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HomeMy Public PortalAbout9803 LAS TUNAS DR_Building__ 76-y63i8A CE.R,,03 12/69 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING Jr JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS, SUPT OF BUILDING / LOCALITY FOR APPLICANT TO FILL IN NEAREST //'' / Print ort only) CROSS ST. IC, 1&,— BUILDING r DISTRICT NO. GROUP TYPEQCESSED BY ADDRESS / j.C __/ CONST./ :{! 0 LOT NO. STATISTICAL CLASSIFICATION �_ SEWER MAP :�- BLOCK CLASS NO.�DWELL.UNITS�— BK� PG13 j TRACT .Sw USE ZONE MAP NO.OF BLOGS, NO, Z OC) 7 SIZE OF LOT NOW ON LOT SPECIAL USE OF z CONDITIONS EXISTING BLDG. OWNER TEL. NO. BLDG.SETBACK FROM T ADDRESS I / _ FRONT PROP.LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY ` / - HIGHWAY WIDTH FROM C.L. ARCHITECT OR TEL, � /c 6) + 'n = C7 ENGINEER NO. BLDG.SETBACK FROM ADDRESS SIDE PROP.LINE OF �' �7�� �'_` (STREET) TEL. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CONTRACTOR _ / NO. HIGHWAY WIDTH FROM C.L. ADDRESS e� ,` LO t("+aC �� + - c LIC. _ C C. CITY CL CORNER CUTOFF YES ❑ NO ©— CONSTRUCTION LENDER NAME AND BRANCH q I SEE REVERSE SIDE FOR SPECIAL APPROVALS ADDRESS c c SQ. FT. NO. OF NO. OF NEW ❑ SIZE STORIES FAMILIES USE OF — _ ADD ❑ STRUCTURE %; ALTER ❑ SIGNATURE OF� REPAIR❑ APPLICANT fc- DEMOL c> / VALUATIONS APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE $ FEE S �Z•G' ` 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 ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTION. IC THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE STATE OF 'CALIFORNIA. IN RELATING TO WORKMEN'S COMPENSA.JION INSURANCE. j LATH, EXT, SIGNATURE O HOUSE NUMBER COR- PERMITTEE _ RECT AND POSTED ADDRESS ' u <<' FINAL 15 JOHN F. LEWIS. PRI CIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK, M 0. CASH _ PERMIT VALIDATION CK. M.O. CASH Ar_ 6 6 1 3 SEP 3 1 D 1 2.0 ON A TIEMPLE CATV 'U1888A CE#803'1/80 APPLICATION FOR BUILDING PERMIT - Z COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. DISTRICT NO. GROUP TYPE PR ESSED BY FOR APPLICANT TO FILL IN A G+ � r CONST. �. BUILDING pp STATISTICAL C SSIFICATION S ER MAP ADDRESS �Q/3 � , .$K G) ++� CLASS.NO.—,K DWELL.UNITS G / LOT NO. 1✓ BLOCK MAPSTATE NUMBER ` !Z HWY. YES NO TRACT USEZONE SPECIAL NO.OF BLDGS. CONDITIONS SIZE OF LOT I NOW ON LOT C - 2- USE OF EXISTING BLDG. BUILDING EXIST. i TEL. SETBACK YARD HWY , STREET AME WIDTH OWNER NO. till FRONT ADORES S% SIDE ARCHITECT TEL P.L. P- ENGINEER NO. INSPECTION RECORD ADDRESS TEL.//�� �p W CONTRACTO I NO.&V O ADDRESS ` U DESCRIPTION OF WORK oG O H NEW ADD ALTER REPAIR DEMOLISH SO.FT. NO.OF NO.OF QI SIZE STORIES FAMILIES y USE OF ( "& TRUCTURE SIGNATURE OF �- APPLICANT nn VALUATION 'ice I APPROVALS DATE INSPECTOR'S SIGNATURE P.C. MT. ,/Lt FOUNDATION: LOCATION P FEE $ FEE $ FORMS, MATERIALS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME:FIRE STOPS, PLICATION AND STATE THAT THE ABOVE IS CORRECT Al— BRACING, BOLTS FURNACE: LOCATION, AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT,DUCTS STATE LAWS REGULATING BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED 1 LATH, INT. WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE WORKMEN'S COMPEWkATION LAW OF CALIFORNIA. LATH,EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEF RECT AND POSTED ADDRESS FINAL �Z 2Z ) CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL E PLAN CHECK VALIDATION CK. M.O. CASH PERM VALIDATION cK M.O. CASH Lir 8 � 9 7� NOy 17 1 D 5.0 0 _/�ll'et� APPLICATION FOR COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEERq; BUILDING PERMITBUILDING AND SAFETY DIVISION BU LDING FOR APPLICANT TO FILL IN ADDRESS p ,y BUILDING e, LOCALITY CITY / ZIP NEAREST ) y- CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT J NOW ON LOT MAP BOOK PAGE PARCE), pee DISTRICT GROUP TYPE FIRE P OCE D BY Ji TRACT BLOCK �./'La p `� UrS /_ CONST�� Z —S t OWNER STATISTICAL IV r STATISTICAL CLAtiIFICATiON _ -�WER MAP I" cn ADDRESS CLASS NO DWELL.UNITS BK/ 1P i l CITY ZIP Z O USE ZONE NOP ARCHITECT OR TEL. , SPECIAL ENGINEER NO. CONDITIONS N ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ Q TEL. z CONTRACTOR NO BLDG.SETBACK FROM LIC. FRONT PROP.LINE OF (STREET ADDRESS No. HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF XISTING LIC. FRONT PROP. LINE HIG Y WIDTH CITY CLASS CONSTRUCTION LENDER + — NAME AND BRANCH BLDG.SETBACK FROM C ADDRESS CITY SIDE PROP.LINE OF (STREET) SQ. FT. NO. OF NO. OF CHECK HIGHWAY + YARD - ITOW S BACK FROM TYPE OF EXISTING 09 SIZE STORIES FAMILIES ONE SIVE ROP. LINE HIGHWAY WIDTH DESCRIPTION OF WORK NEW ❑ + ADD CORNER CUTOFF YES NO ❑ Z ALTER ❑ IN OPEN SPACE Y S ❑ I`:O ❑ USE OF L REPAIR❑ EXISTING 8EMOL ❑ IN CO�A STAL PERMIT ZONE YE/S� ❑ ISO ❑ APP PLICR INT yler J /L..2- BY BY (SIGNATU E1 r �. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLIC ION , AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO C PLY WITH ALLORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. 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 COMP N TI INSU NCE. f SIGNATURE / FINALel BY PERMITTEE IE ADDRESSdw !/ e CITY NO P.C. Fee$ / y.�` �' Permit FeeIf 3Issuance Fee VALUATION $ ��� �y � Total Fee PLAN CHECK VALIDATION CK) M.O. CASH _ PERMIT VALIDATION CK. O. CASH 9 1 4 1l-:"iAR 1 ;r,, 3 n 1 9.8 0 76A638A CE#803B 12/75 9`1 5lZm" 0 ♦�*5 ,. z • .r -�761��' GC-NJIB03 12/69 APPLICATION FO BUILD PERMIT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPT OF BUILDING V LOCALITY FOR APPLICANT TO FILL IN NEAREST Print or tvDe onl CROSS ST. BUILDING DISTP NO GyR-O-U TYPE �� R S BY ADDRESS �, f— CONST, STATISTICALL/ SIFICATION v SEWER MAP +` LOT NO. .. 7S^ BLOCK _ CLASS NO.-Z6; BK J/ PG .2 �6 TRACT USE ZONE MAP D r NO.OF BLDGS. ^, NO. SIZE OF LOT /VI �I Q NOW ON LOT SPECIAL USE OF CONDITIONS =� EXISTING BLDG. J TEL. / j OWNE p NO• BLDG.SETBACK FROM ADDRESS FRONT PROP.LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY �- �O C� HIGHWAY WIDTH FROM L. p. ARCHITECT O Lr TEL. + —_ ENGINEER LK NO. BL .SETBACK FROM ADDRESS SI PROP.LINE OF (STREET) TEL. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CONTRACTOR ANO,. /2 1 HIGHWAY WIDTH FROM C.L. 4.+•Y LICi n ADDRESS r v . + r LICc LX CITY •, LA,,,,►yQ CLASS CORNER CUTOFF YES E] ILNO ❑ IL CONSTRUCTION LENDER C NAME AND BRANCH o SEE REVERSE SIDE FOR SPECIAL APPROVALS' c v ADDRESS I Im SQ. FT. NO. OF NO. OF NEW / I7v SIZE Z f STORIES FAMILIES -- USE OF ADD ❑ f�G� '�iL( f �� I C_. U L C� STRUCTURE _ yt ALTER ❑ Q REPAIR❑ SIGNATURE OF _ - ❑ APPLIC N IqOL SJ jz" cr � VALUATION $ APPROVALS DATE INSPECTOR'S SIGNATURE P.C. /� PMT. FOUNDATION: LOCATION FEE $ 83i 7V FEE $ fb, �() FORMS, MATERIALS Z O • 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, WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS ST RUC TI ON. I CERTIFY T IN DOING THE WORN AUTHORIZED HEREBY I WILL NOT MPL ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF E ST E OF CALIFORNIA IN RELATING TO WORKMEN'S COMP A , INSURANCE. LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE _ RECT AND POSTED 11 IIA ADDRESS �'� FINAL JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION cK. .o. CASH _ PERMIT VALIDATION CK. M.O. CASH 6716 2 3 D 70.20, ! Ar„ 66569 SEP 823 D 83.70~ Ar 665'7 SEP $ . 1 D 256.50N 76A638A .0803 12/69 APPLICATION FOR I[DI G PERMI COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING �(��3 JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS (J COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST Print or tvDe only) CROSS ST.BUILDING !� DISTRICT N rGROUP TYPE O SED BY ADDRESS c 3 S_0 /" Z CONS STATISTICAL CLASSIFICATION SEWER MAP LOT NO. �l e 1 BLOCK CLASS NO, OWELL,UNITS BK�:-7 PG L TRACT USE ZONE MAP2vv7 NO.OF BLDGS. NO. G SIZE OF LOT NOW ON LOT SPECIAL USE OF CONDITIONS EXISTING BLDG, TEL. OWNER A&Cn/ NO. BLDG.SETBACK FROM ADDRESS / 0� FRONT PROP.LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY I HIGHWAY WIDTH FROM C.L. ARCHITECT OR TEL. + _ ENGINEER NO. BLDG.SETBACK FROM ADDRESS SIDE PROP.LINE OF (STREET) �rTEL. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CONTRACTOR ' gj(�Np. t' HIGHWAY WIDTH FROM C.L. ADDRESSY , LIC. _ > 6-[.