HomeMy Public PortalAbout5444 MCCULLOCH AVE_Building_6/11/1960_ 78A ep BA CE01q3 9-67
- . APPLICATION FOR BUILDI G PERK
COUNTY OF LOS ANGELES BUILDING
,,,0EPhHTMENT OF COUNTY ENGINEER ADDRESS 5"4MCCu11Ough
BUILDING AND SAFETY DIVISION LOCALITY Temple City.9 California
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST. r'7eistraetDISTRICT NOOUP TYPE PROCESSED BY
FOR APPLICANT ' FILL IAV 7'� CONST. 1
• 1.1-1• (Print or type only) �.7 n � Df C-.rC
BUILDING ADDRESS 544 MCCu11Ou STATISTICAL CLASSIFICATION SEWER MAP
/. CLASS NO.__s_DWELL.UNITS '— r- BK PG107
LOT NO. par/ Lp , BLOCK USE ZONE MAP 2 O 70
TRACT LL11 1 {�." 1 V'dL1:T- �� SPECIAL
CONDITIONS
NO.OF BLDGS.
SIZE OF LOT NOW ON LOT 1
USE OF Residuece
EXISTING BLDG. BLDG.SETBACK FROM /
H Kornai TEL. FRONT PROP.LINE OF Me. e, //Ce 6- (STREET)
•
OWNER It NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS 5� MoCu11O h HIGHWAY WIDTH FROM C.L.
.1 Gd + �U = 20
CITY Temple City., Ca1lfOrnia 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.
a
CONTRACTOR aCi C n13 • TENO•L, p� + _ }
ADDRESS 10920 Be Grand NO.' 211898 CORNER CUTOFF YES ❑ NO C.'
LIC. E
CITY rj' a Cit CLASS C 2 SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK CL
NEW ADD ALTER REPAIR DEMOLISH
SQ. FT. NO. OF NO. OF
SIZE STORIES FAMILIES
USE OF —Aru mi
STRUCTURE Install-inoec
plug in type .
SIGNATURE OF
APPLICANT
VALUATION Sr 200000
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. FOUNDATION: LOCATION
FEE$ FEE FORMS, MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ APPL ACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT ANI ACRE TO FURNACE: LOCATION,
WITH ALL COUNTY ORDINANCES AND ST LAWS EGULA NO GAS VENT, DUCTS
BUILDING CONSTRUCTION. 1 CERTIFY TH IN DO. THE RK
AUTHORIZED HEREBY I WILL NOT EMPL ANY P ON IN V LA-
TION OF THE LABOR COD F THE E IFORNIA ELAT- LATH, INT.
ING TO.WORKMEN'S COM ATI RANCE. '
' LATH, EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS FINAL
JOHN F. LEWIS. PRINCIPAL STR RAL ENGINEER
PLAN CHECK VALIDATION CK. M.D. CASH _ PERMIT VALIDATION CK. M.O. CASH
LFiL05. 0_2 420 jUN 11 1 D -6.0.0" Iq
8A898p,vCE.#809.10-38APPLICATION FOR BUILDING PERMIT
BUILDING AND SAFETY DIVISION BUILDING
Department of County.Engineer ADDRESS 7 t
County of Los Angeles LOCALITY
JOHN A.LAMBIE. COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROG TYPE SEWER MAP
FOR APPLICANT TO FILL IN
ol! I CONST. I
BUILDING
ADDRES ;1/ C/ 7'>�c r f /. r 1/ STATISTICAL CLASSIFICATION
LOQ/f �.� BLOCK CSS.
NO,o� �DyWELL.IUNITS_L STATE YES O
NUMBERHwy
TRACT ' G USE ZONE S�PEEC AL �
NO.OF BLDGS. CONDITIONS
SIZE OF LOT P O X.` !'A I NOW ON LOT &J
USE OF
EXISTING BLDG. l�~'•.^' Cz BUILDING EXIST.
YARD HWY STREET NAME
SETBACK WIDTH-
OWNER G7�- r � I ' n/ FRONT
MAIL P. L. l�
a�
ADDRESS-� �]'� I� - 'TEL
�Pa i !-� SIDE ,
�p�. P. L.
CITY fG++-r+ .•-.i i".''-.r NO.:i'y• 4-1/m, INSPECTION RECORD
ARCHITECT OR ° TEL.
ENGINEER NO.
ADDRESS --
ITEL.
