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HomeMy Public PortalAbout5241 SANTA ANITA AVE_Building__ J _ 'BA68BADBAB-a.eAPPLICATION FOR BUILDING PERMIT 1 DIVISION OF BUILDING AND SAFETY ADD Ess r ,gyp eZI Deportment of County Engineer County Of LOs Angeles LOCALITY �✓ • WM.J.FOX,COUNTY ENGINEER NEAREST ✓� CASSATT D.GRIFFIN,SUPT OF BUILDING. CROSS ST. c��o& / DISTRICT NO: GROUP TYPE SEWER MAP G FOR APPLICANT TO FILL IN �� 1 I CONST. BUILDING PI) •r�` r _ �' MAP / STATE ADDRESS jai i� ���I,>L •s.. A,P �— NUMBER HWY C =J LOT NO. / BLOCK USE ZONE SPECIAL CONDITIONS TRACT 4%3 "OIC-7619 d / NO.OF BLDGS. BUILDING EXIST. SIZE OF LOT T� / S NOW ON LOT SETBACK YARD HWY STREET NAME WIDTH USE OF FRONT EXISTING BLDG. ° fvCT � P.L. OWNER�Jflf� r�G19 -/"f( dT:/ ��►.✓rGl+"l` G°;ti BIDS. �'OMAIL ' ADDRESS S 1"' , l'R�``^ c� +�I LIC O TRACT DWELL. I UNIT 5 INDUSTRIAL v F TEL •:1� / 1 DWELL. I UNIT ' CITY ./�J r �" i�I�, (..C/UT - NO. �]�S r. ~I 6 PUBLIC BLDG. ARCHITECT CR TEL. 2 DUPLEX I UNIT, 7 ADDN..ALT.. ETC. ENGINEER NO. 3 APT. UNITS-*: 8 MISCEL.Gg r%$,5 C, ADDRESS 4 COMMERCIAL ;;JJ �J TEL. f INSPECTION RECORD CONTRACTIOR NO. ' a'/J'� _ADDRESS r „��p �JI�G DESCRIPTION OF WORK y� �f�,- �,,, Jyt; ►`y EW ADD LTER REPAIR DEMOLISH FT. /� NO.OF NO.OF Y) RIP lly, r SIZE oCTORIES FAMILIES_ ®r USE OF STRU TOREf s'f a 74e J kre Ylo (oJ a a- SIGNATUREOF r APPLICANT APPROVALS ADDRESS DATE INSPECTORS SIGNATURE FOUNDATION:LOCATION � 6 P.C. S. ' FORMS,MATERIALS /I. ®� FEE. FRAME: FIRE STOPS. VALUATION / ",/7, S 'Q� BRACING,BOLTS FE FURNACE:LOCATION, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT,DUCTS APPLICATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH.INT. AND 'STATE LAWS REGULATING BUILDING CONSTRUC- TION. LATH.EXT. SIGNATURE OF f� � 1 '� � r�,�� HOUSE NUMBER COR- PERMITTEE _ RECT AND POSTED f �j ADDRESS FINALy "'t" 'G'� "•:'o WM.J.FOX,COUNTY ENGINEER VALIDATION C.N.DIRLAM,CHIEF BLDG. INSPECTOR Ac0 3 3 7 4 Nul FEB 21 1 8.0 0 tn 76A5.-.SA CE0e;23 9-67 D►� -� ' e'T APPLICATION FOWBUILDING PERMIT . ,COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS 5241 BUILDING AND SAFETY DIVISION LOCALITY Tem le City, .Ca. JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRICT NO. GROUP TYPE -PRO SSED BY /^ CONST (Print or type only) �y •a T � 0115 BUILDING STATISTICAL CLASSIFICATION SEWE�RQQMA��P++ ADDRESS 5PLLICLASS NO._X DWELL.UNITS BK'�isGf LOT NO. BLOCK USE ZONE MAP NO. CIAL NO.OF BLDGS. 2a --/TRACT 13363 240 CONDITIONS ' SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. is BLDG.SETBACK FROM TE ��/�p FRONT PROP.LINE OF 1, r (STREET) OWNER 8 erson NO. 44 - 2 TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS 5241 Double Drive HIGHWAY WIDTH FROM C.L. CITY Temple City, Mad, boa + BLDG.SETBACK FROM F� H SIT- (STREET) ARCHITECT OR TEL.. SIDE PROP.LINE OF ENGINEER . NO. TYPE OF EXISTING SETBACK HIGHWAY + 'YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. / CONTRACTOR NO. � + `� - �Q a O ADDRESS NO. CORNER CUTOFF YES NO ❑ CJI CD CITY CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK a y NEW ADDATE Z •� REPAIR DEMOLISH SQ. FT. '" NO. OF NO. OF SIZE STORIES FAMILIES USE OF STRUCTURE Rome Remodel Kitchen SIGNATURE OF APPLICANT VALUATION$ 480.00 APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT _ r -FOUNDATION: LOCATION FEE S FEE FORMS, MATERIALS FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY DINAN ES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING CONST N. I ERTIFY THAT IN DOING THE WORK AUTHORIZED H EB. :W O PLOY ANY PERSON IN VIOLA- LATH, INT. TION OF THE FT ST LIF OR A RELAT• ING TO WORKMEN _ I LATH, EXT. SIGNATURE OF OUSE NUMBER COR- PERMITTEE- RECT AND POSTED ADDRESS 241 Double Drive FINAL - JOHN F. LEWIS. PRI CIPAL STR/UC�TURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION /CK.') M.O. CASH 0 5 19 0 MA25 1 0 �� 9.0 ' 1JZ-FAtiTl%=.N T OF BUILDING AND SAFETY &.vj "j&,A i iwa r va Yr mmu l � COUNTY OF LOS ANGELES B I L P WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING ( DISTRICT NO. PLAN CK.NO. PERMIT NO. ADDRESS ® /} 6 LOCALITY �,/y�.� ��( REC7 D BY DATE OF APPL. /DATE BBaUU NEAREST L �� 0 7 CROSS ST.. �+ BUILDING � ry��� OWNER ADDRESSMAIL ADDRESS S/O��hyd ; LOCALITY , NEAREST �� TEL y CROSS ST. CITY i) / NO. S!g & ARCHITECT O TEL ZONE PLAN © TYPE GROUP ENGINEER NO. ADDRESS SETBACK LINE APPROVED TEL. BY DATE CONTRACTOR NO. �.+ USE /I/ APPROVED ADDRESS u!r ZONE BY DATE LEGAL .� VOV/ CORRECTIONS DESCRIPTION LOT NO. BLOCK eh� p7 TRACT /3 3C,r�C^ �-y NO.OF BLDGB. SIZE OF LOT �.;y V®I NOW ON LOT USE OF w?7✓A2fL& NO.OF NO.OF EXISTING BLDG. ONA6:�%r FAMILIES ROOMS DESCRIPd RK' NEW ALTERATION ADDITION O REPAIR MOVING q DEMOLISH / p S ZE j �4C� RONo.OMB /` STORIES / D WALLr COVERINGIVO T7}'/�/(/ �I. COVERING IIJ1ROOFc 1- r BUILDDI BUNGNEW--a' a I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION:LOCATION 'SBP CTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS / AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE OF BRACING,BOLTS OWNERy�'i�:/V"7 LATH.INT.0 AUTHORIZED AGT LATH,EXT.: r DBS-3 25M SETS 4-47 $ P. .R PLASTER,INT. C FEE PLASTER,EXT. VALUATION ®®' -7-1 --FINAL • a ®® j FEE � " .^.F3S-3 25M SETS 8-45 DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES BUILDING VA1M. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY ten{� � ��� �Y�/� DISTRICT NO. PLAN CK. NO. PERMIT NO. SUILDADDRESS 11 J D /) (J � ✓ -„'n- //+ LOCALITY L ' f e? r RECEIVED BY DATE OF APPL. �TE �SU D_ r+ n NEAREST �y ri e E`7�1 CROSS ST. {j�J��1 I / JJ BUILDING �D t�.gLF (/R ix-1- MAIL -4 OWNER i"I(J[�` x/"/ e.le�i J"/��" ADDRESS 4::1. ��y�/I AlMAIL '�}1 j 1 4 c � LOCALITY .Cr 1 7 /OArf ADCRESS 3 4 D 3 /lJ d-[��..(,1--(,Q NEAREST TEL. CROSS ST. /5z oiff—r- CITY � � �f 1 F t-f- NO. FIRE I NO.OF I TYPE I GROUP7" ARCHITECT OR TEL. ZONE PLANS / ENGINEER NO. .yam � BLDG. ORD. NO. ADDRESS , I y�- SETBACK LINE APPROVED TEL. CONTRACTOR NO. BY DATE USE APPROVED ADDRESS ZONE BY DATE LEGAL CORRECTIONS DESCRIPTION I LOT NO. l BLOCK ------- -TRACT TRACT J.336. 3 NO. OF SIZE OF LOT <iy� '56, * I NOW ON LOTS USE OF NO.OF NO. OF .y EXISTING BLDG. '7-?-�`?• ' I FAMILIES I ROOMS DESCRIPTION OF WORK NEW ALTERATION ADDITION O _ REPAIR MOVING DEMOLISH O Sq. FT. NO.OF SIZE q ,! Z ROOMS STORIES Dr WALL ( ROOF COVERING COVERING / T L' - USE OF NEW ( BUILDING � APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS ----- APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION, INSPECTOR DATE i AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, BRACING, BOLTS SIGNATURE OF OWNER LATH, INT.: AUTHORIZED AOT LATH, EXT.: $ P C. >$ PLASTER, INT. FEE PLASTER, EXT. VALUATION FEE FINAL DEPARTMENT Or' BUILDING AND SAFETY �arra.a�.ra s ava� _�_� .•_•___ COUNTY OF LOS ANGELES C WM. J. FOX, CHIEF ENGINEER , FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK. NO. PERMIT NO. BUILDING /� ^ �'I _ADDRESS T �IJM_ 10. _ LOCALi TY � '\ 6 j:j�"'e b� RECEIVED BY DATE OF APPL. DATE ISSUED NEAREST CROSS ST. (� /} BUILDING OWNER /\ Q.