HomeMy Public PortalAbout8841-41 1/2 LAS TUNAS DR_Building__ 7BA636A CE#aOS-6-39 APPLICATION FOR BUILDING PERMIT 1-
COUNTY OF LOS ANGELES A""DING
DEPARTMENT OF COUNTY ENGINEER DDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A.LAMBIE.COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS.ST.
MMnDISTRICTNO. I GROUP TYPE BE MAP
FOR APPLICANT TO FILL INr BK PG
BUILDING o p — CONST
ADORE
SS p (y'� � j i�daw STATISTICAL CLASSIFICATION
I CLASS.NO. DWELL. UNITS
LOT NO. BLOCK MAP ,[ STATE
NUMBER �/ HWY. YES _ NO
TRACT USE ZONE SPECIAL
NO,OF BLOGS. CONDITIONS
SIZE OF LOT NOW ON LOT ^ —.3`�L
USE OF (l J
EXISTING BLDG. BUILDING EXIST.
SETBACK YARD HWY STREET NAME WIDTH
OWNER FRONT
MAIL (� P.L I /
ADDRESS p q f cy �11A.,hp d SIDE
l+ TEL. P.L.
CITY NOL INSPECTION RECORD
ARCHITECT OR TEL.
ENGINEER NO.
ADDRESS
TE LT
CONTRALTO NO.A. / 7 0
ADDRESS - 36 6tiL•(.IH '
DESCRIPTION OF WORK
NEW ADD ALTEREPAIR DEMOLISH
SO. FT. NO.O NO.OF
SIZE STORIES FAMILIES
USE OF STRUCTURE
SIGNATUREOF APPROVALS
APPLICANT ✓/�
ADDRESS rT& DATE INSPECTOR'S SIGNATURE
FOUNDATION:MATERIALS CATION
- FORMS.MATERIALS
P.C E FRAME: FIRE STOPS.
1 J FEE BRACING. BOLTS
VALUATIONE oo�� FURNACE: LOCATION.
FEE CP GAS VENT.DUCTS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP. LATH, INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY ALL COUNTY ORDINANCES AND
STATE LAWS RE U T NG B 1 I CONSTRUCTION. LATH, EXT.
SIGNATURE OF HOUSE NUMBER COR- t
PERM... RECT AND POSTED
ADDRESS FINAL I9 ,—gr
JOHN A. LAMBI .COUNTY ENGINEER. CLYDE N. DIRLA M. P NCIPAL SrRUCTU RAL.ENG ER
PLAN CHECK VALIDATION CK. M.O. CASH - PERMIT VALIDATION CK. M.O. CABH
I,ACO2 S 3 OR APR-14 1 A 2.0 0
®.
76A639ADE;F0031-6E APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING /
DEPARTMENT OF COUNTY ENGINEER ADDRESS
o GtG
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMSIE. COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROUP TYPE P OCESSED
FOR APPLICANT TO FILL IN CONST.' 1
BUILDING Jp_ _ Y STATISTICAL CLAS VFICATION EWER MAP
ADDRESS Cfev�,/ K
_ CLASS. NO. DWELL. UNITS `
LOT NO. �." ^� e� BLOCK WATER
CERTIFICATE: NOT REQUIRED ❑ RECEIVED ❑
TRACT MAP qp_ HGHWAY
NO.OF BLDGS.
NO. ¢IRCLE) STATE AJ R SECOND. LOCAL
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG. c--
i TEL.
OWNER fj� NO. BUILDING' EXIST.
SETBACK YARD HWY TREET AME WIDTH
ADDRESS FRONT
ARCHITECT OR TEL, P. L.
ENGINEER NO. SIDE B r
P. L.
ADDRESS d
ppJJ 0
CONTRACTOR NO aC� V
ADDRESS 3 f ,A O
DESCRIPTION OF WOR W
PZa
H
NEW ADO ALTER REPAIR DEMOLISH Z
SQ. FT. NO. OF NO. OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE
SIGNATUOF
APPLICANT
VALUATI .-Y
�� �7 APPROVALS DATE INSPECTOR'S SIGNATURE
FEE $ ��/�U PMT" /_ ( FOUNDATION: LOCATION L
FEE $ Cq FORMS. MATERIALS �.
