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HomeMy Public PortalAbout9611 LAS TUNAS DR_Building__ APPLLCAnON FOR. COUNTY OF LOS ANGELES 'BUILDING PER'MIT DEPARTMENT BUILD NG AND SAFETY DIV SION ENGINEER FOR APPLICANT TO FILL IN ADDRRESS.. 7 V- S' BUILDING f LOCALITY ADDRESS S k� {�/��/ ��r" NEAREST CITY �� ZIP CROSS ST. ��►�i L C L, NO.OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT MAP•BOOK. PAGE PARCEL DISTRICT. GROUP TYPEFIRE PROCESSED BY -TRACT BLOCK LOT NO. -` CONST. ZrO,NE i TEL. % !.o s 6 OWNER �i NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS /'>I CLASS NO. DWEL4.UNITS �-BK CITY ZIP USE ZONE. MAP ARCHITECT OR TEL: NO.'..' ENGINEER NO. SPECIAL CONDITIONS ' ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ TEL. CONTRACTOR 'GPoO. 6 / BLDG.SETBACK FROM., 2 FRONT PROP.LINE OF (STREET) .ADDRESS/ IU As P IC3,,are S3 TAL SETBACK FROM r TYPE OF I EXISTING HIGHWAY + YARD-32 RONT PROP.LINE HIGHWAY WIDTH LIC. . CITY 6IG' CLASS�� CONSTRUCTION LENDER + - y NAME AND BRANCH BLDG.SETBACK FROM u SIDE PROP.LINE OF (STREET) ADDRESS CITY O SQ.FT NO.OF NO.OF CHECK HIGHWAY + YARD = TOTAL SETB K FROM TYPE OF EXISTING ~ SIZE STORIES FAMILIES ONE SIDE PROP. INE HIGHWAY WIDTH . a V) DESCRIPTION OF WORK ADD. ❑ CORNER CUTOFF YES ❑ NO ❑ Agb �cnr . ' a7_ Q ALTER ', ❑ IN OPEN SPACE YES. ❑ ❑ !� REPAIR' USE OF. ❑ -IN COASTAL PERMIT ZONE YES ❑ NO\(:] EXISTING BLDG. DEMOL- APPLICANT�� TEL (PRINT)/ t�� rLtNO. D�I / -L� /D�� ��.. W. Cab BY(SIGNATURE) `713' 7 'I"HEREBY'ACKNOWLEDGE"T T I.HAVE READ THIS APPLICATION AND STATE /'I/D wS. �j-�Ti q/Q THAT THE ABOVE IS CORRECT-AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THEy- WORK AUTHORIZED HEREBY I-WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM, .PENSATION INSURANCE I SIGNATURE FINAL BY - PERMITTEE DATE ADDRESS CIT `C NO P.C. Fee$ Permit Fee Q 'Issuance Fee VALUATION$ Total Fee V "� PLAN CHECK VALIDATION . CK. 'M.o, ' CASH PERMIT VALIDATION M.O. CASH . 2 4.0 (),A? p '5 6"ter' ©5'76A638A CE i803A 6/76 " - .76A638tlCE #803 1/71 � t APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING ADDRESS COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST Print ort a only)--- CROSS ST. u. BUILDING DISTRICT NO. G UP TYPE P E�$$%S DD B ADDRESS �,� ` CONST. JU LOT NOSTATISTICAL CLAS FICATION SE ER MAR BLOCK. l CLASS NO.!??O_QIWEL L,UNITS BKPG TRACT USE ZONE MAP NO.OF BLDGS. NO. SIZE OF LOT NOW ON LOT SPECIAL USE OF CONDITIONS EXISTING BLDG. OWNER F jTEL. (' ^, NO BLDG.SETBACK FROM ADDRESS kc 641 FRONT PROP.LINE OF (STREET) I TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL CITY - F f'c.l C HIGHWAY WIDTH FROM C.L. ARCHITECT O TEL. } _ ENGINEER NO. BLDG.SETBACK FR ADDRESS SIDE PROP. LINE OF (STREET) S- TYPE OF EXISTING SETBACK HI AY } YARD = TOTAL CL TEL c:)CONTRACTOR ` NO. HIGHWAY WIDTH FROM C.L. C') LIC. . _ ADDRESS C�'r Q"(' NO. 1 - 2 p LIC. C ~' CITY + CLASS CORNER CUTOFF YES ❑ NO ❑ W CONSTRUCTON LENDER NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS Z ADDRESS SQ. FT. NO. OF NO. OF I NEW ( SIZE STORIES FAMILIES ❑ e, USE OFADD ADD STRUCTURES �... � ALTER ❑ _ REPAIR❑ SIGNATURE OF --- . '7Z=l _ APPLICANT V:+L�l'tail DEMOL ❑ VALUATION $ /_S CSS �� APPROVALS DATE INS PEC TOR's SIGNATURE R,C. / PMT, y FOUNDATION: LOCATION FEE $/ � FEES 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 ANY PERSON IN VIOLATION OF THE LATH, INT, LABOR CODE OF TME STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION INSURANCE. LATH, EXT, SIGNATURE OFLL RECT AND POSTED tyt rtsti►t HOUSE NUMBER COR- ADDRESS -'S LCt„Ze C�-f "'I. c FINAL JOHN F. LEWIS, PR NCIPAL SCCK. URAL ENGINEER PLAN CHECK VALIDATION CK, M.O. CASH _ PERMIT VALIDATION M.O. CASH 1 ^ 24y9L` .,���. 