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HomeMy Public PortalAbout9549 LAS TUNAS DR_Building__ I ©S 76A638A 1 CE#803(REV.6/781 � „ /' �i'�, ` �� �•• �. _ APPL.IGATIO FOR BCJI ING PERMIT f ' COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDING' ADDRESS _s BUILDING ADDRESS tom �3. ) LOCALITY NEAREST CITY L ZIP ``'• CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT D NOW ON LOT MAP BOOK PAGE I PARCEL TRACT ,� (p f BLOCK.: AOT N�4 DISTRICT GROUP TYPE FIRE CESSEDBY CONST. ZONE pp TEL.. ut,xY- 3. OWNER Co� NO. STATISTICAL CLASSIFICATION SEWER MAP/) ADDRESS 4- CLASS NO. DWELL.UNITS'___�j L— BK C3-� CITY ZIP ARCHITECT OR TEL VALUATION $ ENGINEER NO.' ADDRESS BLDG.SETBACK FROM TEL. FRONT PROP.LINE OF (STREET) CONTRACTOR5=%-- L4 is N Y TOTAL SETBACK FROM TYPE OF EXISTING LIC'` HIGHWAY_ + YARD. .= FRONT PROP.LINE HIGHWAY WIDTH ADDRES 47 (7 O. c d LIC. + CITY �•�&. CLASS CONSTRUCTION LENDER BLDG.SETBACK FROM . SIDE PROP.LINE OF (STREET) NAME AND BRANCH HIGHWAY + YARD — TOTAL SETBACK FROM TYPE OF EXISTING IL ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH ®- SQ.FT. NO.OF NO.OF CHECK + = u SIZE STORIES FAMILIES ONE ^'//�� DE CR(PTION OF WORK C NEW ❑ P.C. Fee$ C:-1`(�(! Permit Fee 7 1 ADD ❑ Issuance Fee ❑ �© z REPAIR ❑ Total Fee USE OF elf DEMOL EXISTING BLDG, ZG APPLICANT TEL (PRINT) NO. Q BY(SIGNATURE) 6 o Y I HEREBY ACKNOWLEDGE THA' A E READ THIS APPLICATION AND STATE m THAT THE ABOVE 15 CORRECT AND REE TO COMPLY WITH ALL ORDINANCES LU AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT-IN DOING THE _ WORK AUTHORIZED HEREBYW ILL NOT.EMPLOY ANY PERSON IN VIOLATION OF ! d - r7,�' U THELABOR CODE OF THE STATEOF CALIFORNIA•IN RELATING,TO WORKMEN SCOM- Z 05'7 8 9,2 A PENSATION INSURANCE., 0 0 0 0 0 SIGNATURE OF # PERMITTEE 2'0 o 34 Q 0 ADDRESS Z TEL. 0 °;° ° 3 D 0 c=a rFINAL NO. G MAP �`2 -79 No. Od .SPECIALCONDITIONS. BYZ.`?'�� m m 76A838A DBS-3 3-59 APPLICATION FOR BUILDING PERMIT 1. DIVISION OF BUILDING AND SAFETY AADUDESS `� Department of County Engineer County of Los Angeles LOCALITY WM.J. FOX, COUNTY ENGINEER NEAREST ` � I CASSATT D. GRIFFIN. SUPT OF BUILDING - CROSS ST. DISTRICT NOJ GROUP TYPE SEWER " MAP FOR APPLICANT TO FILL IN D / �/4_+ BK PG - _- [ I CONST. � 4 , 1<d)' BUILDING iJ ,4 /r ,f MAP ���p STATE YES' 6 ADDRESS :vJ �S ��U ftl[�! ( Il t/ .. - NUMBER V �. ENZ4Z BLOCK U�SOEZONE SPECIAL - LOT NO. A1 ' CONDITIONS TRACNO. OF BLDG SIZE OF LOT �lt �: wl 1 I NOW ON LOTS i BUILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH USE c'A.t,4 • - FRONT EXISTING BLDG. ,r• P. L. OW_ N�Ofl3 C.3+- PL. DE MAIL ADDRESS,34 O TRACT DWELL. 1 UNIT 5 INDUSTRIAL - TEL ��g 1 DWELL. I UNIT NO.'��-�Qa 6 PUBLIC BLDG. ARCHITECT OR TEL. 0 cpm 2 DUPLEX I UNIT 7 ADDN., ALT.. ETC. ENGINEER �! �87L.-�.'.�"L.4;.- `�'4��'1.NO. !"' 3 .APT. UNITS ADDRESS 6 zao ".7--. 4 COMMERCIAL 8 MISCEL. Q} � �' Nt`- j INSPECTION RECORD CONTRACTOR NO-t^��y .-�,, ADDRESS✓5'4� L(���T1 U 4 r�-. S-'t�•e�� ` r-, �. X-',m bt" \ r+.e. e=..,... DESCRIPTION OF WORK - J NEW ADD- < LTER. REPAIR DEMOLISH Q SO. FT. t� NO. OF NO.OF - SIZE �. c^•t�_i, STORIES FAMILIES _-l. --x USE OF STRUCTUREws SIGNATURE OF APPLICANT.-� J¢PPROVALS ADDRESSGC1� llL, '' DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION $ P. C. $ ( FORMS, MATERIALS > "'••' FEE FRAME: FIRE STOPS, VALUATION $ ;`Qom. - --BRACING, BOLTS - - FEE' Id FURNACE: LOCATION. I HEREBY ACKNOWLEDGE THAT 1 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. c _LATH.EXT. SIGNATURE OF ~ •°' {,+-a HOUSE NUMBER COR- _ PERMITTEE �-.-'x""3°`1` RECT AND POSTED ADDRESS V' F y Z­NJ Q�r FINAL WM.J. FOX.COUNTY ENGINEER VALIDATION C. N. DIRLAM, CHIEF BLDG. INSPECTOR j 5 343, FEB 9 1. 6 To ( — •�. LAGd 5 3 4. 4 4 FES 19 1 1 4.0 0' 78A588A CE#805 10-58 - APPLICATIONI - - - ' - FOR, ��UIL.D[NC� �'ERll�IT . 1 - COUNTY`OF LOS ANGELES BUILDING DEPARTMENT-OF COUNTY ENGINEER =A°°REss BUILDING AND SAFETY DIVISION. LocALITY , JOHN A. LAMBIE, COUNTY ENGINEER_ NEAREST CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST...,' -DISTRICT NO.. G OUP TYPE � P SSED BY FOR APPLICANT TO FILL IN S F I .CONST. I BUILDING: a STATISTICAL CLASSIFICATION L I SEWER MAP ADDRESS :EK PG CLASS.NO. DWELL.UNITS LOTNOi '/ tS BLOCK- MAP �sJ HWY. YES . __ CSTATE / NUMBER ! _ TRACT S ( USE ZONE SPECIAL- `�- ' - J NO.OF.