FRAME: FIRE STOPS. '" I {j4 - ,
I HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION BRACING. BOLTS /J> l ✓ .I,k/.�' • 'e, 1+'�
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. • / I �'
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS / I
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR CODE OA THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMPENSATION INSURANCE. LATH, EXT.
SIGNATURE` /�� L'i%?i' HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS / FINAL
JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENG
PLAN CHECK VALIDATION —M:o.— GAsn_� PERMIT VALIDATION CK. M.D. CASH
Ljli,o4352SEP 1444 A •00 a
LA(;o4 3 5. 3 o SEP 14 1 A 6_.00"
CE/603(REV.6/1d)
• Y
APPLICATION FOR BUILDING *PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN nooeEss v'�.�'F / •3 i `..v
[ADDRESS
ILING J/ !..
�2 LOCALITYNEAREST
TY ZIP CROSS ST.
ZEOFLOT ✓^s - `ZI NOWONLOT MAF BLDGS. ASSESSOR
PBOOK PAGE PARCEL
DISTRICT GROUP TYPEFIRE ESSED BY
ACT -/BLOCK, LOT NO.
a CONST. ZONE
NO.J'7 IEOY
S190 �,,,, STATISTICAL CLASSIFICATION SEWER
ADDRESS 5190 5- itT ! '0I _ [/ CLASS NO. L DWELL.UNITS 8 PG
CITY )04f- ZIP IQD .
ARCHITECT OR TEL. VALUATION $ 269 0o
ENGINEER NO. C+'
ADDRESS BLDG.SETBACK FROM
TE__LLL-.) ,/ FRONT PROP.LINE OF (STREETI
CONTRACTOR rA.S J -NOJ )L �(•OY TOTAL SETBACK FROM TYPE OF E%ISTING
_ LIC / HIGHWAY + YARD. _ FRONT PROP.LINE HIGHWAY WIDTH
ADDRESS07z, ,�LR� LI 4 /
CRY �/r CLASS13 LIC + -
BLDG.SETBACK FROM
CONSTRUCTION LENDER SIDEPROP.LINE OF (SiREE71
NAME AND BRANCH I.UG7✓
TOTAL SETBACK FROM TYPE OF EXISTING
/meq
HIGHWAY + YARD = G
ADDRESS (P.p�c ( CITY SIDE PROP.LINE HIGHWAY WIDTH V
SO.FT. jNO,OF NO.OF CHECK + -
SIZE I STORIES FAMILIES ONE L - /'' O
DESCRIPTION OF WORK NEW ❑ P.C. Fee$ �/ �` )--dPermitFee f`J 7
R&C?Zt7 ADD ❑ Issuance Fee N
,ALTER I& Z
(.•]- REPAIR - Total Fee
USE OFDE
G` ( MOL /�
EXISTING BLDG:®/ /T f-II J. r� / Ir 10) Z
APPLICANT TEL l/ G
//L.S N�� �(��Y a Q
O
BY ISIGNATUR
I HEREBY A \ AT I HAVE READ THIS APPLICATION AND STATE' - - 9 w r I'
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES `�(L).T{///_ b
AND LAWS REGULATING BUILDING CONSTRUCTION. CERTIFY THAT IN DOING THE -'� u
WORK AUTHORIZED IHIST 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THELABOR CNSURAN E.STAT CAlIf9RNlA IN RELATING TO WORKMEN S COM- Z
PENBATIONINSURANCE.
