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Home My Public Portal About5516 PAL MAL AVE_Building__ FeAi1sA DDf•i APPLICATION FOR BUILDING PERMIT Z DIVISION OF BUILDING AND SAFETY BUILDINGDRESS ITL1, Dep. &at of County Engineer County of Los Angeles LOCALITY WM.J. FOX. COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST. DISTRICT NO. GROUP I SEWER FOR APPLICANT TO FILL IN % I CONST, K MAP i ADDRESS 16 N Palmal NMAPBUILDING STATE YM O / 0 USE ZONE UMBER i HWY AT LOT NO. Lot 2 •• 01 5 cc� SPECAL BLoK CONDITIONS.K./f= I,Ix"e-Sro SC TRACT E. J.Bldain' s Add No. 1 A coop 2,a eel- NO. _ 'S ^''�' a SIZE OF LOT 0 X 100 NOW ON LOTS Z BUILDING YARD HWY a EST NAM[ EXIST. SETBACK WIDTH .USE OF eS a ce "to.be use a �' (STING BLDG. C�i1P�IN..T �Q '� !i2 OWNER v incent & EleanorMAILSIDE _ l.. P. L. ADDRE59 16 N. Palinal U TRACT DWELL. I UNIT S INDUSTRIAL CITY Temple Cit rTFI FO g 1 DWELL. I uNlr B PUBLIC BLDG. ARCHITECT OR TEL. 2 DUPLEX I UNIT 7 ADDN„ ALT.. ETC. ENGINEER NO. 3 APT. _UNITS 8 MI9CEL. ADDRE59 nO4 COMMERCIAL C CONTRACTOR r1S � Inc . NO.AT 79691 INSPECTION RECORD ADDRESS 4519 Rosemead BlvC, ✓ r ti� I: DESCRIPTION OF WORK r r NEW X ADD ALTER REPAIR DEMOLISH �! 8 ZE T 1000 IF .TORI E9 I FAM IILIIE9�_ USE OF RUCTU fi e amily resider:ce J . SIGNATURE APPL ICANTOF `'P — �T ZVe PPR /. , ADDRESS L519 osemendvd . DATE INsFEcT R's SIS TYRE FOUNDATION: LOCATION f P. C. S cc FORMS. MATERIALS v7.�'/E<✓ •vv Cn FEE '� FRAME: FIRE STOPS. VALUATION S A BRACING, BOLTS Y FEE FURNACE: LOCATION, 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT. DUCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECT _ l AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. - LATH. MT. SIGNATURE OF HOUSE i� HOUSE NUMBER COR- PERMITTEE �-i RECT AND POSTED ADDRESS 4519 Rosemead Blvd. FINAL WM.J. FOX,COUNTY ENGINEER VALIDATION C. N. DIRLAM, CHIEF BLDG. INSPECTOR f,03828e MR 7 ]. 6 11 .00A0 l 76AWBA C11[[07 f-BB APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS WE / � QL BUILDING AND SAFETY DIMON LOCALITY cr/PL E T JOHN A LAMBIE, COUNTY ENGIN!!R COLEMAN W, JENKINS$ YUP T OF BUILDING NEAREST CROSS ST FOR APPLICANT TO FILL IN DlsrRl T NO I cF�ur CONS TYPe PR eD By Print o,rvow only) • O BUILDING ,L y' STATISTICAL CLASSIFICATION SEWER IMP ADDRESS 16 NA P8l Nal CLASS NO_Q_DWELL UNITS_ BKL POAr LOT NO BLOCK USE ZONE OP O TRACT 12_ I I SPE AL NO OF BLDGS yool CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG �npjnff BLDG SETBACK FR TEL OM �� EFRONT PROP LINE OF REETI OWNER NTP V• L• VO[YA/u NO 55 . TYPl OF ISTI BYTMCK HIGHWAY } YARD = TOTAL ADDRESS HIOMWA WIDTH FROM C L CITY Temple City 1 E} BLDG SETBACK FROM ARCHITECT OR TEL SIDE PROP 1-61411 OF • ISTREETI ENGINEER NO TYP!OF I I AY YARD = TOTAL rAPPLICANT S --• /�/y� HIGHWAY w ACTOR VtT Roof NO287-0507O� SS S Sen 08hrlelNO 160650 C CUTOFF YES ❑ NO ❑ cg cuss C- 9 SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK d TOO z ADD ALTER REPAIR DEMOLISH NO OF NO OF D STORIES FAMILIES USE OF Houm with 30i & Rock. URE OF ANTeTION f 363D00APPROVAL9 DATE uEP[ctaw•S naKATu[[ PMT FOUNDATION LOCATION FEES FEES 9.00 FORMS MATERIALS FRAME FIRSTOPS I HERESY ACKNOWLEOOE THAT 1 HAVE READ THIS APPLICATION BRACINGE BOLTS AND STAT[ THAT THE ABOVE IS CORWC[ AND AGREE TO CO Y FURNACE LOCATION WITH ALL COUNTY ORDINANCES -No STATE LAWS "GULATINO GAS VENT DUCTS euILDINo CONSTRUCTION 1 CERTIFY THAT IN GOING THE WORK AUTHOHIISO HEREBY I WILL NOT EMPLOY ANY PERSON Ir VIOLA LATH INT TION OF THE W COO[ OF THE STATE OF CALIFORNIA REPT .NO TO wwKrERN u 00 LATH EXT SIGNATURE O Yl �f0 MOUSENUMBER COR- PERMITTEE RECT AND POSTED ADDRESSISM SO San QAbri6l,San aabTle FINAL S b AL PLAN CHECK