�BLDGS CONDITIONS J - - SIZE OF LOT • �,x /.I® � I• NOW ON LOT � - USE OF g EXISTING BLDG. dZ2_G.l - BUILDING YARD-�.HWY REET NAME EXIST SETBACK WIDTH OWNER S �,� l/ "f FRONT / . P.L. 6 MAIL _ ' ADDRESS. - •SIDE P._L.' CITY No INSPECTION RECORD ARCHITECT OR TEL. ENGINEER NO.L.0 1 7,y2 �. „ c //� yqI,�•/ �A ADDRESS, G .. Z - pm l _ I TO I CONTRACTOR-�77") ✓ i �r NN Cj;. ADDRESS _7 � - DESCRIPTION OF/WORK ::2' NEW ADD ALTER REPAIR DEMOLISH' - - y SQ.FT.y NO:OF NO.OF SIZE J - STORIES FAMILIES (s'--��-�USE OF '\ _ STRUCTURE 1_/ \ ' SIGNATURE OF -'�• - APPLICANT �.rq APPROVALS DATE INSPECTOR'S SIGNATURE ADDRESSFOUNDATION:LOCATION _FORMS,MATERIALS / VALUATIONS FRAME:FIRE STOPS, �J _BRACING,BOLTS �/ yq{ .FURNACE:LOCATION, FEE $ ®� I FEE- $ �I _GAS VENT,DUCTS A I`HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH.INT. �� `� PLICATION AND STATE THAT THE ABOVE IS CORRECT AND ILAGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REG A ING-. B .4 DING CONSTRUCTION. LATH,EXT. SIGNATURE OF __ HOUSE NUMBER COR- PERMITTEERECT AND POSTED - - -. ADDRESS I FINAL CLYDE N. DIRLAM, PRINCIPAL ST RAL ENGINEER PLAN. CHECK VALIDATION CK. M.O. 'CASH PERMIT VALIDATION �K: M.o. CASH J 4 j1J ','' 1 n 0 . . 3 1 ;> .. - - .. (p)P -Fe:»pi� Gr 76A638A C£#803 9-67 .1 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING ..-DEPARTMENT O�'vCOUNTY ENGINEER ADDRESs -, Las s BUILDING AND SAFETY DIVISION LOCALITY �� JOHN A. LAMBIE, COUNTY ENGINEER tv COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST , CROSS ST. FOR APPLICANT TO FILL IN DISTRICT NO. GROUP TYPE PROCESSED BY r d .Z CONST. (Print or type only) r�C! BUILDING STATISTICAL CLASSIFICATION SEW R MAP 47 ADDRESS 57 CLASS NO. DWELL,UNITS BKL PG/� LOT NO. BLOCK USE ZONE MAP NO. 00 TRACT 2 CONDITIONS NO.OF BLDGS. SIZE OF LOT NOW ON LOT - - USE OF I/r' TA Ax .7-C, G!G. 4 y7V EXISTING BLDG. BLDG.SETBACK FROM ' TEL; = A FRONT PROP.LINE OF (STREET). OWNE P e NO. `.v"�/G6 TYPE OF EXISTING SETBACK HIGHWAY .+ YARD = TOTAL ADDRESS "��"OlA+' HIGHWAY WIDTH FROM C:L. + CITY /,'.' /"j 'BLDG.SETBACK FROM ARCHITECT OR TEL SIDE PROP.LINE OF (STREET) ENGINEER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS - - HIGHWAY WIDTH FROM C.L. TEL + _ CONTRACTOR le NO. O _ LIC. CORNER CUTQFF -YES ❑ NO ,❑ V ADDRES IO-5 't NO. Q �. - LIC. '� CITY • - IL-C. ' CLASS ' SEE REVERSE•'SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORKLu NEW ADD ALTER REPAIR DEMOLISH SQ. FT. NO. OF / NO. OF SIZE _ STORIES / FAMILIES USE OF ;,. '•/r�r L�f. � _ STRUCTURE ,v ilel SIGNATURE OFfJ"'C ',t` /�tv( 6 ././✓ � APPLICANT VALUATION $ � ' s.< .,, i .I•` - .! - w:? .S ..3 i 3i:1 APPROVALS{y, DTE INSP. TORS SI 'ATURE P.C. PMT, FOUNDATION: LOCATION FEE $ , �� FEE $j,?, O O FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACf.NG, BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY - FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE.LAWS REGULATING GAS VENT, DUCTS':'. BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK _ AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON.IN VIOLA- C - TION OF TME LABOR CODE'OF THE STAT CALIFORNIA RELAT- LATH,.INT. ' ING TO WORK MEN'S P ION 5 ANCE. I - >LATH,EXT, - SIGNATURE OF S - HOUSE NUMBER COR-. PERMITTEE - - RECT-ND POSTED / i ADDRESS FINAAL •,J,OHN F. LEWIS.'PRINCfPAL STRLLCTURAL ENGINEER PLAN CHECK VALIDATION CK.` M O. CASH T_.;PERMIT VALIDATION CK. M.P. . CASH Y V+ LjL WORKERS' COMPENSATION DECLARATION I hereby affirm that I'have a certificate of consent to self insure, or a certificate of Workers"Compensation Insurance, A P P L I CATION FOR .BUILDING PERMIT 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 ADDREuS y" �.f /!�� ❑ Certified copy is filed with the,county building inspec- BUILDING /y� �� / I tion department. ADDRESS �n Date Applicant CITY `w .L �i�T cLIP�` // o LOCALITY 0NO. OF BLDGS. NEAREST _ IC. �� CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT 2J X11d 53, NOW ON LOT CROSS ST. COMPENSATION INSURANCE J !� (� (This section need not be completed if the permit is for one TRACT a BLOCK LOT NO. Zi MAp BOOK J PAGE 0� PARCELS/ / hundred dollars ($100) or less.) I TE • b OWNER ,UNC CI�hN� A N9. '11p y USE ZONE MAP I certify that in the performance of the work for which this SPE CIAL permit is issued, I shall not employ any person in any manner ADDRESS �'y� /L� / CONDITIONS n- so as to become subject to the Workers'Compensation Laws. ^ / n O CITY S/7 �` L ZIP �/ / Date—IJP Applicant `��` �yIf� ARCHITECT OR TEL. � T DISTRICT GROUP TYPE FIRE. PROCESSED BY O NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. . (j CONST. NE F— Exemption, you should become subject to the Workers' d , ADDRESS v v Compensation provisjons of the Labor Code, you must forth- � t1 with comply with such provisions•or this permit shall be �� TEL. STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. CONTRACTOR NO. Z LICENSED CONTRACTORS DECLARATION ADDRESS_44/2! NO CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter9 SEWER MAP ; (commencing with-Section 7000)of Division 3 of the Business LIC. t and Professions Code,and my license is in full force and effect. CITY Z h Cj} CLASS � BK. PG. -_`-VALIDATION 7 SQ. FT. NO. OF NO. OF CHECK License Number �����'3' lic.Class SIZE STORIES FAMILIES ONE } VALUATION _i_`•.r _t r=e-: Contractor fi4 f�r r%3 / DESCRIPTION OF WORK NEW ❑ . LQ�Date $ •� OQ�� . t l ADD ❑ ► ❑I am exempt under Sec. eGJ _ ALTER ❑ B.