HomeMy Public PortalAbout9229 KEY WEST ST_Building__ APPLICATION FOR ,`.
BUILDING PERMIT
BUILDING - k
FOR APPLICANT TO FILL IN ADDRESS
LDING
ADDRESS_ (� Zti il 7 LOCALITY
NEAREST
CITY ��J, C ]- ZIP CROSS ST. YLL ✓•�
O.OF BLDGS. ASSESSOR
SIZE•OF LO/TT NOW ON LOT MAP BOOK PAGE PARCEL
TRACT LL /7�1 BLOCK LOT NO. DISTRICT GROUP TYPE .� FIRE E PROCESSED BY
CONOWNER Iy1 (7" .'9 icy N0. 5-TEL. ,� -f-
-
✓ Y' /�
STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS a i� CLASS NO. DWELL.UNITS BK PG
CITY /M - C ZIP USE ZONE NOP
ARCHITECT OR' TEL. / SPECIAL
ENGINEER NO. 1 CONDITIONS
ADDRESS ��yy ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO E]CONTRACTOR eo fU S NO.a2c'7 `A/76� BLDG.SETBACK FROM
IC. p FRONT PROP.LINE OF (STREET) •'
ADDRESS /U NO..21 I HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
22 LIC. FRONT PROP.LINE HIGHWAY •WIDTH
CITY 6- R (� CLASS
CONSTRUCTION LENDER + a
NAME.AND BRANCH BLDG.SETBACK FROM OV
ADDRESS CITY SIDE PROP.LINE OF (STREET)
SQ.FT. NO.OF NO.OF CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING U
SIZE STORIES FAMILIES ONE SIDE PROP.LINE HIGHWAY WIDTH a
N
❑ + = Z
DESCRIPTION OF WORK NEW
•A iV G, d T=i,d ADD n❑ CORNER CUTOFF YES ❑ NO ❑
F D I ,�RC v P ALTER 4P� IN OPEN SPACE YES ❑ NO ❑
/W REPAIR ❑
USE OF ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑
EXISTING BLDG. R L'S - DEMOL
APPLICANTTEL IO .fair y� f
(PRINT) /� C�¢�(�16 NO. 7 %✓�Z✓G� C/
BY(SIGNATURE)
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE ISCORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION.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- _
PENSATION INSURANCE.
SIGNATURECF �j T�
FINAL �- o ! l BY �
PERMITTEE DATE
ADDRESS
TEL. P.C.Fee$ Permit Fee r---
CITY NO.
Issuance Fee
VALUATION$ Q j p o od
Total Fee ` 57 0
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
1 3
4 ri'-ST Gti 1 U 8.J 0-AZ)
tS 76A638B CE B803B 6/76 '
i
TEMPLE CITY
76A638A CE 9803 2-63APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALIT
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST.
DIST TTN GROUP TYPE P Oc D B
FOR APPLICANT TO FILL IN 5 cON
BUILDING STATISTICAL CL ICATION, / SEWER MAP
ADDRESS / fj/i
CLASS. NO. DWELL.jUNITS
LOT NO. BLOCK WATER 11
CERTIFICATE: NOT REQU17ED/ RECEIVED
TRACT MAP HIGHWdv LOC
STATE MAJOR SECON , AL'
NO. OF S / NO. - (CIRCL'Ej /
NOW ON LOT
SIZE OF LOT y�� USE ZONE SPECIALUSE OF /
EXISTING BLDG L�S' /V'� C CONDITIO J ,
TEL.
OWNER NO. BU1LD1 G YARD H �Y STREET NAME EXIST.
SETBACK WIDTH
ADDRESS FRONT r
ARCHITECT OR TEL. P. L. _
ENGINEER NO. SIDE O}.
P. L.
ADDRESS 77 f ¢ r 0
CONTRA / V T ix
ADDRESS�o b�Cv,. 0
i V
DESCRIPTION OF WORK off.
i h
Z
NEW ADD ALTER REPAIR DEMOLISH 1
SQ. FT. Q/� NO. OF NO. OF
SIZE pfi0 v STORIES FAMILIES
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATION S
®OO APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. _ PMT. S` FOUNDATION: LOCATION
FE FEE S FORMS, MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS `{ -f r!'•.)?� /,'FA .w
AND STATE THAT THE ABOVE IS CORRECT AND FURNACE: LOCATIONAGREE TO COMPLY .A//'? �"•'�"' /
,
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHORIHVIOLA.ZED HEREBY I WILL NOT EMPLOY ANY PERSON IN V -
TION RTHE LABOR CODE OF THE STATE OF CALIFORNIA OLA. LATH, INT. ,,{{
ING TO WORKMEN'S COMPENSATION RANCE. ,.p .
