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HomeMy Public PortalAbout5570 ROSEMEAD BLVD_Building__ 7GA635A CEREOa o-Sr flL APPLICATION FOR BUILDINt PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER ADIIRFssJ'i% BUILDING AND SAFETY DMSION LOCALITY JOHN A LAMBIE, COUNTY ENGINEER COLEMAN W JENKINS. SUIT DF BUILDING NEAREST CROSS ST J DIST ICT N G OUP TYPE PR B FOR APPLICANT TO ILL N °�Y TYPE PTIDT Grtype GOI Ij , 19 CONST BUILDING STATISTICAL C ASS(F(CATION SEWER MAP ADDRESS CLASS NO DWELL UNITS_ BI�¢U-- LOT NO T T BLOCK USE ZONE P NO TRACT SPECIA L NO OF BLDGS CONDITIONS SIZE OF LOT NOW ON LOT USE O EXISTING BLDG emwagEBLDG SETBACK FROM T FRONTPROP LINEOF (STREET) OWNER S NO T (STING SETBACK HIGHWAY } YARD = TOTAL ^�O HIGHWA WIDTH FROM C L ADDRESS CITY i } BLDG SETBACK FR ARCHITECT OR TEL SIDEPROP LINEOF (STREET) ENGINEER NO TYPE OF %(STING SETBACK AV } YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C Lil CONTRACTOR NO LIC TEL ADDRESS NO CORNER CUTOFF YES ❑ ❑ U clry CLASS 'SEE REVERSE SIDE FOR SPECIAL APPROVA DESCRIPTION OF WORK z NEW ADD ALTER REPAIR DEMOLISH SO FT NO OF NO OF SIZE STORIES (n FAMILIES USE OF STRUCTURE TE / S- SIGNATURE OF APPLICANT VALUATION 3 • APPROVALS GATE INSPECTOR'S SIGNATURE P C PMT FOUNDATION LOCATION FEE S FEES7,= FORMS MATERIALS FRAME FIRE STOPS I N[REBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS AND sun TNA* rwe Awve IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION WITH ALL COUNTY ORDINANCES ANO STATE LAWS REGULATING GAS VENT DUCTS SVILOING CONSTRUCTION 1 CERTIFY THAT IN GOING THE WORK AUTHONIIEO M[R[SY 1 WILL NOT EMRLOY ANY PERSON IN VIOLA LATH INT TION OF THE LABOR COD[ OF TH[ STATE OF CALIFORNIA R[LAT IND TO WORKMEN S CODE I SORANCE T LATH EXT SIGNATURE 1 HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS T.2SV rAOFifL' t•� !N!O FINAL JOHN F LEWIS PRINCIPAL STRUCTURAL ENGIN ER PLAN CHECK VALIDATION CK NO CASH MIT_ PERVALIDATION CK AID CASH LAW4735�8 -HAY17 1 D 6.O I A ROAD DEPT PERMIT IS REQUIRED FOR ANY MATERIAL 5fORAGE OR WORK _ DONE IN THE ROAD RIGHT OF WAY APPLICATION FOR BUILDING PERMIT I COUNTY OF LOS ANGELES BUILDING SS 7p ^/ jS�.�{��Q B[I,o DEPARTbUM OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A LAMBIE COUNTY ENGINEER NEAREST CAHeATT D GRIFFIN Burr OF BOILGINO CROSS ST DISTRICT N GROUP TYPE ROC BY FOR APPLICANT TO FILL IN ' CONST BUILDING STATISTICAL CLASSIFICATION HEWER MIAP ADDRESS 7570 N R4SPME'ijJJ /3L Llb / BK /� P6 CLASS NO WELL UNITS MI-7 NO /'d.NT /.3 Z �� BLOCK NUMAP MBER �� WYE E9 NO TRACT Sll�t/Nf/(//ew USE ZONE SPECIAL NO OP SLOGS / _ CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG J F)ev/c Ls BUILDING YARD HWY STREET NAME EXIST SETBACK WIDTH OWNER SC/>?S JPO P/3[/CK CO FRONT O / MAIL P L ADDRESS S y 70 Al /7oSC,[AL�/O !3L�/� HIDE T� HPLC G/. P L CITY —� No/fT7o4�/ INSPECTION RECORD ARCITECT ENGINEER OR �[J.4 Sa,vrf , NocV431'14 ADDRESS /-do/ C LL'K/.vGTor yowwwA40' CONTRACTOR P/1.fc�c'' SrEG[ No T' yq,�/q// �� ��/� /Iii/ ADDRESS /-ioJ r DESCRIPTION OF WORE c A lVleflf-, NEW ADD ✓ALTER REPAIR DEMOLISHn [� SO E /�/'/JO NO OF NO OF O STORIES / FAMILIES ` STRUCFTURe SL P✓/cr / T E P SIGNATURE OP -t Z i APPLICANT APPROVALS DATE INSPECTORS SIGNATURE JLYn ADDRESS .34/ - L�.Y/�VG'TQ/l� AlrV,4111 FOUNDATION LOCATION �� FORMS MATERIALS GIG VALUATION $ -rtr oZOO FPAME FIRE STOPS BRACING BOLTS ^ �/ FURNACE LOCATION FEE ��aO PEE GAS VENT DUCTS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH INT PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS R OEGULATING BUJILD�ING CONSTRUCTION LATH EXT HOUSE NUMBER R- �0 SIGNATURZ : RECTANDPOSTEDjZ QPERMITTE ADDR FINAL q CLYDE N DIRLAM PRINCIPAL bcK ■�ENGINEER A PLAN CHI= VALIDATION cIc No CAIIH PEBbOT VALIDATION GASH °j !Af' 0581 Ib.Y102 3 A 1200 , ,I 11122 hky20 1 A 24_ .00 mF� r r 7aA53SACE#pD3 5-82 APPLICATI N FOR BUIL ING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER woDRESS 5S 7 fLo Scnc• u nLw� BUILDING AND SAFETY DIVISION LOCALITY j ff 1PL.e Ci T JOHN A LAMBIE COUNTY ENGINEER NEAREST y WILLIAM A JENSEN SUPT OF GUILDING CROSS ST DROP W,S DISTRICT NO GROUP TYPE PROCESSED BV FOR APPLICANT TO FILL IN 5,�� CONsr � 6o V BUILDINGD STATISTICAL CLASSIFICATION SEWER MAP ` ADDRESS i C y' K e,4b L✓ BK PG n CLASS NO DWELL UNITS LOT NO AR Q `f" ZV BLOCK WATER NOT REQUIRED ® RECEIVED ! CERTIFICATE TRACT JVH r4 Y 91 FLU MAP / HIGHWAY NO OF BLDGS NO ZOOD (CIRCLE) STAT MAJOR SECOND LOCAL SIZE OF LOT NOW ON LOT larIIG USE ZONE SPECIAL USE OF H-1 CONDITIONS EXISTING BLDG n wkpfiilvK v iI-O FEL(TELATuBG 16,]Z I / '1 1NO BUILDING O "ISTOWNER SETBACK YARD HWY STREET NAME WIDTH ADDRESSFOS: O 2nOiBKfs FRONT T 1 ARCHITECT OR TEL P L V a Mo S e a(SAD /00 ENGINEER NO SIDE P L Y ADDRESS A Q CONTRACTOR (ItFL0 C, NO FAtw U 1 N ADDRESS I] L C If. I1 p[ DESCRIPTION OF WORT{ O NEW ADD ALTER REPAIR DEMOLISH N SONO NO OF NO OF Z 512E tu Fi STORIES FAMILIES ✓ USEOF