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Home My Public Portal About5950 TEMPLE CITY BLVD_Miscellaneous__ 70M444•DOS 75 12.54 MISCELLANE®VV A PLICATION DIVISION OF BUILDING AND SAFETY OCCUPANCY-;SAFETY-TRAILERS Deportment of County Engineer County of Los AngelesP-'l�.1,�, f�� WM.J. FOX, COUNTY ENGINEER. BUILDING J %v O / � T NH � �i Gf CASSATT D.GRIFFIN.SUP'T OF BUILDING _ FOR APPLICANT TO FILL IN 9 LOCALITY ' -re,I�In.�7�L`' c I�V J�` NEAREST a OWNER !��R�//a�'1',,1/��/�!!y �'�I/�.J��I//`►/',)p•J/jyP� CROSS ST. � MAIL R.��.7 l/✓/?��/1✓�QN�Il/9Y ;: im ADDRES/Sqq A/�ryry ry TEL. /� DISTRI T NO. I GROUP 0 I TYPE CONST. CITY f l ZdjaA1 9& 62-112' Tht h-T 7 41 MAP �y •�"dam STATE TEL. _NUMBER f�{/ -7 HWY YES CONTRACTOR NO. r USE ZONE SPECIAL ADDRESS I or 200 '-'Jfe 616F7.9401.0r a v/ -X�s CONDITIONS Al lRerLEGAL ' Oj. DESCRIPTION I LOTNO.P ,200 BLOCK "- BUILDINGEXIST. SETBACK YARD HWY STREET NAME I WIDTH / NO.OF BLDGS. TRACT +-O / I NOW ON LOT _ FRONT USE OF P. L. VV 0 SIZE OF LOT /1 I✓ EXISTING BLDG. SIDE APPLICATION FOR P L OCCUPANCY ,r' INSPECTION RECORD _INSPECTION t/ I SAFETY PERMIT TRAILER USE I LIMITED TIME USE Will J) �+ ...._......._ ... f�tl`�...�7i I10��• d T w�4 G a d 701• ..I ' ...................... t.....,f tY ?......�Il.�. �ll.?H.. ' �i.Ff#rrQ.Gfr Sd re fa GIt I1L1"G - DATEDATE ........................I...... /•!1'- .I ..'`... ... I......... .9�:. $Y. ....... FROM: TO: f ..................I.....de AA-2�?�. t�+��dV�t`Ye .e!1 .. tr�Zl... USE OF STRUCTURES OR DEVICES _ .. _.... r..J!. ................_....I..W... ..� .�a.t /? .�5' ��FLC p... t`�f 1..,F,�l/ ......... .......................1.....111�f� �... Q../, ... �r�t_ Ilf[111..�......._..... ........I....f�fl..�F�+tL1, pfd.... t�`�a� I�LS'A&Ae.e fir............. ..................I.._.. �?t6�6�' :: .I......................................I..................._........_ - ....................I..............................................................................................I.........................._....... . APPROVALS INSPECTION FOR /��y_� ' I DATE I INSPECTOR'5 SIGNATURE • ./W V OCCUPANCY A OCCUPA CY APPROVAL I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GROUP OCC.LOA APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES TRAILER USE AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. ONSTRUC- C%! ` SAFETY.PERMIT SIGNATURE IF TEMPORARY PERMIT TE 'STRUCTURE APPROVED TEMPORARY ADDRES lIJ '� STRUCTURE REMOVED FINAL APPROVAL WILLIAM J. FOX.COUNTY ENGINEER VALIDATION__ 5` 4-o_003�-M'T g 2 2 A 5.0 0 An - -- p: BY !;bra 6Y.1 2 0 O OCT 2_8 4 8 A :7 DEPUTY - DEPUTY WORKERS*CUbtl'LNSr\IION !)I•('!_AItAII()NI „1^III MISCELLANEOUS APPLICATION Ii-NUI,:.I+f't''/1.• 'xl i hereby affirm that I have a certificate 0l' con-,,nit it, Sell' COUNTY Of LOS ANGELES BUILDING AND SAFETY DIVISION I insure,or a certificate of Worker,'C'ompen,;Jion In,ur.ince. or a certified copy ibereol' (Sec. 380(1, I.ab. ('.) _ Policy No. Company I Uli AI'I'LICAN 1 IU 1 ILL IN dUILU1NG — —--- - -- — BUILDING ADDRESS i ADDRESS ❑ Certified copy is hereby t'urnished. Y 5_'�5'p 12f"d LOCALITY ❑ C'ertif'ied copy is filed with the county building mslwction CITY —� �/++ ZIP /� department. %� /� L' , li� 17 V CROSS ST. Date Applicant SIZE O LOT NO.OF BLDGS.NOW ON LOT DISTRICT