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HomeMy Public PortalAbout6320 ROSEMEAD BLVD_Building__ 76A638A CE9803 5-65 APPLICATION FOR 'BUILDI G PERMIT COUNTY OF LOS ANGELES .BUILDING ZP -DEPARTMENT "OF COUNTY ENGINEER - A D D R ESS BUILDING'AND SAFETY DIVISION_ LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST COLEMAN W JENKINS,SUP T OF BUILDING CROSS ST , DISTRICT NO GROUP TYPE- _ P.RE Y_ FOR APPLICANT TO FILIN „-/-" y �� CONST L' BUILDING STATISTICAL CLASSIFICATION _ SEWER MAP ADDRESS �a� �S�.Q'��G A� VCLASS NO °DWELL UNITS LOT NO 7v ARI. BLOCK,' USE ZONEMAP n/ N O T R A C T5,f /I sL P .SU 7�' R f /`.� SPECIAL NO -OF BLDGS , C•+ CONDITIONS-' - SIZE OF LOT NOW ON LOT - USEOF EXIST NG B BLDG SETBACK FROM " ��ss y� TEL FRONT PROP LINE OF (STREET OWNE A K ar, /E� NO TYPE_OF EXTINO SET CK HIGHWAY + YA = TOTAL ADDRESS- HIGHWAY WIDTH IF M C L + CITY — _ ARCHITECT OR _TEL BLDG SETBACK F OM ENGINEER - NO SIDE PROP LI OF IS ET) TYPE OF E STING SETBACK- HIGHWAY +• YARD = TOTA ADDRESS T y HIGHWAY IDTH FROM C ' CONTRACTOR - /,1e/ofJi4�./ ([�� NO ..,`�}�� ' + _ — O , ADDRESS Z Mo,4,QOL' V7✓,4 NO L�`1 V _ CORNER CUTOFF Y'ES NO V_ CITY ia # ') LILA G ij SEE REVERSE SIDE FOR SPECIAL APPROVALS O DESCRIPTION OF WORK W " - a ADD ALTER REPAIR DEMOLISH h SQ.FT NO OF _ NO OF _ SIZE STORIES. _ FAMILIES _ USE OF - STRUCTURE .�' SIGNATURE OF APPLICANT VALUATION$ iQ(,� •APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION, LOCATION - FORMS, MATERIALS _ FRAME, FIRE STOPS, ' I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT _ 'AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION ' WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS _ BUILDING CONSTRUCTION I C TIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL _ EMPLOY ANY PERSON IN VIOLA- LATH INT , TION OF THE--LABOR CODE F THE ST E OF CALIFORNIA RELAT _ ING TO WORKMEN S COMP TION I U ANCE LATH EXT - SIGNATURE OF HOUSE NUMBER COP- PERM ITTEE OR-PERMITTEE _ RECT AND POSTED - ADDRESS O F1 NAL ', PLAN CHECK VALIDATION CK' ASH _ JOHN F L T V PRINCIPALS' RMOAL ENc SHER MO C . PERMIT VALIDATION cK C3 Lei,✓ v 3 w �ru�4 2 u .. 2 40, a 'L�6 5`'6. 6 Q; JAN 3 1 0 2.2.0 ON `0� 76A638A CE 4803 2-63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING 63- DEPARTMENT OF COUNTY ENGINEER ADORE BUILDING AND SAFETY DIVISION LOCALITY 7-&',J�P7 JOHN A. LAMBIE. COUNTY ENGINEER NEARS T WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRICT NO. GROUP TYPE - PROCESSED BY / / � CONST ADDREISS E� X f5 STATISTICAL CLASSIFICATION SEWER MAP CLASS. NO. f/(LV•DW ELL. UNITS f� LOT NO. 75 Sunnyslope Vineyard WATER CERTIFICATE: NOT REQUIRED ElNOT TRACT Subdivision No. •1 MAPNo. 'Tj�/ C/ (iC RCLEI STATE MAJOR ECOND, LOCAL N OF BLDGS. SIZE OF LOT 692 .20 ' x361 WON LOT 2 USE ZONE SPECIAL USE OF CONDITIONS EXISTING BLDG. Market & Retail Sho sTEL C� OWNER Market Basket NO OV.5-75 UILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS 6014 S. Eastern Ave. FRONT cry�J `ie`�O ARCHITECT OR TEL. P. L. ./�'��• (� ENGINEER NcL -o3o SIDE ADDRESS 2930 Westm p TEL. u CONTRACTOR NO. ce ADDRESS �" - F- DESCRIPTION OF WORK L x . z NEW ADD ALTER REPAIR DEMOLISH - Z SQ. FT. NO. OF NO. OF SIZE 9 OlJ4 STORIES ]- FAMILIES .. USE OF .��" ,!• �; 41 „� Lt L•G" ./.-'�' STRUCTURE Drug Store SIGNATURE OF APPLICANT VALUATION $ 90, 000 / APPROVALS DATE INSP OR',�SIGNATURE FOUNDATION: LOCATION FEE S?-4-7 ~ FORMS. MATERIALS f FRAME: FIRE STOPS, I I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS C" BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK E AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THLABOR CODE OF THE STATE OF CALIF IA RELAT- ING TO WORKME .S COMPENSATION INSURANC LATH. EXT. SIGNATURE Off' ' - HOUSE NUMBER COR- PERMITTEF, RECT AND POSTED a ADDRESS J FINAL - JOHN F. LEWIS. PRINCIPA ST C URAL ENGINEER PLAN CHECK VALIDATION CK. M.D. CASH _ PERMIT VALIDATION CK. M.U. CASH >✓, 71i ,~�� 25 � 3 � 123.5 UA E 5450ZE OCT25 1 D 247.00- 76A638A CE4803 5-65 APPLICATION FOR BUILDIG PERMIT i COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMME. COUNTY ENGINEER NEAREST COLEMAN W. JENKINS,SUP'T.OF.BUILDING CROSS ST. DISTRICT NO ROU .TYPE, FADDRESS OR APPLICANT TO FILL IN Gl CONST. / ` STATISTICAL C SSI ICATION SEWER MAP CBv � CLASS NO. D ELL UNITSBLOCKUSE ZONE MAPNO _ SP/ " SPECIALN0. OF BLDGS. CONDITIONSOT NOW ON LOT BLDG. L BLDG. SETBACK FROMTEL, FRONT PROP. LINE OF (STREETNO. TYPE OF EXISTING SETBACK HIGHWAY + YARD TOTAL _ J HIGHWAY WIDTH -'FROM C.L. CITY C ARCHITECT OR TEL: BLDG. SETBACK FROM ENGINEER NO. SIDE'PROP. LINE OF _ (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. TEL. + CONTRACTOR NO IC g�Q CORNER CUTOFF YES NO OV AD DR E S 5 O� + 7,02.4 O CITY SOS .C' CLASSeloe'O SEE REVERSE SIDE FOR SPECIAL APPROVALS. O DESCRIPTION OF WORK t 1 W f a ADD ALTER REPAIR DEMOLISH -- h Z .FT. NO. OF NO 'OF - SIZE STORIES FAMILIES USE OF STRUCTURE SIGNAT F01 APPL /y A.P PROVA LS DATE INSPECTOR'S SIGNATURE P'C. PMT. y FOUNDATION, LOCATION - FEE FEE$ (f FORMS, MATERIALS _ FRAME, FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION WITH ALL COUNTY ORDINANCES AND,STATE LAWS REGULATING GAS VENT. DVCTS 9UILDING CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK AU ORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. - TIO THE LABOR CODE OF THE STA CALIFORNIA.-RELAT- INGT ORKMEN'S COMPENSATION I URANC LATH. EXT. SIG UR F OUSE NUMBER COR- , PE MITE RECT AND POSTED AD Ess . EF' INAL JOHN F. LEWIS, PRINCIPAL S(,)U RAL ENGINEER PLAN CHECK.VALIDATION CK. M.O. CASH PERMIT VALIDATION M.O CASH L&O6 6 7 6`,�; JAN 1.1 1 D 8.00-. y.. 6AE- :3�pl CE #803 1/71 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ASSESSOR i DEPARTMENT OF COUNTY ENGINEER MAP BOOK PA PARC L BUILDING AND SAFETY DIVISION BUILDING �O ADDRESS G COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY', FOR APPLICANT TO FILL IN NEAREST Print ort a onl CROSS ST. _ DISTFLLCT N GROUP T PE PR ESSED BY [EXISTING ING S NST, ESS �`— STATISTICAL�CL1ASSI - ATION SEWER MAP NO. n BLOCK CLASS NO. W DWELL,UNITS T I USE ZONEkN AP NO.OF BLDG S. O. OF LOT NOW ON LOT / - .,,;., PECIAL FONDITIONS BLDG, TEL.R NO. BLDG.SETBACKFROMESS ,. FRONT PROP.LINE OF (STREET) ��� T1WE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL 'HIG WIDTH FROM C.L. ARCHITECT '1 TEL. + _ ENGINEE NO. 1 - - BLDG.SETBACK FROM ' ADDRESS SIDE PROP.LINE OF - (STREET) TE TYPE OF EXISTING SETBACK HIGHWAY YARD = TOTAL d CONTRACTOR N HIGHWAY WIDTH FROM C.L. '+ CD LIC. - _ = ADDRESS NO + O LI . F CITY CLASS CORNER CUTOFF YES ❑ NO CONSTRUCTION LENDER Z NAME AND BRANCH SEE REVERSE SIDE-FOR SPECIAL APPROVALS _ ADDRESS SQ. FT. NO. OF NO. OF SIZE G STORIES FAMILIES NEW ❑❑ USE OF ADD STRUCTURE ALTER , SIGNATURE OF �✓ � ! REPAIR❑ - APCANT DEMOL ❑ �+/1 VALUATION $ - APPROVAL /'j/f P1j r DAT IN -S SIGNATURE P.C /J� _, FOUNDATION: LOCATION FEE $ FEE $ //t2 �O FORMS, MATERIALS `- FRAME: FIRE STOPS, ` I HEREBY<.ACK NOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS I AND STATE THAT.T'HE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL-ORDI_N'A.NCES AND LAWS REGULATING BUILDING*CON- GAS VENT, DUCTS" t STRUCTION. I GERTLFY THAT IN DOING THE WO K AUTHORIZED HEREBY I WILLN*MPLOYY ERSON IN LATIO OF THE LATH, INT. LABOR CODE OFF 'C IN N TO WORKMEN'S COMc LATH, EXT. SIGNATURE O HOUSE NUMBER COR- PERMITTEE - RECT AND POSTED ADDRESS - FIN"AEZ: JJOHN F. LEWIS. PRINCIPAL STRUET.URAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH cv 9.!5 2,4 JUL13 1 'o 1. 