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Home My Public Portal About5515 PAL MAL AVE_Building__I A ROAD DEPT. PERMIT IS REQUIRED FOR ANY MATE.',' .. :] _ "c OR WORK DONE IN THE i._. _ _.i OF WAY. .......=.#. .,.,• APPLICATION FOR BUILDING PERMIT Z COUNTY OF LOS ANGELES BUILDING [ ? ' DEPARTMENT OF COUNTY ENGINEER ADDRESS J 1 BUILDING AND SAFETY DMSION LOCALITY JOHN A. LAMSIE, COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN 6u PT OF Bui LDING CROSS ST. DISTRI OUP TYPE P Y FOR APPLICANT TO FILL IN coNsr. 2c ' ADDRESNG S / STATISTICAL CLASSIFICATION SEWER MAP �� ,jl BK PG CLASS. NO. DWELL.UNITS �� L O� - d BLOCK MAP STATE NUMBER O HWY. YES O TRACT USE ZONE SPECIAL / NO.OF SLOGS. //-�} / CONDITION SIZE OF LOT I NOW ON LOT / ` USE OF / EXISTING BLDG. /UNC — jr4-. K BUILDING EXIST. SETBACK YARD HWY STREET NAME W DTH OWNER FRONT MAIL P.L' ADDRESS / HIDE TEL. P.L. CITY e<7' NO. INSPECTION RECORD ARCHITECT OR_.. / TEL ENGIN / )/ ) NO.-f d' ENGINEER / / ADDRESS U -C a . CONTRACTOR 'NOfL//G1 jFl ADDRESS A ' -f DESCRIPTIC& OF WORr NEW ADD ALTER REPAIR DEMOLISH SO. FT. NO. OF NO. OF SIZE STORIES FAMILIES USEOF STRUCTURE s L / # SIGNATURE OF APPLICANT APPROVALS DATE INSPECTOR'S SIGNATURE ADDRESS U FOUNDATION: LOCATION FORMS,MATERIALS - VALUATION FRAME: FIRE STOPS, -- ///---Taa BRACING, BOLTS P.C. �� PMT. FURNACE: LOCATION, FEE f.") FEE f _ GAS VENT,DUCTS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH, INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH A L COUNTY ORDINANCES AND LATH, EXT. STATE LAWS TI BUILDIN RUCTION. SIGNATURE OF �__ HOUSE NUMBER COR. PERMITTEE RECT AND POSTED / ADDRES4E2-c ��`'1 FINAL - CLYDE N. DIRLAM. PRINCIPAL Sr RAL ENGINEER PLAN S VALIDATION CK. M.O. CAHH PERMIT VALIDATION OK. M.O. CASH �D6266� FEB I () 2 3 A 3 .75 b ®, Ca62672 15.06 SII ]1A.3.ACE:a.,It1-6) APPLICATION FOR BUILDING r'ERMIT Z COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DMSION LocALITY JOHN A. LAMBIE.COUNTY ENGINEER NEAREST ` CASSATT D.GRIFFIN,SUWT OF BIIIL13ING CROSS ST. !' DISTRICT NO. I GROUP TYPE SEWER MA R AP LICANT TO FILL IN � CONST. BK PG BUILDING Pal Mal " ADDRESS b STATISTICAL C SSIFICATI ON LOT NON. 601of S. 23 O 8 K CLASS.NO. DWELL. UNITS TRACT 8822 NUMBER Q Sj.lyyYE YES O USE ZONE SPECTMAP .K '20 x 60 NO.OLDGB. 5 CONDITIONS SIZE F LO /1NOW ONFBLOT USE OF Dwellings &(Garage U+ EXISTING BLI�G BUILDING YARD HWY STREET NAME EXIST. OWNER Harr Hunt SETBACK WIDTH FRONT ` 1 -ADDRESS 5519 Pal Mal SID C (� /� SIDE CITY Temple City TEL. P.L. ARCHITECTOR TEL. INSPECTION RECORD ENGINEER NO. ADDRESS CONTRACT..Selected T�F Selected Homes D 4029 � ADDRESS16322 Arrow Hwy, IrwindAl DESCRIPTION OF WORK NEW x ADD x ALTER REPAIR ( DEOLISH SO.FT. NO.OF NO.0 F SIZE 2)ao _ STORIES FAMILIES USE OF STRUCTURE Laundry ho6m,. a 10 Pool Decki a SIGNATURE OFA Loral APPROVALS APPLICANT ADDRESS16322 row H , Irwindal FOUNDATION: LOCATION LDATE INSPECTOR'S SIGNATURE FORMS.MATERIALS _J $ 6-� P.C. S FRAME: FIRE STOPS, ry I FEE BRACING.BOLTS VALUATION S f1v FURNACE: LOCATION. FEE GAS VENT.DUCTS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP. LATH,INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WI,P4 ALL COUNTY ORDI NCES A STATE LAWS REGU TNG BUI TNG C STRUCT N. LATH,EXT. SIGNATURE OF HOUSE NUMBER COR. PERMITTE Lu �G RECTANDPOSTED ADDRES W H IrwindalA FINAL CLYDE N. DIRLAM, PRINCIPAL STRURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMT VALIDATION c M.o. wH 1Utio;n 70,605 F3 ?,g 1 A 12�?.00 o. a c .o..... APPLICATION FOR BUILDING PERMIT 1 COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE,COUNTY ENGINEER NEAREST. ' CASSATT D.GRIFFIN 8UP•T OF BUILDING CROSS ST. DISTRI O. GROUP TypE FR FOR APPLICANT TO FILL IN CONSTf BUILDING -` STATISTICAL CLASSIFICATION SEWER MAP ADDRESS Pal Mal �I BK PG CLASS. NO. DWELL. UNITS LOT NO. See Legal ICK MAPSTATE YES NO NUMBER OO HWY. TRACT USEZONE SPECT NO. OF BLDGS. CONDITI SIZEOFLOT 60 X 420 NOWONLOT 3 -/ USE OF 2 Dwellings & Garage I D B ILDINGEXIST. SETBACK YARD HWY STREET NAME WIDTH OWNER Harry Elunt FRONTMAIL ADDRESS `5706 Rowland S L _ SIDE Temple City TEL. P.L. CITY NO INSPECTION RECORD ARCHITECT OR TEL. ENGINEER