HomeMy Public PortalAbout5947 TEMPLE CITY BLVD_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES BUILDING
WM. J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING
DISI RO. PLAN CK.NO. PERMIT NO.
: � "•7 j IC /
ADDRESS 111 , / 'r®f/i j
LOCALITY 766 RECEIVED BY DATE OFAPPL. DATE ISSUED
NEAREST (® -
CROSS E
LP14D
ADDRESS �i ��/'y�LECI I
'OWNER /
MAIL LOCALITY (,
ADDRESS
TEL NEAREST
CITY NO. CROSS ST.
FIRE NO.OF TYPE GROUP
ARCHITECT OR TEL. ZONE PLANS
ENGINEER NO.
BLDG. ORD.NO.
ADDRESS SETBACK LINE O
.e w APPROVED
EL. //rJ BY DATE
CONTRACTO O. �,(�V
USE APPR D I •
ADDRE96 • �, ZONE C BY DATE
LEGAL CORRECTIONS
DESCRIPTION LOT NO. BLOCK
TRACT
NO.OF BLDGB.
SIZE OF LOT NOW ON LOT
USE OF NO.OF NO.OF
EXISTING BLDG. FAMILIES I ROOMS
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
O
S
REPAIR MOVING DEMOLISH 0
9q.FT. NO.OF Z
SIZE ROOMS STORIES y
WALL ROOF r
COVERING I COVERING
USE OF NEW
BUIL NG
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION!LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS
AND STATE LAWS GULATING BUILDING CON RUCTION.
FRAME, FIRE STOPS,
SIGNATURE OF BRACING,BOLTS
PERMITTEE LATH, INT.
AUTHORIZED AGT
LATH, EXT.
7S._. S .r - O d PLASTER.INT.
DBS-3 SOM SETS .� p,D. q �'}.�
FEE �i�/V PLASTER,EXT.
VALUATION 4' FINAL 3- Z�-• /I �/j
FEE • .��_
BUILDING BUILDING �•�� !�!. GES/`./ / ��i
ADDRESS
APPLICATION LOCALITY NEARE
'A f/l
DIVISION OF BUILDING AND SAFETY CROBB T. Wa09 v,//_
Department of County Engineer DISTRICT NO. RECEIPT NO. PERMIT NO.
County of Los Angeles
WM. J. FOX, COUNTY ENGINEER GROUP DATE RECEIVED DATE ISSUED
CABBATT D. GRIFFIN, BUP-T OF BI.,ILDIND ` �,
�.�• o
-FOR APPLICANTAQ FILL IN TYPE CONST. RECEIVED BY ISSUED BY A
�1 —=-- �'
. e
OWNER i✓!A J-r-� /1 //]ll.f AJ/!_/ ` . MAP STATE YES NO
MAIL " //rte////� I /� NUMBER HWY
ADDR B_
� � USE ZONE SPECIAL
CONDITIONS
CITY Wi:�'J�?'4253
ARCHITECT OR' V A TEL. '+ '
ENGINEER e V NO. _ BUILDINGEXIST.
/ SETBACK YARD HWY STREET NAME WIDTH
ADDRESS 14-4
FRONT
T P.L.
CONTRAC OR O -.-
v r
-
SIDE
P.L.
ADDRESS
BUILDING DATE CORRECTIONS INSPECTOR
ADORERS
LOT NO. pE p{ 0/ BLOCK
TRACT b�/ •.6� SJ.� / ixIn4 !! 0n q /_ PN-wolo
LOS
SIZE OF LOT NOW ON LOT /
USE OF 1)P 1AA P5/?f;7.'Q Al n/A'AV.-
F_XISTING BLDG.
DESCRIPTION OF WORK ���7 �vn 1,,*v,(,PAI ire ri nis As O
NEW ADD ALTER RegyR DEMOLISH. /� Z
Sq.FT. NO.OF NO.OF .%J ITvL O It n /�/=GvU,P,�C
SIZE STORIES FAMILIES
U STRUCTURE. p�^•� + �3e oejCrA /-`&e 1mrow.)