2.00 ..,,.,. . CE 980 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY.DIVISION BUILDING ADDRESS COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITYjf FOR APPLICANT TO FILL IN. NEAREST CROSS ST. Print or tvoe onl BUILDING DISR,,CT N ROUP Y E PRC Jc ST . ADDRESS ���� STATISTICAL C SSI FICA TI ON S WER MAP LOT NO. BLOCK - 92 CLASS NO. DWELL,UNITS B PG TRACT USE ZONE MAP NO.OF BLDGS. 6 NO. SIZE OF LOT NOW ON LOT'. - C SPECIAL USE OF CONDITIONS EXISTING BLDG. TEL. OWNER O. BLDG.SETBACK FROM ' ADDRESSems! 01 FRONT PROP.LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY HIGHWAY WIDTH FROM, C:L. ARCHITECT OR TEL. } ENGINEER NO. - BLDG.SETBACK F M ADDRESS SIDE PROP.LINE OF (STREET) r i EL. TYPE OF EXISTING SETBACK HWAY + YARD = TOTAL L. CONTRACTO fi NO. — J8 HIGHWAY WIDTH FROM C.L. C� W ! //I, NO.16 36 - CC ADDRESS * _ O LIC. ~ CIT CLASS�G CORNER CUTOFF YES ❑ NO ❑ CONSTRUCTION LEN ER -' c") NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS z ADDRESS SQ, FT. NO. OF NO. OF NEW ❑ SIZE - STORIES FAMILIES USE OF ADD STRUCTURE f` ALTER ❑ REPAIR❑ , SIGNATURE APPLICANT DEMOL ❑ VALUATION $ O • APPROVALS DATE INSPECTOR'S SIGNATURE P.C. _ (�� PMT, DO FOUNDATION: LOCATION FEE $ � FEE$ "O- FORMS, MATERIALS FRAME: FIRE STOPS, _ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE IS CORRECT AND'AGREE TO COMPLY FURNACE: LOCATION, WITHALL ORDINANCES AND _LAWS REGULATING BUILDING CON- GAS VENT, DUCTS ST R UC TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE - LATH, INT. LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION INSURANCE. LATH, EXT. SIGNATURE �', J\/J F� HOUSE NUMBER COR- PERMITTEF /•je RECT AND POSTED ADDRESS � FINAL � ) JOHN F. LEWIS. PRI• cl L STRUCTURAL ENGINEER PLAN CHECK VALIDATION PK.2M.O. ASH _ PERMIT VALIDA7 CK., M.O. CASH L3�110 5 4 3 r,w APR 13 D 0.0 0,,.. 1103431 APR12 1D 15.00 «u 76A638A CE #803 I/7APPL`CAY70pN FOR UILDI G PERMIT- I•, COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAIGE PARCEL_ BUILDING AND SAFETY DIVISION BUILDING �j ADDRESS L/ COLEMAN W. JENK INS, SUP T OF BUILDING LOCALITY r FOR APPLICANT TO FILL IN NEAREST CROSS ST. Print ort a only) - DISTRIC NO GROUP TYPE PR E BY BUILDING y / a ONS T. ADDRESS as �. _ STATISTICAL CLAS ICATION SEWER MAP LOT NO" ��.7 BLOCK CLASS NO.�DWELL,UNITS �"" PG TRACT USE ZONE MAI- %,0 N .OF BL GS. NO. 0— SIZE OF LOT W ON LOT 3 SPECIAL , USE OF CONDITIONS _ EXISTING BLDG. , TE OWNER ^ N ..__..- BLDG.SETBACK FROM y� FRONT PROP.LIN_E OF ---- - - - (STREET) ADDRESS • "�"„' !-"� r L _ - - __ .. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY G �• HIGHWAY WIDTH FROM C.L. ARCHITECT OR TEL. + = ENGINEER NO. '-- - - " BLDG.SETBACK F ADDRESS - SIDE PROP.LINE OF - - -(STREET), } / TEL TYPE OF EXISTING SETBACK HIG + YARD = TOTAL CCL). CONTRACTOR ��/ ry /� HIGHWAY WIDTH FROM C.L. V ADDRESS CITY 1.�-• ASS CORNER_ CUTOFF YES L.�_ NO-❑ a CONSTRUCTION LENDER Z NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS _ ADDRESS SQ. F NO. OF NO. OF NEW SIZ STORIES FAMILIES USE-OF'-- ADD STRUCTURE LL-L� � ALTER ❑ REPAIR[] , SIGNATURE O. APPLICANT DEMOL ❑ - - VALUATION $ ar� D APPROVALS � DATE INSPECTOR•s SIGNATURE FOUNDATION: LOCATION FEES - FEE$ �. FORMS, MATERIALS _ FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY. FURNACE: LOCATION, ' WITH .ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS ' STRUCTION, I CERTIFY THAT IN DOING THE WORK�01 ED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLHE LATH, INT. LABOR CODE M TH STATE OF •C LIF�O�.R NfI/!y I TO -- - '--- WORKMEN'S COMPE A ON IN -UR LATH, EXT, SIGNATURE O - `� „✓_/ _....- --. .. . PERMITTEE - HOUSE NUMBER COR- - RECT AND POSTED _ ADOREss ` FINAL 7L - JOHN F. LEWIS. PRINCIPAL STRU TURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION GK. M.O. CASH L s:� tP 1 3 0 ! D 3 2.00- zGB� CE #803 1/71 i A , . APPLICATION FOR , I LDI NG PER IT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING /�� 0/q ADDRESS 4 rAV COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. Print ort a only) BUILDING �.�1 �} DISS�ICT NO. GROUP T NST. P BY ADDRESS Ct,32 ® gstMZAID X11D t5 A V � F STATISTICA�SIFICATION SEWER MAP LOT NO. �,� BLOCK CLASS NO. DWELL,UNITS BK PG �j TRACT USE ZONE MAP !•, NO.OF SLOGS. NO. VV SIZE OF LOT NOW ON LOT SPECIAL USE OFL ^��y CONDITIONS EXISTING BLDG. R� /?I L �S+ i- �j OWNER L�Rrf �/5�� "t7 NOTE L�// D BLDG.SETBACK FROM ADDRESS ���v f p+ ^J jG— SLvL) FRONT PROP.LINE OF (STREET) ©� ���j r� TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY /!c- HIGHWAY WIDTH FROM C.L. ARCHITECT OR TEL. + = ENGINEER NO. B'-DG.SETBAC-KEROM ADDRESS SIDE PROP.LINE (STREET) K Y ,�]��`KTEL 'yam a TYPE OF EXISTING SETBACHWAY + YARD = TOTAL O CONTRA CTO 'jp '6A4k �P3 vNO. JAY HIGHWAY WIDTH FROM C.L. V LIC ADDRESS14 -jr •$7� NO 0 + p CITY`0-5 p •lr' CLASS CORNER CUTOFF YES ❑ NO ❑ LAJ CONSTRUCTION LENDER `J v� NAME AND BRANCH A/®N1' SEE REVERSE SIDE FOR SPECIAL APPROVALS ADDRESS - SQ. FT, NO. OF INO. OF SIZE STORIES NEW FAMILIES ❑ A �/� ' , � ` USE OF i7 ` ADD ❑ .,t7�'�- d {'s1, ��1,,te IL..f✓�d , STRUCTURE /W ALTER REPAIR❑ SIGNATURE APPLICAN DEMOL ❑ ..L-j)7. FI Y VALUATION ! APPROVALS DATE INSPECTOR'S SIGNATURE ILi P,C. PMT. FOUNDATION: LOCATION f.. FEE $ FEE $ (p� FORMS, MATERIALS - FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT,!,DUCTS ASTIR UC TI ON. I CERTIFY THAT IN DOING THE WORK AUTHORIZED ,I� HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INTJ� ���+{���� � ,i}/�a �,°i- ,.J� LABOR CODE OF T E STATE OF IFORNIA IN RELATING 70 '� WORKMEN'S CO ION 'NSU LATH, EXT. P MITU