SIGNATURE
PERMITTEE
ESS O .�.L
ADDR / •:
CITY ' "!/Y /7•-"r NOJ
USE ZONE NO, / Q
C-� SPECIAL
CONDITIO r+
DATE S-Z S�St `� P���—
CE/803(REV.6/78)
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES Y CBUILDING AND SAFETY / n "
FOR APPLICANT TO FILL IN / AADDRESS b cy.�� 7N�M y.S•YZ E, yrs 71V
ADDRESSILDINGg�(— J, Al^Zl . LOCALITY ��"'�
pct Gj ny
�[ NEAREST
CITY 7�-� - ZIP CROSS NEAREST. \.�S
NO.OF BLDGS. - ASSESSOR
SIZE OF LOT (J (,(/ NOW ON LOT �. MAPBOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE, P20[ESSED$Y�
TRACT BLOCK � LO`NO. �o^ .CONST ZONE
OWNER - L! (. z- C.=I vls� NOS�Ia�&O LSAL JL—
STATISTICAL CLASSIFICATION SEWER ASS
ADDRESS. c7d �� CLASS NO. LZ DWELL.UNITS" BKS ',PG
CITY gx e-f4ZIP 9100-3
ARCHITECT OR TEL VALUATION $
ENGINEER NO. '
ADDRESS BLDG.SETBACK FROM _
Q,�.�, TEl FRONT PROP.LINE OF ISTREEiI
CONiRACiO //�/�'�/ !! NO.S7G'%Cnl HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF E%ISiING
( � LIC. /7O/Y FRONT PROP.LINE HIGHWAY WIDTH
'ADDRESS U OYJ hi NO. N
LIC. +
CITY — CLASS' BLDG.SETBACK.FROM
CONSTRUCTION LENDER C NL SIDE PROP.LINE OF - ISTREETI
NAME AND BRANCH -
HIGHWAY + YARD = TOTAL SETBACK FROM TYPEOF EXISTING
ADDRESS �— _ CITY SIDE PROP.LINE IHIGHWAY WIDTH O
SO.FT. N06 F NO.OF CHECKrP,C+Fee
+ = V
SIZE STORIES FAMILIES ONE •� OC
DESCRIPTION OF WORK NEW ❑ L� Permit Fee/tK /CN ADD
Issuance Fee ALTER Z
REPAIR Total FeeUSE OF DEMOLEXISTINGBLDG. ' OAA L! {/ .� 7aSJ O
APPLICANT TEL C '
IPRINTI
O
By IswNATU EI ,$� ^7 .(/r L�
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE _ CY 9571.6 A
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES -�S 7�'7 W
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE J / UO-010:0 O 1
WORK AUTHORIZED HEREBY I WI i EMPLOY ANY PERSON IN VIOLATION OF
THELA30RCODEOFTNESTATE C IIFORMA IN RELATING TO WORKMEN'5 COM. '
�
PENSATION INSURANCE. Q r� N 1� 6 2'0'6.79.00'
SIGNATURE 6.7 9 60 d
PERMITTEE -
ADDRES/S///'�f/♦� rf�� t- [� G ' 0 7.2 5_7 9
CITY ✓�`-Gkc�L" -(/� NOTEL �,/60 Q
O
USEZONE MAP -
NO. C� O (O
C— SPECIAL C .A - - f
CONDITIONS /
T INA _ BY I W
DATE
L
.CSS Y76A638M
,CE faolfREV.6/781 ;
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN 6UILUIss L
BUILDING -/ /
ADDRESS � � L LOCALITY] NEAREST
CITY / L� ZIP / 7 L° GROSS ST.
gg �/ NO.OF BLDGS. ``''�� ASSESSOR
SIZE OF LOT %�' /-.ZOO NOW ON LOT _7 MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE ESSED BY
TRACT BLOCK'. LOT NO. CONST Z
.i L. '^ 4 I
OWNER' - lLr�.. No L-/60'3 . VA 13.. .
STATISTICAL CLASSIFICATION SEWER M[�
ADDRESS qi9T. J ! �� CLASSNO. L DWELL UNITS Y L BK J G
CITY&////7'n p •-Z. ZIP [�J�'
ARCHITECT OR TEL. IENGINEER NO. VALUATION gj
V
ADDRESS BLDG.SETBACK FROM
TEL FRONT PROP.LINE OF (STREETI
CONTRALTO r /ti 1J CCJ' N0:7_1 L / 70iA1 SETBACK FROM TYPE OF EXISTING
LIC. HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH
ADDRES 7d; / NO. 1 06S'
( F G ./fl—f � BLDG,SETBACK FROM
GONRUCTION c
AND BRANCH N � 1/ SIDE PROP.LINE OF
_
[STREET)
NAME
HIGHWAY + YARD TOTAL SETBACK FROM TYPEOF EXISTING d
ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH O
SO.Fi. NO. IF NO.OF CHECK + = V
SIZE STORIES FAMILIES ONE O
DESCRIPTION OF WORK NEW ❑ P.C.Fee$ Permit Fee ,
!7 L .V [! ADD Issuance Fee
Z fF tr Lc (/LIWL `J
ALTER / a
REPAIR ❑ Total Fee
USE OF DEMOL
EXISTING BLDG. O '( L(} ❑ ZO
APPLICANT
IRITI _CL'•ZI PO- S G �6o Q
O
BY ISIGNATUREI Q
HEREBY AC L Ai AVE READ THIS APPLICATION AND STATE V 2 8 Q 3 A
THAT THE ABOVE IS R AND AGREE i0 COMPLY WITH All ORDINANCES W
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE V # 0 0_0 0 0 1
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF ,
THE LABOR CODZITIFORNIA IN RELATING TO WORKMEN 5 COM. Z
PENSATION INSU2 0 - 61.00
6
SIGNATURE OF - 0 0 6 1.005
PERMITTEE '
ADDRESS
# ZQO
1 2 1 3'_7 8
O
TELWCITY A p // A-
USEZONEMA
NOP -7L/17/
6� b >
C-3
- SPECIAL
CONDITIONS F
BY
DATE
DEPARTMENT OF BUILDING AND SAFETY j AYYL1l H i lVlY r vn rr az+•AA a
CQT_W Y OF LOS ANGELES ®�
VIM. J. FOX, CHIEF ENGINEER ui�l
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
ING /
DIBTR CFNO. PLAN CX.NO. PERMIT NO.