CONTRACTOR j 4x:. a a4k 1wsa3'G NO.jd. /IA---I
ADDRESS/?*✓� ,-
DESCRIPTION OF WORK > ' _
NEW"<. ADD ALTER REPAIR DEMOLISH
SQ. FT. l NO. OF. NO.OF
SIZE / STORIES FAMILIES
USE TRUCTURFI
�,vl �'• _/ice'rT�® / _ ;..J,J' /•�'!ey' Jp' .
APPROVALS
SIGNATURE OF
APPLICANT L r r '' DATE INSPECTORS SIGNATURE
ADDRESS FOUNDATION:LOCATION y ✓� :''/' r
FORMS. MATERIALS !-. , `f. r'.•. 7l=/
7jELEZ
FRAME: FIRE STOPS. r '
�0 V BRACING.BOLTSFURNACE: LOCATION.VALUATION �s GAS VENT. Of `/`J //•G/(�Irl, //f •I. 1
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH. INT. /Ile_.•I'.1•'1.. 1- ✓/"
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH.EXT.
STATE LAWSREGUL.�kIT [G,.BUILDINP- CONSTRUCTION.
SIGNATURE OF ��_j-fr �fl j HOUSE NUMBER COR- / f• •4n.1,
PERMITTEE r i'a, ! t.f.-t'1 RECT AND POSTED
ADDRESS l/ FINAL /5 ,1��( - �7��L!/1•L^fr
OHN A.LAMBIE.COUNTY,ENGINEER. CLYDE N.DIRLAM. ORINCIPAL/STRUCTURAL ENGINEER
PLAN CHECK VAI$DATION It. M.o. CASH PEIIMIT VALIDATION K.' N.C. CASH
1 r
' WORKERS'COMPENSATION DECLARATION I
I,�&eby affcertifi at I haver certificate of consent to self APPLICATION FOR BUILDING P_E RAA I T
`,•�insure, or a certificate of Workers'Compensation Insurance,
or a certified copy thereof (Sec. 3800, Lab. C.)
COUNTY OF LOS ANGELES � BUILDING AND SAFETY
Policy N Company
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING /J
ADDRESS
`�
Certified copy is filed with the county building inspec- BUILDING
tion department. ADDRESS Q °
4 \
Date D ApplicCITY ZIP I � LOCALITY ' •
RTI ICATE OF EXEMPTION FROM WORKER ' NO.OF BLDGS. NEAREST
COMPENSATION INSURANCE SIZE OF LO7 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
r TEL. USE ZONE MAP
I certify that'in the performance of the work for which this OWNER ,/ NO. �sg NO.
IAL
permit is issued, I shall not employ any person in any manner ADDRESS r e CONDITIONS p
so as to become subject to the Workers'Compensation Laws. O
Date Applicant CITY ZIP b
NOTICE TO APPLICANT: If,'after making'this Certificate of ARCHITECT OR TEL. / DISTRICT G UP TYPE FIRE PROCESSED BY O
ENGINEER NO• 3 `, CONST. ZONE F—
Exemption, you should become subject- to the Workers'
Compensation-provisions of the Labor Code, you must forth- ADDRESS
with comply with such proyislons or this permit shall be TEL STATISTICAL CLAS IFI ATION APT. 0
deemed revoked. CONTRALTO "�' �.N 619 z
LICENSED CONTRACTORS DECLARATION • LIC• CLASS N0. DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter.9 ADDRESS SWi NO. 917-3 f
(commencing with Section 7000)of Division 3 of the Business and LIC.
SEWER MAP
Professions Code, and my license is in full force and effect. CITY . CLASSC 3/q 4 0; BK. PGVALIDATION
SQ.FTNO.OF NO.OF CHECK
License Number 3gZ�.31 Lic.Class SIZE X6 STORIES FAMILIES ONE
OF e V To
Contract op � `�'e" �� Date' d 4 DESCRIPTION OF WORK N�" $
I am exempt under Sec.
t DD ❑
LTER
B.BP.C. for this reason REPAIR $
Date: USE OF DOL ❑ 2 8 0 6.0 A
EXISTING BLDG.
Signature APPLICANT `�a, L. ® FINAL '/� # o 0 0 0,0
PRINT ry/v JET p I �� N07
OWNER-BUILDER DECLARATION DATE
I hereby affirm that I am exempt from the Contractor's LicenseADDRESS ��r at t;Tozc� �1 •o:1 2 4 8 8
Law for the following reason (Section 7031.5, Business and
Professions Code): PRESENT--- : 12 g 8 8 cU
❑ BUILDING
I, as owner of the property, or my employees with ADDRESS
wages as their sole compensation,will do the work and •-I Q 0 6 . 87
the structure is not intended or offeredfor 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).
