HomeMy Public PortalAbout6250 LOMA AVE_Building__ 76A638A 05S.3 12.54
APPLICATION FOR, BUILDING PERMIT
DIVISION OF BUILDING AND SAFETY ADDRE SS
NG
Deportment of County Engineer ' ADDRE
County of Los Angeles LocALITY e Yb'� P i- C l
WM. J. FOX, COUNTY ENGINEER
t - CASSATT D. GRIFFIN, SUPT OF'BU1LDING NEAREST ,Ca j I„
CROSS ST
DISTRICT NO. GROUP SEWER MAP
CATOILL IN
FOR APPLINT FI TYPE �_PS��
BUILDING - CONST.
ADDRESS MAP STATE YES O
NUMBER HWY
I� LOT NO. Dfs 7 BLOCK USE ZONE SPECIAL
ITI
C -
TRACT
NO OF-BLDGS.
SIZE OF LOT oX NOW ON LOT I BUILDING YARD HWY STREET NAMEUSE EXIST.
O .p �p SETBACK WIDTH
-EXISTING BLDG Co J Cv. �V ,FPROL T
OWNER SIDE '
_
MA'L
P L
d y
ADD '
//� TEL. •'. DWELL 1 UNIT ' 5- INDUSTRIAL
CITY , e �+ T --
2t DUPLEX_UNIT 6 PUBLIC BLDG.
ARCHITECT O� TEL. -
ENGINEER sem - NO 3 APT UNITS 7 ADDN,ALT., ETC. _
ADDRESS 4COMMERCIAL 8 MISCEL
/J TEL. `
CONTRALTO NO. INSPECTION RECORD
X 1
ADDRESS #
DESCRIPTION OF WORK
NEW ADD //LTER REPAIR DEMOLISH
F' j-- T /V .T
SQ FT. '1 NO. OF NO OF
SIZE �f STORIES FAMILIES
USE =t
USE OF STRUCTURE \ /� �
SIGNAT ' - -
APPLI N ,r APPROVALS
ADDRESS DATE - INSPECTOR'S SIGNATURE
FOUNDATION' LOCATION
OD P'C. S FORMS, MATERIALS -
((�� FEE FRAME' FIRE STOPS, p�er///
S O IBRACING;BOLTS I rJ FRy-/,,,,
VALUATION '-'--- O
FEE s FURNACE LOCATION,
I GAS'VENT, DUCTS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
APPLICATION AND STATE'THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT.
AND STATE WS REG TING ILDIN CONSTRUC-
TION. LATH, EXT.
SIGNATURE O - HOUSE NUMBER COR-
PERMITTEE IRECT AND POSTED
ADDRESS FINAL
WM.'J. FOX. COUNTY ENGINEER VALIDATION
BY
x'9:6-3Ln WR25 1 - 2.0'0
DEPUTY-: L,-7 - - DEPUTY
By .. , �,,,• BY
® DEPUTY - DEPUTY
DEPARTMENTCOUNTY OF LONGELESAFETY �I _6 -
WM. J. FOX, CHIEF ENGINEER APPLICATION®�
S A
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
p� / `1 DISTRICT NO. PLANCK. oR REc:No. - - PERMIT NO.i
BUILDING ADDRESS �j pd,,, �1,[J �/ ,Af] �>pI.AAhFiA ��I�i/ !'
�� �� � � o � /? RECEIVED BY - DATE OF APPL DATE ISSUED
LOCALITY �I. I� �, Z- y'-,s r/ _5--�t-Z
NEAREST
CROSS ST. 1 k 1 BUILDING /
ADDRESS (p/� f Q ft O A4 •Q
OWNER l�1/ �� LAP) tnsjl1 MN f IAA
-MAIL —'� LOCALITY-7:;_,,o J G/.
ADDRESS NEARESTOf
_
�l.r //►y, ,` �s + CROSS ST. ,
CITY '/ �WA_g>/A, 6. V NO. � ^J �� FIRE NO. F TYPE GROUP
ARCHITECT ORi� - TEL J p• ZONE I— I PLAfl
_
ENGINEER �1Y�1q{ (L{y�/ ` C'//4MO.p� ^[� �9 BLDG. ORD: NO.