+1t,e.� T 4- i /� 61 j1 ' C�Y<t ai`.. ADDRESS itMAIL - ----- —ADDRESS /S 1 �(.l rJ i G- LOCALITY .::., �°..-'r_ti+..:-.i•' ., NEAREST a-- TEV CROSS ST. CITY NO. FIRE NO.OF TYPE GROUP ARCHITECT OR TEL. ZONE PLANS ENGINEER NO. .. BLDG. ORD. NO. ADDRESS _SETBACK LINE APPROVED CONTRACTOR F, y�,f �inl NO. BY DATE USE APPROVED ADDRESS ZONE BY - DATE LEGAL CORRECTIONS DESCRIPTION I LOT NO. BLOCK TRACT NO.OF BLDG9. SIZE OF LOT "'�A'y I NOW ON LOT USE OF ND.OF NO.OF EXISTING BLDG. I FAMILIES I ROOMS DESCRIPTION OF WORK NEW ALTERATION ADDITION O REPAIR MOVING DEMOLISH p Sq. FT. NO. OF Z SIZE ROOMS STORIES D WALL ROOF r COVERING I COVERING USE OF NEW BUILDING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE OF BRACING,BOLTS OWNER qh r/1 � LATH,INT.: AUTHORIZED AGT. Is,A IIJ!`.C1 � �%1. �� LATH,EXT.: slow DBS-3 25M SETS 1-47 $ P.C.= PLASTER. INT. FEE PLASTER, EXT. VALUATION FEE FINAL J' WT- '.RS'COMPENSATION DECLARATION het�et3 a 'irm that l have a certificate of consent to self a A p P L I CAT N F O RBUILDING 4 AC ir�isure, or a certificate of Workers'Compensation Insurance, ���� E or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AN® SAFETY Policy No. Company Certified co is hereby furnished. I BUILDING ❑ copy Y FOR APPLICANT TO FILL IN ADDRESS �o� D��,i7 Certified copy is filed with the county building inspec- ! BUILDING /� R I tion department. ADDRESS 5� �rT MJ�7, At) LOCALITY NEAREST Date Applicant CITY / ai� G� ` ZIP CROSS ST. Cites y CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE Z6?ONE MAP hundred dollars ($100)or less.) TRACT BLOCK LOT NO. NO. "— 7 �/� TEL. Z. SPECIAL OWNER ®�Cf r�de � U�i� N0.77y.T3�39 CONDITIONS I certify that in the performance of the work for which this DISTRICT GROUP TYPE FIRE ESSED BY O permit is issued, I shall not employ any person in any manner ADDRESS �/�o->� [f1 / CONST. ZONE u so as to become subject to the Workers'/C'ommpreensation�Laaw.s�.) r Date �r Applicant t J v� �' �r " CITY IP Z d O ARC CT OR TEL. STATISTICAL CLASSIFICATION APT. CONDO. a NOTIC TO PLICANT: If, after making this Certificate of ENGINE NO. CLASS NO. DWELL.UNITS Ida i, Exemption, you should become subject to the Workers' EEEEEEI A. Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be Q deemed revoked. CONTRACTOR NO. BKf PG,& St VALIDATION LICENSED CONTRACTORS DECLARATION LIC, I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 44 NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. / / Professions Code,and my license is in full force and effect. CITY CLASS i SQ. FT. . NO.OF NO.OF CHECK License Number Lic.Class SIZE ISTORIES FAMILIES ONE $ Contractor Date j DESCRIPTION OF WORK NEW i ADD ❑ I am exempt under Sec. ,,wry ALTER ❑ i FINAL B.&P.C. for this reason REPAIR I Date: USE OF EXISTING BLDG. DEMOL,R- ❑ FI I B Signature APPLICANT TEL. OWNER-BUILDER DECLARATION PRINT NO. I hereby affirm that I am exempt from the Contractor's License ` PooLaw for the following reason (Section 7031.5, Business and ADDRESS Professions Code): PRESENT NG I, as owner of the property, or my employees with ADDRESSSS 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). ! 