HomeMy Public PortalAbout5935 TEMPLE CITY BLVD_Building__ 76A686A CE#8032/60 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 ,I
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. - -�
DIST.R4CT NO.. GROUP -HYPE PROCESSED 9Y
FOR APPLICANT TO FILL IN ✓ coNsr:
BUILDING -- _ STATISTICAL CLASSIFICATION _I SEWER MAP
ADDRESS '.r J / %Y B. DWELL.UNITS ! P�
CLASS NO4-
LOT NO. ,� � / _ BLOCK NUMBER - HMAP WYE YES TIO i
TRACT f /;_e / USE ZONE SPECIAL
NO.OF BLDGS. CONDITIONS
SIZE OF LOT I NOW ON LOT
USE OF
EXISTING BLDG. - BUILDING YARD HWY STREET NAME EXIST.
TEL. SETBACK WIDTH
OWNER 'i NO. FRONT
P. L. -�'� '-YAC `)`-- i r "✓'
ADDRESS SIDE
ARCHITECT OR TEL. P.L.
ENGINEER NO. INSPECTION RECORD
ADDRESS
TEL. E3.
CONTRACTOR - NO. O
U
ADDRESS
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH a
SQ. FT. NO.OF NO.OF
SIZE STORIES FAMILIES
USE OF /-'
STRUCTURE /— iC i✓ iJ(J/-- O
_ W
SIGNATURE OF H
APPLICANT
VALUATION$ = I
APPROVALS DATE INSPECTOR'S SIGNATURE
P C �...... PMT ,,,1 �i"'"� FOUNDATION: LOCATION
FEE'76— FEE FORMS, MATERIALS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME: FIRE STOPS,
BRACING, BOLTS
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND FURNACE: LOCATION,
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT,DUCTS
STATE LAWS REGULATING BUILDING CONSTRUCTION.
I CERTIFY THAT IN DOING THE WORK AUTHORIZED I LATH, INT.
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
WORKMEN'S COMPENSATION LAWS OF CALIFORNIA. LATH,EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE - RECT AND POSTED
ADDRESS , FINAL
CLYDE N. DIRLAM. PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
OF
a
#803 � 1
76A888A CE 1:/80 APPLICATION. FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING-ANI) SAFETY'DIVISION LOCALITY '
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROUP TYPE PROCESSED BY
'FOR APPLICANT TO FILL IN ; CONST.
r U--l""I
BUILDING / r i STATISTICAL•CLASSIFICATION SEWER MAP f
ADDRESS G -. �!? Tr;r rf r. , i r.fi _�.+ a� BK PG
_.•r'. CLASS.NO." r DWELL,UNITS I';
LOT NO. BLOCK MAPNUMBER. ; ) `1 STATE YES '
HWY. 1V0�
TRACT USE ZONE SPECIAL
NO.OF BLDGS: CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF t
EXISTING BLDG. /Ire 1< BUILDING EXISTH. .
TEL. SETBACK YARD HWY STREET NAME WIDT
OWNER I P I•r. i` NO. ';!I) FRONT
/ Y {' P.L. ' t
ADDRESS ff/� {., J ,•'l;;Ji' 'J!..• �/� 1f/•!ik/-L SIDE
ARCHITECTOR // TEL P.L.
ENGINEER 1�,.,,? _ `%!', Yt�v N0.7i./r�Z_?r`. INSPECTION RECORD
ADDRESS .�y' ft/.r.^�./, R':/ rl a...si✓i f �y
e.
TEL. py
CONTRACTOR / i �� s.r.: CH��.� NO.4//92P4 O
ADDRESS f a�%/ �:% �. r `fJ'. I/✓. Jl: ' V
DESCRIPTIONF WORK
NEW Peo ADD ALTER REPAIR DEMOLISH - , ;eye1
SQ.FT. NO.OF NO.OF 7
SIZE 411 STORIES FAMILIES
USE OF
STRUCTURE.
SIGNATURE OF
APPLICANT i " r J•/ :[:.•' !' ! i
VALUATION$
sommummm APPROVALS DATE INSPECTOR'S SIGNATURE
J
PMT FOUNDATION:
FOUNDATION:LOCATION
FEE $ J 4 I. FEE r Q FORMS,MATERIALS
.J j
--�—_ FRAME:FIRE STOPS,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- BRACING,BOLTS
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND FURNACE:LOCATION,
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT,DUCTS
STATE LAWS REGULATING BUILDING CONSTRUCTION.
1 CERTIFY THAT IN DOING THE WORK AUTHORIZED 1 LATH,INT.
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
WORKMEN'S COMPENSATION LAWS OF CALIFORNIA. LATH,EXT.
SIGNATURE OF F , .^~ HOUSE NUMBER COR-
PERMITTE f '' _ �% - f RECT AND POSTED
ADDRES P / :. '�• �,/ fr I FINAL
CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION ( CK. , M.O. CASH PERMIT VALIDATION ., cK M.O. CASH
0.1 .1-1. 49 r; T.