9 2 3 D DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES WM.-J.--FCX. CHIEF ENGINEER BUILDING FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING T DISTRICT NO. PLAN CK.NO. PERMIT NO. -77 ADDREBS 211 i�• La S `Punas .lir .. r� -°-��. 3 c�� LOCALITY Temple City, Ca 1 i f . RECEIVED BY DATE OF APPL. DATE ISSUED ...M, Sunset Blvcl . , G'�" Q ,,., -q-�- `� � —S�—So OWNER Hobert Brenneman ADD BUILEISS ADDRESS Same MAIL LOCALITY TEL. NEAREST v , CITY NO. CROSS ST. FIRE NO.OF TYP GROUP ARCHITECT OR TEL. ZONE PLANE ENGINEER NO. ORD.NO. S LD O. �1 ADDRESS SETBACK LINE _ APPROVED CONTRACTOR AA Sign Co, TEL• Ch 022-03 BY DATE IJ9E APPROVED ADDRE89 325 N 77i c tory l31vcl ,Burbank ZONE BY DATE LEGAL I �c CORRECTIONS DESCRIPTION LOT NO. BLOCK TRACT -S NO.OF SIZE OF LOT-Z-- X �/� [� I NOW ON LOTS UBE OF I NO.OF I NO.OF EXISTING BLDG.� �� F ; FAMILI[B ROOMS e DESCRIPTION OF WORK NEW ALTERATION ADDITION O A REPAIR MOVING DEMOLISH G_ Bq.FT. NO.OF Z SIZE ROOMS STORIES ID' WALL I ROOF COVERING COVERING USE or NEW BUILDINIII erect neon sign on existing building 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE OFA �T MIT BRACING,BOLTS 2ir� PERMITTEW LATH, INT. AUTHORIZED AOT LATH, EXT. 76AG38A-3 2-50 P.C.• PLASTER,INT. 10 0 CO FEE PLASTER,EXT. / VALUATION 41 . 50 FEE FINAL12t 41TOM I APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES SE, 21 """BUILDINGWM. J. FOX, CHIEF ENGINEER NO.OF BLDG. ORD.NO DISTRICT NO. PLAN CK. NO. /PERMIT NO, PLANS L- SETBACK LINE FIRE APPROVED ZONE BY DATE RECEIVED BY DATE OF APPL. DATE ISSU/ESD USE '7 APPROVED n It ZONE BY DATE ' +` APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY C BUILDING _" _ T' � .`'�- lJr 0 NAME H"ry T Miller ADDRESS ' Lti UZ ADDRESS 4$14 Lnrp Vista _ LOCALITY Temple City , F - U W CITY Los Angeles 11, California _ CROSS . Q STATE TEL. LICENSE NO. 13-1094 NO. JE 5234 NAME A. L. Hamsony W MAIL NAME Sam. P. Neil Co. � Ltd. 3 ADDRESS 4405 Fruitland Avenue 0 0 Q ADDRESS 4814 Lora Vista . CITY LOS AngelesTEL JE 7151 ~ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS ZO CITY Los Angeles 11, California. APPLICATION AND STATE THAT THE ABOVE IS CORRECT U STATE TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ` LICENSE NO.46 p NO. J—b 5234 AND STATE LAWS REGULATING BUILDING CONSTRUCTION. Z LOT NO. 182 & 183 SIZE OF LOT 50 X 11C SIGNATURE OF 0 _ OWNER J P NO. OF BLDGS. AUTHORIZED AGT.Z�� Q a BLOCK NOW ON LOT W r i -' W TRACT 6561 / CORRECTIONS D USE OF BLDGS. NOW ON LOT -- DESCRIPTION OF WORK USE OF BUILDING Furniture Store J Q %r1 11IJ t Z AA Y ` + AA O NEW X TYPE III GROUP F - NO. OF NO. OF ALTERATION ROOMS 1 FAMILIES ADDITION SIZE �X 50 REPAIR STORIES 1 MOVING WALL COVERING None DEMOLISH ROOF COVERING Q0=08iti 25,000.00 FEE $ 21.00 FINAL APPROVAL $ 42*00 _ INSPECT VALUATION FEE DATIt ' ' ✓•�'�"� NAME 76A638A CE✓"803 5-65 APPLICATION FOR BUILDING PERMIT ' COUNTY OF LOS ANGELES B U I L D I N V / r DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST ``� COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS ST. � � m -f /.