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Home My Public Portal About6326 ROSEMEAD BLVD_Building__ 7BAS38A C8#0096.5. APPLICATION FOR BUILDING PERMIT 1 COUNTY OF LOS ANGELES ABUILDING DDRESS DEPARTMENT OF COUNTY ENGINEER / BUILDING AND SAFETY DIVISION LOCALITY �!< JOHN A.LAMBIE,COUNTY ENGINEER NEAREST L L• �� CASSATT D.GRIFFIN,SuF•T OF BUILDING CROSS ST. DIST RIC NO. ROUP TYPE PR SED BY FOR APPLICANT TO FILL IN I .6. BUILDING SE ER MAP ADDRESS STATISTICAL CLA (CATION I K PG CLASS. NO. DWELL. UNITS LOT NO. r BLOCK MAP STATE NUMBER HWY ES NO TRACT USE ZONESPECIAL ✓ t NO.OF BLDGS. a �( CONDITIONS SIZE OF LOT I NOW ON LOT USE OF EXISTING BLDG. BUILDINGEXIST• r SETBACK YARD HWY STREET NAME WIDTH OWNER L G ��L ( 5 FRONT P.L. ADDRESS S r' OL6'-3e� SIDE TEL. P.L• CITY r--- t NO. INSPECTION RECORD ARCHITECT OR TEL. ENC,,INEER NO. ADDRESS d�_C' %(C li.3 TEL CONTRACTOR sL(C. NO. ADDRESS `IL�.Z S. yt'MCSk- DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH T. ! r NO.OF NO.OF SIZE l7 STORIES FAMILIES USE OF STRUCTURE r CGr=;'L A si'ic ill- T SIGNATURE OF APPROVALS APPLICANT _ DATE INSPECTOR'S SIGNATURE ADDRESS , �: fq.(CSL" 10011L, FOUNDATION: LOCATION FORMS.MATERIALS P.C, $ _ FRAME: FIRE STOPS. FEE BRACING, BOLTS VALUATION $ OO FURNACE: LOCATION. FEE FGAS VENT,DUCTS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH,INT. PLICATION AND STATE WAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WI H ALL COU ORDINANCES AND _LATH,EXT. STATE LAWS,REGU G BUI G STRUCTION. SIGNATURE OF HOUSE NUMBER COR- PERMITTE RECT AND POSTED ADDRESS . (�Q I'VI ROS ,�ZCI�'I FINAL ` CLYDE N. DIRLAM. PRINCIPAL STRUCTURAL EN PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 1 A 3.40 X3341 r — t 76A638A CE#803 2-63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS' ANGELES BUILDING �1 DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND'ISAFETY DIVISION LOCALITY JOHN A. LAMBIE:COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, $UP'T OF BUILDING CROSS ST. DISTRI T O. ,ROUP YPE ' / P FOR APPLICANT TO FILL IN ��' CONST. BUILDING _ STATISTICAL CLASSIFICATION SEWER MAP ADDRESS 3'� t/SIC / ,y? qK PG-y CLASS. NO. WELL. UNITS / .LOT NO. a) BLOCK - WATER CERTIFICATE: NOT REQUIRED RECEIVED ❑ TRACT MAP "> HIGHWAY NO. (CIRCLE) 'STyyyATE AJOR SECOND, LOCAL NO.OF BLOGS. C.J SIZE OF LOT NOW ON LOT USE ZONE SPECIAL USE OF `'j� CONDITIONS EXISTING BLDGN �_r q/L C, TEL. s 2-- OWNER 5- y,�A„S NO. BUILDING YARD HWY ST ET NAME EXIST. ADDRESS /fT /"l �� SETBACK ! WIDTH ARCHITECT OR. TEL. P. L. ENGINEER NO. SIDE P. L. / CL ADDRESS O TEt. V CONTRACTOR ,5',"C NO. ADDRESS • H DESCRIPTION OF WORK. a N NEW ADD ALTER REPAIR DEMOLISH T. NO. OF NO. OF SIZE STORIES FAMILIES USE OF - STRUCTURE - SIGNATURE OFf_._ APPLICANT f!/( VALUATIONi APPROVALS DATE INSPECTOR'S SIGNATURE PMT. FOUNDATION: LOCATION , FFEE $ .� FORMS-MATERIALS`) FRAME: FIRE STOPS, I HER Y AKNOWLEDGE.THAT I. HAVE READ THIS APPLICATION BRACING, BOLTS AND ST E THAC T THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING'CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. ING TO WORKMEN'S COMPENSATION INSURANCE. LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE /'ter RECT AND POSTED / ADDRESS FINAL IpZ7 Z 'G "' 'L . JOHN F. LEWIS. PRINCIPALSAI-U( E RAL ENGIN R_ PLAN CHECK VALIDATION ASH _ PERMIT VALIDATIO c M.O. CASH L.�'ll�o 3 1 4 5 0 C 5 4 4 D .00A Lr'Q 3 2 6 3 DEC . 6 . 1 D 6,00— a' / 76A638W CE#`�?9-67 r' APPLICATION FOR BUIL ING PERMIT COUNTY .OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY_ENGINEER ADDRESS ' 3 2_6 ' Y. BUILDING AND SAFETY DIVISION LOCALITY E _1 JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRICT NO. GROUP TYPE PROCESSED BY CONST. type only) (Print or t BUILDING STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NO.