ADDRESS �.4 Q /`� /� O`bL�CI 1 l 1 SETBACK,LINE •a `��� ��
USE APPROVED '
TEL ZONE BY DATE
CONTRACTOR +B (NNO.��I /!j �.� HOUSE NUMBERING
ADDRESSMAP NUMBER
t NO. ASSIGNED BLEGALY
DESCRIPTION LOT NO. BLOCK ` CORRECTIONS 1
0 t i
TRACT
No OF
SIZE OF LOT .6 I NOW ON LOUSE OFT
B�
OF
EX STN BLDG. �� {/� (� VISI I FAM
ILLIES
DESCRIPTION OF WORK
NEW ALTERATION ADDITION �� Z
REPAIR DEMOLITION r
i
9 ZE ROOMS �`j FT NO.or
STORIES -�
COVERINGEXT.WALL COVERING-C;k1
USE OF STRU rrU E
�.
e4< 9 RA )N.46 �
H#s 4 M4-k �Vl� VIA 19 :fig! 4Vtwn AWlN,i
I SPECTION FOR } APPROVALS -
OCCUPANCYAS INSPECTOR'S SIGNATURE DATE
FOUNDATION: LOCATION
FORMS, MATERIALS
I HEREBY ACKNOWLEDGE THAT I HAVE READ TH19 AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN IS' FRAME: FIRE STOPS,
CORRECT. BRACING, BOLTS
1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION,
AND-STATE LAWS REGULATING BUILDING CONSTRUCTION: GAS VENT, DUCTS
SIGNATURE OF � 4 A ��T�_ LATH. INT.
PERMITTEE moi'�,// filCe4
ADDRESS 4, -ax V �'��a /�/���!' LATH, EXT.
Q � PLASTER, INT.
AUTHORIZED AOT.
PLASTER, EXT. wt jo
'60
P.C.$
FEE HOUSE NUMBER COR-
dL RECT AND POSTED C
VALUATION FEE — FINAL
76A639A DBS 3 7-51
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY-OF LOS ANGELES ® — G
UILDIN
WM. J. FOX, CHIEF ENGINEER V ®
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
/J DISTRICT NO.- PLAN CK.NO. •�JPEE,RMIIT NO.
ADDRESS (D.JU /yV�•7,G,.CO ?' ' �l ,
LOCALITY ����/!-',LLQ ' /T/• �AL��' RECEIVED BY, DATE OF APP_L..[,/ DATE•ISBUED
NEAREST- / /� `' ��yl y�1 �. iJJ
CROSS 9T. L.. /V L7�G AY 6 /L B�E/>'�[.A!/
BUILDING3�
_ OWNER ADDRESS.
/ 0MAIL //r/�'r��/�/// /7��VA���V�f� �
,!O�/� //� /� • �/ LOCALITY
ADDRESS •.� - `J '
NEAREST
p�j a /6
CITY �"�/�`��z V,�� 'NO. /' (�/ CROSS ST. - Y�L/C% Z}�..�.� �►A�-`
_ _ FIRE NO.OF TYPE- OROUIi
ARCHITECT OR -i1 /O'A� y NOEL, ZONE "^� -'PLANH,b -
-ENGINEER
BLDG. ORD.NO.
ADDRESS SETBACK LINE '
APPROVED
CONTRACTOR L.`'`Q Np, �9 BY DATE
yrt A I' USE /Q J APPROVED
ADDRESS (J d��7 y£ ZONE'%�� BY - DATE
LEGAL
DESCRIPTION LOT NO. f l BLOCK CORRECTIONS
TRACT %5/D -
i O%�V/Q C7�7 C I -NO.OF BLDOH. - -
SIZE OF LOT V NOW ON LOT
USE OF p ,I1c p� NO.OF NO.OF /^ '
EXISTING BLDG.fjf.V S)VlC�+ FAMILIES/I ROOM9�C/
DESCRIPTION OF WORK
NEW ALTERATION ADDITION -
O
REPAIR MOVING DEMOLISH 0
Bq.FT. Noor Z
SIZE V ROOMB STORIES D
WALL R OF
/Q' � `�y r
COVERING i ,./ AV -ICy/OVERINl ( /� 'asn'04
USED
BU LDFINGW D ' L/O 40"/
ucp
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVA
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION 1 $PECTOR DATE
AND
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
FRAME: FIRE STOPS, ,
SIGNATURE OF � r�/ / BRACIND,BOLTS
PERMITTEE LATH,INT.:
AUTHORIZED A13T- LATH,EXT.:
DBS-3 SOM SETS 7-47 P.C.lO - PLASTER,INT. /
FEE y PLASTER,EXT.
� v
VALUATION FEE L- FINAL !��
ADBS-3
11.55 APPLICATION FOR BUILDING PERMIT 5
� I1•55
DIVISION OF BUILDING AND SAFETY BUILDING
Department of County Engineer ADDREss
County of Los Angeles LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROUP- SEWER MAP
TYPE..�_._.__..
FOR APPLICANT TO FILL IN /-bK PG
CONST.
BUILDING MAP STATE YES NO
ADDRESS NUMBER HWY
LOT NO. BLOCK USE ZONE SPECIAL
CONDITIONS
TRACT
NO. OF BLDGS.