[ .til. wf,r�R I_r • 6R ,
�T,�•�1;;y�tp�' _ El8r,7y[,-N -
7B GM,=#808 2/80 APPLICATION FOR BUILDING PERMIT
COUNTY. OF LOS ANGELES BUILDING ✓ .��
DEPARTMENT"OF COUNTY ENGIIM11 ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN:A. 44MBIE.. COUNTY ENGINEER NEAREST
WILLIAMA.JENSENI SUPT OF BUILDING CROSS ST.DISTRICT NO. GjZOUP TYPE PRQCESSED BY
FOR APPLICANT TO FILL IN Sr' J-y CONST.
BUILDING`'µ t + / STATISTICAL CLASSIFICATION ER MAP O
ADDRESS 5 / 3J .fr (..IT�jr / BK a
CLASS.NO. DWELL.UNITS _*! I! !��PGr L¢+'
LOT NO. -2 !t. y*A1, AQ- 2 Z A BLOCK MAP STATE YES "10�
NUMBER * HWY. m
TRACT .49.-,!5USE ZONE SPECIAL j !_
SIZE OF.LOT 4 • 1 7S- NO:OF BLDGS. 1r+ CONDITIONS
a� �^• NOW ON LOT-USE OF
EX STING BLDG. [�'/� Z;r f: BUILDING EXIST.
TEL. SETBACK YARD HWY STREET NAME WIDTH
OWNER LnPX ~•I•' NO. FRONT
ADDRESS fd� . /4L E �4'J r ` D SIDE
ARCHITECT OR EL .0 P.L.
ENGINEER
+!., INSPECTION RECORD
ADDRESS
1/ 9 3,/ S. l"Mk11 - ,
�j +�.+ TEL. (�y
C NTRACTOR i >D La ! NO. O
ADDRESS V
ADD)
OF WORK •
NEW FADD1 ALT REPAIR DEMOLISH
SQ.FT. NO.OF NO.OF I
SIZE STORIES FAMILIES v R�ij
USE OF �- f �,r
STRUCTURE f d�A I�f ' r_ ci:- . . s, _ Q
. ,.• r;-r -^may;'..�-, r:��.Q ��z��
SIGNATURE OF� J/. „��j '
APPLICANT 'i'+
VALUATION$
APPROVALS. DATE INSPECTOR'S SIGNATURE
PMTFOUNDATION:LOCATION
FEE P.C• $ I FEE*$ 47.
oz D FORMS,MATERIALS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS/1P• FRAME:FIRE STOPS,
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND: BRACING,BOLTS
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND FURNACE:LOCATION,
STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT,DUCTS
1 CERTIFY THAT IN DOING THE-WORK AUTHORIZED I LATH,INT.
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
WORKMEN'S COMPENSATION LAWS OF CALIFORNIA. LATH,EXT.
SIGNATURE OF �� i- HOUSE NUMBER.COR-
PERMITTE 3 RECT AND POSTED
ADDRESS <>" % r FINAL
f' CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENGIN F�ER
PLAN CHECK VAIATION CK- M.O. CASH PERMIT VALIDATION CK. M.D. cwsti-�
. + 3:7 = ZIP 14 ;2-3 0 :1 10.2 5 • � '
TMENT OF.BUILDING AND SAF f� � 16164
APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES � � ' � ® �
WM. J. FOX, CHIEF ENGINEER
NG
FOR
//��APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDI SG ZVl Ni Ivn1e f DISTRICT NO. PLAN CK.NO. PERMIT NO.
LOCALITY -�
�L, `� jp/,.'± 6 /r, RECEIVED BY DATE OF APPL. DATE ISSUED
NEAREST /
CROSS ST. 'uhGf in""I
BUILDING T r4
OWNER-.,J.�s. '?��<�,�t 7.t I ;•a 1+� 'tADDRESS
MAIL LOCALITY
ADDRESS Ti
v NEAREST
J `
J CITY YV/7/ ���M, •+: i �NILG 3� CROSS T.
ARCHITECT OR . , ✓ j FIRE NO.DF TYPE _ , GROUP
,,,/ r TEL , r ZONE I PLANS
9 ENGINEER �/biJ�
,� ►/ BLDG. _ JA 7/ ORlD.NO.
ADDRESSgym,) j ° ,%J3�/ L 7;� 1 �/ SETBACK LINE
'
TEL. APPROVED
�' /
CONTRACTOR,';;. 4'j t_'j i- `I J f;f,'NO. BY ( DATE
s I . , / I• r USE APPROVED / //r /
ADDRESS e1 • dp 1pi�Y�)l f�lt"P !l-+,l:/)1 j/�[� ZONk�.' BY /I '� Y 4 DATE ��•��y�9
LEGALv •j 3 CORRECTIONS
s DESCRIPTION LOT NO. A F3 BLOCK
FaY w S _
✓ TRACT lC J t[a Q Q V-l>N-r/G+rl Z L��� s�l/ •'� /
s i[� NO.%r ILDGS.
1 SIZE OF LOT f��p� f`*'��/ \ I NOW ON LOT i)a;as,. a,.
USE orEXISTING BLDG. A`p i; (.� I FAMILIES I ROOMS ��M
a
DESCRIPTION OF WORK
NEW l� ALTERATION ADDITION
O
REPAIR MOVING DEMOLISH
9q.FT. ) � -) N
SIZE (z-VROOMP Z
J STORIES
D
COVL Roar
RING •%/e I COVERIN13
USE OF NEW ' ��a J
BUILDING � E.:✓_•7
w
CPA `°� -f- Y C? k f1_
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE 19 CORRECT FOUNDATION: LOCATION 3P UTdR DATE4
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS . 7 4f
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
FRAME. FIRE STOPS,
SIGNATURE OF BRACING,BOLTS _
OWNER LATH,INTO
AUTHORIZED AOr S T. �l. v1i LATH,EXT.: �•`,��1�- �l '='I
PLASTER.INT.
