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HomeMy Public PortalAbout9124 LAS TUNAS DR_Building__ 76A 638A CE#803 3-68 APPLICATION FOR EIUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS c L BUILDING AND SAFETY DIVISION LOCALITY 074 JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST. L(/ DISTRICT NO. GROUP TYPE PROCESSED BY FOR APPLICANT TO FILL IN �.s CONST. (Print or type only) .y J Q 8 /' BUILDING STATISTICAL c-, ASglFICATION SEWLfR MAP ADDRESS CLASS NO. DWELL,UNITS SK /_PG lCJ LOT NO. BLOCK USE ZONE MAP O NO. G C) TRACT — 0 SPECIAL NO.OF BLDGS. / CONDITIONS SIZE OF L014 4,5-aNOW ON LOT USE OF I EXISTING BLDG. b /G BLDG.SETBACK FROM /�S T,7�_5 (STREET). TEL. FRONT PROP.LINE OF OWNER Jfu� NO. TYPE OF EXISTING SETBACK HIGHWAY {. YARD = TOTAL HIGHWAY WIDTH FROM C.L. ADDRESS i } _ CITY R J6 o ~ BL G.SETBACK FROM ARCHITECT MR TEL. SIDE PROP.LINE OF (STREET) ENGINEER NO. TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL ADDRESSHIGHWAY WIDTH FROM C.L. TEL _ CONTRACT O NO. D(,) + d LIC. CORNER CUTOFF YES ❑ NO ❑ U ADDRESS�[J`r_r�r NO. f 7� Z - LIC. ck, CITY CLASS C'-IIS'— SEE REVERSE SIDE FOR SPECIAL APPROVALS o U VDESCRIPITION OF. WORK a NEW AD ALTER REPAIR DEMOLISH z SQ. FT. NO. OF NO. OF SIZE STORIES FAMILIES USE OF STRUCTURE 3� SIGNATURE OF APPLICANT C�f VALUATIONS ` 2V APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION:FORM LOCATION FEE$ /Q0 FEE $ �.Ba FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE 15 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. LATH, EXT. SIGNATURE OFA' ® HOUSE NUMBER COR- PERMITTEE f RECT AND POSTED ADDRESSJ=t=E?2� n ae4 rC FINAL JOHN F. LEWIS, PRINCIPAL ST URAL ENGINEER PLAN CHECK VALIDATION M.O. CASH _ PERMIT VALIDATIO CK. M.O. CASH ( �,7 3 7:7Nov2223 D 5.v�� 7 3 7 81-0 NAR 2 2 1 D r� PPLICATION F'OR BUILDING PERMIT FQR` 1 b FILL IN (Print or type only) COUNTY OF LOS ANGELES a�l> DEPARTMENT OF COUNTY ENGINEER CITY 7p y. ZIP 7Z) BUILDING AND SAFETY DIVISION NO.OF BLDGS. BUILDING ` SIZE OF LOT` P r -7 NOW ON LOT ' ADDRESS C c.. . TRACT Iq BLOCK LOT NO.J LOCALITY TEL. �y NEAREST•;. OWNER Ptd NO..2 p G 24 CROSS ST. ASSESSOR ADDRESS j :2 " 41,j ( e- MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE SSED BY -CITY M , ZIP' flCONST. ZONE ARCHITECT OR TEL. O ��--• , ENGINEER ehel i,4 � NO7 STATISTICAL SEWER MAP ADDRESS 3!'U - 6 :kr -9CLASS NO. ?=� WELL.UNITS BK PG TEL. CONTRACTOR i `7�! NO. USE ZONE MAP:. LIC. NO. G ADDRESS (� `mac Ci i �f NO.. SPECIAL LIC. CONDITIONS CITY c CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO CONSTRUCTION LENDER ❑ NAME AND BRANCH BLDG,SETBACK FROM FRONT PROPAINE OF_ (STREET) -ADDRESS- CITY HIGHWAY + YARD - TOTAL SETBACK FROM TYPE OF EXISTING SO.FT. NO.OF NO.OF _ CHECK FRONT PROP.LINE HIGHWAY WIDTH SIZE n O STORIES FAMILIES ONE } DESCRIPTION Of WORK NEW ❑ + D O ADD BLDG:SETBACK FROM Q &e SIDE PROP.LINE OF (STREET) O r ALTER ❑ TOTAL SETBACK FROM TYPE OF EXISTING w C e.jf 'k4 71 4% j�/ HIGHWAY + YARD = SIDE PROP.LINE HIGHWAY WIDTH USE OF REPAIR ❑ EXISTING BLDG. + _ �. ��./ i n)k'e DEMOL ❑ AP%CAN TEL CORNER CUTOFF YES ❑ NO ❑ (PRINT) eNO. � IN OPEN SPACE - YES ❑ NO ❑ BY(SIGNATUR ' rGa(./e fLE~G� IN COASTAL PERMIT ZONE YES ❑ NO VALUATION I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATETHAT THE ABOVE IS CORRECT AND AGREE TITH ORDINANCES AND LAWS REGULATING BUILDING CO STRUCTIION.nI C RTIFY THATLIN DOING THE r 1. / ,✓' WORK AUTHORIZED HEREBY 6 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM. PENSATION")NSU RA,.NCE. - - a" '�/"^�• �� '- � �!