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Home My Public Portal About10539 LYNROSE ST_Building__ • LI Ioll.e.11ae#.usB.eG APPLICATION- FOR BUILDING PERMIT COUNTY-OF LOS ANGELES ADDRESS 10539 L rose Street. DEPARTMENT OF COUNTY ENGINEER LOCALITY. Temple -City BmmING AND SAFETY DIVISION JOHN A. LAMBIE, COUNTY ENGINEER NEAREST Pal Mal WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST. DIST ICT'NO. GROUP TYM P SED BY FOR APPLICANT TO FILL IN. CONST.• STATISTICAL CLASSIFICATION SE ER MAP ILDADDREISS 10 •L r• se S T K t C: Llt�T CLASS.NO. DWELL.UNITS LOT NO.. .7 BLOCK MAP STATE YES NUMBER 21 HWY. TRACT 2655 . J USEZONE SPECIAL C NO.OF BLDGS. - / CONDITIONS SIZE OF LOT 52 X 100 IN ON LOT None• USE OF EXISTING BL6G. BUILDING EXIST. l�Lpmen • TELry SETBACK YF'RD HWY TREET NAME WIDTH OWNER• l+Ompany NO. (-2151 FRONT L. ADDRESS 132 E•Live Oak Ave. ,Arcad P.E ARCHITECT Cr.., TEL JJ - / ENGINEER �r�• �• Wi Wilke NO. f INSPE9TION RECORD �. • ADDRESS 135 IV.'Vermont Glendora' F ^ 1 0_ a everopm ; 1 C�.-v .. zlv,�� CONTRACTOR v#t!V� dtlY NO. I�a7f1P. / f S as above �� ADDRESS Same- J; .�:/ �'.;• �' r' O DESCRIPTION OF'WORK .�''-�~''� Ai-,:'. { F !1 A t W NEW X ADD. ALTER REPAIR DEMOLISH /" Z SO.FT. NO.OP- , NO.OF SIZE J+03 STORIES' 1 'FAMILIES 1 ,� SUSEOFTRUCTURE Residence with attached "%�� ' �''�' �`''P'�"" ,' "''` � �L . garage - an ;f , h A ,,A d SIGNATURE OF. Vjd APPLICANT j • «fit' ' VALUATION$ oar APPROVALS iDATE INSPECTOR'S SIGNATURE P.C. g ,C, g PMT. B FOUNDATION:LOCATION 9, FEE FEE FEE $ . i 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. 1 CERTIFY THAT IN THE PERFORMANCE /�/� OF THE WORK FOR WHICH THIS PERMIT 15 ISSUED 1 SHALL NOT t�dNT. V EMPLOY ANY PERSON IN ANY MANNER 50 AS TO RECO SUBU ECT ATO THE WORKMF�`f1S C ATI,oeNv AevJ�5 OF N1fy0 LATH,EXT. 11.1 ��-- `/� i ►i! SIGNATURE O 11 1J 11 �IJt HRECT AND POSTED R C Ir PERMITTEOE . ADDRES L FINAL CLYDE_ N..DIRLAM, PRINCIPAL SFRAL ENGINEER PLAN CHECK VALIDATION cI4 M.o. CABH PERMIT VALIDATION, cK M.O. CASH ' I C '7,5.ti 8 E JAN 2 9 2 3 D- 2 5.5 I� � 4a4 FEB 15 1D 51 .00 M s9 08 N: Ki ,,, •mac . - ' • - 7=��C C 76A638A CE#8.03 5-65 APPLICATION FO UILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS' BUILDING AND SAFETY DIVISION LOCALITY JOHN A..LAMBIE:COUNTY ENGINEER ,NEAREST /yJ COLEMAN W. JENKINSSuP-T OF BUDDING- CROSS ST. DISTRIC NO. "GRO TYPE PROCE BY FADDRESS OR APPLICANT TO FILL IN �v CONST G Q STATISTICAL SSIFICATION -SEWER MAP `Q . CLASS NO. DWELL UNITS BK PG BLOCK USE NE. MAP O. S P SPECIAL NO. OF BLDGS. �r"ff CONDITIONS LOT NOW ON LOT-.�/ c2(�BLDG_ T BLDG. SETBACK FROM 1� NOL' /J FRONT PROP. LiNE OF — (STREET) //�� / TYPE OF EXISTING SETBACK HIGHWAY + - YARD — 'TOTAL e1, ✓ L—• N t12, HIGHWAY WIIDT/H FROM C.L. r7 CITY7-•fie.' BLDG. ETBACK FROM _ ARCHITECT OR - _ TEL. ' ENGINEER NO. SIDE PROP.-LINE OF (STREET) � _ TYPE OF EXISTING SETBACK. HIGHWAY -I- YARD = ,TOTAL ADDRESS - HIGHWAY WIDTH FROM C.L. - CONTRACTOR p NOTE L ,C) -+ O ADDRESS �O9�Z�U GQ,�r11Jb` NO �ZL J CORNER CUTOFF YES NO V CITY T �l�l Cli�sj SEE REVERSE SIDE FOR SPECIAL APPROVALS O DESCRIPTION OF WORK EW ADD ALTER REPAIR DEMOLISH SQ.FT... -- NO, OF NO. OF ?• SIZE STORIES "FAMILIES ! USE OF STRUCTURE 04STALL ALL Cc3aL.Ev.