HomeMy Public PortalAbout9666 LAS TUNAS DR_Building__ APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Print or type only)
BUILDING 47 COUNTY OF LOS ANGELES
ADDRESS // s , ) .0 i¢ r9�S DEPARTMENT OF COUNTY ENGINEER
CITY _� C ', ZIP BUILDING AND SAFETY DIVISION
IND.OF BLDGS. BUILDING
SIZE OF LOT NOW ON LOT ADDRESS
TRACTS J BLOCK LOT NO. LOCALITY `
N/ NEAREST
OWNER CROSS ST.
ASSESSOR
ADDRESS 6 Q Z.45 7-u,/Is cl MAP BOOK PAGE 11ARCEL
DISTRICT GROUP TYPE FIRE PRO SSED BY
CITY Z[ �ti ZIP CONST. ZONE 00,
ARCHITECT % � .)�-/ NO. (�L7 u )
ENGINEER h le f/ /V STATISTICAL CLASSIFICATION
SEWER M P
ADDRESS CE) R-.- ' CLASS NO, y2�DWE/L1L.UNITS BK12dPG
CONTRACTOR ' 744 ShW 9 NOL n3O aO USE ZONE NOP 0(/
AoDRESS2 YO I C, /17IY19 A 0419 �7 ` —I CONDITIONS
CITY /v��-�� CLASSG �
ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONSTRUCTION LENDER
NAME AND BRANCH BLDG.SETBACK FROM
ADDRESS CITY FRONT PROP.LINE OF (STREET)
HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
SQ. FT, FNO. OF NO. OF CHECK ` FRONT PROP, LINE HIGH Y WIDTH
SIZE STORIES FAMILIES ONE
b0
•
DES'CRI PTION OF WOR NEW ❑. U
ADD BLDG.SETBACK FROM
A f/ ❑ SIDE PROP.LINE OF (STREET)
ALTER 1 HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF EXISTING Ga~.7
// REPAIR❑ SIDE PROP. LINE HIGHWAY WIDTH
USE
EXISOT NG BLDG.64v1 \ �}/1!ff DEMOL ❑ +
AP PRIN 1 ��a L z1Pj NOLI.^jCY J1OC7' CORNER CUTOFF YES ❑ NO ❑
BY (SIGNATURE) V
1 /� ��• IN OPEN SPACE YES ❑ NO ❑
��
`. C.�f "!!> IN COASTAL PERMIT ZONE YES ❑ NO
VALUATION lQO
❑
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY '
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY AT IN DOING TH WORK AUTHORIZED
i HEREBY 1 WILL NOT f+ P Y ANY PERSON VIOLATION OF THE
'+ LABOR CODE OF T)IE PTE OF •CAL RNIA IN RELATING TO
WORKMEN'S COMPEA I ${IRAN
SIGNATURE OF'I G
PERMITTEE
ADDRES `
A
c{, hh FINL BY
TE
CITY G�'� NOL J0 ' v�• DATE
MAKE CHECKS PAYABLE TO: FEFEE
t
HARVEY T. BRANDT, COUNTY ENGINEERl
� �
PLAN'CHECK VALIDA SON CK. M. . CASH / PERMIT VALIDA ION ' CK. M.O. CASH
7 2 3.1,SEP � � '�!� AJd
7 2 4 SEP 18 1 1 2.0 0 And
76A69BA CE#609 574
T PSE:
I(A638A CE#803. 1-61
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS01(
BUILDING AND SAFETY DMSION LOCALI
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST.
DIST@LCT GROU TYPE PR CES B
FOR APPLICANT TO FILL IN j C' s CONST.
BUILDING STATISTICALC SIFICATION SEWER MAP
ADDRESS ,� J, BK PG
CLASS. NO. DWELL. UNITS - z
LOT NO. BLOCK WATER NOT REQUIREDF\71 RECEIVED
CERTIFICATE:
TRACT MAPHIGHWAY STATE MAJOR , LOCAL
NO.OF BLDGS. NO. Q (CIRCLE) CON
SIZE OF LOT I NOW ON LOT USE ZONE f SPECIAL
USE OF CONDITIONS
EXISTING
/BLDG. + �/J C J z
OWNER O fj/►l'�E DproG/T BUILDING EXIST.
`,, /�, SETBACK YARD HWY STREET NAME WIDTH
ADDRESS !Y(/) 7 �/� ,�/ FRONT _
ARCHITEC OR TEL. P. L.