- `�4 f✓ DISTRICT NQ. GR UP TYPE -� PRO16ESSED BY FOR APPLICANT TO FILL IN �j�`�%3f 7, CONST.,L -/-f BUILDING?7 --77`,,,jc/Yj/004.E STATISTICAL CLASSIFICATION SEWER MAP ADDRESS ��� L BK PG CLASS NO. DWELL UNITS LOT NO. -2_ — 'j BLOCK USE ZONE MAP NO. = L TRACT , 4 C ,-7 SPECIAL NO. OF BLDGS. CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. 'rM j - S re BLDG. SETBACK FROM _ TEL. FRONT PROP. LINE OF (STREET) OWNE R.4erNO. TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL ADDRESS ,�r � j./� S �.•,/R HIGHWAY WIDTH -FROM C.L. CITY / AoO/',PT/lo' BLDG. SETBACK FROM + ARCHITECT OR TEL. SIDE PROP. LINE OF (STREET) ENGINEER NO. — 5/// _ TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL ADDRESS/09C L �/q,- t IGHWAY WIDTH FROM c.L. TEL. S + - d CONTRA CT'weif ,SV4 C ,{ O ADDR T4Al:1014 az NO .,2 CORNER CUTOFF YES NO V CC CITY .G n/A (fAL. CLASS �' SEE REVERSE SIDE FOR SPECIAL APPROVALS 0 DESCRIPTION OF WORK w a N NEW ADD ALTER REPAIR DEMOLISH Z SQ.FT. NO. OF NO. OF SIZE STORIESJ r`, FAMILIES USE OF STRUCTUR !` /^" �QN rA_7 X P, 0 ../ / kc; / SIGNATURE OF APPLICANT VALUATION$ CC APPROVALS DATE INSP EC TO SSIG NATURE P.C. �,�'� PMT. FOUNDATION, LOCATION J -� FEES FEE$ Z FORMS, MATERIALS FRAME, FIRE STOPS, L� HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION BRACING 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 9UILD ING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK y. AUTHORIZED REBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT" ING TO WORKM 'S O NSATION INS NCE. LATH. EXT. --,7 -�i/ SIGNATURE O HOUSE NUMBER COR- PERMITTEE �J RECT AND POSTED ADDRESS • ' �2/ Fl NAL / /V"A e JOHN F. LEWIS. PRINCIPAL STRU URAL ENGINEER PLAN CHECK VALIDATION cK. M.O. CASH _ PERMIT VALIDATION CK. M.O CASH t� 2 ,n �'��,Y 2 2 3 0 1 6.25i 2 2 ` C". '4 1 D 3 2.5v� ,:VJ G{� , 76A 638A CE1803 5-65 APPLICATION FOR BUILDI G PERMIT COUNTY OF LOS ANGELES BUILDING (_— __� I DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST ? COLEMAN W. JENKINS,SUP T OF BUILDING CROSS ST. DISTRICT NO. GR PP TYPE PR ED BY FOR APPLICANT TO FILL IN C) ��" CONST. BUILDING STATISTICAL "ASSIFICATION SEWER MAP ADDRESS T vr. CLASS NO. DWELL UNITS E9K PG T LOT NO, l' .�` BLOCK USE ZTEMAP O. L TRACT J PECIAL N0. OF SLOGS, ONDITIONS SIZE OF LOT NOW ON LOT USE OF d ` EXISTING BLDG.�u r�rJ ISL J • r e BLDG. SETBACK FROM TEL. FRONT PROP. LINE0 (STREET) OWNER L . jl'/ NO. - TYPE OF EXISTING SE CK HIGHWAY '{- YA - TOTAL ADDRESS �G. /3 t� ��, HIGHWAY "WIDTH FROM L. CITYSETBACK ROM ARCHITECT OR TEL. SIDE PROP. LINE F (S REET) ENGINEER NO. TYPE OF I EXISTIN SETBACK HIGHWA -� YARD = T AL ADDRESS r HIGHWAY WIDTH FROM C.L. CONTRACT. a C- NOLr1 3`y7 IJ + + _ O IC 1 CORNERC TOFF YES NO V ADDRESS C NO 1S 7 )L- CC CITYY ' fin CLfL C� �-U SEE REVERSE SIDE FOR SPECIAL APPROVALS 0 DESCRIPTION OF WORK v NEW ADD ALTER REPAIR DEMOLISH SQ.FT. NO. OF NO. OF �.�. ('� 'J-. ' / /- �• : SIZE STORIES FAMILIFS USEOF STRUCTURE J ye � SIGNATURE OF APPLICANT f" t;'�y (,.