�".1��� `�✓' -SIGNATURE OF `- `!G 0M -n®- �XC_-�7- /Q PERMITTEE j ADDRESS FINAL Y TEL. DATE CITY NO. MAKE CHECKS PAYABLE TO: FE $ FET H.4R_EYT. BRANDT,COUNTY ENGINEER 71 PLAN CHECK VALIDATION cK_..M.0. CASH PERMIT VALIDATION CK. M.O. CASH " 1 5 84 :MhR 2.5.�2 3 '111 :3.8 0 8 7' 3 ARR 2'5 2. 2. 3 1..0 0 �f 8':7 2r"_APR 2 5 6 4..x`3'0 ® _- OS 76A63BA CE#803 375' WEPARTMEN-T OF BUILDING AND SAF]fT—YJIL —ruff:Pr+.lvizi y-1` COUNTY OF LOS ANGELES WM. .J. FOX, CHIEF ENGINEER 8 U L ® I N G f FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING /�JC/1 L 41 �T�Al�� DISTRICT NO. PLAN Ci K. NO. 5 PERMIT NO. ADDRESS /��r(�J��(.,. /�/ � ..9 ✓ ,y � LOCALITY / C/C�P7T CA4 jR�EC...EEIIVED BY DATE O/F�AP PL. DATE ISSUED �NEAREST M / / `-",°' 1'l �.0 a � ✓ tip CROSS ST. N N ��J / ��j�1 p }� yj wvy OWNER /d/����/!! /Y /Y✓�� ADDRBUILDESS vNG MAIL �y} �^ 7_7V4­-S . ADDRESS I V '06° /AI S? ULOCALITY°;9c; ,:J �•-��`P`- ' ;'as �� TEL. NEAREST" CITY ✓ ' NO �J� . CROSS ST. FIRE I NO.OF TYPE GROUP ARCHITECT OR TEL. ZONE PLANS PLANS ENGINEER NO. BLDG. ORD. NO. ADDRESS SETBACK LINE • APPROVED TEL. CONTRACTOR NO. BY DATE USE APPROVED- ADDRESS. PPROVEDADDRESS ZONE%.Ol BY DATE. LEGAL DESCRIPTION I LL TT NO.,_e BLOCorml! s�, (� (' CORR(/E�CTIONS TRACT NO. OF SLOGS. / SIZE OF LOT �z. NOW ON LOT USE OF �p �{I-NO.OF NO. OF /J EXISTING BLDG.��}. 0, --- FAMILIES I ROOMS f/ DESCRIPTION OF WORK NEW ALTERATION ADDITION O 0 REPAIRppff MOVING DEMOLISH OSQ. _ S ZEFT�6^ I ROOMS STORIES /WALL ROOFZ COVERING-57e'4(G e' I COVERING . USE OF NEW �"i• s`�dlo l „1' tt.`4r 'U ��ff�"!1 f BUILDING APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS .APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION, INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE OF �l/ �" BRACING, BOLTS OWNER. /r LATH, INT.: - gull AUTHORIZED AOT -LATH, EXT.:' $ P. C.$ PLASTER, INT. ncl' ..mead . FEE PLASTER, EXT. _ VALUATION FEE L/ FINAL I, D.S.-S 19.43 SBM SRTS APPLICATION-FOR PERMIT. DFPA•RTMENT OF BUILDING AND SAFETYi�j COUNTY OF LOS ANGELES B V IL INN . WM. J. FOX, CHIEF ENGINEER NO.OF BLDG. ORD.NO.. DISTRICT O. PLAN CK: NO. PERMIT.NO SETBACK LING PLANS FIRE APPROVED ZONE BY 5" DATE R EI D•BY DAT OF :. DAED USE /�� APPROVED ZONE l•' BY - DATE. APPLICANT FILL- IN,HEAVILY. OUTLINED PORTION NIA BUILDING Iti NAME ADDRESS C3 ° O.E W Z ADDRESS LOCALITY •�p (� NEAREST U w CITY CROSS ST. Q STATE TEL.. NAME LICENSE.NO. NO. MAIL 0 .NAME: ADDRESS'/�2 � , 0 TEL. Q .ADDRESS e CITY NO. C ZCIiY t HEREBY ACKNOWLEDGE. THAT. I HAVE READ THIS V APPLICATION AND STATE'THAT THE ABOVE IS CORRECT STATE TEL. AND AGREE TO COMPLY, WITH ALL COUNTY ORDINANCES LICENSE ,Nr+O. NO. AND STATE LAWS REGULATING BUILDING CONSTRUCTION. C LOT NO.ti7 O /� lrq SIZE OF,LOT.-2S� / SIGNATURE OF y OWNER -1 ►- NO. OF SLOGS. a L BLOCK 7-2- NOW ON LOT AUTHORIZED AGT. W g TRACT �� f%'" COgtRECTIONS ;., . D USE OF SLOGS. 