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HomeMy Public PortalAbout5946-5946 1/2 TEMPLE CITY BLVD_Building__ 7SA666A 136Fi 2 12.64 APPLICATION FOR BUILDING PE R11i1l.1' 1 DIVISION OF BUILDING AND SAFETY BUIL EISS �rC i� • .L�.- Deportment of County Engineer - County of Los Angeles LOCALITY WM.J.FOX, COUNTY ENGINEER NEAREST � CASSATT D.GRIFFIN.SUPT OF BUILDING CROSS ST.NEEIIIIIIgIIIum DISTRICT NO. GROUP SEWER MAP FOR APPLICANT TO FILL IN TYPE BK PG nn /♦ 5, O� CONST. BUILDING"/ UILDING .�} �.6 m h ♦Al i l.u. re-, MAP STATE _g i ADDRESS 1�/f 9 NUMBER HWY LOT NO. / BLOCK USE ZONE SPECIAL-CONDITIONS TRACT �. J (�1 (2j- NO. OF BLDGS. SIZE OF LOT I NOW ON LOT BUILDING YARD HWY STREET NAME EXIST. USE OF SETBACK WIDTH EXISTING BLDG. FRONT OWNER ZVI SIDE MAIL6,904 I rp. pr_ P. L. ADDRESS( ,90 6 /�e�r���l�� (s/ IRv r3� rfEL.A,}.`�/ 1 DWELL. 1 UNIT 5 INDUSTRIAL CITY,/J�/I/J.!/G iG► 'i-/ I•i NO.f7%•Cer7 a I 2 DUPLEX_UNIT 6 PUBLIC BLDG. ARCHITECT OR TEL. ENGINEER NO. 3 APT. UNITS 7 ADDN.,ALT.,ETC. ADDRESS 4 COMMERCIAL 8 MISCEL. J, 24 NO. ,CONTRACTOR INSPECTION RECORD � ADDRESS DESCRIPTION. OF WORK Z J�/r, /!/t9-r P/1-7l/� VL2 5..1 � f, AA NEW ADD ALTER REPAIR DEMOLISH ry - SO.FT. NO.OF NO.OF SIZE STORIES FAMILIES °09 3� -l�/'�T �h DT /[�./JMIA/PY Tf_" USE OF STRUCTURE ri SIGNATURE APPLICANT-- /.[I-l.f� i ffil.l.�{!�.�"/I r'_, APPROVALS ADDRESS DATE INSPECTORS SIGNATURE LVALUATION P•C. S F FORMS, MATERIALS LOCATION FEEFRAME: FIRE STOPS. BRACING.BOLTS 00 - FEE ✓ FURNACE:LOCATION, I 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 STATE LAWS REGULATING BUILDING CONSTRUC- TION. / LATH. EXT. SIGNATURE OF, �t,f !L{1?.13� J HOUSE NUMBER C.OR- PERMI•TTEE RECT AND POSTED . ADDRESS _ I -FINAL WM. J. FOX. COUNTY ENGINEER VALIDATION BY JA Co 3 9 7 Ln JUN 6 -9 TY `In -•• •• DEPUTY - /O � E• TY .. BY BY ® DEPUTY DEPUTY PC . IBA698A CE0809 8.63APPLICATIONBUILDINGFOR ^� /E�R�M�IT COUNTY OF LOS ANGELES BUILDING OF COUNTY ENGINEER Y/ F I/p BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST r WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST. �✓ 00 o R V/ DIS ICT IxO. =- TYPE . P S FOR APPLICANT TO FILL IN , O SVl F 2�G CONST_ BUILDING r- 1� STATISTICAL CLASSIFICATION tEWER MAP ADDRESS /7 rem Pkr- Ca I' `7I AC6K PG/J CLASS. NO. DWELL.UNITS ' LOT NO. BLOCK WATER NOT REQUIRED RECEIVED ❑ ,f` CERTIFICATE: TRACT COS_ MAP 0 d /7 HIGHWAY STATE MAJOR CO LOCAL NO.OF BLDGS. / (CIRCLE) SIZE OF LOT NOW ON LOT USE ZONE SPECIAL USE OF r CONDITIONS EXISTING BLDG. C-2- r�� TEL. .OWN.ER W I O. BUILDING EXIST. _ J SETBACK YARD HWY STREET NAME WIDTH t� Ip. h ADDRESS y FRONT /� ARCHITECT OR EL. P. L. _� G/T V ENGINEER O. SIDE P. L. ADDRESS CONTRACTO �V �/-+fD V ADDRESS (0-6(p g! IVC, rArx (. , 0 DESCRIPTION OF WORK G W a' NEW ADD ALTER REPAIR DEMOLISH y SQ.FT. NO.OF NO. OF Z SIZE STORIES FAMILIES USE OF S STRUCTURE,{ /* D fV 1 / r SIGNATURE OF APPLICANT VALUATION $ �aveI ® APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION F E $ FEE /t� $ / p�p D FORMS, MATERIALS FRAME: FIRE STOPS, 1 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 COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT. TION OF THE DE OF THE STATE OF CALIFORNIA RELAT- ING TO W9R<lMEN*s;,f.QfmPEN.SATION INSURANCE. LATH.EXT. SIGNAT , HOUSE NUMBER COR. PERMI RECT AND POSTED ADDRESS FINAL S JOHN F. LEWIS.