HomeMy Public PortalAbout9559 LAS TUNAS DR_Building__ ' zi4PPL'ICATION FOR.'BUILD-ING PERMIT.
FOR APPLICANT TO"FILL IN' (Pri'nf or +Yoe onIY)
BUILDING (� .�R� l UA�AS /+ COUNTY'OF'LOS ANGELES
ADDRESS DEPARTMENT OF COUNTY, ENGINEER
C,T z"LP' lj BUILDING AND-,SA,FETY DIVISION
NO.OF BL1)GS. - BUILDING. -
SIZE"OF LO `(I J/0- NOW ON LOT ADDRESS"
.L / BLOCK ^' 'LOT NO.�C// LO •'
-TRACT a S (� T " LOCALITY - "
.. TEL. NEAREST
OWNER NO. : CROSS ST.. _
(p• (`7(0 ASSESSOR- j•
ADDRESS ,.L, �//6/ n MAP.800K PAGE PARCEL
DISTRICTGR(?UR'.I TYPE: FIRE -
SEED BY
`CITY, S A•/ -{� •'f1 ZIP IONS
— .'ZON'E
ARCHiTECT'OR" . - TEL. - �`//,'lQ F_
ENGINEER NO.' W, -
STATISTICAL CLASSIFICATION SEWER� � E
_ R MAP
ADDRESS `CLASS
NO'. �2—?f:IE -- BK� ,
CONTRACTORWrn iM ^ria C NS
NO USEFS) USE ZONE NADP
ADDRESS, v _r � /,�.NO G-,JsSSSZ —L. SPECIAL - -
LIC. ' 'CONDITIONS
CITY A' CLASS01 - . ..., _
- ROAD DEPARTM- ..
ENT APP RO- VAL REQUIRED` 'YES❑ NO.❑`
CONS'TRUCTI.ON..LENDER
NAME AND.BRANCH BLDG.SETBACK FROM - - - - C
- -- - - - •• - - 'FRONT.PROP.LINE OP - '(STREET)
ADDRESS CITY :
HIGHWAY } YARD _ TOTAL SETBA CK FROM TYPE OF EXISTING I=
SQ.'FT_ -NO: OF _ _ NO. OF. CHECK- - _ FRONT P.ROP:•.L.INE. HIGHWAY WIDTH Q
SIZE STORIES FAMILIES ONE -
} - - OLL.
DESCRIPTIO O.F WORK' NEW ❑ - V,
BLDG.SETBACK'FROM - - Z
AD[) ❑ ...SIDE PROP.LINE OF (STREET)
ALTER _ TOTAL-S,ETBAC:KFROM .TYPE OF EXISTING
REPAIR'❑ '
HIGHWAY_ } YARD - SIDE PRHIGHWAY WIDTH
,- -- OP. LINE -
USE
EXISOT NG, BLDG.C�Dm(,Y). u 1:3 L DEMOL ❑ t ...
APPLICANT�jM'S;MhP/y3�[�+JLGi/ i3;t+r,EL CORNER CU_ TOFF YES_❑: ., NO ,❑
(PRINT). ZOS— h j /l'f jja A�.8. NO.�
IN OPEN SPACE YES ❑ NO ❑
BY (SIGNATUR `
IN COASTAL ZONE' YES ❑ NO ❑
VALUATION 0.®a - _ ':CATEGORICAL EXEMPTION YES❑ NO ❑
.I HEREBY ACKNOW=LEDGE THAT I HAVE READ THISJE
TION ENVIRONMENTAL
.AND STATE THAT THE ABOVE 'IS CORRECT AND.AGREMPLY .6MPACT ' , EXEMPTION,D.ECLARAT16N SIGNED (DATE) .
WITH ALL .ORDINANCES AND 'LAW.S REGULATING BCON- !7
STRUCTION. I CERTIFY THAT IN DOING THE WORIZED IMPACT REPORT ROCESSED' (DATE)
HEREBY- 1 WILL NOT EMPLOY' ANY PERSON IN VIOLTHE' -
LABOR {ODE OF E STATE OF CALIFORNIA IN RELATING TO
WORKMEN'S CO EN ATION INSURANCE.
l _
'SIGNATURE OF _PERMITTEE
ADDRESS ' T /� �2�• FINAL�/'�JTEL.CITY ,'�\ •' l / - NO., � DA,TE ,,.��MAKE CHECKS PAYABLE TO: P C Q PMT:Q.HARVEY T. BRANDT. COUNTY EN _ FEE' ✓ FEE P
02 02(J
-PLAN CHECK VALIDATION CK. M.o. CASH PERMIT VALIDATION
f
5 2-
'4.2L 0_A
176A638A CE#803 7/73 7,
-- _ -,
DEPARTMENT OF BUILDING MiD SAFETY APPLICATION r OR PERMIT
COUNTY OF==L69 ANGELES 3 ® ' �®
WM. J. "FOX. CHIEF ENGINEER L N
P'PLICANT TO FILL IN + FOR OFFICE USE ONLY '
DISTRICT ALO. PLAN CK,NO. PERMIT NO.