0 NOW ON LOT :«��, z.ur 6 siXF Pd DESCRIPTION.OF WORK �%�j1i_ it USE OF BUILDING s 11 J( ,.e-ca . m a x.a a:,a B7.AT This construction ma 1„ in violation of War, Prodiac°ion �- irci orders. You are 3 Prod6dion caid�7fi:c��before commend X ; e work auttiorizc'd in this permit, Z " y r , NLn,'II TYPE � GROUP � - NO.OF r NO.OF ALTERATION ROOMS FAMILIES ' ADDITION _SIZE REPAIR STORIES / MOVING WALL COVERIN c--6 DEMOLISH ROOF COVERING P.C. FINAL.APPROVAL r -� FEE _ $ 31 y1N8PECTO + VALUATION FE6 +—'► DATE 1 :NAME •76A638A CE#803 I, APPLICATION FORtBUILDINGPERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS "� S 7 U lv A r BUILDING AND. SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST COLEMA�N'W.JENKINS,SUP'T OF BUILDING, - CROSS ST. /r /`.d /C9'/4 / V E DISTRICT NO. GROUP TYPE PROCESSED BY FOR,APPLICANT TO FILL'IN S: O F —L CONST. BUILDING „ STATISTICAL CLASSIFICATION - SEWER MAP ADDRESS // CLASS NO. "� ..DWELL UNITS. BKL FG /10 LOT NO. 517BLOCK, USE ZONENOMAP Q TRACT �`." Or .. C� Z SPEC: IAL " ,/ NO.-OF BLDGS. J CONDITIONS - - SIZE OF ,LOT S y�,�^V � I NOW'ON LOT USE OFEXISTING BLDG. c -- BLDG. SETBACK FROM_ _ I�✓�� - 7 TOEL. - .FRONT PROP.'LINE OF (STREET) , OWNER k� ryry�G�>t M I y N . ETYPE EXISTING SETBACK HIGHWAY + YARD. TOTAL ADDRESS J� �+ ,,( ,� (jj.� 1.. Y WIDTH FROM C.L.CITY trt: f 4 y / _ �Vd ` + BLDG. SETBACK FROM ARCHITECT R TEL,-.-- ENGINEER NO. SIDE PROP. LINE OF "(STREET)• . 's"-' - `•J TYPE OF EXISTING SETBACK HIGHWAY + - YARD = TOTAL_ HIGHWAY WIDTH- FROM C.L. . TEL. - + CONTRACTOR.-- y.' NO ' LIC a ADDRESS� _ NO CORNER CUTOFF, YES NO - C _CITr — LICCLACC SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK 4 In ANIJ Am NEW ADD ALTER REPAIR DEMOLISH /� ?n, ��-y,a„+jC/ SQ.FT. NO O F N O. O F SIZE STORIES FAMILIF_S > P (/�; USE OF ,L �L p. °'J�:" /. .S.d/�IfY illIo.�X 1"�n STRUCTURE /- C j • � . //.�. �.J:•J"flfh..ad. s�✓+!`Je�`..,b%..�,'Il�,p,'�1,,'�-,, �"' r" 1`.�.Gf�..��_/#! SIGNATURE OF AW-s-7- APPLICANT VALUATION$ G��� c00 - APPROVALS , DATE • INSPECTOR'S SIGNATURE FOUNDATION, LOCATION FEE$" _ FEE$ Z FORMS,"MATERIALS "FRAME, FIRE STOPS," g I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS - - JI -AA .�� AND STATE THAT THE ABOVE IS CORRECT ANDAGREETO COMPLY FURNACE: LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING - GAS VENT. DUCTS A BUILDING CONSTRUCTION. I CERTIFY THAT IN 'DOING.THE WORK -. AUTHORIZED'HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA­' TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELAT• LATH. INT. a- • .� A r'� ' ING TO WORKMEN'S CO NSAT ON I SU RANCE. • LATH.'EXT. SIGNATURE OF :71 'HOUSE NUMBER COR- RE CT AND POSTED ADDRESS ri Fl NAL 7v F JOHN F. LEWIS. PRINCIPAL ST ENGINEER GINEER PLAN C CRNA A N K. .o. CASH _ PERMIT VALIDATION CK. M.O a CASH WORKERS'COMPENSATION DECLARATION I,hereby affirm that I have a certificate of consent ,to self insure, or a certificate of Workers' Compensation Insurance, APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company L / ❑ y FOR APPLICANT TO FILL IN - A��RES 1�y C, Com/ Certified copy is hereby furnished. _ Certified copy is filed with the county