-DWELL,UNITS BK PG LOT NO. )' d^K BLOCK USE ZONE MAP TRACT , ��- `� �4 C ^ " SPECIAL COEDIT ONS NO.OF BLDGS, SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. OLS ) BLDG.SETBACK FROM dd i TEL. FRONT PROP.LINE OF (STREET). OWNER&S;-,& O. _ TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL ADDRESS �/,=fGl if/J HIGHWAY WIDTH FROM C.L. � CITY + _ BLDGSETBACK FROM ARCHITECT OR TEL. SIDE PROP.LINEOF (STREET) ENGINEER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. CONTRACTOR '� TO�SYb-5'S 7�+ + _ � C3 ADDRESS NO. l 3 CORNER CUTOFF YES ❑ NO V CITY eon- `�, 9 fir' CI ASs C - SEE REVERSZ SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK _ N NEW ADD ALTER REPAIR DEMOLISH SQ. FT. NO. OF NO. OF SIZESTORIES FAMILIES MVALUATION F ryJn_ GZ$ � APPROVALS DATE INSPECTORS SIGNATURE PMT. ��) FOUNDATION: LOCATION - � FEE $ r, ,�� FORMS, MATERIALS FRAME: FIRE STOPS, 1 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 BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. LATH, INT. ING TO WORKMEN'S COMPENSAT IO INSU ANCE. - 1 LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE - RECT AND POSTED- ADDRESS FINAL f/", JOHN F. LEWIS. PRINCIPAL,ST C RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH LF 0'5 3 3 3 Jird 3 1 D 9.0 0 r 76A 630A CE#803 9-67 �P�AL G ° . APPLICATION O BUILDI G PERMIT COUNTY OF LOS#ANGELESBUILDING .a, DEPARTMENT OF COUNTY ENGINEER ADDRESS �� D BUILDING AND SAFETY DIVISION ami JOHN A. LAMBIE, COUNTY ENGINEER LOCA uTY ^AF 'c U COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST CROSS ST. Ar , y DISTRICT NO. GROU • TY-PE PROCESSED BY FOR APPLICANT TO FILL IN � CONST (Print or-type only) J ! r14 i--),v r BUILDING STATISTICAL CLASSIFICATION SEWE MAP ` ADDRESS � (p� Cd'Iti vD CLASS NO--DWELL.UNITS BKAI PG N USE ZONE MAP O LOT NO. � .'. BL CK '0 NO. 2 c 1 •'^ SPECIAL TRACT NO.OF BLDGS.•„ CONDITIONS L SIZE OF LOT NOW ON OT tl USE OF C EXISTING BLDG.Shfl e4-/ BLDG.SETBACK FROM ,q �� TEL FRONT PROP.LINE OF ( LG.�". _r eE4 ,g • STREET) OWNER �'�� • NO. �7Z�=�y)Z�j TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL ADDRESS"L>' VIA 1-A a j HIGHWAY WIDTH FROM C.L. y CITY `I hrl-c s L-6a'Des. BLDG..SEfBACK FROM QRCHLTECT OR II,, TEL L� SIDE PROP.LINE OF (STREET) ENGINEER�;1 L, raw NO. / l. ��J _ TYPE OF EXISTING SETBACK HIGHWAY } YARD - TOTAL ADDRESS9 02 A2. DD4o,jl& HIGHWAY WIDTH FROM C.L. TEL. } = d CONTRACTOR S a.�l .NO. ��7/$f O �' f` o U ADDRESS 1;'ja'%_ L)LI ��T�fO�' CORNER CUTOFF YES ❑ NO I=v T LIC. CD CITY CLASS -- •• SEE REVERSE SIDE FOR-SPECIAL PROVALS DESCRIPTION OF'W6RK. Lu A i_ it _C�2-. z NEW ADD T REPAIR DEMOLISH ' SQ. FT. NO. OF NO. OF SIZE STORIES FAMILIES USE OF �1f a MLS STRUCTURE - 044 SI'LC J SIGNATURE OF APPLICANT VALUATION $ `7s fJ-D,..,7"G _. - -� A'PPR;OV%1�L.S DA INSPECTOR'S SIGNATURE _ P.C. PMT. - FOUNDATION: LOCATION FEE $ FEE $ j FORMS, MATERIALS t 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 FURNACES LOCATION, ..�. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS -- BUILDING CONSTRUCTION, I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH, INT. TION OF THE LABOR CODE OF THE.STATE OF CALIFORNIA RELAT. •�. >1 ING TO WORKMEN'S COMPENSATION INSURANCE tttr LATH, EXT.SIGNATUREO SE NUMBER COR PERMITTEE t' Fw.rc '� ECT AND POSTED ADDRESS AL �..