BUILDINGS r �' i
ADDRESS Es» LDS Ti1nasDr. S; �� H-�♦ �J
LOCALITY Temle City - y RECEIVED BY DATE OF APPL. DATE ISSUED
NEAREST w7-�.LnS$-L 1 / -S "�• i`r'-_'`\
CROSS.ST. ' -
BUILDING
OWNER Ralph- Giuzst;Y: ; ADDRESS '{.�.J'�' / �•y-c>
AMAIL DDRESS Tunas
LOCALITY -
TEL.R-Ctv 03 d.3 CROSS ST.NEAREST
CITY Tem le Cit - •- NO.
ur l
FIRE NO.OF TYPE GROUP
ARCHITECT OR TEL. ZONE - PLANS -
ENGINEER NO.
' oIV- BLDG. - ORD.NO.
ADDRESS SETBACK LINE
APPROVED.
�•� t ;
lND• 4
27-27BY DATE. _ -
CONTRACTOKC1OCl�et' TJeon- Co. '
CC)�
C USE 'APPROVED
ADDREs,554J Atlantic- Ave-. Long Beach,. Call.'. ZONE BY .DATE
LEGALI CORRECTIONS
DESCRIPTION LOT NO. BLOCK '
TRACT
NO.OF BLOBS. e
SIZE OF LOT I NOW ON LOT -1�2�
USE OF I NO.OF I' NO.OF - -
EXISTING BLDG. FAMILIES ROOMS - - - -
DESCRIPTION OF WORK
NEW ALTERATION I ADDITION
REPAIR MOVING DEMOLISH �.... .
Sq.FT. NO.OF Z
SIZE ROOMS STORIES D
WALL ROOF _ . .__ . . .. r z ... r
COVERING - I--COVERING
USE OF NEW - '
BUILDING Sporting Goods store
Erection of-one double facedineon
electric .sign, onr.roof:• Drawing
o3 method, of erection enclosed'.with
application for..• permit.•
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS , -
APPLICATION AND STATE THAT THE'ABOVE IS CORRECT FOUNDATIDNI: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY.ORDINANCES' FORMS,MATERIALS '
AND STATE LAWS REGULATING BUILDING ONSTRUCTION.
FRAME: FIRE STOPS,
SIGNATURE OF BRACING,BOLTS
PERMITTEE LATH, INT.
AUTHORIZED AGT LATH, EXT.
76A638A 9-4a PLASTER,INT.
DBS-3 SOM SETS $ - P.C.W FEE PLASTER,EXT.
VALUATION
FEE FINAL
08-3 6-40 ZSM APPLICATION.FOIA PERMIT".
DE '��ATT OF BUILDING. AND SAFETY -
' COUNTx.OF LOS ANGELES _
' WM. J. FOX, -CH IEFENGINEER
NO OF LINE `NONO DISTRICT NO PLANCK NO:. PERM/rI_T NO
''PLANS SET ACK
MAPPROVED •.. - � ;:'. � 1 ..114f/- ,.'_'
..•..FIRE'- - _
ZONE BY DATE RECEIVED $Y :DATE OF APPL. DATE ISSUED
g USEAPPROVED
�• ZONE 6V• DATE
c;
APPLICANT FILh;.IN .HEAVILY.- OUa'LI°NED""POIRTION' ONLY,
.. - BUILDING w P I
py ., .. I
Q NAME 1�isF '•'AIS l! iA.A ADDRESS / F , .
It
I_yl r
IUd Z 'ADDRESS z 2 LOCALITY
1-_ i ^
.Z}Z NEAREST ,� J �/q�._
UE W GITY CROSS A
q.: STATE 'NOrEL.1 ?'W NAME
LICENSE NO )� v _
!. Z"
-
-esMAIL -
t�. .� NAME �/1 .�✓{:..s5�.� -ADDRESS
00,
• .'Q ADDRESSS.-D.k.Q 3 'l;J�:.26 Cl y •" CITY. � w`3�"Y!� NO� k
. Z CITY !-J"�d�3 � � I-HEREBY AlKNOWLEDGE THAT1 HAVE READTHIS
O lllddd[[[# 6t'� _ APPLICATION.AND STATE,THAT,THE ABOVE IS CORRECT'
V STATE ,` `�l / -TEL `� 3 G�j .' AND AGREE TO COMPLY WtTH ALL COUNTY ORDINANCES
LICENSE NO 0 _NO f p�7 7 AND STATELAWS REGULATING BUIL DING'CONSTRUGTION._
1} .SIGNATURE OF
:.� LOT: NO':-.,,,(, SIZE OF•LOT _ ;OWNER r•
'J F- NO.'OF.BLDGS AUTHORIZED-,AGTw .