- NO. - + o LIC. C CITYQ SAAA1 4, CLASS CORNER CUTOFF YES ❑ NO �- C CONSTRUCTION LENDER NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS c L ADDRESS C SQ. FT. NO. OF NO. OF ❑ SIZE STO ES FAMILIES NEW USE J ADD ❑ STOUC RE� f ALTER ❑ REPAIR[] SI ATUREO �J d® APPLICANT /OD DEMOL ❑ VALUATION $ APPROVALS DATE INs CTOR S Ic ATURE P.C. PMT; FOUNDATION: LOCATION FEE S FEE$ +PJ v 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, WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- 0 GAS VENT, DUCTS STRUC TION. 1 CERTI THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL N E PLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE STATE OF •CALIFORNIA RELATING TO WORKMEN'S CO N ION INSURANCE. LATH, EXT. SIGNATURE PERMITHOUSE NUMBER COR- ECT AND POSTED ADDRESS �i �!�% FINAL JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGIN R PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH I Ar, 7 0 2 s DCT 2 1 D 1 2.0 0, A :8''838A C,Ij p80312/6APPLICATION FOR BUILDING PERM COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING L"' JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS, SUPT OF BUILDINGt LOCALITY FOR APPLICANT TO FILL IN NEAREST Print ort a onl CROSS ST. BUILDINGJ p DISTRICT NO. GROUP, CON T.TYPE P E D BY ADDRESS �(�0_3 h-i I.,fS 1vx,fs Dl LOT NO. / �J BLOCK STATISTICAL CLAS FI ATION SE ER MAP _ CLASS NO_f�2LDWELL.UNITS PG TRACT USE ZONEkN AP NO.OF BLDGS. O. SIZE OF LOT NOW ON LOT PECIAL USE OFONDITIONS EXISTING BLDG. p OWNERCSP[ A1jf PNEX t /L/ NO. BLDG.SETBACK FROM ADDRESS JZQ� , _lCll FRONT PROP.LINE OF' ' ! ASTREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY HIGHWAY WIDTH FROM C.L. ARCHITECT ORTEL. e S TEL. ENGINEER F/ F� ,7 NO. /� p BL G. ETBACK FROM ADDRESS C7' D Elves/ /�(L, D(�� ` SI E PROP.LINE OF (STREET) TYPE OF CONTRACTOR C�,1S/ 5/6{'w (//7,C TOL�S�G HIGHWAY EXISTING FROM C.L. SETBACK HIGHWAY + YARD = TOTAL ADDRESS Z�YpZ S. t?e,0 1 YNO. 2 2 f 2 Z `j = n Ic. f, C CITE A- if C ASS �� T S CORNER CUTOFF YES ❑ NO ❑ r— CONSTRUCTION LENDER C NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS ADDRESS n SQ. FT. NO. OF NO. OFN 2 SIZE TO I S F LL '❑ / USE OF DD STRUCTURE ALTER ❑ SIGNATURE OF /, / REPAIR[]APPLICANT r DEMOL ❑ VALUATION ���� APPROVALS DTE NS PEC R's S NATURE CPMT. FOUNDATION: LOCATION A FEE S / > J FEES �/ ,�� FORMS, MATERIALS �� Y 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, WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STIR UC TI ON. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE STATE OF -CALIFORNIA IN RELATING TO WORKMEN'S COMPE�TION`IN ANCE. LATH, EXT. SIGNATURE OF PERMITTEE I HOUSE NUMBER COR- ADDRESS S RECT AND POSTED FINAL 70 e JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION c: M... CASH _ PERMIT VALIDATION CK. M.O. CASH 6763h SEP15 2 3 D 16.651 I p(`„ 7 1 7 4 OCT 14 1 D 2 7.7 5 a4i� - - 76A638A CK. N803 12/69 APPLICATION FOR BUILDI 'G PERMIT% fI COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING D JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST Print or tvDe onl CROSS ST. BUILDING C� 2 / r DISTFjJCT NO. R UP YPE E BY ADDRESS J /C S �u 5 /Vd Ci Y\ CONST, LOT NO. 01— BLOCK STATISTICAL CLASSIFICATION S R MAP � ,.-� � CLASS NO._ '�C WELL,UNITS PG TRACT ` USE ZONE MAP NO.OF B .DGS. NO. / SIZE OF LOT NOW ON LOT / SPECIAL USE OF �. CONDITIONS EXISTING BLDG. [ ��y¢L OWNERe,4jf %etf £ie 'tk1 . BLDG.SETBACK FROM ADDRESS �2 Q FRONT PROP.LINE OF ` �1TREET) TYPE OF EXISTING SETBACK I HIGHWAY + YARD = TOTAL CITY 4 Irif HIGHWAY WIDTH FROM C.L. ARCHITECT 01L. .6 '/� + ENGINEER NO. BI SETBACK FROM ADDRESS /�('��j/ �d v f� SID, PROP.LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CONTRALTO S��i+v �C J�ypL�G(�(p�2Q HIGHWAY WIDTH FROM C.LLI . ADDRESSZ15;�UZ KJ NO. 225(227 �µ �' + > O p / �( LIC. c CITY /w/r/ (, /T /Vi/ CLASS &— f CORNER CUTOFF YES ❑ NO ❑ Q CONSTRUCTION LENDER C NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS c u ADDRESS SQ. FT. NO. OF NO. OF NEW SIZE S O IES F ILIE USE OF / ADD 41:11 STRUCTURE l ALTER ❑ SIGNATURE OF REPAIR❑ APPLICANT / OEMOL ❑ VALUATION $ �.�Cl U. APPROVALS DATE INSPECTOR'S SIGNATURE P.C. / �/ PMT, FOUNDATION: LOCATION FEE $ 7 C FEES FORMS, MATERIALS FRAME: FIRE STOPS, 1 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 ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTION, 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIO LATIO OF THE LATH, INT. LABOR CODE OF THE STATE OF •CALIFORNI N RE TING TO WORKMEN'S COMPENSA IONNN ftANCE. / LATH, EXT, SIGNATURE OF HOUSE NUMBER COR- PERMITTEE vvvv���v / RECT AND POSTED ADDRESS Z S�Z FINALC.- JOHN F. LEWIS. PRINCIPAL R STR AL ENGINEER PLAN CHECK VALIDATION cK. ' M.o. CASH _ PERMIT VALIDATION CK. M.O. CASH ! dr�6764c—_ SEP1523 D 13.50A r Ar,. 7 1 7 5c,::-' Oc114 1 D 2 2-50— r , B U ' L D I N G ADDRESS APPLICATION AUG LOCALITY NEAREST DIVISION OF BUILDING AND SAFETY C 06 ST. Department of County Engineer DISTRICT NO. RECEIPT NO. PERMIT NO. County of Los Angeles ? S /d`/ WIAJ. FOX, COUNTY ENGINEER GROUP DATE RECEIVED DATE ISSUED CAssATT D. GRIFFIN, SUPT OF BUILDING FOR APPLICANT TO FILL IN TYPE CONST. RECEIVED BY ISSUED BY OWNER MAP STATE YES NO MAIL NUMBER HWY ADDRESS AVE1Tc 1!2L9� _ 1 A r /' USE ZONE SPECIAL CITY 4 A. TN ��IpI CONDITIONS C ? 1� ENG N ERt� wv `..S` NO. CU 3r-un- 1 BUILDING YARD HWY STREET NAME EXIST. ADDREs6 10 R u S l4 Z � E'L 'n1o1U SETBACK WIDTH � �J,�cc..[.r�r TELFRONT _ ONTMTOR Ab CC N NO.L"U �G � P. L. n BIDE ADDRESS DATE CORRECTIONS INSPECTOR BUILDING — ADDRESS ./ -Ig 4jr NOR r"- LOT NO. aw BLOCK TRACT n NO. OF SLOGS. SIZE OF LOT I��("(.0 I NOW ON LOT LjOV t' USE OF 1.— E IFTINO B DESCRIPTION OF WORK A a NEW >C- ADD ALTER REPAIR DEMOLISH Z Bq. FT. ( NO. OF ` NO. Or D SIZE 1(pO FAMILIES r USE OF STRUCTURE Soli uG ��' �tA-T► o n,1 NO.OF EMPLOYEEB IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IB APPROVALS INSPECTOR'B SIGNATURE DATE CORRECT. IAGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS, MATERIALS "SouTI+wC�T x$07-1CQ'�IN �" FRAME: FIRE STOPS, SIGNATURE OF -_ BRACING,BOLTS PERMITTEE nn �yFURNACE: LOCATION, ADDREBB 'O^e'1 F lL%3 S W- ST F� ft NT - GAS VENT,DUCTS LATH, INT. AUTHORIZED AGT. LATH, EXT. $ Oma. P. C. $ HOUSE NUMBER COR- FEE RECT AND POSTED VALUATION FEE FINAL 76A639A D85 3 4-54 WORKERS' COMPENSATION DECLARATION a certificate of coent to insure,�or affcertifiirm athat tI have te of Woes' Compensation Insuran elf APPLICATION FOR WILDING P E RM I T N acertifie//d//pp��copy,thereof(Sec. 380 L . C. �^ COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy Nc_ ! ��TCompany � / kti � IG ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL N Ao RESS Certified copy is filed �thdcounwildingi spec. BUILDING0tion department. ADDRESS CITY' dk A0 t P LOCALITYMDate ApplicaNO.,OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS'. SIZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCEASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK ) LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) OWNER �e{vd VCA 'P NO. USE ZONE MAP I certify that in the performance-of the work for which this 1 NO. permit is issued, I shall not employ any person in any manner / Q J tJ SPECIAL' a so as to become subject to the Workers'Compensation Laws. uC CONDITIONS Q CITY OA A ) lL r.'� u Date Applicant ARCHITECT OR TEL. DISTRICT G OUP TYPE FIRE O-ESSED BY Ix NOTICE.TO APPLICANT: If, after making this.Certificate.of. ENGINEER 'P5 �" J NO, �` /S' CON Z O Exemption, you should become subject to the Workers' h :3 /V v a ui Compensation provisions of-the•Labor Code, you must forth- ADDRESS lQ S/ �U d(� -with comply with such provisions or this permit shall bet TEL. V a,� STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTOR d J a ) NO. / _ LICENSED.CONTRACTORS-DECLARATION. LIC. CLASS N DWELL. UNITS - I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS ! Y 0'v Ala -NO. Z,76 a W411111 1111111-0-IN"NFRIJ ' (commencing with Section 7000)of Division 3 of the Business Alor LIC. SEWER MAP . and Professions Code,and my license is in full force and effect. CITY CLASS C G f BK VALIDATION "1216 Q C'�/ SIZE TORIES AMILLIIES ONE K License Number •Lic. Class VALUATION Cant r or Date,/./+ Z DESCRIPTION OF WORK 4 NEW 0 / ADD ❑ $ ❑I am exempt under Sec. No ALTER ❑ B.&P.C. for this reason $ USE OF REPAIR ❑ Date: EXISTING BLDG. DEMOL ❑ Signature APPLICANT• )� � TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) W— . �p Np, �3-tf 20 ^ • ,. .. DATE I hereby affirm that I am exempt from the Contractor's License i Law for•the following reason (Section 7031.5; Business and ADDRESS d ': FINAL: s Professions Code): PRESENT By A , BUILDING ACCT A ❑ I, as owner-of the property, or my employees with ADDRESS ` wages as their sole compensation,will do the work and .3307 ••••.