SIZE OF LOT [NOW ON LOT BUILDING YARD HWY STREET NAME EXIST.
USE OF SETBACK WIDTHt
EXISTING BLDG. FRONT
P. L.
OWNER - SIDE
P. L.
MAIL
ADDRESS O TRACT DWELL. 1 UNIT 5 INDUSTRIAL
TEL. I DWELL. 1 UNIT
CITY NO. 6 PUBLIC BLDG.
ARCHITECT OR TEL. 2 DUPLEX 2 UNITS
ENGINEER NO. 7 ADDN., ALT., ETC.
3 APT. UNITS
8 MISCEL.
ADDRESS L} COMMERCIAL
TEL.
CONTRACTOR NO. INSPECTION RECORD
I
I ADDRESS
DESCRIP-TION OF WORK
I
i
NEW ADD LTER EPAIR DEMOLISH
SQ. FT. NO- F NO. OF
-SIZE ORIES FAMILIES
USE OF STRUCTURE
SIGNATURE OF
APPLICANT_
PPLICANT APPROVALS
ADDRESS DATE INSPECTORS SIGNATURE
_ FOUNDATION: LOCATION
P. C. $ FORMS. MATERIALS
FEE FRAME: FIRE STOPS.
VALUATION $ j BRACING. BOLTS
FEE FURNACE: LOCATION,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT, DUCTS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT.
AND STATE LAWS REGULATING BUILDING CONSTRUC-
TION.
LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS FINAL
ON
JOHN A. LAMBIE, COUNTY ENGINEER ,/VALIDATION CLYDE N. DIRLAM, CHIEF BLDG. INSPECTOR
'i CK /MO CASH
76A638A CE#803 4--68 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY _
JOHN A. LAMBIE,COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST.
DISTRICT NO. [7TF37P I TYPE I PROCESSED BY
FOR APPLICANT TO FILL IN - CONST.
BUILDING I SEWER MAP
ADDRESS STATISTICAL CLASSIFICATION BK PG
CLASS. NO. DWELL. UNITS
LOT NO. BLOCK MAP STATE YES NO
NUMBER HWY.
TRACT USEZONE
SPECIAL
NO.OF BLDGS. CONDITIONS
SIZE OF LOT OW ON LOT
USE OF '1 s
EXISTING BLDG. BUILbiNG EXIST.
SETBACK YARD HWY STREET NAME W)'TH
OWNER FRONT
MAIL P.L.
ADDRESS SIDE
TEL. P.L.
ARCHITECT OR NO. INSPECTION RECORD
ARCTEL.
ENGINEER NO.
ADDRESS
TEL.
CONTRACTOR NO.
ADDRESS
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH
SQ. FT. NO.OF NO.OF
SIZE STORIES FAMILIES
USE OF STRUCTURE
SIGNATURE OF APPROVALS
-
APPLICANT
DATE INSPECTOR'S SIGNATURE
ADDRESS FOUNDATION: LOCATION
FORMS.MATERIALS
$ P.C. s FRAME: FIRE STOPS,
FEE BRACING, BOLTS
VALUATION $ FURNACE: LOCATION,
FEE GAS VENT, DUCTS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH. INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS- REGULATING BUILDING CONSTRUCTION. LATH, EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS FINAL
CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
®F
� t
WORKERS'COMPENSATION DECLARATION l
I hereby affirm that I havecertificate of consent to self �1 ��hf O(�n10101120
-�
insure, ora certificate of Workers' Compensation Insurance, v �fv Lf' �fUU
-
ora certified copy thereof (Sec 3800, Lab C ) A LJL u U�.) '
Policy No Company COUNTY-OF LOS ANGELES BUILDING AND SAFETY
Certified copy is hereby furnished FOR APPLICANT�TO�FILL•IN BUILDING
ADDRESS -2 "
Certified copy is filed with the county building mspec- BUILDING
tion department ADDRESS 4/+ cv— LOCALITY
NEAREST
Date Applicant CITY ZIPTZ Z8�
CROSS ST
CERTIFICATE OF EXEMPTION FROM WORKERS' O 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 TRACT BLOCK LOT NO USE ZONE NOP o�O O
hundred dollars-($100)or less ) of
'ITL r+! SPECIAL >.
