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Home My Public Portal About5950 TEMPLE CITY BLVD_Building__ t6A938A CE#803 12/69 ell APPLICATION FOR BUILDING PERMIT fl COUNTY OF LOS ANGELES ASSESSOR • i DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DMSION BUILDING `� JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 0 C\T \�1,-4 COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY T —� FOR APPLICANT TO FILL IN CNEAREST ROSS ST. i (� 1 / Print ort a onl BUILDING ` ( i DISTRICT NO. GROUP TYPE CESSED BY ADDRESS ~ �� t ewe 1 C� \ IV �� .3t' CONST. FSS LOT NO. i STATISTICAL CLA FICA 'ION SEWER MAP V BLOCK CLASS NO.- DWELL.UNITS BK C PG/30 TRACT USE ZONEMAP NO.OF BLDGS. [NO. O0 7 SIZE OF LOT NOW ON LOT SPECIAL USE OF CONDITIONS EXISTING BLDG. OWNERt}�(` d Q V` NO. �. BLDG.SETBACK FROM w ADDRESS e FRONT PROP.LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY HIGHWAY WIDTH FROM C.L. ARCHITECT OR TEL. 90 + Q = Q ENGINEER NO. BLDG.SETBACK FROM ADDRESS SIDE PROP.LINE OF (STREET) `,�,, (� TEL. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL & CONTRACTOR ��, v o t(� E 7ig�"wo. "`�� HIGHWAY WIDTH FROM G.L. ADDRESS'jtj I G S I� {�\�fi NO. = 4 CITY Cr_ ` //�� //�� C. C b VL '\� C ASS \'-A S CORNER CUTOFF YES ❑ NO � C CONSTRUCTION LENDER C NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS c u ADDRESS 0 SQ. FT. �1 NO. OF NO. OF NEW y J 1 O c SIZE " STORIES FAMILIES USE OF c , ADD ❑ C 7 STRUCTURE a ALTER ❑ Of SIGNATURE OF /f REPAIR❑ APPLICANT W DEMOL ❑ - VALUATION$ e70 D APPRO ALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE S O FEES .'.> FORMS, MATERIALS FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS Ch-CAL AND GREE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES AND LAL IN BUILDING CON- GAS VENT, DUCTS STRUCTION. I CERTIFY THAT IN OR AUT RI ZED HEREBY I WILL NOT EMP 0Y IN 10 ATIO F THE LATH, INT. LABOR CODE OF THE TE 1 REL ING TOWORKMEN'S COMPENS 1 R /Jy LATH, EXT. SIGNATURE OF c HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL JOHN F. LEWIS. PRINCIPAL STR URAL ENGINEER PLAN CHECK VALIDATION CK. CASH _ PERMIT VALIDATION CK. M.O. CASH 6 oo e6a222-3—D v , C%��I LAC 0 6— OCT 8 ® /1 D 9.0 03 DEPARTMENT OF BUILDING AND SAFETY AFFL1CATiON YOU k%mull T CQ!NTY OF LOS ANGELES V LD I N WM. J. FOX, CHIEF ENGINEER FOFi APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING ` DISTRICT NO. PLANPLANOK.NO. �PERMIT NO. AD.RZSS.2I� Q. u�s �p Y ��d V®. s�/Q LOCALITY 7�r I,04 6 C 4 CE ED BY /�_ rOAT T•OF PPL. DATE ISSUED NEAREST A CROSS ST. Pfl A LDING OWNER IA. 0- � ffA D � RE9B I �VALM F AMAIL DDRESS / / � �s rw�A s A°'�•�r LOCALITY C c r [sem TEL. j� CROSS ST. a.� CITY 'a NMARMat ��C NO. A" °� � FIRE NO.ANS S TYP GROUP ARCHITECT OR � � e�STEL ENGINEER NO. �!�� ZONE LANS ADDRESS 0 , SETBACK LINE r- y APPROVED CONTRACTOR NO. BY DATE 1}� USE APPROVED ADDRESS S` ZONE BY { DATE sad - I LEGAL. v , ° _.___COR1iIONS DESCRIPT �ECT ION O �� .BL�CK - —"ti� TRACT NO.OF SLOGS. SIZE OF LOT C9 J� . I NOW ON LGT--• USE OF I NO.OF 1`I NO.OF EXISTING BLDG. I FAMILIES. ROOMS,_ 4 DESCRIPTION OF-WORK. _:'- f= _ ,� l _ _`� y___ NEW ALTERATION ADDITION O A REPAIR MOVING DEMOLISH R Sq.FT. NO.OF t Z SIZE' 76 oD - ROOMS / STORIES ( r WALL V �W G @i O ROOF COVERING I CCOVr ERIINNGUSE OF NE /�p I v BUILDING W irisA�_ low 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 RERJU.A TING BUILDIND CONSTRUCTION. FRAME: FIRM STOPS, �� rt/ SIGNATURE ® � BRACING,BOLTS ✓ � /[�•,dr PERMITTE LATH,INT.: / AUTHORIZED AOT LATH,EXT.: / V'6e ` DSS-3 SOM SETS 7-47 $ P.C 6 O PLASTER,INT. /1 .® FEE '� PLASTER,EXT. VALUATION FEE /4 �0 FINAL DEPARTMgNT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES ® 1 w� L WM. J. FOX, CHIEF ENGINEER NV FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY Q,c �tgSy p� DISTRICT NO. PLAN CK.NO. APERMIT NO. BUILDING / / �D iJ�.OVV E7-94 VA � --^-- IT ADDRESS � LOCALITY 7-o °��q /pA E c n/ RECEIVED BY DATE OF APPL. DATEISSUED NEAREST CROSS ST. - OWNER �o 17A s? A &) ADD EIS9 ADDRE�89 � -�'® V I O '*As wAj LOCALITYNEAREST CITY �� ®� N I_.4rZe 1-•.r CROSS ST. W-/0 S'50t-Al/ - FIRE NO.OF '�Y*PE GROUP ARCHITECT OR TEL • � ZONE_ f PLANE ENGINEER NO. fid/ /J / BLDG. SETBACK LINE Sv //� T ��r C/ ADDRESS 4-e-sG.