HomeMy Public PortalAbout9812 LA ROSA DR_Building__ � DING /
7,6A638A.CEU8038-64 APPLICATION FO UI PE MIT
'COUNTY OF LOS.ANGELES BUILDING /
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY.DIVISION `LOCALITY
JOHN A. LAMBIE', COUNTY EN.GINCER EAREST /
COLEMAN W. JENKINS,SUP'T.OF BUILDING' i 'CROSS ST. "
DISTR NO., OR
UP TYPE. PESSED BY.
FOR APPLICANT TO FILL IN 5 % CONST. l
BUILDING STATISTICAL CLASSIFICATION 5 ER MAP
ADDRESS 9 ' CLASS N0- DWELL UNITS G= BK/ PG�
LOT NO. I]v� ] BLOCK USE ZONE MAP
NO.
TRACT 6 �. -SPECIAL NO. OF BLD05. CONDITIONS
SIZE OF LOT �pGG .NOW ON LOT i
E
XISTING N . !�V U N �/ BLDG, SETBACK FROM
FRONT
P. LINE
TRE
ER L•Q 1 NOL 1 ) L TYPE OF ROE%IST MGFSETBACK HIGHWAY YARD = 4TOTALI
RESS / L-. D XIG- AY WID F OM C.L. '
Y TEM��E Cr`Tij I , ✓ - r } - S
LDG. 5ETB a ROM
HITECT OR TEL. SIDE PROP. LINE OF (STREET)
INEER NO.
TYPE OF EXIS
TIN0' 4f TBACK HIGHWAY } YARD = TOTAL -
RESS //II ••�� HIGHWAY WIDTH FROM C.L. CL
TRACTOR PACT rum NO
L^/q Z� IU7V } - — 0
RESS IO9L NO 'Zl I p0J CORNER CUTOFF. YES NO O
r t fT LIC ST Tc. SEE REVERSE SIDE FOR SPECIAL APPROVALS v
w
DESCRIPTION OF WORK y
Z_
ADD ALTER REPAIR - DEMOLISH
T. NO. OF NO. OF
.STORIES -FAMILIESOF OF RE.SNSTAc< C7 SUoUJgTU
v Ac. h'toaR- f oizwRCe
ATURE OFLICANT Z30 _UATIONS APPROVALS DATE . INSPECTOR'SSIGNATURE. PMT. ((,,// U-D FOUNDATION, LOCATION
FEES FEES
p 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'
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. J
LATH. EXT.
SIGNATUREOF � .GG �� HOUSE N BE COR-
PERMITTEE ll RECT D OSTEO
ADDRESS-09 0 CJI FINAL ]�!_ J
JOHN F. LEWIS, PRINCIPAL STPUCTURAL ENGIN R
PLAN CHECK VALIDATION DK. M D. CASH PERMIT VALIDATION DK. M.O CA H
LAA;o7 6xo 2—� IrOv 2 9 1 D 6.0 0- a
a..... APPLICATION FOR BUILDING PERMIT
J
COUNTY OF LOS ANGELES BUILDING—
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A.LAMBIE,COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST.
DISTRICT NO. G I T�.pE P SSED BY
FOR APPLICANT TO FILL-IN
CONST.
BUILDING n STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS. 9812 La ROSa Temple C� lP _� I PSK
LOT NO. , L BLOCK CLASS. NO. DWELL. UNITS
MAP, STATE
NUMBER HWY. YES
TRACT USEZONE SPECIAL
NO.OF BLDGS. CONDITIONS +
SIZE OF LOT 66X268 Approxi NOW ON LOT Z j
USE OF
EXIST,NG BLDG. Welling BUILDING EXIST.
SETBAYARD HWY REET NAME
' FRONT - WIDTH
OWNER Alnexander Tamble ' FRONT
ADDRESS 9812 La Rosa p L. -
SIDE
clTv'-
Temple City .. NO. 608 8 P..L.
INSPECTION RECORD
ARCH ITECT OR none TEL:
ENGINEER NO. - -
ADDRESS
TEL.
CONTRACTOR Santa Anita Const No.
. ADDRE S 8717 Las Tunas, San Gabriel - -
DESCRIPTION OF WORK
NEW '.ADD ALTER REPAIR �DEMOLI
SO.FL NO.OF OF - -
SIZE STORIES FAMILIES ,
USE OF STRUCTURE
To Remove Shed
SIGNATURE OF f APPROVALS '
'APPLICANT '- /' id' A
DATE INSPECTOR'S SIGNATURE
' ADDRESS FOUNDATION: LOCATION
S - FORMS.MATERIALS
/n 11 P.C. S ,rte FRAME: FIRE STOPS.
