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Home My Public Portal About9352 LOWER AZUSA RD_Building__ 7.8A89BA CE0808 8-64 APPLICATION: FOR 1LDING •• RMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER Y BUILDING AND SAFETY DMSION LOCALITY. , JOHN A. LAMBIM COUNTY ENGINEER NEAREST COLEMAN W. JENKINS,SUP•T.OF BUILDING CROSS ST. Lo�JL DIST CTGROUP TYPE..��— . EBBED BY/ FOR APPLICANT T0'FILL IN c ,0-IK _ CONSTlz BUILDING ,r� ) STATISTICAL CLASSIFICATION' _ SEWER MAP D ADRESS 3 !t Tz CLASS NO.42"�LDWELL UNITS BK PG LOT NO., C L IAo BLOCK USE ZONE MAP J SPECIAL TRACT / SPECIAL SIZE OF LOT " N0. OF BLDG$. ] / CONDITIONS NOW ON LOT ' USE OF _ GDO, J Q BLDG. SETBACK FROM It C�/t NOL 7 FRONT PROP. LINE OF L TREET). OWNER TYPE OF E%ISTINO SETBACK HIGHWAY YARD = TOTAL ADDRESS S komIRU HIGHWAY I WIDTH 'F.OM C.L. ' CITY TQMLE 6ILL + BLDG. SETBACK FROM ARCHITECT OR TEL. - ENGINEER S NO. 1� SIDE PROP. LINE OF. (STREET) / TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS G.� HIGHWAY WIDTH - FROM O.L. }• GOIhT�RA=CTORI F�i�eG�` iizP Y NOL�431�q V i _ O C LICORNER CUTOFF YES NO ADDRESS LNO.IC O LI'C,_ CITY CL S 'SEE REVERSE SIDE FOR SPECIAL APPROVALS W DESCRIPTION OF WORK � r J /NEW/ ADD ALTER REPAIR DEMOLISH �'� �y _/� ✓�i't FT. ��/J 7n 1)3D NO. OF NO. OF SIZE STORIES FAMILIES -7 _ 1 SUSETRUOF CTURE )��.I i SIGNATURE OF APPLICANT VALUATION$ ' " APPROVALS DATE IN9PECTOR'991GNA URE P.C. PMT. J FOUNDATION, LOCATION FEE$ FEE$. — F.ORMS,.MATERIALS FRAME, FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLT AND STATE THAT THE ABOVE IS CORRECT AND AGREE,TO COMPLY FURNACE: LOCATION J� WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS 9UILDING CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK f AUTHORIZED HEREBY'1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH'. INT. ��' '� r`•• - TION OF THE LABOR CODE OF THE STATE OF CALIPOR RELAT- ING TO WORKMEN'S C SATION I suRA LATH. EXT. SIGNATURE. f' HOUSE NUMBER COR- PERMITTEE RE .- AND POSTED ADDRESS F'IN'AL OHN F. LEWIS. PRINCIPAL STRUCTURAL ENGI R _'.PLAN CHECK VALIDATION cK. .D. GH _ PERMIT VALIDATION CK. M.O. ASH L Ivo 5 2 8 F L316 1 D 8.00 N II.3S ^°Be.e APPLICATION FOR BUILDING PERMIT ► II-3S D iiIb°!ON.OF BUILDING AND SAFETYADD Ess Department of County Engineer. r County of LOS Angeles LOCALITY v, •n G►�+�r� - JOHN A.LA'MBIE.COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN.SUPT OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRICT NO. GROUP 1.-rfPE SEWER MAP < CONST L BK � PG AD,DREIS��^+��C WE 1Z A y';( Pct NUM ER SjTjWY• YES NOl LOT NO. LOCK USE ZONE SPECIAL CONDITIONS TRACT NO.OF BLS. /�/ SIZE OF LOT •�0 /� ��+" D I NOW ON LOT ,r• BUILDING YARD HWY STREET NAME EXIST. USE OF SETBACK WIDTH EXISTING BLDG. FRONT y� L D / P.L.• . -D OWNER a �/ /E SIDEMAIL ' P.L. ADDREM 3 L/ O TRACT DWELL. I UNIT �1 DWEL . 1 UNIT 5 INDUSTRIAL CITY Q-�.Q NO. J'�O f 6 PUBLIC BLDG. ARCHITECT OR TEL. 2 DUPLEX 2 UNITS 7 ADDN.,ALT., ETC. ENGINEER NO. 3 APT. UNITS B MISCEL. ADDRESS 4 COMMERCIAL r CONTRACTOEP,••��/,syr ��^SOa�NO INSPECTION RECORD y )�� /+yJ-/.