building in ec- BUILDING tion department. ADDRESS LOCALITY NEAREST Date Applicant CITY IF CROSS ST. CERTIFICATE OF EXEMPTION FR M ORKERS' NO, OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT p25 NOW ON LOT w MAP BOOK PAGE PARCEL (This section need not be completed.if the permit is for,one USE ZONE OP hundred dollars($100)or less.) TRACT BOCK' LOT NO. • TEL. C'',2, SPECIAL } I certify that in the performance of the work for which this loh OWNER Q tjLr/�- NO. CONDITIONS 9 permit is issued, I shall not employ any p on in any manner DISTRICT GROUP TYPE FIRE PROC SED BY O so as to become subject to the Worker mpensation L ws. ADDRESS Y' CONST. i ZONE iTDt L Applicant 6 CITY IP ' ' STATISTICAL CLASSIFICATION APT. CONDO. O TICE TO APPLICANT: If, "afterm ing is'Certificate' ARCHITEC R TEL.xemption, you should become subject to the Workers' ENGINEER N © CLASS NO. DWELL. UNITS � Compensation provisions of the Labor Code, you must forth- ADDRESS42-0 SEWER MAP OA With comply with such provisions or this permit shall be TEL. / Z deemed revoked. CONTRACTO NO. BK. /'PG,! D VALIDATION LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. }( ll Professions Code, and my license is in full force'.and effect. CITY POL4 CLASS $ -S—U V ► SQ. FT. N .OF INC.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE $ Contractor Date DESCRIPTION OF WORK NEW I am exempt under Sec. - ADD � ALTER FINAL B.&P.C. for this reason DATE S e? _ REPAIR Date: E S FINAL NG BLDG. DEMOL Signature PUCANT TEL. By e v O v 8, OWNER-BUILDER DECLARATION PRINT NO. I hereby affirm that I am exempt from the Conteactor's License Poo. 0 0 0 Law for the following reason (Section 7031.5, Business and. ADDRESS Professions Code): PRESENT ? - 68613 aBUILDING I, as owner of the' property, or my employees with ADDRESS L o 3 o 6 8.63 c wages as their sole compensation;will do the work and the structure is rsot intended or offered for_sale(Section LOCALITY' 0622"83 44, Business and Professions Code) MOVING TEL. I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project;(Sec- tion 7044, Business and Professions Code). . ADDRESS REQUIRED. TOTAL SETBACK FROM ]WXIDSTTH CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE , 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. (Sec. 3097, Civ. C.).' SIDE Z-0 P.L. Lender's Name Lender's Address P.C. Fee'$ Permit Fee I certify that I have read this application and state that the Issuance Fee U< above information is correct. I agree to comply with.all County Investigation Fee ordinances and State laws lating to building construction, Total Fee j �/ d and hereby authorize repre ntatives,of this County to enter upon the ve-mentioned roperty for insp ction purposes. SIE' REVERSE 1FOR EXPLANATORY LANGUAGE ign/ re of pplicant or Agent Date es WORKERS' COMPENSATION DECLARATION insure, or afirm certif carte of Workers's' Compensat on I have a certificate of coent Insurance, ..APPLICATION FOR BUILDING PERMI T 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 ADDRESS r , El BUILDING . Certified copy is filed with the county building inspec- t V 14 tion department. ADDRESS CITY E ZIP -51796 LOCALITY Date Applicant