I certify that in the performance of the work for which,this OWNECL
R � 6 CONDITIONS '
'permit is issued, I shall not employ any person in any manner DI TRICT GROUP TYPE FIRE PR ESSED BY O
so as to b e subject to the�loq�cers' mpen ion 1Vws ADDRESS b � • CONST ZONE ^- Ix
w /
Date fipplecant CITY^_ ZIP �• STATISTICAL CLASSIFICATION - APT JCONDO O
ARCHITECT TEL
NOTICE TO APPLICANT- If; after making this Certificate of - ' ENGINEER NO U
Exemption, .you should become .subject to the Workers' CLASS NO DWELL UNITS a
Compensation provisions of the,Labor Code, you must forth- ADDRESS, SEWER MAP fA
with comply with such provisions or this permit shall be _
deemed revoked CONTRA L BK �PG, � VALIDATION
LICENSED CONTRACTORS DECLARATIONLIC
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO fVALUATION
(commencing with Section 7000)of Division 3 of the Business and �� LIC Q� ,
Professions Code, and my license is in full force and effect CITY CLASS 00. D
SQ NO O OF CHECK
License Number Lic Class SIZE STORIES FAMILIES ONE
Contractor Date DESCRIPTION OF WORK
NEW $
ADD
1 am exempt under Sec
ALTERFINAL
B.BP C for this reason REPAIR DATE
EX OF O
at EXISTING BL DEMOL FINAL NAL o.+
APPLICANT TEL Y
Signature PRINT NO
OWNER-BUILDE DECLARA ION
I hereby affirm that I am exempt from the Contractor's License D
Law for the following reason (Section 7031 5, Business-and ADDRESS
Profe ns Code): 2 9 3 3 A
BUILDING
I, as owner of the-property, or my employees'with ADDRESS
wages as their sole compensation,will do the work and
the structure is not intended or offered for sale(Section LOCALITY # o 0 010 0.1
7044, Business and Professions Code) MOVING TEL 20 0 9 7 5
1, as owner of the property, am exclusively contracting CONTRACTOR NO
with licensed contractors to construct the project (Sec- ADDRESS 9 7,5 '
tion 7044, Business and Professions Code)
REQUIRED TOTAL SETBACK FROM EXIST
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE WIDTHD 0 Q 1 7-81.3
1 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
m PI: '
v Lender's Name ll
Lender's Address PC Fee$ Permit Fee ,oG
1 certify that I have read this application and state that the Issuance'Fee /U S 0
above information is correct I agree to comply with all County Investigation Fee
g ordinances and State jaws relating to building construction, Total Fee (/ "7
d and hereby authorize representatives of this County to enter
upon t e above-mentio ed r pert °C inspectionurpos s '
SEE R�,;,4- EVERSE FOR EXPLANATORY LANGUAGE
^ ®<
Signature of Applicont or Agent e •
ti
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 0209170038
PHONE: (626) 285-0488 EXT:
-LEGAL ID: NO. OF CONST B G S:
TR: 5904 LT: 272 SO. FT STORIES TYPE 6250 LOMA AV
STRUCTURE: VN TEMP CA 917801634
ASSESSOR0 N NEAREST CROSS STREET: LONGDEN
5384-011-008 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY
D U S SSD ON:
EXIST OCC GRP: 09/17/02 JK 03/16/03
OWNER: TEL. NO: BLDGS. NOW ON L LUATION: FINAL DATE FINAL BY: CODE:
HAWKINS THOMAS W (626) 447-5258- 500 y(�
414 FAIRVIEW AVE 1/-1-3
ARCADIA 91007 5ff§ffflT N OF WORK
REROOF GARAGE
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
APPLICANT:
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION RESID 500.00 VAL 0.50 SPECIAL CONDITIONS:
D2 PERMIT W/O ENzHC=_=_= 500.00 VAL 43.65
=TOTAL—FEES 71.90
CONTRACTOR: TEL. N0: P�PROVALS DATE INSPECTOR SIGNATOR
SAME AS OWNER
LIC. NO ON S
SOILS ENGINEER APPROVAL
ARCHITECT OR NG ER: TEL. ��, --�� � � NAT
LIC. N0:'; I ; LA UNDER FLOOR
� r
; �,� RAISED
AP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: — J - UNDERFLOOR INSULATION
153H265 3 11 O1 T!1 ji�, „(�>> �,,�, ,�/, �,�, ,;,�%� <?
OF FAMILIES: DWELLING APT/CO: SAT CLASS: -�/'' FLOOR SHEATHING
ROOF SHEATHING 2
SC N HAZARDOUS
AIR QUALITY: 0
100 FEET MATERIALS
NO `.� � 1_ AM INSPECTION
REQSE
FIRE S NK E G
SET BACK YARD: HWY: PROP LINE: WIDTH: A, ��-� _ � �
FRONT PL-
SIDE PL- INSULATION/WeATHER STRIP
WTERFfi LATH/DRYWALL
EXTERIOR LATH
RATED F L ASSEM.
RATED WALL ASSEMBLIES
RATED S OP NIN S
TEAR C E IL rN—GT—
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508