HomeMy Public PortalAbout4510 TEMPLE CITY BLVD_Building__ 76A638A CERB031/T1 / MP,(rs GiT
APPLICATION FOR BU LDING PERMIT
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDINGADDRESS �24 --1916W
COLEMAN W, JENKINS, SUP T Or BUILDING LOCALITY JS
FOR APPLICANT TO FILL IN NEAREST
IDN 1 DIVI CROSS ST
BUILDING // (� /' DISTRICT NO GROUP T PE ROCESSEO BY
ADDRESS �(J�/�_ Q CONST I
r��
STATISTICAL CLASSIFICATION EWER MAP
LOT NO �/i BLOCK CLASS NO-,2-0-DW ELL UNITS BK PG
TRACT USE ZONE MAP �O
NO OF SLOGS NO
SIZE OF LOT NOW ON LOT SPECIAL
USE OF CONDITIONS
EXISTING BLDG
TEL
OWNER NO BLDG SETBACK FROM
ADDRESS / FRONTPROP LINEOF (STREET)
L TYPE O HG SETBACK HIGHWAY + YARD = TOTAL
CITY NIGH WAY WID ROM C L
ARCHITECT OR TEL } -
ENGINEER NO SLOG SETBACK FROM
ADDRESS SIDEPROP LINEOF (STREET)
TEL TYPE OF E%(STING SETBACK HIG Y } YARD = TOTAL
CONTRACT NO HIGHWAY WIDTH FROM C L
ADDRES NO Y
O
LIC _ Z
CITY CLASS - CORNER CUTOFF YES ❑ W
CONSTRUCTION LENDER H
NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS =
ADDRESS V
. FT f NO OF NO OF NEW
SIZE J STORIES FAMILIES (L-JI
USE OF ADD
STRUCTURE G` ALTER ❑
SIGNATURE O REPAIR❑ �+
APPLICANT DEMOL ❑ �1
VALUATION S
VATY INav B BI TURA
P C PMTPQ FOUNDATION LOCATION
FEES FEES ` 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
WIT'
ALL ORDINANCES AND LAWS REGULATING BUILDING CON GAS VENT DUCTS
STRUC TION1 CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH INT
LABOR CODE 01 TIE STATE OF CALIFORNIA IN RELATING TO
WORKMEK'f CO SAT( N INS ACL LATH EXT
SIGNATURE O THOUSE NUMBER COR
ADORES
RECT AND POSTED
ADDRESS 9 .yU
F N A L ✓ �'/
JOHN F LEWIS PRINCIPAL STRUCTURAL E R
PLAN CHECK VALIDATION cK MO CAa _ PERMIT VALIDATION CK MIO CA X
9O0
L4,,o44r) 5N FEB15 '. 1 D :; �_ , V
TGAGSSA OEE3 APPLICATION FOR BUILDING PERMIT
DIVISION OF BUILDING AND SAFETY ADDRESS
DBVC�om81Dg1 Of County Engb w '
LOCALITY
JOHN A LAAiB E Co��E GINEER HEAR EST.
CASSATT D GRIFFIN, SUP T OF YUILGINO CRO L4, C
FOR APPLICANT TO FILL IN DISTRICT NO GROUP TYPE S BK MA Pa
CONST L
BUILDING
ADDRESS 0 NUMBER STATE HwY YES
SP
LOT NO LOCK US CONDITI L
ECIAL B
TRACT �)
NO OF BLDG81
SIZE OF LOT NOW ON LOT BUILDING YARD HWY STREET NAM! EXIST
USE OF --MACK WIDTH
8%181
I NG BL FRONT
P L
OWNER K HIDE
MAIL P L
ADDRESS • O TRACT DW 1 UNIT fI INDUSTRIAL
CITY NEL 4 1 DWELL 1 UNIT
B PUBLIC BLDG
ARCHITECT OR TEL 2 DUPLEX 2 UNITS 7 ADDN.ALT. ETC
ENGINEER NO g APT _UNITE
B MIBCBL
ADDRESS 4 COMMERCIAL -
CONTRACTO TEIO INSPEMON RECORD
ADDRESS I G _
DESCRIPTION OF WORE
NEW ADD ALTER REPAIR DEMOLISH
SO FT NO OF Np OF
SIZE STORIESFAMILIES
USE OF STRUCTURE
SIGNATURE OF
APPLICANT APPROVALS
ADDRESS DATE INSPECTOR S SIGNATURE
S o.r) FOUNDATION LOCATION
/ONp
GVP C • FORMS MATERIALS
PHHFRAME FI BOLTSBLVA 8 (} BRACING BOLTS
FEE FURNACE LOCATION,
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS OAS VENT DUCTS
APPLICATION AND STA E THAT THE ABOVE 18 CORRECT
AND AGREE TO COMP WITH ALL COUNTY RDINANCES I LATH INT
AND STATE LAWN GULATING BU I CONSTRUC-
TION
LATH EXT
SI GNATURH O �� HOUSE NUMBER COR-
S
RECT AND POSTED
ADDRESS— FINAL
JOHN A LAMBIE.COUNTY ENGINEER V IP)ATION CLYDE N DIRLAM. CHIEF BLDG INSPECTOR
K No CASH
M2 8 7 En UN2_9 1 200 in
S
WORKERS COMPENSATION DECLARATION t ,
1 herebyaffirm that I hover certificate Cmte of consent r self t _ APPLICATION FOR BUILDING PERMIT
mauve, or a certificate of Workers Compensation Insurance, '
o a 44erhfied copy thereof (Sec 3800, Lab C )
WC0��31 COUNTY OF LOS ANGELES BUILDING AND SAFETY
P ocyNo 3050526 Company Ohio Casualty
Certified co s here furnished BUILDING
