HomeMy Public PortalAbout5921 TEMPLE CITY BLVD_Building__ 76A638ACE08038-64 APPLICATION FOR BUILDI G PERM IT//JJ :
COUNTY OF LOS ANGELES AUILDIN
DDRESS . lXD l
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOC ALIT -_e
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS.BUP'7AW BUILDING CROSS ST.
FOR APPLICANT TO-FILL IN D1sT�JCT N GROUP yYPST. P c _ o By
G� S,_(_
' �� .CONST.
BUILDING ^1 /� '''� STA✓TISTICA`CLASSIFICATION SEWER MAP
ADDRESS L.� ��j I ���"� �td� CLASS NO. DWELL UNITS BK PG/C;;�
LOT NO,7_� BLOCK USE ZONE MAP--gg
f
NO oC 00
TRACT n.��J / SPECIAL
. OF SLOGS. CONDITIONS
SIZE OF LOT A�� NON0W ON LOT
USE O_XISTIF a ) `�
No BLDG, V BLDG. SETBACK FROM
70
OWNER US (�bO S TEL
FRONT PROP. LINE OR - (STREET)
�y� NO. TYPE OR E%ISTING SETBACK.
HIGHWAY YARD - TOTAL
ADDRESS Z1 IJ, +'�j� 0-1 �vn HIGHWAY ID 'F M C.L
'TC--MLL G� TSI D` !. --+ — _
CITYBLDG. SETBACK FROM
ARCHITECT OR TEL. SIDE PROP. LINE OF (STREET)
ENGINEER NO. TYPE OR EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L. d
TELI=-D L4
CONTRA CTO �L'�'TTL� ..I �ldp1.0A l�4��-CLNo p�.�.{�� + 0
ADDRESS. y JO PQW�hNO-X e)11 \ y CORNER CUTOFF YES NO O
CITY 2�-' cic O— SEE REVERSE SIDE FOR SPECIAL APPROVALS w
DESCRIPTION OF WORK Z
NEW 1__� ADD ALTER REPAIR DEMOLISH
SQ.FT. NO. OF NO. OR
SIZE `� STORIES FAMILIES
STRUCTURE IDi-ESTI C S. (cam
rFE
c=
TURE OFICANTATION$ G1 APPROVALS DATE INSPECTOWS810NATURE
PMT. FOUNDATION, LOCATION ~$'�— FE.E$ /) ' FORMS.,,.MATER.IALS
FRAME, FIRE-STOPS,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLT 1
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING, GAS VENT. DUCTS
9 1 1
UILDING CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK :
AUTHORIZED HEREBY.I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INTO
TION OF THE LASO CODE OF THE STATE OF CALIFORNIA RELAT.
ING TO WORKMEN' r)MPENSATI SURAN LATH. EXT.
UO 1 f
SIGNATRE C-� HOUSE NUMBER COR-
PERM1TTEE GC� RJECT AND POSTED ,�• .a
ADDRESS - F I NAL pZ (`(h'� yf.
JOHN F. LEWIS. PRINCIPAL ST RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH
LAU C 4 5 b APR]_ ?j 1 0 6.0 0 Ncu
VpmpLE CITY
7BA08A CE#908:1-6, --APPLICATION FOR BUILDING: PERMIT
COUNTY:OF LOS ANGELES BUILDING
DEPARTMENT' II�OF COUNTY ENGMM ADDREss
BUMDING AND SAFETY•DMSION LOCALITY'
JOHN A. LAMBIE, COUNTY ENCIINEER NEAREST
WILLIAM A.JENSEN SUPT of BUILDING CROSS ST.
DISTRICT NO. GROUP TYPE P SEED BY
FOR APPLICANT TO FILL INe ,��' . CONST.
BUILDING 7�/ T� GfilMl�7/W STATISTICAL CLASSIFICATION SEWER MAP
J 7 f BK _
ADDRESS CLASS.NO. DWEL4•UNITS "�" BK
LOT No. BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE: ly 11
TRACT MAPHIGHWAY STATE A O SECOND, LOCAL
NO.-OF BLDGS. NO. (CIRCLE)
SIZE OF LOT. NOW ON LOT USE ZONE SPECIAL
USE OFCONDITIONS
EXISTING BLDG. iot
T
OWNER BUILDING YARDHWY STREET NAME EXIST.
ETBACK WIDTH
ADDRES RONT
ARCHITECT OR TEL. P.L.
ENGINEER NO. SIDE
P.rL.
ADDRESS TEL. I INSPE�CTION,RECORD,
CONTRACTOR NO.