NO. OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS'! SIZE OF LOT NOW ON LOT '' CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need'not be completed if the permit is for one TRACT BLOCK' LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100),or.lem,) TEL OWNER $i�N NOA( Z 1 USE ZONE' NOP I certify that in the performance-of.the work for which this SPECIAL } . permit is issued, I shall not employ any person in any manner ADDRESS AL f- `>� ', Ci'� CONDITIONS so as to become subject to the Workers'Compensation-Laws. O CITY AJ Q&WA ZIP q 6 6 Date Applicant ARCHITECT OR TEL. DISTRICT'•.. GROUP TYPE FIRE PR CESSED BY M NOTICE TO APPLICANT: If; after..making this Certificate of ENGINEER NO. g CONST. ZO E o Exemption, you should become subject: to the Workers' � Compensation provisions of the Labor Code, you must forth- ADDRESS 001 �' � '+N with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. deemed revoked. CONTRACTOR f:' NO. Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. �� DWELL. U I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (commencing with Section 7000).of Division 3 of the Business LIC. and Professions Code,and my license is in full force and effect. CITY CLASS BK PG VALIDATION SQ. FT. NO. OF NO. OF CHECK License Number Lic. Class SIZE STORIES FAMILIES ONE VALUATION DESCRIPTION OF WORK NEW ❑ Contractor Date ❑ $ �Q, 0O G n ADD Poo, I am exempt under Sec. i`cw4 -ALTER ❑ B.BP.C. for this reason REPAIR ❑ $ Date: USE OF DEMOL ❑ EXISTING BLDG. Signature APPLICANT ' NO. FINAL OWNER-BUILDER DECLARATION DATE j-1© -12,,' I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL Professions Code): PRESENT 'A/ By - BUILDIII NG�. -I VVt� ❑ I, as owner of the property, or my employees with ADDRESS _ -- wages as their soleCompensation,;wiII do the work and , _4,"' dw.-J the structure is not intended or offered for sale(Section LOCALITY L Q C 7044, Business and Professions Code.) MOVING TEL. ❑ I, as owner of theproperty, am exclusive) contracting CONTRACTOR NO. Y 9 `F with licensed contractors to construct the project (Sec- ADDRESS' tion 7044, Business.and Professions Code.).. REQUIRED TOTAL SETBACK FROM EXIST. - CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH s I hereby affirm that there is a construction lending agency for FRONT �•`=�s= the performance of the work#or'which this permit is issued P•L - - • -� (Sec. 3097, Civ. C.). SIDE:. lsl [� 0 � 0 P.L. - Lender's Name. G - LDMA Ref. # ki s P.C. Fee$ �Df Permit Fee or- Lender's Address 0 1 certify that I have read this application and state that the Issuance Fee �.3 LDMA P/C# 8 above information is correct. I agree to comply with all County Investigation Fee I_il if t_ �l;I s _r �r•'_•1 R ordinances and State laws relating to building construction, Total Fee s LDMA Perm. # ,< and hereby authorize representatives of this County to.enterM upon the ove-mentio d pro erty for inspection purposes. }_• L d - l - ��J k, SEE REVERSE FOR EXPLANATORY LANGUAGE Signatur f Applicant or Agent Date / WORKERS' COMPENSATION DECLARATION hereby affirm. that I have certificate of consent to self APPLICATION FOR B U I L D I G. PERMIT insure, or a certificate of Workers' Compensation Insurance; " or a certifi�ed�lc.