S 0. .:BLOCK. '`' ..•,.'•.<: NOW.•ON,LOT
. :- ;.. r. �.� l
W: /'��
_J.U _ , !� . COItI�ECTIONS
•�W` TRACT �I -
• ..U.SE'OF BLDGS.),
NOW ON=LOT -
rDESCRIPTI®N.`O�p('`.-,.WORK j�j
.USE.OF' .l'W!N LAS l LI.t`..K.. - �i 1.3 `7 C•_^ '��/s- .••�•�"'�^�.; _ _ .
5
Zr ,
NEW (/. .TVP^c GROUP �.-
N NO. OF
W 6 .;ALTERATION;, ROOMS . FAMILIES::`- s _
_do -
ADDITION SIZE - ,. a [lJ -ry•
• REPAIR' STORIES I'
"MOVINGWALL COVERING
DEMOLISH I -ROOF COVERING
P.
FINAL APPROVAL.
FEE. !
VALUATION :'.FEEv.
APPL-iCATION FOR PEIdMIT
1-7elbEPARTMENT OF BUILDING, AND SAFETY
COUNTY OF LOS ANGELES
WM. J. FOX, CHIEF ENGINEER
NO. OF BLDG. ORD. NO 5' 'DISTRICT NO PLAN CK. NO. PERMIT NO.
PLANS , SETBACK LINE
A-)
.,y )U_\�Q
FIRE APPROVED Lam/ f
ZONE BY- DATE RECEIVED BY .DATE OF APPL/ /.JDATE) 17SSUED
USE ' A�ROVED
ZONE BY DATE
APPLICANT ,FILL IN HEAVILY OU'rLINE/D"PORTION,,ONLY'/ g,�y
BUILDING 2fl
O� NAME .�' - ADDRESS
� �-��.-�yr.. 1
w Z ADDRESS :/ 9 "LOCALITY �-
WCITY _i/ CROSSSST. U N -.•.
Q S - - TEL. .I �
LICENSE NO. NO.
TATE - W NAME •�„ ,�.14J l j'J�r/f�\
0 3.. MAIL 43� N —4- (Cad' C�
O NAME' 0 .`ADDRESS r (� J
UTEL
y1�
Q ADDRESS y CITY BA-16-DIN4N NO...
Fi HEREBY ACKNOWLEDGE.THAT i HAVE. READ THIS
Z
O CITY APPLICATION AND STATE THAT THE ABOVE IS CORRECT
U STATE TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
LICENSE NO. (w� NO. AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
dill
O LOT. NO. 1 1 SIZE OF LOT SIGNATURE OWNEROF ~
J - NO. OF BLDGS. AUTHORIZED
O BLOCK- - NOW ON LOT
CORRECTIONS "'`
D TRACT
W
D USE OF BLDGS.
NOW ON LOT
DESCRIPTION.
� V Cr CRIPTION OFt / rWORK IT �f/
USE A L /
BUILDING K\/\J DI ..3..y
J
Z
o
NEW TYPE GROUP' -
NO. OF' NO. OF b
ALTERATION -ROOMS �e / FAMILIES-
ADDITION
AMILIES ADDITION L/ SIZE `C
REPAIR STORIES -
MOVING WALL COVERING -
DEMOLISH I ROOF COVERING
s. P.C. $ FINAL APPROVAL
FEE / X
$ O"O `/. - I INSPECTOR'S
_F
VALUATION FEE t DATE / NAME
v
78A899A C7N909,Q-99 APPLICATION FOR BUIL®IN.C-:_PEktVIIT ...; „1.
COUNTY OF LOS ANGELES BUILDING • -
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LoCALITY
JOHN A.LAMBIE,COUNTY.ENGINEER NEAREST
CASSATT•D.GRIFFIN,SUP=T OF BUILDING _ CROSS ST. _
- _ DISTRICTGROUP TYPE _ D
FOR'APPLICANT TO FILL IN P
S ' CONsr h
BUILDING STATISTICAL SSIFICATION
CJ SEWER-MA.P
ADDRESS _ f J�' � .• .. .' - "
CLASS..NO: DWELL. UNITSI'
LOT NO. BLOCK MAP'_ "'STATE
_ NUMBER- •CJ� - .HWY'. YES. NO
TRACT USE ZONE SPECIAL
NO.OF BLDGS. CONDITIONS
SIZE OF LOT I NOW ON LOT .
USE OF ;
EXIST•1NG BLDG: • BUILDING EXIST
YARD HWY STREET NAME
' (^ � //�� SETBACK WIDTH' '
OWNER 1�1s0d' i f C �- ..FRONT -
MAl - - - - P.L. '•
ADDRESS srs
SIDE,
TEL. 'P.L.
c1TY. - No. .' -. INSPECTION-RECORD,
ARCHITECT - TEL.
