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HomeMy Public PortalAbout5442 LOMA AVE_Building__ 76A638A C950803 8-64 APPLICATION FOR ESU I LD NCS PER, COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER AD D RE ss BUILDING AND SAFETY DIVISION LOCALITYLL_&z"y__ JOHN A. LAMBIE. COUNTY ENGINEER NEAREST COLEMAN W JENKINSSUP'T OF BUILDING CROSS ST f p DISTRICT NO I GjRrj TYPE PR BY FOR APPLICANT TO FILL IN (//y coNsr BUILDING STATISTICAL C S IFICATION' SE R MAP � f/.., ADDRESS !/ CLASS NO WELL UNITS BK PG._ LOT NO 3 BLOCK USE ZONE MAP NO TRACTSPECIAL ' NO OF SLOGS CONDITION SIZE OF LOT C>- NOW ON LOT 3 USE OF a'ISTIN BLDG SETBACK FROM TEL FRONT PROP LINE OF (STREET) OWNER NO 1' TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY 'FRQM C L, CITY ARCHITECT O TEL BLDG SETBACK FROM ENGINEER NO. SIDE PROP. LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C L 6. TEL + _ 0 CONTRACTOR W NO - - - ADDRESS LIC NO CORNER CUTOFF YES NO - O Y LIC HSEE REVERSE SIDE FOR SPECIAL APPROVALS w DESCRIPTION OF WORK Z GUTTER,CURB, GER, DRIVEWAY APPROACH; NEW ADD ALTER REPAIR DEMOLISH SQ.FT. NO OF NO. OF '%"% i ♦ '� SIZE STORIES FAMILIES USE OF' Note; Permits for curb, gutter, sidewalk, and driveway approach � _ STRUCTURE -- ,C.. a ations should a ta,:en out a o i.oact U015T., -,1 ;Lgie!V in order to avoid SIGNATURE OF lengthy delay. Survey & Design work tales time and is not started APPLICANT TH rermIT ' ' Hall. VALUATION$ ��0 O ��� APPROVALS DATE INSP ECTOR'S SIGNATURE P.C. PMT FOUNDATION, LOCATION FEE$ FEE$ Q FORMS, MATERIALS FRAME, FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS gU ILDI NG CONSTRUCTION I CERTIFY THAT IN DOING THE WORK Ur, ATHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT I NG TO WORK M EN'S Cn MPENSATION INS RA CE, LATH EXT. SIGNATURE O HOUSE NUMBER COR- PERMITTEE RE ND POSTED ADDRESS Fl N A L JOHN F LEWIS. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDATION M O CASH L4,o75s71-0 KAR15 1D 18.50^' ' wa4 APPLICATION FORPERMIT TMENT OF BUILDING AND SAFETY t` COUNTY OF LOS ANGELES {ggepp�� �4 1- <-c...n.^•'o:.*� WM. J. FOX, CHIEF ENGINEER - i�V NO. OF I'7 BLDG. ORD.NO. DISTRICT NO. PLAN CK. NO. /PERMIT,NO.','- PLANS -C_ SETBACK LINE ^�` i� y FIREAPPROVE ' ZONE _f BY' �- 'DATE - R CEIVED BY DATE,OF;APPL. DATE ISSUED -Z USE APPROVED - j \ [y��� may, ZONE 1 BY DATE A YrIA 6 -+ 7 y APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY 0� BUILDING O C NAME 1 ADDRESS U w FW- Z ADDRESS l 1 LOCALITY •/��- y S O t NEAREST U W CITY °•�:t§ r-..!