— .. SIGNATURE OF APPLICANT VALUATION$ APPROVALS DATE •INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION, LOCATION FEE$_ FEE$ FORMS, MATERIALS FRAME, FIRE STOPS, - 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT ' AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION WITH' ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS 13UILDING CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON VIOLA- LATH. INT. TION OF THE LABOR'CODE OF THE STATE OF CALIF.ORNI RELAT- ING TO WORKMEN'S COMP TIO INS RANGE. LATH. EXT. SIGNATURE OF HOUSE'NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS ZQ FINAL _ JOHN F. LEWIS, PRINCIPAL STIRccy RAL ENGINEER PLAN CHECK VALIDATION CK. M. cash PERMIT VALIDATION M.O CASH i1C,�,3 65.7 a JAIL 21 ; 1 D : 4..0 ON q I 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 certif1'� d op thereof(Sec. 3800,Lab. C.) Policy NoGCompany COUNTY OF LOS ANGELES BUILDING AND SAFETY Certified copy is hereby furnished. I FOR APPLICAN TO FILL IN aooRess C,. C Certified copy is filed withth county buildin inspec- BUILDING department. ADDRESS (O Z LOCALITY NEAREST Date Applicant CITY ZIP 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 ZONE MAP 40 hundred dollars($100)or less.) TRACT BLOCK LOT NO. NO. ' '\ TEL. '` 1 �. SPECIAL r I certify that in the performance of the work for which this I OWNER L 4/ NO, CONDITIONS 9L.. permit is issued, I shall not employ any person in any mannerDISTRICT GROUP TYPE FIRE PROCESSED BY CI so as to become subject to the Workers'Compensation Laws. ADDRESS o S� CONST. ZONEJU L9 I CITY ` , L� ZIP O Date Applicant STATISTICAL CLASSIFICATION PT. CONDO. NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL.UNITS916 Compensation provisions of the Labor Code, you must forth- ADDRESS q SEWER MAP with comply with such provisions or this permit shall be r TEL. ¢ fb z deemed revoked. CONTRACTO . 67Er NOZV �6Q BK. PG, VALIDATION LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS VALUATI N (commencing with Section 7000)of Division 3 of the Business and C C� gyp-3� y�' Professions Code, and mylicenseis in full force and effect. �r CITY o7G� ( < License Number, Lic.Clas �~ � ` SIZES [STORIES FAMILIES CONE ► Contra `; pate DESCRIPTION OF WORK — u�L NEW ❑ ADD F1am exempt under Sec. ❑' ALTER ❑ ' Date: FINAL DATE B.BP.C. for this reason REPAIR USE OF FINAL EXISTING BLDG. DEMOL ❑ Signature APPLICANT TEL. By OWNER-BUILDER DECLARATION PRINT NO. I hereby affirm that I am exempt from the Contractor's License �� Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): PRESENT ❑ BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and , o o a o the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ? 0 1 0/ ? ❑ I, as owner of the property,am exclusively contracting - CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS ° 00' J tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM dEX f /� j �— c ,• 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. tSec. 3097, Civ. C.). SIDE ii P.L. d Lender's Name 3 P.C. Fee$ Permit Fee Lender's Address Icertifytat I have read this application and state that the Issuance Fee 0 !above i rmation is correct. I agree to comply with all County Investigation Fee /n/,,, ordin c s and State laws relating to building construction, Total Fee / n o/ 9 and r y authorize representatives of this County to enter upo t bove-menti property for inspec ion��/os o !oo — SEE REVERSE FOR EXPLANATORY LANGUAGE ®s Signature of Applicant or Agent Date