OMNI
ADDRESS O
DESCRIPTION OF WORK G
' W
NEW ADD (ALTgh 1 4 REPAIR DEMOLISH - a
rA
SQ.FT. NO.OF NO.OF Z
IZE STORIES FAMILIES
USE OF 'r
STRUCTURE
SIGNATURE OF '
APPLICANT
VALUATION
APPROVALS DATE INSPECTORS SIGNATURE
$ FEE $ FOUNDATION:LOCATION
FEE
�' FORMS,MATERIALS
FRAME:FIRE STOPS,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS /�/�''!�. I �� '✓f�✓f
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:LOCATION, /
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS .!,v
BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK +�- `� ••�
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH,INT,
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- +.
ING TO WORKMEN'S COMPENSATION INSU ANCE. LATH,EXT.
SIGNATUR OF �f HOUSE NUMBER COR- J
PERMITTE RECT AND POSTED ) � `
ADDRESS FINAL Age; 4¢� (! L/t' '�
'" CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL E
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.o. ;.InH
0 OT1 �. uE-
76AGS.BA CE#8098-64 APPLICATION FOR BUILDING PERMIT
COUNTY•OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS -( _
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE•. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINSAUP'T.OF BUILDING CROSS ST. /(/�
DISTRI T-NO. GROUP TYPE. P EBBED BY
FOR APPLICANT T•0 FILL IN ti Z.
.CONST. L
F
BUILDING - STATISTICAL CLASSIFICATION, 'S ER MAP
ADDRESS s A q a6zCLASS NO.._�DWELL UNITS `� BK PG JP`
LOT NO. OCK USE ZONE MAP
7 NO.
TRACT C �� SPECIAL
NO. OF BLDGS. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF /r �pi�.ss
NaEXIST, B ` v BLDG. SETBACK FROM
r TEL. FRONT PROP. LINE OF S RE£T)
OWNER . NO. TYPED? EXISTING SETBACK H GHWAY + YA D = TOTAL
ADDRESS R H16HW Y WID F O_M C.L. -
� 7 + _
CITY BLDG. SETBACK FROM
ARCHITECT OR TEL. - SIDE PROP. LINE OF (STREET)
ENGINEER NO. _
TYPE OF EXISTING SETBACK H10HWAY + YARD - TOTAL �
ADDRESS HIGHWAY WIDTH FROM C.L. p:
TEL. '} _ 0
CONTRACTOR pp cc y O
ADDRESS O .90. /"f $/ NO CORNER CUTOFF YES NO O
C LIC 'SEF REVERSE SIDE FOR SPECIAL APPROVALS W
DESCRIPTION OF WORK -j UJ
NEW- ADD ALTER REPAIR DEMOLISH
SO.FT. O. OF- NO. OF "''�j" i"�i� /�ILS /GAJ,, ` LfR�LL�„ •y-
SIZE STORIES FAMILIES
USE OF
, STRUCTURE /^`��.7 ��• �� ��� �
► ry�
SIGNATURE OF
APPLICANT I'
VALUATION$ � OU
APPROVALS DATE INSPECTOR'881GNATURE
FOUNDATION, LOCATION
F E E$ FEE$ p FORMS,..MATE R,IALS'`-
FRAME, FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO-COMPLY FURNACEI LOCATION
WITH ALL COUNTY ORDINANCES AND STATELAWS REGULATING GAS VENT. DUCTS ./ 1
BUILDING CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- -LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIF NIA RELAT• r
ING TO WORKMEN'S CO .SATIONSURANCE. F `•r."''��
LATH. EXT. 9
SIGNATURE OF I hw ift, HOUSE NUMBER COR-• �!
PERMITTEE RECT AND POSTED
ADDRESS l 0 Fl NAL
JOHN F. LEWIS, PRINCIPAL ST RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION , CK. M.O. CASH
Lr`►i r0 y 5 7 4:� i�hR 1 5.0 0
//Zn fI _
6A688A CE#808.10.86 APPLICATION FOR BUILDING PERMIT•
]RUDING AND SAFETY DIVISION
BUILDING
ADDREI• /Ml'j D
Department of County Engineer
County of Los Angeles LOCACITY��/t 919L A-'
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN, SUPT OF BUILDING CROSS ST.
DISTRICT NO. I GROU TYPE MAP
FOR APPLICANT TO FILL IN I [SEWER
• ' BK
CONST..
BUILDINGI
ADDRESS a� ,f �! s7'tl. / ��/G� �,ry.13111p STATISTICAL CLASSIFICATION
LOT NO. +�Q BLOCK CLASS.NO. DWELL.UNITS
MAP STATE .YES NO,
NUMBERQQ HWY
TRACT USE ZONE SPECIAL
NO.OF BLDGS: / CONDITIONS. -
SIZE OF LOT NOW ON LOT
USE OF
EXISTING BLDG. S70 L- BUILDING EXIST.
YARD HWY STREET NAME
/1 1� SETBACK WIDTH
OWNER (,r •/V��rOOA�' FRONT /
MAIL �+ ` P. L.