�o yy h)eLeof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUI NG AND SAFETY Policy No.LL" ' Company.' BUILDING Certified copy is hereby furnished. FR OR APPLICANT TO FILL IN ADDRE /01 ❑ Certified copy is filed with the county building inspec- n^ ) s TuM � :: tion department. L�#' L Date "' ' Applicant ���� ZIP ` • u LOCA NO. OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' NOW ON LOT CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one BLOCK LOT MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) N� G�CJ�. 751MAP GXl USE ZONE . //NO. �7-I certify that in the performance of the work for which thisoe, SPECIALpermit is issued, l shall not employ any person in any manner l2 CONDITIONS so as to become subject to the Workers'Compensation Laws. `,7QrOO O CITY L ZIP ll Date Applicant ARCHITECT OR.. TEL. DISTRCT GROUP TYPE FIRE PROCESSED W IBY NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. � CONST. ZONE 0 Exemption, you should become subject to the. Workers', /t ' / W Compensation provisions of the Labor Code, you must forth ADDRESS - �� � V 0- with with .comply with such 'provisions or this permit shall be TEL. 3 STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTOR �� (/I NO.� _ LICENSED.CONTRACTORS DECLARATION // �o LIC. �`!_3 C r CLASS NO. DWELL. • ITS I hereby affirm that I am licensed under provisions.of Chapter 9 ADDRES lO Vt ISG I LA��� NO. 11A9 SEWER MAP (commencing with Section 7000)of Division 3 of the BusinessCI 'T7�1�I/ l 1� L IL CLASS G and Professions Code,and my license is in full force and effect. BK. PG. t;_I VALIDATION n FT: NO. OF NO: OF CHECK license Number3g2 Lica Class SIZE I STORIES FAMILIES ONE - r 07 f VALUATION �}•=_,�,.:_ �/.�y t ' DESCRIPTION OF WORK NEW S '�L�V�� Contractor t L �ncA� b V\ Date �'' � / ADD ❑ �lJ i (I i_M ❑I am exempt under Sec. F-� ALTER ❑ B.&P.C. for this reason t ; i_i''' REPAIR ❑ S :* t+ a •S Date: USE OF EXISTING BLDG. DEMO, F-1i•I"(iir;� �!= s• Signature APPLICA 1 TEL. p,� G3 FINAL OWNER-BUILDER DECLARATI ON/ (PRIM eyL IG` NO.V DATE (?t1i_'.lju.I }: =1 I hereby affirm that I g r exempt from the C .tractor's License �q�� Vt een'�of � t t ,.�•: P ADDRESS FINAL Law for the following reason (Section 7 1.5, Business and � :�, •�•"rt= ><:.,,•t,-=�, Professions Code): PRESENT BY BUILDING/ ❑ I, as owner of the•propert or my employees with ADDRESS } wages as their sole compe ation,will do the work and / , ? the structure is not inten d or offered for sale Section , LOCALITY 7044;Business and Pr essions Code.) MOVING TEL.- CONTRACTOR NO. ❑ I, as owner of the p petty, am exdusively.coniractin/�ec" with licensed cons actors- project ADDRESS tion 7044, Bust ss and Professions Code.) REQUIRED TOTAL SETBACK FROM EXIST. CONS UCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I I hereby affirm th•t there is a construction lending age ey for FRONT y/d IJ the perforXC ..