&P:C. for this reason REPAIR ❑ $ Date: USE OF DEMOL 171"N !1 I: i ' E587 EXISTING BLDG. Signature APP(PRI TT / �iC>� NO. FINAL l•i� •�. _a. OWNER-BUILDER DECLARATION DATE —�/ - it I hereby affirm that I am exempt from the Contractor's License ttut- _-- Law for the following reason (Section 7031.5, Business and ADDRESS Z1.147 FINAL Professions.Code): PRESENT' By /Q BUILDINGI` — `_,I rr if ; s ❑ I,.as owner of the property,.or my-employees with ADDRESS _ :_€_._I_ R_U•_ __. wages as their sole.compensation,will do.the work and L �. , L�,:yt .�=•J,- the structure is.not intended or offered for sale(Section LOCALITY 7 ?_:; _ H _�•! 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.) REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. 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. (Sec. 3097, Civ. C.). SIDE P.L.. Lender's Name $ LDMA-Ref. # P.C. Fee$ Permit Fee Lender's Address 0 1 certify that I have read this application and state that the Issuance Fee' LDMA P/C# , above information is correct. I agree to comply with all County Investigation Fee, 6 ordinances and State.laws relating to building construction, Total Fee J LDMA Perm. # a and hereby authorize r esentatives of this County to enter upon the aboxe-m ton property for inspectyy/n furposes. (.1&/ / . SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or gent Date WORKERS' COMPENSATION DECLARATION irm that I have a certificate of-consnt td sf insure boraafcertificate of Worke s' Compensation Insuran e,- APPLICATION FOR BUILDING • PERMIT. or.a'certified copy thereof (Sec. 3800,'Lab. C.) COUNTY OF LOS ANGELES BUILDING.AND SAFETY Policy.No. Company 2TLj/�G` l:1\! > El Certified co is hereb furnished. FOR APPLICANT TO FILL .IN BUILDING - PY Y. ADDRESS J ® Certified copy is filed with the eou y buildi inspec- BUILDING. tion department. ADDRESS LOCALITY NO. Date¢+Applicant' CITY" l .OF BLDGS. CERTIFICATE OF EXEMPTION FRO RKERS'. SIZE.OF LOT NOW ON.LOT NEAREST / CROSS SL COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100) or.less:) TEL. OWNER _ NO. - USE ZONE MAP NO. I certify that in the performance-of the work for which this SPECIAL } permit is issued,, Ishall not employ any.person in any manner ADDRESS �liZ-� ��.� CONDITIONS 0- so.as to become subject to the Workers' Compensation Laws. O CITY ZIP U Date Applicant ARCHITECT OR TEL. DISTRICT GROUP. TYPE FIRE PROCESSED BY NOTICE.TO APPLICANT:- If, after makingthis Certificate of ENGINEER NO.. CONST.' ZQJ 1E Exemption,. you should become subject to the Workers' ���/ '0 , . �{, w Compensation provisions of.the Labor Code, you must forth-- ADDRESS 0 / p with ,comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. ' Z deemed revoked. CONTRACTOR O. - _ LICENSED CONTRACTORS DECLARATION _ LIC.• CLASS NO. L. UNITS I.hereby affirm that I am licensed under provisions of Chapter 9 - ADDRESS y4G C a; O' SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. CITY r CLASS C�,G S and Professions Code,and my license is in full force and effect. BK. PG. VALIDATION ! SQ. FT. NO. OF NO. OFCHECK License Number �"-OJ SIZE STORIES FAMILIES ONE n ,��Lic. Class' VALUATION Contractor 10E,�/s 25;, Q to — / DESCRIPTION OF WORK NEW ® $ ❑ ADD I am exempt under Sec. ❑ ALTER ' ❑ ► - i B.&P,C. for this reason REPAIR ❑ $ Date: USE OF D ❑ EXISTING BLDG. DEMO' Signature _ APPLICANT /0 NOTEL. / FINAL OWNER-BUILDER.DECLARATION. PRINT . 44e4 , DATE I hereby affirm that I am exempt from the Contractor's License ADDRESS�A`,�d//r G�7� cS' Law for the following".reason.(Section 7031.5, Business and FINAL Professions Code): PRESENT BY _ 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 pip 7044; Business and Professions Code.) � - MOVING TEL. - _ - CONTRACTOR❑ NO. - a I, os owner of the.property, am.exclusively contracting with licensed contractors to construct the project (Sec- ADDRESS t=� tion-7044, Business and'Professions Code.) - - REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDINGAGENCY. SET BACK YARD• HWY PROP. LINE WIDTH z 1 110111. I.hereby affirm that there is a construction lending'agency for HRNT the performance of the work for which this permit is issued 't tea:® _s (Sec. 3097, Civ. C.): r r Vt'T Lender's Name. / 7LDMA Ref. #(�/ Permit Fee Lender's Address ? 0 1 certify that I have read this application and state that the Issuance Fee' �Or ' LDMA P/C# above informdtio is come . I agree to comply with al l County Investigation Fee o / '3__:! ii_I€ 6 ordinances and•St te'laws relating to building construction, Notal Fee 8 • `� LDMA Perm. # - - _ a and hereby author e, r r entatives of this.County.to enter _f .1 .T,x_t4 upon the above- ti r p ty for'insp'ectjon purposes. •o ���'�"�-�/ SEE.REVERSE FOR EXPLANATORY LANGUAGE Signature o A en Date . . APPUCA ON FOR BULLING PE ST COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR.APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUI DING DDRESS D or a certificate of Workers' Compensation Insurance,or a certified K�u s r ' copy thereof(Sec.3800,Lab.C.) /► CIT ZIP Policy No.