• ......... ..... ■ -' LOCALITY the structure is not intended or offered for sale(Section ® 1 T�E�� 7044, 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- 1►Y/y{ .�0(A� tion 7044, Business and Professions Code.) 1 ( ADDRESS CHECK 49.88 REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH `•' iSt- I hereby affirm that there is a construction lending agency for FRONT 1 CHANGE °0LI the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE- . / �y. P.L. I�IJ1J'iiV 1IJ v7 Lender's Name pyt ry P.C. Fee$ Permit Fee 9 LDMA Ref.# 6528 1 ryitil.,o + Lender's Address c 1 certify thatMe- e propor a d state that the Issuance Fee 01 V LDMA P/C# Investi 8 above informy with all County gation Fee , ordinances aIng construction, Total Fee LDMA Perm. # by is County to enter upon th bpection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE - ignature of pplicant or Agent Date •• APPLICATION FOR BUILDING PERMIT *" COUNTY OF LOS ANGELES BUILDING AND SAFETY ' WORKER'S COMPENSATION DECLARATION. FOR APPLICANT TO FILL IN BUILDING AD KESS I BUILD G ADDRESS Q I hereby affirm that I have a certificate of consent to self insure, L/ Jv�✓�-s or a certificate of Workers'Compensation insurance,or a certified copy-thereof(Sec.3800, b. ){�/' / CIT�L WAer �� ZIP�r Policy No� D �2oTnparrlf �/f�� %� g0 LOCALITY �. SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. I NEAREST CROSS ST. Certified copy 1 filed with the county b ilding inspection TRACT BLOCK LOT NO. depaQrt�m t.� / USE ZONE MAP NO. Date—(' ppllcant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEM ION FROM WORKERS' OWNER �_ TE­LN O. COMPENSATION INSURANCE L. S ✓ WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRES ��03 / �� .s dollars($100)or less.) `7'7 i7' DISTRICT GROUP CONST. FIRE ZONE PROCESSED BY I certify that in the performance of the work for which this permit CITY ZIP f ��� �� -� is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. become subject to the Workers'Compensation Laws. STATISTICAL CLA�SI��FI--,C,ATION APT CONDO Date Applicant ADDRESS CLASS NO. A 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 �-� �s�/� TEL NO. /3^y7 SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor. Code, you must forthwith TE 2-5-L-3 FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS UC.NO. PL LICENSED CONTRACTORS DECLARATION �ev SIDE CITYLIC LASS PL I hereby affirm that I am licensed underprovisions of Chapter 9 LQS �� SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES I NO.OF FAMILIES Professions Code,and my lic se yI�,1►I full force and effect. NEW ❑ BK PG a" �5�9 81 C DESCRIPTION OF WORK ADD ❑ VALUATION d License Number Lic.Class W (' e?O U Contractg , Date 2 �� ALTER ❑ $ ❑ i amexempt under Sec. `3 REPAIR ❑ B.BP.C.for this reason L 6. S DEMOL ❑ LDMA P/C# Date: USE OF EXISTING BLDG. URM ❑ k•I t;}; '301 F11 � Signature APPLICANT(PRINT) TEL NO. LDMA Perm# t, AGE i jt� El1, as owner of the property, or my employees with wages as t 1C. �e a their sole compensation, will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business.and FINAL DATE a =s 1 g i Professions Code.) �It 0' s'n?'Ji 0 4'' WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE r vt 4 f ❑ 1, as owner of the property, am exclusively contracting 4AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY > t'S 1 A !1 ' licensed contractors to construct the project (Section 70444,, � � Business and Professions Code.) YES 11 No 11F{{.�G�o'T HALL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING "�'17 i C� OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH sisl(:+.' Z'i 1 e 55 CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES 2 TTENS I hereby affirm that there is a construction lending agency for YES 11 NO❑ _ m r L the performance Of the work for which this permit is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 110 - 62 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, a TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. o Lender's Address c OWNER OR AGENT o I certify that I have read this application and state under penalty 9 of perjury that the above information is correct.I agree to comply P.C.FEE ��. p'7 PERMIT FEE N with all county ordin ces and State laws relating to building — J Go construction, and y authorize representatives of this County ISSUANCE FEE m to enter upon t -mentioned property for inspectio purpo as. Lv ro 2J INVESTIGATION FEE TOTAL FEE /i5 / ft..t—W rant AMM DAte O� SEE REVERSE FOR EXPLANATORY LANGUAGE WORKERS' COMPENSATION DECLARATIONI hereby I iusure M certificate of Worke s've atiiicate Compensationof Insurance), APPLICATION F®R BUILDING P E RM I 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 ADDRIESS ❑ •Certified'copy is filed'with the county building inspec- BUILDING tion department. ADDRESS Date Applicant .CITY LOCALITY NO. O LDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. CpLy�.�,� s/ • 1 COMPENSATION.INSURANCE //�•- //JJ ASSESSOR (This section-need.not be completed if the permit is for one TRACT 99:; 4/ BLOCK/O LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) TEL. USE ZONE MAP OWNER �'i�C. NO. / NO. 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/�rOt'� s,�2f�G CONDITIONS O so as to become subject to the.Workers'Compensation Laws. 4 U CITY ZIP 0' Date Applicant ARCHITECT OR TEL. O NOTICE TO APPLICANT: If, after making this Certificate of E ;DISTRICT GROUP TYPE FIRE PROCESSED BYENGINEER NO. CONST., / Z E0Exemption, you should become subject to the, Workers' vCompensation provisions of the Labor Code, you must forth- ADDRESS �� a with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. '„ CONTRACTOR G` AZ NO. � r/ _ LICENSED CONTRACTORS DECLARATION LIC. CLASS NO.�DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS' NO. (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP 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 I STORIES FAMILIES ONE' • VALUATION Contractor Date DESCRIPTION OF WORK NEW ❑ 3 D ADD ❑ ; �� ❑lam exempt under Sec. ,�' �� gm,-ow vw ALTER ❑ BAP.C. for this reason / �/ �-- /ono:7 v .REPAIR ❑ $ Date:' USE OF EXISTING BLDG. DEMOL ❑ Signature APPLICANT TEL. FINAL A OWNER-BUILDER DECLARATION (PRINT). NO. DATE C L� 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' , 4' By BUILDING ; 'i ❑ I, as owner of the property,-or my employees with ADDRESS- LOCALITY DDRESS wages as their sole compensation,will do the work and �m'�i k _icy e� LOCALITY ,r,L o..•• the structure is not intended or offered for sale(Section 1 !+ 4, Business and Professions Code. %`MOVING '. TEL. i ' ci' }�7� ) NEM- .1 �r ztiv LJ ,as owner of the property,am exclusive) contracting "CONTRACTOR NO. s P P Y� Y with licensed contractors to construct the project (Sec- ADDRESS tf)1. till' '� ��t$'I �b x-833 e O �_i tion 7044, Business and Professions Code.) � _ ` REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. ;��Ikr,•,Yy-,r I?u o CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE WIDTH (l;l�ll;— l;t11f;"r•' I hereby affirm that there is a construction lena cSding agency for FRONT :i 1 the performance of the work'for which this permit is issued Po Ln - irk (Sec. 3097, Civ. C.).. ;, SIDE. ' 4iJVv 1 Y7!I P.L. Lender's Name Q P.C. Fee$ Permit Fee L O 7 LDMA Ref.