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76A638A CE 4803 2-63APPLICATION FOR BUILDING PER
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY C
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. .
DISTRICT NO. GR PP UP TYE S§ED BY
FOR APPLICANT T(ZrFILL IN CONST.
BUILDING1 n _ STATISTICAL CLASSIFICATION SEE R MAP
G
ADDRESS 01'7-pj OXJ. ,[,
CLASS. NO. DWELL. UNITS
LOT NO. ' i j N k, T r BLOCK WATER NOT REQUIRED F7 RECEIVED
11 d C CERTIFICATE:
TRACT j SSi ON V J EW /��•R�d MAP 1 HIGHWAY STATE MAJOR SECOND. OCA`
�} NO.OF BLDGS. o NO.- (CIRCLE)
SIZE OF LOT O�x �O NOW ON LOT v USE ZONE SPECIAL
USE OF �+� CONDITIONS (
EXISTING BLDG. / J
TEL.
OWNER osE TAMAk( NO. '7-.�A7 BUILDING EXIST.
SETBACK YARD HWY TR T NAME WIDTH
ADDRESS QT .�l' 0&,,eFRONT
ARCHITECT OR TEL. V P. L.
ENGINEER NO. SIDE
ADDRESS O
CONTRACTOR (MAWR(A ``HOMES !NC NO- 3 -pa.
ADDRESS �I2 i++++��ry A'ZU,674 -f s!. O
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH - Z
SQ. FT. NO. OF NO. OF F
:a..'t.
SIZE STORIES FAMILIES _)
USE OF A� �, .(� I� ✓=� '• AI-I _
STRUCTURE i rAm owaL-LI/�I(,` „
r d
SIGNATURE OF
APPLICANT .. _
VALUATION S / � -
v APPROVALS .} p°• DATE INSPECTOR'S SIGNATI/kE
P.C. (� PMT. 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 0� -
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 RELAT4 AIN
-
ING TO WORKMEN'S COMPENSATION INSURANCE.
,s'7 • LATH, EXT. -
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED -
ADDRESS` '� « �q'zuSA FINAL .
JOHN F. LEWIS. PRINCIPAL STR AL ENGINEER
PLAN CHECK VALIDATION cK M.D. CASH _ PERMIT VALIDATION GK. M.O. CASH
V�vj 3 4 1 6' DEC 11 2 3 D ,5 2.0 0 A
V� 3 7 2 3 1 DEC 2 0 1 D 6 4-00-
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76A638A CE x603 2-63
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT -OF COUNTY ENGINEER ADDRESS r
BUILDING AND SAFETY DIVISION' LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN, SUP.'T OF BUILDING CROSS ST.
DISTRJ,C�T NO. GRO TYPE ESSED BY`
FOR APPLICANT TO FILL IN7/C! CONST.
BUILDING �� O` '�� ,
STATISTICAL CLASS( (CATION WER MAP
SS
ADDREq-,,,
l OL
v y K
CLASS. NO. DWELL.UNITS
p rQ7 SE;E, BLOCK WATER
��nn CERTIFICATE: NOT REQUIRED ❑ RECEIVED
LOT NO. o ❑.
TRACT 5Sj0 /lFk). "JeJFS , MAP HIGHWAY
NO.OF BLDGS.. NO. (CIRCLE) STATE MAJOR SECOND(LOCA
SIZE OF LOT IF& IL qd NOW ON LOT 0 USE ZONE PECIAL'
USE OF CONDITIONS
EXISTING BLDG.
OWNER 6S AAAK! No' ,7�' BUILDING EXIST.
SETBACK YARD HWY STWET NAME WIDTH
ADDRESS Q`�z(p I�J� TPtc er FRONT
ARCHITECT OR TEL. ! P. L.
ENGINEER NO. i SIDEa
ADDRESS I O.'. 1 I V
CONTRACTOR I MPk'RQAl- 1110MdB AW
TEL 3314258 f /�� � �- { � � � �f� / I �
ADDRESS712,IZ f'Y !w -7-0SN r ! ).' �i�/l� �`"I9 ,rf�M 1.•Ynif �
DESCRIPTION OF WORK
Clr
NEW ADD ALTER REPAIR DEMOLISH // ' '• c �_�1 Q
SQ.FT. r NO.OF ` NO. OF
SIZED �; STORIES FAMILIES rr 1.4 y ��! �I
USE'OF A6� �, J n_� 'v7STRUCTURE FFQ•- 4ac,
r••�^ `,� i..
