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APPLICATION FOR BU DING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL I BUILDING
ADDRESS �/
BUILDING 9 /,
Al
ADDRESS EO LOCALITY Z
NEAREST
CITY ZIP CROSS ST
SIZE OF LOT �r DGS ASSESSOR
NOW ONOF 9 )e b5619 NO OF LLOT MAP BOOK PAGE or I PARCEL
/ DISTRICT GROUP TYPE T FIRE ESSED BY
TRACT N•I '✓ BLOCK LOLNO A T Q /�3 T
OWNER • S NO U�
�L 1 • fI STATISTICAL CLASSIFICATION /SEWER MAf
ADDRESS `7 r CLASS NO DWELL UNITS 48KI/ PG
CITY
ARCHITECT OR TEL VALUATION
ENGINEER NO
ADDRESS BLDG SETBACK FROM
TEL FRONT PROP LINE OF ISTREETI
CONTRACTOR NO — HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
.A1�-�� � LIC FRONT PROP LINE HIGHWAY WIDTH
ADDRESS( NO 3sv (o
IC +
CITY CLASS
CONSTRUCTION LENDER BLDG SETBACK FROM
NAME AND BRANCH _ SIDE PROP LINE OF (STREET)
HIGHWAY + YARD TOTAL SETBACK FROM TYPEOF EXISTING
ADDRESS CITY SIDE PROP LINE HIGHWAY WIDTH O
SO FT NO OF NO OF CHECK + V
SIZE STORIES FAMILIES ONE ry a
DESCRI N OF WORK NEW PC Fe!S Perma Fee4 14a 2
ADD
Issuonce Fee y�
ALTER El
REPAIR El Total Fee
USE OF , DEMOL
EXISTING BLDG ,
APPLICANT _ TEL
(PRINT) NO
Y(SIGNATURE
I HEREBY A WL THAT 1 H READ THIS APPLICATION AND STATE '
THAT THE ABO IS CORRECT AND A EE TO COMPLY WITH ALL ORDNANCE$
AND LAWS R LATING BUILDING NUCTION I CERTIFY THAT IN DOING THE
WORT(AUT IZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
,THE LABOR DE OF THE STATE OF CAUFORMA IN RELATING TO WORKMEN 5COM 31 994A
PENSATIONI NSURANCE
SIGNATURE OF
PERMITTEE 2 • - 3100
ADDRESS
_ . . . 3100
TEL
CITY NO 1228-78
USE ONE MAP f� U G 7
NO >
SPECIACONDI i
CONDITIONS / 11.414.0-
417f
5�
DATE ! 4 7y
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ca 0a INaV a/Ral 11
APPLICATION FOR BUIL ING PERMIT [IIS
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING �,-y
ADDRESS `J Y/��
BUILDING
ADDRESS S ETY
NEAREST
CITY' CROSS Si
`, PO NO OF BLDG$ ASSESSOR _
SIZE OF LOT IFgO t NOW ON LOT MAP BOOK PAGE PARCEL
p DISTRICT GROUP TYPE FIRE P ESSED BY
TRACT f-/ BLOCK LOT NO DI (J GROG CONST FON
TEL 6 Uo VL-3
OWNER NO
STATISTICAL CLASSIFICATION SEWER MAP _
ADDRESS CLASS NO DWELL UNITS BK PG
CITY
ARCHITECT OR iEl VALUATION $ /
ENGINEER NO
ADDRESS - L ETBA K FROM
all
TEL FRONT PROP LINE OF ISTREETI
CONTRACTOR NO 7 HIGHWAY + YARD TOTAL SETBACK FROM TYPEOF EXISTING
LIC FRONT PROP LINE HIGHWAY WIDTH
ADDRESS NO ,�i
LIC +
CITY CLASS 19
CONSTRUCTION LENDER BLDG SETBACK FROM "
NAME AND BRANCH SIDE PROP LINE OFISiREETI '
HIGHWAY + YARD TOTAL SETBACK FROM TVPEOF EXISTING