-Co). f the work for-which this permit is�ssued P.L. V✓ (Sec. 3097, . SIDE. i Lender's Name. o.' / LDMA Ref. #. P.C. Fee$ i Permit Fee , � Lender's Address 0 1 certify that I.have read this appl talion and state that the Issuance Fee LDMA P/C# 8 above information is correct. I agree to comply with all County Investigation Fee R ordinances and State laws re pting to building construction, Total Fee LDMA Perm. # a and hereby authorize representatives of this County to enter up khe abo -T1"IFiTDned property for inspection purposes. o Q �j-t3 gj SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant.or Agent Date 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 1408040099 PHONE: (626) 285-0488 EXT: - - ILEGAL ID: I NO. OF CONST BUILDING ADDRESS: 1 ITR: 5905 LT: 58 BL: .001 I SQ. FT STORIES TYPE I 9124 LAS TUNAS DR 1 I ISTRUCTURE: 26 V-B TEMP CA 917801903 I (ASSESSOR INFORMATION NUMBER: I I _ NEAREST CROSS STREET: I . 15387-023-035 1 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY CAI I I I I (TENANT: IEXIST BLDG USE: COMME USE ZONE: C-1 (ISSUED ON: PROCESSED BY: 1 (EXIST OCC GRP: 108/04/14 SR I I I I (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IF N D E F Y: CODE: 1 IKWAN FELIX (310) 622-0495- 1 9,000 I 1 12225 W COMMON HEALTH 1 I 1 ALHAMBRA CA FEES PAID D PT ON OF WORK - I I I ITEAR OFF EXISTING ROOFS AND INSTALL A NEW BUILD UP ROOF IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ISYSTFM WITH A CAPSHEET SURFACE 1 ' (APPLICANT: TEL. NO: .I I 1 IGUEVARA, SERGIO (310) 480-3448- IAA BLDG PERMIT ISSUANCE 27.80 1 1 11042 HARBOR VILLAGE IAB STATE GREEN BLDG FEE 9000.00 VAL 1.00 ISPECIAL CONDITIONS: - I IHARBOR CITY 90710 IAE STRONG MOTION OTHER 9000.00 VAL 1.90 I 1 ID2 PERMIT W/O EN-HC 9000.00 VAL 199.80 I I TOTAL FEES 230.50 I 1 ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE ID AND S ROOFING (310) 480-3448- 1 1 I 11042 HARBOR VILLAGE DR LIC. NO I (LOCATION AND SETBACKS I - HARBOR CITY CA 90710 917418 1 1 I I I ISOILS ENGINEER APPROVAL 1 (ARCHITECT OR ENGINEER: TEL. NO: I (FOUNDATION/TRENCH FORMS I ( I 1 LIC. NO: 1 ISLAB/UNDER FLOOR I I I 1 I IRAISED FLOOR FRAMING 1 I I I I I I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( 1UNDERFLOOR INSULATION I I 1 3 oc l 1 11 1 I.FLOOR SHEATHING I I 1 INC. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I I - NO 22 I (ROOF SHEATHING I I SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I I 1AIR.QUALITY: 1000 FEET MATERIALS I I I .I NO NO NO I FRAME INSPECTION I 1 I 1 1 I I I I IFIRE SPRINKLER HANGERS I I I I I ( 11NSULATION/WEATHER STRIPI I I I I (INTERIOR LATH/DRYWALL I I 1 I f I I I I I 1. (EXTERIOR LATH I 1 I I I 1. 1 (RATED FLOOR/CEIL ASSEM. I I i I I I I I RATED.WALL ASSEMBLIES _ I I I I I (RATED SHAFTS/OPENINGS I I I I IT-BAR CEILINGS I I I I I I I ILOT DRAINAGE I I I I I I I IREPORT ID: DPR261 ROUTE TO: BS0508 1 1 P COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9809040010 PHONE: (818) 285-0488 EXT: LEGAL ID: NUMBER OF SIGNS: 1 BUILDING ADDRESS: TR: 5905 LT: 56 BL: .001 SIGN DESCRIPTION: ONE DOUBLE FACED FOAM SIGN 9124 LAS TUNAS DR TEMP CA 917801903 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LOMA 5387-023-029 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: ISSUED ON: PROCESSED BY: EXPIRES ON: TOP HAIR AND NAILS EXIST OCC GRP: 09/04/98 UT 09/04/99 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: BENDER BERNARD B CO TR (818) 