F HOUSE NUMBER COR- PERMIT RECT AND POSTED - ADORES /'r � FINAL JOHN F. LEWIS, PRINCIPAL JVTRUCT RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDA TN CK. M.O. CASH c ©S 76 A638A CE#603(REV.6/78) f" APPLICATION FOR. BUILDING PERMIT COUNTY OF LOS ANGELES I DINGG AND SAFETY FOR APPLICANT TO FILL IN ADDRESS jO�Zo .VV BUILDING �f ddl �i ADDRESS ZO , ��+ T.7W D • LOCALITY A NEAREST CITY R� ��'r ZIP' CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT 4to MAP BOOK PAGE I PARCEL GG `` DISTRICT GROUP TYPE FIRE PROCE SED BY TRACTi�./bWS //k� BLOCK LOT NO. CONST. Z �. OWNER&.' ,Y. 46lA f-4f .NO.TEL,�j 10. SSU v /l •.,� STATISTICAL C"-L'ASSSIFIICATTION VER MAP ADDRESS VW& 4l/� CLASS NO.Q DWELL.UNITS BK�U PG CITY�"TS *Wt4pkCIjb ZIP QO401 . ENGHN ERT /� ��g J7 NO. 3o 91 VALUATION $ D ADDRESS 14 1 0AMAC9.6 BLDG.SETBACK FROM ���.yy�� TEL'Y FRONT,PROP.LINE OF (STREET) CONTRACTOR C&AM� NO. HIGHWAY. + YARD . TOTAL SETBACK FROM TYPE OF EXISTING ADDRESS � « NC4%1 Z4' FRONT-PROP.LINE HIGHWAY WIDTH LIC. % � + _ CITY • .CLASS CONSTRUCTION LENDER l' BLDG.SETBACK FROM NAME AND BRANCH �+{� SIDE PROP.LINE OF (STREET) HIGHWAY + YARD = TOTAL SETBACK FROM TYPEOF EXISTING ADDRESS A. CITY SIDE PROP.LINE HIGHWAY WIDTH -- SO.FT�9Q NO.OF NO.OF CHECK + = 6i SIZE . STORIES �� FAMILIES ONE / c� DESCRIPTION OF WORK NEW ❑ P.C. Fee$ .277-c-2 0 Permit Fee V ADD ❑ Issuance Fee ALTER -19 z REPAIR ❑ Total Fee USE OF ' DEMOL _ EXISTING BLDG.'S W�� [:1ZO APPLICANT TEL IPRINT)�Q NO. c R 4'4 0,0 A 100, 3 � 3t 1 > 2,p,2:77.20 BY(SIGNATURE) 'I HEREBY AC OWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE _ U - )° ° 2 7 7.2 O U THAT THE ABOVE IS CORRECT D AGREE TO COMPLY WITH ALL ORDINANCES W AND LAWS REGULATING BUIL CONSTRUCTION.I CERTIFY THAT IN DOING THE Z G WORK AUTHORIZED HEREBY L NOT EMPLOY ANY PERSON IN VIOLATION OF U Q U 1 6—79 THE LABOR CODE OF THE"F CALIFORNIA IN RELATING TO WORKMEN'S COM- Z PENSATION INSURANCE µg 5 X4`40,-1 A SIGNATURE OF f o,o 0 0 0'1 PERMITTEE ADDRESS �" 3 5 5 0 0 2 ° 3, CITY��1►J�A �A(L1C �F.No.' 3o a ° ° 3 5 3,5 0 xt USE ZONE . MAP � R. Q 0 a 16-79 C� SPECIAL CONDITIONS :E FINAL BY <L DATE .� � WORKERS'COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof.(Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No.", u`Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADBUILDING DRESS Certified copy is filed with the county building inspec- BUILDING I'I tion department. ADRESS D j Date Applicant CITY ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR y, TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) LL USE ZONE AP O I certify that in the performance of the work for which this OWNER d''NO NO. V permit is issued, 1 shall not employ any person in any manner SPECIAL LA so as to become subject to the Workers'Compensation Laws. ADDRESS CONDITIONS r CITY,, ZIP }. Date ", .� Applicant r. ARCHITECT OR TEL. ,w NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER � ; + '�- � `• NO. "� +' DISTRICT GROUP TYPE FIRE PROCESSED BY Exemption, you should become subject to the Workers' CONST. ZONE I O Compensation provisions of the Labor Code, you must forth- ADDRESS ' d with comply with such provisions or this permit shall be C. TEL. STATISTICAL CLASSIFICATION APT. CONDO. � deemed revoked. CONTRACTOR r` NO. la1 LICENSED CONTRACTORS DECLARATION LIC, CLASS NO. DWELL. UNITS H I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. �. (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 CLASS BK PG VALIDATION SQ. FT,. NO. OF NO. OF CHECK License Number Lic.Class SIZE ISTORIES FAMILIES ONE ❑ VALUATION Contractor Date DESCRIPTION OF WORK NEW ADD ❑ $ , ❑ I am exempt under Sec. ❑ ALTER B.&P.C. for this reasonREPAIR ❑ S ® + i Date: USE OF EXISTING BLDG. DEMOL ❑ w r a Signature t ""'"" APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION PRINT NO. DATE 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): PRESERTBy BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and ' the structure is not intended or offered for sale(Section LOCALITY 7044, 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 tion 7044, Business and Professions Code). REQUIRED CK FROR' CONSTRUCTION LENDING AGENCY SETBACK YARD HWY TOTAPROP.pLINE 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. Lender's Name LDMA Ref. # P.C. Fee$ Permit Fee , Lender's Address � ' 3 $ 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 S ordinances and State laws relating to building construction, Total Fee f LDMA perm. # j and hereby authorize representatives of this County to enter m upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent pate WORKERS' COMPENSATION DECLARATION to sf insure, orairm afcertif certificate of Wo ke srlCom}pensation of coent Insuran e, APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy N WP61416 Company Pacific Comp. F-1Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS 6320 Rosemead Blvd. Certified copy is filed with the county building inspec- BUILDING ON 6320 Rosemead Blvd. tion department. ADDRESS Date-12-4-87 ApplicantCITY Temple City Zip 91780 LOCALITY Temple City CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. 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 I certify that in the performance of the work for which this OWNERITT Financial ServTb` e2860342 USE ZONE MAPNO. �P permit is issued, I shall not employ any person in any manner C--L— SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS 6 20 Rosemead Blvd. CONDITIONS 0 Dare Applicant CITY Temple City ZIP 91780 U 0 NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY 0 Exemption, you should become subject to the Workers' ENGINEER NO. CONST. ZONE U Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or this permit shall be aLql TEL STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. CONTRACTOR Bil t—Well Roof No2542888 LICENSED CONTRACTORS DECLARATIONLICCLASS NO. DWELL UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 1.0 Verdu o Roa&o.. 458005 (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 Los Angeles CLASS C-39 BK PG VALIDATION SQ. FT. NO.OF I NO. OF CHECK License Number 458005 Lic.Class C-39 SIZE STORIES I FAMILIES ONE DESCRIPTION OFWORK reroof house Vi> .'h� ❑ VALUATION Contractor Bilt—Well ROOgate 12-4-87 ❑ I am exempt under Sec. ith 12 sqs. 28-11 & 72 ADDER ❑ S 1427.50 1010.ALT ❑ B.BP.C. for this reason hot application REPAIR $' Date: USE EXISTINGBLDG. Dwelling DEMOL ❑ Signature APPLICANT TEL NO. 25112888 FINAl6 PRINT OWNER-BUILDER DECLARATION M. Madero I hereby affirm that I DATE am exempt from the Contractor's License 10 Verdu O Road Law for the following reason (Section 7031.5, Business and ADDRESS g FI L Professions Code): PRESENT ❑ BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). rn� CK FROM CONSTRUCTION LENDING AGENCY SETBACK YARD HWY TOTAPROP.SETBpLINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. ® },®.8.' 