�i- r rTELV APPROVED CONTRACTOR)-' 1.�+-/ �y NO. (�j I1L 2C BY DATE -USE APPROVED ADDRESS �i,JdtS�gfI I1 t'�'filtJ 1 L ZONE BY BY DATE LEGALDESCRIPTION LOT NO D® I BLOCK '140,07CORRECTI�ON/rS `f f TRACT ® 1p A. �1.��• N�GCJK .� A�� NO.OF BLTS. p i' SIZE OF LOT NOW ON LOOT USE OF I NO.OF NO.OF EXISTING BLDG. FAMILIES I ROOMS DESCRIPTION OF WORK Y NEW ILeeALTERATION I I ADDITION O A REPAIR MOVING DEMOLISH m 9q.FT. �y, NO.OF Z _SIZE C i '�i l•'� ROOMS--""- STORIES WALL ~r4Q COVERINGd j ROOF ��:. J e�'�'rU COVERT 13 ' USE OF NEW �qq� � BUILDING �,�1 1 i K;/•= / .0 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE 19 CORRECT INSPECTORTE FOUNDATION, LOCATION � AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS AND STATE LAWS REGULtgT B BUILD,ING-CO:�N9. RUCTION. �9 � FRAME: FIRE STOPS, SIGNATURE OFI � �i± s r ' J�d'��f,'v�?�•+-' ' BRACINB.BOLTS �� / i i- PERMITTEE LATH,INT.7 AUTHORIZED AOT LATH,EXT.: OBS-3 13M SETS 7-47 $� ` PLASTER,INT. / FEE PLASTER,EXT. VALUATION FEE �C O p FINAL �j��(•�1�� y `f r APPLICATION FOR BkJILDING PERMIT ` + COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDINe3 ADDRESS BUILDING ADDRESS /J I hereby affirm that I have a certificate of consent to self insure, r— or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) CITY VP LOCALITY Policy No. Company SIZE OF LOT I NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS Owph TEL NO.It YES NO CERTIFICATE OF EXEMPTION FROM WORKERS' _ f COMPENSATION INSURANCE -1911, S _ S' ( WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESSsD � r4 DISTRICT GROUP TY P ONST. FIRE ZONE PROCESSED BY dollars ($100)or less.) I certify that in the performance of the work for which this permit CIT e zIP is issued, I shall not employ any person in any manner so as t0 ARCHITECT R-ENGINEER TEL/NO. become subject to the Workers'Compensation Laws. STATISTICAL CLAS IFI TION APT CONDO Date Applicant ADDRESS CLASS NO. chz DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR s , TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith L�iJ(��' FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION SIDE CITY LIC.CLASS PL I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW ❑ BK PG ® n License Number Lic.Class DESCR PTION OF WOFLK ADD ❑ VALUATIO C Contractor Date ALTER ❑ $ 0�U L D ❑ I am exempt under Sec. REPAIR $ H BAP.C.for this reason DEMOL ❑ C LDMA P/C# U. Date: USE OF EXISTING BLDG URM ❑ 4_; a /,u� /D SiFL,Gs S ✓Ick =L� _u. Signature ! t APAf�; (PRI'TJX ' �e 0 e TEL NO. LDMA Perm# Z .�,rV•j r.�;� I, as owner of the property, or my a eyes with wages as 1� I �/ iJ• their sole compensation, will do the work and the structure is ADDRESS f� ,,,,j7 ,O O y j T EMr not intended or offered for sale (Section 7044, Business and - rl�j e /ft" ' - L FINAL DATE �p Q �` Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL q� '1 7 ° TYTAL 23 ❑ 1, as owner of theproperty, am exclusive) contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Y g AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY CHECK EEK ;-i a'f• licensed contractors to construct the project (Section 7044, YES❑ No Business and Professions Code.) (:NE1'i ,1€€_ WILL THE INTEND D USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH J {��{ t CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR 1_fTi"ffiE .00 GUIDELINES �{ I hereby affirm that there is a construction lending agency for YES 11 NO the performance Of the Work for Wt11Ch this permit IS ISSUed(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING f. r r`} ray j-1! 3097,Civ.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, IJ ILI-OIJC11 Lr 10/'i` a TITLE 2,CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOV.D. 11187 t{ M 21 4 o Lender's Address tIt C OYlNEN OR AGENT O OI certify that I have read this application and state under penalty O of perjury that the above information is correct.I agree to comply PC FEE PERMIT FEE �/ O� N with all county ordinances and State laws relating to building construction, and hereby authorize representatives of this County ISSUANCE FEEGo m to enter u on the above-mentioned property for inspection purposes. I INVESTIGATION FEE TOTAL FEE CID SQA-IAmu CJ ♦ / y SEE REVERSE FOR EXPLANATORY LANGUAGE