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Home My Public Portal About6022 RENO AVE_Building__ APPLICATION FOR BUfV_ FOR APPLICANT TO FILL IN (Print or type only) ;EMPL ITT( BUILDINGtbOXY OF LOS ANGELES ADDRESSRowland DEPARTMENT OF COUNTY ENGINEER CITY Terable City z 1 P 9-1780 BUILDING AND SAFETY DIVISION /V �v NO OF BLDGS. BUILDING /� tJ t/1�/)t �� SIZE OF LOT (� NOW ON LOT ` ADDRESS (/ (_ A L ` TRACT C SSG p BLOCK LOT 04 NO./�C�� LOCALITY f .%� (-a— !1 TEL NEAREST •- OWNER NO. 286_76 CROSS ST. ADDRESS 6.Q2 2 N Rowland MAP BOOK- ASSESSOR PAGE PARCEL Temple City- ZIP 917$ll DISTRICT GROUP TYPE FIRE PROCESSED BY CITY 5-, 07 GONST. 1 ' Z! 7 ARCHITECT R TEL. 3 IY/ ENGINEER NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NO.-2- I DWELL•UNITS BKg_fG CONTRALTO�TRandnl O USE ZONE NAO. 2-002 ADDRES5529 'E Valle . B1 NO. 860.86 Gr' -- � SPECIAL CITY LIC. CONDITIONS San Gabrip] CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG.SETBACK FROM FRONT PROP.LI NE OF (STREET) ADDRESS CITY 7 - TOTAL SETBACK FROM TYPE OF EXISTING SQ. FT. NO. OF NO. OF CHECK HIGHWAY i• YARD - FRONT PROP. LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE + � DESCRIPTION OF WORK re-roof hQ.Us EW ❑• CLC ❑ BLDG.SETBACK FROM c ADD SIDE PROP.LINE OF (STREET) CY ALTER ❑ _ TOTAL SETBACK FROM TYPE OF EXISTING F HIGHWAY + YARD - HIGHWAY WIDTH C- REPAIR SIDE PROP. LINE 4 _ a USEU, EXISOT NG BLDG. DEMOL ❑ } ? ' AP PRINT)N�{ L Randol N0 $'$�4,Q40, CORNER CUTOFF YES ❑ NO ❑ BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION$ 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PER50VIOLATION OF THE r /7- - LABOR CODE OF THE STATE OF -CALIFORNIAONIIN RELATING TO � WORKMEN'S OF SATION I ANCE. t SIGNATURE O ��, y. � I- /G� "IVCD PERMITTEE-?7./,V ADDRESSr.'I(i•(r°lL:�'jj�:P �� fI'fG. I+ ' � '�!/!� G/l�L- ►►yy pp pp FINAL BY CITY San Gabriel NOL8-8' 4(140. 1 DATE KE CHECKS PA YABLE TO:IT '•P FEE T. BRANDY COUNTY ENGINEER FEE HARVEY2.1 .75 PLAN-PHEC� ALIDATION CK. M.O. CASH — PERMIT VALIDATION cK: M.o. CASH Flt k__r44 � 6/O+...: i f i=OCT '% 1 D 78A838A CE#803 5174 rtY,P 72- /` . V 90 <<k . 76AS38A CE 6091157 APPLICAION FOR BUILDING PERMIT RnIe . COUNTY OF LOS ANGELES ADDRESS O I^Z -DEPARTMENT OF COUNTY•ENGINEER BUILDING AND• SAFETY DIVISION. LOCALITY��' JOHN A.LAMBIE.COUNTY ENGINEER NEAREST •CASSATT D.GRIFFIN.SUP T OF BUILDINR _ CROSS ST. DISTR�CI NO. GR SPE ER MAP FOR APPLICANT TO LL.IN BK G CONST. BUILDINGr ,yq STATISTICAL C SSIFICATION ADDRESS, ,r CLASS.NO. WELL.UNITS' LOT NO.,'S j BLOCK Rl NUMAP MBER' O O yyAT YES O Y. TRACT s / USE ZO E SPECT L NO.OF BLDGS. / CONDITIONS SIZE OF LOT (� 6�b1 ® I NOW ON LOT I1�0d . USE OF EXISTING BLDG. A. BUILDING YARD HWY STREET NAME EXIST. SETBACK WIDTH . OWNER .ZWO FRONT f .MAIL ��nn P:L., ADDRESS6.' ; SIDE i TEL. P•L• CITY Na INSPECTION RECORD ' ARCHITECT OR TEL. ENGINEER.• NO. ADDRESS TEL. ''.!'1-67 15}�• k -rtP` A67- .CONTRACTOR NO-. ADDRESS DESCRIPTION OF WORK nP At.p."'N NEW' ' A D ALTER', REPAIR DEMOLISH �y _ /+ SO.FP. NO.OF NO.OF A)f t/%!�em [ r ILEI /1 I I SIZE @1 STORIES FAMILIES USE OF STRUCTURE -a IS 7T 171RAF /7 IGNATURE OF APPROVALS LITTC I/ ��(SI�1N��F� r APPLICANT } DATE INS E OR'S SIGNATURE ADDRESS ` FOUNDATION: LOCATION FORMS,MATERIALSFIRE o FEE -$ 'FRAME:BRACING.BOLTTSS '� i A O VALUATION FEE 8 FURNACE: LOCATION, 13 ®� GAS VENT,.D.UCTS HEREBY ACKNOWLEDGE THAT 1 H E READ THIS AP- LATH,INT. 1, 11 $y'f8 9,-TW-r /^��fj PLICATION AND STATE THAT THE AB IS CORRECT AND u w v r AGREE TO COMPLY ALL ORDINANCES AND =c STATE .LAWS REG tIN U G CONSTRUCTION. LATH.EXT. SIGNATURE OF, HOUSE NUMBER COR- : c. PERMITTE RECT AND POSTED q ADDRES Q I y� FINAL •-CLYDE N.DIRLAM, PRINCIPAL STRUCTURAL EN R PLAN CHECK VALIDATION CK, 11:0. CASH PERMIT VALIDATION CK. M.O. CASH [ '3 4 8 1'� AUG ,¢ 1 A 1350 top - APPLICATION FORBOLDINGPERMIT ] COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPL CANjrT0 FILL INBUILDING AD ES I hereby affirm that I have a certificate of consent to self insure, BUILtyIVG/rp S �. or a certificate of Workers'Compensation Insurance,or a certified CITY�.