�T �Z-4 �/'f��7?•r!d
No.OF
EMPLOYEES tk ,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP=
PLICATION AND STATE THAT THE INFORMATION GIVEN 18 APPROVALS INBPECTOR'S SIGNATURE DATE
CORRECT.
IAGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION., LOCATION
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS
FRAME: FIRE STOPS.
SIGNATURE,OFfBRACING,BOLTS
PERMITTEE X �1�✓
G� _ �•��' FURNACE: LOCATION,
Lei GAS VENT,DUCTS
[VALUATION
DDRESS
LATH, INT.
UTHORIZED AOT.
LATH, EXT.
$ P.C.$ HOUSE NUMBER COR-
FEE RECT AND POSTED
e/ FEE �, FINAL ���j/�/'
9L A11.1 nD! 1—I a �.
'BA68eADBe.98.8APPLICATION- FOR BUILDING ■ E® .MI ■ -
BUILDING.
�.
DIVISION OF BUILDING AND SAFETY
ADDRESS
Deportment of County Engineer
-county of Los Angeles LOCALITY
INK J.FOX,COUNTY ENGINEER NEAREST I
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST.
DISTRICT O. GROUP SEWER MAP
TYPE
FOR APPLICANT TO FILL INA j� S 19- N I CONST. I HK , PG '
BUILDING MAP STATE
ADDRESS V / NUMBER HWY -
LOT NO. BLOCK USE ZONE SPECIAL
n CONDITIONS
TRACT J /
SIZE OF LOT /oO�[ I NO.OF SLOGS. '� BUILDING EXIST.
NOW ON LOT SETBACK YARD HWY STREET NAME WIDTH
USE OFFRONT
EXISTING BLDG. P. L.
/ SIDE
OWNER P.L.
MAIL 9/ O TRACT DWELL. I UNIT
ADDRESS - - 5 INDUSTRIAL
TEL. 1 DWELL. I UNIT
CITY NO. 6 PUBLIC BLDG.
ARCHITECT O TEL. 2 DUPLEX 1 UNIT 7 AODN..ALT.. ETC.
ENGINEER NO. 3 APT. UNITS
• M18CEL.
ADDRESS 4 COMMERCIAL
TELCONTRALTO /+7.� NOLO INSPECTION RECORD
4-4r N
ADDRESS�/ 0`a- �!; •� TC /I "" "�Gy rt . .
DESCRIPTION OF WORk
NEWADD ALTER REPAIR DEMOLISH
[APPLICATION
Q. FT. NO.OF NO.OF
IZE STORIES FAMILIES
SE CU�FFn STRUCTURE
1�
IGNATURE F
APPLICANT APPROVALS
DDRESS DATE INSPECTOR'S SIGNATURE
FOUNDATION:LOCATION
�` eSP.C. ffi FORMS.MATERIALS
(J1 FEE FRAME: FIRE STOPS,
ALUATION +� BRACING,BOLTS
ffiEEFURNACE:LOCATION,
IHEREBY ACKNOWLEDGE THAT1 HAVE READ THISGAS VENT,DUCTS
AND STATE THAT THE ABOVE 18 CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH.INT.
AND STATE LAWS-REGULATIKO BUILDING CONSTRUC-
TION. LATH,EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED q
ADDRESS � FINAL 17 ,,W
WM.J.FOX,COUNTY ENGINEER VALIDATION, C..N.DIRLAM.CHIEF BLDG. INSPECTOR
1C0 9 1 6 OCT 19 1 4.0 0- .' !P ,
DEPAR" "WT OF BUILDING ANDETY APPLICATION FOR PNEMIT
'�•URTY OF LOS ANGELES T B 4 ' p
I L
-WM. J. FOX, CHIEF ENGINEER �
FOR.APPLICANT TO FILL IN FOR OFFICE USE ONLY
ABUILDING A/DDRESS ,f�fDISTRICT NO. PLAN K.NO. PERMIT NO.