ADDRESS CITY SIDE PROP LINE - HIGHWAY WIDTH O
$0 FT NO OF NO OF CHECK + V
SIZE STORIES FAMILIES ONE 0
0
DESCRIPTIO WORK - NEW PC Fee b Permll Fee _
ADD ❑
Issuance Fee y�
ALTER - Z
REPAIR ❑ Total Fee
USE OF DEMOL
EXISTINGBLDG = i
APPLICANT TEL - _ 2 _
WRINTI NO
O
BY ISIGNAi EI
1 HE ACKNOWLEDGE THAT READ THIS A ICATION AND STATE yYy
THAT iH ABOVE I$CORRECT ANDA E TO COMRY WITH ALL ORDINANCES yI ,
IANOI-A REGULATING BUILDING CO TRUCTKHJ I CERTIFY THAT IN DOING THE Z
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF V
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM 31 9 9 8 A
PENSATION INSURANCE
SIGN
ERMATTEEE OF 2,a-• 3100 ,•
ADDRESS ' _ -'- - 31005
1 TEL
C
ITY
- - - No - 1228-78 -- �
ONE NOIMAP
-� SPECIA d
CONDITIONS _
2 BY '
2 �� 7� -
®i IGAI
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APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES , BUILDING AN A
F//
PLICANT T FILL INPBLDG
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LITYTT /� RESTZIP DGSSSSTX �00 NOW ONNO OF LLOT PBOOASSESSORK PAGEPARCft f
ISTRICT GROUP TYPE FIRE` ESSED BYBLOCK LOT OCONST ZONEL �w OWNER
I6 �• TISTICAL CLASSIFICATION SEWER
ADDRESS LASS NO DWELL UNITS Z L 'PG
BKCITY dip ZIPARCHITECT OR i LUATIIXJ $ !�1/ENGINEER OsJ b � CADDRESS y� / G ETBA K FROMTELNT PROP LINE OF STREETNT CT R NOHWAY + YARD TOTAL SETBACK FROM TYPEOF EXISTING
LICFRONTPROPLINE HIGHWAY WIDTH
ADDRESS NOLIC +CITY CLASSCONSTRUCTION DER G SETBACK FROMNAME AND BRANCH E PROP LINE OF (STREET)
HWAY + YARD TOTAL SETBACK FROM TYPEOF EXISTING
ADDRESS CITY SIDE PROP LINE HIGHWAY WIDTH
SO FT NO OF O OF �� CHECK + N
SIZE ySTORI6 FAMILIES ONE w
DESCRIPTION OF WORK NEW Cl PC Fee$ Permit Fee
Issuance F
ADD 1-1
ee
ALTER
REPAIR Total Fee
USE OF DEMOL
EXISTING BLDG ^ Z
APPLICANT TEL Pl F Q
O
(PRINT) l
O L
BY ISIGNATU 7
I HEREBY CKNO E THAT E READ LHIS A (CATION AND STATE / 9 9.9 > 'q
THAT THE VE R CORKER AND AGREE TI COMPLY WITH ALL N OINAOS / ^ t ,
AND lA REGIAATING WILDING CONSTRUCTION CERTIFY THAT IN DOING THE /yhyF` C
WORK AUTHORIZED HEREBY I WILL NOT E OY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF ZALI FORK IA IN RDA TI NG TO WORKMEN S COM =
PENSATION INSURANCE
SIGNATURE0 R ll�`L2$' ? ,�
PERMITTEE O / o
TEL • .�s �� . „ \ ,
CITY NO i
D
USE ZONE O aG _
SPECIAL - -
J� CONDITIONS
•FINAL // BY v/ -
DATE ,3-217'
APPLICATION FOR- BUILDING PERMIT
I COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER S COMPENSATION DECLARATION -( k JLGP,,APPUCANT:rO FILL IN n , ,. BDILOING E
I hereby affirm that I have a Certificate of consent to Self insure