(J (/ FEE BRACING, BOLTS
VALUATION S LJC- FURNACE: LOCATION. -
FEE GAS VENT.DUCTS -
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP. LATH,INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING BUILDING CONSTRUCTION. LATH. EXT..
I NATURE OF HOUSE NUMBER COR-
ERMITTEE /� /// x.. 11 I /`r RECT AND POSTED
ADDRESS FINAL -".J
CLYDE N.DIRLAM, PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PEBMIT VALIDATION CK. M.O. CASH
lCo 6 4 6 4.u iShY 151 A 2.00 M
f ry,
WORKEK�' COMPENSATION DECLARATION .,.
hereby affirm that I have certificate of consent,ro =elf APPLICA TION FOR BUILDING PERMIT
insure, or a certificate of Workers' Compensation Insurance, - Q
or a certified copy thereof (Sec. 3800, Lab. C.). - -
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. _ Company -
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING
ADDRESS
IEPCertified copy.is filed with he county building inspec- DING " - - - -
tion department. ADDRESS
S F6=fs�b
Date Applicant CITY r, G\ ZIP LOCALITY Q -
CERTIFICATE OF EXEMPTION FROM WORKERS' .NO. OF BLDGS. NEAREST ' -
COMPENSATION INSURANCE - SIZE OF LOT NOW ON LOT CROSS ST.
(This section need'not be completed if the permit is for one ASSESSOR
hundred.dollars ($100)or less.) TRACT BLOCK LOT NO. . MAP BOOK PAGE PARCEL.
TEL, USE?QNE MAP
OWNER -�(� 'I{�'/`,•
���VJC a- TEL �3
I certify That�in the performance of the work for which this //''�� (� 1 NO. '
permit is issued, I shall nat'employ any person iii any manner ADDRESS vl� �d1 L ! ( SPECIAL - 0
so as to become subject to-theWorkers'Compensation Laws. CONDITIONS O
Date Applicant CITy ZIP - -
U
ARCHITECT OR TEL.
Ix
NOTICE TO APPLICANT: If, after making*this Certificate of DISTRICT GROUP TYPE PRE PROC SSED BY O
ENGINEER NO. CONST. Z�E V'
Exemption, you should' become subject to the Workers' (
Compensation provisions of the Labor Code, you must forth- ADDRESS _ W
with comply with such provisions or this permit shall be _ - d'
deemed revoked. CONTRACTOR `\ TEL STATISTICAL CLASSIFICATION APT. ONDO. .
\C�' NO. N� s0 NZ
LICENSED CONTRACTORS DECLARATION \- LIC Q CLASS NO. DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter.9 ADDRESS Uvl Y-� NO.�� O ��S
(commencing with Section 7000)'of Division 3 of the Business and LIC SEWER/ AP
Professions Code, and my license is in full force and effect. CITY 42_�-• CLASSVALIDATION
�(' ` SQ. FT. NO.OF NO.'OF CHECK BK. � PG.
License Number�)I`s ,�J Lic.Class SIZE STORIES FAMILIES - ONE
~�O VAL�j ION
.� ,tQ,,� - - DESCRIPTION OF WORK NEW ❑ O0
I am exempt under Se
Coritrador Date _ �J O�`�='/)
Sec.
F� L` C 1C ADD $ ` J( 1❑ ,
ALTER
B 8P C for this reason Np �`�' REPAIR. ❑ $USE 9 6 2 6 A
Gs+ G 'Date: EXISTOI NG BL DEMOL
Slgndture APPLICANT TELq �r� I #
OWNER-BUILDER DECLARATION PRINT \Q, NO. T'GO L, FINAL ✓���
I hereby affirm that I am exempt from the Contractor's License i'�� DATE l/ i) -1 `Z&8'8
Low for the following reason (Section 7031.5, Business and ADDRESS O'+ pIN r2�4.88U ,
Professions Code): - B
❑ BUILDING -SA
�•`$.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 Cade). MOVING TEL. -
1, as owner of the property, am exclusively contracting CONTRACTOR - NO.
with licensed contractors to construct the project(Sec' ADDRESS
tion 7044, Business and Professions Code).