� ZIP •/ copy thereof(Se 3800,Lab.C.) ° LOCALITY Policy N0. Compa t. SIZE OF LOT O OF BLDGS.NOW ON LOT El Certified copy is hereby furnished. 5-11.5 SIZE CROSS ST. ❑ Certified copy is filed with the count I building inspe 'on TRACT BLOCK LOT NO. department. • USE ZONE MAP NO Date�wA Applicant ASSESSOR MAP BOOK PAGE PARCEL / SPECIAL CONDITIONS CERTIFICATE OF E ION FROM WORKERS' OWNE T L COMPENSATION INSURANCE ^ WITHIN 1000 FT OF SCHOOL? Yes No (This section need not be completed if the permit is for one hundredAD E �� 940 NN DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars($100)or less.) CITY • ZIP I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to ARCHITE OR ENGINEER TEL NO. (/ '\ ✓✓ ✓ S. become subject to the Workers'Compensation Laws. STATISTICAL CL 9SSIFICATION APT CONDO Date Applicant ADDRES CLASS I. � 7 DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' A T O. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. AD ESS U N P L LICENSED CONTRACTORS DECLARATION PILE CI L P L I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code n lice s in full force and eff ct. NEW ❑ BK PG a License Numbe ' Class 2 DESC TION K • ADD ❑ VALUAn / /^ '` C Contractor TER ❑ $ (/ /// • ❑ I am exempt under Sec. �� REPAIR ❑ $ F BAP.C.for this reason DEMOL ❑ LDMA P/C# 11, C Date: USE OF EXISTING BLDG. URM ❑ q n 1 U, Signature APPLICANT(PRINT) TEL NO. LDMA Perm# ❑ I, as owner of the property, or my employees with wages as z ACCT R 4 their sole compensation, will do the work and the structure is ADDRESS -,;I}7 i`3° I� not intended or offered for sale (Section 7044, Business and FINAL DATE X"Q �+� Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL z3 i ITEMS ❑ 1, as Owner of the property, am exclusive) contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Y Y 9 AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUN FINAL BY > �� 0� licensed contractors to construct the project (Section 7044, TOTAL �•,.�3 a 9_v Business and Professions Code.) ves❑ No❑ WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING CHECK 1JJ 33°5j_I OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES CHANGE .013 1 hereby affirm that there is a construction lending agency for YES❑ No❑ tV the performance Of the work for which this permit Is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING W 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, a fit•!f L/•/TITLE 2,CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS �1 1�.1 j 1*3 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. o Lender's Address ��5 1 �� '°54 OYMER OR AGENT O e I certify that I have read this application and state under penalty P.C.FEE PERMIT FEE of perjury that the above information is correct.I agree to comply /b CY with all county o inances State laws relating to building m constructio a ere au o e representatives of this County ISSUANCE FEE "' to t above m ed property for ins pelt�ioq,Ipur es. CD INVESTIGATION FEE TOTAL FEE / fj , of APP!G 1 m AV DV0 �? SEE REVERSE FOR EXPLANATORY LANGUAGE