SIGNATURE OF _ •7� .(J...+k e�i,.s yet ,.,� n�.s .�
APPLICANT • I f 1 .yC3s
VALUATION 5 � z76
::wwe'��{
APPROVALS DATE INSPECTOR'S SIGrfAT,upC
P.C. PMT. /r/r FOUNDATION: LOCATION �/t `�� r1.
FEE S '��•FEE'S / 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.
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK _
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. d✓IL'A
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- _
ING TO WORKMEN'S COMPENSATIOIl INSURA E. LATH,EXT.
SIGNATURENUMBER
PERM TT•EE O aC HOUSE RECT AND POS EDR ¢ �, ✓.tf
ADDREssLMAMAL NOM KL°�F��LDQ � FINAL [[J 2�/� d�r�'•J'
cif� .(tI' r rs* �✓w �"sti.s'
JOHN F. LEWIS. PRINCIPAL STR AL`ENGINEER
PLAN CHECK VALIDATION' .'CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH
aEC 0
LAUD 3 7 2. 4" 1 D
WORKERS'COMPENSATION DECLARATION
hereby affirm that I have certificate of consent to self APPLICATION F R BUILDING P E RM 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
Rd
Policy No00'7WO Company_-f//L's PL4^4
❑ Certified copy is hereby furn' ed. FOR APPLICANT TO FILL IN ADDRESS a`7-32.. OU Vr-
❑ Certified copy is filed with a aunty building' spe - [ADIDY
NG -7 Z
tion department. SS ! OC1d� �T
Date ES L APPlican bZ" I Y zip I l��6 ;LOCALITY
NO.OF BLDGS. � NEAREST
CERTIFICATE OF EXEMPTION FROM WORKE S' F LOT NOW ON LOT CROSS ST. G�L,dL� iCOMPENSATION INSURANCEASSESSOR
(This section need not be completed if the permit is for one BLOCK LOT NO. MAP BOOKPAGE PARCEL
hundred dollars ($100)or less.) TEL. F- USE ZONE MAPR $ 25 T• .,-i A k i NO.2-S7 z'/ NO.I certify that in the performance of the work for which this SPECIAL
permit is issued, I shall not employ any person in any manner SS �'73 2, �„ Ut_ CONDITIONSCL
so as to become subject to the Workers'Compensation Laws. O
CITY 'Tel+uopts T ZIP "If L Z V43 U
Date Applicant ARCHITECT OR TEL. DISTRICrGROUP TYPE FIRE CESSED BY O
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST. ZO E f (–
Exemption, you should become subject to the Workers' ® U
P P y ✓ 0 a
Compensation provisions of the Labor Code, you must forth- t ADDRESS
with comply with such provisions or this permit shall be TEL. " STATISTICAL CLASSIFICATION APT. CONDO. N
deemed revoked. CONTRACTOR NO. `fo2&-_1%S'1ro� Z
LICENSED CONTRACTORS DECLARATION =2.7 AF• y tPAJ4 &SL--VO uC. CLASS NO. �� DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 1�C9. $�/6 NO.s SoZ
.SS (2-307
(commencing with Section of Division 3 of the Business a
and Professions Code,and myy license
CIN /(/T$&_4 CLICLASEWER MAP
license is in full force and effect. .t BK. PG VALIDATION
�–y --� SQ. FT. NO. F NO. OF CHECK
License Number_S S .1'7 Lic. Class G-3 SIZE STORIES FAMILIES ONE
r VALUATION
ContractorGIL01C Date../d.141.9 Z
DESCRIPTION OF WORK S jin���/� s l NEW ❑ $ f45(0
❑I am exempt nder Sec.