REQUIRED TOTAL SETBACK
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,I. - �'x\
(Sec. 3097, Civ. C.). .SIDE
P L.
��.
Lender's Name
2 Q LDMA Ref. #
ro P.C. Fee E - Permit Fee 111q, JU,' . .
Lender's Address
3 1 / /)
I certify that,I have read this application and state that the Issuance Fee ( •�U LDM4.PiC#
above information is correct. I agree to comply with all County Investigation Fee �I _
ordnd State laws relating to building construction, To
a
inances ad Fee WMA perm. # -
cN hereby authorize representatives of ihis County to enter the bove-mentioned property for inspection purposes j
sSEE REVERSE FOR EXPLANATORY.LANGUAGE
ignotvre of pplicant or Agent ,Dote- - f -
I
4'
WORKERS COMPENSATION`DECLARATION
t I'he'reby offirm that,I have a cerhficote of consent to,sell ti
insure Or a certificate of Workers Compensation Insurance APPLICATION--FOR BUILDING -PERMIT- .� .
ora certified copy thereof (Sec 3800,'Cob. C.) '`'°" '" - -"' _.. _ . - - _ ;_
• *r ••. '; , COUNTY OF LOS ANGELES. BUILDING AND SAFETY • , '
Policy No. Company . _ - - - -• - - '
BUILDING
Q w.Certified copy is hereby furnished.. FOR-APPLICANT,TO-FILL IN ADDRESS "• .Jct
❑ din' _ _.._:_ -__.___._ _.
'Certified copy t'filed'wit h the county building inspec- BUILDING ) ^ n n n
• tion-department'' - - ADDRESS /C.o57-I DRIVE
Date •• Applicant .ten ! CITY 1 /"'P E L%IT ZIP I 90 LOCALITY i
CERTIFICATE OF EXEMPTION FROM WORKERS', W • - 7- I -NO. Of BLDGS.-' q - - NEAREST
.COMPENSATION INSURANCE SIZE OF LOTV U X 5S ' NOW ON LOT t;cr CROSS ST.
(Thi section need not be completed•ifahe permit'.is for`one - - JJ'' - ---- -- _ ASSESSOR "I -
hundred dollars ($100)or less.) - , - TRACT r-Y I BLOCK - LOT NO. I MAP BOOK PAGE! PARCEL,
_ -NO.`'O - . .- . �
TEL
I certify that in the performance of the work for whiEh�,this WNER LINDA WM--
� USE ONE NO. r }'
permit is issued,'[shall not employ any person en any tion Laws. /� 'T�/� _ -SPECIAL+ +- -- - -' O
tr - 'ADDRESS I2'-E.-LA-205A-7J,QIV� - CONDITIONS
so as to become'sublect to the Worker41
1, -Compensation Maws.
EM:PLE__cl _ : . , QIP
5^I_q $7 LINDA ' LEb1, arv... 17 v_
Date Applicant , ARCHITECT OR TEL. - - :O
NOTICE TO APPLICANT If;'afteOmoking'this Certificate of G(� DISTRICT _ G OUP,f TYPE FIREP OCESSED,BY. V
Exemption; you should subject to they Workers' ,--- ENGINEER AIO� NO.. ,Tv f([R) CONST='- ZONE ,
Gomponsation provisions'of.the'Labor,Code, you'museforth- FADDRESS • S-�U --Y\!� y --'-:.� 6
•with comply with suchrprovlsions or this permit shall be - - — __ EL _.. ___ `Z
T STATISTICAL CLASSI�N • APT. CONDO 7
deemed revoked. . '-;� '• e ,y CONTRACTOR I _ -
- ._ - _ - _ _.._„_ .__
LICENSED CONTRACTORS DECLARATION: • : - --, -- - :�- - ---- :-- - - -- -- -�- LIC. - -- -,- C1A55 NO. � DWEti. UwTS
I hereby affirm that am licensed under provisions of Chapter 9 ADDRESS NO.