« 64 ` '��Company 5-tATE -FUr� " LOCALITY SIZE F LOT NO.OF BLDGS.NOW ON LOT P-Certified.copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. USE ZONE MAP NO. department. ASSESSOR MAP BOOK PAGE PARCEL . Date `� 7 Applicant L ���-' SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS'' TEL N G YES NO COMPENSATION INSURANCE —fib L WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one.hundred A SS DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars ($100) or less.) CITY ZIP G I certify that in the performance of the work for which this permit D y is issued, I shall_ not employ any person in any manner so as to O o ARCHITECT OR ENGINEER TEL NO. become subject to othe Workers'Compensation Laws. y/ STATISTICAL CLA SI ICATION APT CONDO Date!7Applicant 1 c/ tl�N1,¢�J'� DDRESS -CLASS NO. 1�� DWELL UNITS NOTICE TO APPLICANT If, after making this C Stificate`oT`- REQUIRED TOTAL SETBACK FROM EXIST Exemption, you Should become Subject to the Workers' CONTR T R TE NO. ) SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith S'' S , V? FRONT comply with such provisions or this permit shall be deemed revoked. ADDF (S ._ a 626 P IL LICENSED CONTRACTORS DECLARATION Cd SIDE Y _ r � /'+1 LIC. LASS PL I hereby affirm that I am licensed underprovisions of Chapter.9 — SEWER MAP (commencing with Section 7000)Of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES - Professions Code,jnnd my Iicen e is in full force and effec NEW 0 BK PG 11- License Number Lic.Class DESCRIPTION OF WORK ADD ❑ VALUATION e O p o0• :� Contractor�.� ' Date �- ALTER E3 $ v / __ s I6 , t.. El am exempt under Sec. REPAIR ❑ BAP.C.for this reason DEMOL ❑ LDMA P/C# --- .-- W Date: USE OF EXISTING BLDG. f URM ❑ __� a- Signature APPLICANT(PRINT l TEL O. LDMA.Perm# ;'t'•-t•t cF Z ❑ I, as owner of the property; or my employees with wages as their sole compensation, will do the work and the structure is ADDR S not intended or offered for sale (Section 7044, Business and �* '7�-J� FINAL DATE 9 .!R 1 T""-' Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL �•� 7 4_{TAI - - a - ❑ I, as owner of the property, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE g� Y. Y g AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL B<: s_i L a 1 licensed contractors to construct the project (Section 7044, ' VES El NOK Business and Professions Code.) - -•i_(-jANG' 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 QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR _ GUIDELINES. fy — I hereby affirm that there is a construction lending agency for YES❑ NIA N the performance of the work for which this permit is issued(Sec. (HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING ,_ .. L` a Fr. ,_t 3097, CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE,- i N TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS 3 Lender's Name MATERIALS REPORTING AND FOR OBT A PERMIT FRO CAQMD. o ' Lenders Address o _ O OWNER OR AGENT o I certify that I have read this application and state under penalty 0 of perjury that the above information is correct.I agree to comply P.C.FEE © ' PERMIT FEE N. with all county ordinances and State laws relating to building !� a construction, and hereby authorize representatives of this County ISSUANCE FEE oo to enter LIDO the above mentio ed property for inspection purpos s. D a �2 INVESTIGATION FEE TOTAL FEE / (0 _ sgaawre orwam o�Agem � ome SEE REVERSE FOR EXPLANATORY LANGUAGE CI WORKERS''COMPENSATION DECLARATION ":' . .hereby affirm that I have a certificate, of consent to self APPLICATION FOR BUILDING. : 'PERMIT ' -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 No. Company ;Cert'f.i"d copy.is hereby furnished: FOR APPLICANT TO FILL IN BUILDING ADDRESS 75 �..�Certified copy is filed with the county1building inspec- BUILDINGf/ � „:T.