�L•� ADDRESS � fa / &,411 1Ca DESCRIPTION OF WORK " NEW ADD•. ALTER REPAIR DEMOLISH .ate, SO.FT. NO. OF NO.OF r SIZE /d / TORIES Fi&ILIES US SOF ST CT E ` -r?'••^ '•-( i 4'• '-�NIl X111-"d'`� ..- rr, 'ff vr�i•. +-t. _ R�'6 1r, F=-• �t-L ,.S �1..� A.LL SIGNATURE OF APPLICANT APPROVALS �'`I��7�- LOc-�1.,� ADDRESS'/S.27 11-MG4444_19 "y_ DATE INSPECTORS SIGNATURE FOUNDATION:LOCATION I � G O P.C. S Ov `FORMS.MATERIALS L� s .f.. �1e�'C' AIM•' FEE FRAME:'FIRE STOPS. 1 ` 4— VALUATI N $ q CQ BRACING.BOLTS /f FEE L� _ FURNACE: LOCATION. r 1 f I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT.DUCTS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT I AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH.INT. D,/ l7 AND STATE LAWS GULATING UILDING CONSTRUC- I �j TION. LATH. EXT. \ E ^-a,6' SIGNATURE OF HOUSE NUMBER COR- n PERMIT�T ` EE RECT AND POSTED II �Co ADDRESS •/52 G604FINAL 4e JOHN A.LAMBIE.COUNTY ENGINEER VALIDATION CLYDE N.DIRLAM. CHIEF BLDG. INSPECTOR CK MO CASH »'1110 7 7 F7�� JUL 1 0 1 6 1 1_ .0 0 A Ln 1 i 2-0.0 . 1 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGQY,FS BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATIONId�II.,ppIN E�3g FOR APPLICANT TO FILL IN BUILDING ADDRESS 9352 Low-'r I hereby affirm that I have a certificate of consent to self insure, B7372App��LOWer Azusa Rd. or a certificate of Workers'Compensation Insurance,or a certified Temple City, Calif. 91780 copy thereof(Sec.3800,Lab.C.) CITY ZIP 473368-90 State Fund LOCALITY ; Policy NO. Company SIZE O LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. 1 NEff1Ey CeO SDSr ElUSEE 11 Certified copy is filed with the county ilding in action TRACT BLOCK LOT NO. department. ZONE MAP NO. .�•fp' Applicant ASSESSOR MAP BOOK PAGE PARCEL Date o Mara 003 041 /y�� L SPECIAL CONDITIONS CERTIFICATE OF EX P N RO RKERS' l;lara Reaves TEL 599-7749 WITHIN 1000 Fr.OF SCHOOL? vl=s No g COMPENSATION IN!9U (This section need not be completed if the permit is for one hundred ADDRESS dollars($100)or less.) 16 Cedar Greek Rd. DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY Y ZIP J I certify that in the performance of the work for which this permit a San Dimas 91773 �� 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 CLASUICATION / APT CONDO Date Applicant ADDRESS CLASS NO. 1-W4f DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' C IFR 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 DECLARATION SIDE CITY LIC.CLASS P L I hereby affirm that I am licensed underprovisions of Chapter SEWER 1QAP (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. 1 1 NEW ❑ BK T PG , d License Number Lic.Class DEs�di18q_gFs`1� ullding ADD ❑ VALUATION C Contractor Date ALTER ❑ U ❑ 1 am exempt under Sec. REPAIR El $ F- B.BP.C.for this reason DEMOL N LOMA P/C# L1J Date: USE OF EXISTING BLDG. URM ❑ D_ Unoccu ied home CIT Signaturez APPLICANT(PRINT) TEL NO. LDMA Perm# 818 Palazzolo 579- I, as owner of the property, or my employees with wages as Chuck 3400 ZO ACCT■i their sole compensation, will do the work and the structure is AWJ� Lower Azusa Rd. — Temple City FINAL DA Q 0.3307 175.90 not intended or offered for sale (Section 7044, Business and G Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL J I ITEITS ❑ 1, as owner of theproperty, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Y 9 AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL O a licensed contractors to construct the project (Section 7044, ves�i No❑ TOTAL s a"'�5_90 Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDUNG BY THE APPUCANT OR FUTURE BUILDING ~�"i�[jE:• 175.010 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH es ,/ CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR S� C V G�_/�t3 ,f �7 s GUIDELINES va.L'v 00 I hereby affirm that there is a construction lending agency for YES❑ NO w the performance Of the Work for WI11Ch this permit IS Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING a Lender's CIV.C.m U ry TITLE 2L CHAPTER 2.20 SECTIONS 2.90.00 THROUGH 2.20.14IST.I UNDERSTAND MY REQUIREMENTS UNDER THE 00 CONCERNING S ANGELES UHAZA DNTY %US Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. 1-7 o Lender's AddresscA? AM 10 C OWNER OR AGENT o I certify that I have read this application and state under penalty o P.C.FEE PERMIT FEE 0 of perjury that the above information is correct.I agree to comply a with all county ordinances and State laws relating to building os construction, and hereby authorize representatives of this County ISSUANCE FEE a ret on thea ve-ment' d property for inspection purposes. INVESTIGATION FEE TOTAL FEE5 ,.of A■PH-1«A■ml SEE REVERSE FOR EXPLANATORY LANGUAGE �awee.nWaAPPLICATION FOR BUILDING/PERM.IT 1 COUNTY OF LOS ANGELES BUILDING DEPAENT•OF COUNTY ENGINEER ADDRESS RTM )�✓{— �J��i' ' .BUILDING AND SAFETY DIVISION LOCALITY,-- JOHN OCALITY-JOHN A.LAMBIE,COUNTY ENG)NEER NEAREST ��•• /� CASBATT D.GRIFFIN SUPT OF BUILDING CROSS ST. DISTRICT NO. GROUP I T.pE I PROCESSED BY -BUFOR APPLICANT TO FILL IN CONST. D1 RESSDING STATISTICAL SSIFICATION SEWER MAP ADDRESS .- (,c��,/L-, .7-eis� B � LOT WO: �if �' CLASS.NO. DWELL.UNIT BLOCK MAP STATE YES NO r NUMBER Z v HWY. TRA'CT USE ZONE SPECIAL / NO:OF BLDGS. - CONDITIONS SIZE OF LOT �Qak I S_0 I. NOW ON LOT r USE OF �*17400 v EXISTING BLDG. BUILDING YARD HWY STREET NAME EXIT' SETBACK WIDTH OWNER' AMAIL P. ADDRESS 3J,�;C c 6c.��JC �/� FRONT L C) SIDE CITY ARCH ITECTOR TEL. INSPECTION RECORD ENGINEER NO. r A49 eVAI-;rs DOC 'ADDRESS TEL CONTRACTOR NO,• ADDRESS DESCRIPTION OF WORg tt- _I� �.� �_u s'✓ `ter="�.�r3 c'.•R NEW ADD ALTER REPAIR DEMOLISH -_-„�-yy SO.FT,�! (� NO.OF SIZE b STORIES FAMILIES/ L USC� E OF STRUCTU �/_ +Z).- � 2xC e r•1 mac:, k_ t j� SIGNATURE OF v��YG %I �'Mf7R�PAOVALS APPLICANT ADDRESS• ATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION f' FORMS,MATERIALS v v P,C. $ FRAME: FIRE STOPS. ! FEE BRACING. BOLTS VALUATION $ Jim FURNACE: LOCATION, FEE /O . GAS VENT.DUCTS 1 HEREBY ACKNOWLEDG T�}iAT I PNVE READ THIS AP- LATH.INT. PLICATION AND STATE 7FH AB $CORRECTAND AGREE TO COMPLY LL OUNDINANCES ANDLATH,EXT.STATE- LAWS REG ICU° U1LDONSTRUCTION. SIGNATURE OF / HOUSE NUMBER COR_ PERM RECT AND POSTED '-ADDRES ' FINAL CLYDE N.DIRLAM,PRINCIPAL STRUCTURAL E CINEER PLAN CHECK VALIDATION CK, M.O. CASH PERMIT VALIDATION CK. M.O. CASH LACO 5.5 4 .7 cuO OCT 6 1 .A .1 8,p 0 t ,7 d