DATLO COVIM STRUCTURE SIGNATURE OF APPLICANT Ov VALUATION $ APPROVALS DATE INSPECTOR ppIGNATUR[ PC PMT FOUNDATION LOCATION FEE $ FEE $ FORMS MATERIALS FRAME FIRE STOPS I HERESY ACKNOW LCDG[ THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE A.OVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS SUILOIN0 CONSTRUCTION I CERTIFY THATZ.AINN TE W011K AUTHORRED XCR[pY I WILL NOT EMPLOY VIOLA LATH INT TIOX OF TH[ LABORERESY CODE OF THE ETATC RCLAINOTO SIGNATURE OF pcoyv[AC}= � A u `CO LATH EXT NUMBER PERMITTEE HRECT AND PO6TEDOUSE R 2 // ADDRESS FINAL ,�� PLAN CHECK VALIDATION CK M O c15H JOHN F LEWIS PRINCIPAL STRUCTURAL ENG R PERMIT VALIDATION GK NO CASH LACO 2 6 1 1`0 hAR 2 8 1 D 400 TBABSBA CE REDS ''T,4PPLICATION FOR BUIL N PERMIT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BU ADDRESSILDING -5,-5-270 COLEMAN W JENKINS, Sur T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST T (Prmt CROSS ST / i DISTRICT NO I GROUP Y ER DRESSED BY BUILDING // � a961 ADDRESS 7V,& .E^ LVT J LOT - /3 BLOCK STATISTICAL CLASSIFICATION SEWER MAP ((�� CLASS NO�--DWELL UNITS_ BK PG TRACT,Jjj /t7.0 USE ZONEMAP / F NO OF SLOGS NO 2nob SIZE OF LOT/�-� NOW ON LOT SPECIAL A CONDITIONS USE OF EXISTING BLDG ze,' jav /' �f OWNS j A-W ( NE 7 rl BLDG SETBACK FROM FRONT PROP LINEOF (STREET) ` �! TYPE-OF DUSTING SETBACK HIGHWAY } YARD = TOTAL CITY - HIGH WIDTH FROM C L ARCHITECT TEL } ENGINEER NO BLDG SETBA FROM ADDRESS / 0 'op0" SIDE PROP LIN (STREET) CON TRA CTO OL HIGH WAV WIDTTYPE OFIMG =:C L HIGHWAY } YARD = TOTAL ADDRESS,f 7c/ �/. `� W1, S , &dId I� } - O LIC El �j CITY Lam-C CLASS CORNER CUTOFF YES NO it CONSTRUCTION LENDER NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS z ADDRESS SO FT NO OF NO OF NEW SIZE STORIES FAMILIES USE OFAOL ❑ STRUCTURE L ALTER ❑ REPAIR(_] SIGNATURE OF APPLICANT DEMOL ❑ C VALUATION S Q Q � APPROVALS DATE IxB Pec TOR a ewHArURE P C PMTCom. FOUNDATION LOCATION FEE f FEE f FORMS MATERIALS FRAME FIRE STOPS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AMD STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY FURNACE LOCATION WITH ALL ORDI MANGES AMO LAWS REGULATING BUILDIMO CON- GAS VENT DUCTS STRUCTIOM I CERTIFY THAT IN DOING THE WORK AUT No RIZZO HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH INT LABOR CODE OF THE STATE Of ALIFORNIA IN RELATING TO WORKMEN S COMPEM IOM IMBUR E LATH EXT SIGNATURE OF �f.s HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS5rE _ `�� YO FINAL Q G V PLAN CHECK VALIDATION CM MO CASH PERM JOHN F LEWISPRIN )PAL STRUCTURAL ENG _ PERALIDATION cx MO cwaH JAEo2623% xe30 1 D 15.00~ 4 / 7 76AG39AC *6103 fAGAPPLICATION FOR BUILDING PERMIT ALII.DING AND SAFETY DIVISION ADD El Department of CoBaty Fn9innu ODREHs County of Los Angeles LOCALITY JOHN A LAMBIE COUNTY NEAREST CABBATT D GRIFFIN. Bud i OF BUILDING O 8 D R T N OU SE ER MAP 3 FOR APPLICANT TO FILL IN ITPE n a ADDRESS 0 F EA C Tcu LfC STATISTICAL 91FICATION j LOT NO h ZO BLOCK CLAS NO DWlLL =TS___j TRACT MAP STATE Cv VAoyjt1ff4U UNUMBER SE ZONE �CI(n c HWY mz NO OF SLOGS H- NDIT ONH w SIZE OF LOT 4,7.. V ZQ7/ I NOW ON LOT USE OF 1p _ V EXISTING BLDG C LF S� VK, BUILDING EXIST �+ SETBACK Y RD HWY STREET NAM! WIDTH a< OWNER FRONT MAIL P L / AODRES$ G L✓/� SIDE P L CI S NOL - /� INSPECTION RECORD ENGIiARCNEfiR ITECT OR . C S NEL 1 1G F'l fr- r �..ur�N3 F+ eAi�Cl9/ DDRl9S �• B7�C �� CiU eL C9 CONTRACTOR T /771 Ag, /L ADDRESS V DESCRIPTION OF WORK 1 U N!W ALTER REPAIR DEMOLISH FT NO OF NO OF SIZE / STORIES/ FAMILIES USE OF LOI �l1 At I4LL m APPROVALS SIGNATURE OF APPLICANT DATE INSPECTOR S SIGNATURE / ADDRESS FOUNDATION LOCATION / FORMS MATERIALS FRAME FIRE STOPS _ OO� BRACING BOLTS VALUATION /J FURNACE LOCATION PEE OC GAS VENT DUCTS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH INT 7 �� PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ANDSTATE LAWS LATH EXT SIGNATURE OF REGU TING HUI i Np/GOIJBTRU CTION HOUSE NUMBER COR- PERMITTEE 7 �/ C RECT AND POSTED ADDREs FINAL W JOHN A LAMBIE Aff3MTY ENGINEER CLYDE N DIRLAM RINCIPAL ST R INelR PLA29 CB= VALIDATION CK M o CAeN Pl'JIMIZ VALIDATIO Crc M O CAZH ',GO279a- MAY161 6 35 .7542 m !ACo1417P; Aw21 1 121 .00 . _ r . I I BPe,wRRAt:ueDa G-RTAPPLICATION FOR BUILD[ G PERM CJ COUNTY OF, LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVLSIONLOCALITY JOHN A LAMBIE, COUNTY ENGINEER COLEMAN W JENKINS, SUP T OF SURA Nn NEAREST CROSS ST FOR APPLICANT TO FILL IN DISTRICT NO GROUP TYPE P prl nt ort a only) ONST BUILDINGSTATISTICAL A IFICATION SE R MAP ADDRESS O N, Rosemead Blvd. CLASS NO DWELL UNITS BK PG LOT NO Portions of 1 &20BLOCK ` USE ZONE NOP O TRACT Sunney View SPEC AL OF BLOTS CONDITIONS SIZE OF LOT OOOS •f NO ON LOT USE OF EXISTING BLDG Offices,a licence re LOG SETBACK FROM OWNER Sears ROeb11C$ NO 287-0421 FRONTPROP LINED F (STREET) TYPE OF EXISTING SETBA0K HIGHWAY + YARD = TOTAL ADDRESS 0 N. Rosemead Blvd, HIGKWA WIDTH FRDMCL ZY + CITY Temple City BLO SETBACK FROM ARCHITECT OR T L SIDEPROP LINEOF [STREET[ ENGINEER H. �I,T.R.anS 28T6�.