FEE PLASTER,EXT. I
VALUATION FEE �� FINAL
DEPARTMEIIT_-TSF BUILDING'ANDnSAFETY -��ti� APPLICATION FOR PEHMiT IF
COUNTY OF LOS ANGELES ® '
WM. J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PLAN CK.NO. PERMIT NO.
.BUILDING ADDRESS 201 North Sunset Blvd. '— `J /
LOCALITY Temple
+ City RECEIVED BY DATE OF APDL. DATE IBSUED
NEAREST
CROSS BT. koodruff Ave.
OWNER Danish Maid Bakery ADD EISS 201 North Simset Blvd.
AMAIL DDRESS 2409 Southwest Drive LOCALITY Te le City.
NEAREST Woodruff Ave.
TNO.EL. CROSS BT.
CITY L.Ae ®'•3� •
FIRE NO.OF / TYPE
ARCHITECT OR TEL. ZONE PLANS
ENGINEER NO.
BLDG. (9RD.NO.
ADDRESS SETBACK LINE vV
ElectcProd.Corpe TEL CA 1=6 APPROVED DATE
CONTRACTOR NO.
�
USE �o APPROVED
ADDRESS 1100 N.Main Ste$ LGA® —12 ZONE l ^�BY DATE
LEGALI CORRECTION'S
DESCRIPTION LOT NO. Z p BLOCK
TRACT (� 6
C/ NO.OF BLDGS.
SIZE OF LOT /Iy 1/y J NOW ON LOT
EX ST NE OrG BLDG. NO.OF No.or
A P'KET FAM E8 RCOMB�
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
O
REPAIR MOVING DEMOLISH
B4•FT. NO.OF Z
SIZE ROOMS STORIES y
WALL ROOF r
COVERING COVERING
USE OF NEW
BUILDING
SIGN A) INSTALLATION OF SINGLE FACE S
ON FACE OF BLDG.
SEE ATTACHED DRAWINGS.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOIRMS,MATERIALS
AND STAT WS REGULATING BUILDING CONSTRUCTION.
FRAME. FIRE STOPS,
SIGNATOR BRACING,BOLTS
PERMI E
LAS INT.
.AUT14dRI–ED AGTELECTRICAL UCTS CORP.
• LATH, EXT.
76AS38A 9-48
DSS-3 SUM SETS $ P.C,S PLASTER,INT.
-9PLASTEREXT /
150,00 FEE , . /
VALUATION' . v
FEE 2®00FINAL Q
DEPARTMENT OF BUILDING AND SAFETY riYJrL Lp*L 11V1tl r va rr na-L&
COUNTY OF LOS ANGELES
WM. J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING DISTRICT NO. PLAN CK.NO. PERMIT NO.
ADDRESS /r�1 "y7. ��
V ✓ i
LOCALITY /: r! j' �"�j`'- "�sJV�1 RECEIVED BY DATE OF APPL DATE IBB EO
r
NEAREST
CRO9S 9T.
�' i` �f BUILDING
OWNER 1/ m P �/� b." ADDRESS159-95
MAIL LOCALITY
ADDRESS
NEAREST
CITY NO. CROSS BT.
ARCHITECT OR TEL ZONES PLANS ��FINE a.or TMP /�� GROUP
ENGINEER NO. r
BLDG. ORD.NO.
ADDRESS SETBACK LINE
CONTRACTOR � � ^� �d� / NO., l.( By
APPROVED DATE
'1y APPROVED
ADDRESS /Cj /V�d �n P `. J � ZON�_1 BY DATE
USE
LEGAL
DESCRIPTION I LbAU �I�! I BLOCK CORRECTIONS
NO.
' d
TRACT
on O.OF SLOGS.
ON
SIZE OF L
T NOW ON LOT
USE OF NO.OF -+ NO.OF
EXISTING BLDG.. FAMILIES ROOMS
DESCRIPTION OF WORK
NEW I ALTERATION I I ADDITION 1
O
N "
REPAIR MOVING DEMOLISH p
914.FT. NO.OF Z
SIZE ROOMS STORIES r
WALL ROOF
COVERING COVERING
USE OF NEW
BUILDING S?
:-
1HERB K LfVDW EDGE T AT I HAVE READ THIS APPROVALS
APPLICATIQN AND STATE THAT THE ABOVE IB 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 �f> a>/ BRACING,BOLTS
OWNER ��� A` LATHS INT.:
e�j
)".2 v 2-
AUTHORIZED AOT. �'/� ' e'21'k} 1 LATH,EXT.:
/' AIS
DBS-3 2SM SETS 1-47 $ PLASTER.INT.
P.C.t8
FEE PLAaTERP EXT. l �11
VALUATION FEE FINAL ��
r -• 'T
DIVISION OF BUILDING AND SAFETY
DepmI ent of County.Engineer I L i N :
'County of Los Angeles 1
-WM. J. FOX,
COUNTY .ENGINEERAPPLICATION-
BUILDING 9'
-FOR APPLICANT TO-FILL IN' ' ADDRESS .S`. `B-S •
BUILDING4rf / /LOCiALITY_r7-
ADDRESS J 1
" ,NEAREST ,. ..