�✓-c"--- VALUATION$ APPROVALS DATE INSPECTOR'SSIGNATURE P.C. V PMT. +j _ FOUNDATION, LOCATION FEE ' FEE$ 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 WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS 9UILDI NG CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LABOR CODC OF THE ST E OF CALIFORNIA RELAT- ING TO WORKMEN'S CnMPE AT N I RANCE. LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE_ �" - RECT AND POSTED - ADDRESS F I N A L JOHN F. LEWIS, PRINCIPAL STR RAL ENGINEER PLAN CHECK VALIDATION CK, M O. CASH _ PERMIT VALIDATION CK. M.G. CASH Lr1�Go 5 7 1 `n APR 2 7 1 D 1 5.00- WORKERS'COMPENSATION DECLARATION insurebor afC'ertifcarte off Workers' CompensatoneInsuran a certificate of consnt to of APPLICATION FOR BUILDING PERMIT or aiCertified copy thereof (Sec. 3800, Lab. C.) Policy No.P 0 9 7 5 5 8 SCompon}fieP ub l i C I n d em n .t COUNTY OF LOS ANGELES:. BUILDING AND SAFETY ❑ BUILDING Certified copy is hereby furnished. ,POOR-APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS 96 ' La c . 'i' P LOCALITY NEAREST Date 1 1 —1 -8 5 Applicant$a n d Q 1 " R O o f i n Ct CITYZIP CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' NO. 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 USE ZOi", MAP O hundred dollars ($100)or less.) TRACT BLOCK LOT NO. NO. TEL. SPECIAL �. I certify that in the performance of.the work for which.this OWNER O. CONDITIONS IL permit is issued, I shall notemploy any person in any manner DISTRICT GROUP TYPE FIRE PR ESSED BY O so as to become subject to the Workers'Compensation Laws. ADDRESS 9611 Las `Punas Dr. (� � ONST. l ZONE640-V U ad CITY Temple "City , Ca : ZIP 91780 (� il// I O Date ,1 2 3 0-:8 t Nppl icant R a n d A 1 R 0---F, STATISTICAL CLASSIFICATION APT, JC�ONO V NOTICE TO APPLICANT: If, after making this,Certificate of ARCHITECT OR TEL. ENGINEER NO. CLASS NO. DWELL. UNITSLU Exemption, you should become subject to the Workers'' J_ Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP H with comply with such provisions or this permit shall be deemed revoked. CONTRACTOR Ra n d o 1 Roof"i.n g NOTEL. 288-4040, gK PG VALIDATION LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 'RON203 NO.' VALUATION _j (commencing with Section 7000)of Division 3 of the Business and UC. Professions Code, and my license is in full force and effect. CITY San GAb r i,e 1 , Ca . CLASS C 3 9 $ 4184 . 00 SQ. FT. NO.OF NO. OF CHECK ► t License Number 4 5 1 ()3 7 Lic.Class r— 9 SIZE STORIES IFAMILIES ONE Contractor R a n d o l Ro o f z..n 12-10-84 DESCRIPTION OF WORK — NEW ❑ $ �ate ADD ❑ 1 2 5 2'A p . . ❑ I am exempt under Sec. witbOwens Fiber Blas ALTER E] FINAL #'a ® 0 m 0 1 B.&P.C. for this reason REPA R © DATE/0 1:0 0 0.7Q00 Date: USE OF DEMOL ❑ EXISTING BLDG. gy 0 �'e 7&0 0'5' Signature Si APPLICANT TEL. g OWNER-BUILDER DECLARATION PRINT Ra,n d o 1Ro o f i.n" g NO.2 8 8r-4 040 2 2 =8 LL I hereby affirm that I am exempt from the Contractor's License ^G P . 0. B o X 303 . S , G. 917 7 8 Law for the following reason (Section,7031.5, Business and ADDRESS Professions Code): PRESENT --' ❑ BUILDING I; as owner of the property, ormy employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 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- rADDRE tion 7044,Business and Professions Code). D TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY K YARD HW PROP.PROP. LINE WE I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). " FD 0 Lender's Name PermitFee 7Lender's Address I certify thaT I have read this application and state that.the Issuance Fee $10 . 50above information is correct. I agree to comply with all County on Fee g ordinances and State law luting to building construction, Total Fee878 . 