8 8 v (Sec. 3097, Civ. C.). SIDE Lender's Name J 7a 3 3� 26 �r LDMA Ref. q i m P.C. Fee$ / Pe mit Fee Lender's Address / 1 certifythat I have read this application and state that the .5 PP Issuance Feel 0 0 LDMA P/C# o above information is correct. I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee LDMA Perm. M R and hereby authorize representatives of this County to enter pan the'a1bonve-mentioned property for inspection purposes. �9 (�3► !�> `o t y`/L(� /�•� 12-4-87 SEE REVERSE FOR EXPLANATORY LANGUAGE gnature of Applicant or,Agent Date - 0 APPLICATION FOR ;BUILDING PERMIT � COUNTY OF LOS ANGELES .r BUILDING AND SAFETY • WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDIfyG ADDRESS t I hereby affirm that I have a certificate of consent to self insure, BUIL ADDRESS ,Yr or a certificate of Workers' Compensation Insurance,or a certified dy� v copy thereof (Sec.3800,Lab.C.) CITY LOCALITY Policy NO. Company SIZE OF LQT NO.OF„FSSL GS.NOW-ON LOT - ❑ Certified copy is hereby furnished. 1( �7i�p v� NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection BRACT �(_ / � BLOCK LOT NO. _75- department. wlq 7 7 USE ZONE MAP NO. Date Applicant ASS SOR MAP BOOK PAGE PARCEL 3 g"Z Q L SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS S1 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 nt employ any person in any manner so as to , become S ject t0 the Workers'Compensation Laws. ARCHITECT R ENGINEER TEL NO. l STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS 8� c� CLASS NO. � DWELL UNITS NOTICE T APPLICANTIf, after making this Certificate Of - d` REQUIRED TOTAL SIETBACK FROM EXIST Exemption, you should become subject t0 the Workers' CONTRACTOR EL NO. SET BACK YARD HWY PRGSP'LINE WIDTH Compensation provisions of the Labor Code, you must forthwith - ,_•_,_ - comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.N FRONT _ H„,—,_I e T w {/ IL LICENSED CONTRACTORS DECLARATION CITY ` LIC. LASS P IL SIDE _ i `` ' a 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.PIT.SIZE NO.OF STORIES NO.OF FAMILI . 's._ - - Professions Code,and my license is in full force and effect. NEW ❑ BK PG TOTAL �e 24 a 92 d License Number Lia Class DESCRIPTION OF WORK . ADD ❑ VALUATION t, 4� Cl K UContractor c�� �' Da ALTER . _ NG1 ❑ I am exempt under Sec. ft, ck< REPAIR ❑ 0 B.&P.C.for this reason DEM ❑ ]L!�l I J-�IClC 1 3/15/9? W LDMA P/C# Date: 3 �.� USE OF EXISTING BLDG. ��c i URM ❑ -A0 9 Signature 1t4�1iT i.. C-,-�• " 1, (n APPLICANT(PRINT) TEL NO, LDMA Perm# "'' n 0 ,w,J e Z Wit ❑ I, as owner of the property, or my employees with wages as Z their sole compensation, will do the work and the structure is "-" p ADDRESS .... __ _. _. _. _..--- .......�._. 11TEMS J not intended or offered for sale (Section 7044, Business and FINAL DATE Q �.-, �q/. ._.._._ ..o010-TOTAL.. _ 33 m 43 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL \ 2 1-9 OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE._ l•J / J { ❑ 1, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY CHEC. 53J3.1 .licensed contractors to construct the project (Section 7044, ! ' '- f Business and Professions Code.) VES 1:1 NOEl e0 WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR.. GUIDELINES. -t I hereby affirm that there is a construction lending agency for {j{;!j! -i� l j i 3/188/ � YES❑ NO❑ w the performance of the work for which this permit is issued(Sec. m I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING '+-`746 1 AM 9:03 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, r TITLE 2.CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2,20.140 CONCERNING HAZARDOUS - — - ----- -— — -- - -• -- Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. EL Lender's Address O OWNER OR AGENT 0 1 certify that I have read this application and state under penalty of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE �d �� N with all county ordinances and State laws relating to building CD construction, and hereby authorize representatives of this County ISSUANCE FEE _ to upon the ab ov rationed property for inspectio �pu�/yssseesss a 31����e/ INVESTIGATION FEE TOTAL FEE m .mature of APPI t o,Agent w/ 3/ Y SEE REVERSE FOR EXPLANATORY LANGUAGE -WORKERS' COMPENSATION DECLARATION ,. I herby affirm +hat I have a certificate of consent to se f.s ® insure, or a certificate of Workers' Compensation Insuranc9, �..y APPLICAT I L D I N G PER - IT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF - ti BUILDING AND SAFETY Policy No. Company co/-41�:q-rZ �� ' BUILDING ElCertifiedTO FILL IN Certified copy is hereby furnished.. ADDRESS lP�v�0 ❑ Certified copy is filed with ounty building inspec- BUILDING do department. ADDRESSyYZ Date Applicant CITY % ZIP LOCALITY L NO. OF BLDGS. NEAREST CERT FICATE OF-EXEMPTION FROM WORK RS' 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 I LOT NO. MAP BOOK PAGE I PARCEL hundred dollars ($100) or less.) TEL. OWNER NO.' USE ZONE AP j I certify,that in the performance of the.work for which this SPECIAL } .permit is issued, I shall not employ any person in any manner ADDRESS 6 CONDITIONS a so as to become subject to the Workers' Compensation Laws. 0 CITY ZIP tY Date Applicant ARCHITECT OR TEL. DISTRICT GROUP. TYPE FIRE PROCESSED BY O NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST. ZONE U Exemption, you, should become subject to. the Workers' U Compensation provisions of the Labor Code, you must forth- ADDRESS �� with comply with such provisions or this permit:shall bet� TET ` STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTOR 'f 1r Pb � NO - i/U — LICENSED CONTRACTORS DECLARATION " � LIC. CLASS NO. C�a DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS r L./ C�i4/rT fZNOTESEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. and Professions Code,and my license is in full force and effect. CITY . / m mil CLASS 0 BK PG VALIDATION SQ. FT. NO. OF NO. OF CHECK License Number(00-361 25' Lic. Class_ SIZE I STORIES FAMILIES ONE VALUATION Contractor) � ?RQ&?i•��ate llO Y� DESCRIPTION OF WORK NEW ❑ E d + /L! Os:(7 f'�G �N G� %V O/ ADD EJI am exempt under Sec. ❑ , ALTER ❑ P. . for