-.9137 TYPEOF ISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS O E. Las Tunas Ly , HIGHWAY WIDTH FROM C L CONTRACT R Ot W t@&OL + 0 ADOR NO CORNER CUTOFF YES ❑ NO ❑ U CITY CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS t3 DESCRIPTION OF WORK �, H 11 NEW ADD ALTER REPAIR DEMOLISH I 3 ZE T 450 STORIES 1 FA MIOLFES O USE OF STRUCTURE Offioe u8e IF � t SIGNATURE OF APPLICANT VALUATION S ��©� APPRO ALS DA I P .TOR SIGNATURE P C 9 PMT FOUNDATION LOCATION FEE S 2Z -� FEE 5.38,,2 FORMS MATERIALS 16 FRAME FIRE STOPS I HERE" AC R NOWL[OO[ THAT 1 HAVE MAO THIS APPLICATION BRACING BOLTS AND [TATE THAT THE AGOYE Ie COwR[CT ANOAOR[[ TO COMPLY FURNACE LOCATION WITH ALL COUNTY ORDINANCES AND STATE uW[ R[DUunno GAS VENT DUCTS 'IF DUILOINO CONSTRUCTION I CERTIFY THAT IN DOING THE N AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IA IN VIOLA LATH INT TION OF THE LABOR CODE OF THE STATE OF CALIPORRR[LAT IMO TO WORKMEN S COMPENSATION INSURANCE SIGNAT RE OF// LATH EXT PERMITTEEZ240, HOUSE NUMBER COR- RECT AND POSTED ADDRES FINAL 1E 70 VOHN F LEWISPRINCIPAL ST� N,RENGINEER PLAN CHECK VALIDATION(;::�).- CASH — PERNIIT VALIDATION CK M O CASH Ipr,�,987oFZ MAY 9 23 0 22.95► / _ Ier_ 0081u-12_ 6 1 D 3825`~ a �r1'Lt�2GIMcJ �'�9:r err,/ 1 TeweeeA�leoa-e-eT APPLICATION FOR BUILDING PERMIT 1 COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY e JOHN A LAMBIE COUNTY ENa1NrER NEAREST / CAYSATT D GRIFFIN SUrT Or!!UILDIKG CRO SST DISTRICT O 1 GROUP TYFE 8 ER MAP FOR APPLICANT TO FILL IN BK Po co BUILDING ADDRESS G STATISTICAL CLASSIFICATION CLASS NOS' WEL UNIT LOT NO BLOCK MAP TAT! NUMBER Q SHIN Y NO TRACT USEZONE SPECIAL NO OF BLDGS �l / CONDITIONS SIZE OF LOT NOW ON LOT 'Tr USE OPTI EAISN BIDBIDQ BUILDING YARD HWY STREET NAME EXIST SETBACK WIDTH OWNER `P a FRONT ADDRESS �, s P L SO L �� D SIDE TEL P L CITY .0 NO ARCHITECTOR TEL INSPECTION CORD ENGINEER NO ADDRESS I TEL CONTRACTOR NO S ADD E 1 S DESCRIPTION OF WORK ADD ALTER REPAIR DEMOLISH I NO OF NO OF SIZE STORIES FAMILIES USE OF STRUCTURE bAV � G � e1GNATUREOF APPROVALS APPLICANT- INSP ADDRESS 3 FOUNDATION LOCATION DAT! EISNATURE FORMS MATERIALS P C >< FRAME FIRE STOPS FEE BRACING BOLTS VALUATION • 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 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING BUIL 1{O CONN UCTION LATH EXT SIGNATURE O� HOUSE NUMBER COR- PERMITTE T� RECT AND POSTED ADDRE9 — J ' FINAL JOHN LAMBIE COUNTY ENGINEER CLYDEN DIRLAM PR NCI ALSTRU ENO PLLN CBECL VALMATIOA CK. MO wH PEBWff VALM=ON r o jj� .- -,ICp2 0 3 0 M ruin 14 T 2.00 OF ' I CE X809(R!V 11/70) - �^ APPLICATION ILDI PER�� COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDING D ADDRESS -fZADIDRIE55 O OS�IyJ!" LOCALITY CITY .�.. G ZIP �7 o CROOSSST p NO OF BLDGS ASSESSOR SIZE OF LOT C5 800 NOWONLOT MAPBOOK PAGE PARCEL ' DISTRICT GROUP TV PE FIRE ED BV TRACT /`,—�T BLOCK LOT NO CONST TEL OWNER c�.�E-s2�j NO STATISTICAL CLASSIFICATION SEWER MAP ADDRESS 's CLASS NO WELL UNITS 1---�61< PG CITY GC ZIP -717ba AR HI TELT OR TELT VALUATION S /2SOO CED ENGINEER NOG ADDRESS GoLdu'L BLDG SETBA KFROM T TEL FRONT PROP LINEOF (STREET( CONTRACTOR NO TOTAL SETBACK FROM Tr PE OF EXISTING LIC HIGHWAY + YARD FRONT PROP LINE IHIGHWAY WIDTH ADDRESS NO IC + CITY CLASS CONSTRUCTION LENDER BLDG SETBACK FROM NAME AND BRANCH - SIDE PROP LINE OF (STREET) HIGHWAY + YARD TOTAL SETBACK FROM TYPE EXISTING ADDRESS CITY SIDE PROP LINE HIGHWAY WIDTH 0 SOF NO OF NO OF CHECK + SIZE O STORIES FAMILIES � ONE � U'SE/ZONE MAP O DESCRIPTION OF WORK NE ,n NO SPECIAL ADD ❑ CONDITIONS ALTER ❑❑ FINAL / �) 8Y REPAIR DATE v/ -j � (� USE OF DEMOL �/5�F 7 _ EXISTING BLDG /G _ _ / Q // APPLICANT TEL p� IPRINTI NO Z$�Q3S _1,4 . 9 0 3 8 P BY(SIGNATURE) C Gcra,ad 3 • • • 1 I HEREBY AC WLEDGE THAT I HAVE READ THIS APPUCATION AND STATE Y THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES / 2 • 8 2 2 2 5 AND LAWS REGULATING BUILDING CONSTRUC710N I CERTIFY THAT IN DOING THE �d�a�' D S WORK AUTHORIZED HEREBY WILL NOT EMPLOY ANY PERSON IN VIOLATION OF V c S THE LABOR CODE OF THESTATE OF LIFOYNIAI TING TO WORKMEN 5 COM • A 5222 JU PENSATION(NSU RANCF 42--27-79 0219-80 SIGNATURgOFI�� PERMITTEE _ 1. ADDRESS O aTELCITYJ� NPC FeeC(/ Permit Fee 3 Issuame Fee p Total Fee D LZi r Sign 7eA6l8ADR,4s_s. APPLICATION FOR BUILDING PERMIT Z COUNTY OF LOS ANGELES BUILDING C[ 0 ADDRESS DEPARTMENTENGINEER OF COUNTY ENGINe� J BUILDING AND SAFETY DIVISION LOCALITY JOHN A LAMBIE,CouNTY ENGINEER NEAREST CApGATT D GRIFFIN OUVT OF BUILOING CROSS ST DISTRICT NO GROUPPE S ER MAP FOB APPLICANT TO FILL IN T 1�r CANST K PGA ADDREI9B E (/ STATISTICAL CLASSIFICATION CLASS NO02--j-DWELL UNIT LOT NO BLOCK MAP �.