ADDRESS 15 2-/ lyd rC �f PLe CII' /i L fll� ° SID
E '
TEL. P. L. -
CITY NO. INSPECTION RECORD
ARCHITECT OR TEL.
ENGINEER NO. -
ADDRESS
TEL.
CONTRACTOR NO. / ��_ pp
C2 6 I,1/ I ff ESP
ADDRESS
All-
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH`
SQ.FT. NO. OF / NO.OF
SIZE �/ STORIES / FAMILIES
USE OF STRUCTURE
APPROVALS
SIGNATURE OF
APPLICANT -✓�v ��"'^ DATE INSPECTORS SIGNATURE
ADDRESS FOUNDATION:LOCATION
FORMS, MATERIALS
'54(00—
`�
P.C. S FRAME: FIRE STOPS, Y.
((0 FEE BRACING,BOLTS
FURNACE: LOCATION,
VALUATION FEE $,q �✓ GAS VENT,DUCTS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH, INT.
PLICATION AND STATE THAT THE AB VE IS CORRECT AND
AGREE TO COMPLY WITH AI—.L COU ORDIN&NCES AND LATH. EXT.
STATE LAWS REG ATING B 1 ING CObISTALICTION.
SIGNATURE OFHOUSE NUMBER COR-
PERM ITTEE C i � 1+� RECT AND POSTED
ADDRESS �" FINAL —
OHN A.LAMBIE.COUNTY ENGINEER, CLYDE N.DIRLAM.PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION cK. M. CASH PBItMIT VALIDATION CK. M.O. CASH
L;.Coo JUL 12 1- 2-.00
'OA638A D66.3 9.85
APPLICATION FOR BUILDING PERMIT
DIVISION OF BUILDING AND SAFETY BUADDRILDEING SS p on: 'rCr 1� PA,
DeLI@tment of County Engineer l - -
County of Los Angeles LOCALITY 0 l� 1�I
WM.J.FOX,COUNTY ENGINEER NEAREST
�p V
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. J A tl.l�
DISTRICT NO. I GROUPI TYPE - SEWER MAP
FOR APPLICANT TO FILL IN �+/ ,elm SK PG
U!�/T CONST. .•^^-
"'BIRILD1�G -r•^�p/ .t/ ••I-^Cr , ���J MAP �y - STATE H� YES NO
`:*ADDRESS I G� �Y ! w-Y� NUMBER I�� f
,=:" ..9.'
tL£pTe111p.' v5 J BLOCK USE ZONE
CONDITSPECIONS
ONS
.':TRACT' � �� / •
NO.OF BLDGS. BUILDING EXIST.
SIZE OF.LOT NOW ON LOT SETBACK YARD HWY STREET NAME WIDTH
°;:USE OF FRONT
i;EXISTING P.L.
OWNER (.LJfbill2p, �d.�l..f/I SIDE
MAIL A ` P.L.
ADDRESS ti��/f2 I Al 1A.P f I��tw=�/r O TRACT DWELL. f UNIT
b INDUSTRIAL
CITY Jyee+
Tw 1 DWELL. f UNIT 6 PUBLIC BLDG.
2 DUPLEX 1 UNIT
ARCHITECT ORl TEL. 7 ADDN.,ALT., ETC.
ENGINEER NO• 3 APT. UNITS
8 MISCEL.
ADDRESS 4 COMMERCIAL
��QQ r�1} ��yy TEL. INSPECTION RECORD
CONTRACTOR Rt—Jif I•G.LN'd�// Me �•v
V n['� ' n
ADDRESS f'�l!!1 (/1-+.r+-s ! ,C—
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH.
SQ.FT. NO.OF NO.OF
SIZE STORIES FAMILIES
USE OF s,TRU�uRE
-FOt��=l� OA
u
SIGNATURE OF �e de,
APPLICANT
I'ADDkESSAPPROVALS
cS d DATE iNShCTOR'SSIGNATURE
$ FOUNDATION:LOCATION
P.C. $ FORMS,MATERIALS
FEE FRAME: FIRE STOPS,
VALUATION $ } ..- BRACING,BOLTS
FEE ! FURNACE:LOCATION.
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT,DUCTS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH.INT.
AND STA E LAWS REGULATING BUILDING CONSTRUC-
TION. + �'��,,/ �A,(1.1.1 fir/ �e..V LATH.EXT.
SIGNATURE OF (J ``'• �� Q L HOUSE NUMBER COR-
pE _-"TEE RECT AND POSTED / --7 _/�/
A13DRESB�►1-, r[� + T Xa -7 FINAL �� �� !/!sL(�cfdllJ!!/
WM.J.FOX,COUNTY ENGINEER VALIDATION C. N.DIRL:AM.CHIEF BLDG. INSPECTOR
`JC0490 n M21 1
BUILDIkh
® � ADDRESS
APPLICATION LOCALITY It '
NEAREST
DIVISION OF BUILDING AND SAFETY CROSS ST. a- S
Department of County Engineer DISTR[CT NO. RECEIPT NO. PERMIT NO.