� �� deparimenti ADDRESS `7 Date • Applicant CITY / r� � ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' - NO.OF BLDGS. NEAREST - r -COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT GROSS ST. Jc (This,section need'not be completed if the'permit{is for one ASSESSOR hundred dollars ($100)or, less.), TRACT BLOCK LOT NO. MAP BOOK PAGE' PARCEL• ' - - - USE ZON MAP OWNER �� 9L1 YIZl��1� NE0' . I,certify that.in The performance of the work for which this NO. permit is issued,'I shall not employ any person'in any manner ] SPECIAL IL so as to become subject to the Workers'Compensation Laws. ADDRESS C- CONDITIONS V CtTy.. ZIP Date Applicant + NOTICE TO APPLICANT: If,'°after making"this Certificate of ARCHITECT OR TEL. DISTRICT .GROUP JYPE FIRE PRO SED BY 0 ENGINEER NO. ^ A CONST.t ZONE b Exemption, you should become-subject •to-the-Workers' 0 �r � Compensation provisions of the Labor Code, you must forth- ADDRESS I F� y with comply with such provisions or this permit shall be TELT77ez STATISTICAL CLASSIFICATION ; i APT. NDO. deemed revoked. . CONTRACTOR Q V i a NO —g0/l LICENSED CONTRACTORS DECLARATION LIC. - - -- CLASS NO. Z_1 DWELL. UNITS 1 hereby affirm that I am licensed under•provisions of Chapter 9 ADDRESS` lt/u•S COQ NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC; A Professions Code,-and my license is•in,full'force arid effect. CITY !Z;1?L CLASS C-39 BK VALIDATION ' Q 2 Q SQ. FT. INC.OF NO. OF CHECK License Number!so.1 '!U Lic.iClass 64•3' SIZE STORIES FAMILIES ONE Q�,,^� // .I 3.- e- VALUATIO.N- NEW Contractor�Jk~.:�C.fJC/4xji6 Date DESCRIPTION OF WORK AD ❑ E 37�0a ❑ 1 am'exempt under.Sec. �` ❑ , ALTER B.&P.C. for this reason REPAIR. ❑ $ - D �D�� 14S USE OF EXISTING BLDG. DEMOL Signal e - APPLICANY✓- TEL. ., FINAL L / UILDER DECLARATION PRINT)�l S /ti (iY7O NO /l_'_ DATE C/J .1-hereby affirm that I om:exempt from-the Contractor's License ADDRESS / .�}S TU��S � 7rvv i� �� 3327 A Law for the following'-reason (Section 7031.5, Business and FIN Professions Code): PRESENT' - By •..- o' 0 0 0a BUILDING ❑ I, as owner of the property, or my employees with ADDRESS0 0 8 7'3 8 wages as their sole compensation,will clothe work and the structure is not intended or offered for:sale(Section LOCALITY _,, 7044, Business and Professions Code). MOVING TEL. ° ° 8 7,3 8`u- ❑ 1, as owner of the property, am exclusively contracting CONTRACTOR NO. Io,,2'9-85 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQUIREDTOTAL SETBACK FROM. T. _ 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 - P. - - - - (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name g09, LDMA Ref. # _ :y Lender's Address P.C. Fee$-. .._ .-. - Permit Fee .. ... ._ �- - I.certify that I.have read.this application:and state that the Issuance Fee �- LDMA-P/C#-- a above information is correct. I agree to comply with all County Investigation Fee j �Y N. > i g ordin an State laws relating building construction, _ Total-Fee / r+ LDMA'P.erm'#, L �` ' > - u n hereby orize represe tatives of this County to enter m upon th mentioned operty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE l-� Pi -. ature-of-Applicant or Agent._ .Date � I WORKERS'COMPENSATION DECLARATION I hereby k,offi* tha04 have a certificate of consent to self insure, or a certificate of Workers' Compensation Insurance, APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING,AND SAFETY PolicyNowCuj 7o/- �ry� �S"� �2. ✓f ❑ Certified copy is hereby furnished. . FOR APPLICANT TO.FILL IN BUILDING ADDRESS E t� Certified copy is filed with the qqnty building i spec- BUILDING j tion department. / ADDRESS Date ®—c? Applicant CITY ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one TRACT BLOCK LOT NOASSESSOR . hundred dollars ($100)or.less.) MAP BOOK PAGE PARCEL TEL. G USE ZONE MAP I certify that in the performance of the work for which this OWNS :� NO. NO permit is issued,,I shall not employ any person in any manner ADDRESS j�; �.. SPECIAL so as to become subject to the Workers'Compensation Laws. { (((/// CONDITIONS O CITY �/vL/. •gr.Is�O ZIP �/1d� C.1 Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O ENGINEER NO. CONST. ZO E •/ U Exemption, you should become subject to the Workers' C� Compensation provisions of the Labor Code, you must forth- ADDRESS v," , � W with comply with such provisions or this permit shall be p TEL. STATISTICAL CLASSIFICATION APT. • NDO. N deemed revoked. CONTRACTO ! /Y/ moo NO�� LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS - I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS i„[r/O� NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC �yj/ Professions Code, and my license is in full force and effect. CITY sz- CLASS CC!!�� BK � VALIDATION SQ. FT. NO. OF NO. OF CHECK J A License NuZ�2� Class SIZE STORIES FAMILIES ONE VALUATION ,_�,c�y� # ' 0•0 0 2 3 `/ DESCRIPTION OF WORK �./hL?!�� NEW ❑ $ / 7 ) 0 0 37.50 Contractoro ❑ / ADD I am exempt under Sec. �`� � �� � ALTER ❑ 0 0 0 3 7�5 0 v B.BP.C. for this reason REPAIR ❑ ; - I t 1 2 8 7 Date: USE OF EXISTING BLDG. DEMOL ❑ Signature APPLICANT TEL. FINAL - OWNER-BUILDER DECLARATION PRINT OAC/ 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 fr ❑ BUILDING 42,44 4r 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(SectionLOCAUTY 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- tion 7044, Business and Professions Code). ADDRESS REQUIRED TOTAL SETBACK FROM CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 4 I hereby affirm that there is a construction lending agency for FRONT 8 41,10 A the performance of the work for which this permit is issued P.L, (Sec. 3097, Civ. C.). SIDE # o 0_0 o;o';. '..; P.L. Lender's Name LDMA Ref. # . I o;o 4 9 8.8 Lender's Address P.C. Fee$ 37,50 Permit Fee _3 0 0.