� NUMBER Q Q HSE YES NO TRACT USEZONE SPECIAL NO OF SLOGS CONDITIONS SIZE OF LOT NOW ON LOT M / USE OF EXISTIN BUILDING YARD HWY STREET NAME EXIST SETBACK WIDTH OWNER FRONT MAIL4 P L ADDRESS //L S10E TEL P L CITY No ARCHITECT OR TEL INSPECTION RECORD ENGINEER NO DD TEy� CONTRACTOR • NORIA. BROADWAY - DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH SO FT NO OF NO OF SIZE A STORIES FAMILIES USE OF STRUCTURE &, -Lv SIGN TURE OF APPROVALS APPLICANT ADDRESS O ' .0 DATE INSPECTOR 9116RATURE FOUNDATION LOCATION FORMS MATERIALS f etc P C. i FRAME FIRE STOPS � O FEE BRACING BOLTS VALUATION • COD FURNACE LOCATION FEE GAS VENT DUCTS As I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH INT PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION LATH EXT SIGNATURE084DVANCE NEON SIGN CO. HOUSE NUMBER COR PERMITTERECTAND ADDRESS 960 NO. BROADWAY A 12 FINAL JOHNA LAMBIE COUNTYENGINEER CLYDEN DIRLAM PRINCIPALSTRIICTURA NOI NEER PLIF CBE=V LMATION CK. No CARR PEUM VALMAIION CK, no CASH LACD0 O 9 3 9C Jm 3 1 A 6.00 m. 'SIT WORKERS COMPENSATION DECLARATION here.ry� acct that I have r certificate of tion Int to self - APPLICATION FOR- BUILDING PERMIT LI'S insure or a certificate of Workers Compensation Insurance =t+ or a fl s thereof(Sec 3800 Lob C ) Ls0 COUNTY OF LOS ANGELES BUILDING AND SAFETY Poli No Company Fs!fJL�VI�CA'64A�L�rE L(a��Certified copy Is hereby furs shed �8"'Y FOR APPLICANT TO FILL IN BgUpp Candled copy m filed with the county building mspec BUILDING tion deep+ortmeent p6f Ce EI. Z�C.. ADORE55 LOCALITY NEAREST Date 1l—L�—M Applicant CITU C ZIP q 0 FRO CROSS ST .004 CERTIFICATE OF EXEMPTION FROM WORKERS NO OF BLDGS ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT I MAP BOOK PAGE vARCEI (Thu section need not be completed ifthe permit is for one USE ZONE MAP hundred dollars ($100)or less ) TRACT BLOCK LOT NO NO — — Z-C., TEL C� 2 SPECIAL Y I certify that in the performance of the work for which this OWNER NO S-3OLl CONDfTIONS d permit is Issued, I shall not employ any person in any manner DISTRICT GROUP ITYPE FIRE SSED BY O so as to become subject to the Workers'Compensation Laws ADDRESS Sfiryv�_ AS CONST ZONE V a80 A Dab Applicant CITYZIP OR ZIP TEL STATISTICAL CLASSIFICATION APF ONDO G NOTICE TO APPLICANT If, after making this Certificate of ENGINEER NO Exemption, you should become subject to the WorkersCUSS NO DWELL UNITS_ d Compensation provisions of the Labor Code you must forth ADDRESS SEWER MAP Z with comply with such provisions or this permit shall be deemed revoked CONTRACTOR rAzOW­T, 7y BK /(/14 VALIDATION LICENSED CONTRACTORS DECLARATION LIC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO VALUATION (commencing with Section 7000)of Division 3 of the Busmess and LIC Professions Code and my license is in full force and effect CITY LIC ! D d 'mt iX35 O G L 07 _-3 SO O SO OF F!' NO OF CHECK ► License Num r Lic Claes C--B� SIZE STORIES FAMILIESIi7 ONE t .V• NEW $ ContractorP�Cb�A13E �1dO- Date L�^S—� DESCRIPTION OF WORK -FN ❑ I am exempt under Sec w AUU ALTER ❑ FINAL B BP C for this reason D r O Cj12 Q S REPAIR ❑ DATE Date EXISTING BLDG DEMOL ❑ By G Signature AP' TEL OWNER-BUILDER DECLARATION - PRIM C NO I hereby affirm that I am exempt from the Contractor's License Poo for the following reason (Section 7031 5 Business and Professions Code) I, as owner of the property o• my employees with BUILDINGADDRESS wages as their sole compensation will do the work and LOCALITY structure is not intended or offered for sale(Section 7044, Business and Professions Cade) MOVING TEL 1, as owner of the property, am exclusively contracting CONTRACTOR NO i 5 9 7.7 A with licensed contrarian to construct the project (Sec- ADDRESS tt e e • e e 1 tion 70" Business and Professions Code) CONSTRUCTION LENDING AGENCY REWIRED YARD HWY TOTAL SETBACK FROM EXIST SET BACK PROP LINE WIDTH I • • 4 Q 5 O 1 hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P L poll is • • A Q 5 O 5 ZSec 3097 Civ C ) SIDE PL 1. 1 9t686 Lender s Name - Lender's Address P C Fee i Permit Fee I certify that I have read this application and state that the Issuance Fee above information is correct I agree to comply with all County Investigation Fee mss\ ordinances and State laws relating to building construction Total Fee Q.7 L� and hereby uthon:e repr ntat m of this County to enter 1sy� upon the ve-m tion pro for inspection purposes p/ ^ SEE REVEM FOR EXPLANATORY LANGUAGE rgnottim of Yplicant or Agent Dora T • ms APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY RKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILD�/d I hereby affirm that I have a certificate of consent to seff insure BIA.