# Lender's Address o I certify that I have read this application and state that the Issuance Fee Qr� LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee ordinances an State laws relating to building construction, Total Fee �• LDMA Perm. # and hereby thorize represe fives of his County to enter upon t ove-m gone aperty f inspectiion/p rposes. C D 03 SEE REVERSE FOR EXPLANATORY LANGUAGE Si, re o scant or Agent . Date . WORKERS'COMPENSATION DECLARATION . APPLI - ATI FOR "BUILDING PERMIT �1 e,Geby affirm that I have a certificate of consent to Self insure, or.a certificate of Workers'Compensation Insurance, or a certified copy thereof(Sec. 3800, Lab. C.)' • . I , COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished. : I' FOR APPLICANT TO FILL IN slim' 4DDRESG 3 1 ADDRESS ❑ Certified copy is'filed with the county building insppc- BUILDING tion department. ADDRESS Date Applicant I CITY /-t' ZIP [/7 I LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' { NO.OF BLDGS. NEAREST ' COMPENSATION INSURANCE I SIZE OF LOT NOW ON LOT GROSS ST. (This section need not be completed.if the permit•is for dne . ASSESSOR hundred dollars ($100)or less.) I 'TRACT BLOCK LOT NO. MAP BOOK : PAGE PARCEL ' TEL. USE ZONE MAP I certify that in the performance of the work for which this OWNER J_ a 'eA NO. NO. Perm!t is issued,'I shall not employ any person in any manner _ - SPECIAL so-as to become subject to the-Workers'Compensation Latus. ADDRESS l2�dRRBQK CONDITIONS ! � �l a. I�i� CITY lw-4� &A C ZIP I ®C Date- Applicant a r _ O NOTICE TO APPLICANT: If, after making this Certificate!of ARCHITECT OR; TEL. I DISTRICT GROUP• TYPE FIRE PRO D B ¢`+_ iR . Exemption; you should become subject to the Workers' ENGINEEZONE NO. CONS'T/ a LU Compensation provisions of the Labor Code, you must forth- s.ADDRESS' �r i with comply with such provisions or this permit shall be TEL. 1 STATISTICAL CLASSIFICATION APT. CO DO. deemed revoked. CONTRACTOR,. (6 60457. d®F 'NO. J� ;. •, LICENSED CONTRACTORS DECLARATION /� �( Q LIC. , CLASS NO. �Z• DWELL. UNITS I hereby affirm that I am licensed under provisions of Chaptet 9 JC D ESS rpll ��A✓Q NO. (commencing with Section 7000)of Division 3 of the'Business and /' ff,,,, LIC - SEWER MAP Professions Code,and my liceri'se is in full force and effect.! CITY U`AA 6RID 0•Z CLASS C"3 BK PG.. VALIDATION SQ. FT. NO.OF NO.OF CHECK i Licehse Number Lic.Class I ` SIZE STORIES FAMILIES ONE VAL TION a�3 DESCRIPTION OF WORK r4e_4tSL u 6XX�, NEW ❑ %�` Contractor Date � fl ADD ❑' $ j �s ❑ I am exempt under Sec. -�sL:t13 &A S3 A i ALTER ❑. B.&P.C.for this reason Cr R A U ` REPAIR $ USE OF ❑' ;14.2a3A ' Date: EXISTING BLDG. DEMOL ❑'8: Signature "' APPLICANT TEL. i' FINAL / # o 0 0 0 0 OWNER-BUILDER DECLARATION PRINT NO. DATE �lo hereby affirm that I am exempt from the Contractor's License 0 0 7 a 0 Q Law'for the following reason (Section 7031.5, Business and ADDRESS FINAL Professions Code): PRESENT' BY 0 0 0 7$"o 075 BUILDING ❑ I, as owner of the-property, or my employees with ADDRESS i 5 ,�(Z O'K wages as their sole compensation,will do the work and i 0322-86 the structure is not intended or offered for sale(Section LOCALITY 7044,-Business and-Professions Code). I MOVING TEL. ❑ I, as owner of the property,am exclusively contracting rADDRE TOR NO. with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). D TOTAL.SETBACK FROM l+ CONSTRUCTION LENDING AGENCY K YARD HWY PROP. LINE WIDTH hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name ;a/� LDMA Ref. #Lender's'Address $ Permit FeeI certify that I have read this application and state that theIssuance Fee [/i S1LONA P/C# above information is correct. I agree to comply with all County ion Fee ordinances and State laws relating to building construction, Total Fee 0 !J LDMA Perm:#- b and hereby authorize representatives of this County to enter u on the above-mentio ed property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE I r 1 Signature of Applicant or-Agent Date O {."YORKERS'COMPENSATION DECLARATION 77 " I, hereby rfa.-cer that I have r certificate of consent to self APPLICATION FOR BUILDINGPERMIT � insure, or a.-certificate of Workers'Compensation Insurance, or a certifiedcopy thereof(Sec. 3800 b, c.) ' COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. 6Company ' d t BUILDING Certified copy is hereby furnished. Fe khe02,r. FOR APPLICANT TO FILL IN ADDRESS t�Q Certified copy is filed with the county building inspec- BUILDING tion depattment• ADDRESS /—c-S -,Pt[��\ Date Applicant CITY �� ye (, IP /C t'6 LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOTS CNEAREST ROSS ST. bCsl� - - COMPENSATION INSURANCE (This section need not be completed if the permit is for oneASSESSOR, huhdred,dollars ($100)or less.) TRACT BLOCK LOT EL.NO. MAP BOOK MAP PAGE' PARCEL �l �E(' � I certify that in the performance of the work for which this ! ) NO. OWNER O: USE ZONE " permit is issued, I shall not employ any person in any manner ADDRESS-46 . �7 C'y` SPECIAL 4. S — G so as to become subject to the Workers'Compensation Laws. CONDITIONS V Date Applicant CITY `fit ZIP. . Z 6 I% NOTICE TO-APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP]TYPE FIRE JPO SSED BY ENGINEER NO. a' Exemption, you should become subject to the. Workers' T NST.1/ ZONE Compensation provisions of the Labor Code, you must forth- ADDRESS J`vv V. with comply with such provisions.or this. permit shall be ITEC. CL fA deemed revoked. STATISTICAL CLASSIFICATION APT. Coro. CONTRACTOR dii P . 1N0. LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS - I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP Professions Code,'and my license is in full force and effect. CITY CLASS BK / � �� 1 VAI�QrA-7418 A SQ.FT.. NO.OF _ _ NO.OF- CHECK I SIZE STORIES FAMILIES ONE License Number Lic.Class VAL ATION $��° 0 0 0 2 3 . DESCRIPTIO OF WORK' LJ S� �� Contractor Date Ao ❑ $ / 3 7,5 0 ❑ I am exempt under Sec. ��!' It t't �--- - ❑ _. ALTER ° °'° 7J 7,5 Q ❑J. B.BP.C. for this reason 4J/lf t2 REPAIR ❑ , $ 0.22.6-87 . Date: USE OF DEMOL EXISTING BLDG. ❑' Signature APPLICANT TEL. FINAL ;� OWNER-BUILDER DECLARATION (PRINT) NO. DATE�~ I hereby affirm that I am-exempt from the Contractor's License Law for the following reason'(Section 7031.5, Business and ADDRESS FIN Professions Code): PRESENT i B ❑ BUILDING I, as owner of the property, or my employees withADDRESS wages as their sole compensation,will do the work and 7"- 7044, ' the structure is not intended or offered for sale(Section LOCALITY 7044, 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- " ADDRESS tion 7044, Business and Professions Code). �6 8 8 8'A REQUIRED TOTAL SETBACK FRO ;i CONSTRUCTION LENDING AGENCY SET BACK YARD' HWY PROP.LINE WIDTH 4 I hereby affirm that there is a construction lending agency for FRONT # 0 0.0 0 0,1 the performance of the work for which this permit is issued P.L: (Sec. 3097, Civ. C.). SIDE 0.0 4 0.5 0 'o P.L. Lender's Name LDMA Ref. # °; ° 4 0 5 0 P.C.Fee$ /V permit Fee Lender's Address r r I certifythat I have read this application and state that the / u,•1 J 8 7 PP Issuance Fee ( CDMA P/C# above information is correct. I agree to comply with all County Investigation Fee �-- ordinances and State laws relating'to building construction, Total Fee ILDMA Perm. # and her authorize representatives of this County to enter m ted property for inspection purposes. upon above- SEE REVERSE FOR EXPLANATORY LANGUAGE Signature plicant or Agent Date 0 t APPLICATION FOR BWLD0NG PERMIT COUNTY OF LOG ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDINWES,, I hereby affirm that I have a certificate of consent to self insure, BUILDING AI�' v ��//ll//®gESS 33 3ZAs or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) CITY ZIP LOCALITY p 1�d — ` C Policy No. ( Company.c]�:L = !. gr SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST Of '❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. depart r-r/nt.� USE ZONE MAP NO. Date Applicant-li,-�4^®' ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWN • TEL NO. YES NO COMPENSATION INSURANCE .Q� 9I` WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESS dollars($100)or less.) �• P, DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY CITY ZIP I certify that in the performance of the work for which this permit A ti'o is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. O become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION 'RAPT CONDO ' Date Applicant ADDRESS CLASS NO._5= DWELL UNITS NOTICE TO APPLICANT.' If, after making this Certificate of REQUIRED TOTAL SET BAPLC .P,OM EXIST Exemption, you should become subject to the Workers' COWACTO TEL NO. SET BACK YARD HWY PROP J;{)]!`f�j WIDTH r .u•74 Compensation provisions of the Labor Code, you must forthwith `A LZ t FRONT ER-COR cdmply with such provisions or this permit shall be deemed revoked. ADDRESS l / /� LIC-NO. PL LICENSED CONTRACTORS DECLARATION CITY i 4^IR`sR /v �+ L13 Q 3S /a SIDE' „ _ •r'� 1 hereby'affirm that I am licensed underprovisions of Chapter 9 �^'A SEWER MAP (commencing with Section 7000)of Division 3 of the Business and S .FT.SIZE, NO.OF STORIES NO.OF FAMILIES Professions Code,ancLmy license is in full force and effect. NEW ❑ BK ' PG ACCT 3 n License Number Lic.Class DE RIP ION OF WORK ADD ❑ VALUATION, Oa ® 1303 2408.74 .