•' CROSS ST. a STATE TEL. LICENSE NO. NO. 4 E NAME ILI Z 'MAIL O NAME ,1, /f�(f,,.l 3 .ADDRES A_ i 1 r ra/ O TEL. QADDRESS CITY NO. K Z CITY [ 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS U APPLICATION AND STATE-,THAT THE ABOVE IS CORRECT STATE TEL. t a - AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ' LICENSE NO NO. AND STATE LAWS REGULATING BUILDINS_ICONSTRUCTION. Z SIGNATUR ' p O G LOT NO. J SIZE OF LOT OWNfi OF JER F- NO. OF BLD1S. t QG. BLOCK NOW ON LOT / , AUTHORIZEDAGT,. L l7 It / Ju m TRACT 1 1/ CORRECTIONS W _ • f D USE OF BLDGS. NOW ON N LOT DESCRIPTION OF WORK USE OF BUILDING O / r NEW `' TYPE GROUP NO. OF NO. OF / ALTERATION ROOMS FAMILIES ADDITION SIZE REPAIR STORIES MOVING WALL COVERING�����yy�CI (C �/�v/��p} DEMOLISH OF COVERINGBfcpo `�'r/',//lI5oDLL�I , `� Pte._ P.o•$ G FINAL APPROVAL FEE INSPECTOR'S, VALUATION FEE DATE iT NAME t oe.a -"-4z asm=T�l DEPARTMENT OF_BUILDING AND SAFETY AI�LI4;l�TI"A FOR I'ERIVIIT' COUNTY OP LOS ANGELES V lL WM. J. FOX, CHIEF ENGINEER NO.O BLDG. ORD:NO. DISTRICT NO. PLAN CK. NO. ERMIT NO. PLANS SETBACK LINE FIRE APPROVED ZONE BY DATE RECEIVED BY DATE OF APPL. DATE ISSUED USE APPROVED M a-c�S" 3 ZONE BY DATE rl APPLICANT PILL IN HEAVILY OUTLINED PORTION ONLY N g r� � BUILDING 3-3 (o La /-7dr2T p NAMEee tn ADDRESS z ADDRESS War Floduction Board orders. You ar LOCALITY / e/ au lone O COI7SU t with Your Ioccd W NEAREST U W CITY pro I CROSS ST. jn � Q STATE ing the work authgzed in this per , NAME LICENSE NO. z MAIL q��j _ O NAME 3 ADDRESS // --�'-� '4/0 TEL. U ADDRESS CITY NO. Z z I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS U CITY APPLICATION AND STATE THAT THE ABOVE IS CORRECT STATE TEL. AND-AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LICENSE NO. NO. V r} AND STATE LAWS REGULATING BUILDING'CONSTRUCTION. LqT NO. �3 SIZE OF LOT O X !Ui SIGNATURE OF OWNER •I 1- NO. OF BLDGS. 4 IL- BLOCK NOW ON LOT Q,f,/� AUTHORIZED AG W � Q TRACT CORRECTIONS( D USE OF BLDGS. NOW ON LOT DESCRIPTION OF WORKUSE OF BUILDING > jr5 • Y 0 t ^_ D NEW TYPE f GROUP 'fir NO.OF NO.OF ALTERATION ROOMS FAMILIES �® ADDITION SIZE 2—';0L LL , REPAIR STORIES' I MOVING WALL COVERING DEMOLISH R0211 COVERING IS g $ FINAL APPROVAL7o _ 41U S INSPECTOR'SVy VALUATION -~- F66 �� DATE�� I NAME '� _76F.996A CE#60311-6T APPLICATION FOR BUILDING PE F�Mil' COUNTY- OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY-DMSION LOCALITY JOHN A.LAMBIE,,COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST DISTRI T NO, GROUP TYPE SEWER MAPp FOR APPLICANT TO FILL IN TYPE K J 'BUILDING - ' AUL ISS /9- STATISTICA CLASSIFICATION r LOT NO. BLOCK CLASS NO • - DWELL UNITS - LOT /� _ MAP 'STATE - ,' / I`J NUMBER '0 / O TRACT v �C/ V§EZONE SPECIAL n NO OF BLDGS. CONDITIONS _ SIZE OF LO V v NOW ON LOT USE OF v ' EXISTING BLDG - BUILDINGEXIST YARD HWY STREET NAME SETBACK WIDTH OWNER '. �� FROL T • , . ` MAIL L A� j� J� •D ADDRESS !