(p1L4 -xS/7-1 pAj J ///l ea L ADD ❑
!' .L ALTER ❑ '„
B.BP.C. fort is reason �!S �/�i! /v �/V REPAIR ❑ " $
Y Date: USE OF Covir As ITtcxl/ /oVGLGS
k/ 7Ayy EXISTING BLDG. DEMOL ❑ •i
Signature !/ APPLICANT TEL.
OWNER-BUILDE DE R TION (PRINT) NO. FINAL f�^
I hereby affirm that I am exemp m the Contractor's License ;. DATE
Law for the following reason (Section 7031.5, Business and ADDRESS FINAL 1
Professions Code): PRESENT By
ElI, as owner of the property, or my employees with A ADDRESS
ACT 0
LDIG t'
wages as their sole compensation,will do the work and
the structure is not intended or offered for sale(Section LOCALITY 7;
® ">t , 307 143.C'
7044, Business and Professions Code.) MOVING TEL. 1 ITEM
h7
S
E] 1, NO.I,as owner of the property,am exclusively contracting r.�. - -•o
with licensed contractors to construct the project (Sec- ADDRESS TOTAL 143•tQ 453
tion 7044, Business and Professions Code.) REQUIRED TOTAL SETBACK FROM EXIST. IIiL•it 143ob3
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH ,
I hereby affirm that there is a construction lending agency for FRONT CHANGE .011
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C.). SIDE
P.L. r },
Lender's Name ! 03130-0001 11124/12
i LDMA Ref. # n
P.C. Fee$ Permit Fee U r/ 6672 1 ti1111o5l[t
Lender's Address
L y iPoo
I certify that I have read this application and state that the Issuance Fee- � /� LDMA P/C# Poo
above information is correct.I agree to comply with all County Investigation Fee 1 //
ordinances and State laws relating to building construction, Total Fee 3, �O LDMA Perm. #
= and hereby authorize.representatives of this County to enter
upon the above-mentioned property for inspection purposes.
o SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent Date
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0910070033
PHONE: (626) 285-0488 EXT:
ILEGAL ID: 1 NO. OF CONST I BUILDING ADDRESS: 1
ON FILE I SQ. FT STORIES TYPE 1 9732 OLIVE ST I
ISTRUCTURE: V-B I TEMP CA 917803252
(ASSESSOR INFORMATION NUMBER: 1 I NEAREST CROSS STREET: TEMPLE CITY
18589-003-032 1 1 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, Cl
ITENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 ' (ISSUED ON: PROCESSED BY: 1
1 (EXIST OCC GRP: 110/07/09 SR 1
(OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IF NAL TS FINAL BY: CODE: 1
(CHER, CINDY (626) 287-6243- 1 3,000 1 �
19732 OLIVE ST I I ` I
ITEMP 917803252 I FEES PAID IDESCRIP ION OF WORK 1
I I IREPLACE 11 WINDOWS WITH NEW VINYL/RETROFIT WINDOWS
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:(
[APPLICANT: TEL. NO: I I I
[ARCHITECTURAL CREATIONS (310) 505-4255- IAA BLDG PERMIT ISSUANCE 27.75 1 [
1917 N. BAYVIEW AVE. IAB STATE GREEN BLDG FEE 3000.00 VAL 1.00 ISPECIAL CONDITIONS: 1
1 WILMINGTON, CA 90744 AC STRONG MOTION RESID 3000.00 VAL 0.50 1
D2 PERMIT W/O EN-HC 3000.00 VAL 99.00 1 I
1 TOTAL FEES 128.25 1_ I
[CONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE 1
(ARCHITECTURAL CREATIONS (310) 505-4255- 1 [
1917 N. BAY VIEW AVENUE LIC. NO 1 1LO.CATION AND SETBACKS I 1 I
IWILMINGTON, CA 90744 759571 B I I I
[ I ISOILS ENGINEER APPROVAL [ I [
(ARCHITECT OR ENGINEER: TEL. NO: 1 (FOUNDATION/TRENCH FORMS I I I
1 LIC. NO: 1 1SLAB/UNDER FLOOR 1
[ 1 IRAISED FLOOR FRAMING [ I I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 1UNDERFLOOR INSULATION I I [
1147H269 3 00 1 I I [
I I ]FLOOR SHEATHING I I I
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I I
[ NO 21 1 IROOF SHEATHING I I I
1 SCHOOL WITHIN HAZARDOUS ISHEAR PANELS I I I
(AIR QUALITY: 1000 FEET MATERIALS ] I I I [
] NO NO NO ] IFRAME INSPECTION i I I
1REQUIRED TOTAL SETBACK FROM EXIST ' 1 IFIRE SPRINKLER HANGERS I ]
ISET BACK YARD: HWY: PROP LINE: WIDTH: 1 I I I I
IFRONT PL- 1 ]INSULATION/WEATHER STRIP[ I ]
1 SIDE PL- I- I 1 I
I [INTERIOR LATH/DRYWALL
I 1 I
I I 1EXTERIOR LATH
I I I
I [ IRATED FLOOR/CEIL ASSEM. 1 1 1
1 1 1RATED WALL ASSEMBLIES 1 [ I
[ I RATED SHAFTS/OPENINGS
I
[ 1T-BAR CEILINGS 1 I 1
I [LOT DRAINAGE 1 I 1
I IREPORT ID: DPR261 ROUTE TO; BS0508 ] ] [
I I ] I I I
I
•C 1.