LOCALITY �I'P9 py`�, Szn. 77 ; ��a'1 RECEI ED BY, DATE OF APPL. DATE ISSUED,
NEAREST _ l �' ��'° ep r-6�,1+ `C� P�• �—
CROSS ST. �+)ef i Ir. '. �:+
. BUILDING
® OWNER 1411,1414{ �� ) 0 f 'C l ` ADDRESS
r MAIL /f p /• / LOCALITY
a .ADDRESS ���f0 / T 4� �7 /C.•};r �6 � �♦
j —NEAItET I ! 1 s
CITY ��a > �_�a, '�
NO. �-^ _ CROSS ST.
I, }IQr FIRE NO.OF -r-?PE
ARCHITECTOR,-. r -•'•%� TEE}j,, 1 ZONE Plcgli6--j. 1 --- F
EkglNEERN6:C1 �� �_
BLDG. rr— �' t
�y
—ADDRESS _SETBACK LINE: ,
- �•- �-`,�� �ABPROV6D
T.�..,
CONTRACTOR i,..,•„• •� NO..". � BY DATE
UBEAPPROVED
{ ZON.E�s� BY DATE
ADDRESS . � 0 !� / ' I
LEGALT
DESCRIPTION LOT NO. I BLOCK-- s� lJ CORRECTIONS
TRACT igls"a�! ,
?,t"9 4 I NO.OF BLDGS�
SIZE OF LOT
/i � NOW ON LOT !,?Q � /��� /_i.,.�/.,. .��/`L-�""t /� ft •
USE OFj NO.OF NO.OF
EXISTING BLDG. FAMILIES ROOMS fiL Gl2�G t� i
DESCRIPTION OF WORK �` U
f
NEWAll--ALTERATION ADDITION O
A
REPAIR MOVING p DEMOLISH
SIZE CRDOMS / STORIES r
WALL �� I ROOF Cb WVy"
COVERING ti�S�f 1'� COVERING
USE OF {/NEW �
BUILDING d:y6s u tY a nn /6
�7
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVA�I.
APPLICATION AND STATE THAT THE ABOVE IB CORRECT FOUNDATION: LOCATION N ECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
FRAME: FIRESTOPB,
SIGNATURE OF 1 ! BRACING,BOLTS
PERM ITTE ' , ' /
�p A LATH,INT.: 14'14
AUTHORIZED AST` 11 � 1
LATH,EXT.: �
Des-a SUM SETS 7-47 $ P.C.III
7h PLASTER,INT. }`
FEE : PLASTER,EXT.
VALUATION FEE �' FINAL /�
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES ' ®L ® �
WM. J. FOX, CHIEF ENGINEER
NG
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
E �/// �1/� c e'lsDDRDISTRICT NO. PLAN CK.NO. PERMIT NO.
88/A// �1/I dy/y ��rl �yy
LOCALITY 7r/. PL QRE EIV D BY DA E OF APPL. DATEISSUED
NEAREST L -���� R1 B (G]J�T/ "7 -
CROSS ST. 1)
BU DING
OWNER P/J%•6. /�JJt� dam+♦ P A RE
SMAILB
ADDRESS // c�(��� y�"j .���� LOCALITY e
NEAREST
TEL CROSS ST.
CITY r (. ._. s NO.
FIRE NO.OF TYPE GROUP
ARCHITECT OR TEL. ZONE Qv.� PLANS
ENGINEER NO.
BLDG.
ADDRESS SETBACK LINE d a..-
f �O160, ^^ BBy DATE CONTRACTtr�CCOR �® �ll'a NO./V 7����/�;
g p ^ USE APPROVED
ADDRESS 3�y 10 L�. . ^F3� Tj +W4!C j0L) 7-X ZONE BY DATE
LEGAL CORRECTIONS
DESCRIPTION LOTNO. ga'e I BLOCK -
TRACT
EC NO.OF BLOGB. /
SIZE OF LOT NOW ON LOT
USE OF NO.OF NO.or-
EXISTING
FEXISTING BLDG. FAMII IEe ROOM
DESCRIPTION OF- YORK
NEW ALTERATION ADDITION
O
• A
REPAIR MOVING DEMOLISH
Sq.FT. NO.OF Z
SIZE ROOMS STORIES
WALLROOF
COVERING i COVERING
UBE OF NEW
BMfILDiNG-
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE 18 CORRECT FOUNDATION:LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
/� y�-►������f� FRAME: FIRE STOPS,
SIGNATURE EE �(/� / �!'�+ t.✓f% BRACING,BOLTS
PERMITTEE r//""`jj" / ` � LATH,INT.:
AUTHORIZED AGT LATti,EXT.:
DBS-3 SOM SETS 7-47 $ P.C.G PLASTER,INT.