County of Los Angeles I? cl 21 J
WM. J. FOX, COUNTY ENBINEER GROUP DATE RECEIVED DATE ISSUED_
CASSATT D. GRIFFIN, SUPT OF BUILDING
M
FOR APPLICANT TO FILL IN TYP rLB C• RECEIVED BY400�=I . :B
OWNER C� !�L t'�'� �'' MAP JL- STATEy v O
MAIL tl y S NUMBER 2007 HWY
ADDRESS /�
7-� USEZONE SPECIAL
TEL CONDITIONS
.CITY NO 4 FTCJ ���
ARCHITECT OR TEL
ENGINEER NO.
BUILDING YARD HWY STREET NAME EXIST.
ADDRESS SETBACK WIDTH
FRONT
,� TEL,/�;�� /+!T P.L.
CONTRACTOR M, '" ND.bbl . �F ;r,
ADDRESS issZ�(^�r_ "03� j.
-^ DATE CORRECTIONS INSPECTOR
BUILDING
ADDRESS ,0 /.l
LOT NO. D BLOCK
TRACT a
2 T �//� I NO.OFSLOSS.
SIZE OF LOT J /l NOW ON LOT
USE OF
�6
cXIRTITING 81-6 13.
DESCRIPTION OF WORK °a
0
NEW ADD ALTER REPAIR DEMOLISH,(, Z
Bq.FT. OF NO.OF D
SIZE STORIES FAMILIES r
USE OF STRUCTURE I
ii
� U 7—�-:
No.OF
EMPLOYEES
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN IS APPROVALS INSPECTOR'S SIGNATURE DATE
CORRECT.
1AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION
AND STATE LAWS REGULATING BUILDING CONINTRUCTION. FORMS,MATERIALS
FRAME. FIRE STOPS,
SIGNATURE OF BRACING,BOLTS
PERMITTE — FURNACE: LOCATION.
Q_ OAS VENT,DUCTS
ADDRESS. V e �•
LATH. INT.
AUTHORIZED AGT. SS�Fff
a..
LATH, EXT.
P.FEE.S HOUSE NUMBER COR-
FEE AND POSTED ,r-
VALUATION FEE FINAL
/�
7SAS38A DBS 3 12-53
DEPARTMENT OF BUILDING AND SAFETY r utt k Zlv i i
COUNTY'OF LOS ANGELES 1 ® 1
WM. J. FOX, CHIEF ENmINEER
FOR APPLICANT TO FILL•IN FOR OFFICE USE ONLY
DISTRICT NO.. PLAN CK.NO. PERMIT NO.
O
U"
LD"" A l
�J�� @_ L, RECEIVED BY DATE OF APPL. DATE ISSUED
NEAREST
NEAREST. J dL C/ K of T-49 .
UILDING
F� GL P a ADDRESS N Ilr�
V S LOCALITY 1
��ryry �`
-�� 1++ �.l , NEAREST
TEL CROBBST.
CITY
1 v NO.
FIRE NO.OF TYPE.-/ I-r GROUP
ARCHITECT OR `TEL. ZONE PLANS ( /{
ENGINEER NO. Rte'
OLDS. O D.NO.
ADDRESS SETBACK LINE / C L W S�1
qq APPROVED
CONTRACTOR Q L Q NO. �[3�^ BY DATE
ZONE(2-USE APPROVED DATE
ADDRESS J /C ^.
DESCRIPTION L IOT NO. 3 0 BLOCK p LEGAL
CORRECTIONS
TRACT / *�
s I t NO.OF BLOBS.
SIZE OF LOT S X 7 I NOW ON LOT
USE OFC �• � NO.OF NO.OF
EXISTING BLDG. S•1'6 �IC_I FAMILIES I ROOMS 1
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
O
REPAIR MOVING DEMOLISH
Sq.FT. NO.OF Z
51ZE ROOMS STORIES >
WALL ROOF r
COVERING - I COVERIN13
USE OF NEW
BUILDING C_' -51
O •''{�-�
IAA A Ad A 1 JA n h.4 a- • •
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS, APPROVALS
APPLICATION AND STATE THAT THE ABOVE 19 CORRECT FOUNDATION:LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
t FRAME: FIRE STOPS,
SIGNATURE OF BRACING,BOLTB
PERMITTEr LATH,INT.:
AUTHORIZED ABT Q'jL- LATH,EXT.:
DBS-3 SUM BETS 1-48 $ a0P.C.N PLASTER,INT.
�
®Q FEE N PLASTER,EXT. L
VALUATIONFEE �� FINAL e ��
DNpARTEEUiT OF WELDING AND BAFSTY , ArrLMAUALaALAR rvs mama-
COvNTY OF LOG ANGEM BUILDING
WM■ al. rim OHIER sNSINEm
FOR APPI.ZC� NT P71 T- MR FOR OFF S Un ONLY
SYII�INS DISTRICT PLAN OK.NO. PERMIT NO.