LOCALITY. _;-� >sj CRO 88'ST.
VN
NEAREST y r - ° DISTRICT NO., PUH/CK.6WRBC.•No. PERMIT NO.•='
CROSS ST. 1 `2. t.I r7 1 I � Q
-4,AofI RECEIVED BY DATE:OMAPPL. 'DATE ISSUED.
OWNER e r• y i •�
AMAIL
DDRESS 5
USE ZONEO.:OF TYPE GROUP.• •FIRE ZONE.-
TEL a' PLANS
CITY Ldl/jol
C,3
ARCHITECT OR a TEL:.; v ZONING DATED
ENGINEER —� NOr ,�•'� � APPROVED BY 06—
BUILDING i ARD.NO.
ADDRESS SETBACK LINE:
` ��rr
TEL APPROVED DATE
CONTRACTOR J ci�/�%Udq; 0.r/x,vmv .' BY,
HOWSE_NUMBERING C. f
ADDRESS • ! o�
LEGAL MAP NUMBE NO: ASSIGNED BY
DESCRIPTION LOT NO.AZ�'p BLOCK
/ DATE' ~CORRECTIONS I °INSPECTOR
TRACTap� ± '
y NO. OF BLDG8. �.
SIZE OF LOT {USE OFyid I K I. NOW ON LOT / y' .j
m6. OF
EXISTING BLDG. 1-1 �I`�C� T I''FAMILIEB �,.�r��3 ��y��yr ' _ fe�f `d-A! o
DESCREMON OF'WORK - - :/I,1.7'0 J✓,�EEL ./ R
NEW ALTERATION ADDITION i �^ (ti�lq �� ,+c7 Cit—s' a Y .
_ ref
REPAIR DEMOLITION . I"�. :�'I .v� � f� T/ 7,j ' �If
SQ. FT. ....... NIO:. OF .f . ..:
OO -STORIES
/d&G;Vtl�JY5pSIZE R . ma/ y
EXT. WALL ROOF
COVERING COVERING d
j�
USE OF STRUCTURE t
• /��.�o.����a� ��� /--n-��i �;r f.�t° as x�dx�s �,r��
`�. UNC R
APPROVALS e-tit�y
INSPECTOR'S SIGNATURE DATE _
FOUNDATION:;LOCATION
FORMS, MATERIALS
1,HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME:
PLICATION AND STATE THAT THE INFORMATION GIVEN 18 FRAMBOLTS
CORRECT. BRAE: F•FIRE.STOPB.,
1 AGREE TO COMPLY WITH LL OUNTY ORDINANCES FURNACE: LOCATION,
AND STATE LAWS REGULATI 6 CONSTRUCTION.. 'GAS VENT, DUCTS
t .
SIGNATURE OF r H.
1N7:•SC'• �+V���` �lt.l.. .
1 '
PERMITTE, -
LATH,
ADDRES
PLASTER, INT:
AUTHORIZED,AG
PLASTER, EXT:
:FEE' HOUSE.NUMBER COR -
fl' RECT AND POSTED
/
VALUATION S ✓r/! .3_
;-{,:F !,
FEB,; "�'� FINAL i 1rf j-
78A888A DHS 3-8-53
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES ' ®f•�® �
WM. J. FOX. CHIEF ENGINEER
NG
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
.
�1, DISTRICT NO. PLAN CK.NO. PERMIT NO.,
BUILDING 201 North Sunset Blvd,
ADDRESS
LOCALITY Temple City RECEIVED BY DATE OFAPPL. DATE IS/SUED
NEAREST CROSS Woodruff Ave® �'� ' - •l ;�2-/c% �!
9T.
OWNER Danish Maid Bakery ADDRBUILESS
MAIL
201 North SunsetBlrvdo
MAIL E2409 LOCALITY Temple City'
ADDRPI
ive
N'EARE5T
DiTY L.A. -43 TEL. CROSS ST. Woodruff Ave,
FIRE NO.OF TYPE GROUP G
ARCHITECT OR TEL. ZONE PLANS/
ENGINEER NO.
BLDG. `` ORID NO.
ADDRESS SETBACK LINE
L 1., APPROVED
CONTRACTOREleCtoPrOdo Corp oNpl CA 1-6141 BY qc DATE
ADDRESS
1100 NoMain St. LOA. —12 ZONE �-�7 BY DATE DATE
LEGAL CORRECTIONS
TRACTDESCRIPTION LOTNO. ,Ly L• BLOCK
TRACT
NO.OF BLOBS. /
SIZE OF LOT 7L �� I NOW ON LO
USE OF ��n.��� / I NO.OF �-NO.OF �- 7
EXISTING BLDG. Q_ FAMILiEs ROOMS
DESCRIPTION OF WORK
NEW ALTERATION I ADDITION I Y O
REPAIR MOVING DEMOLISH 0
BE;.FT. NO.OF Z
SIZE ROOMS STORIES D
WALL ROOT r
COVERING I COVERING
USE OF NEW
BUILDING
SIGN (B) INSTALLATION OF-DOUBLE FACE NEO
SIGN INTERIOR OF BLDG, ON WALL
RELR OF RU= DUTO
SEE ATTACHED FRINTSm
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE 15 CORRECT FOUNDATION: LOCATION INSPECTOR DATE
AND GREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS
AND ^AT• EGULATING BU DING CONSTRUCTION.