NO. ,/ I ADDRESSI� CONTRACTOR Selected Homes NOFD 4029 oe D 16322 Arrow ilwy, Irwindal DESCRIPTION OF WORK NEW X ADD ALTER REPAIR DEMOLISH L -7 Zr SO.FT, 1077 NO.OF 1 NO.OF 1 SIZE STORIES FAMILIES _ USE OF STRUCTURE Dwelling and Attached 12 x 20 Carport SI GNATURE OF / APPROVALS APPLICANT w.." DATE INSPECTOR'S SIG ATTIRE ADDRESS 16322 crow HW IrWlndal FOUNDATION: LOCATION y / N SFORMS.MATERIALS 1 O � / Jj $ ' FRAME:RACING, BOLO VALUATION � V FEE f ? FGAS VENT DUCTS N. - '�"�(`'� 'r I HEREBY ACKNOWLEDGE THAT 1 HAVE READTHISAP- LATH. INT. - PLICATION AND STATE THAT THE ABOVE 15 CORRECT/IND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH, EXT. ✓ / STATE LAWS REGU ING BUILDING CO RUCTION. SIGNATURE OF �-✓`/� HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS 16322 Apeow Hwy, Irwindale FINAL CLYDE N. DI RLA M. PR I NCI PAL STR RAL ENGINEER PLANCK VALIDATION a5 M.O. CASH PEXMT VALIDATION U. M.O. CASH P. 2 5 9 !v'v' j n 2 3 A ' �ro8498 4 1 A 36.r) 0 ®, WORKERS' COMPENSATION DECLARATION APPLICATION FOR BUILDING PERMIT I hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers' Come tion Insuran , or a certified ]7c-oy��/th_ereof (Sec, b ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy ll(- Y Compan ❑ LDING Certified copy is hereby furnished. FOR APPLI T TO FIL IN ADESS DR ❑ Certified copy is filedZ, ounty building inspec- BUILDING 'tC'/�/ A.L ti n de rtrm7en�t. ADDRESS ]55 J i'1 D 11074 L, arw_pplic OTV Ems+ ZIP LOCALITY `L® tJO. OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars (5100) or less.) TEL. OWNER NO. USE ZONE 7 I certify that in the performance of the work for which this Q'I _ SPECIAL a permit is issued, I shall not employ any person in any manner ADDRESS /I•�� CONDITIONS so as to become subject to the Workers' Compensation Lows. O CITY ZIP U Date Applicant - ARCHITECT OR TEL, NOTICE TO APPLICANT: If, offer making this Certificate of ENGINEER NO DISTRICT GROUP TYPE FIRE PROCESSED BY CONST. Z E Exemption, you should become subject to the Workers' _ y (i ,( I / 'O{y U Compensation provisions of the Labor Cade, you must forth- ADDRESS G'0 ' rJ ✓ �-/ "g 3 d with comply with such provisions or this permit shall be deemed revoked. OONTRACTQ ^r 205YSTATISTICAL CLASSIFICATION APT. CONDO. Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. OZI/ DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS S. NO: SEWER MAP (commencing with Section 7000)of Division 3 of the BusinessSf LIC11 and Professions Code,and my license is in full force and ect. - CITY (� CLASS - BK PG VALIDATION SQ. FT. NO. OF NO. OF CAKK License Number 'A ClassI SIZE STORIES FAMILIES ONE (*&1f2, VALUATION ContinD RIPTION OF WORK NEW ❑ ADO ❑ , ❑I am exempt under Sec. ❑ ALTER B.BP.C. for this reason A j�k� REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMOL ❑ Signature _ APPLICANT . ._ TEL. OWNER-BUILDER DECLARATION (PRINT) NO. FINAL DATE - n/ I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL Professions Code): PRESENT By ❑ 1, as owner of the properly, ormY employees with BUILDING ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY , .71'h 7044, Business and Professions Code.) MOVING TEL. ❑ [,as owner of the property, am exclusively contracting CONTRACTOR NO. T with licensed contractors to construct the project (Sec- ADDRESS - "�;,I yL t7-s�� 6 S, tion 7044, Business and Professions Code.) c-P '' REQUIRED TOTAL SETBACK FROM E%IST. CONSTRUCTION LENDING AGENCY SET gq YARD HWY PROP. LIN 1 hereby affirm that there is a construction lending agency for FRONT r�Hl'J1.7C the performance of the work for which this permit is Issued P.L. _. (Sec. 3097, Civ. C.). - SIDE P.L Lender's Name Q LD A P.C. Fee$ Permit Fee Q Ref. If Lender's Address �floop, a I certify that I have read this application and state that the Issuance Fee v` �� LDMA P/C N obo formation is correct. I agree to comply with all County Imesagation Fee or roan es and State laws relating to building construction, Totol Fee _DMA Perm. N er ou orize representatives of this County to enter n t a ve-mentioned property for inspecti p poses. �b SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of Applicant or Agent to