� '� v Contractor �AL Date MC46L taM ALTER ❑ SO ' 1 jTEM� C )el. A — REPAIR .•a $ TPTAL 248-74. F El I am exempt under Sec. ttt'''•••u� B.BP.C.for this reason DEMOL ❑ TDMA P/C# 1 1 4 LL 74 Date: USE OF EXISTING BLDG. URM ❑ 4 a Signaturea° APPLICA T(PRINT) 0. LOMA Perm ❑ I, as owner of the property, or my employees with wages as DR, S ' `~ O� ,• ® 1 i I EMS their sole compensation, will do the work and the structure is wA 00132 2Z not intended or offered for sale (Section 7044, Business and /i AAe• A Mr • FINAL DATE G `�Y�h � Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIALY-209 7p7ayY {' + 1 � OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE `�_ )', J 1+1 RIK •�r.G .4 ❑ I, 8S owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY t '� ' licensed contractors to construct the project (Section 7044, t:ilANGE •00 Business and Professions Code.) ves 11 No❑ WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH ' CONSTRUCTION LENDING AGENCY COAST AIR ES QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FORGUIDEL0000-01101 . f!_� i fr,. I hereby affirm that there is a construction lending agency for YES El No Ela the performance of the work for which this permit is issued(Sec. '!] $ 1 AM "P 42 D� I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING ' N 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE,TITLE 2.. ' ER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD.CONCERNING HAZARDOUS 0 Lender's Address DAmeR OR AW°T . 0 o I certify that I have read this application and state under penalty o P.C.FEE y PERMIT FEE IV �1 of perjury that the above information is correct.I agree to comply ��O �J N with all county ordinances and State laws relating to building O pS mconstruction,and hereby authorize representatives of this County ISSUANCE FEE ato enter upon the abo -mentioned property for inspection urposes. 4 CD INVESTIGATION FEE TOTAL FEE I.- ftftl AppM'aM Apert OF ApDale, 1 SEE REVERSE FOR EXPLANATORY LANGUAGE e re of WORKERS'COMPENSATION DECLARATION - hereby affirm that I have certificate of consent to self I���I®� ® BUILDING E RM I T +" insure, or a certificate of Worr kers' Compensation Insurance, '•� k or certifigd copy thereof(Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY G°noZ�oS!/ �.�I a 1�.�: Policy No. Company , Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING C _ ADDRESS ��C�� �� 4✓-V ❑ Certified copy is filed i the cou y building inspec- BUILDING tion department. } :ADDRESS Q� /y Date�/ - � App nt CITY `-/ ZIP LOCALITY , CERTIFICATE OF EXEMPTION FROM WOR S' NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT U CROSS ST. (This section need not be completed if the permit ' r one TRACT BLOCK LOT NO. ASSESSOR hundred dollars($100)or less.) MAP BOOK PAGE PARCEL TEL' USE ZONE MAP I certify that in the performance of work for which this OWNER NO. //�� NO. permit is issued, I shall not emplo ny person in any manner ADDRESS / ,� SPECIAL so as to become subject to orkers'Compensation Laws. �./ CONDITIONS U Date pplicant CITY /M ZIP NOTICE TO AP ANT: If, after making ENGINEER NO.this Certificate of ARCHITE OR TEL. DISTRICT G UP TYPE FIRE PR CESSEDBY O ENGIN ' Exemption, u should become subject to the Workers' V '1 CONST. / ZOD)E Ilia (13 Compe ion provisions of the Labor Code, you must forth- ADDRESS r IV/ with omply with such provisions or this permit shall be O.' debmed revoked. ° .� TEL. yy�� q} V STATISTICAL CLASSIFICATION APT. NDO. N CONTRACTOR NO I.L /I7 z LICENSED CONTRACTORS DECLARATIONLIC, CLASS NO. ?/� DWELL. UNITS -^ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS :5 S' NO., jD SEWER (commencing with Section 7000)of Division 3 of the Business and /� _ LIC. ; Professions Code, and my license is in full force and effect. CITY1�7�0 �. 10 CLASS c - BK. L PG./J2, VALIDATION License Number O �"� G-f SIZE FT HECK S ORIOES FAMIOLIES CONE Lic.Class r VA UA ION ContractoG n-5&-i:h.° Date DESCRIPTION OF WORK / NEW ❑ $ /1 0 27 8 3 O A ❑ I am exempt under Sec. ��, f S% ADD ❑ l oil- ALTER # o o e,0 2 3 r^ B.&P.C. for this reason USE7 �-[� /EV A REPAIR ❑:: $ f•( 'o,e 3 7 5 0 Date: TING BLDG. ��l r DEMOL ❑ 0"o 0 3 7,5 0:05 Signature APPLICANT TEL. Zfl a FINAL OWNER-BUILDER D ARATION PRINT C,dE NO DATE I hereby affirm that I am exe rom the Contractor's License O 9.0 2-8 7 Law for the following re n (Section 7031.5, Business and ADDRESS FI Professions Code): R iNT ❑ BUILDING �7 8 a,1 A I, as owne of the property, or my employees with ; ADDRESS wages eir sole compensation,will do the work and the scture is not intended or offered for sale(Section LOCALITY R Ao o [j 9 8 g 7904, Business and Professions Code). MOVING TEL. as owner of the property, am exclusively contracting 51�-�tion CONTRACTOR 'NO. o,o x0 4 9,8 8 2'O 9.0 2,-8'7 ith licensed contractors to construct the project (Sec- ADDRESS 7044, Business and Professions Code). CK CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAPREOP L NEFR WIDTH Y 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 P.L. Lender's NameLDMA Ref.# '? P.C.Fee$ t61 Permit Fee, �)y Lender's Address e L I certify that I have read this application and state that the Issuance Fae t�v LDMA P/C N above information is correct. I agree to comply with all County Investigation Fee ordinances and St laws relating to building construction, Total Fee L LDMA perm. N an ereby auth Az representatives of this County to enter r. 11 u n he above- a Toned property for inspection purposes. n �- SEE REVERSE FOR EXPLANATORY'LANGUAGE 147 Sign u of Ap t gent Date WORKER:COMPENSATION DECLARATION �r�u � U •I hereby affirm that I have a certificate of consent to.self y insure`, or a certificate of Workers'Compensation Insurance, A fll r ®I I TNG or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Iii 1, BUILDING �• Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS U Certified copy is filed with the county building inspec- BUILDING !6O3 LAS �V�t�S tion department. ADDRESS ` E. LOCALITY NEAREST Date Applicant CITY E 'T ZIP CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKER NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one. USE ZONE MAP O. hundred dollars($100)or less.) TRACT BLOCK - LOT NO. N TEL. �Z SPECIAL } I certify that in the performance of the work for which this• OWNER CC► fii NO. CONDITIONS IL permit is issued, I shall not employ an person in an manner �( 1L A DISTRICTJ.GR P TYPE FIRE PROC E BY U P I P Y Y P Y ADDRESS ZOc� • 417►t' s , 7y G CONST. J ZONE so as to become subject to the Workers'Compensation Laws. �(J6 ✓ Date Applicant CITY ChiV`^ ZIP 9zgo3 a STATISTICAL CLASSIFICATION APT. JCOWP. 11— NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. q 2 U ENGINEER E. tI O. CLASS NO. !J DWELL.UNITS w Exemption, you should become subject to the Workers' i, IL Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP z With comply with such provisions or this permit shall be • (�, TEL•CTIy t VALIDATION deemed revoked. CONTRACTO boL3 ebs yJ� O. .. 1V� BK.97 PG, _ LICENSED CONTRACTORS DECLARATION ? A LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESSVALUATION. /1 (commencing with Section 7000)of Division 3 of the Business and 'NLIC. C �5 . $ d Professions Code,and my license is in full force and effect. CITY ^ CLASS SQ.FT. NO.OF, NO.OF CHECK" License Number d Lic.Class G' -SIZE STORIES FAMILIES ONE �•�. � $ C� TGt�+u DESCRIPTION OF WORK moi- WC"e, NEW Contractor --r=f �}•. I am exempt under Sec. Sv1Zl �), tr ADD :: �7 04.2 A B.BP.C. for this reason .! l IAS' P.IUE s6 S16� REPAIR F]ALTER DATEFINAL # 0 0 0 0 2 3 Date: �T USE OF t NAWMJ %V, 011 !KDEMOL ❑:; FINAL EXISTING BLDG, By ( o e 3 7.5 0 Signature APPLICANT TEL. OWNER-BUILDER DEC N PRINT NO. _ I hereby affirm that I am exempt from a Contractor's License o,o 0 3 7.5 Law for the following reason (Section 7031.5,:Business and ADDRESS Professions Code): PRE 0514-87 I, as owner of the property, or my employees with BUILDING 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 Code). MOVING TEL. A 7.0 4,3 A ❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- # 0 0 0 0 0 tion 7044, Business and Professions Code). ADDRESS REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. ,::. :( o.0 3 3.0 0 CONSTRUCTION LENDING AGENCY SET BACK 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.L. a o.0 3 3.0 0 63 tSec. 3097, Civ. C.). SIDE 5 14-$7 0 ? Lender's Name - S 3 P.C.Fee$ 3. Permit Fee+ •so Lender's Address J r I certify that I have read this application and state that the Issuance Fee ).