This re son /O/LG y�Oti%/ �L� 2sX EPAIR EJS Date: lCo 2/ USE OF EXISTING BLDG. DEMOLI APPLICANT TEL.. Signature (PRINT) NO. FINAL OWNER-BUILD DECLARATION DATE I hereby affirm that I am exempt from the Contractor's License Law for the ADDRESS FINAL following reason (Section 7031.5, Business and i Professions Code): PRESENT BY , A s ❑ I, as owner of the .property,, or m em to employees with BUILDING l t -(•1 z a. Y P Y ADDRESS - wages as their sole compensation,will do the work and , S i- the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code.) MOVING TEL. y IT CONTRACTOR NO. ❑ I, as owner of The property, am exclusively contracting �•� with licensed contractors to construct the project (Sec- FInvestigotion !1 I*AL � tion 7044, Business and Professions Code. r - TOTAL SETBACK FROM EXIST. �=•`-�• CONSTRUCTION LENDING AGENCY YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for °_��i;^+i4f1 0 1 the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). '0101 7`1 Lender's Name. Permit Fee LDMA Ref. # w (.& 1 AM40� �. Lender's Address !'it! 0 1 certify that I have read this application and state that the Issuance Fee LDMA P/C# 0 8 above information is correct. I agree to comply with all County Fee Xf a{ ordinances and State laws relating to building construction, Total Fee !a, v LDMA Perm. # a and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. a SEE REVERSE FOR EXPLANATORY LANGUAGE ' Signature of Applicant or Agent Date r APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFAY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL BUILDING ADDRESS BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers'Compensation Ins n e,ora cert d ZIP copy there ( //�J /�. LO LITY Policy No.��(L:Ompany IZE OF LOT (/ NO.OF BLDGS.NOW ON LOT rtified copy is hereby furnished. NEAREST CROSS ST. ❑ Certifie cop iS filed with th county b�-Idt- ins:pec;tiojn ,/ TRACT BLOCK LOT NO.de n. USEZONE MAP NO. ASSESSOR MAP BOOK PAGE ` PARCEL Date pplica tSPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNS TEL.NO. YES NO COMPENSATION INSURANCE ADDRESS WITHIN 1000_FT.OF SCHOOL? (This section need not to completed if the permit is for one hundred DISTRICT GROUP TYPE CONST.' FIRE ZONE PROCESSED BY dolls $100)or less.) I ZIP 0,v '�\/n, I certifythat in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to AR HITECT OR NGINEER TEL.NO. -7 3 )) A become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CO O Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' SETBACK 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. PL SIDE LICENSED CONTRACTORS DECLARATION I LIC.CLASS PL o I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP v (commencing with Section 7000)of Division 3 of the Business and SQ.FT ZE NO. TORES NO.OF FAMILIES O Professions Cod n y 'c is in full force and ec. NEW BK PG CD DESCRIPTION OF WORK ADD ❑ VALUA ON License Number Lic.ClassCL 606 Contractor Date ALTER ❑ $ z ❑ ❑ I am exempt under Sec. REPAIR $ B.BP.C.for this reason DEMOL ❑ LDMA P/C# Date: u I I L URM ❑ Signature A PL T RI ) LDMA Perm# ❑ I, as owner of the property, or my employees with wages as p OM D711 their sole compensation,will do the work and the structure is A 1 H ACCT.®r not intended or offered for sale (Section 7044, Business and FINAL. Q p s 7 312 1 Professions Code.) M +.r r �i a I_ I WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDO ❑ I,.as owner of the property, am exclusively contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GRquIv P P Y. Y g THE AMOUNTS EC IED ON THE HAZARDOUS MATERIALS INFORMATION GINAL f ITEMS licensed contractors to construct the project.(Section 7044, VES❑ NO Business and Professions Code.) TOTAL AL 43"2- 00 WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THESOUTH 'CHECK V� (}f CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST r1 Lpi a 00 FOR GUIDELINE I hereby affirm that there is a construction lending agency for YES 1-1NO . CHANGE al•}0 the performance of the work for which this permit is issued(Sec. I H41TTING E HAZARDOUS MAT RI 1 ORMATION GUIDE AND THE SCAOMD 30972. ,CIV.C.). PECKLIST.I UNDE TA YR QUIREMENTS UNDER TH LOS ANGELES COTLE 2,CHA .20S TIO 20.100THROUGH 2.20 CONCERNINGt !]—[I[I�is Lender's Name HER L TI F TA I A R TF MTHESCAOMD. r71 iJl 1�1 L Lenders Address 9603 AN 10 a 46 a o 1 certify that I have read this application and state that the above EE PERMIT FEE information is correct. I agree to comply with all county VQ4C? ordinances nd State la I I g to building construction,and `✓ a. hereby au orize repre nt v of this County to en te UPOn ISSUANCE FEE the me i p y in pection ps a INVESTIGATION FEE TOTAL FE m JQSip of Appl W Apant Dato >Y SEE REVERSE FOR EXPLANATOqY LANGUAGE pr WORKERS'COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance, or a 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 ❑ ADDRESS e6 ✓ Q Certified copy is filed with the county building inspec- BUILDING pTy tion department.. ADDRESS ��v, o6t°rnl_v 0 r. Date Applicant CITY ZIP LOCALITY , CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one TRACT BLOCK LOT O. �� MAP gpOK PAGE ASSE! &4&f��_ PARCEL hundred dollars ($100)or less.) TE USE ZONE MAP y P OWNER(& �Y" I NO. 3` 15 O f I certify that in the performance of the work for which this pp NO. _ permit is issued, I shall not employ any person in any manner ADDRESS dcC�O ( ��� , CMZ SPECIAL so as to become subject to the Workers'Compensation Laws. CONDITIONS CITY ZIP V Date Applicant ARCHITECT R TEL. L NOTICE TO APPLICANT: If, after making this Certificate of DISTRICT GROUP TYPE FIRE PROCESSED BY O ENGINEER GIJ NO. %'Exemption, you should become subject to the Workers' / CONST. / ZONE U Compensation provisions of the Labor Code, you must forth- ADDRESS ,j �t/ 1tIF/, ✓/ " W with comply with such provisions or this permit shall be A'— TEL. STATISTICAL CLASSIFICATION APT. NDO. N deemed revoked.. CONTRACTOR �-�y Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. ;1_�lLDWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. EW (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 CLASSn /) VALIDATION SQ. FT. NO.OF NO.OF CHECK BK. PG. !(J License Number Lic.Class SIZE STORIES FAMILIES ONE # ° o a e 2 3 �(� 1. IN a - 37,50 DESCRIPTION OF WORK �/V�,61/1h NEW ❑ r Contractor Date ❑ a�� '00 - 37.505 ❑ I am exempt under Sec. O L t �� ADD ; . ��pp ALTER B.BP.C. for this reason W REPAIR ❑ $ Dat USE OF EXISTING BLDG. DEMOL ❑ Signature / , 7EL, APPLICANT TEL. 7l ;02 I R OWNER-BUILDER DE ARATION PRINT S E/v/4 NO. —/-YO O D ITA ` # 0 I hereby affirm that I am exempt from the Contractor's License ) > � �t— o - 49.88 Law for the following,reason (Section 7031.5, Business and ADDRESS/X 0 gQdOr /� /1Z C' FI ) _ aaa4988� Professions Code): PRESENT1,0 9."