ADDRESS 4 C1 C ---mss
0
a
LO ! R ivm SY DATE OR APPIL DATE ISSUED
NEAREST
ADINM
ORr
OWNER '• " f �r'� •�:+ . _•1,�1
MAIL LOOAIJTV
aNEAREST
TEM. OROm RT.
UAa NILENUHMmMINCEN d. ZUNE PPLaANO TYPE
■LO■. NO.
■!TRACK LINE
APPROVED
cl—DM7 OTOR , NCO. �aa ■Y DATE
E //aa APPROVED
O �_ � NES/- ■Y DATE
DL■ORIN tON LOTNO. 22 ■LOOK CORBECTXM
TRACT G f& f
SIZE OR LOT f NOW ON LD '
`
U■E OR `-' °'_ 1 No.or NOOR
rmlum O
• 1
B�T�O l OF WORE
NEW ALTERATION ADDITION O
RAIN MOVIN■ DEMOLISH 0
BZNo.or
E commR ■TORIES
WALLpnor
OOVEIONR OOVERINS
USE N
BYILDIDINO
1 HERESY ADKNOWLEDEE THAT 1 HAVE READ THIN APPROVALS
APPLICATION AND ■TATE THAT THE A■OVE IS OORREOT FOUNDATIONI LOCATION INlECTUR GATE
AND ASREE TO COMPLY WITH ALL OOUNTV ORDINANDO PORM�MATERIALS
AND STATE EDR
RULATINSUILDINS OOMMMIOTION. _ACEI
SISNATUR �Ga aP ■RN ■�T�
PERNI _ r a LATHS IWm
AWN _ LATH.Mra
ooY-a o1 1M■ /// �0 P.C.S �., PLAIITM INT.
Ia
IFEE PLA■TEW ERR.
VALUATION - !!E O O� FINAL ��'
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES �� ® ' w�
WM. J. FOX, CHIEF ENGINEER N�f
FOR APPLICANT TO FILL IN FOR OFFICE USE.ONLY
DISTRICT NO. PLAN CK. NO. PERMIT NO.
BUILDINGi
�n �� /�'q^/
ADDRESS ( / /1 /f
L13CALITY q�rAAPSS
SCl RECx IVEDBY DATE or APPL. DATE
/ISSUED
NEAR' ' �ry /1-/V_Y CROSS ST. p V1T � /
BUILDING
OWNER S-R ca S N ADDRESS 1 ,
MAI LLOCALITY
n
__ADDRESS Ali 7 1/A/9 Gr'`
TEL NEAREST / /✓/� GSEJl '
CROSS 8T.
CITY �� NO.
FIRE NO.Or
ARCHITECT OR TEL. ZONE "'-�I PLANS I TYPE "'• r I GROUP/ '-
ENGINEER NO. \�/
BLDG. ORD. NO.
ADDRESS SETBACK LINE
pluvivb %kw TrL APPROVED
CONTRACTOR NO./47 13-7 BY DATE
j USEAPPROVED
ADDRESS r� �® ZDNE(� BY DATE
LEGAL I CORRECTIONS
DESCRIPTION LOT NO. BLOCK ��
TRACT 6'5-c/ l11
NO. OF SLOGS. / r rP4
SIZE OF LOT NOW ON LOT w
USE OF q NO.OF NO. OF U E
EXISTING BLDG. C�(��( I FAM:LIEM I ROoMB—
DESCRIPTION OF WORK r e } 1
NEW ALTERATION I ADDITION I 0
11
i
eOi�C'G- {av ~
REPAIR MOVING DEMOLISH p
90. FT. NO.OF Z
SIZE ROOMS STORIES
WALL ROOF S
COVERING COVERING' //�
USE OF NEW �i PJ 8 er '�'A A . -et
.BUIL-DING..s -
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE 19 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 S� � &lINT.:/I
LATH,
AUTHORIZED AG TA r r " LATH, EXT.:
ve P. C.0 PLASTER, INT.
ION
70 FEE
PLASTER, EXT.
FINAL
• �'� •
VALUATz'/G g 6
FEE
7666,91A CE 0803 12/69 �1 � � ` •f'� � r
'•; .�
- .APPLICATION FOR BUILDING P.ERMIT�S7 �
COUNTY 'OF LOS ANGELES ASSESSOR
" DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS, S -t a r�'^ )2 �Ita
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W.-JENKINS, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST'
Print ort a onl CROSS ST. SS Tis n a's
BUILDING pry— DISTRICTNO. GROUP TYPE v CESSED BY
ADDRESS Sg a ? ' Ce JQw9 +L �Jr �y• �,0A CONS
LOT NO. 3Q BLOCK STATISTICAL CLASSIFICATION SEWER MAP
CLASS NO. �7 DWELL.UNITS BK I PG
TRACT Gas G I. USE ZONE MAP
NO.OF BLDGS. NO.