ENGINEER NO. -. -
ADDRESS
CONTRACTOR TEL.NO
/ • '
'ADDRESScTD -
DESCRIPTION OF WORK
NEW. .ADD ALTER REPAIR 'DEMOLISH
SQ. FT. NO.OF-' - NO.OF.- .. t
SIZE STORIES - FAMILIES - •• -
USEOFSTRUCTURE
Ur
SIGNATURE OF�Y1
APPLICAN _ APPROVALS
T LLL d�-�Y � -�
�y ' DATE-'''...`INSPECTOR'S SIGNATURE
-
'ADDRESS �/ L-LfJ(.C_. �- FOUNDATIONS: LOCATION
$_�� .�' FORMS.MATERIALS
- _ P.C. $ FRAME: FIRE STOPS„ _
- FEE BRACING, BOLTS rG
VALUATION - $ FURNACE: LOCATION.
FEE ;GAS VENT,DUCTS / s
'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
,EXT:1 .1
STATE. LAWS REGULATING - UILDING CQNSTRUCTION. •� LATH,EXT.
SIGNATURE'
OF ''' �'q HOUSE••.NU.MBER COR--
"PERMITTEE�- - f✓ /` RECT AND POSTED
ADDRESS - FINAL
"CLYDE N.DIRLAM, PRINCIPAL'STRUCTURAL GINE.
PLAN.CHECS VALIDATION CK. .M.O. CASK PERMIT VALIDATION .CK. m. cnsH
z LAC 23:-, 1 k
. - .' •' /per
70A838A CE}r 80970-SB •'.•�\PPL�ICi4`'I"I®_N :FOR I3.UILDING .:PERMIT. 1
BUILDING
-..COUNTY OF':LOS'ANGELES ADDRESS
-:'DEPARTMENT-OF COUNTY ENGINEER
BUILDING AND-SAFETY DIVISION' LOewLIr,Y
JOHN A. LAMBIE; COUNTY ENGINEER ,
'NEAREST'S T•v
CASSATT'D: GRIFFIN,_SuP'TOF.BUILDING = CROSSST ..
DISTRIGW G�ZOUPq I TYPE j ' PRSED BY
FOR APPI:ICANT:TO. FILL IN c5 /`y: = CONs�)/' M1,
BUILDING _ STATISTICAL CLASSIFICATION SEWERMAP
ADDRESS :jr �� BK PG
_ CLASS.NO. DWELL.UNITS I
LOT NS: BLOCK MAP. : 'Y,�_.L1 STATE YES NO
- NUMBER.-- -HWY._ -
SRACT
USE`ZONE SPECIAL
` NO.OF:BLDGS: CONDITIONS
SIZE OF LOT'_ I C
NOW.ONLOT
- �".L - -
.USE OF ,
EXISTING-BLDG'-." - BUILDING YARD- HWYSTREET-NAME EXIST
SETBACK yy 'WIDTH
OWNER. ._ .! ,. FRONT. Q; ./�c �_..._ ._ . :
P.L:'. I /9? G?
MAIL- -r''. .. .
-
ADDRESS' c� (J" S `SIDE
TEL.
CITY•. .-_ - .. .. L l
P.
NO. - -
INSPECTION RECORD
ARCHI ECT OR � TEL.
ENGINEER I) NO. ���
-.ADDRESS
qqK ff I
_ ✓_. -
TEL.
CONTRACTOR NO.
ADDRESS
DESCRIPTION OF WORK''
NEW ADD zALTER. "REPAIR DEMOLISH.
SQ.FT. .',NO:OF NO.OF
SIZE '•yt-SX6�'.' STORIES FAMILIES.
USEOF « ,
STRUCTURE .
SIGNATURE OF
APPLICANT. - "' -•;gppROVALS" -DATE INSPECTOR'SSIGNATURE
ADDRESS" '.FOUNDATION: LOCATION'
,l FORMS,MATERIALS
VALUATION -.FRAME;FIRE
BRACING,ESTOPS, >
TS-
P.C. PMT. FURNACE:LOCATION.
FEE S, , 'FEE $ '-'--� -I - GAS VENT,.DUCTS -
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP
PLICATION AND'STATE THAT-THE`ABOVEISCORRECT.AND LATH.INT ',-
AGREE'TO-COMPLY WITH ALL COUNTY RDINANCES AND
STATE LAW - EGU G SU]LDq N CONSTRUCTIONI LATH EXT.
SIGNATURE \J" w HOUSE NUMBER COR= -
PERMITTE2- RECTAND'POSTED77
ADDRESS' •• F.INAL- `- /` f-
"CLYDE N DIRLAM, P wCI L-ST R EER
.PLAN-CHECK VALIDATION CK. " M.O.,' CASH,'. PERMIT VA DATION C
4 4 A a o
v
�..;8 6
�r
']8A898A_CE#80310_ge APPLICATION FOR BUILDING •f'ERM'1'i"
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION L0dAL1,TY`
JOHN A.LAMBIE,COUNTY ENGINEER. NEAREST'
CASSATT D.GRIFFIN,SUP'T.OF BUILDING - CROSS ST..�
DISTRICT NO. •AGR U TYpE PROCESSED BY
FOR APPLICANT TO,FILL INT
�s--
CONS
BUILDING. . STATISTICACLASSIFICATION- SEWER MAP
ADDRESS ��S' i L�I�IC/S ,aY • BK PG .