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1003040040
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
ON FILE SQ. FT STORIES TYPE 9732 OLIVE ST
STRUCTURE: 1800 V-B TEMP CA 917803252
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: GOLDEN WEST
18589-003-032 1 1 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, Cl
TENANT: JEXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY:
(EXIST OCC GRP: 103/04/10 SR 1
OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: (FIN TE FINAL BY: CODE:
CHER, CINDY (626) 617-1008- I 4,900
9732 OLIVE ST
TEMP 917803252 FEES PAID IDESCR TION OF WORK
I IREVIOVE EXISTING ROOF INSTALL 30 YEAR CLASS A FIRE RATED
I [FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1SHINGLES AND RIDGE OVER (E) PLYWOOD HOUSE ONLY (NO GARAGE)
APPLICANT: TEL. NO: I I
]KEEFER'S ROOFING CO. (909) 608-0622- IAA BLDG PERMIT ISSUANCE 27.75 I I
11216 BEGONIA COURT IAB STATE GREEN BLDG FEE 4900.00 VAL 1.00 SPECIAL CONDITIONS:
UPLAND, CA 91784 AC STRONG MOTION RESID 4900.00 VAL 0.50
1D2 PERMIT W/O EN-HC 4900.00 VAL 132.60
TOTAL FEES 161.85
CONTRACTOR: TEL. NO: JAPPROVALS DATE INSPECTOR SIGNATURE
IKEEFER'S ROOFING CO. (909) 608-0622- I
11216 BEGONIA COURT LIC. NO ILOCATION AND SETBACKS I 1
UPLAND CA 91784 760903 C39 I
SOILS ENGINEER APPROVAL 1
ARCHITECT OR ENGINEER: TEL. NO: IFOUNLATION/TRENCH FORMS I
1 LIC. NO: 1 1SLAB/UNDER FLOOR 1
RAISED FLOOR FRAMING 1
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( 'UNDERFLOOR INSULATION
I147H269 3 OOI
�[ `�•` c • IFLOOR SHEATHING
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I lV
1 NO 21 1 IROOF SHEATHING
I I I
SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS 1 I I
(AIR QUALITY: 1000 FEET MATERIALS I I I I
NO NO NO I IFRAME INSPECTION I I
IREQUIRED TOTAL SETBACK FROM EXIST I 1FIRE SPRINKLER HANGERS I I
ISET BACK YARD: HWY: PROP LINE: WIDTH: I I I I I
IFRONT PL- I (INSULATION/WEATHER STRIPI I I
1 SIDE PL-
I (INTERIOR LATH/DRYWALL I I I
1 1 (EXTERIOR LATH 1 I 1
I
IRATED FLOOR/CEIL ASSEM. 1 1 I
IRATED WALL ASSEMBLIES
I IRATED SHAFTS/OPENINGS
IT-BAlt CEILINGS I I I
I I �
ILOT DRAINAGE I I I
I 1REPORT ID: DPR261 ROUTE TO: BS0508 I I I
I I I I I I