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Home My Public Portal About5635 LOMA AVE_Building__ I , DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS'ANGELESDING �' WM. J. FOX, CHIEF ENGINEER FOR APPLICANT-TO FILL IN FOR OFFICE USE ONLY DISTRS O. PLA CKNO PE O BUILDING � .3/, ADORE SS ( s(v/Sl , LOCALITY, RECEIVED BY DATE OF APPL. DATE ISSUED NEAREST •� //`''/��y" ��+ CROSS ST, .. �,� ,..� - .—BLrILDING �1 ADDRESS 3 /,o,d OWNER e. C. I �'�69lrer--✓�e�.lv / . `'C. MAIL. ` � � LOCALITY ADDRESS .6 �j` �• .-tib NEAREST TEL. CROSS ST. CITY NO. FIRE NO. OF Ty% • : G, P ARCHI E T OR- TEL. ZONE PLANS �� I \31 I 'ENGINEER „�t.(,•,�,�.-a,M- NO. - BLDG.CK LINE �J I ,- .ADDRESS, �' APPROVED TEL r BY DATE CONTRACTOR ... NO. USE APPROVED ' " � �• - ZONE A BY DATE - ADDRESS 9'D.S !� t �,a,-® , C ♦ _ HOUSE NUMBERING LEGAL `+ DESCRIPTION I LOT NO, tS. I BLOCK - MAP NUMBER OT6 FIELD CHECK BY' TRACT (p ! . NO. ASSIGNED BY �ATEA r —M-w NO. OF BLDGS. - CORRECTIONS- SIZE OF LOT 11,Xr I NOW ON LOTen.Q'----i USE OF I NO. OF . , EXISTING BLDG. FAMILIES DESCRIPTION OF WORK NEW I ALTERATION I I ADDITION. I "y i - •- ' REPAIR I, I DEMOLITION SQ. / NO. OF n SIZEFT. �6 .ROOMS STORIES Y EXT. WALL '�" - ROOF - r COVERING " - I COVERING, .' USE OF STRUCTURE 0 - e as XF6, APPROVALS INSPECTOR-'S SIGNATURE DATE I HEREBY'ACKNOWLEDGE THAT 1 HAVE READ THIS AP FOUNDATION: LOCATION PLICATION AND- STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS •,,,: /-Z CORRECT. , '1 AGREE TO COMPLY WITH THE CORRECTIONS LISTED 'FRAME: FIRE STOPS, (/ ��s,11 HEREON AND WITH ALL COUNTY ORDINANCES AND STATE" BRACING,,BOLTS LAWS REGULATING B ILDIVG :CONSTR CTION. . . FURNACE: LOCATION, SIGNATURE•OF 4/xj GAS VENT, DUCTS PERMITTE LATH, INT.. n e ✓✓�` ✓ ADDRESS .. ♦ ,a :�, //, / LATH, EXT. ' AUTHORIZED AGT. - PLASTER, INT. 7CA688A D888 10-50 /g-� P. C. $ 5� ® - 7 /p.0�0 FEE �� - PLASTER, EXT. / VALUATION Is FEE ,� -�--. FINAL '>r= .-,.�-• •��-- I 76A638A E 803 B-64-APPLICAT'ION FOR BUILDING PERMIT . COUNTY OF LOS ANGELES BUILDING 1 1+' DEPARTMENT OF COUNTY ENGINEER ADOREss J a F BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS.,SUP•T.OF BUILDING -CROSSST. DIST�jCT NO., G TYPE. ePR D. FOR APPLICANT :TO .FILL IN CONST. BUILDING /n• STATISTICAL SIFICATION S -WER AP ADDRESS r /t/• CLASS NO. DWELL UNITS BKPG. 6J2 LOT NO. - - - BLOCK U O MAP. - lam/ _ NO. TRACT - SPECICONDAL ONS NO. OF BLDGS. _ SIZE OF LOT NOW ON LOT USE OF - G lt.F e.. BLDG. SETBACK FROM - TEL. FRONT PROP. LINE OF (STREET) OWNER, O NO• fs- TYPE OF EXISTING I SETBACK HI GHW'AY + YARD = ..TOTAL ADDRESS HI .HWAY WIDTH I'FRQM C.L. C I T Y e/l-,, 6`'C o ,-5—0 +. ARC HI TEC OR TEL. BLDG. S TRACK FROM ENGINEER NO. - SIDE PROP. LINE OF (STREET) TYPE OF EXISTING SETBACK' HIGHWAY -+ YARD _ TOTAL } ADDRESS HIGHWAY WIDTH FROM C.L. C TEL. + _ 0 CONTRACTOR NO LIC ADDRESS NO CORNER CUTOFF YES NO O N CITY LIC SEE REVERSE SIDE FOR SPECIAL APPROVALS w DESCRIPTION OF WORKI / / CL. NEW ADD ALTER REPAIR DEMOLISH :�!,� \ "� SQ.FT. NO. OF NO. OF SIZE STORIES FAMILIES USE OF STRUCTURE OC7r► - `' fi • .,v ¢ori A" , SIGNATURE O APPLICANT VALUATION$ QQ (�— - "/'' "- APPROVALS DATE INSPECTOR'S SIGNATURE �/ FOUNDATION, LOCATION � �.