ENGINEER NO. SIDE
P. L.
ADDRESS
CONTRACTOR'^ (� O. /T�J��OL INSPECTION RECORD v0
ADDRESS j7 00 p jC CLAPP f/¢1U lV&'y5 0
O
DESCRIPTION OF WORK u
W
• d
NEW ADD ALTER REPAIR DEMOLISH N
Z
SQ.FT. NO.OF NO.OF
IZE STORIES FAMILIES
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATION$
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. Y PMT. CFOUNDATION: LOCATION
F 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,
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- LATH,INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA REL T-
ING TO WORKME�S COMPENSATION I URANCE. LATH,EXT.
SIGNATOR Lwr'f/'�J//Wy HOUSE NUMBER COR-
PERMITTEE /�A A. RECT AND POSTED
ADDRESS 0/0 FI AL
EifiC-t CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL EN ER
PLAN CHECK VALIDATIOIN� PERMIT VALIDATION cr- M.O. CABH
305) 1 '? 44
L� 8052F-
76A638A CE4803 5-65 APPLICATION FOR BUILDING PERMIT /
COUNTY OF LOS ANGELES BUILDING Col
DEPARTMENT OF COUNTY ENGINEER ADDRESS !�
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,Su P'T OF BUILDING CROSS ST.
C—
DF ICT ROUP TYPE PROSY
FOR APPLICANT TO FILL IN � CONST.
BUILDING STATISTICA�SSIFICATION SEW .AP��
ADDRESS >/ (//(" CLASS NO. DWELL UNITS EK PG
LOT NO. C BLOCK USEZONE NOP Idd
TRACT 6'J-7 `_ SPECIAL
NO. OF BLDGS. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
EXISTING BLDG. BLDG. SETBACK FROM / �7�i//yf'
TEL. FRONT PROP. LINE OF C• nlxl._�V's TREET)
OWNER AZ_NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS 7 'Q HIGHWAY WIDTH FROM C.L.
/� + _
CITY ��/ ✓ BLDG. SETBACK
FROM
ARCHIT CT OR TEL SIDE PROP. LINE OF (STREET)
ENGINEER NO.
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
CONTRACTOR / NOL (/ + _
ADDRESS Iil9 7 CORNER CUTOFF YES NO S
OL
CITY C A SEE REVERSE SIDE FOR SPECIAL APPROVALS O
DESCRIPTION OF WORK Uw
a
NEW ADD ALTER REPAIR DEMOLISH _ h
SQ.FT. NO. OF NO. OF r ��[�
SIZE STORIES FAMILIF_S
USEPJtRoli
� ,i
STRUCTURE (!�
""% V/SFS/G
SIGNATURE OF
APPLICANT
VALUATION$ 00
APPROVALS DATE INSPECTOR'S SIGNATURE
/y 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
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
SUILDI 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 CODE OF THE STATE OF CALIFOR IA RELAT-
ING TO WORKMEN'S C SATION INwS,URANCE. t9'
LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
G' _ 01 � "
ADDRESSI NAL
LJ JOHN F. LEWIS. PRINCIPALS �1 RAL ENGINEER
PLAN CHECK VALIDA'T'ION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O CASH
L&o2 6 1 7) Jul 9 2 3 D 5.7 5-
2 6 1 0- XN 9 1 D 11.50-
TEMPLE CITY
41AGSBA CE#803 E-38 APPLICATION FOR BUILDING PERMIT 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,SUPT OF BUILDING CROSS ST.
DISTRICT N GROU ypE P Y
FOR APPLICANT TO FII.L IN ONST.
BUILDING SEWER MAP
ADDRESS 9666 Las Tunas STATISTICAL C�J]�SSIFICATION BK / PG
CLASS.NO.__L-DWELL. UNITS / 4
LOT NO. BLOCKMAP STATE
NUMBER HWY. YES NO
TRACT USEZONE SPECIAL
NO.OF BLDGS. " CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF !�
EXISTING BLDG. COmmer lal BUILDINGEXIST.
SETBACK YARD HWY STREET NAME WIDTH
OWNER First" Thrift of L A FRONT
MAIL P.L.
ADDRESS 9666 Las Tunas SIDE
CITY T TE CU 12 L
P
AINSPECTION RECORD
ARCHITECT OR TEL_
ENGINEER NO.
ADDRESS
CONTRACTORSOHtE& AirCOndInc NoL.GA48638
ADDRESS 6 Long, Beach Blvd. L.B.