or a certificate of Workers Compensation Insurance,or a certified
crops thenad $ec3800 Lab C 1 _ �� L�
((,c_ C.L— LOGLRV
,j Com SIZE OF LOT NO OF DLDGS NOW ON LOT
❑ Certified copy hereby fumislled tEAPEST CROSS ST
❑ Cemf d copy is filed with the county uld nlspec dR, TRACT BLOCK LOT NO
de pe ma USE ZONE MAP NO
Date S APpI ASSESSOR MAP BOOK RAGE PARCEL
SPECLAL CONDITIONS -2 O/
CERTIFICATE OF EXEMPTION FROM WO KERS ° TEL No /'—
COMPENSATION INSURANCE � AA1 I Ws N loop FT OF SCHOOL, vas No
(This section need not be completed if the permit s for one hundred ADDRE '
dollars ($100)or low) pSTRICT GROUP Si FIRE ZONE I PROCESSED BY
I certify that in the performance of the work for which this permit Cm'
is Issued I shall not employ arty, pennon In any manner so as to
become subject t0 the Workers Compensation Laws ARCHITECT OR ENGINEER TEL NO
SWTISTICAL C 1F/�CATgN APT CONDO
Date Appioant ADDRESS CLASS NO �L DWELL UNITS '
NOTICE TO APPLI6INT If after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST
Exemption you should become subject to the Workers TOR SET BACK
Conpen wbori provislDn s of the Labor Code you must forthwith C` �0 FRONT YARD 11YVV PROP LINE WpTH
coney d with such provisions or this permshall be deemed revoked I PL
1-7
LICENSED CONTRACTORS DECLARATION SIDE
LIC P L
I hereby affirm that I am licensed underprovsnors of Chapter B �C'e
(commencing with Section 7000)of Drvsion 3 of the Business and 50 FT SIZE N OF STORIES NO OF fNNJES SEWER Al4P /
Profasswns Code my Is in full face NEW ❑ BK PG ► R}
IncenselottioIn Lac C-- DESORPTION OF WORK . ADD ❑ 1WLUATION
Contracttil�`as9� Date 77 ALTER ❑ $ cc
0
❑ lam exempt under Sec of REPAIR O
BBPC for this mason g DEMOL ❑
10;
LDMA PIC {
" Date - URM ❑ 1
Signature n
M LDW Pam• AC'_ �.i Z
as owner a/ this Property or my emPloyeea with wages ae �� •-A = . .(�. i��� ,l�
their sole compensabon will do the Marc and the structure s NXNiESS O 1:
net intended or offered for sale (Section 7044 Business and FILIAL DATE / T
Professions Code) w1LL THE APFtew.fi OR FJTJRE BUlpfe OOCI.RINr 11FN0.E A PAZAfeOUS MArEP G 1 1
❑ 1 aS owner of the Property am exclusivelyOP A 1.N(TIIfE A HAl+NNo0U,4 MATERIAL EOLML TO On GREATER iIUN TE 2r�o_ TOTAL Lp
projec Conhtim 44 wpU;ls SPE�HAZMDOpg AIATEf>tA1 WORlWiX DUDE, FINAL BY j CHEM, 139 - 30
`� ' 4�
hummed contractors to construct the project (Section 7044 _
Business and Professions Code) vesWIL ❑ NO C HE K 1 J
OTIE tL`Ep W OF TIE aLYXfA3 BY TIE APJl1UM CR FlflneE aULUN3 I.