, FRAME: FIRESTOPS, __2
51GNATUR BRACING,BOLTS
0
PERMI L , INT. j
AUTHORIZED AGT T Q0RP_
LATH, EXT.
3BA
DBS- PLASTERINT.
DBS-3 SOM SETS .� P.C.lf+ , �•
FEE PLASTER,EXT.
1�Om00 III � ,
VALUATION FEE 2000 FINAL
WORKERS'COMPENSATION DECLARATION
hereby affirm that I have a certificate of consent to self APPLICATION BUILDING PERMIT
insure, or a certificate of Workers'Compensfion Insurance,or � •
a certified copy thereof(Sec. 3800, b. C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY
' P❑olicyNo. y�7�Company qAft . 'pd
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS �3 s T �_
1 ❑ Certified copy is filed with the county building inspec- BUILDING 3,r � -
1 tion dep rtment. \ ADDRESS �� Gf1 LV�'/ LOCALITY
NEAREST r
Date O L Applicant CITY f ZIP CROSS ST.
ER FICATE OF EXEMPTION FROM RKERS' I NO.OF BLDGS. ASSESSOR
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
(This section need not be completed if the permit is for one USE ZONE MAP Da
hundred dollars ($100)or less.) TRACT BLOCK LOT NO. NO.
TEL. ,,ll C 7 SPECIAL
OWNER LQ� N0.7LT-97CONDITIONS
I certify that in the performance of the work for which this or/ c l ,� (� n DISTRICT GROUP TYPE FIRE PROCESSED BY
permit is issued, I shall not employ any person in any manner ADDRESS ( DC7 �-t701°��jLJ 7• v CONST. ZONE
so as to become subject to the Workers'Compensation Laws. ` l` DO09
-
-Ae
Date Applicant CITY s°•s ZIP STATISTICAL CLASSIFICATION APT. CONDO. U
NOTICE TO APPLICANT: If, after making this Certificate of 1ARCHITECT OR TEL. UJ
Exemption, you should become subject to the WorkersENGINEER NO. CLASS NO. e�---2- DWELL. UNITS IL
Compensation provisions of the Labor Code, you must forth- ;' ADDRESS SEWER MAP
with comply with such provisions or this permit shall be i TEL. q
deemed revoked. CONTRACTOR \ &41 eel NO. (75 1 BK. /_ PG,l'�Z' VALIDATION
LICENSED CONTRACTORS DECLARATION LIC,
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS l X1943 NO.3 VA ATION
(commencing with Section 7000)of Division 3 of the Business and LIC r 00
Professions Code, and my license is in full force and effect. \JE
ITY�`/�nF�T� � Ysr� S. CLASSC`�5 �Yt ��O
License N r 4 r Y Lic.Classy HECK
IZE, caj STORIES G— FAMILIES CONE
Contractor ` Date 3 S Z \ ESCRIPTION OF WORK T1flV E � NEW $Iam exempt rom the licensing requirements as I am a �c.���ADDlicensed architect or a registered professional engineer I r r/ ALTER ❑ FINAL ''� �?acting in my professional capacity (Section 7051, Iox n DATEBusiness and Professions Code). SE OF REPAIR ❑. FINAL
XISTING BLDG. "Is G�' DEMOL ❑ B Lic.or Reg.No. Date PPLICANT TEL. yOWNER-BUILDER DECLARATION (PRINT) NO.
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and DDRESS
Professions Code): RESENTUILDING
I, as owner of the property, or my employees with DDRESS
wages as their sole compensation,will do the work and " 6 n
the structure is not intended or offered for sale(Section OCALITY
7044, Business and Professions Code). kRE
TEL. �' 0 0 0 0 0
❑ I, as owner of the property, am exclusively contracting R NO.
with licensed contractors to construct the project (Sec- - 329.50
tion 7044, Business and Professions Code).
TOTAL SETBACK FROM EXIST. �+ 4, -ri?
CONSTRUCTION LENDING AGENCY YARD HWY
PROP. LINE WIDTH
I hereby affirm that there is a construction lending agency for Q 305-82
the performance of the work for which this permit is issued
(Sec. 3097, Civ. C.).
Lender's Name 4-4&� //Permn Fee Q
O G�tJ u""�`
Lender's Address k� c 3.2/,oe p-
I certify that I have read this application and state that the Issuance Fee 0 i it O 3��`O n
above information is correct. I agree to comply with all County Investigation Fee • J O
a dinanc s and State laws relating to building construction, Total Fee h-2 �' S6Pand reby uthorize repr ntatives of this County to enterio
up the a e-mentio pert or inspection urp ses.