--8 7 BUILDING I, as owner of the property, or my employees with ADDRESS 'wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 70.44, 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 tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE 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. Lender's Name LDMA Ref. # 0P.C. Fee$ SO Permit Fee Lender's Address 3 0 1 certify that I have read this application and state that the Issuance Fee Q J-0 LDMA P/C# o above information is correct. I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total FeeLDMA Perm. # R and hereby authorize representatives of this County to enter upon the d -mentioned pro5brty for inspection purposes. a �! /0, 0SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent at �e F$/91RKERS'COMPENSATION DECLARATION 1 a't„ereby affAn that'I`have a certificate of consent to self APPLICATION FOR BUILDING P E RM I T `fl insure, or a certificate of Workers' Compensation Insurance, or a certified copy theereo c. 3800, Lab. C.) oliiT �)::W46 COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy N0 V pony F-1Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING 63 ZO ADDRESS a ❑ Certified copy is filed with the county building inspec- BUILDING 7 tion department. ADDRESSe Date 1 V Z-L Applicant CITY L `I/4 ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. NEAREST 6- 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. n MAP BOOK PAGE PARCEL OWNER (� 1//O NO. l�IS USE ZONE MAP / I certify that'in the performance of the work for which this NO• ( S3- —6S permit is issued, I shall not employ any person in any manner ADDRESS S&A �s SPECIAL , so as to become subject to the Workers'Compensation Laws. fes. CONDITIONS 0 CITY fJS7.Ai� ZIP V Date Z Applicant ARCHITECT OR / TEL. NOTICE TO APPLICANT: If, after makin this Certificate of CFC y -7 DISTRICT GR UP TYPE FIRE PROCESSED BY Exemption, you should become subject to the Workers' ENGINEER r� ` G NO. CONST. 1-9 NE Compensation provisions of the Labor Code, you must forth- ADDRESSIWo"jC�US .*"I 7 1Z/ " bl-� W with comply with such provisions or this permit shall be �� TEL Cn CONTRACTOR I/ok NO. '6`/ STATISTICAL CLASSIFICATION APT. NDO. deemed revoked. N LICENSED CONTRACTORS DECLARATION n LIC, 'l CLASS NO. Z Z�DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS CI���f !� NO. 3 72 8 (commencing with Section 7000)of Division 3 of the Business and LIC. �Q SEWER MAP Professions Code, and my licerise is in full force and effect. CITY I�a�o � � CLASS v BK PG.-70 VALIDATION Q SO. FT QO S ORIIES F MILONE OFCHECK CK License Number•Z��Z-� �1� Lic.Class SIZE - - {q�� �1� ,,�y VALUATION Goniractor�"�S ©R� pate ]� Z-�-� DESCRIPTION OF.WORK 417/ /"V12� NEW ❑ $ ❑ I am exempt under Sec. La ►�IC�i . j ADD ❑LTER Vv 01111. 9 8 1 7„0 p B.BP.C. for this reason A�Tf �V ���b' ( REPAIR ❑ s • 1 Q(Lt1 .�7 �� Date: USE OF EXISTING BLDG. YAC �� DEMOL ❑ ... 1 060 35 Signature l J APPLICANT TEL. (PRINT)_4/z 1 �� NO, TINA OWNER-BUILDER DECLARATION DATE ) 0.22-- 87 I hereby affirm that I am exempt from the Contractor's License � Zi ,�lJj� Law for the following reason (Section 7031.5, Business and ADDRESS f FI AL Professions Code): PRNT BY E E ❑ BUILDING % I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, 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 tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY REQUIRED YARD HWY TOTAL SETBACKFRRERR SET BACK PROP. LINE 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.). LSIDE P.L. Lender's Name LDMA Ref. # Lender's Address P.C. Fee$ Permit Fee / 7m 1 certify that I have read this application and state that the Issuance Fee / J (/ LDMA P/C k o above information is correct. I agree to comply with oil County Investigation Feea a , ordinances and State laws relating to building construction, Total Fee / LDMA Perm. # and hereby authorize representatives of this County to enter upon the obo - entioned property for inspection purposes. JSEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Dote APPLICATION FOR BUILDINGPERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDINWSS I hereby affirm that I have a certificate of consent to self insure,. BUILDING ADDRESS or a certificate of Workers' Compensation Insurance,or a certified A copy thereof (Sec.3800,Lab.C.) CIT P LOCALITY �,,ffi,ecl Company C�UAIT _ 'l/ SIZE OF LOT O.OF BLDGS.NOW ON LOT copy is hereby furnished. NEAREST CROSS S. ed copy is filed with the county building inspection TRACT. BLOCK LOT NO. ✓rr J) `�iI _ USE ZONE MAP NO. department. Date 1"4 Applicant rrll(, �Y +•- ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' o R TEL NO. YES f No�j► COMPENSATION INSURANCE 1' 7� (THIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESS dollars $100) or less:) DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY ( TY Cl ZI 10 r . I certify that the performance of the work for which this permit ��-((11 ((7 is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. APItHITECT OR ENGINEER Z� TEL NO. v�b t G!'.�� STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS O"'3 CLASS NO. DWELL UNITS NOTICE TO APPLICANT.' If, after making this Certificate of J _ vwhs' REQUIRED � TOTAL SETBACK FROM EXIST Exemption, you should become Subject to the Workers' CONT CI IR I �� TEL _'a SET BACK YARD HWY, PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith T(aT V comply with such provisions or this permit shall be deemed revoked. FRONT p Y P P AD RESS ..� L,L�.NO. PL LICENSED CONTRACTORS DECLARATION -5.51 SIDE CITY UCLA S P L I hereby affirm that I am licensed underprovisions of,Chapter 9 ,/AIA SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE AO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW BK PG , License Number r V�+ Lic. Class DES RIPTION OF WORK ADD ❑ VALUATION O Contractor Vhi9 r►]rt $lhr1�Date - ID 14 AhIJ ALTER ❑ $ o V cc ❑ I am exempt under Sec. 1144 12A 14 REPAIR ❑ $ 0 BAP.C. for this reason DEMOL ❑ LDMA P/C# {j( Date: - USE _xl G BLD r URM EJ - ,�_. 0- Signature APP (CANT(PRINT) EL NO. LDMA Perm# s...:•'''•,�' _� , € I s ❑ I, as owner of the property, or my employees with wages as /Q ��� Z �_.., �:(•j cl•I their sole compensation, will do the work and the structure is ADDRESS O not intended or offered for sale (Section 7044, Business and [ FINAL DATE A Q , Professions Code.) 00 WILL THE APPLICANT OR TUBE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ( 1a `!