BUILD
ADDj � � /J ,J /Q
RE99
LOCALITY ^— RECEIVED-BY OATe� orAPP" DATE IB6U D
'ROSS ST. �
Z
BUILDING.-,I,
S ! //- `+
OWNER AIL �/CC� �/� _ _ _ _
AO DRE89 p[ �L,.�-S T�L�J LOCALITY /
TEL NEAREST
/o �j
CROSS BY. - (.�-A! C A 7–L
TY . NO
FIRE PO NB I T�PE�� GROUP
ARC H ITECT OR /J TEL ZONE PLANE ._i//�--'
ENDINCER NO. I
BLDS. Q'
ADDRESS SET'13 K LINE ��j
TEL APPROVED —T� - er
CONTRACTOR / NO. BY DATE
T USE /� APPROVED
ADDRESS v �'/✓ S / L/ ZONE( BY DATE
LEGAL CORRECTIONS
DESCRIPTION I LOT NO. ( BLOCK Z�d
TRACT 962.? `.
SIZE OF LOT�� /(J I NOWONLOTS O \
USE OF NO.CF NO.OF
EXISTING BLDG. U FAMILIES ROOMS
DESCRIPTION OF WORK co "Po.
NEW ALTERATION ADDITION D
A
REPAIR MOVING DEMOLISH 0
BqNO.OF
p��0 RDOM9 VJ STORIES -
WALL
ROOF _r
COVERING�L T[J OC6 I COVERING C7
USEOFNEW
'WILDING Gr 7-16 _ ^
I'el 70-5
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APP
APPLICATION AND STATE-THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION I ECTOR r DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCT N.
FRAME: FIRE STOPS,
SIGNATURE OF BRACING,BOLTS
OWNER ���LLL...GGG����//////��� LATH.INT.: _ 9'– �� y
AUTHORIZED AGT. LATH,EXT.: 9-I f–y
oes-S 25M S"81-47 P L. ® PLASTER.INT.
0 v PLASTER.EXT. _
VALUATION FEE 30 FINAL
DEPARTMENT OF BUILDING AND SAFETY ', APPLICATION YOx PrnWill,
COUNTY OF LOS ANGELES � � � �
WM. J. FOX, CHIEF ENGINEER BU I
FOR APPLICANT TO FILL
J,IN FOR OFFICE USE ONLY? -/
Ab DRESS /fjFT�v/✓f��J• ��V 72,w-
LOCALITY
PLAN CK.NO.BUILDING
RF—
_LOCALITY J Ej/� /�G� l / Y RECEIVED BY DA7 OF APP" GATE ISBOEO
NsT.
I� BUILDING
OWNER
ADDRE
_ ADDRESS
MAIL q LOCALITY
ADDRESS V� -
1.
TEL I ARE
NEST /�
CRO95 BT. C
ITY � NO. ACX C}
- c FIRE NO.OF - I TYPE
ARCHITECT OR 1 TEL _ ZONE PLANE
EM.IMEER NG. 1 .