� JOHN F. LEWIS. PRINCIPAL ST RAL ENGINEER PLAN CHECK VALIDATION cK., M.o. CASH PERMIT' VALIDATION CK. M.O. CASH LHLa 2.2 30N19 l D 48.75- a F/ APPLICATION F , OR BUILDING PERMIT COUNTY OF LOS ANGELES �f "�`�`'�S BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN s ILDING ADDRESS } I hereby affirm that I have a certificate of consent to self insure8 LDINGADDRESS , 24 � or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3600,Lab.C.) CITY ZIP LOCALITY Policy No. Comp SIZE O LOT NO.OF BLDGS.NOW ON LOT led copy is hereby furnished. NEAREST CROSS ST r TRACT BLOCK LOT NO. 13 Certified copy is filed with the county building inspection USE ZONE MAP NO. department. Date Applican SOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNEIG A' T COMPENSATION INSURANCE v UD /v WITHIN 1000 FT.OF SCHOOL? YES NO ADDRESS (This section need not be completed if the permit is for one hundred rE 6, � DISTRICT GROUP TYPE CONST. FIRE ZONE OCESS BY dollars($100)or less.) ZIP I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any m$nner so as to ARCHITECT OR ENGINEER TEL.NO. 61 or C5, beco a subject to the Workers' mpensation Laws. 7 S jJ!J STATISTICAL CLASSIFICATION APT C O Date��pplicanth �/� f_ ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT., If, after making this Certificate of EFRN D TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR TEL.NO. P Y 1 K YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith l �r comply with such provisions or this permit shall be deemed revoked. D�ES5 LICA.G(LICENSED CONTRACTORS DECLARATION CITjI L C1� UIhereby affirm that I am licensed under provisions of Chapter 9 SQ.FT.SIZE NO.OF STORES NO.OF FAMILIES EER MAP � (commencing with Section 7000)of Division 3 of the Business and NEW BK PG OZ Professions Code,and my license is in full force and,effect. , CD �` DESCRIPTION OF W RK License Number, U Lia Class �� f� � N ADD VALUATION � Contractor AI 1- y ��'FZ Date 7`Z3'�y [ ALTER ❑ � Ii- z`'I°``' z ❑ ❑ I am exempt under Sec. REPAIR 1 I EDIS) �� B.&P.C.for this reason L P DEMOL ❑ LDMA P/C# I1-TA 7� = 3 Date: USr=OF-EXISTING BLDG. LRM ❑ CHECK 7 0 a 2 Signature APPLICANT(PRINT) TEL.NO. LDMA Perm# }Y'" 10 l ❑ I, as owner of the property, or my employees with wages as ZO "•iHl ;"�` a4 their sole compensation,will do the work and the structure is ADDRESS H . not intended or offered for sale (Section 7044, Business and FINAL DA Q �yq J ^y PfOfeSSIOrIS Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL 11010113-1,001 1/,!4 11- ❑ 1, as owner of theproperty, am exclusive) contracting with THE A MIXTURELINTS CONTAINING A HAZARDOUS MATERIAL EQUAL TO TI GREATER THAN Q y p�a e• a Ci Y g THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY � �iF�• � �, }}_,�.%,J e•1:1 licensed contractors to construct the project.(Section 7044, YES❑ NO❑ Business and Professions Code.) WILL THE INTENDED USE OF THE BUILDING 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(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. I hereby affirm that there is a construction lending agency for YES 1:1No Elthe performance Of the work for which this permit IS issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD 3097,Civ.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES Lenders Name COUNTY CODE,TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. Lender's Address ER OR AGENT 0 o 1 certify that I have read this application and state that the above P.C.FEE PERMIT FEE information is correct. 1 agree to comply with all county ordinances and State laws relating to building construction,and ¢. hereby authorize representatives of this County to enter upon ISSUANCE FEE the ab m ioned property fo I ction purposes. /�r �� r INVESTIGATION FEE TOTAL FEE SEE REVERSE FOR EXPLANATORY LANGUAGE,