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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)