DESCRIPTION OF WORK
NEW ALTER REPAIR DEMOLISH
SQ.FT. NO.OF NO.OF
SIZE STORIES FAMILIES
VSE
S�F ll� io E CHAT- C Lennox
package air nditio 'n unit
SIGNATURE I APPROVALS
APPLICANT
DATE INSPECTOR'S SIGNATURE
ADDRESS FOUNDATION: LOCATION
FORMS,MATERIALS
P.C. S FRAME: FIRE STOPS.
�� FEE BRACING, BOLTS
VALUATION S FURNACE: LOCATION.
FEE GAS VENT.DUCTS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH,INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COU TY ORDINANCES AND LATH,EXT.
STATE LAWS RE TING B 1 N CON T C 1
SIGNATURE OF HOUSE NUMBER COR-
EE AND POSTED
ADDRESS FINAL
CLYDE N. DIRLAM, PRINCIPAL STRRAL ENGYNEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
? 250
-- Co u 2 9 1 A
6
AC38A DB3.3 3-55
y •�yy APPLICATION FOR BUILDING PERMIT 1
r
DIVISION OF BUILDING AND SAFETY BUILDING // `� +
ADDRESS "li' � ��f,l_~ 1 f
Department of County Engineer
County of Los Angeles LOCALITY c'/ die
WM.J. FOX, COUNTY ENGINEERNEAREST �A
CASSATT D.GRIFFIN, SUPT OF BUILDING CROSS ST. </sh f /.1 YC
DISTRICTNO. GROUP TYPE SE!WER
BK MAP G
FOR APPLICANT TO FILL IN ,� ,Siq ?V I CONST. I 'p- I;3.
BUILDING /'" MAP C STATE YES O
ADDRESS '![ G /-�XJ,S L�N f S �/► NUMBER C
LOT NO. BLOCK USE ZONE SPECIAL
CONDITIONS
TRACT C, z
NO.OF BLDG$. BUILDING EXIST.
SIZE OF LOT NOW ON LOT SETBACK YARD HWY STREET NAME WIDTH
USE OF FRONT
EXISTING BLDG. P. L.
/ Ln' S►DE
OWNER •Y�/ti ilY�( C. +`'• P. L.
MAIL
ADDRESS � u /GLS �t✓ S jam• O TRACT DWELL. 1 UNIT 5 INDUSTRIAL
J //�• TEL. 1 DWELL. 1 UNIT
CITY (F ` L� NO. 6 PUBLIC BLDG.
ARCHITECT OR TEL, 2 DUPLEX 1 UNIT 7 ADDN.,ALT.. ETC.
ENGINEER NO. 3 APT. UNITS -
$ MISCEL.�/
ADDRESS 4 COMMERCIAL //
/
TEL. / INSPECTION RECORD
CONTRACTOR%%cA/V��r,, IL`1J11°fV'�/[RiNO� Suk ;� b 2
ADDRESS C'C'G /Y. �A�r• L-!Q�S
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH
SO. FT, NO.OF NO. OF
SIZE STORIES FAMILIES
USE OF STRUCTURE
ee& NeON S r'1v
SIGNATURE OF /L l A /
APPLICAAPPROVALS
NT
ADDRESS Q G7rl'1- LL DATE INSPECTOR'S SIGNATURE
FOUNDATION: LOCATION
P.C. $ FORMS, MATERIALS
<<7 �l .i�1 FEE FRAME: FIRE STOPS,
VALUATION BRACING,BOLTS
FEE FURNACE: LOCATION,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT, DUCTS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREETO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT.
AND STATE LAWS GULATING ILDING CONSTRUC-
TION. / LATH, EXT.
SIGNATURE /�/ l HOUSE NUMBER COR-
PERMITT RECT AND POSTED
r,
ADDRESS _ FINAL
WM.J. FOX.COUNTY ENGINEER VALIDATION C. N. DIRLAM,CHIEF BLDG. INSPECTOR
�02 0 8 1Z9 im20 1 2.0 0 n
WORKERS'COMPENSATION DECLARATION •
hereby affirm that I have 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.)