CK FRRVEEE
CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAPROP.L NE 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
P.L.
Lender's Name LDMA Ref. N
m P.C. Fee$ Permit Fee
Lender's Address
0 1 certify that I have read this application and state thatthe Issuance Fee i�i LDMA P/C p
o above information is correct. I agree to comply with all County Investigation Fee
q ordinances and State laws relating to building construction, Total Fee 1.241 LDMA Perm N
Rand her authorize representatives of this County to enter
upon the above- entioned property for inspection purposes.
�.
m - SEE REVERSE FOR EXPLANATORY LANGUAGE ,
Si
gnatur AP
Icarb\Agent Date
.� I
• ' WOR&S'COMPENSATION DECLARATION
hereby affirm that I have certificate of consent self
iTtA P P L I SAT I O N FOR BUILDING PERMIT
sure, or a certificate of Workers' Compensation Insurance,
or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES ' . • -v BUILDING AND SAFETY
Policy No. Company' III- I
El BUILDING
Certified copy is hereby furnished. FOR
lAPPLICANT TO FILL IN ADDRESS
❑ Certified copy is filed with the county building inspec- ADDRess�'" (,T ee j)Ld v�
tion department.. � �j/� ) �y�
Date Applicant CITY.//�NAZ_t_ L/ ZIP / ?ED LOCALITY NO.OF BLDGS. NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST.
COMPENSATION INSURANCE ASSESSOR f
(This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL
undyed dollars ($100)or less.) TEL. USE ZONE MAP �/-7 �1 a 77
permit
OWNER NO. NO. _/ ! '7
I certify That in the performance of the work for which this Pik—IAL
is issued, I shall not employ any person in any manner ADDRESS S�t • �— ��� CONDITIONS
so as to become subject to the Workers'Compensation Laws. O
CITY ZIP U
Date�Applicant��r►,V �.� �� ARCHITECT OR TEL, O
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO DISTRICT GROUP TYPE FIRE PROCESSED BY
Exemption, you should become subject to the Workers' D y CONST. , ZONE 0
Compensation provisions of the Labor Code, you must forth- ADDRESS o "3 a
with comply with such provisions or this you
shall be �i" TEL. v7
i �1 STATISTICAL CLASSIFICATION APT. CONDO. Z
deemed revoked. CONTRACTOR�1��1 �i NO. O
LICENSED.CONTRACTORS DECLARATION ,�,pC�, p, ,r�/� LIC. ,L / CLASS NO.�DWELL. UNITS
I hereby affirm.that I am licensed under provisions of Chapter 9 ADDRESS ,f'I C.V�LfIU// NO. '7oTp�1 q
F LIC. 1� ` SEWER MAP
(commencing with Section y license
of Division 3 of the Business CITY E/� /1_ L e- CLASS J !
and Professions Code,and my license is in full force and effect. !' BK. PG. VALIDATION
SQ. FT. NO. OF P NO. OF fE CHECK
UceAse Number Lic. Class SIZE /pQ�' STORIES FAMILIES G ONE
� Q VALUATION
Contractor—: I�JF� 2_&te 3D. DESCRIPTION OF WORK NEW ❑ $
❑I am exempt under Sec. E/�L' (S�� �J J��� ADD ,
> �I/ �D/V ALTER ❑
B.BP.C. for this reason $
(}. USE OF REPAIR ❑
Date: EXISTING BLDG. Q�GS DEMOL ❑
Signatur L APPLICANT�1^ TEL,
(PRINT)1JON � � NO D ']"� FINAL
OWNER-BUILDER DECLARATION _//`` J� DATE r'
I hereby affirm that I am exempt from the Contractor's License ADDRESS S 7r3� C�LC.00J7 I 7
Law for the following reason (Section 7031.5, Business and FINAL _
Professions Code): PRESENT By
❑ 1, .as owner of the property, or my employees with ADDR SS �•
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 I'�
tion 7044, Business and Professions Code.)
REQUIRED TOTAL SETBACK FROM EXIST. —
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP.tLINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT �: i I r; ti
the performance of the work for which this permit is issued P.L. TOTAL(Sec. 3097, Civ. C.). SIDE • T EA_ 2
P.L. f-�I'jEK 270.79
Lenders Name �✓ LpMA Ref.#
P.C. Fee$ .: Permit Fee j4'i
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 �� �I)II t_ l J , �L , ,
ordinances and State laws relating to building construction, Total Fee A f LDMA Perm. # _
and hereby authorize representatives of this County to enter 5754 1 AM -0v
Upon the above-mentioned property for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
�t Signature of Applicant or Agent Date