�� above information is correct. I agree to comply with all County Investigation Fee �J ordinances and State laws relating to building construction, Total Fee A O I and hereby authorize representatives of this County to enter zI up o the above= ent' ned property.for inspection purposes. f r SEE REVERSE FOR EXPLANATORY LANGUAGE • I'mes ic ignafure of Appanf ent Date WORKERS'COMPENSATION DECLARATION APPLICATION FOIA BUILDING PERMIT .� hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers'Compenstion Insurance, or a certified copy thereof(Sec. 38 Lab. C.) f Policy No ,*�i o ani-�'G/ COUNTY OF LOS ANGELES BUILDING AND-SAFETY Certified copy'is hereby furnished. FOR APPLICANT TO FILL IN q�oRESS 9 Q3 Gym ��� Certified copy is filed with the county building inspec- BUILDING. tion department. �J ADDRESS d3 A5 4-41 7 11;11S LOCALITY T�/>7�1-45 /J pp L?4e //L " �® ;• NEAREST ate TJ A licant Y �� e �91 ZIP CROSS ST. Ca ERTIFICATE OF EXEMPTION FROM W0RKERS&/e,4,'--_ NO.OF BLDGS. .ASSESSOR COMPENSATION.INSURANCE SIZE OF LOT.. NOW ON LOT / MAP BOOK PAGE PARCEL - (This section need not be completed if the permit is for one. USE ZONE MAP hundred dollars ($100)or less.) TRACT BLOCK LOT NO. NO. TEL. C�a. SPECIAL g, OW L s �/ N CONDITIONS I certify_that in the performance of the work for which this 0 DISTRICT GROUP TYPE FIRE PR ESSED BY permit is issued, I shall not employ any person in any manner CONST. ZONE ADDRESS Z GD so as to become subject to the Workers'Compensation Laws. �� L d ' v CITY �9/!/Ah/e� zip Zi.4d 3 A Date Applicant STATISTICAL CLASSIFICATION APT. CONDO. (, NOTICE'TO APPLICANT: If, after makingthis Certificate Of ARCHITECT OR TEL. ^ LU ENGINEER �/ NO. CLASS NO. oR�'' DWELL. UNITS IL Exemption, you should .become -subject to -the�Workers' � Compensation provisions of the Labor Code, you must forth- ADDRESS / SEWER MAP 4 with comply with such provisions or this permit shall be deemed revoked.' . , - . ONTRC`TaR C ��ppL �ies � BK. Fi PG, VALIDATION • LICENSED CONTRACTORS DECLARATION � LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRE NO. VALUATION commencing with Section 7000)of Division 3 of"the Business and QLI �G - �Professions Code, and my license is in full force and effect. • CIN 411#1/fie ./CEAds/ �� $ d® D CHECK License Numb�e/r q4 71 D Lic.Class Ae- SIQZE� STORIES FAMILIES ONE C�,v� //.�/��/y11� ~/T/Ti / i �T NEW $ Con rac or Date DESCRIPTION OF WORK / © ❑ ; I am exempt from the licensing require ents I a go/- ,r ��, ADD �] licensed'architect or d registered,professional engineer i ALTER ❑ FINAL l� '��� acting in my professional 'capacity (Section 7051, — — �}: ❑ DATE C- - REPAIR Business and Professions Code). USE OF EXISTING BLDG. ��/ /� T DEMOL ❑ FINAL 0 9 2,3 A Lic.or Reg.No. Date APPLICA BY � r ' OWNER-BUILDER DECLARATION PRI /�� ff`I / # o 0 0 o 23 I hereby affirm that I am exempt from the Contractor's License �g' p �7 r . . Law for.the following reason (Section 7031.5, Business and,' ADDRESS Ua/vi /� /y G� 20 1:1 5,2 0 Professions Code): PRESENTBUILDING 10 0 1 1 5. 2 00' `❑ I, as owner of the property, or my employees with • ADDRESS wages as their sole compensation,,wilI do the work and ` LOCALITY 2.-6-81 . the structure is Not intended or offered for sale(Section 7044, 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- ' ADDRESS 0 9 2,4 A tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST. s• CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE 'WIDTH I hereby affirm that there is a construction lending agency for FRONT 0 0.0 0 the performance of the work for which this permit is issued P.L. 2 -.151. 00 (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name j� '0'0 1 5 1,0 0 c=i 'o P.C. Fee$ / Lender's Address - Permit Fee 08,26-81 ' I certify that I have read this application and state that the Issuance Fee above information is correct. I agree to comply with all County Investigation Fee 2 ordinances and'State laws relating to building construction, 5 Total Fee � and hereby,authorize representatives of-this County to enterIIIIIIIIIIIINU up o the above-mentioned property for inspe on purpo es. SEE REVERSE FOR EXPLANATORY LANGUAGE :®s Signature of Applicant or Agent ^ Date 4,WORKERS'COMPENSATION DECLARATION � lit/ I, heby, affirm that. I haver certificate of consent tself, `' A P P L I CAT I ®I ��I insure-,' or a certificate of Workers'Compensation Insurance,, or a certified copy thereof(Sec. 3800;Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy N0.114)41 Company Az,-,Age:" BUILDING Certified copy is,hereby furnished. FOR APPLICANT TO FILL IN ADDRESS �o �3 L Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS Date Applicant CITY ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' q �J NO OF BLDGS: NEAREST COMPENSATION INSURANCE SIZE OF LOT I J" e/JJ,� NOW ON LOT 0A0P'7 CROSS ST. (This section need not be completed if the permit is for one I ` TRACT J BL6Eif �. LOT NO./ � ASS BpOK PAGE PARCEL hundred dollars($100)or less.) I'certify that in the performance of the work for which this OWNER ' IT USE ZONE MAP permit is issued, I shall not employ any person in any,manner y SPECIAL- to as to become subject to the Workers'Compensation Laws: ADDRESS (} f�.b? CONDITIONS, Date � ! Applicant CITY ZIP. 0 NOTICE TO APPLICANT: If, after makingthis Certificate of. ARCHITECT OR .. L• r� DISTRICT GROUP TYPE FIRE PROC SED..BY ENGINEER /•'✓ 1I NO. ✓ T Exemption,•you:should become subject tc the Workers' /1 kz CONST. / - E �y Compensation.provisions of the Labor-Code, you must forth- ADDRESS' p U v with comply with such provisions or. this permit shall be TEL. STATISTICAL CLASSIFICATION APT. DO. deemed revoked. CONTRACTOR G� /' NO %' :TJX LICENSED CONTRACTORS DECLARATION - LIC. w CLASS NO. Z2 DWELL. UNITS I hereby affirm fhat.l am licensed under provisions of Chapter 9 = ADDRESS ° NO. SEWER MAP (commencing with"Section 7000)of Division 3 of the Business and __ LIC, Professions Code;"and my license is in full force'and effect. CITY CLASS BK VALIDATION A41 40pu Lr �//d� SQ.FT. NO.OF NO.,OF CHECK_ iyicense Number' Lic.Class� SIZE STORIES '.fle FAMILILS ONE ' �yy� VALUATION. Contratlo � r y/ Date � � DESCRIPTION%OF WORK -NEW $ Aw. ADDLl ❑ I am exempt under Sec. C/ , ,II fGrr ALTER LJ . /f� Q� ® ' .x'6`5 7.9 A B.&P.C. for this reason fie REPAIR ❑' $ ' !0 6-C # 0'a 0 0 2 3 . USE OF 7 3 3 2 Date: EXISTING BLDG. DEMOL ❑ 1'a 0 Signature APPLICANT TE FINAL OWNER-BUILDER DECLARATION PRINT 1 N :T7 DATE - 0 0 -33326. I hereby-affirm that i am exempt from the Contractor's License ' Law for the following reason (Section 7031.5, Business and ADDRESS J FINAL 0 225-87 Professions Code): ;PRE ENT By BUILDING 7(T p ❑ I, as owner of the property, or my employees with w ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section 'LOCALITY ;�',o ° 3 A 8'8 7044, Business and Professions Code). " ' MOVING - TEL. -0 o.0 3 1,8 8 v, I,as owner of the property,am exclusively contracting CONTRACTOR NO. 5 1 ((— 7 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). 2'�0 411 REQUIRED TOTAL SETBACK FROM a o 0 0 to N, YARD HWY-'- # CONSTRUCTION LENDING AGENCY SET BACK PROP.LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT .c 11 3 4,2'S the performance of the work for which this permit is issued P.L. (Sec. 3097, civ. C.). SIDE 1 3 4,2 5 , P.L. 5- Lender's Name tJa �i� o'0' 117 3 LDMA Ref.a Lender's Address '� P.C.Fee$ +v Permit Fee t 7 5 1 4,87 ' r I certify that I have read this application and state that the 4-3 Issuance Fee JD LDMA P/C# 0 above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, -- - -• --• ••Total Fee - , ,v LDMA Perm. b and hereby outhorize'representatives of this County to enter - ( upon the above-mentioned property for inspection purposes. �• ��/r �'+� `�e2fT SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Ap scant or Agent Date N. 0 WORKERSyCOMPENSATION DECLARATION �t L t 11(-3 1/ S I hero �affirn that I have a certificate of consent to self ` r insure or a certificate of Workers'Compensation Insurance, APPLICATION F®R BUILDING PERM1T or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. I FOR APPLICANNC1 FJ T TO FILL IN ADDRESSS O ❑ Certified copy is filed with the county building inspec-; BUILDING L-466 p G 1` 1 p tion department. ADDRESS: a L-66 V 1V'''( LOCALITY CI-14 ff r 1 t� U NEAREST 1 Date J''� Applicant ` CITY rN% 1r-G ZIP ` 7 CLQ CROSS ST. 1,.