•� FEE$ FEE$/ FORMS.,_MATERIALS #bol FRAME, FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ° BRACING BOLT .1re1 AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION ('g,/qp Y sF�.•v/'w WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING, GAS VENT. DUCTS 93UILDING CONSTRUCTION, I CERTIFY THAT. IN DOING THE WORK rte' AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH. INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. ING TO WORKMEN'S COMP N TIO NSU RANCE. LATH. EXT. �� 4 SIGNATURE HOUSE NUMBER COR PERMITTEE RECT AND POSTED. -7 7 ' ADDRESS FINAL. ®�-Y.l,�� JOHN.F. LEWIS. PRINCIPAL STR RAL ENGINEER PLAN CHECK VALIDATION K. M.O. CASH _ PERMIT VALIDATION cK. M.O. CASH r> J 76A638A CE #803 12/69 APPLICATION FOR' BUILDING PERMIT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL B_ UILDING AND SAFETY DIVISION BUILDING 5� ezJ JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY .FOR APPLICANT TO FILL IN NEAREST Print ort a only) CROSS ST. BUILDING DISTRICT NO. GROUP TYPE CONST•. ESSE ADDRESS 635 North Loma - :5_ -`-^ Z �� D BY STATISTICAL CLASSIFICATION SEWER MAP LOT NO. BLOCK CLASS NO. ;L;�'/ DWELL,UNITS BK PG 6� TRACT - USE ZONEMAP NO.OF BLOGS. NO. SIZE OF LOT NOW ON LOT - / SPECIAL USE OF CONDITIONS EXISTING BLDG, TEL. OWNER Arthur Johnson NO. BLDG.SETBACK FROM ADDRESS Same..- FRONT PROP.LINE OF (STREET) TYPE OF STING SETBACK HIGHWAY } YARD = .TOTAL CITY Temple City HIGHWAY WI FROM C.L. ARCHITECT OR TEL. ENGINEER NO: BLDG.SETBACK FROM ADDRESS SIDE PROP.LINE OF (STREET) TEL p TYPE OF EXISTING SETBACK HIGHWAY T. YA = TOTAL CONTRACTOR Roof C,D� NO. 287-0507 HIGHWAY WIDTH FROM C.L. - ADDRESS 600, S. Sari Gabriel Bl;o`' 160650 - + I a CITE' San Gabriel 91776 CLASS C-39 - CORNER CUTOFF YES' E] NO ❑ U CONSTRUCTION LENDER � O NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS W ADDRESS CL h SQ. FT. NO. OF NO. OF NEW ❑ z SIZE STORIES 1 FAMILIES USE El STRUOCTURE eroof With Z-354�t ADLTER ❑ - - composition. shingles REPAIRQ - SIGNATURE OF APPLICANT �/� DEMOL El .. - VALUATIONS 9ytp/.00 - APPROVALS; - DATE INSPECTOR'S SIGNATURE I P.C. PMT. FOUNDATION: LOCATION FEE S FEE� 00 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. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANYL.PERSON IN VIOLATION OF THE LATH, INT, LABOR CODE OF THE TATE OF 'CALIFORNIA IN RELATING TO' WORKMEN'S CO MPENSAT INSURANCE. LATH, EXT, - SIGNATURE OF. _ HOUSE NUMBER COR- PERMITTEE - RECT AND POSTED ADDRESS FINAL F JOHN F. LEWIS. PRIN IPAL TR TUR N 'INEER PLAN CHECK VALIDATION CK. M.O. -CASH _ PERMIT VALIDATION CK. M ASH ` too 2 :. .:rui! 1,;0 COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ApDs� III I hereby affirm that l have a certificate of consent to self insure, But1 D SS "or a certificate of Workers' Compensation;Insurance,Or a certified ��y LO copy thereof(Sec.38017,.Lab.C.) C/ % ZIP t O Policy No. = Company ( ( CAUTY / . _ SIZE OF LOT;'- � NO:OF�BLDGS.NOW ONLOT �. ❑ Certified copy is hereby furnished. S(� — �j, Z NEAREST CROSS'ST. ❑ Certified copy Is filed with the county building inspection TRACT BLOCK LOT NO. •department.. ' 3 ".� USE ZONE -. MAP NO. - �_ ASSESSO P Q - ' PAGE PARCEL - Date Applicant- SPECIAL CONDITIONS' -CERTIFICATE OF EXEMPTION FROM WORKERS' • O � TEL NO. - COMPENSATION INSURANCE WITHIN 1000 FT OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred AD /Ss�s/� ` ,. ' dollars($100).or less.).' 