1 ;2733 1 A REQUIRED TOTAL SETBACK FROM EXIST., CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH # 0 0 0 0.0 1 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. - 9675 tSec. 3097, Civ. C.). I SIDE P.L. a e ag6759 Lender's Name 0625-87 3 Lender's Address P.C.Fee$ Permit Fee a - 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 ordinances and State laws relat'ng to building construction, Total Fee • �� f and hereb uthorize repre tives of this County to enter upon the v/e�-,m�ent�ione pr erty forinspection/�purposes. I oCv✓% �jt�� 416 zsSEE REVERSE FOR EXPLANATORY LANGUAGE Sig ature of Applicant or Agent D to ®6 �n ��WORKERS'COMPENSATION DECLARATION ' certif cane of WorkersrtCompensat on ensuto ran elf APPLICATION FOR BUILDING PERMIT o'r��'nfied copy thereof (Sec. 3800, Lab. C.) , COUNTY OF LOS ANGELES BUILDING AND AFETY Policy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS / ❑ Certified copy is filed with the county building inspec- BUILDING �� 41 tion department. ADDRESS Date Applicant CITY' CITY ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ) NEAREST COMPENSATION INSURANCE SIZE OF LOT )( U NOW ON LOT / CROSS ST. f (This section need not be completed if the permit is for oneASSESSOR hundred dollars($100)or less.) TRACT IF3 BLOCK LOT NO. MAP BOOK PAGE PARCEL USE Z E MAP I certify that in the performance of the work for which this OWNER i eAe �/+� NOQ' NO. permit is issued, I shall not employ any person in any manner ADDRESS �.��✓r Z aLC ~ CONCIAL DITIONS so as to become subject to the Workers Compensation Laws. Date !O Applicant, CITY ZIP L9�} NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY ENGINEER NO. CONST. ZONE Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or this permit shall be L. STATISTICA CLASSIFICATION APT. DO. deemed revoked. CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION LT LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY CLASS BK 3 VALIDATION >a- SQ. SQ. FT. TNO.OFNO.OF CHECK License Number Lic.Class SIZE ISTORIES FAMILIES ONE VALUATION DESCRIPTION OF WORK NEW 0: ' Contractor Date ADD 1-1 ; I am exempt under Sec. Z '9 ALTER ❑ W' B.BP.C. for this reason REPAIR ❑ $ U• Date: USE OF EXISTING BLDG. DEMOL Z Signature APPLICANT E TEL. FINAL f NT OWNER-BUILDER DECLARATION ) No )_ DATE I hereby affirm that I am exempt from the Contractor's License ADDRESS 2� E. Gtf�3�1� FI Law for the following reason (Section 7031.5, Business and Professions Code): PRESENT. B BUILDING 1, 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 t 7044, Business and Professions Code). MOVING TEL. 1 ❑ 1, as owner of the property, am exclusive) contracting CONTRACTOR NO. P P Y� Y 9 - ACC T.a with licensed contractors to construct the project (Sec- ADDRESS 60.50 tion 7044, Business and Professions Code). 331 REQUIRED TOTAL SETBACK FIRM CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I ITEMI -3 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. i OTAI 60-50 (Sec. 3097, Civ. C.). SIDE �_ 10r 011 P.L. -+r cil ASH Lender's Name LDMA Ref. # CHANGE - m P.C.Fee$ Permit Fee Lender's Address I certify that I have read this application and state that the Issuance Fee LDMA P/C# }�t 'Ittf! i''t—�'`�I i R above information is correct. I agree to comply with all County Investigation Fee " 0ordinances and State laws relating to building construction, Total F--K" ^ee LDMA Perm. # i AM10;;pti R and hereby authorize representatives of this County to enter e� � upon the ove_mentigpecl property for inspection purposes. s SEE REVERSE FOR EXPLANATORY LAiFUAGE .Signature of Applicant or Agent Date 1�s 3' W