BLDG. ./ G
ADDRESS SETBACK LINE /
�f/(� TEL APPROVED 01
rp (/,/
CONTRACTOR / �J� BY DATE NO. /�j7']f
//.. USEo APPROVED -
ADDRESS 2 `� : ��� &�V 145L ZONE yBY DATE
LEGAL
DESCRIPTION I LOT NO. I BLOCK ZV D CORRECTIONS
TRACT
912E OF LOT NO.OF NGW GN LOTS
USE OF NO.DF NO.OF Gf�
EXISTING BLDG. "— FAMILIES RDOMS�_
DESCRIPTION OF WORK Ci
NEW i ALTERATION' ADDITION
- O
L
REPAIR MOVING DEMOLISH Q
BG FT � R OM3 STORIES
2
612E /� Z,
COVERING TUJ-coa COOVERING L.Q
LIRE O DI 7 NEW GYaM
USE ND CTJ V
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IB-CORRECT FOUNDATION! LOCATION INSPECTOR' DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS. MATERIALS .� h
AND STATE LAWS REGULATINGILDING CONST UCTION.
y�Bi� {$ FRAME: FIRE STOPS, �
SIGNATURE or . /�/ // _� BRACINO�BOLTS
OWNER LLCC i M1N
� LATH.INT.;
AUTHORIZED AGT LATHS EXT.:
oss=a .11 scrs 1•q7 ^ P C PLASTER.INT.
yv' fEE_ PLASTER.EXT.
VALUATION V'� FINAL �� g `/�J i,.G,Ci, /'✓j✓
FEE
76A638A DSS-3 12.54 l
'APPLICATION FOR : BUILDING PE M.IT 1
DIVISION OF BUILDING AND SAFETY IgILDISNG S7 lZ •f �/
Department of County EngDRE
U14
.County of Los Angeles LOCALITY
WM. J, FOX, COUNTY ENGINEER NEAREST
CASSATT D. GRIFFIN,.SUPT of BUILDING ' /�
CROSS ST. `
FOR APPLICA TO FILL IN OISTRIC�O. I �DUPITiYPE (SEWER MAP
V BK PG
CONST.
BUlIDtNG [�1 -` _
AO DRESS 1( ♦ JP.A! MAPNI HWY//' YES NO
- 'NUMBER 1 I
LOT NO. y J 60 BLOCK USE ZONE SPECIAL
•�y3 ) CONDITIONS
TRACT G, A .v p,/
NO. OF BLOCS.
SIZE OF LOT I NOW ON LOT BUILDING , J
YAR HWY ( OTREET N M
A E EXIST.
USE OF - SETBACK �� JJ WIDTH
EXISTING SLOG. FRONT /11 I{vl ✓�� 1�i�� �
OWNER Ld'^,,^^
MAIL
ADDRESS ll VV
C TEL. I 'DWELL. 1 UNIT 5 INDUSTRIAL
CITY �. `�,- 2 OUPLEX_UNIT 6 PUBLIC BLDG.
ARCHITECT OR TEL: - ."
ENGINEER CAATRR A[�Si TELNO. 3 APT: UNITS 7 ADDN., A ETC.
ADDRESS .-:SIGNS--- q COMMERCIAL 8 MISCEL +
4357 N.Peak".
CONTRACTOR _ NO. INSPECTION RECORD
ADDRESS .•155 �.>x iar �-AFie k� r.a�s�nl
DESCRIPTIONOF WORK
- _ .. __ _ ._
NEW ADD I/ ALTER✓ REPAIR DEMOLISH R �^
50. FT. NO. OF NO. OF Q1li
SIZE 'STORIES - FAMILIES
USE OF STRUCTURE
(htiV� Exl$TnA�e "lao"I SIC - -
di P
SIGNATURE OF 1
APPLICANT APPROVALS
ADORES _ ( ` M DATE INSPECTOR'S SIGNATURE
FOUNDATION: LOCATION
®� P. C. 5 FORMS, MATERIALS
'I/,�/f (�tt^1� FEE n/ry FRAME: FIRE STOPS,
VALUATION {y/) I 5�J`��� BRACING. BOLTS '
FEE ate( FURNACE: LOCATION. _
G
I HEREON ACKNOWLEDGE THAT HAVE READ THIS AS VENT. DUCTS
THE-
. APPLICATION AND STATE THAT ABOVE�•IS'CORRECT .
•AND STATE TOC PLY WI ALL CNTYO NCES LATH. INT.
ANDSTATELAREGN UNCONSTRUC-
TION.
