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Home My Public Portal About5549-5549 1/2 SANTA ANITA AVE_Building__ APPLICATION FOR RELOCATI N �� F r os ANosr�s '�'-- -BUILDING PERMIT , i T OF >IXcBSR IMAND MFIETT D VMM • FOR APPLICANT TO FILL IN ' LolNs . ows■■ ROPOwi �..Y � ■YILCIMe C � LOC/IiITT w■RwisW P NNAIJN■T d CITY �- 1 f :Ir 7p CRO.i MT. fir r� .of RLoe■. A*■sR■o(I ■1!N OR L 2 5 OY ON LOT MAP ROOM IASM PARCMIL MISTRICT i'tofow—ULP3 ITTPoy--- FINE i■wm OT, TRACT ee RLOCN' NO. I� OONwry.�!wi■wwT OYILe1N■ STATIw7ICAL OLANI'IO ACCRSRS ■wA� CLAN NO.=WEILL.YMRO LOeAYTT awn umn OWNER• LA 1� nr� FAI MAIL -� . nf C ' jj�l V CIALACOREN f ,, V CRIOwE CAO OMFANTMENT AF OPAL N IMEM TEM R ❑ N ❑ CT (R w0. MOIIINO TEL. OLDS.S ACw rw Cw OY CONTEALTwe. FNCNT MOF.Ywi Or (wTRMET, NNNMAT • VAM TeTAL SSTMACM FROM TT�D Or ii1STlwe ACCEDES C f -27 FRONT■RCF.YDE MIMIIMAT MIO•III OYILCINe TELbeawmAcrom no. * O J AeCODSS MMM-Poor.LINN AER FROM RIREETI ■nIUORew LiweDN - MEN AM ORANON NISNMAT i FARO TOTAL SDTEAOE FROM vvm or 11311117111101SIDE FOOF.LINN NIONWAT MOVE ADDRESS ��ryf'��/� ,/�/ ., + q i�-r7#4L �" YI 1 - e011wE.ewf'OFF .i.❑ no❑ ■ulLolw Ywe of Ru1lalwe ^ jr IN e�sw wFwai Tei❑ No❑ M.FT. w0.ow IM COARrAL MUMR sews TMS 0'. NO❑ - w1Es wooY■ .Nftgr wrP CART lA!t e` r_ 1 2W Ir e e o:W o6 RY(wNwwTuw 1 xEwEOY ACICICMIiCRE THAT 1 M YE OEAO TN PPUCATIM AN ETATs TNAT THE AOOYi IN CONNECT AND E To aONnr c 1• �� +` SIRM ALL ONCINANCEN ANO LAME OieY�lIT1 ■ ILEINe CON• EDD U ION. 1 CENTIFT THAT IN COINS TRi AUTRONREC O ' ,' 'G ',�- MiwENT 1 WALL NOT EMPLAT ANT PENSION IN TIOLATIOM ow THE C LANCE GOOD er VNE STATE OF CAYFowMIA to WELATID■ To 11 MbwYEw'W COMFEN■ATIew INSURANCE. - t rIMAL NT �( . R14Mwryws oR f� C FNRNITNN OAYN (\}( woowiu a N �` 3- ► InV=dpedon fee Permit Fee Imam Fee YALOATION $ TvW FM PLANCHNM VALIDATVH CR M.G. CAME! PELI VALIDATION f rr/7 / Z �+.Do WORKERS' COMPENSATION DECLARATION v I I hereby affirm that I ehaver certificate of consent to self APPLICATION FOR BUILDING P E RM I T insure, or aertificata,oi'Workers'' Compensation Insurance, �or a certifie� the e •(Sec. 3800, La C COUNTY OF LOS ANGELES I BUILDING ND SAFETY BUILDINPolicy No. Cly+ Company ❑ Certified copy is hereby furnished. FOR PPLICANT TO FILL IN ADDRESS �J ADDRESS J BUILDING Certified copy is filed with the county building inspec- gpDREss qp tion department. �j/ Date" �O Applicant ggtCITY ZIP -// LOCALITY O. OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCE f j �� ASSESSOR (This section need not be completed if the permit is for one TRACT Z/i/3147 BLOC LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) TEL. OWNER NO• USE NE OP 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 CONDITIONS CL O so as to become subject to the Workers'Compensation Laws. CITY ZIP i U Date Applicant ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO DISTR GROUP TYPE FIRE ROCES E BY O Exemption, you should become subject to the Workers' CO NE i- Compensation provisions of the Labor Code, you must forth- ADDRESS (� r�� r-- nw N with comply with such provisions or this permit shall be ST ISTICAL CLASSIFICATI N PT CONDO. Z deemed revoked. CONTRACTO _ LICENSED CONTRACTORS DECLARATION to. /9/. AlaCLASS No. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)-of Division 3 of the Business LIC. SEWER MAP and Professions Cod ,and my license is in full force and effect. CITY CLASS ! BK. VALIDATION SQ. FT. NO. OF NO.OF CHECK ., License Number w Lic. Class. /SIZE STORIES / FAMILIES ONE, 23 VALUATION Contractor Date ` �3 DESCRIPTION OF WORK &171 A4 50 NEW ❑ i ACCT.qX ElI am exempt under Sec. ADD $ ► 3307 et0°ill B.