�� /? SIDE ' " P L CITYZ_ C NOL Z INSPECTION RECORD; ARCHITECT OR - - TEL. - ENGINEER NO ADDRESS TEL CONTRACTOR" - NO ADDRESS DESCRIPTION OF'WORK ' NEW ADD ALTER REPAIR - DEMOLISH /'� 'NO OF NO OF SIZE V STORIES FAMILIES USE OF STRUCTURE I SIGNATURE O APPROVALS APPLICANT ` - DATE INS P TURE ADDRESS (/V , FOUNDATION LOCATION FORMS,MATERIALS P C S FRAME FIRE STOPS. �Q ' FEE� BRACING, BOLTS Lv s;Y,-- VALUATION,• - $ D FURNACE LOCATION, FEE GAS VENT,DUCTS - 1 HEREBY ACKNOWLEDGE 'AT AVE READ HIS AP- LATHINT PLICATION ,AND STATE'THAT E A _ VE IS COR CT A „ AGREE TO COMPLY A COU Y NA CES STATE =LAWS R IN BUI G N T LATH,EXT. SIGNATURE O HOUSE NUMBER COR- i - PER ITT RECT AND POSTED ADDRESS FINAL _ CLYDE N. DIRLAM, FrRINCI P L ST NGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION C . M O. CASH DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES BUILDING WM. J. FOX, CHIEF ENGINEER NO' O ` BLDG. - ORD.NO. DISTRICT NO. PLAN CK. NO. PERMIT NO. PLANS SETBACK LINE_ FIREAPPROVED Q J ZONE BY _ DATE RECEIVED BY DATE OF APPL. DATE ISSUED USE /^y APPROVED I - ZONE ' I BY DATE (/I(� M L-9 �tJ Tom+ SA�pPPp�LIC'pA7 TNT/�FIL IN HEAVILY OUTLINED PORTION/\ ONLY d tY V'i/ d� :,z! d r...7 ADDRESS BUILDING O N M% �'' ' I- m r u u «�_ ;� 3 ti i0' ion id" ' U w rr n, H Z ADDR$SSC== A1C 7 L'CGrCi o.d�*� 1 LOCALITY LE ,/T = Z CC'L1.10 iJ C 3L ii�'7.i11}"O.:local ��C{I NEAREST U w C 77 .._ CROSS ST. 1r e)l� W/7 7 L��TN,,p.WCrk C;L?i�20r1ZC:CI li EL. - K NAME /i/I'i`�/%�i I /— w It Z MAIL NAME -�,�� .,,�{I�r�. /I� .E O ADDRESS _< Q ADDRESS ' ( / u-/ CITYNOL Z CITY , - fv!�'L l �/T y 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS 0 APPLICATION AND STATE THAT THE ABOVE IS CORRECT U STATE TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LICENSE NO. NO. AND STATE LAWS REGULATING BUILDING'CONSTRUCTION. ZO LOT NO / SIGNATURE OF SIZE OF LOT, , � OWNER J I- _ NO. OF SLOGS' AlJ <1 BLOCK NOON LOT ffQle AUTHORIZED AGT. wu t7� JN TRACT 77? G�Lp ! CORRECTIONS / n � D USE OF BLDGS. /h /„ ! 101 NOW ON LOT � 1,(/j/I�✓ DESCRIPTION OF WORKUSE OF BU LDII/Nj,G/ —J/"/I/T/T'045 [f5h ,1/�'.�.Nv/7�•y/�� //� 1Y\- .! sx 71 r O Z -7�- D NEW TYPE _.- I GROUP:Z IF _ NO. OF NO. OF ALTERATION ROOMS FAMILIES ADDITION SIZE ZQ 3 REPAIR STORIES / MOVING WALL COVERING /T U-ry,r (J DEMOLISH ROOF COVERING �- $ P.C.$ FINAL AEP ROVA 1 FEE / /�}� $ �y/f I INSPECTO(R'41'0S`� VALUATION './ ✓ FEE �� DACE NAME WO-3 XZM�"` R44 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES lQ �J TIT"�T6 WM.J. FOX, CHIEF ENGINEER �l� NO. OF BLDG. - ORD.NO. DISTRICT NO. PLAN CK. NO. PERMIT NO. PLANS I SETBACK LINE -. - G- •�/s FIRE APPROVED o v ZONE BY DATE RECEIVED BY DATE OF APPL. DATE ISSUED USE APPROVEDC,C y C,\ ZONE BY DATE Q /� !a _ Y v _a� APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY BUILDING 0 Q O m NAME ADDRESS FZ ADDRESS LOCALITY c� I Z NEAREST U�W CITY CROSS ST. STATE TEL. `- LICENSE NO. NO. � NAME W - • MAIL F NAME 3 ADDRESS ` A- UO TEL. ADDRESS v/I CITY NO.lz - Z CITY I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS U APPLICATION AND STATE THAT THE ABOVE IS CORRECT STATE TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LICENSE NO. NO. AND STATE LAWS REGULATING BUILDING CONSTRUCTION. SIGNATURE OF ZO LOT NO. J SIZEEfF�LOT�/ � OWNER - A J F NO. OF BLDGS. Q IL BLOCK NOW ON LOT Z' AUTHORIZED, J W TRACT ` CORRECTION, D USE OF BLDGS. /n/ 1 I / /r "\w R F� ,J�_/ NOW ON LOT DESCRIPTION OF WORK USE OF BUILDING 5'' OGa r O _ - a r NEW I/ TYPE GROUP NO. OF NO. OF -" ALTERATION ROOMS FAMILIES ADDITION SIZE ! k REPAIR STORIES MOVING WALL COVERING - DEMOLISH ROOF COVERING $ P.C.$ FINAL APPROAVAL G FELE ECT NAM VALUATION FEE DATE NAME 7GA638ACE•#G031I-37 APPLICATION FOR BUILDING PERM-I." . COUNTY.OF. LOS- ANGELES BUILDING DEPARTMENT OF COUNTY ENGADDRESS INEER BUILDING AND SAFETY DIVISION LOCALITY -JOHN A.LAMBIE,COUNTY ENGINEER NEAREST CASSATT D-GRIFFIN,SUPT OF BUILDING -CROSS ST FADDRDISTRICT NO. GROUP I TYPE I SEWER MAP E OR APPLICANT TO FILL IN K CONST _ STATISTICALxASSIFICATION -I BLOCK GLASS NO� DWELL UNITS v MAP J STATE YES NO �LLNgggUMBER / HWY - SPECIAL NO OF BLDGS. E%ONE CONDTIONS© 7� NOW ON LOT �DG. r1 Com' BUILDING EXIST SETBACK YARD HWY STREET NAMEWIDTH n2 FROL T _ S MAIL Z ADDRESS A SIDE L-'- C-� 1 NEL O P L. - cITY INSPECTION RECORD ARCHITECT OR z TEL ENGINEER NO. ' 3 ' ADDRESS - TE CONTRACTOR //��ATIE N 1 q� ADDRESS /'T P T DESCRIPTION OF WORK NEW .ADD ALTER REPAIR DEMOLISH FT.. NO OF NO OF- SIZE STORIES FAMILIES UshoT T SIGNATURE O APPROVALS - APPLICANT - - 'DATE INS I ATURE ADDRESS 13 FOUNDATION LOCATION - FORMS,MATERIALS '$ 1 0 ,�.-�'� P C_ S FRAME FIRE STOPS. FEE, BRACING,BOLTS VALUATION MMs „SL7 FURNACE LOCATION, _ FEE GAS VENT,DUCTS I HEREBY ACKNOWLEDG HAT 1 HAVE R D THIS LATH, INT - PLICATION AND STA A HE OVE IS RR T % AGREE TO COMPL I CO D AN S D STATE LAWS U TI BU G C C N LATH,EXT. L I SIGNATURE O HOUSE NUMBER COR- - - PERMITT RECT AND POSTED ADDRESS' I FINAL / CLYDE N. DIRLAM, PRINCIPAL CT ALS ER PLAN CHECK VALIDATION CK M G. CASH PERMIT VALIDATI N cK. M O. CASH \..° ` 'a- 2 3 0; . v ' 1`;I' +rWORKERS' COMPENSATION DECLARATION r, I hereby affirm-that .1 have a certificate of-consent to self D D 4 O j insure, or a certificate of Workers'FCompensotion.Insurance, or a ertlfi copy'thereof'(S P;�8d0; Lab/�. COUNTY.OF LOS ANGELES BUILDING AND SAFETY, Policym an / r BUILDING Q rq, ❑ Certified copy is hefeby furnished FOR'APPLICANT TO FILL IN ADDREss ��4 `/ 2 _ �ot. uc Certified copy-is filed with the county building-inspec- gDDRESS tion,department ' _ � 'Q�} f �• C% C�!