LATH, EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
'ADDRESS FINAL lc7 2ta)5S
WM.'J. FOX. COUNTY ENGINEER - VALIDATION -
BY . _ . . . �,. .. �i(;�5Ya 3 21 JUL20 1 2.0 0
•DEPUTY - "' DEPUTY
9y - BY
® . DEPUTY `J ��/ �•-/,+ DEPUTY
` WORKERS' COMPENSATION DECLARATION !., �_ ' !.•. 1 - _Yj /
hereby affirm that I nsfhave Wo a certificate of consent to self APPLICATI®N FOR BUILDING _ PERMIT
insure, or certificate of Workers'Com pen sti c Insurance if _
a certified copy thereof (Sec. 3800, Lab. C.) - -
" ' - COUNTY OF LOS ANGELES - BUILDING AND SAFETY
Policy No. Company
Certified copy Is hereby furnished. LDIN
BUI
.FOR APPLICANT TO-FILL IN - ADDRESS
G
J
• Certified copy is filed with the on , lding inspec- BUILDINGQ / .-y--
tion department. ADDRESS rr ]/ /qj LOCALITY L G
NEAREST
Date l0�-`I SaApplicant CITY L ZICROSS ST.
- CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS •7 ASSESSOR '
'COMPENSATION INSURANCE SIZE OF LOT 5 _ NOW ON LOi i MAP BOOK PAGE PARCEL
(This section need not be completed if the permit:is for one q s USE ZONE MAP
it.hundred dollars ($100)or.less.) TRACT d ' BLOCK LOT NO.. 3 NO. I 1�
f T�^ - L.7 SPECIAL C) g ._ Q. r� Si..vpr'oO
r- OWNER G 1 O. ZY-57'01YCONDITIONS O ! '►
_ terrify that in the performance of rh war. for which this.
permit is issued„I shall not employ an pers in ny manner DISTRICT GROUP TYPE FIRE PR CESSEO BV FJ
j - ADDRESS J rl/ 1�1�-11
{I so"as to become subj dto the Work s' Co pe s do Laws. / „7 CONST. ZONE 'W
' CIT �J a11d LfL ZIP /775- Sob/ ✓ O
5 Date I / Applicant STATISTICAL CLASSIFICATION - APT. CONDO. V
l NOTICE TO APPLICANT: If, after g tis Certificate of ARCHITECT OR - TEL. - ++LL� Ly
Exempt'an, you .should become subject to the Workers' ENGINEER NO. CLASS.NO. DWELL. UNITS H
Co mpen sarion provisions of the Labor Code, you must forth- ADDRESS SEWER MAP t/ Z
_with comply with such provisions or this permit shall be / - _
deemed revoked. CONTRACTOR / (.per NOf BK. PG, VALIDATION
LICENSED CONTRACTORS DECLARATION ./ LIC _
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS/ d� /Ll/V NO. VALUA ION
(commencing with Section 7000)of Division 3 of the Business and - LIC. I D
Professions Code, and my license is`in full force and effect ! CITY `tom CLASS_.. - $
���'���(�)'�`y� 'Ay 00
SQ. FT. NO, OF NO. OF _ CHECK
License Nu�m�p)berLic Class 1/ I SIZE STORIES FAMILIES ONE, -
G a(l �R ,n L� I o 711, (l� DESCRIPTION OF WORK NEW � $
Cantracto VV^^'+/ Dore _ ADD 10F-1 '
_ - ,
I am exempt from the licensing requirements as I am a 'tA-((
licensed architect or a registered professional engineer - / _ - ALTER. ,Q FINAL y
acting in my professional capacity (Section 7051, N �1•� r/ I�(o �- ® DATE S f -
REPAIR
Business and Professions Code). T
FINALUSEOF 'V / 7EXISTING BLDG. DEMOE E]
BY FI •rr F^�+� -
LicrorReg.No - Date ” APPLICANT / TEL / Y ,
' OWNER-BUILDER DECLARATION - - (PRINT) �L,.�y (�/' (K.-1!� NC,?4g 77
I herebyaffirm that I am exempt from the Contractor's License /!r n eG�l�-3
Law for the,following.reason (Section 7031 .5, Business and ADDRESS(3v) !iZV r -
ProfessionsCode): PRESENT -
BU LDING. . �3 3 6 2:8 A
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 sole(Section LOCALITY
7044, Business and Professions Code). MOVING TEL.
I, as owner of theproperty, am exclusively contracting CONTRACTOR NO. �1� — L Z ° 1 5 1,00
With licensed contractors to construct the project (Seo-
ADDRESS
O o V - _ 1 5 ,. C)O.
tion 7044, Business and Prafessions Code). ° °
REQUIREDTOTAL SETBACK FROM - EXIST.