00 u and reby authorize Y ntatives of this County to enter m u n a v e i prope f inspection.pur oses. - a .,111aSEE REVERSE FOR EXPLANATORY LANGUAGE Signature o Applicant or Agent Date - ®a WORKERS'COMPENSATION DECLARATION I ,heveb affirm.that I have a certificate of consent to self #insure, or a certificate of Workers' Compensation Insurance, APPLICATION F_ O_ B U I L D I N G PERMIT or a certified copy thereof Set. 3800, Lab. C-L ����� y ����. COUNTY OF LOS ANGELES BUILDING AND SAFE Y Policy No. ompany BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDINADDRESS 1 �,/,�/C`ertifiepd copy jis filed�with•the county building inspec- BUILDING�/' j u n A w -' tion department. y r ADDRESS 6 [a�[5 �/J 331 R 7 Applicant ' / C �, J 0^) _ t . _ Date wrlyL� CITY + O ZIP / ��v LOCALITY CERTIFICATE OF,EXEMPTION FROMWORKERS' NO. OF BLDGS.- - NEAREST COMPENSATION INSURANCE SIZE OF LOT, �- O✓ NOW ON LOT CROSS ST. (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 TEL U E ZONE MAP OWNER o I certify That in the performance of the work for which this y- �UC� NO. � ^ NO. >- permit is issued, I shall not employ any person in any manner (J/. SPECIAL d. so as to become subject to the Workers'Compensation Laws. ADDRESS" CONDITIONS Q CITY ZIP _ p� Date Applicant ARCHITECT OR TEL. DISTRICT G OUP TYPE FIRE PROCE ED.BY NOTICE TO APPLICANT: If, after making this Certificate of- Exemption, f ENGINEER NO. CONST. ZONE V Exemption, you should become subject to the Workers'' �j Compensation provisions of the.-Labor Code,-you must forth- ADDRESS t/� `' N with comply with such provisions or this permit shall be +* TEL ,Z/3 STATISTICAL CLASSIFI ATION APT. CO O: deemed revoked. CONTRACTOR ! X NO. 3 C� LICENSED CONTRACTORS DECLARATION `> LIC.,,ss �j,��� CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS &o,2 ���� NO.7�%�J (commencing with Section 7000)of Division 3 of the Business and LIC: SEWER_&pAP Professions Code, and my license is.in full force and effect. CITY �je(1/L� CLASS �3 BK PG J{ VALIDATION j/��i� /`� _ SQ. FT. SNO.TO IE FA OF CHECK vvv License Number 7 (rte Lic.Class 1. SIZE STORIES FAMILIES ONE QEF NEW ❑ V UATION DESCRIPTION OF-WORK- Contractor � � Date �J V E/�ouE' aG �o� ADD ❑ am exempt under Seca ❑ ALTER B.&P.C. for this reason f7dT �/' �LcfE/t/So REPAIR ❑ $ " USE OF ❑ Date: EXISTING BLDG. OL - - Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) 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 FI Pfofessions Code): PRESENT BUILDING ❑ 1, 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 7044, Business and Professions Code). MOVING TEL: - g 6 7 7, 1 A ❑ I, as owner of The property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct'the project (Sec- #,o 0 0 0'0 tion 7044, Business and-Professions Code). ADDRESS CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY` TOTAPROBACNEFROM WIDTH. i ® - 59.25 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. ' o'o 0 5 9,2 5 5 (Sec. 3097, Civ. C.). SIDE P.L. 8'7 Lender's Name g �( LDMA Ref. # m P.C. Fee$ Permit Fee O >= Lender's Address ^ I 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 ordinances and State laws relating to building_construction, Notal Fee 1 LDMA Perm. u and eby autho a representatives of this County to enter m up t e ab a ne top ty for inspection purposes. 