The URL can be used to link to this page

Home My Public Portal About9600 LOWER AZUSA RD_Building__ Y, 78A888A CEitBDB gs' lr APPLICATION FOR 13UILDI G PERM T LJ 'PC*UNTYI OF LOS ANGELES BUILDING DEPARTMENT"OF COUNTY ENGINEER ADDRESS U BUILDING AND SAFETY DMSION LOCALITY JOHN A LAMBIE COUNTY ENGINEER JOA e COLEMAN W JENKINS, SUP T OF BUILDING NEAREST CROSS ST 1 0 G -r (� FADDRESS OR APPLICANT TO FILL IN DISTRICT NO GR UP TYPE PROCES�ED BY ` B CONST (Print ort a only) r +. m/ /� h STATISTICAL CLASSIFICATION SEWER MAP (D 0® �.DW+Lr2� /"�-V Z h Q C CLASS NO DWELL UNITS BKG— PG '3'71y elF BLOCK USE ZONE MA NO C7O�f TRACT • SPECIAL NO OFBLDGS 'k CONDITIONS SIZE OF LOT NOW ON LOT USE OF ,/t EXISTING BLDG a BLDG SETBACK FROM OWNER No FRONT PROP LINE OF L VWICAC AAO-SA(STREET) 01 *� Ow _Z*2 TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS i 2 ju- ( {J HIGHWAY WIDTH FROM C L O p' + _ CITY DO 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 CONTRACTOR D N NOL 'Fn,? QI ' + AyQ O ADDRESS d( Sf .J- NO ZSG gS� CORNER CUTOFF YES jo NO ❑ CD CITY RG d A i ; C.ts I_ c A /ASS SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK a- NEW ADDALTE REPAI DEMOLISH SQ FT r7 NO OF NO OF V SIZE I J m 0 STORIES FAMILIES USE OF y� STRUCTURE A S u Pj y SIGNATURE APPLICANT . i • I VALUATION l O 1 APPROVALS DATE INSPECTOR S SIGNATURE In C PMT FE7$ jrg FEE$ 3�3, FOUNDATION LOCATION O O FORMS MATERIALS FRAME FIRE STOPS 1KNOWLEDGETHAT I HAVE READ THIS APPLICATION BRACING BOLTS ANDT THE ABOVE IS CORRECT AND AGREE TO COMPLYFURNACE LOCATION WITHALL CUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED H ILL NOT EMPLOY ANY PERSON IN VIOLA TION OF THE BOR CO OF THE STAT CALIFORNIA RELAT LATH INT -r ING TO WC If B COMP NSATION INS ANC / LATH EXT (o SIGNATURE O E NUMBER COR + PERMITTEE RECT AND POSTED ADDRESS FINAL 6 JOHN F LEWIS PRINCIPAU STRU URAL ENGINEER PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION aK M 0 CASH s a 54 JM18 2 P 1 6.50A ro i. a - L&O6 7� .�uL3 0 33-00M Iq '^rte 94etw� T_ WORKERS COMPENSATION DECLARATION insurebor a certificate of Workers saffirm that I have a rtCompensat oificate of n Insurance ent to lf APPLICATION FOR BUILDING PERMIT or a ciertifi o 3800 b C •Vy - Q C ��G G_'-A COUNTY OF LOS ANGELES BUILDING AND SAFETY P y No Company `""'f BUILDING Certified copy is hereby furnished F R APPLICANT TO FILL IN ADDRESS G�0 0 oyt/t4 Z4.pk Certified copy is filed with the county building inspec [ADDRESSLDIADDRESS Qa a ege- ko J' tion department / « /e 'C" t CG ` � � �G.® 'j/�C1 L/•9�C, Y !w �� e/T zlp LOCALITY Dc tee Applicant NO OF NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS �� E OF LOT NOw ON LOTS CROSS STCOMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one CE 99d BLOCK LOT NO MAP BOOK PA PARCEL hundred dollars ($100)or less ) TEL.NE ejV& Y..' ZQ NO USE ZONE MAP / I certify that in the performance of the work for which this �, SPECIAL /l O permit is issued I shall not employ any person in any manner ADDRESS / 6 `�` CONDITIONS o_ so as to become subject to the Workers Compensation Laws O CIN (''� QCT ZIP Date Applicant ARCHITECT OR TEL NO DISTRICT GROUP TYPE FIRE PROCESSED BY O NOTICE TO APPLICANT If after making this Certificate of ENGINEER CONST Z NE t- Exemption you should become subject to the Workers p U Compensation provisions of the Labor Code you must forth ADDRESS �04 N with comply with such provisions or this permit shall be -.TEL f/ STATISTICAL CLASSIFICATION APT CONDO Z deemed revoked CONTRACTOR T O - LICENSED CONTRACTORS DECLARATION i�r//Q 1 CLASS NO DWELL UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS r<'r!i[ !M� Q,�&A� w2 3LIC AP MAP(commencing with Section 7000)of Division 3 of the Business CITY C40�4 . Ca CLASS SEWER and Professions Code and my license is in full force and effect BK p- PG 310 VALIDATION ��l�� SQ FT ST OF FA OF CHECK License Numbe ! Lic Class SIZE STORIES G FAMILIES ONE /� VALUATION �L 1� + Contractor G..&V_XrA4La bate 1A - Q DESCRIPTION OF WORK NEW ❑ $ 1 OED j II_E� ❑ 3 Elam exempt under Sec /� Q' �4d`�' 'R' ��4 ADDPoll, ALTER ❑ TUTAL 83® 387 B&P C for this reason REPAIR $ 1/ -+ ^- Date I��B r O EUSE XISTOING BLDG DEMOL ❑ ��i it �.�r.