CONSTRUCTION LENDING AGENCY SET BACK "YARD HWY PROP. LINE + WIDTH Q 1. 0 9_8 1.
I hereby affirm that there is a construction lending agency Por FRONT ,
the performance of the work for which this permit is issued P.I.
(Sec. 3097, Civ. C). - .SIDE' - - -
t�Lender's Name /VO n/
P.C. Fee 5 !S Permit Fee
Lender's Address '
w I certify that I have read this application and state that the Issuance Fee
above inforrnar' m correct. agree to comply with oil County Investigation Fee - - -
0 ordinance$ - of laws relating to building construction,
'ondh a or' a representatives of th' unty to enter ' Total Fee
aupo Ih ab e- n tied ropert inspe/cjt,'sQ/n purpyQses. _ •
a C (/^'� I SEE REVERSE FOR EXPLANATORY LANGUAGE
Slgnotare of Applicant or Agent. Date - 'Os
WORKERS'COMPENSATION DECLARATION � �'s C?
�.
hereby affirm that I have Workers'
oens consent to self APPLICATIOWFOR BUILDING PERMIT
insure, ora<eriificateof Workers' Compensation Insurance,
or acertified copy thereof (Sec. 3800, Lob. C.) +•
�
J � Q����- T . COUNTY OF.LOS ANGELES BUILDING AND SAFETY
P®cy No.&_ Lompony J' T'� F •�Vy'✓� - �..- !' -
Certified copy is hereby furnished: FOR APPLICANT T02FILL IN - BUILDING
ADDRESS
Certified copy is filed with the county building inspec- ,BUILDING /
tion eparEl ent ^� ADDRESS /. �'r9S TuAJ9S -,�J2; .LOCALITY.- /�
- Date `� 2� 8 Applicant /�.tL� � +7s, CITY 7Q V? rs4 IP CROSSSST. Gsj f� /vl Ai -
CERTIFICATE OF EXEMPTION FROM WORKERS' NO F BLDGS. ASSESSOR
' COMPENSATION INSURANCE SIZE OF LOT - N ON LOT MAP BOOK PAGE PARCEL
(This section need not be completed if the permit is for one - - USEZONE MAP
hundred dollars ($100)or less.) TRACT BLOCK LOT NO. NO. -
•� TEL.' SPECIAL y
I certify.that in the performance of the work for which this OWNER NO. CONDITIONS' d
�� ��,s,, DISTRICT .GROUP TYPE FIRE PR ESSED BY O
permit is issued„1 shall not employ any person in any manner ADDRESS /Kly” CONST. ZONE L�
so as to become subject to the Workers'Compensation Laws. _/� - ,6 V L / -1 5
W
Date Applicant CITY ` ZIP STATISTICAL CLASSIFICATION V APT. -NDO. O
ARCHITECT OR - TEL p
NOTICE TO APPLICANT If,.after making this Certificate of ��j�'O r 7
Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS_ d
} Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP N
with comply with such provisions or this permit shall Be .�
Z
deemed revoked. TEL- �/ ��,At y VALIDATION
CONTRACTOR J 1'e DONS . NO._ Z` X16 BK./fl PG,
LICENSED CONTRACTORS DECLARATION '
I hereby affirm that I'am licensed under provisions of Chapter 9 ADDRESS JY J 3l-I- F%T U, W9I Y NO. Z�&0.454A .VALUATION
,(commencing with Section 7003)of Division 3 of the Business and ". 't•"EIC.
Professions'Code, and my license is in full force and effect. CITY ICO Se ML¢C C/IG CLASS ?3- 9
R. NO. OF NO. OF - C ECK
License Number 6 0 Lic.Class �l SIZE -
no, C FAMILIES _ ONE
Contractor /Gr�L �0•951Date �Z� DESCRIPTION OF WORK C.�Q 2•L NEW S ;2 7 Q 7.8 A
OI am exempt under Sec Cj° �J., ADD 0 # e e e e 2 3
ALTER C] FINAL _% •-
B.BP.C. for this reason REPAIR DATE 37.50' t•
USE OF
Date: EXISTING BLDG. - gY AL
DEMOL � � � •,e•e 3 7.5 0 i'
Signature APPLICANT {� TEL. 6/$
PRINT) F�C.L'1 - . SL t
OWNER-BUILDER DECLARATION GO "J .NO.