%//1 CITY G/-2!y, ZIP / (J`r LOCALITY" I e E Date / -Applicant - NO OFIBLDGS CERTIFICATE OF EXEMPTION FROM WORKERS'. " �'-' NOW ON LOT s NEAREST SIZE'OF LOT CROSS,ST ' COMPENSATION'INSU RANCE ASSESSOR (This section need not'be completed'if the petmrt'is'for one TRA_Ci" BLOCK LOT NO ',' MAP BOOK PAGE, PARCEL ' hundred dollars ($100) or less ) ' TEL OWNER . G1L TEL Q'� USE ZONE MAP I certify thaT,m,the'.perFormance of INO the work}for which this " permrt,is issued, l shall not employ any person an qny manner ADDRESS ,!j �, SPECIAL, _ a ject to the Workers'Compensation Laws CONDITIONS so as to,become,sub , t. . ,'`, ., CIN ZIP �' U Date ^'Applicant ARCHITECT O / � . NOTICE,TO APPLICANT If,, after m6km This Certificate of ENGINEER, ro DISTRICT _GROUP TYPE FIRE PR CESSED BY Q Exemption, you;,should -become—subject- to, the-Workers' // �- (� p CONST w""' NE U Compensation;p,ovisions o'f the;Labor Code, you,must forth- ADDRESS C(� 1 �'`' 1_ `-+'= a with comply with such provisions or, this permit,shall be �1f/� / TELN deemed revoked. lh CONTRACTOR / NO ^p�Sp� STATISTICAL'CLQSSJFIJATION APT CO O Z LICENSED CONTRACTORS DECLARATION PP �9 UC CLASS NO 2 DWELL'UNITS ` ADDRESS � W, ) NO ' I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP m (commencing with Section 7000),of4Drvision 3,,of the Business - LIC and Professions Code,7 1{�?y license is rri•full force and effect " ' CITY , �� a CLASS' � BK p, VALIDATION 9 %// SQ FT'' - NO OF NO OF' t.CHECK License'Number ((! Lic Class SIZE -STORIES FAMILIES ONE � NEW El� VALUATION _ CRIPTION OF WORK D Q n - Coj� � , DES ntractor nDate , Elam-exempt'under Sec At , 'r�• -ADD ' ALTER ❑ - - )� B&P C•for this reason f iS • �� REPAIR- ate USE OF EXISTING BLDG "I'r "DEMOL ❑ Signature APPLICANT p /+' TEL FINAL' - OWNER-BUILDER DECLARATION' (PRINT)' !`�IL�ci I-+ c NO '(2� DAT ^ 't'" V I hereby,affirm that I am exempt from the Contractor's License r4DDRE�S �) �[�`�{�D ( � i I1 �� a - Law for the following reason, (Section 7031 5, Business and rg , `^' ` ' "`'�(' '" �b` � FIN 73 r �• _' ,Professions Code) PRESENT. BY.7XII 4= _ ' BUILDING ❑.' I, as owner of the property, or my employees with ADDRESS —s- -wages as their sole'compensation,will do the work and m ',� ' the structure is not intended or offered for sole(Section LOCALITY 7044, Business and Professions Code ) MOVING _ ,TEL _ •, ;�fT �•t> tC� = CONTRACTOR- NO ❑ ],`'os owner of the property, am exclusively contracting • with licensed contractors to construct the project (Sec- ADDRESS' �' 4^ tion 7044, Business and,Professions Code') ' REQUIRED,. TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY' PROP LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work'for