�.Lv CH .fly Signature APPLICANT TEL FINAL _f q OWNER BUILDER DECLARATION (PRINT) NO DATE / 1 hereby affirm that I am exempt from the Contractor s license Law for the following reason (Section 7031 5 Business and ADDRESS FINAL 11IM-131301 1/70/5+1 Professions Code) PRESENT By 5335 Ely■4(l BUILDING 1 A!1 I as owner of the property or my employees with ADDRESS W wages as their sole compensation will do the work and �y the structure is not intended or offered for sale(Section LOCALITY 7044 Business and Professions Code ) MOVING TEL r, p ❑ I as owner of the property am exclusively contracting CONTRACTOR NO with licensed contractors to construct the project (Sec ADDRESSG66/+ tion 7044 Business and Professions Code) REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE 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 PL Lender's Name ��jj�^ P C Fee$ .0 Permit Fee D LDAAA Ref # � Lender s Address 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 ordinances and State laws relating to building construction Total Fee 3 I av LDMA Perm # and hereby authorize representatives of this County to enter upo he abov nhamed property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of A Ilgpnt or Agent Date _WORKERS COMPENSATION DECLARATION reby affirm that 1 have a certificate of consent to self AP P L I CATION FOR BUILDING P E RM I T re or a cert tate f orkers Compensation Insurance c t ec 3600 ab C) COUNTY OF LOS ANGELES BUILDING AND SAFETY y No Id G Company/--A- ompan / /C BUILDING/ 6 Certified copy is hereby furnished FOR APPLICANT TO FILL IN ,,�� // ADDRESS ❑ Certified copy is filed with the county building inspec ADDRESS Q6 Au ILDING g=W - Date department P�,�, , /_ Date Applicant"- y'"��+w CITY—� ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS NO OF BLDGS NEAREST SIZE OF LOT NOW ON LOT CROSS Si COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT,/.2 BLOCK LOT NO MAP BOOK AG PARCEL hundred dollars ($100)or less) TEL OWNER NO USE ZONE NOP I certify that in the performance of the work for which this /n• SPECIAL } permit is issued I shall not employ any person in any manner ADDRESS C/ CONDITIONS a so as to become subject to the Workers Compensation Laws � CITY IP Date Applicant ARCHITECT OR TEL DISTRICT GROUP TYPE FIRE PROCESSED BY O oe NOTICE TO APPLICANT If after making this Certificate of ENGINEER NO CONST E U Exemption you should become subject to the Workers U Compensation provisions of the Labor Code you must forth ADDRESS �o� with comply with such provisions or this permit shall be ,TEL STATISTICAL CLASSIFICATION APT CONDO to deemed revoked CONTRACTOR • � � 04 z LICENSED CONTRACTORS DECLARATION LIC 3 CLASS NO_ r DWELL UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC /� and Professions Code and m license is in full force and effect CITY CLASS /J f BK M-10 VALIDATION Q SQ FT NO OFF NO OF ---- License Number Lic Class.._ SIZE I STORIES FAMILIES ONE ��vE.GR�elIF) _ oO VALUATION Contractor �� ate •?F ! DESCRIPTION OF WORK NEM1 ❑ _ ElI am exempt under Sec �.. �e a ADD ❑ PoolAITER ❑ B 8P C for this reasone/�/(C REPAIR $ D„�e,_ USE OF DEMOL �"�� EXISTING BLDG Signature � �,agryi� APPLICANT TEL FINAL OWNER BUILDER DECLARATION (PRINT) DATE Illa —5P/ 1 hereby affirm that I am exempt from the Contractor s License ADDRESS Law for the following reason (Section 7031 5 Business and FINAL Professions Code) PRESENT By BUILDING ANT $ ❑ 1 as owner of the property or my employees with ADDRESS wages as their sole compensation will do the work and 3�7 ■I}I� the structure is not intended or offered for sale(Section LOCALITY ITEMS 7044 Business and Professions Code) MOVING TEL 1 ❑ I as owner of the property am exclusively contracting CONTRACTOR NO Ti iTAL �8 ■.0103 with licensed contractors to Construct the project(Sec ADDRESS tion 7044 Business and Professions Code ) H 88.011 REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE WIDTH �HANGE �!