( j. SEE REVERSE FOR EXPLANATORY LANGUAGE
Si5oiurefof Applicant or AGht to 0 ®s
WORKER$'CQMPENSATf9pi DECLARATION
.,
insure,retiy certificate
that I have r cerfii`om a of consent to self APPLICATION F®RBUILDING PERMIT �
insure, or a certificate of Workers'eomperlsation Indurance,
or a certified copy thereof (Sdc. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No of G'g67/70company 2EPyt6tla IfJPe3"y"
Certified copy is hereby furnished. ML FOR APPLICANT TO FILL IN BUILDING -ADBU IDRESS 1:•,_5 7'-�� J ! (/ ��1 /
Certified copy is filed with the county building inspec- BUILDING �b .ne,,,
tion department. ` ADDRESS l�� I ���r�E c L 8� r LOCALITY
Date 8 Applicant A• CITY—rE--AE Gt ' 1 ZIP C OSNEARSST. LL'JG�
CERT KATE OF EXEM N FROM ORKERS' NO.OF BLDGS. ASSESSOR /
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
(This section need not be completed if the permit is for one ; USE ZONE MAP
hundred dollars($100)or less.) TRACT BLOCK LOT NO. NO.
p� TEL. C—�' SPECIAL y
I certify that in the performance of the work for which this OWNER �o Aet',� NO. CONDITIONS Ib
permit is issued, I shall not employ an person in an manner r- DISTRICT GR UP TYPE FIRE PROCESSED BY O
P p y y P i ADDRESS rg 3� TeW IPLE C.1 el L CONST. ZONE
so as to become subject to the Workers'Compensation Laws. l /
CITY T�++P / f�J� V
Date Applicant �� Gt ZIP 'STATISTICAL CLASSIFICATION APT. CONDO. I-
NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL.
Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. 2 DWELL. UNITS P UJI
Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP
with comply with such provisions or this permit shall be
TEL.
deemed revoked. ,�CONTRACTOR dLS ce�tl�.� 1 NO. BK.L_ PG, � VALIDATION
LICENSED CONTRACTORS DECLARATION LIC, p�_
I hereby affirm that I am licensed under provisions of Chapter 9 p ADDRESS -L O 1..30 IS +NN E NO. VALUATION oC
(commencing with Section 7000)of Divisioft 3 of the Business and LIC.
Professions Code,and my license is in full force and effect. CITY uos �(�L'ES CLASS �' ys $ 000�— 2 7 1 2 0 A
021 /O Lic.Class G`4S ;SIZE F7 ]STORIES AMILLIIES CHECKONE , # o o 0 '2
License Number •1 a o89,25
ContractorQt2S CO ZP ' Date Z-$ DESCRIPTION OF WORK l2•�s"'JO V6 m L-p NEW $ 0 0 0 8 9.2 5 5
I am exempt under Sec. .S f(a t'`� �a ADD
ALTER ❑ FINAL
052887
B.&P.C. for this reason 1105ML— PJ60 5M.0 0,J C-YJ577N REPAIR ❑ DATE
Date: USE OF JULC S.I-�v C- 7 �C DOL FIN
EXISTING BLDG. �O By
Signature APPLICANT
PRINT .,&.fZNO. 7y$^,i-,01 -27121 A
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's LicenseADDRESS # 0 0 0 0 0 1
Law for the following reason (Section 7031.5, Business and
Professions Code): BUILDING ( - 1 1 5.5 0
I, as owner of the property, or my employees with a ADDRESS =
wages as their sole compensation,will do the work and LOCALITY 0 0 1 1 5,5 0 v
the structure is not intended or offered for sale(Section
7044, Business and Professions Code). MOVING TEL. 0528-87
I, as owner of the property, am exclusively contracting CONTRACTOR NO.
with licensed contractors to construct the project (Sec- .ADDRESS
tion 7044, Business and Professions Code).
•. REQUIRED TOTAL SETBACK FROM EXIST.
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C.). SIDE
0
P.L.
P Lender's Name r -C `_
3 Lender's Address P.C.Fee$ �.g��S Permit Fee /as
i
rI certify that I have read this application and state that the Issuance Fee rt o' I'J
above information is correct. I agree to comply with all County Investigation Fee
ordinances and State laws relating to building construction, Total Fee er ✓ '�
and hereby authorize representatives of this County to enter
I
!�=� ti ned pro arty for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
®s
Signature of Applicant or Agent 150te
> WORKERS'Ct'.�•MPENSATlplf DECLARATION
%nsureby ra certificate
that I have r certificate of consent to self L I CAT N FOR BUILDING PERMIT
insure, or a certificate of Workers'Com erisation Insurance,
or a certified copy
thereof (Sec. 3800,, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. C 617/ Company `�eueJG iNpe"RNt 1. BUILDING '
E] Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS `� 3 S �� `
494
Certified copy is filed with the county buil 'ng inspec- BUILDING 1r"q 3� Iff
---L��7��Le G(� L-0 p r
L�• tion department. ADDRESS J 1 LOCALITY
NEAREST
Date 2g Applicant • CITY � 1e(-E �'( ZIP .C OSSST.
CERTIFI ATE OF EXEMPT N FROM WORKERS' NO.OF BLDGS. ASSESSOR
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
(This section need not be completed if the permit is for oneUSE ZONE MAP
hundred dollars ($100)or less.) e TRACT BLOCK LOT NO. NO.