-PWIobPAL STRAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION C M.O. CASH LA(4 01 8 3o AW-22 1 D 12.0.0- cQ 78A698A CE#809 t-62 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDI s ` DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A.JENSEN, SUP'T OF BUILDING CROSS ST. DIST ICT NO. GROUP TYPECESSED B FOR APPLICANT TO FILL IN Z coNST. BUILDING ti_101 /% STATISTICAL CLASSIFICATION 4EWER MAP ADDRESS . (per HK PG CLASS.NO. DWELL.UNITS Ze LOT NO. BLOCK WATER NOT REQUIRED RECEIVED ❑ CERTIFICATE: TRACT MAP HIGHWAY STATE MAJOR E1609 ,LOCAL NO.OF BLDGS. NO. (CIRCLE) SIZE OF LOT NOW ON LOT USE ZONE SPECIAL PSE EXISTINGBLDG. �F,F G U ,/ r CONDITIONS OWNER O O T �/� BUILDING YARD HWY .,STREET NAME EXIST. SETBACK WIDTH ADDRESS iG FRONT t ARCHITECT oR EL. P. L. -ENGINEER O SIDE ADDRESS IP L 6 CONTRACTOR TEL. c Cd NO. /O ADDRESS F DESCRIPTION OF WORK L a v NEW ADD ALTER REPAIR DEMOLISH Z SQ.FT. NO.OF NO.OF SIZE STORIES FAMILIES USE OF STRUCTURE �/✓ SIGNATURE O APPLICANT VALUATION!S APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE $ FEE $ — FORMS, MATERIALS Aq FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT. TION OF THE LABOR CODE OF TH STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S CO NS IN NCE. LATH,EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL �� /6j i/trlrf JOHN F. *L�EWIS. PRINCfPAL ST URAL ENGINdER PLAN CHECK VALIDA ON CK. M.O. CASH _ PERMIT VALIDATION CK. _ M.O:' CASH Lfluo 5 1 9 6 OCT 4 1 D 8.00- It 76AG38ACIVS038-64 APPLICATION FOR BUIL ING PER IT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY / JOHN A. LAMBIE. COUNTY ENGINEER NEAREST COLEMAN W. JENKINS,SUP'T.DF BUILDING CROSS ST. [� REXINDISTRICT NO ROUP TYPE._ P D G OR APPLICANT TO FILL IN 1-5-70 . CONST. [� STATISTICAL CLASSI ICATION SEWER MAP ?� /�% CLASS NO. DWELL UNITS BK/i PG BLOCK USE ZONE�MIAP 'T7 C Gr /� NO. vC L/ ✓ I4 SPECIAL N0. OF SLOGS. l� CONDITIONS LOT NOW ON LOT B G. BLDG. SETBACK FROM V9 TELFRONT PROP. LINE OF (STREET) ge NO. YPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL �.�►CI / HIGHWAY WIDTHFROM C.L. CITY XW//� �s / + SETBACK FROM ARCHITECT OR TEL. BLDG. ENGINEER NO. SIDE PROP. LINE OF (STREET) TYPE OF EXISTING SETBACKHIGHWAY } YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. G TEL. / + = C CONTRA CTO L.Y L ADDRESSIA^ Az LI CORNER CUTOFF YES E] NO E] C CITY ® v CL SC 440 SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH .FT. NO. OF NO. OF SIZE STORIES FAMILIES USEOF .d? /// /.o STRUCTURE J Tam 1 Xliogf 1-40 doe l SIGNATURE O`P IF APPLICANT VALUATION$ ®� APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION, LOCATION FEE$ FEE$ V (/'v FORMS,MATERIALS FRAME, FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS SUILDI NG 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 COMPENSATI INSU N LATH. EXT.00, _ SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED _ ADDRESS FINAL � /�/� &7 JOHN F. LEWIS..PRINCIPAL STRUCTURAL EN R PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VLIDATION CK. M.O. CASH X0.7 4 4 W9 NOV 19 D 8.0 WORKERS' COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self P P L I CATION F O BUIL®I N G PERMIT insure, or a certificate of Workers'Compensation Insurance, or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No.O �1; Company s��0.t� Certified copy is hereby furnished. FOR APPLICANT TO FILL IN " ADDRESS �'6 s• T C ' L_ RL Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS 114 l• s � A ff ZIP LOCALITY 2 Date �'` -a'Applicant CITY Cr• NO.OF BLDGS. z EAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. !PAGE (RCOMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. F Mqp BOOK PARCEL hundred dollars ($100)or less.) �y� TEL' ,,,py USE ZONE MAP OWNER 1GvC'IZ ��F NO. 1 NO. I certify that in the performance of the work for which this I permit is issued, I shall not employ any person in any manner ADDRESS L f CONDITIONS CL soas to become subject to the Workers'Compensation Laws. O CITY ZIP 1 Tc, U Date Applicant ARCHITE OR TEL, NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. DISTRICT GROUP TYPE FIRE PROCESSED BY Q Exemption, you should become subject to the Workers' + 4 2 CON ZONE Compensation provisions of the Labor Code, you must forth- ! ADDRESS �/ G�iGl-eft-`lL a with comply with such provisions or this permit shall be TEL. N deemed revoked. + CONTRACTOR L4V3_Q_ 1 NO.g yC�L s STATISTICAL CLASSIFICATION APT. CONDO. Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. &:; DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. 6 (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP and Professions Code,and my license is in full force and effect. CITY C M Q- CLASS C*-T BK PG. VALIDATION 6205111 � lr1''S SQ. FT. NO. OF NO. OF CHECK License Number Lic. Class C SIZE I STORIES FAMILIES ONE VALUATION Contractor yf 1 Date i DESCRIPTION OF WORK NEW,7C ADD $ O / ❑I am exempt under Sec. 0 _ 7110"44- Z ❑ ' ALTER ❑ B.BP.C. for this reason fi'tf REPAIR ❑ $ Date: USE OF rJ EXISTING BLDG. DEMOL 1-1 Signature APPLICANT TEL.=t 14 FINAL 23 OWNER-BUILDER DECLARATION (PRINT) V! NO. - Ihereby affirm that I am exempt from the Contractor's License DATE ` ACCT.4 Law for the following reason (Section 7031.5, Business and ADDRESS � AVe.. _.r.q[Iq 7HQf'1? FINAL 1 C if T I ( 3 y �'r�'� ! s o•�� Professions Code): PRESENT B ❑ I, as owner of the property, or m employees with BUILDING P P Y� Y .. f wages as their sole compensation,will do the work and ADDRESS 1 the structure is not intended or offered for sale(Section LOCALITY ® ti"iXTas 7044, Business and Professions Code.) MOVING TEL. ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. 3-607 64.13 with licensed contractors to construct the project (Sec- ADDRESS 2 ITEMS tion 7044, Business and Professions Code.) , CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTALSETBACKFROM WIDTH TOTAL 91.69 1 hereby affirm that there is a construction lending agency for FRONT '' the performance of the work for which this permit is issued P.L. �'�'(� 91.69 (Sec. 3097, Civ. C.). SIDE c CHANGE a 00 * P.L. Lender's Name s $ �j ? LDMA Ref. # P.C. Fee$ c;2 . Permit Fee 12d5? Lender's Address1I/L•�/Q�'. I certify that I have read this application and state that the Issuance Fee P., LOMA P/C# , Cf1 �4 Aft 9:35 $ above information is correct. I agree to comply with all County Investigation Fee // ordinances and State laws relating to building construction, Total Fee lv • LDMA Perm. # and hereby authorize representatives of this County to enter upon t bove-me tinned pr perty for inspection purposes. r J l YS Y SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date I WORKERS'COMPENSATION DECLARATION 1 hereby affirm that I have certificate of consent to self P P L I j� T F®' 3 U I L®I � PERMIT IL insure, or o certificate of Workers'Compensation Insurance, or a certified copy there f(Sec. 3800, lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY PolicyNo.'/ s CompanyTi r"fin ❑ Certifi d copy is hereby furnished. '--z FOR APPLICANT TO FILL IN BUILDING ,.