� I hereby affirm that there is a construction lending agency for FRONT T'AIG ' the performance of the work for which this permit is issued PL (Sec 3097 Civ C ) SIDE ��ryryr�-��y,rrt� {��yyaa { P L t,1i_00-i ,001 12/28/9ll Lender's Name LDMA Ref # pp a v P C Fee$ Permit Fee 17.00 , �t7 f AME � 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 Q ordinances and State jaws relating to building construction Total Fee O LDMA Perm # and hereby authorize representatives of this County to enter upon the abo ent property for inspection purposes A— Jct SEE REVERSE FOR EXPLANATORY LANGUAGE n Signa ure Applicant or Agent Date WORKERS COMPENSATION DECLLI'ATION hereby affirm thilit I have a certificate of consiont to self p I ATI N- FOR BUILDING PERMIT insure ofa certificate of Workers Compensation Insurance' or a certified copy thereof(Sec 3800 Lab C ) � �� Policy NoC953 165 Company Ohio Casualty COUNTY OF LOS ANGELES BUILDING AND SAFETY 1:1Certified co is hereby furnished BUILDING ower Azusa Rd 0 copy Y FOR APPLICANT TO FILL IN ADDRESS " Certified copy is filed with the county building inspec BUILDINl9600-9616 E Lower Azusa Rd tion department ADDRE LOCALITY Temple City Date 4-8-83 Applicant Donald F. Laughlin CITY Temple Cit zip 9 17 80 CROSS sT S.E. corner at E Lower zusa R CERTIFICATE OF EXEMPTION FROM WORKERS 5 X 8 NO OF BLDGSCommermial ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK 264 PAGE24&25 PARCEL (This section need not be completed if the permit is for one 7 I 72 73 USE ZONE MAP hundred dollars($100)or less ) TRACT BLOCK COT NO /� NO TEL — ,0 SPECIAL I certify that in the performance of the work for which this OWNER Town & Count Ind Inoue CONDITIONS d permit is issued I shall not employ any person in any manner _ DISTRICT GROUP TYPE FIRE PROCESSED BY O so as to become subject to the Workers Compensation Laws ADDRESS 9608 E. Lower Azusa Road � CONST ZO E W CITY Temple Cit zip` 91780 c/_ O Date Applicant _ STATIS IFICATIO CONDO M NOTICE TO APPLICANT If after making this Certificate of ARCHITECT OR TEL $ — V ENGINEER Alan Smith & Co NO 4 CLASS NO 'Z�WELL UNITS tu Exemption you should become subject to the workers Business Center Dr Compensation provisions of the Labor Code you must forth ADDRESS 9651—D SEWER MAP Z with comply with such provisions or this permit shall be t _ _ deemed revoked C ona ORF Laughl6nn C000mpanstr Ly NO l 8 BK4& PG VALID LICENSED CONTRACTORS DECLARATION 9631-C Business Cebj C LIC 1 0 9 1 P I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO 326065 VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC it 0 0 0 0 23 Professions Code and my license is in full force and effect cITYRTTancho Cucamon a CA CLASS B $ 100 00 00 326065 B s°E400 L.F NO OF NO OF N A CHECK , 2 o 6 7 9 0 5 License Number Lic Class STORIES 1 FAMILIES / ONE Donald F. Laughlin Replace lass NEW ❑ $ o Contractor Count. C6. Date LI—S-83 DESCRIPTION OF RK 1 am exempt under Sec facing, install metal over woo ADD ❑ 04,0 "-3.3 ALR FINAL mansard, instal signs DA B&PC forthisreaso REPAIR ❑ 4D9te USE OF tore ron s — FI EXISTING BLDG ommerclatt Center DEMOL ❑ Signature [ , APPpRiNTT Donald F Laughlin TEL NO 3 4980- s OWNER BUILDER TIO I hereby affirm that I am exempt from the C tractor s License 9631—C Business Center Dr. Law for the following reason (Section 7031 5 Business and _ ADDRESS A (31730 Professions Code) 1W 1 ' 196 2 r 1:1BUILDING N/A 1 as owner of the property or my employees with ADDRESS 4 0 0 a a o 1 wages as their sole compensation will do the work and the structure is not intended or offered for sale(Section LOCALITY N/A c - 80-925 8 9 2 7044 Business and Professions Code) MOVING TEL ❑ 1 as owner of the property am exclusively contracting c NTRACTORN/A NO o o 8 0 9 2 5 cs. with licensed contractors to construct the project (Sec ADDRESS tion 7044 Business and Professions Code) 051 2— 3 REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LIN 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 m PL a Lender's Name Owner Financed Lender's Address (leaner Financed P C Fee$ Permit Fee 417 I certify that I have read this application and state that the - Issuance Fee 3d above information is correct I agree to comply with all County Investigation Fee l ordinances gp4 State laws relating to building construction Total Fee C1 and here home re re to oft is County to enter upon th a ve m fo Stion purposes r D i —$-83 I SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant gent Date j es J