NO. GROUP TYPE �/�—�� PROCESSED BY , S D�U CONSIa". C'ERl II I('AI I: OF L XLMI'71()N FROM \A/()ILI:I.I :�' C'OMPE'NSATION INSURANCE TRACT BLOCK LOT NO. MAP HIGHWAY C' NO ,CIRCLED STATE MAJOR SECOND LOCAL (This section need not be completed if the work inkohed ASSESSOR MAP BOOK PAGE PARCELi by the permit is ror 011e' hundred dollars 0.4100) Illi less.) USE ZONE SPECIAL CONDITIONS 1 I OWNER TEL NO. certify that d. the ll not empi of the hook 11 any ib this ph�� e)/,X_ /c'2 6-c y6-.2040 permit is issued, I shall not Cmpluy any person ill ,uly lu,ulner - --- so as to become subject to the Workers' ('0nlpen,ati0J Lllt•,. ADDRESS �• OCCUPANCY GROUP e, Date----_ _ Applicant CITY ZJ� NOTICE TO APPLICANT: II'. alter staking this Certil'Icate "n�oElim G� %/U/E' OCCUPANT LOAD of Exemption, you should become Subject to the Workers' APPLICATION FOR EXIT HARDWARE: Compensation provisions orthe Labor COLIC.you Joust 1171•:11Widh comply with ltich prinisio is Or this pernut shall lie dcCllled TRAII.Ert IItiE FI GEOLOGY INSPECT ION f revoked. _ No Spec.Krtowl. ❑ ! LICENSED CONTRACTORS 1)1:CLAR.UION OCCUPANCY INSPECTIONN Panic Devices ❑ I hereby affir111 that I am licensed tinder provisions or Chapter SAFETY PERMIT❑ ,LIST ITEMS BELOWI ': �� I 9(commencing with Section 7000)of Division 3 of the Bu,iness NO. EXITSED and Prulessions Code,and my license is in fu11 force and el7ect. PARKING• REQ'D PROVIDED D License Number l..ic. ('la„ SPACES t I I Contractor Oalc LIMITED TIME USE-- - - -- -.-•.-- --- ---•-! I ❑ 1 am exempt from the licensing requirements as I ;Int a ' FROM: DATE TO. DATE licensed architect or it registered professional engineer Ji — ilcting 111 Illy prolessllonal capacity (Section 7()11, Iltl,llless SIZE OF JO.OF ) INSPECTOR'S ''•�) and Prtolessions Code). EXIS rINC,dl.l,G. r041l.5 --.-_• _ SIGNATURE Lie. or Reg. No. I):ItePRESENT USE OF BUILDING -h, , I -L- I FINAL APPROVAL I HOME OWNER-1111ILDLR 1)h( LARAIION Nu.or'•IxISUNUBUILDING5 1 NN LOT AND USE l` ✓`�� I hereby affirm that I ant c,cmpt franl the Contractor's l'.enx Oj Law ror the Iiollowing reason (Section 7031.i, Bu,ines: and —_— Prolesslons Code): NO.PARKING ' El Las owner of the properly. dill do the l%Nrk andISPACES PROVIDED Structure -- —• ---- ._. -.-------- structure is not intended or offered tut sale(Secnoll 70.1-1.$ PROPOSED USE OF BUILDING I Business and Professions Code). 1 i CONSTRUCTION I.I:NI)IN(i AGLNCY hereby affirm that there is a construction lending .henry lea• ! the perl'orin;utcC ur the eork for tthich this pennrt Is Isued --- — - _- -- J1 (Sec. 3097,Civ.C.)• PROPOSED MAX.OCC. Lender's NameAP,LICANT IRaliI) TEL NO.�ji 26•—� X =v5-U_c,4 •Fnc• S F-Zzs-moiisL. Lender's Address ADDRESS , 6 its 1 certify that 1 have read this application and state dial the 1115, 6-j. ALleUr 010, C772d5d' above information is correct. I agree to comply will.111(011111) PERMIT FEE I ordinances and State laws relating lo building consdructiol,and __- hereby authorise representatives of this County d0 Cofer upon [TOTAL SUANCE FEE the above-mentioned property fur inspection purposes. �t 4 5_LJ5A7Yl2 FEE I �� SFF RI'\'ERSE� FOR EXPLANATORY LANGUAGE1 r _ Signature W' I'ernlil} c Date . I 6 {' 1 WORKERS'COMPENSATION DECLARATION. zo oossDPwi2/90 MISCELLANEOUS APPLICATION I hereby•affirm