�� CERTIFICATE OF EXEMPTION FROM WOR ERS' SSOR SIZE OF LOT 3O�e� NO.OF BLDGS. Qa Mqp NOW ON LOT BOOK PAGE PARCEL COMPENSATION INSURANCE (This section need not be completed if the permit is for one I ) // a'7Z 3 USE ZONE MAP hundred dollars($100)or less.) TRACT 496 0� LOT No. 7� //� NO. OWNERGAP_� y ?_ .I7 7�4� b V�� CONDITIONS ct SPECIAL I certify that in the performance of The work for which this �,�" tom' •moi`I DISTRICT .GROUP TYPE FIRE TED BY O permit is issued, I shall not employ any person in any manner ADDRESS �l w 'y a j �q2 5W> `'� Q-� CONST. / ZONE so as to become subject to the Workers'Compensation Laws. U !9✓� v %JG clrr �.1 �6 zip �}7,f303 Date Applicant STATISTICAL CLASSIFJ�',ATION APT. IONDO. I- NOTICE TO APPLICANT: If, after makingthis Certificate'of ARCHITECT OR TEL •� { ff�� ENGINEER E�Ah•I��>t►�NO. 7b�J CLASS NO. y DWELL.UNITS Jim Exemption, you should become subject to the Workers' o,L.0 i-A0W h Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be r deemed revoked. r CONTRACTOR T BK.C-' `1 VALIDATION LICENSED CONTRACTORS DECLARATION (I LIC. f .. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS O.�Jt�7 ►- VALUATION (commencing with Section 7000)of Division 3 of the Business and ' """lll LIC, Q 0 Professions Code, and Omy license is in full force and effect. x 'CITY �Akie(ty- CLASS $ 66 , (� y'I `^t AN SQ. ZEA NO.OF NO.OF CHECK ONE License Number - ;Lic.Class 1 D I\ { $ Contrac S(!to DISP�te 5-I 4 I� � 'DESCRIPTION OF WORK %3 e,9 NEW ❑ I am exempt under Sec. 'd i 'rte(,(, ADD ❑ ALTER ❑ FINAL B.BP.C. for this reason '� 1 I REPAIR ❑ DATE o Date: IT USE OF DEMOL ❑ FINAL 7.0 4 4 A on 4EXISTING BLDG. - 23 Signature APPLICANT T �p•�� By # o 0 0 0 ER-BU E DECLAR PRINT IOAP-L yG A�,Q1..1ta�lA Tj- 1 17#57q I hereby affirm that I am exempt from t actor's License ADDRESS lov �t, Rn''o� AqAL 1 -- 137.07 Law for the following reason (Section 7031.5, Business and Professions Code): PRESENT ° ° 1 3 Z 0 7 5 ❑ BUILDING •1, as owner of the property, or my employees with ADDRESS 0 5'14-8 7 wages as their sole compensation,will do the work and i LOCALITY the structure is not intended or offered for sale(Section ' ' 7044, Business and Professions Code). o MOVING. TEL. ❑ 1, as owner of the property, am exclusively contractingi "CONTRACTOR NO. 27Q4,5A with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). # 0 0 0 0 0.1 REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 1 hereby affirm that there is a construction lending agency for M FRONT ( -.171,75 the performance of the work for which this permit is issued i r_P.L. tSec. 3097, Civ. C.). SIDE °'a;1 7.1.7 5 5 P.L. P Lender's Name �/,�� 051 4=87 P.C. Fee$ 13'7.0 Permit Fee Lender's Address f/�j re certify that I have read this application and state that the j Issuance Fee `VL� = above information is correct. I agree to comply with all County ' r. Investigation Fee J ordinances and State laws relating to building Construction, Total Fee / eIT and hereby authorize representatives-of this County to enter i upon t e above-me io property for inspection purposes. J _I4—9,`L SEE REVERSE FOR EXPLANATORY LANGUAGE nature of Applicant or A t D Date ®s WORKERS'COMPENSATION DECLARATION "I hgyQJgy+L#firm that I have a'certificate 'of consent to self •• �''"' insure; dr„a certificate of Workers'Compensation Insurance, or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF'LOS ANGELES BUOLDING AND SAFETY Policy No. 1822 Company Self--Insured' E] Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS 9803 E. Las Tunas Certified copy is filed with the county building inspec-/�, BUILDING tion department. � �lD/ ADDRESS 9803-E. I.�as Tunas Drive LOCALITY . le City NEAREST - Date 1/08/87 Applicant 4_*, CITY le Ci zip 91780 CROSS ST. Golden West Avenue CERTIFICATE OF EXEMPTION FROM WORKERS' l3 r 8O8.30 sf NO OF BLDGS. One ”ASSESSOR SIZE OF LOT COMPENSATION INSURANCE NOW ON LOT MAP BOOK I PAGE PARCEL (This section need not be completed if the permit is for one6561 B• USE ZONE MAP hundred dollars($100)or less.) TRACT *w**72 34&3 OT No. 74 & 75 NO. T C-2 SPECIAL } I certify that in the performance of the work for which this OWNER Carl Karcher En riws 8-7162 CONDITIONS IL permit is issued,I shall not employ any person in any manner DISTRICT G UP ITYPESi/- FIRE PROCESSED BY O so as to become subject to the Workers'Compensati n Laws. 3 ADDRESS 1200 North Harbor Boulevard �'� CONZ Ix 1/08/87 • �r CITY' Anaheim Ca. L5`/,may/ Date Applicant ZIP 92803 STATISTICAL CLASSIFICATION APT. NDO. F_ NOTICE TO APPLICANT: If, after making this Certific a of ARCHITECT O TEL. ENGINEER ame as Above NO. CLASS NO. �� DWELL. UNITS LU Exemption, you should become subject to the Workers' :w. CL .Compensation provisions of the'Labor Code, you must forth- ADDRESS - SEWER MAP with comply with such provisions or this permit shall be deemed revoked. TEL VALIDATION CONTRACTOR Carl Karcher Ent.NO. 778-7162 BK. PG,1�� LICENSED CQNTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 1200 N. Harbor Blvd.NO. 396710 VALUATION (commencing with'Section 7000)of Division 3 of the Business and LIC.,I lO OOO.00 Professions Codep and my license is in full force and effect. CITY Anaheim California CLASS B $';, r SQ. FT.. NO.OF NO.OF CHECK License'Number 396710 Lic.Class B SIZE --- STORIES One FAMILIES--- ONE Carl Karcher DESCRIPTION OF WORK Addition of U1Ck— NEW ❑ $ �6 3 0.5 A Contractor Enterpri$I S_ 8/26/81 _ ❑ _ #.� a °.° 23 u window area. (47.5sq:ft.)al DD ❑ I am exempt under Sec. o o ^ ALTER ❑ FINAL I Q.7.C 2......._.._.._,. DATE ///� B.BP.C. for this reason add avenin s & 'lighting t0 the REPAIR ❑ o a o 9 7.2 2 Date: USEOING BLDG.exterior DEMOL ❑ Ftp A APPLant ICANT �1, 01.08-87 ' ICANT TEL. B && Signature PRINT Muck MCBurne N — OWNER-BUILDER DECLARATION - I hereby affirm that•I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS 1200 N. Harbor BlVd. Anaheim - Professiohs Code): PRESENT El 1, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and LOCALITY the structure is not Intended or offered for sale(Section 7044, Business and Professions Code). MOVING TEL. ;2 7 0 3,4'A A ❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO. 3 # o e o 0 0 1 ' with licensed contractors to construct the project'(Sec-' ADDRESS ' tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST. I ° 124,88 CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT a.- 1 5 the performance of the work for which this permit is issued P.L. 2 4,8 8 v tSec, 3097, Civ. C.). SIDE Lender's Name Self P.L. 051 2=87 3 P.C.Fee$ t Permit Fee Lender's Address N/A I certify that I have read this application and state that the Issuance Fee 00 , above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws-relating to building construction, Total.Fee i and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. •1/08/87 SEE REVERSE FOR EXPLANATORY LANGUAGE Si a ure of Applicant or Agent Date IDS h l COUNTY OF LOS ANGELES : .TEMPLE. CITY # 0508 BUIL NG PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS CALTE$ALION/.RERAIR BUILDING AND SAFETY /..LAND DEVELOPMENT . - TEMPLE CITY CA 91780 BL-0508 9907240021 PHONE- (626) ,285-0488 EXT: GA D: 0. OF CONST eB IL - DR SS: TR: 6561 LT: 74 BL: .001 SQ. FT STORIES TYPE. - , r%9803 LAS T.UNAS?DR STRUCTURE: 0 :- VN TEMP-.:.CA-917-802209 "'ASSESSOR 0 ATION B NEAREST CROSS-STREET- GOLDEN.WEST' • 8587-026-015 I THOMAS PAGE: 597 GRID: A3. LOCALITY: TEMPLE CITY ENA BDGS COE ROC SSED B EXPIRES .. CARL'S JR. RESTAURANT EXIST OCC GRP: 07/29/99 UT 01/25/00 ' ER: TEL. NO:. BLDGS. N ON. OT: VALUATION: FINAL--DATE ti -F-I AL• BY: CODE: CARL KARCHER ENTERPRISESR (805) 577-4130 1 28,870 3700 INLAND EMPIRE ONTARIO, CA 91269 FEES PAID - DB. C ---• --• - -- I TEAR OFF"_INSTALL._4 PLY.BUILT-UP FIBERGLASS,CAPSHEg CLASS A' FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: - - APPLICANT: 0: SADLER ROOFING COMPANY (949) 675-5095- .