(common Ing with Section 7000)of Division of the Business and ., -„ _ ._ _._.__ UG - ._ �., SEWER MAP
R
Professions Code, and my license Is In full force and effect. CITY _ �- CLASS i 'VALIDATION'
�' ' '• - 's - _ SO. FT. _ _ _ NO.OF __ N0. OF _ _CHECK BK. PG I
L¢ense Number tLic Class SIZE" - STORIES - FAMILIE; - ONE 't
ts., _� t:-X /fit __ _.,NEW. :_.❑ VALUATION -'_ ._....y .$-7'O 7. 6
` DESCRIPTION OF WORK- $
Contractor Date Q ADD
MI am exempt under Sec s - --� F^' - Gf.�'10-^ U1 UO�.. - - - - - 1
ALTER El 1
6.8P.C. for this reason REPAIR
CLmS�nuci tOn _._$ ( .• • 4 9
.
' . - - --� .-•
Date: USE OF DEMOL
EXISTING BLDG.
APPLICANT TEL - n ) f
9 . .... (PRINT) I NDA LG NO �Q�i1L113 FINAL//'' ,� Q Q�... 8 8
OWNER-BUILDER DECLARATION _ _ - .DATE, • - - .
--•I�hereby affirm that Lom exemptfromahe Contradods.License ADDRESS z C t-A pwsA 7)kfVE t. F� < `a '-' `j s7 '• i+b�.C�
Low for the following reason,(Section 7031.5, Business and r
Professions'Code): PRE ENT
BUILDING -
R. _I, as owner of the property, or my employees with ADDRESS _ _ _, --
i
__ _ __ . .:.. _. - ... ..__ _ _
wages as their sole compensation,will do the work and .
the structure is not intended or offered for sale(Section LOCALITY
--704Q Business and Professions Code) ' "' - - MOVING- - - -TEL.- ,• - I__ __.� . ..T
I, as owner of the property, am exclusively contracting CONTRACTOR - NO. t _ 1
_
with licensed contractors to'construct the project (Sec-
....:�_.
tion 7044, Business and Professions Code). ADDRESS -
- CONSTRUCTION LENDING AGENCY - - ..REQUIRED-- -YARD""HWy -TOTAL SETBACK FR T.I. _a _�Y s1. .... .__„•
SET BACK PROP. LINE WIDTHr
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- -- - - �- - - ' --- -- - '- -- ^- -• - -- - - '•- - qq --
(Sec. 3097, Civ. C.).
P.I.
lender's Name ,
LDMA Ref. # ?,
Lender's:Address - - P.C. Fee-$- - Permit Fee--
t
I.certify that.,l,have read this application andstate.that.the --� Issuance Fee =lU - I -LDMA P/ If a r•v-- �•'
¢ above information is correct. I agree to comply with all County Investigation Fee - J V T '
o _ordinances and State laws relating to,building construction, _ _._. - - Total Fee--- 4k.- -LDMA-Perm. # - - - - - •- -- -- ^and hereby authorize representatives of+is County to enter
¢ .upon the above-mentioned property for inspection purposes. - - t _
¢ �/, V�f �Z4A- �.I`'r-8� SEE REVERSE FOR EXPLANATORY LANGUAGE I
=f1
. __
Signature of Applicant or Agent-- Date
WORKERS' COMPENSATION DECLARATION
hereborr a certificate
that havecertificate of consent to self APPLICATION FO.R.SUILDING PERMIT
'•insure, or o certificate of Workers'-Compensation Insurance,
or a certified copy.thereof (Sec. 3800,.Lab..C.), .COUNTY OF LOS ANGELES ` BUILDING AND SAFETY
Policy No. Company-
El - .
BUILDING p
Certified copy is hereby furnished. :.` FOR APPLICANT TO FILL TN ADDRESS Q ";Z
Certified copy is filed with the county building'inspec- BuuREss // ,�, Q -T� v -
tion department. - - ADDRESS ,L. T•!b RosQ L/Y'(I]�Vq�-zT
• r CITY' Q.✓11 IQ ZIP _I I !D✓' LOCALITY
Date -"• Applicant- - ` - NO. OP BLDGS. NEAREST - _ -
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS 5T.
COMPENSATION INSURANCE ASSESSOR pp
(This section need not be completed if the permit is for one .-- TRACT BLOCK LOT NO. MAP BOOK O�� PAGE a`� PARCEL c"3C
hundred dollars ($100) or less.) - �I TEL n
' OWNER N t ,.NO. > _I USE ZONE MAP - -
I certify that in the performance of the work for which this O pp�� /�J NO.
