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Home My Public Portal About6219 PRIMROSE AVE_Building__ ®3 E cr CE/ V.6/76) �r APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFE FOR APPLICANT TO FILL IN ' BUILDING ADDRESS � v'c BUILDING /.Z iC{ fi.ykj„�.p+ gal r ADDRESS �rvv ` f�1 1��IG TCY LOCALITY �( NEAREST Y �� u CIT �11. 7 ZIP CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT: MAP BOOK I PAlf I PARCEL DISTRICT GROUP TYPE Lw ED BY TRACT BLOCK . LOT NO. CONST. TEL. Q$ OWNER1:5NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS • 'CLASS NO. DWELL.UNITS BK PG CITY ZIP ARCHITECT OR TEL.. QtCy ENGINEER NO. VALUATION 7D0 ADDRESS BLDG.SETBACK FROM `// FRONT PROP.LINE OF (STREET) CONTRACTOR 0SeJw�0 (RIO, V !E0. 'TOTAL SETBACK FROM TYPE OF EXISTING 33 ��AA,,tt /�� +� LIC HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH ADDRESS Sf.SIVT4+ P'�. NO. ��33__ �� /` ,/�� LIC. CITY��`t Iu �lat� 1�� CLASS r CONSTRUCTION LENDER BLDG.SETBACK FROM NAME AND BRANCH SIDE PROP.LINE OF (STREET) HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH O SO.FT. NO.OF NO.OF . CHECK + _ {� SIZE STORIES FAMILIES ONE OC rte- L� DESCRIPTION OF WORK 11 NEW ❑ P.C.Fee$ Permit Fee /�,/�OP I �S ADD ❑ Issuance Fee y �( fy- dip■>l Arf� ALTER Z �V 1 ,,��L��1��11 rV��r �± REPAIR Total Fee 2 EXISTUSE OING BLDG.—I kli-�-� rAPA DEM�OjL ❑ r n _ O APP(P (PRINT) rl,4S' lc-, 11*rlw NO :�go BY(SIGNATURE) �v a IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES Si AND.LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE S WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF v .;2 4 5 1.4 A THE LABOR CODE OF THE STAT OF CALIFORNIA IN RELATING TO WORKMEN'S COM- Z PENSATION INSURANCE. g # 0 0-0 0-0 1 O. SIGNATURE OFWA4.., /,/ 1.0 0 1//:,1 2 ° ° 2'2 0 0 PERMITTEE ADDRESS %�� ;p, Z o 0 o 2 2 0 0 0' CITY B�'�/�/F-L NO.57 `f// 0 a 2 3-7 9 0 ZONE MAP � NO. � �7 SPECIAL t- 200 CONDITIONS FINAL h DATE /r=®= PA BY .,,,�, /( , �� TEMP LIS-CITY . FGA/80ACC#809.1-61 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING f L/ ��n /�d 5� L DEPARTMENT OF COUNTY ENGINEER ADDRESS cs BUILDING AND SAFETY DMSION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST. IST CT O. GROUP TYPE SED HY FOR APPLICANT TO FILL IN 5 rl� coNsr. BUILDINGg g p /� STATISTICAL C SIFICATION SHYER-MAP ADDRESS 6 Z / /�/ �JJi�/-0 /`7 vL' � K PG +��j CLASS.NO. DWELL.UNIT LOT NO: •J 2— BLOCK WATER NOT REQUIRED ❑ RECEI ED ` CERTIFICATE: TRACT ` / MAP /A HIGHWAY STATE MAJO SECOND. L / 6.2 4 S O.OF BLDGS. NO. C v (CIRCLE) - SIZE OF LOT , 7Y'L 6 E •;/ NOW ON LOT USE ZONE SPECIAL USE OF ! CONDITIONS EXISTING BLDG. `/ // TEL /� OWNER 'DIY! S• /7 17.50AJ NO / d,? BUILDING YARD HWY STREET NAME EXIST. ADDRESS SETBACK •r WIDTH FRONT ARCHITECTOR TEL. P.L. y+ ENGINEER NO. SIDE ADDRESS P L Off. TEL Y �/ IN,SPECTION RECORD „/' O CONTRACTOR IYJA�//I/S O/✓ NO-Ar js��a �� :/ '� i v 7ti•, V ADDRESS S-317 CL CYCQc y (�jl� / C ,- /�' ��Yl/.P%`L Ieo / :-Lrim DESCRIPTION OF WORK iti / NJ d i r i0 NEW ADD ALTER REPAIR DEMOLISH SQ.FT. 77 NO.OF NO.OF (// ,JI/F 4L� I- 4✓�/!"