445-1244 650 1114 RANCHO RD CJtai*j 6 ��'� �_9__/A/ A/ / G c� ARCD 910062238 FEES PAID DESCRCPTION OF WORK ONE DGUBLE FACED FOAN SIGN FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: GOLD SIGN CO. (626) 814-3003- AA BLDG PERMIT ISSUANCE 27.75 1406 W. VIRGINIA AE STRONG MOTION OTHER 650.00 VAL 0.50 SPECIAL CONDITIONS: BALDWIN PARK, CA AX BUILDING REVIEW-FEE 54.70 D2 PERMIT W/O EN-HCS Q65 0 VAL 43.50 �f(��°C� TOTAL FEES 126.45 CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE GOLD SIGNS (626) 814-3003- 1406 VIRGINIA AVE #3 LIC. NO LOCATION AND SETBACKS BALDWIN PARK, CA 91706 6618llClO SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO- FOUNDATION/TRENCH FORMS LIC. NO: \ SUPPORT STRUCTURE MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP; n �� 7 r �n I, NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLANO 20 SS: I ` 77 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO ✓� \��� � �j/ 1 * ADDITIONAL DATA ON FILE REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS TENANT IMPROVEMENT BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0712110039 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: 1TR: 5905 LT: 58 BL: .001 SQ. FT STORIES TYPE OCCUP GROUP 9124 LAS TUNAS DR STRUCTURE: 0 1 VN C I TEMP CA 917801903 (ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: LOMA 1 15387-023-035 1 I THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, Cl (TENANT: (EXIST BLDG USE: COMME USE ZONE: JISSUED ON: PROCESSED BY: EXPIRES ON: 1 I (EXIST OCC GRP: C 101/10/08 SR 07/08/08 1 IOWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IFINAL DATE FIN Y: CODE: 1 ICHAN, VIVIAN (626) 664-3312- 1 3,600 19124 LAS TUNAS DR ITEMP 917801903 1 FEES PAID 16ESCRIPTION OF WORK I I TENANT IMPROVEMENT RELOCATE RESTROOM AND REMOVE EXISTING 1 I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: IWALLS I APPLICANT: TEL. NO: I I I IYUM (626) 410-3113- 1A1 PLANCHECK W/EN-HC 3600.00 VAL 113.19 I I 1260 E. GARVEY AVE. IAA BLDG PERMIT ISSUANCE 27.75 ISPEC,IAL CONDITIONS: I IMONTEREY PARK 91755 IAE STRONG MOTION OTHER 3600.00 VAL 0.76 1 I I IA2 PERMIT W/ENERGY-HC 3600.00 VAL 133.17 I I 1 TOTAL FEES 274.87 I 1 CONTRACTOR: TEL. NO: IAPPROVALS DATE INSPECTOR SIGNATURE IC S P A/C & HEATING CO. INC. (626) 922-8783- - 1 1 1316 N. PRIMROSE AVENUE LIC. NO 1 ILOCATION AND SETBACKS I I I 1ALHAMBRA, CA 91801 907161 B I I I 1 ISOILS ENGINEER APPROVAL I I I (ARCHITECT OR ENGINEER: TEL. NO: 1 IFOUNDATION/TRENCH FORMS I I 1 LIC. NO: I (SLAB/UNDER FLOOR I I I IRAISED FLOOR FRAMING 1 I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 1 1UNDERFLOOR INSULATION I 1 3 041 1 11 I I IFLOOR SHEATHING 1 1 INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I I NO 22 1 IROOF SHEATHING 1 1 1 SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS I I I (AIR QUALITY: 1000 FEET MATERIALS 1 I I _ I 1 NO NO NO 1 IFRAME INSPECTION 1 1 711 1 1 IFIRE SPRINKLER HANGERS 1 1 1 11NSULATION/WEATHER STRIPI I 1 11NTERIOR LATH/DRYWALL 1 I I 1EXTERIOR LATH 1 I I IRATED FLOOR/CEIL ASSEM. I I I IRATED WALL ASSEMBLIES I I IRATED SHAFTS/OPENINGS I i IT-BAR CEILINGS I I 1LOT DRAINAGE I 1 1 IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I I I