CCCLTAffr nEOLWE A FOR O(kl3IRl1C11W OR EE MHAlioN ERCM TIE 9oFOR CHANGE�I�E .I II
CONSTRUCTION LENDING AGENCY ��uR auurry olslwcr IsaaMDl BEE vEnwnNo clEaaar von -
aLpELaEs
I hereby affirm that there is a construction lending agency for vEs❑ No
m the perfonm ice of the work for which this permit Is issued(Sac
I READTEIuwioous AUTEFVLSI TXINGIIpE A1D THE SOAOAOPERAQI'T!!0 fIL1rXl—p[I�1 i� _�j^
3087 Crv, C) TITLE JSI U'1 R M1'REp NS LMtE'THE LOS AxeELES COUHIV LODE
Lenders Name MATERAL9 111,102 20 �� p�e l�ptAO LO �f�Wp HAZAfpOU9 C. 17
Lenders Address /} ��!'j'°lL9E ._�: 1 F'h 1�:11�
I certdy that I have read this afeplcabon and state under penalty
of perjury that the above mformaten 1s cored I agree to campy PC FEE PEFMT FEE �,✓
with all County ordinances and State laws relating to building .7
C truchon and heraby authonzep representatives of this County ISSUANCE FEE
to an r upon tfp a tarred for inspedl Dur p( Ci
m �� v-T J INVESTIGATION FEE TOTAL FEE
SEE REVERSE FOR EXPLANATORY LANGUAGE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 9912060021
PHONE. (626) 285-0488 EXT
LEGAL jD NO OF ---M9T- BUILDING ADDRESS
TR 31952 UN 5 SO FT STORIES TYPE 5611 SULTANA AV A
STRUCTURE 0 VN , TEMP CA 917802352
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET BROADWAY
5387-028-027 I THOMAS PAGE 596 GRID H4 LOCALITY TEMPLE CITY
I
TENANT EKI ST BLDG USE RESIDISSUED ON PROLESSED
N
EXIST OCC GRP 12/06/99 UT 06/0 /QO
OWNER T NO BLVGS NOW ON LOT VALUATION FINAL DATE FINAL BY CODE
GILBESULTANDAAV TR GILBERT TRUST (818) 287-5039- 1 4,800 `,-
TEMP 91(802352 FEES PAID D rSCRI F7 10
REFOOF HOUSE 8 GARAGE WITH 25 YR 1VOTEX (REMOVE EXISTING
APPLICANT --Tn--wc- FEE DESCRIPTION QUANTITY UOM AMOUNT ROOFING,NEW SHEATHING)
CLASSIC ROOFS (626) 286-6990- AA BLDG PERMIT ISSUANCE 27 75
10603 FREER ST AC STRONG MOTION RESID 4800 00 VAL 0 50 SPECIAL
TEMPLE CITY, CA D2 PERMIT W/O;EN-HC 4800 00 VAL 132 60
EN;-HC
GELESrorO FEES 160 85
CONTRA R S DATE E
CLASSIC ROOFS (626) 286-6990- �.o Tf.
10603 FREER ST LIC N01 UZATION AND SETBACKS
TEMPLE rITY CA 91780 382938 C39
I/ SOILS EhG APP
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A-itZ;HCTEC -DR ENG7F I
N T C
OOO
LIC N 1111111 SLAB/UNDER HLR
MAP NO SLIER MAP 1300K PAGE T IR 1'N IUBLIC WORKS NDEN On
147H265 3 1 OV
SHEATHING
0 IL G 1
NO 21 ii_ SHEA TH'
G
✓li r'>jj�h_
AIR QUALITY 1000 FEET MATERIALS C7��111ef '�
NO NO NO A � PyFRAME INSPECTION
REQUIRED -----T6TAE SETBACK FROM EXISTFIRE SPRINKLER HANGERS
SETFROBACK YARD HWY PROP LINE WIDTH Gb//CT PL- Service That��` INSULATION/WEATHER
EATHER STM
SIDE PL-
INTERIOR LATH/DRYWAIF
E
RATED WALL ASSEMBLIEF—
RATED
T-BAR CEILINGS
LOT DRAINAGE
REPORT ID DPR261 ROUTE TO BS0508