�CIG or a centdicete of workers Compensation Insurance or a cerahad J ` copy tmeig4 b C) �Mn /L _ ZIP Pokc Policy hY IU 0 n �'YlY l LOGILRV SIZE OF LOT I NO OF BLDGS NOW ON LOT G ❑_/Candied copy Ia hereby furnished NEAREST CROSS Sr IWC hied copy Is filed with the oun Inspection TRACT BLOCK LOT NO tlap0rtment 'A USE ZONE MAP NO Date IS 1>p Applltan A ASSESSOR MAP BOOK PACE PARCEL SPECIAL CONDITIONS ` D CERTIFICATE OF EXEMPTION FROM WORKERS' °itt'IE n COMPENSATION INSURANCE 'I d3 WITHIN 1000 FT of SCHOOL? SBS ^O (This section need not be Completed If the Wind Is for one hundred � DISTRICT GROUP ONST FIRE ZONE ESSED BY dollars 1$100)or law) 1 certify that In the performance of the work for which this permit C%kn1 LZ Z p O 0 Is issued I shall not employ any person In any manner So ss to X77 become subject to the Wakens Compensation LewdAPICHWT OR ENGIN ER TEL NO STATIST)CPI SIFICATION APT CONDO Date Applicant ADDRESS CLASS NO OwELL UNITS NOTICE TO APPLICANT It after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption you should become subject to the Workers SET BACK YARD HINY PROP UNE WIDTH Compensation provrsnne of the Labor Code you must forthwith comply with such proviso a this permit shall be deemed revoked FRONT PL LICENSED CONTRACTORS DECLARATION I� SIDE UC P L I hereby affirm that I am licensed under",sans of Chapter B SEWER MAP (Commencing with Section 70001 of Dmsnon 3 of the Bu9nea9 and � j00 OF 5 9 OF FPMSJES Professions Code and license is In full force NEW ❑ BK PG Pilo. d Co, t00 p� LicDa Class ' ADD ❑ wLu O Contract Date Z lu � ALAR ❑ $ U �[ ❑ 1 am exempt under Sec:SeREPAIR QU 49 BSPC for thus reason L I DEMOL /❑` LDNa P/C1�U Date Ne URM El1 L SrenatunejU�1y1DMA ❑ 1 as Owner of the property or rry employees with wages as f T' `q 0"gyp"!' L �m _ �1•{T•i their sole compensation w111 do the work and the structure is F � I„SL not Intended or offered for sate (Section 7044 Business and L FINAL DATE Q Professions Code) VN1 TIE APPJGNn OR FUIUI>f a11LDTlG OOLI.FMNi ole s NAIERAL 1 I1 EM'. ❑ I a3 owner of the property am exclusively, conitrach With OR A VU E CONIN N A 142AfSara MAl ER41 E TO pRFATER THW TIE ^� a ng AMOWI^.+sr:;O THE HAZAADcus MATFlIIALa R cIX MON Cum? FINAL BY > ITFL Incensed contractors to Construct the project (SectuW 7044 T1 ,9 JO - 66 Business and Professions Code) �s 13No c VA1 T1E MENDED ISE OF TIE eIADDAO BY TIE APPUCANT OR nn11RE RAJU 1Nn l HEiY =11•L�= CONSTRUCTION LENDING AGENCY oWIn+AN REauE A�EM FOR D��oR EE F M[Tfl FReM CK '_H�N� ,Oct WAST AN OW11TY NANAGEMEM or$nnlOn ISCADMo)SEE FERMTING OHECJ(LI9T FOR 6lIpEIJl�9 �-// I hereby affirm that there is a Construction lending agency for YE9❑ NO Itl a the performance of the work for which this Permit IS Issued(Sec m III.wE MA IraoraAATloNouoEAw TIE scAVMOFErwnTrvo 3087 CIV D) (aECA( AErlm UNI£R THE lDe ANGElE9 COUImY CDDE i)�O—)�)��1 J,J,i lUy�AI' Lenders Name TATE V e V 1NG A PEHMIT FROM aCXMno S] e Y 1NG A PERMIT FROM 9LAa.T HAZA3001S Lenders Address `21?1 i Prii,-2 �,6 m W 6Hr I certify that I have read this application and state under penalty S of perjury that the above mf flan m correct I agree to con0y PC FEE PERMIT FEE $ with I county ordlna antl Slate laws relab g to building au presentatnes Of this ISSUANCE FEE toe rty for I O m 1 NJESTIGAMON FEE TOTAL FEE SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATIONTY 4COUNTY OF LOS ANGELES FOR BUILDINGGPERANDEMIT WdeKER'S'COMPENSATION DECLARATION qpp FOR APPLICANT TO FILL IN A ESS !� r a car affirm that have a certificate of consent to self insure e �� J 9/ �8d or g certificate of Workers Compensation Insurance o e certified LAITY [hereof(Sec 3800 Lab C) e LOCALITY Pecy NO CornPany SIZE OF L NO OF SUGGS NOW ON LOT ❑ Caddied ropy is hereby furnished tN:EA7REST CROSS ❑ Cerin ed Copy is fQed with the county building Inspectuen TRACT BLOCK LOT NO As A department ONE AVP NO Date Applicant ASSESSOR MAP&OLY( PAGE PARCEL SPECIAL COt.IDLTI0N9 � �J O CERTIFICATE OF EXEMPTION FROM WORKERS' Q r ER S TEL NO /— COMPENSATION INSURANCE WITHIN 1000 FT OF SCHOOL? YES NO (This section meed not be completed it the permit is for one hundred Q AA ro *W DISTRICT GROUP TYPE CONST FIRE IDNE PROCESSED BY dollars($100)or less) r' ivw I certify that in the performance of the work for which this permit s issued I shall not employ arry person in ary manner so as to OmO b r become subject t0 the Workers Compensation Laws ARCHITECT OR E GINEER w,A I BATISTK:ALIF/I]CATK)N APT CONDO Date Applicant ADDRESS CLASS NO —= DWELL UNITS NOTICE TO APPLICANT If after making thin Certificate of REWIRED TOTAL SETBACK FROM EXIST ExernptDn you should become subject to the Workers CO TEI-f4O SET BACK YARD IM1YY PROP UNE WIDTH CompensatiDn provisions of the Labor Cade you must forthwith dhA� r Y coney with such provsKKs or this permit shall be deemed revoked ADDRESS LIC NO FRONT LICENSED CONTRACTORS DECLARATION ►'�fr SIDE LIC CLASS PL I hereby affirm that I am licensed underprovrsons of Chapter 9 tri P k. SEMrER MAP (commencing with Sechon 7000)of Division 3 of the Business and SO FT SIZE NO OF STOfIES NO OF FAMLES Professions Code and my license Is in full force and effect NEW ❑ BK PG Q} I , J V License Number LNc Class DESCR OF WORK Agegr' /V/I ADD NL YALORTION Contractor Date ALTER ❑ $ DDD. 0: ❑ 1 am exempt under Sec REPAIR ❑ 23 BBPC for this DEMOL ❑ �,M PLC♦ us reW Date USE OF EXISTING BLDG URM ❑ p�}ry�y�3 Signature APPLICANT(PRINT) TEL NO LOAM Perm♦ • - ` ❑ I as owner of the property o Try employees with wages as Z 4CCT.A their sole compensation will do the work and the structure is ADDRESS v net intended or offered for sale (Section 7044 Business and FINAL DATE F G Professmns Code) WILL THE APRIVJrT OR FunARE euLIXN3 OCCLiMNT HN,RE A HAZA)DWS MATERIAL 147.