❑ copy FOR APPLICANT TO FILL IN ADDRESS -
® Candied copy a fled with the county budding impec BUILDING
tion department Donald F. Laughlin ADDRESS 4510 Temple City Blvd. LOCALITY _
Date 1/25/83 Applicant Constr. Co. CTemple Cit zip 91780 CROSS S
CITY T
NO Of SSE
i CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT 60'x244 tort oN LA'S 2 MAPAeoSSOoK P Pnrz �
COMPENSATION INSURANCE
(Thrs section need not be completed if the permit is for one TRACT USE ZONE M
hundred dollars (stop)or lea. ) 12998 eLOIX 4500 LOT 97 AP
i NO /
/y SPECIAL
1 certify that in the performance of the work for which this OwNERTown & Count Ind.Incl40 ZN--9328 •T CONDITIONS d
permit is issued I shall not employ any person in any mannerADISTRICT GROUP TYPE FIRE PROCESSED BY
so as to became subject to the Workers'Compensation Lows ADDRESS 9608 Lower Azusa Road CONST ZONE V
CITY Temple City zip 91 80 p
Date Applicant ARCHITECT ISTICAL IFICATION APT CONDO
NOTICE TO APPLICANT If after making this Certificate of ENGINEER Lau hlin Constr. NO 980-7414 CLASS NO DWELL UNITS_ uVi
Exemption, you should become subject to the Workers'
Compensation provisions of the Lobar Code you must forth ADDREss9631-C Business Center,% Cacamo
with comply with such provisions or this permit shall be SEWER MAP Z
deemed revoked CONTRACTOR •Lau Laughlin Constr, per,Lp 980-7414 BK PG - VALIDATION -
LICENSED CONTRACTORS DECLARATION UC
I hereby affirm that I am licensed under provisionsof Chapter 9 ADDRESS B D NO 32 0 V LUATION
(commencing with Section 70Do)of Division 3 of the Business and LIC o0
Professions Code, and my license is in full force and effect Cm Rancho Cucamonga CLASS B S0!.L'10`- '
OF NO OF CHE
License Number 326065 Lic Clou B SIZEF1464 STORIES 1 FAMI II S 1 ONE ► i
Donald F. Laug-1 n— o $
Contractor Constr, Co. Date 1/25/83 DEscRjvrjoNoFwoRKre-furbish existin NEW ADD ❑
N/A❑Ions exempt under Sec structure & interiors. Add on"
B 8P C for this reso
an 6 56 news . ft. liven a ace. REPAIR C]TER ® DAEL4 -f 2
i °t° EXISTING BLDG residentialY
DEMOL C] FINAL
PPLOfiPRNT
Signature( ADonald F. Lau hlin t�Lp 980-7414
OWNER-BUILD D W
1 hereby affirm that I am exempt from the Contractor s License 9631-C ncho ►�� Oi/�8.� ,
Law for the following reason (Section 7031 5, Business and Y'
Professions Code) _
❑ I, as owner of the property, or my employees with BUILDING
ADDRESS N/A
wages cis their sole compensation,will the work and LOCALITY N/A
the structure is not intended w fa offered for sale(Section
7044 Business and Professions Code) TEL f
El1, as owner of the property, am exclusively contracting r,
CTOR N/A NO 9 3 k9 A
with licensed contractors to construct the project (Sec- �� N/A
44 # • • • • 1
tion 70 , Business and Professions Code)
ICED TOTAL SETBACK FROM EXIST
t
CONSTRUCTION LENDING AGENCY �ggIX YARD HWY PROP a WIDTH _ Y 2 • 4 7 1 7 5
1 hereby affirm that there is a construction lending agency for FRONTi t
the performance of the work for which this permit is issued P L poll. t �, • • 4 7 1 7 55
15ec 3097,Civ C ) SIDE
PL 0125 -83
Lender's Name Owner Financed01
8 Lender's Address PC F"$ Permit Fee
I certify that I hove read this application and state that the Issuance Fee d 157V ^
above Information is correct I agree to comply with all County Inveattpotion Fee C `
ordinance and State jaws relating to building construction, T°taI Fee vJ
and hereby ize representative of this County to enter
upon thW27"ns tied o 15VOction purposes
1-25-83 w REVEII MR IDt1lANATORY LANGUAW
ignoture of Appl or N Dos ms
Donald F. Laughlin, (Agent for CINver)