&P.C, for This reason ALTER f ITEMSREPAIR ❑ $USE OF _ _ Date: EXISTING BLIJ. DEMOI ❑ I O I AL A-6 m 40 Signature APPLICANT NT)(,(' Np, (' E If C O f OWNER-BUILDER DECLARATION FINAL ��) 1 hereby affirm that I am exempt from the Contractor's License DATE "��G'`� 4HANG °jfl Law for the following reason (Section 7031.5, Business and ADDRESS FINAL Professions Code): PRESENT By y a l O113/913 ❑ I, as owner of the property, or my'employees with ADDRESS � 0000—I-j�l•+� 8� wages ct their sole compensation,will f o the(e and :770,60 asa/P ,4*5 1 AM 8:,.tr the structure is not intended or offered'for sale Section LOCALITY � .L 2� �•! 7044, Business and Professions Code.) MOVING TEL. �✓1n (Q ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code.) REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH i I hereby affirm that there is a construction lending agency for FRONT the performance of the ork for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE r? —! t•.i P.L. Lender's Name O•~ '_' �^� ]moi• �J 3 LDMA Ref. N g t t-'ti t"` P.C. Fee$ Permit Fee t i Lender's Address I certify that I have read this application and state that the Issuance Fee LDNIA P/C N o-+ r— , C above information is correct. I agree to comply with all County Investigation Fe Gn ardina es and State laws relating to building construction, i Total Fee LDMA Perm. # r and eby authorize re sentatives ojthn*s Countyto enterupo t eab a propert foe n pu poses. I r� 00 9 Csy J SEE REVERSE FOR EXPLANATORY LANGUAGE °° ° ° I,ml ° Signature of Applicant or A Ent Date fad•. � G O u APPLICATION FOR BUILDING PERMIT C� COUNTY OF LOS ANGELES BUILDING AND SAFETY BUILDING ADDRESS FOR APPLICANT TO FILL IN WORKER'S COMPENSATION DECLARATION •� `" .f I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS„,,...•.,.., P.r^• �,� or a certificate of Workers' Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) CITY Z LOCALITY�U- <. �'r T -7- �1 Policy 1�C/.y 1L`7L7�—��,� Company., SIZE OF LOT NO.OF BLDGS.NOW ON LOT El Certified copy is hereby furnished. / ” By z'i.- •5-,2/ , � NEAREST CROSS ST./ Certified copy is filed vv)W the CQunty''buildin inspection TRACT LOCK LOT NO. depart ent. USE ZONE MAP NO. r ASWSSOR MAP BOOK PAGE PARCEL Date �. pplica ,N 2-CSPECIAL CONDITIONS CERTIFICATE OF EXEMP ON FR� WORKERS' OWNER 3 TEL NO. COMPENSATIQ ll S NCE �'�r'✓l '-' % / !J �� WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS a: DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars( 100)or less.) CITYZIP 1;5"11/1 I certify that in the performance of the work for which this permit / is issued, I shall not employ any person in any manner so as to R ENGINEER �� ' become subject to the Workers'Compensation Laws. ARCHITECT OR GINEER TEL NO. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. ! DWELL UNITS NOTICE TO APPLICANT.' If, after making this Certificate Of AV REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become Subject t0 the Workers' CONTRACTOR ,,.^ TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith GL/l!—: ( ,yc C ,o,/ .r/1 11:273" " FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS ,... LIC.NO, P L LICENSED CONTRACTORS DECLARATION G.-� /"/�✓�" �� SIDE IT LIC.CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 vin G�'!�T SEWER MAP O_ (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES Q Professions Code,and my license is in full force arid-effect. NEW ❑ BK PG ' U License Number & DESCRIPTION OF WORK ADD VALUATION �! /� Lia Class W LIL Conefl 0�7 �l/z 7 Date - - $ 1 - y.' ALTER ❑ J REPAIR ❑ $ � ❑ am e m pt under Sec. BAP.C.for this reason DEMOL ❑ LDMA Pic# + 5t a Date: USE OF EXISTING BLDG. URM ❑ .