VALIDATION CK MO CASH _ JOHNPE Lam=VALIDATIO IS PRINCIPAL S7 CK RM OENOI"lR LhLo 7 b 7�8 OCT 9 1 D 9 .00- i�4�n�CCGrt/� 900270 SB WORKERS' COMPENSATION DECLARATION hereby affirm that I have certificate of consent to APPLICATION FOR BUILDING PERMIT insure, w o certificate of Workers Compensation Insurance ce w a certified copy thereof(Sec 3800 Lob C ) Policy No PC997500 Company Republic Ind. COUNTY OF LOS ANGELES 61111DING AND SAFETY I❑ Certified copy u hereby furnished FtRACTIBLOCK PPLICANT TO FILL IN ADDRESS L A L LS Certified copy Is filed with the county building inspec- ADDRESS . 981 Mal hon deportment Date 8/22/90 Applicant Virgin Roof Co, CITY No ZIP LOcwun CERTIFICATE OF EXEMPTION FROM WORKERS' NOW ON LOT NEAREST COMPENSATION INSURANCE ASSESSOR CROSS ST (This section need not be completed if the permit n for one I LOT NO MAP BOOK I PAGE I PARCEL hundred dollars ($10D)or len ) OWNERMr.SMrs. V. Cannon NO USE ZONE I MAP 1 certify that in the performance of the work fat which this permit o issued,I shall not employ any pa wn in any manner ADDRESS 5516 N. Pal Mal — CONDITIONS d soas to become subject to the Workers' Compensation Laws CITY Temple City ZIP OV Dote Applicant ARCHITECT OR TEL NOTICE TO APPLICANT If after making this Certificate of ENGINEER No ��CT 10 ROUP TYPE FIRE � BY O Exemption, you should become subject to the Workers OJNST E G Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or this permit sholl be TEL STATISTICAL CLASSIFICATION APT deemed revoked CONTRACTOR Vir in Roof Co. No 287-0507 LICENSED CONTRACTORS DECLARATION ADDRESS 600 S. San Gabrie co 160650 CLASS NO ' UNITS_ I hereby affirm that I am licensed under provis ons of ter 9 MAP (commencing with Section 7000)of Diviuon 3 of the Business Cit, San Gabriel LICSEWER C39 IR and Professions Code and my license a in full force o d effect ECK BK L FG VALIDATION License Number 160650 Lic Clan C39 ZE FT OR� FFAAMJUEES OF Or Virgin Roof Co. 8/22/90 DESCRIpnONOFwORK REroof house NEW $ 2877 Contractor g ❑ 2 . Date f 87 .00 EDI am exempt under Sec with 1 #40, 2011 and green rock ADD ❑ pop. 10 B 8P C for this reason SQ. REPAIR ❑ $ Date OF EXXIISTIING BLDG dwelling OfMOt ❑ Signature APPLICANT OWNER BUILDER DECLARATION PRINT) Virgin Roof Co. NND 287-0507 FINAL I hereby affirm that I am exempt from the Contractor s LicenseDATE Law for the following reason (Section 7031 5, Business and ADDRESS 600 S. S8II Gabriel Blvd. S.G. FINAL 1 Profecsrom Code) BF ACCT.A ❑ I as owner of the property or my employees with BUILDINGp � G wages tis then sale compensation,will fa the work tion ADDRESS , `�71 ITQ E2•00 the4 Bu ure is not intended or offered fat sale(Semon LOCALITY 7044 Buuneas and Profession Code ) MOVING TEL ❑ 1,os owner of the property, am exclusively contracting CONTRACTOR NO with licensed contractors to construct the protein (Sec- TOTAL $2 �� tion 7044, BwADDRESS ineu and Professions Code ) 82MCONSTRUCTION LENDING AGENCY I y,� Inw' «FROM .(]I] I hereby off irm that there is a construction tending agency fat FRONT l rvalvTc the performance of the work for which this permit is inued P L (Sec 3097, Civ C ) SIDE PL 0000-0001 /23/90 Lenders Nome Pc Fe. Pe mit Fee o awRef • 2543 1 A11 932 Lenders Addrau 00.a I certify that I hove read this application and state that the bsvonce F 13.00 LOMA PIC• above information is correct I agree to comply with all County Investigation ordinances and State lows relating to building construction, I Tow Fee $82.00 LDMA Perm F a h reby authorize rgf, esentatwea of this County to enter IsS� a ve-men b d pr perry for inspection pttposes ^ /P-1s —9d SU RFVIUSF FOR EXPLANATORY LANOUAG4 Sgmwre of Applicant or Agent Date