3 3% ' a SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of App ican l r'Agent- -- Date - ' " •"- '-' '- _ - COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS COMMERCIAL ADD/ALT/REP BUILDINZ AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0206120041 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: TR: 6561 LT: 182 BL: .001 SQ. FT STORIES TYPE OCCUP GROUP 9611 LAS TUNAS DR STRUCTURE: 0 2 VN B TEMP CA 917802109 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: TEMPLE CITY 8587-019-017 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: COMME USE ZONE: C-1 ISSUED ON: PROCESSED BY: EXPIRES N: EXIST OCC GRP: B 06/12/02 JK 12/09/02 OR OWNER: TEL. NO: BLD S. NOW ON LOT: VALUATION: FINAL DAT L BY: CODE: TAI JI MEN QIGONG ACADEMY 100 9611 LAS TUNAS DR EXFIKLLJ TEMPLE CITY 91780 FEES PAID DESCRIPTION OF WORK REMOVE PARTITION WALLS ON SECOND FLOOR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: SAME AS OWNER (626) 673-5094- AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 100.00 VAL 0.50 SPECIAL CONDITIONS: CHENGCHEN SHIN D2 PERMIT W/O EN-HC 100.00 VAL 43.65 TOTAL FEES 71.90 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. NO: SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION X 3 04 FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 22 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION FIRE SPRINKLER HANGERS INSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1302110053 PHONE: (626) 285-0488 EXT: LEGAL ID: INUMBER OF SIGNS: 1 BUILDING ADDRESS: ITR: 6561 LT: 182 BL: .001 ISIGN DESCRIPTION: INSTALL ONE SET OF ILLUMINATED CHANNEI 9611 LAS TUNAS DR I _I I TEMP CA 917802109 1 (ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: TEMPLE CITY 18587-019-017 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl (TENANT: (EXIST BLDG USE: (ISSUED ON: PROCESSED BY: 1 IMR. WONG JEXIST OCC GRP: 102/11/13 SR 1 OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: (FINAL DATE FINAL BY: CODE: CENTRAL MATRIX INC. (626) 780-5704- I 1,600 19611 LAS TUNAS DR. TEMPLE CITY CA 91780 FEES PAID IDESCRI T�IO13 OF WORK I JINSTALL ONE SET OF ILLUMI TED CHANNEL LETTERS 1 I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( 1 APPLICANT: TEL. NO: I I ISHAR, KYI CHOW (626) 444-6027- 1AA BLDG PERMIT ISSUANCE 27.80 I 1 19868 KALE ST IAB STATE GREEN BLDG FEE 1600.00 VAL 1.00 ISPECIAL CONDITIONS: 1 ISO EL MONTE CA 91733 IAX BUILDING REVIEW FEE 54.70 1 ID2 PERMIT W/O EN-HC 1600.00 VAL 82.20 TOTAL FEES 165.70 ICONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE IKYI CHOW SHAR (626) 444-6027- I 19868 KALE STREET LIC. NO ILOCATION AND SETBACKS SOUTH EL MONTE CA 91733 652665 I ISOILS ENGINEER APPROVAL (ARCHITECT OR ENGINEER: TEL. NO: (FOUNDATION/TRENCH FORMS I I I 1 LIC. NO: 1 I'SUPPORT STRUCTURE I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: I I I I I ool I I I INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I I I I NO 20 -i I SCHOOL WITHIN HAZARDOUS I I I I (AIR QUALITY: 1000 FEET MATERIALS I NO NO NO I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I* ADDITIONAL DATA ON FILE I I I I I IREPORT ID: DPR261 ROUTE TO: BS0508 I I I 13. t COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0512290035 PHONE: (626) 285-0488 EXT: LEGAL ID: NUMBER OF SIGNS: 1 BUILDING ADDRESS: TR: 6561 LT: 182 BL: .001 SIGN DESCRIPTION: CHANNEL LETTERS SIGN 9611 LAS TUNAS DR TEMP CA 917802109 