•"C) Signature NT(PRINT) TEL NO. LDMA Perm# LLI ❑ 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 . .. not intended or offered for sale (Section 7044, Business and FINAL DATE Q ; Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ 1, as Owner of the property, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE JQ •�' +••�• "' P P Y, Y 9 AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY Ou licensed contractors to construct the project (Section 7044, YES NO Business and Professions Code.) 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 QUAUTY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. •�dl<MS•.710• w f.�, I hereby affirm that there is a construction lending agency for YES❑ NO a the performance of the work for which this permit is issued(Sec. IHAVE REAp_hJE.HA7PS R�DOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 3097,CIV.C.) CHECKLISSTT I UNDER D MY REO RE ITS UNDER THE LOS ANGELES COUNTY CODE, a TITLE 2,CHAPTER 2.20�ECTIONS .20.1 THROUGH 2.20.140 CONCERNING HAZARDOUS trr'h`-(}.: +� ^• «' " Lender's Name MATE#IALS REPORTIN ANet FO BTAI A PERMIT FROM THE SCAQMD Lender's Address S":+ O OWNER o I certify that I have read this application and state under penalty q of perjury that the above information is correct.I agree to comply P.C.FEE _ PERMIT FEE $ with all qc tlty ordinances nd State laws relating to building m construction, a6Q hereb��gfipned orize representatives of this CoL ,� ISSUANCE FEE m CID to enter upo v property for inspecti0 purpo • '! INVESTIGATION FEE TOTAL FEE//,, - Synama m Ap,,.,,l oy"Dim Date SEE REVERSE FOR EXPLANATORY LANGUAGE ;WORKERS';COMPENSATION DECLARATION ` herebt*6ffirm that I Have a certificate of consent to self ,,e` t insure, or a certificate of Workers'Compensation Insurance, APP, I;�.^`T I.Q:N �F.O•I� BUILDING PERMIT or a Gertifigd copy'thereof (Sec. 3800, Lab. C.) . . ' €36d vQ`1T/�a COUNTI OFAO'k ANGELES` BUILDING AND SAFETY . Policy NolfN""" Company - ,BUILDING ,�^ Certified copy is hereby furnished. ' FOR APPLICANT TO FILL IN ADDRESS s Z Certified copy is filed with the county building inspec- FADDREss tion department. 49 1 2 Santa AnitaAve. Date -4 Applicant e City zip 91780 LOCALITY CERTIFICATE OF EXEMPTION FROM WORKE ' NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. NJL (This section need not be completed if the permit is for one 44319 ASSESSOR hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL OWNER J•E. Plount & CO. TEL 576-8737 USE ZONE MAP 7 7 I certify that in the performance of the work for which this NO. !V permit is issued, I shall not employ any person in any manner �� SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS 217 W. Las Tunas Dr. CONDITIONS c0 CITY San Gabriel ZIP 917 09 Dcite Applicant ARCHITECT OR TEL DISTRICT GROUP TYPE FIRE PRO SED BY o NOTICE TO APPLICANT: If, after making this Certificate of Neil Esurki 576-7456 `7 ENGINEER NO. CONST. ZONE Exemption, you should become subject to the Workers' f IW Compensation provisions of the Labor Code, you must forth- ADDRESS 116 with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. I fONDO. Z deemed revoked. CONTRACTOR same Rq Owner NO. L LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. 61-1dDWELL. UNITS LL 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. Q r,,11 Professions Code, and my license is in full force and effect. CITY CLASS BK pG U'S(J VALIDATION �j Q SQ.FT• 1440 NO.OF 2 NO.OF CHECK License Numbber � - �' Lic.Class ^' SIZE STORIES FAMILIES ONE VALUATION �9_4 3 2 8 A EW Contractor 'J� o�•!��NT �� Date DESCRIPTION OF WORK N $ �d /�O i) 0 0 0 0 I am exempt under Sec. single family detached ADD (/ V # 2 3 p ALTER � - 566.20 B.BP.C. for this reason 'e I REPAIR $ Date: USE OF 5 6 G,2 0 c�i' EXISTING BLDG. DEMOL ❑. Signature APPLICANT John Plount TEL. 576-8737" FINAL 0 3,3 1 =8 6 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): PRESENT BY ❑ 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. 