(V ❑ I as ommair of the property, am exclusively CDMrwtuV With OR A 1AIRLFE COHWNIC A HAZAROp)S MATERIA-EO TO OR GREATER II VN THE l T GGII TTCyc I�J7 hrenses contractors t0 construct file pmjecl ($BCt10r1 7044 ' NTS SPCFED ON TRE HAZAf S MATERws i1FORL MCN GLIDE? FINAL BY �J Business and Pcto sotto cede) YES❑ No❑ ) /T(Q�TryAL 193- 21 Nil THE INTENDED USE OF THE WDLNI BY TIE A3.LIWfT OR FUTIXRE BM-DNO MGWy 193.21 OCCLiNNi IEIX E A PERW FOR CONSTRl1CTbN GA MOp MON FROM TIE SIX /y�L,A`I� CONSTRUCTION LENDING AGENCY COAST NR a Y WNAOEUENT DSmdCT IecADMoI SEE FEnearmno u CRUST FOR A�BV11K <x UEs .00 I hereby affirm that there Is a construction lending agency for YES❑ No❑ ' ry the performance Of the work for which this permit s Issued(Sec IHAYE READ THE HAZARWU9 MATEPYLSINFCRMATIONptAEAN011E 9CA01O FEwurnNo ec m 3087 Civ C) o CKUST I UNMRsowD MY REOUREMTa�iTs UNDER THE LOS ANGELES CDurm COOE i Mnn_nnnl 1��23�7 J TrTE 3 CWPTER 220 SEOTpNe 210100 TRAd)GH]p tAe rgNOERNNG HAIATiVL9 w+w—WU Lenders Name MATERALS REPORTING Me FOR OB RANO A P ff FROM THE 9(%pAD Lenders Address 2945 1 AM 8:28 0 oAsin era.oulT o I cerldy That 1 have read this apWDatan and state undo penalty O of perjury that the above information s Correct I agree 10 Comply PC FEE PERMIT FEE with all county, ordinances and State Laws relating to building D .l UCti0n end hereby uthz = of this County ISSUANCE FEE 10 er upOn the BbOVe- ntgne� fo /� OC a INVESTIGATION FEE TOTAL FEE HroIf y a. SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN SLIMING SS I hareby affirm that I have a certili=te of consent to sell insure BULDING ADDRESS UO• or a csrbfK to of Workers Compensation Insurance s a cerbled 76 210&4�ObInzw, 60L copy thereof (Sec 3800 Lab C I ZIP '/ LOCAIJTY �� NoComperry SIZE LOT NO OF BLDGS NOW ON L 11CertAred Copy a hereby furnished NE�ST� ❑ Certified copy is filed with the county building rnspecton 7FiA—C7 BLOCx LOT NO department USE LONE MAP NO Data Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' ANO COMPENSATION INSURANCE �G. WITHIN 1000 FT OF SCNOOLI YES NO (This Becton need not be completed If the permit Is for one hundred ADORE dollars($100)s less) W DISTRICT GROUP TYPE CONST FIRE LONE PROCESSED BY is Issued I slmp hall not eloy arty personthe performance of the nin any manner so asreto CTTAm Qp LP + become subfect to the Worker Compeasaton Laws ARCHITECr OR ENGINEER A sawli CLASSIFICATION CLASSCATION APT CONDO Date AppllCant ADDRESS O CL NO a-'91 DWELL UNITS NOTICE TO APPLICANT If after making this Certificate of REOUIRED TOTAL SETBACK FROM EXIST Exemption you sh cud become subject to the WorkerC SET BACK YARD HWY PROP UNE WIDTH Compensation prows" of the Labor Cade you must forthwith 82 FRONT comply with such prMMOM s this permit shell be deemed revoked ESS LIC NO P L LT LICENSED CONTRACTORS DECLARATION SIDE LIC CLASS P L herby affirm that am 000)o underpr 3 of the of Chapter 8 (ComlrlerK.ing with Section 7000)of Drvmon 3 d Ne BU91r1e89 and SO FT Siq NO OF STOkIES NO OF FAM0.JE9 SEWER MAP Professions Code and my IK*mse Is In full face and effect I I I I NEW ❑ BK PG , d License Number Lc Class )ESCRIPTON OF tA>RK r,1 ADD A � O� Q Contracts Date hi 42NW ALTER ❑ $ �'�' Vcc ❑ 1 am exempt under Sec REPAIR ❑ $ B BPC for this reason DEMOL ❑ LDNA PIC♦ 23 W Date USE OF EXISTNO BLDG URM ❑ ACCT.4n'IL gcD nelLfe APPLICANT(AVVT) TEL NO 1 LDMA F m as avrrer of the DroWty or my empboy with wages as = 1 3 ITEMS ��JLA JJJi0.U// V 1 Voir sole canpsreabon will do the work and the structure is ADDRESS not intended or offered fa sale (Section 7044 BIISmeaa and FINAL DATE T . 193.21 Professions Code) _ a WILL THE AFRILWT OR FUTUW eULDING OCCLi141i WNDLE A HAZARDIXI9 N4REHAL —ZL— I T ❑ FINAL I as owner of the property am exdusrvety contracting with OR A NOrrU E correaala A IurARooLIs WGTRAL EOLIAL To OR orenEn THAN THE a i M AN10UNm 19.b."'�ID licensed Contractors N LOrxslruct the SKMED ON THE HAZARWU9 MREIdAla NFORWMON OIADE'! 