CLASS.NO.' 'DWELL.UNITS L
LOT-NO: / ..,BLOCK MAP'• STATE YES_<In-
���7' • - NUMBER b Ci '' HWY.. -
TRACT' !� USE ZONE
SPECIAL
NO.OF SIZE.OF LOT .J� / Q1 I .NOW ON LOTS 'CONDITIONS
USE OF
EXISTING BLDG. BUILDING . YARD• HWY - _STREET NAME EXIST-
BUILDING
/ �U SETBACK WIDTH
OWNER / - � '. � FRONT
MAIL // P.L.
ADDRESS
GanYQlI7 R SIDE " .
CITY e-1/ e -NEL O. ���dJ.? Ps Le
" INSPECTION RECORD
ARCHITECT OR TEL.
ENGINEER ;NO. t - -
ADDRESS
TEL. -
CONTRACTOR NO. - -
'ADDRESS
DESCRIPTION OF WORK
NEW ADD ALTER: REPAIR DEMOLISH
SQ,""FT. -•'NO.OF NO.OF
SIZE. STORIES FAMILIES - -
USE OF,STRUCT.�RE
SIGNATURE OF APPROVALS ,
APPLICANT
DATE �� INSPECTOR'S SIGNATURE
ADDRESS , J. 5' FOUNDATION: LOCATION" "` ✓ -
FORMS,MATERIALS
$ .. P.C. $ FRAME:'FIRE STOPS,,'
FEE '. -- .BRACING;BOLTS•` �¢-:;5 S"G�12.FY11'
VALUATION � FURNACE: LOCATION, •" _
FEE -
GAS VENT.DUCTS
1-H ERE BY'ACKNOWLEDGE THAT I HAVE REA6 THIS AP LATH,INT.
PLICATION AND STATE THAT THE ABOV IS CORRECT A ..
AGREE TO COMPLY I ALL COUNT 1 ANCES D -- � -
STATE .LAWS RE ING BUI LATH,*EXT:' -
SIGNATURE OF 1 HOUSE NUMBER COR
PERMITTEE RECT AND-POSTED
'ADDRESS FINAL �.7 ..
"CLYDE'N."DIRLAM. PRI NCI PALSTRUCTUW; E:!T .
PLAN CHECK VALIDATION. CK. M.O. cases PERMIT VALIDATION
Ego 72,8 0 144.29Z. :p 9. .
APPLICATION FOR BUILDING PERMIT
COUNTY,OF LOS ANGELESBUILDING AND,,SAFETY
WORKER'S COMPENSATION DECLARATION FOR.APPLICANT TO FILL IN BUILD G ADDRE S /2f
I hereby affirm that I have a certificate:of consent to self.insure,
BUILDING ADDRESS : J�
or a certificate of Workers' Compensation Insurance,or a certified 5 UNilil S
copy thereof(Sec 3800,•Lab.C.) p�
!
CITY l.7 ZIP
I /* 6 LOCA ITY
Policy NOi _ .
X5490
Company SIZE OF-LOT NO.OF BLDGS.NOW ON LOT
❑ Certified copy-is hereby furnished.} - - - - - NEAREST CROSS ST
-- ❑ Certified copy Is filed with-the'county building inspection TRACT BLOCK• - LOT NO., • AP '
department. - •4 . M NO. -
ASSESSOR MAP BOOK - --' PAGE PARCEL USE
ZONE
Date 'Z$_P5" Applicant O�1P�b�S�
SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS', OWNER /1/ Lg�7/7� WITHIN 1000 FT.OF SCHOOL? YES '
`COMPENSATION INSURANCE / No
(This section need not be completed if the permit is for one hundred ADDRESS'
DISTRICT GROUPTYP ONST. FIRE ZONE PROCESSED BY
dollars($100)or less.)
CITY - ZIP
I certify that in the performance of-the work for which this permit '
is issued, ( shall not employ any person in.any manner s0'as to.: ARCHITECT OR ENGINEER - • TEL NO.