'LATH. EXT. -
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS O� INAL � �'��'`
-JOHN F. LEWIS. PRINCIPAL+'Sp iUCJ RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATIO CK.` M.G. CASH
76A638A CE 4803 2.63 APPLICATION FOR BUILDING PERM.( _
COUNTY OF LOS ANGELES BUILDING G^3 �
DEPARTMENT OF COUNTY, ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY. -
JOHN A. LAMBIE. CoUN'TY ENGINEER NEAREST '
WILLIAM A. JENSEN, $UP'T OF BUILDING CROSS ST. -
DISTRICTN G C1P TYPE �� .PROGES f.BY _
FOR APPLICANT TO FILL IN Y CONST.
BUILDING - STATISTICAL CLASSI (CATION S WER MAP
ADDRESS BK P
CLASS. NO. / DWELL. UNITS �����J11JJ1
LOT NO. BLOCK WATER NOT REQUIRED '��'^RECEIVED "
CERTIFICATE: <
TRACT MAP HIGHWAY
NO. OF NO. (CIRCLE) STATE MAJOR SECON .LOCAL
BLOGS.
SIZE OF LOT I NOW ON LOT USE-ZO E SPECIAL r
USE OFCONDITIONS '
EXISTING BLDG. '
TEL. r
OWNER NO. BUILDING YARD- HWY STREET NAME f EXIST.
2 SETBACK- WIDTH.
ADDRESS
FRONT
ARCHITECT OR T L. -
ENGINEER NO. SIDE -
�J
ADDRESSE .
. `9 -
CONTRACT �( TO. ,S y - OV
ADDRESS / v 6, d .- ,• , W
O
DESCRIPTION OF WORK v
Lu
CL
NEW AD - . ALTER - REPAIR DEMOLISH H
Z
SQ. FT: NO. OF NO.OF 1
SIZE D STORIES FAMILIES
USE OF - -
.STRUCTURE yy
V.
SIGNATURE OF
APPLICANT -
VALUATION $ ?
666���666��� APPROVALS . . DATE SP To s SIGNATURE
FOUNDATION: LOCATION. ,
FEE $ _ FEE $ 1 �I ' FORMS, MATERIALS /
FRAME: FIRE STOPS, ♦. a f �
-/
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION I BRACING. BOLTS ♦,I p /// zAN
D STATE THAT THE ABOVE IS CORRECT AND AGREE..TO COMPLY FURNACE: LOCATION. a
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. LATH, INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. -
ING TO WORKMEN'S LOMPENSATIONURANCE.
V t007".�
-SIGNATURE OF HOUSE NUMBER COR- - %'^"-�..,,e,._,,,�_`
PERMITTEE RECT AND POSTED
ADDRESS )?0-4 FINAL
JOHN F. LEWIS. PRINCIPA+L'!ST 'RAL.ENGINEER'
PLAN CHECK VALIDATION CK. M,O. CASH PERMIT VALIDATION cK. M.O. CASH
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES
� WM. J. FOX. CHIEF ENGINEER
I FOR APPLICANT.TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PLAN CK.NO. PERMIT NO.
DDREISS 22
NM
_-
A 9 9 Key West Street -6644,97-<o
LOCALITY Temple City„ California RECEIVED BY DATE OF APPL. DATE IBSUED
ossr. Fratus Drive g
OWNER TURNER HOMES INC. BUILDING e�p q "
�MAILy BUILDING
ADDRESS L "cs 4a 8
ADDRESS 26 East Santa Clara St-o,. LOCALITY �.
NEAREST
CITY Arcadia No'DO 7- , 63 CROSS BT,
FIRE O.OF TYPE GROUP
ARCHITECT OR TEL. ZONE PLAN9
ENGINEER NO.
SLOG.
ADDRESS SETBACK LINE �d bear
�a
APPROVED
CONTRACTOR Same NO.� U DATE
USE t APPROVED
AD RE G ZONE \ BY DATE
LEGAL �� CORRECTIONS
DESCRIPTION LOT NO. 91 BLOCK F�
TRACT 16475 FS� p
NO.OF BLDGB. r
SIZE OF LOT 59 R 111 NOW ON LUT No
U 0 r I NO.OF I NO.OF
EXISTING BLDG. No FAMILI[8 ROOMS
DESCRIPTION OF WORK
NEW ALTERATION ADDITION O
A
REPAIR MOVING DEMOLISH p
8Q.FT. ND.OF Z
SIZE �,IOS�-G7 ROOMS 5 STORIES' 1
WALL ROOF
COVERING Plaster-' I COVERING pj'.,jl m qA
UBE OF Nf111V Dwelling
4 /I
—BUILDING
1 HEREBY ACKNOWLEDGE THAT 1. HAVE READ THIS APPROVALS,-
APPLICATION AND STATE THAT THE ABOVE 19 CORRECT FOUNDATION.' LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS ,
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
FRAME: FIRE STOPS, �=�7
SIGNATURE OFT 4obtL+s f1• BRACING.BOLTS
PERMITTEELATH, INT.