^� ❑ I, as owner of the property, am exclusively contracting with OROA MIXTURE CONT G A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE I Q S 8 AMOUNTS SPECIFIE N THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY > F74S.•e c E' licensed contractors to construct the project (Section 7044, YES❑ NO Business and Professions Code.) _�;�I{�� .e:.•-��,� WILL THE INTENDED USE,OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANTREQUIRE A RMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH +' s+'`• CONSTRUCTION LENDING AGENCY COAST AIR QUALITY ANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR = '•{= GUIDELINES. •-�•a i _ I hereby affirm that there is a construction lending agency for YES E] No —�=3 a ' ' the performance Of the Work for Wf11Ch this permit is ISSUBd(SBO. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING x• `�" 3097,Civ.C. ::H=t_K !-'-'_-- N ) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS i;EG,..� n Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. f CHAI j o Lender's Address 0 OWNER OR AGENT _ o I certify that I have read this application and state under penalty 0 of perjury that the above information is correct.1 agree to comply P.C.FEE PERMIT FEE 7/O N with all county ordinances and State laws,relating to building _ m construction, and hereby authorize representatives of this County ISSUANCE FEE h = °:` 3 {: •-• to enter upon the above tion d property for inspectio/n�pyurp�o�se�s. ID �F'TI INVESTIGATION FEE TOTAL FEE r Signature If Applicant or Agent D ✓ �I SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANC LES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDINP ADDRESS7 .�y RGS� (�_ , ice./ . I hereby affirm that'I have a certificate of consent to self insure, BUILDING ADDRESS IV 1 or a certificate of Workers' Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) CITY —1ZIPcA ^ �� LOC "( A ITY Policy NO. Company SIZE OF LOT 11�l �1 SNO.OF BLDGS.NO WN LOT ElCertified copy is hereby furnished. NEAREST CROSS S. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. I USE ZONE MAP NO. Date Applicant ASSESSOR MAP BO K0 PACS/ PARCEL / C/1__ SPECIAL CONDITIONS /prf Q CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER yrA' /��; TEL NO. (j COMPENSATION INSURANCE v `� ,�°V -41.% QW WITHIN 1000 FT.OF SCHOOL? Yes No (This section need not be completed if the permit is for one hundred ADDRESS1160 n �on �` ' dollars($100)or less.) 11 6 0 S. f� f� V DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY I certify that in the performance of the work for which this permit U,L LE � -d- is issued, I shall notemploy any person in any manner so as to CITY .�` ' ZIP 91 T � �� � � become subject to the Workers'Compensation Laws. ARCHITECT�OR,ENGINEER IV TEL1J0.� WW Pvv tY7 STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS ga" ,t, P�y ,r� �, CLASS NO. � DWELL UNITS APPLICANT TO APPLICANIf, after making this Certificate of �i1k-�GA�- Exemption, you should become Subject t0 the Workers' CONTRACTOR TEL NO. REQUIRED TOTAL SETBACK FROM EXIST 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. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATIONSIDE CITY LIC.CLASS PL I hereby affirm that I am licensed underprovisions of Chapter 9 >- (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES SEWER MAP a. Professions Code,and my license is in full force and effect. NEW ElBK PG U DESCRIPTION OF WORK ,. License Number Lic.Class ��S.1-A, l pT tt DD ❑ VALUATI N CD CD Contractor Date 1 RTW. I $ ZI �© • ��' U D®©R 0� bzooq DOO ALTER ❑ W ❑ REPAIR ❑ ti I am exempt under Sec. $ � B.BP.C.for this reason DEMOL ❑. LDMA P/C# _. Date: USE OF EXISTING BLDG. URM ❑ Signature APPLICANT(PRINT) TEL NO. LDMA Perm# - _-• Cil ❑.I,>as owner of the property, or my employees with wages as Z their sole compensation, will do the work and the structure is ADDRESS O not intended or offered for sale (Section 7044, Business and FINAL DATE a Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL / - 1, as owner of the property, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ((( licensed contractors t0 construct the project (Section 7044, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY VES❑ NO❑ 1_ E Business and Professions Code.) tt WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING 444 •- OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH •�•-,y-;,- CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKUST FOR {mac'n GUIDELINES. I hereby affirm that there is a construction lending agency for 'YES❑ No❑ - N the performance of the work for which this permit is issued(Sec. ^`` _ -'`"; O> I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING N ^ 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, i TITLE I CHAPTER TNG SECTIONS OBTAINING THROUGH 2.20.140 CONCERNING HAZARDOUS 3 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. o Lender's Address OWNER OR AGENT i ti t_}'1{ ` 1 i j 'JI_ r, o I certify that I have read this application and state under penalty of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE cm with all county ordinances and State laws relating to building �O co construction, d eby authorize representatives of this County I�SUANCE FEEco ; to enter upon a entioned rogerty f9oinspection urposeJr INVESTIGATION FEE TOTAL FEE r s��wre.a G SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION FOR OR BUILDING PERMIT � COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING�gDDRESiS. ` I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS /�� /•� (���!