which this permit is"issued, ••PL"* G�/ �' 2 S st-f't•' (Sec 3097, Civ C ) SIDE_ L'f, Ytti ' P L Lender's Name - 2 _ .CDMA Ref # Lender's Address P C.Fee$ Permit'Fee MV o 1 certify.that I have read this application and state that the Issuance Fee `v • LDMA P/C# 8 above information,is correct I agree To comply with al l County Investigation Fee ordinances and State laws relating To bullding'consfruction, Total Fee 'O LDMA Perm a he 'b authoriz representatives of This County o enter up ve- boned property for inspection p rpose ? a 79SEE REVERSE FOR EXPLANATORY LANGUAGE _ Signature of Applicant or Agent ate J WORKERS' COMPENSATION DECLARATION I hereby affirm that I haver cer"hfo p of consent to self insure,•or a certificate of Workers' Compensation Insurance,•'•• or a certified copy the�eof�(Sec 3800, Lab C )' s, y ; COUNTY OF LOS APdGELES' '" "BUILDING AND SAFETY- Policy No Q Com Par 4rr..1/j(1�/1) i� i/1/{ldf� - ' � BUILDING, �- Cerhfied c"opy is hereby furnished x FOR APPLICANT TO FILL IN ° ADDRESS El Ce ` Certified copy is filed with the county building ' y , inspec- tion•department " ADDRESS Dater Applicant! CITY• ZIP �- LOCALITY NO OF BLDGS NEAREST "CERTIFICATE'OF EXEMPTION FROM'WORK RS'. -�'JI SIZE'OF LOT NOW ON LOT CROSS ST COMPENSATION INSURANCE ASSESSOR `(This'sechon'neecl norbe cornpleted if the perm'it'is'for one TRACT BLOCK LOT NO MAP BOOK PAGE PARCEL -,hundred dollars ($100) or less )' ? TEL OWNER No-302' USE-ZONE MAP 67 .1 I certify'that'in the performance.of the work for which this SPECIAL } permit ississued,';I shall not employ'any person to any manner'`' ADDRESS CONDITIONS i1 so as to become subject to the Workers.CompensationQ CITY G ZIP ,� , U ^Applicant ARCH 0 OR TIL, DISTRICT' GROUP TYPE " FIRE PROCESSED BY Q'' NOTICE TO APPLICANT If, after making this Certificate of ENGINEER - NO CONST ZONE Exemption, you should.'become•subject to the 'Workers' .�;( U Compensation provisions of the Labor,Code, you must forth ADDRESS G°�O '�' �' �G���� d wiih comply with such provisions,or.this,,permit shall be EL,, STATISTICAL CLASSIFICATION _ :APT CONDO Z deemed revoked,. y_ CONTRACTOR/9 e. O LICENSED CONTRACTORS DECLARATION r LIC CLASS NO rel' DWEUL UNITS I hereby affirm that I am licensed under.provisions of,Chapter9 ' ADDRESS' NO 7111 1 SEWER MAP -, (commencing,with Section 7000)of.'Division 3 of the Business LIC r and Professions Code,and.my license is in full force and effect " CITY CLASS e BK—�e-/ VALIDATION T� J pp// SQ FT NO OF NO OF C ECK License NumberbFj�lj / 7.t71' Lic Crass G3� SIZE ^`Y STORIES FAMILIES ONE - > �• VALUATION Contractorl�i Gtr/P14��f Dote DESCRIPTION OF WORK �� ' ir' `NEW ❑ O ❑. ; ,MJr ADD ❑ `' 0,00_ ' i am exempt underSec .ALTER ❑ B&P C• for this reason /� �+ REPAIR u Date ...