Policy No.ze) 3176-&t p y_ �TI�T� FL1'�IID COUNTY OF LOS ANGELES BUILDING AND SAFETY
om an
91 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING
ADDRESS �A L(tgA5 1::m
❑ Certified copy is filed with the county building inspec- BUILDING >� / c /��.,
tion department. ^^ ADDRESS UMi4S t✓7'
Datele� Applicant�/ArL1<+� =A/ cGrDr/�( CITY ZIP LOCALITY
C RTI KATE 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 / ASSESSOR
hundred dollars ($100)or less.) TRACT �(� BLOCK LOT NO. �� MAP BOOK PAGE PARCEL
OWNER �Np USE ZONE MAP _ 6
I certify that in the performance of the work for which this NO. S�
permit is issued, I shall not employ any person in any manner ADDR S ( SPECIAL O
so as to become subject to the Workers'Compensation Laws. ll CONDITIONS
U
Date Applicant CITY ZIP
NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE ESSED BY O
ENGINEER NO. CONST. ZONE ~
Exemption, you should become subject to the Workers' U
Compensation provisions of the Labor Code, you must forth- ADDRESS 3OGg, d
with comply with such provisions or this permit shall be to
deemed revoked. TEL. y� STATISTICAL CLASSIFICATION APT. CONDO. Z
CONTRACTOR i✓ NO.
LICENSED CONTRACTORS DECLARATION LICy CLASS NO. 2—"-- DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS - NO.-3f p
(commencing with Section 7000)of Division 3 of the Business and y— LIC SEWER MAP
Professions Code, and my license is in full force and effect. CITY / t �/r CLASS BK PG VALIDATION
/,FRO
/1 SQ. FT NO.OF NO. OF CHECK
License Number 397 013 1% Lic.Class li SIZE STORIES FAMILIES ONE
❑ VALUATION
t��K r &JDate 10 G DESCRIPTION OF WORK NEW $ /� 0 a t�
Contractor �� tr_A1 ,��/,..i
ADD 0111. 5 5 1,6 A
❑ I am exempt under Sec. ALTER ❑ # • • • • 2
B.BP.C. for this reason USE OF REPAIR ❑ $
Date: EXISTING BLDG. rTC -��� DEMOL ❑ • - 97.22
Signature APPLICANT TEL. /� FINAL ' • • • 9 7 2 2
PRINT ST�.rc- /J��rl NO. 3b3'- Pf, !L^✓
OWNER-BUILDER DECLARATION DATE
I hereby affirm that I am exempt from the Contractor's License 09,26,-86
Law for the following reason (Section 7031.5, Business and ADDRESS Ati�l�� �}C ti-�T TINA
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
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). Z"5 5 6 2 A
REQUIRED YARD HWY TOTAL SETBACK FR M c
CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT # • • • • • 1
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C.). SIDE ) • 1 2�8 8
W
P.L.
Lender's Name
P.C. Fee$ Z Permit Fee LDMA Ref. # • • 124,885
Lender's Address
1 certify that I have read this alp lication and state that the Issuance Fee J� LDMA P/C# ' 1. 3`.8 6
abov tion is correct. I a e to comply with all County Investigation Fee
ordi ance nd St a laws rel ng to building construction,
U and h z represe ajlves of this County to enter Total Fee LDMA Perm. #
upo above- a tione drty for it
purposes.
0
SEE REVERSE FOR EXPLANATORY LANGUAGE
'l-' nature al 4plicant or Agent Date
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION
FOR APPLICANT TO FILL IN BUIL ING ApD SS
1, �G a
I hereby affirm that I have a certificate of consent to self insure, BU I ESS L S —n w
or a certificate of Workers'Compensation Insurance,or a certified CI ZIP LOCALITY I
copy thereof(Sec.3800,Lab.C.)
d
Policy No. —Company G 1 ��l r
SI OF LO NO.OF BLDGS.NOW ON LOT
E] Certified copy is hereby furnished.
NEAREST CROSS ST.
TRACT BLOCK LOT NO.
❑ Certified copy IS filed With the txj build' g ction USE ZONE MAP NO.
department.
1l ASSESSOR MAP BOOK PAGE PARCEL
Date pplicant L��- SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS OWNER TEL.NO. YES NO
COMPENSATION INSURANCEWITHIN 1000 FT.OF SCHOOL?