- AA-BLDG PERMIT ISSUANCE 27.75 125 GRAND CANAL AE STRONG:MOTI.ON. 0 E 28870.00 VAL 6.06• SPECIAL CONDITIONS: BALBOA ISLAND, CA D2 PERMIT W/O.EN-. I�� �fC=---�28870.00•VAL: 523.65 GELES j® E S 557.46 CONTRACTOR: TEL. NO:. SOS �1�T� APPROVALS. DATE. INSPECTOR SIGNATURE 'SADLER ROOFING CO. (949)•675=5095-- •125 GRAND CANAL LIC. NO LOCATION AND SETBACKS BALBOA ISLAND CA 92662 284857/C39 SOILS ENGINEER APPROVAL ARCHITECT.OR ENGI 0: / I• DA IO TR C FORMS LIC. N0� 111.1111 SLAB/UNDER. FLOOR RAISED FLOOR FRAMING MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: M�:j�] [�� (\/�j]� Fl� D RFLOOR INSULATION 150H269 3 0�4- l`{=✓f' L C \,�j/ �uJ`�u FLOORS HI G 0. OF FAMILIES: I G UNITS: AP COND: STAT CL SS:- NO 22. K ROOF SHEATHING .- • '- �I I. I SCHOOL WITHIN HAZARDOU19 � �d7 �=• �� • EAR PANELS ' AIR QUALITY: 1000 FEET MATERIALS r_J } NO NO NO FRAME INSPECTION REQUIRED 0 SETBACK FROM. EXIS 4b �t�' RE SPRINKLER HANGERS SET FRONTAPL•- YARD: HWY: PROP LINE: WIDTH: @rVjce That Vv ISOLATION/WEAT ER STRIP SIDE PL- ' TERIOR LAT EXTERIOR LATH RATED FLOOR/F ASSEM. TED WALL ASSEMBLIES ATED SHAFTS/WE G T=BAR CEILINGS �OT DRAINAGE REPORT ID: DPR261- ROUTE TO: BS05O8 I.T. ' I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT,, DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS �ALTERATION/REPAI;R -' -=- --40ILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL-0508 990519,0048 PHONE: (626) 285-0488 EXT: LEGAL 10: NO.-OF CONST BU tLD I NG-ADDRES : TR: 6561 LT: 74 BL: .001 SQ. FT STORIES TYPE 9803 LAS TUNAS DR STRUCTURE: 0 VN TEMP CA 917802209 ASSESSOR INFORMATION NEIMB R: NEAREST CROSS STREET: GOLDEN WEST 8587-026-015 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY TENANT: E ST USE: COMME USE ZONE: C-2 ISSUED ON: PRO SS D EXPIR ON: CARLIS JR. EXIST OCC GRP: - 06/02/99 UT 11/29/99 OW ER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FI.NAL DATE FINAL BY: CODE: VERMEULEN CHARLES I CO TR - 1. 1,500 �,//, 11591 CIELO PL 42 S AI DP . . 0 -OF- OR NEW FIRE PROTECTION SYSTEM FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: - APPLICANT: TEL. N FIRE MASTER (323) 225-6666- D1 PLANCHECK W/O EN-HC 1500.00 VAL 81.98 2684 LACY STREET AA BLDG PERMIT IS_SIJANCE 27.75 -SPECIAL CONDITIONS: ANGELES, CA AE STRONG MOTI.O -OJHE �- �.1500.00 VAL 050 D2 PERMI r�O��N�ELER�S1r+1'oa`g VAL 82.20 � CONTRACTOR: TEL. O: OS -'�T 192.43 APPROVALS DATE INSPECTOR SIGNATURE FIRE MASTER PROTECTION (323) 225-6666- V y •.2684 LACY ST. LIC. NO LOCATION AND SETBACKS LOS ANGELES, CA 90031 CIO SOILS ENGINEER APPROVAL Z ARCHITECT OR ENGINEER: TEL. NO: _ 0 DATION R C F0 . S LIC. NOSLAB/UNDER FLOOR RAISED FLOOR FRAMIiG y 150H269 SEWER MAP BOOK., PAGE: FIRE ZONE: P�)U FQ,UC ® �� UNDERFLOOR INSULATION WLOOR SHEAT I G 0. OF FAMILIES: DWELLING UNIAPT COND: ST T CL S NO 22�\ ROOF SHEAT I G SCHOOL WITHHAZARDOUS �i AIR QUALITY:. ICON FEET MATERIALS ` a o SHEAR ELS . NO NO NOr FRAME INSPECTIO REQUIRED TOTAL SETBACK FROM S 4�j�. 0th IRE SPRINKLER HANGERS SET BACK FRONT PL- YARD: HWY: PROP LINE: WIDTH: Servic e That INSULATION/WEATHER STRIP SIDE PL- INTERIOR L- N R OR LATH/DRYWALL EXTERIOR LATH ' TED FLOOR/CSS RATED WALL ASSEMBLIES MtTED S F S/0 S * ADDITIONAL DATA ON FILE T-BAR CEILINGS • OT DRAINAGE REPORT ID: OPR261 ROUTE TO: BS05O8 '• ' . COUNTY OF LOS ANGELES TEMPLE CITY # OS" BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS i TENANT IMPROVEMENT BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA ` BL 0508 9705010027 PHONE: (818) 285-0488 EXT: f' LEGAL ID: 0. OF CONST- NEW Sul G ADDRESS: TR: 6561 LT: 74 BL: .001 ' SQ. FT STORIES TYPE OCCUP GROUP 9803 LAS TUNAS DR STRUCTURE: 2200 1 V B Tg4P CA 917802209 ASSESSOR-INFORMATION NBE : NEAREST CROSS STREET: GOLDEN WEST 8587-026-015 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY f TENANT: EXIST BLDG USEw-COMM5S 0 : TSSUED 0 PROCESSED . CARL'S JR. EXIST OCC GRP: B 06/27/97 TC 06/27/,98 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATIOF FINAL DITE FINAL IT ah: VERNEULEN CHARLES I CO TR - 18,500 11591 CIELO PL f FEES PA D DESCRIPTION TENANT IMPROVEMENT, NEW PARAPET, NEW SIGNAGE, NEW LIGHTING FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: EL. EXPRESS PERMITS (310) 328-6300- 81 PLANCHECK W/ENERGY 18500.00 VAL 346.27 AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: AE STRONG NOTION (OTHER Fr— �18300.00 VAL 3.89 B2 PERMIT W/ENERGY L L1.8500'00 VAL 407.39 1OIdL �FEEESS 785.30 CONTRACTOR: TEL. N0: �����-�� APPROVALS DATE INSPECTOR SIGNATURE KARCHER CARL ENTERPRISES, INC. (714) 774-5796- 1200 NO HARBOR BLVD LIC. NO ® LOCATION D SETBACKS ANAHEIM CA 92801 396710 B - SOILS ENGINEER APPROVAL AR C I C OR ENG ar G� FO T ON/ RE CH FOR S GILBERT, PHILLIP (714) 443-1820- 34102 VIOLET LANTERN -LIC. NO: II ;-� �1 SLAB/UNDER FLOOR DANA POINT, CA 92629 NONE RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CNP' �' FC �f' UNDERFLOOR INSULATION � . 3 04 I L Lj 1Y �/ d h ��� , --- —' -- FLOOR S . OF F LCI CLASS: / NO 22 . �\� r` /I ❑ _i�;l / r_�Co ROOF.SHEATHINC SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS " `� FRAME INSPECTION NO NO NO �� ❑ . � FIRE—SPRINKLER HANGERS INSULATION/WEA HER STRIP INTERIOR LATH/DRYWAL EXTERIOR LATH - TED FLOOR/CEa WSW.FLOOR/CE RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR ,CEILINGS T DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES.. I TEMPLE CITY # 0508 BUILDING PERMIT bEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9706250009 PHONE: (818) 285-0488 EXT: LEGAL D• NU14BER O S G S: 3 IlUl LD G SS: TR: 6561 LT: 74 BL: .001 SIGN DESCRIPTION: CHANNEL LETTERS, REFACE EXISTING POLE 9803 LAS TUNAS DR i TEMP CA 917802209 ASSESSOR 0 NEAREST CROSS STREET:-GOLDEN WEST 8587-026-015 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY TENANT: EXIST 8 • GISSUED-ON: PROCESSED-BY: S 0 CARL'S JR. EXIST OCC GRP: 06/25/97 TC 06/25/98 OWNER: TEL. NO: SLOGS. NOW ON LOT: .VALUATION: FINALATE FI AL BY: VERNEULEN CHARLES I CO TR - 8,000 . 11591 CIELO PL ' 6� ES PAIF DESCRIPTION OF WORK THREE NEW SIGNS FOR CARL'S JR. - REP ACEMENTS • FEE"DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: COAST SIGN, INC. (714) 520-9144- ' AA BLDG PERMIT ISSUANCE 27.75 AE STRONG NOTION OTHER 8000.00 VAL 1.68 SPECIAL CONDITIONS: AX BUILDING REVIEWFEE 54.70 B2 PERMIT W/ENERRGGYL L a 8000,:00 VAL ' 202.29 �® TOTAL �E�ES, 286:42 CONTRACTOR: TE 0: APPROVALS DATE INSPECTOR SIGNAT RE COAST SIGN INCORPORATED (714) 520-9144-229 1345 S ALLEC ST LIC. NO �i� LOCATION SETBkCKS ANAHEIM CA 92805 CIO * �� S I S GI E R APPROVAL CHITEC ENGINEER: 0: 0 DA LIC.-NO: SUPPORT STRUCTURE MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CNP 0 jUIt L C W'f I NO 20 al AIR QUALITY: 1000 FEET MATERIALS . NO - NO NO - �cl. * ADDITIONAL DATA ON FILE REPORT ID: DPR261 ROUTE TO: BS0508 s~ • .COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 HL 0508 1002180053 PHONE: (626) 285-0488 EXT: LEGAL ID: INUMBEP OF SIGNS: 3 BUILDING ADDRESS: ITR: 6561 LT: 74 BL: .001 ISIGN DESCRIPTION: NEW ILLUM CARL'S JR. WALL SIGN 9803 LAS TUNAS DR 1 -1 TEMP CA 917802209 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 1 18587-026-015 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl TENANT: EXIST BLDG USE: (ISSUED ON: PROCESSED BY: 1CARL'S JR. 1EXIST OCC GRP: 102/18/10 SR OWNER: TEL. NO: IBLDG3. NOW ON LOT: VALUATION: IF TE FINAL BY: CODE: IMAYSON-LOONEY LLC, MARTIN TERRY - 15,500 772 W. TOWN & COUNTY ORANGE, CA FEES PAID RTPTThig OF WORK I (1) NEW ILLUM 38.5" CARL'S JR. WALL SIGN (2) NEW ILLUM 42- 1 FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:ICARL'S JR. WALL SIGN'S (1) REFACE PYLON SIGN & 1 REFACE APPLICANT: TEL. NO: BLEND (909) 951-4742- IAB AA BLDG PERMIT ISSUANCE 27.75 I_ 13580 5TH STREET STATE GREEN BLDG FEE 15500.00 VAL 1.00 ISPECIAL CONDITIONS: CHINO, CA 91710 AX BUILDING REVIEW FEE 54.70 1D2 PERMIT W/O EN-HC 15500.00 VAL 317.40 TOTAL FEES 400.85 CONTRACTOR: TEL. NO: JAPPROVALS DATE INSPECTOR SIGNATURE NATIONAL SIGN AND MARKETING CORP. (909) 591-4742- 113580 5TH ST LIC. NO [LOCATION AND SETBACKS CHINO, CA 91710 745030-C45 _ SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDiTl'ON/TRENCH FORMS 1 LIC. NO: ISUPPORT STRUCTURE 1 (MAP N0: SEWER MAP HOOK: PAGE: FIRE ZONE: CMPo1 O INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 1 NO 20 SCHOOL WITHIN HAZARDOUS -1 AIR QUALITY: 1000 FEET MATERIALS NO NO NO �* ADDITIONAL DATA ON FILE REPORT ID: DPR261 ROUTE TO: BS0508