- O Q O O H 8
hereby affirm that.l am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and ADDRESS - _ , 7 O 7.9 A
Professions Code): PRIES
RE ENT QQ ,/' - # e e e e e
OBUILDING � C7 / `„gD -I- 4b - - - -
-I, as owner of.the property, or my employees with ADDRESS U VL
wages as their sole compensation,will do the work and LOCALITY ''tee '2 it e - 49.88
_
the structure isnot intended a,offered for sale(Section - -
7044, Business and Professions Code). MOVING TEL. • e:a 4 Q f}8.�'
F1, as owner of the property, am exclusively contracting CONTRACTOR rr NO. l\'L- (� - _ '
with licensed contractors to construct the project (Sec- ADDRESS 3�J Tj a' w YY %6f-J - KOSeM ' 0 Q Q�n 8 8
tion 7044, Business and Professions Code). _
'REQUIRED TOTAL SETBACK FROM EXIST. '
CONSTRUCTION LENDING SET BACK YARD HWV 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.
(Sec. 3097, Civ. C.). SIDE
P.L. -
m Lender's Name
Lender's Address 3 2
P.C. Fee$ 3-715Z Permit Fee
- _
I certify that I have read this application and state that the Issuance Fee O
Q above information is correct. I agree to comply with all County Investigation Fee •�,� '
g ordinances and State laws relatiqq� to bui ding construction, - Total Fee
u and hereby authorize repre nt dives o is County to enter .
m upon the above=mentionedro or inspection p posey,
a r✓-- $ B SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applica enI Data .®s
t
COUNTY OF LOS ANGELES TEMPLE CITY # 0506 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0703060014
PHONE: (626) 285-0488 EXT:
ILEGAL ID: NO. OF CONST BUILDING ADDRESS:
ITR: 3623 LT: 68 UN: .002 SQ. FT STORIES TYPE 8841 LAS TUNAS OR
ISTRUCTURE: 80 VN TEMP CA 917801821
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
5387-011-009 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, Cl
I TENANT: IEXIST BLDG USE: CONV!E USE ZONE: C-3 (ISSUED ON: PROCESSED BY: EXPIRES ON:
IB20 BAR GRILL RESTAURANT IEXIST OCC GRP: 103/06/07 SK 02/29/08
I I
OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL CODE:
(TSU-TSAI CHAD (626) 285-6920- I 1,000 SII "-
9722 LONGDEN AVE.
ITEMPEL CITY CA 91780 FEES PAID (DESCRIPTION OF WORK
0PENT_NG WALL TO DINING AREA AND 80 S.F. STORAGE ROOM
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
(APPLICANT: TEL. NO:
SAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.75
AE STRONG MOTION OTHER 1000.00 VAL 0.50 ISPECIAL CONDITIONS:
ID2 PERMIT W/O EN-HC 1000.00 VAL 65.40 I
TOTAL FEES 93.65 1
CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE
(SAME AS OWNER LIC. NO (LOCATION AND SETBACKS
I
(SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. N0: IFOUNDATION/TRENCH FORMS
LIC. NO: ISLAB/UNDER FLOOR
I I I
RAISED FLOOR FRAMING
IMP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: (UNDERFLOOR INSULATION
I I I
115OH261 3 011 I
I I FLOOR SHEATHING
N0. OF FAMILIES: DWELLING UNITS: APT/CONDI STAT CLASS:
NO 22 (ROOF SHEATHING
1 SCHOOL WITHIN HAZARDOUS I (SHEAR PANELS I I I
1AIA QUALITY: 1000 FEET MATERIALS I
NO NO NO (FRAME INSPECTION
REQUIRED TOTAL SETBACK FROM EXIST (FIRE SPRINKLER HANGERS
SET BACK YARD: HWY: PROP LINE: WIDTH: I I
I
FRONT PL- (INSULATION/WEATHER STRIPI
I SIDE PL-
IINTERIOR LATH/DRYWALL
I IEXTERIOR LATH
RATED FLOOR/CEIL ASSEM.
I I RATED WALL ASSEMBLIES
)I
(RATED SHAFTS/OPENINGS
II I IIT-BAR CEILINGS I I I
1LOT,URAINAGE I I I
I
' IREPORT ID: OPR261 ROUTE TO: BS0508
I