SPECIAL >-
permit is issued, I shall not employ any person in any manner ADDRESS 8�2 /C,C$Q 7j/y✓1L-- A — / CONDITIONS a
so as to become subject to the Workers' Compensation Laws, /�� - O
.. CIN ZIP _ _ . _
:Date Applicant ARCHITECT OR . TEL U
NOTICE TO APPLICANT: If,..after. making this Certificate of ENGINEER _ ,.NO. - DISTRICT GROUP TYPE - - FIRE PR CESSED BY Q
CONST. Z NE H
- Exemption, you should become•subject to the Workers" - V
Compensation provisions of the Labor Code,•you must forth- ADDRESS .C� �' a
with comply with such provisions or .this permit shall be , o TEL• STATISTICAL CLASSIFICATION APT. CONDO. to
deemed revoked. CONTRACTOR Y �5� � � z
LICENSED CONTRACTORS DECLARATION - - LIC. CLASS NO, :;;L UNITS—
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO.
LIC. SEWER MAP
.(commencing with Section 7000)of Division 3 of the Business CIN CLASS BK C� VALIDATION -
and Professions Code;and my license is in,full force and effect. ,.- G -
SO. FT[ NO. OF NO. OF - CHECK
License Nun Lic:Class - S12E D STORIES FAMILIES ONE
- - VALUATION
Contractor Date DESCRIPTIONN(,O,F WORK J L NEW ❑ f l" oDD
❑I am exempt under Sec. &L ' jobre' a_0(Al7 r1,% ADD "❑ 77 , -
AUER F-1
B.BP.C. for this,reasom _ _ REPAIR ❑ $
Date: USE OF - - -
EXISTING BLDG. `DEMOL ❑
Signature APPLICANTx,Z . -'i. TEL. FINAL
OWNER-BUILDER DECLARATION. (PRINT) NO. -
I hereby affirm that I am exempt from the Contractor's License `"�• DATE Zi
Law for the following reason (Section 7031.5, Business and ADDRESS FINAL
Professions Code):. _ PRESENT B a
VUI, as owner of the property, of my employees with • ADDRESS BUILDINGY H41'T'2
wages as their sole compensation,Mill dotheworkand - - - --
the structure is not intended or offered for sole(Section LOCALITY POP
7044, Business and Professions Code.)- . - MOVING . . .. _ - TEL _. _
❑ I, as owner of the property; am exclusively'<ohiracting
CONTRACTOR NO. - 1
with licensed contractors to construct the project (Sec- ADDRESStion 7044, Business and.Professions Code.) tom) .`t" _ iS
-.REQUIRED - iOTALSETBACK•FROM EXIST. �.
CONSTRUCTION LENDING AGENCY YARD HWV t
SET BACK PROP. LINE i' WIDTH _
I hereby affirm that there is a construction lending agency for FRONT TEM
the performance of the work for which this permitisissued PA.' -
(Sec. 3097, Civ. C.). - SIDE 19
-
Lender's Name _'i .- CHECK '^N*],:
i8 LDMA Ref. R -_4.:4 ,
P.C. Fee$ G• Permit Fee1 ;; :j_ 1{)y
Lender's Address T n
o I certify that I have read this application and state that the Issuance Fae• r7` LDMA P/C R
8 above information is correct. agree to comply with all County Investigmion Fee - _ -
R ordinances and State lows relating to building construction, Total Fee 44 LDMA Perm. N LLLIU'j"�I�'GZ 4r (i
a and hereby authorize representatives of this County to enter '�.i rt
upon thea ve/mention d property for inspection purposes. - -
_
;Z u L- / �'/ SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent F Date '
Drr-A:RTrZNT OF COUNTY MGINF.r1t
Building & Safety Division
Los Angeles, California
Records Search
Information
Ad dre s s�_/�'J I`. . Q 911 SCc, • _
Building --t. Issued (D�te) Final Inspection;,_,
Descripti .of work
Sq. 7t.
2u_ldl-zg PWt.# Issued(Dat ) Finial Inspection
Desc_iption of work
Sq.Ft.
�.
Building F`t.j • Iasued(Date) Final Inspection
•1 '
Description of work
• Sq. Ft.
Baild:np ?--t.# Issued(Date) Final Inspection,.
Description of work
Building utr Is,sued(Date) Final Inspection. .
Description of work
Sq.Ft.
Build.:Lmg Wit. Issued (Date) Final Inspection..
Descriptior of work
COUkTY OF LOS ANGELES
•DE►ARTMENT OF COUNTY ENGINEER •,
WILDI►tG A SAFETY DIVISION '
•S '