-7/� r FEE PLASTER,EXT. / J
VALUATION FEE FINAL �_ )-/ ! y
WORKERS'COMPENSATION DECLARATION
hereby affcertifica I have r certificate of consent to self APPLICATION
P P L I CI T I®N F®R BUILDING PERMIT
insure,e�r,r a certificate of Workers'Compensation Insurance,
or a cerTified copy thereof (Sec. 3800, Lab. C.)
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company
LDING
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN `t
BUIy�
ADDRESS
Certified copy is filed with the county building inspec- BUILDING
tion department. ADDRESS �fy/
Date Applicant CITY �� � C/ ZIP Tot / t/ LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT /d ',— NO.OF BLDGS. NEAREST
SS ST. `�'�/�v{� �•
COMPENSATION INSURANCE NOW ON LOT CRO
(This section need not be completed if the permit is for one ASSESSOR
hundred dollars($100)or less.) TRACT l BLOCK LOT NO. MAP BOOK PAGE PARCEL
I certify that in the performance of the work for which this OWNER � yfLS/ �v,�j tel• —(� US/E/ZON� No
7-5
permit is issued, I shall not employ any person in any manner ADDRESS vb ��� �°''/� �/- SPECIAL
CONDITIONS
so as to become subject to the Workers'Compensations Laws. f /� U
/ - 9� 7-OS�3 2>0 /�o CITY 1 / C /Q,�T ZIP e � �'
Date Applicant ARCHITECT OR TEL.
NOTICE TO APPLICANT: If, offer making this Certificate of ;W1
I
UP TYPE FIRE PROCESSED BY O
ENGINEER NO. CONST. ZONE t;;
Exemption, you should become subject to the Workers' ,i �i V
Compensation provisions of the Labor Code, you must forth- ADDRESS �/ \J � AW.
with comply with such provisions or this permit shall be / TEL. STATISTICAL CLASSIFICATION APT. I VONDO. N
deemed revoked. CONTRACTOR NO. i
LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 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 PG VALIDATION
SQ.FT. NO.OF NO.OF CHECK
License Number Lic.Class SIZE STORIES FAMILIES ONE
VALUATI Ni
DESCRIPTION OF WORE4
I U'
NEW
Contractor Date ❑ /
ADD O $ L�
❑ 1 am exempt under Sec. // � . ' Q ,tom, t1 k .09527A
_ ALTER
B.BP.C. for this reason iYZIF t-S T I T*L ❑
A" $
-REPAIR
0 0 0 0 0
Date: EXISTING BLDG:';;DA- 15 G1 P-00&,k DEMOL ❑ ) o a 2 a 5 O
Signature APPLICANT TEL. FINAL �Q
g OWNER-BUILDER DECLARATION PRINT NO. DATE "C1 0 0 0 2 $ 5 v
I hereby affirm that I am exempt from the Contractor's License 5 3 : 8
Law for the following reason (Section 7031.5, Business and ADDRESS FIN
N
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
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
4'
tion 7044, Business and Professions Code).
REQUIRED TOTAL SETBACK
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT t
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C.). SIDE
P.L.
Lender's Name "'
cO d LDMA Ref.♦Y
Lender's Address P.C. Fee$ Permit Fee
L 1 certify that I have read this application and state that the Issuance Fee . LDMA P/C tY
2 above information is correct. I agree to comply with all County Investigation Fee �(
ordinances and State laws rel ting to building construction, Total Fee �0 a S e LDMA Perm.H
and hereby authorize re
F t'tives of this County to enter
S upon Yh above-mention 8' operty for inspection purposes.
r'
Imo/ SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent Date