1 ` "' DISTRICT GROUP 7 ZONE Y 7� DIST (j GRO TYPE CONST. FIRE NE PROCESSED 6 I certify that in the performance of the work.for whi _this permit. O/`�y� QIP �'�� is issued, I Shall not employ an erSon in any neer SO aS t0 ARCHITECT�{OF�^EN IN R - - TEL NO. become subject to the Worke s'CO nsation ws. ��/ STATISTICAL CLASSIFICATION APT CONDO Date` 3Applicant ADDRESS .' - CLASS NO. ��" 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' • - TEL NO. SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor,Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS - LIC.NO. _ P L - .. LICENSED CONTRACTORS DECLARATION PILE CITY LIC.CLASS '� PL I'hereby affirm that I am licensed underprovisions of Chapter 9 FEWER MAP (commencing with Section 7000)of Division 3 of the Business and. SO.FT.SIZE NO.OF/OR NO.OF FAMILIES } Professions Code,and my license is in full force and effect. J Q ' - NEW BK PG- Professions a License Number Lic.Class' DESCRIPTION OF WORK- ADD ❑ VALUATION Q U Contractor Date ALTER cc El SLREPAIR ❑, ❑.I am'exempt under Sec. _ O' BAP.C.for,this reason DEMOL ElLDMA PIC# W Date: USE OF EXISTINGBLDG. . - •URM I,❑. Signature: a Z - APPLICANT(PRINT - r TEL NO. - LD_MA Perm# . ❑ I, as owner of the property, or my employees with wages as - g ' .! their sole compensation, will do the work-and the structure is ADDRESS .. FINAL:DATE".`.-. .. .....: ._. .._.� -, •-,_ r, not intended or offered for sale (Section 7044, Business anda •i 0 = f F Professions Code.) WILL THE APPLICANT'OR FUTURE BUILDING OCCUPANT,HANDLE A HAZARDOUS MATERIAL t=_ , OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE .. 1IJ • a _ ❑ 1, as owner Of the property, am exclusively contracting With .AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE?- licensed contractors to construct the project. (Section 7044, '- :, (ITi�'`s ' G � -. ,FINAL,BY _ ... .. 90 BUSIneSS and PfOfeSSIODS Code.). .. ._ YES❑. NO❑' - 1 - 1 HL .L� C m WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT {{ y�i '- OCCUPANT REQUIRE,A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH - - ,1' ECK S P o/L CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR-..... .. ... .. __,:...._.._,. _. .. jr {'� GUIDELINES. _ e00 I hereby affirm that there is'a construction lending agency"for :'vEs❑ No❑ __. _. w _the performance of.' the work for which this permit IS issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND�THE SCAOMD PERMITTING 3097,CIV.C.)' CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS.ANGELES COUNTY'CODE,. y a TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS _!ie —1_IIh i 5/19/93 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. - o Lender's Address Hsi 9 O OWNER OR AGENT o I certify that I have read this application and state-under,penalty o - of perjury that the aboveinformation is correct. I agree t0 comply P.C.FEE PERMIT FEE with'all "county ordina s' and:•State laws relating to building uction, and'her y authorize representatives of this County ISSUANCE FEE l— o ente upon the ve mentioned property for insp tion urposes lf� a INVESTIGATION FEE TOTAL FEE r - Signat re of Apoiicant or Agent Da SEE-REVERSE FOR EXPLANATORY LANGUAGE