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8587-019-017 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 12/29/05 JK 12/24/06 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DAT& L BY: CODE: RU HUA SONG (323) 261-1198- 1,800 VIA 9611 LAS TUNAS DR A4 TEMPLE CITY CA 91780 FEES PAID -DESCRIP7tM OF WORK' CHANNEL LETTER SIGN _ FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: ARTIST SIGNS & ART SERVICE CORP. (626) 288-6872- AA BLDG PERMIT ISSUANCE 27.75 8919 E. GARVEY AVE AX BUILDING REVIEW FEE 54.70 SPECIAL CONDITIONS: ROSEMEAD, CA 91170 D2 PERMIT W/O EN-HC 1800.00 VAL 82.20 TOTAL FEES 164.65 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE ARTIST SIGNS AND ART SERV CO. (626) 288-6872- 8919 E GARVEY AVE #C3 LIC. NO LOCATION AND SETBACKS ROSEMEAD CA 91770 811413 C45 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. NO: SUPPORT STRUCTURE MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 00 NO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS _ NO 20 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO REPORT ID: DPR261 ROUTE TO: BS0508 4� COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS TENANT. IMPROVEMENT BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1209170037 PHONE: (626) 285-0488 .EXT: LEGAL ID: NO. OF CONST NEW I BUILDING ADDRESS: ITR: 6561 LT: 182 BL: .001 SQ. FT STORIES TYPE OCCUP GROUP 9611 LAS TUNAS DR STRUCTURE: 2800 1 V-B B i TEMP CA 917802109 (ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: TEMPLE CITY 18587-019-017 1 1 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl (TENANT: JEXTST BLDG USE: COMME USE ZONE: IIS ED ON: PROCESSED BY: I I IEXIST OCC GRP: B (09 25/12 SR OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFINAL DATE FINAL BY: CODE: CENTRAL MATRIX INC. (626) 780-5704- 1 20,000 19611 LAS TUNAS DR. I ITEMPLE CITY CA 91780 I FEES PAID IDESCR PTION OF WORK ITENANT IMPROVEMENT W/2 RESTROOMS, 5 PRIVATE OFFICE, LUNCH IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: IROOM, CONFERENCE ROOM & ACCESIBLE RAMP APPLICANT: TEL. NO: I (CENTRAL MATRIX INC. (626) 780-5704- IA1 PLANCHECK W/EN-HC 20000.00 VAL 375.90 I 19611 LAS TUNAS DR. IAA BLDG PERMIT ISSUANCE 27.80 ISPECIAL CONDITIONS: -" TEMPLE CITY CA 91780 IAB STATE GREEN BLDG FEE 20000.00 VAL 1.00 IAE STRONG MOTION OTHER 20000.00 VAL - 4.20 _IA2 PERMIT W/ENERGY-HC 20000.00 VAL 442.30 CONTRACTOR: TEL. NO: 108 CERTIF OF OCCUPANCY 101.40 JAPPROVALS DATE INSPECTOR SIGNATURE (CENTRAL AIR SYSTEM (909) 985-9542- 1 TOTAL FEES 952.60 1_ 12105 N 2ND LIC. NO I ILOCATION AND SETBACKS (UPLAND, CA 91784 445225 * 1 I ISOILS ENGINEER APPROVAL (ARCHITECT OR ENGINEER: TEL. NO: I IFOUNDATION/TRENCH FORMS 1 I - II . I I LIC. NO: ISLAB/UNDER FLOOR I I IRAISED FLOOR FRAMING I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: I (UNDERFLOOR INSULATION I I I 3 041 IFLOOR SHEATHING INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I 0 NO 22 I IROOF SHEATHING 1 I I I I I I I SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS (AIR QUALITY: 1000 FEET MATERIALS I NO NO NO I IFRAME INSPECTION rh/ I I IFIRE SPRINKLER H?1VGERS I` I I (INSULATION/WEATHER STRIPI I -��---- IINTERIOR LATH/DRYWALL EXTERIOR LATH IRATED FLOOR/CEIL ASSEM. IRATED WALL ASSEMBLIES I I I I IRATED SHAFTS/OPENINGS I I I I IT-BAR CEILINGS I* ADDITIONAL DATA ON FILE II ILOT DRAINAGE IREPORT ID: DPR261 ROUTE TO: BS0508 I I