SIZE OF LOT NOW ON LOT �7 SPECIAL
USE OF C!"' CONDITIONS
EXISTING BLDG.
OWNER�ehb r >,G NL
O
BLDG.SETBACK FROM
ADDRESS .,�� `�QM 1' Y• FRONT PROP.LINE OF (STREET)
�--� _ TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
CITY - 1 e �j HIGHWAY WIDTH FROM C.L.
ARCHITECT OR f TEL. + _
ENGINEER NO. BLDG.SETBACK FROM
ADDRESS SIDE PROP.LINE OF (STREET)
TEL TYPE OF EXISTING SETBACK HIGHWAY + -YARD = TOTAL
CONTRACTOR ��Y�Q NO, 69 .3- HIGHWAY WIDTH FROM C.L.
'ADDRESS '? CS IV, NO. + _
LIC. r ❑ `, c
CITE' \lf�j i eYJ CLASS CORNER CUTOFF YES Q NO
CONSTRUCTION LENDER
NAME AND BRANCH 0
SEE REVERSE SIDE FOR''SPECIAL' APPROVALS �
ADDRESS
SQ. FT. NO. OF NO. OF NEW / �7 v
SIZE STORIES FAMILIES
USE OF ADD
STRUCTURE L� — ALTER J� •• C�
❑ _
SIGNATURE OF y� REPAIR -
-44
APPLICANT cz�9 DEMOL ❑
VALUATION S APPROVALS -DATE INSPECTOR'S SIGNATURE
P,C. PMT. FOUNDATION: LOCATION
FEE S FEES / Q< FORMS, MATERIAL'S
FRAME: FIRE STOPS, y7
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION - BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTION. I'CERTIFYTHAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT. EMPLOY ANY PERSON IN VIOLATION OF THE • "LATH, INT.
LABOR CODE OF THE
STATE OF •CALIFORNIA IN RELATING TO '
WORKMEN'S COMPENSATION INSURANCE. _ LATH, EXT,
SIGNATURE OF- �ie HOUSE NUMBER COR-
, PERMITTEE RECT AND POSTED
ADDRESS ti FINAL 7
JOHN F. LEWIS. PRINCIPAL STRUCTU L ECCASH
R
PLAN CHECK VALIDATION' CK. M.D. CASH _ PERMIT VALIDATION CK. M
COIINt--'Y OF LOS ANGELES I I I� G
WM. J. FOX. CHEF ENSINEER -
FOR APPLICANT TO FELL IN FOR OFIFICE USE ONLY
BUILDING DISTRICT .N4 PLAN OK. NC. PERMIT NO.
wDDREB■ 7—// el
LOCALITY .+C-e+e� ,R[EECC'EEIIVEE,D my DATE OR APPL DATE lB M
NEA
WEBB ST. c'�"—r —I C� A-le lel
OWNER
` _ a ADDREW �� 7
MAIL
ADDRl IILOCALITY
TEL N
CIEAREST
TY D. DROSS ST. wJ
RN-.OF TYP! ,
ENSINRO O * N L. 3 s'3 ZONE Inc -_ PLANS
(j! I SROUP
AND
y ■LOW. ORD.NO.
ADDRESS I �/ SETBACK LIN! .
APPROVED
L.
CONTRACTOR ME. BY DAT!
U■EAPPROVED
ADONE ZOM � BY DAT!
DESCRIPTION I LOT`NO. �3•��/I ■LOOK +� E=0NS
TRACT G
BIZ! OR LOT /7 d I NO. OR BLOTS.
NOW ON LOT
U■E OF `— I NO.CR --I NO. QZ.
EXI■TINS OLDS. RAMILQS ROOMS
DESCRWTION OF WORE
NEW ALTERATION I ADDTTICN O
S
REPAIR`S MOVINS /, `DEMOLISH p
ENIL or
lm +�.WALL ��'" ROOMS . STORMS
O01/ERINO �Gi.�ld.-C� no
nor
OVERINS �aG X{y
USE OR NEW 0
■UILDINE
1 HEBERT ACKNOWLEDSE THAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STAT! THAT THE ABOVE IS CORRECT ROUNDATIONI LOCATION, IN OA
AND ASREE TO COMPLY WITH ALL COUNTY OR-INANUM RORMS. MATERIALS Ae�
AND STATE LAWS REBULATINS BUILDINS CONSTRUCTION. RRAMEI FIRE STOPS.
RISNATURE OF BRACINS. ■OLTE
OWNER LATH, INT.1
AUTHOR--l- AST '
LATH. DIT.1
6(,/ P. O.* / 6 PLANTER T
IN .
rcc e3
PLANTER. EXT.