--•G _ �W ADDRESS / 91 Certified copy is filed with the county building inspec- BUILDING L tion departm ADDRESS Gc> /( �� ! � / r Date Applicant �� CITY � C� ZIP . LOCALITY G CER IFI A E OF EXEMPTION FROM WOR RS' N .OF BLDGS. NEAREST COMPENSATION INSURANCE 11 SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars($100)or less.) ;.TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL 4. OWNER V e �p• USE ZONE MAP zv 1 certify that in the performance of the work for which this _ NO. permit is issued, I shall not employ any person in any manner I ( C 0 _5 SPECIAL so as to become ubje$to the Worke Compensation Laws. ADDRESS S !v Lv CONDITIONS U Date Applicant k ry CITY ' C ' 1 IP ff5 ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY NOTI E PPLICANT: If, after making this ertificate of ENGINEER NO. NST. ZONE Exemption, you should become subject to the Workers' t Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. ONDO. deemed revoked. CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION V. UC ' C CLASS NO. :2-2- DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS01: r 7 NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY �,+ , CLASS BK VALIDATION 61� SQ.FT. NO.OF f NO.OF CHECK License NuR�ZaLVML6ate , Lic.Class T8 SIZE STORIES FAMILIES ONE VALUATION D� . DESCRIPTION OF WORK NEW Contractor -J��/ ADD $ Lama ❑ I am exempt under Sec. YJ `C" ALTER ❑ B.&P.C, for this reason REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMOL [:] . 03 61.9 A Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) NO. DATE # 0 0 0 0 0 1 1 hereby affirm that I am exempt from the Contractor's License ile I a o49,88 Law for the following reason (Section 7031.5, Business and 9 ADDRESS _ FINA Professions Code): :.PRESENT By 0 o a 4 9.8 8 C6 El ". BUILDING I, as owner of the property, or my employees with ADDRESS 1209-85 wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Codb). I MOVING TEL. ❑ 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). SETIVAC CONSTRUCTION LENDING AGENCY SETQBACK YARD HWY TOTAPROP . LNEFROM 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 a P.L. v Lender's Name HIM G LDMA Ref. # P.C. Fee$ Permit Fee f 3 O - Lender's Address /U �0 I certify that I have read this application and state that the Issuance Fee LD P/C# s above information is correct. I a ee to comply with all County . Investigation Fee 4P V ordinances State lows relat g to building construction, Total Fee LDMA Perm. # and hereb out orize re pr nt fives of this County to enter $ upon the bove-mentione ro e�ty for this purposes. o v SEE REVERSE FOR EXPLANATORY LANGUAGE Sig ture of Aioliqpfil or Agent I Dofe Oo 11 o CORKERS'COMPENSATION DECLARATION in�c boraafcertificate tharof Workers've a tificate of Compensat consent to Insurance, APPLICATION FOR BUILDING PERMIT � or a certified copy thereof(Sec. 3800, Lab. C.) 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 _�� % 1 e (- V� tion department. `� / /1 ADDRESS l/ `1 31 Date A Applicant ll ,� 1� CITY`� V-1 t�� ZIP �lJ LOCALITY ERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS!5) NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. �� ASSESSOR hundred dollars($100)or less.) :MAP BOOK v PAGE PARCEL TEL. USE ZONE MAP OWNER 1 certify that in the performance of the work for which this NO. NO. permit is issued, I shall not employ any person in any manner //Z •.��� /� ` -2- SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS L l �c ' CONDITIONS VO CITY L ZIP 7�6 99 Date Applicant ARCHITECT OR TEL. '1L DISTRICT GROUP TYPE FIRE PRO SSED BY 0 NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER O/��1)AC EV• NO. ��O�-�(O + Exemption, you should become subject to the Workers' �//1 D CONST., ZONE b Compensation provisions of the Labor Code, you must forth- ADDRESS 4S Vy1c Co r v%AClLLn! Y1tXe-. t �U() /� with comply with such provisions or this permit shall be •�' ` ( t i TEL. p STATISTICAL CLASSIFICATION APT. CONDO. g deemed revoked. CONTRACTOR JCS"►rl lllr\O t�C NO. s LICENSED CONTRACTORS DECLARATIONp LIC. y CLASS NO. ��DWELL. UNITS - C hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS ' O Z-Z Jhv.n 171 NO. /a�/� (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP Professions Code, and my license is in full force and effect. CITY Q d'SI C CLASS 13 - 1 BK r' PG 130 VALIDATION SQ.FT. ?' NO.OF NO.OF CHECK License Number -1040 Lic.Class 43-1 SIZE STORIES � FAMILIES ONE �{�( t- �y/ VALUATION Contractor �x °n R,AaC - Date I� DESCRIPTION OF WORK NEW ❑.. s v p 0 ;25438A ADD ❑ # 0 0 0 02 1 ❑1 am exempt under Sec. ( ALTER - 251.82 B.