1, as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to'construct the project (Sec- ADDRESS t tion 7044, Business and Professions Code). N z 5 0 3.4 A REQUIRED TOTAL SETBACK FROM CONSTRUCTION LENDING AGENCY SFInvestigation YARD HWY PROP. LINE WIDTH # 0 0 0 0 0 1 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued ° 6 4 4 2 5 (Sec. 3097, Civ. C.). z •r L 'i 64425 Lender's Name J� 2LDMA Ref. #•! (/ Permit Fee _33.7� 0.71 5�-8 6 Lender's Address• _J�I certify that I have.read this application and state that the Issuance Fee 5 L/ t LDMA P/C# above information is correct. I agree to comply with all County ordinances and State laws relating to building construction, Total Fee t �v LDMA Perm. # and hereby authorize representatives of this County to enter upon the above-ment71, property for inspection purposes. � SEE REVERSE FOR EXPLANATORY LANGUAGE Signature a Applicant or Agent Date A - ,r.:WORKERS(COMPENSATION DECLARATION hereby affirm that I have r certificate of consent to self A P P O-CAT;IO N- FORBUILDING PERMIT c insure, or o certificate of Workers'Compensation Insurance, � ora certified copy thereof(Sec. 3800, Lab. C.) - ' •" � j��6� �j�� COUNjY.OF 1, ANGELES BUILDING AND SAFETY Policy N ompany_ a/ BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL:IN ADDRESS �,S I� Certified copy is filed with the county building inspec- BUILDING 5549 Santa Anita Ave. t ? tion department. _ ADDRESS Date 3`r' Applicant ` CITY Temple City zip 91780 LOCALITY CERTIFICATE OF EXEMPTION FROM WORKE ' 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 44319 ASSESSOR hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL. USE ZONE NO. I certify that in the performance of the work for which this OWNER J.E. Plount No.576-8737 /] / permit is issued,I shall not employ any person in any manner /( SPECIAL d SQ as to become subject to the Workers'Compensation Ldws. ADDRESS ` CONDITIONS V CIN ZIP Date Applicant ARCHITECT OR 93776 TEL. DISTRICT GW-3 P TYPE FIRE P SSED BY NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER Neil Esurki No.576-7456 _ `7 Exemption, you should become subject to the•Workers' CONST/ ZONE W Compensation provisions of the Labor Code, you must forth- ADDRESS ��v V J y with comply with such provisions or this permit shall be - TEL. STATISTICAL CLASSIpKATION J APT. J�NDO. Z deemed revoked. CONTRACTOR same as owner NO. 041f r('/ LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. lL of 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_r $ VALIDATION SIZES" 1440 S STORIES 2 FAMILIESNO. CHECK AONE License Number Lic.Class VALUATION Contractory(�s r Tw Date DESCRIPTION OF WORK ' NEW $ gG �Uv 4 3 2 7 A single family detached ADD ❑ ALTER ❑I am exempt under Sec. ❑ # 0 0 0 0 2 3 q B.BP.C. for this reason condominiums -r#001E 6-'a REPAIR ❑ $ II o56&20 Date: USE OF DEMOL ❑ EXISTING BLDG. Signature APPLICANT John Plount No 576-8737 FINAL 5 6 4,2 0 OWNER-BUILDER DECLARATION DATE• Z2 c3,31 —8 6 I hereby affirm that J am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FIN Professions Code):" 1 11 PRESENT BY ❑ 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 TOTAL SETBACK FROM ;25033A CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT # 0 0 0 0 0 1 the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. I ° 6 4 4 2 5 g _ Lender's Name 0 ° 6 4 4,2 5 LDMA Ref. # �., P.C.Fee$ 6-6112� Permit Fee 3 7. 1 5-86 Lender's Address r I certify that I have read this application and state that the Issuance Fee Q kLDA P/C# = above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee and hereby authorize representatives of this County to enter LDMA Perm. # upon the above-mentioned property for inspection purposes. ��Cge� � SEE REVERSE FOR EXPLANATORY LANGUAGE €ter Signature oJApplicant or Agent s Date