become subject tp,the Workers'Compensation Laws. - STATISTICAL CLASSIFICATION APT CONDO
Date Applicant `' ADDRESS- - - - CLASS NO. DWELL UNITS
NOTICE TO •APPLICANT. If, :'after' making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST
Exemption, you- should. become subjedt .to the Workers' CONTRACTORS - TEL NO. .'. SET,BACK_ YARD HWY- - PROP,LINE `WIDTH ,
Compensation provisions of the Labor Code, you must forthwith �. K00riLtl� e_c,l � FRONT
comply with such provisions or this permit shall be deemed revoked., ADDRESS LIC.NO.- P L
LICENSED CONTRACTORS DECLARATION
a7 DU-�r �//9 R✓d ��ps°Z SIDE
CITY.T- - LIC.CLAS �? P L
I hereby affirm that I am`'licensed underprovisions-of'Chapter 9 ( � �pLL Cl'� G r .SEWER MAP
(commencing with Section 7000)Of Division 3 of the Business and SO.FT.SIZE , _NO.OF STONES NO.OF FAMILIES
Professions Code,and my license is in•full force*and effect. ozyOD — NEW BK PG >_
r�q+pp o_
License Number �i(O•� - - -LIC:Class G—�• DESCRIPTION WORK � ADD ❑ VALUATIONS- •. ® - 0-
C—T7 CD
Contractor L-A.�Cs` P-o Date `�'�$ ALTER ❑
Pt�La,�C P MPJ°?F� REPAIR ❑ 0
❑ I am exempt'under'Sec: $ V
BAP.C.for this reason DEMOL ❑ LDMA P/C# 1 W
Date: :` USE OF EXISTING BLD ' URM ❑
Signature ACCT°1r Z
, APPLIC T(PRINT) � �L NO. LDMA Perm#; - n
❑ I, as'owner of the.property, or.my employees with wages as. F� /y0�7P') �ti ZRIrj`7dD Z �V31 T
their sole compensation, will do the work and the structure is ADDRESS 1 ITEMS
3� N"$L 9/19 AV4' 7 C_ FINAL DATE p TOTAL 1-42 m"
not intended or offered for sale (Section•7044, Business and. 6 ? /� Q 1.
PfOfeSSIODS Code.) _ WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL - ,Y/ Z- L {{
OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Q 142.7 L'
❑ 1, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON'THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY �� NECK n
licensed contractors to,construct,the project (Section 7044, YES❑ No❑ �tA �E °flu
Business and Professions Code.), V
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(SCAQMD)SEE PERMITTING CHECKLIST FOR - '
GUIDELINES. - O
I hereby affirm that there is a construction lending agency for. YES❑ NO❑ SOD-0001 9/218 �
a the performance of the work for which-this permit is issued(Sec. - rryy����II (y{ °
I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 2,534 1 AM S.-12
30.97,Civ.C.) - _ CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, -
w TITLE 2.CHAPTER 2.20 SECTIONS 220.100 THROUGH 2.20.140 CONCERNING HAZARDOUS - -
3 Lender's Name _ MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. .,. j
o Lender's Address
O - OWNER OR AGENT - -
0 1 certify that I have read this application and state under penalty; '
0 of perjury that,the above information is correct.I agree t0 Comply F.C:FEE' PERMIT FEE
with all 'county ordinances and State laws relating to building
constr ction, and hereby authorize representatives of this County - - - ISSUANCE�FEE
to en r upon th bove-mentioned property for inspection purposes. /
Q � - INVESTIGATION FEE - - TOTAL FEE
-
SEE REVERSE FOR EXPLANATORY LANGUAGE -
WORKERS' COMPENSATION DECLARATION
I hereby affirm 'that I have d certificate of consent to'self
1. �►PPLhC/�ThON AOR UILDINIC9 [PERMIT
insure:or a certificate'af Workers' Compensation Insurance,
ur,a ce tif'ed copy Ther of (Sec: 3800, Lab. C f 1'.
� « /E,•Ca �..CA f.. SAFETY OF.LOS,ANGELES, " AB
Poliompany
CEirtifi6d:fcopy is tiereby furnished., , FOR APPLICANT JO:FILL,IN- ADDRESS
Certified copy i's.filed--w,ith,the.county building inspec- BUILDING
tion department': ADDRESS Ll./�_, LOCALITYLV.
NEAREST.
Date Applicant CITY �� ZIP CROSS'ST -' to
:CERTIFICATE.OF EXEMPTION FROM.-WORKERS' =- O. OF BLDGS..' r ASSESSOR
COMPENSATION'INSURANCE,
SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
( section need not be completed if the permit-is for one
USE ZONE MAP
This se c -.zCt.
hundred dollars ($100)or less.} ,., �"
SPECIALO /_
_ TRACT .BLOCK LOT NO.
.. TEL
OWNER NO G OUDITIONS }
certify that,in the performance of,the•work."for which-this FIRE PRO SSED BY O
permit is issued, I,shall not eriploy.any person,in any,manner DISTRICT P TYPE
CONST. ZONE t,
so as to.become subject to the•Workers•Compensation Laws "� -
5 <
qq
ADDRES /J'
CITY ZIP '
r � t'
Date ` Applicant TEL'. STATISTICAL CLASSIFICATION - APT. CONDO.
ARCHITECT OR
NOTICE TO"APPLICANT: If, after making this Certificate 'of . : '':-- _ �
Exemption,' you,.should become,'subject to'the Workers ENGINEER NO.
S5..
-C S5. DWELL UNITS
Compensation provisions of.the Labor Code, you-must forth- ADDRESS SEWER MAP
P P TEL.
VALIDATION
"*deemedwith �revokedh such rovis�ons or'.This ermit shall be NO: _ BK. PG,
P Y Z.