UO
ATHRIZED AO LATH, EXT.
7GA63EIA-3 2-50 $ ! P.C.0 6.o PLASTER,INT.
FEE 21 0O PLASTER,EXT. /
VALUATION FEE $30-00 FINAL
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUIL/D�I�G ADDRESS
WORKER'S COMPENSATION DECLARATION /ate� /i/���. ��.,,p
I hereby affirm that I have a certificate of consent to self insure, BUI IN A b SS _i ` to _4:/09.
•
or a certificate of Workers' Compensation Insurance, or a certified J I "T
copy thereof(Sec.3800,Lab. C.) CITYTe , �� ^ Zn 0
LOCALITY
Policy No. Company SIZE OF O 1\L. i NO. BL S.N W ON LOT
❑ Certified copy is hereby furnished. L 5 NEAREST CROSS S17
❑ Certified copy is filed with the County building inspection TRACTBLOCK LOT NO.
department.
1641S_ USE ZONE MAP NO.
ASSESSOR MAP BOC`�� - PAGDate Applicant .< F2,1 RCE
1lll
SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER t TEL NO. _
COMPENSATION INSURANCE CF. O I`u&7` WITHIN 1000 FT OF SCHOOL? YES NO
(This section need not be completed if the permit is for one hundred ADDR i
S7• DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY
dollars($100)or less.)
CITY
y Z Jaf �3 -3 Guam,
I certify that in the performance of the work for which this permit L �i • 7�
is issued, I shall not employ any person in an manner so as to
become subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO.
STATISTICAL CLASSIFJCATION APT CONDO
Date • Applicant ADDRESS CLASS NO. DWELL UNITS
NOTICE TO APPLICANT If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST
Exemption, you Should become subject to the Workers' CONTRACTOR TEL NO. _ SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor Code, you must forthwith FRONT
comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL
LICENSED CONTRACTORS DECLARATION T SIDE
CITY � LIC.CLASS` PL
I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and SQ. E/ NO.OF STORIES NO.O FAMILIES
Professions Code,and my license is in full force and effect. NEW BK PG , a
License Number Lic.Class DESCRIPTION OF WORK ADD ❑ VALUATION �1() Q
Contractor Date TO �I�'} ����� ALTER ❑ $ 9� U
cc
❑ I am exempt under Sec. REPAIR ❑ $ 0
BAP.C.for this reason DEMOL ❑ 0
LDMA P/C#
Date: USE OF EXISTING BLDG. URM - ❑ a'
y- 0
Signature �ORPL N (PRI ) T NO. LDMA Perm# Z
,/ N 1u 2�C)gZAl z '? �9a r g
tld I, as owner of the property, or my employees with wages as Z ii •:t e 8
their sole compensation, will do the work and the structure is A ff S ^^ i O C
not intended or offered for sale (Section 7044, Business and �1� .1 F� � i ( 1 {� �1l 17 FINAL DATE Q :ri -'•T=
Professions Code.) _�._�
WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL J
OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE
❑ I, as owner of the property, am exclusively contracting with FINAL BY
AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? _
licensed contractors t0 construct the project (Section 7044, :
YES 1:1 No.l� / �
CT.4;
Business and Professions Code.)
WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING i 31'
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH —
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR —
GUIDEUNES. ' !T EMS
I hereby affirm that there is a construction lending agency for YES❑ NO❑
N the performance of the work for which this permit is issued(Sec. i t�(IL a
rn I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING
3097, CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, r,tZ 151.05 N TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS CHECK 1_r 1 a�15
Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD.
aLender's Address CHANGE
O OWNER OR AGENT -
o I certify that I have read this application and state under penalty
o P.C.FEE PERMIT FEE -- --
of perjury that the ab formation is correct.I agree to comply yrT
with all county ordinance and State laws relating to building o " 00110
OD construction, and h th rize represe tatives of this County ISSUANCE FEE / �1
to e r upon t ov entio ed p ert or inspection purposes. !O vi��a AM ;o 4,
n �,�C/ INVESTIGATION FEE TOTAL FEE 1f
Sgnatu of Appli or Agent Date 0! C/
SEE REVERSE FOR EXPLANATORY LANGUAGE