VALUATION �T D 6 O
Fse O.d d FINAL ver"
-DEPARTMENT OF ]BUILDING,AND SAFETY ~ I APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES D ' 1
WM. J. FOX, CHIEF ENGINEER BU I
NG
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY .
BUILDING ee rx DISTRICT NO. PLANCK.NO. PERMIT NO.
ADDRESS mss/!
LOCALITY `t� - * = RE IVED BY DATE OrAPPL. DATE ISS ED
r-
NEAREST ��//rr i �.iL-vL�-t� /,£7 / •' ���/ P
CROSS ST. .[7`!
NO
OWNERADORE
MAIL
ADDRES �' a4„Qctl LOCALITY ,`000-1 s
NEAREST f
�� TEL. CROSS ST.
CITY . NO.
FIRE NO.OF
L. I / GROUP
ARCHITECT OR TEL G,j •-z'•"= ZONE'`` PLANS TYPE 1
'- / l
ENGINEER i'�� _ NO. /
BLDG. ORD.NO.
ADDRESS SETBACK LINE
CONTRACTOR _ ` NO.. 13YTEL. APPROVED Y DATE
USE /j-0 APPROVED
ADDRESS y ZONE BY DATE
LEGAL
DESCRIPTION LOT NO.j: + ✓J BLOCK CORRECTIONS
TRACT
SIZE OF LOTv p(�v I NOW ON LOTS /
USE OF } I NO.OF I NO.OF
EXISTING Lb G: y FAMILIES ROOMS
DESCRIPTION OF WORK
NEW /ALTERATION ADDITION
O
REPAIR MOVING DEMOLISH
Sq.FT. NO.OF Z
SIZE ROOMS / STORIES f D
WALL. �, A/�
'� -_ r
COVERING,0J-' fR'L1n�41.6bLSVl COVERI �I"
U8E>OF NEW rt�x»• ,
BUILDING144� `F`!•4��a!r�
,,✓ 4�cI4,..
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROV
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION ECTOR / DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORM$, MATERIALS ) 'Ile
FRAME:
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. or
y FRAME: FIRE STOPS,
SIGNATURE OFBRACING,BOLTS
OWNERp LATH,INT.: '
AUTHORIZED AOT.`�(\/ LATH,EXT.:
P.C.6 PLASTER. INT.
FEE \ PLASTER,EXT.
T/ALUATICN FEE v;D FINAL
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL BUILDING
BUILDIR SD SS� /
I hereby affirm that 1 have a certificate of consent to self insure, <
or a certificate of Workers'Compensation Insurance,or a certified
copy thereof(Sec.3800,Lab.C.) CITY ZIP
IF LOCALR
Policy No. S'r 0
Comp
SIZE OF LOT NO OF BLDGS.NOW ON LOT G�
❑ Certified Copy is hereby furnished. NEAREST CROSS ST'
�0'Certified copy is filed with the county building inspection TRACTBLOCK LOT NO.
department.t� /1 USE ZONE MAP NO.
DateR-II-l Applicant 4 f11�/ ASSESSOR MAP BOOK PAGE PARCEL
14 It I
SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' T91YES NO
COMPENSATION INSURANCE Y—� I / • WITHIN 1000 FT.OF SCHOOL?
(This section need not be completed if the permit is for one hundred ADD E
dollars($100)or less.)
DISTRICT GROUP TY CONST FIRE ZONE PROCESSED BY
ZIPY
I certify that in the performance of the work for which this permit f
O.�c p J �
is issued, I shall not employ any person in any manner so as to IR�CHITEORg
ENGINEER OQ 6
become subject t0 the Workers'COmpensO awS. STATISTICALCLA SIE ATION APT CONDO
Date---_—------Applicant ADDU&&$— CLASS N0. DWELL UNITS
A10710E TO APPLICANT. If, after making this Certificate of 1 REQUIRED TOTAL SETBACK FROM EXIST
Exemption, you should become subject to the Workers' CO SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor Code, you must forthwith d/L✓`t ����� FRONT
comply with such provisions or this permit shall be deemed revoked. DRE S l ;.) Lig.VO P L >
1�L [�( SIDE
a
LICENSED CONTRACTORS DECLARATION CITY �v LIC.C� ' P L
I hereby affirm that I am licensed underprovisions of Chapter 9 ,
(commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES SEWER MAP fY
Professions Code, nd my license is in full force and effect. / NEW ❑ BK PG C
IG Com' DESCRIPTION OF WOR
License Numb Lic.Class ADD ❑ VALUATION L�'G C
LL
Contracto Date — / ALTER ❑ $
u
❑ 1 am exempt under Sec. ' REPAIR ❑ $ z
BAP.C.for this reason � .(i DEMOL ❑ LDMA P/C#
at USE OF EX STING B G '2 URM ❑
Signature APPLICAN (PRINT) �✓ TE1LJd — LDMA Perm# /�(�
(s1 ACCT
eV
❑ I, as owner of the property, or my employees with wages as # P1+� Pee � � �� Z
their sole compensation, will do the work and the structure is ADDRESS / O 3,303 176064
not intended or offered for sale (Section 7044, Business and 16 L.4# FINAL DATE
� F
Professions Code.) D101 1 ITEMS
WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL v
❑ 1, as owner of the property, am exclusively contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE
licensed contractors to construct the project (Section 7044, FINAL BY ~ > ����� � '
AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE?