�, USE,OF _ - - „ ;. -..•. .. ., EXISTING BLDG DEMOL ❑_ Signature �7 ✓✓yl-�f����� APPLICANT, _ FINAL OWNER-BUIL t[XDECLARATION (PRINT)yjjiG /rK NO DATE s I hereby affirm that,I am exem t'from,the Contractor's License t Law`fof the following recison (Section 7031 5, Business and.. ADDRESS I$ fVt rC / - FINAL �_07 _05'. Professions Code) .. PRESENT By- - __t- BUILDING 2 1(�FI- ❑ I, as owner of the property;-or, my employees with ADDRESS �• Y, p� x wages as<their sole compensation,will do the work and " t i "-'� the structure,is riot intended or offered for sole(Section LOCALITY D 7044, Business.and Professions Coda-) MOVING'-'--❑ i - - TEL 5 :HSC�:I, as'owner of4he property, am exclusively contracting CONTRACTOR NO 00, 'with licensed contractors to,construct the.prolect (Sec- E��- S-t<ANGE ° ADDRESS tion 7044, Business and Professions Code ). ,REQUIRED TOTAL SETBACK FROM EXIST ' CONSTRUCTION"LENDING AGENCY SET BACK YARD 'HWY' PROP LINE WIDTH i ,. I'hereby'offirm that there is a construction lending agency for FRONT - , -- - - � _ (..U 1 1-_ the-performance of'the work for-which this permit is'issued PL" r' a '2I (Sec 3097, Civ G) SIDE 5 J i 7 lyi f it t° ` P L_ r Cender's Name _ - LDMA Ref•# _ Fee$ Peimit Fee 1 ', Lender s Address , I certify that I'have read this opplicahon'and state that the Issuance Fee lie• �� LDMA P/C# above info?matron is correct I,agree to comply with all County In-vestigation,Fee ordinances and State laws relating to building construction, Total Fee ✓ oC� LDMA Perm-# a and hereby authorize representatives of'this County to enter M_ upon.the above-mentioned property for inspection purposes ` a SEE REVERSE-FOR EXPLANATORY LANGUAGE• Signature of Applicant or Agent Date _ COUNTY OF LOS ANGELES TEMPLE CITY E # 0508. BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0506 1112220069 PHONE (626) 285-0488 EXT ILEGAL ID. I NO OF CONST BUILDING ADDRESS 1 ITR 7796 LT: 13 SQ FT STORIES TYPE 1 5442 LOMA AV 1 I (STRUCTURE V-B TEMP CA 917803003 (ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET BROADWAY I 15388-001-013 1 I THOMAS PAGE 596 GRID H4 LOCALITY TEMPLE CITY, Cl I I I I ITENANT (EXIST BLDG USE RESID USE ZONE R-1 (ISSUED ON PROCESSED BY I EXIST OCC GRP 112/22/11 SR (OWNER TEL NO- IBLDGS NOW ON LOT VALUATION IFINAL DATE FINAL BY CODE 15442 LOMA AVENUE TRUST - 1 12,000 1 i 1 15442 LOMA AV I L/ ITEMP 917803003 FEES PAID IDE,�CRIPTION OF WORK IKITCHEN REMODEL, 3 BATHROOMS AND REPLACE 18 WINDOWS I IFEE DESCRIPTION QUANTITY UOM AMOUNT I J 1APPLICANT TEL NO I I I (SAME AS OWNER - 1AA BLDG PERMIT ISSUANCE 27 80 IAB STATE GREEN BLDG FEE 12000 00 VAL 1 00 ISPECIAL CONDITIONS I 1 IAC STRONG MOTION RESID 