(This section need not be completed if the permit is for one hundred ADDR 66 I tu) I r—, DISTRICT GROUP TYPE C NST. FIRE ZONE PROCES ED BY
dollars($100)or less.) CITY //�� l ZIP f/
I certify that in the performance of the work for which this permit Ltd/ � , �1 ��
is issued, I shall not employ any person in any rganne So as to ARCHITECT OR GINE TEL.NO. 1
become subject to the Workers'CSLaw STATISTICAL CLASSIFICATION APT C DO
Date Applicant ( ADDRESS rd_ CLASS NO. DWELL UNITS
L � �
NOTICE TO APPLICANT: If, after making this C@rtIfICBt@ f CONTRACTOR TE .NO. REQUIRED TOTAL SETBACK FROM EXIST
Exemption, you should become subject to the Worke S' SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor Code, you must forthw h `C I :,)& FRONT
comply with such provisions or this permit shall be deemed revok ADORE / �/ LIC.NO. PL
9 01(/SS C 1 -.e6. _ c .Z cP fl, SIDE >"
LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS P L d
nn^ o
I hereby affirm that I am licensed under provisions of Chapter 9 4�7 'r r'Jn (A SEWER MAP V
(commencing with Section 7000)of Division 3 of the Business and SO.Fr.SIZE NO.OF STORES NO.OF FAMILIES cz
Professions Code,and my license is in full force and effect.
NEW ❑ BK PG o
License Number Lic.Class DESCRIPTION OF WORK ADD ❑ VALUATION , W
Contractor Date ALTER ❑ z_
❑ I am exempt under Sec.
f C/ REPAIR ❑
BAP.C.for this reason—_ DEMOL E] LDMA P/C N
Date: USE OF EXISTING BLDG. URM ❑
Signature APPLICANT(PRINT) /ff
NO. 9 LDMA Perm a Z i
❑ I, as owner of the property, or my employees with wages as �I O
their sole compensation, will do the work and the structure is ADDRESS � __ ___:3 •i
not intended or offered for sale (Section 7044, Business and , ZJt/ " (�: FINAL DATE Q M
Professions Code.) r 0 31 1 =4'
W I LL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL J
❑ I, as owner of the property, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN I [�j
P P y. Y 9 THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL Y` � 1 ITEMS
licensed contractors to construct the project (Section 7044,
Business and Professions Code.) WILL
1-1 NO❑ ! y�TAL 583
WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING ��]]
OCCUPANT REQUIREA PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH r{4,� CIV■f
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST ' n 1 1.��`.r`,
FOR GUIDELINES.
I hereby affirm that there is a construction lending agency for YES❑ No❑ .00
the performance of the work for which this permit is issued(Sec.
3097,Civ.C. . I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD
m ) PERMITTING CHECKLIST.I UNDERSTAND MV REQUIREMENTS UNDER THE LOS ANGELES
COUNTY CODE,TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING
Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD.
i1 Yf�f�_4 {
3 'JL10 ffil a yyy�� �
o Lender's Address
ONTIER OR AGEM
ef�11!•3Ir
l� c fl ii V■
o_ I certify that I have read this application and state that the above
information is correct. I agree to Comply With all County P.C.FEE PERMIT FEE
ordinances and State laws rel Ing to building construction,and
a hereby auth ize repreYentati es of this County to enter upon ISSUANCE FEE 00
the Shove-m !L#8ned p(opert for inspection purposes. �y 3 r
/- � _ ��7 I INVESTIGATION FEE
(/ TOTAL FEE
n
S,-I.—f Applra pA■M■ D■1■
SEE REVERSE FOR EXPLANATORY LANGUAGE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS I ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT I TEMPLE CITY CA 91780 I BL 0508 1103020024
( PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST [ BUILDING ADDRESS: 1
ITR: 6561 LT: 526 BL: .001 1 SQ. FT STORIES TYPE 1 9666 LAS TUNAS DR I
I ISTRUCTURE: V-B TEMP CA 917802139