1�LIJMUL+ project (Section 7044 YE9 El No ElI ( I Business and Professions Code) WLL THE Ir CIJII EO USE W THE Bl➢DIJNa n THE APRJGNT OR FUIIJ E SOUl0 OCCVPAM PEOWE A FERAfT FCR CQISLatDTiON OR A10DFICATDN FFDM THE 90lJrH 11 Fy�tr�r��rNn� CONSTRUCTION LENDING AGENCY GUDE MR ouMrrY A IAENT am�T tsu )SEE PERN.TT.lr aeaD.mT FOR i„ L W{JI,r—iJLrLJ 1 1/ 4/96 rnADEures 1 hereby affirm that there m a construction Iendlm0 agency fa yEs❑ No❑ 1 m the performance of the work for which the permit m issued(Sec IHAYE FeAn Tie luzumolrsruTEwusrraauTroNowEuw THE scAovnaEFavrtnv 4IN6 1 fM 9:20 3097 CN C) CNECIalsT I UDERS wD Arc REOUFEMENT9 u DER THE Los MD S COUNTY CODE T z CIMPTER a n Mi=Ne z a0 100 TIMaXYI 3 n 140 CCTICFRNNG HAZAADDL e Lenders Nam NIAMRALS PEPCRRIp AND FOR ORPNPlll A ME FROM TIe SU610 Lenders Address I certify that I hese read this apdca and state parmity of perjury that the abga informaterl m nee fp comply PC FEE OA E—f1 PERMIT FEE $ with all Gaudy ordlnen state relehrg b lwlldlrg `/V •fL pin entl hereby atrvas of Mm CaUrrty ISSUANCE FEE . gd m t er IWn tte above- props for Inspection purposes a J INVESTIGATION FEE TOTAL FEE /J 3! Int. m SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION FOR -BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDI ESS I hereby affirm that I have a certificate of consent to self msure ESS J 2 h ora ccrhfKate of VAxkers Compereabon Insurance or a cerhlled BUI Ah net Y�Vd copy thereof fSec 3800 Lab C) CITY r /'r /� (",{�I C�/ D v LOCAUTY �� CCompany � SIZE OF LCIT IF NO OF BLOBS NOW ON LOT ❑ Certified copy a hereby furnished NEAREST CROSS ST ❑ Certified copy a filed with the county budding inspection TRACT BLOCK LOT NO S department I USE ZONE MAP NO Date App icanl ASSESSOR LIAP BOC( PAGE PARCEL SPECWL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS OWNER / L COMPENSATION INSURANCE S S7' b� WITHIN 1000 FT OF SCHOOL' YES No (This section need not be completed if the permit is for one hundredSS dollars ($100) or less) J,.. �A fqN /C DISTRICT GROUP TYPE CONST RRE ZONE PROCESSED BY I rtify that in the performance the work for which this permit CITY ced `d' 'T P'is issued I shall not employ arty person in any manner so as to �0� -O� y become subject to the Workers Compensation Laws Cr OR EN(aN TEL NO 1 r l� Q /b1 STATISTICAL CLASSFICATION APT CONDO Date Applicant pp SS an� ../(j CLASS NO y�� DWELL UNITS NOTICE TD APPLMi]NT If after making the Carhf tate of C I•� N,41t9 � REWIRED TOTAL SETBACK FROM E)0.ST Exemplon you should become subject to the Workers CO TEL NO SET BACK VARA FM14V PROP LINE WQTFI Compensation pro`nsons of the Labor Code you must forthwith FROM cOmpry with such provrsx>re or the permit shall he deemed revoked ADDRESS LIC NO PL LICENSED CONTRACTORS DECLARATION SIDE CITY LIC CLASS P L I ommo affirm w that em licensed undarprov,siortsthe d Chapter 9 SEWER MAP Professions with anion 7000) a Drveon 3 d the Business and SO FT SIZE NO STORIES NO OF FAAYLIES Professrore Coda and my Icense a in full face and effect NEW ❑ BK PG , } beense Number Lo Class OF 1M7RK / ADD er MLUARON O Contractor Date -J CW / ALTER ❑ $,57 O00 `� U ❑ 1 am exempt under Sec a�n REPAIR ❑ BSPC for the reason DEMOL ❑ LONA PIC A W Date USE OF EXLRRNG BLDG URM Ela Srgrature APPLICANT(FRxrl TEL NO LONA Perm♦ iJ ? ElI as owner of the property or my employees with wages as = }{I_{ .i their sole compensation will do the work and the structure a ADDRESS F net intended or offered for sale (SectKm 7044 Business and FINAL DATE - Q Prdesstons Code) vU THE APRJCANT OR FunFE SULUNG 0ccw,wT HANDLE A HAZMnOIA MTER C 1 ❑ 1 as owner of the property am exclusive ocntrac with OR A NOUIRE CONMUNPG A NAZMWUe WM RIAL EQUAL TO M CHEATER TIANlicensTIE N AwWHF SFECFlED ON THE HNMWIIe WTERAl8 VFORNR GI x? FINAL BY . > s Business contractors to caode)cl DIa protect (Section 7044 P��/, r ANI.. Baseless and Professors Code) WU❑ No V^ IwLL T1E PREMED USE OF TIE eUDllq eV TIE AF0.1CANr OR FUTURE BUlANO v-l3Z 1`_4.+J OCCnCAAR REQUIRE A FEeaR NT STRICT(G On MODFK'.ATpN FAgA THE 9IXItH CONSTRUCTION LENDING AGENCY �u� �Ra uwTr Nu+AOE"rEnT psrwcT lecbrAO)sE[aERMrnM c�EClcusr wR -� i i I-EMj I hereby affirm that there is a constructor lending agency for No 1(1TAL 204 - 787 the performance of the work for which the permit Is issued(Sec N n CKLIAD TUNDEFr OCUs 4AT()UIEINFOfLNDER THE ANDANGEUE CONT'(CTW {Abri RI'Y•�J 3087 CN C) CIEIXLer VOEeeUJO NV eEQA'r1EAEN19 UNDER THE LOS ANGELES CWNTV COLE TTJF Lancer a Nemo wvE�us E� it o° °NSOR cen0 100m AH s20 140 wo AnwoaS o Lenders Address ( I o w�cR rn.mR I certify that I have read this applcabort and state under penally g of penury that the above information Is correct I agree to comply PC FEE rD. PERMrr FEE /a vnth all ortlinarces and State Lam relating to buiYlrg aJ A -rc w> epts hereby auBonze representatives d the County ISSUANCE FEE / , — I'd�i i Iy'7 �`"t to en property,for inspect- purpose (p a INVESTIOATION FEE TOTAL FEE ! �J m J T SEE REVERSE FOR EXPLANATORY LANGUAGE 'WORKERS COMPENSATION DECLARATION APPLICATION FOR BUILDING PERMIT f I hereby affirm that I have a certificate of consent to self 1, insure ora certificate of Workers'Compensation Insurance or,o certified copy thereof (Sec 3800 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY policy No Company ❑ Certified copy is hereby furnished FOR APPLICANT TO FILL IN BUILDING ❑ Certified copy is filed with the county budding mspec- BUILDING, ADDRESS tion deportment ADDRESS Date Applicant CIT' /Dr tilt ZIP / LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' nip OF&DGS NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON L T CROSS ST (This section need not be completed if the permit is for one ASSESSOR hundred dollars($100)or less ) TRACT BLCCK LOT NO MAP BOOK PAGE PARCEL I certify that in the performance of the work for which this OWNER u 115E^ZONE NO permit is issued,I shall not employ any person in any manner /? SPECIAL so as to become subject to the Workers'Compensation Lam RE55 CONDITIONS Dotei�Applicon ramdCrtY ZIP 7/ at NOTICE TO APPLICANT If, after making ilii of ARCHENGIER OR TT �.! ✓O GROUP TYPE FIRE SSED BY O Exemption you should become subject t err iVl CAST Z� Compensation provisions of the Labor Code, u must forth- ADDRESS L 3 with comply, with such provisions or this permit shall be deemed revokedCONTRACTOR TEL STATISTICAL CLASSIFICATION APT 60NDO N LICENSED CONTRACTORS DECLARATION LIC CLASS NOy DWELL UNITS_ I hereby affirm that I am licensed under provisions of Chopter 9 ADDRESS NO (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP 1�L1DAH�- 9J p PG Professions Code and my license is In full force and effect CITY CUSS L b �A SO FT NO OF NO OF CHECK BK t ' J Y G V 7 License Number Lic Cla SIZE STORIES ILIES ONE e e = vuuAnoF4 9 Contracto. Date DESMFrION OF Vi NEW $ ,Op 0928,98 ❑ I am exempt under Sec ADO Poo ALTER B&P C for this reason REPAIR Dote USE OF EXISTING BLDG DEMOL Signature APPLICANT TFL RNAL /� / �q OWNER-BUILDER DECLARATION PRINT NO DATE SVrf_/ I hereby affirm that 1 am exempt from the Contractor's License Low for the following reason (Section 7031 5, Business and S5�7O - t10 I Professions Code) By ❑ I, as owner of the property, or my employees with BUILDING wages as their sole compensation,will do the work and L 17V the structure a not Intended or offered for sale(Section 7011 Business and Professions Code) MOVING TEL ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO with licensed contractors to construct the project (Sec- ADDRESS 1 bon 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY S& YARD FIWY TO SETBACK FROM MST PROP LIFE WIDTH ni-C� •' I hereby affirm that there is a construction lending agency for FRONT .ice W _T71.75 the performance of the work for which this penin is issued P L _ (Sec 3097 Civ C ) SIDE 1 Il Gni PL Lender s Name IDA1A Ref • fCITAL 471 - 75 32 0-7 Lander s Address P C Fee$ P'mlt Fee CHECK 471.75 I certify that I have read this application and slate that the huwnce Fee �� IDMl1 P/C/ , CHANGE .011 above information is correct I agree to comply with all County Investigation Fee ordinances a tate laws relating to budding construction, ! a hereby th ize representatives of this County to enter Total fee ID/s1A Pam 1 u0pri Ike oboe entho Pr perty for inspection purposes _ 77---�=.7 - _ a�WI-•,!V�.'1_„W 7/89 R-Ag_� 60IL1VElf1 KM l0111"M7OIY LAUGUA01 1037 1 Ali 9:3n Signature of Applican or Agent Date COURTY OF LOS ANGELES TEMPLE CITY Y 0508 BUILDING PHRNIT DEPARTMENT OF PUBLIC WORKS9701 LAS TUNAS ALTRRATION/REPAIR BUILDING AND SAFETY / LAND DRVRLOPN®iT^ TEMPLE CITY CA 91760 BL 0508 0610270036 PHONE (626) 385-0488 EST LEGAL ID NO OF CONST BUILDING ADDRESS ON PILE SQ FT STORIES TYPE 5570 ROSRMBAD HL STRUCTURE VH TENS CA 917801801 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LAS TUNAS 5767-028-019 THOMAS PAGE 596 GRID H4 LOCALITY THELE CITY, C TENANT BAST BLDG USE CONNE USE ZONE C-3 ISSUED ON PROCESSED BY B IRKS ON MIST OCC GRP 10/27/06 JK 10/22/07 OWNER TEL NO SLUGS NOW ON LOT VALUATION FINAL DATA FINAL BY LODE LAI, NAI H (323) 868-1666- 2,000 cn _� ^ 5570 N ROSENIAD BL / I !7 TEMPLE CITY CA 91780 FRES PAID DESCRIPTION OF WORK TRASH ENCLOSURE FEE DESCRIPTION QUANTITY DON AMOUNT APPLICANT TEL NO SATS AS OWNER - AA BLDG PERMIT ISSUANCE 27 75 AZ BUILDING BRVIEM FEE 54 70 SPECIAL CONDITIONS D2 PERNIT N/O EN-HC 2000 00 VAL 82 20 TOTAL PEES 164 65 CONTRACTOR ML NO APPPOVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC NO LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER TEL NO FOUNDATION TRENCH FORMS LIC NO BLAB FmUEE, FLOOR RAISED FLOOR FRAMING MAP NO SEWER NAP BOOR PAGE FIRE EONS CNP UNDERFLOOR INSULATION 117H265 3 01 FLOOR SHEATHING NO OF PANILIES DWELLING WITS APT CORD STAT CLASS NO 22 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SnIAR PANELS AIR QUALITY 1000 FEET MATERIALS NO NO NO FRAKE INSPECTION REQUIRED TOTAL SETBACK FROM MIST FIIB SPRINKLER RANGERS SET BACK YARD HWY PROP LIRE YIDTH U� /�/ V , PRONE PL- .e5 INEJLAT ION WEATHER STRIP SIDE PL- IROERIOR LATH DRYWALL EXTERIOR LATH EMKO FLOOR CBIL ASSBM RAISD WALL ASSENBLIES RAI® SBATTB OPENINGS T-SAR CEILINGS LOT DRAINAGE REPORT ID DPR261 ROOM TO BS0508