11NO❑ CHECK
LIC+}t,
Business and Professions Code.) YES 176.64
42
WILL THE INTENDED USE OF THE BUIDUNG BY THE APPUCANT OR FUTURE BUILDING .00OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CHANGE
CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT ISCAOMDI SEE PERMITTING CHECKLIST FOR
GUIDELINES
I hereby affirm that there is a constructiog,lending agency for YES❑ No❑ (�{y i 4/11/96/ i p�7
the performance of the work for whlCh th• ermit IS Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 0000-0001 `i'f 1L/76
3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE,
TITLE 2•CHAPTER 2 20 SECTIONS 2 20.100 THROUGH 2 20.140 CONCERNING HAZARDOUS cc/c�i �H 10: .J
a3 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD JV• S
Lender's Address
OWNER OA AGENT
3 I certify that I have read this f.pplication and state under penalty
c of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE
W
with all county ordinances and State laws relating to building
W constr ' n, and hereby authorize representatives of this County ISSUANCE FEE .1
to B the a - Rtjoned property for inspection rpo es 7✓d
dINVESTIGATION FEE TOTAL FEE
N Wa pEcml d Aybp � Da10 (o (o T
SEE REVERSE FOR EXPLANATORY LANGUAGE
-'� COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS TENANT IMPROVEMENT
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1208200041
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST NEW BUILDING ADDRESS: 1
ON FILE SQ. FT STORIES TYPE OCCUP GROUP 5921 TEMPLE CITY BL
ASSESSOR INFORMATION NUMBER: STRUCTURE: 55 1 V-B B I TEMP CA 91780
18587-014-007 1 NEAREST CROSS STREET: LAS TUNAS
1 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl
ITENANT: ]EXIST BLDG USE: COMME USE ZONE: (ISSUED ON: PROCESSED BY:
II 1EXIST OCC GRP: B 109/18/12 SR
OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFIN DATE FINAL BY: CODE: ]
ITHE CREST (562) 498-0612- I 5,000 I
15921 TEMPLE CITY BL. 1 IPl.-Po ]
TEMPLE CITY CA 91780 FEES PAID I DlESCRIPTIOAOF WORK
I JINTERIOR ADA RESTROOM T.I.
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: � V{
(APPLICANT: TEL. NO: I I I
]SAME AS OWNER - IA1 PLANCHECK W/EN-HC 5000.00 VAL 129.60 I ; 1
JAA BLDG PERMIT ISSUANCE 27.80 ISPECIAL CONDITIONS:
]AB STATE GREEN BLDG FEE 5000.00 VAL 1.00 1 ]
JAE STRONG MOTION OTHER 5000.00 VAL 1.10 ]
I JA2 PERMIT W/ENERGY-HC 5000.00 VAL 152.50
ICONTRACTOR: TEL. NO: I TOTAL FEES 312.00 (APPROVALS DATE INSPECTOR SIGNATURE ]
]SAME AS OWNER - I I ]
I LIC. NO ] ]LOCATION AND SETBACKS
1 I ]SOILS ENGINEER APPROVAL I ] ]
1ARCHITECT OR ENGINEER: TEL. NO: i 1FOUNDATION/TRENCH FORMS I I 1
1 LIC. NO: ] (SLAB/UNDER FLOOR
1 1 1RAISED FLOOR FRAMING I I ]
1MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP4I ]UNDERFLOOR INSULATION I ] ]
1 1
I I IFLOOR SHEATHING ] I 1
INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I I I I I
1 0 NO 22 1 IROOF SHEATHING I I
] SCHOOL WITHIN HAZARDOUS ] ]SHEAR PANELS ] ]
]AIR QUALITY: 1000 FEET MATERIALS ] I I
1 NO NO NO 1 1FRAME INSPECTION I [I-( M
] I 1FIRE SPRINKLER HANGERS
I I (INSULATION/WEATHER STRIP(
] 1 11NTERIOR LATH/DRYWALL
I I (EXTERIOR LATH '
] I �
1RATED FLOOR/CEIL ASSEM. I 1 I
1 1 IRATED WALL ASSEMBLIES
1 1 1RATED SHAFTS/OPENINGS ' 1
1 1T-BAR CEILINGS 1
1 ILOT DRAINAGE I I
1 1REPORT ID: DPR261 ROUTE TO: BS0508