12000 00 VAL 1 20 1 I 1 JB2 PERMIT W/ENERGY 12000 00 VAL 276 00 1 1 JFR INV WORK W/O PERMIT 257 00 DOL 257 00 I ICONTRACTOR TEL NO I TOTAL FEES 563 00 JAPPROVALS DATE INSPECTOR SIGNATURE I ISAME AS OWNER - I LIC NO 1 ILOCATION AND SETBACKS I I I ISOILS ENGINEER APPROVAL I 1ARCHITECT OR ENGINEER TEL NO I IFOUNDATION/TRENCH FORMS I I I LIC NO I (SLAB/UNDER FLOOR I I IRAISED FLOOR FRAMING IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP I JUNDERFLOOR INSULATION I I I147H265 3 001 I I I IFLOOR SHEATHING I J I INO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS I I I I 0 NO 21 1 IROOF SHEATHING I I I SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I JAIR QUALITY 1000 FEET MATERIALSI_ I NO NO NO 1 I FRAME INSPECTION I I I IFIRE SPRINKLER HANGERS I J 11NSULATION/WEATHER STRIPI I I I 1 JINTERIOR LATH/DRYWALL I 1 I I I J I EXTERIOR LATH I I I I 1 IRATED FLOOR/CEIL ASSEM I, 1 I I I I I I I I IRATED WALL ASSEMBLIES I I I IRATED SHAFTS/OPENINGS I I I IT-BAR CEILINGS I I I I I I to ILOT DRAINAGE J I I IREPORT ID DPR261 ROUTE TO BS0508 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 0605160014 PHONE (626) 285-0488 ERT LEGAL ID NO OF CONST BUILDING ADDRESS TR- 7796 LT: 13 SQ. FT STORIES TYPE 5442 LOMA AV STRUCTURE: VN TEMP CA 917803003 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET. BROADWAY 5388-001-013 THOMAS PAGE: 596 ,IGRID H4 LOCALITY TEMPLE CITY, C TENANT: EXIST BLDG USE: RESID USE ZONE R-1 ISSUED ON: PROCESSED BY EXPIRES ON EXIST OCC GRP. 05/16/06 JK 05/11/07 OWNER TEL NO: BLDGS NOW ON LOT VALUATION FINAL DATE BY, CODE STRICKLER ERROL;DEANNE J (626) 309-9204- 500 5442 LOMA AV TEMP 917803003 FEES PAID DESCRIPTION OF WORK CONVERTED CLOSET INTO BATHROOM FEE DESCRIPTION: QUANTITY. UOM: AMOUNT. APPLICANT TEL NO: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27 75 AC STRONG MOTION RESID 500 00 VAL 0 50 SPECIAL CONDITIONS: B2 PERMIT W/ENERGY 500 00 VAL 48 02 TOTAL FEES 76 27 ' CONTRACTOR- TEL NO: APPP)VALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC NO - LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER. TEL NO FOUNDATION/TRENCH FORMS ' LIC NO: SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE FIRE ZONE: CMP UNDERFLOOR INSULATION XX 3 0' _ FLOOK SHEATHING NO OF FAMILIES DWELLING UNITS APT COND: STAT CLASS NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAF PANELS AIR QUALITY. 1000 FEET MATERIALS NO NO NO FRAM-, INSPECTION REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS SET BACK YARD HWY PROP LINE: WIDTH: FRONT PL- INSULATION/WEATHER STRIP SIDE PL- INTEF:IOR LATH DRYWALL EXTERIOR LATH RATED FLOOR CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS OPENINGS T-BAR CEILINGS LOT LRAINAGE REPORT ID DPR261 ROUTE TO BS0508