CONTRACTOR ��
LICENSEDrCONTRACTORS DECLARATION L�
I herebysbffirrri that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION
(commencing with Section 7000)of Divisiort3'of the Business and
'. LIC. l� t
Professions Code, and,my'l,icense is in full force and effect.', CITY. CLASS
SQ:.F.T. O.OF) NO.OF CHECK
icenseNumber Lic..Class SIZE STORIES FAMILIES : ONE
r., DESCRIPTION OF:WORK NEW $
❑ l actor Date
-Contr _
? .ADD
am exempt under Sec FINA
8, _
8P C. for"this reason
♦ . �'. DATE` :
,.-
ALTER
m
USE OF REPAIR
Date: EXISTING'BLDG: - _ DEMOL�.
• FINAL
Signature
APPLICANT` TEL.
jam° / _.
PRINT / CAM NO- n
By
OWNER-BUILDER DECLARATION �j7 ,O A
Thereby affirm That I qm exempt from the Contractor s License' t
. _ y •.
Law for the following,reason (Section J031:5; Business and ADDRESS #•,o.o 0 0-0
"�':-
- Professions Code) • :..: PRESENT
2004
BUILDING _ �, a �'
L; as-o'wn'er of;the property or. my employees with ADDRESS° `
wages as their-solecompensation,will do the work and { �Q a'e_4 Q,.>5 op,
LOCALITY
the.strbctureis'notintended'orofferedfor,sole'(Section, t '
7044 Business and Professions Code). MOVING " ' TEL:
: ❑ CONTRACTOR NO:
with%licensed cont ac ors_o'construct thely.c ject'(contracting
1,as owner of the ro ert am exclusive project (Sec- ADDRESS
tion 7044;Business and Professions Code);
REQUIRED, TOTAUSETBACK FROM ° ;EXIST,
CONSTRUCTION LENDING-AGENCY SETBACK YARD HWY� PROP. LINE `WIDTH
I hereby affirm that there is-o construction lending agency for FRONT
- 4 the•performance of the:work-for which this permit is.issiied P.L.:
(Sec. 3097`.Civ.-C ): SIDE
zo
P.
r
„s
'4 Lender's Name-
.
Lender's Address Fee
P C Fee$ Permit
> .,
,.� I certify-'that I;have read this,applicatiori-pnd,state that the' ' Issudnce Fee . ,/Q.:
a . above information"i5 correct. I_agree to'comply with.all County. Investigation Fee
g ordinances and:State laws relating to build ing'construction, Total,
v and hereli auf rize representatives of-this.County to enter
m upo e a o - ned pro rty or inspection-purposes:
y a
:
Q. Sfi
a E REVERSE,FOR;EXPLANATORY LANGUAGE.
Signature of Applicant or Agent Date
t ®s'
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT x!,
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0811180020
PHONE: (626) 285-0488 EXT:
ILEGAL ID: 1 NO. OF CONST 1 BUILDING ADDRESS: 1
ITR: 6561 LT: 241 I SQ. FT STORIES TYPE I 9559 LAS TUNAS DR 1
I (STRUCTURE: 2600 V-B i TEMP CA 917802107 I
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: I
18587-014-014 1 1i - THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl
' ITENANT: IEXIST BLDG USE: COMME USE ZONE: -C-1 (ISSUED ON: PROCESSED BY: I
I IEXIST OCC GRP: 111/18/08 SR 1
(OWNER: TEL.. NO: IBLDGS. NOW ON LOT: VALUATION: IFINAL DATECODE:
1CHIU DAVID (626) 286-9720- 1 4,800 1 , �� _ Y: I
9559 LAS TUNAS DR
ITEMP 917802107 - I FEES PAID IDESCRIPTION OF WORK
I - IREMOVE OLD ROOFING MATERIAL AND REROOFING WITH BUILT UP ROOFI
I IFEE DESCRIPTION: - QUANTITY: UOM: AMOUNT: 1 I
(APPLICANT: TEL. NO: I - I
IJIN (213) 675-3297- IAA BLDG PERMIT ISSUANCE 27.75
12426 W. 8TH ST. #222 IAE STRONG MOTION OTHER 4800.00 VAL .1.01 ISPECIAL CONDITIONS: 1
ILOS ANGELES CA 90057 ID2 PERMIT W/O EN-HC 4800.00 VAL ''132.60
1 TOTAL FEES 161.36 I 1
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1
IA & J MASTER ROOFING (323) 261-6600- I 1 I
12426 W. 8TH STREET, STE 222 LIC. NO ILOCATION AND SETBACKS I
ILOS ANGELES, CA 90057 726275 1 1 I