^ 7 IZE J�/ v STORIES I FAMILIES r USE OS' r _ I STRUCTURE_FAMIL ATFL A Sejku-. >M- `^ SIGNATURE OF APPLICANT VALUATION$ !�/ 9 0 d• 1 APPROVALS Df,T`E 8C -11-NSPECTOF;(S SIG/NATURE FEE $ �� FEE $ ` FOFORMS!MATER MATERIALSLOCATION FRAME:FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS I,% (, / ,• ,J'/ �'K/f�l AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY 'FURNACE:LOCATION, "J Flf WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS �) ' f i/" BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK ^ >/ AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH,INT. _ / ��-'�',t'�-�? �M�r/ tj TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- •]/ ING TO WORKMEN'S COMPE ISAT ON INSURANCE. ` LATH,EXT. f`�/� PERMITTEE-SIGNATURE OFa, . HOUSE RECT AND POSTEDR. t Il i � - N l i t1/ A ADDRESS -� 3� 7` G' FINAL ' I 1 �p I 1/ `�J CLYDE N. DIRLAM, P •NcIPAL-_STR RAL ENGINEER- PLAN CHECK VALIDATION cK. M.o. cAsm PERMIT VALIDATION cm. m.o. CASH. DEPARTMENT OF BUILDING AND SAFETY wrrLt�:w rtc�ty r vtt rrlu a COUNTY OF LOS ANGELES 3 B u ' L D WM. d■ FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DIST ICT NO. PLAN CK.NO. PERMIT NO. BUILDING ADDRESS �� Primrose Ave. 3 7 a 77-3 LOCALITY, RECEIVED BY DATE OF APPL. DATE ISSUED CR09BgT Flaherty St.� Temple City 'a;' ,5wa t-�-,¢�'p�'O� - ` f 1. BUILDING 7 OWNER Meeker Land Company ADDRESS ef r�,�� t +� i MAIL 11236 E. Live Oak Ave. LOCALITY c ADDRESS Arcadia TEL.DO-72151 OR'D STT. ,a�'��.� a�F CITY NO. FIRE No.or ARCHITECT O TEL ZONE PLANS TSfPEDRO�Y� ENGINEER Geo._A.Bissell NO. FL-7/+J+20 BLDG. ORD.NO. ADDRESS SETBACK LINE .�� Pt jP F!V, e' APPROVED CONTRACTOR NE . BY DATE OL USEAA APPROVED ADDRESSZONE/,/ BY DATE LEGAL32 BLOCK D b CORRECTIONS DESCRIPTION LOT NO. TRACT 17179 SIZE OF LOT 58x126 I NO.OF SLNOW ON LOT OGS. none '�Q B I 1 USE 13e NO.OF NO.OF 6 EXISTING BLDG. FAMILIES RO nonOMS DESCRIPTION OF %YORIC n In/ NEW X1 ALTERATION ADDITION O REPAIR MOVING DEMOLISH G No orZ 9 ZE * 1161 ROOMS 6 STORIES 1 D CWALLOVERING Plaster I ROOF W.Shgl�es. r COVERING USEOFNEw Residence BUILDING Plan-4-A Garage 18 x 20 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT IN P CTOR DAT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION:LOCATION AND STATE LAWS R TING BUILDING CONSTRUCTION. FORMS.MATERIALS �" I �C', . �1 FRAME: FIRE 9TOPB. �v9_�' ,�t1 SIGNATURE OF D L v BRACING.BOLTS [ Y b y PERM ITT R i LATH. INT. Infj AUTHORIZED A f 1 LATH, EXT. 7GA63BA-3 7149 $ P.C.N e PLASTER.INT. Q Q FEE �+ PLASTER.EXT. VALUATION B� ® r� FINAL r FEE � �� • WORKERS'COMPENSATION DECLARATION I !,therek!affirm that I have a certificate of cpnsent to self , Fna'clettificate of.Workers'Compensation Insurance, A B P��Y� N F 0� I7 I or a oertif;ed-oopy thereof (Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy NoRj� 6 Company RST, TNS, CO BUILDING G098 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS 6121 T WC41LCI0-16w-- lid Certified copy is filed with the county building inspec- BUILDING 6219 PR�20SE AVENUE ) tion department. ^ ADDRESS Date 7/24/86 Applicant `e de,1— CITY TEMPLE CITY ZIP CA 91780 LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. Y NEAREST COMPENSATION INSURANCE SIZE OF LOT 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 OWNER MR•& MRS BRTHKE NO' 286-7578 USE ZONE MAP I certify that in the performance of the work for which this fin/ NO. permit is issued,I shall not employ any person in any manner ADDRESS 6219 PRIlOSE AVIIV[IE 1"� CONDITIONS U SPECIAL JIL so as to become subject to the Workers'Compensation Laws. t CIT, TEMPLE CITY ZIP CA 91780 Date Applicant ARCHITECT OR TEL. O DISTRICT G NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. ROUP TYPE FIRE PRIES ED BY Exemption, you should become subject to the Workers' L,?+j !{ CONST. ZONE b Compensation provisions of the Labor Code, you must forth- ADDRESS , with comply with such provisions or this. permit shall be TEL STATISTICAL CLASSIFI TION APT. CO DO. deemed revoked. CONTRACTOR CAL—PAC ROOFING No. 661-3711 LICENSED CONTRACTORS DECLARATION LIC, CLASS NO. DWELL. UNITS - I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 3265 'CASITAS AVE No. 379503 (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 CA90039 CLASS B BK PG VALIDATION License Number 179543 Lic.Class B SSIZE EFT.2560 INO.OF I NO.STORIES ONE FAMILILIES ONE CO EK VALUATION Contractor-CAL—PAC Date 7/24/86 I DESCRIPTION OF WORK —ROOF WITH NEW ADD $ 3,900.00 11 I am exempt under Sec. 26 SWAM. ICBG # 3409ALTER .. i❑: B.BP.C. for this reason REPAIR ®` $ 951 9. 1 A USE OF Date' EXISTING BLDG.SINGLE FAMILY DWELLING DEMOL ❑. . Signature APPLICANT TELFINA # o 0 0 0 0 OWNER-BUILDER DECLARATION PRINT CAL—PAC ROOFING No 661-3711 DATW. I e e 6 a 6 3 1 hereby affirm that I am exempt from the Contractor's License ADDRESS 3265 CASITAS AVE LA CA 90039 FIN ' x Law for the following reason (Section 7031.5, Business and o 0 0 6 3 b 3 v Professions Code): PRESENT BY ,�j ❑ BUILDING 8 8 0 6—8 6 I, as owner of the property, or my employees with •ADDRESS ,r f+ wages as their sole compensation,will do the work and p� r h�i.� the structure is not intended or offered for sale(Section LOCALITY 1 7044, Business and Professions Code). I 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). i CONSTRUCTION LENDING AGENCY SETGBACK YARD HWY TOTAPROP. LINE BACK FROM 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. Q Lender's Name I :: ,........:.... .. LDMA Ref. # i P.C. Fee$ Permit Fee ' Lender's Address 1 @ 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 Q' ordinances and.State laws relating to building construction, Total Fee a — LDMA Perm. # and hereby authorize representatives of this County to enter upon the above-mentioned pro ty for inspection purposes. _ 3, SEE REVERSE FOR EXPLANATORY LANGUAGE 0 Sig a ure of Applicant or Agent Date —ti ,