that I have a certificate of consent to self COUNTY OF LOS-ANGELES BUILDING•AND SAFETY DIVISION cIte,or a certificate of.Wdrkers'Compensation Insurance,or errtified copy thereof(Set 3800,Lab.C,)• Policy'Na Company FOR APPLICANT TO FILL.IN BUILDING ; BUILDING ADDRESS // ADDRESS I ❑ Certified copy is hereby:furnished. g 2 o LOC/►uTY { ❑ Certified copy is filed with the county building inspection CITY ZIP U NEAREST • department. CROSS ST. ' Date �'• °� Applicant SIZE OF LOW U NO.OF BLOGS.NOW ON LOT DISTRICT NO. GROUP TYPE PROCESSED BY a . 1 CONST. CERTIFICATE OF EXEMPTION FROM WORKER' I V ( I COMPENSATION INSURANCE TRACT BLOCK LOT NO. • MAP HIGHWAY No. ICIRCLE) STATE MAJOR SECOND LOCAL.. (This section need not be completed if the work inv.Ived ASSESSOR MAP BOOK PAGE PARCEL USE ZONE SPECIAL CONDITIONS I= by the permit is for one hundred dollars ($100) or,less.) O I@�y er TEL NO. I.certify that in the performance.of the work for which this . /O I IS�1= .4s-/, /S permit is issued:I shall not employ any person in any manner r% I so as to become subject to the Workers' Compensation Laws. ADDRESS WIC S 19 so R ) 1. p� OCCUPANCY GROUP Z ( ) Date Applicant . CI y, ZIP NOTICE TO APPLICANT: If. after making this Certificate (2, Y—) �l 1 ) 07 OCCUPANT LOAD of Exemption, you should become subject to the Workers' APPLICATION FOR Compensation provisions of the-i*lior Code,you must forthwith EXIT HARDWARE: comply with such provisions or this permit shall be deemed TRAILER USE❑ GEOLOGY INSPECTION❑ No Spec.Knowl. ❑ t ' revoked. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION Panic Devices ❑ i I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT❑ (LIST ITEMS BELOW) f I 9(commencing with Section 7000)of Division 3 of the Business NO.OF EXITS and Professions Code,and my license is in full force and effect. Nam O lis ss PARKING i License Number Lic.Class SPACES REQ'D E= PROVIDED { I I Contractor Date LIMITED TIME USE DATE DATE El FROM:I am exempt from the licensing requirements as I am a To: licensed architect or a registered professional engineer acting in my professional capacity(Section 7051,Business SIZE OF NO.OF INSPECTOR'S and Professions Code). EXISTING BLDG. STORIES SIGNATURE. LIG or Reg.NO. '' Date PRESENT USE OF BUILDING O .l e FINAL APPROVAL ' HOME OWNER-BUILDER DECLARATION NO"OF EXISTING BUILDINGS • ON LOT AND USE I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Code): NO.PARKING SPACES PROVIDED i ❑ I, as owner of the property, will do the work and the structure is not intended or offered for sale(Section 7044_1 PROPOSED USE OF BUILDING Business and Professions Code). { CONSTRUCTION LENDING AGENCY i' I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued ' (Sec. 3097,Civ.C.). PROPOSED MAX.OCG Lender's Name APPLICANT[IBM, TEL NO. 1 N i eR Is�;=A aze� ��4,--14 lS Lender's Address ADDRESS I certify that I have read this application and state that the I *5-q ra above information is correct. I agree to comply with all County PERMIT FEE r ordinances and State laws relating to building construction,and ~ hereby authorize representatives of this County to enter upon ISSUANCE FEE •• •C',.I the above-mentioned property for inspection purposes - -• I S ' TOTAL FEE SEE REVERSE FOR EXPLANATORY LANGUAGE Si ature o ermittee Date