,pp � TEL. Z SPECIAL
I certify that in the performance of the work for which this ! OWNER 00(7 e^ I NO. �' CONDITIONS
permit is issued, I shall not employ any person in any manner t U DISTRICT GROUP TYPE FIRE PRQCESSED BY o
so as to become subject to the Workers'Compensation Laws. ADDRESS S 9 3 ALE C I 6 r `S` CONST. ZQNE // U
CITY QE Ct ZIP J {) `' O
Date Applicant •STATISTICAL CLASSIFICATION APT. NDO. k-
NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. ;: �
Exemption, you should become subject to the Workers' :ENGINEER NO. CLASS NO ,�, DWELL.UNITS a-
Compensation provisions of the Labor Code, you must forth- 4n
with comply with such provisions or this permit shall be TELL2.4
deemed revoked. CONTRACTOR ,/L CO 2VALIDATION
�' NO. -Z23 BK. PG,
LICENSED CONTRACTORS DECLARATION LIC.
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS It wI-J£ �' NO. 027cly
O* VALUATION ;2 71 1.9
(commencing with Section 7000)of Division 3 of the Business and LIC.
Professions Code, and my license is in full force and effect. CITY LO S A40(6LES CLASS G s
r• -'SQ.FT. NO.OF NO.OF CHECK �� ® 1 0 2 1 a _
License Number 0 Z-?4 O Z Lic.Class G�5 SIZE STORIES FAMILIES
//��J) ONE i
Contractor n S `� g R Date
� $ DESCRIPTION OF WORK u r� /� GURGb$t $ 20 oo U
ADD
I am exempt under Sec. FFjW � ''11'S ALTER FINAL
B.BP.C. for this reason 4� REPAIR � . DATE
USE OF pl
Date: ❑
EXISTING BLDG. DEMOL
Signature APPLICANT TEL. •-1 41
OWNER-BUILDER DECLARATION PRINT GEOr�.G-E IL'J<bw�NO.-1'+ Z23 1
I hereby affirm that I am exempt from the Contractor's License �
, .•+-tO Nt` 1 � Lo A-AJCr�ES
Law for the following reason (Section 7031.5, Business and ADDRESS« l®
Professions Code): PRESENT
❑ BUILDING
I, as owner of the property, or my employees with ADDRESS
wages as their sole compensation,will do the work and LOCALITY
the structure is not intended or offered for sale(Section
7044, Business and Professions Code). [ADDRESS
OVING TEL.
I,as owner of the property,am exclusively contracting ONTRACTOR NO.
with licensed contractors to construct the project (Sec-
tion 7044, Business and Professions Code). �•
REQUIRED TOTAL SETBACK FROM EXIST.
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH ® '
I hereby affirm that there is a construction lending agency for FRONT
the performance of the work for which this permit is issued P.L.
tSec. 3097, Civ. C.). SIDE
'r
F L
Lender's Name
Lender's Address P.C.Fee$ rP—it Fee
I certify that I have read this application and state that the Issuance Fee
above information is correct. I agree to comply with all County Investigation Fee J
ordinances and State laws relating to building construction, Total Fee r'
and hereby authorize representatives of this County to enter
Jt�he above-m a prope y for inspection purposes.
A • /J SEE REVERSE FOR EXPLANATORY LANGUAGE
Signatur of Applicant or Agent Dot ( ®s
` Y WORKERS'COMPENSATION DECLARATION 1
I hereby affirm that I have certificate of consent to self ®PLIC ®T 'R BUILDING
L I ' P I T
insure, or a certificate of Workers'Compensation Insurance, �'" mil LJ
or a certified copy thereof (Sec. 3800, Lab. C.)
�, � JL�� COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company BUILDING '
❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS
Certified copy is filed with the county building inspec- BUILDING /+/ -
tion ep fitment. ADDRESS ._ �, , / L�
Date Applicant . i ter . CITY ' C L, ZIP LOCALITY
CE IFICATE OF EXEMPTIO F O WO ERS' NO.OF BLDGS. ` NEAREST
COMPENSATION,I SURANCE SIZE OF LOT NOW ON LOT CROSS 5T.
(This section need not be com l ted if the permit is for one 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 NO.
SPECIAL
permit is issued, I shall not employ any person in any manner ADDRESS / �' �^� CONDITIONS
so as to become subject to the Workers'Compensation Laws.
U
CITY ZIP
Date Applicant ARCHITECT OR TEL.
NOTICE TO APPLICANT: If, after making this Certificate of DISTRICT GROUP TYPE FIREqAP'r. l
SED BY O
Exemption, you should become subject to the Workers' ENGINEER NO. ' CONST. ZONE „ V
Compensation provisions of the Labor Code, you must forth- ADDRESS0 W
with comply with such provisions or this permit shall be L� TEL STATISTICAL CLASSIFICATION ONDO. CO
deemed revoked. CONTRACTOR
LICENSED CONTRACTORS DECLARATION LIC,. CLASS NO. DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS r ,'I NOto 7 J 7 SEWER MA
(commencing with Section 7000)of Division 3 of the Business and I / LIC. L
Professions Code, and my license is in full force and effect. CITY 1 CLASS / L BK PG ✓ VALIDATION
SQ.FT. NO.OF NO.OF CHECK
License Nu b Lie.Class SIZE STORIES FAMILIES ONE
VALUATION
Contractor sr Date DESCRIPTION OFWORK
NEW ❑ $
'1— 1 C ADD C3❑I am empt under Sec.
ALTER ❑•';
oil.