I I ISOILS ENGINEER APPROVAL I I 1
(ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I I
LIC. NO: (SLAB/UNDER FLOOR I I
IRAISED FLOOR FRAMING 1 1
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( (UNDERFLOOR INSULATION I I I
1150H269 3 001 1 - I
I I (FLOOR SHEATHING I 1
INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I 1_1
I I 1
NO 22 1 IROOF SHEATHING 1 1
'
SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS " - I I
(AIR QUALITY: 1000 FEET MATERIALS 1 I I I 1
NO NO NO I IFRAME INSPECTION 1 I I
IREQUIRED .TOTAL SETBACK FROM EXIST �I IFIRE SPRINKLER HANGERS I I I
ISET BACK YARD: HWY: PROP LINE: WIDTH: 1 I
IFRONT PL- 1 (INSULATION/WEATHER STRIPI I
I SIDE PL- 1 I 1 I
1 1 (INTERIOR LATH/DRYWALL I I I
1 IEXTERIOR LATH I 1
I 1 IRATED FLOOR/CEIL ASSEM. I 1
(RATED WALL ASSEMBLIES I
I IRATED SHAFTS/OPENINGS I
IT-BAR CEILINGS
I (LOT DRAINAGE I,
I IREPORT ID: DPR261 ROUTE TO: BS0508 1 I I
COUNTY OF LOS ANGELES - TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS COMMERCIAL ADD/ALT/REP
BUILDING AND SAFETY f LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1308210054
PHONE: (626) 285-0488 EXT:
ILEGAL ID: NO. OF CONST NEW 1 BUILDING ADDRESS: 1
ITR: 6561 LT: 241 j SQ.', FT ,, STORIES - TYPE OCCUP GROUPI 9559 LAS TUNAS DR 1
I ISTRUCTURE: � 49 1 V-B B I TEMP CA 917802107 1
(ASSESSOR INFORMATION.,NUMBER: I ( 1 NEAREST CROSS STREET: TEMPLE CITY 1
18587-014-014 I "!' _ I THOMAS-PAGE.: •596 -. GRID:. J3 LOCALITY:_ TEMPLE CITY CAI
I t I I
(TENANT: (EXIST BLDG USE: COMME - USE ZONE: C-1 (ISSUED ON: 'PROCESSED BY: 1
ITEMPLE CITY CAMERA (EXIST OCC GRP:' B - 108/26/13 SR 1
I I I I
(OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: (FINAL . ATE r FINAL BY- CODE: 1
ITEMPLE CITY CAMERA - 10,000, 1 / ;�d
19559 LAS TUNAS DR
I TEMP 917802107 j FEES PAID 1 DECF�SPT�I N�F WORK 1
IREMOVE AND REPLACE DAMAGED WALL FRAMING, CEILING,FRAMING 1
IEEE DESCRIPTION: QUANTITY: UOM: AMOUNT: I INTERIOR FINISHES & EXTERIOR FINISHES W/NEWMATCHING FRAMING(
(APPLICANT: TEL. NO: I - - (AND FINISHES 1
IERSTAD ENGINEERING (818) 249-8400- IA1 PLANCHECK W/EN-HC- 10000.00 VAL 211.70 1
13463 OCEAN VIEW BLVD IAA BLDG PERMIT ISSUANCE 27.80, ISPECIAL CONDITIONS:
IGLENDALE CA 91208 jAB STATE GREEN BLDG FEE 10000.00 VAL 1.00 1 -
I IAE STRONG MOTION OTHER 10000.00 VAL 2.10 i
IA2 PERMIT W/ENERGY-HC 10000.00 VAL 249.10 1 -
ICONTRACTOR: TEL. NO: ! TOTAL FEES 491.70 (APPROVALS DATE INSPECTOR SIGNATURE 1
(AMERICAN TECHNOLOGIES INC. (818) 700-5060- 1-
1210 W. BAYWOOD LIC. NO I ILOCATION AND SETBACKS
IORANGE,CA 92865 571784 I
. ISOILE ENGINEER APPROVAL
I ! I I I I
(ARCHITECT OR ENGINEER: TEL. N0: I (FOUNDATION/TRENCH FORMS
IERSTAD ENGINEERING (818) 249-8400- 1
13463 OCEAN VIEW BLVD LIC. NO: I ISLAB/UNDER FLOOR
IGLENDALE CA 91208 NONE I
I - I RAISED FLOOR FRAMING
I I I I I I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: ( UNDERFLOOR INSULATION
3 001 l y
IFLOO: SHEATHING
INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: - I
1 0 NO 22 1 (ROOF SHEATHING I I
SCHOOL WITHIN HAZARDOUS ","ISHEAR. PANELS I I
(AIR QUALITY: 1000 FEET MATERIALS
1 NO NO NO 1FRAME INSPECTION 1
IFIRE SPRINKLER HANGERS
(INSULATION/WEATHER STRIPI I I
I i I I I I
I I (INTERIOR LATH/DRYWALL 1 ^ 1
I I (EXTERIOR LATH I
IRATED FLOOR/CEIL ASSEM. 1 1 1
I I I I I I
IRATED WALL ASSEMBLIES I I
IRATED SHAFTS/OPENINGS I I
I I I I I
IT-BAR CEILINGS - I
I I I I I I
. 1 (LOT DRAINAGE - I
t �
IREPORT ID: DPR261 ROUTE TO: BS0508 I I
I I I I I I