(ASSESSOR INFORMATION NUMBER: 1 1 NEAREST CROSS STREET:
18587-021-015 � 1 I THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl
(TENANT: [EXIST BLDG USE: COMMS USE ZONE: C-2 (ISS ED ON: PROCESSED BY: 1
KUMON EDUCATION JEXIST OCC GRP: iO3/i2/11 SR
IOWNER: TEL. NO: IIBLDGS. NOW ON LOT: VALUATION: (FINAL DATE FINAL BY: CODE: I
IT.H. VICTORIA STORES LLC (626) 403-6868- 1 150 1 I
11005 E. LAS TUNAD DR
SAN GABRIEL CA 91776 1 FEES PAID 1D .iCRIPTION OV WORK 1
I
RETVE NON BEARING PARTITIO WALL 1
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 (• I
[APPLICANT: TEL. NO: I I I
IKAO, BRIAN Y (626) 336-1616- IAA BLDG PERMIT ISSUANCE 27.80 1
116354 VALLEY BLVD. IAB STATE GREEN BLDG FEE 150.00 VAL 1.00 ISPECIAL CONDITIONS: 1
ILA PUENTE, CA 91744 1AE STRONG MOTION OTHER 150.00 VAL 0.50 I I
I1A2 PERMIT W/ENERGY-HC 150.00 VAL 50.10 [ [
I_1 TOTAL FEES 79.40
I
ICONTRACTOR: TEL. NO: j1 ]APPROVALS DATE INSPECTOR SIGNATURE [
IBRIAN Y KAO (626) 347-3434- I 1
12128 S. 7TH AVENUE LIC. NO I1 ILOCATION AND SETBACKS I I ]
IARCADIA, CA 93.006 897876 C36 , I I -1-1 I
I II (SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. NO: - i (FOUNDATION/TRENCH FORMS I I I
1 LIC. NO: 1 1 (SLAB/UNDER FLOOR I I I
RAISED FLOOR FRAMING I I I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP':I 1UNDERFLOOR INSULATION I I ]
115OH269 3 OOI 1 1-1 ]
I 1 IFLOOR SHEATHING I I ]
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I_ I I I
NO 22 iIROOF SHEATHING I I
I SCHOOL WITHIN HAZARDOUS ISHEAR PANELS I I I
(AIR QUALITY: 1000 FEET MATERIALS I I [ [ I
NO NO NO I [ (FRAME INSPECTION 1 I I
I I (FIRE SPRINKLER HANGERS I I I
I
] 1 INSULATION/WEATHER STRIP] I I
11NTERIOR LATH/DRYWALL I I I
I I JEXTERIOR LATH I I I
I I
I I IRATED FLOOR/CEIL ASSEM. I I [
11 (RATED WALL ASSEMBLIES I I I
I I IRA ED SHAFTS/OPENINGS I [ I
IT-AM CEILINGS
I I I
[ I I (LO,T DRAINAGE I I I
IREPORT ID: DPR261 ROUTE TO: BS0508 I I I [
I � I I I I I
• r
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 1011170050
PHONE: (626) 285-0488 EXT:
ILEGAL ID: INUMBER OF SIGNS: 1 I BUILDING ADDRESS: 1
ITR: 6561 LT: 526 BL: .001 ISIGN DESCRIPTION: ONE SET INTERNAL ILLUMINATED CHANNEL9666 LAS TUNAS DR I
I 1 RACEWAY 1 TEMP CA 917802139 1
(ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: 1
18587-021-015 1 1 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl
1(TENANT: ]EXIST BLDG USE: ISSUED ON: PROCESSED BY: I
KUMON (EXIST OCC GRP: 111/17/10 SR 1
(OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IFINAL DATE FINAL BY: CODE: I
IKUMON (626) 455-4921- .1 2,800 I I
19666 LAS TUNAS DR.
TEMPLE CITY CA 91780 FEES. PAID IDESCRIPTION OF WORK. 1
I I IONE SET INTERNAL ILLUMINATED CHANNEL LETTER WALL SIGN WITH 1
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IRACEWAY 1
1APPLICANT: TEL. NO: I I I
YU, ALLISON (626) 336-1616- IAA BLDG PERMIT ISSIIANCE 27.80 I I
116354 VALLEY BLVD. IAB STATE GREEN BLDG FEE 2800.00 VAL 1.00 ISPECIAL CONDITIONS: 1
ILA PUENTE, CA 91744 AX BUILDING REVIEW FEE 54.70 I I
I 1D2 PERMIT W/0 EN-HC 2800.00 VAL 99.10 I I
TOTAL FEES 182.60 1
ICONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE 1
(FIRST SIGN CO. ti (626) 336-1616- I
116354 VALLEY BLVD LIC. NO I ILOCATION AND SETBACKS I I I
ILA PUENTE CA 91744 605688 C45 I I I I I
I I ISOILS ENGINEER APPROVAL I I I
(ARCHITECT OR ENGINEER: TEL. NO: 1 IFOUNDATION/TRENCH FORMS I I
1 LIC. NO: 1 1SUPPORT STRUCTURE 1 1
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:I I I I I
I 001 I I I I
INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: 1 I I I I
NO 20
I I I I I
1 SCHOOL WITHIN HAZARDOUS I I I I I
1AIR QUALITY: 1000 FEET MATERIALS
1 NO NO NO I I I I I
EXPIRE I I I I
I I 2 I I I I
REPORT ID: DPR261 ROUTE TO: BS0508