© 4 9 8 8 c=i. 0 1 certify that I have read this application and state that the Issuance Fee - (/ LDMA P/C# .8 5? above information is correct..I agree to comply with all County Investigation Fee ,I �,2.0:.•8 7 0 ordinances and State laws relating to buil ing construction, Z - and h r by authoriz r resentatives of is County to enter Total Fee o LDMA Perm. # upo th abov -m i n d property for nspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date l APPLICATION FOR BUILDING PERMIT COUNTY OF L A BUILDING AND SAFETY OS ANGELES WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS or a certificate of Workers' Compensation Insurance,or a certified copy thereof (Sec.3800,Lab.C.) CITY ZIP LOCALITY Policy No. Company SIZE OF LOT NO,OF BLDGS.NOW ON LOT ElCertified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. COMPENSATION INSURANCE WITHIN loon FT OF scHooL� YES NO (This section need not be completed if the permit is for one hundred ADDRESS DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars ($100)or less.) CITY ZIP I certify that in the performance of the work for which this permit 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 CLASSIFICATION APT CONDO Date Applicant 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 WorkersCONTRACTOR TEL NO. SET BACK 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 DECLARATIONSIDE } CITY LIC.CLASS P L 0- I I hereby affirm that I am licensed underprovisions of Chapter 9SEWER MAP 0 ( commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW El BK PG U.I License Number Lic.Class DESCRIPTION OF WORK ADD ❑ VALUATION ► J_ Contractor Date ALTER ❑ W LL} REPAIR ❑ ❑ I am exempt under Sec. $ < B.AP.C. for this reason DEMOL ❑ cc LDMA Pic# Date: USE OF EXISTING BLDG. URM ❑ ' 142.71 d I, Signature APPLICANT(PRINT) TEL NO. LDMA Perm# S LLI B-I, as owner of the property, or my employees with wages as Z 1i7 their sole compensation, will do the work and the structure is ADDRESS 0 TrITA- 142. not intended or offered for sale (Section 7044, Business and FINAL DATE Q Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL O • � s" ❑ I, as Owner Of the property, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE P Y g AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY § • licensed contractors to construct the project (Section 7044, YES El No 11Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH0000—mot fy'�('�{ 10/ 5/9111 CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR '�„P of 10 / GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ NO❑ A,�W r 9247 N the performance Of the work for which this permit Is Issued(Sec. IHAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. N 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 SCAQMD. CL Lender's Address 0 OWNER OR AGENT o I certify that I have read this application and state under penalty q of perjury that the above information is correct.I agree t0 comply P.C.FEE PERMIT FEE with all county ordinances and State laws relating to building < construction, and hereby authorize representatives of this County ISSUANCE FEE 00 CO to enter upon the above-mentioned property for inspection purposes INVESTIGATION FEE TOTAL FEE m Svnature of Appl,cant o,Agent Date f� SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION-POR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS or a certificate of Workers' Compensation Insurance,or a'certified 91_t —"/_ copy thereof.(Sec.3800,.Lab.C.). CITY ZIP LOCALITY OV Policy No. Company _ SIZE OF LWT— NO.OF BLDGS.NOW ONdLOT ❑ Certified copy is hereby furnished. NEAREST CROS T. . ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. - department. USE ZONE MAP NO. Date - 'Applicant ASSESSOR MAP BOOK - PAGE- PARCEL SPECIAL CONDITIONS" CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS' . / - ��•! �2 'DISTRICT GROUP TYPE CONST. FIRE.ZONE PROCESSED BY dollars($100)or less:) c� CITY ZIP R, I certify that in the performance of the work for which this permit 7 7 e i? J -�O _� 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. Et STATISTICAL CLAssIIFIICATION APT CONDO V7 4 Date� ' 3 Applicant ef7.�}'�L(c -K �r7A�\ 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 CCtoTC).y TEL NO. ` � SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith 5'!b QY SL"�U Z FRONT comply with such provisions or this permit shall be deemed revoked: ADDRESS Zv J'� LAG— LI lv, NO. P L - LICENSED CONTRACTORS DECLARATION ��'� G4"" SIDE CITY `/'. .. LIC:CLASS/�•�- P L I hereby-affirm that I am licensed underprovisions of Chapter 9 �� C2��ow7Z C—`�'� SEWER MAP 1' (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES 11 Professions Code,and my license is in full force and effe�ctt.