/ //. or a certificate of Workers' Compensation Insurance,or a certified Roses copy thereof(Sec.3800,Lab.C.) CITY zIP n LOCALITY Policy No. Company SIZE OF/LOT L NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. I NEAREST CROSS ST. 01 ❑ LOCK LOT NO. Certified copy is filed with the county building inspection TRACT B department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL ' SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER kYO S CHOO TEL NO. / COMPENSATION INSURANCE YES No f� WITHIN 1000 FT OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESS � dollars ($100)or less.) 63zo A). ROSI:r/ ,Mt '6AD DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY CITY 1 6MPL� ZIP I certify that in the performance of the work for which this permit• G, � v ✓f( iS issued, I Shall not employ any per n in any manner SO as t0 ARCHITECT OR ENGINEER TEL NO. D� become subject to the Workers'Comp ation Laws. STATISTICAL CLASSIFICATION APT CONDO Date,�� Applicant ADDRESS CLASS NO. � DWELL UNITS NOTICE TO APPLICANT. If, after mng this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become s jest to the Workers' CONTRACTOR TEL NO, SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith II!A• S 1 AJ _013)373#33 / FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS ,^� LIC.NO. pp P L LICENSED CONTRACTORS DECLARATION -3fi0� ''�' �� rl Co �� 3,1 SIDE CITY c� y / c LIC.CLASS ���•- P L I hereby affirm that I am licensed underprovisions of Chapter 9 LOS N `w �`*`� SEWER MAP (Commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and y license is infull force and�efffectt.. NEW R" BK PG d License Numb Lic. Classr� _ DESCRIPTION OF WORK ADD E] VALUATION. , O Contractor Date .3/31 93 S/ ALTER 11 $ Z O U ❑ I am exemp der Sec. REPAIR ❑ $ Q BAP.C.for this reason DEMOL ;❑ LDMA P/C# W Date: USE OF EXISTING BLDG. URM ❑ - n- r,❑ Signature Z co APPLICANT(PRINT) qq ) TEL NO. LDMA Perm# i•i LA• S16 I, as owner of the property, or my employees with wages as / 3 34 33 6 1 Z •.r•-:•z .i their sole compensation, will do the work and the structure is ADDRESS / O ACC! a s not intended or offered for sale (Section 7044, Business and �� P / FINAL DATE Q ' �^ u`i1`? V't a 36 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ 1, as owner of the OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE .I property, am exclusively contracting 44, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044, _ �.•�•�aS Business and Professions Code.) YES 11 N-A WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING- OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH ,,, .51017 117. 90 a CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. "' ` I hereby affirm that there is a construction lending agency for VES❑ NO A !TENS+- i w the performance of the work for which this permit is issued(Sec. TOTAL� �, .� 3097,CIV.C.) IHAVE READ THEH ZARDOUSMATERIALSINFORMATION GUIDE AND THE SCAQMD PERMITTING t q�2 ® 8 N CHECKLIST.I UND RSTAND MV REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, , TITLE 2,CHAPTE 20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS CHECK J� •f { "• 3 Lender's.Name MATERIALS REP NG AND FOR OBTAINING A PERMIT FROM THE SCAQMD. CHECK S L'0i.48 IL Lender's Address O OWNER OR AGEN CHANGE a 01D o I certify that I have read this application and state under penalty o P.C.FEE PERMIT FEE _ / of perjury that the above information is correct.I agree to comply a with all coun ordinances and State laws relating to building E .. t < construction, d ereby authorize representatives of this County ISSUANCE FEE 1�013ri-1313 0 `f 3 1i 933 10 to enter upon t above-mentioned property for inspectio purposes. Jct t AM 11: ay 1 10 `� INVESTIGATION FEE TOTAL FEE / /y D .. ... 1 r Signature of APPIic.�t t Dale SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 9904010073 PHONE: (626) 285-0488 EXT: LEGAL ID: NUMBER OF SIGNS: I BUILDING ADDRESS: ON FILE SIGN DESCRIPTION: CHANNEL LETTERS 6320 B ROSEMEAD BL TEMP CA 917801544 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN 5382-021-026 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: ISSUED ON: PROCESSED BY: EXPIRES ON: CHECK INTO CASH EXIST OCC GRP: 04/01/99 UT 04/01/00 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: ODE: VANNIER WILTON E CO TR VANNIER TRUS (818) 355-1239- 1,500Q,. 14`1.56 209 OAK MEADOW RD V !D SIER 910242611 FEES PAID DESCRIPTION OF WORK ILLUMINATED INDIVIDUAL CHANNEL LETTER SIGN FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: F. BRADLEY SIGN ADVERTISING (909) 948-7232- AA BLDG PERMIT ISSUANCE 27.75 10390 REGIS CT. AC STRONG MOTION-RESID�- 1500.00 VAL 0.50 SPECIAL CONDITIONS: a+: RANCHO CUCAMONGA, CA AX BUILDING,REVIEW=FEE- `\ 54.70 B2 PERMI=T%W/ENERGY-R=LE(,1.500,00 VAL 90.42 �TOTAL6FEES 173.37 CONTRACTOR: ONTR CTOR: ADVERTISING TEL. N948-7232- d�� o��m APPROVALS DATE INSPECTOR SIGNATURE BRADL10390 REGIS COURT LIC. NO LOCATION AND SETBACKS .:. RANCHO CUCAMONGA, CA 91730 616633C-45 SOILS ENGINEER APPROVAL .ARCHITECT OR ENGINEER: TEL. NO: -J FOUNDATIO /TRENCH FORMS LIC. � —_ 1111111 SUPPORT STRUCTURE MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: ''.00 LulL Tq(�U ') NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS- NO 20 ��� O �� O 0 SCHOOL WITHIN HAZARDOUS ' 'f, AIR QUALITY: 1000 FEET MATERIALS n ij'' v _ NO NO NO U �o• V � o � "uce sk REPORT ID: DPR261 ROUTE TO: BS0508 ' COUNTY OF LOS ANGELES „TEMPLE CITY .. # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS T1,19AS ALTERATION/REPAIR BUILDING,AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 9904210050 PHONE:.(626) 285-0488. EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE 6320 U ROSEMEAD BL STRUCTURE: 0 VN TEMP CA 917801544 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:. LONGDEN 5382-021-026 THOMAS PAGE: 596 GRID: H2 . LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: COMME USE ZONE: C ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 07/01/99 UT 12/28/99 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: VANNIER WILTON E CO TR VANNIER TRUS (818) 355-1239- 1 _ 80,000 209 OAK MEADOW RD -�� ez SIER 910242611 FEES PAID DESCRIPTION OF WORK UNMANNED COMMUNICATION FACILITY FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: NEXTEL COMMUNICATIONS (949) 862-2300-. D1 PLANCHECK W/O EN-HC 80000.00 VAL 929.34 17275 DERIAN AVE. AA BLDG PERMIT ISSUANCE, - 27.75 SPECIAL CONDITIONS: IRVINE, CA 92614 AC STRONG MOTION RESID 80000.00 VAL 8.00 D2 PERMIT W/O EN-,HC.. 80000.00 VAL 1,122.45 -TOTAL FEES 2,087.54 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE J EVANS CONSTRUCTION (805) 495-7461-1 128 AUBURN CT. #208B LIC. NO LOCATION AND SETBACKS WESTLAKE VILLAGE, CA 91302 563536 f ,� SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. N0: _ FOUNDATION/TRENCH FORMS -' LIC. N0: SLAB/UNDER_ FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:r UNDERFLOOR INSULATION 153H265 3 04 " FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: . NO 22 :`. ! / - ROOF SHEATHING SCHOOL WITHIN HAZARDOUS � ; a % SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO \\ j A' �, , FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: - FRONT PL- a INSULATION/WEATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CE L ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508