&P.C. for this reason at Al ©� LC' REPAIR ❑I $ USE OF ❑ 0 - 251.8210 EXISTING BLDG. A Signature APPLICANT n .� TEL. _ FINALS 0 9. 15-8 6 (PRINT) Orz I`. D 6� NO. a W -BUILDER DECLARATION DA Ey I hereby affirm t at I am exempt from the Contractor's License / / ` C �� `+ �� : , Law for the following reason (Section 7031.5, Business and ADDRESS YCs / tl�. ( FIN,i Professions Code): PRTEE NT ❑ BUILDING �r I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. I,as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS = ;yt- ;25757A tion 7044, Business and Professions Code). MITM CONSTRUCTION LENDING AGENCY SET BACK YARD HWY TOTAL SETBACK LIINEFR M WIDTH 0 0 0 0 0.1 I hereby affirm that there is a construction lending agency for FRONT i 1 - 30675 the performance of the work for which this permit is issued i. P.L. (Sec. 3097, Civ. C.). SIDE 0 0 3 0 6R5 P.L. o Lender's Name -� ^ LDMA Ref. # I Q24-86 Lender's Address P.C. Fee$ -Permit Fee oc x I certify that I have read this application and state that the Issuance Fee =�� kLDA P/C# 1011. x above information is correct. I agree to comply with all County y`Investigation Fee ^ ordinances and State laws relating to building construction, Total Fee 4 LDMA Perm.# and hereby authorize representatives of this County to enter $ upon the ove-mentio a property for inspection purposes. i tl SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of Applicant or Agent Date I � COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS i 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 9811240048 PHONE: (818) 285-0488 EXT: LEGALD: N0. OF CONST WILDING A RESS: TR: 6561 LT: 198 BL: .001 SQ. FT STORIES TYPE 5946 1/2 TEMPLE CITY BL STRUCTURE: 0 VN TEMP CA 917802010 ASSESSOR INFO NUMBER: NEAREST CROSS STREET: WOODRUFF 8587-019-030 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG SE: COMME USE ZONE: C-2 ISSUED'ON: PROCESSED—BY: EXPIR ON: DJB TECHNICAL SALES EXIST OCC GRP: 11/24/$18 UT 1 /99 I OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL CODE: WILLIAMS EVELYN TRUSTEE;WILLIAMS TR - I 1 300 6342 TRELAWNEY AV G TEMP 917801311 FEES PArD— RIPTION 0 R FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: PLASTIC INSERT FOR EXISTING IG 0 ELECTRICAL APPLICANT: . SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 D2 PERMIT W/O EN-HC 300.00 VAL 43.50 SPECIAL CONDITIONS: AL_ EES 71.25 .00 ���ELES CO CONTACTOR: TEL. NO: - �O� U�1A� APPROVALS DATE INSPECTOR SIGNATURE LIC. NO LOCATION D SETBACKS SO LS'ENGINEER APPROVAL ARCHITECT OR ENGINEER: 0: OUNDPTION/TRENCH 0 S LIC. NO: 1111111 SLAB/UNDER FLOOR RAISED 00 G MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CNN - v��I I1 O �I UNDERFLOOR INSULATION 150H269 3 04 IUC u t� oo SHEATHING 0. OF FAMILIES: DWELLING TS: CO D: S CLASS: NO2 — ROOF SHEATHING O ❑ SCHOOLD S - AIR QUALITY: 1000 FEET MATERIALS 4�4 I, NO NO NO A Uiu FRAME'INSPECTION REQUIRED TO SETBACK 0EXIST— ��� L �pQe/ SPRINKLERHANGERS SET 13ACK FRONT PL- YARD: HWY: PROP LINE: WIDTH: �p Se rviC G ThO INSULATION/WEATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CE A Syff RATED WALL ASSE BLIES RATED SHAF 5 0 INGS T-BAR,CEILI GS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508