRE SPRINKLER HANGERS I
I I I -
I (INSULATION/WEATHER STRIPI I I '
I IINTERIOR LATH/DRYWALL
I I I
(EXTERIOR LATH
I I I
IRATED FLOOR/CEIL ASSEM. I I
IRATED WALL ASSEMBLIES 1 I
IRATED SHAFTS/OPENINGS
I I I
I I I -
I I IT-BAR CEILINGS
ILOT DRAINAGE _
I I I
IREPORT ID: DPR261 ROUTE TO: BS0508
I I I I I i