B.8 .C. for this reason REPAIR ❑ ' $
DUSE OF
Date: �J ”
EXISTING BLDG. �f DEMOL ❑
Signature APPLICANT TEL. FINAL
OWNER-BUILDER DECLARATION PRINT NO. DATE
I hereby affirm that I am exempt from the Contractor's License p
Law for the following reason (Section 7031.5, Business and ADDRESS FIN
Professions Code): PRESENT By
❑ BUILDING
I, as owner of the property, or myemployees with ADDRESS
wages as their sole compensation,will do the work and 41
the structure is not intended or offered for sale(Section LOCALITY
7044, Business and Professions Code). MOVING TEL. D0111,
❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. 9 Pyo 7
with licensed contractors to construct the project (Sec- ADDRESS O/QQ /
tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK 1 ;o o 9�9 8
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP.LINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT o 0 0 6Q50'0
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C.). SIDE 01.08-88
P.L.
Lender's Name
• LDMA Ref. #
°o P.C. Fee$ Permit Fee 6-72
Lender's Address
I certify that I have read this application and state that the Issuance Fee 14••47 LDMA P/C#
o above information is correct. I agree to comply with all County Investigation Fee
q ordinances and State laws relating to building construction, 0
Total Fee -�./(/ LDMA Perm.#
N a d hereby a rize r eptatives of this County o ter
m n the a me io pro "rty for inspection ur oses.
m �
< SEE REVERSE FOR EXPLANATORY LANGUAGE
gnature of plicant a Dote
WORKERS'COMPENSATION DECLARATION • "� �s p�t
hereby affirm that I, have certificate of consent to self A P P L I CA t N FOE ��I L®I PERMIT
insureor a certificate of Workers'Compensation Insurance,
r a4 a certifirad copy thereof(Sec. 3800, Lobb. C.) COUNTY OF LOS ANGELES 1 BUILDING AND SAFETY
Po(ic ��_Coinpany C/NA
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ..ADDRESS
❑ Certified copy is filed with the county building inspec- BUILDING
tion department. ADDRESS ,5
Z406 .4 /a-p -
Date �pplicant^ CITY ZIP i.,•LOCALITY
CERTIFI E OF EXEMPTION FROM WORKERS' IFNO.OF BLDGS. .NEAREST
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST.
(This section need not be completed if the permit is for oneASSESSOR
TRACT BLOC LOT NO. "MAP BOOK PAGE PARCEL
hundred dollars($100)or less.) i
OWNERfd NO. USE ZONE MAP LD
I certify that in the performance of the work for which this NO.
permit is issued,I shall not employ any person in any manner Cr SPECIAL
so as to become subject to the Workers'Compensation Laws. ADDRESS CONDITIONS
CITY ZIP
Date Applicant
ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO.
Exemption, you should become subject to the Workers' ICONS
`T./ ZONE
Compensation provisions of the Labor Code, you must forth- ADDRESS �� ✓ I/
with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFI TION APT. NDO.
deemed revoked. CONTRACTOR .- NO.
LICENSED CONTRACTORS DECLARATIONLICCLASS NO. DWELL. UNITS
—
I
t�
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS '� NO.oW SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and i LIC. �^
Professions Code,and my license is in full force and effect. CITY . CLASS �F BK 4 PGLIS VALIDATION
` SQ.FT. N OF N .OF CHECK
License Number`'�+ `y y Lic.Class SIZE STORIES F (LIES ONE
I ❑ VALUATION
IDESCRIPTION OF WORK NEW $
Contractors 1VUDate
t " • ADD ❑
❑I am exempt under Sec. s�(,1 ALTER ❑
pill.
B.BP.C. for this reason REPAIR ❑. $
SE OF # �����
Date: XISTING BLDG. DEMOL ❑
Signature PPLICANT — TEL.�/ FINAL
NO.: o o ���ev
OW ER-BUILDER DECLARATION PRINT DATE dao 2
1 hereby affirm that I am exempt from the Contractor's License DDRESS 47J,6 �O !�� `�)da�i0{-�� FINAL2, 08 -87
Law for the following reason (Section 7031.5, Business and1
Professions Code): r, n By
❑ UILDING I►�
I, as owner of the property, or my employees with DDRESS d
wages as their sole compensation,will do the work and
the structure is not intended or offered for sale(Section , LOCALITY ^• �o
7044, Business and Professions Code). MOVING TEL oC e O
❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO. n L
with licensed contractors to construct the project (Sec- ADDRESS �(
tion 7044, Business and Professions Code). )
REQUIRED YARD HWY TOTAL SETBA K / S !)
CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE WIDTH �1
I hereby affirm that there is a construction lending agency for FRONT �� lf/�• /T
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C.). SIDE
�! P.L.
Lender's Names `'
,r�J� ( 6) LDMA Ref. q
Lender's Address P.C.Fee$ Perm!?Fee l/7/(�J6 7)
I certify that I have read this application and state that the Issuance Fee L v��`r LDMA P/C q
R above information is correct. I agree to comply with all County Investigation Fee
0 ordinances and State laws relating to building construction, Total Fee s�� LDMA Perm. q
N and hereby authorize representatives of this County to enter SIR
3 upon the above-mentioned prop rt(for inspection purposes.
m ) SEE REVERSE FOR EXPLANATORY LANGUAGE
,ignt.ture of Applicant or Agent Date