� NEW ❑ BK PG , 0 License Number ��z G 6� Lic.Class C 4/"`i •DESCRIPTION OF WORK ADD ❑ ,VALUATION V Contractor CNA2�/? pate �� '�—�� �'� _ ALTER ❑ $ �� ElI am'exempt under Sec. L REPAIR 1:1 $ BAP.C.for this reason O USE OF EXISTING BLDG. DEMOL 1:1 LU P/C# CL W Date: C 3 URM ❑ --• V1 Z Signature APPLICANT(PRINT) TEL NO. - LDMA Perm# t�j(_ •:Q ❑ I, as owner of the propert , or my employees with wages as Z - -t•z. i their sole compensation, will do the work and the structure is ADDRESS O ='rl== i--"'-t'-" not intended or offered for sale (Section 7044, Business and FINALE Professions Code.) WILL THE APPLICANT OR FUTUREBUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J (•I •5' ❑ 1, as owner of the property, am exclusively contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044, YES❑ No❑ `` 1 Business and Professions Code.) ---- WILL THE INTENDED USE OF THE 6UIDLING BY THE APPLICANT OR FUTURE BUILDING- _ OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH TTf:.e- CON.S^TRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR 1' 'i GUIDELINES. I hereby affirm that there is a construction lending agency for YES ElNo❑ i 0TA1160 _' 30 the performance of the work for which this permit is issued(Sec. t L' F r I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING r!-!Ir'•.:t•: 1:1» 3097,CIV.C.) CHECKLIST.I UNDERSTAND MV REQUIREMENTS UNDER-THE LOS ANGELES COUNTY CODE, TITLE 2,CHAPTER 2.20 SECTIONS 220.100 THROUGH 2.20 140 CONCERNING HAZARDOUS CHOSE ~E ` t s� 3 Lender's Name � - MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. - o Lender's Address 0 OWNER OR AGENT I certify that I have read this application and state under penalty a Ea_ i';'J^•F ff;" o Y PP I r': I o P.C.FEE PERMIT FEE / �.y +JIJ .L - i•_: i.: of perjury that the above information is correct.I agree to comply ,y� y/� V with all county ordinances and State laws relating to building ,1 2 o x m construction, and hereby authorize representatives of this County ISSUANCE FEE coto enter upon he above-mentioned property for inspection purposes. INVESTIGATION FEE TOTAL FEE sgnallre of APPI-y Agent Date C1 SEE REVERSE FOR EXPLANATORY LANGUAGE y , APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES =`.. BUILDING AND SAFETY WORKER'S COMPENSATION,DECLARATION FOR APPLICANT TO FILL IN BUILDIN DDRESS- BUILDING ADDRES I hereby affirm that I have a certificate of consent to self insure, !� ZIK ` or a certificate of Workers' Compensation Insurance, or a certified S` I•� copy thereof (Sec.3800,Lab.C.) CITY ZIP i LOCALITY Policy No. Company 1.SIZE OF OT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ' ❑ Certified copy is filed with the County building inspection TRACTBLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL PP SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. YES ( NO COMPENSATION INSURANCE (THIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESS DISTRICT GROUP TY CONST. FIRE ZONE PROCESSED BY dollars($100)or less.) CITY ZIP �� ,A I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO. 1 P ,STATISTICAL CLASSIFICATION 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 TEL NO. SET BACK 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 IL - SIDE LICENSED CONTRACTORS DECLARATION CITY LIC:CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 Of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES } Professions Code,and my license is in full force and effect. NEW BK PG a License Number, Lic.Class DESCRIPTION OF WORK ADD ❑ VALUATION , O ' /J aD� ��p Contractor Date J� ALTER El $ cc EI I am exempt under Sec. rz'- �"' 1"'� REPAIR C3 $ U B.&P.C. for this reason DEMOL ❑ LDMA P/C# a 1 d Date: USE OF EXISTING BLDG. URM ❑ ag 142.'7 CL Signature APPLICANT(PRINT) TEL NO. LDMA Perm# Z �1, as owner of the property, or my employees with wages as • Z •_ 1 ITEMS their sole compensation, will do the work and the structure is ADDRESS ° TOTAL 142�71 not intended or offered for sale (Section 7044; Business and FINAL DATE - Q Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL 141. i 12 CHECK 142.71 ❑ I, as owner of the property, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE 1 Q y y g AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINA / > CHANGE .00 licensed contractors to construct the project (Section 7044, YES❑ No❑ Business and Professions Code.) ' WILL THE INTENDED USE OF THE BUtDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH ((''�� n(} (� 5/?5 JpC CONSTRUCTION LENDING AGENCY COAST AIR OUAUTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR 0000-0041 10/ 5 7-� GUIDELINES. f� t I hereby.affirm that there is a construction lending agency for YES El NO El �r0 2644 1 Aid 9:47 N the performance Of the Work for Which this permit Is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097,CIV.C.) CHECKLIST,I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, w TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS 3 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. 2 o Lender's Address OWNER OR AGENT O o I certify that I have read this application and state under penalty 0 of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE o with all county ordinances and State laws relating to building < construction, and hereby authorize representatives of this County ISSUANCE FEE00 �^ ato enter upon the above- e boned property for inspection purposes._ �75v C INVESTIGATION FEE TOTAL FEE //,(�. /7 j Sgnatore of AoPlioent or Agent Date _/ / SEE REVERSE FOR EXPLANATORY LANGUAGE 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 0502020026 PHONE: (626) 285-0488 EXT: LEGAL ID: N0. OF CONST BUILDING ADDRESS: TR: 6561 LT: 244 BL: .001 SQ. FT STORIES TYPE 9549 LAS TUNAS DR STRUCTURE: VN TEMP CA.'917802107 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8587-014-017 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, C TENANT: E:EX ST BLDG USCOM USE ZONE: C ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 02/02/05 JK 01/28/06 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DAT FINAL BY: CODE: CHU, SICK - 900 /v, ^ 9549 LAS TUNAS DR TEMPLE CITY CA 91780 FEES PAID DESCRIPTION OF WORK REPAIR 25% ROOF ON COMMERCIAL BUILDING. FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: PPLICANT: TEL. NO: KIN (213) 272-3473- AA BLDG PERMIT ISSUANCE 27.75 13900 E. ROSECRANS AE STRONG MOTION OTHER 900.00 VAL 0.50 SPECIAL CONDITIONS: SANTA FE SPRINGS D2 PERMIT W/O EN-HC 900.00 VAL 65.40 FR INV WORK W/O PERMIT 257.00 DOL 257.00 _ TOTAL FEES 350.65 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE ALL SEASONS HOME IMPROVEMENTS (213) 272-3473- 968 S. NEW HAMPSHIRE AVE #6 LIC.-NO ILOCATION AND SETBACKS LOS ANGELES, CA 90006 830895C39 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDAT ON/TRENCH FORMS LIC. NO: SLAB/UNDER FLOG RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION XX 3 01 FLOOR SHEATHING N0. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 22 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SMEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATION/WEATHER STRIP SIDE PL- INTE IOR LATH/DRYWALL EXTERIOR LATH BATED FLOOR/CEIL ASSEM. RATE WALL ASSEMBLIES RATED SHAFTS/OPEN NGS r=BAR CEILINGS LOT DRA NAGE REPORT ID: DPR261 ROUTE TO: BS0508 r - 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 0711270045 PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST BUILDING ADDRESS: ITR: 6561 LT: 244 BL: .001 1 SQ. FT STORIES TYPE 1 I 9549 LAS TUNAS DR I I ISTRUCTURE: 40 VN I TEMP CA 917802107 1 (ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: I (8587-014-017 I THOMAS *PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl I I 1 (TENANT: IEXIST BLDG USE: COMME USE ZONE: C-3 (ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 111/27/07 SR 05/25/08 (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: (FINAL DATELXPI" Y: CODE: 1 IWU CHUNG CHENG;SU JU L (213) 718-0525- 10,000 1 _ ED I 1321 GERONA AV I - ISGAB 917752953 1 FEES PAID IDESCRIPTION OF WORK i I ICOMM BUILDING 40 S.F. TEAR OFF B.U.R. INSTALL (4) PLY B.U.R. 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: IENERGY STAR CAPSHEET 1 (APPLICANT: TEL. NO: I I 1BATIOFF (626) 614-7059- 1AA BLDG PERMIT ISSUANCE 27.75 1 I IAE STRONG MOTION OTHER 10000.00 VAL 2.10 ISPECIAL CONDITIONS: ID2 PERMIT W/O EN-HC 10000.00 VAL 216.60 I TOTAL FEES 246.45 I I (CONTRACTOR: TEL. NO: 1APPROVALS DATE INSPECTOR SIGNATURE 1 IROYAL ROOFING (562) 928-1200- 1 _ 16320 CLARA STREET LIC. NO ILOCATION AND SETBACKS I ILOS ANGELES, CA 90201 432352 C39 1 I 1 I I (SOILS ENGINEER APPROVAL 1 1ARCHITECT OR ENGINEER: TEL. NO: 1 IFOUNDATION/TRENCH FORMS 1 1 1 LIC. NO: 1 ('SLAB/UNDER FLOOR I I I PRAISED FLOOR FRAMING I I I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CM_P:1 1UNDERFLOOR INSULATION I I 1150H269 3 011 I 1 1 IFLOOR SHEATHING INO.. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: 1 I ' I - /gIj 1 NO 22 1 IROOF SHEATHING I I i SCHOOL WITHIN HAZARDOUS ISHEAR PANELS I 1AIR QUALITY: 1000 FEET MATERIALS I NO NO NO 1 IFRAME INSPECTION I I I IREQUIRED TOTAL SETBACK FROM EXIST 1 IFIRE SPRINKLER HANGERS I ISET BACK YARD: HWY: 'PROP LINE: WIDTH: 1 I IFRONT PL- 1 1INSULATION/WEATHER STRIPI I I SIDE PL- 11 11 INTERIOR LATH/DRYWALL EXTERIOR LATH I I IRATED FLOOR/CEIL ASSEM. I IRATED WALL ASSEMBLIES 1 I I I _ (RATED SHAFTS/OPENINGS 1 I I I IT-BAR CEILINGS 1 I I I ILOT DRAINAGE 1 I (REPORT ID: DPR261 ROUTE TO: BS0508 1 I I I I I I I